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Phase 3a (You) > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What does ADHD stand for?

A

Attention Deficit Hyperactivity Disorder

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2
Q

What are the core symptoms?

A

Inattention, Impulsivity, Hyperactivity

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3
Q

What is the diagnostic criteria for ADHD?

A

DSM-V

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4
Q

What are the criteria for DSM-V?

A

6/9 Inattentive
6/9 Hyperactive/ Impulsive disorder

Present before 12 years
Developmentally Inappropriate
Symptoms interfere with QoL

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5
Q

What is Inattention (ADHD)?

A 
Easily distracted
Not listening
Doesn’t like tasks needing sustained mental effort
Loses important items
Attention to detail low
Difficulty organising tasks
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6
Q

What are the symptoms of hyperactivity (ADHD)?

A

Fidgety, runs and climbs, talks excessively, can’t perform tasks quietly

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7
Q

What are the symptoms of Impulsivity (ADHD)?

A

Not thinking about consequences
Quickly answering
Difficulty awaiting turn
Interrupts

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8
Q

What is the epidemiology of ADHD?

A

4-7% of school age children

4:1, Male:female

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9
Q

What are some Primary school symptoms of ADHD?

A

Distractability, impulsive behaviour, low self-esteem, rejection by peers, learning disorders

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10
Q

What are some adolescent symptoms of ADHD?

A

Difficulty planning and organising
Reduction of motor restlessness,
Antisocial behaviour

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11
Q

What are some Adult symptoms of ADHD?

A

Mental health,
Antisocial behaviour,
Lack of professional development

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12
Q

In what situations does ADHD worsen?

A 
Unstructured situations,
Burning situations,
When there are distractions,
Low supervision,
Sustained mental effort
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13
Q

In what situations can ADHD not be observable?

A

Structures situations,
Interesting activities,
One-2-one,
Rewards

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14
Q

What are the 4 main categories of aetiologies of ADHD?

A

Neuroanatomic, genetic, environmental, CNS insults

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15
Q

What are some examples of acquired brain injury (ADHD)?

A

Prematurity, Fetal alcohol syndrome, Neuro fibromatosis 1

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16
Q

What is the treatment of ADHD?

A

Education, parenting programme, school support,
Methylphenidate,
Atomoxetine,
Lisdexamfetamine

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17
Q

What is important when diagnosing ADHD?

A

Must show impairment in multiple settings (school and home)

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18
Q

What is the epidemiology of Autism?

A

1-30%,
4:1 males:females,
Aetiology unknown,
Genetic component

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19
Q

What are the 3 principles of autism?

A

Communication,
Social interaction,
Behavioural poor imagination

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20
Q

What are some communication difficulties with autism?

A 
Lack of desire to communicate,
Only their needs,
Delayed/ disordered body language,
Repeats speech,
No social awareness,
Poor joke understanding.
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21
Q

What are some social interaction difficulties with autism?

A

No unspoken rules understanding,
Limited interaction with unfamiliar people,
Touches inappropriately,
Plays alone, stressful with others,
Poor eye contact, finds it hard to take turns

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22
Q

What are some difficulties with imagination in autism?

A 
Using toys as objects,
Inability to write creatively ,
Resist change,
Using same game repetitively,
Obsessions,
Asking same question over and over,
Inability to see others point of view
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23
Q

What is the management of autism?

A

Education,
Parenting education,
School liaison,
Visual timetables in schools

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24
Q

What age can Austin be diagnosed from

A

2 years

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25
Q

What is the hierarchy of cell haematopoiesis?

A

Pluripotent stem cells, precursor cells, mature ‘cytes’

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26
Q

When would uncleared red cells be seen in a new born?

A

Stressful, long labour

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27
Q

What are reticulocytes?

A

RBC with nucleus fragments in the serum

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28
Q

What are the 3 mechanisms of anaemia?

A

Decreased production, increased consumption, increased loss

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29
Q

What causes severe anaemia at birth?

A 
Haemolytic disease (rhesus),
Bleeding (vas’s praevia, umbilical cord, internal haemorrhage)
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30
Q

What is erythroblastosis fetalis?

A

Excess of erythroblasts

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31
Q

What causes erythroblastosis fetalis?

A

Rh -VTE mother previously sensitised to Rh +ve cells. Transplacental passage and haemolytic of fetal cells

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32
Q

What are the signs and symptoms of erythroblastosis fetalis?

A

Anaemia,

Hyperplasia of blood forming organs (spleen and liver)

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33
Q

What is the treatment of erythroblastosis?

A

Anti D,

Intrauterine transfusion

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34
Q

What is the affinity of HbF for oxygen compared to HbA?

A

Higher, less easy to offload?

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35
Q

What causes the physiological anaemia of the newborn?

A

Switch from HbF to HbA, decreased RBC production, plasma dilution, shorter life span, more fragile

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36
Q

When is physiological anaemia of the newborn reached?

