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Y3/4--5 Paediatrics > passmed random rashes, resp and gastro illnesses > Flashcards

passmed random rashes, resp and gastro illnesses Flashcards

1
Q

feverish
looks sickly and flushed
diffuse maculopapular rash across chest and back and small white papules on the inside of his cheeks

what is the most frequent complication of this condition

A

Otitis media

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2
Q

sx of the bronchiits which is also a complication of measals

A

lower respiratory infection, is a complication of measles but is not as common as otitis media. This would typically present with a persistent productive cough, dyspnoea, wheezing and malaise

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3
Q

how quickly should an unvaccinated child who comes into contact with measals be treated with MMR

A

72hours

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4
Q

what is the mode of inheritance in haemophilia A

A

x linked recessive - so no male to male transmission

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5
Q

tetralogy of fallot what murmur is heard

A

ejection systolic murmur

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6
Q

VSD murmur heard

A

pansystolic murmur

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7
Q

mild systemic upset
oral ulcers
vesicles on the palms and soles

A

hand foot and mouth

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8
Q

chest compresssion rate in paed BLS

A

15:2
100-120/min

infants use the two thumb technique

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9
Q

characteristic features of kawasaki disease- CRASH and burn

A

C: conjunctivitis (bilateral).
R: rash (non-vesicular).
A: adenopathy (cervical).
S: swollen, strawberry tongue.
H: hand swelling (or feet).
Burn: fever lasts >5 days and is very high.

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10
Q

cardiac abnormality seen in turners - 3 things

A

bicuspid aortic valve
arotic root dialtion
coarctation of aorta

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11
Q

pink maculopapular rash on the face which spreads to the whole body. There is also suboccipital and post-auricular lymphadenopathy

A

rubella

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12
Q

baby with no femoral pulse at 6-8weeks what should you do -and what condition are you thinking of

A

discuss with paeds - thinking of coarctation of aorta

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13
Q

neonatal sepsis prestns with vague signs what are these

A

poor feeding
grunting lethargy
resp distress
jaundice
seizures and abdo distention

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14
Q

what causes neonatal sepsis

A

group b strep
e coli
ealy onset is GBS
late normally staph epidermidits or psdueo

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14
Q

cows milk protein intolerance presents like

A

gastrointestinal upset and itching or atopy.

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15
Q

Acute lymphoblastic leukaemia may present with haemorrhagic or thrombotic complications due to

A

DIC

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16
Q

dx of acute epoglottis

A

flexible larynoscopy

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16
Q

under age of 2 eczema presetns on face and extensor surfaces true or false

A

true

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17
Q

what is an umbilical grnauloma

A

An umbilical granuloma is an overgrowth of tissue which occurs during the healing process of the umbilicus. It is most common in the first few weeks of life. On examination, a small, red growth of tissue is seen in the centre of the umbilicus. It is usually wet and leaks small amounts of clear or yellow fluid. It is treated by regular application of salt to the wound, if this does not help then the granuloma can be cauterised with silver nitrate.

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18
Q

threadworm how to treat

A

one of dose of mevendazole for whole fmaily and hygiene measures

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19
Q

most common cause of cardiac arrest in children

A

resp causes such as bronchiolitis - crackles,wheezing and increased respiraotry effort, hypoxia, history of poor feeding, cough and fever

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20
Q

sx of threadworms

A

perianal itching, particularly at night
girls may have vulval symptoms

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21
Q

An 18-year-old male presents to his local GP surgery. He is due to start university in two months time and has been told by his friends that he should ‘have a vaccine’ before he starts. He identifies himself as ‘White British’, has no past medical history of note and is due to study history at the University of Birmingham. Which one of the following vaccines should he be offered as part of routine NHS immunisation?

A

13-18 years ‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)
Men ACWY

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22
Q

prodome of raised temperature pre illness

A

chickenpox

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23
Q
A
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24
Q

post fever in chcikenpox what comes next and how does the rash present

A

itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular

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25
Q
A
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26
Q

pyloric stenosis what metabolic abnromality

A

Hypochloremic hypokalemic metabolic alkalosis

The most likely diagnosis here is pyloric stenosis. Due to vomiting up stomach contents which is acidic (hydrogen chloride - HCl), the patient will be hypochloraemic. Potassium is also lost in the vomitus.

