Disease Profiles Flashcards
(266 cards)
1
Q
Premature Infants: Altered Approach to Management (4 stages)
A
Delay cord clamping
Keep the baby warm
Gentle Lung Inflation
Saturation monitoring for careful oxygen control
2
Q
The Sick Term Infant: APGAR scoring meaning
A
Appearance - skin colour
Pulse
Grimace - Reflex irritability
Activity - Muscle tone
Respiration
3
Q
The Sick Term Infant: APGAR Appearance - Score of 0
A
Blue or Pale
4
Q
The Sick Term Infant: APGAR Appearance - Score of 1
A
Blue in extremities but pink in the body
5
Q
The Sick Term Infant: APGAR Appearance - Score of 2
A
No cyanosis
6
Q
The Sick Term Infant: APGAR Pulse - Score of 0
A
Absent
7
Q
The Sick Term Infant: APGAR Pulse - Score of 1
A
<100 BPM
8
Q
The Sick Term Infant: APGAR Pulse - Score of 2
A
> 100 BPM
9
Q
The Sick Term Infant: APGAR Grimace - Score of 0
A
No response
10
Q
The Sick Term Infant: APGAR Grimace - Score of 1
A
Grimace or feeble cry when stimulated
11
Q
The Sick Term Infant: APGAR Grimace - Score of 2
A
Cries or pulls away when stimulated
12
Q
The Sick Term Infant: APGAR Activity - Score of 0
A
None
13
Q
The Sick Term Infant: APGAR Activity - Score of 1
A
Some flexion
14
Q
The Sick Term Infant: APGAR Activity - Score of 2
A
Flexed arms and legs that resist extension
15
Q
The Sick Term Infant: APGAR Respiration - Score of 0
A
Absent
16
Q
The Sick Term Infant: APGAR Respiration - Score of 1
A
Weak and irregular gasping
17
Q
The Sick Term Infant: APGAR Respiration - Score of 2
A
Strong cry
18
Q
The Sick Term Infant: Examples of respiratory problems (3)
A
TTN - Transient Tachypnoea of the Newborn
Pneumothorax
Congenital Respiratory Disease - Tracheo-oesophageal fistula or Diaphragmatic hernia
19
Q
The Sick Term Infant: Examples of cardiac problems (3)
A
Hydrops foetalis - due to rhesus disease or chromosomal abnormalities
PPHN - Persistent pulmonary hypertension of the newborn
Congenital heart disease
20
Q
The Sick Term Infant: Examples of Congenital Heart Disease (5)
A
Tetralogy of Fallot
Transposition of the Great Arteries
Coarctation of the Aorta
TAPVD - Total Anomalous Pulmonary Venous Drainage
Hypoplastic heart
21
Q
The Sick Term Infant: Examples of Neurological Disease (3)
A
Hypoxic ischaemic encephalopathy
Microcephaly
Spina bifida
22
Q
The Sick Term Infant: Example of a Renal Disease
A
Potters Syndrome
23
Q
The Sick Term Infant: Main two causes of bacterial infection in neonates (2)
A
Group B Streptococcus
E. coli
24
Q
The Sick Term Infant: Syphilis - Causative organism
A
Treponema Pallidum
25
The Sick Term Infant: Syphilis - Highest risk
Mothers infected within the last two years - early stage
26
The Sick Term Infant: Syphilis - Clinical Presentation (4)
Bone abnormalities
Anaemia
Hepatosplenomegaly
Jaundice
27
The Sick Term Infant: Syphilis - How to reduce risk to neonate?
Treat 30 days prior to delivery
28
The Sick Term Infant: Respiratory Distress Syndrome - Presentation (4)
Tachypnoea
Recession
Grunting
Blue - Cyanosed
29
The Sick Term Infant: Respiratory Distress Syndrome - Investigation and result
CXR - ground glass with air bronchograms
30
The Sick Term Infant: Transient Tachypnoea of the Newborn - Most at risk
Infants delivered by C-section
31
The Sick Term Infant: Transient Tachypnoea of the Newborn - How is lung fluid cleared in the normal neonate?
