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Paeds PACES > Paeds > Flashcards

Paeds Flashcards

(40 cards)

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1
Q

APGAR

A

Appearance - Colour - (Blue or pale/extremities blue/completely pink)
Pulse - HR - 0/1/2 (Below/above 100)
Grimace - Reflex - 0/1/2 (Grimace/Cough or sneeze)
Activity - Muscle tone - 0/1/2 (Limp/Some flexion/Active motion)
Respiration - Resp effort - 0/1/2 (Slow, irregular/good crying)

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2
Q

2 month/8 week vaccines

A

6 in 1, Rotavirus, Men B

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3
Q

3 month vaccines

A

6 in 1, Rotavirus, PCV

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4
Q

4 month vaccines

A

6 in 1, Men B

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5
Q

1 year vaccines

A

HiB/Men C, PCV, Men B, MMR

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6
Q

2-10 year vaccines

A

Flu annually

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7
Q

3 years 4 months vaccine

A

4 in 1 booster - DTaP/IPV, MMR

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8
Q

12-13 year vaccines

A

HPV

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9
Q

14 year vaccines

A

3 in 1 booster T/D/aP, Men ACWY

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10
Q

Normal urine output

A

> 2ml/kg/hr if <2yrs

>1ml/kg/hr if >2yrs

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11
Q

Fluid resus bolus

A

0.9% NaCl STAT
20ml/kg under 10 mins - children
10ml/kg under 10 mins - neonates

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12
Q

Fluid deficit

A

% deficit x weight x 10

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13
Q

Maintenance fluid

A

0.9% NaCl + 500ml 10% dextrose + 40mmol KCl

<10kg 100ml/kg/day (4/hr)
next 10-20kg 50ml/kg/day (2/hr)
>20kg 20ml/kg/day (1/hr)

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14
Q

DKA bolus

A

10ml/kg over 30 mins and subtract from fluid deficit

If shocked 20ml/kg and don’t subtract

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15
Q

Febrile convulsions

A

Mx - offer fluids and paracetamol
Next seizure - note when it starts, protect from injury but do not restrain, 5 min rule for ambulance and buccal midazolam (rpt at 10 mins)

NOT epilepsy

1 in 3 will have repeat febrile seizure

Safety net - non-blanching rash, reduced GCS, dehydration, fever >5 days

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16
Q

Sepsis Abx

A

Meningococcal - IM benpen in community, IV ceftriaxone in hospital

Neonates - IV benpen + gentamicin

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17
Q

Sepsis possible CNS infection or <1mth old

Study These Flashcards
A

High risk: meropenem + amikacin + ampicillin

Moderate risk: cefotaxime + amikacin + ampicillin

18
Q

T1DM

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A

Body does not produce enough insulin - can lead to kidney damage, visual problems, skin ulcers

Mx: teach how to self-inject insulin into tummy/thigh before meals, teach how to finger prick - advise re continuous subcut insulin

High protien/low-fat diet, exercise

Regular GP review

If tired, dizzy, shaky, lips tingling, heart pounding - sugary energy drink - if not getting better 999

19
Q

Epilepsy

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A

Brain condition causing seizures - aetiology not known - lifelong, can get better over time

Ix: ECG, MRI/CT EEG (will only support diagnosis)

Mx: carbamazepine/lamotrigine, avoid sodium valproate in girls, go for levetiracetam
Buccal midazolam for future seizures

Advise avoiding swimming/bathing unsupervised

Care team, epilepsy society

20
Q

West Syndrome

Study These Flashcards
A

Infantile spasms

Mx: pred or vigabatrin (if due to tuberous sclerosis)

Refer to tertiary epilepsy specialist

21
Q

Childhood absence seizures

Study These Flashcards
A

Mx: ethosuximide (or valproate for boys)

22
Q

Asthma (under 5)

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A

Ix: clinical, spirometry (FEV1/FVC < 70%)

23
Q

Asthma (under 5)

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A

Ix: clinical, spirometry (FEV1/FVC < 70%), bronchodilator reversibility test, fractional exhaled nitric oxide, PFR, asthma control questionnaire

Mx:
- SABA reliever
- 8wk trial moderate dose ICS, stop then monitor - if resolved then remit:
within 4wks low dose
after 4wks moderate 8wk
- Consider LTRA to ICS maintenance therapy
- Specialist

