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Year 4 Finals > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Fill in the blank:
Allergic rhinitis is an ____ mediated response to allergens within the environment

A

IgE

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2
Q

Name 4 risk factors for developing epistaxis

A
  • Antiplatelet therapy or anticoagulant therapy
  • Haemophilia or von Willebrand’s
  • NSAIDs
  • Trauma or septal perforation
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3
Q

Anterior epistaxis involves which plexus?

A

Kiesselbach’s plexus
AKA Little’s area

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4
Q

Posterior epistaxis involves branches of which artery?

A

Sphenopalatine

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5
Q

Mild hepatosplenomegaly may be a symptom of which common virus? What should patients experiencing this be advised?

A

Epstein Barr virus
- avoid contact sports until resolved

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6
Q

Which 2 antibiotics should be avoided in cases of EBV?

A

Ampicillin and amoxicillin

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7
Q

If an EBV patient is given amoxicillin, what side effect may occur?

A

Itchy maculopapular rash

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8
Q

Fill in the blank:
Cholesteatoma is an abnormal accumulation of skin and ____ ____ within the middle ear cleft

A

Squamous epithelium

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9
Q

Fill in the blank:
Cholesteatoma often results from chronic ____ ____

A

Otitis media

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10
Q

Name the ENT complaint:
Persistent foul smelling ear discharge + otalgia + headache

A

Cholesteatoma

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11
Q

What is the primary management of symptomatic cholesteatoma?

A

Surgical removal of skin and squamous epithelium accumulation

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12
Q

Name 2 complications of untreated cholesteatoma

A

Any of:
Facial nerve palsy, meningitis, epidural abscess, sigmoid sinus thrombosis

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13
Q

Name 4 red flag symptoms for head and neck

A

Any of:
- hoarseness or change in voice
- refractory mouth ulcers or coloured lesions
- painless mouth or neck lumps
- weight loss
- blood in saliva or phlegm
- unilateral nasal polyp
- unilateral hearing loss
- unilateral persistent node bleeds

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14
Q

Chronic nasal polyps could indicate what disease?

A

Cystic fibrosis

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15
Q

What is the main visual symptom of hereditary haemorrhagic telangiectasia?

A

Small red or purple s[pots on fingertips/lips/nostril lining/ears/face

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16
Q

What 2 organisms most commonly cause otitis externa?

A

Pseudomonas or staph aureus

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17
Q

When should oral antibiotics be considered in otitis externa?

A

Systemic upset, immunosuppression, ear canal occluded by swelling and debris

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18
Q

Which combined antibiotic and steroid ear drops may be given in mild to moderate otitis externa?

A

Gentamix

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19
Q

What type of gauze can be inserted into the ear for deeper penetration of antibiotic preparations in severe otitis externa?

A

Wick gauze

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20
Q

Name 4 circumstances in which we would admit children with otitis media

A
  • under 3 months old
  • temperature 38+
  • systemically unwell
  • suspected meningitis, mastoiditis, facial nerve palsy
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21
Q

Otosclerosis is abnormal growth of what within the ear?

A

Bone growth around the stapes

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22
Q

What is Schwartz sign on otoscopy and what does it suggest?

A

Reddish blue hue seen through tympanic membrane, suggests otosclerosis

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23
Q

Name the ENT complaint:
Progressive hearing loss + family history positive + Schwartz sign on otoscopy