Active epithelial Sodium Channels pump it into the interstitium and then into the lymphatic system
32
The Sick Term Infant: Transient Tachypnoea of the Newborn - Investigations and result
CXR - fluid in the lungs within the horizontal fissure
33
The Sick Term Infant: Transient Tachypnoea of the Newborn - Management
Resolves within 24 hours
34
The Sick Term Infant: Pneumothorax - Aetiologies (4)
Meconium
Infection
Resuscitation
Surfactant deficiency
35
The Sick Term Infant: Pneumothorax - Management
Pig tail chest drains
36
The Sick Term Infant: Meconium Aspiration Syndrome - Pathophysiology
Foetus inhales liquor with meconium in it, leading to airway obstruction, inflammation and surfactant dysfunction
37
The Sick Term Infant: Meconium Aspiration Syndrome - Complications (2)
Asphyxia
Persistent pulmonary hypertension
38
The Sick Term Infant: Hypoxic Ischaemic Encephalopathy - Pathophysiology
Multi-organ damage due to tissue hypoxia - in the brains, kidneys, liver and gut
39
The Sick Term Infant: Hypoxic Ischaemic Encephalopathy - Primary aetiologies (3)
Placental failure
Cord prolapse
Uterine rupture
40
Cyanosed babies with congenital heart disease are often not responsive to what?
Oxygen
41
Bilious Vomiting
Green vomit
42
The Sick Term Infant: Hypoglycaemia - Aetiologies (3)
Low birth weight or small for gestational age
Maternal Disease - Diabetes
Mother on Labetalol
43
The Sick Term Infant: Inborn Errors of Metabolism - Presentation (3)
Acidosis
Hypoglycaemia
Jaundice
44
The Sick Term Infant: Pathophysiology of Potters Syndrome
Lack of amniotic fluid leads to kidney disease
45
Vital Signs: Heart rate normal
120-140 BPM
46
Vital Signs: Perfusion normal
Capillary refill of 2-3 seconds with >95% oxygen saturation
47
Vital Signs: Respiratory Rate Normal
40-60 per minute
48
Infection: Main three antibiotics used
Benzylpenicillin
Gentamicin
Cefotaxime
49
Infection: Main three antibiotics used
Benzylpenicillin
Gentamicine
Cefotaxime
50
Cover of Benzylpenicillin
Gram positive and negative
51
Cover of Gentamicin
Gram negative
52
Cover of Cefotaxime
Gram positive and negative
53
Neonatal Sepsis: Early Onset is mainly due to what? (2)
Bacteria acquired before or during delivery - Group B Streptococcus or Gram Negative Bacteria
54
Neonatal Sepsis: Late Onset is mainly due to what? (3)
Noscomial or Community Sources - Coagulase Negative Staphylococci, Gram Negative Bacteria or Staphylococcus aureus
55
Neonatal Sepsis: Symptoms (4)
Fever
Reduced tone and activity
Poor feeding
Vomiting
56
Neonatal Sepsis: Signs - Respiratory (2)
Respiratory distress or apnoea
Hypoxia
57
Neonatal Sepsis: Signs - Cardiovascular
Tachycardia or Bradycardia
58
Neonatal Sepsis: Signs - Gastrointestinal (2)
Jaundice - within 24 hours
Hypoglycaemia
59
Neonatal Sepsis: Signs - Neurological
Seizures
60
Neonatal Sepsis: Five Stages to Management (5)
Give high flow oxygen
Obtain IV access to take blood tests - cultures, glucose and lactate analysis
Give IV or IO antibiotics - broad spectrum
Fluid resuscitation
Consider Inotropic Support with Adenaline
61
Neonatal Sepsis: Management - Fluid Resuscitation
20ml/kg isotonic fluid over 5-10 minutes
Assess for fluid overload after 40ml/kg fluids and titrate further if no signs of overload
62
Neonatal Sepsis: Management - Adrenaline Dose
Administer with 3rd fluid bolus - 0.3mg/kg in 50ml 5% dextrose 1ml/hour
63
Anatomical Differences: Head (2)
Large head
Prominent occiput
64
Anatomical Differences: Ratios
Large Surface Area:Volume Ratio
65
Anatomical Differences: URTI (2)
High anterior larynx
Floppy epiglottis
66
Anatomical Differences: Ribs
More flexible
67
Anatomical Differences: Blood volume
80ml
68
Anatomical Differences: Haemoglobin
HbF at birth
69
Anatomical Differences: Over time what trend is seen with HR?
