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5th yr- Finals- CCD1 revision > Paediatric emergency > Flashcards

Paediatric emergency Flashcards

1
Q

Give examples of special test we can carry out on children to come to a diagnosis

A
  1. Palpations
  2. Mobility
  3. Percussion
  4. Radiographs
  5. Childs temperature
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2
Q

List some paediatric diagnosis we can come to

A
  1. reversible Pulpitis
  2. Irreversible pulpitis
  3. Acute apical abscess
  4. Pericoronitis
  5. Teething
  6. Natal and neonatal teeth
  7. Eruption cysts
  8. Oral ulcerations
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3
Q

List some characteristics of pulpits with reversible symptoms

A
  1. Precipitated by sweet, hot, cold
  2. Pain stops when stimulus removed
  3. Short duration
  4. Mainly occurs when eating
  5. Early carious lesions
  6. Caries into dentine
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4
Q

List some characteristics of pulpits with irreversible symptoms

A
  1. Constant toothache
  2. Relieved only by analgesics
  3. Kept awake at night
  4. Lymphadenopathy
  5. Pyrexia
  6. Extensive marginal ridge breakdown
  7. Sinus/ intra oral swelling
  8. Caries close to pulp
  9. Evidence of periodical pathology
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5
Q

What can happen if reversible pulpits is left untreated

A

Will progress to irreversible pulpit its

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6
Q

What initial temporary pain relief treatment would you give to a patient with reversible pulpits

A

Gently excavate the caries and debris then dress with GIC

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7
Q

What initial/ temporary pain relief treatment would you give to a patient with irreversible pulpits

A

Gently excavate the caries and debris then dress with ledermix on a cotton roll pledget and zinc oxide eugenol paste

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8
Q

What things do we need to consider for post emergency care

A
  1. Is the child at increased risk of caries or high priority
  2. Prevention?
  3. Is the child compliant
  4. Should we save the tooth or extract
    5/ Are parents regular attenders
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9
Q

What definite care can we give to a child

A
  1. Extraction
    2/ Restoration
  2. Pulp therapy with stainless steel crown
  3. First stages of pulpectomy
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10
Q

When would we carry out a pulpectomy

A

Non vital tooth

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11
Q

What is an acute apical abscess

A

Acute inflammation of the tooth and surrounding tissues often caused by tooth decay and pulpal necrosis

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12
Q

What are some other terms for cute apical abscess

A

Acute peri radicular abscess
Acute dental avower abscess
Acute peri apical abscess

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13
Q

If we have a co operative child with an acute apical abscess how woudl we treat them

A

Extract the teeth under LA

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14
Q

If we have a NON co operative child with an acute apical abscess how would we treat them

A
  1. Drain through tooth
  2. Sedative dressing
  3. Offer analgesia
  4. Arrange to complete treatment with GA or inhalation sedation
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15
Q

Who can give consent for a child

A
  1. Childs birth mother and father
  2. Legally appointed guardian
  3. Person with a residence order for the child
  4. Local authority who holds protection order for the child
  5. Child who is gillick competent
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16
Q

What do we do if a child comes in with a large extra oral swellign without fever

A
  1. If the infection is spreading give antibiotics, analgesics and monitor
  2. Most likely will need to extract/ restore tooth later
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17
Q

What do we do if a child comes in with a large extra oral swelling without fever

A
  1. If the infection is spreading give antibiotics, analgesics and monitor
  2. Most likely will need to extract/ restore tooth later
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18
Q

When should we be really concerned about a large extra oral swelling

A

If the patient is systemically unwell with:
1. high temp
2. Dehydrated
3. Lethargic

Refer to the hospital

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19
Q

What do we do if a child comes in with a large extra oral swelling WITH fever

A
  1. Refer to hospital for intra venous antibiotics and further treatmetn
  2. Call A+E and warn them the child is on the way and needs to be hospitalised immediately
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20
Q

What is pericoronitits

A

inflammation of the soft tissues surrounding the crown of a partially erupted tooth, including the gingiva and the dental follicl