A

Otosclerosis

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24
Q

Name the neck lump:
Soft painless fluctuant mass that transilluminates

A

Cystic hygroma

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25
Name the neck lump: Palpable painless midline mass that moves up on swallowing and protrusion of tongue
Thyroglossal cyst
26
Name the neck lump: Painless mass located anterior to the sternocleidomastoid muscle
Branchial cyst
27
What is the definitive treatment for quinsy?
Aspiration
28
What 2 organisms are most commonly causative of quinsy?
Group A strep or staph aureus
29
Name the 4 points of the CENTOR criteria for acute tonsillitis
- fever - absence of cough - tonsillar exudate - tender anterior cervical lymphadenopathy
30
Fill in the blank: A CENTOR score of __ or __ indicates a 32-56% likelihood of isolating ____
- 3 - 4 - strep
31
Name 3 circumstances in which we would give antibiotics in suspected tonsillitis
- CENTOR score 3 or 4 - evidence of systemic upset - immunosuppressed patients
32
What is the first line treatment for suspected acute bacterial tonsillitis without penicillin allergy?
500mg penicillin V PO QDS 5-10 days
33
What is the first line treatment in suspected acute bacterial tonsillitis complicated by penicillin allergy?
250-500mg clarithromycin or erythromycin PO BD for 5 days
34
Lemierre’s syndrome is a complication of which common infection?
Tonsillitis - characterised by internal jugular vein inflammation and septic emboli
35
Name the ENT complaint: Significant hearing loss + chalky white patches on tympanic membrane on otoscopy
Tympanosclerosis
36
Which type of vasculitis may cause recurrent epistaxis and chronic sinusitis?
Wegener’s (granulomatosis with polyangiitis)
37
What autoantibody will be positive in cases of Wegener’s?
C-ANCA
38
What is the first line induction therapy for cases of Wegener’s?
High dose glucocorticoids e.g. prednisolone, dexamethasone, methylprednisolone, betamethasone
39
Name 2 agents which can be used for maintenance therapy in Wegener’s patients
Azathioprine, methotrexate
40
Which 2 systems are most commonly affected in Wegener’s?
ENT and renal
41
When is whooping cough vaccinated against in children?
8, 12 and 16 weeks, plus 3 years and 4 months
42
What test should be carried out for confirming pertussis infection?
PCR
43
Name 3 complications of whooping cough
Any of: Bronchiectasis, hernias, secondary pneumonia, hernias, rib fractures
44
Which antibiotic class should be given in cases of whooping cough?
Macrolides (azithromycin, clarithromycin, erythromycin)
45
Why are macrolides given in whooping cough?
To reduce infectivity NB does not affect the course of the disease
46
What is the most common nephrotic disorder in children?
Minimal change disease
47
Name the presentation: Child with periorbital oedema + frothy urine + normotensive
Minimal change disease
48
What is the first line treatment in children with minimal change disease?
Prednisolone
49
What 2 agents may we use in cases of minimal change disease complicated by severe fluid overload?
Human albumin + furosemide
50
What are the 5 features of Kawasaki disease aside from a persistent fever?
C - conjuctivitis R - rash E - erythema - of hands and feet A - adenopathy M - mucosal involvement - strawberry tongue, oral fissures
51
How long should a fever have been present for a diagnosis of Kawasaki disease?
5+ days
52
What complication are Kawasaki disease patients at risk of?
Coronary artery aneurysm
53
What is the first line treatment for Kawasaki disease?
IV immunoglobulin + high dose aspirin
54
Explain the step wise approach in acute asthma attack management
1 - oral prednisolone in ALL patients 1-2mg/kg OD max 40mg, salbutamol (spacer in mild/moderate, nebulised in severe/life threatening), oxygen if sats under 92% 2 - nebulised ipratropium bromide 3 - nebulised magnesium sulfate 4 - IV salbutamol
55
PEFR of below what percentage indicates a life threatening asthma attack?
33%
56
What is the most common causative pathogen of bronchiolitis?
RSV
57
What is the mainstay of treatment for bronchiolitis?
Supportive
58
Double bubble sign on AXR indicates what?
Duodenal atresia
59
Duodenal atresia is associated with what genetic abnormality?