Reduces
70
Anatomical Differences: Over time what trend is seen with RR?
Reduces
71
Anatomical Differences: Over time what trend is seen with Systolic Blood pressure?
Increases
72
Bronchiolitis
Acute inflammatory injury to the bronchioles
73
Bronchiolitis: Causative organism
RSV
74
Medical word for Croup
Laryngotracheobronchitis
75
Croup: Most common causative organism
Parainfluenza Virus
76
Croup: Clinical presentation
Stridor - due to ~70% of airway impacted
77
Meningicoccaemia: Causative Organism
Neisseria meningitidis
78
Meningicoccaemia: Clinical Presentation
Purpura the spreads on the skin
79
Respiratory Distress in the Newborn: Most common in what patient group?
Infants born before 29 weeks - before the lungs begin producing surfactant
80
Respiratory Distress in the Newborn: Pathophysiology
Inadequate surfactant leads to high surface tension within the alveoli to cause lung collapse and thus inadequate gaseous exchange
81
Respiratory Distress in the Newborn: Clinical Presentation (5)
Tachypnoea
Grunting
Intercostal recession
Nasal flaring
Cyanosis
82
Respiratory Distress in the Newborn: Management (3)
Maternal steroid
Surfactant replacement
Ventilation
83
Respiratory Distress in the Newborn: Aetiologies - Metabolic (3)
Acidosis
Inborn errors of metabolism
Hypoglycaemia
84
Respiratory Distress in the Newborn: Aetiologies - Haematological (3)
Polycythaemia
Blood loss
Anaemia
85
Respiratory Distress in the Newborn: Aetiologies - Neurological (3)
Seizures
Intra-cranial bleed
Withdrawal
86
Hypochondroplasia: Clinical Presentation - Neurological (2)
Severe neonatal seizures
Temporal lobe epilepsy
87
Hypochondroplasia: Clinical Presentation - General (4)
Short stature
Bossed prominent forehead
Short triangular fingers
Rhizomelic limb shortening of the femurs and humeri
88
Hypochondroplasia: Genetic Mutation
FGFR3 - c.1620C>A or p.Asn540Lys
89
Hypochondroplasia: Example of Management
Vosoritide
90
Russell Silver Syndrome: Genetic mutation mechanisms (3)
Methylation on C bases just before G bases
Imprinting
UPD 7 mutations
91
Russell Silver Syndrome: Management
Growth Hormone
92
Russell Silver Syndrome: Clinical Presentation - Gastrointestinal (3)
Vomiting - due to Reflux
Poor weight gain
Poor Appetite
93
Russell Silver Syndrome: Clinical Presentation - General features (2)
Short stature
Elfin features - triangular face with ears that stick out
94
Turners Syndrome: General features (7)
Short and wide neck - due to cystic hygroma
Low hairline
Teeth probelms
Broad chest with wide spaced nipples
Short fourth finger or toe
Low weight
Short stature
95
Reactive Attachment Disorder
Markedly disturbed and developmentally inappropriate social relatedness that begins before the age of 5 years old
96
Reactive Attachment Disorder: Main Aetiologies (3)
Persistent disregard for the child's emotional needs for comfort, stimulation and affection
Persistent disregard for child's physical needs
Repeated changes for primary caregivers
97
Reactive Attachment Disorder: Risk Factors
Adverse childhood experiences - Abuse, Neglect or Household dysfunction
98
Reactive Attachment Disorder: More common in what children?
