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Paeds Flashcards

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1
Q

All live vaccines can be given at any time before and after each other except which?

A

Vaccination with yellow fever or varicella/zoster requires a 4 week minimum between giving MMR.

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2
Q

Normocytic normochromic anaemia + arthralgia + raised ESR + fine “salmon pink” rash

Dx and Rx

A

JIA

Rx: NSAIDs
Consider DMARD eg. methotrexate if severe

RF+ve associated with worse prognosis

NB. Rash distinguishes JIA from other causes

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3
Q

Definition of SGA births

A

Birth weight <10th centile for gestational age

50-70% physiological; 30-50% IUGR

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4
Q

Post-partum complications of SGA babies

A

Hypoglycaemia (low glycogen stores)
NEC (bowel hypoxia)
Polycythaemia + thrombocythaemia
Hypocalcaemia (delayed vD pathway development)

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5
Q

Maternal IUGR RFs

A

Substance abuse eg. smoking
Congenital infection
Maternal age >40

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6
Q

10 year old boy with marble like swellings in neck and armpit

A

Lymphoma
NON-Hodgkins most common

Usual px: painless lymphadenopathy
B symptoms if more severe

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7
Q

10 year old with visual impairment and brown patches on skin

A

Optic glioma as manifestation of NF1 (cafeaulait spots)

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8
Q

Most common paed malignancy

Px?

A

ALL 2-5yo

Rash, anaemia, infections, HSM, LNopathy

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9
Q

CF complications

A

DM
Recurrent chest infection
Infertility
NASAL POLYPS

(not CKD)

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10
Q

Initial Rx of acute apiglottitis

A

Neb adrenaline

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11
Q

Headache -> chest infection Sx

Dx and Rx

A

Mycoplasma pneumonia

PO Erythromycin

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12
Q

DiGeorge S features

A 
CATCH22
Cardiac anomalies
Abnormal facies
Thymic hypoplasia
Cleft palate
Hypocalcaemia + hypoPTH
c22 deletion

IE. poor immunity to infection
NB. also get cognitive/behavioural/psych problems

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13
Q

When can a child:

  1. copy a cross
  2. copy a circle
  3. copy a square
  4. copy a triangle
A
  1. 3 years
  2. 4 years
  3. 4.5 years
  4. 5 years
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14
Q

How old can tell their age?

A

3 years

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15
Q

How old can enjoy symbolic play?

A

18-24months

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16
Q

Laryngotracheobronchiolitis Rx

A

aka. Croup

Rx: oral dex

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17
Q

Age for febrile convulsions

A

6mo-3yo

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18
Q

HSP features and Rx

A

Colicky abdo pain + palpable pruritic rash + arthritis
+/- haematuria, proteinuria
Rx: NSAIDs, roids

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19
Q

Asian/AfroCarrib
dark blue lesion on back/buttocks
present from birth

Dx and prognosis

A

Mongolian blue spot/slate grey nevus

Slowly resolve over first few years

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20
Q

Itchy annular lesions with central clearing

A

Tinea

Ddx: annular psoriasis

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21
Q 
Immunodeficiency presdispositions:
NP defect?
T-cell defect?
B-cell defect?
Leukocyte defect?
Complement/MAC defect?
A

NP defect: recurrent abscess and fungals
T-cell defect: severe or atypical viral/fungal
B-cell defect: severe bacterial, but not Neisseria meningitidis
Leukocyte defect: poor wound healing, skin ulcers
Complement/MAC defect: Recurrent Meningococcal disease

