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3A Flashcards > Paeds peer teaching > Flashcards

Paeds peer teaching Flashcards

1
Q

Croup symptoms

A

barking cough, stridor, runny nose/fever
NO DROOLING

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2
Q

Croup age

A

6 months to 3 years

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3
Q

what is croup

A

mucosal inflamation of upper airway

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4
Q

croup causative organism

A

parainfluenza virus

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5
Q

X-ray investigation for croup

A

steeple sign

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6
Q

Mild/moderate croup treatment

A

oral dexamethasone 0.15mg/kg

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7
Q

bronchiolitis symptoms and what age

A

widespread wheeze, 3 - 6 months, tachyonoea, elevated resp rate. accessory muscle use. NO FEVER

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8
Q

Bronchiolitis cause organism

A

RSV

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9
Q

acute epiglottitis symptoms

A

rapid onset, Drooling, stridor, tripod position, cant swallow. Unvaccinated/T1DM

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10
Q

Acute epiglottitis causative organism

A

Haemophilus influsezae B

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11
Q

X ray sign epiglotitis

A

thumb print sign

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12
Q

Croup Treatment

A

high flow oxygen
Corticosteroids (dexamethasone)
nebulised adrenaline

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13
Q

impetigo causative organism

A

staphylococcus aureus, group b strep pyrogens

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14
Q

impetigo symptoms and age

A

golden yellow crusting, 2-6 years, red sores around mouth and nose, itchy

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15
Q

mild impetigo treatment

A

topical antibiotics - fusidic acid 2% for 5 days
regular hand washing, no touching lesions

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16
Q

Stephen Johnson syndrome symptoms

A

erythematous macules causing target like lesions,
Nikolsky’s sign (skin peels when rubbed)
lamotrigine use

blistering erosion on oral mucosa
burning eyes

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17
Q

Stephen Johnson syndrome causative drug/organism

A

lamotrigine, carbamazepine, allopurinol, NSAID’s

mycoplasma pneumoniae

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18
Q

what is Stephen Johnson treatment

A

stop offending drug, supportive
wound care similar to burns
topical steroids - maybe not effective

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19
Q

What is Stephen Johnson syndrome

A

a rare immune mediated hypersensitivity reaction affecting the skin and mucus membranes

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20
Q

what is the criteria for mild croup

A

no stridor at rest, mild work of breathing

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21
Q

what is the criteria for moderate croup

A

stridor at rest

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22
Q

what is the criteria for severe croup

A

significant stridor at rest, significant respiratory distress, pale, tired child

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23
Q

severe croup treatment

A

nebulised adrenaline, oxygen, oral/IV dexamethasone 0.3mg/kg

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24
Q

what is bronchiolitis

A

inflamation and mucous build up in the lower airways

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25
Q

When does bronchiolitis occur

A

before 1 (3-6 months most common)

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26
Q

Risk factors for severe bronchiolitis

A

chronic lung disease
congenital heart disease
prematurity
downs syndrome
cystic fibrosis

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27
Q

bronchiolitis investigation

A

x ray to rule out pneumonia

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28
Q

management of bronchiolitis

A

oxygen, CPAP, fluid support

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29
Q

Short term complications of bronchiolitis

A

dehydration, hyponatraemia, apnoea, respiratory failure

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30
Q

what is epiglottitis

A

life threatening inflamation of the epiglottis

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31
Q

risk factors for epiglottitis

A

Non-vaccinated, immunocompromised, diabetes

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32
Q

Epiglottitis investigation

A

only if airway stable
first line: laryngoscopy
second line: lateral neck xray

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33
Q

What type of condition is eczema classified as?

A

chronic atopic condition

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34
Q

what causes eczema

A

defects in the skin barrier, causing inflamation, which causes more defects in the skin barrier

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35
Q

How does exzema present

A

dry red itchy patches, on face, neck and flexor surfaces, history asthma/FH

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36
Q

What is the first line management for eczema

A

emollient cream - thin=E45, thick =50/50 hydromol

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37
Q

what is second line treatment for eczema (and medication names

A

topical steroids
Mild: Hydrocortisone
Moderate: Eumovate
Potent: Betnovate
Very potent: Dermovate

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38
Q

which medications make up the steroid ladder for eczema

A

Mild: Hydrocortisone
Moderate: Eumovate
Potent: Betnovate
Very potent: Dermovate

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39
Q

what should you consider when prescribing potent steroids

A

not near face or eyes

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40
Q

lifestyle advice for eczema maintenance

A

avoid hot water,
no scratching,
no harsh soaps/soap substitute.
use emollients

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41
Q

what disease causes golden yellow crusts around the mouth

A

impetigo

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42
Q

widespread impetigo infection treatment

A

oral flucloxacillin
clarithromycin if allergic

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43
Q

impetigo lifestyle advice

A

short nails
no close contact with others for 48 hours
wash infected areas gently with soap and water

