Week 2 - B - Sick child 1 - common acute illness Flashcards
What is the volume of blood in an adult compared to the volume in a baby?
In a baby there is roughly 330ml of blood
In an adult there is roughly 5litres
What is the difference between adult and foetal haemoglobin?
Foetal haemoglobin (HbF) has a greater affinity for oxygen than adult
Why does foetal haemoglobin have a greater afinity for oxygen?
This greater affinity for oxygen is explained by the lack of fetal hemoglobin’s interaction with 2,3-bisphosphoglycerate (2,3-BPG or 2,3-DPG).
In adult red blood cells, this substance decreases the affinity of hemoglobin for oxygen.
foetal haemoglobin
Just info
What is the difference in a childs larynx and epiglottis to an adults?
In chidldren, they have a high anterior larynx and a floppy epiglottis
What system is the most common cause of presentation in children?
Respiratory system
What respiratory disorder presents with a barking cough and a steeple sign on x-ray?
Croup (laryngeotracheobronchitis)
What causes croup? What does a thumb sign on x-ray make you think?
Croup is caused by human parainfluenza virus (HPIV)
Thumb sign on x-ray makes you think epiglottits - usually caused by haemophilus influenza
What is the commonest reason for acute illness in children?
Sepsis
What are some of the features of presentation of sepsis in a child?
looks mottled, bluish or pale
is very lethargic or difficult to wake
feels abnormally cold to touch
is breathing very fast
has a rash that does not fade when you press it
has a fit or convulsion
Is bronchiolitis caused by a virus or bacteria? What is its treatment?
When would you admit someone with bronchiolitis to hospital?
It is a virus
Give supportive treatment
NICE recommend that clinicians ‘consider’ referring to hospital if any of the following apply:
- a respiratory rate of over 60 breaths/minute
- difficulty with breastfeeding or inadequate oral fluid intake (50-75% of usual volume ‘taking account of risk factors and using clinical judgement’)
- clinical dehydration.
What is laryngeotracheobronchitis better known as? What can be used as treatment to prevent hospitilization and open the airway?
Croup
Give steroids to open airway - barking cough is caused by the narrow airway
What is the test carried out in patients suspected with meningococcal bacteria?
Tumbler test
When you press the glass against the rash it wont blanch because the blood is in the S/C tissues
What three bacteria can cause meningitis? What is the most dangerous type of meningococal?
Haemophilus influenza b (Hib), Neisseria meningitidis, streptococcal pneumoniae
bacteria meningococcal B
What is probably the most common arrythmia in epilepsy?
SVT (supra-ventricular tachycardia)
