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Paediatrics Flashcards

(108 cards)

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1
Q

What is bronchiolitis ?

A

Inflammation of the bronchioles.
It usually occurs in the winter and common in very young children

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2
Q

What are the causes of bronchiolitis ?

A

Most is caused by the respiratory syncytial virus
The remainder are due to other respiratory viruses such as parainfluenza virus, influenza and rhinovirus.

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3
Q

Which groups of children are at risk of bronchiolitis ?

A

Prematurity
Chronic lung disease
Cardiac / respiratory disease
Immunocompromised

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4
Q

What are some clinical features of bronchiolitis ?

A

Usually occurs in children under 2
Fever
Poor feeding
Breathlessness
Wheeze
Pyrexia
Tachycardia

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5
Q

What investigations should be performed when suspecting bronchiolitis ?

A

Nasopharyngeal aspirate
Pulse oximeter
Chest radiograph

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6
Q

What are some differentials for bronchiolitis ?

A

Bronchial asthma
Congestive heart failure
Foreign body
Pertussis
Pneumonia
CF

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7
Q

What is the treatment for bronchiolitis ?

A

Treatment is supportive.
Intercostal recession should be hospitalised and give o2 and ventilation may be required
Paracetamol for fever

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8
Q

When should you call 999 when a child has bronchiolitis ?

A

Apnoea
Child looks seriously unwell
Severe respiratory distress
Resp rate over 70
Central cyanosis

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9
Q

What is chicken pox ?

A

A highly infectious, acute contagious disease predominately affecting children under 10 years old though it can occur at any age. It is caused by the varicella zoster virus.

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10
Q

How is chicken pox transmitted ?

A

Direct person to person contact
Airborne droplets
Through infected articles such as clothing or bedding

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11
Q

What are some clinical features of chicken pox ?

A

Incubation is 14 to 21 days
Rash begins as macular lesions which develop into papular or vesicular lesions which then become pustular.
Erythema and itchy
Scar if scratched

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12
Q

What are some differentials for chicken pox ?

A

Herpes simplex
Impetigo
Contact dermatitis
Scabies

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13
Q

What is the treatment for chicken pox ?

A

Paracetamol
Calamine lotion

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14
Q

What are some complications of chicken pox ?

A

Pneumonia
Cerebellar ataxia
Secondary bacterial infections
Affects pregnancy

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15
Q

What is croup ?

A

An upper respiratory tract infection occurring in infants and toddlers.
Parainfluenza viruses account for the majority of cases.

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16
Q

What are some clinical features of croup ?

A

May have a previous history of croup
Slow onset
Barking cough
No dysphagia
Hoarse voice
Agitation

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17
Q

What are some investigations for croup ?

A

Indicated if child has suffered lots of prisoners of croup
Plain neck radiograph
Bronchoscopy

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18
Q

What are some differentials for croup ?

A

Cute epiglottis
Foreign body
Diphtheria
Peritonsillar abscess
Smoke inhalation

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19
Q

What is the management for croup ?

A

Steroid treatment - dexamethasone oral
Nebulised adrenaline
Oxygen with caution

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20
Q

When should a child be admitted for hospitalisation for croup ?

A

Cynaosis
Pallor
Resp distress
Hypoxaemia
Stridor at rest

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21
Q

What are some differences between croup and epiglottis ?

A

E : H.Influenza , C : parainfluenza
E : rapid C : gradual
E : dysphagia
C : barking cough
E : grey C : pink

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22
Q

What is head lice ?

A

An infestation of blood-feeding insects - pediculus capitis.

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23
Q

What are some clinical features of head lice ?

A

Direct contact needed for transmission
Itching is commonly seen

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24
Q

What is the treatment of head lice ?

A

All the family should be treated
Insecticides - malathion or pyrethroids
Wet combing
Dimeticone lotion

