Sick Child

Question 1

anatomical differences in children compared to adults

Answer 1

• high anterior larynx and floppy epiglottis
• flexible ribs (more difficult to break)
• blood volume 80mls/kg
• HbF physiological jaundice

Question 2

common respiratory problems in a child

Answer 2

bronchiolitis
croup
asthma
pneumonia

Question 3

causes of bronchiolitis (virus so viral causes)

Answer 3

RSV
adenovirus
rhinovirus

Question 4

presentation of bronchiolitis

Answer 4

cough
crackles (increased secretions)
poor feeding > poor growth
apnoea
secretions (wet mouth, etc.)

Question 5

management of bronchiolitis

Answer 5

oxygen
NG tube
CPAP (caution)

Question 6

define croup

Answer 6

larygnotracheobronchitis

patient’s are not too unwell despite airway narrowing

Question 7

presentation of croup

Answer 7

stridor (inspiratory whoop)
chest wall collapses on breathing in
snotty
cough
noisy chest sounds

Question 8

causes of stridor

Answer 8

croup
epiglottitis (H. influenza B)
bacterial tacheitis
foreign body

Question 9

diagnosis of croup

Answer 9

clinical

XR shows narrowed trachea and hypopharynx distension

Question 10

management of croup

Answer 10

steroids

Question 11

presentation of asthma

Answer 11

atopic with eczema, hayfever and food allergies

wheeze (consider episodic wheeze)

Question 12

diagnosis of asthma

Answer 12

IgE

often given inhalers as spirometry and PF cannot be done until 7

Question 13

causative organism for pneumonia in neonates

Answer 13

group B strep

can be viral

Question 14

CNS problems in childhood

Answer 14

meningitis

encephalitis

Question 15

presentation of encephalitis

Answer 15

focal seizures
focal weakness
personality change

Question 16

meningitis presentation

Answer 16

non-blanching rash (tumblr test)
can have no rash
bacterial or viral

Question 17

diagnosis of CNS problems

Answer 17

lumbar puncture

imaging

Question 18

causes of fits and faints

Answer 18

meningitis 
febrile seizures (only in children, reaction to temperature, grow out of it by 6)
vasovagal episode
reflex anoxic seizure
breath holding attacks
behavioural episodes
epilepsy
arrhythmias

Question 19

common GI/UG presentations

Answer 19

viral gastroenteritis
GI obstruction (pyloric stenosis, volvulus, intussusception and malrotation)
appendicitis (older children)
testicular torsion

Question 20

cardiac problems in childhood

Answer 20

congenital heart disease
arrhythmias (WPW= ablate when 4-5)
bacterial endocarditis

Question 21

management of ill child on admission

Answer 21

NPEWS
sepsis 6
ABCDE