Paediatrics Flashcards

1
Q

What is the common pathogen causing pneumonia in infancy?

A

RSV

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2
Q

What are the common organisms causing pneumonia in childhood?

A

Strep pneumoniae

Mycoplasma pneumoniae/H.influenza

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3
Q

What are the four categories of child development?

A

Vision and fine motor
Gross motor
Speech, hearing and language
Social development

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4
Q

What can be given to aid closure of the ductus arteriousus?

A

Indomethacin (prostaglandin inhibitor)

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5
Q

What is the definition of precocious puberty?

A

Puberty occurring before 8 years in girls and 9 years in boys

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6
Q

When is puberty considered delayed?

A

If first signs have not shown by 13 years in girls and 14 years in boys

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7
Q

What is a red flag in terms of developmental milestones at 6 weeks?

A

Not smiling

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8
Q

By when should the developmental milestone of smiling be reached?

A

6 weeks

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9
Q

What is a red flag in terms of developmental milestones at 4 months?

A

Cannot bring hands together

Head lag still present

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10
Q

What is a red flag in terms of developmental milestones at 6 months?

A

Cannot roll over

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11
Q

What is a red flag in terms of developmental milestones at 9 months?

A

Cannot sit unsupported

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12
Q

What is a red flag in terms of developmental milestones at 12 months?

A

Unable to crawl

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13
Q

What is a red flag in terms of developmental milestones at 18 months?

A

Not walking

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14
Q

By when should the developmental milestone of bringing hands together and supporting their own head be reached?

A

4 months

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15
Q

By when should the developmental milestone of rolling over be reached?

A

6 months

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16
Q

By when should the developmental milestone of sitting unsupported be reached?

A

9 months

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17
Q

By when should the developmental milestone of crawling be reached?

A

12 months

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18
Q

By when should the developmental milestone of walking be reached?

A

18 months

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19
Q

What are the common complications of measles?

A

Febrile convulsions
Otitis media
Bronchopneumonia

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20
Q

What are the rarer, more serious complications of measles?

A

Meningitis
Encephalitis
Subacute sclerosing panencephalitis

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21
Q

What are the possible complications of Rubella?

A

Thrombocytopenia
Encephalitis
Arthritis
If exposure

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22
Q

What are the possible complications of mumps?

A
Meningitis
Encephalitis
Pancreatitis
Nephritis
Orchitis (older males)
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23
Q

What is the criteria for Kawasaki’s disease? (5/6)

A
Fever for 5 days
Conjunctivitis
Cervical lymphadenopathy
Polymorphous exanthema
Reddening, oedema and desquamation of hands and feet
Mucous membranes -Strawberry tongue
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24
Q

What is the common organism causing pneumonia in neonates?