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27
Q

undescended testicle when to review

A

in 3 months
surgeon seen before 6 motnhs

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28
Q

seziure at night, partial eg only parathesia affecting face but secondary generalisation may also occur such as tonic clonic movement of an arm
child normal
4-12

A

benign rolandic epilepsy

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29
Q

6 months to 5 years following a sudden increase in temperature such as viral infection - what seizure type

A

febrile convulsion

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30
Q

4-6months of life, characterised by flexion of head trunk and limbs followed by extension of arms - salaam attacks - EEG hypsarrhythmia

A

infantile spasm

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31
Q

features of CF

A

neonatal period (around 20%): meconium ileus, less commonly prolonged jaundice
recurrent chest infections (40%)
malabsorption (30%): steatorrhoea, failure to thrive
other features (10%): liver disease

Other features of cystic fibrosis
short stature
diabetes mellitus
delayed puberty
rectal prolapse (due to bulky stools)
nasal polyps
male infertility, female subfertility

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32
Q

1st 24hr jaundice what diff

A

rhesus haemolytic disease
ABO haemolytic disease
hereditary spherocytosis
glucose-6-phosphodehydrogenase

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33
Q

over 14 days jaundice

A

biliary atresia
hypothyroidism
galactosaemia
urinary tract infection
breast milk jaundice
jaundice is more common in breastfed babies
mechanism is not fully understood but thought to be due to high concentrations of beta-glucuronidase → increase in intestinal absorption of unconjugated bilirubin
prematurity
due to immature liver function
increased risk of kernicterus
congenital infections e.g. CMV, toxoplasmosis

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34
Q

crawls

A

9months

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35
Q

sit withou suppor twhen

A

7-8months

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36
Q

wlaks

A

13-15mon

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37
Q

slow to meet developmental milestones and feeding difficulties

A

cerebral palsy

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38
Q

explanation of oro-motor porblems and athetoid movemnt in dyskinetic cerebral palsy

A

The athetoid movements are shown in this stem by the slow writhing movements of his hands and feet and also the difficulty of holding onto objects. Patients with dyskinetic cerebral palsy experience difficulty in holding objects due to fluctuating muscle tone. The oro-motor problems are evidenced by this child’s drooling.

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39
Q

newborn hearing screen

A

Otoacoustic emission test is used to screen newborns for hearing problems - if this abnormal Auditory Brainstem Response test

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40
Q

At what age would the average child start to say ‘mama’ and ‘dada’?

A

9-10mon

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41
Q

A mother presents with her baby to the GP for review. She asks for advice regarding her milestones and explains that her son was born was born prematurely at 32 weeks gestation.

With the premature age in mind, when should this baby begin to show a responsive social smile?

A

6 to 8 weeks is the normal age when a child should show a responsive smile. The reference range of the corrected age is 40 weeks. In this case, the baby was born at 32 weeks gestation which means 8 weeks have to be backdated. So 14 to 16 weeks is the answer.

The corrected age is taken into consideration when looking at milestones until the age of 2.

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42
Q

fever followed later by rahs - rose pink macules and papules - starts on trunk and spreads to limbs

A

roseola infantum

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43
Q

herald patch and mutlipe smaller oval scaly plauqes distributed along skin cleavage lines in xmas tress apttern

A

pityriasis rosea

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44
Q

differentiate cardiac from non-cardiac causes of cyanosi sin neonate

A

nitrogen washout test

45
Q

what keeps PDA open

A

alprostadil

46
Q

tx for children of meningitis

A

< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
> 3 months: IV cefotaxime (or ceftriaxone)

47
Q
A
48
Q

A 4-year-old boy is brought in by his mother. He was mildly unwell yesterday with a fever, lethargy and sore throat. Today, his mum is alarmed as she has noticed ‘blisters’ in and around his mouth and he is reluctant to eat or drink. On examination the child looks miserable, but not unwell, his temperature is 38.2ºC and he has a mix of shallow ulcers and erythematous papules scattered over his hard palate, tongue and lips. Examining further you also notice that there are a few erythematous maculopapular lesions along the sides of his fingers, around his right heel and over his buttocks. What is the most likely diagnosis?

A

hand foot and mouth

49
Q

how should you feed people with CF

A

High calorie and high fat with pancreatic enzyme supplementation for every meal

49
Q

Small testes in precocious puberty

A

Adrenal hyperplasia

50
Q

managment of hypoglycaemia in a newborn
asx
sx

A

asx- encourage normal feeding - breast or bottle nad montiro blood glycose

sx - admit to neonate uni, IV of 10% dextrose

51
Q

You are reviewing a 9-month-old child with suspected bronchiolitis. Which one of the following features should make you consider other possible diagnoses?

A

temperature of 40

A low-grade fever is typical in bronchiolitis. NICE state the following:

Consider a diagnosis of pneumonia if the child has:
high fever (over 39°C) and/or
persistently focal crackles.

52
Q

problem with the valve in her ureters, with some backflow of urine from the bladder up towards the kidneys. ix of choice

A

Micturating cystography

53
Q

At what age would the average child acquire the ability to sit without support?

