Paeds Flashcards
(154 cards)
1
Q
laryngomalacia presents at
A
4 weeks
2
Q
fever, rash starting on head/trunk before spreading, mac/pap –> vesicular
A
Chicken pox
3
Q
Which children get varicella IGs
A
immune comp
peripartum exposure
4
Q
Prodrome (irritable, conjunctivitis, fever)
Koplik spots in mouth
Rash starting behind ears (discrete mac pap rash that becomes confluent on whole body)
A
measles
5
Q
what if child exposed to measles but not vaxxed
A
give vax within 72h (MMR)
6
Q
mumps management
A
supportive
7
Q
macpap rash on face spreads to whole body, fades 3-5 days
lymphadenopathy
A
rubella
8
Q
erythema infectiosum (slapped cheek) pathogen
A
parvovirus B19
9
Q
slapped cheek can cause what in adults
A
acute arthritis
10
Q
Group A strep disease
A
scarlet fever
11
Q
scarlet fever rx
A
oral pen v 10 days (azithro if allergy)
12
Q
hand food and mouth pathogen
A
coxsackie A16 virus
13
Q
what rash has a strawberry tongue and sandpaper rash
A
scarlet fever
14
Q
Projectile non bilious vomiting at 4-6 weeks
A
pyloric stenosis
15
Q
Blood gas result in pyloric stenosis
A
hyperchloraemic metabolic acidosis
16
Q
how to diagnose pyloric stenosis
A
test feed
USS
17
Q
Colicky pain, diarrhoea and vomiting, sausage shaped mass, red jelly stool 6-9 months
A
intussusception
18
Q
intussusception rx
A
air insufflation
19
Q
Scaphoid abdomen with bilious vomiting
A
malrotation (with volvulus)
20
Q
Delayed meconium and abdo distension
A
Hirschsprung’s disease OR CF
21
Q
Hirschsprung’s diagnosis?
A
Full thickness rectal biopsy
22
Q
Hirschsprung’s Rx
A
rectal washouts
then anorectal pullthrough procedure
23
Q
Choking and cyanotic spells following aspiration
May be associated with VACTERL
A
oesophageal atresia
24
Q
biliary atresia rx
A
Kasai procedure
25
biliary atresia is an increase in which bili
conjugated
26
Premature baby with abdo distention and bloody stools
Free air on XR
necrotising enterocolitis
27
Necrotising enterocolitis rx
complete gut rest (TPN)
Laparotomy if perf.
28
Commonest cause of acute abdo in children
appendicitis
29
intususseption age range
6-9months
30
pyloric stenosis age range
4-6 weeks
31
appendicitis age range
>5y
32
abdo pain following URTI/LRTI/gastroenteritis
mesenteric adenitis
33
Basis of asthma diagnosis
response to bronchodilator rx
34
Child over 5 asthma inhaler regime
SABA
+ICS
+LABA/LTRA
SABA + MART
35
Child under 5 inhaler regime
SABA
+ICS
+LTRA
(refer)
36
What is APGAR used for
the infant's condition after birth
37
Many cafe au lait spots and axillary freckling indicates
neurofibromatosis
38
port wine stain localised to trigeminal area could be
Sturge-Weber syndrome (underlying meningeal haemangioma and IC calcification - associated with fits)
39
How to differentiate between reflex anoxic seizures and epilepsy
no post ictal drowsiness
RAS is post minor injury
40
Are reflex anoxic seizures dangerous?