A

Group B strep

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25
What is McArdle's disease?
Glycogen Storage disease type 5 Glycogen storage disease caused by a deficiency of myophosphorylase Exercise intolerance - pain, early fatigue, painful cramps and myoglobin in the urine
26
What is Kawasaki's disease?
Acute vasculitis of medium vessels, which classically involves the coronary arteries. Prolonged fever, lymphadenopathy and desquamation of the fingers and toes
27
What are the possible complications of Kawasaki's disease?
Coronary artery aneurysm | Myocarditis
28
What is a cavernous haemangioma?
Type of blood vessel malformation which leads to a collection of dilated blood vessels forming a benign tumour
29
What is Wilms tumour?
Nephroblastoma | Most common kidney cancer in children
30
What is the commonest presentation of a child with Wilm's tumour?
An assymptomatic abdominal mass | Rarely - abdo pain, vomiting, HTN
31
What are the features of pyloric stenosis?
Projectile vomiting, typically 30 minutes after feeds Constipation and dehydration occasionally Occ. palpable mass may be present in abdomen Hypochloraemic, hypokalaemic alkalosis
32
What are the features of Intussusception?
Paroxysmal abdominal colic pain Vomiting Blood stained stool - 'red current jelly' Sausage-shaped mass in the RLQ
33
At what age should a child with a fever automatically be referred to a paediatrician?
Any child less 38 is regarded as a red flag
34
What four things should be recorded in all febrile children?
Temperature Heart rate RR CRT
35
What are the possible features of Wilms Tumour?
Abdominal mass Painless haematuria Flank pain Other - anorexia, fever
36
What is Hirschsprung's disease?
Aganglionic section of bowel due to the failure to develop the parasympathetic plexuses (Auerbach and Meissner)
37
What is the possible presentation of Hirschsprung's?
Neonates - failure or delay to pass meconium | Older - constipation, abdominal distension
38
What is Erbs palsy?
Damage to the upper brachial plexus most commonly from shoulder dystocia Adduction and internal rotation of the arm Pronation of the forearm 'Waiters tip'
39
What is Klumpke's palsy?
Damage to the lower brachial plexus Commonly affects the nerves innervating the hand 'Claw hand'
40
What are the features of Acute Epiglottitis?
Rapid onset High temperature, generally unwell Stridor Drooling of saliva
41
Which organism causes Acute Epiglottitis?
Haemophilus Influenzae Type B
42
At what age should a child be referred to a paediatric surgeon regarding an undescended testis?
3 months Make a diagnosis of cryptorchidism at this age Need to be seen before 6 months old
43
What are the possible complications of cryptorchidism?
Infertility Torsion Testicular cancer Psychological
44
What is the most common cause of headaches in children?
Migraines
45
What is the acute management for migraines in children?
Ibuprofen (more effective than paracetamol) Prophylaxis - 1st - pizotifen and propranolol - 2nd - valproate, topiramate, amitryptiline
46
What is Hand, foot and Mouth disease?
Self-limiting disease affecting children. Caused by coxsackie A16 and enterovirus 71 most commonly Contagious Most common in age
47
What are the clinical features of Hand, foot and mouth disease?
Mild systemic upset: sore throat, fever Oral ulcers Followed later by vesicles on palms and soles of feet
48
What is the most common pathogen associated with Croup?
Parainfluenza Virus
49
What are the features of Croup?
Stridor Barking cough (worse at night) Fever Coryzal symptoms
50
What features of croup prompt admission?
Moderate/severe
51
What are the important differentials for Croup?
Acute Epiglottitis Bacterial tracheitis, Peritonsillar abscess Foreign body inhalation
52
What is the Rx for Croup?
Single dose of Dexamethasone (0.15mg/kg) to all children regardless of severity Emergency - high flow 02, Nebulised adrenaline
53
What is the major risk factor for NRDS?
Prematurity
54
What is the major risk factor for Tachypnoea of the Newborn (TTN)?
Caesarean section
55
What is the major risk factor for Aspiration Pneumonia in a newborn?
Meconium staining in the liquor
56
What are the common organisms that cause meningitis in neonates to 3 months old?
Group B strep E.coli Listeria monocytogenes
57
What are the common organisms that cause meningitis in the age group 1 month to 6 months?
Neisseria meningitidis Streptococcus pneumoniae Haemophilus Influenzae
58
What are the common organisms that cause meningitis in children greater than 6 years?
Neisseria meningitidis | Streptococcus pneumoniae
59
What are the main features of Erythema Infectiosum?
Fifth disease or 'slapped cheek' syndrome Caused by parvovirus B19 Lethargy, fever, headache 'Slapped cheek' rash spreading to proximal arms and extensor surfaces
