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Child Health > Next Steps in Child Health > Flashcards

Next Steps in Child Health Flashcards

1
Q

what micro-organism causes diphtheria?

A

Corynebacterium diphtheriae

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2
Q

what type of bacteria is Corynebacterium diphtheriae?

A

aerobic gram-positive

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3
Q

is diphtheria an URTI or LRTI?

A

URTI

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4
Q

which serotype of meningococcal disease is most serious?

A

serotype B

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5
Q

which serotypes of meningococcal disease have vaccines available?

A

A, C, W, Y135

recently B

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6
Q

what is the difference between elimination and eradication?

A

elimination: reduction to zero incidences of disease in a defined geographical area, continued measures are required
eradication: permanent reduction to zero of worldwide incidence, intervention measures are no longer needed

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7
Q

what diagnosis should you suspect of a 6 week old child who has ‘milky vomit’?

A

pyloric stenosis

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8
Q

what is pyloric stenosis?

A

thickening of the pylorus causing narrowing

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9
Q

what is shown in ultrasound of pyloric stenosis?

A

pylorus is seen

normally should not be seen

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10
Q

what is the treatment of pyloric stenosis (due to thickened pylorus)?

A

surgery to cut open pylorus

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11
Q

what diagnosis should you suspect of a 6 months old child who has ‘green vomit’ and ‘red currant jelly’ within their stool?

A

intussusception

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12
Q

what do you see on ultrasound of intussusception?

A

target lesions

folds of bowel

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13
Q

how do you treat intussusception?

A

air reduction

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14
Q

what diagnosis should you suspect of a 6/7/8 year old child with vomiting and peritonitis?

A

appendicitis

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15
Q

what is the name of hte point 1/3 of the wasy from the ASIS to the umbilicus that becomes painful in appendicitis?

A

McBurney’s point

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16
Q

what can you see on ultrasound of appendicitis?

A

appendix

you can only see it when it is inflamed

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17
Q

what is the treatment of appendicitis?

A

appendisectomy

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18
Q

what does vomiting bile suggest?

A

high GI obstruction

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19
Q

what is malrotation of the gut?

A

when the gut is in the wrong place

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20
Q

what is the major complication of malrotation

A

volvulus

bowel obstruction, can lead to ischaemia/necrosis

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21
Q

how do you diagnose malrotation with volvulus?

A

upper GI contrast with follow through

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22
Q

what is seen in upper GI contrast with follow through in a patient with volvulus following malrotation?

A

twisted bowel is shown

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23
Q

what is the treatment of volvulus following malrotation?

A

operation to untwist bowel

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24
Q

what is the most common cause of an acute scrotum?

A

torsion of hydatid of Morgani

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25
Q

what is a hydatid of Morgani?

A

remnant mullerian duct structure (left over females bit)

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26
Q

is torsion of hydatid of morgani a serious diagnosis?

A

no

no consequences

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27
Q

what self-resolving condition presents as acute scrotum with large swollen, red, testes that are itchy but not painful?

A

idiopathic scrotal oedema

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28
Q

what is the treatment of idiopathic scrotal oedema?

A

will settle on it’s own

maybe analgesia or anti-histamines

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29
Q

what is phimosis?

A

congenital narrowing of the foreskin so it becomes tight and can’t be retracted
(can be physiological during the period babies where nappies)

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30
Q

what is paraphimosis?

A

a condition where the foreskin can’t be returned to it’s normal position after being retracted

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31
Q

what is hypospadias?

A

congenital abnormality of urethra in males where the urinary opening is not at the head of the penis

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32
Q

what is a hydrocele?

A

peritoneal fluid around the testical causing swelling

size can vary as the fluid moves between peritoneum and scrotum

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33
Q

why should you wait till after 2 years old to operate on a hydrocele?

A

many close on their own before the age of 2

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34
Q

why are undescended testicles operated on to bring them down?

A

so they are in a position where they can be examined and changes can be seen

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35
Q

as a child ages what happens to the heart rate, systolic BP and resp rate?

A

HR decreases
SBP increases
RR decreases

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36
Q

why anatomically are children more likely to struggle with smaller respiratory infections than adults?

A
  • high anterior larynx
  • floppy epiglottis

(if these get inflamed, more likely to cause compromise)

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37
Q

what is the commonest reason for acute illness in children?

A

sepsis

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38
Q

why might a child be in respiratory distress due to sepsis from an infection where the source is outwith the lungs?

A

infection might cause patient to become acidotic

fast breathing to try blow our CO2

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39
Q

what is the most common causes of bronchiolitis?

A

respiratory synctial virus (RSV)

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40
Q

what noises are present in croup?

