Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

UCPEX > Paeds > Flashcards

Paeds Flashcards

(86 cards)

Start Studying
1
Q

Difference in presentation between vasovagal syncope and anaphylaxis with collapse

A

Vasovagal - pale, bradycardic
Anaphylaxis - flushed, tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Presentation for simple febrile seizure

A

6-60 month child, previously well

generalised tonic-clonic, no focal component
<15 mins
No more than once in 24 hours
No prev neuro problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Admission criteria for febrile seizure

A

> 15 mins
Recurrence within 24 hours
Focal component
Needing medication to terminate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment for status epilepticus (>5 mins)

A

Position semi-prone
O2 via face mask

Diazepam
0.25mg/kg PO or IV
0.7mg/kg PR
Max 10mg

Midazolam
0.5mg/kg, buccal
Max 10mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of seizures

A

Partial:
From focal lesion, often temporal lobe

Simple partial (unimpaired consciousness)
- motor, somatosensory, autonomic, psychic signs

Complex partial (impaired consciousness, amnesia)
- +/- automatism

Complex partial proceeding to generalised

Generalised:
Absence - lapse of consciousness
Myoclonic - sharp jerking
Clonic - rhythmic shaking
Tonic - increased rigidity
Tonic-clonic - rigidity + rhythmic shaking
Atonic - drop attack

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Appropriate parent given emergency medication doses for child with prev hx non-febrile seizure

A

Diazepam 0.3-0.5mg/kg PR
Midazolam 0.2-0.3mg/kg buccal
Repeat only under medical supervision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

HR range in children

A

<1 - 110-160
1-2 - 100-150
2-5 - 95-140
5-12 - 80-120
12+ - 60-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sinus tachycardia vs SVT

A

Sinus tachycardia: <220bpm, normal wave form, child unwell/in pain

SVT: >220, abnormal P wave axis, child looks well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of SVT in children

A

Vagal manoeuvres:

Infants - cold water immersion
Child - ice cold face cloth
5+ - blowing on thumb with straining, handstand, trendelenburg, legs up

Adenosine:
100mcg/kg
200mcg/kg
300mcg/kg

Amiodarone - usually used in post-op setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causative organisms for meningitis in neonates and children

A

Neonates: Group B Strep, Enterococci, E. coli, Listeria

Children: Strep pneumoniae, N meningitidis, H influenza type B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antibiotics for suspected meningicoccal disease in children

A

Ceftriaxone 100mg/kg (max 2g) IV/IM

Benzyl penicillin 50mg/kg (max 2g) IV/IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Risks for asthma in children

A

Atopy
Passive smoker
Crowded home, damp, mouldy
Family hx asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When to consider prednisolone in child with asthma

A

Moderate to severe asthma
Age >5

Or age 1-5 if
- severe attack
- Hx prev severe attacks
- Likely prolonged hospital stay (>6 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of asthma in children

A

Mild:
6 puffs salbutamol via spacer
Discharge when can space to 2hours

Moderate:
Above plus:
May need full blast
Prednisolone 1mg/kg if >5 or meeting criteria
Discharge when can space to 2 hours and no O2 requirement

Severe:
Above plus:
Salbutamol 2.5-5mg nebs
Ipratropium 4 puffs or 250mcg nebs

Life threatening:
Urgent transfer
Nebs - continuous
High flow O2
IV lines
Hydrocortisone 4mg/kg IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms of hypovolaemic shock in children

A

Early:
Pallor, cool peripheries, drowsiness/disinterest, tachycardia disproportionate to fever/distress, reduced urine output
Cap refill not reliable

Late:
Low BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of shock in children

A

IV access - aim 24G + or intraosseous
IVF - 20mg/kg bolus
Consider trauma - C spine immobilisation, exsanguination - FFP and blood

Hypotension refractory to volume replacement - dopamine 5mcg/kg/min increase to 10-15
Consider spinal shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Age group for unintentional poisoning

A

12-36 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Medications where 1-2 tabs can be lethal to <10kg toddler

A

CCBs
Amphetamines
Dextropropoxyphene
Chloroquine
TCAs
Opioids
Sulphonylureas
Theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Non pharmaceuticals which can results in severe toxicity if ingested

