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paeds Flashcards

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1
Q

jaundice

A

first 24 hours pathological
1 day- 2 weeks normal
over 2 weeks conjugated- bilirubin test
unconjugated could be breast milk jaundice

treat unconjugated treat w phototherapy not UV

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2
Q

biliary atresia

A

bilious vomiting
pale stool and dark urine
check for sepsis
coombs test
US
liver biopsy definitive
treat w kasai surgery

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3
Q

kernicterus

A

bilirubin in brain
seizures
encephalopathy
poor feeding
lethargy

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4
Q

ckd

A

eGFR >90

polyuria
hyponatremia
hypokalaemia
congenital anomolies
glomerulonephitis
turners
downs
prune belly

gold standard sphygonometre

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5
Q

pertussis

A

whooping
vomit
catarhall phase- coryza and then 3-6 weeks coughing fits
bordetella pertussis
macrolides- clarithomycin, azithromycin, doxy

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6
Q

celft lip

A

pataus associated
congenital abnormalities
retracted jaw
alocholic mom, obese, lack of folic acid
surgery and lip taping

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7
Q

undescended testis

A

leave for a year
infertility risk
orchidopexy surgery to pull it down
3 types- true, retractile, ascending ectopic testes not on track
US

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8
Q

sepsis treated

A

under 18 yrs- ceftriaxone
under 28 days- IV benzpen and gen
listeria - amoxiccilin

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9
Q

meningitis and sepsis causes orgn under 1 month

A

Group B strep
E coli
Listeria

GEL

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10
Q

meningitis and sepsis causes after 1 month

A

SHN

strep pneumonai
haem inf type B
neisseria

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11
Q

meningitis treatment

A

IM BEN PEN
ceftiaxonr in hospital

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12
Q

meningitis presentation

A

bridinskis sign - reflexive flexion of the knees and hips following passive neck flexion
fever
rash non blanching
bacterial - increased protein decreased glucose
viral- increased protein low glucose high lymphocytes

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13
Q

patau

A

trisomy 13
cleft lip
-combined test 10-14 weeks
-high beta HCG
-low pepperoni PAPP-A
-high nucle translucency

less big gap than downs
small head, extra fingers and toes polydactyly, small chin

learning support and meds for whatever

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14
Q

parvovirus B 19

A

slapped cheek
death to babies
children fine

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15
Q

perthes

A

increased joint space
avascular necrosis
Observation and Conservative Management if <7 years: Hip movement and Analgesia
Restrict painful activities
Consider osteotomy in older children >7 years or <7 years with severe disease
stiff hip and decreased movement
crescent shaped femoral head
can predispose u to ostoarthritis
Herring Grade (Lateral Pillar Classification)
Head-at-risk signs (Stulberg)
The nearer the femoral head is to round, the better the prognosis (Stulberg)
waldenstrom stages

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16
Q

duodenal atresia

A

down syndrome
polyhydramnios causes
bilious vomiting
duodenalstotomy
double bubble sign

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17
Q

down syndrome

A

AVSD and VSD mostly
one palmar crease
trisomy 21
lower IQ smaller ears
duodenal atresia
hypotonia, hyperflexibility
hypothyroidism
early alzheimers
combined test at 10-14
if not then quadruple test at 16-20 weeks

diagnostic is amniocentesis (11-13 weeks)

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18
Q

patent ductus arterois

A

aorta and pulmonary
machine like crescendo decrescendo
echo
observation- closes within year 1
fluid restriction
indomethacin and ibuprofen
surgical ligation

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19
Q

neuroblastoma

A

under 5 years
cancer on adrenal cell
catecholamines on urine
small round blue cells on biopsy
urgently refer within 48 hours and surgery

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20
Q

bronchiolitis

A

under 1 years
no fever mild fever
supportive
Nasopharyngeal aspirate with PCR
RSV
Cough with crackles +/- wheeze
normally resolves within 2 weeks

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21
Q

henoch schlonlein

A

abdo pain
arthritis
palpable purpura
renal failure
biopsy shows IgA deposits
bloods
urinalysis

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22
Q

AVSD

A

systolic murmur
down syndrome
found 2-3 weeks
Signs of cardiac failure (poor feeding, faltering growth, breathlessness, vomiting, pulmonary oedema crackles)

