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Y5 Paediatrics > Paeds new > Flashcards

Paeds new Flashcards

1
Q

Cx of maternal DM

A

On foetus:

  • macrosomia
  • IUGR
  • congenital abnormalities

At birth: shoulder dystocia, obstructed labour, brachial plexus injury etc

In neonate:

  • hypoglycaemia
  • RDS
  • Polycythaemia
  • hypertrophic cardiomyopathy
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2
Q

Foetal alcohol syndrome presentation

A

face:
- maxillary hyperplasia
- saddle shaped nose
- absent philtrum
- short upper lip

Growth restriction, developmental delay, cardiac defectss

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3
Q

Which maternal bleeding disorder can cross to the foetus, and what will it cause

A

Immune Thrombocytopoenic purpura
because maternal IgG crosses the placenta and damages foetal platelets

Risk of intracranial haemorrhage following birth trauma

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4
Q

What is HIE

A

Hypoxic brain injury caused by a significant hypoxic event immediately before or during delivery

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5
Q

Causes of HIE

A
  • failure of gas exchange across placernta (prolonged contractions, placental abruption, uterine rupture)
  • interruption of umbilical blood flow (cord compression/prolapse)
  • inadequate maternal placental perfusion
  • compromised foetus (anaemia, IUGR)
  • failure of CR adaptation at birth > failure to breathe!!
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6
Q

NEC symptoms

A

stops toleratging feeds
vomiting (bile stainsed)
abdo distension
rectal bleeding

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7
Q

NEC on AXR

A

distended loops of bowel
thickened bowel wall
intramural gas
gas in portal tract

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8
Q

Important investigations for prolonged jaundice

A

serum bilirubim (total, conjugated)
TFT (hypothyroidism)
LFT (neonatal hepatitis)
liver uss (cholecodal cyst,biliary atresia)

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9
Q

what is the key presentation of PPHTN of newborn

A

CYANOSIS

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10
Q

What ix should you get urgently for PPHTN

A

echo - to exclude congenital cyanotic heart defect

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11
Q

What can cause PPHTN

A
  • idiopathic
  • RDS
  • MAS
  • birth asphyxia
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12
Q

How do you manage PPHTN

A

inhaled nitric oxide (vasodilator)
sildenafil (vasodilator)
high freq oscillatory ventilation
ECMO

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13
Q

management of clinically dehydrated child (UNDER/OVER 5YO)

A

UNDER 5YO:
- give ORAL REHYDRATION SOLUTION
- 50 ml/kg over 4 hours (fluid deficit replacement) + maintainance
+ monitor response to rehydration

OVER 5YO:
- 200mls ORS after each loose stool

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14
Q

When do you give IV fluid in dehydrated child’

A

if child is shocked
if child is vomiting the ORS
If red flag sx despite ORS

give 20ml/kg bolus if septic > if no response, second bolus + consider why isn’t he responing=?!? if responding, then proceeed normally (maintainance + deficit)

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15
Q

Coeliac follow up management

A

avoid gliadin

refer to dietician

review annually

advise risk of EATL and micronutrient deficiency

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16
Q

red flag fts in septic child

A 
fever >38 if under 3m, >39 if under 6m 
colour pale/cyanosed/mottled
reduced consciousness, neck stiffness, status epilept, focal neuro sign 
resp distress 
bile stained vomit 
severe dehydration/shock
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17
Q

safety net for febrile child

A 
fever >5 days 
signs of dehydration 
non-blanching rash 
seizure 
child generally unwell
18
Q

most likely consequence of bacterial meningitis - and explain why

A

hearing impairment

because of inflammatory damage to cochlear hair cells

19
Q

best investigation for bronchiectasis

A

chest CT

20
Q

Describe presentation of chondromalacia patella

A 
Repeated extension (e.g. walking upstairs)causes pain and grating feeling 
\+ crepitus / small effusion

mx with physio

21
Q

Describe presentation of Osgood Schattler

A

Overly Sporty boys - knee pain after exercise + swelling + tenderness

22
Q

Describe what happens to bone of Osteomalacia Patella

A

cracking in cartilage and bone

23
Q

Presentation of spina bifida occulta

A

gradual sx onset
in childhood

lower back pain
gait disturbance
scoliosis
neuro difficulties (bowel and bladder dysfunction)

24
Q

How do you manage Hep C in neonate if mother is infected?

A

No treatment until 3 years of age!

Vertical infections may resolve spontaneously

25
Q

which form of viral hep is most dangerous in pregnancyh

A

Hep E -fulminant hepatic failure, high mortality rate

26
Q

how do you manage inguinal hernia depending on age?

A

ALWAYS do surgery

  • if neonate: high risk of strangulation, perform urgently
  • if > 1yo: lower risk, elective surgery

perform HERNIOTOMY (without mesh)

27
Q

explain how and when you UPSCALE management in CONTACT (IRRITANT) dermatitis

A

mild erythema + asymptomatic child: use barrier protection

If rash appears inflamed + causing discomfort + children over 1: addtopical hydrocortisone 1% (7 days)

If nappy rash persists + bacterial infection is
suspected / confirmed: oral flucloxacillin 7 days

28
Q

describe candida nappy rash

A

does NOT spare skinfolds

satellite lesions

29
Q

RF for sudden infant death

A

child: male, 1-6 yo, low birth weight
family: low income, no qualif, overcrowding, maternal age >21, smoking/alcohol

30
Q

How does hydroxycarbamide work and how long does it take to cause improvement in sickle cell?

A

works by increasing concentration of foetal Hb

good if recurrent painful crises / acute chest syndrome

takes about 2 months to cause improvement

31
Q

when do you need to call an ambulance in a seizing child

A

if seizure does not stop within 5 mins of giving midazolam

32
Q

Sickle cell anaemia - traits

A

SICKLED MP

Stroke, cerebral injury, cognitive defect
Infections (hyposplenism)
crises (splenic, sequestration, chest, pain)
kidney (papillary necrosis, neprotic syndrome)
liver (gallstones)
eyes (retinopathy)
dactilitis (impaired growth)

mesenteric ischaemia
Priaprism

33
Q

associated signs with congenital hypothyroidism

A

macroglossia

umbilical hernia

34
Q

how can you distinguish hydradid of morgagni from testic torsion

A

Hydradid of morgagni:

  • pain less severe
  • cremasteric reflex present
  • blue dot sign
35
Q

tetratolgy of fallot acute episodes of SOB management

A

analgesia, oxygen > phenylephrine (for vasoconstriction, to increase vascular resistance > reduce RtoL shunt)

36
Q

what is acrodermatitis enteropathica

A 
AR metabolic disorder 
characterised by malabsorption of zinc, resulting in: 
- diarrhoea, 
- inflammatory rash around mouth/anus 
- hair loss
37
Q

rapid test for EBV

A

MONOSPOT test

38
Q

what is the biggest risk with roseola infantum

A

risk of FEBRILE SEIZURE

39
Q

who do you admit with asthma

A

severe / life threatening asthma

40
Q

in what order does anaphylaxis present as wheeze / stridor?

A

Wheeze first!

then stridor if very severe

41
Q

whooping cough how long are they infection

A

48 h after starting to take antibiotic

or 21 days if no antibiotic

42
Q

what tumour is likely to cause bone pain

A

osteoid osteoma

Y5 Paediatrics (30 decks)

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