Paediatric Revision Lecture - part 1 Flashcards
(34 cards)
Signs of respiratory distress in child
- Tachypnoea
- Tracheal tug
- Intercostal/subcostal recessions
- Grunting
How to do correction on growth chart?
- Do up until 2 years
- Place dot on actual age and use arrow and dotted line for corrected
Bedside tests for child with fever
- Blood glucose
- Urine dipstick
- Nasopharyngeal aspirate - flu, covid, RSV
- Capillary blood gas if unwell
FeverPAIN and Centor score
- Fever
- Purulent tonsils
- Attend rapidly <3 days
- Inflamed tonsils
- No cough
Maculopapular rash key features
- Roseola infantum - fever for 3-5 days first then rash. Fever stops when rash begins. Self limiting.
- Slapped cheek (Parvovirus B19) - fever 2-5 days then malar erythema. Main complication is aplastic crisis - pale.
- Measles - incubation period 10-14 days (till temp and rash), Kopliks spots (rash = 14, temp = 10 days)
- Scarlet fever - sandpaper, can peel after (kawasaki differential) - phenoxymethylpenicillin.
Palmovirus - slapped cheek
Causes of vesicular rash
- Chicken pox
- Hand foot and mouth
- Herpes simplex
- Erythema multiforme
Causes of maculopapular rash
- Measles
- Slapped cheek
- Scarlet fever
- Roseola infantum
Incubation period chicken pox
14-16 days (10-21 range)
What are main viruses that can cause aspetic meningitis in children?
Measles
Varicella zoster
Key features of hand foot and mouth
- Coxsackie virus - enterovirus
- Can affect heart - if get palps need urgent review
- Self limiting
HSV presentation - primary or reactivation
- Primary - gingivitis and generalised oral vesicles
- Secondary - reactivation, localised vesicular lesion
Erythema multiforme major vs minor
- Major - if two or more mucosal surfaces involved
- Minor if not
Differentials for purpuric rash in child
- Meningococcal sepsis
- ITP
- HSP
- Leukaemia
If child very unwell, how many attempts for cannulation?
- 2 cannulation attempts
- If fail, go to interosseus
2 most key bloods for unwell child
- Blood glucose - prevent brain damage
- Blood culture - need to write that it is bone marrow sample if so
Maintenance vs resus fluid type
- Maintenance - 0.9% NaCl and 5% glucose
- Resus - 0.9% NaCl - 10ml/kg
Max resus fluids for child before calling ICU
- 4 lots of 10ml/kg boluses
Abx choice for sepsis in children older than 1 month
Ceftriaxone (not given in children under 1 month as worsens jaundice, cefotaxime given or benzylpenicillin and gentamicin)
Inv for ?meningococcal sepsis
Meningococcal PCR
Useful if benzylpenicillin given in community prior to admission, will remain positive
What is pleocytosis?
High WCC in CSF
When should LP be delayed/not done?
General info re meningitis diagnosis
- Prophylactic rifampicin for contacts/household - stains bodily fluids orange, contact lenses orange
- Colonise nose, spread to blood stream
HSP advice
- Monitor urine dipstick and BP via GP for 6 months - for hypertension, haematuria, proteinuria
- Monitor for joint swelling
- Often occurs after strep infection
- Blood PR - check - will need steroids if yes
ITP managements
- Weekly monitoring of FBC
- If not bleeding - just monitor, should improve
- If bleeding can give steroids, IVIG etc
