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1MSRA - Learning Points > Paediatrics > Flashcards

Paediatrics Flashcards

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1
Q

What are the two causes of strawberry tongue?

A

1) Scarlet fever
2) Kawasaki disease

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2
Q

What is scarlet fever?

A

Skin rash reaction to toxins produced by Group B haemolytic strep (e.g Strep Pyogenes)

Sandpaper rash

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3
Q

What timeframe neonatal jaundice always pathological?

A

In the first 24hrs

(can be normal day 2 - day 14)

(and likely pathological if prolonged after 14 days)

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4
Q

Which scalp swelling crosses suture lines?

A

Caput succadenum
(scalp oedema due to pressure during delivery)

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5
Q

White cysts in mouth?

A

Epstein Pearls

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6
Q

Causes of congenital aortic stenosis?

A

1) Turner’s syndrome in girls
2) Aortic Coarctation
3) Edward’s syndrome (wide lips, low ears, saddle nose)

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7
Q

What age does intussusception occur?

A

0.5 years to 1.5 years

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8
Q

How do you manage an umbilical hernia in 1 year old?

A

If no complications, advise no action needed and that usually resolves by age 3. If it doesn’t, can later assess for surgery.

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9
Q

Can children under 18 refuse life saving treatment?

A

No, given in best interests

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10
Q

What to do if under 13 reports they are having sex with person 13 or over?

A

This is statutory rape, so inform authorities

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11
Q

Can child under 16 consent to treatment? incl COCP

A

Yes, if they have capacity according to Fraser Guidelines.
Encourage to avoid sex, educate them on safe sex, encourage them to tell parents, but if you think they will have sex anyway and not providing COCP will harm them, you can prescribe it

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12
Q

Red umbilical lesion leaking discharge, in a baby a few weeks old.
How do you treat it?

A

Umbilical granuloma

Apply salt

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13
Q

Young child, gets fever. Following fever develops macular skin rash on trunk?

A

Roseola infantum

(FEVER THEN RASH)

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14
Q

16 year old with one spot of rash (herald patch) followed by oval scaly plaques in chirstmas tree distribution

A

Pityriasis rosacea

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15
Q

What’s the difference between Roseola Infantum and Pityriasis Rosacea?

A

RI - infants
HHV6/7 primary infection
Fever then rash

PR - adolescents/adult
HHV6/7 reactivation
Herald patch then rash follows Langer’s lines

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16
Q

When are MMR doses given?

A

1 year and 3-4 years

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17
Q

Minimum time interval between live vaccine doses?

A

4 weeks

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18
Q

Ataxia, loss of proprioception + Cardiomyopathy?

A

Friedrich’s ataxia

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19
Q

What is inheritance pattern of Friedrich’s ataxia?

A

Autosomal recessive

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20
Q

Features of Tetralogy of Fallot?

A

Overriding aorta
Pulmonary stenosis
Right Ventricular Hypertrophy
VSD

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21
Q

How does Tetralogy of Fallot present?

A

Cyanotic episodes called ‘Tet spells’

Triggered when infant upset, feverish or in pain

Systolic murmur due to pulmonary stenosis

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22
Q

What does CXR show in Tetralogy of Fallot?

A

Boot shaped heart

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23
Q

Which cyanotic heart disease is most common at birth and which is most common overall?

A

Birth - TGA

Overall - TOF

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24
Q

What age does TOF present?

