Pediatrics Flashcards
Eczema first line
Emollient cream
Primitive reflexes disappear
4-6 months
12-13 year old vaccines
HPV
Pulses to check in infant
Brachial and femoral
Treating pertussis
macrolide
Vaccine in 20-32 Week pregnant women
for pertussis
Machine like murmur, bounding pulse, collapsing pulse, left subclavicular thrill
PDA
Management of PDA
indomethacin or ibuprofen
Microcephaly causes
Congenital infection, Hypoxic ischemic injury, fetal alcohol syndrome, patau syndrome and Craniosynstosis
Father to son in Hemophilia
0% transmission
Acute epiglottitis Cause
H. Influenza
Tripod position, dysphagia, drolling and distress
Epiglottitis
Steeple sign on XR
Croup
Thumb sign on XR
Epiglottitis
Bite and blister cells
G6PD
Osmotic fragility test
Hereditary spherocytosis
Long face and protruding ear, neuro developmental delay and X dominant
Fragile X syndrome
Benign cause of Stridor in very young infant (4-6 weeks)
Laryngomalacia
Coxsackie A16 causes what disease
Hand, foot and mouth disease
Ulcers caused
Vesicoureteric reflux diagnosis
Micturating cystourethrogram
Scarring in VER test
Radionuclide scan using DMSA
> 48 hours to pass meconium, abdominal distension
Hirschsprung disease
Sausage shaped mass and red jelly currant stools
Intussuception
Exomphalos and Diaphragmatic hernia are associated with what GI condition
Malrotation
Chromosomal abnormality affecting females, short stature, webbed neck, Bicuspid aortic valve- E/S murmur, Coarcation of aorta, primary AMENORRHEA, horseshoe kidney, hypothyroidism
Turner Syndrome
Pica syndrome
Iron deficiency anemia
LRTI, up to 9 months, wheeze
Bronchiolitis
Stridor is a common sign of URTI
Croup
Commonest cause of Croup
Parainfluenza
Hepatomegaly in a child
Related to HF in children and suggests Congenital heart failure
Ejection systolic murmur in children
Are generally benign and innocent
Down syndrome Heart defect
AVSD
Down syndrome haematological relationship
Leukemia is associated with Down’s
AVSD will cause what type of murmur
Pan systolic Murmur
APGAR Score: important to Know
A: Activity (muscle tone): Absent (0), flexed arms or legs (1) and active (2)
P: Pulse: absent (0), below 100 (1), above 100 (2)
G: grimace: Floppy (0), minimal to stimuli (1) and prompt response to stimuli (2)
A: Appearance: blue/ pale (0), pink body and blue extremes (1) and pink body (2)
R: Respiration absent (0), Slow and regular (1) and vigorous cry (2)
A child that has weaned (post 6 months), diarrhoea or constipation, non-bloody stool, malabsorptive child - FTT
Celiac disease
Sickness, purpuric rash buttocks and lower limbs , abdominal pain; Proteinuria and hematuria
Henoch Schnlein Purpura (HSP)
Red blood shot eyes, red cracked lips and red tongue, red swollen hands, high fever, swollen feet and rash involving the body; No pus from eyes- non purulent conjunctivitis
Kawasaki disease
Complication of Kawasaki
Heart aneurysms and cardiovascular problems
Not passed meconium >48 hours, X-ray shows distended loop of bowel including rectum
Hirschsprung disease
Bilious vomiting; passed meconium - Fluidy
Duodenal atresia
Gold standard diagnosis of Hirschprung disease
Rectal biopsy
Cystitis vs Pyelonephritis
Fever, flank pain, abdominal pain - pyelonephritis
Cystitis: afebrile, UTI symptoms
Glomerulonephritis: Hematuria
Epistaxis, child, WBC raised, generalised enlargement, low platelets and HB; Lymphoid proliferation and less myeloid cells
ALL
Most common cause of Leukemia in children
ALL
Purpuric rash + High temperature + Viral symptoms
Meningococcal Septicaemia
Management of Meningococcal septicaemia
Ceftriaxone IV
ITP management
Steroids or immunoglobulin
Fever, presence of multiple joint swelling, Anemia; negative Antibodies and raised ESR in a child.
