Plant Flashcards
What is the classic triad of Henoch–Schönlein purpura?
Purpura
Joint pain/ Arthritis
Abdominal Pain
What is HSP?
Henoch–Schönlein purpura.
It is a systemic Vasculitis caused by deposition of immune complexes containing IgA
Most common in children under 10 (90%) under 6 (60%)
At what age does the anterior fontanelle usually close?
18-24 months of age
What is most common cause of gastroenteritis in children? (UK)
Rotavirus
Most will have by 5 years and develop immunity
Next most common is adenovirus
What is Intussusception?
Invagination if the proxinal bowel into a dustal segment- usually ileum into caecum through the ileocecal valve
What is common presentation of Intussusception?
3 months- 2yrs
RED CURRENT JELLY stool containing blood and mucus
Paroxysnal colicky pain when child draws legs upward
What are kernig and bardzinski’s signs?
Kernig +ve when thigh is flexed at the hip + knee is at 90• angle. Extension of knee from this postition is painful
Burdzinski +ve when forced flexion of the neck elicits a reflex flexion of the hip and knee and abduction of the leg
What are +ve kernig and burdzinski’s signs suggeative of?
Meningitis
Subarachnoid haemorrhage
Possibly encephalitis
What is pre-hospital setting treatment for meningitis?
IM benzylpenicillin
What is the hospital management of meningitis?
Lumbar puncture to confirm diagnosis
IV ceftriaxone ASAP!
Dexamthasone as adjunct to antibiotic (reduce complications)
What test are run on CSF sample in suspected meningitis?
PCR for virology, pneumococcus, meningitis, glucose, protein, culture and sensitivity , microscopy and gram stain
Children at high risk of sepsis are those with:
Congenital heart disease Significant burn injury Sickle cell Neonates Asplenia Chronic steroid dependency
What is the treatment for moderate/severe croup (aka laryngotrachealbronchitis)
Nebulised adrenaline
Oral dexamethasone 0.15mg/kg as a single dose
Paracetamol
Mutation in what gene causes Cystic Fibrosis and what type of mutation is it?
The CFTR gene
Most common serious autosomal recessive condition in the European Caucasian population (approximately 1/2500 live births)
What is the function of the CFTR Gene?
Codes for the CFTR protein essential to sodium transport channels across epithelial cell membranes. Mutations cause thickening of mucus predisposing to the blockage of pancreatic ducts, vas deferens and recurrent respiratory and sinus infections.
What are neonates tested for when screening for CF?
Immunoreactive Trypsinogen (IRT), this is released from the pancreas, usually in low levels but is usually high in CF- not reliable after 2 weeks of life
How is CF managed?
regular (at least twice daily) chest physiotherapy and postural drainage. Parents are usually taught to do this.
Deep breathing exercises are also useful
high calorie diet, including high fat intake*
vitamin supplementation
pancreatic enzyme supplements taken with every meals
heart and lung transplant
What is hirschprungs disease?
Absence of ganglion cells from myenteric and submucosal plexuses results in neonate not passing meconium
Occurs in 1/5000 births
Full thickness rectal biopsy for diagnosis
What is the treatment for hirschprungs disease?
Initially rectal washout procedure
Then an anorectal pull through procedure
What is a meconium
Meconium is the earliest stool of a mammalian infant. Unlike later feces, meconium is composed of materials ingested during the time the infant spends in the uterus: intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water.
Dark green sludge!
What is Roseola infantum?
A common disease of infancy caused by the human herpes virus 6 (HHV6). It has an incubation period of 5-15 days and typically affects children aged 6 months to 2 years. Treatment supportive
What are the symptoms of roseola infantum?
high fever: lasting a few days, followed by a
maculopapular rash
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen
Define Cerebral Palsy
A disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain. It affects 2 in 1,000 live births and is the most common cause of major motor impairment
Projectile vomiting after every feed that is not settling is suspicious of what in neonates?
Pyloric stenosis
What is pyloric stenosis?
Hypertrophy of the circular pyloric muscles leading to stenosis of the pylorus.
Incidence of 4 per 1,000 live births, 4 times more common in males, 10-15% of infants have a positive family history,first-borns are more commonly affected
What is hand foot and mouth disease?
