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Flashcards in Paeds Deck (58):
1

Koplik's spots

Measles

2

Slapped cheeks

Fifth disease aka erythema infectiosum (Parvovirus B19)

3

Strawberry tongue

Scarlet fever + Kawasacki disease

Scarlet fever has an incubation period of 2-4 days and typically presents with:
fever
malaise
tonsillitis
'strawberry' tongue
rash - fine punctate erythema ('pinhead') which generally appears first on the torso and spares the face although children often have a flushed appearance with perioral pallor. The rash often has a rough 'sandpaper' texture. Desquamination occurs later in the course of the illness, particularly around the fingers and toes

Diagnostic features for Kawasaki disease requires a fever >5d with 4 of the following criteria: A) Conjunctival injection B) Mucous membrane changes (dry cracked lips, strawberry tongue) C) Cervical lymphadenopathy D) Polymorphous rash E) Red and oedematous palms/soles, peeling of fingers and toes.

4

Hypokalaemia, hypotension + alkalosis in a newborn

Bartter syndrome

Defect in the ascending limb of the loop of Henle

5

Most common cause of gastroenteritis in children

Rotavirus

6

1st line treatment for uncomplicated constipation

Movicol Paediatric Plain (Polyethylene glycol 3350 + electrolytes)


- If movicol is not tolerated switch to osmotic laxative

7

Most common cause of nephrotic syndrome in children

Minimal change disease

8

1st sign of puberty in

1. Boys

2. Girls

1. Testicular growth (around 12)

2. Breast development (then height spurt, then menarche)

9

Grey coating on tonsils + cervical lymphadenopathy in unvaccinated child

Diphtheria

10

Most common cause of croup

Parainfluenza

11

When is the Men B vaccine given? (All 3 dates)

2, 4, and 12-13 months

12

The only childhood congenital syndrome that presents with polydactyly (also with microcephaly, small eyes, clept lip)

Patau syndrome (3* 13)

13

Rocker bottom feet (+ low set ears and micrognathia)

Edwards (3* 18)

14

The only childhood congenital syndrome that presents with macrocephaly (+ macro-orchidism, learning difficulties, long face and large ears)

Fragile X

15

The only childhood congenital syndrome that presents with pectus excavatum (+ webbed neck, short stature + pulmonary stenosis)

Noonan Syndrome (aka the male Turners, however affects males and females equally)

16

The only childhood congenital syndrome that presents with posterior displacement of the tongue (+ micrognathia, cleft palate)

Pierre-Robin syndrome

17

The only childhood congenital syndrome that presents with friendly, extrovert personality (+ short stature, learning difficulties, transient neonatal hypercalcaemia, supravalvular aortic stenosis)

William's syndrome

18

IM benzylpenicillin doses for suspected meningococcal septicaemia in the community at age...

1. 300mg

2. 600mg

3. 1200mg

(always doubles)

19

1. 1st line investigation for complications of Kawasaki's

2. Management

1.Echocardiogram (due to possible coronary artery aneurysms)

2. High-dose aspirin (one of the very few indications for the use of aspirin in kids). + IV immunoglobulin

20

Definition of precocious puberty = 'development of secondary sexual characteristics before the age of '____'


1. Females

2. Males

1. 8 years

2. 9 years

21

What are the live attenuated vaccines? (3) + 2 less important ones

BCG
MMR
Oral polio

Yellow fever
Oral typhoid

22

Most common presentation of Wilms' nephroblastoma

Abdominal mass

Also painless haematuria, flank pain, anorexia + fever.

Management - Nephrectomy + chemotherapy

Prognosis - Good, 80% cure rate

23

Most common complication of Roseola infantum?

Febrile Convulsions

Roseola infantum (also known as exanthem subitum, occasionally sixth disease) is a common disease of infancy caused by the human herpes virus 6 (HHV6). It has an incubation period of 5-15 days and typically affects children aged 6 months to 2 years.

Features
high fever: lasting a few days, followed by a
maculopapular rash
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen

Other possible consequences of HHV6 infection
aseptic meningitis
hepatitis

24

A baby is born at 32 weeks gestation (i.e. 1 month early), what should happen regarding the normal first set of vaccines beginning at 2 months?

Give vaccines as per normal timetable (i.e. don't account for premature)

25

Most common cause of death in the first year of life?

SIDS

26

Most common cause of Bronchiolitis

RSV (also mycoplasma, adenovirus)

27

What are the 4 components of Tetralogy of Fallot?

