Textbook Notes Flashcards
what is exomphalos?
herniation of abdominal contents through umbilicus
covered by membrane
what is gastroschisis?
herniation of abdominal wall defect to the right of the umbilicus
not covered with membrane
management of gastroschisis
cover with clingfilm due to fluid loss
NGT
IV fluids
surgery
what is oesophageal atresia associated with?
trachea-oesphageal fistula
presentation of oesophageal atresia
polyhydramnios (foetus unable to swallow amniotic fluid)
excess oral secretions
aspiration
regurgitation
diagnosis of oesophageal atresia
CXR shows NG tube curled up and unable to pass into the stomach
management of oesophageal atresia
surgical repair
what are congenital infections?
those that are obtained antenatally/ perinatally
what are the TORCH infections?
toxoplasmosis others= HBV, syphilis, varicella zoster, HIV, parvovirus B19 rubella CMV HSV
what is malrotation?
mobile midgut with short mesentery causing twisting due to failure of midgut rotation during embryogenesis
presentation of malrotation
bile-stained vomit
GORD
abdo pain
diagnosis of malrotation
contrast study
management of malrotation
surgery
risks in malrotation
volvulus
bowel obstruction
what is a neuroblastoma?
neuroendocrine tumour arising from the sympathetic nervous system
what is fragile X?
a trinucleotide repeat expansion disorder (X-linked recessive)
presentation of fragile X
learning difficulties
low IQ
prominent ears
enlarged testicles
what should all children <3 months with a fever have?
immediate prophylactic IV antibiotics (ceftriaxone) and full septic screen
what is orchidopexy?
surgical correction of undescended testes
what is hypoxic ischaemic encephalopathy?
neonatal brain injury secondary to prenatal, perinatal or postnatal asphyxia
presentation of HIE
poor APGAR
lethargy
reduced tone
seizures
diagnosis of HIE
CFM
EEG
MRI brain
grading of HIE
Sarnat staging
management of HIE
therapeutic hypothermia (33-34 degrees measured via rectal probe for 72 hours)
how much weight is acceptable to lose in the first 5 days of life?
10% and be back to birth weight by 10 days
management of Hep C in children >3
pegylated interferon and ribavirin
what is tongue tie/ankyloglossia?
short lingual frenulum so unable to extend tongue out of the mouth leading to poor attachment for breast feeding
management of tongue tie/ ankyloglossia
frenotomy
what is the genetic configuration of androgen insensitivity syndrome?
46XY
presentation of androgen insensitivity syndrome
primary amenorrhoea undescended testes (groin swelling) female phenotype
management of androgen insensitivity syndrome
bilateral orchidectomy due to testicular cancer risk oestrogen therapy (raise as a female)
grading of vesicoureteral reflux
- I= reflux into ureter only, no dilatation
- II= reflux into renal pelvis on micturition, no dilatation
- III= mild/mod dilatation of ureter, renal pelvis and calyces
- IV= dilation of renal pelvis and calyces with moderate ureteral tortuosity
- V= gross dilation of ureter, pelvis and calyces with ureteral tortuosity
perianal itching at night?
threadworm
management of threadworm
mebendazole (+ whole household)
what can NSAIDs in chickenpox cause?
necrotising fasciitis
management of Perthes based on age?
<6 = observation >6 = surgery
classification used for Perthes
Catterall staging
Catterall staging for Perthes
- Stage 1= clinical and histological features only
- Stage 2= sclerosis with or without cystic change and preservation of articular surface
- Stage 3= loss of structural integrity of femoral head
- Stage 4= loss acetabular integrity
enuresis management pathway
triggers/ advice on lifestyle, toileting
reward system
enuresis alarm
desmopressin
triad in shaken baby syndrome
subdural haemorrhage
retinal haemorrhage
encephalopathy
how can you suppress lactation?
cabergoline
what can hand preference before 12 months indicate?
cerebral palsy
diagnosis of DDH
clinical
if >4.5 years use XR
when to refer undescended testes rather than watchful waiting?
> 3 months
murmur in Turner’s syndrome?
ejection systolic due to bicuspid aortic valve + coarctation
what are signs of childhood sexual abuse?
anal fissures
recurrent UTIs
what can occur 5-10 years after measles infection?
subacute sclerosing panencephalitis
murmur in transposition of the great arteries?
loud single S2
screening tests for hearing
otoacoustic emission test for new-borns at birth
if abnormal go to auditory brainstem response test
measuring bilirubin in neonates
<24 hours old measure serum bilirubin
>24 hours old use transcutaneous bilirubinometer
urine sample in UTI for children
clean catch
why should rotavirus vaccine not be given late?
theoretical risk of intussusception
meningitis causes based on age
<3 months= GBS, e. coli or listeria
1 month - 6 years= neiserria, strep pneumonia, H. influenza
>6 years= neisseria or strep pneumonia
what is a RF for neonatal hypoglycaemia
mother on beta blockers e.g. labetalol used in hypertension
management of neonatal hypoglycaemia
if asymptomatic encourage breast feeding
if symptomatic admit to NICU for IV infusion of 10% dextrose
William’s syndrome
short, LD, extrovert friendly personality, hypercalcaemia, aortic stenosis
cri du chat syndrome (5p chromosome)
characteristic cry
LD
feeding difficulties
patau syndrome
microephalic small eyes cleft lip polydactyly scalp lesions
Edward’s syndrome
micrognathia
low set ears
rockerbottom feet
overlapping fingers
fragile X
LD macroephaly long face large ears macro-orchidism
noonan syndrome
webbed neck
pectus excavatum
short stature
pulmonary stenosis
Pierre-Robin syndrome
micrognathia
posterior displacement of the tongue
cleft palate
