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Paediatrics > Paediatric Medicine > Flashcards

Paediatric Medicine Flashcards

1
Q

What are the adverse effects of stimulant medications used to treat children with ADHD?

A

General: tics, anorexia, weight loss, poor growth, sleep disturbance, headache, GI symptoms CVS: hypertension, tachycardia Rare: priapism, peripheral vasculopathy

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2
Q

What are the cardinal features of nephritic syndrome?

A
  • Haematuria
  • Proteinuria (<3.5g/day)
  • Hypertension
  • Uraemia +/- azotaemia, oliguria
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3
Q

What investigations should be performed in suspected post-streptococcus glomerulonephritis?

A
  • Urinalysis + MCS
  • CBE
  • EUC
  • ASOT, anti-DNAse B titre, throat swab
  • Consider renal biopsy
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4
Q

What are the cardinal features of haemolytic uraemic syndrome?

A
  1. Haemolytic anaemia
  2. Thrombocytopenia
  3. Acute renal insufficiency
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5
Q

Which organism is associated with HUS?

A

Shiga-like toxin producing E. Coli (diarrhoea usually precedes ARF)

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6
Q

Which type of HUS has a poorer prognosis?

A

D- HUS (not associated with shiga-like toxin)

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7
Q

What are the cardinal features of nephrotic syndrome?

A
  • Oedema
  • Heavy Proteinuria (>3.5g/day)
  • Hypoalbuminaemia
  • Hyperlipidaemia
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8
Q

What is the most common cause of primary nephrotic syndrome in children?

A

Minimal change disease (90%)

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9
Q

Give 3 complications of nephrotic syndrome.

A
  1. Hypovolaemia
  2. Thromboembolism
  3. Infections (loss of Ig)
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10
Q

At what age do most children obtain urinary continence during:

(a) Daytime
(b) Nighttime

A

(a) 2-4 years
(b) 90% by 7 years

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11
Q

What are the three major symptom domains in Autism Spectrum Disorder?

A
  1. Impaired communication
  2. Impaired social interaction
  3. Repetitive, restricted, stereotyped behaviour
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12
Q

What are the motor consequences of cerebral palsy?

A
  • Spasticity
  • Drooling
  • Incontinence
  • Orthopaedic issues (e.g. knee contractures, hip subluxation)
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13
Q

What is cerebral palsy?

A

Permanent motor impairment due to non-progressive brain disorders, occurring before age 5

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14
Q

What are the three patterns of motor impairment seen in cerebral palsy?

A
  • Spastic (70%) - motor cortex / corticospinal tract damage
  • Dyskinetic (10-15%) - basal ganglia damage
  • Ataxic (<5%) - cerebellar damage
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15
Q

At what age should the following be introduced into a child’s diet?

(a) Solids
(b) Cow’s milk
(c) Low-fat milk

A

(a) 6 months
(b) Cow’s milk
(c) Low-fat milk

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16
Q

Beyond which age should bottle feeding be avoided?

A

18 months

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17
Q

What is the most common type of atrial septal defect?

A

ASD Secundum (patent fossa ovale in the centre of the septum)

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18
Q

What is the most common type of congenital heart disease?

A

Ventricular septal defects (VSD)

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19
Q

What is the most common form of obstructive congenital heart disease?

A

Pulmonary stenosis (8%)

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20
Q

What are the components of Fallot’s Tetralogy?

A
  • VSD
  • Pulmonary stenosis
  • RV hypertrophy
  • Overriding aorta
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21
Q

What are the two most common cyanotic congenital heart defects?

A
  • Tetralogy of Fallot
  • Transposition of the Great Arteries
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22
Q

What is the first-line treatment for PDA in preterm infants?

A

Indomethacin (inhibits PG synthesis to cause constriction of defect)

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23
Q

How does the onset of cyanosis differ between a breath holding attack and a seizure?

A
  • Cyanosis preceeds a breath holding attack
  • Cyanosis occurs after LOC in a seizure
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24
Q

How are replacement fluid requirements calculated in a child?

A

Weight (in grams) X Estimated % dehydration

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25
Q

How are maintenance fluid requirements calculated in a child?

A
  • 4mL/kg/hour for first 10kg of weight
  • 2mL/kg/hour for second 10kg of weight
  • 1mL/kg/hour for every kg of weight thereafter
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26
Q

What diagnosis should be considered in a child with arthralgia, abdominal pain and a rash on the buttocks and legs?

A

Henoch-Sconlein purpura

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27
Q

What diagnosis should be considered in a child with pallor, abdominal pain and inactivity?

A

Intussusception

28
Q

What diagnosis should be considered in a child with drowsiness, fever and a purpuric rash?

A

Meningococcal infection

29
Q

What diagnosis should be considered in a child with an URTI, brassy cough and inspiratory stridor?

A

Croup

30
Q

What diagnosis should be considered in a child with malaise, fever, polyarthritis and rash?