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44
Q

Stephen Johnson syndrome what affects prognosis

A

extent of skin involvment
older age = worse

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45
Q

Stephen Johnson syndrome complications

A

Sepsis, pneumonia, dehydration, long term blindness

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46
Q

What is ADHD

A

Persistent patterns of inattention, hyperactivity and impulsivity that interfere with functioning

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47
Q

what is inattention in ADHD

A

Easily distracted/forgetful
difficulty following instructions
difficulty planning tasks
often daydreaming/off task

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48
Q

what is hyperactivity in ADHD

A

fidgets or squirms
can’t sit still
talks excessively

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49
Q

what is impulsivity in ADHD

A

interrupts others
inability to queue/wait turn
engages in risky behaviours

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50
Q

what behavour assessments are used for ADHD

A

Conners’ rating scale, SNAP rating scale

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51
Q

what is the diagnostic criteria for ADHD

A

6 months of symptoms
two or more settings
symptoms before age 12

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52
Q

what is management for ADHD

A

Behavoural therapy (first line)
stimulants - methylphenidate/
non stimulants - atomoxetine

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53
Q

what is ASD

A

A neurodevelopmental disorder characterised by difficulties in social communication, restricted interests, repetitive behaviour and sensory sensitivities

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54
Q

what social communication difficulties occur in autism

A

delayed speach development
difficulty engaging in conversation
struggles to respond to social cues
lack of eye contact
difficulty showing empathy

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55
Q

what is an example of restricted interests/behaviours in autism

A

repetitive movements
fixation on specific activities or objects
strong preference for routines

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56
Q

Paediatric red flags

A

mottled skin, appears ill to health care professional, grunting, signs of increased work of breathing/accessory muscles, Non-blanching rash, bulging fontanel

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57
Q

what is a Macule

A

flat non palpable lesion

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58
Q

what is a papule

A

elevated palpable lesions

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59
Q

what are vesicles

A

fluid filled blisters (chicken pox)

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60
Q

2 weeks ago upper respiratory infection
kolpik spots in mouth - white spots
unvaccinated

A

measles

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61
Q

Measles causative organism

A

RNA paramyxovirus

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62
Q

measles management

A

supportive - notifiable disease

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63
Q

Measles complications

A

otitis media, pneumonia, encephalitis

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64
Q

rough (sandpaper) rash in flexor creases, strawberry tongue, swolen glands

A

scarlet fever

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65
Q

scarlet fever cause

A

strep pyrogens

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66
Q

Scarlet fever treatment

A

10 days penicillin

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67
Q

non-vaccinated
low grade fever then after resolved

face downwards rash
red spots on soft palate (palatal petechiae)
swelling lymph nodes behind ears - suboccipital/postauricular

A

rubella

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68
Q

rubella cause

A

toga virus

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69
Q

congenital rubella complications

A

teratogenic, cause deafness, congenital cateracts, heart defects, cerebral palsy

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70
Q

why no MMR vaccine for pregnant mum

A

live vaccine - risky

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71
Q

bright red rash on face, 2 days later spotty Rash on trunk/arms/legs

A

slapped cheek

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72
Q

slapped cheek cause

A

parvovirus B19

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73
Q

slapped cheek+sickle cell =

A

sickle cell crisis

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74
Q

1 year old
high fever then

trunk-peripheral rash
red spots on uveal and soft pallate

A

roseola infantum

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75
Q

roseola infantum complication

A

febrile seizure more likely

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76
Q

petechiae on back - purple/red

small patch on arm

A

Abuse/Non-accidental injury

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77
Q

Kawasaki diease symptoms

A

Crash and Burn
conjunctivitis, rash, adenopathy, strawberry tongue, hands (palmar erythema, swelling)
Burn = fever

cracked lips
japanese/afrocarribean

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78
Q

kawasaki disease investigation/treatment

A

echocardiogram - aortic aneurism
give high dose aspirin - reduces risk
IV immunoglobulins

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79
Q

what is Reyes syndrome

A

swelling of the liver and brain, associated with aspirin use

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80
Q

shock definition

A

inadequate circulation to meet tissue demands causing end organ damage

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81
Q

septic shock definition

A

an infection in your body causes extremely low blood pressure and organ failure due to sepsis

