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Child health > Pathology Part 2 > Flashcards

Pathology Part 2 Flashcards

1
Q

Homocystinuria

A

A rare autosomal recessive disease caused by a deficiency of cystathionine beta synthase. This results in severe elevations in plasma and urine homocysteine concentrations.

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2
Q

Features of Homocystinuria

A

> often patients have fine, fair hair
Marfanoid body habitus: arachnodactyly
kyphosis
may have learning difficulties, seizures
downwards dislocation of lens
severe myopia
increased risk of arterial and venous thromboembolism
also malar flush, livedo reticularis

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3
Q

Arachnodactyly

A

Spidery fingers, and describes the long, slender fingers typical of patients with Marfan syndrome (MFS).

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4
Q

kyphosis

A

A curvature of the spine measuring 50 degrees or greater on an X-ray,

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5
Q

Investigations for Homocystinuria

A
  1. increased homocysteine levels in serum and urine

2. cyanide-nitroprusside test: also +ve in cystinuria

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6
Q

Treatment for Homocystinuria

A

Vitamin B6 (pyridoxine) supplements

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7
Q

Infantile colic

A

It typically occurs in infants less than 3 months old and is characterised by bouts of excessive crying and pulling-up of the legs, often worse in the evening.

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8
Q

Infantile spasms

A

A type of childhood epilepsy which typically presents in the first 4 to 8 months of life and is more common in male infants. They are often associated with a serious underlying condition and carry a poor prognosis

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9
Q

Infantile spasms features

A

Characteristic ‘salaam’ attacks

Progressive mental handicap

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10
Q

Salaam attacks

A

Seen in Infantile spasms

Flexion of the head, trunk and arms followed by extension of the arms - lasts only 1-2 seconds but may be repeated up to 50 times

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11
Q

Investigations for Infantile spasms

A
  1. EEG shows hypsarrhythmia in two-thirds of infants

2. CT demonstrates diffuse or localised brain disease in 70% (e.g. tuberous sclerosis)

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12
Q

Infantile spasms management

A

> poor prognosis
vigabatrin is now considered first-line therapy
ACTH is also used

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13
Q

Vigabatrin

A

Anti-epileptic drug

Inhibits the GABA-degrading enzyme, GABA transaminase, resulting in a widespread increase in GABA concentrations in the brain.

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14
Q

Still’s murmur

A

Innocent murmur

Low-pitched sound heard at the lower left sternal edge

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15
Q

Venous hums

A

Innocent murmur - Due to the turbulent blood flow in the great veins returning to the heart. Heard as a continuous blowing noise heard just below the clavicles

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16
Q

Innocent murmurs

A

Are ejection murmurs including the Still’s murmur and Venous hums

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17
Q

Characteristics of an innocent ejection murmurs

A
  1. soft-blowing murmur in the pulmonary area
  2. short buzzing murmur in the aortic area
  3. may vary with posture
  4. localised with no radiation
  5. no diastolic component
  6. no thrill
  7. no added sounds (e.g. clicks)
  8. asymptomatic child
  9. no other abnormality
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18
Q

Intraventricular haemorrhage

A

A haemorrhage that occurs into the ventricular system of the brain. In premature neonates it may occur spontaneously. The blood may clot and occlude CSF flow, hydrocephalus may result.

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19
Q

What is the time-frame for development of intraventricular hemorrhage in neonates?

A

In the first 72 hours after birth

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20
Q

Intussusception

A

Describes the invagination of one portion of bowel into the lumen of the adjacent bowel, most commonly around the ileo-caecal region.

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21
Q

What is the time-frame for development of Intussusception?

A

Infants between 6-18 months old.

Boys are affected twice as often as girls

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22
Q

Features of Intussusception

A
  1. Paroxysmal abdominal colic pain
  2. During paroxysm the infant will characteristically draw their knees up and turn pale
  3. Vomiting
  4. Bloodstained stool - ‘red-currant jelly’ - is a late sign
  5. Sausage-shaped mass in the right upper quadrant
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23
Q

Investigation for Intussusception

A

Ultrasound - show a target-like mass

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24
Q

Management of Intussusception

A

> Reduction by air insufflation under radiological control,
If fails, or signs of peritonitis, surgery is performed

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25
Q

Causes of Jaundice in the first 24 hours of life

A

Always pathological

  1. rhesus haemolytic disease
  2. ABO haemolytic disease
  3. hereditary spherocytosis
  4. glucose-6-phosphodehydrogenase
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26
Q

Jaundice in the neonate from 2-14 days

A

Common (up to 40%) and usually physiological.

