Paeds Flashcards
(63 cards)
At what age should a child fix and follow?
Fix & follow at 4-6 weeks
At what age should a child have head control?
Head control at 10-12 weeks
At what age should a child be able to sit unsupported?
Sitting at 6 months
At what age should a child be able to use a pincer grip or finger feed?
Pincer grip and finger feed at 9-10 months
At what age should a child be able to pull to stand/cruise?
Pull to stand/cruise at 11 months
What are the 4 fields of development?
1) Gross Motor
2) Fine motor and vision
3) Language and hearing
4) Social and play
4 year old boy, who has developed muscle weakness which now means he is unable to walk. He has been slow to reach his developmental milestones and has mild cognitive impairment. He has scoliosis. He has a positive Gower’s sign.
a) What disease is the dx?
b) What type of inheritance is it?
c) What blood test would you expect to be very high?
4 year old boy, who has developed muscle weakness which now means he is unable to walk. He has been slow to reach his developmental milestones and has mild cognitive impairment. He has scoliosis. He has a positive Gower’s sign.
a) Duchennes muscular dystrophy
b) X linked recessive
c) Creatine kinase would begin in the 1000’s/10,000
What are the primitive reflexes and when do they go?
Primitive reflexes: Stepping 6wks Palmer/plantar grasp 3m Moro's 4ms Fencing - asymmetric tonic neck reflex 6m Sucking and rooting 6m Parachute 9m
What are the two tests for the hips in a new born examination?
Barlows - aDDucts hip with posterior force to promote disslocation (knees in pushing into bed)
Ortolani’s - aBDucts hip with anterior force to reduce the hip joint (knees out and pushing forwards from behind)
What are the main things not to forget in a new born examination?
Eyes (red reflex - cataracts?)
Heart
Hips (developmental dysplasia of the hips - barrows and ortolani’s)
Anus - is there a hole?
If developmental dysplasia of the hip is suspected in a 5 wk old, what Ix would you order?
USS - proximal femoral epiphysis hasn’t ossified yet so US provides enough information
What are the complications if hip dysplasia is not treated?
Limp, hip pain and OA when older
A 3 wk old, ex prem - born at 28wks presents with blood PR and brining up bile/blood in his NG tube. O/E he has abdo distension and has abdomen is has a shiny red appearance.
a) Dx
b) Appearance on AXR?
A 2 wk old, ex prem - born at 28wks presents with blood PR and brining up bile/blood in his NG tube. O/E he has abdo distension and has abdomen is has a shiny red appearance.
a) Necrotising enterocolitis - damage to gut wall, causing inflammation and oedema - air enters the gut wall with risk of perforation
b) Appearance on AXR? air in wall of intestine and portal hepatic gas, dilated loops and thickened bowel wall
Who is at risk of getting NEC (necrotising enterocolitis)
Risks of NEC?
Born at <32 weeks
Babies that are unwell or were unwell/poor growth in the womb
Not being breast fed
Give examples of congenital infections
Rubella (hearing impairment and cataracts)
CMV (neurodevelopment)
Toxoplasmosis (undercooked meats and cat poo - retinopathy, cerebral calcification, hydrocephalus and LT neurological disabilities)
Syphilis (rash on soles and palms - give penicillin to infants)
Varicella Zoster
A mum received morphine during delivery - what medication do you give and why?
Naloxone to prevent respiratory distress
Until what age do you account for prematurity on Growth Charts?
<18m
What abs do you test for with coeliac’s?
Tissue tranglutaminase
Anti endomysial
What are the risks of non-compliance to a gluten free diet in a patient with coeliac’s disease?
Cancer 3.5x GI cancer 8x Small bowel lymphoma 25x Male infertility osteopenia
What is the fluid calculation to correct for dehydration?
% dehydration X 10 X wt in kg
How do you calculate maintenance fluids?
What fluid do you use for maintenance?
100 mls/kg/day = 1st 10
50 mls/kg/day = 2nd 10 (11-20 kg)
20 mls/kg/day = everything after
0.45% saline and 5% dextrose
What are the causes of hypothyroidism:
a) world wide
b) UK
What are the causes of hypothyroidism:
a) world wide = iodine deficiency
b) UK= maldescent of the thyroid and athyroisis (linguine mass/unilobular small gland O/E
When and how is newborn screening done?
5-6 days post birth
Blotting sheet - heel prick test
What is screened for on the new born screening test?
1) Sickle cell disease
2) CF
3) Congenital hypothyroidism
4) PKU Phenylketonuria
5) MCADD
6) Maple syrup urine disease
7) Isovaleria acidaemia
8) Glutaria aciduria
9) Homocystinuria