Child Health Flashcards by Ella Weir

Presentation of bronchiolitis

A non-productive cough, tachypnoea and intercostal recession
Manage supportively

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Common deficiency in cystic fibrosis

Vitamin A, D, E and K
(impaired absorption of fat soluble vitamins due to reduced pancreatic enzyme secretion)

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WHat does double bubble sign indicate?

Duodenal atresia
(NOT SEEN IN OESOPHAGEAL)

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Presentation of oesophageal atresia

Antenatal - Polyhydraminos
Post-natal - Respiratory distress, Distended abdomen, Choking/problems with swallowing, Saliva overflow, No NG tube passage

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Baby with APGAR 4, greenish tinge to skin, intercostal recession, poor cry?

Meconium aspiration syndrome

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Diagnosis of Hirschprung disease

Rectal suction biopsy

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Grossly distended bowel loops and pneumointestinalis on AXR indicates?

Necrotising enterocolitis

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ABG findings in pyloric stenosis?

Hypokalaemic hypochloraemic metabolic alkalosis

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First line investigation in suspected vesicoureteric reflux

Micturating Cystourethrogram (MCUG)

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First line antibody test for coeliac disease

Anti-tissue transglutaminase (tTG) IgA antibody

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First line management of gastroenteritis

Nasogastric fluid replacement with rehydration sachets

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Unvaccinated coughing baby to the point of vomiting, milky vomit, strange sound breathing in?

Whooping cough
(test for bordetella via pernasal swab)

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What factors can increase risk of Neonatal Respiratory Distress Syndrome?

Premature (lack of surfactant)
Diabetic mothers

Presents with:
resents with increased work of breathing shortly after birth, and the chest x-ray demonstrating diffuse granular opacities

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What pulses should be felt in an unresponsive child?

In the neck (carotid pulse) in children over 1 year
In the inner aspect of the upper arm (brachial pulse) in an infant

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Vesicular rash on hands, soles of feet and buccal muscoaa?

Coxsackie A
(hand, foot and mouth disease)

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Halo sign in oesophagus on CXR after possible foreign object swallow?

Button battery
Urgent endoscopy!!!!!!

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What is the cause of acute bilirubin encephalopathy?

It is caused by a toxic build-up of unconjugated bilirubin

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What HR in an unwell child would indicate admission to hospital?

HR 160bpm

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Adrenaline dose for anaphylaxis in kids

Under 6 months - 100-150mg
6m-6y - 150mg
6-12 - 300mg
Adults - 500mg

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Test contraindicated in suspected meningitis

Lumbar puncture
- risk of coning

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Most common congenital heart defect in babies of diabetic mothers

Transposition of great arteries

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Presentation of acute lymphocytic leukaemia

Features of bone marrow failure:
- anaemia
- neutropaenia (resulting in frequent infections)
- thrombocytopaenia (which leads to petechiae and easy bruising)

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How is secondary reperfusion injury prevented?

Cool newborn to 33-34deg
- slows cerebral metabolism and subsequently slows neurotransmitter and oxygen free-radical release

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First line management of meningitis if penicillin allergic

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Characteristic features of scarlet fever

Sandpaper feeling rash Strawberry tongue - preceded by non-specific symptoms e.g. sore throat, headache, fever

2/6 pansystolic murmur suggests

VSD

Example of macrogol laxative

Movicol

Management of Hirschprung's

Surgical removal of the aganglionic segment

What complication of Kawasaki disease does immediate IV immunoglobulin prevent?

Coronary artery aneurysm

Widespread scarring rash after tonsillitis managed with antibiotics?

EBV infection - if viral tonsillitis is incorrectly treated with antibios e.g. amoxicillin/ampicillin

Rectal suction biopsy in Hirschprung's would show....

Absence of ganglion cells in the colonic submucosa

How long does fever in Kawasaki have to last?

Persistent and for more than 5 days

Presentation of strangulated hernia

Generalised tenderness worse on inguinal palpation Mass in the right inguinal region Cremasteric reflex present/Prehn’s test negative Mass is not reducible Bowel sounds heard on auscultation over the mass

Aspirin given to children can cause which syndrome?

Reye's syndrome

What does neiserria menigitides look like on gram stain?

gram-negative intracellular diplococci

First line investigation for suspected minimal change/nephrotic syndrome

Urine dip for proteinuria - biopsy if no response to steroids

First line investigation of Perthes

X-ray - assess density of femoral head

First line management of Perthes

Bed rest and analgesia Physio and reduction in high impact sport

Which type of newborn head swelling crosses suture lines?

Caput Succedaneum - Crosses Sutures - Clears Soon

Key bits to remember in child health history taking

Birth Vaccinations Milestones/school attainment Family at home HEADSS for teenagers

Most common complication in kids with measles

Otitis media

Which drug can reduce period of infectivity in pertussis?

