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Paeds Flashcards

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0
Q

What causes physiological neonatal jaundice (>24hrs)? 3 things

A

Billirubin production due to shorter RBC lifespan
Low conjugation due to hepatic immaturity
Absence of gut flora impedes elimination of bile pigment

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1
Q

Give 4 causes of neonatal jaundice within 24hrs?

A

Sepsis
Rhesus haemolytic disease
ABO incompatibility
Red cell anomalies (spherocytosis)

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2
Q

State 4 causes of prolonged (>14 days) jaundice?

A 
Breastfeeding
Sepsis
Hypothyroidism
CF
Galactosaemia
Biliary atresia
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3
Q

How do you treat neonatal jaundice?

A

Phototherapy - converts unconjugated bilirubin to soluble products
Exchange transfusion - warmed blood through umbilical vein with removal via artery

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4
Q

Give 5 complications of prematurity?

A 
Hypothermia
Apnoea
Bradycardia
Infection
Difficulty feeding
Hypoglycaemia
Anaemia
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4
Q

Give 3 risk factors for prematurity?

A 
Young maternal age
Multiple pregnancy
Maternal illness
Smoking
Alcohol
Infection
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5
Q

What is kernicterus?

A

High levels of unconjugated bilirubin in the basal ganglia causing acute encephalopathy with irritability, poor feeding and high pitch crying. Can lead to athetoid cerebral palsy.

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6
Q

Give 4 areas Downs Syndrome can affect?

A

Respiratory
Cardiovascular
Ears
GI

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7
Q

Give 4 causes of IUGR?

A 
Multiple pregnancy
Placental insufficiency
Maternal smoking
Congenital infections
Genetic syndromes
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8
Q

Give 6 features that can be seen in Down’s syndrome?

A 
Neonatal hypotonia
Flat occiput
Epicanthic folds
Round face
Protruding tongue
Strabismus
Nystagmus
5th finger clinodactyly
Sandal gap
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9
Q

Give 4 causes of respiratory failure?

A

Upper airway-foreign body, epiglottis, croup
Lower airway-asthma, bronchiolitis, pneumonia
Neuro-head injury, meningitis, raised ICP

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10
Q

State 2 genetic ways Downs syndrome occurs?

A

Non-disjunction

Robertsonian translocations

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11
Q

Give 4 signs of respiratory distress in a child?

A 
Tachypnoea
Subcostal, intercostal and sternal recession
Nasal flaring
Use of abdominal muscles
Tracheal tug
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12
Q

Give 5 clinical features of respiratory failure in kids?

A 
SOB
Tachypnoea
Cyanosis
Nasal flaring
Grunting
Recession
Restlessness
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16
Q

What causes croup?

A

Para-influenza virus

RSV

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17
Q

Give 3 signs of severe croup?

A

Increased work of breathing
Cyanosis
Restlessness

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18
Q

How do you manage croup?

A

O2
Dexamethasone OR Prednisalone
Nebulized adrenaline
ITU

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20
Q

Give the pathology of bronchiolitis?

A

Bronchioles become inflamed
Secrete mucus
Oedema and necrosis cause obstruction of the airways

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21
Q

Give 2 investigations of choice for Bronchiolitis?

A

CXR - hyperinflation & collapse/consolidation

Nasopharyngeal aspirate (NPA) - RSV using immunofluorescence

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22
Q

State the causative organism of bronchiolitis?

A

RSV (respiratory syncytial virus)

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23
Q

What are the indications for admission in Bronchiolitis? 4 things?

Study These Flashcards
A 
Poor feeding
Apnoea
>50 bpm
Dehydration
Exhaustion
23
Q

What is the prophylactic treatment for Bronchiolitis?

Study These Flashcards
A

Monoclonal antibody (palivizumab) providing passive immunity through winter months

24
Q

Give 4 ways intussusception might present in a child?

Study These Flashcards
A

Episodic:
Crying
Drawing the legs up

Vomiting
Blood PR (red currant jam)
Sausage shaped abdominal mass
24
Q

How is intussusception investigated and subsequently treated?

