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

Paediatric emergency Flashcards

(75 cards)

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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
List some signs of a teething babay
1. Cheeks may look rosy 2. Baby wants to bite or avoid particular area 3/ Drooling or dribbling 4. Gums may look red 5. Disturbed sleep
26
What tips can we give to guardians of a teething baby
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
27
What are natal teeth
Teeth erupted at birth
28
What are neonatal teeth
Teeth erupted in the first 30 days post natal life
29
How many babies are born with natal or neonatal teeth
1 in 2000 to 1 in 3500 (more common in females)
30
How do we treat neonatal and natal teeth
Extract them
31
Why do we extract neonatal and natal teeth
1. Danger of inhalation 2. Difficulties with breast feeding and bottle feeding 3. Causing trauma to the ventral surface of the tongue
32
What are eruption cysts
They precede the eruption of primary and permanent teeth
33
Describe the shape and location of an eruption cyst
They occur where a tooth should be erupting They are well circumscribed, dome shaped fluctuant enlargements that are usually asymptomatic
34
How do we treat eruption cysts
No treatment as they usually drain own when the tooth erupt
35
Name a common oral ulceration you may encounter in children
Recurrent aphthous stomatiitis
36
Why might ulcers from in the oral cavity
1. Ill fitting dentures 2. From adjacent teeth 3. From orthodontic appliance 4. Due to anaesthetised tissue 5. Underlying medical conditions
37
How do we treat an ulcer that may have formed due to ill fitting dentures
Tell the patient to rinse with chlorohexidene (if over 7 years) and avoid wearing the denture till it is fixed
38
How do we treat an ulcer that may have formed due to trauma from a sharp adjacent tooth
Smooth the adjacent tooth that is sharp and hopefully the ulcer shoudl heal in a few days
39
How do we treat an ulcer caused by an orthodontic appliance
Add wax to any sharp wires coming off the orthodontic appliance and refer the patient to their orthodontist to get the appliance fixed§
40
How do we treat an ulcer that may have formed due to anaesthetised tissue
Advice the patient to avoid hot food/drinks till the anaesthesia has worn off
41
Which disease and infections can lead to oral ulcerations
1. Viral infections 2. Bacterial infections 3. Mucocutaneous diseases 4. Haematological diseases 5. Gastrointestinal diseases
42
Give examples fo some viral infections that can lead to oral ulcerations
1. Herpatic stomatitis 2. Chicken pox 3. Hand foot and mouth disease 4. HIV 5. Herpangina
43
Give examples fo some Bacterial infections that can lead to oral ulcerations
1. Syphillis 2. TB
44
Give examples fo some Mucocutaneous diseases that can lead to oral ulcerations
1. Lichen planus 2. Behcet's syndrome 3. Pemphigus vulgaris 4. Erythema multiform 5. Pemphigoid and variants 6. Chronic ulcerative stomatitis
45
Give examples fo some Haematological diseases that can lead to oral ulcerations
1. Anaemia 2. Leukaemia 3. Haemantinic deficiencies 4. Neutropenia
46
Give examples fo some Gastrointestinal diseases that can lead to oral ulcerations
1. Coeliac disease 2. Ulcerative colitis 3. Crohn's disease
47
What is primary herpetic gingivostomatitis caused by
Herpres simplex virus
48
In whom is primary herpatic gingivostomatitis common in
2-5 year olds
49
What is the incubation period for primary herpetic gingivostomatitis
7 days
50
How many patients are systemically affected by primary herpetic gingivostomatitis
5%
51
What symptoms may a patient with primary herpetic gingivostomatitis present with
Febrille illness: Headache, malaise, oral pain, mild dysphagia and cervical lymphadenopathy
52
What do we need to be careful of when treating a patient with primary herpetic gingivostomatitis
It is very contagious so wear PPE
53
How would we manage primary herpetic gingivostomatitis
Advise the patient to 1. Bed rest 2. Soft diet 3. Fluids 4. Paracetamol
54
What antibiotics can we prescribe to children
Amoxicillin Erythromycin Metronidazole
55
How much Amoxicillin can we prescribe to a 1 month- 1 year old child
125mg TDS for 5 days
56
How much Amoxicillin can we prescribe to a 1-5 year old child
250mg TDS for 5days
57
How much Amoxicillin can we prescribe to a 5-12 year old child
500mg TDS for 5 days
58
How much Amoxicillin can we prescribe to a 12-18 year old child
500mg TDS for 5 days (if severe increase to 1g TDS)
59
List the ages and max doses of amoxicillin we can prescribe to Childs
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
How much Erythromycin can we prescribe to a 1 month- 2 year old child
125mg QDS 5 days
61
How much Erythromycin can we prescribe to a 2-8 year old child
250qds
62
How much Erythromycin can we prescribe to a 8-18 old year child
250-500 QDS
63
What are the side effects of Erythromycin
Nausea
64
What are the contra indications for Erythromycin
Patients who are taking warfarin
65
How much Metronidazole can we prescribe to a 1-3 year old child
50mg every 8 hours
66
How much Metronidazole can we prescribe to a 3-7 year old child
100mg every 12 hours
67
How much Metronidazole can we prescribe to a 7-10 year old child
100mg every 8 hours
68
How much Metronidazole can we prescribe to a 10-18 year old child
200-250 mg every 8 hours
69
List the ages and doses of metronidazole we can prescribe to children
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
contra indication foe metronidazole
Patients taking warfarin
71
Name the most common analgesics we recommend
1. paracetamol 2., Ibuprofen 3. Aspirin
72
What is a key problem of paracetamol
It is hepatotoxic
73
How much paracetamol would we recommend a parent to give a 1month -12 year old
15-20mg/ kg every 4-6 hrs
74
How much paracetamol would we recommend a parent to give a 12 -18 year old
1g every 4-6 hours
75
Who do we avoid giving ibuprofen
Patients with coagulation defects and asthmatics

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

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