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Year 5 😊✌🏼 > Paeds 6 > Flashcards

Paeds 6 Flashcards

1
Q

What organism causes head lice?

A

pediculus capitis (obligate ectoparasite)

small insects that live only on humans and feed our blood

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2
Q

diagnosis of pediculosis capitis / head lice

A

fine toothed combing of wet or dry hair

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3
Q

What is the blood glucose cut-off when you should send to NICU and treat neonatal hypoglycaemia?

A

<1.5 mmol/L

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4
Q

What is the medical management of neonatal hypoglycaemia?

A

IV 10% dextrose 2ml/kg bolus

then infusion of 3.6 ml/kg/hr of 10% glucose

-> frequently check blood glucose until stable (aim 3-4 mmol/L)

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5
Q

What medication can be given to manage Mg sulfate induced respiratory depression?

A

calcium gluconate

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6
Q

Which of the following drugs should NOT be used in breastfeeding women?
1. aminophylline
2. carbamazepine
3. Sodium valproate
4. methyldopa
5. amiodarone

A
  1. Amiodarone (antiarrythmic)
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7
Q

What is the commonest heart defect in patientsb with down syndrome?

A

AVSD

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8
Q

How common are congenital heart defects in patients with down syndrome?

A

50% of pts have them

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9
Q

What does MCUG stand for?

A

micturating cystourethrogram

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10
Q

Mx of UTI in children

A

<3 months: admit, sepsis 6, give IV abx e.g. ampicillin or gentamycin or cefotaxime

3m - 15y: lower UTI give PO abx (trimethoprim, nitrofurantoin (if eGFR >/= 45ml/min); if upper UTI consider paeds referral and cephalexin/co-amoxiclav

if recurrent refer to paediatric specialist for USS, MCUG, DMSA

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11
Q

Medical management of migraines in children and adolescents

A
  1. simple analgesia
  2. nasal sumatriptan (oral triptans are not licensed in people under 16)
  3. combination therapy with nasal triptan and NSAID/Paracetamol; consider adding an anti-emetic, e.g. metoclopramide or chlorpromazine

F/U in 1 month or sooner if sx worsen

specialists can prescribe prophylactic treatment:
- topiramate (nb high risk of foetal malformations) or propranolol

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12
Q

What medication for bacterial tonsillitis in children

A

phenoxymethylpenicillin for 5-10 days

clarithromycin if penicillin allergy (macrolide, works by inhibiting 50s subunit in protein synthesis)

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13
Q

What centor / feverpain scores would prompt abx ?

A

FeverPAIN 4 or 5
CENTOR 3 or 4

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14
Q

What are the features seen in prader willi syndrome?

A

hyperphagia
obesity
muscular hypotonia
short stature
scoliosis
almond shaped eyes
thin upper lup
developmental delay
behavioural problems (e.g. temper tantrums, stubbornness)

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15
Q

Underlying pathology in Prader-Willi Syndrome?

A

genetic syndrome caused by a microdeletion at 15q11-q13 in combination with genomic imprinting

in PW-syndrome there is deletion or mutation of the paternal copy and the maternal gene is methylated (silenced)

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16
Q

What are the features of angelman syndrome?

A

delayed mental development and acquisition of motor skills
intellectual disability
microcephaly
in >80% there are pronounced epileptic seizures
ataxia
fascination with water
hyperexcitability, short attention span

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17
Q

When should children be able to draw a circle?

A

3 yo

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18
Q

When should children be able to draw a vertical and horizontal line?

A

veritcal: 2 yo
horizontal: 2.5 yo

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19
Q

When should children be able to draw a square and a triangle, person and cross?

A

cross: 4 yo

square: 4.5 yo

triangle/person: 5 yo

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20
Q

What is the first line chemotherapy option given in ovarian cancer?

A

combination of platinum compound and paclitaxel

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21
Q

What is the first line chemotherapy option given in ovarian cancer?

A

combination of platinum compound and paclitaxel

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22
Q

What are the chemotherpy cycles used in Ovarian cancer?

A

outpatient

3 weeks apart for 6 cycles

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23
Q

Follow up investigations in ovarian cancer

A

CT scan following completion of chemotherapy to review the response

clinical examination
Ca-125 (tends to rise before the onset of clinical signs of disease recurrence)

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24
Q

What is the management in recurrence of ovarian cancer?

