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PaedsJaz > The ill child > Flashcards

The ill child Flashcards

1
Q

as a child ages their hr, rr and sbp __ (increase/decrease?)

A

hr and rr decrease

sbp increase

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2
Q

blood volume of kids =

A

80ml/kg

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3
Q

3 common things kids present with

A

bronchiolitis/URTI/croup
gastroenteritis
seizures

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4
Q

commonest reason for child’s acute illness =

A

sepsis

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5
Q

febrile seizures are seen in this age group
why do they happen?
how do they present?

A

2,3,4yo
minor infection => brain temperature increases rapidly
tonic clonic seizures and possibly lack of consciousness

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6
Q

in a child - brief asystole and then turn white and faint usually due to fright/injury =

A

reflex anoxic seizures

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7
Q

breath holding attacks =

A

child will hold breath and turn blue until they faint

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8
Q

most common arrhythmia in kids =

A

SVT

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9
Q

6 wk old will milky vomit, projectile shortly after gettin fed
sunken fontanelle
abdo lumps that are transient =

A

congenital pyloric stenosis

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10
Q

why do you get transient abdominal lumps with pyloric stenosis

A

stomach peristalsis against closed pylorus

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11
Q

olive that glances off of hand on abdo exam=

A

pyloric stenosis

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12
Q

how to feel pyloric stenosis

A

feel left side of abdomen with left hand

= olive glancing off of hand

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13
Q

US result for pyloric stenosis

A

thin channel and very thickened pyloric muscle

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14
Q

treatment for pyloric stenosis

A

fix metabolic alkalosis

Sx - Bransted’s pylorothyrotomy (cut circular muscle)

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15
Q

sausage shaped abdo mass in 6m old

A

intususception

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16
Q

redcurrent jelly in nappy =

caused by

A

late stage intususception

mucosal layer falling off and haemorrhage

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17
Q

target lesion and pseudokidney seen on abdo US -

A

intususception

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18
Q

signs of intususception

A 
6m old
sausage shaped abdo mass
vomit
temperature
waves of pain
redcurrent jelly in nappy
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19
Q

treatment for intususception

A

air enema reduction (works 80% of the time ) => Sx

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20
Q

6yo with acute abdomen =

A

appendicitis

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21
Q

bumps to hospital were sore =

A

peritonitis

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22
Q

treatment of appendicitis in kids =

A

appendectomy

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23
Q

vomit bile - mossy green =

A

malrotation causing SMA occlusion = emergency

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24
Q

most malrotation is picked up at age

A

1m-6k 60%

<1yo 95%

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25
Q

investigaion for malrotation -

A

upper GI contrast with follow through

26
Q

treatment for malrotation

A

Sx

27
Q

red and painful scrotum with possibly a black dot visible

sore only at top of testicle =

A

mullerian dot structures (remnants of femal parts - may lead to torsion)

28
Q

treatment of mullerian dot structures =

A

Sx to remove appendages

29
Q

whole testicle is blue =

A

torsion

30
Q

red and painful scrotum

A

infected epididymis

31
Q

swollen and red bilateral testicles spreading up groin and perineum - not usually sore =

A

idiopathic scrotal oedema

32
Q

treatment for idiopathic scrotal oedema =

A

antihistmaines and analgesia

33
Q

phimosis =

A

prepuce cant retract

34
Q

if phimosis is causing scarring treatment -

A

Sx - circumcision

35
Q

benign phimosis treatment =

A

steroids, daily bathe it and stretch prepuce

36
Q

paraphimosis =

A

prepuce stuck and glans fills with fluid

37
Q

hypospadias =

Rx =

A

congenitally urethral opening is on underside of penis

extensive Sx

38
Q

scrotal swelling that you can get above and transilluminates, usually gets bigger when standing up

A

hydrocele

39
Q

treatment for hydrocele

A

Sx - close PPV

40
Q

gubernaculum =

A

white tissue that guides testicle down into the scrotum normally

41
Q

treatment for undescended testicle

A

orchioplexy Sx

42
Q

if can’t feel undescended testicle after sweeping the groin next Ix =

A

scope the abdomen

43
Q

loss of continence in previously continent child suggests

A

UTI

44
Q

most common cause of uncomplicated UTI in kids

A

E. coli

45
Q

poor urinary flow in a young male suggests

A

posterior urethral valve

46
Q

red flag for Hirschsprung’s

A

no meconium >24hrs after birth

47
Q

encopresis =

A

normal stool but in abnormal place eg in classroom

a behavioural problem

48
Q

signs of an innocent heart murmur

A 
systolic
low density
2nd intercostal space
medial to apex
beneath either clavicle
venous hum - disappears when supine
49
Q

red flags for a heart murmur

A 
diastolic
loud >=grade 3
harsh
thrill
radiate widely
FH
50
Q

fluid loss or maldistribution => ___ failure => __ arrest

A

circulatory failure

cardiac arrest

51
Q

respiratory diistress or depression can lead to __>__>__

A

resp failure
resp arrest
cardiac arrest

52
Q

sbp = __+ 2x___

A

85

2x age in years

53
Q

due to a high larynx what should you not do in airway management of a paed

A

overextend the neck

54
Q

stridor indicates ___ airway obstruction

A

> 70%

55
Q

____ = 25% of circulating volume in a kid => point at which clinical __ is detected

A

20ml/kg

shock

56
Q

posture __ to __ = patients condition is deteriorating (D in ABCDE for kids)

A

decorticte ( hands curled up to face)

decerebrate ( hands down by sides straight out)

57
Q

if born on or after ___ in Scotland then both parents are on birth certificate irrespective of whether they are married or not

A

4th may 2006

58
Q

Centor criteria is used to __

=

A 
determine if the likely cause of tonsillitis is bacterial
Tonsilar exudate
Tender anterior cervical lymph nodes
History of fever
Absence of cough
59
Q

immediate Abx are given if have a centor score of

A

> =3

60
Q

Indications for a tonsillectomy

A

7 episodes of tonsillitis in the past year
5 episodes of tonsillitis each year in 2 consecutive
years
3 episodes of tonsillitis per year for 3 consecutive years

61
Q

most cases of tonsillitis are ___ in origin

A

viral

PaedsJaz (9 decks)

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