Common Paediatric Problems Flashcards

1
Q

top 10 reasons for GP referral

A
growth concerns
UTI
constipation
abdominal pain
headaches
funny turns
heart murmur
food allergies and intolerances
minor abnormalities
asthma
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2
Q

causes of short stature

A

familial

if obese consider endocrine cause (red flag)

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3
Q

UTI red flags

A
younger
frequent
non E.coli
FH of renal disease
poor growth/general health
poor flow
voiding problems/constipation
spinal abnormality
raised BP
renal tract abnormalities
abdominal mass
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4
Q

management of constipation

A

laxatives
attention to diet
toileting advice

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5
Q

red flags in constipation

A

no passage of meconium more than 24 hours after birth

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6
Q

abdominal pain diagnoses not to miss

A

Coeliac’s
IBD
malrotation
intermittent volvulus

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7
Q

red flags in abdominal pain

A
weight loss
deceleration in linear growth
GI blood loss
significant vomiting (especially if bilious)
chronic diarrhoea
unexplained fever
FH of IBD
mouth ulcers
perianal disease
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8
Q

red flags for headache

A
worse on waking/coughing/ bending
associated vomiting
visual change
gait disturbance
cranial nerve palsy
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9
Q

examples of funny turns causes

A

seizure
breath-holding
reflex anoxic seizure
night terror

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10
Q

red flags for cardiac syncope

A
known congenital HD
syncope during exercise/ when supine
FH of sudden death
prolonged QT or hypertrophic cardiomyopathy
syncope preceded by palpitations
heart murmur
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11
Q

features of an innocent heart murmur

A

systolic
low intensity
2nd left ICS
medial to apex or beneath clavicle (continuous venous hum that disappears when supine)

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12
Q

red flags for heart murmur

A
diastolic
loud
harsh
thrill
radiates
other symptoms
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13
Q

what are examples of minor abnormalities

A

abnormal growth

abnormal development

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14
Q

when is asthma more likely in a child?

A
atopic disease
FH
widespread wheeze
worse at night/early morning
exercise and other triggers
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15
Q

what are four surgical problems in neonates?

A

meconium ileus
jejunal atresia
inguinal hernia
malrotation with volvulus

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16
Q

what causes meconium ileus?

A

intraluminal obstruction

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17
Q

presentation of meconium ileus

A

vomiting
no opening of bowels for more than 24 hours after birth
doughy abdomen

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18
Q

diagnosis of meconium ileus

A

XR enema contrast shows soap bubble sign

narrow bowel that has never been used

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19
Q

common cause of meconium ileus

A

CF

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20
Q

what is jejunal atresia?

A

dead end

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21
Q

presentation of jejunal atresia

A

vomiting
no stool passage
bowel stretching

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22
Q

diagnosis of jejunal atresia

A

XR shows enlarged bowel (compare with size of vertebrae)

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23
Q

what is an inguinal hernia

A

outer wall obstruction

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24
Q

presentation of inguinal hernia

A

loss of groin creases on affected side

risks perforation

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25
Q

diagnosis of inguinal hernia

A

clinical

XR shows laddering

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26
Q

is malrotation with volvulus an emergency?

A

yes

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27
Q

presentation of malrotation with volvulus

A

mossy green vomit (bile) within first year of life

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28
Q

diagnosis of malrotation with volvulus

A

upper GI XR with contrast shows bowel not in correct place

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29
Q

management of malrotation with volvulus

A

early surgery required

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30
Q

what is malrotation with volvulus

A

mesentery twists

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31
Q

what are examples of surgical problems in childhood?

A
pyloric stenosis
intussusception
peritonitis
acute scrotum
scrotal/ reproduction organ problems
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32
Q

what is pyloric stenosis

A

thickening of the stomach wall that prevents passage of food

33
Q

presentation of pyloric stenosis

A

projectile milky vomit
6 weeks of age
bumps on abdomen with waves of peristalsis

34
Q

diagnosis of pyloric stenosis

A

USS

35
Q

what is there a risk of in pyloric stenosis?

