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Paeds other Flashcards

1
Q

What investigations are offered if Newborn hearing screen is abnormal?

A

Auditory brainstem response test

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2
Q

Otitis media is infection of which part of the ear?

A

Middle ear

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3
Q

What are the clinical features of otitis media?

A

Pain
Fever
Irritability
Anorexia
vomiting

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4
Q

When should you admit a child under 3months with otitis media?

A

If their temperature is above 38C

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5
Q

When should you admit children over 3 months with otitis media?

A

Complications of the disease such as:
Meningitis
Mastoiditis
Facial nerve palsy

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6
Q

What is the management of otitis media?

A

Most children just require paracetamol/ibuprofen for pain and fever control.
Antibiotics if systemically unwell or doesn’t improve within 4 days

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7
Q

What is glue ear?

A

Otitis media with an effusion

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8
Q

What type of hearing loss does glue ear cause?

A

Conductive hearing loss

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9
Q

What are the risk factors for glue ear?

A

Male sex
Siblings with glue ear
Winter and spring
Bottle feeding
Day care attendance
Parental smoking

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10
Q

What age does glue ear usually present?

A

Peaks at 2 years

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11
Q

What is the treatment for glue ear?

A

Grommet insertion to allow air to pass through into the middle ear

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12
Q

What is a concomitant (comitant) squint?

A

Non paralytic
Full movement of extraocular muscles
The angle of deviation of the squint remains the same during eye movements

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13
Q

What is an incomitiant squint?

A

Damage to the extraocular muscles or their nerves.
Diplopia
Paralysis of the extraocular muscles

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14
Q

What is periorbital cellulitis?

A

Inflammation and infection of the tissue and skin surrounding the eye

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15
Q

WHat is the cause of periorbital cellulitis?

A

Scratch or bite around the eye, letting bacteria in.

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16
Q

Treatment of periorbital cellulitis?

A

Antibiotics as soon as possible

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17
Q

How long does the fever last for it to be considered Kawasaki disease?

A

Over 5 days

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18
Q

What is the acronym for remembering the other features of Kawasaki disease?

A

CREAM

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19
Q

What does CREAM stand for?

A

Conjunctivitis
Rash
Erythema (hands and feet)/Edema
Adenopathy
Mucosal involvement (strawberry tongue)

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20
Q

What is the treatment for Kawasaki disease?

A

IV immunoglobulins and high dose aspirin

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21
Q

What is the typical onset of measles like?

A

Conjunctivitis followed by a rash 2-5 days later

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22
Q

What are the symptoms of measles?

A

Fever above 40C
Coryzal symptoms
Koplik spots

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23
Q

What are koplik spots?

A

Small grey discolourations of the mucosal membranes in the mouth. Appearing 1-3 days after measles infection begins

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24
Q

What is the management of measles?

A

Supportive care
Antipyrexial treatment
Vit A in children under 2

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25
Q

What are the main complications of measles?

A

Otitis media
Pneumonia

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26
Q

What does the rash look like in chicken pox?

A

Pustule filled blisters

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27
Q

Which virus causes chicken pox?

A

Varicella virus

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28
Q

Management of chicken pox?

A

Conservative management
Reduce scratching
Oatmeal baths

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29
Q

Where does the rash caused by rubella typically start and then move to?

A

Starts on the face and moves down to the trunk, sparing the arms and legs

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30
Q

How does the rubella rash differ from the measles rash?

A

Rubella spares the limbs
Measles includes the limbs

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31
Q

Which 5 symptoms does rubella typically present with?

A

Fever
Coryza
Arthralgia
Rash
Lymphadenopathy

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32
Q

How long does it take symptoms of rubella to resolve?

A

7-10days

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33
Q

Which 4 complications can rubella infection cause in pregnancy?

A

In the first 20 weeks can cause:
Cataracts
Deafness
PDA
Brain damage

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34
Q

What is the management for rubella?

A

Supportive treatment

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35
Q

What type of bacteria cause diptheria?

A

Corynebacterium

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36
Q

What are corynebacterium?