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27
Q

Physiological jaundice

A

Jaundice in the neonate from 2-14 days - common

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28
Q

Causes of Prolonged Jaundice >14 days

A
  1. biliary atresia
  2. hypothyroidism
  3. galactosaemia
  4. urinary tract infection
  5. breast milk jaundice
  6. prematurity - due to immature liver function
  7. congenital infections e.g. CMV, toxoplasmosis
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29
Q

Investigations for prolonged jaundice

A

> conjugated and unconjugated bilirubin: the most important test as a raised conjugated bilirubin could indicate biliary atresia which requires urgent surgical intervention

>   direct antiglobulin test (Coombs' test)
>   TFTs
>   FBC and blood film
>   urine for MC&S and reducing sugars
>   U&Es and LFTs
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30
Q

Important diagnostic investigation for Biliary atresia

A

Conjugated and unconjugated bilirubin: the most important test as a raised conjugated bilirubin could indicate biliary atresia which requires urgent surgical intervention

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31
Q

Juvenile idiopathic arthritis (JIA)

A

Now preferred to the older term juvenile chronic arthritis, describes arthritis occurring in someone who is less than 16 years old that lasts for more than 6 weeks.

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32
Q

Pauciarticular JIA

A

Refers to cases where 4 or less joints are affected. It accounts for around 60% of cases of JIA

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33
Q

Features of systemic onset JIA

A
  1. pyrexia
  2. salmon-pink rash
  3. lymphadenopathy
  4. arthritis
  5. uveitis
  6. anorexia and weight loss
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34
Q

Investigations for JIA

A

ANA may be positive

Rheumatoid factor is usually negative

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35
Q

Kawasaki disease

A

A type of vasculitis which is predominately seen in children.

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36
Q

Features of Kawasaki disease

A
  1. high-grade fever which lasts for > 5 days.
  2. Fever is characteristically resistant to antipyretics
  3. conjunctival injection
  4. bright red, cracked lips
  5. strawberry tongue
  6. cervical lymphadenopathy
  7. red palms on hands and soles of feet which later peel
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37
Q

Management of Kawasaki disease

A
  1. high-dose aspirin

2. intravenous immunoglobulin

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38
Q

Why is aspirin contraindicated in children usually?

A

Due to the risk of Reye’s syndrome aspirin is normally contraindicated in children

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39
Q

What is one condition where aspirin can be used in children?

A

Kawasaki disease

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40
Q

Investigation for Kawasaki disease

A

Clinical diagnosis - no specific test

Echocardiogram is used as the initial screening test for coronary artery aneurysms

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41
Q

What is a complication of Kawasaki disease

A

Coronary artery aneurysm

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42
Q

Chondromalacia patellae

A

Softening of the cartilage of the patella
Common in teenage girls
Characteristically anterior knee pain on walking up and down stairs and rising from prolonged sitting
Usually responds to physiotherapy

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43
Q

Osgood-Schlatter disease

tibial apophysitis

A

Seen in sporty teenagers

Pain, tenderness and swelling over the tibial tubercle

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44
Q

Osteochondritis dissecans

A

Pain after exercise

Intermittent swelling and locking

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45
Q

Patellar subluxation

A

Medial knee pain due to lateral subluxation of the patella

Knee may give way

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46
Q

Patellar tendonitis

A

More common in athletic teenage boys
Chronic anterior knee pain that worsens after running
Tender below the patella on examination

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47
Q

McCune-Albright syndrome

A

Not inherited, it is due to a random, somatic mutation in the GNAS gene.

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48
Q

Features of McCune-Albright syndrome

A
  1. precocious puberty
  2. cafe-au-lait spots
  3. polyostotic fibrous dysplasia
  4. short stature
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49
Q

Measles

A

> RNA paramyxovirus
spread by droplets
infective from prodrome until 4 days after rash starts
incubation period = 10-14 days

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50
Q

Features of Measles

A
  1. prodrome: irritable, conjunctivitis, fever
  2. Koplik spots (before rash):
  3. white spots (‘grain of salt’) on buccal mucosa
  4. rash: starts behind ears then to whole body,
  5. discrete maculopapular rash becoming blotchy & confluent
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51
Q

What is the prodrome symptoms of measles?

A

Irritable, conjunctivitis, fever

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52
Q

Koplik spots

A

Seen in measles - small, white spots that occur on the inside of the cheeks early in the course of measles.

