Paediatric Revision Lecture - part 2

Question 1

Septic arthiritis vs transient synovitis

Answer 1

Septic:
* Unable to weight bear
* Looks unwell
* Fever - moderate/high
* Pain at rest

Question 2

How long does JIA have to be there for to have as differential?

Answer 2

For more than 6 weeks
If systemic - get salmon pink rash with fever

Question 3

Organism causing croup

Answer 3

Parainfluenza

Question 4

Cut off for O2 in bronchiolitis

Answer 4

If under 92%

Question 5

Inv for croup

Answer 5

Nasopharyngeal aspirate
Nose swab

Question 6

Cause of bronchiolitis

Answer 6

• Respiratory syncytial virus
• Rhinovirus
• Adenovirus
• Influenza
• Coronavirus

Question 7

Cause of acute wheeze

Answer 7

• Virus
• Bronchiolitis
• Pneumonia - mycoplasma, chlamydia
• Foreign body
• Anaphylaxis

Question 8

Laryngomalacia presentation

Answer 8

• Mild - stridor when feeding/crying - will resolve likely by 12-18 months
  If problems with growth, choking or feeding problems will need surgery

Question 9

Pierre robin sequence

Answer 9

• Micrognathia - hypoplasia of mandible
• Cleft palate
• Tongue tends to prolapse backwards causing obstruction
• If mild - will resolve as chin grows, support with feeding.
• If very severe - tracheostomy to maintain airway

Question 10

Adverse effect of prostaglandin (given to prevent duct closure)

Answer 10

• Not really - very safe drug
  High doses can lead to apnoea but rare

Question 11

Management constipation in children

Answer 11

• Paediatric Movicol - osmotic
• If not controlled - add stimulant laxative eg senna or sodium picosulfate

Question 12

Most common cause early vomitting baby

Answer 12

• Amniotic fluid gastritis
• Posseting
• GORD or CMPA (allergy likely to have faltering growth)
• Pyloric stenosis - do a CBG (hypoChlor hypoKal metabolic alkalosis)

Question 13

Management of GORD

Answer 13

• New position during feeds - 30 degrees head up
• Smaller feeds
• Milk thickener for formula
• Gaviscon (not with thickener)
• PPI
• Erythromycin as a prokinetic

Question 14

CMPA management

Answer 14

• Extensively hydrolysed formula
• Amino acid based formula
• Refer to dieticians - likely resolve by 1 yr, need milk ladder trials

Question 15

2 causes of short stature

Answer 15

• Familial short stature
• Constitutional growth delay - takes more time, then grow to expected height

Do x-ray of non-dominant hand and get bone age

Question 16

Predicted height for children

Answer 16

• Mother + fathers height divided by 2
• Add 7cm for boys, minus 7cm for girls

Question 17

Craniofacial features of down syndrome

Answer 17

Question 18

Other anomalies of down syndrome

Answer 18

Question 19

Clinical features of Turner syndrome

Answer 19

Question 20

Infantile spasms(west syndrome) EEg

Answer 20

Hypsarrythmia - even when not seizing

Question 21

Childhood adolesence epilepsy EEG

Answer 21

3 hz spike and wave - even when not seizing

Question 22

Where does spinal muscular atrophy arise from?

Answer 22

Anterior horn cell

Question 23

3 features of muscular dystrophy

Answer 23

• Delayed motor milestones
• Gower sign
• Hypertrophic calf

Question 24

Inv for ?ITP - bloods

Answer 24

FBC - if more than 1 cell line involved - COULD THIS BE LEUKAEMIA- follow up
Blood film

Question 25

Management of oromucosal bleed in ITP

Answer 25

* Oral steroids * If severe - IVIG

Question 26

Prophylaxis for nephrotic syndrome

Answer 26

* Penicilln V * VTE prophylaxis

Question 27

Differentials for nephrotic syndrome

Answer 27

* Protein losing enteropathy * R sided heart failure - feet and face