A

Gram positive bacilli

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37
Q

Which part of the body does diphtheria affect?

A

Nose and throat
Sometimes skin

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38
Q

What are the 5 main symptoms of diphtheria?

A

Thick grey/white coating covering throat nose and tongue
High temp
Sore throat
Swollen glands
Difficulty breathing and swallowing

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39
Q

What is scalded skin syndrome?

A

A rare skin infection which looks like the child has been burned and their skin is peeling

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40
Q

What age children are at highest risk of SSSS?

A

Children under 5 at greatest risk

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41
Q

What type of bacteria causes SSSS?

A

Staph aureus

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42
Q

What is the appearance of SSSS on the skin?

A

Fluid filled blisters
Large sheets of the top layer of skin can peel away

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43
Q

How is SSSS diagnosed?

A

Skin biopsy
Culture

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44
Q

How is SSSS treated?

A

Antibiotics

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45
Q

Symptoms of TB?

A

Productive cough
Haemoptysis
Weight loss
Night sweats

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46
Q

Risk factors for TB?

A

Travel to Africa, south asia, south america, russia etc

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47
Q

Treatment of TB?

A

Isoniazid and rifampicin for 6 months
Pyrazinamide and ethambutol for 2 months

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48
Q

Which of the TB treatments can cause liver toxicity?

A

Rifampicin
Isoniazid
Pyrazinamide

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49
Q

Which of he TB treatments causes visual problems?

A

Ethambutol (remember E for eyes)

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50
Q

Which TB treatment might cause urine to go red/orange?

A

Rifampicin (R for red wee)

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51
Q

When does a baby qualify for the BCG vaccine?

A

If they come from a country/ have parents and grandparents from a country whose TB incidence if more than 40 per 100,000

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52
Q

How is polio transmitted?

A

Faecal oral route

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53
Q

What symptoms do patients with polio most commonly get?

A

URTI symptoms
Diarrhoea and vomiting

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54
Q

What is a rare complication of polio?

A

Paralysis, can affect the diaphragm meaning respiratory support is needed

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55
Q

What is coxsackie’s disease?

A

Hand foot and mouth

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56
Q

What are the features of hand, foot and mouth?

A

Sore throat and fever
Oral ulcers
Vesicles on the palms and soles of feet

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57
Q

What is the management for hand foot and mouth?

A

Hydration and analgesia
Supportive treatment
Keep off school until feeling better

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58
Q

Which viruses are hand foot and mouth caused by?

A

Coxsackie A16 and enterovirus 71

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59
Q

Which bacteria is usually responsible for scarlet fever?

A

Strep pyogenes

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60
Q

How is scarlet fever spread?

A

Respiratory route by inhaling or ingesting droplets

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61
Q

How long is the incubation period of scarlet fever?

A

2-4 days

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62
Q

What are the characteristic symptoms of scarlet fever?

A

Fever
Malaise
Sore throat
Strawberry tongue
Rash

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63
Q

What are the characteristic signs about the rash in scarlet fever?

A

Pinhead spots
First appears on torso
Spares the palms and soles

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64
Q

What is the management of scarlet fever?

A

Penicilin for 10 days
Notifiable disease!

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65
Q

When can the child return to school if they have scarlet fever?

A

24 hours after starting antibiotics

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66
Q

What is TSS?

A

A severe systemic reaction to staphylococcal exotoxins

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67
Q

What are the symptoms of TSS?

A

Fever > 38.9C
Hypotension
Diffuse erythematous rash
De squamation of rash
Involvement of other organ systems

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68
Q

What is the management of TSS?

A

Removal of infected focus e.g. tampon
IV fluids
IV antibiotics

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69
Q

Which bacteria causes impetigo?

A

Staph or strep

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70
Q

Where do impetigo lesions tend to occur?

A

On the face
Flexures of the limbs

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71
Q

How is impetigo spread?

A

Direct contact with the infected scabs of a person.

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72
Q

What are the characteristic features of an impetigo lesion/

A

Golden crusted skin lesions typically around the mouth

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73
Q

How do you treat impetigo?