Juvenile Rheumatoid arthritis/ Still’s Disease
Salmon-pink rash
Juvenile Arthritis
Positive Kernig’s Sign; Neck stiffness and fever. Causative agent
In 1-3 months: GBS
3 months to 3 years: s pneumoniae, Meningitidis
3-10: Pneumoniae and meningitidis
10-19: Meningitidis
Rapid fever, Stridor and drooling with tripod position. Cause and pathogen
Epiglottitis and H. influenza
West’s Syndrome on EEG aka infantile spasms
Hypsarrhythmia
<3 month old, excess crying, pulling legs, benign
Infantile colic
Physiological jaundice
Day 2 to 14
Post gastroenteritis can cause what type of diarrhoea in children
Lactose intolerance
Most common cause of neonatal infection (<7 days)
GBS
Cyanosis or collapse in the first month of life, hypercyanotic spells, ejection systolic murmur at left sternal edge
TOF
Micrognathia; Low set ears, rocker bottom feet and overlapping fingers
Edward’s Syndrome
Risk factors for abruption
Previous history, BP high, premature ROM, Uterine injury, polyhydraminos, twins, Infection of the uterus, older age, and narcotic use
2 month vaccines
6 in 1 -DTAP
Oral rotavirus
Meningitis B
3 Month vaccine
6 in 1 vaccine (DTap + whooping cough, Hib and hepatitis B
oral Rotavirus vaccine
PCV
4 month
6 in vaccine and Men B
12-13 months
Hib/Men C, MMR, PCV, Men B
2-8 years
Flu vaccine - Annual
3-4 years
4-in 1 pre-school booster (diphtheria, tetanus, whooping cough and polio); MMR
12-13 years
HPV
13-18 years
3 in 1 teenage booster (tetanus, diphtheria and polio); Men ACWY
Prolonged neonatal jaundice (conjugate raised), HSM, abnormal growth, cardiac murmurs, Raised bile acids, dark urine and pale stools, deranged LFTs
Biliary atresia
Retinal hemorrhages, sub dural hematoma and encephalopathy
Shaken baby syndrome
> 3 month old baby and Meningitis - antibiotics?
Cefotaxime or ceftriaxone only No amoxicillin (that is for <3 month old baby)
Most common complication of Measels
Acute otitis Media
Most common cause of death in Measels
Pneumonia
Fever first Rash later
Roseola Infantum
Cause: HHV-6
Nagayama spots- Uvula and soft palate
coarctation of aorta
Common in males
associated with turners
Causes HF in infancy and Hypertension in adulthood
Mid systolic murmur
USE PDA TO KEEP OPEN
2-4 weeks of life, vomiting, FTT, > males, projectile; Hypochloraemic, hypokalemic alkalosis
Pyloric stenosis
Thickened and elongated pylorus
Diagnosis: USS
management: Ramstedt Pylorotomy
migraine in children is commonly associated with
GI symptoms
Dilated bowel loops, bowel wall oedema, pneumatosis intestinalis, portal venous gas
Necrotising enterocolitis
Management of biliary atresia (neonatal jaundice)
Surgery
Severity signs in Bronchiolitis
Apnea, grunting, recession, RR>70, cyanosis, persistently low saturations <92
Neonatal Hypoglycemia
<2.6 mmol/L
Microcephaly, small eyes, low set of ears, cleft lip and polydactyly
Patau’s Syndrome
Transient tachypnea of the newborn is most associated with
C-section
Red jelly like stools, diagnosis and investigation
And management
ABdo USS - target sign
Intussuception
Air insufflation under radiology
Turner’s Syndrome is associated with what heart defects
Bicuspid aortic valve
Aortic root dilation
Coarctation of aorta
Duchenne muscular dystrophy is associated with this cardiac pathology
DILATED cardiomyopathy
Movicol Paediatric plan is a type of
Osmotic laxative
Definitive management of Hirschsprung disease
Anorectal pull through
Sandpaper rash
Scarlet fever
Strawberry tongue, rash, caused by S. Pyogenes or GAS
Scarlet fever
Prebirth is related to
Neonatal hypoglycemia
Papular to vesicopapular conversion and also affected a contact of the child
Chickenpox
Slapped cheek rash
Parvovirus B19
Also related to Aplastic crisis
Sand paper rash, rough rash, erythematous, strawberry tongue
S. Pyogenes or GAHS
Impetigo caused by
Staphylococcus (Aureus)
Delayed puberty, wide short neck, low set ears and mid-systolic murmur (coarctation)
Turner’s Syndrome
1st sign of puberty in a girl
Breast development
First sign in boy puberty
Testes (6ml)