60
What are the key features of Rubella?
Rash - pink, maculapapular, initially on face before spreading to whole body, usually fades by the 3-5 day Lymphadenopathy - suboccipital and postauricular
61
Which is the pathogen responsible for scarlet fever?
Group A haemolytic streptococci (Usually strep. Pyrogenes) Reaction caused to the erythrogenic toxins caused by strep.
62
What are the characteristics of ADHD?
Extreme restlessness Poor concentration Uncontrolled activity Impulsiveness
63
What are the key features of patau syndrome?
Microencephalic, small eyes Cleft lip/palate Polydactyly Scalp lesions
64
What are the key features of Edwards syndrome?
Micrognathia Low set ears Rocker bottom feet Overlapping of fingers
65
What are the key features of Fragile X?
``` Learning difficulties Macrocephaly Long face Large ears Macro-orchidism ```
66
What are the features of Noonan syndrome?
Webbed neck Pectus excavatum Short stature Pulmonary stenosis
67
What are the features of Pierre-Robin syndrome?
Micrognathia Posterior displacement of the tongue Cleft palate
68
What are the key features of Prada-Willi syndrome?
Hypotonia Hypogonadism Obesity
69
What are the key features of Williams syndrome?
``` Short stature Learning difficulties Friendly, extrovert personality Transient neonatal hypercalcaemia Supra valvular aortic stenosis ```
70
What is the commonest cause of gastroenteritis in children?
Rotavirus
71
What are the features of hypernatraemic dehydration in children with diarrhoea?
``` Jittery movements Increased muscle tone Hyperreflexia Convulsions Drowsiness/coma ```
72
What three features must be present for a diagnosis of autism to be made?
Global impairment of language and communication Impairment of social relationships Ritualistic and compulsive phenomena
73
What conditions are associated with Autism?
Fragile X | Rett's syndrome
74
List the criteria for admitting a child with Bronchiolitis
Episodes of apnoea | Persistent sats 50
75
What are the commonest causes of haemorrhagic gastroenteritis?
Campylobacter | Salmonella
76
What is the management for threadworms?
Single dose of mebendazole for the whole household and issue hygiene advice
77
What are the features of Bronchiolitis?
``` Coryzal symptoms (inc mild fever) precede: Dry cough Increasing breathlessness Wheezing, fine inspiratory crackles Occ feeding difficulties ```
78
What are the central causes of hypotonia in a child?
Down's syndrome Prader-Willi syndrome Hypothyroidism Cerebral palsy (hypotonia may precede spasticity)
79
What are the neurological and muscular problems that can cause Hypotonia in a child?
``` Spinal muscular atrophy Spina bifida Guillain-Barré syndrome Myasthenia Gravis Muscular dystrophy Myotonic dystrophy ```
80
What are the risk factors for developmental dysplasia of the hip?
``` Female Breech Positive family history First born child Oligohydramnios Birth weight >5kg Congenital calcaneovalgus foot deformity ```
81
What are the three features that form the classical triad of Haemolytic Uraemic syndrome?
Haemolytic anaemia Raised urea Thrombocytopenia
82
What pathogen commonly causes Haemolytic Uraemic syndrome?
Escherichia Coli Subtype 0157
83
What are the main features of DKA?
Abdominal pain Polyuria, polydipsia, dehydration Kussmaul respiration (deep ventilation) Acetone-smelling breath
84
What are the features of Roseola Infantum?
High fever lasting a few days Then a maculopapular rash develops Occ febrile convulsions Diarrhoea and cough common
85
What causes Roseola Infantum?
Human Herpes Virus 6 (HHV6)
86
What are the main types of cerebral palsy?
Spastic (hemiplegia, diplegia, quadriplegia) Dyskinetic Ataxic Mixed
87
Which type of cerebral palsy is intraventricular haemorrhage most commonly associated with?
Spastic diplegic CP
88
What is the criteria for severe asthma in a 2-5 year old?
Sats 140/min RR >40/min Use of accessory muscles
89
What is the criteria for a severe asthma attack in a child over the age of 5?
Sats 125/min RR >30/min Use of accessory neck muscles
90
What is the criteria for a life-threatening asthma attack in a child aged between 2 and 5?
Sats
91
What is the criteria for a life-threatening asthma attack in a child over the age of 5?
Sats
92
What are the features for Achondroplasia?
short limbs (rhizomelia) with shortened fingers (brachydactyly) large head with frontal bossing midface hypoplasia with a flattened nasal bridge 'trident' hands lumbar lordosis
93
What are the antibiotics used to treat meningitis?
3 months: IV cefotaxime
94
Which immunisations are live attenuated viruses?
``` BCG MMR oral polio yellow fever oral typhoid ```
95
Causes for neonatal hypoglycaemia?
``` maternal diabetes mellitus prematurity IUGR hypothermia neonatal sepsis inborn errors of metabolism nesidioblastosis ```