Childrens Health Flashcards by Mark Brown

Whats the best prognostic factor for children up to the age of 12?

Dad jokes…

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What do you call someone with no body and no nose?

NO BODY KNOWS

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Did you hear about the guy who invented the knock knock joke?

He won the “NO BELL” prize

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Why do crabs never give to charity?

Because they are SHELLFISH

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What age is defined as a Neonate?

Birth to 1 month

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What age is defined as an infant?

1 month to 1 year

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What signs are there of respiratory distress?

Tracheal tug - Retraction of suprasternal notch - Inter or subcostal indrawing

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A child comes in with a loud cough and difficulty breathing, what DD are there?

Viral Croup - Epiglossitis - Foreign body aspiration - bacterial tracheitis

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What does drooling indicate in a child?

Upper airway restriction, present in Epiglottitis and bacterial tracheitis

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What is Croup?

Inflammation of the larynx and trachea by a viral cause

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What is the most common pathogen for Croup?

Parainfleunza virus

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What symptoms can occur in Croup?

Seal bark cough Stridor Acute SoB Corhzal symptoms

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What cause of SoB is likely after seeing this?

Strawberry mark = Laryngeal capillary haemangioma

Grows from 12-24 months

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When can Larngomalacia cause SoB/ obstruction?

From Birth

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Why is Epiglottits becoming less common?

Due to Heamophilis influenza type B

This conditions can quickly lead to airway obstruction

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What is the managment of Severe Croup?

Get help - airway managment

Neb. Adrenaline - 1/1000

Oral steroids

Reassure peraent, therefore pt. keeps calm

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At what age deos the MMR vaccine start?

Vaccinaiton at 1 year old

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What cause of diarrehoa is unlikely after 8 weeks?

Rota virus gastroenteritis due to vaccunation

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At what age does the majority of vaccination causes start?

8 weeks

Diptheria

Tetanus

Pertussis

Polio

Heamophilis infeuza type B

Pneumoccal

Mennigoccocal

Ratovirus

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How old is this child?

Understands No

Makes simple sounds - “mama” “dada”

Aware of strangers

Plays peeker boo

> 8 weeks if reached development miles stones

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How old is this child?

Has simple conversations

Copies others

Takes turns

> 3 years according to developemental milestones

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How old is this child?

Smiles

Turns head to sound

Can track objects

Gurgling sound

> 2 months according to developemental milestones

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What is Kussaul breathing and what can it indicate?

A form of hyperventilation by long, deep breaths. This increases blow of CO2

Indicates acidosis like that of DKA

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Causes of large heart size on peadiatric CXR?

Large L to R chunt

VSD

PDA

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Causes of small heart size on peadiatric CXR?

Fallots tetralogy

What does Plethoric mean for lungs in a CXR?

Too much blood going to the lungs leading to increased contrast on lungs. Cause by L to R shunts, CCF, VSD, PDA

What does Oligaemic mean for lungs in a CXR?

Less blood going to the lungs and therefore lungs are blacker on CXR. Fallot's tertralogy Pulmonary stenosis

What congenital heart conditions cause systolic mumurs?

Fallots tetralogy VSD truncus arteriosus

Why are postroglandins used in heart condistions?

Maintain patent the ductus arteriosus. Closure of the duct can be assisted with NSAIDS

What conditions has a "continous cresendo-decresendo machinary mumur?

Patent duct arteriosus

What septal defect has a pansystolic mumur?

Ventral septal defect

What symptoms and sign may a child with cardiac failure have?

SOB, Tachycardia Poor feeding Hepatomegaly Acidosis Sweating

Management of cardiac failure in children

Diuretics ACEi O2 Prostin Inotropes

What signs are there of respirtory distress in baby?

Nasal flaring Tachypnoea Gruniting Mild head bobbing Intercostal breathing Subcostal indrawing

Which conditions are asynotic congential heart diseaes?

Septal defects - VSD, ASD Coarctation PDA Valvular disease

That signs may a baby with coarctation of the aorta have?

Upper limb pulses \> lower limb pulse Associated VSD and bicuspid aortic valve

What conditison are cyanotic CHD?

Fallots tetralogy Transposition of the greater arteries

What is the clinical presentation of Fallot's tetralogy?

Central cyanosis Pulmonary oligaemia on CXR ``` Hypercyanotic episodes (tet spells) Ejection systolic mumur -PS ```

What heart conditions are associated with T21?

AV septal defects

What does the heal prick test for?

Metabolic conditions Sickle cell, hypothyroidism, CF and more...

Which heart condition should we not give high concentrations of O2 to?

Patent ductus arteriosus Maintain duct with prostin infusion

What is Harrison's sulcus?

in-drawing of the ribs dring inspiration, indicates chornic respiratory condition or week bones

What investigation to consider with reccurent LRTI?

sweat chloride test - CF Measurement of serum immunoglobulins - Vaccines responce, ?HIV CT of chest

When should a metered dose inhaler be used?