Lens dislocation, aortic/Mitral valve prolapse, aortic dissection, elongated limbs and high arched palate
Marfan’s Syndrome
AVSD, VSD or ASD; In what common genetic condition; Pulmonary hypertension causing eissenmenger
Down’s Syndrome
NRDS risk factor
Prematurity
TT of new born
C-section
Confirm diagnosis of Post-streptococcal glomerulonephritis
Anti-Streptococcal serology
Maculopapular rash becoming confulent
Measels
Primary ciliary dyskinesia is associated with
Dextrocardia
Test for Meckel’s Diverticulum; pain and bloody stool
Meckel’s Scan
Red-Currant jelly stools; Suasage shaped mass; Knee draw up to stomach
Intussuception
Purpuric rash, abdominal pain
HSP
Double bubble sign
Duodenal atresia
Vomiting at the end of paroxysmal cough
Whooping cough
Projectile vomiting early in life
Pyloric stenosis
Treat mycoplasma
Macrolides such as clarithromycin
No eye contact, pushes toys back and forth, impaired social interaction and repititive behaviour and rituals
Autism disorder
Hand preferable before 12 months
Cerebral palsy
A child can smile at
6 weeks
Grasp and to mouth and sits with support by
6 months
Peek a boo and sits without support; wave bye bye and pincer grip
9 months
when can a child speak 2 word sentences and draw a line
2 years
Screams intensely after feeds and arching back
Infant colic
Yellow crusting and fever, weeping area of skin
Impetigo - S. Aureus, Streptococcus, HSV, allergens
2 year old wheezing, coryza, increased RR
Viral induced wheeze
Undigested food, brown in colour, loose stools no FTT
Chronic non-specific diarrhoea
Also called toddlers diarrhoea
The ideal sleeping position for a pregnant woman is
On her left side; uterus is naturally dextro-rotated and left lateral position is good to prevent pressure on IVC and improves circulation
Heavy bleeding in post-menopausal woman refractory to medical treatment
Hysterectomy
Test in PCOS to find source of testosterone
DHEAS - adrenals gland vs ovarian
USS Measurement that most accurately identified SGA
Humerus length <5th centile for gestation age
Neonate heel prick tests
Sickle cell disease, cystic fibrosis, congenital hypothyroidism, PKU, MCADD, Maple syrup urine disease, isovaleric acidemia, HCU, Glutaric acid test
Asthma ladder in children <5 years
Age <5 Step 1: SABA Step 2: SABA + 8 week trial of ICS Step 3: SABA + Low ICS + LTRA Step 4: Specialist
Asthma ladder in children >5 to 16 years
SABA SABA + Low ICS SABA + Low ICS + LTRA SABA + Low ICS + LTRA +/- LABA SABA + MART +/- LTRA
Robertsonian translocation in mother is assocaited with
Down’s Syndrome
GBS is also called
S. Aglactiae
GAS
S. Pyogenes
Apgar score Appearance
Blue or pale (0); Blue extremes only (1); pink all over (2)`
Apgar pulse
No pulse (0), <100 (1), >100 (2)
Apgar Grimace*
No response to stimulation (0); weak cry when stimulated (1) and cries or pulls away when stimulated (2)
Activity Apgar
No activity (0); some flexion of limbs (1); limbs completely flexed and resist extension (2)
Apgar Respiration
No breathing(0); Irregular or gasping (1); regular and crying (2)
pneumonitis, patchy infiltrates and delivery associated complication and treat using surfactant in a neonate
Meconium aspiration syndrome
Treatment of persistent pulmonary hypertension of the newborn
Nitric oxide
Delay in resorption of lung fluid; associated with C-section and resolves spontaneously; fluid is seen in horizontal fissure and wet lungs
Transient tachypnea of the newborn
age range of prematurity
28 to 36 weeks
Age range of extreme prematurity
23 to 27 weeks
Lack of surfactant production by type 2 pneumocytes causing hypoxia and tachycardia, ground glass appearance on CXR
Hyaline membrane disease or RDS
Unconjugated bilirubin accumulation in basal ganglia leading to choreoathetoid cerebral palsy and sensorineural hearing loss
Kernicterus
Herniation through umblicus, bowel and viscera covered with membranous sac
Exomphalos
Gastroschisis
herniation through abdominal wall right of umblicus, bowel is not covered with membrane
