- Starts on trunk then to neck and extremities -Maculopapular - HHV6-7

Midazolam 0.2-0.3mg/kg (up to 10mg) buccally or intranasal repeat 10 mins later if still seizing

Paediatrics Flashcards by Francis Katoa

Inguinal hernia surgery timing

<6 weeks : Within 2 DAYS

6 weeks- 6 months: within 2 WEEKS

> 6 months; within 2 MONTHS

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Roseola Infantum

Starts on trunk then to neck and extremities

-Maculopapular

HHV6-7

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Laterothoracic exanthem

Unilateral axila or groin- spreads centrifugally then bilatreal

Resolves within 5 weeks

EBV, parvovirus, adenovirus

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Erythema infectiosum

SLAPPED cheek
Parvovirus b19

Stage 1: cheeks
Stage 2: lace like limbs

Note: pregnant woman who’ve been exposed: Have immune status checked and refer to O&G

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Gianotiii-Crosti Syndrome

Self limiting
Multiple viruses

EXTENSOR surfaces: Vesiculopapular rash NON pruritic

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Measels rash

Koplik’s spots

Red macules and papules cephalocaudal spread

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Rubella rash

Pink maculopapular face then to trunk and extremities over 24 hours

Erythematous papules on palate (Forchheimer spots)

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Paediatric dose of Augmentin

22.5/3.2 mg/kg

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First line testing for bruising in children

Second line testing for bruising in children

APTT
PT/INR
Fibrinogen
FBC

VWD screen
Blood group
Factor VIII & IX
Ca
LFT
EUC, creatinine

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Signs of adequate milk supply

Weight gain 150-200g /wk (first 3 months)
5-8 nappies/24hrs
Passing soft stool once daily
Waking spontaneously for feeds
Settling between feeds
Alert and content when awake

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Poor growth /slow weight gain investigations

Urine MCS
FBC, EUC, LFT
TSH
Glucose
Coeliac serology
B12
Stool fat globules, fatty acid crystals
>12m :ESR & Fetal calprotectin

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Hypoxia levels to indicate severe respiratory condition (paediatrics)

<90%

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Signs of severe respiratory condition (paediatrics)

Irritability/lethargy
Marked increased accessory muscle use
Marked increased RR
02 sats <90% or cyanosis
Tachycardia (significantly increased)

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CAP antibiotics dosing for children

Amoxicillin 25mg/kg up to 1g 8 hourly for 3 days

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Rheumatic Fever (1st line 2 agents) PLUS allergy to penicillin 2 options

Benzathine benzylpenicillin 1.2million units

Phenoxymethylpenicillin 500mg BD for 10 days

Delayed nonsevere hypersensitivity
Cefalexin 25mg/kg BD 10 days

Immediate or delayed severe allergy
Azithromycin 500mg Daily 5 days

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Rheumatic Fever Hypersensitivity to penicillins

Delayed Non-severe hypersensitivity
Cefalexin 25mg/kg BD 10 days

Immediate or Delayed severe allergy
Azithromycin 500mg Daily 5 days

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Rheumatic fever treatment of arthralgia or arthritis

Naproxen
5-10mg/kg up to 500mg BD

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Impetigo non endemic setting - dose of oral abx

Flucloxacillin 12.5mg/kg 6 hourly 7 days

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Examination findings for OSA

Boggy inferior turbinates
Nasal mucous inflammation
Tonsillary hypertrophy
OME
Adenoid facies
Retrognathia
obesity

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Protracted Bacterial Bronchitis treatment

2-6 weeks of Augmentin 22.5, 3.2mg/kg

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Dose of Macrogol 3350 for disimpaction (child)

Then maintenance dose

1-1.5g/kg/day for 3-6 days

0.75g/kg/day

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Upper limit of normal for gynaecomastia in adolescent (measurement of enlargement)

4cm

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Red flags for gynaecomastia

> 4cm
Pre-pubertal
Rapid progression
Persistent for >1yr or after 17

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Febrile seizure dose

Midazolam 0.2-0.3mg/kg (up to 10mg) buccally or intranasal

repeat 10 mins later if still seizing

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Severe nappy rash differentials

- Staph scalded skin syndrome - Streptococcal perineal dermatitis - Bullous impetigo - Kawasakis disease (if fever) - Candida albicans infection - Infantile seborrheic dermatitis - Steven Johnsons syndrome

Kawasaki findings

Fever 5 or more days with 4 of the following - Bilateral non exudative conjunctivitis - Polymorphous rash - mucositis - Cervical lymphadenopathy - extremity changes (palmar erythema, oedema and desquamation) ** also a desquamating nappy rash can be present in initial phase

12 month vaccines

MMR Prevenar Meningococcal ACWY Optional Flu Bexsero (meningococcal b)

Crying baby history questions to establish cause (long list)