A

1% H202 cream for patients not systemically unwell
Topical antibiotic creams such as fusidic acid can also be used

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74
Q

How long should kids with impetigo be off school for?

A

Until lesions are crusted and healed
Or until 48 hours after Abx treatment

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75
Q

What are the symptoms of slapped cheek syndrome?

A

High temp
Runny nose and sore throat
Headache
Red rash on one or both cheeks

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76
Q

Management of slapped cheek syndrome?

A

Conservative management
Fluids, rest, paracetamol
Moisturiser if pruitis

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77
Q

Who does klinefelters syndrome affect?

A

Men

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78
Q

What is the pathophysiology of klinefelters?

A

XXY chromosomes. The characteristics typically do not develop until later on.

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79
Q

Name 5 features of Klinefelter’s.

A

Taller than expected with long arms and legs
Broader hips
Poor muscle tone
Reduced facial and body hair
Small penis ad testicles
Gynaecomastia
Infertility

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80
Q

What is the treatment for klinefelters?

A

testosterone replacement therapy

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81
Q

Who does Turners syndrome affect?

A

Only girls

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82
Q

What is the pathophysiology of turners?

A

Only 1 X chromosome

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83
Q

Name 5 key features of turners?

A

Shorter than average
No menstrual periods
Infertility due to underdeveloped ovaries
Broad chest and widely spaced nipples
Heart conditions
Kidney abnormalities

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84
Q

What is the treatment for Turners?

A

Supplemental oestrogen and progesterone from age 10 to bring on periods.

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85
Q

What is the prevalence of downs syndrome?

A

1 in 691 births

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86
Q

What is the genetic cause of down’s?

A

Trisomy of chromosome 21

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87
Q

How can Down’s be diagnosed prenatally?

A

Chorionic villus sampling or amniocentesis

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88
Q

What features are seen in down’s syndrome in the neonatal period?

A

Hypotonia
Poor moro reflex
Slanted palpebral fissures

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89
Q

What are the facial features of Down’s?

A

Slanted palpebral fissures
Flat facial profile
Extra skin on the back of neck

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90
Q

How is the development of children with Down’s affected?

A

Delayed developmental milestones
Mild to moderate intellectual disability

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91
Q

What is the genetic issue of Edwards syndrome?

A

3 copies of chromosome 18

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92
Q

What percentage of children with Edwards syndrome live longer than 5 years?

A

10%

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93
Q

What are the features of Edwards syndrome?

A

Heart defects
Intellectual disability
Developmental delays
Contractures
Seizures
Microcephaly
Low set ears
Rocker bottom feet

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94
Q

Which heart defects are seen in Edwards syndrome?

A

VSD
ASD
PDa

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95
Q

What is the chromosomal abnormality in patau’s syndrome?

A

Trisomy of chromosome 13

96
Q

Name 3 characteristic features of pataus syndrome?

A

Cleft lip and palate
Abnormal small eye or only one eye
Problems with the development of nasal passages

97
Q

When is screening offered for Down’s, Edwards and Patau’s?

A

Between 10 - 14 weeks gestation

98
Q

Who is more severely affected by fragile X syndrome?

A

Males are more adversely affected than females

99
Q

What are the characteristic facial features seen in Fragile X syndrome?

A

Long narrow face
Large ears
Prominent jaw and forehead

100
Q

What are the other, non facial features of fragile X?

A

Flexible fingers
Flat feet
Macro orchidism
ASD or ADHD

101
Q

What is the most common type of muscular dystrophy?

A

Duchennes

102
Q

Who does Duchenne’s most commonly affect?

A

Most commonly affects boys

103
Q

At what age are most patients with Duchennes wheelchair bound by?

A

Age 12

104
Q

What are the features of Duchennes?

A

Imbalance of lower limb strength
Contractures
Lumbar lordosis
Calf hypertrophy
Diminished muscle tone and deep tendon reflexes

105
Q

Gower’s sign is positive in which genetic condition?

