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*** Exam Medicine > Paeds Summary Q's > Flashcards

Paeds Summary Q's Flashcards

1
Q

ages of puberty onset - M & F

A

M - 10-14

F - 10 - 13 –> menstration starts around 18 months later

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2
Q

what are the common causes of acutely unwell child (split into systems)

A 
Resp - Croup / Asthma exac / acute epiglott / foreign object
Inf Dis - Sepsis / GastroEnt
CV - arrythmia
Neuro - Meningitis / 
Other - Hypoglyc / NAI / Volvulus
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3
Q

positive of breastfeeding (mother and child)

A

Mother - decrease risk of breast cancer / ovarian cancer , increase bond between baby, helps lose weight, lowers risk of osteoporosis

Baby - lowers risk of atopy, lowers risk of diabetes, lowers risk of obesity??

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4
Q

contra-indications to breastfeeding

A

HIV?
psychological aspect?
radioactive iodine therapy

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5
Q

feeding methods for sick child

A

NG tube feeding
hypotrophic feeding
central line feeding?

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6
Q

signs of dehydration in a sick child?

A 
dry mucous membranes
low urine output
low core cap refill
low BP
high HR
sunken eyes
sunken fontanelle
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7
Q

causes of fluid loss in child

A

fever, burns, diarr, vomiting

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8
Q

causes of motor development delay

A

Cerebral Palsy, DMD, Global development decrease (downs)

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9
Q

investigations for failure to thrive

A

Bloods - TFT’s and TSH (hypothy causes decreased growth hormone), FBC (B12/Iron/ WCC), TTF (coeliacs) Faecal Eleastase

Sweat Tst - CF
karyotyping - genetic

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10
Q

causes of febrile child (split into systems)

A

Resp - bronchiolitis, croup, pneumonia, epiglotitis
GI - viral gastroent, appendix, intuss,
Renal - UTI
Neuro - meningitis
Inf Dis -
ENT - viral throat/ strep throat, ottitis media,

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11
Q

definition of respiratory distress syndrome

A

inability of lungs to fully expand as a result of decreased surfactant production, most commonly becuase of prematurity. This leads to increased effort of breathing and eventually exhaustion.???

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12
Q

causes of seizures (5 H’s, D, E, M)

A 
Hyperthermia
Hypoglycaemia
Hypernatramia/hypocalcemia
hypoxia
h
drugs
epilepsy
meningitis
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13
Q

signs of NAI

A

child is:
unkempt, overly friendly to strangers, poor developed speech, weird bruises, failure to thrive, odd hx given, suspicious injuries, any STI

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14
Q

acute abdo DDx

A

??

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15
Q

What are the COntra-Indications to Immunizations

what are contra-indications to giving live/attenuated vaccines?

A

CI - Severe confirmed anaphyllaxis reaction / current febrile illness

CI to live - Immunocompromised or suppressed / HIV /

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16
Q

what predisposes to needing resusitation peri-natally OR causes of fetal resp distress

A 
prematurity
fetal distress
transient tachpnea of neonate
meconium stained liquor
emergency c-section
congenital abnorm
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17
Q

causes of IUGR

A

TORCH
teratogens
chromosomal abnorm
smoking / alcohol

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18
Q

meningitis signs

A 
photophobia
neck stiffness
fever
sweaty
headache
dizzy
N+V
\+/- meningococcal rash
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19
Q

umbilical cord components

A

2 arteries

1 vein

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20
Q

Meningitis in infancy, initial signs and complications

A

Signs - Irritable cry, Gastroent, bulging fontanelle, apnoea, head retraction and resistance to flexion (coma, convulsion)

Compl - seizures, cerebral oedema, hypoNat, deafness, drug fever, mental handicap

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21
Q

cause of paediatric deafness

A
  • meningitis
  • congenital syndrome
  • Pre Natal infection (TORCH)
  • Ototoxic drugs
  • Perinatal problems
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22
Q

Causes of Raised Intra-cranial pressure

A

Meningitis, CA, haemorrhage (stroke?) any cause og hydrocephalus (TORCH??)

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23
Q

causes hydrocephalus

A

NTD’s, post haemorhage (stroke etc), infection (meningitis)

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24
Q

what can cause lymphadenopathy in kids

A

Malignant - Leukaemia, Lymphoma,
Infection - anything?? TB?
AutoImmune - Sarcoid, SLE,

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25
Q

scarlet fever - ? / CF / I / T

A

group A beta-haemolytic strep

sore, red throat with strawberry tongue, fever and red sandpaper rash on cheeks

Nasopharyngeal swab / rapid strep test

Pencillan V for 10 days

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26
Q

Sturge Webber Triad

A

Glaucoma
Port Wine Stain rash
Brain abnormality

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27
Q

nname teratogenic drugs (and some CF)

A 
Lithium - ebsteins anomlay
Warfarin - cardiac defects
Sodium Valproate - NTD's
Phenytoin - cleft palate/ cardiac
alcohol - low IQ, cardiac defects
28
Q

TORCH infections

A

Toxoplasmosis - chorioretinitis/ hydrocephalus
Other (Syphilis) -
Rubella - cataracts/hearing loss/ cardiac defects
Cmv - deafness?
Herpes?

29
Q

Main neural Tube defects and why are these not common anymore?

A

Ancephaly,

Spina bifida - failure of the neural tube to close in early pregnancy.