- Sudden onset of crying (red flag) - Known triggers (eg feeding) - Bilious or projectile vomiting - Changes to feeding - Changes to formula - Poor weight gain - Blood or mucous in stool - Watery/frothy diarrhoea - New onset rash - Bruise or deformity - Change in alertness - Maternal coping - red eye, not opening eye

Dose of midazolam for seizures 1) IM/IV 2) buccal/IN

1) 0.1mg/kg up to 10mg 2) 0.3mg/kg up to 10mg

Complications of EBV

- Splenic rupture - Prolonged fatigue - Derranged LFTs - DIC - Meningitis - Myocarditis - Pancreatitis - Pneumonia

Straddle injuries management

- Salt water baths - Topical anaesthetic cream or barrier cream - reduced strenuous activity 24 hrs - Simple analgesia

Differentials for ADHD and Behavioural issues

- ODD - PTSD - ASD - GDD - FASD - Early-life trauma (disrupted attachment) - Anxiety - Child abuse - Hearing or visual impairment - OSA - Iron deficiency - Thyroid disease

Bowed leg intercondylar distance cut off for referral

>6cm

Bowed leg cut off for age (when no longer normal)

Beyond 3 years

Dark urine and pale stools (jaundice) type of hyperbilirubinaemia

Conjugated

Conjugated hyperbilirubinaemia (dark urine, pale stools) what to do

URGENT referral

Vaccinations for ATSI (special)

- BCG (NT, QLD, North SA) - Hep A (NT, SA, QLD, WA) (2 doses before 5, first in 2nd year of life) - HEP b- ALL AGES CAN GET THIS - Bexsero - 13vPCV (NT, SA, QLD, WA) & adults >50 - Influenza >6m - 23vPPPV (4yrs old & again in 5 yrs) & >50 12 months post 13 and then agin in 5 yrs

Vaccine hesitancy strategies

- Inform about no jab no pay - Explain herd immunity - Non - judgemental approach - Find out about barriers - Explain limitations to childcare attendance - explain how it prevents serious infections

Recent infection (eg impetigo) then now with facial oedema.... What are you worried about?

Post streptococcal Glomerular nephritis

Post strep glomerulonephritis triad

- Discoloured urine (haematuria) - Oliguria - Oedema

Premature babies and vaccinations: - Gestational (corrected) or chronological age?

Chronological

Most common causes of short stature

1) Constitutional delay of growth and puberty 2) Familial short stature

Diagnosis (physical signs) of constitutional delay in growth and puberty

GIRL: Lack of breast development (tanner stage 2) >13 BOY Testicular Volume <4mL by age 14

Poor Growth Investigations

Simple bloods CMP Coeliac TSH IGF Karyotype Bone age Xray

Fever temperature cut off for vaccine safety

Can be given if <38.5

Signs of mild dehydration (trick)

Most have none

Measels triad of early symptoms (hint: three cs)

Cough Coryza Conjunctivitis

FLU vax inital dose for children >6months but <9 years

Dose PLUS BOOSTER in 4 weeks

What am I ? When do I peak (age)

Erythema toxicum neonatorum 2 days to 2 weeks

What age can you add LABA in kids

Over 6 years

Treatment time course for aspirin in Kawasakis

6 weeks

Mongolian spot duration expected

Up to 4 years old

Bronchiolitis signs of severity

- O2 (<92 moderate, <90 severe) - APNOEAS - Feeding difficulty - Accerssory muscle use: moderate or marked - RR - Irritable

Best antihistamine for children

Certirizine (can use from 6 months)

Normal time frame for passage of meconium

48 hours

Henoch Schonlein Purpura Follow up protocol

Urinalysis and BP - weekly 1st month - Forthnightly from weeks 5-12 - Then review at 6 months and 12 months

Vaccine-Proximate febrile seizure- time frame

- 5-14 days following live - Within 48hours post innactivated' NOTE: However, vaccine proximate status epilepticus should be referred to a pediatrician due to association with Dravet syndrome.

Risk factors for ADHD

- Concurrent ASD, Anxiety, ODD, Learning disorder - Low birth weight - Pre-term birth - In care - Family history

What is included on the neonatal screening test (Guthrie test)

- Phenylketonuira (PKU) - Congenital hypothyroidism (CHT) - Cystic Fiborisis - Galactoseamia - Rare disorders of metabolism

Causes of conjugated hyperbilirubinaemia (>10% fraction of total bili)

- Biliary atresia - choledochal cyst - Alpha1 anti-trypsin - Neonatal hepatitis - Bile plug

Chronic (wet) cough in a small child differentials?

- CF - Protracted bacterial bronchitis - Primary ciliary dyskinesia - Alpha1 Anti-tripsin - Recurrent aspiration - Bronchiectasis - Primary immunodeficiency -