Children orphaned at a young age
99
Reactive Attachment Disorder: What are the subtypes? (2)
Inhibited
Disinhibited
100
Reactive Attachment Disorder: Inhibited Subtype
Children who continually fail to initiate and respond to social interactions in a developmentally appropriate way
101
Reactive Attachment Disorder: Inhibited Subtype - Interactions characterised by what? (4)
Avoidance
Resistance to comfort
Hyper-vigilance
Ambivalence
102
Reactive Attachment Disorder: Disinhibited Subtype
A child with an inability to display appropriate selective attachments
103
Reactive Attachment Disorder: Disinhibited Subtype - How is this displayed?
Displays excessive familiarity with strangers or lack of selectivity in their choices of an attachment figure
104
Reactive Attachment Disorder: Clinical Presentation - Signs in Relationships (4)
Neglectful behaviour by the primary caregiver
Lack of smiling or responsiveness from the baby or child
Lack of distress in situations that should cause distress
Excessive friendliness to healthcare workers
105
Reactive Attachment Disorder: Clinical Presentation - Common Co-morbidities (3)
Emotional Disorders
ADHD
Behavioural Disorders
106
Reactive Attachment Disorder: Diagnosis - 1-2 Years
Strange Situation Procedure
107
Reactive Attachment Disorder: Diagnosis - 2-4 Years
Modified Strange Situation Procedure
108
Reactive Attachment Disorder: Diagnosis - 1-4 Years
Attachment Q-sort - children observed in a number of set environments
109
Reactive Attachment Disorder: Diagnosis - 4-7 Years
Story Stem Attachment Profile - use toys or verbally communicate stories
110
Reactive Attachment Disorder: Diagnosis - 7-15 Years
Child Attachment Interview
111
Reactive Attachment Disorder: Diagnosis - 15+ Years
Adult Attachment Interview
112
Reactive Attachment Disorder: Management - Pre-school (3)
Parental sensitivity and behaviour therapy
Home visiting programmes
Parent-child Psychotherapy
113
Reactive Attachment Disorder: Management - School Age (4)
Parental sensitivity and behavioural training
Group play sessions
Group-based educational sessions for caregivers and children
Trauma-Based Behavioural Therapy
114
Reactive Attachment Disorder: Complications if not Managed (3)
Developmental delay
Reduction in academic achievement
Increased risk of contact with youth justice
115
Conduct Disorder
Repetitive and persistent pattern of behaviour in which the rights of others or major age-appropriate norms or rules are violated
116
Conduct Disorder: Name in younger children
Oppositional Defiant Disorder
117
Conduct Disorder: Aetiologies - Examples of Brain Injury (2)
Intrauterine trauma
Post-natal CNS trauma
118
Conduct Disorder: Aetiologies - Family Circumstances (4)
Families with parents with mental illness
Drug and alcohol concerns
Domestic violence
Single parent families
119
Conduct Disorder: Aetiologies - Parenting Style (4)
Lack of house rules
Lack of clarity on how a child should behave
Lack of supervision
Lack of techniques to deal with crises
120
Conduct Disorder: Subtypes - Mild to Moderate
Restricted to the Family Environment
121
Conduct Disorder: Subtypes - Severe two types
Unsocialised - predominantly violent behaviour
Socialised - anti-social acts or better ability to avoid getting involved with criminal justice system
122
Conduct Disorder: Diagnosis
Presence of a3+ of the following criteria within 12 months and 1 in the last 6 months:
- Aggression towards people or animals
- Destruction of property
- Deceitfulness or theft
- Serious violations of rules
123
Conduct Disorder: Clinical Presentation - Triad
Inattention
Hyperactivity
Impulsivity
124
Conduct Disorder: Management - Under 11 years old
Parent or Foster parent training
125
Conduct Disorder: Management - Aged between 9 and 14 years
Child-focused programmes
126
Conduct Disorder: Management - Aged between 11 and 17 years
