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Yr 5 PACES > Paeds VIVAs > Flashcards

Paeds VIVAs Flashcards

1
Q

why do children <5yrs wheeze when they have an URTI

A

narrower airways -> any small degree of narrowing caused by inflammation can cause wheeze/stridor

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2
Q

examination findings of long-standing asthma

A

Harrison sulci
hyper inflated chest

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3
Q

medications contraindicated in asthma

A

beta blockers
NSAIDs
ACEi
adenosine

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4
Q

why is asthma worse at night

A

lower levels of cortisol -> reduced anti-inflammatory effect

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5
Q

main features of autism

A

impaired social interaction
speech and language disorder
ritualistic repetitive behaviours

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6
Q

comorbidities assoc. w. ASD

A

learning difficulties
ADHD
sezirues
affective disorders

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7
Q

features of severe respiratory distress

A

grunting
marked chest recession
RR > 70

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8
Q

causative organism of bronchiolitis

A

RSV

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9
Q

preventative measure for high-risk pre-term infants for bronchiolitis

A

palivizumab

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10
Q

RFs for bronchiolitis

A

preterm w. BPD
underlying lung disease
congenital cyanotic heart disease

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11
Q

define cerebral palsy

A

non-progressive movement disorder due to damage in motor cortex around time of birth

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12
Q

RFs for CP

A

antenatal: infection
perinatal: sepsis, LBW, prematurity, asphyxia
postnatal: meningitis, head trauma

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13
Q

primitive reflexes

A

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

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14
Q

causes of vomiting in a child

A

posseting
gastroenteritis
GORD
pyloric stenosis
intussusception
biliary atresia

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15
Q

causes of rash in infants

A

viral infection
Mongolian blue spot
nappy rash
skin infection

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16
Q

classification of CMPA

A

IgE mediated = immediate
non-IgE mediated = delayed

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17
Q

mechanism of CMPA

A

IgE: mast cells -> histamine release
non-IgE: T cell mediated

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18
Q

pathophysiology of CF

A

AR mutation in CFTR gene causes reduced movement of chloride -> thick mucus

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19
Q

CF screening in UK

A

neonatal Guthrie: test for serum IRT
raised IRT -> screen for gene mutations
2 mutations -> sweat test

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20
Q

presentation of CF in newborn

A

dx at screening
meconium ileus

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21
Q

cause of loose stool in CF

A

pancreatic exocrine insufficiency

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22
Q

organisms that commonly cause infection in CF

A

s. aureus
h. influenza
pseudomonas
aspergillus
non-TB mycobacteria

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23
Q

complications of CF

A

diabetes mellitus
liver disease
infertility (vas deferent absence)

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24
Q

pH limit for severe DKA

A

<7.1

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25
Q

complications of DKA treatment

A

cerebral oedema
hypokalaemia

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26
Q

management of cerebral oedeoma

A

mannitol + hypertonic saline

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27
Q

how much fluids in DKA

A

20ml/kg bolus + maintenance

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28
Q

Down syndrome screening

A

10-14 weeks: combined test
14+ weeks: quadruple test

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29
Q

triple test for Down syndrome components

A

nuchal translucency
beta hCG
PAPP-A

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30
Q

genetic mechanisms of Down syndrome

A

nondisjunction
Robertsonian translocation
mosaicism

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31
Q

causes of feeding difficulties in neonate

A

non-specific illness
GORD
CMPA
cleft palate

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32
Q

Down syndrome has increased risk of which cancer

A

AML

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33
Q

classification of bed wetting

A

primary +/- daytime Sx
secondary: after dry for 6 months

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34
Q

causes of primary enuresis w.out daytime Sx

A

sleep arousal difficulties
polyuria
bladder dysfunction

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35
Q

causes of primary enuresis w. daytime Sx

A

disorders of lower urinary tract
overactive bladder
congenital malformations
neurological disorders

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36
Q

causes of secondary enuresis

A

diabetes
UTI
constipation

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37
Q

age group for febrile convulsions

A

6 months - 6 years

38
Q

when in illness do febrile convulsions tend to occur

A

start - rapid rise in temp

39
Q

risk of recurrence of febrile convulsions

A

1 in 3

40
Q

what are complex febrile convulsions

A

> 15 mins
focal seizure symptoms
1 in 24hrs

41
Q

most common cause of febrile convulsions

A

roseola infant (HHV6)

42
Q

what is functional abdominal pain

A

≥4 per month for ≥2 months
somatic symptoms
insufficient criteria for other functional GI disorders

43
Q

condition that accounts for most causes of functional abdominal pain

A

IBS

44
Q

when to admit infant with GORD

A

faltering growth
feeding aversion
unresponsive to medical therapy
Sandifer’s syndrome - paroxysmal limb sparing spasms

45
Q

normal breastmilk intake for babies

A

160-180ml/kg/day

46
Q

features of serious cause of headache

A

new severe/unexpected
progressive/persistent
associated features
contacts w. similar Sx
comorbidities
preceding factors

