Peadatrics Flashcards
Acute stridor
Croup (laryngotracheobronchitis)
Inhaled foreign body
Anaphylaxis
Epiglottitis
Rare: bacterial tracheitis, severe tonsillitis, inhalation of hot gas, retropharngeal abscess
Stridor in an infant
Laryngomalcia Laryngeal cyst Laryngeal haemangioma Laryngeal web Laryngeal stenosis Vocal cord paralysis Vascular ring Gastro-oesophageal reflux Hypocalcemia - laryngeal tetany Respiratory papillomatosis Subglottic stenosis
Recurrent or persistant cough in childhood
Recurrent viral URTI
Asthma
Allergic rhinitis
Chronic non-specefic cough
Post infectious - pertussis, adenovirus, mycoplasma, chlaymdia
Recurrent aspirations - gastro oesophageal reflux
Environmental e.g smoking
Supportive lung disease - CF, Primary cillarly dyskinesia
Tuberculosis
Habit
Chest pain
Trauma e.g fractured rib Exercise e.g overuse injury Idiopathic Psychological e.g. Anxitey Chostochondritis Respiratory cause ♣️Pneumonia with pleural involvement ♣️Asthma ♣️severe cough ♣️pneumothorax ♣️reflux oesophagitis Sickle cell disease with crest crisis and or pneumonia Pericarditis Angina - from severe aortic stenosis
Collapsed neonate
Infection: GBS, Herpes simplex
Cardiogenic: hypoplastic left heart syndrome, SVT, severe coartication, critical aortic stenosis, aortic arch interruption
Hypovolemic - dehydration, bleeding
Neurogenic: meningitis, subdural heamatoma (shaken baby syndrome)
Lung: delayed presentation of congenital diaphragmatic hernia
Metabolic: propionic acidemia, methylmalonic acidemia
Endocrine: panhypopitusrrism
Clinical signs suggesting pathological cause of short stature
Extreme short stature - 0.4 centile
Short for family size - outside targert range for parents
Short and relatively overweight - suggest endocrinopathy
Short and very underweight - failure to thrive
Growth failure - crossing downward on centiles
Dysmorphic features
Skeletal disproportion
Signs of systemic disease
Cause of obesity
Simple obesity Genetic Endocrine disease ➖hypothyroidism ➖Cushing syndrome ➖growth hormone ➖pseudohypoparathyrodism Drugs : steroids, sodium valproate Syndrome ➖downs ➖prader-willi ➖Laurance - moon- biedl Disorders associated with immobility e.g. Cerebral palsy Hypothalamic damage - secondry to brain tumours or trauma Leptin defficancy
Ambiguous genetilia
Congenital adrenal hyperplasia
Disorder of gonadotropin production - kallman
Defect of testerone synthesis
Androgen reception abnormalties-
Rectal bleeding
Gastroenteritis Anal fissure Intussuception Cow milk protien allergy Meckels Diverticulum Inflammatory bowel disease Polyp Clotting abnormality Sexual abuse
Chronic diarrhoea
Infection ➖bacterial: campylobacter, salmonella ➖protozoal: Giardia ➖post-gastroenteritis diarrhoea Malabsorption ➖lactose intolerance ➖cows milk Protien intolerance ➖cystic fibrosis ➖coeliac disease Gastrointestinal disorder ➖chrons disease ➖ulcerative colitis Toddlers diarrhoea IBS Drugs ➖laxatives ➖antibiotics ➖chemotherapy Immunodefficincy
New onset wheeze
️Asthma Hypersensitivity reaction Irritant gas Increased pulmonary venous pressure Foreign body Reflux Cholingergic drugs
Non blanching rash
Minor trauma Enteroviral infection Raised superior venal-cava pressure Purpara fulminans due to N. Meningitidus infection ITP - idopathic thrombocytopenia pupura Haemophillia A and B Leukemia
Headache
Tension Migrane Myopia/ hypermetopria Post ictal Meningitis/ encephalitis Sinusitis Raised ICP Trauma
Myopathy
Central - affect the nerves in the anterior horn
➖polio
➖spinal muscular atrophy
Peripheral nerves
➖heridatry motor or sensory neuropathy
➖bells palsy
➖Guilin bare
Neuromuscular junction: myasthenia gravis
Muscle disorder
➖muscular dystrophy: Duchen’s and beakers
➖dermatomoysitis
Erythema multiforme
Viral infection: HSV, HBV, CMV, ADV, HAV
Bacterial infection
Mycoplasma
Fungal
Parasite infections
Drugs: antibiotics, anti-epileptics, NSAID, Systemic illness