A

The answer (6-8 months) includes the 6 months as stated in the MRCPCH Development Guide. Most other sources suggest a slightly later age of 7-8 months.

53
Q

Short stature + primary amenorrhoea

A

turner

54
Q

DDH imaging

A

US usually
if over 4.5 months then Xray

most stabalise 3-6 weeks

pavlik harness in children younger than 4-5 motnhs

55
Q

amily law reform act of 1969

A

those over 16 can consent to treatment, but cannot refuse treatment under 18 unless there is one consenting parent, even if the other disagrees’.

55
Q

apgar scores when

A

1,5 and then if poor again at 10minutes

56
Q

managemnt of SUFE

A

internal fixation across growth plate

57
Q

joint widening on xr

A

rickets

58
Q

after advice for enuresis what next

A

alarm after star chart

59
Q

risk factors for DDH

A

female sex: 6 times greater risk
breech presentation
positive family history
firstborn children
oligohydramnios
birth weight > 5 kg
congenital calcaneovalgus foot deformity

60
Q

how to tx biliary atresia

A

surgical tx early

61
Q

what is toddler diarrhoea

A

Toddler’s diarrhoea is a benign condition that causes the child no problems. It is due to the fast transit through their digestive system and often contains undigested food. It requires no treatment. It is prudent to plot their height and weight to ensure no severe underlying diagnosis is present such as coeliac, which would present with the child falling centiles on the growth chart.

62
Q

sx umbilcial hernia

A

repair 2-3 years

62
Q

whooping cough exlcusion from school how long

A

48hr

63
Q

cf tx

A

lumacaftor and ivacaftor - homozygous for delta F508

64
Q

SUFe

A

xr both elgs

64
Q

MEn b vacine when

A

2, 4, and 12 months

65
Q

surgical repair then keep PDA open

A

PDA close with ndomethacin if dosent worrant that

66
Q

5TS of cyanotic heart disease

A

Tetralogy of fallot
Transposition of great vessels (TGA)
Tricuspid atresia
Total anomalous pulmonary venous return
Truncus arteriosus

66
Q

floppy neonate unrepsonsive what should you do first

A

dry baby and note time

67
Q

A 5-month-old boy presents to the emergency department, following a 1-week history of a persistent dry cough and difficulty feeding. His notes indicate that he had presented a week ago with a mild fever and coryzal symptoms. He has no other past medical history. On examination, the respiratory rate is 56/min and a wheeze is heard bilaterally on auscultation. There are no signs of an increased work of breathing and chest expansion is symmetrical. His temperature is 37.5ºC and oxygen saturation is 98% on room air.

Which of the following is the most appropriate next step in the management?

A

Bronchiolitis does not require antibiotics, children requires supportive management only

68
Q

primary headache in children

A

migraine

69
Q

intial mx of hirschprung to prevent what

A

rectial washouts and bowel irrigation
Serial rectal irrigation should be performed before surgery to help prevent enterocolitis.

70
Q

sandpaper rash

A

scarlet fever

71
Q

A 30-year-old woman with cystic fibrosis is attending her regular check-up with the respiratory nurse. Over the last 4 months, she has received three courses of antibiotics for chest infections, which is an increase from her normal requirements. Additionally, she describes feeling more tired than usual and has lost approximately 2kg in the last 3 months.

What therapy may be appropriate to manage this woman’s developing condition?

A

CF DM

72
Q

tapering of the upper trachea.

A

croup

73
Q

Diabetes (new onset) with weight loss, age 60 years and over

A

pancreatic cancer

74
Q

when is a NIPE doen

A

first 72hours of life
then also 6-8weeks later

75
Q

cx of both a sunken and bulging fontanelle

A

Sunken fontanelle = ?dehydration

Bulging fontanelle = ?raised ICP

76
Q

neonate what is classed as tachyP

A

~30-50 resps/minute
Tachypnoea > 60 resps/minute

77
Q

infant what is classed as TachyP

A

~20-30 resps/minute
Tachypnoea > 50

78
Q

most common batceria detetched in diarrhoea

A

The most frequently identified organisms causing bacterial diarrhea are Escherichia coli (most common worldwide), Shigella, Salmonella, Campylobacter (most common in children), Yersinia, and Clostridium spp.

79
Q

sclerosis of the right upper femoral epiphysis and moderate of resorption of the femoral head.

A

perthes more common in boys

80
Q

perthes mx under 6

A

observe

over surgery

81
Q

when do you use a pvlick harness

A

in A Pavlik harness is used in developmental dysplasia of the hip.

82
Q

restricted internal rotation painful hip

leg can be held in external rotation

A

SUFE - 20% bilat

83
Q

ewing sarcoma

A

boys 10-20 , pelvis and long bones, periods of rapid growth throughout childhood

pain worse at night
swelling lump - diagnosed after fracture due to bone weakened
onion ski on XR

84
Q

most common type of primary malignant once in children
occurring in middle of long bones.

