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Phase 3a > Paeds (things I forget) > Flashcards

Paeds (things I forget) Flashcards

1
Q

At what age does a child start to talk in short sentences?

A

2.5-3 years

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2
Q

At what age does a child have a vocabulary of 2-6 words?

A

12-18 months

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3
Q

At what age does a child start to respond to their own name?

A

9-12 months

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4
Q

At what age does a child start to ask ‘what’ and ‘who’ questions?

A

3 years

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5
Q

At what age does a child start to combine 2 words?

A

2 years

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6
Q

At what age does a child start to ask ‘why’, ‘when’ and ‘how’ questions?

A

4 years

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7
Q

At what age does a child start to sit without support (with a straight back)?

A

7-8 months

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8
Q

At what age does a child start to run?

A

16 months-2 years

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9
Q

At what age would you be concerned that a child still isn’t walking by?

A

18 months

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10
Q

At what age does a child start to ride a tricycle using pedals?

A

3 years

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11
Q

Describe the typical features of chicken pox

A
  • Rash usually starts on trunk/face
  • Widespread, erythematous, raised, vesicular blistering lesions
  • Itch
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12
Q

Describe the typical features of Coxsackie’s

A
  • Viral sx
  • Mouth ulcers
  • Blistering red spots/vesicles on hands/feet/mouth
  • Itchy
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13
Q

What are the differences between Kawasaki’s disease and Scarlet fever?

A

Kawasaki - longer fever (>5 days); desquamation (skin peeling); conjunctivitis

Scarlet - sandpaper rash, tonsilitis

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14
Q

Describe the typical features of measles

A
  • Fever
  • Coryzal sx
  • Conjunctivitis
  • Koplik spots (blue/white spots in cheek)
  • Rash starts behind ears and spreads
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15
Q

Describe the typical features of roseola infatum

A

High grade fever followed by rash –> febrile convulsions/seizures

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16
Q

What is an umbilical granuloma?

A
  • Overgrowth of tissue which occurs during healing process of umbilicus
  • Most common in first few weeks of life
  • Small, red growth of tissue in centre of umbilicus
  • Wet and leaks small amounts of clear/yellow fluid
  • Treated by regular application of salt - if not then cauterised with silver nitrate
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17
Q

What is osteochondritis dissecans?

A
  • Fragment of bone in knee joint becomes detached due to lack of blood supply
  • Chronic knee pain typically after exercise
  • Swelling and locking of joint
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18
Q

What is the most common cause of stridor in neonates?

A

Laryngomalacia

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19
Q

What does spastic cerebral palsy result from?

A

Damage to upper motor neurones in the periventricular white ball/pyramidal tracts

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20
Q

What does ataxic type cerebral palsy result from?

A

Damage to upper motor neurones in the cerebellum

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21
Q

What does dyskinetic cerebral palsy result from?

A

Damage to the basal ganglia and substantia nigra - athetoid movements and oromotor problems

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22
Q

What is seborrhoeic dermatitis?

A
  • Common in infants - often presents within first few weeks of life
  • Greasy/yellow rash with flaky scales
  • Most common on scalp/face/ears/neck
  • Treat with baby shampoo and baby oil
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23
Q

What is mesenteric adenitis?

A
  • Inflamed mesenteric lymph nodes
  • Often preceded by viral infection
  • Abdominal pain
  • Normal eating/drinking/bowel movements/no vomiting
  • Self limiting
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24
Q

Describe the typical features of Edward’s syndrome (18)

A
  • Small mouth/chin
  • Flexed, overlapping fingers
  • Rocker-bottom feet
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25
Q

Describe the typical features of Patau’s syndrome (13)

A
  • Cleft lip/palate
  • Scalp defects
  • Small eyes/eye defects
  • Polydactyly
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26
Q

Describe the typical features of Pierre-Robin syndrome

A
  • Micrognathia (undersized jaw)
  • Glossoptosis (posterior displacement of tongue)
  • Cleft palate
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27
Q