A

barking cough

stridor

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41
Q

why are steroids sometimes given in croup

A

to reduce oedema

-doesn’t treat virus

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42
Q

what is croup?

A

(viral) infection around larynx and upper trachea that can cause severe airway obstruction

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43
Q

what are febrile seizures?

A

a seizure that happens when a child has fever

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44
Q

what is a reflex anoxic seizures?

A

syncope caused by reduced oxygenation to the brain due to a brief period of asystole

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45
Q

what is a breath holding attack?

A

when a child holds their breath until they turn blue and pass out

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46
Q

compare food allergy to food intolerance?

A

food allergy- acute allergic reaction (IgE mediated)

food intolerance- delayed reaction, more varied symptomatology

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47
Q

in 2012, 1 in how many children were at risk of obesity? (at or above 95 percentile)

A

1 in 6

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48
Q

what bacteria is the most common cause of uncomplicated urinary tract infections in children?

A

E. Coli

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49
Q

in the UK the median symptom interval for childhood brain tumours is how long?

symptom interval = time between symptom onset and diagnosis

A

2.5- 3 months

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50
Q

what is the commonest kind of heart murmur in childhood?

A

innocent heart murmur

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51
Q

what is a sensitive innocent heart murmur?

A

an innocent heart murmur which changes with child’s position or with respiration

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52
Q

what is a short duration innocent heart murmur?

A

an innocent heart murmur which is not holosystolic

53
Q

what is a single innocent heart murmur?

A

an innocent heart murmur which has no associated clicks or gallops

54
Q

what is a small innocent heart murmur?

A

an innocent heart murmur which is limited to a small area and not radiating

55
Q

what is a soft innocent heart murmur?

A

an innocent heart murmur with low amplitude

56
Q

what is a sweet innocent heart murmur?

A

an innocent heart murmur which is not harsh-sounding

57
Q

what is a systolic heart murmur?

A

an innocent heart murmur which is limited to systole

58
Q

in a child which is more likely to cause cardiac arrest- circulatory failure or respiratory failure?

A

respiratory failure

59
Q

in an adult which is more likely to cause cardiac arrest- circulatory failure or respiratory failure?

A

circulatory failure

60
Q

what does respiratory failure lead to?

A

respiratory arrest

61
Q

what does respiratory arrest eventually lead to?

A

cardiac arrest

62
Q

what does circulatory failure lead to?

A

cardiac arrest

63
Q

what are the 2 main cause of circulatory failure?

A

fluid loss

fluid maldistribution

64
Q

what are the 2 main causes of respiratory failure?

A

respiratory distress

respiratory depression

65
Q

if BP is low in a child, how much 0.9% saline should be given initially? (not in trauma)

A

20mls per kg of child’s weight

66
Q

at what percentage of dehydration does shock occur?

A

over 10% dehydration

67
Q

if a child is in trauma, how much 0.9% saline should be given initially?

A

10mls per kg of child’s weight

68
Q

what is Henloch-Schonlein Purpura?

A

vaculitis which affects children post-viral

69
Q

what type of murmur is PDA? and where is it heard best?

A

harsh systolic murmus, best heard at left sternal edge

70
Q

what is the triad of symptoms/signs of nephrotic syndrome?

A

oedema
proteinuria
hypercholesterolaemia

71
Q

what is the most common diagnosis of a child with projectile vomitting, weight loss and a palpable epigastric mass during feeding?

A

pyloric stenosis

72
Q

what diagnosis is most common of a child with a webbed neck, broad chest, wide spaced nippled and absent secondary sexual characteristics?

A

Turners syndrome

73
Q

A child presents with a fever and maculopapular rash and kopik spots (small, white lesions on the oral mucosa), what does this suggest?

A

measels

74
Q

what infection does drooping saliva suggest?

A

epiglottitis

75
Q

outsline the management of Perthes disease?

A

before 6: physio

after 6 surgery

76
Q

which is more common- viral or bacterial meningitis?

A

viral

77
Q

which is more severe- viral or bacterial meningitis?

A

bacterial

78
Q

what is the most common viral infection in children?

A

enteroviruses eg coxsackie

79
Q

what is the treatment for suspected bacterial meningitis in a child under 3 months?

A

IV cefotaxime and amoxicillin

80
Q

once the pathogen has been confirmed as gram-neg bacilli, what is the treatment for meningitis in a child under 3 months?

A

cefotaxime 21 days

81
Q

once the pathogen has been confirmed as group B strep, what is the treatment for meningitis in a child under 3 months?

A

cefotaxime for 14 days

82
Q

once the pathogen has been confirmed as Listeria monocytogenes, what is the treatment for meningitis for a child under 3 months?