24
Q

Asthma (over 5)

Study These Flashcards
A

Ix: clinical

Mx:

  • SABA reliever
  • Low dose ICS
  • Consider adding LTRA and review in 4-8wks
  • Stop LTRA, start LABA
  • Change ICS and LABA to MART w/ low dose ICS and SABA
  • Increase ICS to moderate dose
  • Specialist

Itchywheezysneezy.co.uk

25
Bronchiolitis/croup safety net
111 Less than half usual amount of feed in last 3 Dry nappy 12 hrs 38 persistently Drowsy, irritable 999 Cyanosed Lots of work of breathing Pauses in breathing
26
Whooping Cough
Ix: NPA or swab Mx: if <21 days of cough - macrolide - <1 m - clarithromycin - >1 m or not pregnant - azithro/clarithromycin - Pregnant - erythromycin Do not use co-trimoxazole
27
Cystic Fibrosis
Ix: Guthrie Sweat Karyotyping ``` Mx: High fat diet Don't meet other CF kids antibiotic cover prophylactically Inhalers Creon ?steroids oral rhDNase ``` Cystic fibrosis trust
28
Measles
Mx: School exclusion for 4d after rash develops MMR
29
Mumps
Ix: saliva swab Mx: School exclusion for 5 days after onset
30
Rubella
Ix: Saliva swab B19 testing if pregnant Mx: 5d exclusion
31
Rheumatic fever
Ix: Jones Criteria, Throat Culture rapid antigen testing for GAS, Anto-streptolysin O titre Mx: if unconfirmed - paracetamol confirmed - benpen IM or penV - ?NSAIDs If HF - furosemide/spironolactone or enalapril AF - steroids, amoidarone/digoxin If chorea - emergency valve surgery - carbamazepine (LFTs) Long-term IM benpen monthly for 10 yrs or until age of 21 yrs Regular check-ups
32
Infective Endocarditis
Ix: Follow up with cardiologist Mx: abx for 6 weeks (started IV inpatient) Penicillin-susceptible streptococcus - beta-lactam + gentamicin OR vanc Penicillin-resistant streptococcus - beta-lactam + gentamicin OR vanc + gent MSSA - beta-lactam/vancomycin/daptomycin/co-trimaxole + clindamycin MRSA - vanco/dapto/co-trim + clindamycin Penicillin-sensitive enterococci: beta-lactam/van + gent Penicillin-resistant enterococci: ampicillin/vancomycin + gentamicin HACEK: ceftriaxone + gent Fungal: surgery + antifungal
33
Scarlet Fever
Ix: Clinical, consider throat swab GAS Mx: penV / amoxicillin School exclusion 24hrs post-abx start
34
Urticaria
Ix: Urticaria Activity Score (UAS7) Mx: Antihistamines, prednisolone if severe Antipruritic treatment (calamine lotion, topical menthol in aqueous cream), chlorphenamine at night Montelukast, cyclosporin, omalizumab, mycophenolate mofetil
35
Eczema
Ix: Swabs if infected, CDLQI questionnaire Mx: Emollients Hydrocortisone 1% --> Betamethasone valerate 0.025% or clobetasone butyrate 0.05% --> betamethasone valerate 0.1%
36
Nappy Rash
Mx: High absorbency, leave nappies off, clean skin and change nappies every 3-4 hrs, change nappies ASAP after soiling or wetting, fragrance-free, alcohol-free, dry gently, avoid excessive bathing Barrier preparation to protect the skin - Diprobase Topical hydrocort up to 7 days
37
KDIGO/RIFLE/AKIN criteria for AKI
- Rise of serum creatinine of 26micromol/L or more within 48 hours - 50%+ rise in creatinine in 7 days - UO decreases to less than 0.5ml/kg/hr for more than 6hrs in adults, 8 in children - 25% or greater fall in eGFR in children within 7 days
38
Iron-rich foods
dark green vegetables, iron-fortified bread, meat, aprcots, prunes, raisins
39
Hodgkin Lymphoma
Doxorubicin, bleomycin, vinblastine, dacarbazine
40
Septic arthritis
Ix: Synovial fluid joint aspiration Mx: G+ fluclox + joint aspirate OR clindamycin OR vanc G- ceftriaxone + joint aspirate OR ciprofloxacin

Paeds PACES (1 decks)

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