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53
Q

Investigations for Measles

A

IgM antibodies can be detected within a few days of rash onset

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54
Q

Management of measles

A

> mainly supportive
admission may be considered in immunosuppressed or pregnant patients
Inform public health

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55
Q

Most common complication of measles

A

Otitis media

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56
Q

Most common complication causing death in measles

A

Pneumonia

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57
Q

Meckel’s diverticulum

A

A congenital diverticulum of the small intestine.

A remnant of the vitellointestinal duct and contains ectopic ileal, gastric or pancreatic mucosa

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58
Q

Features of Meckel’s diverticulum

A

Abdominal pain mimicking appendicitis
Rectal bleeding
Intestinal obstruction

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59
Q

Most common cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years

A

Meckel’s diverticulum

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60
Q

Management of Meckel’s diverticulum

A

Removal if narrow neck or symptomatic

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61
Q

Meconium aspiration syndrome

A

Refers to respiratory distress in the newborn as a result of meconium in the trachea. It occurs in the immediate neonatal period.

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62
Q

What ages are the 3 doses of the MEN B vaccine given?

A

2 months
4 months
12-13 months

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63
Q

Contraindication to lumbar puncture

A 
focal neurological signs
papilloedema
significant bulging of the fontanelle
disseminated intravascular coagulation
signs of cerebral herniation
meningococcal septicaemia
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64
Q

Management of Meningitis in children

A

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

> 3 months: IV cefotaxime (or ceftriaxone)

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65
Q

Meningitis organisms - Neonatal to 3 months

A

Group B Streptococcus
E. coli and other Gram -ve organisms
Listeria monocytogenes

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66
Q

Meningitis organisms - Greater than 6 years

A 
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
67
Q

Meningitis organisms - 1 month to 6 years

A 
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
Haemophilus influenzae
68
Q

When are the MMR vaccine doses given?

A

12-15 months

3-4 years

69
Q

Contraindications for the MMR vaccine

A
  1. severe immunosuppression
  2. allergy to neomycin
  3. Received another live vaccine within 4 weeks
  4. pregnancy should be avoided for at least 1 month following vaccination
  5. immunoglobulin therapy within the past 3 months
70
Q

Irritant dermatitis nappy rash

A

The most common cause, due to irritant effect of urinary ammonia and faeces
Creases are characteristically spared

71
Q

Candida dermatitis nappy rash

A

Typically an erythematous rash which involve the flexures and has characteristic satellite lesions

72
Q

Atopic eczema nappy rash

A

Other areas of the skin will also be affected

73
Q

Seborrhoeic dermatitis nappy rash

A

Erythematous rash with flakes. May be coexistent scalp rash

74
Q

Thyroglossal cyst

A

Located in the anterior triangle, usually in the midline and below the hyoid (65% cases)
Derived from remnants of the thyroglossal duct

75
Q

Branchial cyst

A

Usually located anterior to the sternocleidomastoid near the angle of the mandible - in the neck or just below the collarbone.

76
Q

Leading causes of death among premature infants

A

Necrotising enterocolitis

77
Q

Symptoms of Necrotising enterocolitis

A

Initial symptoms can include feeding intolerance, abdominal distension and bloody stools, which can quickly progress to abdominal discolouration, perforation and peritonitis.

78
Q

Necrotising enterocolitis

A

Serious gastrointestinal problem that mostly affects premature babies. The condition inflames intestinal tissue, causing it to die. A hole (perforation) may form in your baby’s intestine. Bacteria can leak into the abdomen (belly) or bloodstream through the hole.

79
Q

Features of Necrotising enterocolitis on abdominal X ray

A

> dilated bowel loops
bowel wall oedema
pneumatosis intestinalis (intramural gas)
portal venous gas
pneumoperitoneum resulting from perforation

80
Q

Guthrie test

A

Neonatal blood spot screening ( ‘heel-prick test’) is performed at 5-9 days of life

81
Q

What conditions are screened for in the Guthrie test (heel-prick test)?

A 
congenital hypothyroidism
cystic fibrosis
sickle cell disease
phenylketonuria
medium chain acyl-CoA dehydrogenase deficiency (MCADD)
maple syrup urine disease (MSUD)
isovaleric acidaemia (IVA)
glutaric aciduria type 1 (GA1)
homocystinuria (pyridoxine unresponsive) (HCU)
82
Q

Neonatal hypoglycaemia

A

Normal term babies often have hypoglycaemia especially in the first 24 hrs of life.

