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FLASH FINALS > Child Health > Flashcards

Child Health Flashcards

1
Q

Live attenuated vaccines:

A

MMR
Rotavirus
BCG
Smallpox

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2
Q

Inactivated vaccines: Polysachharides

A

Hib
Meningococcal
Pneumococcal

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3
Q

Vaccines at 2 months

A

6 in 1
ORAL rotavirus
Men B

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4
Q

What comprises the 6 in 1 vaccine:

A

Diptheria, tetanus, pertussis, polio , Haemophilus B, hepatitis B

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5
Q

Vaccines at 3 months:

A

6 in 1
Oral rotavirus
PCV

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6
Q

Vaccines at 4 months:

A

6 in 1

Men B

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7
Q

Vaccines at 12-13 months:

A

Hib/Men C
MMR
PCV (pneumococcal conjugate)
Men B

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8
Q

Vaccines at 2-8 years

A

Flu vaccine (annual)

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9
Q

Vaccines at 3-4 years:

A

4 in 1 preschool booster (DTaP w/ MMR)

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10
Q

Vaccines at 12-13 years:

A

HPV vaccination

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11
Q

Vaccines at 13-18 years:

A

3 in 1 teenage booster (Diptheria Tetanus and POLIO)

Men ACWY

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12
Q

Stimulants for growth:
Infant
Child
Pubertal

A

Nutrient and insulin led (0-3)

GH and Thyroxine led (3-12)

Sex steroid led (12-18)

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13
Q

What weight loss is considered normal in new borns:

A

5-10% of body weight

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14
Q

What deviation from line is considered normal regarding child’s height on graph:

A

+/- 2 standard deviations

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15
Q

Puberty in girls: 3 stages

A

Thelarche - budding of breasts
Adrenarche - Development of body hair and odour
Menarche - menstruation

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16
Q

How long after thelarche does menarche occur on average

A

2 years

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17
Q

Benefits of breast feeding to baby:

A

Reduces lifetime risk of obesity, diabetes and atopy

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18
Q

Breast feeding benefits to mother:

A

Improves bonding

Reduces risk of breast cancer

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19
Q

Thrush of breast tx. mum and baby:

A

Maternal: topical meconazole or oral fluconazole

Baby if < 4 months: oral nystatin
Baby if > 4 months: Miconazole gel

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20
Q

Developmental red flags:

what should occur by 10 weeks

A

smile

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21
Q

Developmental red flags:

What should baby be able to do by 12 months

A

Sit unsupported

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22
Q

Developmental red flags:

What should baby be doing by 18 months:

A

Walking

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23
Q

When should baby be able to speak:

A

10 months

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24
Q

Other red flags for developmental issues:

A

Asymmetry of movement
Concerns over vision and hearing
Loss of skills

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25
Q

Microcephaly
Micrognathia
Overlapping of fingers
Rocker bottom feet

A

Edward’s syndrome (trisomy 18)

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26
Q

Cleft lip
Extra fingers
Microcephaly
Cyclopia

A

Patau syndrome (trisomy 13)

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27
Q 
Long protruding ears
Long face 
High arched palate 
Flat feet 
Hypermobility
A

Fragile X

Also MARCOorchidism

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28
Q

Abormal face
Cleft lip
HYPOCALCAEMIA
increased risk of schizophrenia

A

DiGeorge syndrome (22)

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29
Q

Duchenne muscular dystrophy inheritance

A

X-linked recessive (anomaly as most structural diseases are autosomal dominant)

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30
Q

Very high ___ (blood test) in DMD

A

CK

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31
Q

Croup causative organism

A

Parainfluenza virus

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32
Q

Time of year croup typically occurs:

A

Autumn

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33
Q

Croup: breathing in earlier stages

A

Intermittent loud, harsh stridor

worse when upset

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34
Q

Croup: cough

A

BARKING cough which is typically worse at night

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35
Q

Croup indicators of severe disease:

A

Agitation and restlessness
Sternal retractions
Constant stridor
Cyanosis

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36
Q

Croup Ix.