A

Few weeks

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25
What is Transient Tachypnoea of the newborn? What is a risk factor for it? What may CXR show?
Increased RR occurring at birth, can last for couple days Caused by fluid not cleared from lungs Risk factor - C-section CXR - fluid in horizontal fissure
26
When does newborn exam in GP occur and what do you look for?
6-8 weeks DDH Undescended testis Heart sounds Growth
27
Which manoeuvres test for DDH? What is the 1st line Ix? What is the Mx?
Barlow - dislocate Ortelani - relocate Ix - USS Hip Mx - Pavlik harness
28
Symptoms of pyloric stenosis? Age of onset? Electrolyte abnormalities?
Projectile vomiting shortly after feeds 6 weeks low Cl, low K, alkalosis
29
Features of 'innocent' murmur?
Systolic Soft Short Sitting/Standing Symptomless
30
Joint pain following recent viral infection? Mx?
Transient synovitis Mx - supportive
31
What causes Hand, Foot and Mouth Disease and how do you treat?
Coksackie virus Therefore, supportive management only
32
What are exclusively breastfed babies going to be deficient in, that requires a top up at birth?
Vitamin K! All newborn babies offered Vit K
33
In premature babies at risk of RSV, what can be given as prophylaxis?
Pavilizimumab (monoclonal antibody to prevent RSV)
34
Protrusion of bowel at para-umbilically at birth - 2 types, what are they, how to differentiate and how are they managed?
Gastroschiasis (visible exposed bowel), therefore take to theatre same day Exomphalocele (protruding bowel but covered in amniotic sac), therefore let it form a shell and surgically correct at later date
35
Most common cause of stridor in baby? (i.e. may present as noisy breathing during feeds)
Laryngomalacia i.e. floppy epiglottis which folds into airway during feeding malacia = soft
36
Organisms which cause meningitis >3 months?
NHS
37
Organisms which cause meningitis <3 months
GBS Listeria
38
tall, small balls, lack of secondary sexual characteristics, low testosterone, high LH
Kleinfelter's (XXY) primary hypogonadism (i.e. problem in testis)
39
delayed puberty and lack of smell
Kallmann's Hypogonadotropic hypogonadism
40
Genotypically male but phenotypically female (small breasts, amenorrhoea)
Androgen insensitivity syndrome (testosterone normal/high, LH high) raise as female
41
How do you manage reflux in breastfed baby?
Following conservative advice (smaller, more frequent feeds at 30 degrees, continue to sleep on back) 2 week - Gaviscon if fails - 4 week PPI if able to have formula, try thickener first, but do not give gaviscon simultaneously
42
Regarding measles, what's the most common complication, most common cause of death and any other complications?
Most common - otitis media Most common cause of death - pneumonia Other - keratoconjunctivitis - encephalitis - subacute sclerosis pan encephalitis (years later, poor prognosis)
43
In children with asthma, should you give steroids?
YES All asthma exacerbations in children - give steroids
44
Sandpaper like rash, sore throat, fever, strawberry tongue?
Scarlet fever (caused by Group A strep) Give phenocymethylpenicillin Exclude from school for 48hrs from Abx
45
Do you need to exclude from school for hand, foot and mouth disease?
NO (cocksakie A virus)
46
Do you need to exclude from school for Rubella?
YES 5 days from rash onset Notifiable disease
47
When is heel prick test done and what is tested?
Day 5-9 of life Sickle cell CF Congenital hypothyroidism Phenylketonuria MCAAD and more
48
Which organism causes scarlet fever?
Group A beta haemolytic STREP (i.e. streptococcus progenes)
49
Hand preference before what age is abnormal?
12 months
50
Why is UTI, especially recurrent UTI concern in children?
reflux nephropathy Need to exclude vesicoureteric reflux essentially, as can lead to kidney scarring
51
Investigation for VSU?
Micturating cystoureterogram (radiopaque dye injected into
52
Investigation to assess if there is renal scarring?
DMSA scan IV injection of radioactive dye, and then scan. maps kidneys
53
Which diseases are X-linked recessive?
Haemophilia A and B Duchenne Muscular Dystrophy
54
Which transmission is not possible in X-linked recessive diseases?
male to male not possible male to daughter only as carrier assuming unaffected mother i.e. father cannot pass on active disease to children father cannot pass any gene onto son father can only at most make daughter carrier
55
Criteria to diagnose septic arthritis?
Kocher criteria /4 temp >38.5 WCC>12 Unable to weight bear ESR>40
56
When can rotavirus vaccine be given to child?
2 months, 3 months cannot be given after 15 weeks
57
Management of SUFE?
urgent surgery
58
How do you determine cause of precocious puberty in boys?
Based on size of balls big balls - central cause one big ball - testicular cause small balls - adrenal cause
59
What hearing screening tests are done for all children?
newborn - echo test start of school - pure tone audiogram
60
What are the knee problems in teenagers/older adults
Locking knee - osteochondritis dissecans Tibial tuberosity tender - osgood schlatter disease Pain on bending knee - chondromalacia patellae Knee giving way - patellar subluxation
61
Triad for nephrotic syndrome?
Proteinuria, low albumin, oedema
62
Most common cause of nephrotic syndrome and its Treatment?
Minimal change disease Oral prednisone
63
Which age groups do Bronchiolitis and Croup affect?
ALPHABETICAL ORDER B, C Bronchiolitis 3-6 months Croup 6 months - 3 years
64
Causes of upper airway obstruction (Stridor) in kids?
Acute epiglottitis Croup Peritonisillar abscess Inhaled foreign body Laryngomalacia (Most common cause of stridor)
65
How does the distribution of eczema differ in infants?
Located om extensors rather than flexures!!
66
How do you treat eczema in child?
Hydromol Dermol Hydrocortisone
67
When do you screen for DDH with USS?
Breech Family history of DDH Multiparty (Saba must have been screened)
68
How do you manage a non-IgE mediated allergy?
given no risk of anaphylaxis in theory, can reintroduce slowly
69
Primary amenorrhoea, short, no breasts?
turner's Ddx is PCOS, but breasts normal, not necessarily short and may be primary or secondary amenorrhoea
70
Is all cyanosis harmful?
Only if its central Peripheral cyanosis and at mouth is normal in neonates - called acrocyanosis. If central, 100% oxygen test - if pO2 still low (<15), suggests cyanotic heart disease
71
Fever >5 days in a chid, what should you suspect?
Kawasaki's
72
Which 2 conditions cause strawberry tongue? Difference between them
Scarlett fever Kawasaki's Sandpaper course rash, face sparing vs Hand desquamation
73
Which congenital syndrome associated with pectus excavatum?
Noonan's
74
How many initial rescue breaths in Paeds ALS?
5 rescue breaths then 15:2
75
What is the management of DDH?
Pavlik Harness If this fails, surgery
76
What should be given to all children who have an asthma exacerbation?
Oral prednisolone 2mg/kg for 3 days (max 40mg)
77
When is whooping cough vaccine given to pregnant women?
Whooping cough vaccine is given to pregnant women between 16-32 weeks, because neonates are particularly susceptible to it. NB// babies then receive it at 2,3,4 and 3-5 years

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