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Medicine > Paeds > Flashcards

Paeds Flashcards

0
Q

What causes physiological neonatal jaundice (>24hrs)? 3 things

A

Billirubin production due to shorter RBC lifespan
Low conjugation due to hepatic immaturity
Absence of gut flora impedes elimination of bile pigment

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1
Q

Give 4 causes of neonatal jaundice within 24hrs?

A

Sepsis
Rhesus haemolytic disease
ABO incompatibility
Red cell anomalies (spherocytosis)

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2
Q

State 4 causes of prolonged (>14 days) jaundice?

A 
Breastfeeding
Sepsis
Hypothyroidism
CF
Galactosaemia
Biliary atresia
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3
Q

How do you treat neonatal jaundice?

A

Phototherapy - converts unconjugated bilirubin to soluble products
Exchange transfusion - warmed blood through umbilical vein with removal via artery

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4
Q

Give 5 complications of prematurity?

A 
Hypothermia
Apnoea
Bradycardia
Infection
Difficulty feeding
Hypoglycaemia
Anaemia
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4
Q

Give 3 risk factors for prematurity?

A 
Young maternal age
Multiple pregnancy
Maternal illness
Smoking
Alcohol
Infection
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5
Q

What is kernicterus?

A

High levels of unconjugated bilirubin in the basal ganglia causing acute encephalopathy with irritability, poor feeding and high pitch crying. Can lead to athetoid cerebral palsy.

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6
Q

Give 4 areas Downs Syndrome can affect?

A

Respiratory
Cardiovascular
Ears
GI

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7
Q

Give 4 causes of IUGR?

A 
Multiple pregnancy
Placental insufficiency
Maternal smoking
Congenital infections
Genetic syndromes
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8
Q

Give 6 features that can be seen in Down’s syndrome?

A 
Neonatal hypotonia
Flat occiput
Epicanthic folds
Round face
Protruding tongue
Strabismus
Nystagmus
5th finger clinodactyly
Sandal gap
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9
Q

Give 4 causes of respiratory failure?

A

Upper airway-foreign body, epiglottis, croup
Lower airway-asthma, bronchiolitis, pneumonia
Neuro-head injury, meningitis, raised ICP

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10
Q

State 2 genetic ways Downs syndrome occurs?

A

Non-disjunction

Robertsonian translocations

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11
Q

Give 4 signs of respiratory distress in a child?

A 
Tachypnoea
Subcostal, intercostal and sternal recession
Nasal flaring
Use of abdominal muscles
Tracheal tug
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12
Q

Give 5 clinical features of respiratory failure in kids?

A 
SOB
Tachypnoea
Cyanosis
Nasal flaring
Grunting
Recession
Restlessness
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16
Q

What causes croup?

A

Para-influenza virus

RSV

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17
Q

Give 3 signs of severe croup?

A

Increased work of breathing
Cyanosis
Restlessness

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18
Q

How do you manage croup?

A

O2
Dexamethasone OR Prednisalone
Nebulized adrenaline
ITU

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20
Q

Give the pathology of bronchiolitis?

A

Bronchioles become inflamed
Secrete mucus
Oedema and necrosis cause obstruction of the airways

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21
Q

Give 2 investigations of choice for Bronchiolitis?

A

CXR - hyperinflation & collapse/consolidation

Nasopharyngeal aspirate (NPA) - RSV using immunofluorescence

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22
Q

State the causative organism of bronchiolitis?

A

RSV (respiratory syncytial virus)

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23
Q

What are the indications for admission in Bronchiolitis? 4 things?

A 
Poor feeding
Apnoea
>50 bpm
Dehydration
Exhaustion
23
Q

What is the prophylactic treatment for Bronchiolitis?

A

Monoclonal antibody (palivizumab) providing passive immunity through winter months

24
Q

Give 4 ways intussusception might present in a child?

A

Episodic:
Crying
Drawing the legs up

Vomiting
Blood PR (red currant jam)
Sausage shaped abdominal mass
24
Q

How is intussusception investigated and subsequently treated?

A

USS

Reduction by air enema

26
Q

Give 4 common organisms causing gastroenteritis?

A

Rotavirus
Norovirus
E. Coli
Campylobacter

27
Q

Give 6 parameters for assessing dehydration?

A 
Pulse
BP
Mucous membranes
Urine output
Skin turgor
Fontanelles
CRT
28
Q

How do you calculate fluid deficit in a child?