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25
What are threadworms ?
A common helminthic infection which reside in the caecum which females migrating to the anus to lay eggs usually at night.
26
How are threadworms transmitted ?
Faecal-oral route
27
What are some clinical features of threadworms ?
1/3 are asymptomatic Pruritis ani at night Irritation may spread to the vagina Occasionally you might see an adult threadworm in faeces
28
How is threadworms diagnosed ?
Early morning application of sellotape to the anus with microscopy for typical eggs.
29
What is the treatment of threadworms ?
Mebendazole - one dose followed by another dose 2 weeks after
30
What is osgood-schlatter’s disease ?
A painful condition affecting the tibial tuberosity.
31
What are some differentials for osgood-schlatter’s disease ?
Fracture of the tibial tuberosity Infre-patellar bursitis Osteomyelitis Patellar tendonitis
32
What is the management of osgood - Schlatter’s disease ?
Self-limiting Reduce physical activity Physiotherapy Ice packs
33
What is the most common causes of diarrhoea in children ?
Infectious - viral - rotavirus
34
Why do infectious organisms cause diarrhoea ?
Mucosal damage caused by direct attack Toxin production after ingestion Toxin production before ingestion
35
What are the types of diarrhoea ?
Secretory - deranged membrane transport results in decreased electrolyte absorption and thus decreased water absorption Osmotic - decreased absorption due to mucosal damage or increased gut motility
36
What is the treatment for childhood diarrhoea ?
Maintain hydration Medical intervention is often not recommended
37
What are some non-infectious causes of diarrhoea in children ?
Monosaccharide intolerance Cow milk’s intolerance Coeliac disease CF
38
What is GORD ?
The uncontrolled passage of gastric contents into the oesophagus. Commonly seen in infants
39
What are some clinical features of GORD ?
Regurgitation or persistent vomiting Feeding refusal Back arching Irritability / persistent crying Poor weight gain Sleeping difficulties
40
What are some investigations for GORD ?
Usually based on clinical presentation Barium contrast radiography Upper GI endoscopy
41
What are some differentials for GORD ?
Cow’s milk allergy Infections - GI Medications Pyloric stenosis
42
What is the management of GORD ?
Dietary measures - removal of certain foods form diet Antacids H2 antagonists Omeprazole Domperidone
43
What is infantile colic ?
A benign condition where there are paroxysms of uncontrollable crying for more than 3 hours per day in more than 3 days a week for more than 3 weeks. They have to be healthy child younger than 3 months old.
44
What is infantile colic associated with ?
Postpartum depression Shaken baby syndrome
45
What are some differentials for infantile colic ?
Infection - meningitis, UTI Constipation Cow’ milk allergy GORD Hypoglycaemia Trauma
46
What is the management of infantile colic ?
Dietary modifications Self limiting - resolves after 4 months
47
What is asthma ?
An inflammatory disorder of the conducting airways where they become hyper-responsive and constructive easily in response to a range of exogenous and endogenous stimuli.
48
What are some risk factors for asthma ?
Genetics Allergens in environment Infections Diet Stress
49
What are some clinical features of asthma ?
SOB Wheezing Cough Triggers
50
What are some differentials ?
Inhaled foreign body Bronchiectasis CF Congenital heart disease
51
What are some investigations for asthma ?
Spirometry - showing reversibility Peak flow FeNo testing
52
What is the management of asthma ?
SABA - intermittent reliever Inhaled corticosteroids - regular preventer
53
What signifies a moderate asthma attack ?
Increasing symptoms Peak flow of 50-75% of best or predicted No features of severe asthma
54
what signifies a severe asthma attack ?
Any one of the following : - peak flow of 33 - 50 % - RR over 25 - HR over 110 - Inability to complete a sentence in one breath
55
What signifies a life threatening asthma attack ?
Any one of the following : - peak flow lower than 33% - O2 sats below 92 % - silent chest - cyanosis - arrhythmia - exhaustion - hypotension - altered consciousness
56
what indicates a near fatal asthma attack ?
Raised PaCO2 and / or mechanical ventilation with raised inflation process
57
What is atopic eczema ?
A chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. Usually presents in episodes - flare ups
58
What are some features of atopic eczema ?
Relapsing course Pruritus Redness Swelling Blisters Dry skin Excoriations
59
What investigations can be performed when suspecting atopic eczema ?
Serum IgE levels Skin prick test Radioallergosorbent testing Skin biopsy White dermographism
60
What are some complications of atopic eczema ?
infections Cataract Growth retardation
61
What are some associated conditions of atopic eczema ?
Asthma Allergic rhinitis Dry skin Foot intolerance Alopecia areata
62
What treatment is offered for atopic eczema ?
Emollients Topical corticosteroids
63
What are the types of Allergic rhinitis ?
Seasonal - caused by grass and tree pollen Perennial - caused by dust mites and animals Occupational - allergens at the workplace
64
What are some clinical features of allergic rhinitis ?
Rhinorrhoea Nasal blockage Sneezing Itching Watery eyes Malaise Headache SOB
65
What is allergic rhinitis associated with ?
Asthma Eczema Chronic sinusitis
66
What causes seasonal rhinitis ?
Reaction to pollen, usually grass and trees
67
What causes perennial allergic rhinitis ?
Dust Mites Feathers Animal dander
68
What is the management of allergic rhinitis ?
Avoid triggers Oral / nasal antihistamines Corticosteroids in people with severe symptoms Leukotriene receptor antagonist
69
What are some signs and symptoms of idiopathic constipation ?