A

Organophosphates
Paraquat
Camphor
Naphthalene
Hydrocarbons, solvents, eucalyptus oil, kerosene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Medications that cause sodium channel blockade

A

TCA
propanolol
Quinidine, flecainide, first gen antihistamines
Cocaine
Bupivicaine
Dextropropoxyphene
Carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of poisoning

A

Airway - intubate if airway corrosion, GCS <8, prolonged seizure

Breathing - O2, ventilations as required

Circ - IV fluid bolus 20mg/kg, inotropes
Avoid B blockers in sympathomimetic OD
NaHCO3 if sodium channel blockade

Disability
Seizures - Midazolam 0.15mg/kg IV, repeat
Phenobarbitone 20mg/kg IV (2nd line)
Do not use phenytoin (prolongs Na channel blockade)
Naloxone if suspect opioid OD - 0.1-0.8mg/kg
If suspect benzo OD - observe. Flumazenil dangerous in mixed OD

Correct hypoglycaemia
- dextrose 10% 5mL/kg bolus + 4mL/kg/hour infusion
Maintain normothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Criteria for referral for fever in child

A

<28 days (adjusted age)
<3 months (adjusted age) discuss with paeds, bloods
>3 months: significant illness, sepsis, unknown source

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

NICE traffic light fever risk in children

A

Amber:
Age 3-6 months, temp >39
Fever >5 days
Reported pallor, decreased activity
Increased WOB, sats <95
Tachycardia
Mild dehydration
Signs of bone/joint pain

Red:
Age <3 months, temp >38
Pale, mottled, appears ill
Severe WOB, RR>60
Reduced skin turgor
Signs of meningitis
Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Types of croup

A

Viral laryngotracheitis
- Parainfluenza, RSV, adenovirus, influenza
- Younger age group
- Coryzal illness