A

osteosarcoma

sunburst

85
Q

VF - 3rd shock adrenaline and amiodarone

A

4 Hs and Ts when in cardaic arrest

86
Q

after 5 shocks with amiodarone and adrenaline given - what dose to you titrate down to of amiodarone

A

150mg

87
Q

raised anion gap MUDPILES

A

methanol
uraemia
DKA
paraldehyde
isoniasid
lactic acidosis
ethyleen glycol
rhabdo
salciylates

88
Q

metformin plus AKI - side effect leading to

A

lactic acidosis

89
Q

how much calcium gluconate should you give someone in hyperklamaia

A

10 to 20 mL of 10% calcium gluconate diluted in 50 to 100 mL dextrose or normal saline intravenously over 10 minutes is recommended.

90
Q

binding agent for potassium in the bowel to reduce high potassium

A

lokelma

91
Q

why do you use furosemide in hyperkalami a

A

push potassium back into the cell

92
Q

moa lokelma - sodium zirocnium

A

Lokelma increases fecal potassium excretion through binding of potassium in the lumen of the gastrointestinal tract. Binding of potassium reduces the concentration of free potassium in the gastrointestinal lumen, thereby lowering serum potassium level.

93
Q

side effect of neb salbutamol

A

tachy cardia

94
Q

when you give insulin and dextrose will they rebound

A

yes - need to recheck

95
Q

is a midly elevated amaylase seen in anything else other than pancreatitis

A

yes small bowel obstruction

also if you cannot see the large bowel on xray may be becuase it has collapsed due to small bowel being so dilated

96
Q

biliary atresia presentation

A

Biliary atresia can present with prolonged jaundice (present > 14 days of age), hepatomegaly, splenomegaly, abnormal growth, cardiac murmurs if associated cardiac abnormalities are present

97
Q

triad of shaken baby syndrome

A

Retinal haemorrhages, subdural haematoma and encephalopathy is the triad of the shaken baby syndrome

98
Q

differecnce between presentation of infantile spasms and colic

A

In infantile spasms the child will become distressed between spasms, whereas in colic the child will become distressed during the ‘spasms’

99
Q

Newborn babies are relatively deficient in vitamin K. This may result in impaired production of clotting factors which in turn can lead to haemorrhagic disease of the newborn (HDN). Bleeding may range from minor brushing to intracranial haemorrhages

Breast-fed babies are particularly at risk as breast milk is a poor source of vitamin K. Maternal use of antiepileptics also increases the risk

because of this what are they offered - one off what

A

Both oral and IM routes of vitamin K are licensed for neonates, but IM should be recommended to parents due to reduced concerns about compliance and shorter (one-off) treatment duration

100
Q

features of vesicouteric reflex

A

bnormal backflow of urine from the bladder into the ureter and kidney. It is a relatively common abnormality of the urinary tract in children and predisposes to urinary tract infection (UTI), being found in around 30% of children who present with a UTI. As around 35% of children develop renal scarring it is important to investigate for VUR in children following a UTI

Pathophysiology of VUR
ureters are displaced laterally, entering the bladder in a more perpendicular fashion than at an angle
therefore shortened intramural course of the ureter
vesicoureteric junction cannot, therefore, function adequately

101
Q

difference between androgen insenstivity and congential adrenal hyperplasia

A

Congenital adrenal hyperplasia would likely be diagnosed much earlier than puberty and is typically characterised by ambiguous genitalia and other symptoms of adrenal insufficiency, such as arrhythmias and vomiting.

andorgen

primary amenorrhoea’
undescended testes causing groin swellings
breast development may occur as a result of conversion of testosterone to oestradiol

102
Q

what is a cephaloheamatoma

A

A cephalohaematoma appears as a swelling due to bleeding between the periosteum and the skull. It is most commonly noted in the parietal region and is associated with instrumental deliveries. The swelling usually appears 2-3 days following delivery and does not cross suture lines. It gradually resolves over a number of weeks.

103
Q

what is caput succadeneum

A

Caput succadeneum is commonly seen in newborns immediately after birth. It occurs due to generalised superficial scalp oedema, which crosses suture lines. It is associated with prolonged labour and will rapidly resolve over a couple of days.

104
Q

the ejection systolic murmur in tetralogy of fallot is caused by what amnd why

A

Note the murmur is a result of pulmonary stenosis, not the ventricular septal defect as this is too large to produce a murmur.

105
Q

Generalised tenderness seen in what in kids

A

Generalised in mesenteric adenitis and peritonitis.

Y3/4--5 Paediatrics (30 decks)

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