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82
Q

early signs of shock

A

altered mental state
tachypnoea
tachycardia
prolonged cap refill time
decreased urine output

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83
Q

late signs of shock

A

loss of skin turger
prolonged central refill time
hypotension
hypothermia
decreased oxygen sats

84
Q

meningitis viral and bacterial cause

A

viral: HSV 1
bacterial cause in under 3 months = group B strep
over 3 months = meningococcus

85
Q

Meningitis pathophysiology

A

virus/bacteria colonised nasopharyngeal airway and invades blood stream. from there it crosses the meninges and is in the brain. the hosts immune system causes oedema/raised ICP whilst fighting the infection

86
Q

meningitis symptoms

A

purpuric rash, fever, headache, neck stiffness, photophobia, seizures, papilloedema/bulging fontanel

87
Q

Meningitis signs

A

KErnig’ s sign - Knee extension is painful
BrudziNsKi’s sign - neck flexion leads to knee flexion

88
Q

when to avoid LP in children

A

raised ICP (headache more painful lying down, vomiting)
Rash present - blood culture will give same info

89
Q

meningitis treatment in all settings

A

IM benpen GP

IV cefotaxime (if under 3 moths also amoxicillin for listeria)

Dexamethasone only if no septicaemia (just meningitis)

notify public health england

90
Q

meningitis prophylaxis

A

ciprofloxacin
young children rifampicin

91
Q

innocent murmur

A

soft/blowing murmur
systolic
asymptomatic
change between lying/sitting (disappear lying)
left sternal edge

92
Q

foetal circulation

A

ductus venosus - oxygenated blood to heart. foramen ovale bypasses lungs and shunts from right to left atrium. ductus arteriosus connects pulmonary artery to aorta.

First breath decreases pulmonary resistance because oyxgen is a pulmonary dilator. this means left atrium pressure is greater than right atrium pressure which causes foramen ovale to close

93
Q

causes of tetralogy of fallot (genetic and IU)

A

downs syndrome, di georges syndrome, FAS

94
Q

what makes up tetralogy of fallot

A

VSD
pulmonary stenosis
right ventricle hypertrophy
overriding aorta

95
Q

symptoms of tetralogy of fallot

A

tet spells
squating todler
heart failure before 1

96
Q

which feature of tetralogy of fallot controls severity

A

pulmonary stenosis

97
Q

tetralogy of fallot murmur

A

harsh systolic ejection murmur over pulmonic/left sternal area with systolic thrill

98
Q

what is Transposition of great arteries

A

aorta is connected to right ventricle and pulmonary artery is connected to left ventricle, creating two separate circulations and resulting in only deoxygenated blood being pumped around the body

99
Q

transposition of great arteries risk factors

A

maternal diabetes

100
Q

VSD genetic association

A

Edwards (trisomy 18), turners (45x0) downs

101
Q

appendicitis symptoms

A

central to Right illiac fossa abdo pain, , nausea/vomiting, anorexia, mild pyrexia

102
Q

appendicitis treatment

A

appendectomy

103
Q

appendicitis examination signs

A

guarding, rebound tenderness, percussion tenderness,
rosvings sign - LIF palpatation causes RIF pain
psoas sign - right hip extension = pain
obturator sign - right hip internal rotation

104
Q

investigations appendicitis

A

USS - free fluid
raised inflamatory markers

105
Q

GORD - symptoms

A

milky vomiting after feeds, knees to chest, arching back, crying/irritable

106
Q

GORD cause in first 6 months of life

A

still developing oesophageal sphyncter

107
Q

management GORD

A

conservative - keep upright, spontaneous resolve, check not too much feed

medical - Gaviscon 2 weeks, add feed thickener, omeprazole/ranitidine if no improvement

surgical - laparoscopic fundoplication

108
Q

pyloric stenosis symptoms

A

non-milky projectile vomiting after feed, olive size mass in left epigastrium

109
Q

pyloric stenosis investigation

A

USS - hypertrophic sphincter

110
Q

management pyloric stenosis

A

pyloromyotomy

111
Q

Pyloric stenosis ABG results

A

hypokalaemia, hypochoraemic metabolic acidosis

112
Q

hirshprungs disease what is it

A

aganglionic distal colon (caused by failure of the parasympathetic plexus

113
Q

hirschprungs disease symptoms

A

no passage of meconium in 48 hours, distended abdomon, forceful passage after DRE