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21
Q

Which tooth is pericoronitis usually associated with

A

Erupting teeth

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22
Q

List some signs and symptoms of pericoronitis

A
  1. Pain
  2. Swelling of operculum (gingiva surrounding teeth)
  3. Discomfort when swallowing
  4. Unpleasant taste/ odour
  5. Limited mouth opening
  6. Pyrexia
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23
Q

How do we manage pericoronitis

A
  1. Exclude airway risk
  2. Advice optimal analgesia
  3. Encourage oral hygiene
  4. Advise to rinse mouth after food
  5. Consider irrigation with 0.2% chlorohexidine gluconate under LA
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24
Q

What do we need to aware of before prescribing chlorohexidine mouth wash

A

Not suitabel for childern under 7

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25
Q

List some signs of a teething babay

A
  1. Cheeks may look rosy
  2. Baby wants to bite or avoid particular area
    3/ Drooling or dribbling
  3. Gums may look red
  4. Disturbed sleep
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26
Q

What tips can we give to guardians of a teething baby

A
  1. Cool teething rings
  2. Sugar free teething gels
  3. Massage gums with clean fingers
  4. Try cooling fingers of cucumber. carrots. breadsticks if baby is weening
  5. Sugar free Calpol
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27
Q

What are natal teeth

A

Teeth erupted at birth

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28
Q

What are neonatal teeth

A

Teeth erupted in the first 30 days post natal life

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29
Q

How many babies are born with natal or neonatal teeth

A

1 in 2000 to 1 in 3500 (more common in females)

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30
Q

How do we treat neonatal and natal teeth

A

Extract them

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31
Q

Why do we extract neonatal and natal teeth

A
  1. Danger of inhalation
  2. Difficulties with breast feeding and bottle feeding
  3. Causing trauma to the ventral surface of the tongue
32
Q

What are eruption cysts

A

They precede the eruption of primary and permanent teeth

33
Q

Describe the shape and location of an eruption cyst

A

They occur where a tooth should be erupting
They are well circumscribed, dome shaped fluctuant enlargements that are usually asymptomatic

34
Q

How do we treat eruption cysts

A

No treatment as they usually drain own when the tooth erupt

35
Q

Name a common oral ulceration you may encounter in children

A

Recurrent aphthous stomatiitis

36
Q

Why might ulcers from in the oral cavity

A
  1. Ill fitting dentures
  2. From adjacent teeth
  3. From orthodontic appliance
  4. Due to anaesthetised tissue
  5. Underlying medical conditions
37
Q

How do we treat an ulcer that may have formed due to ill fitting dentures

A

Tell the patient to rinse with chlorohexidene (if over 7 years) and avoid wearing the denture till it is fixed

38
Q

How do we treat an ulcer that may have formed due to trauma from a sharp adjacent tooth

A

Smooth the adjacent tooth that is sharp and hopefully the ulcer shoudl heal in a few days

39
Q

How do we treat an ulcer caused by an orthodontic appliance

A

Add wax to any sharp wires coming off the orthodontic appliance and refer the patient to their orthodontist to get the appliance fixed§

40
Q

How do we treat an ulcer that may have formed due to anaesthetised tissue

A

Advice the patient to avoid hot food/drinks till the anaesthesia has worn off

41
Q

Which disease and infections can lead to oral ulcerations

A
  1. Viral infections
  2. Bacterial infections
  3. Mucocutaneous diseases
  4. Haematological diseases
  5. Gastrointestinal diseases
42
Q

Give examples fo some viral infections that can lead to oral ulcerations

A
  1. Herpatic stomatitis
  2. Chicken pox
  3. Hand foot and mouth disease
  4. HIV
  5. Herpangina
43
Q

Give examples fo some Bacterial infections that can lead to oral ulcerations

A
  1. Syphillis
  2. TB
44
Q

Give examples fo some Mucocutaneous diseases that can lead to oral ulcerations

A
  1. Lichen planus
  2. Behcet’s syndrome
  3. Pemphigus vulgaris
  4. Erythema multiform
  5. Pemphigoid and variants
  6. Chronic ulcerative stomatitis
45
Q

