Sick Child I Flashcards
What are some important features of the anatomy of children?
Infants have relatively large head and prominent occiput
Sitting height is proportionally more
Relatively large surface area compared to volume
High anterior larynx/floppy epiglottis, more flexible ribs
What is the average blood volume of infants?
80ml/kg = foetal Hb at birth
What are the most common reasons for children to present to doctors?
Bronchiolitis, URTI and croup = 28% Gastroenteritis = 8.8% Seizures/epilepsy = 6.6% Pneumonia or LRTI = 6.2% Asthma = 5.7%
What is the most common reason for acute illness in children?
Sepsis = varying presentation, treatment is supportive/antimicrobial
What is bronchiolitis?
Acute inflammatory injury to the bronchioles caused by viral infection = supportive treatment
What is croup?
Viral larygnotracheobronchitis = treated with steroids
What is the most common reason for a wheeze in children?
Asthma = important to remember that there are other causes though
What are some features of pneumonia in children?
Occurs at any age, different pathogens are more common at different ages, may be viral
What are some conditions that affect the CNS?
Meningitis = bacterial and viral
Encephalitis = commonly viral
Presentations and findings may vary at different ages
What investigations are done for CNS illnesses in children?
Lumbar puncture
Imaging
What are some common causes of fainting, fitting and funny turns in children?
Febrile seizures, vasovagal episode, reflex anoxic seizure, breath holding attacks, behavioural episodes, epilepsy, arrhythmias
What is meant by saying accidents and trauma in children are often age specific?
Certain injuries are associated with particular age groups (i.e broken bones aren’t associated with non-mobile babies)
What are some common accidents and causes of trauma in children?
RTA, trampoline incidents, sports injuries, burns, ingestion, drowning/near drowning, choking, NA injury
What is the initial management for children suffering from trauma?
ABCDE approach
What are some things to remember about non-accidental injuries?
Must always be considered
Clues are in the history
First priority is safety and well-being of the child
What are some GI and urogenital reasons for children presenting?
Viral gastroenteritis
GI obstruction
Testicular tortion
UTI
What are some causes of GI obstruction in children?
Congenital pyloric stenosis, volvulus, intussusception and malrotation (in infants)
What may be a cause of an acute abdomen in an older child?
Appendicitus
What must be considered in a child with recurrent UTIs or UTIs from a young age?
Abnormal renal tract
What are some causes of CV disease in children?
Congenital heart disease (present with cyanosis/heart failure), supraventricular tachycardia, bacterial endocarditis (rare but severe)
Why may a child wheeze if they don’t have asthma?
Child had bronchiolitis when they were little and now wheeze every time they get a cold
How does epiglottitis present?
Stridor, systemically unwell, drooling
What are the differentials for stridor?
Croup, foreign body, epiglottitis, bacterial tracheitis,
How does encephalitis present?
Seizures, personality changes, focal weakness
Do you do lumbar punctures for suspected meningitis?
No = investigate and treat as for sepsis
What is the tumbler test for?
Rash due to meningococcaemia = rash doesn’t blanch when glass is placed around it
In what age group are febrile seizures most common?
Babies 18 months old = lasts under five minutes, goes stiff and shakes, due to high temperature
When do most children grow out of febrile seizures?
By age 6
What investigation should always be done in a child that is having funny turns?
Heart tracing = incase of long QT syndrome
What age group is pyloric stenosis most common in?
Babies about 6 weeks old = skinny, starving, vomiting everything back up