114
Q

Hirschprungs diagnosis

A

First line DRE - explosive passage following
rectal biopsy gold standard

115
Q

hirschprungs management

A

rectal wash out then aganglionic bowel resection

116
Q

what is intussusception

A

telescoping of bowel

117
Q

intussussception symptoms

A

colicy abdo pain, goes pale and draws in legs

118
Q

intussussception sigsn

A

sausage shaped mass, red currant jelly stools

119
Q

intusussception Investigation

A

ultrasound - target sign

120
Q

intususception management

A

air enema - inflation of bowel

121
Q

what are the 2 types of cows milk protein allergy

A

immediate IgE or delayed non-IgE

122
Q

cows milk protein symptoms

A

regurgitation, vomiting, diarrhoea, atopic eczema, chronic cough, wheeze

123
Q

cows milk protein allergy management

A

if formula fed: hydrolysed formula

if breast fed: maternal cows milk elimination and baby Ca supliments

124
Q

what is Colic

A

excessive crying don’t know cause - diagnosis of exclusion

125
Q

diagnositic crieria for colic

A

under 5 months
recurrent prolonged crying with no underlying cause

126
Q

biliary atresia symptoms

A

jaundice over 14 days

127
Q

biliary atressia investigation

A

raised conjugated bilirubin

128
Q

biliary atresia management

A

kasai procedure

129
Q

febrile convulsions criteria

A

jerky movement and fever without CNS infection

130
Q

pateu’s what chromosome

A

trisomy 13

131
Q

pateus features

A

dysmorphic features, cleft lip, rocker bottom feet, small eyes

132
Q

pateu’s complications

A

abdominal wall dysfunction (exomphalos)/kidney cysts

133
Q

edwards chromosome abdnomality

A

trisomy 18

134
Q

edwards features

A

rocker bottom feet (more common than in pateu’s)
dysmorphic features and learning disability

135
Q

downs syndrome chromosome

A

trisomy 21

136
Q

downs syndrome features

A

hypotonia, brechycephaly (small head with flat back), flatterned face and nose, single palmar crease, short neck/stature

137
Q

downs syndrome comlications

A

learning disability, recurrent otitis media

138
Q

Turners syndrome chromosome abnormality

A

45xo

139
Q

turners syndrome features

A

short stature
webbed neck
high arching palate
widely spaced nipples

140
Q

turners syndrome complication

A

coarctation of aorta

141
Q

what is leukaemia

A

excessive production of single type of abnormal white blood cell in bone

142
Q

investigation for diagnosis of leukaemia

A

FBC - anaemia, leukopenia, thrombocytopenia
blood film - blast cells
bone marrow biopsy
lymph node biopsy

143
Q

treatment for leukaemia

A

caemotherapy, radiotherapy, bone marrow transplant

144
Q

leukaemia symptoms

A

night sweats, fever, weight loss
abnormal bruising/petechiae/bleeding
fatigue, fever, failure to thrive
lymphadenopathy

145
Q

wilms tumour what kind of tumour

A

kidney

146
Q

wilms tumour sympoms

A

abdo pain, haematuria, night sweats fever weight loss, hypertension

147
Q

wilms tumour investiagations

A

USS abdo
then
CT/MRI for staging
biopsy is dignostic

148
Q

wilms tumour managment

A

surgical excision of tumour and nephrectomy

adjuvant chemo/radiotherapy

149
Q

osteosarcoma symptoms

A

bone pain worse at night, palpable swelling/mass that restricts movement

150
Q

osteosarcoma investgation

A

urgent (within 48 hour) x ray - sunburst appearance - poorly defined and fluffy

blood test - raised alkaline phosphatase

151
Q

osteosarcoma management

A

surgical resection (often with limb amputation)
adjuvant chemotherapy

152
Q

APGAR

A
153
Q

cerebral palsy cause

A

TORCH infections, placental insufficency
Birth asphixia, maternal hypotention, hypoxic, ischaemic encephalopathy

154
Q

non-motor cerebral palsy

A

learning disability
eplilepsy
dysphagia
scoliosis
deafness

155
Q

location of lesion for spastic cerebral palsy

A

upper motor neurone

156
Q

location of lesion for dyskinetic cerebral palsy

A

basal ganglia/substantia nigra (think parkinsons)

157
Q

treatment for spasticity in cerebral palsy

A

botox - botulinium toxin type A
baclofen - oral/into CSF (intrathecal)
oral diazapam

