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paeds Flashcards

1
Q

what are the features of benign rolandic epilepsy?

A
  • form of childhood epilepsy characterised by partial seizures (usually) during sleep.
  • hemifacial paraesthesias, oropharyngeal manifestations (e.g. strange noises) and hypersalivation.
  • occasionally progress to generalised tonic-clonic seizures.
    -usually fhx of the condition and are usually seizure-free during the day.
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2
Q

At what age would the average child start to play alongside, but not interacting with, other children?

A

2 years

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3
Q

how would a baby with congenital rubella syndrome present?

A
  • sensorineural deafness
  • congenital cataracts
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4
Q

how does congenital CMV present?

A
  • hearing loss
  • low birthweight
  • petechial rash
  • microcephaly
  • seizures
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5
Q

how is duchenne muscular dystrophy diagnosed?

A

genetic analysis

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6
Q

how should a child with an unexplained enlarged abdo mass be referred?

A

urgent paeds review within 48h

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7
Q

what is the probability that a man with haemophilia A’s daughter’s son will have the disease?

A

XhY -> XhX -> either XhY or XY
so 50%

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8
Q

how do infantile spasms present?

A
  • repeated flexion of head/arms/trunk
  • followed by extension of arms
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9
Q

when do children usually grow out of feb cons?

A

5 years
(occur 6mo-5y)

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10
Q

what are the features of an innocent murmur?

A

8 S
- soft
- short
- systolic
- sounds s1 and s2 normal
- symptomless
- special tests normal (XR, ECG)
- standing/sitting (varies with posture)
- sternal depression

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11
Q

what are the causes of jaundice in the first 24 hours?

A
  • rhesus haemolytic disease
  • ABO haemolytic disease
  • hereditary spherocytosis
  • G6PD
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12
Q

After confirming cardiac arrest and following paediatric BLS protocol, what is the rate you should perform chest compressions at?

A

100-120 compressions/min

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13
Q

how does transposition of the great arteries present?

A
  • no murmur
  • loud single S2
  • prominent right ventricular impulse palpable
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14
Q

what is fragile X?

A

trinucleotide repeat disorder of the x chromosome

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15
Q

how does fragile x present in males?

A

learning difficulties
large low set ears, long thin face, high arched palate
macroorchidism
hypotonia
autism is more common
mitral valve prolapse

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16
Q

how does fragile x present in females?

A

normal to mild symptoms of males
autism

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17
Q

how is slipped capital femoral epiphysis managed?

A

orthopaedics - in situ fixation with cannulated screw

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18
Q

how to remember gross motor milestones in first year of life?

A

3 6 9 12 head shoulders knees and toes
3 - head control
6 - sitting
9 - crawling
12 - walking

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19
Q

what is the most common cause of pulmonary hypoplasia?

A

CDH

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20
Q

what are the 4Hs of cardiac arrest?

A
  • hypoxia
  • hypothermia
  • hypovolaemia
  • hypo/hyper - kalaemia, glycaemia, calcaemia, H+
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21
Q

what are the 4 Ts of cardiac arrest?

A
  • tension pneumothorax
  • tamponade
  • thromboembolism
  • toxicity (digoxin, local anaesthetics, insecticides)
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22
Q

what is ebstein’s anomaly?

A

atrialisation of the right ventricle
- echo: low insertion of tricuspid valve, large RA, small RV, tricuspid incompetence

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23
Q

what type of antibiotics are given in pertussis/whooping cough?

A

macrolides - azithromycin or clarithromycin (if within 21 days)

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24
Q

how does ITP present?

A
  • bruising
  • petechial or purpuric rash
  • bleeding less common and typically presents as epistaxis or gingival bleeding
  • may follow infection or vaccination
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25
Q

how does meckel’s diverticulum present?

A

painless massive GI bleeding requiring transfusion in child 1-2 years

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26
Q

how is neonatal hypoglycaemia managed?

A

> 1mmol and asymptomatic - encourage early breastfeeding and monitor
<1mmol or >1mmol and symptomatic - IV 10% dextrose

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27
Q

dietary advice for patient with CF?

A
  • high calorie
  • high fat
  • pancreatic enzyme supplementation for every meal
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28
Q

which virus causes slapped cheek syndrome? (erythema infectiosum)

A

parvovirus b19

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29
Q

what are the features of cephalohaematoma?

A
  • several hours after birth
  • doesn’t cross suture lines
  • can take months to resolve
    cephalOH my gosh this wasn’t here a few hours ago
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30
Q

what are the features of caput succedaneum?

A

present at birth
typically forms over vertex and crosses suture lines
resolves within days
caPUT a hat on this baby to hide the swelling it was born with

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31
Q

what is wests syndrome?

A

(infantile spasms)
4-8mo
M>F
salaam attacks - flexion of head, trunk, arms then ext of arms
1-2 seconds, repeated
progressive mental handicap

32
Q

what is shown on eeg in wests syndrome?

A

hypsarrhythmia (2/30)
CT - diffuse or localised brain disease in 70%
- eg tuberous sclerosis

33
Q

what heart defect is associated with fragile X?

A

mitral valve prolapse

34
Q

what type of laxative is movicol/macrogol?

A

osmotic

35
Q

what type of laxative is senna?

A

stimulant

36
Q

what type of laxative is lactulose?

A

osmotic

37
Q

what type of laxative is fybogel?