\> 12yo with obvious no coordination problems effecting use of MDI

A newborn has abdominal distension and vominting. Strong FH for CF. What is the likely diagnosis?

Meconium ileus Testing for CF doesnt occr until 10d

What injuries occur in shaken baby syndrome?

subdural haemorrhage Retinal bleeding Hypoxaemic encephalopathy

What differentials to consider with muiltiple bruises?

NAI Leukaemia Aplastic anaemia

Child risk factors for abuse?

younger age increased needs - disability low birth weight muitliple births

Parental risk factors for chuld abuse?

Younger parental age mental illnes substance abuse lower social-economic group Parents experince child abuse

What features of fractures are consistent with NAI?

metphyseal fractures posterior rib complex skull fractures long bone fractures

What features of bruising are consistent with NAI?

Face, buttock, back Outline of objects Patern of fingers etc.

What burns would indicate NAI?

Glove-stockng distribution Uniform shape - circular for cigarette burns

What should be done if there is a child protection concern?

Refer to social services

What bruises are not NAI?

Immune thrombocytopenia Meningococcal rash Henoch scholein purpura Mongolion blue spot

Is this NAI?

No, this is simply a mongolion blue spot

What NAI can cause fractures?

acidental injury oesteogenesis imperfecta (rare) Vit C/D copper deficiency Connective tissue disorders JOBs syndrome

What red flags are there with peadiatric abdo pain?

poor growth symptoms regularly waking child \<5yo Weight loss Blood in stools

What test is there for coelaics screen

IgA anti-tissue transglutaminase

6w of increased stool frequency ,pale **bulky** stools, wieght loss, fratique and pallor. FBC shows microcytic aneamia.

A classical history of coeliacs disease. Therefore TTG antibodies

DD for rapid weight loss in adolescent?

Cealiacs T1 DM Hyperthyroidism Mailgnancy Anorexia Nervosum IBD

What is lanugo hair?

Soft body hair like that in babies. Can indicate poor nutrition from loss of fat tissue, like that of anorexia nervosa

What is the acute treatment of anorexia nervosa?

muiltivitamines inc. vit B increase 0.5-1kg/week Monitor bloods Regular ECG

A patient with Anorexia has refugular blood monitoring. Her phosphate drops. What does the indicate?

A fall in phosphate can indicate refeeding syndrome

What types of eatng disorders are there?

Anorexia Nervosa Bulimia Nervosa EDNOS - easting disorder not otherwise specified

What features of a history are more typical of Bulimia nervosa?

Bing eating followed by vomiting Self harm Normal wieght, unlike AN

What common conditions are accompanied with eating disorders?

OCD Depression

What is used instead of BMI for grownig, young people?

Weight-height ratio

What common causes of death are there for anorexia nervosa?

Refeeding syndrome - Sudden cardiac death Suicide

Features of bulimia nervosa?

gastric acid --\> dental erosion, callouses on fingers Parotid enlargement Normal wieght

What is found on blood test for anorexia nervosa? WCC ALT Phosphate BMs Cortisol

WCC, ALT, Phosphate and BMs are normally low Cortisol (stress) can be high

What features of dehrydration are there in an infant?

Sunken fontanelle and eyes Dry mucous membrane Tachycardia Redeuced CRT, skin turgor Weight loss

Common cause of gastritis in the UK?

Rota virus Adeno cirus

What organisms can cause blood in stools?

Shigella E coli 0157 Rota virus Campylobacter (also thing intersusspection)

1yo with history of paroxysmal, severe colicky pain. Child draws legs up. There is vominting and red current jelly stools. MLD?

Intussesception

What cuases red current jelly stools in intussesception?

Mucus and blood

Red flags in vomiting?

Bulgind frontanelle Bile, blood in vomit Abdo pain and distention Blood in stools Projectile vomit

What is the most likely diagnosis for vomiting with paroxysmal cough?

Wooping cough

At what age can solid foods be introduced?

6 months of age

Synmptoms of hyper natraemia?

Jittery movements Increased muscle tone Hyperreflexia Convulsions Drowsiness or coma

Symptoms of hyponatraemia?

Weakness fatigue headache confusion Nausea and vomiting

What organisms can cause infective diarrehoa by a secretory mechaism?

Cholera Ecoli C diff

What organisms can cause infective diarrhoea via a mucosal invasiion mechanism?

Campylobacter Rota virus Salmonella shigealla Therefore they cause blood and WCC in stools

Which organisms which cuase diarrhoea are notifiable?

Cholera Giardia Salmonella Camplylobacter (this in not exhaustive)

What organisms can cause Haemolytic Ureamic syndrome?

E coli 0169 Heamolysis and renal failure can occur LDH raised in heamolysis

What does the picture?

Intussusception diagnose from USS Draw this picture in OSCE

Childrens Health Flashcards

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