cards- TTN, DDH

Question 1

cause of scarlet fever

Answer 1

Group A streprococcus

Question 2

Clinf scarlet fever

Answer 2

Rough, sandpaper like rash
Fever
Strawberry tongue
Following an episode of pharyngitis or tonsilits

Question 3

Tx of scarlet fever

Answer 3

PO phenoxymethlypenicillin
If penicillin allergic then azithromyocin

Question 4

Tx Kawasaki disease

Answer 4

PO aspirin
IV immunoglobulin - if unresponsive to IVIG then plasmapheresis

Question 5

Complications of scarlet fever

Answer 5

Otitis media - MC
Rheumatic fever- typically 20days after infection
Acute glomerulonephritis - typically 10days after infection

Question 6

Wiliam’s syndorme features

Answer 6

Elfin faces, strabismus, broad forehead, short stature
Very friendly and social

Question 7

Clinical features of transient tachypnea of the newborn

Answer 7

Late preterm or Term infant- born by c section with early onset tachypnea, mild resp distress (recession/retraction/nasal flaring, grunting) and CXR showing hyperinflation, fluid in horizontal fissure
Cynanosis that appears to resolve with <40% oxygen

Question 8

Def/ cause of transient tachypnea of the newborn

Answer 8

delayed resorption of fetal lung fluid
Fetal lung fluid is essential for normal lung development and is secreted by lung
epithelium. A few days prior to the onset of labour, lung fluid production decreases.
During labour, maternal epinephrine and glucocorticoids stimulate absorption of
alveolar fluid through activation of an amiloride-sensitive epithelial sodium channel.8,9
“Vaginal squeeze” only accounts for a fraction of the fluid absorption. TTN results from
disturbance in the mechanisms responsible for fetal lung fluid clearance.

Question 9

Mng of Transient tachypnea of the newborn

Answer 9

Self limiting and resolves within 24-48hours
Supportive with supplemental oxygen to maintain sats >94%

If moderate to severe resp distress, needing high con of supplemental oxygen or shoring increasing signs of respiratory fatigue, then CPAP

Question 10

Differentials for transient tachypnea of the newborn

Answer 10

Resp distress syndrome
Pneumonia
Meconium aspiration
PTX
Tachypnea from CNS irritation or metabolic acidosis
Inborn error of metabolism
Congenital lung and heart malformations

Question 11

Ix for suspected transient tachypnea of the newborn

Answer 11

Baseline vitals
Blood gas (ID: resp acidosis), glucose level
CXR
Septic screen
ECG/ Echo if congenital heart disease is a dx

Question 12

What investigation should all breech babies at or after 36 weeks gestation have

Answer 12

USS for DDH screening at 6 weeks - irregardless of mode of delivery

Question 13

Risk factors for developmental dysplasia of the hip

Answer 13

Female
Breech
Positve FH
Firstborn
Oligohydraminios
Brith weight >5kg
Congenital calcaneovalgus foot deformity

Question 14

Which hip is DDH more common in

Answer 14

left

Question 15

Which infants require an US to screen for DDH

Answer 15

First depress FH of hip problems in early life
breech presentation at or after 36 weeks gestation, irrespective of presentation at birth or mode of delivery
multiple pregnancy

Question 16

mng of DDH

Answer 16

most unstable hips will spontaneously stabilise by 3-6 weeks of age
Pavlik harness (dynamic flexion-abduction orthosis) in children younger than 4-5 months
older children may require surgery

Question 17

Examination findings consistent with DDH

Answer 17

Barlow and ortolanis positive
limited hip abduction
deep uneven gluteal crease
Leg length discrepancy
waddling gait after walking age

Question 18

Ix for DDH

Answer 18

if under 6mo- USS
If >6mo- XR