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Teaching Flashcards

1
Q

Difference between acrocyanosis and true cyanosis?

A

Acrocyanosis is vasospasm of peripheral BV mainly hand and feet effected whereas true cyanosis everywhere will be effected

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2
Q

If a baby is breathing rapidly what investigations need to be performed?

A

IEM - blood gas, urine sample, urinalysis, BM
Sepsis - blood culture, FBP, septic screen
Lumbar puncture
CXR
CRP
BM
Any hepatomegaly

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3
Q

2 investigations for coarctation of the aorta?

A

ABPI, femoral pulses

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4
Q

Why are retinas checked before babies are discharged?

A

Retinal blastomas

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5
Q

Differentials for early tailing on growth chart?

A

Heart disease, metabolic or neglect, 6 months tailing suggests coeliac

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6
Q

Chronic heart disease presentation in older children?

A

Growth tailing, breathless on exertion, murmur, femoral pulses off, respiratory infections, cyanosis, hypertension

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7
Q

How does aortic stenosis usually present?

A

Chest pain

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8
Q

What is a stills murmur?

A

blood resonating through papillary muscles

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9
Q

What is a venous hum?

A

Blood resonating from head and neck vessels

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10
Q

When measuring height of a child what plane should the head be in?

A

Frankfurt plane

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11
Q

If a child has hypothyroidism what are they started on?

A

Thyroxine

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12
Q

What does GH stimulate release from the liver and what does this do?

A

IGF-1 which stimulates fat, bone and metabolic effects on the whole body

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13
Q

Symptoms of Turner Syndrome?

A

Increase nuchal fold, coarctation of aorta, horseshoe kidney, recurrent ear infections, ovaries havent grown, dont make oestrogen

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14
Q

Conditions that can cause a child to grow too fast?

A

Hyperthyroidism, Kleinefelter Syndrome, Fragile X Syndrome, Marfans

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15
Q

Management of Kleinefelter Syndrome?

A

Testosterone and maintenance treatment

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16
Q

How will babies who have congenital adrenal hypoplasia appear at birth?

A

Ambiguous genetalia, lack of aldosterone and cortisol shunts pathway causing increased testosterone

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17
Q

Condition associated to obesity in early childhood?

A

Prader-Willi Syndrome

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18
Q

How do you calculate fluid bolus for a child? with dka?

A

kg x 20mls (x10mls for dka)

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19
Q

What 2 situations do you not use 20mls/kg in fluid bolus?

A

DKA or trauma

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20
Q

How do you work out fluid deficit in a child?

A

% dehydrated (0/5/8) x weight in kg x 10 (-bolus)

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21
Q

Maintenance fluid in a child, first 10kg, second 10kg, anything over 20kg?

A

First 10kg = 4ml/kg/hr
second 10kg = 2ml/kg/hr
over 20kg = 1ml/kg/hr

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22
Q

When would you fluid restrict rather than give full maintenance fluid?

A

Hyponatraemia in cases of sepsis, meningitis, bronchiolitis, renal problems, CNS, vomiting

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23
Q

What is an ideal starting fluid for children?

A

0.9% saline, 5%dextrose

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24
Q

Define neonate

A

birth to 28 days

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25
Q

Preterm is classified as what?

A

Before 37 weeks

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26
Q

Extremely preterm is classified as what?

A

before 28 weeks

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27
Q

Low birth weight classified as below?

A

2.5kg

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28
Q

Very low birth weight classified as below?

A

1.5kg

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29
Q

Extremely low birth weight classified as below?

A

1kg

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30
Q

Gut issue suffered in premature babies?

A

Nectrotizing fasciitis

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31
Q

Brain issue that can be suffered in premature babies?

A

Intra-ventricular haemorrhage

32
Q

What questions should you ask the parents of a sick child?

A

UO, wet nappies, bowel motions (pain/blood), behaviour, lethargy, playing

33
Q

Observations needed on a sick child?

A

Distended neck veins, SOB, wheeze, accesory muscles, colour/cyanosed, agitated, rash, limp, dehydrated

34
Q

Charts used to monitor children wellbeing?

A

PEWS

35
Q

Initial airway symptoms of foreign body occlusion?

A

Vomiting, coughing, distress, stridor

36
Q

What would you look for in C section of child ABCD approach?

A

HR, murmur, BP, pulses, liver edge, previous cardiac scars

37
Q

Most common reason for seizure in child?

A

Febrile seizure

38
Q

Disability section of ABCD approach in child?

A 
behaviour
lethargy
posture
pupils
seizures
39
Q

If there is found to be decorticate (flexor) posturing in a child what is most likely effected?

A

Cervical spinal tract or cerebral hemisphere

40
Q

If there is found to be decerebrate (extensor) posturing in a child what is most likely effected?

