Paeds Summary Q's Flashcards
ages of puberty onset - M & F
M - 10-14
F - 10 - 13 –> menstration starts around 18 months later
what are the common causes of acutely unwell child (split into systems)
Resp - Croup / Asthma exac / acute epiglott / foreign object Inf Dis - Sepsis / GastroEnt CV - arrythmia Neuro - Meningitis / Other - Hypoglyc / NAI / Volvulus
positive of breastfeeding (mother and child)
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??
contra-indications to breastfeeding
HIV?
psychological aspect?
radioactive iodine therapy
feeding methods for sick child
NG tube feeding
hypotrophic feeding
central line feeding?
signs of dehydration in a sick child?
dry mucous membranes low urine output low core cap refill low BP high HR sunken eyes sunken fontanelle
causes of fluid loss in child
fever, burns, diarr, vomiting
causes of motor development delay
Cerebral Palsy, DMD, Global development decrease (downs)
investigations for failure to thrive
Bloods - TFT’s and TSH (hypothy causes decreased growth hormone), FBC (B12/Iron/ WCC), TTF (coeliacs) Faecal Eleastase
Sweat Tst - CF
karyotyping - genetic
causes of febrile child (split into systems)
Resp - bronchiolitis, croup, pneumonia, epiglotitis
GI - viral gastroent, appendix, intuss,
Renal - UTI
Neuro - meningitis
Inf Dis -
ENT - viral throat/ strep throat, ottitis media,
definition of respiratory distress syndrome
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.???
causes of seizures (5 H’s, D, E, M)
Hyperthermia Hypoglycaemia Hypernatramia/hypocalcemia hypoxia h drugs epilepsy meningitis
signs of NAI
child is:
unkempt, overly friendly to strangers, poor developed speech, weird bruises, failure to thrive, odd hx given, suspicious injuries, any STI
acute abdo DDx
??
What are the COntra-Indications to Immunizations
what are contra-indications to giving live/attenuated vaccines?
CI - Severe confirmed anaphyllaxis reaction / current febrile illness
CI to live - Immunocompromised or suppressed / HIV /
what predisposes to needing resusitation peri-natally OR causes of fetal resp distress
prematurity fetal distress transient tachpnea of neonate meconium stained liquor emergency c-section congenital abnorm
causes of IUGR
TORCH
teratogens
chromosomal abnorm
smoking / alcohol
meningitis signs
photophobia neck stiffness fever sweaty headache dizzy N+V \+/- meningococcal rash
umbilical cord components
2 arteries
1 vein
Meningitis in infancy, initial signs and complications
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
cause of paediatric deafness
- meningitis
- congenital syndrome
- Pre Natal infection (TORCH)
- Ototoxic drugs
- Perinatal problems
Causes of Raised Intra-cranial pressure
Meningitis, CA, haemorrhage (stroke?) any cause og hydrocephalus (TORCH??)
causes hydrocephalus
NTD’s, post haemorhage (stroke etc), infection (meningitis)
what can cause lymphadenopathy in kids
Malignant - Leukaemia, Lymphoma,
Infection - anything?? TB?
AutoImmune - Sarcoid, SLE,
scarlet fever - ? / CF / I / T
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
Sturge Webber Triad
Glaucoma
Port Wine Stain rash
Brain abnormality
nname teratogenic drugs (and some CF)
Lithium - ebsteins anomlay Warfarin - cardiac defects Sodium Valproate - NTD's Phenytoin - cleft palate/ cardiac alcohol - low IQ, cardiac defects
TORCH infections
Toxoplasmosis - chorioretinitis/ hydrocephalus
Other (Syphilis) -
Rubella - cataracts/hearing loss/ cardiac defects
Cmv - deafness?
Herpes?
Main neural Tube defects and why are these not common anymore?
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
3 causes of neonatal cyanosis
RDS
cyanotic heart lesion (Tetralogy of F)
diaphargmatic hernia
??perinatal hypoxia??