ecg
ECHO gold standard

Manage cardiac failure with diuretics (e.g. Furosemide)
Surgical repair

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23
Q

orofacial granulomatosis

A

swollen lips
if diarrohea then check foecal calprotectin to check for crohns

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24
Q

tumour lysis electrolyte imbalance s

A

hyperkalaemia
hyperuricaemia
hyperphosphataemia
hypocalcaemia

Uand E
ECG
give fluids and allopurinol

never give potassium

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25
scalded skin
conjuctivis nikolsky- skin peels away supportive iv ceftriaxone
26
TGA
birth a smurf rigth to left prostaglandins to keep PDA open until 2-3 day then do surgery ech0
27
tracheitis
croup tht gets worse Airway control and stabilization with valve mask or intubation if required Pain and Fever Pus laden trachea Croup (Stridor, Hoarse voice, Barking cough) May be productive or unproductive cough Staph/Strep Infection Mild-Moderate: Oral Antibiotics (e.g. Co-amoxiclav/Augmentin) Severe: IV antibiotics (e.g. Ceftriaxone, Clindamycin)
28
asthma
under 5- ICS then SABA then LTRA then add ICS. over 5- ICS then SABA then add ICS then add LABA PEFR- 50-75 mod- non rebreath O2, ipatropium bromide, severe 33- 50 life threat- <33 near fatal PaCO2 increasing
29
angelman
widely spaced teeth water lovers happy loss of function of UBE3A 15q11-13 deletion
30
scarlet fevr
strawberry tongue sandpaper rash alert inflamed tonsilitis phenoxymethylpencillin V
31
inguinal hernia
under 1 referral urgent over 1 elective surgery superolateral to pubic tubercle can form hydrocele
32
uti
DMSA isotope scan for underlying dysplasia vesicoureteric reflux and recurrent uti MCUG scan lower UTI oral antibs dor 3 days upper- Iv for 7-10 days or systemically unwell but oral if well
33
status epilepticus
IV benzos if cant get access then buccal medazolam after that then try phenytoin
34
diarrhoea
secretory diarrhoea - toxin production. large. >6 osmotic- movement of water eg cows milk protein. allergy. fasting stops this but doesnt for secretory pH <5.5
35
ASD
upper left sternal edge ejection systolic left to right shunt can lead to eisenmengers Amplatzer/occlusion device insertion and transvenous cardiac catheter closure Patch closure with open heart surgery
36
cerberal palsy
GMFCS prematurity is most common TORCH causes head problems
37
toxoplasmosis infection for preg
baby gets- intracranial caclification hydrocephalis chorioretinitis
38
wilms tumour
kidney blue cell tumour abdominal mass pain haematuria uti anaemia hypertension US ct or MRI biopsy not recommended urgent referral within 48 hours nephrectomy often resolves hypertension
39
molluscum contagiosum
pearly papules with dimple in middle self limiting potassium hydroxide if concerned
40
tracheomalacia
recurrent croup so u can give antibiotics if bad CXR for tracheomalacia and laryngomalacia
41
cows milk protein allergy
first step trial of hydrolysed feed- neutramigen or aptamil pepT 1 biscuit things
42
when to induce labour
pH 7.21–7.24 OR lactate 4.2–4.8 mmol/L = BORDERLINE. Repeat FBS within 30 min or consider delivery pH ≤7.2 OR lactate ≥4.9 = ABNORMAL. Immediate delivery indicated
43
prader willi
insatiable chromosome 15 no leptin
44
hep b in pregnancy
tenofovir in 3rd trimester babies dox within 24 hrs deluvery
45
hiv in preg
<50 vag birth 50- 399 - consider c section > 400 same
46
ectopic
methotrexate dont get preg for another 3 months give anti D
47
induction of labour
membrane sweep. over 41 weeks if bishops <8 offer vaginal prostaglandins cook balloon amniotomy head must be engaged. >7 is favourable
48
jia
pauci type 1 positive ana. uveitis 2 HLAB27 ankylosing spondylitis 3 psoriatic arthritis poli 1 RF pos- systemic 2 RF neg- Systemic Onset Juvenile Idiopathic Arthritis (JIA) start early and disappear after 2-5 years. stills - salmon rash, fluctuating temperature
49
ANTEPARTUM HAEMORRHAGE
after 24 weeks Spotting: streaks of blood on underwear Minor haemorrhage: less than 50ml blood loss Major haemorrhage: 50 – 1000ml blood loss Massive haemorrhage: more than 1000 ml blood loss or signs of shock
50
what for preterm
tocolysis IM betamethasone- for lungs IM magnesium sulphate - for the heart
51
amenorrhea
primary secondary - absence of menses for ≥ 3 months in a previously menstruating woman
52
hand foot and mouth
Coxsackie B self limiting and emollients
53
gestational diabetes
induce labour at 38 weeks folic acid 5g not 400mg
54
gest hypertension
mild 140-149 mod 150-159 severe over 160 labetalol nifepidine if astham HELLP is complication
55
PPH
Primary Postpartum Haemorrhage (PPH) is blood loss of >500ml within 24 hours of delivery Severe Primary Postpartum Haemorrhage (PPH) is blood loss of >2000ml within 24 hours of delivery Secondary Postpartum Haemorrhage (PPH) is blood loss >500ml from 24hrs postpartum to 6 weeks
56
PCOS
Oligoamenorrhoea or amenorrhoea Hyperandrogenism (Clinical – Hirsutism and Acne or Biochemical – raised testosterone >2.5nmol/L) Polycystic ovaries (≥12 follicles) screen for diabetes lifestyle Combined hormonal contraception (to regulate menstruation) Spironolactone (may reduce acne and hirsutism) Eflornithine cream (given for hirsutism) mirena coil clomifene if want to be preg
57
treatment placenta praevia
If bleeding - Corticosteroids before 34 weeks if bleeding - Planned C-section between 34-36 weeks if bleeding - Emergency C-section may be required with premature labour or antenatal bleeding
58
sufe treatment
Treatment of Stable Slipped Upper Femoral Epiphysis (SUFE) Stable slips (i.e. able to bear weight) External in-situ pinning Treatment of Unstable Slipped Upper Femoral Epiphysis (SUFE) Severe unstable slips (i.e. unable to bear weight) Open reduction and internal pinning (high AVN risk)
59
endometrial cancer
transvag pipelle biopsy gold stand
60
oesophageal atresia
cant pass NG tube] choking cant eat frothing cgastric bubble surgical repair

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