Multi-modal interventions
127
Conduct Disorder: Management - Pharmacological main drug of choice
Risperidone - atypical anti-psychotic
128
Conduct Disorder: Management - If co-existing ADHD
Stimulant medication
129
Conduct Disorder: Management - If co-existing depression
SSRIs
130
Prader-Willi Syndrome: Genetic Involvement
Deletion on the paternal chromosome 15 or complete loss of parental chromosome 15 causes uniparental maternal disomy
131
Prader-Willi Syndrome: Presentation at Birth (3)
Hypotonia - floppy
Unable to suck or reduced ability - tube feeding is common
Hyperphagia - food seeking and lack of satiety
132
Prader-Willi Syndrome: Facial Features
Small hands and feet with almond shaped eyes with a narrow face and high-arched palate
133
Prader-Willi Syndrome: Stature
Short
134
Prader-Willi Syndrome: Later stage features (2)
Developmental delay
Failure to thrive in infancy
135
Prader-Willi Syndrome: Dysregulation in what region is present?
Hypothalamus
136
Prader-Willi Syndrome: Endocrine features (3)
Hypogonadotropic hypogonadism
Cortisol deficiency
GH deficiency
137
Prader-Willi Syndrome: Indications for Paediatric Review (3)
Obesity-related morbidity that requires weight loss - Intra-cranial hypertension, Sleep Apnoea or Orthopaedic problems
Suspected underlying cause of obesity
Children under 24 months that are >99.6th centile
138
Prader-Willi Syndrome: Pharmaceutical Options for Obesity (2)
Orlistat
Saxenda
139
Prader-Willi Syndrome: Surgical Options (3)
Laparoscopic Adjustable Gastric Banding
Roux-en-Y Gastric Bypass
Laparoscopic Sleeve Gastrectomy
140
Prader-Willi Syndrome: Indications for surgery
Post-pubertal adolescents with severe to extreme obesity with severe co-morbidities
141
Bardet-Biedl Syndrome: Genetic Pathophysiology
Autosomal recessive disease affecting the proteins of the cilia basal body to prevent intercellular sensing
142
Bardet-Biedl Syndrome: Clinical Presentation (6)
Obesity
Neurocognitive Delay
Syn- or Polydactyly
Retinal dystrophy or pigmentary retinopathy
Hypogonadism
Renal dysfunction
143
Neonatal Abstinence Syndrome
Withdrawal symptoms that happens in neonates of mothers that used substances in pregnancy
144
Neonatal Abstinence Syndrome: Related Substances (6)
Opiates
Methadone
Benzodiazepines
Cocaine
Alcohol
Amphetamines
145
Neonatal Abstinence Syndrome: Neurological Symptoms (3)
Irritability
Tremors
Seizures
146
Neonatal Abstinence Syndrome: Vasomotor and Respiratory Symptoms (3)
Sweating
Unstable temperature
Tachypnoea
147
Neonatal Abstinence Syndrome: Metabolic and GI Symptoms (3)
Poor feeding
Regurgitation
Hypoglycaemia
148
Neonatal Abstinence Syndrome: Monitoring time
3 days of NAS chart
149
Neonatal Abstinence Syndrome: Monitoring time for SSRI anti-depressants
48 hours of NAS chart
150
Birth Asphyxia
Baby does not receive enough oxygen before, during or after birth
151
Birth Asphyxia: Aetiologies (4)
Maternal shock
Intrapartum haemorrhage
Prolapsed cord
Nuchal cord - wrapped around the neck of the baby
152
Birth Asphyxia: Main complication
Hypoxic Ischaemic Encephalopathy
153
Hydrocephalus
Abnormal CSF build up within the brain and spinal cord
154
Hydrocephalus: Clinical Presentation (5)
Enlarged and rapidly increasing head circumference
Bulging anterior fontanelle
Poor feeding with vomiting
Poor tone
Sleepiness
155
Hydrocephalus: Management
Ventriculoperitoneal shunt
156
Necrotising Enterocolitis
Disorder affecting premature neonates in which part of the bowel becomes necrotic
157
Necrotising Enterocolitis: Aetiology
Intestinal injury to the immature gut causing perforation e.g. fed too early
158
Necrotising Enterocolitis: Clinical Presentation (5)
Intolerance to feeds
Vomiting - green bilous vomit
Distended tender abdomen
Absent bowel signs
Blood in stools
159
Necrotising Enterocolitis: Diagnosis - What test is used?
