Flashcards in Paeds Deck (58):
Fifth disease aka erythema infectiosum (Parvovirus B19)
Scarlet fever + Kawasacki disease
Scarlet fever has an incubation period of 2-4 days and typically presents with:
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.
Hypokalaemia, hypotension + alkalosis in a newborn
Defect in the ascending limb of the loop of Henle
Most common cause of gastroenteritis in children
1st line treatment for uncomplicated constipation
Movicol Paediatric Plain (Polyethylene glycol 3350 + electrolytes)
- If movicol is not tolerated switch to osmotic laxative
Most common cause of nephrotic syndrome in children
Minimal change disease
1st sign of puberty in
1. Testicular growth (around 12)
2. Breast development (then height spurt, then menarche)
Grey coating on tonsils + cervical lymphadenopathy in unvaccinated child
Most common cause of croup
When is the Men B vaccine given? (All 3 dates)
2, 4, and 12-13 months
The only childhood congenital syndrome that presents with polydactyly (also with microcephaly, small eyes, clept lip)
Patau syndrome (3* 13)
Rocker bottom feet (+ low set ears and micrognathia)
Edwards (3* 18)
The only childhood congenital syndrome that presents with macrocephaly (+ macro-orchidism, learning difficulties, long face and large ears)
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)
The only childhood congenital syndrome that presents with posterior displacement of the tongue (+ micrognathia, cleft palate)
The only childhood congenital syndrome that presents with friendly, extrovert personality (+ short stature, learning difficulties, transient neonatal hypercalcaemia, supravalvular aortic stenosis)
IM benzylpenicillin doses for suspected meningococcal septicaemia in the community at age...
1. 1st line investigation for complications of Kawasaki's
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
Definition of precocious puberty = 'development of secondary sexual characteristics before the age of '____'
1. 8 years
2. 9 years
What are the live attenuated vaccines? (3) + 2 less important ones
Most common presentation of Wilms' nephroblastoma
Also painless haematuria, flank pain, anorexia + fever.
Management - Nephrectomy + chemotherapy
Prognosis - Good, 80% cure rate
Most common complication of Roseola infantum?
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.
high fever: lasting a few days, followed by a
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen
Other possible consequences of HHV6 infection
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)
Most common cause of death in the first year of life?
Most common cause of Bronchiolitis
RSV (also mycoplasma, adenovirus)
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
Most common cause of hypertension in children
Renal parenchymal disease
(+ renal vascular disease,
coarctation of the aorta,
congenital adrenal hyperplasia)
1st line management of minimal change glomerulonephritis?
Good prognosis - full recovery however 80% will have recurrences
Acyanotic congenital heart disease causes (5)
VSD - most common!
Coartation of aorta
aortic valve stenosis
Cyanotic congenital heart disease causes (4)
Tetralogy of Fallot (most common)
Transposition of great arteries (TGA)
Pulmonary Valve Stenosis
What is the most appropriate way to confirm a diagnosis of pertussis?
Management - oral course of erythromycin to reduce spread. However does not alter course of illness
What 5 criteria make up the APGAR score?
Treatment for threadworms
Hygiene measures + single dose mebendazole for all the family
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
What is the causative agent of roseola infantum
When is the oral rotavirus vaccine given?
2 + 3 months
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
Causative organism of hand, foot and mouth
Coxsackie A16 virus (occasionally enterovirus 71)
Investigation to confirm DDH if clinically suspected
How long should a child with chickenpox be excluded from school?
Until 5 days after skin lesions have APPEARED
Treatment for HSP
Analgesia for arthralgia
Treatment of nephropathy is generally supportive. There is inconsistent evidence for the use of steroids and immunosuppressants
What is the investigation of choice to diagnose vesicoureteric reflux?
Most appropriate initial investigation for suspected coeliac disease
IgA TTG antibodies
jejunal biopsy showing subtotal villous atrophy
anti-endomysial and anti-gliadin antibodies are useful screening tests
What birth weight = fetal macrosomia?
Most common palsy due to shoulder dystocia?
Pink maculopapular rash, initially on face before spreading to the whole body
+ suboccipital and postauricular lymph nodes
Causative organism for Scarlet fever
Group A haemolytic streptococci
What length of school exclusion is recommended for kids with head lice
At what age should a child be referred if they are not walking?
'Jittery' newborn with absent philtrum + dysmorphic feathures
Fetal alcohol syndrome
Fetal alcohol syndrome
'Onion skin-like' appearance on X-ray
Positive technetium-99m pertechnetate scan
Anosmia + low LH / FSH / Testosterone in male adolescent
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
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
1st test to perform on a child who presents with jaundice after 14 days
Split Bilirubin. Need to rule out biliary atresia
Management of UTI in...
1. 3 months
1. Admit and treat with IV antibiotics
2. 3 day course of oral antibiotics (usually trimethoprim)