Paeds Flash Cards

Question 1

Age needed for conduct disorder? What is it called before this?

Answer 1

7

Oppositional defiant disorder

Question 2

Egs of trinucleotide repeat disorders?

Answer 2

Hungtingtons
Fragile X
Myotonic dystrophy

Question 3

Gene in fragile X?

Answer 3

FRAXA gene - FMR1

Question 4

3 hallmarks of ADHD

Answer 4

Inattention
Hyperactivity
Impulsiveness

Question 5

How long features of ADHD for diagnosis? Age?

Answer 5

6/12

Pervasive features and onset <7

Question 6

3 conditions with high rates of autism

Answer 6

Fragile x
TS
Untreated phenylketonuria

Question 7

Rettes syndrome in? Natural Hx? Features? Diagnosis?

Answer 7

X linked disorder almost exclusively in girls

Normal development - 5 months onwards head grows slow
Decreased interest in social activities
Impaired communication + psychomotor retardation
Stereotyped movements develop Eg hand wringing

Sequencing of MECP2 gene mutations

Question 8

Age if enuresis

Answer 8

At least 5

Question 9

Two types of allergy?

Answer 9

IgE mediated - Eg peanut allergy

Non IgE - Eg coeliac

Question 10

Mechanism of allergy ?

Answer 10

Body identifies allergen and APC presents to TH2 cells

• > release cytokines -> B-Cells make IgE
• > IgE presents to mast cells

Question 11

Immediate and delayed reaction to allergen?

Answer 11

Immediate
Degranulation of mast cells -> produce histamine (also basophils)

Delayed
After 4-6 hours eosinophils

Question 12

Ix for allergy?

Answer 12

Skin prick testing

• quick cheap and safe
• positive test only gives 60% chance of true reaction (use Hx)

Serum specific IgE (RAST) testing

Food challenge
-Gold standard

Question 13

Mx of Allergy’s

Answer 13

MDT 
Avoid allergen 
Antihistamines 
-Piriton 
-piriteze (non-drowsy)

Question 14

What is uticaria? Also called? How long? Usual cause?

Answer 14

Itchy rash ‘nettle rash’ Hives
Chronic is >6weeks but can be acute

Usually idiopathic
IgE mediated - Food, infection, NSAIDS, heat ….

Question 15

Heart defect in Williams

Answer 15

Supraventricular AS

Question 16

Mx of speculum ASD?

Partial AVSD?

Answer 16

Cardiac catheterisation with insertion of occlusive device

Open surgical correction

Question 17

ECG in ASD?

Answer 17

(RVH) -> R axis deviation
Partial right bundle branch block

[WiLLiaM MaRRoW]

Question 18

Explain William marrow

Answer 18

Leads V1 and V 3
LBBB V1=w, v3=M

RBBB V1 = M, V3 =w

Question 19

Ix in small VSD?

Answer 19

CXR / ECG normal

Echo - demonstrates location

Question 20

Ix in Large VSD

Answer 20

CXR - cardiomegaly - increased pulmonary vascular marking, pul oedema

ECG - biventricualr hypertrophy
-Tall T waves (RVH)

Echo - Can demonstrate HTN severity + anatomy

Question 21

Mx of large VSD? (In young infants?)

Answer 21

In young infants - pulmonary artery bending can be down to a low the child respite while grows to be big enough for surgery

Initial mx of Hf and Pulm HTN

Surgical repair under Cardiopulmonary bypass

Question 22

Features of PDA

Answer 22

Continous murmur beneath L clavical

Increase pulse pressure - bounding pulse

Question 23

Ix in PDA

Answer 23

ECG / CXR - usually normal

Echo - with Doppler will allow detection

Question 24

Usual location of PS?

Answer 24

Valvular

Can be supra / sub

Question 25

Features of PS?
IX
MX?

Answer 25

Usually asx
Ejection systolic murmur at upper L sternal edge
-Ejection click

Ix
CXR - usually normal
ECG - RVH -> tall T wave in V 1

Mx
Trans catheter balloon dilation

Question 26

AS sx?
Signs?
IX?
Mx?

Answer 26

Asx - could have reduced exercise tolerance

Slow rising pulse
Carotid thrill
Ejection systolic murmur - upper R sternal edge

Ix
CXR - normal / some LVH
ECG - normal / LVH -> inverted T waves in V6

Mx
Avoid strenuous exercise
Balloon / surgical valvectomy

Question 27

What is pre ductal coarctation also called

Answer 27

Aortic interruption

Question 28

Post ductal coarctation of aorta
Signs?
Ix?
Tx?

Answer 28

HTN in right arm - Cardio-femoral delay / absent femoral

CXR - Rib notching (hypertension in intercostal vessels)
-‘3 sign’ visible notch in descending aorta

ECG - LVH - inverted T / tall R in v6,

Stunting by cardiac catheterisation
Surgical repair if severe

Question 29

Some DDX of newborn with resp distress

Answer 29

Cyanotic CHDS
Surfactant deficiency
Persistent pulmonary hypertension of newborn
Infection

Question 30

ECG in ToF

Answer 30

RVH - tall T in v 1

Right axis deviation

Question 31

What happens in surgical correction of TOF

Answer 31

Shunt between subclavian and Pulm arteries (increase Pulm blood flow)
Patch closure of VSD
Widening of R ventricular outflow tract

Question 32

Eg of prostaglandin to maintain PDA

Answer 32

Prostaglandin E1

PGE1

Question 33

Supraventricular tachycardia mx?

Answer 33

Vagal stimulation - cold water to face / valsalva manoeuvre

IV adenosine -> if fails DC cardioversion

Question 34

Otitis media features?
Mx?
Complications?

Answer 34

Red eardrum -> may perforate
Fever, vomiting, distress

Sx relief
Amoxicillin if bacterial

Recurrent infection -> otitis media with effusion
Mastoiditis, meningitis

Question 35

What is otitis media with effusion?
Features?
Mx?
Complication?

Answer 35

Glue ear
Common if recurrent URTI
Conductive hearing loss

Mx
Usually resolve but if persistent - Grommets

Recurrent infections
Could interfere with normal speech development

Question 36

OSA features?

Mx?

Answer 36

Hx of snoring followed by 30 seconds of apnea

Often in Craniofacial disorders Eg Pierre-robin
Downs - hypotonia
Neuromuscular

Mx
Nasal mask ventilation
Adeno-tonsillectomy is usually curative

Question 37

What should you always rule out with acute lung children

Answer 37

Inhaled foreign body

Question 38

Ix of pneumonia

Answer 38

CXR - lobe consolidation -> bacterial

FBC - Neutrophilia -> bacterial

USS - Distinguish between effusion and empyema

Question 39

Usual cause of wheeze in children ? How to differentiate from asthma ?>

Answer 39

Viral induced - only get with with viral infections