A

2 months

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37
Q

What is anaemia of prematurity?

A

Low birth weight infants have a poor erythropoietin response,

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38
Q

What are the symptoms and signs of anaemia of prematurity?

A

Apnoea, poor weight gain, pallor, decreased activity, tachycardia

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39
Q

What causes iron deficiency in neonates?

A

Poor intake (less requirement in children from recycles cells), breast feeding

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40
Q

What are the most common causes of iron deficiency anaemia in children?

A

LBW, diet, GI Bleeding, hookworm, cows milk intolerance,

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41
Q

What is the presentation of iron deficiency anaemia in children?

A

Pallor, irritability, anorexia, tachycardia, dilation myopathy, murmur, splenomegaly

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42
Q

What can be seen on blood film in iron deficiency anaemia?

A

Microcytic, hypochromic low/normal reticulocytes, pencil cell

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43
Q

What is seen in blood tests in iron deficiency anaemia?

A

Low ferritin, high TIBC, low serum iron, high ZPP

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44
Q

What is the treatment of iron deficiency?

A

Oral ferrous sulphate, 6mg/kg/day, 3-6 months, iron store replenishes in 3 months

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45
Q

What are some complications of iron treatment for iron deficiency?

A

Constipation, non-compliance, not addressing diet

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46
Q

What physiological responses occur in haemolysis?

A

Increased RBC turnover, shortened lifespan, splenomegaly, lysis syndrome

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47
Q

What are intracorpuscular causes of RBC destruction?

A

Haemoglobin, enzyme, membrane

48
Q

What are extracorpuscular causes of increase RBC destruction?

A

Autoimmune, fragmentation, hyper selenium, plasma factors

49
Q

What can cause iron overload?

A

Long term haemolysis, with blood transfusions

50
Q

What is the management of iron overload?

A

Ferritin monitoring, imaging, chelation

51
Q

What is the management of sickle cell disease?

A

Family history, pneumococcal, influenzas, meningococcal vaccine, prophylactic penicillin

52
Q

What are the problems associated with sickle cell disease?

A

Anaemia, infarction, sepsis, infection, acute chest, splenic sequestration, aplastic crisis, iron overload, stem cell transplant.

53
Q

What is the blood picture of SCD?

A

75 Hb, raised reticulocyte count, chronic anaemia, elevated WBC

54
Q

What is the management of SCD infection?

A

Blood cultures, CxR, Iv fluids, pain killers, pneumonia = admit

55
Q

What can dactylitis indicate?

A

SCD crisis in the fingers

56
Q

What is the treatment of SCD?

A

Hydroxycarbamide, transfusion, stem cell transplant.

57
Q

What is the clinical picture of beta thalassemia minor?

A

Asymptomatic, mild anaemia. Low MCV, raised HbA2

58
Q

What is the clinical picture of beta thalassaemia major?

A

Progressive severe anemia, low MCV, HbF and A2 increased, jaundice, splenomegaly, skeletal deformity, delayed puberty,

59
Q

What is the management of beta thalassaemia major?

A

Genetic counselling, blood transfusions, iron overload treatment, bone marrow transplant

60
Q

What are the 3 main presentations of G6PD?

A

Neonatal jaundice, chronic non-spherocytic haemolytic anaemia, intravascular haemolysis

61
Q

What can cause sporadic haemolysis in G6PD?

A

Drugs, fav a beans, fever, acidosis

62
Q

When are bite cells seen?

A

G6PD

63
Q

What is the epidemiology of hereditary spherocytosis?

A

1 in 5000, commonest haemolytic anaemia in Europeans

64
Q

What is the most common cause of admission to hospital in children?

A

Respiratory Infection

65
Q

What organisms can cause pharyngitis/ tonsillitis?

A

Group A strep, adenovirus, EBV

66
Q

What organism causes epiglottitis?

A

Hamophilis B

67
Q

What organisms cause otitis media?

A

Pneumococcus, haemophillus, group A strep, moraxella

68
Q

What organisms cause tracheitis?

A

Staph aureus, strep A, haemophilus

69
Q

What organisms cause pneumonia?

A

Strep A, pneumococcus, staph aureus, haemophillus, TB

70
Q

What are 2 atypical pneumonia’s?

A

Bilateral change (mycoplasma, chlamydia)

71
Q

What organisms cause bronchiolitis?

A

RSV, rhinovirus, flu, adenovirus.

72
Q

What causes complicated chicken pox infections?

A

Co infections with staph or strep

73
Q

What are the symptoms of HSV?

A

Stomatitis, cold sore, encephalitis, eczema

74
Q

What are the symptoms of Kawasaki disease?

A

Fever, rash stomatitis adenopathy, thrombocytosis, coronary artery aneurysm

75
Q

What can affect growth rates in children

A

Nutrition and emotional support

76
Q

What are the important determinants of child growth?

