Pediatric Flashcards
ADHD?
hyperactivity and impulsivity, which are pervasive (occurring at home and school in this case) and causing moderate impairment (in this case affecting performance at school).
affects the frontal lobe
under 12 years
Hydrocele?
A hydrocele is a collection of fluid around the testicle; the tunica vaginalis.
occur where the tunica vaginalis around the testicle is connected with the peritoneal cavity via a pathway called the processus vaginalis. this process vaginalis should be closed.
resolved by itself over 12 months if not surgery to close the process vaginalis.
transilluminate with light in examination
pyloric stenosis?
Pyloric stenosis is a condition resulting from the hypertrophy of the pyloric sphincter.
On examination, especially during feeding, the hypertrophic pyloric sphincter might be palpable as a smooth** olive-sized mass**
vomiting after feeds
Hypoxic ischaemic encephalopathy (malfunction of the brain)? HIE
brain damage due to hypoxia
acidosis (pH < 7) on the umbilical artery blood gas, poor Apgar scores also the features
Pre-partum (e.g., placental abruption-reduced blood flow from the placenta)
During delivery (e.g., cord compression)
Post-partum (e.g., prolonged respiratory arrest)
Mx
therapeutic hypothermia-cooling off the baby to 34 degree by cooling blankets and a cooling hat
The intention of therapeutic hypothermia is to reduce the inflammation and neurone loss after the acute hypoxic injury. It reduces the risk of cerebral palsy, developmental delay, learning disability, blindness and death.
Just read.
This premature infant is at high risk for hypoxic damage, as there was reduced blood flow from the placenta (abruption) and the neonate did not breathe spontaneously at birth (required resuscitation). This, combined with the subsequent hypotonia and seizures means a diagnosis of hypoxic ischaemic encephalopathy (HIE) is likely. Further damage in HIE can be reduced by inducing mild hypothermia by cooling the baby to 34 degrees.
Febrile Seizures?
Type of seizure that occurs in children with a high fever e.g. due to underlying viral illness or bacterial infection
Mx
identify the infection and control the fever with analgia like Paracetamol and ibuprofen
Reflex anoxic seizures
occur when the child is startled-most commonly a minor bump to the head. The vagus nerve sends strong signals to the heart that causes it to stop beating.
The child will suddenly go pale, lose consciousness and may start to have some seizure-like muscle twitching. Within 30 seconds the heart restarts and the child becomes conscious again.
Reassuring the parent
Nb- one type of breath holding attacks
Breath holding spells or Breath holding attacks?
They are involuntary episodes during which a child holds their breath, usually triggered by something upsetting or scaring them. They typically occur between 6 and 18 months of age. The child has no control over the breath holding spells. They are not harmful in the long term, do not lead to epilepsy and most children outgrow them by 4 or 5 years.
Vasovagal episode?
most common cause if syncope in children
Syncope is the term used to describe the event of temporarily losing consciousness due to a disruption of blood flow to the brain, often leading to a fall. Syncopal episodes are also known as vasovagal episodes, or simply fainting.
When the vagus nerve receives a strong stimulus, such as an emotional event, painful sensation or change in temperature
Erythema infectiosum?
Erythema infectiosum, also known as ‘Slapped Cheek Syndrome’ or ‘fifth disease,’ is a viral infection that is most common in children
It has two stages:
The first is the initial headache, fever, and cold-like symptoms. This is then followed by a rash developing over the following few days; appearing bright red on the cheeks and more lacy in pattern over the rest of the body
What is this diagnose?
This child is presenting with a two day history of ear pain following an upper respiratory tract infection; together with inflammation of the tympanic membrane the most likely diagnosis is ——–. First-line management is adequate ——- with appropriate ——-.
otitis media
analgesia
safety netting
Antibiotics are only indicated in children in otitis media if:
-Eardrum is perforated
-< 2 years old and bilateral infection
-Present for ≥4 days
-< 3 months old
This patient with very low insulin requirements after a recent diagnosis of type 1 diabetes mellitus (poly—-, poly—-, weight —-, raised —- blood —–) presenting in moderate —– (vomiting, ketonuria) is experiencing a honeymoon period.
polydipsia (excessive thirst)
polyuria
W loss
random-DKA
What is honeymoon period?
The ‘honeymoon period’ in T1DM describes a time where the disease has been identified and is being treated with exogenous insulin, but there is still some residual insulin production as not all beta pancreatic cells have been destroyed. As a result, the patient’s insulin requirements may be very low. Children should be monitored closely during this period, as once the last few pancreatic cells are destroyed and endogenous insulin production completely stops, the child’s exogenous insulin requirements will suddenly jump.
Just read
This teenager with learning difficulties and epilepsy, social anxiety, poor eye contact, echolalia (repeating your speech), mitral valve prolapse and prominent ears and jaw with a long thin face most likely has a diagnosis of fragile X syndrome. The underlying genetic defect in fragile X syndrome is a trinucleotide repeat in the FMR1 (familial mental retardation 1) gene
