Year 5 passmed Flashcards
mx of threadworm
CKS recommend a combination of anthelmintic with hygiene measures for all members of the household
mebendazole is used first-line for children > 6 months old. A single dose is given unless infestation persists
threadworm - what extra sx can girls get
vulval itching
infantile colic is what adn characterised by
less than 3 months old and is characterised by bouts of excessive crying and pulling-up of the legs, often worse in the evening.
resolve 6 months of age
scarlet fever caused by
group a strep - usually pyogenes
main complications of scarlet fever
otitis media: the most common complication
rheumatic fever: typically occurs 20 days after infection
acute glomerulonephritis: typically occurs 10 days after infection
invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness
most serious health conditions with peoles with turners
Aortic dilatation and dissection
why do you need to dry the baby first in resus
Babies are born small and wet. They get cold very easily, especially if they remain wet and in a draught.
Birth: Dry the baby, remove any wet towels and cover and start the clock or note the time.
Within 30 seconds: Assess tone, breathing and heart rate.
Within 60 seconds: If gasping or not breathing - open the airway and give 5 inflation breaths
Re-assess: If no increase in heart rate look for chest movement
If chest not moving: Recheck head position, consider 2-person airway control and other airway manoeuvres, repeat inflation breaths and look for a response.
If no increase in heart rate look for chest movement
When the chest is moving: If heart rate is not detectable or slow (< 60 min-1) - start chest compressions with 3 compressions to each breath.
Reassess heart rate every 30 seconds. If heart rate is not detectable or slow (<60 beats per minute) consider venous access and drugs
constipation in kids first line and what do you do if this does not work after 2 weeks
polyethylene glycol 3350 + electrolytes (Movicol Paediatric Plain)
add stimulant laxative such as senna
substitute a stimulant laxative singly or in combination with an osmotic laxative such as lactulose if Movicol Paediatric Plain is not tolerated
Infants who have or are being weaned
offer extra water, diluted fruit juice and fruits
if not effective consider adding lactulose
for a constipated infant who is not yet weaned what else can you do to help - both bottle fed and breast fed
Infants not yet weaned (usually < 6 months)
bottle-fed infants: give extra water in between feeds. Try gentle abdominal massage and bicycling the infant’s legs
breast-fed infants: constipation is unusual and organic causes should be considered
SUFE what key sign
Reduced internal rotation of the leg in flexion
osgood schalltter disease
what is it
main sx
how does it resolve
It is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia). The symptoms usually include pain and swelling over the tibial tubercle, which can be exacerbated by physical activity
stop growing resolve
when do you not give steriods in meningitis
, do not use corticosteroids in children younger than 3 months with suspected or confirmed bacterial meningitis [NICE 2010] as there is insufficient evidence to prove the benefits of corticosteroids in younger children. Dexamethasone should also be avoided in those with congenital or acquired abnormalities of the central nervous system; or those with aseptic, nonbacterial, or gram-negative enteric meningitis*
abx given in meningitis
< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
> 3 months: IV cefotaxime (or ceftriaxone)
when do you give dexamethasone in meningitis
frankly purulent CSF
CSF white blood cell count greater than 1000/microlitre
raised CSF white blood cell count with protein concentration greater than 1 g/litre
bacteria on Gram stain
all children with asthma attack should be given
oral steriods
and bronchodilator therapy
dose to weight ratio of dexamethasone for croup
oral dexamethasone (0.15 mg/kg)
Parainfluenza virus is the most common cause of croup, also known as
laryngotracheobronchitis,
6-1 vaccine when
3 and 4 months
4 in 1 booster when with MMR
3-4 years of age
3 in 1 whne
13-18 yer old
Evidence of bowel sounds in a respiratory exam of a neonate in respiratory distress
what it cause
congential diaphragmatic hernia
pulmonary hypoplasia and hypertension due to failure of pleuroperitoneal canal closure
What is the first sign of puberty in girls?
breast development
first sign of puberty in men
first sign is testicular growth at around 12 years of ag
gynaecomastia may develop in boys
asymmetrical breast growth may occur in girls
diffuse enlargement of the thyroid gland may be seen
are these normal chnages in puberty
yes
breast fed baby with gord what should they have a trial of
Prescribe a 1-2 week trial of an alginate (e.g. Gaviscon)
Infant < 8 weeks, presents with milky vomits after feeds, often after being laid flat, excessive crying →
GORD
keep head at 30 degrees when feeding
what is antalgic gait
like if you have a limp
whereby the stance phase is shortened relative to the swing phase
signs of respiratory distress (7)
Grunting
Nasal flaring
Use of accessory respiratory muscles
Tachypnoea
retractions
wheeze
tracheal tug
most common cause of primary headache in children.
migraine
ibuprofen is used to treat migraine over paracetamol when can you give triptan
over 18
the other common headache in children is tension headaches how many do you need to have to be dx
10 previous headache
describe the roseola infantum rash
Roseola infantum typically starts with a high grade fever which resolves before the onset of the rash. The rash typically starts abruptly after the temperature subsides, and usually starts on the trunk before spreading to the limbs. It is a maculopapular rash and it not itchy.
risk factor for neonatal sepsis
low birth weight
mx of neonatal sepsis
intravenous benzylpenicillin with gentamicin as a first-line regimen for suspected or confirmed neonatal sepsis
false Labor
Occurs in the last 4 weeks of pregnancy
Presentation:
contractions felt in the lower abdomen. The contractions are irregular and occur every 20 minutes. Progressive cervical changes are absent.
Microcephaly may be defined as an occipital-frontal circumference < 2nd centile
Causes include
main ones i think (5)
normal variation
congenital
HIE
fetal alcohol syndrome
syndromes: Patau
craniosynostosis
An older child with missed DDH may present with a
Trendlenberg gait and leg length discrepancy
hypospadias as linked with
crypotorchidism - undescended testis
what vaccines included in the 6 in 1 vaccine at 3 months
Diphtheria, tetanus, pertussis, polio, haemophilus influenzae type b and hepatitis B
peadiatric red flag signs (5)
Moderate or severe chest wall recession
Does not wake if roused
Reduced skin turgor
Mottled or blue appearance
Grunting
where is meatus found in hypospadiaas
On the distal ventral surface of the penis
What is the investigation of choice to look for renal scarring in a child with vesicoureteric reflux?
Radionuclide scan using dimercaptosuccinic acid (DMSA)
Micturating cystourethrogram (MCUG) is used to diagnose vesicoureteric reflux itself rather than its complications like renal scarring
Preterm infants with haemodynamically significant patent ductus arteriosus 1 week after birth - what do you give
ibuprofen
Prostaglandins are instead used in cases where there is a need to keep the duct open, such as congenital heart defects that require surgical intervention, like transposition of the great arteries. In this case, this infant has PDA causing cardiovascular compromise, which requires closure via pharmacological intervention.
Turner’s syndrome is associated with what murmur
ejection systolic murmur due to bicuspid aortic valve
Delayed puberty with short stature
(3)
Delayed puberty with normal stature
polycystic ovarian syndrome
androgen insensitivity
Kallman’s syndrome
Klinefelter’s syndrome
what are those 3
Delayed puberty with short stature
Turner’s syndrome
Prader-Willi syndrome
Noonan’s syndrome
diet in CF
High calorie and high fat with pancreatic enzyme supplementation for every meal
RF for Surfactant deficient lung disease
male sex
diabetic mothers
Caesarean section
second born of premature twins
prevention during pregnancy: maternal corticosteroids to induce fetal lung maturation
