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Paediatrics Flashcards

1
Q

At what week are surfactants produced in the lungs

A

17-26 weeks
so babies worn before this will require ventilation support

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2
Q

Name some difference on resp tract in child vs adult

A

Tongue: Childs is larger in proportion to mouth
Epiglottis: it is floppier, u-shaped in child and shorter in adults
Vocal cords: it is upwardly slanted in child whereas it is horizontal in adults
The larynx is more anterior and superior in child
less lung capcity in a child

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3
Q

Treatment for surfactant deficiency

A

CPAP + steroids +diuretics +RSV monoclonal antibody

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4
Q

What is laryngomalacia

A

congenital abnormality of the larynx cartilage causes supraglottic collapse during the inspiratory phase of respiration

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5
Q

How does laryngomalacia present

A

harsh cough
stridor
breathing/ feeding/ sleeping difficulties

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6
Q

What is meckel’s diverticulum

A

formation of a small pouch consisting of tissue found elsewhere in the body like pancreatic or gastric tissue
it is clinically indistinguishable from appendicitis

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7
Q

what are the rules of 2 in meckel’s diverticulum

A

Occurs in 2% of population
2cm long
2 feet from ileocaecal valve
Presents under 2 years of age
2 x more common in males

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8
Q

in meckels diverticulum if gastric cells are present then how would the patient present

A

bloody stools as the gastric cells will cause ulceration

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9
Q

what is volvulus

A

occurs when the bowel twists so the blood supply to that part of the bowel is cut off
life threatening

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10
Q

symptoms of volvulus

A

bilious vomiting
severe abdominal pain
irritability
poor feeding
diarrhoea
fever

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11
Q

examination findings on volvulus

A

distended abdomen
very tender
dehydrated
tachycardia

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12
Q

Investigation for volvulus

A

AXR
Bloods- FBC, CRP, U&E
Barium swallow- if child stable

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13
Q

Management for volvulus

A

Resuscitate- iv fluids, analgesia, abx
NG tube insertion to decompress the abdo distension
Emergency laparotomy for ;adds procedure +/- stoma formation

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14
Q

what are the 2 types of stomas and what do they contain

A

colostomy- contents more solid
ileostomy - contents more liquid

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15
Q

what is wilms tumour

A

unilateral renal tumour

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16
Q

2 common finding in wilms tumour

A

palpable abdo mass and abdominal distention

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17
Q

treatment for wilms tumour

A

chemo and surgical resection

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18
Q

what is neuroblastoma

A

a form of cancer that develops from specialised nerve cells (neuroblasts) left behind from a baby’s development in the womb