Abdominal X-ray
160
Necrotising Enterocolitis: Diagnosis - Presentation on AXR (4)
Dilated loops of bowel
Bowel wall oedema
Gas within the bowel wall
Gas in the pertioneal cavity - indicates perforation
161
Pneumoperitoneum
Gas within the peritoneal cavity
162
Necrotising Enterocolitis: Management (3)
NBM
Clindamycin and Cefotaxime
Urgent referral to surgery
163
Intraventricular Haemorrhage
Bleeding into the ventricles within the brain
164
Intraventricular Haemorrhage: Most common type
Germinal Matrix Subtype
165
Intraventricular Haemorrhage: When does risk reduce and why?
35-36 weeks gestation - as the germinal matrix has disappeared by then
166
Jejunal Atresia
Congenital Anomaly characterised by obliteration of the lumen of the jejunum in that it is not connected to the large intestine
167
Jejunal Atresia: Clinical Presentation
Abdominal distension and bilious vomiting within the first 24 hours of birth
168
Jejunal Atresia: Diagnostic approach
Abdominal X-ray
169
Jejunal Atresia: Management
Surgical correction
170
Malrotation
Congenital anatomical anomaly that results from an abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis
171
Malrotation: Clinical Presentation
Mid gut volvulus - presenting with bilious green vomiting mainly within the first month of life
172
Malrotation: Diagnostic Test
Upper GI contrast test
173
Malrotation: Management
Surgical correction
174
Meconium Ileus
Bowel obstruction of the neonate due to thick and impacted meconium
175
Meconium Ileus: Main aetiology
Cystic Fibrosis
176
Meconium Ileus: Main diagnostic test
X-ray
177
Inguinal Hernia
Weakness in the muscle around the groin resulting in a loop of bowel bulging through
178
Cerebral Palsy
Permanent neurological problems resulting from damage to the brain near birth
179
Cerebral Palsy: Aetiologies - Antenatal (2)
Maternal infections
Trauma during pregnancy
180
Cerebral Palsy: Aetiologies - Peri-natal (2)
Birth Asphyxia
Pre-term Birth
181
Cerebral Palsy: Aetiologies - Post-natal (3)
Meningitis
Severe neonatal jaundice
Head injury
182
Duchenne's Muscular Dystrophy
Genetic disease causing muscular weakness and wasting
183
Duchenne's Muscular Dystrophy: Genetic Pathophysiology
X-linked recessive mutation of dystrophin gene on the X-chromosome
184
Duchenne's Muscular Dystrophy: Clinical presentation
Progressive weakness in the muscles around the pelvis of boys at around 3-5 years old
185
Duchenne's Muscular Dystrophy: What sign is significant?