Recurrent/spasmodic croup
- older children
- Without URTI signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
RR normal values for children WHO criteria for tachypnoea
<1: 30-60 1-2: 24-40 2-5: 22-34 5-12: 18-30 12+: 12-16 WHO: <2 months: >60 2-12months: >50 1-5 years: >40
26
Symptoms of epiglottis
Sniffing position Drooling Sudden onset fever, dysphagia
27
Symptoms of mild, moderate, severe croup
Mild No iWOB, stridor with distress, no hypoxia Moderate Stridor at rest, mild WOB, no hypoxia Severe Severe WOB, tachycardia, pallor, restlessness, lethargy, cyanosis, reduced breath sounds
28
Management of croup
Mild-moderate Dexamethasone 0.16mg/kg, or prednisolone 1mg/kg 2 days Reduce anxiety Usually resolves in <48 hrs Contagious for 4-6 days Severe Dexamethasone 0.6mg/kg O2 high flow Consider nebulised adrenaline Refer to hospital
29
Causes of gastroenteritis
Viral >70% rotavirus, norovirus, enteric adenovirus Bacteria 10-20% Salmonella, Campylobacter, E coli, Shigella Parasites <10% - giardia, cryptosporidium
30
Causes of bacillary dysentery Abx management
Entero-invasive E coli - no abx Enterohaemorrhagic E coli - abx contraindicated, risk of HUS Salmonella - amoxicillin/cotrimoxazole 7/7 Campylobacter - erythromycin 5-7/7 Shigella - ceftriaxone Yersinia - 3rd gen cef C diff
31
Gastroenteritis notifiable diseases
Campylobacter Cryptosporidium Cholera Giardia Shigella Salmonella Yersinia Suspected outbreak, person in high risk category Chemical/bacterial/toxic food poisoning - botulism, toxic shellfish poisoning, verotoxin, shiga toxin E coli
32
Indication for NG rehydration
Refusing oral fluids Failed oral rehydration Intractable vomiting/profuse diarrhoea Caregiver not coping with giving oral fluids
33
Indication for IV rehydration in children
Shock Unsafe (decreased LOC, ileum, surgical abdo) Hyperosmolality (Na >170, osmol >350) Failed oral and NG >4 years old, better tolerating IV than NG
34
Ondansetron dose in children
8-15kg 2mg 15-30kg 4mg 30kg + 8mg
35
Presentation and management of haemolytic uraemia syndrome
Enterohaemorrhagic E coli or Shiga toxin producing Shigella (outside NZ) Severe anaemia, thrombocytopenia, AKI - Do not use antibiotics, antidiarrhoeals - Early aggressive rehydration - Paeds urgent referral
36
Symptoms to suspect hypernatraemia/hyperosmolality in gastroenteritis
Moderately dehydrated Symptoms disproprotionate to level of dehydration - Irritability, lethargy, doughy skin, fever
37
ORT amounts in child with gastroenteritis
Mild dehydration ~50ml/kg deficit Shocked ~100mL/kg deficit 5mL/min or 25mL/5 mins Or 25mL/kg/hour for 4 hours Extra 10mL/kg for each loose stool
38
Bronchiolitis age group
6-12 months 12-24 months less common
39
Timeline of bronchiolitis infection
Cough, wheeze, WOB, nasal discharge, fever Peaks day 2-3 Resolves by day 7 Cough for 3 weeks
40
Risk factors for bronchiolitis
Premature <37 weeks Young <10 weeks Maori/Pacific Low SES Smoking Crowded, damp housing <2 months breastfeeding Comorbidities - Down, congenital heart disease, chronic lung disease, CF, immunodeficiency, chronic neurological disease
41
Mild, moderate, severe bronchiolitis
Mild Normal behaviour, normal RR, no accessory muscles, sats >92, no apnoea, normal feeding Moderate Some irritability, mild increased RR, tracheal tug/nasal flare, sats 90-92, brief apnoea, some trouble with feeding Severe Lethargy, fatigue, severe raised RR, marked chest wall retraction, sats <90, frequent, prolonged apnoea, unable to feed
42
Indications for chest xray in children
Ambiguous clinical findings Unresponsive to abx therapy <3 months age Severely unwell
43
Management of CAP in children
Amoxicillin 25mg/kg tds 7 days or Erythromycin 10mg/kg QID 7 days (>5 years)
44
Signs of sexual abuse in child with UTI
Unusual/excessive genital itching Bruising, swelling, bleeding, redness in genitals Age inappropriate sexual play/knowledge/interest Fear of certain people/places
45
Indication for USS in child with UTI
<12 months with first febrile UTI Severe illness Recurrent febrile UTI Atypical hx Outpatient USS renal tracts within 6 weeks
46
Indication for empiric treatment of UTI
Specific urinary symptoms 3 months - 3 years with non-specific symptoms (fever, lethargy, abdo pain) >3 years, dipstick positive for nitrites >3 years, dipstick with leuks, urinary symptoms Do not treat asymptomatic bacteriuria in children/infants
47
Types of UTI in children
Cystitis - lower UTI without fever Pyelonephritis/febrile UTI - renal or lower UTI with fever Atypical UTI - sepsis, bacteraemia, obstructive uropathy, fail to respond to abx in 48 hrs, renal impairment, non-E.coli organism Recurrent UTI - 2+ episodes febrile UTI 1 febrile UTI + 1 cystitis 3x cystitis
