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YEAR 5 MEDICINE Specialties > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Meckels diverticulum symptoms?
investigation?
management
complications?

A

GI bleed - most common cause in kids age 1-2
abdominal pain mimicking appendicitis

technetium scan

surgery

volvulus and intussuception risk

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2
Q

Management for newly delivered baby not breathing, cyanosed

A

HR >100 = 5 breaths of air via face mask
HR <60 = CPR
if thought meconium causing airway obstruction = suction

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3
Q

Jaundice in 1st 24 hours after birth (pathological jaundice) is due to?

A
  1. problems in red blood cells
  2. cross reaction with maternal blood (eg rhesus hemolytic disease) - more likely if 2nd pregnancy
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4
Q

Risk factors for UTI in children?

A

vesicoureteral reflux - dilated and tortuorus ureter, dilated calyxes. rather than UTI in child, can also present antenatally as hyrdonephrosis on ultrasound

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5
Q

CONTINUOUS mumur in child, best heard under left clavicle is most likely? management?

A

Patent ductus arteriosus
manage with indomethacin

(pulmonary stenosis instead has a systolic murmur and ASD has a fixed split S2)

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6
Q

management of fever >38 in a child <3 months

A

urgent admission to hospital

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7
Q

Child aged 5-16 years with asthma not controlled by a SABA + low-dose ICS. next step?

A

add a leukotriene receptor antagonist

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8
Q

ALL symptoms

A

Anemia, neutropenia! (Despite leukocytosis) and thrombocytopenia (Petechiae)

ITP can cause thrombocytopenia but not neutropenia or leukocytosis. ITP often follows viral illness.

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9
Q

Bed wetting treatment?

A
  1. Changes in routine, reward system = 1st line
  2. Alarm = 2nd line
  3. Desmopressin

child <5 years is normal, give reassurance and advcie

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10
Q

Top causes of meningitis in children

A

Neonates to 3 months = group b strep!!, listeria, E. coli
1 month to 6 years = neisseria, hemophilus influenza, strep pneumonia

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11
Q

ADHD 1st line management? Side effects?

A

Stunted growth due to decreased appetite
Cardiotoxic - ecg

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12
Q

Down syndrome complications?

features?

A

hypothyroidism, dementia, leukaemia, and seizures, atlanto-axial instability (always screen for in patients that play sports)

sandal gap between big and first toe
brushfield spots on iris
etc

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13
Q

Necrotising enterocolitis symptoms and findings?
managment

A

Bilious vomiting
Abdominal distention
Bloody stools
AXR = dilated bowel loops, intramural gas, portal venous gas

  • common I premature neonates
  • broad spectrum antibiotics
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14
Q

Croup
Diagnosis?
investigation?
Management?

A

clinical diagnosis
Clinical or steeple sign on CXR

never perform throat examination due to risk of airway obstruction

Oral dexamethasone (0.15mg/kg)

if severe = marked sternal wall retractions/resp distress = oxygen + nebulised adrenaline

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15
Q

Congenital rubella syndrome?

A

Cataracts
Sensorineural deafness

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16
Q

Congenital CMV

A

Sensorineural deafness
NO cataracts

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17
Q

Congenital toxoplasmosis

A

Cerebral calcification
Chorioretinitis
Hydrocephalus

18
Q

Pyloric stenosis
symptoms?
investigation?
management?

A

‘projectile’ vomiting, typically 30 minutes after a feed
constipation and dehydration may also be present
a palpable mass may be present in the upper abdomen
hypochloraemic, hypokalaemic alkalosis due to persistent vomiting ( elevated bicarbonate)

ultrasound abdomen - target/dougnut sign

pyloromyotomy

19
Q

Whooping cough
symptoms
Investigations
Management

A

cattarrhal phase - viral infection symptoms
coughing - worse after feeds, associated with vomiting
INSPIRATORY whoop

Per nasal swab

infants under 6 months with suspect pertussis should be admitted

an oral macrolide (e.g. clarithromycin, azithromycin or erythromycin) is indicated if the onset of the cough is within the previous 21 days

20
Q

Neonatal hypoglycemia management?

A

< 2.6 mmol/L

  • asymptomatic
    encourage normal feeding (breast or bottle)
    monitor blood glucose
  • symptomatic or very low blood glucose
    admit to the neonatal unit, intravenous infusion of 10% dextrose
21
Q

bronchiolitis
management

A

supportive measures only

22
Q

Epiglottis
symptoms
investigations
management

A

stridor, drooling saliva, tripod positioning

if suspected do not examine throat due to risk of airway collapse.

direct visualisation by senior aiway trained staff = 1st line. CXR also useful - thumb and steeple sign

intubation if necessary, oxygen, antibiotics

22
Q

DMD
symptoms
investigations
management

A

calf pseudohypertrophy
Gower sign
progressive proximal muscle weakness

genetic testing = 1st line
can also do proximal muscle biopsy

supportive management

23
Q

management of undescended testes?