A

amoxicillin for 21 eays

83
Q

once the pathogen has been confirmed as neisseria meningitidis (meningococcal) what is the treatment for meningitis for a child under 3 months?

A

ceftriaxone 21 days

84
Q

what is the treatment for viral meningitis?

A

IV aciclovir

85
Q

what can be given as prophylaxis for close contacts with people with meningitis?

A

ciprofloxacin

vaccination booster

86
Q

what virus causes mumps?

A

rubulavirus

87
Q

which salivary glands are mainly affected by mumps?

A

parotid glands

88
Q

how is mumps spread?

A

saliva droplets

89
Q

what is the incubation period of mumps

A

17 days

90
Q

how does the parotitis typically present in mumps?

A

begins unilaterally then spreads bilaterally
swollen, red, painful angle of the jaw
may limit movement (eating, swallowing)

91
Q

how long does parotitis in mumps usually last before settling?

A

3-5 days

92
Q

what is parotitis?

A

inflammation of the parotid gland

93
Q

what is orchitis?

A

inflammation of the testes

94
Q

what percentage of patients with mmps get orchitis?

A

10%

95
Q

when does orchitis usually present in mumps?

A

4-7 days after parotitis

96
Q

what serious complication can occur from mumps?

A

viral meningitis

97
Q

when does viral meningitis usually happen in the course of mumps?

A

a few days after parotitis

98
Q

what is the management of mumps?

A

supportive care

notify public health

99
Q

what pathogen causes measles?

A

morbillivirus

100
Q

how is measles spread?

A

airborn (coughing, sneezing)

direct contact with nasal/throat secretions

101
Q

what is the incubationperiod of measles?

A

10 days

102
Q

what is coryza?

A

irritation/inflammation of mucous membrane inside the nose

103
Q

what is a prodromal phase?

A

a period between initial symptoms and rash

104
Q

what is the classic triad of the prodromal phase in measles?

A

conjuncitivits
cough
coryza

105
Q

what are the pathopneumonic clustered, white lesions in the buccal mucosa in measles called?

A

koplik spots

106
Q

what kind of rash appears in measles?

A

morbilliform rash

107
Q

what sites does the morbilliform rash appear on in measles?

A

first the face/shoulder
then extends down trunk
palms/soles last

108
Q

how do you confirm measles?

A

salivary swab for measles specific IgM

109
Q

what is the management of measles?

A

supportive care

notify public health

110
Q

what is the prophylaxis for people who are in contact with a person with measles?

A 
post-exposure vaccination
human IgG (in immunocompromised etc)
111
Q

what can measles in pregnancy cause?

A

miscarriage
prematurity
low birth weight

112
Q

what ages of children are affected by croup?

A

6 months - 3 years

peak at 2 years

113
Q

what viruses mainly cause croup?

A

parainfluenzae viruses

114
Q

what cause of croup is associated with particularly severe disease?

A

influenza A

115
Q

what is the presentation of mild croup?

A

occasional barking cough
no audible stridor at rest
minimal intercostal/suprasternal recession
child is happy, interactive and feeding normally

116
Q

what is the presentation of moderate croup?

A

frequent barking cough
stridor at rest
intercostal/suprasternal retraction at rest
child is alert and undistressed

117
Q

what is the presentation of severe croup?

A 
frequent barking cough
prominent stridor at rest
marked intercostal recession
significant distress or lethargy
may have tachycardia
118
Q

what is the management of moderate to severe croup?

A

oral dexamethosone
(severe, unresponsive croup- nebulised adrenaline)
oxygen as required

119
Q

what part of the airways does croup affect?

A

larynx and trachea (upper airway)

120
Q

what part of the airways does bronchiolitis affect?

A

bronchioles (lower airway)

121
Q

what age of children are affected by bronchiolitis?

A

3 months to 1 year

122
Q

in bronchiolitis, what might be heard upon auscultation of the lungs?

A

fine inspiratory crackles

expiratory wheeze

123
Q

what part of the gut is most commonly affected by ischaemia in a volvulus due to malrotation?

A

midgut

superor mesenteric artery affected

124
Q

what are the symptoms of malrotation?

A

asymptomatic

125
Q

what are the symptoms of volvulus secondary to malrotation?

A

irritability, reduced stool frequency, green vomit

126
Q

what is the most common cause of bowel obstruction?

A

intussesception

127
Q

what are the 3 main risk factors to intusseception?

A

meckels diverticulum
henoch schonlein purpura
rotavirus (occasionally vaccine)

128
Q

what are the symptoms of intussusception?

A

intense abdo pain episodically lasting 2-3 minutes
vomiting
red currant jelly stool
sausage shaped abdominal mass

Child Health (4 decks)

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