No
41
Murmur that is systolic, musical, does not radiate, varies with position
Innocent
42
7 Ss of a reassuring murmur
Sensitive (moves with positional changes)
Short duration
Single (no click, gallop or extra HS)
Small (doesn't radiate)
Sweet (not harsh)
Systolic (diastolic are typically bad)
43
Machinery murmur L subclavicular suggests
PDA
44
Harsh pan systolic murmur at lower left sternal edge with parasternal thrill
VSD
45
PResentation soon after birth with cyanosis/murmur
ToF
46
ToF XR finding
boot shaped heart
47
Treatment for PDA
prostaglandin inhin (ibuprofen)
48
shock and poor perfusion in first days of life with weak femoral pulses
Coarctation of the aorta (as the duct closes)
49
Severe cyanosis and acidosis after birth
Transposition of great arteries
50
Transposition of great arteries rx
Keep duct open with prostaglandin E2 and atrial septostomy to allow blood to mix until surgical switch
51
When is heel prick test done
5-9th day of life
52
When is jaundice pathological
first 24h and after 2 weeks
53
causes of jaundice in first 24h
Rhesus haemolytic disease
ABO haemolytic disease
Hereditary spherocytosis
G6PD
54
Partial seizures at night in children
Benign rolandic epilepsy
55
Referral points (3) for dev delay
No smiling at 10 weeks
Cannot sit unsupported at 12 months
Cannot walk at 18 months
56
CXR findings of transient tachypnoea of the newborn
hyperinflation, fluid in horizontal fissure
57
Teenage girl with anterior knee pain on stairs and getting out of a chair
Chondromalacia patellae
58
Sporty teen with pain, tenderness and swelling over tibial tubercle
osgood schlatter
59
Knee pain after exercise with intermittent swelling and locking in absence of trauma
osteochondritis dissecans
60
Medial knee pain and giving way
patellar subluxation
61
Chronic anterior knee pain in an athletic teenage boy that worsens after running, o/e tender below patella
patellar tendonitis
62
Soft, fluctuant swelling on head soon after birth that doesn't cross suture lines of skull
Cephalohaematoma
63
Cephalohaematoma mx
generally just observe
Don't aspirate
64
Soft, fluctuant swelling on head soon after birth that crosses suture lines of skull
Subgaleal haemorrhage
OR
Caput succedaneum if pitting
65
Rx for chlamydial opthalmia neonatorum
oral erythro or topical tetracycline
66
Rx for gonococcal opthalmia neonatorum
IV cephalosporin
67
How to differentiate between chlamydial, gonococcal and viral neonatal conjunctivitis
gonococcal more severe (lid swelling, copious discharge)
Viral may have subconj haemorrage and lymphadenopathy.
68
Definitive diagnosis for coeliac
jejunal biopsy - shows subtotal villous atrophy, intraepithelial lymphocytes and crypt hyperplasia
69
Toddler's diarrhoea can only be diagnosed if
the child is thriving
70
'Ribbon stools' indicates?
Hirschprungs
71
Treatment for mild impetigo
fuscidic acid cream
72
Treatment for more severe/bullous impetigo
PO fluclox/erythro
73
Most common cause of ambiguous genitalia
Congenital adrenal hyperplasia
74
90% congenital adrenal hyperplasia have what deficiency
21-hydroxylase
75
What would the general chemical/hormonal cause of small testes be
An adrenal cause
76
Cafe au lait spots, precocious puberty suggests
McCune Albright syndrome
77
Age of precocious puberty
<8 girls, <9 boys
78
Age of delayed puberty
13+ in girls
14+ in boys
79
Delayed puberty with no sense of smell
Kallman's
80
Delayed puberty and tall
What are the chromosones
Klinefelter 47XXY
81
Short, webbed neck, shield chest, primary amenorrhoea, short fourth metacarpals, high arched palate
Turner's Syndrome 45X
82
Most common metabolic disease
phenylketonuria
83
Thumb print sign on lateral neck XR
Epiglottitis
84
Main pathogen viral gastroenteritis
rotavirus
85
Management of GORD
Feed little and often
Thickener
Gaviscon
PPI/ranitidine
86
Wide set eyes, hooded eyelids, tubular nose, broad nose tip. small mouth
Di George syndrome
87
Cocktail party speech, blue eyes, sunken nasal bridge, small teeth (elfin)
William's syndrome
88
Ptosis, wide set eyes, webbed neck, sternal deformity, deeply grooved philtrum
Noonans
89
Long philtrum, monobrow, thin lips, low ears
Cornelia De Lange syndrome
90
White forelock, bright blue eyes, deafness
Waardenberg
91
large testicles,
Learning difficulty
Dev delay
High forehead,
hyperextendible joints
Fragile X
92
Central hypotonia that improves with age
Excessive appetite and weight gain
Sleep apnoea
Global dev delay
Prader-Willi
93
Prader Willi chromosome
15
94
Micrognathia, microcephaly, rocker bottom feet, overlapping fingers
Trisomy-18 (Edwards)
95
polydactyly
Scalp lesions
Midline facial defect
Neural tube defects
Microcephaly,
Rocker bottom feet
Trisomy 13- Pataus
96
Kawasaki disease rx
Igs and aspirin
97
Complication of kawasaki
coronary artery aneurysm
98
Inguinal hernia in children rx
elective surgery unless strangulated
99
Unconjugated hyperbilirubinaemia causes
haemolysis
sickle cell
spherocytosis
Premature (immature liver enzymes)
Infection
Bruising
Hypothyroid
Breast milk jaundice
100
Conjugated hyperbilirubinaemia causes
Hepatitis
CF
Cirrhosis
Biliary atresia
101
Complication of unconj bili being high
kernicterus (acute encephalopathy) can cause athetoid cerebral palsy and deafness
102
Hip pain following illness, refusal to wt bear but ok at rest. otherwise well, toddler
Transient synovitis
103
Painful swelling and restricted movement of large and small joints
Systemically ok, some mild anaemia
Morning stiffness
RF -ve, ANA +
Poly articular juvenile idiopathic arthritis
104
3yo girl with elbow (or knee or ankle) swelling and pain. Otherwise well. RF -ve, ANA +.