A

Muscular dystrophy (Patient climbs up their body from sitting to standing due to an imbalance of strength)

106
Q

When do signs of Angelman’s syndrome begin to show?

A

6-12 months of age

107
Q

What signs of Angelman’s begin to show at 6-12 months of age?

A

Not being able to sit unsupported
Not being able to babble

108
Q

What are the distinctive features of Angelman’s?

A

Frequent laughter and smiling with little stimulus
Excitable and flapping hand
Restless
Short attention span
Trouble sleeping

109
Q

Which chromosome does Prada-Willi affect?

A

Chromosome 15

110
Q

What are the symptoms of Prada-Willi in childhood?

A

Excessive appetite and constant hunger
Restricted growth
Lack of sexual development

111
Q

What are the consequences of Prada-Willi?

A

Obesity and T2DM

112
Q

Features of Noonan syndrome?

A

Broad forehead
Ptosis
Wide set eyes
Short broad nose
Low set ears
Small jaw
Short stature
Heart defects at birth

113
Q

What is the most common cardiac pathology associated with Duchennes?

A

Dilated cardiomyopathy

114
Q

What hearing test is performed on school entry in the UK?

A

Pure tone audiometry

115
Q

What type of genetic condition is haemophilia A?

A

X linked

116
Q

What are the presenting features of eczema?

A

Itchy erythematous rash
Scratching

117
Q

Description of mild eczema.

A

Areas of dry skin
Infrequent itching
May be some redness

118
Q

Description of moderate eczema.

A

Areas of dry skin
Frequent itching
Redness
Excoriation of skin

119
Q

Description of severe eczema.

A

Widespread dry skin
Incessant itching and redness
Bleeding, skin thickening, cracking
Alteration of pigment

120
Q

Treatment of mild eczema?

A

Lots of emollients
Mild topical corticosteroids for areas of redness

121
Q

Treatment of moderate eczema?

A

Lots of emollients
0.01% betamethasone for redness and inflammation
1% hydrocortisone on delicate areas
Non-sedating antihistamines for itch

122
Q

Treatment of severe eczema?

A

Lots of emollients
0.1% betamethasone for redness and inflammation
0.01% betamethasone on delicate areas
Non-sedating antihistamines for itch

123
Q

When do you refer to derm for severe eczema?

A

If treatment has been trialled for 1 week and shows no benefit

124
Q

What is Stephen Johnson syndrome?

A

Severe systemic reaction involving the skin usually caused by drugs

125
Q

What are the clinical features of Stephen Johnson syndrome?

A

Maculopapular rash
Mucosal involvement
Fever
Arthralgia

126
Q

Name 4 causes of Stephen Johnson syndrome?

A

Penicillin
Sulphonamides
Lamotrigine
NSAIDs

127
Q

Which 4 drugs commonly cause urticaria?

A

Aspirin
Penicillins
NSAIDs
Opiates

128
Q

Between what ages do febrile seizures typically occur in children?

A

6 months and 5 years

129
Q

What are the features of a febrile convulsion?

A

Last less than 5 mins
Occur early on in viral infection
Most commonly tonic clonic

130
Q

What is the management following a first febrile seizure?

A

Admission to paediatrics

131
Q

What is the risk of another febrile convulsion after a first one occuring?

A

1 in 3

132
Q

What are the risk factors for another febrile seizure occuring?

A

Age of onset under 18 months
Fever < 39C
Shorter duration of fever before seizure

133
Q

When should patients be advised to call an ambulance in a febrile seizure?

A

If it lasts longer than 5 mins

134
Q

Which vaccines are in the 6 in 1 vaccine?

A

Diphtheria
Tetanus
Polio
Whooping cough
Hep B
HIB

135
Q

Which vaccines are in the 4 in 1 vaccine?

A

Diphtheria
Tetanus
Polio
Whooping cough

136
Q

Which vaccines are in the 3 in 1 vaccine?

A

Diphtheria
Tetanus
Polio

137
Q

Which vaccines do babies get at 8 weeks?

A

6 in 1
Oral rota virus
Men B

138
Q

Which vaccines do babies get at 12 weeks?