158
Q

patent ductus arteiosus murmur

A

machinery like

159
Q

patent ductus arteriosis treatment

A

indomethacin

160
Q

Scarlet fever complications

A

rheumatic fever, otitis media

161
Q

rosella infantum causative organism

A

Human Herpes Virus 6

162
Q

rosella infantum age of effected kids

A

6-36 months/ under 2 years more likely

163
Q

Kawasaki’s disease age of affected kids

A

under 4 years

164
Q

types of acyanotic heart disease

A

with shunt
ASD
VSD
patent ductus arteriosus

without shunt
coarctation of aorta/aortic stenosis

165
Q

types of cyanotic heart disease

A

with shunt
tetralogy of fallot
transposition of great artery

without shunt
pulmonary stenosis
pulmonary atresia
hypoplastic heart

166
Q

what heart defects with downs syndrome

A

AVSD

167
Q

which heart defects with turners syndrome (45x0)

A

coarctation of aorta

168
Q

what heart defect with Pateu’s syndrome (trisomy 13)

A

patent ductus arteriosus

169
Q

what heart defect with edwards syndrome (trisomy 18)

A

ventricular septal defect

170
Q

tetralogy of fallot investigation

A

chest x ray - boot shaped heart

171
Q

tetralogy of fallot treatment

A

neonates - prostoglading infusion for keep ductus arteriosus patent

surgical repair
beta blockers

172
Q

transposition of great arteries presentation

A

on day two when ductus arteriosus closes - cyanosis

173
Q

transposition of great arteries investigation

A

chest x ray - egg on a string

174
Q

transposition of great arteries management

A

prostaglandin infusion then surgery

175
Q

when is transposition of great arteries compatible with life

A

with PDA, VSD or ASD

176
Q

Ventricular septal defect presentation

A

sweating, fatigue, poor weight gain

177
Q

ventricular septal defect murmur

A

pansystolic lower left sternal edge

178
Q

VSD investigation

A

echocardiogram/chest xray

179
Q

VSD management

A

most close spontaneously by 10 years

if significant, consider furosimide +ace inhibitor, then surgery

180
Q

atrial septal defect murmur

A

split double murmur and ejection systolic murmur

181
Q

atrial septal defect risk factors

A

maternal rubella
maternal diabetes
lupus

182
Q

atrial septal defect symptoms

A

asymptomatic OR chest pain and excersice intolerance

183
Q

atrial septal defect management

A

surgery to close form 3-5 years

184
Q

atrial septal defect investigation

A

echocardiogram

185
Q

what is pyloric stenosis and what age does it occur

A

hypertrophy of pyloric sphyncter
6-8 weeks

186
Q

pyloric stenosis blood results

A

hypokalaemia, hypochoraemic metabolic acidosis

187
Q

Intussusception risk factors

A

Meckel’s diverticulum, polyps, viral infection, lymphoma

188
Q

what is Meckel’s diverticulum

A

Embryological remnant. Incomplete obliteration of
the vitelline duct

189
Q

Meckel’s diverticulum symptoms

A

asymptomatic / with rectal
bleeding, obstruction (redcurrant stools etc
-intussusception),

190
Q

Meckel’s diverticulum management

A

Surgical- small bowel resection or simple
diverticulectomy

191
Q

what to ask about in colic (that it is not colic and is a problem)

A

detailed history, antenatal and birth history, family history and coping strategies

192
Q

red flags in colic (that it isn’t colic)

A

infection, fever, faltering growth

193
Q

At what age can febrile seizures occur

A

6 months to 5 years

194
Q

what is a simple febrile seizure

A

generalised seizure - less than 15 minutes, recovery within an hour and only 1 per febrile illness

195
Q

what is a complex febrile seizure

A

may be focal, last more than 15 minutes, more than one per febrile illness

196
Q

risk factors for febrile seizures

A

high fever, viral infection, family history

MMr vaccine (1/3000)

197
Q

management for simple febrile seizures

A

admit and observe, safety netting (no objects in mouth, recovery position when over, stay with child, video seizure)

198
Q

management of complex febrile seizures

A

diazepam if prolonged

199
Q

do febrile seizures increase risk of epilepsy

A

NO

200
Q

at what age does acute lymphoblastic leukaemia occur

A

2-3 years

201
Q

at what age does acute myeloblastic leukaemia occur

A

under 2 years

202
Q

leukaemia risk factors

A

xray exposure in utero
trisomy 21 (ALL)

203
Q

Investigations after diagnosis of leukaemia

A

chest x-ray - mediastinal mass
lumber puncture - CNS involvment
bone marrow biopsy

204
Q

factors affecting the change of recovery from leukaemia

A

better =
age 1-10
WCC over 50 at presentation
Female
no CNS involvement

205
Q

side effects of leukaemia treatment

A

avascular necrosis
peripheral neuropathy
infertility
anxiety

206
Q

which bone is commonly affected with osteosarcoma

A

femur (most common)
tibia
humerous

3A Flashcards (9 decks)

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