48
ABx for mild uncomplicated UTI in children
Cotrimoxazole 24mg/kg, BD 3/7 Cefalexin 25mg/kg BD 3/7 Augmentin 30mg/kg tds 3/7 Nitrofurantoin 1.5mg/kg QID 3/7 - nor for pyelo or renal impairment Moderate - treat for 7 days Severe - single dose IV gentamicin, then 6/7 oral
49
Types of lice
Head lice - Pediculus humanus, captitis Body lice - Pediculus humanus, corporus Pubic lice - Phthirus pubis
50
Management of lice
Environmental - hot wash, dryer or dry clean or seal in bag for 2/52, vacuum environment Medication: Head lice - dimethicone, 2 treatments, 7/7 apart Wet combing every 4 days until no lice with 3 consecutive combings Pubic lice - permethrin, 2 treatments, 7/7 apart
51
Scabies presentation
Symmetrical lesions, sparing head and neck, burrows in peripheries Crusted scabies in elderly, young, immunocompromised - can occur on neck + face Intense itch, may last for weeks after completing treatment
52
Management of scabies
Launder/air for 72 hours Vacuum Clean nails Medical - permethrin for pt and all close contacts. 2 treatments 7/7 apart - PO ivermectin - failure of topical treatment, crusted scabies, outbreak Repeat in 2/52 Topical steroids/antihistamines for itch
53
Modified GCS for children
Eyes: 4 - open spontaneously 3 - open to shout/speech 2 - open to pain 1 - not opening Voice: 5 - appropriate words, smiles, coos 4 - inappropriate words (<5), confused, consolable crying 3 - inappropriate words (>5), inconsolable, cries/screams (<5) 2 - incomprehensible, grunts, agitation 1 - none Movement: 6 - follow commands, normal movement 5 - localises pain 4 - flexion withdrawal 3 - flexion - abnormal decorticate 2 - extension - decerebrate 1 - no movement
54
Causes of chest pain in children Signs of organic disease
Idiopathic - most common MSK Resp/asthma GI/GORD Psychogenic Cardiac < 1% Wakes from sleep, acute origin, fever
55
Indications for investigation in children with chest pain
Sudden onset, exertional Fever, cough, SOB Foreign body, trauma, drooling Unwell, abnormal vital signs, examination Tall, thin, pectus excavatum/carinatum Cardiac risk factors - systemic inflammatory disorder, malignancy, thrombophilia, myopathy FHx sudden unexplained death, cardiomyopathy, severe familial hyperlipidaemia,
56
Most common medical and surgical causes for abdominal pain in children
Medical - gastroenteritis (vomiting, then pain) Surgical - appendicitis (pain then vomiting)
57
Ddx child with abdo pain
Constipation (LLQ, suprapubic) Obstruction - intussusception, incarcerated hernia, volvulus (colicky) Mesenteric lymphadenitis PID Abdominal trauma Don't forget Diabetes HSP pneumonia Sickle cell crisis Mediterranean fever HUS Drugs Porphyria
58
Presentation of appendicitis in <3
Late presentation, non classical symptoms Pain, fever, vomiting, diarrhoea Cough, rhinitis, grunting, pain on right hip movement
59
Presentation of appendicitis age 3-6
24hr vague abdo pain fever, vomiting, anorexia
60
Paediatric Appendicitis Score
+2 each: - RLQ tenderness to cough/percussion/hop - Tenderness RIF +1 each: Anorexia Fever Nausea/vomiting leukocytosis Neutrophilia Migration to RLQ <4 low risk, 4-6 equivocal, >6 high risk
61
Alvarado score for paediatric appendicitis
+2 each: RLQ tenderness Leukocytosis +1 each: Fever Rebound tenderness Migration to RLQ Anorexia Nausea, vomiting Neutrophilia <4 low risk, 4-6 equivocal, >6 high risk
62
Most common cause of bowel obstruction in <3
Intussusception
63
Risk factors for intussusception
Male Intestinal malrotation Prev intussusception Sibling with intussusception cystic fibrosis Intestinal polyps Recent viral illness
64
Symptoms + signs of intussusception
Intermittent crying, pulling knees to chest Blood in stool - currant jelly Vomiting, fever, diarrhoea Abdominal mass, sausage shape, usually in RUQ, enlarges during episodes of pain
65
Status of inguinal hernia
Reducible - sac completely empties Irreducible - cannot completely empty sac, due to adhesions, faeces, fibrosis of neck of sac Obstructed - causing mechanical bowel obstruction, loop of bowel viable Strangulated - blood supply impaired, imminent gangrene
66
Cause of inguinal hernia
Patent processus vaginalis Herniation of bowel, omentum, ovaries, peritoneal fluid (hydrocele)
67
Risk factors for inguinal hernia
Males Prematurity Undescended testes Family history hernias Cystic fibrosis Developmental hip dysplasias Urethral abnormalities
68
Indications for referral for inguinal hernias
Irreducible Strangulated Obstructed Suspected ovary - do not attempt reduction Signs of perforation, peritonism, sepsis Reducible hernias - outpatient referral Neonate <1 week Infant 2-4 weeks Child 1-3 months
