teaching session paeds

Question 1

when does NEC present

Answer 1

day 3-5

Question 2

how does nEC present

Answer 2

blood stool distention erythema shock bilious vomiting apnea

Question 3

mx of nEC

Answer 3

NBM IV fluids antibiotics -10 days oxygen tpn NUTRITION surgical review

Question 4

what is NEC often seen with

Answer 4

polycynthemia

Question 5

complications of nEC

Answer 5

short bowl syndrome 75% survival if less than 1500g decreased survivsl stricture abscces

Question 6

what is protective for nEC

Answer 6

breast feeding if < 28 weeks will encourage mum to breast feed, if she does not want to then ask if can use donor milk

Question 7

what can present similar to pyloric stenosis

Answer 7

UTI –> vomiting, lethargy weight loss in kids

Question 8

who is pyloric stenosis seen in

Answer 8

first borns esp males

Question 9

what is seen in Hirschsprung on xray

Answer 9

fecal loading boy> girls

Question 10

when does neural crest close

Answer 10

failure closure In hirschprung 8-12 weeks gestation

Question 11

first lien tests for Hirschsprung

Answer 11

xray -cheap easy first done diagnostic -barium enemia rectal biopsy- diagnostic

Question 12

what is important in hirshprung

Answer 12

give laxatives to allow recover of bowel can take years to get back to normal

Question 13

thing to note in child with Hirschsprung

Answer 13

if has d and v need to culture due to risk of enteroclitis

Question 14

complications of Hirschsprung

Answer 14

stricture incontinence obstruction entercolitis soiling

Question 15

when is perforation risk greatest in intusseption

Answer 15

< 24 hour history or unwell

Question 16

what is likely trigger in young child and older

Answer 16

phsyiological-inflammed epyes patches older - pathological meckels and polyp for example

Question 17

VACTERL

Answer 17

vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities WHEN ONE is present, screen for rest tend to come as triad ro more

Question 18

whats seen with oesophageal atresia

Answer 18

include excessive secretions, coughing and cyanosis after attempts at feeding

Question 19

umbilicall hernia

Answer 19

at 4-5 year more cosmetic -no medical reason inguinal hernia has risk of strangulation so needs earlier higher rates in afro-carrbiean children

Question 20

posh name for undescended testes

Answer 20

cyrptochordism increased risk of testicular cancer and infertility so need surgical repaired by 1 year latest

Question 21

exomphalos and omphalocele

Answer 21

same thing VIA UMBILICus UNCOVERED

Question 22

what does this show

Answer 22

olive mass in pyloric stenosis

Question 23

what does this show

Answer 23

target sign in intusseption

Question 24

what does this show

Answer 24

cofee bean sign in volvulus

Question 25

what dos this show

Answer 25

congenital diaphragmatic hernia

note how GI in lung space

apex beat will be deviated

Question 26

wnhat does this show

Answer 26

hirshsprung

dilated segements

pool

Question 27

what is ITP

Answer 27

idiopathic thrombocytopnia purpura

usually seen after an infection

Question 28

what does ITP present with

Answer 28

epistaxis

gum bleeding

petechiae and bruisig

Question 29

Rx for ITP

Answer 29

self limiting in 80% will resolve within 3 months

but need to bear in mind amy need PREDNISOLOEN sterio therapy

Question 30

with ITP which jab

Answer 30

splectomy can be done but so can rituximab

Question 31

bloods for ITP

Answer 31

clotting

FBC UE LFT

film

Question 32

what increases and what decreases in ITP

Answer 32

decrease-platelet

increase-megokarocytes