Paediatrics Flashcards Preview

DONE RTS > Paediatrics > Flashcards

Flashcards in Paediatrics Deck (28):
1

What are the age ranges for...
Neonates
Infants
Children
Adolescents

Neonates - 0-1 month
Infant - 1 month - 2 years
Children - 2 years - 12 years
Adolescents - 12 years to 18 years

2

What age range can the following cough and cold products NOT be used in?

- Chlorphenamine (amines)
- Dextromethorphan and pholcodeine
- Guaifenesin and ipecacuanha
- Phenylephrine, pseudoephedrine, ephedrine

Under 6 years

3

Describe irritant napkin dermatitis...

- Nappy rash
- Red raw rash
- Contact from dirty nappies on skin, damp, humid, friction

- NOT in flexures
- NO satellite lesions
- NO other sites effected

4

Describe Candidal infected napkin dermatitis

- Nappy rash with candidal infection
- Bright red and well demarcated

- IN flexures (creases of skin)
- SATELLITE lesions (small red/white lesions away from main rash)
- OTHER sites infected

5

Describe Seborrhoeic dermatitis (nappy area)

- Mistaken for irritant nappy rash
- Shiny or greasy red nature

- IN flexures of skin
- NO satellite lesions
- OTHER sites infected

6

Describe psoriasis (nappy area)

- Thick, brittle skin, can be scaly

- IN flexures of skin
- NO satellite lesions
- OTHER sites infected

7

What are the referral symptoms of suspected napkin dermatitis or differential diagnoses?

- Severe rash (over most of nappy area)
- Signs of bacterial infection (broken skin, crusting, weep)
- Treatment failure after 7 days treatment
- Psoriasis

8

How do you treat napkin dermatitis?

- Avoid coarse towelling (quality nappies)
- Change frequently
- Allow skin to breathe
- Avoid perfumed washes/wipes

- Use barrier prep after every change
- ZINC (SUDOCREM)
- TITANIUM (METANIUM)
- DIMETHICONE (CONOTRANE) protect against water

9

How do you treat napkin dermatitis with candidal infection?

- Use clotrimazole cream 2-3 times a day
- Do not use the barrier cream when using the clotrimazole cream
- The oily cream may cause infection to spread otherwise

10

How do you diagnose eczema?

- Dry, itchy skin
- Babies may present with it on cheeks
- Flex of elbow and behind knees

11

How do you treat eczema?
- Different age ranges

- Under 10 years - emollient cream
- Over 10 years - Hydrocortisone cream
- Over 12 years - Clobatasone

LIFESTYLE:
- Mittens at night to reduce scratching
- Wet wrap to relieve itching and soothe

12

When would you refer eczema?

- If suspicion that skin is infected
- Weeping, crusting
- IMPETIGO = crusted yellow lesions

13

What virus causes the chicken pox virus?

- Varicella Zoster Virus
- Herpes virus

14

What are the symptoms of chicken pox?

- Fever, headache, sore throat
- Rash a few days later
- Fluid filled vesicles

15

What are the referral symptoms of chicken pox?

- Secondary infection due to scratching
- Signs of chest infection
- Severely ill
- Pregnancy
- New born

16

What is the treatment for chicken pox?

- Antipyretics - paracetamol
- Antihistamines - piriton, sedating?

- Calamine lotion - cooling, helps itch AQ CREAM LESS DRYING THAN LOTION
- Mitts at night
- Keep cool

17

What are some signs and symptoms of measles?

- Fever
- Cough and cold
- Sore throat
- Reddish eyes
- Photophobia
- Kopliks spots (in mouth, like glued sugar)

- RASH STARTING AT HAIR LINE AND PROGRESSES

REFER

18

What virus is measles caused by?
What are some complications?

- Paramyxo virus

- Otitis media
- Pneumonia
- Encephalitis

19

What are the symptoms of head lice?
What must be done before treatment commences?
REFERRAL?

- Itching, irritation of scalp, crawling sensation

- Must identify live louse for treatment on patients head (could just be empty eggs)
- Small black dots, crawling

- Refer if crusting, bleeding, weeping, itching elsewhere
- Scalp condition
- ASTHMA, ECZEMA (alcohol based)

20

What are the three treatment options for head lice?

WET COMBING:
- Bug buster comb
- Every 4 days for at least 2 weeks

PHYSICAL INSECTICIDE:
- Dimeticone:
(HEDRIN) lotion leave 8 hrs
6 months +
- Isopropyl myristate, cyclomethicone:
(FULL MARKS) leave for 5 mins
2 years

CHEMICAL INSECTICIDE:
- Malathion liquid (DERBAC) not as effective (immune)

21

How do you use head lice treatments?
Lifestyle advice?

- Leave product on for specified time
- Sometimes requires combing though with metal comb
- Wash out with normal shampoo

- ADVISE to carry out twice, 7 days apart

- Separate hair into sections for ease
- Tie hair up to avoid contact
- REASSURE NOT A CLEANLINESS ISSUE!

22

What are the symptoms associated with threadworm?
What are referral criteria?

- Night time perianal scratching, local tingling to acute pain
- Sleep disturbances due to itching
- Secondary infection due to itching
- Worms in stools

- Recent foreign travel (other worms)
- Under 2 yrs (no treatment)
- Pregnant (no treatment)
- If treatment failure occurs after 2 doses

23

What treatment is available for threadworm?
Lifestyle?

- Mebendazole (Ovex) Suspension
- Mebendazole (Ovex) Tablets

- Stat dose, repeat after 2 weeks if reinfestation
- Family members can be treated with oral solution

- Hygiene measures - hand washing
- Do not share towels
- Wash bed sheets regularly
- Advise children not to scratch (faecal oral route)
- Short fingernails
- Underwear at night to prevent transmission to sheets

24

What is the normal temperature of a child?
- What is classed as a fever?
- Where should temperature be taken?

- 37 +/- 1
- Fever over 38

Suggest under arm
(mouth and rectal not suggested by guidelines)

25

When should you refer a child with a fever?

- Fever in under 3 months
- Child 3-6 months with fever above 39
- Fever and no other symptoms
- Febrile convulsions
- Purpuric rash CHECK MENINGITIS
- Stiff neck
- Long than 5 days
- Unresponsive
- Dehydration

26

What is the treatment for temperature?

- Antipyretics:
- Paracetamol > 3months
- Ibuprofen > 3months

27

What may be reasons for vomiting in infants?
- Refer when?

- Posseting (regurgitation when fed)
Advise that this is normal (unless excessive)

REFER - Gastro-oesophageal reflux
Crying, colic, weight loss

REFER - Projectile vomiting

REFER - if lasts longer than 24hrs or bile present

28

What can be recommended for children/infants with diarrhoea?
- LIFESTYLE
- What could be the cause
- Refer?

- ORT
- Dioralyte
- Infants make up with boiled and cooled water
- Give sips throughout the day

- Wash hands, don't share towels
- Sterilise bottles
- Extra fluids
- No swim for 2 weeks

- See if change in feed
- Vomiting
- Sunken soft spot on head

REFER:
- Over 24hrs 1 year
- Over 48hrs 3 years