Gower's Sign - Children with proximal muscle weakness use knees to stand up
186
Bronchiolitis
Acute inflammatory injury of the bronchioles
187
Bronchiolitis: Most common cause
RSV
188
Bronchiolitis: Most common age
<6 months old
189
Bronchiolitis: Clinical Presentation - Signs on auscultation
Wheeze and crackles
190
Bronchiolitis: Clinical Presentation - Viral URTI symptoms (4)
Running or snotty nose
Sneezing
Mucous within the throat
Watery eyes
191
Croup: Clinical Presentation (4)
Barking cough
Increased work of breathing
Hoarse voice
Stridor
192
Croup: Management - First stage
Oral Dexamethasone
193
Croup: Management - Second stage
IM Dexamethasone or Nebulised Budesonide
194
Croup: Management - Third Stage
Oxygen
195
Croup: Management - Fourth Stage
Nebulised adrenaline
196
Croup: Management - Fifth Stage
Intubation and ventilation
197
Most common heart rhythm disturbance in children
Supraventricular Tachycardia
198
SVT
Supraventricular Tachycardia
199
SVT: Pathophysiology
Abnormally fast heart rhythm arising from inappropriate electrical activity in the upper part of the heart
200
SVT: 4 types
Atrial fibrillation
Paroxysmal SVT
Atrial flutter
Wolff-Parkinson-White Syndrome
201
Infective Endocarditis: Most common causative organism in paediatrics (2)
Gram positive bacteria
Viridans group
202
Main causes of Gastroenteritis in children? (2)
Rotavirus
Norovirus
203
Congenital Pyloric Stenosis
Narrowing of the opening from the stomach to the first part of the small intestine
204
Congenital Pyloric Stenosis: Clinical Presentation - Symptoms (2)
Projectile vomiting without the presence of bile (milk in vomit) after feeding
Keen to feed
205
Congenital Pyloric Stenosis: Clinical Presentation - Typical age of symptoms
2-12 weeks old
206
Congenital Pyloric Stenosis: Clinical Presentation - Signs (3)
Signs of dehydration
Peristalsis across the abdomen
Abdominal mass may be present - olive-like structure at the top right of the abdomen
207
Congenital Pyloric Stenosis: Main Diagnostic Test
US scan of the upper abdomen
208
Congenital Pyloric Stenosis: Management
Pyloromyotomy
209
Congenital Pyloric Stenosis: Complications
Metabolic imbalance leading to metabolic acidosis
210
Volvulus
Loop of intestine twists around itself and the mesentery supporting it, resulting in bowel obstruction
211
Volvulus: Congenital intestinal malrotation increases the risk of what?
Midgut volvulus
212
Volvulus: What increases the risk of segmental volvulus?
Meconium ileus
213
Volvulus: Clinical Presentation (4)
Abdominal pain and bloating
Vomiting bile
Constipation
Bloody stool
214
Volvulus: Diagnostic test
Abdominal X-Ray
215
Intussusception
Bowel invaginates into itself, narrowing the lumen which results in a palpable mass in the abdomen and obstruction to the passage of faeces through the bowel
216
Intussusception: Symptoms (3)
Severe colicky abdominal pain
Lethargy
Vomiting
217
Intussusception: Signs (3)
Signs of dehydration
Redcurrant Jelly stool
Right upper quadrant mass
218
Intussusception: Diagnostic test and result
USS - Shows a target sign
219
Intussusception: Management - First line
Air reduction
220
Intussusception: Management - Second line
Surgical reduction
221
Intussusception: Characteristic symptom
Cycle of pain and then goes limp
222
Appendicitis
Inflammation of the appendix
223
Appendicitis: Classic Clinical Presentation
Abdominal pain that starts as central abdominal pain and migrates to the right iliac fossa over time
224
Appendicitis: Signs - Tenderness is located where?
McBurney's Point
225
Appendicitis: Signs - What result is shown on Rosving's Test?
Palpation of the left iliac fossa causes pain in the right iliac fossa
226
Appendicitis: Management
Appendicectomy
227
Urinary Tract Infection: More common in what sex?
