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Phase 3a- flashcards I forget > paeds- things i forget > Flashcards

paeds- things i forget Flashcards

1
Q

causes of newborn pneumonia

A

group B strep (maternal)

gram negative enterococci

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2
Q

causes of pneumonia in infants and young children

A

strep pneumoniae
HiB
Staph aureus
mycobacterium tuberculosis

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3
Q

atypical causes of pneumonia

A

mycoplasma pneumoniae

chlamydia pneumonia

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4
Q

Tx of pneumonia

A

O2 <92%= admit

Abx- Amoxicillin

can also use clarithromycin, co-amoxiclav, azithromycin

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5
Q

Abx used in acute epliglottitis

A

cefotaxime

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6
Q

Tx of whooping cough

A

macrolides ! Azithromcyin etc

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7
Q

long term RF of an ASD

A

stroke due to a DVT

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8
Q

what is Eisenmenger’s syndrome?

A

when an initial L-R shunt (ASD,VSD,AVSD etc) results in pulmonary hypertension

this causes pulmonary pressure to increase greater than systemic pressure- so the shunt changes to R-L, resulting in cyanosis

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9
Q

what is Rheumatic fever?

A

cross-sensitivity reaction to group A-B haemolytic strep occuring 2-4 weeks after infection (throat usually)

autoimmune

type II hypersensitivity reaction

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10
Q

signs and symptoms of rheumatic fever

A
  • high fever
  • joint pain (migrating polyarthritis- i.e. moves from joint to joint)
  • carditis (myocarditis etc)- leads to chest pain, dyspnoea and palpitations
  • mitral regurgitation
  • nodules on extensor surfaces
  • rash- erythema marginatum
  • synedhams chorea
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11
Q

what PPI can be used to help manage GORD?

A

Ranitidine

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12
Q

presentation of pyloric stenosis

A

projectile vomiting after feeds NO BILE

constipation

dehydration

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13
Q

what is exomphalos also known as

A

omphalocele

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14
Q

differences between omphalocele and gastrochisis

A

omphalocele is enclosed in peritoneum

gastroschisis is open (i.e. herniating organs are fully visisble)

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15
Q

what maternal blood test can be done to confirm a diagnosis of a fetal abdominal wall defect (omphalocele/ gastrochisis)?

A

maternal serum alpha-fetoprotein will be raised

higher in gastroschisis than in omphalocele

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16
Q

diagnosing IBD

A

faecal calprotectin

endoscopy

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17
Q

DD of bilious vomiting

A

malrotation

atresias (bowel ones only ! )

hirchsprungs

meconium ileus

anorectal malformation

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18
Q

DD of non-bilious vomiting (surgical and non-surgical)

A

surgical:

  • pyloric stenosis
  • oesophageal atresia
  • intussusception (can be bile stained early on)

non-surgical:

  • GORD
  • infections
  • coeliac
  • appendicitis
  • peptic ulceration
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19
Q

Tx of biliary atresia

A

Kasai procedure

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20
Q

presentation of a congenital diaphragmatic hernia

A
  • respiratory distress
  • displaced apex beat
  • bowel sounds in hemithorax
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21
Q

presentation of oesophageal atresia

A

dribbling
polyhydramnios
cyanotic on feeding
respiratory distress and aspiration

coiling of NG tube !!

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22
Q

symptoms and sign (X-ray) of duodenal atresia

A

obstruction (constipation etc) and bilious vomiting

double bubble on x ray

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23
Q

x ray sign of malrotation w/ volvulus

A

coffee bean sign

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24
Q

most common cause of large bowel obstruction?

A

hirchsprungs !

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25
Q

difference between indirect and direct inguinal hernia

A

indirect- through deep ring to superficial ring

direct- through defect in posterior wall of inguinal canal to the superficial ring

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26
Q

aetiology of neonatal inguinal hernias

A

patent processus vaginalis

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27
Q

describe Prehn’s sign

A

differentiates between testicular torsion and epididymis

lift testicle:

  • pain relieved= epididymis
  • pain not relieved= torsion
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28
Q

symptoms of Wilsons disease

A
  • Kayser-Fleischer rings
  • hepatitis etc
  • neurological- dystonia etc (adolescents mostly)
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29
Q

causative organism and tx of bacterial skin infection in eczema

A

organism= staph aureus

Tx= flucloaxcillin

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30
Q

describe the steroid ladder in eczema

A

1st- hydrocortisone
2nd- Eumovate (clobetasol butyrate)
3rd- Betnovate (betamethasone)
4th- dermovate (clobetasol proprionate)

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31
Q

causitive organism and presentation of eczema herpeticum

A
  • HSV most common, can also be VSV

child w/ eczema presenting with:
- painful vesicular rash
- fever, lethargy, reduced oral intake
lymphadenopathy

