Paediatrics Flashcards
1
Q
itchy rash over face, golden crust, fever
Mx
A
Impetigo
Hydrogen peroxide 1% cream, fusidic acid cream
2
Q
rough maculopapular rash on face, periorbital sparing, red tongue
A
scarlet fever
3
Q
Mx of scarlet fever
A
phenoxymethylpenicillin
4
Q
red rash all over body, white Koplik spots inside buccal cavity
A
Measles
5
Q
red rash on both cheeks, fever
A
Parvovirus B19
6
Q
drooling, soft inspiratory stridor, unwell child
cause:
A
acute epiglottis
cause: haemophilus influenza B
7
Q
widespread polymorphic rash across her torso, and she has oedematous feet. Examination of the mouth shows widespread mucosal erythema and a strawberry tongue.
A
Kawasaki disease
8
Q
criteria to treat tonsillitis
A
CENTOR: no cough, has fever, has cervical lymphadenopathy, has exudate
give phenoxymethylpenicillin for 5 days
9
Q
measles Px
A
conjunctivitis
raised red rash
high fever
white koplik spots in oral mucosa
10
Q
hand foot and mouth MX
A
supportive
11
Q
croup cause
A
parainfluenza
12
Q
fever >5 days
conjunctivitis
swollen neck glands
red tongue
rash
A
Kawasaki
13
Q
Kawasaki Mx
A
IV Ig + aspirin
echo to assess cardiac effect
14
Q
ADHD not responding to conservative measures. Med:
A
methylophenidate
15
Q
similar symptoms to SUFE but child under 10
A
perthes disease
16
Q
failure to pass meconium
distended abdomen
explosive diarrhoea after removing finger during rectal examination
what is it, Ix, Mx
A
hirshsprungs disease
Ix: rectal suction biopsy
Mx: remove unhealthy bowel
17
Q
machine whirring murmur
A
patent ductus arteriosus
18
Q
use of prostaglandin E in ASD/VSD
A
allows the ductus to remain patent
blood will continue to flow into the heart
19
Q
immediate/premature Mx of PDA
A
indomethacin (NSAID) to inhibit prostaglandin and therefore keep the ductus closed
20
Q
Eisenmenger syndrome
A
the left -> right shunt reverses to become right -> left.
This happens when the pulmonary pressure > systemic pressure
21
Q
coarctation of the aorta
A
narrowing of the aorta
22
Q
systolic murmur loudest in the back. radio-femoral delay
wide neck, low set ears
A
coarctation of the aorta in a pt with turners syndrome
23
Q
teratology of fallot
A
- right ventricular hypertrophy
- pulmonary stenosis
- overriding aorta
- ventricular septal defect
24
Q
boot shaped heart on CXR
A
ToF
25
transposition of the great arteries
the aorta and pulmonary arteries are switched in position. creates two parallel circuits. incompatible with life in theory but there are many shunts which allow blood to still flow
26
feverish child, trouble swallowing, drooling, sitting forward (tripod position)
epiglottitis
27
cause of epiglottitis
haemophilia influenza B (there is a vaccine)
28
Dx and Mx of epiglottitis
lateral x ray of the neck = thumbprint sign
secure airway (may need intubation), IV antibiotics, dexamethson
29
what to prescribe in constipated child first line
movicol disimpaction regimen, then senna/lactulose etc
30
biliary atresia
congenital issue where the final part of the bile duct is not formed
bile cannot leave the gallbladder
raised conjugated bilirubin
jaundice!