Study These Flashcards
A

USS

Reduction by air enema

26
Give 4 common organisms causing gastroenteritis?
Rotavirus Norovirus E. Coli Campylobacter
27
Give 6 parameters for assessing dehydration?
``` Pulse BP Mucous membranes Urine output Skin turgor Fontanelles CRT ```
28
How do you calculate fluid deficit in a child?
Weight (kg) x percentage dehydration (%) x 10 = Fluid deficit (ml)
29
What is the normal APGAR score & when would you consider resuscitation?
7-10 is normal | Below 3 must be resuscitated
30
Give key milestones in child development? 1 month/ 6 month/ 12 month
Gross Motor, Fine motor, Language, Social ``` 1 month GM: Lift head FM: Track with eyes L: Coo S: Track parents ``` ``` 6 month GM: Sit up FM: Raking grasp L: Babbles S: Stranger anxiety ``` ``` 12 month GM: Walk FM: Pincer grip L: Mama/Dada S: Imitate parents ```
31
What are the congenital infections? (TORCH)
``` Toxoplasmosis Other (Syphilis) Rubella Cytomegalovirus Hepatitis HIV ```
31
When and who does pyloric stenosis mostly affect?
First 4-6 weeks of life | First born male infants
32
Which investigations can be taken and what would they show in pyloric stenosis? 2 investigations
Ultrasound: Thickened and elongated pyloric muscle Bloods: Hypochlorimic, Hypokalaemic and Metabolic alkalosis
33
Give 4 causes of developmental delay?
Severe learning disabilities (Downs, Fragile X and Cerebral palsy) Intrauterine infections (TORCH) Fetal alcohol syndrome Congenital hypothyroidism Inborn errors of metabolism Abuse & Neglect
33
When should you worry about the growth of a child?
Weight under 2nd centile Height under 2nd centile When height and weight cross 2 centiles
33
What is the management of pyloric stenosis?
Rehydration | Surgery: Pyloromyotomy
34
What is hirschsprungs disease and how can you treat it?
Congenital absence of ganglia in a segment of colon leading to obstruction, constipation and megacolon Treat with excision of segment +/- colostomy
35
Give 2 common causes of malabsorption in children?
Coeliac disease | Cystic fibrosis
36
Give 3 complications of tonsillitis in children?
Otitis media Peritonsillar abscess Post streptococcal glomerulonephritis
37
Give 2 organisms implicated in Otitis media in children?
Strep. Pneumoniae | Haemophilus influenzae
38
What causes epiglottis and why is not around anymore?
Haemophilus influenzae Hib vaccine introduction
39
How can you investigate reflux in children?
Barium swallow | PH monitoring probe
40
How can you manage simple reflux in children? 4 things
Nursing infant in upright position Thickening agents Gaviscon Drugs: PPI, H2 receptor blockers, Domperidone
41
What are the possible causes of bile stained vomit in a child? 3 things
Duodenal atresia Ileal atresia Malrotation of small bowel
42
Complex febrile convulsions in children have the same features as simple ones. There are some differences. What are they? 3 things
Seizure focal or prolonged >15mins Many seizures occurring in close succession Status epilepticus
43
Give 4 features of a simple febrile convulsion in children?
Single seizure lasting <15mins Neurologically normal before and after Normal neurodevelopment Fever not due to CNS infection
45
What is status epilepticus?
Continuous seizure activity >30mins | OR Series of seizures without full recovery in between
47
Give 3 common associations of cerebral palsy?
Epilepsy Learning difficulties Hearing & visual loss Incontinence
47
Give 4 causes of cerebral palsy?
Prenatal- infections (TORCH) Perinatal - Hypoxic ischaemic encephalopathy, Trauma Post natal - Meningitis, head trauma, encephalitis
47
Give 4 tests for diagnosing cystic fibrosis?
Sweat test Antenatal test - chorionic villus sampling Karyotyping Guthrie test
48
Give 3 causes of a global developmental delay in children?
``` Chromosomal abnormality - Downs, Turners, Klinefelters Foetal alcohol syndrome Abuse and neglect Congenital hypothyroidism Trauma CNS malformation ```
50
Give 6 causes of failure to thrive in children?
``` Poor nutrition Abuse and neglect Unskilled feeding Malabsorption Down syndrome Ongoing illness ```

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