A

metabolic alkalosis due to acid loss

36
Q

management of pyloric stenosis

A

surgery

fluids

37
Q

what is intussusception?

A

bit of bowel telescopes in on itself

38
Q

presentation of intussusception

A

6 month old
abdominal pain in cycles
poor feeding
vomit with food/green colour
little stool passage (often red currant jelly-like blood)
bumps on abdomen at mid-gut region that on palpation feel like a sausage

39
Q

diagnosis of intussusception

A

USS (target lesion and pseudo-kidney)

40
Q

management of intussusception

A

surgery or in radiology (blow air up anal canal)

41
Q

what is peritonitis?

A

inflammation of the peritoneum

42
Q

presentation of peritonitis

A

abdominal pain worsened by jumping

temperature

43
Q

diagnosis of peritonitis

A

clinical

USS shows thickened wall

44
Q

management of peritonitis

A

surgery to remove

45
Q

three causes of acute scrotum

A
  1. testicular torsion
  2. twisting of hydatid of Morgagni
  3. epididymis infection
46
Q

how long do you have in testicular torsion?

A

4 hours due to risk of testicular death

47
Q

presentation of twisting of hydatid of Morgagni

A

blue dot

pain

48
Q

cause of twisting of hydatid of Morgagni

A

ovarian duct

49
Q

management of epididymis infection

A

antibiotics

50
Q

presentation of idiopathic scrotal oedema

A

redness in scrotum that can extend to groin
bit achy
tissue can look waterlogged

51
Q

does idiopathic scrotal oedema require surgery?

A

no

52
Q

what is BXO?

A

balanitis xerotica obliterans

white scar over end of the penis that can extend into the urethra

53
Q

management of BXO

A

circumcision

54
Q

management of paraphimosis

A

non-surgical

squeeze out oedema

55
Q

what is hypospadias?

A

urethra is not coming out of the tip of the penis, can be anywhere along shaft

congenital abnormality

56
Q

management of hypospadias

A

elective surgery

57
Q

what is patent processus vaginalis?

A

the canal where the testes descended remains open

58
Q

presentation of patent processus vaginalis

A

fluid accumulation
swollen scrotum at the end of the day, but not in the morning
blue-ish
not sore

59
Q

management of patent processus vaginalis

A

gone by aged 4, if not do surgery

60
Q

common respiratory problems in children

A
  1. bronchiolitis
  2. croup
  3. asthma
  4. pneumonia
61
Q

causes of bronchiolitis

A

RSV
adenovirus
rhinovirus

62
Q

presentation of bronchiolitis

A

cough
crackles
poor feeding/growth
secretions

63
Q

management of bronchiolitis

A

oxygen
NG tube
CPAP

64
Q

what is croup?

A

larynotracheobronchitis

65
Q

presentation of croup

A

stridor
chest wall collapses
snotty

66
Q

XR of croup

A

narrowed trachea

hypopharynx distension

67
Q

management of croup

A

steroids

68
Q

associations with asthma

A

atopic eczema
hay-fever
food allergies

69
Q

presentation of asthma

A

wheeze (bronchiolitis in early life can cause episodic wheeze)

70
Q

what age can spirometry be done?

A

7 so give inhalers if earlier presentation

71
Q

examination sign for asthma

A

Harrison’s sulcus

72
Q

cause of pneumonia in neonates

A

group B strep

73
Q

management of pneumonia

A

antibiotics

74
Q

CNS problems in childhood

A

meningitis

encephalitis

75
Q

what is febrile seizure?

A

fits/faints due to a reaction to temperature

grow out of it by 6

76
Q

what to do miss cardiacally in kids?

A

long QT

77
Q

GI/urogenital problems

A

gastroenteritis
GI obstruciton (pyloric stenosis)
appendicitis
testicular torsion

78
Q

CVS problems in childhood

A

CHD
arrhythmias (WPW)
bacterial endocarditis