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spin the wheel notes > paeds > Flashcards

paeds Flashcards

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
Q

scalded skin

A

conjuctivis
nikolsky- skin peels away
supportive
iv ceftriaxone

26
Q

TGA

A

birth a smurf
rigth to left
prostaglandins to keep PDA open
until 2-3 day then do surgery
ech0

27
Q

tracheitis

A

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
Q

asthma

A

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
Q

angelman

A

widely spaced teeth
water lovers
happy
loss of function of UBE3A
15q11-13 deletion

30
Q

scarlet fevr

A

strawberry tongue
sandpaper rash
alert
inflamed tonsilitis
phenoxymethylpencillin V

31
Q

inguinal hernia

A

under 1 referral urgent
over 1 elective surgery
superolateral to pubic tubercle
can form hydrocele

32
Q

uti

A

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
Q

status epilepticus

A

IV benzos
if cant get access then
buccal medazolam
after that then try phenytoin

34
Q

diarrhoea

A

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
Q

ASD

A

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
Q

cerberal palsy

A

GMFCS
prematurity is most common
TORCH causes
head problems

37
Q

toxoplasmosis infection for preg

A

baby gets-
intracranial caclification
hydrocephalis
chorioretinitis

38
Q

wilms tumour

A

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
Q

molluscum contagiosum

A

pearly papules with dimple in middle
self limiting
potassium hydroxide if concerned

40
Q

tracheomalacia

A

recurrent croup
so u can give antibiotics if bad
CXR for tracheomalacia and laryngomalacia

41
Q

cows milk protein allergy

A

first step trial of hydrolysed feed- neutramigen or aptamil pepT 1
biscuit things

42
Q

when to induce labour

A

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
Q

prader willi

A

insatiable
chromosome 15
no leptin

44
Q

hep b in pregnancy

A

tenofovir in 3rd trimester
babies dox within 24 hrs deluvery

45
Q

hiv in preg

A

<50 vag birth
50- 399 - consider c section
> 400 same

46
Q

ectopic

A

methotrexate
dont get preg for another 3 months
give anti D

47
Q

induction of labour

A

membrane sweep. over 41 weeks
if bishops <8 offer vaginal prostaglandins
cook balloon
amniotomy head must be engaged. >7 is favourable

48
Q

jia

A

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
Q

ANTEPARTUM HAEMORRHAGE

A

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
Q

what for preterm

A

tocolysis

IM betamethasone- for lungs
IM magnesium sulphate - for the heart

51
Q

amenorrhea

A

primary
secondary - absence of menses for ≥ 3 months in a previously menstruating woman

52
Q

hand foot and mouth

A

Coxsackie B
self limiting and emollients

53
Q

gestational diabetes

A

induce labour at 38 weeks
folic acid 5g not 400mg

54
Q

gest hypertension

A

mild 140-149
mod 150-159
severe over 160
labetalol
nifepidine if astham
HELLP is complication

55
Q

PPH

A

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
Q

PCOS

A

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
Q

treatment placenta praevia

A

If bleeding
- Corticosteroids before 34 weeks if bleeding
- Planned C-section between 34-36 weeks if bleeding
- Emergency C-section may be required withpremature labourorantenatal bleeding

58
Q

sufe treatment

A

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
Q

endometrial cancer

A

transvag
pipelle biopsy gold stand

60
Q

oesophageal atresia

A

cant pass NG tube]
choking
cant eat
frothing
cgastric bubble
surgical repair

spin the wheel notes (4 decks)

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