Females
228
Urinary Tract Infection: Diagnostic Test
Urine sample with microbiology
229
Urinary Tract Infection: Management - Children <3 months with a fever
Immediate IV antibiotics
230
Urinary Tract Infection: Management - Children with features of sepsis or pyelonephritis
IV antibiotics
231
3 Causes of Acute Scrotal Pain (3)
Torsion of testicle
Epididymoorchitis
Hydatid of Morgagni - Torsion of the appendix testes
232
Torsion of Testicles
Testicle rotates to twist the spermatic cord that is responsible for bringing blood to the scrotum
233
Torsion of Testicles: Management
Surgical correction
234
Epididymoorchitis
Acute bacterial infection of the epididymis involving the testis that occurs as a result of retrograde bacterial colonisation via the ejaculatory ducts and vas deferens
235
Hydatid of Morgagni
Appendix testis is located at the upper pole of the testes between the testis and head of the epididymis
236
Hydrocele
Collection of fluid within the tunica vaginalis that surrounds the testes
237
Hydrocele: Clinical presentation
Soft, smooth non-tender swelling around one of the testes
238
Hydrocele: Presentation on exmaination with pen torch
Transilluminate
239
Hydrocele: Management - Simple Hydrocele
Resolves within 2 years
240
Hydrocele: Simple Hydrocele definition
Has no connection with the peritoneal cavity
241
Hydrocele: Management - Communicating Hydrocele
Surgical correction
242
Hydrocele: Communicating Hydrocele definition
Connects with the peritoneal cavity
243
Undescended Testes
Testes have not descended through the abdomen by birth
244
Undescended Testes: Clinical presentation
Empty scrotum
245
Undescended Testes: Management
Watch and wait for first 6 months - surgically correct between 6-12 months if not descended
246
Normal Physiological Non-Retractability
The prepuce (foreskin) is attached to the glans with a tight opening (preputial ring) - this is not retractable in most newborns
247
Bxo Balantis Xerotica Obliterans
Chronic inflammatory process that affects the foreskin - and can extend to the glans and external urethral meatus
248
Bxo Balantis Xerotica Obliterans: Presentation
Keratinisation of the tip of the foreskin causes scarring and non-retractile foreskin
249
Bxo Balantis Xerotica Obliterans: Management
Circumcision
250
Paraphimosis
Foreskin cannot be returned to its original position after being retracted
251
Paraphimosis: Conservative Management
Manual reduction following application of a local anaesthetic
252
Hypospadias
Congenital defect causing the urethral meatus to be located at an abnormal site - normally on the under side of the penis
253
Encephalitis
Inflammation of the brain
254
Encephalitis: Most common cause
Herpes Simplex Virus
255
Encephalitis: Diagnostic tests (2)
Lumbar puncture
Imaging
256
Meningitis
Inflammation of the meninges of the brain and spinal cord
257
Meningitis: Bacterial causes in children (2)
Neisseria meningitidis
Streptococcus pneumoniae
258
Meningitis: Bacterial causes in neonates
Group B Streptococcus
259
Meningitis: Viral Causes (3)
Herpes Simplex Virus
Enterovirus
Varicella Zoster Virus
260
Meningitis: Diagnostic test
Lumbar puncture
261
Meningitis: Management - <3 months
Cefotaxime + Amoxicillin
262
Meningitis: Management - >3 months
Cefotaxime followed 6 hours later with Ceftriaxone
263
Meningitis: Management - Can combine with what?
Dexamethasone
264
Down Syndrome: Genetic Pathophysiology
Trisomy 21 - three copies of chromosome 21
265
Down Syndrome: Distinctive Facial Features (4)
Prominent tongue
Flattened face and nose
Prominent epicanthic folds
Brushfield spots - speckled iris
266
Down Syndrome: General features (4)
Hypotonia
Short neck
Short stature
Brachycephaly - small head with a flat back
