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Child Healthcare Block > Presentations & Differential Diagnosis > Flashcards

Presentations & Differential Diagnosis Flashcards

1
Q

A child is brought to A+E with acute onset abdominal pain. What is the most common surgical cause of acute abdo in children?

A

Appendicitis

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2
Q

A child is brought to A+E with acute onset abdominal pain. What is the most common non-surgical cause of acute abdo in children?

A

Gastroenteritis

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3
Q

A neonate is brought to A+E with persistent crying and difficulty feeding. What might be wrong?

A

The child might have acute abdominal pain

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4
Q

How does acute abdominal pain present in a child who can talk?

A

They tell you, duh

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5
Q

What symptoms are important to ask about when taking an acute abdomen history in a child?

A

Vomiting, diarrhoea, fever, groin pain, urinary symptoms, bowel symptoms inc. bloody diarrhoea, vaginal discharge.

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6
Q

What sign might a baby have to indicate pain?

A

Abnormal facial expression

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7
Q

What are we testing when we ask a child to suck their abdomen in and blow it out?

A

To check for the level of the pain and exclude peritonitis if they do it without pain.

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8
Q

What are the medical causes of acute abdominal pain for infants?

A

Gastroenteritis, UTI, constipation.

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9
Q

What are the medical causes of acute abdominal pain for children aged 2-5?

A

Gastroenteritis, UTI, and constipation.

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10
Q

What are the medical causes of acute abdominal pain for children aged 6-11?

A

Gastroenteritis, UTI, and constipation.

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11
Q

What are the medical causes of acute abdominal pain for children aged 12-18?

A

Gastroenteritis, UTI, and constipation.

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12
Q

What are the surgical causes of acute abdominal pain for infants?

A

Intussusception, volvulus, incarcerated hernia, Hirschsprung’s

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13
Q

What tool can be used to assess the need for further investigation of abdominal pain?

A

Paediatric appendicitis score (PAS)

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14
Q

What are the other non-surgical causes of acute abdominal pain for children aged 12-18?

A

Dysmenorrhoea, DKA, mittelschmerz, threatened abortion, ectopic pregnancy, IBD, adrenal crisis, PID

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15
Q

What are the surgical causes of acute abdominal pain for children aged 2-5?

A

Appendicitis, intussusception, volvulus, trauma

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16
Q

What are the surgical causes of acute abdominal pain for children aged 6-11?

A

Appendicitis, trauma

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17
Q

What are the surgical causes of acute abdominal pain for children aged 12-18?

A

Appendicitis, trauma, ovarian torsion, testicular torsion

18
Q

What are the other non-surgical causes of acute abdominal pain for infants?

A

Infantile colic

19
Q

What are the other non-surgical causes of acute abdominal pain for children aged 2-5?

A

Mesenteric lymphadenitis, HSP, DKA, Sickle cell crisis

20
Q

What are the other non-surgical causes of acute abdominal pain for children aged 6-11?

A

Mesenteric lymphadenitis, HSP, DKA, Sickle cell crisis, pneumonia, functional pain, abdominal migraine.

21
Q

What is the PAS?

A

Score designed to show if abdominal pain needs further assessment in children.

22
Q

What scores points on the PAS?

A

Migration of pain (1), anorexia (1), N+/or vomiting (1), RLQ pain (2), cough/percussion/hopping tenderness (2), fever (1), leukocytosis or neutrophilia (1 each)

23
Q

What 2 socially concerning things would make the differential list for an acute abdomen?

A

Drug use and child abuse.

24
Q

A child is brought to A+E with a high pitched whistling sound when they breath out. What 4 ways can this occur?

A

Bronchospasm, mucosal lining swelling, excessive secretions, or inhaled foreign body.

25
Q

A child is brought to A+E with a high pitched whistling sound when they breath out. They were previously playing with some lego, and then all of a sudden this noise started. What is your top differential?

A

Inhaled foreign body, probably a bit of lego

26
Q

When in wheezing least common in childhood?

A

In the immediate neonatal period

27
Q

A child is brought to A+E with a high pitched whistling sound when they breath out. This occurred after a P.E lesson in which they did the beep test. What is your top differential?

A

Exercise induced wheeze ?asthma

28
Q

What is a frequent cause of wheeze in pre-school children?

A

Viral/bacterial URTIs e.g. croup, bronchiolitis, cold/flu

29
Q

What GI problem could cause a wheeze in a child?

A

Gastro-oesophageal reflux

30
Q

A child with a wheeze comes to A+E. What red flags would indicate the need for immediate assessment and care?

A

Poor feeding, cyanosis, respiratory distress, drowsiness, poor response to treatment

31
Q

What does a wheeze starting perinatally suggest?

A

A structural abnormality

32
Q

What kind of structural abnormality might cause a perinatal wheeze?

A

Tracheo-oesophageal fistula, heart failure/congenital heart disease, extrinsic airway compression, tracheobronchomalacia

33
Q

How is a transient wheeze in infancy managed?

A

Short term inhaled bronchodilators, treat the cause if possible.

34
Q

What investigations might be necessary for a child presenting with a wheeze?

A

CXR if foreign body, structural abnormality, or pulmonary mass/infiltrate suspected, swaet test for CF, allergy test, Barium swallow, spirometry if over 6 years old.

35
Q

What are the main priorities when first assessing a pt with vomiting or diarrhoea?

A

Presence and degree of dehydration, and underlying cause especially if life-threatening

36
Q

What are some of the more sinister causes of vomiting?

A

DKA, meningitis, subarachnoid, RICP, bowel obstruction, malignancy, peritonitis, torsion (test/ovarian)

37
Q

What are the consequences of untreated vomiting?

A

Dehydration, metabolic alkalaemia, hyponatraemia, hypokalaemia, haematemesis

38
Q

What are the consequences of untreated diarrhoea?

A

Dehydration, hypokalaemia

39
Q

A child comes to the GP with it’s mother because they have been having back pain. How common is nonspecific back pain in children?

A

Depends on population, but can be up to 2/3s of children at some point.

40
Q

When is back pain most common in children?

A

Times of rapid growth, so more common with increasing age

41
Q

Which sports is back pain most associated with?

A

Gymnastics, dancing, american football, diving, wrestling, rowing, rugby

Child Healthcare Block (17 decks)

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