Key 1 Flashcards
(18 cards)
causes of acute epiglottis
Haemophilus influenzae type B.
feature of acute epiglottis
rapid onset, high temp, unwell toxic child, stridor, drooling, (MUFFLING/ HOARSE)change voice, thumb sign (lateral neck x-ray)
Rx acute epiglottis
- anaesthetist – intubation
- secure his airways
Acute epiglottitis - Thumb sign.
look at the pdf
features of Coup
- stridor
- barking cough (WORSE AT NIGHT)
- fever
- corzyal symptoms
- Steeple sign (X-ray)
what is Croup (Laryngotracheobronchitis) and who get affected and what the common organism
- URTI
- in infants and toddlers
- parainfluenza viruses
severe coup
- frequent barking cough
- prominent inspiration stridor at rest
- marked sternal wall retraction
- significant distress and agitation or lethargy or restlessness (sign of hypoxaemia)
- tachycardia occurs with more severe obstructive symptoms and hypoxaemia
Rx coup
- single oral dose of dexamethasone – 0.15mg/kg regardless severity (prednisolone is not available)
- emergancy: high flow O2, nebulised adrenaline in severe croup,
Enuresis
‘involuntary discharge of urine by day or night or both, in a child ≥ 5 YO, in the absence of congenital or acquired defects of the nervous system or
urinary tract’.
Nocturnal enuresis
(primary and secondary)
Primary – The child has never achieved continence before
secondary – the child has been dry for at least 6 months before
management of primary enuresis with day time symptoms
Refer all children > 2 YO with night and day enuresis to 2ry care or enuresis clinic.
management of primary enuresis with only night bedwetting
if >5yr:
-< 2 weeks - reassure
- > 2 weeks - short term- desmopressin
- long term- enuresis and reward system
management of secondary enuresis
refer to paediatrics - dry for st least 6 months of their life and then start wetting themselves night +/- daytime
CC of 2ry enuresis
- emotional upset
- UTI
-DM - constipation
when give desmopressin first line
children over the ago 7years, particularly if short-term control is needed or an enuresis alarm has been
ineffective/is not acceptable to the family.
reflex nephropathy
- urine goes back into the kidney from the bladder and cause repeated UTI and causes progressive renal failure
- occur mainly in children
Dx reflex nephropathy
- Initial - Renal Ultrasound (+) Urinalysis, urine culture and sensitivity.
– Gold standard - Micturating Cystourethrogram.
– For parenchymal damage (cortical scars) - Technetium Scan (DMSA).
Rx reflex nephropathy
– inital - low dose prophylaxis daily antibiotics (trimethoprim)
–Failed? Or Parenchymal damage? - Surgery (Ureters Re-implantation).