A

6 in 1
Oral rotavirus
Pneumococcal

139
Q

Which vaccines do babies get at 16 weeks?

A

6 in 1
Men B

140
Q

Which vaccines do infants get at 1 year?

A

MMR
HiB/Men C
Men B
Pneumococcal

141
Q

Which vaccines are included in the preschool booster at 3-4 years?

A

4 in 1
MMR

142
Q

What is DKA?

A

A complication of pre-existing T1Dm or the first presentation

143
Q

What is the pathophysiology of DKA?

A

Uncontrolled lipolysis, resulting in an excess of free fatty acids which are converted into ketone bodies.

144
Q

What are the clinical symptoms of DKA?

A

Abdo pain
Polyuria, polydipsia, dehydration
Acetone smelling breath
Kussmaul respiration (deep hyperventilation)

145
Q

What are the criteria for the BM, pH, bicarb and ketones for a diagnosis of DKA to be made?

A

Glucose > 11mmol/l
pH < 7.3
Bicarb < 15mmol/l
Ketones > 3mmol or 2+ on dipstick

146
Q

What are the principles of management of DKA?

A

Fluids but not too quickly
IV infusion of insulin
Correct electrolytes

147
Q

What electrolyte disturbances are commonly seen in DKA?

A

Seum K high but total body potassium is low (this then falls with insulin so needs to be corrected)
Low bicarb
High ketones

148
Q

Which fluids should you give in the first hour management of DKA?

A

Isotonic saline (0.9% NaCl)

149
Q

What fluids should you give after the first hour in management of DKA?

A

0.9% saline with potassium chloride

150
Q

When should dextrose be given in DKA?

A

When blood glucose is less than 15mmol/l

151
Q

At what rate should insulin be given in DKA?

A

0.1 unit/kg/hour

152
Q

Name 4 complications of chicken pox?

A

Pneumonia
Encephalitis (with cerebellar involvement)
DIC
Arthritis

153
Q

Name 8 drugs which can cause Stephen Johnson syndrome?

A

Penicillin
Sulphonamides
Carbamazepine
Phenytoin
Lamotrigine
NSAIDS
Allopurinol
COCP

154
Q

A Wilm’s tumour is found in which part of the body?

A

Kidney (nephroblastoma)

155
Q

At what age does a Wilm’s tumour typically present?

A

Children under 5 with a median of 3 years

156
Q

What are the most common symptoms of a Wilm’s tumour?

A

Abdo mass
Painless haematuria
Flank pain
Anorexia/Fever

157
Q

Where is the most common place for metastes to be found in a Wilms tumour?

A

Lung

158
Q

When should a child be reffered for suspected wilms tumour?

A

Children with an unexplained enlarged abdo mass

159
Q

Which is the most common childhood leukaemia?

A

ALL

160
Q

What are the 3 features you will see on blood tests of leukaemia?

A

Anaemia
Neutropoenia
Thrombocytopenia

161
Q

What age is the peak incidence of ALL?

A

2-5 years

162
Q

What are the characteristic features of NAI?

A

Children under 2
Delayed presentation with injury
Changing narratives
Injury doesn’t match with story

163
Q

What are the triad of symptoms for shaken baby syndrome?

A

Retinal haemorrhage
Subdural haemorrhage
Hypoxaemic encephalopathy (brain swelling)

164
Q

What is hypoxic ischaemic encephalopathy?

A

Brain damage resulting from antenatal or perinatal hypoxia

165
Q

What is the pathophysiology of HIE?

A

Lack of Oxygen in the foetal circulation results in poor blood supply of oxygen to the brain
This causes irreversible brain damage from both primary neuronal death and secondary reperfusion injury.

166
Q

Name 3 causes of HIE.

A

Placental abruption
Cord compression
Prolonged respiratory arrest after delivery

167
Q

How do you diagnose HIE?

A

EEG and MRI

168
Q

Which condition is HIE associate with?

A

Cerebral palsy

169
Q

In children and infant life support how many rescue breaths should be given before starting chest compressions?

A

5 initial rescue breaths.