(*TOF generally presents at 1-2 months)

ventricular septal defect (VSD)

right ventricular hypertrophy

right ventricular outflow tract obstruction, pulmonary stenosis

overriding aorta

28

Most common cause of hypertension in children

Renal parenchymal disease

(+ renal vascular disease,
coarctation of the aorta,
phaeochromocytoma,
congenital adrenal hyperplasia)

29

1st line management of minimal change glomerulonephritis?

Prednisolone

Good prognosis - full recovery however 80% will have recurrences

30

Acyanotic congenital heart disease causes (5)

VSD - most common!

ASD

PDA

Coartation of aorta

aortic valve stenosis

31

Cyanotic congenital heart disease causes (4)

Tetralogy of Fallot (most common)

Transposition of great arteries (TGA)

Tricuspid atresia

Pulmonary Valve Stenosis

32

What is the most appropriate way to confirm a diagnosis of pertussis?

Nasal swab

Management - oral course of erythromycin to reduce spread. However does not alter course of illness

33

What 5 criteria make up the APGAR score?

Pulse

Respiratory effort

Colour

Muscle tone

Reflex irritability

34

Treatment for threadworms

Hygiene measures + single dose mebendazole for all the family

35

1st line management for uncomplicated enuresis (bed wetting)

1. Below the age of 5

2. Below the age of 7

3. Above the age of 7

1. Reassure, bed wetting is common until age 5

2. Enuresis alarm

3. Desmopressin

36

What is the causative agent of roseola infantum

HHV6

37

When is the oral rotavirus vaccine given?

2 + 3 months

38

1st line management of absence seizures

Sodium valproate + ethosuximide

(Good prognosis, 95% become seizure free in adolescence)

SE of Sodium valproate: Weight gain + hair loss

39

Causative organism of hand, foot and mouth

Coxsackie A16 virus (occasionally enterovirus 71)

40

Investigation to confirm DDH if clinically suspected

Ultrasound

41

How long should a child with chickenpox be excluded from school?

Until 5 days after skin lesions have APPEARED

42

Treatment for HSP

Analgesia for arthralgia

Treatment of nephropathy is generally supportive. There is inconsistent evidence for the use of steroids and immunosuppressants

43

What is the investigation of choice to diagnose vesicoureteric reflux?

Micturating cystourethrogram

44

Most appropriate initial investigation for suspected coeliac disease

IgA TTG antibodies


Coeliac
HLA-DQ2 association

Diagnosis:
jejunal biopsy showing subtotal villous atrophy

anti-endomysial and anti-gliadin antibodies are useful screening tests


45

What birth weight = fetal macrosomia?

>4kg

46

Most common palsy due to shoulder dystocia?

Erb's palsy

47

Pink maculopapular rash, initially on face before spreading to the whole body

+ suboccipital and postauricular lymph nodes

Rubella

48

Causative organism for Scarlet fever

Group A haemolytic streptococci

49

What length of school exclusion is recommended for kids with head lice

None.

50

At what age should a child be referred if they are not walking?

18 months

51

'Jittery' newborn with absent philtrum + dysmorphic feathures

Fetal alcohol syndrome

52

saddle-shaped nose

Fetal alcohol syndrome

53

'Onion skin-like' appearance on X-ray

Ewing's sarcoma

54

Positive technetium-99m pertechnetate scan

Meckel's diverticulum

55

Anosmia + low LH / FSH / Testosterone in male adolescent

Kallman's Syndrome

Kallman's syndrome is a recognised cause of delayed puberty secondary to hypogonadotrophic hypogonadism. It is usually inherited as an X-linked recessive trait. Kallman's syndrome is thought to be caused by failure of GnRH-secreting neurons to migrate to the hypothalamus.

The clue given in many questions is lack of smell (anosmia) in a boy with delayed puberty

Features
'delayed puberty'
hypogonadism, cryptorchidism
anosmia
sex hormone levels are low
LH, FSH levels are inappropriately low/normal
patients are typically of normal or above average height

Cleft lip/palate and visual/hearing defects are also seen in some patients

56

1st test to perform on a child who presents with jaundice after 14 days

Split Bilirubin. Need to rule out biliary atresia

57

Management of UTI in...

1. 3 months

1. Admit and treat with IV antibiotics

2. 3 day course of oral antibiotics (usually trimethoprim)

58

Cyanotic heart defect with no murmur

Transposition of the great vessels