Occulta- hidden defect, presenting as a tuft of hair etc over sacral area

Folate supplementation has decreased this

30
Q

3 causes of neonatal cyanosis

A

RDS
cyanotic heart lesion (Tetralogy of F)
diaphargmatic hernia
??perinatal hypoxia??

31
Q

3 causes acute and chronic cough

A 
Acute = Foreign object / croup / exacerbation asthma
Chronic = Whooping Cough / Asthma / CF
32
Q

3 causes of Stridor

A

Croup
Acute epiglottitis
Foreign Body
- glandular fever

33
Q

Cystic Fibrosis Xray findings AND assoc illnesses

A

thickened trachea?

pancreatic insuff
liver failure / biliary cirrhosis
no VAS DEFERENS

34
Q

technique for using asthma spacer

A 
clean spacer
prime inhaler
attach
insert into mouth
spray approp dose
breath in deeply, hold for 3 long count, breath out.
35
Q

emergency asthma exacerbation management

A 
O2 if sat low
Nebulised Salbutamol (via O2) and Oral Pred/IV hydrocortisone
ABG's and vitals
if no response, repeat Nebs + pred
if life threatening IV salb + ipratrop
36
Q

what would collapsing pulse in a child indiciate?

A

patent ductus arteriosis

37
Q

what would unequal BP in arms and legs indicate?

A

co-arctation of aorta

38
Q

what is seen on cxray of RDS?

A

ground glass lung fields + bell shaped thorax

decreased lung vol, air bronchograms

39
Q

how to distinguish conjugated and unconjugated jaundice in neonate

A

Total Bilrubin + Conjugated bilirubin fraction (should be

40
Q

what is kernicterus?

A

free conjugated bilirubin which has crossed the blood brain barrier resulting in:

  • acute encephalopathy
  • high pitched cry
  • coma
  • cerebral palsy
41
Q

what should be done in the management of neo-natal jaundice if phototherapy is unsuccessful?

A

exchange transfusion

42
Q

describe henoch schloen purpura

A

vasculitic condition often following a viral illness causing;

  • purpuric rash on legs and buttocks
    +/- abdo pain +/- arthritis +/- nephritis
43
Q

name 5 causes of vomiting in child?

A 
GORD
overfeeding
pyloric stenosis
hirschprungs
raised ICP
gastroenteritis
44
Q

name causes of diarrohea in infant

A

coeliacs, UC, crohns
toddlers
gastroenteritis

45
Q

name causes of constipation in infant

A

medication
obstruction
functional

46
Q

what sort of symptoms do UTI’s present with in infancy?

A

vague, infectious sounding symptoms:

  • vomiting
  • irritability
  • fever
47
Q

how should a child under 3 months with a UTI be treated?

A

give IV cefotaxime

48
Q

PCKD - inheritance pattern and CF

A

AD

haematuria, large palp kidneys, hypertension +/- renal failure in future

49
Q

causes of haematuria

A 
GN
CA
UTI
Goodpastures
Supra-pubic aspiration
PCKD
50
Q

what is the bedwetting triad / causes?

A
  • heavy sleeper (sleeps through urge to pee)
  • overstimulated/unstable bladder (give oxybutymin)
  • increased production of urine (give desmopressin)
51
Q

causes of neonatal jaundice

A 
Physiological (normal)
Hyper Conjugated = biliary atresia
Hyper UNConjugated = 
 - haemolytic / ABO incomopatibility
 - sepsis
 - breast milk jaundice
52
Q

neonatal sepsis causes

A 
prolonged rupture of membranes, premature rupture of membranes,
maternal infection (particularly Group B strep)
53
Q

DOWNS characteristics (ROSEOLA)

A 
Round face
Occipatal Flattening
Spots on iris (Brushfield)
Epicanthic folds decreased
Open mouth, tongue out
Low set ears
Almond eyes
54
Q

Causes of Low Birth Weight

A

TORCH (CMV
Fetal Alcohol
Prematurity
Familialy small

55
Q

heart failure in kids

A

PDA / coarctation/ cardiomyopathy

56
Q

chickenpox timeline and complications

A

fever and malaise for 48 hours then macules appear
infectious from 4 days before rash and 5 days after

main complications pneumonitis and encephalitis

57
Q

signs of DKA

A

ketotic breath, kussmal breathing, N+V, abdo pain, confused or drowsy,
Dehydrated = cool periph, sunken eyes, low skin turgor, up RR, down BP

58
Q

complications of phototherapy

A

loose stools, dehydration

59
Q

what is the worst end result of neo-natal jaundice following unsuccessful phototherapy and exhange transfusion?

A

kernicterus

60
Q

how to stop a febrile convulsion in child and when to intervene?

A

rectal diazepam / buccal midaz after 5 minutes if still fitting

61
Q

neo-nate with normal investigations but still deteriorating could be?

A

cardiac cyanotic lesion (PDA)

62
Q

what comprises a septic screen?

A

Blood Culture
Urine Culture
LP

63
Q

methods of urine collection in kid?

A 
supra pubic (most reliable)
catheter
clean catch (best)
64
Q

when examining/ history taking a child with ?? developmental delay, what should be noted?

A
  • any perinatal problems?
  • consanguinity
  • dysmorphic features on face
  • size of head
  • hepatospleno-megaly
65
Q

ages for each of surgical issues

A

Hirschprungs - neo nate

pyloric stenosis -

66
Q

what advice might you give to a mother about when to re-present following their child having a fever?

A
  • any non-blanching rash
  • any decrease in GCS
  • seizures
  • fever >5 days

*** Exam Medicine (20 decks)

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