Describe the typical features of Fragile X syndrome

A
  • Trinucleotide repeat of FMR1 gene
  • Intellectual disability
  • Long narrow face
  • Large ears
  • Large testicles
  • Associated with mitral valve prolapse
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28
Q

Describe the typical features of Noonan syndrome

A

Essentially male version of Turner’s syndrome

  • Chromosome 12 (autosomal dominant)
  • Short
  • Broad forehead
  • Webbed neck
  • Low set ears
  • Pulmonary stenosis
  • Factor XI deficiency
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29
Q

Describe the typical features of Prader Willi syndrome

A
  • Chromosome 15
  • Imprinting pattern
  • Obesity
  • Dysmorphic features
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30
Q

What is Prader-Willi syndrome associated with?

A
  • Neonatal hyptonia
  • Neonatal sepsis
  • Spinal muscular atrophy
  • Hypothyroidism
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31
Q

What is Down’s syndrome associated with?

A
  • AVSD (most common)
  • VSD
  • Tetralogy of fallot
  • Hypothyroidism
  • ALL
  • Alzheimer’s
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32
Q

Describe the typical features of Turner syndrome

A
  • Short
  • Webbed neck
  • Broad chest
  • Late/incomplete puberty/infertility
  • ESM
  • Associated with bicuspid aortic valve/coarctation of aorta/aortic stenosis
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33
Q

What is the management for Turner syndrome?

A
  • Human growth hormone replacement e.g. somatotropin
  • Oestrogen replacement therapy
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34
Q

Describe the typical features of Williams syndrome

A
  • Bubbly, trusting personality
  • Learning difficulty
  • Elfin facies
  • Associated with supravalvular aortic stenosis/pulmonary stenosis
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35
Q

What are the main complications of measles?

A

Otitis media and pneumonia

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36
Q

What should you not give when treating chickenpox?

A

NSAIDs e.g. ibuprofen - increase risk of necrotising fasciitis (e.g. group A strep infections)

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37
Q

Why is aspirin not commonly given to children and what is the exception?

A

Risk of Reye’s syndrome - Kawasaki’s disease

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38
Q

What murmur is heard in tetralogy of fallot?

A

Ejection systolic murmur in pulmonary area

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39
Q

What murmur is heard in PDA?

A
  • Continuous machinery murmur
  • Loudest at left sternal edge
  • Left subclavicular thrill
  • Collapsing pulse
  • Wide pulse pressure
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40
Q

What murmur is heard in pulmonary stenosis?

A
  • Ejective systolic murmur
  • Loudest at left upper sternal edge
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41
Q

What is heard in TGA?

A

Loud S2 sound

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42
Q

What murmur is heard in coarctation of aorta?

A
  • Crescendo decrescendo murmur
  • Loudest at left upper sternal edge
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43
Q

What murmur is heard in VSD?

A
  • Pansystolic murmur
  • Loudest at left lower sternal edge
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44
Q

What murmur is heard in ASD?

A
  • Ejection systolic murmur
  • Fixed wide split S2
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45
Q

How can innocent murmurs be identified?

A
  • Precipitated by febrile illness
  • Soft
  • Systolic
  • Changes with posture
  • No additional sounds
  • Localised to an area (doesn’t radiate)
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46
Q

When is the 6-in-1 vaccine given?

A

2/3/4 months

47
Q

When is the rotavirus vaccine given?

A

2/3 months

48
Q

When is the MenB vaccine given?

A

2/4 months and 1 year

49
Q

When is the pneumococcal vaccine given?

A

3 months and 1 year

50
Q

When is the HiB/Men C vaccine given?

A

1 year

51
Q

When is the MMR vaccine given?

A

1 year and 3 years 4 months

52
Q

When is the HPV vaccine given?

A

12-13 years

53
Q

When is the MenACWY vaccine given?

A

18 years

54
Q

What is the management for croup?

