Spot Diagnosis Flashcards
I am a condition that arises from damage to the immature brain.
Cerebral Palsy
I am a condition arising from damage to the immature brain. You are the doctor what is the condition given that there are 4 main forms of this condition
spastic (70%): hemiplegia, diplegia or quadriplegia
dyskinetic
ataxic
mixed
which condition am I?
Cerebral Palsy
I am a condition arising from damage to the immature brain. You have finished the history and examination and go on to make a diagnosis.
The medical management for my condition includes spasticity medication such as oral diazepam, oral and intrathecal baclofen, botulinum toxin type A, orthopaedic surgery selective dorsal rhizotomy
Which condition am I?
Cerebral Palsy
- M>F
- 5-10% Family history of parents
- Projectile vomiting at 4-6 weeks of life
- Diagnosis is made by test feed or USS
- Treatment: Ramstedt pyloromyotomy (open or laparoscopic)
- Hypochloremic Hypokalaemic metabolic alkalosis
which condition am I?
Pyloric stenosis
- Proximal to or at the level of, ileocaecal valve
- 6-9 months age
- Colicky pain, diarrhoea and vomiting, sausage shaped mass, red jelly stool.
- Treatment: reduction with air insufflation
Which Condition am I?
Intussusception
Jaundice > 14 days
Increased conjugated bilirubin
Urgent Kasai procedure
Which condition am I?
Biliary atresia
emergency department
4-year-old child
sore throat which has rapidly become worse over the last 3 hours,
a high fever and has begun drooling from the sides of his mouth. His mother admits he has missed some of his vaccinations
soft high pitched sound is just audible on inspiration
Which condition am I?
acute epiglottitis
Haemophilus influenza type B
18-month-old
Three days ago he started with fever, cough and rhinorrhoea
wheezy
On examination his temperature is 37.9ºC, heart rate 126/min, respiratory rate 42/min and a bilateral expiratory wheeze
inhaler has made little difference to the wheeze
viral-induced wheeze
a degenerative condition affecting the hip joints of children, typically between the ages of 4-8 years
5 times more common in boys
hip pain: develops progressively over a few weeks
x-ray: early changes include widening of joint space, later changes include decreased femoral head size/flattening
Perthes’ disease
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions
Patau syndrome (trisomy 13)
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
Edward’s syndrome (trisomy 18)
Hypotonia
Hypogonadism
Obesity
syndrome has no cure
Prader-Willi syndrome
NICE issued guidance in 2010. Management:
look for possible underlying causes/triggers (e.g. Constipation, diabetes mellitus, UTI if recent onset)
advise on fluid intake, diet and toileting behaviour
reward systems (e.g. Star charts). NICE recommend these ‘should be given for agreed behaviour rather than dry nights’ e.g. Using the toilet to pass urine before sleep
Nocturnal Enuresis
The commonest murmur heard in children
- Soft
- Systolic
- Asymptomatic
- Left sternal edge
and no added heart sounds
Innocent murmur
Example:Increased flow across branch pulmonary artery, Stills murmur, Venous hum
Long Systolic Murmur
VSD
Overriding Aorta
Right Ventricular Hypertrophy
Pulmonary Stenosis (right ventricle blood vessel narrowing)
Tetralogy of Fallot
Right Lateral thoracotomy scar
right modified Blalock Taussig Shunt (RMBTS)
Tetralogy of Fallot