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32
Q

management of eczema herpeticum

A

aciclovir

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33
Q

Presentation of Steven-Johnson syndrome

A
  • initially vague upper resp tract infections after starting a new drug
  • follow by a rash

rash:
- painful, erythematous macules
severe mucosal ulceration

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34
Q

causative drugs of Steven-Johnson syndrome

A
  • sulfonamides
  • anti-epileptics
  • Penicillin
  • NSAIDs
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35
Q

presentation of allergic rhinitis

A

runny, blocked, itchy nose

sneezing

itchy, red, swollen eyes

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36
Q

management of allergic rhinitis

A

non-sedating antihistamines- cetirizine, loratadine, fexofenadine

sedating antihistamines- chlorphenamine (Piriton) and promethazine

nasal corticosteroid sprays- fluticasone/ mometasone

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37
Q

type of hypersensitivity reaction in anaphylaxis

A

severe type 1 hypersensitivity reaction. (IgE) stimulates mast cells to release histamine and other pro-inflammatory chemicals. This is called mast cell degranulation. This causes a rapid onset of symptoms, with airway, breathing and/or circulation compromise.

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38
Q

management of anaphylaxis

A 
ABCDE
Causes:
 o establish airway
o High flow oxygen
o IV fluid - crystalloid
- Early administration of adrenaline IM/IV
  • Additional:
  • Chlopheniramine - antihistamine
    o Hydrocortsone
    o Salbutamol if wheeze
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39
Q

what is a strawberry mark?

A

cavernous haemangioma

40
Q

what is a port wine stain

A

capillary haemangioma

permanent !

41
Q

UTI Tx in paeds

A

<3 months= amoxicillin and gentamicin (IV both)

> 3 months= trimethoprim, nitrofurantoin, amoxicillin

42
Q

features and immediate management of an atypical UTI

A
  • poor urine flow
  • abdo mass
  • seriously ill
  • raised CK
  • septicaemia
  • no response to Abx in 48h
  • non-E Coli infection

management- immediate USS

43
Q

What scan is used to detect renal scarring

A

DMSA (Dimercaptosuccinic acid scan)

44
Q

scan used to detect vesicouteric reflux

A

MCUG

Micturating Cystourethrogram Scan

45
Q

what is vesicouteric reflux

A

Retrograde flow of urine from bladder into ureter due to developmental anomaly where ureters are displaced laterally and enter bladder directly, rather than at an angle

46
Q

consequences of vesicouteric reflex

A
  • incomplete emptying= increased risk of infection
  • pyelonephritis from infrarenal reflux
  • increased bladder voiding pressure= renal damage
  • reflux nephropathy due to scarring
47
Q

presentation of autosomal recessive polycystic kidney disease

A

antenatally

oligohydramnios and polycystic kidneys

48
Q

consequences of a lack of amniotic fluid in ARPKD

A

potter syndrome- leads to dysmorphic features- in the face, pulmonary hypoplasia

49
Q

presentation of nephrotic syndrome

A

frothy urine

generalised oedema (periorbital, scrotal/ vulval, leg and ankle)

pallor

breathlessness

50
Q

presentation of nephritic syndrome/ acute glomerulonephritis

A
  • haematuria
  • proteinuria
  • decreased urine output
51
Q

presentation of Alport syndrome

A

sensorineural deafness

pyelonephritis

haematuria

renal failure

52
Q

what is HSP

A

IgA mediated autoimmune hypersensitivty vasculitis

can affect all organs

53
Q

triad seen in HSP

A
  • purpura (can be non-blanching)- typically on lower limbs/ buttocks
  • arthritis/ arthralgia
  • abdo pain

also affects the kidneys- resulting in haematuria and proteinuria

54
Q

triad of signs seen in haemolytic uraemic syndrome

A
  • acute microangiopathic haemolytic anaemia
  • thrombocytopenia
  • acute renal failure (AKI)
55
Q

Cause of haemolytic uraemia syndrome

A

Shiga-Toxin producing E.Coli

56
Q

presentation of haemolytic uraemia syndrome

A
  • bloody diarrhoea
  • reduced urine output
  • haematuria
  • abdo pain
  • lethargy and irritability
  • confusion
  • HTN
  • Bruising (purpura)
57
Q

complications of measles (which is most common, which is most common cause of death) + other complications

A

most common= ottitis media

cause of death= pneumonia

other:

  • croup
  • encephalitis
  • subacute sclerosing panencephalitis (chronic complication)
58
Q

aetiology of scarlet fever

A

strep pyogenes (group A haemolytic strep)

59
Q

how long should children with measles isolate for?

A

until 4 days after symptoms resolve

60
Q

Tx and isolation of children with scarlet fever

A

Tx- phenoxymethylpenicillin

isolate until 24h after Abx have started

61
Q

presentation of rubella

A
  • pink macular rash- starts on face then spreads
  • lethargy
  • low grade fever
  • headache
62
Q

isolation rules for rubella

A

isolate until 5 days after the rash presented

63
Q

aetiology and presentation of roseola infantum

A

Ax= Herpes virus 6/7

Sx- high fever, coryzal sx, swollen lymph nodes

fever then setlles and is followed by a rash- mild erythematous macular rash

64
Q

isolation rules of roseola infantum

A

none- if the child is well enough they can attend nursery

65
Q

main complication of roseola infantum

A

febrile convulsions (temperature can reach up to 40’c)

66
Q

how long is a child with chicken pox infective for?