LP CI as raised ICP in a suspected meningitis patient
CT scan
Increased lymphocytes on LP
Viral, TB
Increased neutrophils on LP (polymorphonuclear (PMN))
Bacterial meningitis
Antibiotics in meningitis
Benzylpenicillin + Gentamycin in neonates or Ceftriaxone
N. Meningitidis infection; fever, non blanching purpura, septic shock
Meningococcal septicaemia
Do a PCR
Chemoprophylaxis for close contacts in Meningococcal septicemia
Rifampicin
Most common cause of acquired heart disease in childhood in developed country
Kawasaki disease
Fever >5 days; rash, non-purulent conjunctivitis, mucosal changes such as strawberry tongue, cracked lips and red pharynx; inflammed BCG scar; raised CRP or ESR and thrombophilia and associated with coronary aneurysms
Kawasaki disease
6 months to 6 years is the age range for
Febrile seizures
Jacksonian march and Todd’s paresis
Frontal lobe epilepsy
Temporal lobe epilepsy
Automatisms, DEja vu and sensory
sensory symptoms, distorted body image and vertigo
Parietal lobe epilepsy
3 Hz spikes precipitated by hyperventilation
Absence seizures
Infantile spasms or Wests syndrome
Salaam attacks, Hypsarrhythmia
Lennox-Gastaut syndrome
Myoclonic jerks, atypical absence seizures and atonic seizures
Benign rolandic seizures
Tonic -clonic during sleep, partial during day
Spastic symptoms including tone and reflexes, reduced power and dystonic features such as involuntary movements in a neurodevelopmental disease
Cerebral palsy
Arnold-Chiari is associated with what type of hydrocephalus
Communicating
ALL is associated with what neurodegenrative disorder of DNA repair
Ataxia telengiectasia
Meconium ileus, bowel obstructions, rectal prolapseand pseudomonas or Burkholderia colonization are complications of
CF
Sandifers syndrome is associated with what disorder
GORD
Peas and carrots stool +/- mucous in a preschool child
Toddlers diarrhea
Investigation of malrotation
contrast study
treatment of biliary atresia
Kasai procedure also called hepatoportoenterostomy
Small vessel vasculitis, purpura rash in thigh and buttock, abdominal pain, joint arthritis, hematuria, BP
HSP
Undescended testes referral month
9 months
Systolic, soft, does not radiate, change with posture and often heard in febrile child
Innocent murmur
Absent or weak femoral pulse and hypertension in arms only, rib notching on CXR, RVH; Treat by balloon dilararion or stent; use PGE to keep ductus open
Coarctation of aorta
Associated with de george; E/J murmur, cyanotic spells, Single heart sound, boot shaped heart
TOF
Egg on side appearance
transposition of the GV
Immune response to group A steph causing valve disease
Rheumatic fever
What is the criteria of Rheumatic fever
Jones criteria
Imprinting genetic conditions
prader-willi (Paternal) and Angleman (maternal)
Round face, flat occiput, protruding tongue, epicanthic folds, brushfield spots in iris and singla palmar crease, sandal gap and reduced tone
Down’s
edematous hands, feet, short stature, webbed neck, wide nipples, horseshoe kidney and normal IQ’ Coarctation **
Turner’s
Kleinfelter
47XXY; tall, hypogonad, small testes, gynomastia, infertile
Low IQ, prominent ears and enlarged testes; learning difficulty
Fragile X
A dip in Hb at 6-9 weeks of age in healthy term baby
physiological anemia of infancy
Test of hemolytic anemia
direct coombs test
how to treat Helminth infections
Albendazole or mebendazole
Anaphylaxis is a type of
Type 1 hypersensitivity reaction
adrenaline IM in Anaphylaxis
0-6 years - 150 mcg
6-12 years 300 mcg
adults - 500 mcg
WHat type of allergy is milk protein
Type 4 hypersensitivity reaction
Describe severe attack of asthma
spO2 <92% too breathless to talk or feed HR >140 RR> 40 Use of accessory muscles PEFR 33-50
life-threatening attack of asthma
SPO2 <92%; PEFR <33%. silent chest, poor respiratory effort, normal pCo2
treating acute asthma in children
SABA upto 10 puffs
steroid - prednisolone
chronic asthma under 5
SABA
SABA + Mod ICS (8 weeks)
after 8 weeks give low dose
SABA + Low dose ICS + LTRA
