Pass med 29/03/24 peads Flashcards
What to do if hand preference <12 months?
This is abnormal - could indicate cerebral palsy - refer urgently to peads
What is a key feature of NEC on abdominal X-Ray?
pneumatosis intestinalis (intramural gas)
What is the investigation of choice for intussusception?
Abdominal ultrasound
What are the presenting features of cystic fibrosis?
Neonatal peridod: meconium ileus (can get stuck as it is thicker than normal), prolonged jaundice (less common)
Recurrent chest infection
Malabsorption: steatorrhoea - due to pancreatic insufficiency , failure to thrive
Other features - liver disease
What is seborrhoeic dermatitis?
Also known as cradle cap - it is characterised by an erythematous rash with coarse yellow scales
also found on nappy, flexures and face
How is cradle cap or seborrhoeic dermatitis treated?
-doesn’t affect the baby and resolves within a few weeks
-Massage a topical emollient onto the scalp to loosen scales, brush gently with a soft brush and wash off with shampoo
-If severe/persistent a topical imidazole cream may be tried
What is the most common heart condition associated with DMD?
Dilated cardiomyopathy
What is the most common organism that causes meningitis in <3 months ?
-Group B streptococcus - usually acquirted from mother at birth - most common in low birth weight babies and prolonged rupture of membranes
-E.coli and other gram - organisms
-Listeria monocytogenes
What is the most common organism that causes meningitis in 1month -6 years?
-Neisseria meningitidis (meningococcus)
-Streptococcus pneumoniae (pneumococcus)
-Haemophilus influenzae
What is the most common organism that causes meningitis in >6 years?
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
What is the prognosis like for infantile spasms?
Poor prognosis - often associated with serious underlying health condition
What are infantile spasms?
Also known as west syndrome - is a type of epilepsy that presents in first 4-8 months of life
-It is more common in males
What are the features of infantile spasm?
-“Salaam attack” - flexion of head, trunk, arms, followed by extension of arms
-Only lasts 1-2 seconds
What do the chosen investigations show in infantile spasms?
-EEG - 2/3 infants show hypsarrhythmia
-CT demonstrates diffuse or localised brian disease in 70%
What is the management for infantile spasms?
-vigabatrin is 1st line
-ACTH is also used
-Poor prognosis
What is the management used to reduce chances of severe brain damage in neonates with hypoxic injury?
Therapeutuc cooling
What organism causes Roseola infantum?
human herpes virus 6 (HHV6)
What age is roseola infantum most common in?
6 months to 2 years
What are the features of roseola infantum?
-Fever then rash - child can present with “cold”
-Maculopapular rash
-Associated with febrile convulsions (10-15%)
-diarrhoea and cough are also commonly seen
School exclusion with roseola infantum?
No not needed
What investigation is done to screen for complciation of Kawasaki disease
Echocardiogram
What heart condition is associated with Fragile X syndrome?
Mitral valve prolapse
What does Ortolani’s test do?
attempts to relocate a dislocated femoral head
What does the Barlows test do?
attempts to dislocate an articulated femoral head
What is the most common complication of measles?
Otis media
How do migraines present in children?
Unilateral headache
Pulsating in nature
Nausea
Often a trigger or exacerbating by stress
Where are thyroglossal cysts located?
Anterior triangle
-Usually in the midline and below the hyoid
What treatments can be used for spasticity in cerebral palsy?
oral diazepam
oral and intrathecal baclofen
botulinum toxin type A
orthopaedic surgery
selective dorsal rhizotomy
When do you give treatment in neonatal hypoglycaemia?
If neonate is symptomatic
If glucose is very low
What is the treatment for neonatal hypoglycaemia?
Admit to neonatal unit and give IV 10% dextrose
What maternally can cause neonatal hypoglycameia?
labetalol
What is immune thrombocytopenia?
-An immune mediated reduction in the platelet count
-Antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex
-It is a type II hypersensitivity reaction
Difference between ITP in adults and children?
ITP is more acute in childrena dn usually follows after illness or vaccination
What is the treatment for ITP ?
- Usually no treatment resolves within 6 months in 80% of cases
-Advised to avoid activies that result in trauma
How to treat ITP if platelet count very low (<10*109/L) or significant bleeding?
-Oral/IV corticosteroid
-IV immunoglobulins
-Platelet transfusions only in an emergency and temporary as they are destoryed quickly by curculating antibodies
WHat should you not give to children <3 months with suspected bacterial meningtis?
Corticosteriods
Why is are corticosteroids such as dexamethasone given to children with bacterial meningitis?
Reduce the risk of neurological sequelae
What age is infantile colic common and when do you expect it to resolve?
-Common in infants less than 3 months old
-Improves 3-4 months
-Resolves 6 months
When do babies start to smile?
6 weeks
What are the causes of jaundice in the first 24 hours of life?
-Jaundice is always pathological
-rhesus haemolytic disease
-ABO haemolytic disease
-hereditary spherocytosis
-glucose-6-phosphodehydrogenase
What is the inherintence pattern of huntington’s disease?
Autosmonal dominant
