Paeds Flashcards
(55 cards)
What is a viral wheeze?
Whistling expiratory sound triggered by viral infections - viral infection leads to inflammation and narrowing of the small airways leading to obstruction and wheeze
How is mild viral wheeze managed?
Supportive only
How is moderate to severe viral wheeze treated?
If required a salbutamol inhaler
Oral Prednisolone may be required
How does viral wheeze differ to asthma?
Viral - episodic wheeze whereas asthma wheeze is variable and persistent
Viral - family Hx often absent, asthma Fhx common
Viral - variable response to salbutamol/steroiod, asthma has good response consistently
How does viral wheeze differ to bronchioloitis or pneumonia?
Viral - fever not too common, bronchiolitis/pneumonia often accompanied by fever
Viral - just wheeze on auscultation, pneumonia has crackles and reduced air entry
Viral - feeding maybe normal, pneumonia often has reduced feeding in infants
How can viral wheeze be differentiated between an inhaled foreign body?
Viral - gradual onset, foreign body is sudden onset after choking
Viral - bilateral wheeze, inhaled foreign body has unilateral wheeze or reduced air entry
Viral - fever maybe present, foreign body often wont have fever
What is Osgood-Schlatters disease?
Apophysitis of the tibial tuberosity in adolescence caused by repetitive strain of the patella tendon at its insertion point on the apophysisis of the tibial tuberosity causing ANTERIOR KNEE PAIN. Often feel enlargement of the tibial tuberosity
What are the risk factors for Osgood-Schlatters disease?
High impact sports
Running
Jumping
Kneeling
Squatting
What is the management of Osgood-Schlatters disease?
Reduced activity until patient is able to bare low impact activities (stretching quads and hamstrings)
NSAIDs (ibuprofen) + Ice the area up to 3 times a day
How can Osgood-Schlatters be differentiated from an MSK injury?
MSK - acute onset following trauma, knee effusion?
How can Osgood-Schlatters by differentiated from SUFE?
SUFE (Slipped Upper Femoral Epiphysis) is a pathology of the hip so will bare a normal knee examination
SUFE - trendelenburg +ve , shortened and exxternally rotated lower limb, Drehmanns +ve
What is Drehmanns sign?
When the hip is flexed it involuntarily externally rotates
How is Osgood-Schlatters differentiated from Perthes disease?
Perthes - leg length discrepancy, trendelenburg +ve, internal rotation + hip abduction worsens the pain
What is toddlers diarrhoea?
A self limiting condition caused by non-bloody diarrhoea in otherwise healthy toddlers
What causes toddlers diarrhoea?
Immature gut motility
Excess fluid
How is toddlers diarrhoea managed?
Reassurance and parental education
Avoid excess fruit juice or sugary drinks
Sufficient fat and fibres
What are some important differentials to consider before diagnosing toddlers diarrhoea?
Infection
IBD
Coeliac
Dietary insufficiency
How does toddlers diarrhoea differ to a dietary intolerance?
Toddlers diarrhoea tends to be daytime whereas dietary intolerance is worse after the offending food
Dietary - bloating, flatulence and discomfort (toddlers does not), growth. May be impaired with chronic dietary intolerance , growth normal with toddlers diarrhoea
How can toddlers diarrhoea differ to gastrointestinal infection?
Infection - sudden onset, may have bloody or mucousy stool, fever or vomiting
Toddlers diarrhoea - chronic, normal stool colour no blood or mucous, no systemic symptoms, growth normal
How can toddlers diarrhoea differ to coeliac disease?
Coeliac - weight loss and stunted growth, pale and offensive stools, abdominal symtpoms like bloating and distension, often a Fhx
Toddlers diarrhoea - normal growth, no abdominal symptoms, no Fhx necessary
How does IBD differ to toddlers diarrhoea?
IBD - stunted growth, weight loss, anaemia, bloody mucous stool, tender abdomen, Perianal disease
Toddlers diarrhoea - normal growth, no systemic signs, no abdominal tenderness
What are threadworms?
Intestinal parasitic infectiont caused by Enterobius vermicularis (fecal oral transmission)
Leads to very intense Perianal itching, girls can cause vulval irritation
What is the management for threadworms?
Mebendazole
Treat all household members
Strict hygiene measures - daily morning baths, wash bedding, towels and toys, cut finger nails
