Peadiatrics Flashcards
causes of meningitis in neonates
Group B strep, s. pneumoniae, e. coli
causes of meningitis in children
neisseria meningitidis, H. influenza, s. pneumoniae
what causes slapped cheek and fever
erythema infectiosum (parvovirus B19)
diagnosis of kawasakis
Mucosa - strawberry tongue, inflamed mouth Hands - erythema Eyes - bilateral conjunctivitis Adenopathy - cervical Rash Temperature >5/7
management of kawasakis
aspirin, IvIg
echo in 6 weeks - coronary artery aneurysm
maculopapular rash on face which spreads to trunk + low grade fever
rubella
cough and coryza, conjunctivitis, mucosal involvement ? and complications
measles (mucosa= koplik spots)
giant cell pneumonia and ecephalopathy
strawberry tongue and flushed face?
scarlet fever - strep A
what causes rheumatic fever and what are the criteria?
strep pyogenes
jones criteria: arthralgia pericarditis fever nodules chorea rash raised ESR/CRP ECG changes
acid-base problem in pyloric stenosis and investigation
hypokalemic hypochloremic metabolic alkalosis
test feed with USS
investigation and management of intussusception
USS- target sign
AXR - distended proximal bowel and reduced gas distally
contrast enema
air reduction/ surgery
management of GORD in babies
breast feeding assessment thickened formula alginate 1-2 weeks trial removing cows milk for 3 weeks trial PPI/ H2RA
investigations in coeliac
anti TTG and endomysial Abs
jejunal biopsy - flat villi
investigations in hirshsprungs
DRE and suction rectal biopsy (no ganglion cells in submucosal and myenteric plexus)
what causes nephrotic syndrome and presentation in children
minimal change disease
periorbital oedema, genital/lg oedema, ascites, pulmonary oedema , proteinuria
what can trigger nephrotic syndrome in children
steroid sensitive - URTI
what symptoms does steroid resistant nephrotic syndrome cause
haematuria, decline in kidney function, thrombosis, hypovolaemia, hypercholesterolemia
presentation of HSP
purpuric rash on extensors
arthralgia
abdo pain
glomerulonephritis
what causes haemolytic uraemic syndrome and how does it present
e.coli - prodrome of bloody diarrhoea
microangiopathic haemolytic anemia
AKI
thrombocytopenia
teenager with myoclonic seizures in the mornings? management?
juvenile myoclonic epilepsy
sodium valproate - generalised
child having tonic clonic seizures most likely to be ..? management?
benign rolandic epilepsy
sodium valporate
what is congenital adrenal hyperplasia
AR inheritance - defective 21 hydroxylase enzyme
causes excess androgens
precocious puberty and virilisation of genitalia
investigations in congenital adrenal hyperplasia and treatment
17 hydroxy-progesterone levels
low sodium
high potassium
hypoglycemia
hydrocortisone
what causes a left to right shunt in heart and how do they generally present
ASD, VSD, PDA
heart failure / asymptomatic
what do you hear on auscultation in ASD
ejection systolic at left sternal edge
what do you hear on auscultation in VSD
pansystolic murmur (loud = small, quiet =big) loud 2nd heart sound
what do you hear on auscultation in PDA
continuous machinery murmur under clavicle
findings in coarctation of aorta
HTN , radio-femoral delay, weak femorals, ejection systolic murmur
what are the cyanotic heart defects
complete AVSD
tetralogy of fallot
transposition of great vessels
what is tetralogy of fallot
pulmonary stenosis RVH overriding aorta VSD ejection systolic murmur
management of transposition
prostaglandins
surgery
complications of jaundice and management
kernicterus
transcutaneous bilirubinometer
phototherapy
exchange transfusion
causes of neonatal jaundice
<24 hours: ABO incompatibility, rhesus, infection
>24h: physiological
2 weeks: biliary atresia
what is pataeus
trisomy 13
brain defect, microcephaly, small eyes, cleft palate, cardiac and renal abnormalities
what is edwards
trisomy 18
rocker bottom feet, small mouth and chin, short sternum, cardiac and renal abnormality
what is turners
missing x chromosome in female (X0)
short, webbed neck, widely spaced nipples, delayed puberty, infertility
what is kleinfelters
extra X, (XXY)
small testicles, infertility, tall, gynaecomastia
what causes epiphyseal growth plates to fuse?
oestradiol and testosterone at puberty
investigations for short stature
growth charts
left hand and wrist x ray
FBC, U+E, TFTs, Calcium, phosphate, GH, cortisol
what is precocious puberty
secondary sexual characteristics by the age of 8 for girls and 9 for boys
causes of precocious puberty
familial or pituitary adenoma if raised gonadotropins
CAH, adrenal tumours, gonadal tumour if normal gonadotropins (but raised sex hormones)
when is puberty said to be delayed
absence of secondary characteristic by 13 for girls and 14 for boys
what are the 5 areas of development
gross motor, fine motor and vision, speech, hearing and language, social and behavioural
child with pain only on active movement following a viral infection?
transient synovitis
an unwell child with fever, not weight bearing with leg held in flexion and abduction?
septic arthritis
joint aspiration and IV Abx
child with antalgic gait of insidious onset with pain on internal rotation and abduction?
perthes disease- avascular necrosis of femoral head
obese 12 year old who is not weight bearing with hip and knee pain, held in abduction and external rotation
slipperd upper fermoral epiphysis
a small child with shortened leg that won’t abduct. ortolani and barlow’s test positive?
DDH
diagnosis of JIA
> 6 weeks of joint pain and morning stiffness
management of osteogenesis imperfecta
bisphosphonates
maintenance fluids?
0.9% NaCl
5% glucose
10 mmol KCl
fluid bolus in children? and what instances not to give
20ml/kg 0.9% NaCl
10ml/kg in trauma, DKA, neonates