There is no agreed definition of neonatal hypoglycaemia but a figure of < 2.6 mmol/L is used in many guidelines.

83
Q

Management of Neonatal hypoglycaemia

A

Asymptomatic - encourage normal feeding & monitor blood glucose

Symptomatic or very low blood glucose - admit to the neonatal unit & intravenous infusion of 10% dextrose

84
Q

Neonatal sepsis

A

Occurs when a serious bacterial or viral infection in the blood affects babies within the first 28 days of life.

85
Q

Neonatal sepsis categories

A

Early-onset within 72 hours of birth

Late-onset between 7-28 days of life

86
Q

Cause of Early onset Neonatal sepsis

A

GBS infection

87
Q

Cause of late onset Neonatal sepsis

A

Staphylococcus epidermidis, Pseudomonas aeruginosa, Klebsiella, Enterobacter, and fungal species

88
Q

Nephrotic syndrome in children

A

proteinuria (> 1 g/m^2 per 24 hours)
hypoalbuminaemia (< 25 g/l)
oedema

89
Q

Common cause of Nephrotic syndrome in children between 2 and 5 years old

A

Minimal change glomerulonephritis - good prognosis and responds well to high dose steriods

90
Q

Newborn resuscitation

A
  1. Dry baby and maintain temperature
  2. Assess tone, respiratory rate, heart rate
  3. If gasping or not breathing give 5 inflation breaths*
  4. Reassess (chest movements)
  5. If the heart rate is not improving and <60bpm start compressions and ventilation breaths at a rate of 3:1
91
Q

Management of Nocturnal enuresis

A 
>   Possible underlying causes/triggers 
>   Advise on fluid intake, diet and toileting 
>   Reward systems (e.g. Star charts). 
>   Enuresis alarm for children <7 years
>   desmopressin for children  >7
92
Q

Paediatric basic life support - rate of compressions

A

Compression:ventilation ratio: lay rescuers should use a ratio of 30:2.

If there are two or more rescuers with a duty to respond then a ratio of 15:2 should be used

93
Q

Paediatric basic life support

A 
>   unresponsive?
>   shout for help
>   open airway
>   look, listen, feel for breathing
>   give 5 rescue breaths
>   check for signs of circulation
>   infants use brachial or femoral pulse, children use femoral pulse
>   15 chest compressions:2 rescue breaths
94
Q

Pyloric stenosis features

A

Projectile non bile stained vomiting at 4-6 weeks of life

95
Q

Pyloric stenosis diagnosis

A

Test feed or USS

96
Q

Pyloric stenosis management

A

Ramstedt pyloromyotomy

97
Q

Pyloric stenosis

A

Uncommon condition in infants that blocks food from entering the small intestine. Normally, a muscular valve (pylorus) between the stomach and small intestine holds food in the stomach until it is ready for the next stage in the digestive process.

98
Q

Oesophageal atresia

A

Associated with tracheo-oesophageal fistula and polyhydramnios
May present with choking and cyanotic spells following aspiration

99
Q

Meconium ileus

A

Usually delayed passage of meconium and abdominal distension

The majority have cystic fibrosis

100
Q

Patent ductus arteriosus

A

Form of congenital heart defect where a connection between the pulmonary trunk and descending aorta exists.

Usually, the ductus arteriosus closes with the first breaths due to increased pulmonary flow which enhances prostaglandins clearance

101
Q

Features of Patent ductus arteriosus

A 
>   left subclavicular thrill
>   continuous 'machinery' murmur
>   large volume, bounding, collapsing pulse
>   wide pulse pressure
>   heaving apex beat
102
Q

Patent ductus arteriosus management

A

Indomethacin or ibuprofen - inhibits prostaglandin synthesis & closes the connection in the majority of cases

If associated with another congenital heart defect amenable to surgery then prostaglandin E1 is useful to keep the duct open until after surgical repair

103
Q

Perthes’ disease

A

Ages of 4-8 years.
Avascular necrosis of the femoral head
Impaired blood supply to the femoral head causes bone infarction.

104
Q

Perthes’ disease features

A

hip pain: develops progressively over a few weeks
limp
stiffness and reduced range of hip movement

105
Q

Complications of Perthes’ disease

A

osteoarthritis

premature fusion of the growth plates

106
Q

Diagnosis of Perthes’ disease

A

Plain x-ray

Technetium bone scan or magnetic resonance imaging if normal x-ray and symptoms persist

107
Q

Phenylketonuria (PKU

A

An autosomal recessive condition caused by a disorder of phenylalanine metabolism. Due to defect in phenylalanine hydroxylase, an enzyme which converts phenylalanine to tyrosine.