31
born preterm, bloody stool, abdominal distension, bilious vomiting
Mx
necrotising enterocolitis
broad spectrum ABs and parenteral feeding
32
intussuception
the bowel telescopes into itself
sausage shaped mass, red currant stool, intermittent abdominal pain
33
Ix and Mx for intussuception
contrast enema, reduction for Mx
34
hirschsprungs disease
dysfunctional myenteric plexus; lack of parasympathetic ganglionic cells
no peristalsis, so faeces gets backed up, constipation
abdominal pain, doesn't pass meconium, explosive excretion after digital rectal exam
35
intestinal obstruction Px
abdominal distention, bilious vomiting, failure to pass stool or wind
dilated loops of bowel proximal to the obstruction
abnormal bowel sounds (tinkling, then absent later in the obstruction)
36
olive shaped mass
pyloric stenosis
37
Mx for pyloric stenosis
pylomyotomy
38
Px of pyloric stenosis
olive shaped mass, projectile vomiting
39
Px of appendicitis
pain in central abdo that then travels to RIF
Rovsings sign: palpated on LIF, pain on RIF
40
x ray of duodenal atresia
double bubble
41
x ray of jejunal atresia
triple bubble
42
joint pain, fever, salmon-pink rash
Juvenile idiopathic arthritis / stills disease
43
how to differentiate roseola infantum vs slapped cheek
roseola infantum has a higher fever
44
lethargy, slurred speech, hepatomegaly, fever after taking aspirin
what has happened>
reyes syndrome
liver failure and subsequent encephalopathy
45
Presentation of phenylketonuria
Hypopigmentation
Musty odour
Eczema
Microcephaly
46
Two conditions which cause abdominal contents to protrude from the foetus’ abdomen and how to diffferentiate
Gastroschisis vs omphalocele
Omphalocele has organs covered in the peritoneum
47
Baby immediately vomiting uncurdled milk when breastfeeding
Tracheo oesophageal fistula
Milk is uncurdled as it hasn’t reached the stomach
48
Signs of clinical dehydration in children
Dry mucus membranes
Sunken eyes
Irritability
Normal crt
49
Signs of clinical shock in children
Mottled pale skin
Altered consciousness
Low bp
Prolonged cap refill time
50
Legg calve perthes disease
Comprised blood flow to the femoral head
Usually presents age 4 to 9 with limp and pain upon walking, better when sitting
Self limiting
51
how many inhaler puffs is equal to 1 nebule
6 (childs dose)
52
what is burst therapy in asthma attack Mx
100mcgs of salbutamol 10 puffs with spacer
every 20 mins for 1 hour
53
bilateral palpable flank masses
renal cysts, hepatic fibrosis
autosomal recessive pckd
54
potter syndrome
pulmonary hypoplasia
oligohydramnios
due to ARPKD / bilateral renal agenesis
55
appearance of a kid with potters sydnrome
low set ears
beaked nose
limb deformities
56
bilateral renal agenesis
both kidneys fail to develop
can cause potters sydnrome
57
Px of haemolytic uraemic syndrome
bloody diarrhoea
vomiting
hypertensive
pallor
seizures
58
haemorrhage disease of newborn is caused by..
vitamin k deficiency
59
unilateral wheeze, no signs of infection
foreign body inhalation
60
murmur in ASD
ejection systolic murmur heard in the pulmonary region
fixed split s2 (pulmonary valve closes later than the aortic valve)
61
murmur in VSD
systolic murmur at the pulmonary region
diastolic murmur at heart apex
62
most significant risk factor for developmental dysplasia of the hip
breech position in 3rd trimester
63
tests for DDH
barlow and ortolani
64
what type of heart sound is heart in ASD?
and why
fixed split second heart sound.
ASD = left to right shunt causes an increased pressure in the Right Atrium. This means the pulmonary valve closes later than the aortic valve. “fixed” means that it happens irrespective of inspiration and expiration.
65
most common cerebellar neoplasm in childhood
astrocytoma
66
blood gas reading on pyloric stenosis
hypochloraemic hypokalaemia metabolic alkalosis
67
murmur and heart sounds heard in VSD
holosystolic murmur
loud s2
68
maternal diabetes is assoc with what congenital heart abnormality
VSD
69
maternal rubella is assoc with what congenital heart abnormailty
PDA
70
turners syndrome karyotype and association
45XO
coarctation of the aorta
71
what abnormalities are seen in ToF
pathophis
1. VSD
2. RV hypertrophy
3. pulmonic stenosis
4. overriding aorta
deoxygenated blood cannot leave the pulmonary artery due to stenosis
shunts through the VSD instead
cyanotic
72
murmur heard in ToF
ejection systolic in left upper sternal border
73
short term and long term Mx of TGA
short term: prostaglandin e2 to maintain PDA. balloon atrial septostomy
Long term: arterial switch opereation
74
cyanotic heart disease presenting in the first week of life
transposition of the great arteries
75
cyanotic heart anomaly presenting after the first week of life
ToF
76
4 examples of acyanotic heart disease
VSD
ASD
PDA
CoA
77
signs of unwell child (A/B,C,D)
A/B: increased work of breathing, tachypnea, poor air entry
C: blue, long cap refill time, cool peripheries, tachycardia
D: AVPU, irritability
78
cephalohaematoma
what is it, px, associations, Mx
subperiosteal haemorrhage
caused by birth trauma
assoc with prolonged 2nd stage of labour, instrumental delivery,
does not cross suture lines
well-circumscribed fluctuant mass, parietal bone
appears in first week of life, disappears by few months
79
caput succedaneum
px, mx
diffuse swelling of the scalp that is above the periosteum, so it crosses suture lines
resolves within first few days of life
80
subgaleal haemorrhage
associations Px Mx
assoc with instrumental delivery
rupture of emissary veins, leading to bleeding between the periosteum and the gala aponeurosis.