170
Q

What is the ratio of compressions to breaths in children life support?

A

15:2

171
Q

In children what compression technique should be used?

A

Compress lower half of the sternum

172
Q

In infants what compression technique should be used?

A

2 thumbs encircling the chest

173
Q

Why does neonatal respiratory distress happen?

A

Babies lungs not having produced enough surfactant

174
Q

When does NRDS affect babies not born prematurely?

A

Mother has diabetes
Baby is underweight
Babies’ lungs haven’t developed correctly

175
Q

What are the symptoms of NRDS?

A

Blue coloured lips, fingers and toes
Rapid shallow breathing
Flaring nostrils
Grunting noise

176
Q

Management of NRDS?

A

Steroid injection before mum gives birth
Oxygen for baby, either nasal cannula or ventilation depending on severity

177
Q

What is meconium aspiration syndrome?

A

Where the meconium has passed into the amniotic fluid and then made its way into the lungs
This leads to blockage and inflammation of the airways.

178
Q

What is bronchopulmonary dysplasia?

A

Affects babies who have been born prematurely with breathing problems and need long-term breathing support and oxygen.

179
Q

When is bronchopulmonary dysplasia typically diagnosed?

A

At 14-30 days old. If the baby is still needing oxygen or their condition is worsening.

180
Q

What is Kallman syndrome?

A

Hypogonadotropic hypogonadism (delayed puberty)
As well as loss of sense of smell

181
Q

What is the appearance of CSF in bacterial meningitis?

A

Cloudy

182
Q

What are the characteristic findings of CSF in bacterial meningitis?

A

Low Glucose
High protein
High polymorphs

183
Q

How do you manage a 4 years old with bed wetting?

A

Reassurance and advice until 5 years
After 5 years use bedtime monitoring

184
Q

Hypotonia, macroglossia, an umbilical hernia and poor feeding are characteristic symptoms of what in a neonate?

A

Congenital hypothyroidism.

185
Q

You suspect a 14 year old boy has an osteosarcoma as there is a swelling in his shoulder, what is the most appropriate next step?

A

Urgent x-ray within 48 hours

186
Q

How much is a fluid bolus in children?

A

10mls/kg over less than 10 mins

187
Q

What type of fluid is used in a fluid bolus?

A

0.9% normal saline

188
Q

Name 2 signs of meningism.

A

Kernig’s and brudzinski

189
Q

What is kernigs sign?

A

Inability to straighten the leg when hip is flexed at 90 degrees

190
Q

What is brudzinski’s sign?

A

Forced flexion of the neck illicit reflex flexion of the hips

191
Q

Which antibiotics for bacterial meningitis in under 3 months?

A

Cefotaxime plus amoxicillin for listeria cover

192
Q

Which antibiotics in children over 3 months?

A

Cefotaxime

193
Q

Which investigations in children with suspected meningitis?

A

Blood cultures
FBC, CRP, U&E, LFT
Coagulation
Blood gas
Urine culture
Viral throat swab
Lumbar puncture

194
Q

What are contraindications for LP?

A

Raised ICP: Fluctuating consciousness, bradycardia, HTN, abnormal posture, eye signs
Coagulation abnormalities: platelet count lower than 100
Local superficial infection at LP site
Shock
Extensive or spreading purpura

195
Q

What are the causative organisms of meningitis under 3 months?

A

GBS
E.coli
Listeria
Strep pneumonia

196
Q

What are the causative organisms of meningitis over 3 months?

A

Neisseria meningitidis
HIB
Strep pneumonia

197
Q

What is the chemoprophylaxis for meningitis?

A

Ciprofloxacin

198
Q

What is the treatment for meningitis if suspected in the community?

A

IM Benxylpenicillin

199
Q

What 3 investigations would you do if you suspect DKA?

A

Check glucose, ketones and pH (blood gas)

200
Q

What are the criteria for a diagnosis of DKA?

A

Acidosis less than 7.3 or bicarb less than 15
Blood ketones greater than 3
Hyperglycaemia

201
Q

What is the management of DKA?

