Paeds Flashcards
a prodromal fever + uni/bilateral parotid gland swelling suggests which condition
mumps
flu-like Sx occur few days before swelling
what is the tx for mumps
Supportive/ Tx complications self limiting condition
Sx last 1 week
mumps may also present with symptoms of compliocations, what are these?
Pacreatitis - abdo pain
orchitis - testicluar pain/selling
meningits/ encephalitis
sensorinural hearing loss
what causes mumps
RNA paramyoxyvirus
a pt presents with fever, generalised muscle ache and pain on chewing. what PH notifiable disease could be the cause?
mumps
fever
malaise, muscular pain
parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%
The NICE guidelines on sepsis recommend LP in children with suspected sepsis who are… (x2) :
- <1m w/ fever
- 1 - 3 m and are unwell or have a low or high WCC
what should be given in community to children with suspected meningitis and a non-blanching rash
IM/IV benzylpenicillin (should not delay transfer).
In true penecillin allergy - prioritise transfer
Doses:
* <1 yo – 300mg
* 1-9 yo – 600mg
* >10 yo – 1200mg
what is the Mx in meningitis for
<3m (x2)
> 3m
- <3 m – cefotaxime plus amoxicillin (listeria)
- > 3 months – ceftriaxone
give a complication of meningitis
hearing loss ** key
seizures/epilepsy
cognitive impairment/learning disability
memory loss
focal neurological deficits (limb weakness/spasticity)
what bone is most commonly affected in osteosarcoma
femur
others include tibia, humerous
Sx of bone cancer
persistent bone pain ( e.g. 4month Hx)
worse at night - may wake them from sleep
bone swelling, & palpable mass
restricted joint movement
A 12-year-old girl presents to her general practitioner with a 4-month history of a dull, aching pain and swelling in the distal aspect of her right thigh. She is otherwise well. What is the most appropriate next step
X-ray within 48hrs
Xray in child w/ unexplained bone ain/ swellign due to sarcoma
What does an X-ray of sarcoma show
poorly defined leson in bone
destruction of bone
“fluffy appearance”
periosteal reaction (irritation in lining of the bone) - Sunburst appearance
what blood test would indicate osteosarcoma
raised ALP
Mx of osteosarcoma
surgical resection
often limb amputation
w/ adjuvant chemo
X-rays in osteosarcoma a triangular area of new subperiostal bone ( sunburst appearance) . what is this area known as
Codman triangle
Ewing’s sarcoma appearance on x-ray.
‘onion skin’ appearance on x-ray.
( also shows EWS-FLI1 protein on fine-needle aspiration of the tumour)
diagnostic criteria for JIA
arthritis
without any other cause
lasting > 6 weeks
in a patient < 16yo
what are the 5 subtypes of JIA
- Systemic JIA ( stills disease)
- Polyarticular JIA (arthritis in >/= 5 joints)
- Oligoarticular JIA
- Enthesitis related arthritis
- Juvenile psoriatic arthritis
what are the features of stills disease
- Subtle salmon-pink rash
- High swinging fevers
- Enlarged lymph nodes
- Weight loss
- Joint inflammation and pain
- Splenomegaly
- Muscle pain
- Pleuritis and pericarditis
in stills disease ( systemic arthitis), the following bloods ill be …
ANA
RF
CRP
ESR
PLTS
Serum ferritin
ANA -ve
RF -ve
CRP raised
ESR raised
PLTS raised
Serum ferritin raised
what are the key differentials for children with fevers >5days
kawasaki
still’s disease
rheumatic fever
leukaemia
what life-threatenign complication may occur in stills disease
macrophage activation syndrome ( MAS
severe activation of immunie system, huge inflammatory response
presents: child with DIC, anaemia, thrombocytopenia, bleeding, non-blanching rash
what are the features of polyarticular JIA
symmetrical arthritis
small joints - hands& feet
large joints - hips & knees
minimal systemic sx - mild: fever, anaemia, reduced groeth
seronegaive (-ve RF) - most children
seropositive - some older pts, more like RA