A
  • unilateral = review at 3 months if still undescended
  • bilateral = review by senior pediatrician within 24 hours
24
Q

enterobious vermicularis/pinworm management?

A

metronidazole

25
Q

Benign rolandic epilepsy vs Juvenile myoclonic epilepsy

A

BRE - focal siezure in children - one side of face, drooling, one limb involvement. may become generalised. occur before or after sleeping

JME - myoclonic jerks of LIMBS, typically on background of daytime absences. can become generalised

26
Q

Children below 0.4th centile for height management?

A

review by pediatrician

27
Q

child < 3 years presenting with an acute limp management?

A

refer urgent pediatric assessment

28
Q

neonatal sepsis symptoms?

top causes?
investigations?
management

A

Respiratory distress!!!: Apnea, tachypnea, nasal flaring, grunting, subcostal recessions.

Tachycardia
Jaundice
Seizures: if cause of sepsis is meningitis
Abdominal distention

  • GBS, ecoli. higher risk in low birth weight + pre term
  • blood cultures, LP
  • IV benzylpenicillin with gentamicin
29
Q

GORD symptoms?

A

typically develops before 8 weeks
vomiting/regurgitation
milky vomits after feeds
may occur after being laid flat
excessive crying, especially while feeding

30
Q

Hirschsprungs management?

A
  • bowel irrigation = 1st
  • followed by surgery
31
Q

Wilms tumour presentation?

A

abdominal mass
PAINLESS hematuria
no pain on palpation - contrast Polycystic kidney disease and renal cyst with pain

32
Q

Kawasaki disease symptoms?
management?

A

high-grade fever which lasts for > 5 days.
conjunctival injection
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel

aspirin
IV immunoglobins
ECHO - must rule out coronary artery aneurysm

33
Q

Describe the APGAR score and interpret it.

(it should be taken at 1 and 5 minutes after birth)

A

Appearance
- pink = 2
- body pink, extremities blue = 1
- blue all over = 0

Pulse (heart rate)
- >100 = 2
- <100 = 1
- absent = 0

Grimace (reflex irritability)
- cries on stimulation/sneezes/coughs = 2
- Grimace = 1
- nil = 0

Activity (muscle tone)
- Active movement = 2
- limb flexion = 1
- flaccid = 0

Respiratory effort
- strong, crying = 2
- weak, irregular = 1
- Nil = 0

0 -3 = very low
4 -6 = moderate low
7-10 = good state

34
Q

Intussusception
symptoms?
investigation?
management?

A

abdominal pain
vomiting
currant jelly red stool

abdominal ultrasound - target like mass

reduction by air insufflation under radiological control,

35
Q

Key risk factor for Developmental dysplasia of hip?

DDH when missed can present as?

A

breech presentation
USS hips at 6 weeks for breech babies at or after 36 weeks gestation

Trendelenberg gait
limb length discrepancy
(no pain compared to other differentials)

diagnosis = Ultrasound
if the infant is > 4.5 months then x-ray is the first line investigation

36
Q

Neonatal Hypoglycemia
risk factors?
symptoms

management?

A

preterm birth (< 37 weeks)
maternal diabetes mellitus
neonatal sepsis
inborn errors of metabolism

jitteriness, pallor, poor feeding, weak cry, drowsy, siezures

asymptomatic
encourage normal feeding (breast or bottle)
monitor blood glucose

symptomatic or very low blood glucose
admit to the neonatal unit
intravenous infusion of 10% dextrose

37
Q

Slipped upper femoral epiphesis

symptoms
investigation
management
complications

A

hip, groin, medial thigh or knee pain
loss of internal rotation of the leg in flexion
rf: obese children and boys

pelvic xray

internal fixation

avascular necrosis, limb length discrepancy

38
Q

Osteosarcoma
symptoms

A
  • pain in long bones - arms/ legs near growth areas (metaphysis), including around the knees.
  • worsening pain over time, more severe at night or with rest
  • systemic symptoms: weight loss or fever and

xray
biopsy = onfirmatory

39
Q

Rubella symptoms?
investigations?
management?

A
40
Q

Cystic fibrosis management

A
  • high calorie high fat diet
  • pancreatic enzyme supplementation
  • modulators
41
Q

Management when concerned about hypoxic brain injury?

A

Therapeutic cooling

YEAR 5 MEDICINE Specialties (4 decks)

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