A

Single dose of oral dexamethasone (o.15mg/kg)

  • Nebulised adrenalien + oxygen
55
Q

What is the management for whooping cough?

A

Macrolide abx - azithromycin/clarithromycin

56
Q

What is the typical presentation for roseola infantum?

A
  • 1 year old
  • 2-3 day history of malaise/reduced eating/cough
  • High grade fever that is worse in evenings
  • Maculopapular rash
57
Q

What is the typical presentation for parvovirus-19?

A
  • Biphasic
  • School aged child
  • Many are asx or non-specific viral sx (low grade fever/headache)
  • Rose-red rash on cheeks that spreads to body (lace-like) - no longer infectious once rash appears
58
Q

What is the typical presentation for rubella?

A
  • Unvaccinated
  • Rash starts on face then spreads to rest of body (pink)
  • Forchheimer spots (spots on soft palate)
59
Q

What are the clinical features of congenital rubella?

A
  • Sensorineural deafness
  • Congenital cataracts
  • Purpuric skin lesions
  • Hepatosplenomegaly
60
Q

What is the typical presentation for measles?

A
  • Unvaccinated
  • Maculopapular rash that starts behind ears then spreads to rest of body (dark red/brown) and becomes confluent
  • Koplik spots (white spots on buccal mucosa)
  • Conjunctivitis
61
Q

What is the typical presentation for Kawasaki’s disease?

A
  • Phasic
  • Fever >5 days
  • Strawberry tongue
  • Desquamation of palms/soles
  • Conjunctivitis
  • Cracked lips
  • GI symptoms
62
Q

What is the typical presentation for scarlet fever?

A
  • Fever
  • Strawberry tongue
  • Sandpaper rash
63
Q

What is the pattern of inheritance for Duchenne muscular dystrophy?

A

X linked recessive

64
Q

What condition is duchenne muscular dystrophy associated with?

A

Dilated cardiomyopathy

65
Q

Why should you not give ceftriaxone to infants <3 months?

A

Displaces bilirubin –> kernicterus (unconjugated bilirubin crosses blood brain barrier)

Give cefotaxime instead

66
Q

What diet can be used in children with epilepsy that is hard to control and is generally unresponsive to antiepileptic medications?

A

Ketogenic diet - high fat, low carbohydrate, controlled protein diet

67
Q

What are the clinical features of benign rolandic epilepsy?

A

Partial seizures at night

68
Q

What are the clinical features and investigations for West’s syndrome?

A
  • Infantile spasms that appear to look like colic
  • Abnormal EEG/MRI/CT (definite pathology)
69
Q

What would the heel prick test show in someone with CF?

A

Raised immunoreactive trypsinogen (IRT)

70
Q

What are the clinical features of congenital CMV infection?

A
  • Hearing loss
  • Low birth weight
  • Petechial rash
  • Microcephaly
  • Seizures
71
Q

What are the distinguishing clinical features of necrotising enterocolitis, what will the investigation show and what is the management?

A
  • Bilious vomiting
  • Blood in stool
  • AXR = dilated bowel loops, thickened bowel walls, gas in bowel wall and free gas in peritoneal cavity (if perforation)
  • NBM
  • IV fluids
  • TPN
  • Abx
  • Worsens - laparotomy
72
Q

What are the distinguishing clinical features of intussusception, what will the investigations show and what is the first-line management?

A
  • Bilious vomiting
  • Redcurrant jelly stools
  • Sausage-shaped mass in RUQ
  • Abdominal USS = target sign
  • Rectal air insufflation (air enema)
73
Q

What are distinguishing features of duodenal atesia, what will the investigation show and what is the first-line management?

A
  • Associated with Down’s syndrome
  • Presents few hours after birth
  • AXR = double bubble sign
  • Duodenostomy
74
Q

What are the distinguishing clinical features of Hirschsprung’s and what will the investigation show?

