Pediatrics Flashcards by Derin King

Meckels diverticulum symptoms?
investigation?
management
complications?

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

technetium scan

surgery

volvulus and intussuception risk

How well did you know this?

Not at all

Perfectly

Management for newly delivered baby not breathing, cyanosed

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

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

Risk factors for UTI in children?

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

How well did you know this?

Not at all

Perfectly

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

Patent ductus arteriosus
manage with indomethacin

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

How well did you know this?

Not at all

Perfectly

management of fever >38 in a child <3 months

urgent admission to hospital

How well did you know this?

Not at all

Perfectly

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

add a leukotriene receptor antagonist

How well did you know this?

Not at all

Perfectly

ALL symptoms

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

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

How well did you know this?

Not at all

Perfectly

Bed wetting treatment?

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

child <5 years is normal, give reassurance and advcie

How well did you know this?

Not at all

Perfectly

Top causes of meningitis in children

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

How well did you know this?

Not at all

Perfectly

ADHD 1st line management? Side effects?

Stunted growth due to decreased appetite
Cardiotoxic - ecg

How well did you know this?

Not at all

Perfectly

Down syndrome complications?

features?

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

How well did you know this?

Not at all

Perfectly

Necrotising enterocolitis symptoms and findings?
managment

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

common I premature neonates
broad spectrum antibiotics

How well did you know this?

Not at all

Perfectly

Croup
Diagnosis?
investigation?
Management?

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

How well did you know this?

Not at all

Perfectly

Congenital rubella syndrome?

Cataracts
Sensorineural deafness

How well did you know this?

Not at all

Perfectly

Congenital CMV

Sensorineural deafness
NO cataracts

How well did you know this?

Not at all

Perfectly

Congenital toxoplasmosis

Cerebral calcification
Chorioretinitis
Hydrocephalus

Pyloric stenosis
symptoms?
investigation?
management?

‘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

Whooping cough
symptoms
Investigations
Management

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

Neonatal hypoglycemia management?

< 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

bronchiolitis
management

supportive measures only

Epiglottis
symptoms
investigations
management

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

DMD
symptoms
investigations
management

calf pseudohypertrophy
Gower sign
progressive proximal muscle weakness

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

supportive management

management of undescended testes?

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

enterobious vermicularis/pinworm management?

metronidazole

Benign rolandic epilepsy vs Juvenile myoclonic epilepsy

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

Children below 0.4th centile for height management?

review by pediatrician

child < 3 years presenting with an acute limp management?

refer urgent pediatric assessment

neonatal sepsis symptoms? top causes? investigations? management

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

GORD symptoms?

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

Hirschsprungs management?

- bowel irrigation = 1st - followed by surgery

Wilms tumour presentation?

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

Kawasaki disease symptoms? management?

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

Describe the APGAR score and interpret it. (it should be taken at 1 and 5 minutes after birth)

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

Intussusception symptoms? investigation? management?

abdominal pain vomiting currant jelly red stool abdominal ultrasound - target like mass reduction by air insufflation under radiological control,

Key risk factor for Developmental dysplasia of hip? DDH when missed can present as?

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

Neonatal Hypoglycemia risk factors? symptoms management?

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

Slipped upper femoral epiphesis symptoms investigation management complications

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

Osteosarcoma symptoms

- 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

Rubella symptoms? investigations? management?

Cystic fibrosis management

- high calorie high fat diet - pancreatic enzyme supplementation - modulators

Management when concerned about hypoxic brain injury?

Therapeutic cooling