A

Dx. clinical

AP neck x-ray may show ‘steeple’ sign on epiglottis

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37
Q

Croup mx.

A

ORAL dexamethasone single dose (0.15 mg/kg) for ALL children regardless of severity

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38
Q

Croup emergency treatment (severe)

A

Nebulised adrenaline

High-flow oxygen

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39
Q

Epiglottitis: causative organism:

A

Haemophilus influenzae type B

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40
Q

Epiglottitis presentation:

A 
SUDDEN on-set -> no prodrome
Drooling
Unable to swallow 
Muffled voice 
Adopts TRIPOD position
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41
Q

Epiglottitis Dx.

A

Direct visualisation from trained staff

X-rays may be done if concern about foreign body

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42
Q

Epiglottitis - neck x-ray:

A

THUMB sign

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43
Q

Epiglottitis mx.

A

Immediate senior involvement
DO NOT examine the throat
Oxygen/IV antibiotics

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44
Q

Antibiotics of choice for epiglottitis:

A

IV CEFTRIAXONE

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45
Q

Bronchiolitis: typically seen in

A

Children < 1 years

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46
Q

Bronchiolitis causative organism:

A

Respiratory syncytial virus (RSV)

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47
Q

Bronchiolitis fx.:

A

Coryzal symptoms w/ mild fever: precede
Dry cough
Increasing breathlessness
wheezing and fine inspiratory crackles

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48
Q

Bronchiolitis consider referral if
RR >
difficulty w/

A

60

Breastfeeding or inadequate oral intake

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49
Q

Bronchiolitis mx.

A

Supportive

Humidified oxygen may be used if saturations are persistently < 92%

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50
Q

CAP non severe and < 1 yrs antibiotic

A

Co-amoxiclav

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51
Q

CAP non severe and > 1 yrs antibiotic

A

Amoxicillin

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52
Q

Whooping cough: causative organism

A

Bordatella Pertussis

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53
Q

Pertussis (whooping cough) px.

A

1-2 weeks of cold symptoms plus cough at night

Followed by 2-3 weeks of:
Paroxysms of COUGH -> fits
Inspiratory whoop

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54
Q

Pertussis other assoc. symptoms:

A

vomiting, cyanosis

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55
Q

Diagnosis of pertussis dx.

A

Nasal swab

PCR and serology

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56
Q

Tx. Bordatella pertussis:

A

ORAL MACROLIDE (Clarithromycin, azithromycin)

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57
Q

Is whooping cough a notifiable disease:

A

YES Pertussis is a notifiable disease

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58
Q

Household contacts of pt. w/ whooping cough should receive:

A

Antibiotic prophylaxis

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59
Q

School exclusion: whooping cough

A

48 hours from commencing antibiotics

or 21 days of no antibiotics

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60
Q

Pregnant women should be offered which two vaccines:

When are they offered

A

Influenza
Pertussis (2012)

16-32 weeks gesation

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61
Q

What should all children w/ an exacerbation of asthma receive:

A

Bronchodilator therapy: b2 agonist
Steroid therapy for 3-5 days
(<2 yrs 10 mg, >2: 20 mg)

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62
Q

Secondary management of asthma (if no response to inhaled therapy)

A

IV salbutamol
Aminophyline (only if unresponsive to inhaled therapy)
IV MgSO4

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63
Q

When should antibiotics be considered in AOM:

A

<2 yrs
Bilateral
Marked otorrhoea
Bulging tympanic membrane

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64
Q

Which antibiotic is used (if indicated) in AOM

A

Amoxicillin

Clarithromycin

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65
Q

Scarlet fever: develops following infection from which organism

A

GABHS and tonsilitis

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66
Q

Scarlet fever: Following onset of sore throat ->

A

Fever
Strawberry tongue
Lymphadenopathy
SANDPAPER RASH

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67
Q

Scarlet fever tx.

A

Oral Penicillin V for 10 days

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68
Q

Scarlet fever school exclusion:

A

24 hours after starting antibiotics

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69
Q

Is scarlet fever a notifiable disease?