A

mainly palliative

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25
RFs for Ov Ca
age FH obesity HRT endometriosis smoking diabetes
26
what are protective factors for ovarian cancer?
COCP pregnancy breastfeeding hysterectomy
27
What is the management of stage 1 ov ca?
total hysterectomy with bilateral salpingo-oophrectomy +/- chemo if fertility needs to be preserved, only one ovary may be removed (only 1a)
28
What is the management of stage 2 ov ca?
debulking surgery to remove as much as possible adjuvant or neo-adjuvant chemotherapy
29
What is the management of stage 3 ov ca?
debulking surgery to remove as much as possible adjuvant or neo-adjuvant chemotherapy + targeted treatment bevacizumab (targets VEGF A) if surgery not an option, platinum based chemo can be given as well as symptomatic treatment e.g. ascitic drain, mx of constipation
30
What is the management of stage 4 ov ca?
like stage 3 but palliative care is more likely
31
What are the components of the RMI for ovarian cancer?
Ca 125 (units/ml) findings on TVUSS (0,1,2 depending if 0, 1 or 2+ features seen ) menopausal status (1 pre; 2 post) RMI = U x M x Ca125 -> if >250 refer to gynae
32
what is the cut off for RMI to refer to gynae? How is RMI calculated?
if >250 refer to gynae RMI = U x M x Ca125
33
how does platinum based chemotherapy work?
causes cross-linkage of DNA strands leading to cell cycle arrest
34
Which platinum based chemotherapy agent is mainly used in ov ca and why?
carboplatin it is less nephrotoxic than e.g. cisplatin and causes less nausea dose of carboplatin is calculated using the GFR
35
How does Paclitaxel work?
causes microtubular damage prevents replication and cell division steroids can be given to reduce hypersensitivity reactions and reduce side effects causes total loss of body hair
36
what medication is used to treat threadworms?
mebendazole everyone in the household should be treated.
37
At what age does biliary atresia present?
a few weeks
38
blood findings in biliary artresia
Conjugated hyperbilirubinemia ↑ Aminotransferases and alkaline phosphatase ↑ GGT
39
What is the procedure called that is used to correct biliary artresia?
Kasai hepatoportoenterostomy -> involves ligating the fibrous ducts above the join with the duodenum, dissecting proximally to the portal hepatis (from which the bile usually flows from the liver), facilitating bile duct drainage
40
Complications of HSP
GI - intussusception - bowel ischaemia/perforation Renal - progressive kidney involvement (e.g. nephrotic syndrome) - CKD
41
What is the minimal acceptable level of observation in psychiatric inpatients?
every 60 minutes (Level 1)_
42
What is the minimal acceptable level of observation in psychiatric inpatients?
every 60 minutes (Level 1)
43
What are the different levels of observation in psychiatry?
Level 1 - General observation observation every 60 minutes (minimum required) Level 2 - intermittent observation every 15-30 minutes Level 3 - 1-2-1 within eyesight Level 4 - 1-2-1 observation within arms reach. sometimes may need more than 1 person, people on Level 4 observation cannot go to the bathroom alone.
44
What is the first line antibiotic used in PPROM?
1. erythromycin 250 mg QDS for a max of 10d or until in established labour 2. line: oral penicillin
45
What is the risk of giving steroids in premature labour?
increased risk of learning difficulties some research showing that there may be issues with wellbeing later on in life.
46
what supplement should be prescribed in hyperemesis gravidarum?
thiamine (vitamin B1)
47
What chronic infectious conditions are women screened for in early pregnancy?
HIV Hep B Syphilis
48
A woman in her 1st pregnancy develops an itchy rash on her abdomen that spares the umbilical area - dx?
polymorphic eruption of pregnancy a benign, inflammatory condition that most commonly affects primiparous women in the 3rd TM or immediately PP. the lesions last for 4-6 weeks and then resolve spontaneously. lesions spare the face, palms and soles.
49
What site is most commonly affected by cephalohaematoma?
parietal bone (does not cross suture lines)
50
what is a cephalohaematoma?
swelling on newborns head typically develops hours after birth is due to bleeding between the periosteum and the skull
51
What is a possible complication of cephaloheamatoma?
jaundice
52
in what timeframe to cephalohaematoma and caput succedaneum develop?
cephalohaematoma: a few hours after delivery caput succedaneum: generally present at birth
53
where is caput succedaneum generally found?
over the vertex crosses suture lines
54
in what timeframe cephalohaematoma and caput succedaneum resolve?
cephalohematoma: can take up to 3 months caput succedaneum: resolves within days
55
What enzyme should be measured in children with ?muscular dytrophy?
creatine kinase (elevated in 50% cases) but also elevated in 50% female carriers
56
minimum duration to diagnose schizophrenia
1 month of sx
57
What is pemphigoid gestationis
a rare skin blistering condition associated with pregnancy usually presents in mid to late pregnancy (13-40w) with an itchy rash that develops into blisters
58
What skin areas does pemphigoid gestationis affect?
commonly starts in the periumbilical region during the 2nd/3rd TM pruritic, mostly non-blistering lesions grouped vesicles with herpetiform appearance
59
Management of pemphigoid gestationis
usually self-limiting heals spontaneously after delivery
60
what complications is pemphigoid gestationis associated with?
premature labour increased lifetime risk of autoimmune disease
61
What is the chance of developing T2DM in women who had GDM?
30% in 5 years 70% in 10 years -> according to Chat GPT
62
How long after LLETZ for CIN 1/2 should you have a smear?
6 months (wait for discussion with girls before being sur ere this Q)
63
When following a sensitising event should you give anti-D?
within 72h
64
What are the cut-offs for iron supplementation in pregnancy?
<110 g/L in the 1st TM <105 g/L in the 2nd/3rd TM <100 g/L PP
65
How does iron supplementation in pregnancy work?
100-200 mg oral iron (ferrous sulphate) re-chech Hb in 2-3 weeks once hb is normal, continue oral iron for 3 months or 6 weeks PP give dietary advice (e.g. leafy greens, nuts, beans, seeds)
66
Intrapartum advice for pregnant women with anaemia
- give birth on LW - have a cannula - G&S on arrival - active management of the 3rd stage of labour - consider prophylactic syntocinon infusion in the 3rd stage of labour (to prevent PPH) active mx of PPH if occurs
67
Do you need scan confirmation for management of ?VTE in pregnancy
no you should start LMWH management immediately (unless it is contraindicated)
68
What location would prompt a GP to refer someone with molloscum contagiosum onwards
eye or eyelids
69
What virus causes molloscum contagiosum?
molloscum contagiosum virus
70
What is the scoring system used for croup?
Westley Croup Score
71
What are the best opioid replacements to use in pregnancy?
methadone or buprenorphine (double check this)

Year 5 😊✌🏼 (53 decks)

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