A

Weight (kg) x percentage dehydration (%) x 10 = Fluid deficit (ml)

29
Q

What is the normal APGAR score & when would you consider resuscitation?

A

7-10 is normal

Below 3 must be resuscitated

30
Q

Give key milestones in child development? 1 month/ 6 month/ 12 month

A

Gross Motor, Fine motor, Language, Social

1 month
GM: Lift head
FM: Track with eyes
L: Coo
S: Track parents
6 month
GM: Sit up
FM: Raking grasp
L: Babbles
S: Stranger anxiety
12 month
GM: Walk
FM: Pincer grip
L: Mama/Dada
S: Imitate parents
31
Q

What are the congenital infections? (TORCH)

A 
Toxoplasmosis
Other (Syphilis)
Rubella
Cytomegalovirus
Hepatitis
HIV
31
Q

When and who does pyloric stenosis mostly affect?

A

First 4-6 weeks of life

First born male infants

32
Q

Which investigations can be taken and what would they show in pyloric stenosis? 2 investigations

A

Ultrasound: Thickened and elongated pyloric muscle

Bloods: Hypochlorimic, Hypokalaemic and Metabolic alkalosis

33
Q

Give 4 causes of developmental delay?

A

Severe learning disabilities (Downs, Fragile X and Cerebral palsy)

Intrauterine infections (TORCH)

Fetal alcohol syndrome

Congenital hypothyroidism

Inborn errors of metabolism

Abuse & Neglect

33
Q

When should you worry about the growth of a child?

A

Weight under 2nd centile
Height under 2nd centile
When height and weight cross 2 centiles

33
Q

What is the management of pyloric stenosis?

A

Rehydration

Surgery: Pyloromyotomy

34
Q

What is hirschsprungs disease and how can you treat it?

A

Congenital absence of ganglia in a segment of colon leading to obstruction, constipation and megacolon

Treat with excision of segment +/- colostomy

35
Q

Give 2 common causes of malabsorption in children?

A

Coeliac disease

Cystic fibrosis

36
Q

Give 3 complications of tonsillitis in children?

A

Otitis media
Peritonsillar abscess
Post streptococcal glomerulonephritis

37
Q

Give 2 organisms implicated in Otitis media in children?

A

Strep. Pneumoniae

Haemophilus influenzae

38
Q

What causes epiglottis and why is not around anymore?

A

Haemophilus influenzae

Hib vaccine introduction

39
Q

How can you investigate reflux in children?

A

Barium swallow

PH monitoring probe

40
Q

How can you manage simple reflux in children? 4 things

A

Nursing infant in upright position
Thickening agents
Gaviscon
Drugs: PPI, H2 receptor blockers, Domperidone

41
Q

What are the possible causes of bile stained vomit in a child? 3 things

A

Duodenal atresia
Ileal atresia
Malrotation of small bowel

42
Q

Complex febrile convulsions in children have the same features as simple ones. There are some differences. What are they? 3 things

A

Seizure focal or prolonged >15mins

Many seizures occurring in close succession

Status epilepticus

43
Q

Give 4 features of a simple febrile convulsion in children?

A

Single seizure lasting <15mins

Neurologically normal before and after

Normal neurodevelopment

Fever not due to CNS infection

45
Q

What is status epilepticus?

A

Continuous seizure activity >30mins

OR Series of seizures without full recovery in between

47
Q

Give 3 common associations of cerebral palsy?

A

Epilepsy
Learning difficulties
Hearing & visual loss
Incontinence

47
Q

Give 4 causes of cerebral palsy?

A

Prenatal- infections (TORCH)

Perinatal - Hypoxic ischaemic encephalopathy, Trauma

Post natal - Meningitis, head trauma, encephalitis

47
Q

Give 4 tests for diagnosing cystic fibrosis?

A

Sweat test
Antenatal test - chorionic villus sampling
Karyotyping
Guthrie test

48
Q

Give 3 causes of a global developmental delay in children?

A 
Chromosomal abnormality - Downs, Turners, Klinefelters
Foetal alcohol syndrome
Abuse and neglect
Congenital hypothyroidism
Trauma
CNS malformation
50
Q

Give 6 causes of failure to thrive in children?

A 
Poor nutrition
Abuse and neglect
Unskilled feeding
Malabsorption 
Down syndrome
Ongoing illness

Medicine (17 decks)

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