47
Q

location of lesion causing superior homonymous quandrantopia

A

temporal

48
Q

location of lesion causing inferior homonymous quandrantopia

A

parietal

49
Q

location of lesion causing hemianopia with macular sparing

A

optic radiation

50
Q

location of lesion causing homonymous hemianopia

A

optic tract

51
Q

common causative organisms for bacterial meningitis in infants

A

NHS organisms

52
Q

common causative organisms of bacterial meningitis in neonates

A

GBS
E coli
listeria

53
Q

contraindications for LP

A

raised ICP
coagulopathy
local infection
meningococcal septicaemia

54
Q

classic CSF findings in bacterial meningitis

A

turbid
high polymorphs + protein
low glucose (<50% of plasma)

55
Q

triad of NAI

A

subdural haematoma
retinal haemorrhage
encephalopathy

56
Q

RFs for NAI

A

domestic violence
mental health disorders
drug/alcohol misuse
disability/chronic illness

57
Q

causes of drowsiness in infants

A

normal
sepsis
intracranial infection
hypoglycaemia

58
Q

consequences of smoking/alcohol during pregnancy

A

alcohol -> fetal alcohol syndrome
smoking -> IUGR, LBW, abruption, miscarriage

59
Q

dxic imaging for orbital cellulitis

A

CT orbit

60
Q

complications of orbital cellulitis

A

sight loss
abscess
meningitis
intracranial infection

61
Q

cause of reactive arthritis

A

extra-articular infection

62
Q

common causative organisms of septic arthritis

A

s. aureus
n. gonorrhoeae

63
Q

what is Osgood Schlatter disease

A

tibial apophysitis
inflammation at tibial tuberosity caused by repeated avulsion where patellar tendon inserts

64
Q

age limits for precocious puberty

A

girls: <8 years
boys: <9 years

65
Q

physiological changes of puberty in girls in order

A

body growth
breast development
pubic hair
sweating
oily skin
genital development
discharge
period

66
Q

causes of delayed puberty

A

AN
excessive exercise
gonadal dysgenesis
Kallmann syndrome
Turner syndrome

67
Q

hormonal axis responsible for pubtery

A

hypothalamic pituitary gonadal axis

68
Q

where else are sex steroids produced

A

adrenals

69
Q

what is sickle cell disease

A

AR point mutation in codon 6 of beta global gene: glutamine -> valine

70
Q

What is TGA

A

aorta and pulmonary arteries switched -> 2 independent circulations which only mix via PDA

71
Q

cyanotic congenital heart disease

A

TGA
ToF
tricuspid atresia

72
Q

four main features of TOF

A

VSD
overriding aorta
pulmonary stenosis
RVH

73
Q

long-term consequence of VSD which may present later in life

A

Eisenmenger syndrome: L-R shunt becomes R-L

74
Q

scoring systems to assess severity of UC

A

Truelove and Witts
PUCAI

75
Q

classes of drugs used in UC

A

aminosalicylates
steroids
steroid sparing agents
biologics

76
Q

UC vs Crohn’s

A

UC:
continuous
only affects colon
mucosa and submucosa

Crohn’s:
mouth to anus
skip lesions
transmural

77
Q

complications of UC

A

toxic megacolon
bowel cancer
erythema nodosum
enteric arthritis
PSC

78
Q

common causative organisms of UTIs in children

A

E coli
klebsiella
proteus

79
Q

Structural anomalies that increase risk of UTIs

A

vesicoureterix reflux: ureteres insert directly into bladder -> short intramural path

posterior urethral valve: obstructing membrane -> bladder outflow obstruction in males

80
Q

what does DMSA assess for

A

renal scarring

81
Q

paediatric sepsis 6

A

oxygen + fluids + abc
blood cultures + UO + lactate
involve senior clinicians early
consider inotropic support

82
Q

Triad of West Syndrome

A

2/3 of:
infantile spasms
developmental delay
hypsarrhythmia on EEG

83
Q

at what age is peak incidence of West Syndrome

A

4-7 months

84
Q

causes of West syndrome

A

prenatal: microcephaly, hypoxic/ischaemic damage
perinatal: hypoxia, ischaemia, infection
postnatal: maple syrup urine disease, PKU

85
Q

prognosis of West syndrome

A

poor
idiopathic has better prognosis than symptomatic cases

86
Q

complications of scarlet fever

A

glomerulonephritis
rheumatic fever

87
Q

types of laxatives

A

bulk forming: fybogel
osmotic: movicol
stimulant: Senna
softening: arachis oil

88
Q

risk stratification of Crohn’s disease

A

low:
inflammatory
no strictures/penetrating disease

medium:
growth delay
no clinical/biochemical remission

high:
stricture/penetrating disease
additional RFs

89
Q

risk of recurrence in intussusception

A

5%

90
Q

high risk features of ALL

A

<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

Yr 5 PACES (5 decks)

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