A

Rheumatic fever

31
Q

What diagnosis should be considered in a child with desquamation of the palms/soles?

A

Kawasaki disease

32
Q

How does Osgood-Schlatter disorder present?

A
  • Knee pain after activity
  • Tender knee lump
  • Pain on kneeling
  • Adolescence
33
Q

What is the incidence of febrile seizures in children?

A

5% (1 in 20)

34
Q

What is the recurrence risk of febrile seizures in children?

A

1 in 3 risk of recurrence

35
Q

In what age group can febrile seizures occur?

A

6 months to 6 years (but be more suspicious at the extremes of this range)

36
Q

What are the three main pathological domains in CF?

A
  1. Suppurative lung disease
  2. Exopancreatic disease
  3. Absent vas deferens
37
Q

What are the 3 key features of McCune-Albright Syndrome?

A
  1. Hormones: precocious puberty
  2. Skin: unilateral cafe au lait spots
  3. Bones: fibrous dysplasia of bones
38
Q

What is this device?

A

Autohaler

39
Q

What is this device?

A

Turbuhaler

40
Q

What is this device?

A

Accuhaler

41
Q

List 3 common organisms implicated in viral gastroenteritis.

A
  1. Adenovirus
  2. Norovirus
  3. Rotavirus
42
Q

What is the first-line therapy for suspected bacterial meningitis?

A

IV dexamethasone, cephtriaxone + vancomycin

43
Q

Give 5 differential diagnoses for acute breathlessness in a 5 year-old child.

A
  1. Acute asthma
  2. Inhaled foreign body
  3. Cardiac failure (cardiac asthma)
  4. Anaphylaxis
  5. Acute laryngiotracheobrinchitis
  6. Viral respiratory infection
  7. Pneumothorax
  8. Pneumonia
44
Q

What is the escalation of management in acute, severe asthma?

A
  1. ABCDE
  2. Supplemental O2
  3. Salbutamol
  4. Ipratropium bromide
  5. Prednisolone
  6. IV magnesium sulphate
  7. Paediatric ICU
45
Q

At what age do the following close?

  1. Anterior Fontanelle
  2. Posterior Fontanelle
A
  1. 1-3 months of age
  2. 7-19 months of age
46
Q

Which organism is most commonly implicated in bronchiolitis?

A

Respiratory syncitial virus (RSV)

47
Q

Which organisms are most commonly implicated in croup?

A

Parainfluenza virus (but also influenza and RSV)

48
Q

Which organism is most commonly implicated in epiglottitis?

A

HiB (although less common due to vaccination)

Also: strep pneumoniae, staph aureus

49
Q

Which routine immunisations are live attenuated vaccines?

A

Measles, mumps, rubella and varicella

50
Q

What is the managment for encopresis?

A
  1. Disempaction (paraffin oil, enema)
  2. Maintenance (paraffin oil or movicol)
51
Q

What are the 6 diagnostic features of Kawasaki disease?

A
  1. Temperature >38.5 for 5 days
  2. Mucous membrane changes (red tongue/lips/pharynx)
  3. Conjunctival injection
  4. Maculopapular rash
  5. Cervical lymphadenopathy
  6. Erythema and desquamation of hands/feet
52
Q

How is Kawasaki Disease treated?

A

IV immunoglobulin and aspirin

53
Q

What is the first-line treatment of suspected meningococcal disease?

A

IV?IM cephtriaxone (or penicillin)

54
Q

What chemoprophylaxis should be given to contacts of a child who has been diagnosed with meningococcal?

A

Oral rifampicin or IM cephtriaxone (if rifampicin is contraindicated)

55
Q

Describe the typical rash of measles.

A
  • Blotchy, red, confluent in areas
  • Koplik’s spots on buccal mucosa
56
Q

What is the next step in management for nephrotic syndrome that is unresponsive to steroids?

A

Renal biopsy

57
Q

Which antibiotic is first-line in the treatment of GABHS pharyngitis?

A

Phenoxymethylpenicillin

58
Q

What is the empirical antibiotic therapy for meningococcal infection?

A

Cephtriaxone

59
Q
A
60
Q

What is the aetiology of a petechial rash?

A

Low platelets

61
Q

Which 3 organisms are most commonly implicated in meningitis in children?

A
  • Strep pneumoniae
  • Neisseria meningiditis
  • Haemophilus influenzae
62
Q

Which organisms are commonly implicated in encephalitis?

A
  • Herpes simplex virus
  • Enteroviruses
  • Other herpesviruses (e.g. VZV, CMV)
63
Q

List 3 acute complications of meningitis.

A
  • Seizures
  • SIADH
  • Subdural abscess
  • Shock / DIC
64
Q

List 3 long-term complications of meningitis.

A
  • Hearing impairment
  • Learning difficulties / developmental delay
  • Permanent neurological deficit
  • Hydrocephalus
  • Seizure disorder
65
Q

What is the pattern of inheritance for G6PD deficiency?

A

X-linked recessive

Paediatrics (5 decks)

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