Pass Medicine Flashcards
Which defect is caused by lithium in pregnancy?
Ebsteins’ Anomaly
Tricuspid regurgitation and stenosis
Acynatoic heart disease in babies
VSD (most common)
ASD
PDA
Coarctation of the aorta
Cyanotic heart disease
Transposition of the great arteries (presents at birth)
Tetralogy of Fallot ( 1-2 months old)
Tricuspid atresia
Differential of neonatal hypotonia
Sepsis
Hypoglycaemia
Hypothyroidism
Prader -Willi - excessive appetite and weight gain in future
Pierre Robin Syndrome
1) Micrognathia (small jaw)
2) Posterior displacement of tongue —> airway obstruction
3) Cleft palate
What is the commonest childhood cancer? WHen is peak incidence
ALL
Peak - 2-5
Management of whooping cough
1) Oral azithromycin if within 21 days
2) Inform public health as notifiable disease
Where is the purpuric rash of HSP most likely to be?
Buttocks, extensor surfaces of arms and legs
Define neonatal death
Death in the first 28 days of life
Commonest meningitis organisms
1) <3 months old = Group B strep
2) otherwise = neisseria meningococcus/ strep pneumonia
First line medication for ADHD?
Methylphenidate
Other than prematurity, what are the RF for surfactant deficiency?
Male
DM mother
LSCS
Causes of nephrotic syndrome?
In children the vast majority are caused by minimal change glomerulonephritis
Proteinuria
Hypoalbuminaemia
Oedema
Where is the commonest site of Wilm’s tumour metastasis?
The lungs
Typically presents with an abdominal mass, haematuria and flank pain
Girls with Turner’s syndrome only have 1 X chromosome. This means they can get X linked diseases such as haemophilia
This is interesting
Asthma guideline in 10 year old
1 = SABA 2 = SABA + ICS 3 = SABA + ICS + LTRA 4 = SABA + ICS + LABA (stop LTRA e.g. montelukast if it has not been beneficial)
What is the most common cause of inherited neurodevelopmental delay?
Fragile X
Associated with long face, protruding ward, recurrent otitis media and ADHD
Why is aspirin normally CI in children?
The risk of Reye’s syndrome
Rare but can cause permanent brain and liver damage
Kawasaki’s disease is a vasculitis normally seen in children. It is rare. What are the symptoms?
1) Fever for >5 days
2) Pharyngeal infection - Strawberry tongue and fissured lips
3) Cervical lymphadenopathy
4) Conjunictivits
5) Polymorphus rash (trunk)
6) Red palms/ soles of feet - skin can peel
The main complication is coronary artery aneurysm
Treat with aspirin/ immunoglobulin
Talk through the steps of neonatal resuscitation - from birth
1) Dry baby
2) Assesss APGAR - tone, colour, breathing, HR and movement
3) Open airway and give 5 inflation breaths if not breathing adequately
4) Reassess and move onto CPR/ IV drugs etc as appropriate
MMR is a live attenuated vaccine. When is it given?
First dose at 12 months
Second dose at 3 - 5 years
List some poor prognostic factors for ALL
1) Male
2) <2 or >10 at diagnosis
3) WBC >20 X10^9 at diagnosis
How would you differentiate between a caput succedaneum and cephalohaematoma?
Caput succedenum causes is a boggy swelling which crosses the suture line
A cephalohaematoa will not cross the suture line
How do you screen for coronary artery aneurysms associated with Kawasaki Disase?
Echo
Features of noonan’s syndrome?
Pectus excavatum
Short stature
Pulmonary stenosis
Webbed neck
Features of Edwards syndrome?
Trisomy 18 Low set ears Rocker bottom feet Micrognathia Overlapping finger
What features necessitate 999 if child has suspected bronchiolitis?
1) Cyanosis
2) Severe Respiratory distress e.g. RR> 70, grunting, marked chest recession
3) Apnoea
Most likely diagnosis in a baby born with a big tongue (micro-glossia), macrosomia and hypoglycaemia
Beckwith Wiedemann syndromes
A 10 year old child is in for a cosmetic mole removal. His parents have consented but he is adamant that he does not want it. What do you do?
Inform your consultant and recommend that they cancel the procedure
Define precocious puberty?
Development of secondary sexual characteristics before age 8 in girls and 9 in boys
What is thelarche and adrenarche?
Thelarche = development of breast buds Adrenarche = development of pubic hair
Give 5 features of hypernatraemia?
1) Jitteriness
2) Increased tone
3) Confusion/ coma
4) Hyperreflexia
5) Convulsions
Teenage girl with intermittent anterior knee pain, swelling and locking
Osteochondritis dissecans
Children should have: Head control at 3m Roll over/ sitting at 6m Crawling/ standing at 9m Cruising at 12 months Walking unsupported by 15 m
Remember some children don’t crawl - they bottom shuffle. This is a normal variant
Testicular pain worse on elevation and absent cremasteric reflex
Most likely testicular torsion
What vaccines are given a 8 weeks?
6 in 1
Pneumococcal
Rota virus
Men B
6PRM
What conditions are covered by the 6-in-1 vaccine?
Diptheria Pertussis Polio Hep B His Tetanus
What vaccines are given at 3 months?
6 in 1
Rotavirus
6R
What vaccines are given at 4 months?
6 in 1
Pneumococcal
Men B
6PM
What is the commonest cause of nose bleeds in children?
Nose-picking
Advise to stop!
A short dose of chlorhexidene (disinfectant) and neomycin (antibiotic) is recommended
2 year old presents to GP with mild croup. Management?
Give a dose of dexamethasone 0.15mg/kg/ PO
Helps relieve symptoms temporarily!
Features of intussusception?
Paroxysmal colicky pain
Bilious vomit
Blood PR - ‘red currant stool’
US will show ‘target lesion’