Give examples fo some Haematological diseases that can lead to oral ulcerations

A
  1. Anaemia
  2. Leukaemia
  3. Haemantinic deficiencies
  4. Neutropenia
46
Q

Give examples fo some Gastrointestinal diseases that can lead to oral ulcerations

A
  1. Coeliac disease
  2. Ulcerative colitis
  3. Crohn’s disease
47
Q

What is primary herpetic gingivostomatitis caused by

A

Herpres simplex virus

48
Q

In whom is primary herpatic gingivostomatitis common in

A

2-5 year olds

49
Q

What is the incubation period for primary herpetic gingivostomatitis

A

7 days

50
Q

How many patients are systemically affected by primary herpetic gingivostomatitis

A

5%

51
Q

What symptoms may a patient with primary herpetic gingivostomatitis present with

A

Febrille illness: Headache, malaise, oral pain, mild dysphagia and cervical lymphadenopathy

52
Q

What do we need to be careful of when treating a patient with primary herpetic gingivostomatitis

A

It is very contagious so wear PPE

53
Q

How would we manage primary herpetic gingivostomatitis

A

Advise the patient to
1. Bed rest
2. Soft diet
3. Fluids
4. Paracetamol

54
Q

What antibiotics can we prescribe to children

A

Amoxicillin
Erythromycin
Metronidazole

55
Q

How much Amoxicillin can we prescribe to a 1 month- 1 year old child

A

125mg TDS for 5 days

56
Q

How much Amoxicillin can we prescribe to a 1-5 year old child

A

250mg TDS for 5days

57
Q

How much Amoxicillin can we prescribe to a 5-12 year old child

A

500mg TDS for 5 days

58
Q

How much Amoxicillin can we prescribe to a 12-18 year old child

A

500mg TDS for 5 days (if severe increase to 1g TDS)

59
Q

List the ages and max doses of amoxicillin we can prescribe to Childs

A

1mth-1yr: 125mg TDS for 5 days
1-5yrs: 250mg TDS for 5 days
5-12yrs: 500mg TDS for 5 days
12-18yrs: 500 TDS for 5 days

60
Q

How much Erythromycin can we prescribe to a 1 month- 2 year old child

A

125mg QDS 5 days

61
Q

How much Erythromycin can we prescribe to a 2-8 year old child

A

250qds

62
Q

How much Erythromycin can we prescribe to a 8-18 old year child

A

250-500 QDS

63
Q

What are the side effects of Erythromycin

A

Nausea

64
Q

What are the contra indications for Erythromycin

A

Patients who are taking warfarin

65
Q

How much Metronidazole can we prescribe to a 1-3 year old child

A

50mg every 8 hours

66
Q

How much Metronidazole can we prescribe to a 3-7 year old child

A

100mg every 12 hours

67
Q

How much Metronidazole can we prescribe to a 7-10 year old child

A

100mg every 8 hours

68
Q

How much Metronidazole can we prescribe to a 10-18 year old child

A

200-250 mg every 8 hours

69
Q

List the ages and doses of metronidazole we can prescribe to children

A

1-3yr olds: 50mg every 8 hours
3-7year olds: 100mg every 12 hours
7-10years olds: 100mg every 8 hours
10-18year olds: 200-250 every 8 hrs

70
Q

contra indication foe metronidazole

A

Patients taking warfarin

71
Q

Name the most common analgesics we recommend

A
  1. paracetamol
    2., Ibuprofen
  2. Aspirin
72
Q

What is a key problem of paracetamol

A

It is hepatotoxic

73
Q

How much paracetamol would we recommend a parent to give a 1month -12 year old

A

15-20mg/ kg every 4-6 hrs

74
Q

How much paracetamol would we recommend a parent to give a 12 -18 year old

A

1g every 4-6 hours

75
Q

Who do we avoid giving ibuprofen

A

Patients with coagulation defects and asthmatics

5th yr- Finals- CCD1 revision (9 decks)

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