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19
Q

where does neuroblastoma most commonly originate from

A

adrenal or paraspinal sites

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20
Q

what does a neuroblastoma present with

A

abdominal distension or mass +anorexia

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21
Q

what in urine is suggestive of neuroblastoma

A

catecholamines

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22
Q

Treatment for neuroblastoma

A

chemotherapy, surgery and radiotherapy

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23
Q

what is rhabdomyosarcoma

A

soft tissue sarcoma in children , occurs around muscular structures

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24
Q

what syndrome is rhabdomyosarcoma associated with

A

Li-Fraumeni syndrome

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25
what is gastroschisis
defect in the abdominal wall, gut exposed
26
what is omphalocele
failure of viscera to return into abdo cavity
27
How can a button battery indigestion present as
increased drooling poor oral intake distress when feeding
28
what is hypospadias
meatus on underside of penis
29
if hypospadias is noted earlier on then what must you avoid doing
do not circumcise, because foreskin used in repair
30
what age is a hypospadias usually repaired at
6-9 months
31
most common symptoms of an UTI in infants younger than 3 months
Fever vomiting lethargy irritability
32
Treatment for UTI in children under 3 months
send urine sample for urgent microscopy and culture refer to paeds specialist care for further investigation also think safeguarding
33
Treatment for UTI in children over 3 months
if leukocyte or nitrate or both positive then start antibiotics and send for culture
34
what ages are neonate
new-born to 4 weeks of age
35
What is SCBU
Low dependency unit (Special care), if babies >32 weeks that only require some extra support before going home
36
What is NICU
neonatal intensive care- different levels
37
What is PICU
Babies aged 28 days and over (also if babies have previously been discharged home)
38
What week is term
40 weeks
39
preterm meaning
Preterm is defined as babies born alive before 37 weeks of pregnancy are completed extremely preterm (less than 28 weeks) very preterm (28 to 32 weeks) moderate to late preterm (32 to 37 weeks).
40
what is the leading cause of bacterial sepsis in neonates
group b strep infection
41
risk factors for group b strep infection in neonates
Previous sibling: GBS+ in pregnancy or GBS+ infection Maternal colonization Prolonged rupture of membranes (PROM) ≥ 18 hrs prior to delivery Intrapartum maternal fever Pre-term
42
name of complication of neonatal jaundice
bilirubin encephalopathy = brain damage
43
what time range does physiological jaundice occur and when odes it peak
more than 24 hrs of life up to 2 weeks levels peal around 3-5 days of life and start to resolve slowly over 2 weeks
44
Treatment for normal physiological jaundice
require reassurance hydration and adequate feeding +stooling
45
Management for jaundice
plot on bilirubin threshold graph ways to treat: exchange transfusion or phototherapy
46
what gender is muscular dystrophy more common in
male
47
what are the 3 main types of muscular dystrophy
duchenne (most common) becker limb-girdle dystrophies
48
ix for muscular dystrophy
serum CK cardiac -ECG, echo muscle biopsy and genetic testing
49
appearance of rash caused by neissereria meningitidis
non blanching purpuric or petechial rash
50
appearance of stevens - Johnson's syndrome
widespread blisters/ bullae over erythematous /macular/haemorrhagic skin
51
symptoms of stevens-Johnson's syndrome
fever arthralgia myalgia conjunctivitis pneumonitis
52
what is the cause of eczema herpeticum
type 1 HSV co-infection with active atopic eczema
53
appearance of molluscum contagiosum(viral)
flesh-coloured dome shaped papules on skin
54
Management for molluscum contagiosum
self resolves after approximately 18 months
55
appearance of slapped cheek/parvovirus b19
malar rash with circumoral pallor then a lace like rash on trunk and extremities follows
56
Management for parvovirus b19
supportive , self limiting
57
appearance of chickenpox
starts on head and trunk then spreads throughout the body red macules-> papules ->pustules ->crusting
58
symptoms of chickenpox
headache anorexia URTI fever itching
59
Management for chickenpox
Antihistamines paracetamol acyclovir VZIG for prophylaxis for contact at risk individual
60
appearance of roseola
after 3-5 days -fine maculopapular rash lasting 2 days
61
symptoms of roseola
high fever runny nose tiredness
62
appearance of rubella
maculopapular exanthem pink and pinpoint starting on face first then spreading caudally to trunk and extremities. Generalised over 24 hours
63
symptoms of rubella
Fever, arthritis, arthralgias. Can lead to a rubella panencephalitis.(after a week)
64
appearance of measles
Maculopapular rash lasts 6-8 days
65
symptoms of measles
Fever, coryza, cough, non- purulent conjunctivitis, Koplik spots
66
cause of impetigo
Staphylococcal aureus or streptococcal skin infection
67
appearance of impetigo
Erythematous macules (may progress to be vesicular/bullous) on face, neck or hands
68
symptoms of impetigo
The rash presents as oozing or crusted blisters which can be present anywhere on the body but are usually found around the mouth and nose
69
Management for impetigo
Topical (fusidic acid, mupirocin) or systemic (flucloxacillin or clarithromycin)
70
cause of scarlet fever
group a strep
71
appearance of scarlet fever
The rash has a rough (sandpaper-like) texture, and is usually worse in the skin folds (Pastia’s lines)
72
symptoms of scarlet fever
Fever, sore throat, general fatigue/headache/nausea. 24- 48 hours later, a rash appears on the abdomen and spreads to the neck and extremities
73
appearance of tinea capitis (head), tinea corporis (body)
fungal Pruritic, circular, erythematous scaly patch spreading centrifugally. Central clearing is seen
74
Management for tinea capitis (head), tinea corporis (body)
Daily application of topical antifungals for 3 weeks. Systemic therapy indicated in patients with failed topical therapy (terbinafine, fluconazole or itraconazole).
75
diff between pityriasis alba and versicolor
alba (eczema) vs versicolor (fungal)
76
appearance of pityriasis alba and versicolor
Small, scaly patches of skin became hypopigmented (or sometimes hyperpgimented). Often the smaller patches join together over time
77
treatment for pityriasis alba and versicolor
The treatment is with topic antifungal cream or shampoo (e.g. ketoconazole) if practical – usually for up to two weeks. Or if this fails, oral antifungals (ketoconazole or fluconazole) can be considered. The colour can take a few months to return to normal.
78
appearance of nappy rash
An erythematous macular, papular rash located around the nappy area that can spread to the lower abdomen or upper thighs
79
physiological response of poor pulmonary drainage in LVF
pulmonary oedema causes RR to increase, SOB and recession
80
physiological response of low systemic output in LVF
SNS activation and adrenaline causes tachycardia, vasoconstriction, pallor and long CRT and sweatiness
81
3 physiological response of RVF
peripheral oedema Hepatomegaly Ascites
82
examples of acyanotic heart disease
L side problem -L to R shunt - L ventricle outflow obstruction - pulmonary stenosis- don't cause much problem other than murmurs
83
examples of L-R shunts
( ventricular septal defect, PDA, ASD,AVSD)
84
examples of left ventricle outflow obstruction
AS Coarctation of aorta PS
85
causes of cyanotic heart disease
R sided obstruction Right to left shunt
86
3 cyanotic heart disease
TOF - tetralogy of fallots TGA - transposition of the great arteries PA - pulmonary atresia
87
4 characteristic of fallots tetralogy
pulmonary stenosis overriding aorta VSD Right ventricular hypertrophy
88
what type of murmur is heard in tetralogy of fallot
Aortic regurge- diastolic decrescendo murmur
89
what is transposition of the great arteries
the Pulmonary artery and aorta switches place meaning RV pumps blood into the aorta and LV pumps blood into the Pulmonary artery
90
if the heart in a featus is duct dependant what must you avoid when it comes to treatment and why
Oxygen as the duct will close if excess oxygen is present
91
6 differences between an innocent and significant murmur
INNCOENT : 1.soft 2.no radiation 3.Praecordial only 4.systolic and short 5.varies with posture 6.well SIGNIFICANT: 1.harsh 2.radiates 3.audible elsewhere 4.not! 5.doesnt 6.other signs (failure, blue)
92
how does varicella spread
respiratory route
93
incubation period for varicella
12-14 days
94
description of varicella rash
macular-papular- vesicular dew drop on a rose petalrose petal”” (vesicle surrounded by halo(vesicle surrounded by halo erythema) - initially clear then cloudy 2-3 D.erythema) - initially clear then cloudy 2-3 D. Superficial lesions. Superficial lesions

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