Specialist referral
chronic asthma above 5 - 16
SABA SABA + Low ICS SABA + Low ICS + LTRA SABA + Low ICS + LTRA + LABA SABA + MART +/- LTRA
Causative agent in bronchiolitis
RSV
Bronchiolitis age group
under 1 year olds
management of bronchiolitis
ventilatory support, oxygen, CPAP, Palivizumab in premature or congenital HD babies
Itchy rash, dry, scaly, crusty, lichenification
Eczema
HSV eczema herpeticum
Severe disease, vision, acyclovir must be used, painful rash, punched out lesion
Management of eczema
1st: hydrate with emollients
2nd: topical corticosteroids (avoid on face)
wet wraps and cyclosporin for severe cases
What predisposes to candida infection
use of oral antibiotics
WHat are signs of a candida rash
Rash extending into the skin folds, large red macules, well-demarcated scaly borders, Satellite lesion, oral thrush
rash with flakes, scalp rash
Suborrheic dermatitis
Causes of hypoxic ischemic injury
Placental abruption, uterine rupture, embolism, severe bradycardia and prolonged labour
What staging is used in Hypoxic ischemic injury
Sarnat staging: mental status, muscular tobe, reflexes and autonomic function
what is the temperature range in therapeutic cooling in neonates
33.5 to 35
HEI gold standard diagnosis
diffusion weighted MRI
Starting at head and trunk then rest of the body, progress through papules, vesicles, pustule, crusting.
VZV - chicken pox
GAS aka S. Pyogenes can lead to what in VZV infection
Necrotizing fasciitis or toxic shock syndrome
Failure of the frontonasal and maxillary processes to fuse
Cleft lip
Failure of the palatine processes and the nasal septum to fuse
Cleft palate
Surgical correction of cleft lip and palate
at 3 months - Cleft lip
at 3-12 months- Palate
Dermatitis herpetiform is associated to
coeliac disease
Investigations in coeliac disease
TTG IgA; total IgA; biopsy is gold standard
Cynotic heart diseases
Truncus arteriosus, Transposition of the great arteries, tricuspid atresia, TOF
Egg on a string appearance on CXR
Transposition of the great arteries
TOF
overriding aorta over a VSD, pulmonary stenosis and RVH
Boot-shaped appearance on CXR
TOF
what prevents closure of PDA
Prostaglandins PGE
Absent femoral pulse and hypertension in child
Coarctation of aorta
Rib notching
COA
Washing machine murmur (continous murmur)
PDA
Closure of PDA- drugs
NSAIDs such as ibuprofen or indomethacin
benign obstructive condition, fixed S2 split
ASD
Most commo congenital heart defect
VSD
VSD is associated to
Down’s
Sticky eyes cause and treatment
S Aureus, P aeruginosa and Streptococcus
treat with topical ointment such as neomycin and cholarmphenicol
purulent discharge with swollen eye lids within 48 hours of life
IV antibiotics such as Cephalosporins treat gonococcal conjunctivitis
Discharge at the end of 1st week
Chlamydial conjunctivitis - erythromycin or topical tetracycline
Treat bacterial conjunctivitis with
fusidic acid or gentamycin
Treating allergic conjunctivitis
Sodium cromoglicate and nedocromil - mast cell stabilizer
croup age
6 months to 3 years
Cause of croup
Parainfluenza Virus 1 and 2
Management of croup
Mild dexamethasone
moderate: Dexamethasone + Adrenaline (nebulized)
severe: oxygen + As above
X-ray of croup
Steeple sign in frontal neck radiograph
Lateral: thumb sign
Cause of cutaneous warts
HPV
What causes of Molluscum contagiosum and what are its features
Poxvirus causes molluscum contangiosum and features include skin coloured papule with central umblication, multiple and widespread
Inheritance of Cystic fibrosis
Autosomal recessive
Chloride in CF
Out in sweat and inside in pancreas
Thick secretion and blocked ducts
Is meconium ileus linked to CF
yes
What is the most common cause of death in CF
P aeruginosa
What causes loss of elidibility to lung transplant
Burkholderia Cepacia complex
Investigation in CF
Sweat test
Trypsin
Pancreatic biopsy
Management of CF
Ivacaftor is a CFTR potentiator
Lumacaftor corrects misfolded protein
Diet in CF
Fat rich diet