Clarithromycin - give booster vaccine to any contacts

Clin pres of Turner syndrome

Short stature Spoon nails, webbed neck Shield chest, wide nipples Wide carrying angle Delayed puberty, amennorhoea Hypothyroidism Bicuspid aortic valve

Medical management of ADHD

Methylphenidate

Virus presenting with facial rash an flu-like symptoms causing hydrops fetalis

Parvovirus B19 (slapped cheek syndrome)

When are kids with slapped cheek syndrome not infectious anymore?

When the rash appears

Severe complication of bronchiolitis requiring lots of hospital care presenting with seizure, resp distress, pneumonia, terminal bronchiolar dilatation with areas of air trapping?

Bronchiolitis obliterans - caused by adenovirus

Complication resulting from failure to operate on hydrocele in baby

Indirect inguinal hernia

Prescribing amoxicillin in glandular fever can result in what kind of drug reaction?

Mobiliform

Describe TTN

Caused by: delayed resorption of fluid in the lungs Strongly associated with caesarean section and prematurity X-ray signs: hyperinflation, and fluid in the horizontal fissure

Which test can determine whether leg length discrepancy is a femoral or tibial cause?

Galeazzi

Most common cause of neonatal sepsis

Group B strep (from genital tract) - risk factors include prolonged prelabour rupture of membranes, intrapartum fever and suspected or confirmed bacterial infection

First line management of precocious puberty

Ref to peds

Low-set ears, microcephaly and omphalocele are characteristic of which genetic condition?

Edward's syndrome

Management of HSP

Analgesia Steroids if severe Potentially anti-HT if hypertensive

What is the most common cause of rectal bleeding in kids and how is it investigated?

Meckel's diverticulum (embryological remnant) - investigate with Technetium scan

Managment of perforated eardrum assoc with otitis media

<4 day history - reassure and discharge >4 day history - oral amoxicillin

When should you not prescribe antibiotics in whooping cough?

After 21 days of persistent symptoms

Most common causative organism of osteomyelitis in sickle cell

Salmonella typhi

How is Prader-Willi inherited?

Genomic imprinting

Midwife home visit finds baby to be jaundiced but otherwise well, what action should they take?

Check serum bilirubin with transcutaneous bilirubinometer if bilirubin level is >250 micromoles/L

Investigation of child with recurrent UTI after positive cultures

Request an ultrasound scan within 6 weeks and a DMSA scan 4-6 months later

What is roseola infantosum?

Benign illness characterised by several days of high temperatures followed by a widespread rash that starts on the torso/neck

After starting bilirubin phototherapy, when should levels be rechecked?

4-6 hours

Presentation of cogenital hypothyroidism

Hypotonia, macroglossia, an umbilical hernia, reduced feeding and constipation (mild soft abdominal distention)

Reed Sternberg cells on lymph node biopsy suggest...

Hodgkin's lymphoma

What medication can be used to encourage patent ductus arteriosus in ToF?

Prostaglandins e.g. alprostadil

Management AOM with sudden otorrhoea and perforated tympanic membrane?

Immediate oral antibiotic prescription

Initial management of UTI in suspected urosepsis

Tazocin

First line for chronic constipation in kids

Movicol - senna second line

CFTR mutation in cystic fibrosis is found on which chromosome?

Chromosome 7

Baby with stridor and coryzal symptoms...

Bronchiolitis

Management of choking infant after back blows

Chest thrusts

First line investigation of child with recurrent UTIs

Abdominal US

If a mother has preeclampsia, what type of jaundice does baby most likely have?

Haemolytic jaundice

4h old baby with jaundice and sick mum is physiological or pathological?

Pathological (less than 24h old)

ST elevation in leads V2-5 suggests infarct where?

Anterior infarct

What HIV viral load is acceptable for breastfeeding?

<20

Diagnostic investigation for eosophageal atresia

NG tube and a chest X-ray

Complication of coarctation of aorta

Cerebral aneurysm

Investigation for child under 3 months with high fevers...

Blood cultures, urine cultures and CSF cultures - always suspect sepsis first

Key marker of biliary atresia on LFTs

Abnormally high levels of conjugated bilirubin - also jaundice, pale stools, palpable masses in upper quadrants

Premature babies who are approaching bronchiolitis season should be started on which prophylactic therapy?

Palivisumab

How to tell if a rash is HSP not Kawasaki?

Bum and leg rash Bloody diarrhoea Abdo joint pain Recent URTI Kawasaki has strawb tongue

Breast cancer difficult to see on mammogram

Invasive lobular carcinoma - most have MRI to ID and stage

Drugs lowering seizure threshold

“I am Tramadol’s friend, keeping life less anxious” I for imipenem AM for abx:penicillins, cephalosporins, metronidazole, isoniazid Tramadols for tramadol Friend for fentanyl Keeping for ketamine Life for lidocaine Less for lithium Anxious for antihistamines

Child Health Flashcards

(87 cards)