Paeds VIVAs Flashcards
why do children <5yrs wheeze when they have an URTI
narrower airways -> any small degree of narrowing caused by inflammation can cause wheeze/stridor
examination findings of long-standing asthma
Harrison sulci
hyper inflated chest
medications contraindicated in asthma
beta blockers
NSAIDs
ACEi
adenosine
why is asthma worse at night
lower levels of cortisol -> reduced anti-inflammatory effect
main features of autism
impaired social interaction
speech and language disorder
ritualistic repetitive behaviours
comorbidities assoc. w. ASD
learning difficulties
ADHD
sezirues
affective disorders
features of severe respiratory distress
grunting
marked chest recession
RR > 70
causative organism of bronchiolitis
RSV
preventative measure for high-risk pre-term infants for bronchiolitis
palivizumab
RFs for bronchiolitis
preterm w. BPD
underlying lung disease
congenital cyanotic heart disease
define cerebral palsy
non-progressive movement disorder due to damage in motor cortex around time of birth
RFs for CP
antenatal: infection
perinatal: sepsis, LBW, prematurity, asphyxia
postnatal: meningitis, head trauma
primitive reflexes
Moro: rapidly tipped backwards -> arms and legs extend
Rooting: tickle cheek -> turn to stimulus
Palmar: finger in palm -> grasp
Stepping: held upright with feet touching surface -> stepping motion
causes of vomiting in a child
posseting
gastroenteritis
GORD
pyloric stenosis
intussusception
biliary atresia
causes of rash in infants
viral infection
Mongolian blue spot
nappy rash
skin infection
classification of CMPA
IgE mediated = immediate
non-IgE mediated = delayed
mechanism of CMPA
IgE: mast cells -> histamine release
non-IgE: T cell mediated
pathophysiology of CF
AR mutation in CFTR gene causes reduced movement of chloride -> thick mucus
CF screening in UK
neonatal Guthrie: test for serum IRT
raised IRT -> screen for gene mutations
2 mutations -> sweat test
presentation of CF in newborn
dx at screening
meconium ileus
cause of loose stool in CF
pancreatic exocrine insufficiency
organisms that commonly cause infection in CF
s. aureus
h. influenza
pseudomonas
aspergillus
non-TB mycobacteria
complications of CF
diabetes mellitus
liver disease
infertility (vas deferent absence)
pH limit for severe DKA
<7.1
complications of DKA treatment
cerebral oedema
hypokalaemia
management of cerebral oedeoma
mannitol + hypertonic saline
how much fluids in DKA
20ml/kg bolus + maintenance
Down syndrome screening
10-14 weeks: combined test
14+ weeks: quadruple test
triple test for Down syndrome components
nuchal translucency
beta hCG
PAPP-A
genetic mechanisms of Down syndrome
nondisjunction
Robertsonian translocation
mosaicism
causes of feeding difficulties in neonate
non-specific illness
GORD
CMPA
cleft palate
Down syndrome has increased risk of which cancer
AML
classification of bed wetting
primary +/- daytime Sx
secondary: after dry for 6 months
causes of primary enuresis w.out daytime Sx
sleep arousal difficulties
polyuria
bladder dysfunction
causes of primary enuresis w. daytime Sx
disorders of lower urinary tract
overactive bladder
congenital malformations
neurological disorders
causes of secondary enuresis
diabetes
UTI
constipation
age group for febrile convulsions
6 months - 6 years
when in illness do febrile convulsions tend to occur
start - rapid rise in temp
risk of recurrence of febrile convulsions
1 in 3
what are complex febrile convulsions
> 15 mins
focal seizure symptoms
1 in 24hrs
most common cause of febrile convulsions
roseola infant (HHV6)
what is functional abdominal pain
≥4 per month for ≥2 months
somatic symptoms
insufficient criteria for other functional GI disorders
condition that accounts for most causes of functional abdominal pain
IBS
when to admit infant with GORD
faltering growth
feeding aversion
unresponsive to medical therapy
Sandifer’s syndrome - paroxysmal limb sparing spasms
normal breastmilk intake for babies
160-180ml/kg/day
features of serious cause of headache
new severe/unexpected
progressive/persistent
associated features
contacts w. similar Sx
comorbidities