3 causes acute and chronic cough
Acute = Foreign object / croup / exacerbation asthma Chronic = Whooping Cough / Asthma / CF
3 causes of Stridor
Croup
Acute epiglottitis
Foreign Body
- glandular fever
Cystic Fibrosis Xray findings AND assoc illnesses
thickened trachea?
pancreatic insuff
liver failure / biliary cirrhosis
no VAS DEFERENS
technique for using asthma spacer
clean spacer prime inhaler attach insert into mouth spray approp dose breath in deeply, hold for 3 long count, breath out.
emergency asthma exacerbation management
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
what would collapsing pulse in a child indiciate?
patent ductus arteriosis
what would unequal BP in arms and legs indicate?
co-arctation of aorta
what is seen on cxray of RDS?
ground glass lung fields + bell shaped thorax
decreased lung vol, air bronchograms
how to distinguish conjugated and unconjugated jaundice in neonate
Total Bilrubin + Conjugated bilirubin fraction (should be
what is kernicterus?
free conjugated bilirubin which has crossed the blood brain barrier resulting in:
- acute encephalopathy
- high pitched cry
- coma
- cerebral palsy
what should be done in the management of neo-natal jaundice if phototherapy is unsuccessful?
exchange transfusion
describe henoch schloen purpura
vasculitic condition often following a viral illness causing;
- purpuric rash on legs and buttocks
+/- abdo pain +/- arthritis +/- nephritis
name 5 causes of vomiting in child?
GORD overfeeding pyloric stenosis hirschprungs raised ICP gastroenteritis
name causes of diarrohea in infant
coeliacs, UC, crohns
toddlers
gastroenteritis
name causes of constipation in infant
medication
obstruction
functional
what sort of symptoms do UTI’s present with in infancy?
vague, infectious sounding symptoms:
- vomiting
- irritability
- fever
how should a child under 3 months with a UTI be treated?
give IV cefotaxime
PCKD - inheritance pattern and CF
AD
haematuria, large palp kidneys, hypertension +/- renal failure in future
causes of haematuria
GN CA UTI Goodpastures Supra-pubic aspiration PCKD
what is the bedwetting triad / causes?
- heavy sleeper (sleeps through urge to pee)
- overstimulated/unstable bladder (give oxybutymin)
- increased production of urine (give desmopressin)
causes of neonatal jaundice
Physiological (normal) Hyper Conjugated = biliary atresia Hyper UNConjugated = - haemolytic / ABO incomopatibility - sepsis - breast milk jaundice
neonatal sepsis causes
prolonged rupture of membranes, premature rupture of membranes, maternal infection (particularly Group B strep)
DOWNS characteristics (ROSEOLA)
Round face Occipatal Flattening Spots on iris (Brushfield) Epicanthic folds decreased Open mouth, tongue out Low set ears Almond eyes
Causes of Low Birth Weight
TORCH (CMV
Fetal Alcohol
Prematurity
Familialy small
heart failure in kids
PDA / coarctation/ cardiomyopathy
chickenpox timeline and complications
fever and malaise for 48 hours then macules appear
infectious from 4 days before rash and 5 days after
main complications pneumonitis and encephalitis
signs of DKA
ketotic breath, kussmal breathing, N+V, abdo pain, confused or drowsy,
Dehydrated = cool periph, sunken eyes, low skin turgor, up RR, down BP
complications of phototherapy
loose stools, dehydration
what is the worst end result of neo-natal jaundice following unsuccessful phototherapy and exhange transfusion?
kernicterus
how to stop a febrile convulsion in child and when to intervene?
rectal diazepam / buccal midaz after 5 minutes if still fitting
neo-nate with normal investigations but still deteriorating could be?
cardiac cyanotic lesion (PDA)
what comprises a septic screen?
Blood Culture
Urine Culture
LP
methods of urine collection in kid?
supra pubic (most reliable) catheter clean catch (best)
when examining/ history taking a child with ?? developmental delay, what should be noted?
- any perinatal problems?
- consanguinity
- dysmorphic features on face
- size of head
- hepatospleno-megaly
ages for each of surgical issues
Hirschprungs - neo nate
pyloric stenosis -
what advice might you give to a mother about when to re-present following their child having a fever?
- any non-blanching rash
- any decrease in GCS
- seizures
- fever >5 days