A 
Phenotype and genotype,
Quality and duration of pregnancy,
Nutrition,
Organ integrity,
Psychosocial environment,
Growth promoting hormones
77
Q

What is chondrogeneisis?

A

Growth of the skeleton

78
Q

What are the regulators of bond growth?

A 
Nutrition,
Inflammatory cytokines (TNF-alpha, IL-1,6),
Oxygen deficiency,
Toxins,
Acidosis
79
Q

What factors must be considered when assessing growth?

A

Ethnic background,
Social inequalities,
Parental heights

80
Q

What are the anatomical differences between newborns and adults?

A

Newborns: Larger head, smaller madable, smaller neck, short limbs, abdomen rounded, chest rounded

81
Q

What can short limbs indicate?

A

Hypochondroplasia

82
Q

What can a short back and long legs indicate?

A

Delayed puberty

83
Q

What are the causes of inaccuracy in measuring lengths in children?

A

Faulty technique

Faulty equipment

84
Q

What is the formula for boys age predication from parents age?

A

Height=fathers height + (mother’s height + 12.5) / 2

85
Q

What is the formula for girls predicted height from parents height?

A

Height=mother’s height+(fathers height -12.5) / 2

86
Q

What is the formula for 95 CI for height in children

A

Mid parental height +/- 8.5cm

87
Q

What is the normal border centipede of heights in children?

A

3-97th

88
Q

What is the normal centipede border for growth velocity?

A

25-75

89
Q

What is the Tanner Stages used for?

A

Indicate puberty in boys and girls

90
Q

What are the categories of the Tanner Stages in boys?

A 
Pubic hair,
Testicular length (2.5 in longest diameter),
Testicular volume (>3ml),
91
Q

What is the genotype of klinefelter syndrome?

A

47XXY

92
Q

What is the epidemiology of Klinefelter syndrome?

A

1 in 1000 males,

93
Q

What are the complications of Klinefelter syndrome?

A

Hypogonadism, azospermia,

Osteoporosis, tall stature, reduced IQ, Breast cancer

94
Q

What is hypergonadotrophic hypogonadism?

A

Primary hypogonadism

95
Q

What is hypogonadotrophic hypogonadism?

A

Secondary/ tertiary hypogonadism

96
Q

What can cause hypogonadotrophic hypogonadism?

A

Craniopharyngiomas, astrocytomas (other CNS)

97
Q

What are the categories of the Tanner Stages in girls?

A

Pubic hair, papilla elevation, breast bud noted,

98
Q

What is the genotype of tuners syndrome?

A

45XO

99
Q

What are the complications of tuners syndrome?

A

Recurrent otitis media,

Cardiac malformations, hypogonadotrophic hypogonadism, short stature, horseshoe kidney, neck webbing,

100
Q

What is the first sign of puberty in girls?

A

Breast buds

101
Q

What is the first sign of puberty in boys?

A

Testicular enlargement

102
Q

What is the range of puberty age in boys?

A

9-14

103
Q

What is the range age of puberty in girls?

A

8-13

104
Q

What can cause a delayed Bone age?

A

GH deficiency

105
Q

What is a cause of advanced bone age?

A

Precocious puberty

106
Q

What factors affect birth weight?

A

Parity, maternal weight and size, gestational diabetes, smoking, paternal size

107
Q

What are the common associations of weight loss?

A

Vomiting,
Diarrhoea,
Dystrophic disorder,
Poor social circumstances

108
Q

What are the causes of short stature?

A

Constitutional, delayed puberty, nutrition, environmental, idiopathic, physical, tuners, endocrine, chronic diseases

109
Q

What can cause overgrowth in children?

A

Congenital adrenal hyperplasia,

Precocious puberty, hyperthyroidism, McAlbriet syndrome, Klinefelter, GH Excess, marfans

110
Q

What are the differences between an adult x-ray and a paediatric X-ray?

A

Size, growth plates, skull sutures, plastic bones, apophyses

111
Q

What congenital abnormalities can be picked up on X-ray?

A

Dextrocardia, status invertus, osteogenesis imperfecta,

112
Q

What lines and tubes can be seen on X-ray?

A

NG tube, umbilical vein catheter, umbilical artery catheter, temperature probe, ET tube

113
Q

What things are important to look at on chest X-ray?

A

Quality of film (penetration/ rotation), trachea, lung fields and volumes, heart and mediastinum, diaphragm, bones, soft tissue

114
Q

What are some indications for abdominal X-ray?

A

Distension, recurrent UTI, constipation, foreign body, calculi, tube positions

115
Q

What diameter is considered dilated in adult intestine?

A

> 2.5 cm

116
Q

What rib must meet the hemidiaphragm to be a good insiratory effort in an X-ray?

A

5-6th rib

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