preceding factors
location of lesion causing superior homonymous quandrantopia
temporal
location of lesion causing inferior homonymous quandrantopia
parietal
location of lesion causing hemianopia with macular sparing
optic radiation
location of lesion causing homonymous hemianopia
optic tract
common causative organisms for bacterial meningitis in infants
NHS organisms
common causative organisms of bacterial meningitis in neonates
GBS
E coli
listeria
contraindications for LP
raised ICP
coagulopathy
local infection
meningococcal septicaemia
classic CSF findings in bacterial meningitis
turbid
high polymorphs + protein
low glucose (<50% of plasma)
triad of NAI
subdural haematoma
retinal haemorrhage
encephalopathy
RFs for NAI
domestic violence
mental health disorders
drug/alcohol misuse
disability/chronic illness
causes of drowsiness in infants
normal
sepsis
intracranial infection
hypoglycaemia
consequences of smoking/alcohol during pregnancy
alcohol -> fetal alcohol syndrome
smoking -> IUGR, LBW, abruption, miscarriage
dxic imaging for orbital cellulitis
CT orbit
complications of orbital cellulitis
sight loss
abscess
meningitis
intracranial infection
cause of reactive arthritis
extra-articular infection
common causative organisms of septic arthritis
s. aureus
n. gonorrhoeae
what is Osgood Schlatter disease
tibial apophysitis
inflammation at tibial tuberosity caused by repeated avulsion where patellar tendon inserts
age limits for precocious puberty
girls: <8 years
boys: <9 years
physiological changes of puberty in girls in order
body growth
breast development
pubic hair
sweating
oily skin
genital development
discharge
period
causes of delayed puberty
AN
excessive exercise
gonadal dysgenesis
Kallmann syndrome
Turner syndrome
hormonal axis responsible for pubtery
hypothalamic pituitary gonadal axis
where else are sex steroids produced
adrenals
what is sickle cell disease
AR point mutation in codon 6 of beta global gene: glutamine -> valine
What is TGA
aorta and pulmonary arteries switched -> 2 independent circulations which only mix via PDA
cyanotic congenital heart disease
TGA
ToF
tricuspid atresia
four main features of TOF
VSD
overriding aorta
pulmonary stenosis
RVH
long-term consequence of VSD which may present later in life
Eisenmenger syndrome: L-R shunt becomes R-L
scoring systems to assess severity of UC
Truelove and Witts
PUCAI
classes of drugs used in UC
aminosalicylates
steroids
steroid sparing agents
biologics
UC vs Crohn’s
UC:
continuous
only affects colon
mucosa and submucosa
Crohn’s:
mouth to anus
skip lesions
transmural
complications of UC
toxic megacolon
bowel cancer
erythema nodosum
enteric arthritis
PSC
common causative organisms of UTIs in children
E coli
klebsiella
proteus
Structural anomalies that increase risk of UTIs
vesicoureterix reflux: ureteres insert directly into bladder -> short intramural path
posterior urethral valve: obstructing membrane -> bladder outflow obstruction in males
what does DMSA assess for
renal scarring
paediatric sepsis 6
oxygen + fluids + abc
blood cultures + UO + lactate
involve senior clinicians early
consider inotropic support
Triad of West Syndrome
2/3 of:
infantile spasms
developmental delay
hypsarrhythmia on EEG
at what age is peak incidence of West Syndrome
4-7 months
causes of West syndrome
prenatal: microcephaly, hypoxic/ischaemic damage
perinatal: hypoxia, ischaemia, infection
postnatal: maple syrup urine disease, PKU
prognosis of West syndrome
poor
idiopathic has better prognosis than symptomatic cases
complications of scarlet fever
glomerulonephritis
rheumatic fever
types of laxatives
bulk forming: fybogel
osmotic: movicol
stimulant: Senna
softening: arachis oil
risk stratification of Crohn’s disease
low:
inflammatory
no strictures/penetrating disease
medium:
growth delay
no clinical/biochemical remission
high:
stricture/penetrating disease
additional RFs
risk of recurrence in intussusception
5%
high risk features of ALL
<1yr or >10yrs
male, non-caucasian
WBC > 50x10^9
t(9;22), t(8;14)
presence of T/B cell markers
poor response to chemo
high residual disease