A self-limiting condition affecting children characterized by vesicles on the palms and soles of the feet, oral ulcers and mild symptomatic unwellness. It is caused by the intestinal viruses of the Picornaviridae family (most commonly coxsackie A16 and enterovirus 71). It is very contagious and typically occurs in outbreaks at nursery
What childhood syndrome has the following features? Micrognathia Low-set ears Rocker bottom feet Overlapping of fingers
Edward’s syndrome , trisomy 18
What childhood syndrome has the following features? Microcephalic, small eyes Cleft lip/palate Polydactyly Scalp lesions
Patau syndrome, trisomy 13
What childhood syndrome has the following characteristics? Learning difficulties Macrocephaly Long face Large ears Macro-orchidism
Fragile X syndrome
What childhood syndrome has the following features? Webbed neck Pectus excavatum Short stature Pulmonary stenosis
Noonan syndrome
What childhood syndrome has the following features?
Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate
Pierre-Robin syndrome or Treacher-Collins syndrome (the autosomal dominant version)
What childhood syndrome has the following features?
Hypotonia
Hypogonadism
Obesity
Prader-Willi syndrome
What childhood syndrome has the following features? Short stature Learning difficulties Friendly, extrovert personality Transient neonatal hypercalcaemia Supravalvular aortic stenosis
William’s syndrome
What are the types of acute lymphoblastic leukaemia ?
common ALL (75%), CD10 present, pre-B phenotype
T-cell ALL (20%)
B-cell ALL (5%)
What is inheritance of haemophilia A?
X linked recessive
What are the signs, in the baby, of maternal alcohol abuse during pregnancy.
Presentation: Intra Uterine Growth Restriction, microcephaly, midfacial hypoplasia, micrognathia, smooth philtrum, microphthalmia, short palpebral fissures, thin upper lip, irritability, ADHD.
Define micrognathia
The jaw is undersized
Define dermoid cyst
Dermoid cysts occur at sites of embryonic fusion and may contain multiple cell types. They occur most often in children.
When can a child go back to school after gastroenteritis infection
48hours after symptoms subside
What is the triad of haemolytic uraemic syndrome?
Haemolytic anaemia
Thrombocytopenia
AKI
How to reduce likelihood of sudden infant death syndrome?
Lie baby flat on back, don’t share bed with baby, don’t bundle the baby up too much with too many quilts/ blankets and breastfeed
What two dangerous types of infection can haemophilus influenza B cause?
Epiglotitis
Meningitis
What are the components of fallot’s tetralogy
Ventricular septal defect, pulmonary artery stenosis, right ventricular hypertrophy, overriding aorta
How much should I feed my baby?
If under a month old 150mL/kg/day
If over a month old 100mL/kg/day
What is the inheritance of Marfan syndrome?
Autosomal dominant (though 25% of cases are spontaneous mutations of FBN1 gene)
What are the features of Marfan syndrome?
Connective tissue disorder-Dislocated lens (ectopia lentis), Aorta weakness leading to aneurysm and aortic dissection also atrial valve regurgitation, mitral valve prolapse, Tall, slender, elongated fingers and toes (arachnodactyly)
What is Hyper obstructive cardiomyopathy ?
Autosomal dominant condition characterized by thickening of Diastolic dysfunction Mitral regurgitation (due to the Venturi effect) Arrhythmia End-stage HOCM results in systolic dysfunction, or “burnt out HOCM”
What is the autism triad of impairments?
Deficits in flexible thinking regarding interests, routines, perspectives and rules
Deficits in understanding how to behave and interact with other people
Deficits in ability to communicate effectively with other people
Treatment for GORD in children?
Sit baby up for 30mins after eating.
Gaviscon
Ranitidine
What is shoulder distocia
Shoulder of baby’s gets stuck on the pubic symphysis. Can cause bruising, broken clavicles and nerve damage.
Define anorexia nervosa
BMI less than 17.5 or weight less than 85 % of predicted based on height
What are the three categories of reasons a child might fail to thrive?
Inadequate calorie intake
Inadequate calorie absorption
Excessive calorie requirement
What is choanal atresia?
Congenital disorder where posterior nasal airway is occluded by soft tissue or bone. Associated with other congenital conditions, cyanosis is worse during feeding
What is the classic presentation of androgen insensitivity?
groin swellings, ‘primary amenorrhoea’ and no public hair