A

from 4 days prior to the rash till 5 days after/ until all lesions have scabbed

67
Q

causative organism of impetigo

A

superficial skin infection by staph aureus/ strep pyogenes

68
Q

isolation rules for impetigo

A

48h after commencement of treatment/ until all lesions have healed

69
Q

clinical presentation of diptheria

A

sore throat, fever, lymphadenopathy and respiratory distress (usually presents as a stridor)

O/E- back of the throat will appear covered in a thick grey substance

70
Q

polio- aetiology, transmission, clinical presentation

A

VIRUS

faecal-oral transmission

  • can be asymptomatic
  • generalised Sx- fever, malaise, headache
    some cases can have CNS involvement- aseptic meningitis
  • rarely can get paralytic polio- attacks spinal cord
71
Q

TB- presentation and diagnosis

A

presentation:

  • cold abscess- firm, painless abscess in the neck (no inflammation or erythema)
  • lethargy
  • fever
  • weight loss
  • cough w/wo haemoptysis
  • lympadenopathy
  • erythema nodosum

Dx:

  • Ziehl- Neelsen stain
  • Mantoux test
72
Q

isolation rules with Coxackie’s (Hand foot and mouth)

A

stay of school until feeling systemically well

73
Q

what glands are classically swollen in mumps?

A

parotid glands

74
Q

what is infectious mononucleosis also known as?

A

glandular fever

75
Q

classic presentation of infectious mononucleosis

A

sore throat, lymphadenopathy

may develop itchy rash after taking amoxicillin

76
Q

most common complication of meningitis in kids

A

deafness (sensorineural hearing loss)

77
Q

most common complication of meningitis in kids

A

deafness (sensorineural hearing loss)

78
Q

meningitis Tx:

  • under 3 months
  • over 3 months
  • GP
A

under 3 months= cefotaxime and amoxicillin

over 3 months= ceftriaxone and dexamethasone

GP= Benzylpenicillin

79
Q

presentation of toxic shock syndrome

A

high fever
hypotension
diffuse erythematous macular rash

80
Q

Tx of toxic shock syndrome

A

ceftriaxone and clindamycin

81
Q

types of Herpes- the virus and what is causes (3-7)

A

HHV3- VZV- chicken pox and shingles

HHV4- EBV- glandular fever

HHV5- cytomegalovirus

HHV6/7- Roseola

82
Q

management of candidiasis in children

A

oral antifungal- nystatin

83
Q

what is tuberous sclerosis

A

A multisystem disorder characterised by the forma5on of hamartomas in
many organs, commonly the brain, skin and kidneys

autosomal dominant !

84
Q

clinical presentation of tuberous sclerosis

A
  • epilepsy- focal and infantile spasms
  • ash leaf macules
  • adenoma sebacum
  • Shagreen patches
  • Poliosis
  • learning difficulty
85
Q

Tx of tuberous sclerosis

A

vigabatrin

86
Q

Diagnostic criteria for anorexia

A
  • weight <85% predicted
  • BMI <17.5kg/m2
  • fear of gaining weight with persistent behaviour that intereferes with weight gain
  • feeling fat when underweight
87
Q

cardiovascular malformations due to anorexia

A

bradycardia
hypotension
QT prolongation
Arrhythmia’s

88
Q

what hormones/ electrolytes are low/ high in anorexia

A

LOW- glucose, potassium, phosphate, TSH, FSH, LH, oestrogen

HIGH- T3/T4, LFT, GH, cortisol, cholesytokinin, cholesterol

89
Q

red flags for anorexia

A

BMI <13 or below 2nd centile

weight loss >1kg/ week

temp <34.5

BP <80/50

SaO2 <92%

weakness in muscles

90
Q

what extra signs are seen in bulimia to differentiate from anorexia

A
  • binge eating
  • vomiting/ exercise etc
  • oesophagitis
  • Russell’s sign
  • gastric dilation
  • cardiomyopathy- due to laxative use
91
Q

what medication can help in bulimia

A

Fluoxetine (SSRI)- reduces binging and purging

92
Q

what must be avoided in a pt with a suspected Wilms tumour

A

renal biopsy !!

93
Q

absent red reflex- what is the biggest concern?

A

retinoblastoma

94
Q

presentation of osteogenesis imperfecta

A
  • history of fractures
  • small stature
  • dental problems
  • hypermobility
  • BLUE SCLERA
  • bone deformities (bowed legs, scoliosis)
95
Q

what is Kohler’s disease

A

avascular necrosis of the navicular bone that occurs in young children and presents with pain on the dorsal and medial surface of the foot.

96
Q

presentation of a discoid meniscus

A
  • ‘popping’ sound heard
  • pain
  • locking of the joint

Phase 3a- flashcards I forget (8 decks)

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