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22
Q

EEG centrotemporal spikes

A

Benign rolandic epilepsy of childhood

most common cause of childhood seizures

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23
Q

Hearing loss, developmental delay, CT intracranial calcificaiton

A

Congenital CMV

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24
Q

Hearing loss and prog renal disease

A

Alport’s sydrome

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25
Hearing loss and goitre
Pendred syndryome (~hypothyroid)
26
What gestation at risk of RDS due to surfactant deficiency
<34/40
27
haematuria + resp infections at same time
IgA(t same time) nephropathy
28
6 week old with jaundice, umbilical hernia, dry skin
Hypothyroidism | often non-uk residents
29
First day new born jaundice. negative Coombs. Heinz bodies present
G6PD deficiency | Middle East/SE Asian/Mediterranean
30
Complications of cleft palate
``` Feeding Speech Hearing Ear infections Jaw development eg. displaced teeth (no ocular association) ```
31
Features of salicylate poisoning and sources
N+V lethargy Dizzy + tinnitus Severe: hyperventilation, deafness Sources: aspirin wintergreen oil eg. tiger balm, deep heat
32
Clumsiness Poor coordination Headache worse in morning
intracranial tumour
33
What is Reye's syndrome
Life-threatening complication of viral infection, associated with use of aspirin Fever, hypoglycaemia, hepatomegaly, deranged LFTs (no jaundice)
34
Imaging in UTI guidelines
<6mo + recurrent or atypical UTI = USS during infection <6mo and typical UTI = 6 week USS <3mo = refer to paeds urgently
35
Newborn ALS compressions:breath ratio
3:1
36
FTT Unwilling to breastfeed Became blue on bottle
Congenital cyanotic heart disease
37
Most common organism of pneumonia in >2yo
Strep pneumoniae
38
APGAR score description
0/1/2 Appearance: cyanotic/peripheral cyanosis/pink Pulse: 0/100/140 Grimace: No response/weak cry/cry Activity: Floppy/some flexion/well flexed and resisting extension RR: Apneic/slow irregular/strong cry
39
Paeds ALS - how to assess circulation?
Check brachial or femoral (not carotid) pulse for TEN seconds
40
Most common cause of NEWBORN intestinal obstruction
Hirschsprungs disease
41
3 days old, unable to feed, vomiting bile, "scaphoid abdomen"
Duodenal atresia - requires radiology to Dx
42
3 days old. Abdo mass, distension, passing meconium regularly, now blood PR Dx, usual age, late signs
Intussusception 6-18mo but can present earlier Bleeding per rectum: suggests mucosal necrosis "redcurrant jelly"
43
Sudden infant death: - Major RFs: - Other RFs:
Major RFs: - Parental smoking - Bed sharing - Sleeping prone - hyperthermia - prematurity Other RFs: - winter - multiple birth - male - maternal drug use - social class IV or V
44
Commonest cause of death in 1st year
SIDS ~3months NB. Screen all siblings for sepsis or inborn errors of metabolism
45
DDH RFs, Ix, Rx
RFs: - FH - Female - First born - Breech - Oligohydramnios - Birth weight <5kg Ix: urgent hip USS Rx: - Usually spontaneously resolve in 3-6 weeks - Pavlik harness if <5mo - Consider surgery if older
46
Labial adhesions: - age of presentation - Rx
3mo-3yo Rx: - usually spontaneously regress around puberty - if multi UTI, trial TOP Oes cream - if fails, consider surgical
47
Nocturnal enuresis: - age of presentation - Rx
Should achieve incontinence at 3-4yo ie. abnormal if 5+ Rx: - Look for possible cause eg. constipation, UTI, DM - Advise on diet and toileting behaviour (do not restrict fluids) - Trial reward system eg. star chart - If fails: • <7yo = enuresis alarm • >7yo = trial of oral desmopressin (esp. if need short term control)
48
Who is offered HPV Vaccine (Gardasil) and when?
