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medicine year 3 > paeds > Flashcards

paeds Flashcards

1
Q

why is grunting a sound made during severe resp distress?

A

caused by exhaling with the glottis partially closed to increase positive end expiratory pressure -trying to keep airways open n

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2
Q

what is an important complication to screen for in kawasaki disease and how do you screen for it?

A

coronary artery aneurysms
echocardiagram

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3
Q

what is the classic scarlet fever rash?

A

‘sandpaper’ rash

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4
Q

why does down’s syndrome cause sleep apnoea and snoring?

A

low muscle tone in upper airways and large tongue /adenoids
increased risk of obesity -another predisposing factor to snoring

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5
Q

what are the causes of snoring in children?

A

obesity
nasal problems (polyps, deviated septum, hypertrophic nasal turbinates)
recurrent tonsilitis
down’s syndrome
hypothyroidism

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6
Q

what is the first sign of puberty in males and females?

A

males -testicular growth at around 12 years of age
females -breast development at around 11.5 years of age

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7
Q

what rate should chest compressions be done for all children?

A

100-120bpm

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7
Q

how do you measure temperature in different ages of children?

A

<4 weeks old: electronic thermometer in axilla
4 weeks or older: use electronic/chemical dot thermometer in axilla or infra-red tympanic.

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7
Q

what is the temperature level that’s a red flag in different ages of babies?

A

if under 3 months: >38
if 3-6 months: >39
hypothermia in <1m old-sepsis red flag

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7
Q

what drug is usually given if encephalitis is suspected in a febrile child

A

acyclovir

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7
Q

what are the key non-infective differentials for children who have fevers for more than 5 days?

A

kawasaki disease
still’s disease (systemic JIA)
rheumatic fever
leukaemia

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7
Q

what sort of vaccine is the polio one?

A

inactivated

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8
Q

what are some important vaccines that are live vaccines?

A

MMR
BCG
oral polio (not used in this country anymore because we have it in the 6in1 but used in developing countries)
typhoid
yellow fever

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9
Q

what are the 2 peaks for T1DM presentation in children?

A

4-6yo and 10-14yo

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10
Q

how long does insulin stay in the body?

A

half life 6 min, cleared from circulation completely in 10-15min.

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11
Q

what are the key newborn screenings?

A

NIPE, 6 week examination, new born hearing screening, neonatal heel pick blood spot

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12
Q

what is in the heel prick test?

A

sickle cell, CF, congenital hypothyroidism, 6 inherited metabolic diseases (PKU, MCADD, MSUD, IVA, GA1, HCU)

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13
Q

what is the management of binge eating disorder in children?

A

1st line =guided self help programmes

2nd line (unacceptable or ineffective after 4 weeks)-group CBT-ED

3rd line =individual CBT-ED

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14
Q

when do you consider inotropes in management of paeds sepsis and which ones could be given peripherally?

A

if normal physiological parameters are’nt restored after >or equal to 40ml/kg of fluids
adrenaline or dopamine, peripheral IV or IO

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15
Q

what is the treatment of SUFE?

A

INTERNAL fixation

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16
Q

what is thelarche?

A

also known as breast budding
is the onset of secondary breast development.

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17
Q

what is the most common cause of stridor in children and how does it present?

A

laryngomalacia
usually presents with stridor in first 4 weeks of age

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18
Q

what is the most common causative organism in the UK of early onset neonatal sepsis?

A

group B strep

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19
Q

what is the actual thing they’re testing for in the heel prick test for CF and what’s the next step?

A

immunoreactive trypsingogen (IRT) -raised is positive. if raised they get a sweat test.

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20
Q

when can you give adrenaline in a neonatal resus situation?

A

if bradycardic <60bpm

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21
Q

why is aspirin contraindicated in kids <16 (unless specific circumstances)?

A

risk of reyes syndrome -disease of liver and brain. MOA unknown but something to do with mitochondria getting damaged. causes repeated vomiting, seizures, lethargy, tachypnoea.

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22
Q

what age is adenovirus most common in?

A

1-4

23
Q

what is the classic presentation of adenovirus?

A

classic triad -URTI, conjunctivitis, GI symptoms (diarrhoea/change in bowel habit)

24
Q

how long does adenovirus usually take to resolve itself?

A

7-21 days

25
Q

what are the clinical features of mumps?

A

fever, malaise, muscular pain, parotitis

26
Q

what can parotitis present as?

A

‘ear pain’, ‘pain on eating’ ‘sore throat’

27
Q

what are the complications of mumps?

A

swollen testicles
viral meningitis
encephalitis

28
Q

what is the transmission route for mumps?

A

respiratory

29
Q

how do you diagnose HHV1 or 2?