A

YES

70
Q

Most common complication of scarlet fever:

A

Otitis media

71
Q

Features of innocent cardiac murmur in childhood:

A

Patient asymptomatic
No radiation or thrill
Change w/ respiration and position

72
Q

Innocent murmurs will
___ when sitting up
___ when lying down

A

Decrease

Increase

73
Q

Continuous murmur heard best below the clavicles:
Disappears when child lies down
Due to turbulent flow in the head and neck veins

A

Venous hum

74
Q

Cyanosis plus murmur (1-2 months):

A

Tetralogy of Fallot

75
Q

Cyanosis plus murmur (1-2 days):

A

Transposition of the great vessels or tricuspid atresia.

76
Q

VSD murmur

A

PANsystolic - assoc. with thrills and symptoms of heart failure.

77
Q

Coarctation of aorta murmur:

A

Ejection systolic

78
Q

Atrial septal defect murmur:

A

Soft ejection systolic murmur

79
Q

Patent ductus arteriosus murmur:

A

Continuous machine-like murmur best heard below left clavicle

80
Q

Rotavirus ix.

A

Stool PCR

81
Q

Mesenteric adenitis px.
mimics?
mx.

A

occurs secondary to a viral URTI
Appendicitis
Self-limiting

82
Q

Diagnosis of Henoch Schonlein Purpura:

A

Skin or RENAL biopsy

83
Q

Pyloric stenosis electrolyte disturbance:

A

Hypochloraemic, hypokalaemic metabolic alkalosis due to persistent vomiting

84
Q

Pyloric stenosis diagnostic investigation:

A

Abdominal ultrasound

85
Q

Green bilious vomit is what until proven otherwise:

A

Malrotation w/ volvulus

86
Q

Paediatric assessment of chronic diarrhoea initial investigations:

A

Bloods: incl. anti-TTG
Sweat test
Stool culture
GROWTH CHARTS

87
Q

If all ix. in chronic diarrhoea are normal w/ no visible allergy trial ->

A

Cows milk-free diet

88
Q

Constipation red flags:

A

Failure to pass meconium w/in 48 hours
Abnormal appearance of anus
Constipation from birth
Faltering growth

89
Q

Failure to pass first meconium in 48 hours w/

explosive passage of stool following PR exam:

A

Hirschprung’s

90
Q

Hirschprung’s diagnostic ix.

A

Rectal biopsy

91
Q

Lower UTI tx.
< 3 months
> 3 months

A

IV amoxicillin, gentamicin

Trimpethoprim/nitrofurantoin (3 days)

92
Q

Upper UTI tx.

A

IV Amoxicillin and Gentamicin

93
Q

Investigation of UTI in children:

A

USS of renal tract

94
Q

Which children get ix. in UTI

A

All children < 3 months
During infection if atypical
Up to six weeks otherwise
All children > 6 months who suffer recurrent infections

95
Q

Measles virus: organism

A

RNA Paramyxovirus

96
Q

Measles Px.

A

4 days prodromal cough, fever nasal discharge

Koplick spots - white spots on red background that develop on the buccal mucosa

Maculopapular rash - starts on face, neck, behind ears

97
Q

Measles: notifiable disease?

A

Yes

98
Q

Pink discrete maculopapular rash that starts on face and spreads to whole body

Sub-occipital and post auricular lymphadenopathy

A

RUBELLA

99
Q

Eczema distribution in infants:

A

Face and trunk often affected

100
Q

Eczema distribution in younger children:

A

Eczema on extensor surfaces

101
Q

Roseola infantum causative organism:

A

Human herpes 6 (HHV-6)

102
Q

Roseola infantum px.

