Paediatrics in primary care Flashcards
(40 cards)
Red flags for headaches in children
- Has the headache interrupted sleep
- Headache present on wakening
- In teenagers ‘headache that never goes away’ suggests space occupying lesion
- Prohibits usual activities
- Worse on lying down
- Altered personality
- Seizures
- Head Trauma
Meningitis symptoms in children with headache
Fever
Photophobia
Neck pain / stiffness
Periorbital cellulitis symptoms
- Unilateral eyelid swelling and erythema
- Eye pain
- Fever/malaise
- Ptosis (drooping upper eyelid)
- ?history of foreign body or trauma
SEND TO HOSPITAL
Treatment of otitis media
- Admit children under 3 months 38C or more temp
- Consider admitting children 3-6 months 39C or more temp
- Give antibiotics - amoxicillin 5-7 days
Otitis externa treatment
Acetic Acid 2% ear drops or spray – available OTC usually otomize
Consider prescribing antibiotics if the person is immunocompromised or the infection is severe
Otitis externa advice to pt
- Keep the ears clean and dry.
- Avoid swimming and water sports for at least 7–10 days during treatment.
- Use ear plugs and/or a tight-fighting cap when swimming.
- Keep shampoo, soap, and water out of the ear when bathing and showering, for example by inserting ear
plugs or cotton wool (with petroleum jelly). - Consider using a hair dryer (at the lowest heat setting) to dry the ear canal after hair washing, bathing, or
swimming
Blocked nose treatment in children
Saline nose drops
DO NOT GIVE ANTIBIOTICS
Epistaxis management
Sit up and lean forward with mouth open
Pinch cartilaginous part of nose and hold for 10-15 mins and breath through mouth
If not stopped in 10-15 mins = A+E
If recurrent = naseptin, if not resolved = ENT referral
Impetigo cause and presentation
Staph infection
yellow crusting around mouth
Candidia treatment in children
Miconazole oral gel - first line
If not suitable give oral nystatin suspension (not in neonates tho)
Treat mother if she is breast feeding regardless of symptoms
Impetigo treatment
Avoid school until healed or 48 hrs after starting treatment
- hydrogen peroxide or fucidic acid
Scarlett fever cause and presentation
Strep A
Flu like symptoms
Sandpaper rash
White coating on tongue that disappears
Strawberry tongue
Notify and give antibiotics (stay away from school and avoid sharing utensils for at least 24 hrs)
Asthmas presentation in children
wheeze, cough, breathlessness, and chest tightness
commonly episodic, diurnal (worse at night or in the early morning),
and/or triggered or exacerbated by exercise, viral infection, and exposure to cold
air or allergens
triggered by emotion and laughter in children
expiratory polyphonic wheeze on auscultations
possible atopy (hayfever, eczema)
Asthma investigations in children
Over 5 = spirometry
5-16 = FeNO testing if diagnosis still undercertain
Cannot diagnose under 5 due to not being able to do tests
Bronchiolitis cause and symptoms
Respiratory synctial virus (RSV)
coryzal prodrome (rhinorrhea + fever + develop increased work of breathing (tachypnoea or chest recession) with wheeze and cough)
Bronchiolitis treatment
Antipyretics
Regular fluids
Supportive
No smoking in household
Viral wheeze presentation and treatment
Wheezing associated to infection only causing difficulty breathing - happens when getting repeated illnesses
Salbutamol 2 puff every 4-6 hrs should improve within 48 hrs
Bacterial acute cough symptoms
Temp
No wheeze
No other symptoms - no runny nose
Productive - colour
Crackles on asucultation
Viral acute cough symptoms
Temp
Ear pain
Sore throat with tonsillar enlargement and no exudate
Wheeze
Runny nose
Respiratory red flags in children
- O2 stats <95%
- Grunting
- Chest recession
- Cyanosis
- doesn’t wake, if roused doesn’t stay awake, not responding
- Temperature 38C or higher in a child aged three months or less
- Tachycardia
- Reduced fluid intake
- Nasal flaring
- Tracheal tug
- Signs of clinical dehydration skin turgor, CRT more than 3 seconds, dry mucus membranes
Red flags for GI pain and constipation in children
Associated vomiting
No flatulence
Ribbon stool patter - anal stenosis
Constipation treatment in children
Movicol
Continue laxatives for weeks after symptoms improval
Movements and massages
Faecal impaction symptoms and treatment
Overflow soiling
Constipation history
Faecal mass palpable on examination
Movicol and review in a week
Acute diarrhoea investigations and treatment
Stay hydrated - safety net for signs of dehydration
Urine dip for ketones
If diarrhoea for 7-10 days - liquid stool MCS