Pauci articular JIA
105
Complication of pauci articular JIA
chronic iridocyclitis
106
What is the other type of JIA
Still's disease (systemic)
107
JIA management
NSAIDs
Corticosteroids/immunesuppresants in severe
PT/OT
108
What types of white cells are seen in CSF in bacterial vs viral meningitis
polymorphs in bac
lymphocytes in viral
109
What does fibrin web indicate in CSF
TB
110
What is waterhouse friderichsen syndrome
Complication of meningococcal meningitis
coagulopathy --> haemorrhagic necrosis of the adrenals.
-DIC
-Acute adrenal failure
-Resp failure
111
genetics of duchennes
x linked recessive
112
What blood result would you find in duchennes
raised CK
113
Difference between duchennes and beckers
Beckers is rarer
Milder, later age and better prognosis
Also X linked recessive
114
What is anencephaly
type of spina bifida - cranial part of neural tube doesn't develop, infant dies soon after birth
115
What is myelomeningocele
type of spina bifida -
open lesion
SC covered by meninges
Severe weakness of lower limbs
bladder and anal denervation
Hydrocephalus
116
What is meningocele
type of spina bifida -
SC intact but sac of meninges exposed- risk rupture and meningitis
117
What is spina bifida occulta
type of spina bifida - vertebral bodies fail to fuse properly. Will have a sign on their lower back eg tuft of hair, pit, naevus.
118
What investigation is indicated in spina bifida occulta
spinal USS
119
What do cold agglutins in serum indicate
Mycoplasma pneumoniae (will get haemolytic anaemia)
120
CXR sign in respiratory distress syndrome of preterm infants
Ground glass appearance, air bronchograms
121
Mx resp distress syndrom
surfactant replacement via ETT
122
Way to avoid resp distress syndrom
maternal steroids 48h prior to delivery
123
'honey comb lung' and hyper expanded on cxr in pre term infant
bronchopulmonary dysplasia
124
HSP needs what follow up
renal
125
commonest cause of thrombocytopenia in children
ITP
126
ITP antibody
IgG
127
ITP normally follows what
viral infection
128
ITP mx
treatment not normally required, 6-8 week disease course
Ensure to differentiate from leukaemia/aplastic anaemia
If bleeding- pred PO but needs BM examination before this as could mask diagnosis of leukaemia.
IV anti D
IV IG
Avoid contact sports while plts low
129
Most common cause of AKI in children
HUS
130
HUS mx
generally supportive
131
Commonest type of childhood leukaemia
ALL
132
pancytopenia in child could be
Aplastic anaemia
133
Aplastic anaemia mx
immune suppressant
Stem cell transplant
134
what age does squint need referral
>5-6months
135
commonest type of thalassaemia
beta
136
does thalassaemia trait need treatment
no
137
beta thalassaemia features
Frontal bossing
Dental abnormalities
Severe haemolytic anaemia
Hepatosplenomegaly (increased production to compensate for no HbA being produced)
138
Beta thalassaemia mx
regular blood transfusions
139
80% nephrotic syndrome is due to
minimal change glomerulopephritis
140
Bilateral undescended testes could indicate
hypopituitarism
141
cryptorchidism mx
orchidopexy before 2 yrs
142
Double bubble sign on AXR
duodenal atresia
OR
volvulus
Both will have distended stomach and duodenumd
143
Eczema herpeticum mx
aciclovir systemic and urgent derm rv
144
umbilical hernia mx
usually self resolve by 3yrs
145
order of puberty in girls
boobs, pubes, grow, flow
146
Turners is associated with what heart issue
bicuspid valve
147
How long off school for mumps
5 days from the onset of swollen glands
148
Congenital rubella syndrome symptoms
sensorineural deafness, eye abnormalities and congenital heart disease
149
labial adhesions and recurrent utis
oestrogen cream
150
What category of babies require USS for DDH (regardless of ortolani etc)
All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery
151
Bow legs in a child < 3 is..?
a normal variant and usually resolves by the age of 4 years
152
Concave abdo at birth and dyspnoeic and tachypnoeic
congenital diaphragmatic hernia
153
Risk factors for SIDS
prone sleeping
parental smoking
bed sharing
hyperthermia and head covering
prematurity
154
William's syndrome murmur
aortic stenosis