A

High fever: lasting a few days
followed by maculopapular rash
Nagayama spots: uvula and soft palate papules

103
Q

Roseola infantum school exclusion:

A

NONE required

104
Q

Erythema infectiosum: also known as:

A

Slapped cheek, Fifths disease

105
Q

Measles school exclusion:

A

4 days from onset of rash

106
Q

Mumps school exclusion:

A

5 days from onset of swollen glands

107
Q

Rubella school exclusion:

A

5 days from onset of rash

108
Q

Impetigo school exclusion:

A

until lesions have crusted over or 48 hours after commencing antibiotic therapy

109
Q

Scabies school exclusion:

A

Until treated

110
Q

Influenza school exclusion:

A

Till recovered

111
Q

Chicken pox school exclusion:

A

Till all lesions have crusted over

112
Q

Diarrhoea and vomiting school exclusions

A

Until symptoms have settled for 48 hours

113
Q

Hand foot and mouth causative organism:

A

Coxsackie

114
Q

Purpura - how does ITP present:

A

Post-infective w/ mild mucosal bleeding in an otherwise well child

115
Q

Skin lesions as DDx. for NAI

A

Mongolian blue spot - birth mark

116
Q

Mx. Bacterial Meningitis:
< 3 months:
> 3 months:

A

IV Cefotaxime + Amoxicillin

IV cefotaxime

117
Q

Infective encephalitis prominent presenting symptom in children:

A

Odd behaviour

118
Q

Febrile convulsions: Simple

A

Generalized tonic clonic seizure that lasts < 5 minutes

Complete recovery of consciousness w/in one hour

119
Q

Febrile convulsions: complex

A

Focal onset
Lasts longer than 10 minutes
recurrent seizures in one febrile illness

120
Q

Below what age is red flag for febrile convulsions and why?

A

< 2 years

as children this age often show the classic signs and symptoms of meningitis

121
Q

Febrile convulsions tx.

A

Rectal or buccal midazolam - parents are trained in this

122
Q

Febrile convulsions risk of epilepsy?

A

Risk low but slightly higher than population average
Overall risk of epilepsy will increase if:
Complex febrile seizures
Family history of epilepsy
pre-existing neurodevelopmental condition

123
Q

Hepatic metabolism in children ->

A

Greater than in adults due to comparative size of liver thus require higher doses of anti-epileptics and theophylline. - doses should not exceed adult dose.

124
Q

Means of measuring temperature in child:
< 4 weeks
4 weeks - 5 years

A

Electronic thermometer in axilla

Electronic thermometer in axilla or infrared thermometer in axilla

125
Q

Traffic light system for feverish child:
Respiratory ->
Amber risk:

A 
AMBER:
Nasal flaring,
> 50 RR in 6-12 month 
> 40 RR for >12 months
Oxygen saturation < 95% 
Crackles in chest
126
Q

Traffic light system for feverish child:
Respiratory ->
Red risk:

A

Grunting
Tachypnoea: RR > 60 breaths/minute
Moderate or severe chest in-drawing

127
Q

Traffic light system for feverish child:
Circulation and hydration:
Amber risk:

A 
Tachycardia 
>160 beats/minute < 12 months
>150 beats/minute 12-24 months
>140 beats/minute if 2-5 years 
Cap refill > 3 secs 
Dry, poor feeding, reduced urine output
128
Q

Traffic light system for feverish child:

Red: age and temperature

A

<3 months with temperature over 38*

129
Q

Mx. Amber pathway:

A

Safety netting or refer to paediatric specialist for advice

130
Q

Suspected meningococcal meningitis presenting to primary care: what to give before transfer to hospital

A

IM Benzyl penicillin

131
Q

Suspected NAI: Protocol

A 
Admit to hospital for:
Senior escalation
Blood tests 
Foresnic examination 
Skeletal survery always done if < 2
132
Q

Autism spectrum disorder: what are the 4 domains of impairment

A

Social interactions
Thoughts and behaviours
Communication
Sensory hypersensitivity

133
Q

Describe Kawasaki disease:

A

Large to medium cell vasculitis

134
Q

Kawasaki px.

A 
Resistant fever > 5 days
Red palms of hands
Dry, cracked lips and strawberry tongue 
Bacterial conjunctivitis 
Widespread polymorphous rash
135
Q

Kawasaki disease tx.

A

High dose aspirin

136
Q

Investigation for Kawasaki disease:

A

Echocardiograph - due to complication of Coronary artery aneurysm

137
Q

Cow’s milk allergy tx.