A
  • Meconium ileus
  • Palpable mass in lower abdomen
  • Empty rectal vault
  • Rectal biopsy = absence of parasympathetic ganglion cells in the myenteric plexus
75
Q

What is Hirschsprung’s associated with?

A
  • Down’s syndrome
  • Waardenburg syndrome
  • Multiple endocrine neoplasia T2
76
Q

What are the distinguishing clinical features of pyloric stenosis and what will the investigations show?

A
  • Projectile vomiting
  • Abdominal USS - thickened pylorus
  • Blood gas analysis - hypochloraemic, hypokalemic metabolic alkalosis
77
Q

What are the distinguishing clinical features of biliary atresia, what will the investigations show and what is the first-line management?

A
  • Jaundice
  • Hepatosplenomegaly
  • High conjugated bilirubin
  • Surgery - Kasai portoenterostomy
78
Q

What is line of management options for ADHD?

A
  • Watch and wait for 10 weeks
  • Refer to secondary care
  • Medication (patients >5) = methylphenidate –> lisdexamfetamine –> dexamfetamine
79
Q

What is the management for viral induced wheeze?

A

Same as asthma - first line is inhaled salbutamol

80
Q

What are the causes and clinical features of impetigo and what is the management?

A
  • Staph. aureus or group A strep (strep pyogenes)
  • Golden crust lesions typically starting on the face
  • FIRST LINE = topical hydrogen peroxide cream
  • Topical fusidic acid
  • IF BULLOUS = systemic abx e.g. flucloxacillin/erythromycin
81
Q

Damage to which nerves causes Erb’s palsy?

A

C5-C6

82
Q

What is the most common cause of meningitis in neonates amd children?

A

Neonates = group B streptococcus

Children = neisseria meningitidis

83
Q

What is the management for meningitis?

A

Community = IM benzylpencillin

Hospital = IV cefotaxime/ceftriaxone

Prophylaxis = oral ciprofloxacin/rifampicin

84
Q

What are the clinical features of congenital syphilis?

A
  • Generalised lymphadenopathy
  • Hepatosplenomegaly
  • Rash
  • Skeletal malformations
85
Q

What are the complications of chlamydia infection in pregnancy?

A

Increased risk of:
- Chorioamnionitis
- Preterm rupture of membranes
- Neonatal conjunctivitis
- Neonatal pneumonia

86
Q

What imbalances are seen in congenital adrenal hyperplasia?

A
  • Hyponatraemia
  • Hyperkalaemia
  • Metabolic acidosis
87
Q

What are the clinical features and investigations for haemolytic uraemic syndrome?

A
  • Diarrhoea that turns bloody
  • Triad = AKI, thrombocytopenia and normocytic anaemia
  • Blood film - schistocytes and helmet cells
88
Q

What is the typical presentation of IgA nephropathy?

A

Haematuria following URTI

89
Q

What are the causes of infectious mononucleosis (glandular fever)?

A
  • Most common = EBV (HHV-4)
  • CMV/HHV-6
90
Q

What are the clinical features of infectious mononucleosis?

A
  • Sore throat
  • Pyrexia
  • Lymphadenopathy
  • Maculopapular, pruritic rash in patients who take ampicillin/amoxicillin
91
Q

What is the inheritance pattern of Kallmann’s syndrome and what are some distinguishing clinical features?

A
  • Usually x-linked recessive
  • Delayed puberty and anosmia
92
Q

Describe CSF in bacterial meningitis vs viral meningitis/encephalitis

A

Bacterial = turbid appearance/raised polymorphs/raised protein/low glucose

Viral = clear appearance/raised lymphocytes/normal or raised protein/normal or low glucose

93
Q

What is the management for JIA?

A
  • NSAIDs
  • Oligoarticular JIA = steroids (oral/IM/intra-articular)
  • DMARDs e.g. methotrexate/sulfasalazine
  • Anti-TNFa e.g. infliximab
94
Q

What are the risk factors for developmental dysplasia of the hip?

