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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
Preterm is classified as what?
Before 37 weeks
26
Extremely preterm is classified as what?
before 28 weeks
27
Low birth weight classified as below?
2.5kg
28
Very low birth weight classified as below?
1.5kg
29
Extremely low birth weight classified as below?
1kg
30
Gut issue suffered in premature babies?
Nectrotizing fasciitis
31
Brain issue that can be suffered in premature babies?
Intra-ventricular haemorrhage
32
What questions should you ask the parents of a sick child?
UO, wet nappies, bowel motions (pain/blood), behaviour, lethargy, playing
33
Observations needed on a sick child?
Distended neck veins, SOB, wheeze, accesory muscles, colour/cyanosed, agitated, rash, limp, dehydrated
34
Charts used to monitor children wellbeing?
PEWS
35
Initial airway symptoms of foreign body occlusion?
Vomiting, coughing, distress, stridor
36
What would you look for in C section of child ABCD approach?
HR, murmur, BP, pulses, liver edge, previous cardiac scars
37
Most common reason for seizure in child?
Febrile seizure
38
Disability section of ABCD approach in child?
``` behaviour lethargy posture pupils seizures ```
39
If there is found to be decorticate (flexor) posturing in a child what is most likely effected?
Cervical spinal tract or cerebral hemisphere
40
If there is found to be decerebrate (extensor) posturing in a child what is most likely effected?
Midbrain or pons
41
E section of ABCDE?
exposure - rash, bruising, infections, mouth for scarlet fever and slapped cheek, sepsis, abuse
42
What happens in necrotising fasciitis?
gut lining breaks down, distended and red, hyperosmolar feeds, drain bowel perforations
43
What drugs link to gastroschisis?
cocaine, tobacco
44
What happens in exomphalos? assocaited with?
First trimester bowel moves into the umbilical cord | Diabetes, turners
45
What are babies with diaphragmatic hernias prone to? | How do they present?
Pulmonary hypertension, primary shunting | Initially good sats, then ductus arteriosus opens again, shunting, deoxygenated blood around body
46
Jejunal atresia associated to what? | Usually pathophysiology of it?
Trisomy 21 | Decreased blood supply, ischaemia, no bacteria so scars
47
Volvulus neonatarum symptoms?
Copious vomiting of green bile
48
3 main causes of lower GI obstruction in newborns?
CF Meconium ileus Hirschsprung disease
49
VACTERL stands for? week what of development?
``` vertebral anorectal cardiac tracheo-oesophageal esophageal atresia renal limb abnormalities Occur at week 11 of development ```
50
Complication that babies usually face due to spina bifida?
Constant bladder stimulation - renal damage Need intermittent catheterisation Take folate
51
what 2 hormones cause penis formation?
Testosterone and DHT
52
Why is hypospadias becoming more common?
Pesticides/insecticides/hormones in meat, antihistamines
53
What can form between back fo tongue and where thyroid descends?
thyroglossal cyst
54
If epidermoid cyst occurs between brows then what needs to be done?
Intracranial scanning as could be mass or within sinuses
55
Balanitis xerotic obliterans?
Lichen sclerosis in children, premalignant, need circumcised
56
How can you easily test between inguinal hernia and hydrocoele? Difference?
Light cant be shone through hernia, hernia more risk and complications needing treatment, hydrocele go away by itself
57
What age is a referral made for undescended testes?
3 months
58
Blue berry muffin sign?
Baby destroying neuroblastoma malignant tumour and depositing in t cells within the skin
59
If there is air in the gut with a baby presenting with oesophageal atresia what must be present?
Tracheooesophageal fistula linked to the lower oesophageal pouch
60
Double bubble sign on xray is indicative of what?
Duodenal atresia
61
Pneumatosis intestinalis? sign in what condition?
air trapped in bowel wall, sign of necrotising fasciitis
62
Most common cause of mortality in a baby who suffered congenital diaphragmatic hernia?
hypoplasia of the lungs
63
What congenital abnormality is usually present in babies suffering meconium ileus?
CF
64
Symptoms of intussusception?
vomiting, PR bleeding, pain
65
How does hypertrophic pyloric stenosis present?
non-bilious vomit, pain, 6 weeks old
66
Rigler's sign?
when air is present on the insane and outside of the bowel wall, abnormal
67
Causes of acute abdomen?
Testicular torsion, NSAP, acute appendicitis, malrotation of the intestines, UTI, pneumonia, DKA
68
Presentation of infant with acute appendicitis?
Unwell for few days, diarrhoea, septic, dehydrated
69
3 early complications of appendicectomy?
Abscess, ileus, wound infection
70
Findings for NSAP? | causes?
central pain, no radiation, disappears in 24-36 hours Viral Colonic spasm Intermittent intussusception
71
Constipation symptoms? | CAuses?
runny stools, multiple stools, difficult to pass, palpable left colon Diet, lack of fluids, lack of exercise, toilet training bad
72
2 investigation for UTI?
dipstick them MSU for O&S
73
What is Dietl's Crisis?
Flank pain, vomit, severe collapse | Pelvic outlet obstructed by renal vessel crossing
74
When does midgut return to abdominal cavity from umbilical cord? What can occur as this happens? FIndings?
10 weeks gestation Intestinal malrotation, volvulus of SI, ischaemia Bilious vomiting, gasless abdomen, guarding, tenderness, pain
75
How does pneumonia present in a child?
abdominal pain, RR, recent infection | Need xray
76
3 dangers in abdominal pain?
bilious vomiting, dka, hyponatraemia

Paediatrics (20 decks)

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