A

Midbrain or pons

41
Q

E section of ABCDE?

A

exposure - rash, bruising, infections, mouth for scarlet fever and slapped cheek, sepsis, abuse

42
Q

What happens in necrotising fasciitis?

A

gut lining breaks down, distended and red, hyperosmolar feeds, drain bowel perforations

43
Q

What drugs link to gastroschisis?

A

cocaine, tobacco

44
Q

What happens in exomphalos? assocaited with?

A

First trimester bowel moves into the umbilical cord

Diabetes, turners

45
Q

What are babies with diaphragmatic hernias prone to?

How do they present?

A

Pulmonary hypertension, primary shunting

Initially good sats, then ductus arteriosus opens again, shunting, deoxygenated blood around body

46
Q

Jejunal atresia associated to what?

Usually pathophysiology of it?

A

Trisomy 21

Decreased blood supply, ischaemia, no bacteria so scars

47
Q

Volvulus neonatarum symptoms?

A

Copious vomiting of green bile

48
Q

3 main causes of lower GI obstruction in newborns?

A

CF
Meconium ileus
Hirschsprung disease

49
Q

VACTERL stands for? week what of development?

A 
vertebral 
anorectal
cardiac
tracheo-oesophageal
esophageal atresia
renal
limb abnormalities
Occur at week 11 of development
50
Q

Complication that babies usually face due to spina bifida?

A

Constant bladder stimulation - renal damage
Need intermittent catheterisation
Take folate

51
Q

what 2 hormones cause penis formation?

A

Testosterone and DHT

52
Q

Why is hypospadias becoming more common?

A

Pesticides/insecticides/hormones in meat, antihistamines

53
Q

What can form between back fo tongue and where thyroid descends?

A

thyroglossal cyst

54
Q

If epidermoid cyst occurs between brows then what needs to be done?

A

Intracranial scanning as could be mass or within sinuses

55
Q

Balanitis xerotic obliterans?

A

Lichen sclerosis in children, premalignant, need circumcised

56
Q

How can you easily test between inguinal hernia and hydrocoele? Difference?

A

Light cant be shone through hernia, hernia more risk and complications needing treatment, hydrocele go away by itself

57
Q

What age is a referral made for undescended testes?

A

3 months

58
Q

Blue berry muffin sign?

A

Baby destroying neuroblastoma malignant tumour and depositing in t cells within the skin

59
Q

If there is air in the gut with a baby presenting with oesophageal atresia what must be present?

A

Tracheooesophageal fistula linked to the lower oesophageal pouch

60
Q

Double bubble sign on xray is indicative of what?

A

Duodenal atresia

61
Q

Pneumatosis intestinalis? sign in what condition?

A

air trapped in bowel wall, sign of necrotising fasciitis

62
Q

Most common cause of mortality in a baby who suffered congenital diaphragmatic hernia?

A

hypoplasia of the lungs

63
Q

What congenital abnormality is usually present in babies suffering meconium ileus?

A

CF

64
Q

Symptoms of intussusception?

A

vomiting, PR bleeding, pain

65
Q

How does hypertrophic pyloric stenosis present?

A

non-bilious vomit, pain, 6 weeks old

66
Q

Rigler’s sign?

A

when air is present on the insane and outside of the bowel wall, abnormal

67
Q

Causes of acute abdomen?

A

Testicular torsion, NSAP, acute appendicitis, malrotation of the intestines, UTI, pneumonia, DKA

68
Q

Presentation of infant with acute appendicitis?

A

Unwell for few days, diarrhoea, septic, dehydrated

69
Q

3 early complications of appendicectomy?

A

Abscess, ileus, wound infection

70
Q

Findings for NSAP?

causes?

A

central pain, no radiation, disappears in 24-36 hours
Viral
Colonic spasm
Intermittent intussusception

71
Q

Constipation symptoms?

CAuses?

A

runny stools, multiple stools, difficult to pass, palpable left colon
Diet, lack of fluids, lack of exercise, toilet training bad

72
Q

2 investigation for UTI?

A

dipstick them MSU for O&S

73
Q

What is Dietl’s Crisis?

A

Flank pain, vomit, severe collapse

Pelvic outlet obstructed by renal vessel crossing

74
Q

When does midgut return to abdominal cavity from umbilical cord?
What can occur as this happens?
FIndings?

A

10 weeks gestation
Intestinal malrotation, volvulus of SI, ischaemia
Bilious vomiting, gasless abdomen, guarding, tenderness, pain

75
Q

How does pneumonia present in a child?

A

abdominal pain, RR, recent infection

Need xray

76
Q

3 dangers in abdominal pain?

A

bilious vomiting, dka, hyponatraemia

Paediatrics (20 decks)

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