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4th year Paeds > select > Flashcards

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1
Q

In constipation after initial disimpaction, how long should stools be kept soft for?

A

3-6m

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2
Q

croup all children should get what rx

A

single dose dex po

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3
Q

coryza and mild fever –> dry cough –> breathless, wheeze, crackles.

Decreased feed

A

Bronchiolitis

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4
Q

Bronchiolitis pathogen?

A

RSV

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5
Q

Bronchiolitis age

A

<1y

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6
Q

coryza, fever–> stridor –> barking cough, wheeze and hoarse

A

Croup

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7
Q

Croup age

A

6m-2y

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8
Q

Who should be admitted in croup

A

mod/sev/<6m

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9
Q

Epiglottitis age

A

1-6y

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10
Q

What do contacts get in epiglottitis

A

Rifampicin prophylaxis

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11
Q

Cold agglutins indicate what?

A

Mycoplasma pneumonia

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12
Q

What do cold agglutins cause?

A

Haemolytic anaemia

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13
Q

4w old with stridor?

A

Laryngomalacia

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14
Q

Do you treat wheezy baby with or without asthma differently?

A

no

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15
Q

a wheeze developed <2y is likely to persist into childhood? t/f

A

false likely to become asymptomatic mid childhood

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16
Q

Assessing probability of asthma in an older child

A

PEFR measurements 2-4w, take mean variability- if >20% = positive test

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17
Q

Unsure of asthma diagnosis wyd?

A

Either watchful waiting with review, or monitored initiation of rx (6-8w bronchodilator then diagnose or not)

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18
Q

asthma maintenance steps

A
  1. SABA
    • very low dose ICS
  3. +LABA (or LTRA)
  4. ±LABA, increase ICS to low, add LTRA/LAMA (refer if <5yo)
  5. Increase ICS to medium or add 4th drug e.g. theophylline and refer
  6. Daily steroid tabs, maintain medium ICS
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19
Q

Example of ICS in paeds

A

fluticasone or budesonide

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20
Q

Moderate acute asthma =

A

PEFR 50%

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21
Q

Acute severe asthma?

A

sentences

33-50%

HR >140/125 (under/over 5yo)

RR>40/30

22
Q

Life threatening asthma

A

SpO2 <92%

PEF <33%

Silent chest, cyanosis etc

23
Q

Management acute asthma

A

O2

Salbutamol inh in mild/mod 2-10puffs/10-20m

neb in AS/LT- O2 driven, 2.5-5mg/20-30min

Prednisolone (10mg <2y, 20mg 2-5y, 30-40mg >5y) for 3 days

Ipratropium if refactory 250mcg added to the salbut nebs every 20-30m

24
Q

Length of whooping cough

A

6-8w

25
Q

Erythromycin is only effective at what stage of whooping cough?

A

Before the whoop is heard (paroxysmal stage) so give early in the catarrhal stage

26
Q

Normal APGAR at one minute

A

7-10

27
Q

If baby isn’t breathing at 1m what is done?

A

Head to neutral and 5 inflation breaths

28
Q

what if not breathing after first 5 inflation breaths?

A

Recheck head position

Consider 2 person airway control or other airway manoeuvres

Repeat inflation breaths

29
Q

What do you do once breaths are successful but HR<60BPM?

A

Chest compresssions 3:1 breath

30
Q

How often do you reassess HR

A

30s

31
Q

Main cause gastroenteritis

A

Rotavirus

32
Q

Recommended volume of formula feed?

A

150ml/kg/24hr (given in 6-8 daily feeds)

33
Q

Rx GORD

A

Only if FTT/faltering

Check volume of feed

1st line Thickening agents

2nd line gaviscon

3rd PPH/H2 receptor antag

General: upright position, wind

Surgical fundoplication if recurrent aspiration

34
Q

left subclavicular thrill

continuous ‘machinery’ murmur

large volume, bounding, collapsing pulse

wide pulse pressure

heaving apex beat

A

PDA

35
Q

ejection systolic murmur, fixed splitting of S2

A

ASD

36
Q

harsh pan-systolic murmur at lower left systolic edge which is louder in smaller defects

Parasternal thrill

A

VSD

37
Q

Boot shaped heart and oligaemic lung fields on CXR

A

Tetralogy

38
Q

Rx PDA

A

Prostaglandin inhibitors- NSAIDs

39
Q

when do you give babies prostaglandins?

A

In transposition of great vessels to keep DA open

40
Q

Weak femoral pulses, BP higher in arms

A

Coarcatation of the aorta

41
Q

Cardiac assoc with Turners

A

Coractation and bicuspid valves

42
Q

Hand preference before ___ is worrying

A

10m

43
Q

when can they sit?

A

6m

44
Q

When do children get stranger anxiety

A

7m

45
Q

When do children drink from cup

A

15m

46
Q

When is attachment behaviour seen

A

6-36m

47
Q

What are insecure avoidant infants like

A

Suppress emotion

48
Q

What are securely attached infants like

A

distressed in absence of caregiver, happy when return

49
Q

What are insecure ambivalent attachment infants like

A

distressed on separation, angry on reunion

50
Q

What are disorganised attached children like

A

mix of no emotion/distressed and angry

51
Q

Abnormalities must be present before ___ for a diagnosis of ASD

A

36m

4th year Paeds (13 decks)

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