Week 3 - F(2) - Childhood Diseases Peer Tutoring 2.0

Question 1

Cold like symptoms eg cough and fever Oral white lesions on the mucosa Maculopapular rash that may be itchy What is this?

Answer 1

Measles

Question 2

How long does the cold like symptoms precede the rash in measles?

Answer 2

• Cold like symptoms followed by rash 2-4 days later

Question 3

How does mumps present?

Answer 3

Mumps presents with parotid gland swelling Temperature Headache

Question 4

What is spread by an RNA virus where it is infectious for the 5 days before and after a rash the rash starts on the face before spreading down the body and lasts 2-3days Also have lymphadenopathy What is this?

Answer 4

This is rubella

Question 5

A 2 year old boy attends with a fever, cough, maculopapular rash that first appeared behind the ear and has now spread to the tunk. On further investigation you notice small white lesions on the oral mucosa What is the diagnosis?

Answer 5

Measles

Question 6

Describe how the symptoms of measles appear?

Answer 6

Patient usually presents with cold like symptoms and koplik spots that precede a rash by 2-3 days The rash then usually starts on the head/neck region before spreading to the rest of the body

Question 7

What are the white lesions on the oral mucosa in measles known as?

Answer 7

Koplik spots

Question 8

A 7 year old girl present with painful elsions around her mouth which have a golden crust. What is this and what is the treatment?

Answer 8

Impetigo -treat with flucloxacillin

Question 9

A 3 year old boy presents with 1 day history of feeling unwell, high fever and noisy breathing. He is noted to be drooling saliva What is this?

Answer 9

Epiglottitis

Question 10

2 year old is admitted at 2am with a cough and inspiratory stidor. His mum describes his feeling hot with a runny nose for the past 3 days/ What is this? What causes it?

Answer 10

Croup caused by parainfluenza Virus

Question 11

An 8 month old boy presents with a dry cough. On examination you find a high pitched expiratory wheeze and suspect his chest is hyperinflated. What is this and what causes it?

Answer 11

Bronchiolitis due to respiratory syncitial virus

Question 12

Type of breathing in bronchiolitis vs croup?

Answer 12

Croup is child with inspiratory stridor Bronchiolitis tends to be expiratory wheeze

Question 13

An infant presents, following a 1 week history of a cold, with coughing fits. His mother expresses concerns as he seems to stop breathing at the ends of these fits What is this and what causes it?

Answer 13

Pertussis Caused by bordatella pertussis

Question 14

What is the treatment of epiglottitis?

Answer 14

Give IV ceftriaxone

Question 15

What tests are done to diagnose developmental dysplasia of the hip?

Answer 15

Ortolani and barlow Barlow - adduct and the move hip posteriroly to dislocate hip Ortolani - abduct and then move hip anteriorly to relocate

Question 16

What are some of the common cause of groin pain in children?

Answer 16

Transient synovitis and septic arthritis are the most common causes of hip pathology Perthes and DDH also cause this

Question 17

What is used to diagnoses a child with developmental dysplasia of the hip below and above 6 months?

Answer 17

Below 6 is ultrasound Above 6 is xray as the femoral head epiphysis has ossified

Question 18

What are signs of DDH? Whatt is used as treatment?

Answer 18

Shortned limb with antalgic gait Palvik harness for treatment

Question 19

idiopathic osteochondritis of the femoral head which usually occurs between the ages of 4 to 9 and is more common in boys (around 5:1), particularly very active boys of short stature. The femoral head transiently loses its blood supply resulting in necrosis with subsequent abnormal growth. The femoral head may collapse of fracture. What is this? What type of gait does it cause?

Answer 19

This is Perthe’s disease Can cause trendelenburgs gait

Question 20

Patients have pain and a limp. The pain may be felt in the groin (like other hip pathology) however the major pitfall is that patients can present purely with pain in the knee (due to the obturator nerve supplying both the hip and knee joint) What is this and what is the major first clincial sign?

Answer 20

SUFE - loss of internal rotation is first clinical sign

Question 21

What is the most common cause of neonatal jaundice?

Answer 21

Physiological jaundcie

Question 22

What time scale can physiological jaundice occur?

Answer 22

Occurs between 24 hours and 2 weeks - treatment is just observation

Question 23

What is the physiology behind physiological jaundice?

Answer 23

Newborn jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can be removed from the body in the stool. The liver takes some time to fully work effecieintly in jaundice

Question 24

What is a cause of physiological jaundice?

Answer 24

* Increased bilirubin production in neonates due to shorter RBC lifespan * Decreased bilirubin conjugation due to hepatic immaturity * Absence of gut flora impedes elimination of bile pigment * Breastfeeding increases enterohepatic circulation of bilirubin

Question 25

What immunoglobulin does breastfeeding provide the baby with? What supplements are given to the mother / baby in addition to breastfeeding?

Answer 25

Provides baby with IgA, Mother is supposed to take 10 micrograms / day vitamin D during pregnancy and when breastfeeding All infants from 6 months - given 7 micrograms vitamin D

Question 26

What is used to treat pathological neonatal jaundice?

Answer 26

Use photo-therapy to teat this

Question 27

What are some causes of neonatal jaundice?

Answer 27

Hypothyroidism, sickle cell anaemia, infection

Question 28

is a rare but serious complication of untreated jaundice in babies. It’s caused by excess bilirubin damaging the brain or central nervous system. What is this?

Answer 28

Kernicterus

Question 29

What are differentiating factors between rubella and measles?

Answer 29

Both have cold preceding the rash by 2-3 days Rash in rubella usually begins behind the ears Rash in measles usually begins on head/neck Measles also have spots on oral mucosa - koplik spots Rubella has associated adenopathy