108
Q

Most likely causative agent of a bacterial pneumonia in children

A

S .pneumoniae

109
Q

Most common diagnoses made on paediatric wards

A

Viral-induced wheeze

110
Q

Precocious puberty

A

‘development of secondary sexual characteristics before 8 years in females and 9 years in males’

111
Q

Moro reflex

A

Head extension causes abduction followed by adduction of the arms
Present from birth to around 3-4 months of age

112
Q

Grasp reflex

A

Flexion of fingers when object placed in palm

Present from birth to around 4-5 months of age

113
Q

Rooting reflex

A

Assists in breastfeeding

Present from birth to around 4 months of age

114
Q

Stepping reflex

A

Also known as walking reflex

Present from birth to around 2 months of age

115
Q

Males first sign of puberty

A

First sign is testicular growth at around 12 years of age

116
Q

Females first sign of puberty

A

first sign is breast development at around 11.5 years of age (range = 9-13 years)

117
Q

Pulmonary hypoplasia

A

A term used for newborn infants with underdeveloped lungs

118
Q

Blood gas changes in pyloric stenosis

A

hypochloraemic, hypokalaemic alkalosis

119
Q

Most common ocular malignancy found in children

A

Retinoblastoma

120
Q

Inheritance of retinoblastoma

A

Autosomal dominant

Caused by a loss of function of the retinoblastoma tumour suppressor gene on chromosome 13

121
Q

Roseola infantum features

A 
>   High fever: lasting a few days, followed later by a
>   maculopapular rash
>   Nagayama spots
>   febrile convulsions 
>   diarrhoea and cough
122
Q

Nagayama spots

A

Erythematous papules on the uvula and soft palate - seen in Roseala Infantum

123
Q

Scarlet fever

A

A reaction to erythrogenic toxins produced by Group A haemolytic streptococci (usually Streptococcus pyogenes). It is more common in children aged 2 - 6 years with the peak incidence being at 4 years.

124
Q

Features of scarlet fever

A 
fever: typically lasts 24 to 48 hours
malaise, headache, nausea/vomiting
sore throat
'strawberry' tongue
rash
125
Q

Rash features in Scarlet fever

A

Fine punctate erythema (‘pinhead’) which generally appears first on the torso and spares the palms and soles

It is often described as having a rough ‘sandpaper’ texture

126
Q

Diagnosis of Scarlet fever

A

A throat swab is normally taken but antibiotic treatment should be commenced immediately, rather than waiting for the results

127
Q

Management of Scarlet fever

A
  1. oral penicillin V for 10 days
  2. penicillin allergy should be given azithromycin
  3. Return to school 24 hours after antibiotics started
  4. scarlet fever is a notifiable disease
128
Q

Seborrhoeic dermatitis in children

A

It typically affects the scalp (‘Cradle cap’), nappy area, face and limb flexures.

129
Q

Cradle cap

A

An early sign of Seborrhoeic dermatitis in children which may develop in the first few weeks of life.

It is characterised by an erythematous rash with coarse yellow scales.

130
Q

Shaken baby syndrome

A

Triad of retinal haemorrhages, subdural haematoma, and encephalopathy. This is caused by the intentional shaking of a child (0-5 years old).

131
Q

Craniosynostosis

A

premature fusion of skull bones

132
Q

Slipped capital femoral epiphysis

A

Rare hip condition seen in children, classically seen in obese boys.

133
Q

Slipped capital femoral epiphysis features

A
  1. hip, groin, medial thigh or knee pain
  2. loss of internal rotation of the leg in flexion
  3. bilateral slip in 20% of cases
134
Q

Sotos syndrome

A

Autosomal dominant disorder characterised by excessive physical growth during the first 2 to 3 years of life - Caused by a mutation in the NSD1 gene

135
Q

Causes of Stridor in children

A

Croup
Acute epiglottis
Inhaled foreign body
Laryngomalacia

136
Q

Commonest cause of death in the first year of life.