Infrequent bowel activity Foul smelling wind and stools Excessive flatulence Irregular stool texture Passing enormous stools or frequent pellets Abdo pain / distension / discomfort
70
What are some causes of constipation in children ?
Hypothyroidism Idiopathic Anal fissure Severe vomiting Cow’s milk intolerance
71
What are some investigations for constipation ?
Abdominal radiography Barium enema or rectal biopsy Blood test - coeliac / hypothyroidism
72
What is the management of constipation ?
Laxatives Dietary modifications Increase fluid and fibre intake
73
What are some indicators of abuse or neglect ?
Children with behavioural changes - more become aggressive, disruptive or challenging Children with ill-fitting or dirty clothing Children with poor hygiene Children who don’t want to change clothes in front of others Trouble at school Developmental delay Regularly missing from school Children who shy away from being touched
74
What are the 4 main types of abuse and neglect ?
Physical Emotional Sexual Neglect
75
What is physical abuse ?
Deliberately physically hurting a child such as hitting, pinching, shaking, throwing, poisoning, burning, drowning or suffocating.
76
What are some signs of physical abuse ?
Children with frequent injuries Children with unexplained or unsual fractures Children with unexplained bruises, cuts, burns or bite marks
77
What is emotional abuse ?
The persistent emotional maltreatment of a child. Also called psychological abuse and can affect a child’s emotional development.
78
What are some signs of emotional abuse ?
Children who are excessively withdrawn, fearful or anxious about doing something wrong Parents who withdraw attention form their child - cold shoulder Parents who blame their problems on their child Parents who humiliate their child - name calling
79
What is sexual abuse ?
Any sexual activity wit a child. Many children who are victims of sexual abuse don’t recognise themselves as such.
80
What may sexual abuse involve ?
Physical contact Rape Oral sex Masturbation Kissing Rubbing and touching outside clothing Producing sexual images Forcing children to look at sexual imagery
81
What are some indicators of sexual abuse ?
Children who display knowledge or interest in sexual acts inappropriate to their age Children who use sexual language or have sexual knowledge you wouldn’t expect them to have Children who ask others to behave sexually or play sexual games Children with physical sexual health problems - sore genitals or STI
82
What is sexual exploitation ?
A form of sexual abuse where children are sexually exploited for money, power or status. It can involve violent, embarrassing or degrading sexual assaults.
83
What are some signs of sexual exploitation ?
Children with unexplained gifts Older boyfriends or girlfriends STI’s or pregnancy Changes in emotional wellbeing Misuse of drugs or alcohol Children who go missing for large amounts of time or return late Regularly miss school
84
What is neglect ?
A pattern of failing to provide for child’s basic needs whether it be adequate food, clothing, hygiene, supervision or shelter. It can severely impact the child’s heath and development.
85
What are some signs of neglect ?
Living in a home that is dirty or unsafe Children who are hungry or dirty Left without adequate clothing Living in dangerous conditions - around drugs Children who are aggressive, angry or self harm Fail to receive basic healthcare Parents who fail to seek help when their child is ill or injured
86
What does the newborn physical examination check for ?
Eyes - appearance and movement, check for cataracts and red reflex Heart - pulses, arrhythmia Hips - developmental dysplasia and movement Abdomen - any hernias Testicles - located in the correct place
87
What is tested for in the heel prick spot test ?
Sickle cell disease Cystic Fibrosis Congenital hypothyroidism Phenylketonuria Homocystinuria
88
What are developmental milestones separated into ?
Gross motor Vision and fine motor Hearing, speech and language Social, emotional and behavioural
89
At what age do babies sit without support ?
6 - 8 months
90
At what age do babies crawl ?
8-9 months
91
At what age do babies stand independently ?
10 months
92
At what age do babies walk steadily ?
15 months
93
At what age do babies run and jump ?
2.5 years
94
At what age do babies say words such as dada or mama ?
10 months
95
At what age do babies join 2 or more words together ?
20-24 months
96
When do babies smile responsively ?
6 weeks
97
At what age do babies put food in their mouth ?
6 -8 months
98
At what age do babies become toilet trained ?
2 years
99
What are some signs that a baby is unwell ?
Poor feeding Altered cry / drowsy High temp Irritability and lethargy Dry nappies / not passing urine Prematurity
100
What are some clinical features of meningitis ?
Non-blanching rash Neck stiffness Photophobia Drowsiness Vomiting High temp
101
What medication is given for meningitis ?
Benzyl penicillin IM
102
What features of the history are important to ask if a baby is failing to thrive ?
Maternal smoking Maternal illness during pregnancy Use of medications during pregnancy Relationship of symptoms to mealtimes Ethnic origin
103
What features of a physical exam would be essential to assess a malnourished child ?
Measuring head circumference Looking for signs of vitamin deficiency Assessing skin turgor
104
What are some physical signs elicited which would indicate malnutrition ?
Oedema Muscle wastage Rash or skin changes Hair colour or texture changes Mental state changes
105
What would indicate a dehydrated child ?
Decreased skin turgor Decreased sensory awareness Sunken fontanelles Dry mucous membranes Absence of tears Acutely ill appearance
106
What type of vaccine is MMR ?
Live attenuated
107
What are some toxoid vaccines ?
Diphtheria Tetanus
108
What are some examples of killed vaccines ?
Flu and hepatitis A

Y3 GP (12 decks)

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