Paediatrics in General Practice Flashcards
(24 cards)
List the challenges of paediatric presentations in GP
Undifferentiated illness Lack of access to investigation Dealing with uncertainty Lack of team Only have 10 mins to get it right
List some common presentations of neonates in GP
Jaundice - UTI, hypothyroidism, galactosaemic, breast milk jaundice etc
Vomiting - reflux, pyloric stenosis, sepsis etc
Failure to thrive - often a feeding issue
Sepsis
What is the definition of prolonged jaundice
Jaundice lasting up to 14 days in a full-term baby or 21 days in a pre-term
What are the 4 most common paediatric respiratory symptoms that present to GP
Cold
Infant not feeding
Cough
Wheeze
List common respiratory problems in children
Bronchiolitis Croup Viral URTI Asthma - new or exacerbated Acute tonsillitis
What is bronchiolitis
Inflammation of the bronchioles
Caused by RSV
Can occur after a cold
Gives you a wheezy baby
List rare respiratory problems in children
CF Acute epiglottitis Pneumonia Foreign body Cardiac causes Malignancy
Why is epiglottitis rare these days
Use of the HiB vaccine
Haemophilus influenza is the most common cause of epiglottitis but now immunised against it
List some clinical signs of respiratory issues in children
Cyanosis
High RR
Nasal flaring/ intercostal or subcostal recession
Wheeze/stridor/cough
Pulse oximetry
Abnormality on percussion or auscultation
How does the normal respiratory rate in children differ from adults
Much higher
e.g. normal for an under one to have RR of 30-40
List some common GI symptoms that kids present to their GP with
Abdominal Pain Vomiting Diarrhoea Nausea Constipation Poor school attendance
What are the most common causes of GI problems in kids
Gastroenteritis UTI Constipation Appendicitis Volvulus and intussusception in young kids Torsion in older kids Coeliac
What MSK symptoms do kids often present to their GP with
Painful joint(s)
Limp
Trauma
List common causes of joint pain in children
Inflammatory arthritis Perthes disease Slipped femoral epiphyses Osgood slatters Growing pains Bone tumours
List common causes of limps in children
DDH
Perthes
What is Osgood Slatters
Condition seen in young active boys
Present with localised knee pain around the attachment of the patellar tendon
Gets better with rest
Describe Scarlet Fever
Infection caused by strep
Causes florid rash on trunk, diffuse rash on the face and a white then red tongue (strawberry tongue)
Treated with penicillin
Describe hand foot and mouth
Caused by coxsackie virus
Painful lesions in the mouth so children often wont eat
Papules on the hands and feet
What is checked at the childhood development screening at 6-8 weeks
Red light reflex - checks for congenital retinoblastoma
Hips
Genitalia
Femoral pulse
List some red flags for sepsis in kids
Difficult to rouse Weak, high or continuous cry Grunting or apnoea's Severe tachypnoea Severe tachy or bradycardia Low urine output Non-blanching rash Cyanosis Temp <36C or more than 38C
If a young child has a temperature over 38C what do you do
Send straight to hospital as this is a major red flag
List amber flags for sepsis
Parent concerned Not smiling Very sleepy/inactive Moderate tachycardia/tachypnoea Cap refill >3 secs Pale or flushed Leg pain Cold extremities
What is intussusception
When part of the bowel ‘telescopes’ into itself
List the differentials for a young child who is vomiting but otherwise okay
Viral/bacterial gastroenteritis Intussusception Volvulus Incarcerated hernia Infantile colic
