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Paediatrics (Y4) > Revisions deck (VERY HELPFUL) > Flashcards

Revisions deck (VERY HELPFUL) Flashcards

1
Q

sources of fever

A

otitis media
viral illness:
- viral exanthum e.g. measles
- sesonala influenza
- covid-19
uti
meningitis
pneumonoa
cellulitis
sepsis

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2
Q

how to screen if a chuld is unwell

A

A to E
- RR is the most important first sign to look for

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3
Q

PEWS

A

nursing/parent concern
RR
resp distress
oxygen
heart rate
level of cosncpusness

not temp or BP

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4
Q

point of care tests - remember

A

capillary blood gas
blood glucose
urine dipstix
nasopharngeal aspirate e.g. flu, cobid rsb

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5
Q

complifcations of otitits media

A

hearing loss
balance problem
perforation
mastoiditis
venous sinus thrombosis

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6
Q

maculopapular rashes

A

roseola infantum
slapped cheek
measles (cough, coryza, conjunctivitis)
scarlet fever

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7
Q

vesicular rahses

A

chicken pox - herpes varicella zoster
hand foot and mouth disease
herpes simplex virus- herpes 1
erythema multiform- herpes 1

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8
Q

petechial (<2mm)/ pupuric (>2mm) rash

A

Non blanching
- meningococcal
- Henoch-Schönlein purpura (HSP) - lower limbs due to gaviravity

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9
Q

management of possible sepsis

A
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10
Q

management of possible sepsis

A
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11
Q

kawasaki

A
  • One of the most common vasculitides in children; also occurs in adults.
  • Acute self-limiting an acute self-limiting inflammatory disorder affecting predominantly medium sized arteries, particularly coronary arteries causing aneurysms in 15-25% if untreated.
  • Commonest causes of acquired heart disease in children in developed countries.

Presentation
CRASH AND BURN

Management: (no laboratory investigation included in diagnostic criteria):
Systemic inflammation with mild anaemia, leucocytosis with left shirt and thrombocytosis (end of week 2).
Raised ferritin (acute phase reactant). Needs ECG, CXR and cardiac ECHO.
Treatment: IV Ig; Aspirin - high dose in acute phase followed by low dose maintenance.

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12
Q

viral vs bacterial meningitits

A

viral:
- entervorus
- herpes virus

bacterial
- younger: Neisseria meningiditis (meningococcal), E.coli, Group B strep
- adults: Haemophilus influnzae and streptococcus pneumoniae

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13
Q
A

neisseria meningiditis

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14
Q

cough type. andspecific causes summary

A
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15
Q

examples of increased work of breathing

A

Nasal flaring

Expiratory grunting – increase PEEP

Use of accessory muscles - sternomastoids

Retractions – suprasternal, SC and IC

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16
Q

features of

A

bacterial
- high fever
- pain- pleurisy
- no whezze

viral
- coryzal
- young
- wheeze

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17
Q

features of

A

bacterial
- high fever
- pain- pleurisy
- no whezze

viral
- coryzal
- young
- wheeze

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18
Q

summary of LRTI management

A
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19
Q

UTI urine dipstix and MCS findings

A
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20
Q

management of UTI

A
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21
Q

indication for urianry tract Ultrasound

A

Under 6 months with first-time UTI that responds to treatment – US within 6 weeks.

6 months to 3 years:

  • Atypical UTI- organism
  • Seriously ill.
  • Septicaemia.
  • Failure to respond to suitable antibiotics within 48 hours.
  • Infection with non-E.coli organisms.
  • Poor urine flow.
  • Abdominal mass.
  • Raised creatinine.

Recurrent UTIs

  • 3 or more UTIs with lower UTI.
  • 2 or more UTIs with acute upper UTI (acute pyelonephritis).
  • 1 episode of acute upper UTI and 1 episode of acute lower UTI.
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22
Q

Kocher Criteria for Septic Arthritis

A
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23
Q

transient synovitis vs septic arthritis

A
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24
Q

differential diagnosis of an autrauamtic limp

A
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25
Q

antibiotic prescribing

A
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26
Q

antibiotic prescribing

A
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27
Q

typical clinical features of croup

A

hoarseness
barking cough
stridor

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28
Q

infectious differential for croup

A

Acute epiglottitis
Bacterial tracheitis
Severe LN swelling
Tonsillar abscess
Retropharyngeal abscess

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29
Q

non infectious differential for croup

A

Acute laryngeal oedema (allergy)
Inhaled foreign body
Inhalation of smoke or hot fumes
Trauma to throat
Hypocalcaemia
Psychological (VCD)

30
Q

investigations for bronchiolitis

A
  • Naso-pharyngeal aspirate PCR.
  • Blood gas: assess respiratory status.
  • Blood tests: FBC, CRP rarely helpful. U&E to assess hydration.
  • CXR: only to exclude complications.

clinical diagnosis!

31
Q

complications of bronchiolitis

A

Acute: dehydration, lung collapse, pneumonia, respiratory failure.