69
Rome III criteria for functional constipation
Under 4: 2 of following over at least 1 month Over 4: 2 of following at least weekly over last 2 months, IBS excluded - <2 BM/week - >1 faecal incontinence/week (toilet trained) - Excessive stool retention - Painful/hard BM - Large faecal mass in rectum - Large diameter stool obstructing toilet
70
Red flags for organic causes of constipation in children
Onset <1 month Delayed meconium passage Failure to thrive Abdo distension Intermittent diarrhoea + explosive stools Empty rectum Tight anal sphincter Pilonidal dimple with hair Midline pigmentation of lower spine Abnormal neuro exam Occult blood in stool Extraintestinal symptoms Gushing of stools with rectal exam No hx withholding/soiling No response to conventional treatment
71
Treatment of constipation
Increased fruit, vegetable, fluid intake Regular toileting after meals 1. Lactulose 2. Molaxole - can be used for disimpaction + maintenance 3. Glycerol supps for significant faecal impaction Treat for duration of constipation, wean slowly
72
Most common epiphyseal injury in children
Salter Harris II
73
Most common site for Salter Harris III fracture
Proximal and distal tibial epiphyses
74
Most common site for Salter Harris IV fracture
Lateral condyle humerus
75
Complications of elbow fractures
- Vascular - brachial artery, median nerve injury - Compartment syndrome - anterior compartment swelling, compression of median nerve, radial artery - Volkmann's isachaemic contracture - flexor compartment > flexion + pronation - Malunion - Myositis ossificans
76
Child with a limp - ddx
Fracture Acute abdomen, psoas abscess Discitis, vertebral OM Malignancy Haemarthrosis Lyme disease Acute rheumatic fever, gonococcal arthritis Rheumatological Meningitis Septic arthritis
77
Types of gait
Steppage - abnormal hip and knee flexion. Foot drop. Trendelenburg - pelvis tilts towards unaffected side. DDH, weak hip abductors Circumduction - knee hyperextended, abduction of hip. Leg length discrepancy, neurological joint stiffness. Equinus - tip toed. Club foot, cerebral palsy, tight Achilles, calcaneal fracture, foreign body, leg length discrepancy.
78
SUFE - mild, moderate, severe slip
Mild <33% or <30 degrees Moderate 33-50% or 30-50 degrees Severe >50% or >50 degrees
79
Complications of SUFE
AVN Early OA Necrosis of articular cartilage Gentle manipulation or traction can cause aseptic necrosis
80
Non-pharmalogical ways to manage pain
Explanation Relaxation Distraction Splinting
81
Indication for EMLA
3-5mm tissue depth for 2 hours Apply 90 mins prior to procedure To intact skin under occlusive dressing Venepuncture, cannula, LP, bladder aspiration
82
Maximum dose EMLA
1 tube = 5g 3-11 months - 2g over 20cm2 1-5 years - 10g over 100cm2 6-11 years - 20g over 200cm2 Complications Methaemoglobinaemia Local oedema, vasoconstriction
83
Symptoms of LA toxicity
Mild: Perioral tingling, tongue numbness Tinnitis, dizziness Flushing Anxiety/agitation Severe: Muscle twitch Nystagmus Hypertonia, seizure Bradycardia, hypotension Arrhythmia LOC, coma
84
Risk factors for NAI
Child - behavioural difficulties, chronic illness, disability, preterm, unwanted child, unplanned pregnancy Parent - Low self esteem, poverty, poor impulse control, substance/ETOH, young parent, hx abuse, mental illness, poor knowledge of child development/unrealistic expectation, negative perception of normal child behaviour Environment - isolation, poverty, unemployment, low education, single parent, non-biological male, family-partner violence
85
Red flags in presentation for NAI
Delayed presentation - no reasonable explanation No hx injury, uncorroborated, changes, vague Injury inconsistent with development Injury inconsistent with history Repeated trauma Young child <2 with head injury
86
Injuries suspicious for NAI
Complex skull #, parental, linear fracture, subdural bleed, hypoxic-ischaemic brain injury, retinal haemorrhage Bite marks, bruises of different ages, clustered/patterned bruises, bruises in shielded places (axilla, inner arm, thigh) Burns - sharply demarcated, shielded areas (posterior body, LL buttock, perineum, back of hand), bilateral/symmetrical Contusion, laceration, ruptured internal organs without major trauma Rib fractures Metaphyseal fractures (corner, bucket handle) Unusual fracture site - lateral clavicle, hand, feet sternum, scapula, spine Femoral fracture in child not yet walking <3 years old with humeral shaft fracture Ligature marks Oral injuries Genital/perineal trauma without straddle injury

UCPEX (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions