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Finals > Paeds > Flashcards

Paeds Flashcards

1
Q

Inguinal hernia in infants management?

A

Urgent surgery

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2
Q

management of transposition of the great arteries?

A
  • maintenance of the ductus arteriosus with prostaglandins (e.g. alprostadil)
  • surgical correction is the definite treatment.
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3
Q

organism most commonly responsible for hand, foot and mouth disease?

A

coxsackie A16
enterovirus 71

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4
Q

Gold standard investigation for pyloric stenosis?

A

abdominal USS

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5
Q

management of pyloric stenosis?

A

pyloromyotomy (cut to pyloric sphincter to widen outlet)

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6
Q

investigation for intussusception?

A

USS - may show target like mass

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7
Q

management of intussusception?

A
  • reduction by air insufflation under radiology
  • if fails then surgery
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8
Q

What is Henoch-Schonlein Purpura?

A

Most common small vessel vasculitis in children. It most commonly affects children aged 3-5 years old.

presents after a viral illness with rash on buttocks and lower limbs associated with arthralgia and nephritis (haematuria + protein)

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9
Q

Management of Henoch-Schonlein Purpura?

A
  • NSAIDs for analgesia and their anti-inflammatory effect
  • Antihypertensives may be needed to control blood pressure
  • children should have regular urine dips for 12 months to check for renal impairment.
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10
Q

Female puberty - first sign?

A

breast development

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11
Q

What is complete androgen insensitivity syndrome?

A

X-linked recessive condition due to end-organ resistance to testosterone causing genotypically male children (46XY) to have a female phenotype

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12
Q

Joint pain + pink salmon rash + child = ?

A

idiopathic juvenile arthritis

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13
Q

umbilical hernia in child management?

A

conservative

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14
Q

Organism which causes scarlet fever?

A

Group A haemolytic streptococci (usually Streptococcus pyogenes)

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15
Q

How does scarlet fever usually present?

A
  • fever: typically lasts 24 to 48 hours
  • malaise, headache, nausea/vomiting
  • sore throat
  • ‘strawberry’ tongue
  • rash (pinhead, appears first on torso, palm/sole sparing, sandpaper texture)
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16
Q

Investigations for scarlet fever?

A

throat swab but start antibiotics immediately on suspicion

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17
Q

Management of scarlet fever?

A
  • oral penicillin V for 10 days ( penicillin allergy should be given azithromycin)
  • children can return to school 24 hours after commencing antibiotics
  • scarlet fever is a notifiable disease
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18
Q

Complications of scarlet fever?

A
  • otitis media (most common)
  • rheumatic fever: typically occurs 20 days after infection
  • acute glomerulonephritis: typically occurs 10 days after infection
  • invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness
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19
Q

Growth failure, tachycardia and tachypnoea in the context of weak femoral pulses = ?

A

coarctation of the aorta

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20
Q

what is coarctation of the aorta?

A

a congenital narrowing of the descending aorta

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21
Q

What is coarctation of the aorta associated with?

A

Turner’s syndrome
bicuspid aortic valve
berry aneurysms
neurofibromatosis

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22
Q

Management of coarctation of the aorta?

A

Prostaglandin E is used keep the ductus arteriosus open while waiting for surgery.

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23
Q

scoring system used to assess health of newborn baby + when is it used?

A

APGAR
At 1 and 5 minutes of age. If the score is low then it is again repeated at 10 minutes.

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24
Q

Diagnostic investigations for Pertussis?

A

per nasal swab culture for Bordetella pertussis
PCR and serology

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25
Q

Management of whooping cough in infants?

A

admit to hospital

26
Q

management of whooping cough (not in infants)?

A

oral macrolide (e.g. clarithromycin, azithromycin or erythromycin) - within first 21 days

household contacts should be offered antibiotic prophylaxis

notifiable disease

school exclusion: 48 hours after commencing antibiotics (or 21 days from onset of symptoms if no antibiotics )

27
Q

Delayed puberty + lack of smell in male = ?

A

Kallman syndrome

28
Q

Kallman syndrome LH/FSH/testosterone pattern?

A

all low

29
Q

Management of Kallman syndrome?

A

testosterone supplementation
gonadotrophin supplementation may result in sperm production if fertility is desired later in life

30
Q

Management of meningitis in <3m old baby?

A

IV amoxicillin (or ampicillin) + IV cefotaxime

31
Q

Management of meningitis in >3m old child?

A

IV cefotaxime (or ceftriaxone)

32
Q

Shaken baby syndrome triad?

A

Retinal haemorrhages + subdural haematoma + encephalopathy

33
Q

CXR findings in transient tachypnoea of the newborn?

A

hyperinflation of the lungs and fluid in the horizontal fissure.

34
Q

Management of transient tachypnoea of the newborn?

A
  • observation, supportive care
  • supplementary oxygen may be required to maintain oxygen saturations

-usually settles within 1-2 days

35
Q

What is cerebral palsy?

A

A disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain.

36
Q

Causes of cerebral palsy?

A
  • Antenatal (80%): e.g. cerebral malformation and congenital infection (rubella, toxoplasmosis, CMV)
  • Intrapartum (10%): birth asphyxia/trauma
  • Postnatal (10%): intraventricular haemorrhage, meningitis, head-trauma
37
Q

Clinical presentation of cerebral palsy?

A
  • abnormal tone early infancy
  • delayed motor milestones
  • abnormal gait
  • feeding difficulties.
38
Q

How can cerebral palsy be classified?

A

spastic (70%)

dyskinetic

ataxic

mixed

39
Q

Asthma guidelines in children 5-16years?

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + LTRA
  4. SABA + ICS + LABA
40
Q

Asthma guidelines in children <5years?

A
  1. SABA
  2. SABA + ICS (8 week trail)
  3. SABA + ICS + LTRA
  4. Asthma specialist
41
Q

At what age are children usually affected with croup?

A

6 months - 6 years

most commonly under 3 years

42
Q

What causes croup?

A

parainfluenza - most common
other viruses e.g. adenovirus, influenza, RSV
can be bacterial - much more severe

43
Q

Barking, seal like cough + stridor + fever in a child under 6years old = ?

A

Croup

44
Q

Management of croup?

A

Dexamethasone - single dose

if severe then hospital, oxygen, neb budesonide

45
Q

Investigations for Hirschsprung’s disease?

A

abdominal x-ray
rectal biopsy - gold standard for diagnosis

46
Q

management of Hirschsprung’s disease?

A

initially - rectal washouts/bowel irrigation
definitive management - surgery to affected segment of the colon

47
Q

What is Hirschsprung’s disease?

A

Where nerve cells of the myenteric plexus are absent in the distal bowel and rectum. No parasympathetic ganglion cells at the end of the colon = no peristalsis = constipation.

48
Q

what is patent ductus arteriosus?

A

Congenital heart defect (‘acyanotic’) - connection between pulmonary trunk and descending aorta.

49
Q

Causes of Patent ductus arteriosus?

A
  • prematurity
  • maternal rubella infection in 1st trimester
  • born at high altitude
50
Q

Features of PDA?

A
  • left subclavicular thrill
  • continuous ‘machinery’ murmur
  • large volume, bounding, collapsing pulse
  • wide pulse pressure
  • heaving apex beat
51
Q

Management of PDA?

A

indomethacin or ibuprofen

52
Q

Infantile spasms first line management?

A

Vigabatrin

53
Q

Childhood syndrome - microcephalic small eyes, cleft lip, polydactyly and scalp lesions - what is it?

A

Patau syndrome (trisomy 13)

54
Q

Childhood syndrome - micrognathia, low set ears, rocker bottom feet and overlapping of fingers - what is it?

A

Edwards syndrome (trisomy 18)

55
Q

Childhood syndrome - large testes, learning difficulties, long face, large ears and macrocephaly - what is it?

A

Fragile X syndrome

56
Q

Childhood syndrome - webbed neck, pectus exacavatum, short and pulmonary stenosis - what is it?

A

Noonan syndrome

57
Q

Investigation for NEC?

A

abdominal XRAY

USS - if inconclusive

58
Q

DDH screening in breach babies?

A

USS at 6 weeks

59
Q

Red flag for RR in children?

A

> 60

60
Q

Which heart murmur is associated with turner’s syndrome?

A

ejection systolic heard loudest over aortic valve - this is due to bicuspid aortic valve.

Finals (18 decks)

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