Chronic: persistent bacterial bronchiti, bronchiolitis obliterans (adenov)
(Scarring and fibrosis of small airways

32
Q

manaagment of bronchiolitis

A
  • supportive: oxygen, nutirtion, IV fluids

NO SALBUTAMOL

33
Q

management of viral induced wheeze

A

-nebulised salbutamol

34
Q

differentials for wheeze

A
35
Q

examples of chronic asthma treatment drugs

A

LTRA- suidical ideation
theophylline- awful drug

36
Q

causes of central cyanosis in neonates

A

Airway obstruction

  • choanal atresia
  • larygomalacia
  • macroglossia
  • micrognathia or rethrognathia (Pierre-Robin syndrome)

Pulmonary

  • alveolar capillary dysplasia
  • lobar emphysema
  • pneumonoa/PE/ pneumo
  • perissdtent pulmonary hypertension of newborn
  • pulmonary hypoplasia
  • resp distress syndrome
  • transient tachypnoea of the newborn**
37
Q

chonal atresia

A
38
Q

laryngomalacia

A
39
Q

micrognathia (pairee robin sequence)

A
40
Q

congential lobar emphysema

A
41
Q

congenital diaphragmatic hernia

A
42
Q

congneital diaphagmatic hernia

A
43
Q

congenital heart disease presentations at birth

A
44
Q

heart murmurs

A
45
Q

intussusception

A
46
Q

red flags for constipation

A
47
Q

constipation summary

A

: <3 complete stools/week.
Large, infrequent stools (Bristol 3/4).
‘Rabbit droppings’ (Bristol 1)
Overflow soiling: very loose/smelly.
unaware passed.

48
Q

dehyration summary

A
49
Q

presentation of dehydration

A
50
Q

dehydration risk factors

A
51
Q

diarrhoea management

A
52
Q

causes of vomiting in infants

A

Gastro-oesophageal reflux
Feeding problems

Infection:
Gastroenteritis
Upper/lower respiratory tract infection
Whooping cough
Urinary tract infection
Meningitis

Intestinal obstruction
Pyloric stenosis
Atresia – duodenal and other sites
Intussusception
Malrotation/Volvulus
Strangulated inguinal hernia
Hirschprung disease

Inborn error or metabolism
Congenital adrenal hyperplasia
Renal failure

53
Q

causes of vomiting in older children

A

Gastroenteritis
Appendicitis
Intestinal obstruction¶
Intussusception/malrotation/volvulus
Adhesions/foreign body (bezoars)
Coeliac disease
Cyclical vomiting syndrome§
Torsion of the testis

Infection: upper/lower UTI/RTI
septicaemia, meningitis

Migraine§
Raised intracranial pressure

Renal failure
Diabetic ketoacidosis §
Inborn errors of metabolism¶

Alcohol/drug ingestion§
Bulimia/anorexia nervosa§
(¶ - pre-school; § school aged/adolescents)

54
Q

presentation of pyloric stenosis

A

Vomiting is non-bilious and forceful; may become more forceful over time.
Vomiting immediately after feeds; GOR vomiting not forceful and later after feeds.
Infants have strong appetite; hungry after vomiting.

Peristaltic waves in upper abdomen from left to right immediately before vomiting.
Palpable hypertrophied pylorus (known as ‘olive’) – pathognomonic.

55
Q

investigation findigns for pyloric stenosis

A

Blood gas: Metabolic alkalosis

Hypochloraemia Hypokalaemia ± hyponatraemia.

56
Q

management of pylorisic stenosis

A

NBM
rehdyration
Ramstedt pyloromyotomy

57
Q

options for cows milk protein allergy

A
58
Q

assessment for child who is short of age

A

Predicted height:- - (Father’s + Mother’s height/2) + 7cm (boys) or -7cm (girls).
- 9th to 91st centile range: ± 10cm (boys) or 7.5cm (girls).

Screening tests:
* FBC, U&E, LFT.
* Vitamin D
* Coeliac screen
* Thyroid function
* Karyotype (in girls)- Turners
* Bone age – x-ray left wrist and hand
* (Delayed bone maturity: endocrine disorders e.g., growth hormone deficiency
* constitutional delay of growth and puberty)
*

59
Q

cuases of short stature in children

A
60
Q

presentation of down syndrome

A
61
Q

presentation of Turner Syndrome

A
62
Q

classification of headache

A
63
Q

red flags for SoL

A
64
Q

differnntials for suspected seizure

A

Seizures
Pyrexial convulsion
Apyrexial convulsion
Epilepsy

Associated/triggering conditions
Inflammation (meningitis/encephalitis)
Trauma (accidental/non-accidental)
Intoxication/poisoning
Medication/drug withdrawal
Metabolic (hypo-glycaemia, -calcaemia)
Hypoxia/Stroke

Paroxysmal disorders
Breath-holding spells
Reflex anoxic seizures
Syncope
Migraine
Benign paroxysmal vertigo
Reflux (Sandifer Syndrome)
Cardiac arrhythmias

65
Q

status epilpeticus

A

Generalised convulsive SE defined as:

‘generalised convulsion lasting ≥30-minutes’ – or –
‘successive convulsions over 30-minutes so frequent that patient does not recover consciousness between them’

66
Q

investigations for seizures

A

Bedside glucose monitoring in all children.

FBC, U&E, LFT, CRP, BG, Blood culture.
Anticonvulsant levels (if epilepsy).
Toxicology screen (if appropriate).

Plasma ammonia and lactate, serum amino-acids and urine amino- and organic-acids (seek metabolic disorder).

CT head (if NAI/SOL suspected).

ECG in all with prolonger seizures – rule out prolonged QT-syndrome.

67
Q

epilepsy syndromes

A
68
Q
A

immune thrombocytopaenic purpura
- no need for treatment

69
Q
A

nephrotic syndrome

70
Q

neonatal jaundice classification

A
71
Q

aetiology of neonatal jaundice

A
72
Q

phototherapy for jaundice

A

Paediatrics (Y4) (42 decks)

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