Low platelet, increased bleeding time, Increased PT, increased APTT, D-dimer and FDP are high
DIC
Superficial bleeding, deep bleeding, bleeding from every orifice, causes: obstretic complications, trauma, sepsis, snake bite
DIC
treatment of DIC
FFP + Platelet transfusion + cryoprecipitate
11-13+6 weeks down’s screening
HCG (increased) + PAPP-A (decreased) + thickened nuchal translucency
trisomy 18
Edwards
Trisomy 13
Pataus
Triple test
AFP + HCG + unconjugated oestriol
Quadruple
AFP + HCG + Inhibin A + Oestriol
Phenotypical features of down’s Syndrome
Flat nasal bridge, epicanthal folds, brushfield spots in iris, round and flat face, up slanting palpebral fissures, small chin, small mouth, broad hands, short stature, hypotonia and poor mororeflex
Inadequate gubernacular fixation of the lower pole of the testes to the tunica vaginalis, acute scrotal pain, profound swelling and diffuse tenderness, high rising testes, spermatic cord is not tender, cremasteric reflex is lost and no ease of pain with lifting testes
Testicular torsion
diagnosis of testicular torsion
Doppler USS
Management of torsion
urgent surgical detorsion (within 6 hours of onset) + bilateral orchipexy
Fixation of both the testes
Manual detorsion if surgery not available in 2 hours
Cause of epididymitis
<35 year old: gonorrhea and chlamydia
>35 year : E coli
Non-infective / drug cause of epididymitis
amiodarone
diagnosis of epididymitis
cremasteric reflex is present, cord is tender, UTI signs
Urine NAAT for gonorrhea and Chlamydia
Management of Epididymitis
Doppler uss to rule out torsion
<35 year: Ceftriaxone + Azithromycin or doxycyline
>35 year: Fluoroquinolone or trimethoprim
Most common cause of Epiglottitis
H Influenza B (before vaccine)
GAS (pyogenes)
Tripod position is associated with
epiglottitis
Lateral neck radiograph shows thumbprint sign in
Epiglottitis
Age group for febrile seizures
6 months to 5 years
Commonest cause of vomiting in infancy
GORD
What is Sandifer syndrome
Arch back and turns head due to GORD
Trial of PPI in infants for GORD only if
Unexplained feeding difficulty, distressing behaviour, and faltering growth
Treatment surgical for GORD
Nissen Fundoplication
Hematuria, Proteinuria, RBC cast, hypertension, and renal failure
Post-streptococcal glomerulonephritis
RBC casts suggest
Acute glomerulonephritis
Berger’s disease is
IgA nephropathy
C3 and C4 in glomerulonephritis
C3 low and C4 normal
Small vessel vasculitis, peaks in 4-6 year olds, preceded by viral infection, purpuric rash with predominant thigh and buttock distribution and abdominal pain, large joint arthritis, can lead to Berger’s
HSP
Groin hernias in children
indirect inguinal
a hernia in newborns should be corrected within
few weeks of life
Umblical hernia
resolve by 3 years
surgery at 5 years
Roseola Infantum or Erythema subitum cause
HHV-6
High spiking fever up to 41 C, rash appears after fever
Roseola
When does transitional hypoglycemia occur
2-3 hour after birth
Neonatal hypoglycemia most common causes
prematurity, diabetic mother and SGA
Management of hypoglycemia
support breast feeding, IV dextrose 2nd line,
refractory to feeding- hypoglycemia management
Dexamethasone + hydrocortisone
glucagon
Ocreotide
Golden crusted lesion around mouth, blister, only epidermis involved
impetigo
Cause of impetigo
S. Aureus; GAS; P. Aeruginosa
Treatment of impetigo
1st line Mupirocin
fluocoxacillin
Allergy - Erythromycin or cephalosporin
Most common type of influenza
type A
Aspirin leading to encephalopathy and liver disease in young child
Reye syndrome
treatment of influenza
Neuraminidase inhibitor
Adamantane
Persistent vomiting, bilious, green bile, distention, failure to pass stool or wind, abnormal bowel sounds, tinkling and high pitched and absent later
obstruction
Diagnosis of intestinal obstruction
AXR- dilated loop of bowel proximally
collapsed distally
Obstruction management
NBM
NG tube
IV fluids
Common age for intussuception
<2 years, 3 month to 6 years
Most common site of intussuception
Ileocecal
Triad of intussusception