fluctuant mass, overlying bruising
crosses over suture lines
Mx: monitor for haemorrhagic shock
81
Moro reflex
Arms flayed out
Then pulled back in tight to chest
Crying
82
Asymmetrical Moro reflex shows
Brachial plexus / isolated nerve injury
83
Waiters tip deformity …
Erbs palsy
84
son had a runny nose and sore throat for the past few days but then developed bright red rashes on both cheeks. He now has a raised itchy rash on his chest that looks lace-like in appearance
Parvovirus b19
85
Mx of bordetella pertussis
Azithromycin
86
congenital adrenal hyperplasia pathophis
defect in hydroxylase 21 gene
hydroxylase 21 is required to convert progesterone into aldosterone and cortisol
so it can't happen in CAH]
however hydroxylase 21 isn't required to convert progesterone into testosterone.
so all free progesterone is converted to testosterone
87
Px of Congenital adrenal hyperplasia in females
tall, virilised genitals, large clitoris, absent periods
88
Px of congenital adrenal hyperplasia in males
tall, large penis, small testicles, deep voice
89
general Px of CAH and why
poor feeding, vomtiing, diarrhoea, bronzed skin
due to the production of ACTH (due to lack or cortisol and aldosterone)
90
Ix findings in CAH
unequivocally elevated serum conc of 17-hydroxyprogesterone
91
pathophis of phenylketonuria
defect in phenylalanine hydroxylase gene
buildup of phenylalaine
92
inheritance pattern of phenylketonuria
autosomal recessive
93
prevention of migraines when propranolol is contraindicated
topiramate
94
at what age is enuresis alarm offered for bed wetting
over 7 years
95
small jaw, low-set ears, rocker-bottom feet and overlapping fingers.
what is the syndrome and what is the chromosomal abnormality
edwards
trisomy 18
96
webbed neck, pectus excavatum, short stature and pulmonary stenosis.
noonans syndrome
97
microcephaly, small eyes, cleft lip/palate, polydactyly and scalp lesions.
syndrome + chromosomal abnormality
patau
trisomy 13
98
features of turners syndrome but in a boy
noonans syndrome
99
hearing screening for newborns (2 tests)
1. otoacoustic emission test
if failed:
2. impedance audiometry
100
3 examples of oral live attenuated vaccine
rotavirus
polio
typhoid
100
intestinal malrotation is more likely to affect where? + Mx?
small bowel
Ladd's procedure
101
Williams syndrome
Px, what chromosome
elfin facies, strabismus, broad forehead, short stature
very friendly, learning difficulties
micro deletion on chromosome 7
102
what is in the 6 in 1 vaccine
diptheria
tetanus
polio
pertussis
Haemophilus influenza B
Hep B
103
2 cardiac defects associated with turners syndrome
coarctation of aorta
bicuspid aortic valve
104
unilateral undescended testis - when should pt be reviewed and managed
review at 3 months, if it persists a paediatric urologist should see within 6 months of age
surgery at 1 year
105
bilateral undescended testis - when should pt be reviewed
urgent 24hr review by senior paediatrician for endocrine or genetic testing
106
congenital CMV
low birth weight, purpuric rash, sensorineural deafness, microcephaly, hepatosplenomegaly
107
congenital herpes infection
vesicular rash, low with weight microcephaly
108
congenital toxoplasmosis
chorioretinitis, hydrocephalus, big head, intracranial calcifications, maculopapular rash
109
congenital varicella syndrome
hypertrophic scars, hypoplastic limbs, seizures, cataracts, microphthalmia
110
what does TORCH stand for
toxoplasmosis
other: syphilis, listeria, parvovirus b19, varicella
rubella
CMV
herpes simplex 2
111
congenital syphilis
fetal loss/hydrops fetalis
discharge from nose, maculopapular rash
112
neonatal hypoglycaemia: very low capillary blood glucose + symptomatic Mx
IV dextrose 10%
113
neonatal hypoglycaemia: mild blood glucose reading + asymptomatic Mx
regular feeding, monitor blood glucose levels