A

IV fluids first then IV insulin

202
Q

List 3 complications of DKA therapy.

A

Cerebral oedema
Hypokalaemia
Hypoglycaemia

203
Q

If the patient is not shocked do you subtract the fluid bolus later?

A

Yes!

204
Q

How would you treat cerebral oedema?

A

Hypertonic saline
Mannitol

205
Q

What is the consequence of untreated kawasaki’s?

A

Coronory artery aneurysms

206
Q

What is the treatment of kawasaki’s?

A

IV immunoglobulins
High dose aspirin

207
Q

What is the commonest cause of complications with measles?

A

Pneumonia

208
Q

What symptoms may you see in congenital rubella syndrome?

A

Deafness, eye abnormalities and cardiac defects

209
Q

Which virus causes slapped cheek syndrome?

A

Parvovirus B19

210
Q

What are the typical symptoms of ITP?

A

Sudden appearance of petechial rash
Spontaneous bleeding or bruising in an otherwise well child.

211
Q

What would you avoid in newly diagnosed ITP?

A

NSAIDS
Contact sports
IM injections
Careful with head injuries

212
Q

What is the treatment for mild bleeding in ITP?

A

Tranexamic acid

213
Q

Which drug is given for prophylaxis of bronchiolitis?

A

Palivizumab

214
Q

Antibiotics in UTI in children?

A

Usually cefuroxime

215
Q

What imaging is required if the baby responds well to UTI treatment?

A

6 weeks post infection renal tract USS

216
Q

What do you see on USS in intussuception?

A

Target sign

217
Q

Which other condition is associated with Hirschsprungs?

A

Down’s syndrome

218
Q

What is the surgical intervention for pyloric stenosis?

A

Ramstedt pyloromyotomy

219
Q

What do you treat the household with in scabies?

A

Permethrin

220
Q

Where is the most common site for scabies lesions?

A

Webs between fingers

221
Q

What is necrotising enterocolitis?

A

Due to growth of bacteria in the gut lining, causing erosion of the wall, reduced oxygen and blood flow then necrosis of tissue.

222
Q

When does NEC commonly occur?

A

Within a few days into the neonates life

223
Q

What are the key clinical features of NEC?

A

Abdo distension
Intolerance to feeds
Metabolic acidosis
Green bilious vomitting
Dark bloody stools
Absent bowel sounds

224
Q

What does NEC look like on abdo x-ray?

A

Dilated loop of bowel
Thickened bowel wall
gas in the bowel

225
Q

What is the management of NEC?

A

Nil by mouth
IV fluids
Antibiotics
Nasogastric decompression
Surgery

226
Q

What is the management of GBS in a neonate?

A

Benzyl penicillin
Gentamicin
Cefotaxime

227
Q

What symptoms of inattention are seen in ADHD?

A

Easily distracted
Difficulty sustaining tasks
Often loses things
Forgetful
Doesn’t seem to listen when spoken to

228
Q

What are the hyperactivity symptoms of ADHD?

A

Unable to play quietly
Talks excessively
Doesn’t wait their turn
Spontaneously leaves seat
On the go
Interruptive or intrusive

229
Q

What is the first line medical management of ADHD?

A

Methylphenidate

230
Q

If inadequate response to methylphenidate in ADHD what is the next line treatment?

A

Dexamphetamine

231
Q

What are the most common causes of iron deficiency anaemia?

A

Low dietary intake
Menorrhagia
Bleeding disorder
IBD
Growth spurt
Hookworms

232
Q

What is the typical presentation of iron deficiency anaemia?

A

Fatigue
Lethargy
Dyspnoea
Palpitations
Headache
Pallor
Tachycardia

233
Q

What does a blood film show in iron deficiency anaemia?

A

Hypochromic microcytic RBC’s

234
Q

What is vesicoureteral reflux?

A

Abnormal backflow of urine from the blader into the ureter and kidneys.

235
Q

What investigations would be done for vesicoureteral reflux?

A

Diagnosis following a micturating cystourethrogram

Phase 3A content (15 decks)

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