A

bulk forming

38
Q

what is the most common complication of measles?

A

otitis media

39
Q

what is the mode of inheritance for prader willi syndrome?

A

imprinting

40
Q

what are the features of prader willi syndrome?

A
  • hypotonia during infancy
  • dysmorphic features
  • short stature
  • hypogonadism and infertility
  • learning difficulties
  • childhood obesity
  • behavioural problems in adolescence
41
Q

what is weak femoral pulses a sign of in an infant?

A

coarctation of the aorta
-> SAME DAY discussion with paeds

42
Q

what is a risk factor for the development of surfactant deficient lung disease in the newborn?

A

maternal diabetes mellitus

43
Q

what are the features of atypical UTI in children?

A
  • seriously ill
  • poor urine flow
  • abdo or bladder mass
  • raised creatinine
  • septicaemia
  • failure to respond to treatment within 48h
  • infection with non-e.coli organisms
44
Q

what resp rate is a red flag according to NICE paeds traffic light system?

A

> 60 in any age

45
Q

what is in the 6 in 1 vaccine?

A

Parents Will Immunise Toddlers Because Death
Polio
Whooping cough (pertussis)
Influenzae (haemophilus type b)
Tetanus
B (hepatitis)
Diphtheria

46
Q

what are trident hands a feature of?

A

achondroplasia

47
Q

what are poor prognostic factors in ALL?

A
  • age <2y or >10y
  • WBC >20 at dx
  • T or B cell surface markers
  • non-caucasian
  • male sex
48
Q

how is a moderate asthma attack managed?

A

oral pred
salbutamol via spacer - 1 puff every 30-60 seconds to max 10 puffs

49
Q

how is scarlet fever managed?

A

oral pen V 10 days and return to school after 24h of starting abx

50
Q

what does VSD increase the risk of?

A

endocarditis, aneurysm of the ventricular septum, pulmonary htn

51
Q

asthma mgt in child under 5?

A
  1. saba
    • moderate dose ICS
    • LTRA
  4. stop LTRA and refer to specialist
52
Q

asthma mgt in child 5-16?

A
  1. SABA
    • low dose ICS
    • LTRA
  4. stop LTRA, + LABA
  5. SABA + MART (inc low dose ICS)
  6. SABA + moderate dose ICS MART
  7. SABA + one of inc ICS, add theophylline, seek expert advice
53
Q

how does biliary atresia present?

A

first few weeks of life
- jaundice over 2wks
- dark urine and pale stools
- appetite and growth disturbance
- hepatosplenomegaly
- associated cardiac murmurs

54
Q

what are the risk factors for ddh?

A

fat
female
first born
foot first
family hx
fair (caucasian)
fluid (oligohydramnios)

55
Q

what heart defect is associated with turners syndrome and what murmur does it cause?

A

bicuspid aortic valve
> ejection systolic murmur

56
Q

how to remember patau syndrome

A

trisomy 13 - 13 fingers

57
Q

how to remember patau syndrome

A

trisomy 13 - 13 fingers
paTau - Thirteen

58
Q

how to remember edwards syndrome

A

trisomy 18 - age at rock bottom Eighteen - Edwards

59
Q

what is the most common cause of childhood hypothyroidism in the uk?

A

autoimmune thyroiditis

60
Q

what is the most likely dx in a 14 month old with a loss of red reflex?

A

retinoblastoma
(10% hereditary)

61
Q

what are the causes of snoring in children?

A
  • obesity
  • nasal problems (polyps, dev sept, hypertrophic nasal turbinates)
  • recurrent tonsillitis
  • downs
  • hypothyroidism
62
Q

when is newborn blood spot screening test performed?

A

5th-9th day of life

63
Q

how do growing pains present?

A

never present at waking
no limp
no limitation of physical activity
systemically well
normal examination
motor milestones normal
sx often intermittent and worse after activity
leg pain

64
Q

how far apart do you give mmr vaccines in a prev unvaxxed child?

A

3mo

65
Q

what is the management for bacterial meningitis in a 2 month old?

A

iv amoxicillin and cefotaxime

66
Q

what is a venous hum?

A

benign murmur in children
continuous blowing noise
below clavicles

67
Q

what is a stills murmur?

A

benign
low pitched sound
lower left sternal edge

68
Q

what is a pulmonary flow murmur?

A

benign
upper left sternal border

69
Q

what is the best predictor of clinical severity in tetralogy of fallot?

A

degree of pulmonary stenosis

70
Q

what is the typical distribution of atopic eczema in a 10-month-old child?

A

face and trunk
(and extensor surfaces)
nappy area usually spared

71
Q

when can a child with chickenpox return to school?

A

when all lesions have crusted over

72
Q

what is the recommended compression: ventilation ratio for the newborn?

A

3:1

73
Q

what features are seen in hypernatraemic dehydration?

A
  • jittery movts
  • inc muscle tone
  • hyperreflexia
  • convulsions
  • drowsiness or coma
74
Q

when should a child be able to hop on one leg?

A

3-4y

75
Q

what are the features of osteochondritis dissecans?

A

pain after exercise
intermittent swelling and locking

76
Q

what proportion of roseola infantum cases do febrile convulsions occur in?

A

10-15%

77
Q

which TWO heart defects are associated with turners syndrome?

A

coarctation of the aorta
bicuspid aortic valve

revision (11 decks)

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