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Peadiatrics Flashcards

1
Q

causes of meningitis in neonates

A

Group B strep, s. pneumoniae, e. coli

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2
Q

causes of meningitis in children

A

neisseria meningitidis, H. influenza, s. pneumoniae

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3
Q

what causes slapped cheek and fever

A

erythema infectiosum (parvovirus B19)

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4
Q

diagnosis of kawasakis

A 
Mucosa - strawberry tongue, inflamed mouth
Hands - erythema
Eyes - bilateral conjunctivitis
Adenopathy - cervical
Rash 
Temperature >5/7
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5
Q

management of kawasakis

A

aspirin, IvIg

echo in 6 weeks - coronary artery aneurysm

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6
Q

maculopapular rash on face which spreads to trunk + low grade fever

A

rubella

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7
Q

cough and coryza, conjunctivitis, mucosal involvement ? and complications

A

measles (mucosa= koplik spots)

giant cell pneumonia and ecephalopathy

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8
Q

strawberry tongue and flushed face?

A

scarlet fever - strep A

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9
Q

what causes rheumatic fever and what are the criteria?

A

strep pyogenes

jones criteria:
arthralgia
pericarditis
fever
nodules
chorea
rash
raised ESR/CRP
ECG changes
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10
Q

acid-base problem in pyloric stenosis and investigation

A

hypokalemic hypochloremic metabolic alkalosis

test feed with USS

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11
Q

investigation and management of intussusception

A

USS- target sign
AXR - distended proximal bowel and reduced gas distally
contrast enema

air reduction/ surgery

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12
Q

management of GORD in babies

A 
breast feeding assessment
thickened formula
alginate 1-2 weeks
trial removing cows milk for 3 weeks
trial PPI/ H2RA
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13
Q

investigations in coeliac

A

anti TTG and endomysial Abs

jejunal biopsy - flat villi

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14
Q

investigations in hirshsprungs

A

DRE and suction rectal biopsy (no ganglion cells in submucosal and myenteric plexus)

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15
Q

what causes nephrotic syndrome and presentation in children

A

minimal change disease

periorbital oedema, genital/lg oedema, ascites, pulmonary oedema , proteinuria

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16
Q

what can trigger nephrotic syndrome in children

A

steroid sensitive - URTI

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17
Q

what symptoms does steroid resistant nephrotic syndrome cause

A

haematuria, decline in kidney function, thrombosis, hypovolaemia, hypercholesterolemia

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18
Q

presentation of HSP

A

purpuric rash on extensors
arthralgia
abdo pain
glomerulonephritis

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19
Q

what causes haemolytic uraemic syndrome and how does it present

A

e.coli - prodrome of bloody diarrhoea
microangiopathic haemolytic anemia
AKI
thrombocytopenia

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20
Q

teenager with myoclonic seizures in the mornings? management?

A

juvenile myoclonic epilepsy

sodium valproate - generalised

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21
Q

child having tonic clonic seizures most likely to be ..? management?

A

benign rolandic epilepsy

sodium valporate

22
Q

what is congenital adrenal hyperplasia

A

AR inheritance - defective 21 hydroxylase enzyme
causes excess androgens
precocious puberty and virilisation of genitalia

23
Q

investigations in congenital adrenal hyperplasia and treatment

A

17 hydroxy-progesterone levels
low sodium
high potassium
hypoglycemia

hydrocortisone

24
Q

what causes a left to right shunt in heart and how do they generally present

A

ASD, VSD, PDA

heart failure / asymptomatic

25
what do you hear on auscultation in ASD
ejection systolic at left sternal edge
26
what do you hear on auscultation in VSD
``` pansystolic murmur (loud = small, quiet =big) loud 2nd heart sound ```
27
what do you hear on auscultation in PDA
continuous machinery murmur under clavicle
28
findings in coarctation of aorta
HTN , radio-femoral delay, weak femorals, ejection systolic murmur
29
what are the cyanotic heart defects
complete AVSD tetralogy of fallot transposition of great vessels
30
what is tetralogy of fallot
``` pulmonary stenosis RVH overriding aorta VSD ejection systolic murmur ```
31
management of transposition
prostaglandins | surgery
32
complications of jaundice and management
kernicterus transcutaneous bilirubinometer phototherapy exchange transfusion
33
causes of neonatal jaundice
<24 hours: ABO incompatibility, rhesus, infection >24h: physiological 2 weeks: biliary atresia
34
what is pataeus
trisomy 13 | brain defect, microcephaly, small eyes, cleft palate, cardiac and renal abnormalities
35
what is edwards
trisomy 18 | rocker bottom feet, small mouth and chin, short sternum, cardiac and renal abnormality
36
what is turners
missing x chromosome in female (X0) | short, webbed neck, widely spaced nipples, delayed puberty, infertility
37
what is kleinfelters
extra X, (XXY) | small testicles, infertility, tall, gynaecomastia
38
what causes epiphyseal growth plates to fuse?
oestradiol and testosterone at puberty
39
investigations for short stature
growth charts left hand and wrist x ray FBC, U+E, TFTs, Calcium, phosphate, GH, cortisol
40
what is precocious puberty
secondary sexual characteristics by the age of 8 for girls and 9 for boys
41
causes of precocious puberty
familial or pituitary adenoma if raised gonadotropins | CAH, adrenal tumours, gonadal tumour if normal gonadotropins (but raised sex hormones)
42
when is puberty said to be delayed
absence of secondary characteristic by 13 for girls and 14 for boys
43
what are the 5 areas of development
gross motor, fine motor and vision, speech, hearing and language, social and behavioural
44
child with pain only on active movement following a viral infection?
transient synovitis
45
an unwell child with fever, not weight bearing with leg held in flexion and abduction?
septic arthritis | joint aspiration and IV Abx
46
child with antalgic gait of insidious onset with pain on internal rotation and abduction?
perthes disease- avascular necrosis of femoral head
47
obese 12 year old who is not weight bearing with hip and knee pain, held in abduction and external rotation
slipperd upper fermoral epiphysis
48
a small child with shortened leg that won't abduct. ortolani and barlow's test positive?
DDH
49
diagnosis of JIA
>6 weeks of joint pain and morning stiffness
50
management of osteogenesis imperfecta
bisphosphonates
51
maintenance fluids?
0.9% NaCl 5% glucose 10 mmol KCl
52
fluid bolus in children? and what instances not to give
20ml/kg 0.9% NaCl | 10ml/kg in trauma, DKA, neonates

Finals (18 decks)

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