w/c 19/02 Flashcards
what is the most specific sign of meningococcal disease?
non blanching rash
what is kernigs sign?
inability to fully extend leg flexed at hip- seen in meningitis
whencan transcutaneous bilirubin be measured in babies?
GA >35 weeks
>24 hrs old
at what level of transcutaeous bilirubin does serum bilirubin need to be checked?
> 250 micromoles/L
what 2 tests are done on examination for suspected meningitis?
kernigs
brudzinskis
whats the most common cause of precocious puberty?
idiopathic central precocious puberty
how much adrenaline IM is given for anaphylaxis to kids of different ages?
under 6= 150 micrograms 1:1000
6-12= 300 micrograms 1:1000
over 12= 500 micrograms 1:1000
how many parents consent does a doctor need to provide treatment to a child?
1
they can be a stepparent- married to the other parent either before or after the birth of the child, both ways they have parental responsibility
whats gold standard ix for coeliacs and what is seen?
jejunal/duodenal biopsy
villous atrophy, crypt hyperplasia, intraepithelial lymphoycytes
what murmur is seen on tetralogy of fallot, where is it auscultated and why?
harsh ejection systolic murmur on upper sternal border left side due to pulmonary stenosis
anatomically, what causes an inguinal hernia in children?
a patent processus vaginalis
whats the incubation period of chickenpox?
up to 3 weeks
what are the first signs of puberty in boys and girls? what age do they happen
boys= enlargement of testes at age 9
girls= development of breasts at age 8.5
what is adenomyosis?
presence of endometrial tissue in the myometrium
what are rf for adenomyosis?
multiple pregnancies
sustained trauma to uterus- multiple c sections
older reproductive age
how is adenomyosis managed?
wanting to concieve: mefanamic acid for analgesia
not wanting to concieve: hormonal contraception
what medication can be used to stop breastfeeding and how?
carbergoline
dopamine receptor agonist inhibiting prolactin production
what abnormality occurs in baby with maternal lithium use?
ebsteins
what is ebsteins abnormality?
congenital heart defect associated with maternal lithium use- 2 leaflets of the tricuspid valve are displaced the long way so blood leaks from the right ventricle to the right atrium leading to right atrial enlargement and congestive heart failure
what is lynch syndrome?
a genetic condition causing familial malignancy at a younger age, its associated with ovarian, endometrial and bowel cancer
when are women admitted for placenta praevia?
if its symptomatic past 34 weeks
what are the 7 layers to get through in a c section
skin
subcut fat
rectus sheath
rectus abdominis
peritoneum
myometrium
amniotic sac
how long after delivery is contraception not required?
21 days
whats the most common type of fibroid?
intramural
what antidepressants cause anticholingeric side effects?
TCAs
what are anticholingeric side effects?
falls
dry mouth
drowsiness
blurred vision
constipation
urinary retention
what class of drugs are given for dementia?
acetylcholinesterase inhibitors
what is splitting?
a phenomenon seen in EUPD where people regard others as wholly good or wholly bad as their relationships fluctuate between idealisation and devaluation
whats given to household contacts for meningitis?
cipro or rifampicin
how is mild croup managed?
single dose oral dex
how is severe croup managed?
IV dex
adrenaline nebs
high flow oxygen
what type hypersensitivity reaction is asthma?
type 1
what is transient tachpnoea in the newborn associated with?
c section
prematurity
how might you identify an innocent murmur?
soft systolic
no diastolic component
no radiation, localised
no heaves/thrills
not symptomatic
may vary with posture
what age do children with UTIs need to be admitted?
under 3 months
what is galaezzi test?
the test used to indicate wether shortening is femoral or tibial
when is jaundice abnormal in neonates?
first 24 hrs of life
when does physiological jaundice usually present?
after 24 hrs
how is foreign body ingestion managed?
is patient is asymptomatic and theres no evidence of obstruction they can be discharged
what mutation is associated with digeorge syndrome?
22q 11.2 deletion
what heart defects are seen in digeorge syndrome?
interrupted aortic arch
VSD
what is salmon pink rash in paediatric MSK indicative of?
JIA
what are other features of JIA?
salmon pink rash
lymphadenopathy
uveitis
pyrexia
anorexia
weight loss
describe wilms tumor
most common primary renal tumor in kids
nephroblastoma
usually unilateral
painless mass in abdomen with distention
fever and haematuria
how is wilms tumor imaged?
ultrasound
how do you recognise croup?
high pitched barking cough and hoarse voice
how is severe croup managed in the community
give steroids (oral dex or budesonide nebs) and transfer to hospital
what are features of severe croup?
stridor
resp distress
hypoxia
what is otitis media with effusion?
presence of fluid behind in the ear without infection
what are the causes of conjugated vs unconjugated hyperbilirubinaemia?
conjugated: biliary atresia, CF
unconjugated: breast milk jaundice, gilberts syndrome, crigler-najjar syndrome
how does cerebral palsy affect development?
delay in one specific developmental region
what chromosome and gene are affected in cystic fibrosis?
CTFR gene on chromosome 7
what sign do you see on x ray in croup?
steeple sign- due to subglottic narrowing
how do you differentiate croup and whooping cough
croup= barking cough, inspiratory stridor
whooping cough= severe bouts of coughing, cant breath during so inspiration when cough ends
how is croup managed?
supportive
responds well to steroids- dexamethasone especially
how is whopping cough managed
supportive care
macrolide abx
how does clomiphine work?
selective oestrogen receptor modulator
reduced negative feedback from oestrogen so increases fsh and lh to encourage ovulation
when is clomiphine given/
day 2 and 6 of the cycle
what weight is defined as macrosomia?
over 4 kg
in what patients is ergometrine contraindiciated?
hypertension
PVD
heart disease
when is ECV performed?
nulliparous= 36 weeks
multiparous= 37 weeks
regarding the cervix, when can you perform artificial rupture of membranes?
when the cervix is ripe and dilated to 4cm
how do you differentiate postpartum blues and depression
blues= presents 3-7 days post delivery
depression= presents after 6 weeks/present for 6 weeks
what is capgras delusion?
a belief that close people (friends/family) have been replaced by clones
what is the belief that close people (friends/family) have been replaced by clones?
capgras delusion
when can therapy be started after a traumatic event?
immediately
a diagnosis of ptsd is not needed, trauma focused cbt can be given in acute stress disorder
what medication is used for extrapyramidal side effects of antipsychotics? whats the moa
procyclidine- anticholinergic
what extrapyramidal side effects does procyclidine improve vs not?
improves: tremor, akithesia, dystonia
doesnt improve: bradykinesia and rigidity
whats the tetrad for neuroleptic malignant syndrome?
hypertonia
hyperthermia
autonomic instability
mental state change
what medication is neuroleptic malignant syndrome associated witgh?
antipsychotics
what is lewy body dementia associated with?
visual hallucinations- often small/non harmful creatures/animals
REM sleep disorder
falls
