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Year 3 GP Block > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

At what intervals are baby checks done (up to 6 weeks)?

A

At birth - within 72 hours
At 5-8 days - heel prick test
At 10-14 days - health visitor review
At 4-5 weeks - newborn hearing screening test
At 6-8 weeks - physical examination by GP

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2
Q

What conditions are screened for in heel prick test?

A 
Sickle cell disease 
Homocystinuria 
CF
Congenital hypothyroidism 
Phenylketouria 
Medium chain CoA dehydrogenase deficiency
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3
Q

What is done at 6 week baby check?

A

Thorough physical examination - eyes, heart, hips, testicles, weight, height, head circumference.
Vaccinations discussed.

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4
Q

What are the key milestones in development of baby?

A 
Newborn = should be able to lie on back and turn head 
6-8m = should be able to sit up and look at objects. Should be able to crawl. 
12m = should be able to walk with a broad gait.
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5
Q

Types of abuse that need to be considered in child safe guarding?

A

Neglect - do not meet child’s basic needs
Physical - deliberately hurting a child
Emotional - persistent emotional maltreatment of child
Sexual - any sexual activity with a child.

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6
Q

Signs of abuse in children?

A 
Consistent poor hygiene
Ill fitting or dirty clothes 
Behavioural changes 
Avoidance of family members
Problems at school 
Child mentions being left alone 
Do not want to go home
Milestones not met 
Sexualised behaviour 
Children concern for younger siblings
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7
Q

Causes of neonatal jaundice?

A 
Liver staring to work and take over from placenta (to excrete bilirubin)
Neonatal hepatitis 
Galactosemia 
Biliary atresia 
Breast milk jaundice
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8
Q

RF for neonatal jaundice?

A

Pre-term (before 38wks)
Exclusive breastfeeding
Siblings needed phototherapy

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9
Q

Complication of neonatal jaundice?

A

High levels of bilirubin = encephalopathy

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10
Q

Management of neonatal jaundice?

A

Phototherapy

Further investigations needed —>paeds

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11
Q

Describe cradle cap

A

Seorrhoeic eczema of infant
Starts in first few weeks of life.
Affects body folds - axilla, groin, behind ears, neck, face/scalp

Scaly erythematous flexural lesions
Yellowish crust

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12
Q

Management of cradle cap?

A

Emollients
1% hydrocortisone
If only on scalp - can get OTC cradle cap cream

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13
Q

Associations to atopic eczema in paeds?

A

Asthma

Hayfever

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14
Q

How to manage paeds atopic eczema ?

A

Avoid perfumed products.
Cover area - stop drying out
Bandage at night if very itchy

Flare up = hydrocortisone 1%
Manage any infections in cracked skin or from excoration

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15
Q

Signs and symptoms of H,F&M?

A 
Sore throat 
Temperature 
Loss of appetitie
Headache 
Fatigue 
Ulcers and rash appear after a few days of these initial symptoms
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16
Q

Management of H,F&M?

A 
Self limiting 7-10 days 
Drink fluids for any dehydration 
Eat soft foods
Paracetamol and ibuprofen for symptom relief 
Mouth ulcer gel and washes
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17
Q

Management of candidas infection in paeds?

A

Clotrimazole - topical anti fungal

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18
Q

Symptoms and signs of chicken pox/varicella zoster?

A

Fever
Blistered rash or itchy erythematous papule that progress to vesicles.
On stomach, back and face.

19
Q

How does chicken pox spread?

A

Airborne respiratory droplets

20
Q

Management of chicken pox?

A 
Self limiting so symptomatic management 
Trim nails to reduce scratching 
Warm bath 
Moisturiser 
Paracetamol to reduce fever and pian 
Calamine lotion, antihistamines for itching

Older patients = aciclovir

21
Q

Presentation of fifth’s disease?

A 
Runny nose 
Headache 
High temperature 
Rash on cheeks
Spotty rash on chest, arms and legs
22
Q

When is pt with fifth’s disease contagious?

A

Before rash appears

23
Q

How to manage fifth’s disease?

A

Symptomatic relief only - fluids, moisturiser on rash, antihistamine for itching, paracetamol, ibuprofen.

24
Q

What is scarlet fever?

A

Bacterial infection associated with Group A streptococcus

Pts who have recently had strep throat or impetigo

25
Q

Presentation of scarlet fever?

A 
High temp/fever 
Sore throat 
Swollen LN in neck 
Loss of appetite 
Headache 
Nausea
Fatigue 
Rash appears in 12-48hrs on chest and abdominal then spreads.

Rash = generalised, red, pinpoint “feels like sandpaper”

26
Q

Investigation for scarlet fever?

A

Throat swab to confirm Dx

27
Q

Management of scarlet fever?

A

Abx - 10 days phenoxymethylpenicillin QDS
Notify local health protection team - as is notifiable disease.
Rest, fluids, symptomatic analgesia

Advise on hygiene measures to reduce spread.

28
Q

Complications of scarlet fever?

A 
Caused by group A strep, so complications are:
Rheumatic fever 
Otitis media 
Pneumonia 
Septicaemia 
Glomerulonephritis 
Osteomyelitis 
Death
29
Q

What is measles?

A

Viral illness spread via respiratory droplets. Lasting 7-10days.

30
Q

Presentation of measles?

A

Presents 10-12 days after exposure
Cold symptoms
Conjunctivitis
Kopek spots

Rash starts a few days after this:
Red/brown flat rash behind ears and upper neck —> spreads.
Fever starts with rash.
Contagious 5 days after rash starts.

31
Q

Management of measles?

A

Symptomatic treatment only for 7-10 days

32
Q

Complications from measles?

A 
Encephalitis 
Pneumonia 
Otitis media 
Acute glomerulonephritis 
Myocarditis 
Pericarditis 
Laryngobronchitis 
Measles croup
33
Q

What is rubella?

A

Viral infection spreads via direct contact with nasal or throat secretions of an infected individual
Contagious 7 days before rash appears to 7 days after rash appears

34
Q

Presentation of rubella?

A 
Fever
Swollen glands in neck and behind ears 
Runny nose 
Malaise 
Petechaie on soft pallet 
Rash in face first then spreads - lasts for up to 5 days.
35
Q

Presentation of osgood schlatters?

A

Sporty teenager usually
Progressive tenderness and swelling localised to the tibial tuberosity
Pain worse on running, jumping, squatting, stairs, kneeling

36
Q

Management for osgood schlatters?

A

Rest, ice

Resolves with apophysis fuses.

37
Q

What is Perthes disease?

A

Femoral head loses blood supply and becomes misshapen - 4-10 years old

38
Q

Presentation of Perthes disease?

A

Pain in groin, thigh or knee esp after activity
Abnormal gait
Reduced movement of hip joint
Symptoms on and off for many months

39
Q

Investigation for suspected Perthes disease?

A

XR - to find misshapen femoral head

40
Q

Presentation of Slipped upper femoral epiphysis SUFE?

A

Boys>girls
11-17yrs
Overweight children

Pain in knee, hip or groin. 
Difficulty walking 
Externally rotated and shortened 
Reduced range of movement 
Sudden onset
41
Q

What is Slipped upper femoral epiphysis SUFE?

A

Femoral head slips posteriorly

42
Q

Investigation for Slipped upper femoral epiphysis SUFE?

A

XR

43
Q

Management of Slipped upper femoral epiphysis SUFE?

A

Surgical fixation

Year 3 GP Block (14 decks)

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