Radiology and Immunology Flashcards
R: How does Paeds radiology/imaging differ from adults
1) Growth plates
2) Size
3) Skull sutures (Fontanels..)
4) Ossification
5) Congenital problems (Detrocardia, osteogenesis imperfecta)
What circumstances would indicate an abdo XR?
1) Abdominal distension e.g. obstruction
2) Abdominal pain of unknown cause
3) Constipation
What are examples of live attenuated vaccines?
MMR
BCG
Rotavirus (oral vaccine)
What are examples of inactivated vaccines?
Influenza
Diptheria
What are 5 vaccine preventable diseases?
1) Mumps, Measles, Rubella
2) Diptheria
3) Whooping cough
4) Polio
5) Tetanus
What virus causes croup?
Parainfluenza
What are 2 respiratory infections common in Paeds?
1) Bronchiolitis
2) Croup
What are the main signs of Bronchiolitis?
1) Recurrent cough
2) Noisy breathing
3) Crackle/wheeze
4) Use of resp. muscles
What virus causes Bronchiolitis?
MAIN: RSV
Others: Rhinovirus, influenza, adenovirus, parainfluenza
What is croup aka?
Laryngotracheobronchitis
(Trachea, Larynx and Bronchi affected)
LP: Raised proteins and lowered glucose. What type of infection?
Bacterial
What are the main signs of immune deficiency?
1) Frequent infections
2) Infection with unusual organisms
3) Severe infections
4) Failure to thrive
What is a septic screen?
Tool used to check for infection (particularly Meningitis)
1) Urine sample
2) LP
3) Blood tests
Why does a child with meningococcal septicaemia develop rash?
1) Blood toxins damage vessels
2) Vasculitis formed
3) Bleeding into SubCut Tis
4)Thrombosis and DIC -> Purpuric Rash
What can be given as meningitis prophylaxis?
1) Rifampicin
2) Ciprofloxacin
What are common URTI?
1) MOUTH: Rhinitis
EAR: Otitis Media
2) THROAT: Tonsillitis
Pharyngitis, Laryngitis
What are common LRTI?
1) Bronchitis
2) Croup
3) Epiglottitis
4) Tracheitis
5) Bronchiolitis
6) Pneumonia
Why would a Bronchiolitic pt be tachypnoeic and hypoxic?
Inflammation of area where gas exchange takes place impairing function
(Bronchitis not as above this in conducting area)
What are 3 signs of Bronchitis?
1) Cough (Chronic)
2) Cough most worse at night
3) No fever
Why are infants more highly susceptible to descending infections?
Infants have a poor innate immune response and so are more susceptible to descending infections.
What are LRTI caused by RSV?
1) Bronchiolitis (Acute)
2) Wheezy Bronchitis
3) Pneumonia
4) Croup
5) Asthma exacerbation
What antibiotics would you prescribe empirically to reduce the risk of neonatal infections in a pre-term baby?
Benzylpenicillin (50mg/kg BD).
Gentamicin (5mg/Kg OD).
What bacteria commonly causes meningitis in children?
-Neonates: GBS, E.coli, lysteria monocytogenes.
- 1m -> 6 years: Neisseria meningitidis, S.pneumoniae, H.influenzae.
- > 6 years: Neisseria meningitidis.
What investigations /treatment might you do on a child who you suspect has meningitis?
INV: Thorough history and examination, Blood cultures, Lumbar puncture, EDTA blood for PCR.
Treat: IV ceftriaxone (80mg/kg/od) or cefotaxime (50mg/kg/tds).
- Prophylaxis is needed to prevent further spread.
Dexamethasone is given to reduce swelling.
What are bacterial organisms that commonly cause pneumonia in children.
Group B strep in neonates.
S.pneumoniae.
H.influenzae.
K.pneumoniae.
M.pnuemoniae.
What are some signs of pneumonia?
Fever.
Miserable.
Rapid breathing.
Cough.
Poor feeding.
Lethargy.
What investigations might you do in a child who you suspect has pneumonia?
CXR: look for consolidation.
Blood cultures.
It is often difficult to get a sputum sample.
What is treatment plan for pneumonia?
If acutely unwell: IV benzylpenicillin.
If stable: PO amoxicillin.
What is most common cause of UTI?
E. Coli
What are the main signs of UTI in children?
Fever.
Miserable.
Vomiting.
Dysuria.
What investigations done for a UTI?
Urine dip.
MCS on clean catch urine. A sample can also be obtained using an in-out catheter.
USS KUB.
DMSA - renal scarring.
MCUG - reflux.
How would UTI be treated if caused by ESBL E. Coli?
You would give meropenem.
ESBL bacteria are resistant to all penicillins and cephalosporins.