A
  • Female
  • Breech presentation
  • Fhx
  • First-born
  • Oligohydramnios
95
Q

What is the management for developmental dysplasia of the hip and what are some complications if not treated?

A
  • <6 months = pavlik harness
  • Surgical intervention for reduction and stabilisation
  • Gait abnormalities
  • Hip pain
  • Osteoarthritis
96
Q

What is the management for slipped capital femoral epiphysis?

A

Refer to orthopaedics for in situ fixation with cannulated screw

97
Q

What is the most common causes of neonatal sepsis?

A

Early-onset (<72 hours) = group B strep (strep agalactiae)

Late-onset (>72 hours) = staph aureus

98
Q

What is the sepsis 6?

A

Give 3, take 3

Give:
- O2
- Abx
- Fluids

Take:
- Blood cultures
- Lactate
- Urine output

99
Q

How do you differentiate between orbital cellulitis and periorbital cellulitis?

A

Orbital cellulitis is more severe and may present with:
- Reduced visual acuity
- Proptosis
- Ophthalmoplegia/pain with eye movement

  • Managed with IV abx
100
Q

What are some complications of sickle cell disease?

A
  • Osteomyelitis (due to salmonella)
  • Sickle cell crises e.g. vaso-occlusive crisis, acute chest syndrome, aplastic crisis and sequestration crisis
101
Q

What malignancy is coeliac disease associated with?

A
  • Enteropathy associated T-cell lymphoma
  • Small bowel adenocarcinoma
102
Q

What is the management for testicular torsion?

A

Urgent surgical exploration and bilateral orchidopexy

103
Q

Where does hypospadias commonly affect and what is the management?

A
  • Distal ventral surface of penis
  • Corrective surgery at 12 months (PATIENT SHOULD NOT BE CIRCUMCISED)
104
Q

What is Henoch-Schonlein purpura, what are the clinical features, investigations and management?

A
  • Small vessel vasculitis
  • Precipitated by viral URTI
  • Purpura (over legs and bottom), abdominal pain and joint pain
  • Raised ESR/CRP
  • Raised IgA
  • Symptomatic treatment (NSAIDs)
105
Q

What is acute lymphoblastic leukaemia associated with?

A

t(12:21) translocation genetic abnormality - associated with better prognosis

106
Q

What are the features of apgar?

A
  • Muscle tone
  • Reflex irritability
  • Colour
  • Respiratory effort
  • Pulse
107
Q

What are the ratios for neonatal and paediatric resuscitation?

A
  • 5 inflation breaths
  • Neonatal = 3:1
    Paediatric = 15:2
108
Q

What are red flag signs in children?

A
  • Pale/mottle/ashen blue
  • No response to social cues
  • Does not wake/stay awake
  • Weak
  • High pitced/continuous cry
  • Grunting
  • RR > 60
  • Age <3 months with temp >38
  • Reduced skin turgor
  • Non blanching rash
  • Bulging fontanelle
  • Neck stiffness
  • Status epilepticus
  • Focal neurological signs
109
Q

What is the difference between gastroschisis and omphalocoele?

A

Gastroschisis - protrusion of abdominal contents through anterior abdominal wall lateral to the umbilical cord, NOT covered

Omphalocoele - protrusion of abdominal contents through anterior abdominal wall through umbilicus, covered by amniotic sac

110
Q

Where does atopic eczema commonly present?

A

Infants = face and trunk

Young children = extensor surfaces

Children = flexor surfaces

111
Q

What is an organic cause of precocious puberty in females?

A

McCune Albright syndrome (rare)

112
Q

What tests are done to screen for DDH?

A

Barlow = attempts to dislocated articulated femoral head

Ortolani = attempts to relocated dislocated femoral head

113
Q

What will an x-ray show in a patient with Perthes disease?

A
  • Widening of joint space
  • Decreased femoral head size

Technetium bone scan or MRI if normal plain x-ray but symptoms persist

Phase 3a (21 decks)

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