A

PCR test of lesion, CSF, or blood

30
Q

what antivirals can you use for HHV1/2?

A

acyclovir, valacyclovir

31
Q

what is dress syndrome?

A

delayed hypersensitivity reaction to a drug causing fever, rash, lymphadenopathy, haematological abnormalities and organ involvement. can be caused by a lot of drugs.

32
Q

how does carbamazepine work and what are its notable side effects?

A

inhibits sodium channels
agranulocytosis (low WCC)
aplastic anaemia (bone marrow not making enough blood cells)
induces p450-many drug interactions

33
Q

what are the notable side effects of phenytoin?

A

folate and vit D deficiency

34
Q

who can pure tone audiometry be used on?

A

people over 3yo.

35
Q

which test is 1stline for vesicoureteric reflux?

A

MCUG (micturating cysturethrogam)

36
Q

what is a DMSA scan?

A

nuclear medicine scan of kidneys -to detect renal morphology structure and function

37
Q

where are inhaled foreign bodies most likely to be found?

A

right main bronchus

38
Q

which sort of CP can kernicturus lead to?

A

dyskinetic CP -bilirubin loves to lurk in basal ganglia appaz

39
Q

what’s the difference in presentation of post strep glomerulonephritis and IgA nephropathy?

A

post strep -7-14 days after strep infection
IgA nephropathy -1-3 days post URTI

40
Q

what do you need to make sure you do with a child post head injury?

A

don’t leave them alone in 1st 24 hours

41
Q

what makes up the apgar scoring and what is its significance?

A

a-appearance
p-pulse
g-grimace (‘reflex irritability’)
a-activity (muscle tone)
r-respiration (breathing rate and effort)
needs to be performed on every live newborn at 1 and 5 minutes of life.
7-10=reassuring
4-6=moderately abnormal
0-3=low

42
Q

what is the management of neonatal hypoglcyaemia?

A

symptomatic -glucose 10% IV infusion and retest BM in 15 minutes. if delay in IV access consider buccal glucose gel or IM glucagon (but still do the IV)
asx -increase breast feeding frequency, can supplement with formula/buccal glucose gel. check BMs in 1h to ensure response.
if ineffective: same infusion

43
Q

what can you do to try and prevent neonatal hypoglycaemia once baby is born?

A

feeding early and regularly, keeping baby warm

44
Q

what is the initial and definitive managements of hirschpring’s?

A

initial-rectal washouts/bowel irrigation
definitive -surgery

45
Q

what is the management of mild depression in children?

A

watchful waiting for 2 weeks then review
if nothing changes psych therapies for 2-3 months
if no response refer to cahms

46
Q

what is the treatment of moderate or severe depression in children?

A

immediate cahms review
aged 12-18: 3 months of individual CBT, consider fluoxetine alongside or 2nd line

47
Q

what are the normal and abnormal heart rates at birth?

A

> 100 =satisfactory
60-100 =intermediate, possible hypoxia
<60 =critical, hypoxia likely

48
Q

what syndrome is linked to angelman?

A

prader willi -from mum

49
Q

what is the management of constipation in kids?

A

macrogol (movicol) -1st line
stool softener eg lactulose, docusate -can add
stimulant 2nd line -senna, bisacodyl, dulcolax

50
Q

what is the most common cause of painless massive GI bleeding requiring transfusion in children between ages 1 and 2?

A

meckel’s diverticulum

51
Q

when is soiling considered patholigical?

A

4 years old

52
Q

what is in the heelprick test?

A

sickle cell
CF
congenital hypothyroidism
metabolic diseases

53
Q

when is the newborn hearing test done and what is it?

A

screening -everyone should get it
age 4-5 weeks ideally, can be done up to 3 months
otoacoustic emission test

54
Q

what is the treatment for whooping cough?

A

if 21 days or less since onset -azithro/clarithro
if >21 days: advice and supportive

55
Q

what is infantile colic?

A

common and benign set of sx -excessive crying, pulling up legs, worse at night usually and usually <3m

56
Q

what is the murmur caused by ASD?

A

ESM loudest in pulm area and fixed splitting of S2
because L->R shunt increases loading time of RV and more blood going through pulm valve

57
Q

in tet of fallot what determines clinical severity?

A

degree of pulmonary stenosis (RV outflow obstruction)

58
Q

what is the classic presentation of patellar tendonitis?

A

chronic knee pain -worse after movement, tender below patella o/e

59
Q

what is the diagnostic investigation for reflux nephropathy?

A

MCUG (micturating cystography)

60
Q

which sex is perthe’s more common in?

A

boys-5x more common

medicine year 3 (21 decks)

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