Trisomy 21/Downs
60
Failure to pass meconium in the first 48 hours of life may indicate what disease?
Hirschsprung’s
61
What is the gold standard for diagnosing Hirschsprung’s disease?
Rectal suction biopsy
62
Name the presentation: Episodic colic + vomiting + red currant jelly stools
Intussusception
63
Target sign on USS is indicative of what disorder?
Intussusception
64
What is the first line treatment for intussusception?
Air enema
65
Meconium ileus is associated with what disease?
Cystic fibrosis
66
Polyhydramnios may indicate what abnormality in the infant?
Gastrointestinal obstruction
67
Volvulus is treated with what procedure?
Ladd’s procedure
68
Acidosis on blood gas with features of bowel obstruction indicates what?
Necrotising enterocolitis
69
Children with recurrent UTIs and unexplained fevers should be investigated for what?
Vesicoureteric reflux
70
Negative Prehn’s test (elevation of testicle) may indicate what?
Testicular torsion
71
Positive Prehn’s test (elevation of testicle) may indicate what?
Acute or chronic epididymitis
72
A partial thickness fracture with the concave surface intact and convex side breaking is named what?
Greenstick fracture
73
Toddler’s fracture is what type of fracture?
Spiral
74
A fracture extending through the metaphysis, growth plate and epiphysis is what class of Salter-Harris?
4
75
A fracture involving just the physis is what class of Salter-Harris?
1
76
A crush injury to the physis is what type of Salter-Harris?
5
77
Osteogenesis imperfecta is a disorder of what substance?
Collagen
78
Name 2 non bony manifestations of osteogenesis imperfecta
Blue sclera and sensorineural deafness (due to otosclerosis)
79
Deficiency in what is the most common cause of rickets?
Vitamin D
80
What class of drugs may lead to an acquired case of rickets?
Anticonvulsants - watch for bone pain in patients with epilepsy
81
Which gastrointestinal disorder may lead to rickets?
Coeliac disease - due to malabsorption
82
Isolated raised ALP is indicative of what disease?
Paget’s disease
83
Paget’s disease is characterised by what?
Increased but uncontrolled bone turnover
84
Name the complaint: Bone pain and warmth + sunburst appearance on xray
Osteosarcoma
85
Ewing’s sarcoma typically presents on what portion of the bone?
Diaphysis
86
Onion skin periosteal reaction is indicative of what?
Ewing’s sarcoma
87
Which radiological finding may be found in rickets?
Widened growth plate
88
Which imaging modality is most sensitive for detecting osteomyelitis?
MRI
89
Which type of medication should ALL children with an acute asthma attack receive?
Oral prednisolone
90
Biliary atresia is characterised by high levels of what?
Conjugated bilirubin
91
Fill in the blank: Kernicterus only occurs when bilirubin is __.
Unconjugated
92
What is the first line treatment for biliary atresia?
Kasai procedure
93
What kind of blood gas abnormality may pyloric stenosis produce?
Hypochloraemic hypokalaemic metabolic alkalosis
94
Ulcerative colitis is closely related to what other disease?
Primary sclerosing cholangitis
95
Which class of medications is first line in inducing remission in ulcerative colitis?
ASAs e.g. mesalazine
96
What is first line treatment in acute exacerbations of ulcerative colitis?
IV hydrocortisone
97
Erythema nodosum is an extraintestinal sign of what?
Inflammatory bowel disease
98
What is the first line treatment for inducing remission in Crohn’s disease?
Oral prednisolone
99
What is the first line therapy for maintaining remission in Crohn’s disease?
Azathioprine or mercaptopurine
100
Which endocrinological abnormality may lead to chronic constipation?
Hypothyroidism
101
What is the first line treatment in chronic constipation?
Movicol
102
Dermatitis herpetiformis is an extraintestinal manifestation of what disease?
Coeliac disease
103
Abdominal guarding and rebound tenderness are signs of what?
Peritonitis
104
Ileus is a disruption of what?
Normal propulsive activity of the bowel
105
Chronic H.pylori infection can lead to what?
Duodenal ulcers, gastric carcinoma
106
Which type of peptic ulcer pain is: 1. Relieved on eating? 2. Worsened by eating?
1. Relieved - duodenal 2. Worsened - gastric

Year 4 Finals (15 decks)

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