Intermittent colicky pain + vomiting + bloody stools
Palpable RUQ suasage mass
Intussecption
red currant jelly stools
Intussecption
Test of choice in intussecption
Target sign
Treatment of intussecption
Rectal air insufflation
Rash + bloody stools + 3 months of lofe, wheeze,
Cows milk protein intolerance
1st line for paediatric pneumonia
Ampicillin or amoxicillin
2nd line is Vancomycin or Clindamycin
Add Azithromycin in infants under 6 weeks to cover for chlaymdia
Treatment of mycoplasma pneumonia
Azithromycin for 5 days
Cause of whooping cough
Bordetella pertussis
women between 20-32 weeks pregnant get vaccine for
Whooping cough
Bordetella pertussis treatment
Azithromycin
Measels is also called
Rubeola
3 Cs of Measels
Cough, conjunctivitis, and coryza
Classic koplik spots, maculopapular rash
Complication of measels
Acute otitis media common; LRTI, encephalitis, Subacute sclerosing panencephalitis; febrile convulsions, giant cell pneumonia
Most common inborn error of AA
PKU (Autosomal Recessive)
PKU
Developmental delay, infantile spasm, behaviour issues and mousy urine smell
Treatment of Homocystinuria
AD, Vitamin B6 pyridoxine
Krebs cycle disease
Maple-syrup disease
treat with thiamine
Mumps
Respiratory tract epithelial cells - Parotid glands - other tissues
Complications of mumps
Meningoencephalitis; orchitis - post-pubertal males
DMD is X linked or autosomal
X-linked recessive
what can improve strength in DMD
Creatine oral
DMD is associated with what cardiac problem
Dilated cardiomyopathy
Most common cause of preseptal cellulitis
Staphylococcus and GAS
Orbital cellulitis presents with
swelling, diplopia, abnormal eye movement, pain with eye movement and proptosis
Diagnosis of orbital cellulitis
Ct with contrast
treatment of orbital cellulitis
cephalosporin + vancomycin
Abscess - drain
Peptic ulcers in children are commonly
Duodenal
Investigation for ulcers in children
Breath test and Upper Gi endoscopy and biopsy
Treat ulcers in children
Triple therapy with amoxicillin or clarithromycin, bismuth, metronidazole and omeprazole
what is a type of hereditary peripheral neuropathy
Charcoat Marie tooth disease
Inheritance of Charcoat Marie
AD
presentation: progressive distal weakness, lower limbs with peroneal muscle weakness and atrophy
also involves tibial muscles; sensory as well
Strok legs, Pes cavus, hammer toes and claw hands
Charcoat marie- atropy, sprains, contractures
Diagnosis of Charcoat marie
Sural nerve biopsy
Non bilious vomit, firm olive mass, projectile, post prandial, hungry, peristalsis, dehydration and jaundice
Hypochloremia and metabolic alkalosis
Pyloric stenosis
Test of choice in pyloric stenosis
USS
Treatment of Pyloric stenosis
Ramstedt pylorotomy
NRDS risk factors (leading to surfactant LD)
prematurity, male, c-section, asphyxia, second twin
Surfactant stimulants
Glucocorticoids, thyroxine, prolactin
SLD on CXR
ground lung appearance
biopsy shows pink hyaline membrane
Purulent exudates in tonsils
GBS or EBV
positive culture for GBS
10 day antibiotics - use penicillin V or erythromycin
hot potato voice
Epiglottitis
retropharyngeal abscess
Lateral neck film; CT may be
Infant under 3 month with UTI
admit always
itchy edematous plaques, trunk extremities and ears
urticaria
treatment of urticaria
Antihistamines, steroids, LTRA and immunosuppressants
important: cause of Scarlet fever
GAS / S Pyogrenes
Sandpaper skin, strawberry tongue
GAS, scarlet
treat with penicillin V
complications of Rubella
Thrombocytopenia and encephalitis
Triad of congenital rubell syndrome
deafness, blindness and congenital heart disease
Slapped cheek
Parvovirus B19
can cause myocarditis
Roseola caused by
HHV; high fever
cause of volvulus
incomplete rotation of the gut during embryonic period
what type of vomit in volvulus
bilious vomit
Associated conditions with volvulus
Exomphalous and diaphragmatic hernia
management of volvulus
Laparotomy or ladd procedure
UMN lesion, toe walk, hypertonicity, dystonia and chorea, ataxia and scissor gait
Cerebral palsy