A

Sudden infant death syndrome

137
Q

Major risk factors for Sudden infant death syndrome

A
  1. putting the baby to sleep prone
  2. parental smoking
  3. prematurity
  4. bed sharing
  5. hyperthermia
138
Q

Protective factors against Sudden infant death syndrome

A
  1. breastfeeding
  2. room sharing (but not bed sharing)
  3. the use of dummies (pacifiers)
139
Q

Surfactant deficient lung disease

A

A condition seen in premature infants. It is caused by insufficient surfactant production and structural immaturity of the lungs

140
Q

Threadworms

A

Infestation with threadworms (Enterobius vermicularis, sometimes called pinworms) is extremely common amongst children in the UK. Infestation occurs after swallowing eggs that are present in the environment.

141
Q

Threadworms features

A

Usually asymptomatic
Perianal itching, particularly at night
Girls may have vulval symptoms

142
Q

Threadworms management

A
  1. Combination of anthelmintic with hygiene measures for all members of the household
  2. Mebendazole is used first-line for children > 6 months old. A single dose is given unless infestation persists
143
Q

Transient synovitis

A

Referred to as irritable hip. It generally presents as acute hip pain following a recent viral infection. The typical age group is 3-8 years.

144
Q

Commonest cause of hip pain in children

A

Transient synovitis

145
Q

Transient synovitis features

A
  1. limp/refusal to weight bear
  2. groin or hip pain
  3. a low-grade fever maybe present
  4. high fever should may point to septic arthritis
146
Q

Transient tachypnoea of the newborn

A

The commonest cause of respiratory distress in the newborn period. It is caused by delayed resorption of fluid in the lungs

147
Q

The commonest cause of respiratory distress in the newborn period

A

Transient tachypnoea of the newborn

148
Q

Transposition of the great arteries features

A 
>   cyanosis
>   tachypnoea
>   loud single S2
>   prominent right ventricular impulse
>   'egg-on-side' appearance on chest x-ray
149
Q

Treatment of Transposition of the great arteries features

A
  1. maintenance of the ductus arteriosus with prostaglandins

2. surgical correction is the definite treatment.

150
Q

Umbilical hernia

A

Are relatively common in children and may be found during the newborn exam. Usually no treatment is required as they typically resolve by 3 years of age

151
Q

Complications of Undescended testes

A
  1. infertility
  2. torsion
  3. testicular cancer
  4. psychological
152
Q

Management of Unilateral undescended testis

A

Referral should be considered from around 3 months of age, with the baby ideally seeing a urological surgeon before 6 months of age

153
Q

Management of Bilateral undescended testis

A

Should be reviewed by a senior paediatrician within 24hours as the child may need urgent endocrine or genetic investigation

154
Q

Common causes of Urinary tract infection in children

A

> E. coli (responsible for around 80% of cases)
Proteus
Pseudomonas

155
Q

Features of Urinary tract infection in children

A

> infants: poor feeding, vomiting, irritability
younger children: abdominal pain, fever, dysuria
older children: dysuria, frequency, haematuria

156
Q

Vesicoureteric reflux (VUR)

A

Abnormal 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).

157
Q

Whooping cough (pertussis)

A

An infectious disease caused by the Gram-negative bacterium Bordetella pertussis. It typically presents in children.

158
Q

Whooping cough (pertussis) features

A 
>   coughing bouts
>   central cyanosis
>   inspiratory whoop: not always present
>   infants may have spells of apnoea
>   seizures
>   symptoms may last 10-14 weeks
>   marked lymphocytosis
159
Q

Diagnostic criteria in Whooping cough

A

Acute cough that has lasted for 14 days or more
Paroxysmal cough.
Inspiratory whoop.
Post-tussive vomiting.
Undiagnosed apnoeic attacks in young infants.

160
Q

Management of Whooping cough in infants less than 6 months

A

Should be admitted

161
Q

Management of Whooping cough in infants more than 6 months

A

in the UK pertussis is a notifiable disease

An oral macrolide (e.g. clarithromycin, azithromycin or erythromycin) is indicated if the onset of the cough is within the previous 21 days to eradicate the organism and reduce the spread

Household contacts should be offered antibiotic prophylaxis

162
Q

School exclusion in Whooping cough

A

School exclusion: 48 hours after commencing antibiotics

163
Q

Common cause of UTIs in children

A

Vesicoureteric reflux (VUR)

164
Q

What antibiotic are given in Whooping cough?

A

An oral macrolide (e.g. clarithromycin, azithromycin or erythromycin) is indicated if the onset of the cough is within the previous 21 days to eradicate the organism and reduce the spread

Child health (2 decks)

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