All boys and girls aged 12-13yo | 2 doses
49
Kawasaki features + Rx
``` Fever >5 days Conjunctivitis Red, cracked lips Strawberry tongue Cervical LNopathy Red, peeling hands and soles ``` Rx: high dose aspirin, IVIg, Echo (to r/v coronary aneurysms)
50
Paediatric marks features
Strawberry naevus/capillary haemangioma: o Small red patch develops in first month and increasing in size until around 9 months o Rx: first line = propranolol Mongolian blue spots: blue spots on buttocks and lower back, resolve by 1yo Port wine stains: purplish/red macule with irregular contours – do not resolve ie. Cosmetics or laser therapy Stork mark/salmon patch: vascular birthmark, self resolves
51
Carrier rate in CF
1/25
52
Perthe's disease: - age of presentation - Rx
~4-8 yo Rx: - Keep femoral head in acetabulum ie. Cast, braces - <6yo = conservative, unless severe deformity - >6yo = surgical
53
Paediatric BLS:
Start with 5 rescue breaths -> Check for circulation -> 15:2 compressions
54
AR inheritance rule of thumb
Metabolic EXCEPT ataxias too
55
AD inheritance
Structural EXCEPT Gilbert’s, hyperlipidaemia type II
56
Responds to own name
9-12mo
57
Most common cardiac congenital abnormality in Downs Syndrome
AVSD
58
Presentation of HF in neonates
poor feeding/FTT hepatomegaly SOB
59
Paeds Px of hereditary spherocytosis
Jaundice, gall stones Hepatomegaly Splenomegaly Aplastic crisis
60
Vitamin supplementation in paeds, what ages? what replace?
Vit A, C, D from 6mo-5yo
61
Headbanging. When concern? What may it suggest?
Normal up to 2yo | >3yo ?autism
62
Which metabolic disease does neonatal blood spot not test for?
galactosaemia
63
First line pharm Rx for paeds constipation
Movicol
64
Indication for admission for NG feed
Child feeding <50%
65
Scarlet fever features
o Fever o Sore throat o Strawberry tongue o Rash: punctate/pinhead erythema on torso, spares palms and soles
66
Bowed legs in child should resolve when?
by 4yo
67
Risk of Downs Syndrome in pregancy depends on mother of age, how?
1/1000 at mother 30yo, divide by 3 for every 5 years
68
<3mo + >38 deg ?action
same day paeds assessment (do not Px Abx w/o source)
69
Coxsackie A16 ftrs
~hand, foot, mouth disease + mild systemic upset
70
Parvovirus B19
~Erythema infectiosum aka 5th disease aka slapped cheek syndrome + fever
71
Rubella ftrs
pink maculopapular rash on face then spreads + LNopathy
72
Child with squint ?action
Refer all children with squints to Ophthal | o UNLESS <3mo old
73
"mama/dada"
9-10/12
74
Overlapping bones and positional head moulding in newborn ?Action
Normal in newborn but document clearly for GP
75
Non-IgE mediated cows milk protein allergy ?Rx
initiate milk ladder with malted milk biscuits first
76
When should not have head lag?
~3mo
77
When crawl
8-10mo
78
Roseola infantum Px
Fever -> settles -> rash
79
Jaundice in first 24h DDx
Always pathological - ABO/Rh haemolysis - G6PD - Hereditary spherocytosis
80
Jaundice in first 2-14/7 DDx
Common and physiological | - investigate if persists
81
Prolonged jaundice DDx
``` o Biliary atresia o Hypothyroid o Galactosemia o UTI o Breast milk o Congenital infection ```
82
Sit without support, when able? when refer if not able?
7-8mo | 12mo
83
Noonan syndrome ftrs
``` o Pulmonary stenosis o Pectus excavatum o Ptosis o Short o Webbed neck ```
84
Pierre-Robin ftrs
o Cleft palate o Posterior displacement of tongue o Micrognathia
85
Recurrent sticky eye in neonates Dx and Rx
Congenital tear duct obstruction | Self resolves by 1yo ie. reassure
86
Tuberous sclerosis features
adenoma sebaceum | epilepsy
87
FGM and police
Refer all to police if <18yo | - does not apply for over 18s

Tomakesense 2 (18 decks)

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