A

1st line is extensively-hydrolysed formula feed.

138
Q

Hypospadias tx.

A

Corrective surgery before the age of 12 MONTHS - 1 year

139
Q

Undescended testes
Referred before:
seen by surgeon before:

A

3 months
6 months

Orchidopexy to treat

140
Q

Shaken baby triad of signs:

A

Retinal haemorrhages
Subdural haemorrhage
Encephalopathy

141
Q

First line investigation for DDH if pt. > 4.5 months

A

X-ray

US can be used also

142
Q

Measles complication occurring soon after infection:

A

Pneumonia

143
Q

Perthe’s tx. if < 6 years old

A

Observation as good prognosis

144
Q

Causes of obesity in children:

A 
Growth hormone deficiency
Hypothyroidism
Down's syndrome
Cushing's syndrome
Prader-Willi syndrome
145
Q

Wilm’s nephroblastoma tumour: presenting fx.

A

Abdominal mass (most common presenting fx.)
Painless haematuria
Flank pain

One of the most most common childhood malignancies

146
Q

Tx. for Children w/ immune thrombocytopenia: (ITP)

A

None required for children w/ petichiae only and no significant bleeding

147
Q

Age where most children achieve day and night urinary continence:

A

3-4 years-old

148
Q

Second hearing test for newborns/infants if otoacoustic test is abnormal

A

Auditory brainstem response test

149
Q

Airway manoeuvre which may be required in acute epiglottitis

A

Endotracheal intubation

150
Q

Features of growing pains:

A 
NEVER present at the start of the day 
worse after a day of activity 
No limp, limitations of physical activity
systemically well 
Normal physical examination
151
Q

What is used to make a diagnosis of muscular dystrophy:

A

Genetic testing

used to be muscle biopsy

152
Q

Which other trinucleotide repeat disorders also exhibit genetic anticipation:

A

Fragile X
Huntington’s
Myotonic dystrophy
Spinocerebellar ataxia

153
Q

Most common finding related to neonatal sepsis:

A

Respiratory distress

154
Q

Noonan syndrome features:

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

155
Q

Pierre robin syndrome features:

A

Posterior displacement of tongue (may result in airway obstruction)
Cleft palate
Micrognathia

156
Q

Friendly extroverted personality with learning difficulties and elf like face
Supravalvular aortic stenosis

A

Williams syndrome

157
Q

Meningitis organisms in <3 months

A

GBS
E.coli
Listeria

158
Q

Meningitis organisms in 3 months - 6 years

A

Strep pneumoniae
N. meningitidis
H.influenzae

159
Q

Meningitis organisms in > 6 years

A

Strep pneumoniae

N. meningitidis

160
Q

Croup: which inspiratory sound and when is an indication for admission:

A

Audible stridor at rest

161
Q

Mode of inheritance for Prader-Willi

A

Imprinting

162
Q

Neonatal hypoglycaemia if symptomatic:

A

Admit to neonatal unit

IV 10% dextrose

163
Q

CXR features in TTN

A

Hyperinflation and fluid in the horizontal fissure

164
Q

Age to consent

Age to refuse treatment

A

16

18

165
Q

Paediatric laxative ladder:

A

1) Movicol
2) Stimulant laxative - Bisacodyl, Senna, glycerol
3) Osmotic laxative - Polyethylene glycol, lactulose

166
Q

Hand, foot and mouth school exclusion:

A

No need to stay off school if child feels well.

167
Q

Rate of chest compressions all children:

A

100-120 compressions/minute

168
Q

Infant < 3 months w/ UTI action:

A

Refer immediately to paediatrics

169
Q

Most common cause of primary headache in children

A

Migraines

170
Q

Adverse effects of CICLOSPORIN

A 
Nephrotoxicity 
Hepatotoxicity 
Fluid retention 
Hypertension 
Hyperkalaemia

Everything UP: fluid, BP, K+, Hair, Gums, Glucose)

FLASH FINALS (34 decks)

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