Paeds Flashcards
(149 cards)
1
Q
Trisomy 21 Cardiac - VSD, AVSD, ToF Endocrine - HypoThy, Addisons, T1DM Ocular - cataracts Malignancy - Leukaemia GI -duodenal atresia, Hirschprungs Musk - Atlanto-axial instability Neuro - Alzheimers
A
Down’s (complications)
2
Q
Genetic imprinting - Loss of some of paternal chromosome 15
Px -Hypotonia, hypogonadism, obesity
A
Prader-Willi
3
Q
X linked.
Px - Long face, big ears, macroorchidism, LD’s
A
Fragile x
4
Q
CATCH 22 Cardiac Abnormal facies Thymic aplasia Cleft lip HypoCa
A
DiGeorge
5
Q
Ax - Trisomy 13
Px - Microcephalic, small eyes, cleft lip/palate, polydactyly, scalp lesions (progression of features?)
A
Patau’s
6
Q
Ax - Trisomy 18
Px - Micrognathia (overbite)/small chin, low ears, rocker bottom feet, overlapping of fingers
A
Edwards
7
Q
Ax - Def in galactose-1-phosphate uridyl transferase
Px - Illness with lactose containg milks. Vomiting, cataracts and recurrent E.coli infx
A
Galactosaemia
8
Q
Ax - Autosomal dominant
Px - Tall, arm span>Ht, Long thin fingers, scoliosis, pectus excavatum.
A
Marfan’s
9
Q
Ax - Autosomal recessive. Def phenylalinine hydroxylase
Ix - newborn bld spot screening
A
Phenylketonuria
10
Q
Ax - Dystrophin gene abnormality. X-linked
Px - delayed development+walking
A
Duchennes’
11
Q
Ax- def in hormones that convert sex hormones to cortisol
Px - ambiguous genitalia (accumulation of sex hormones), Salt losing crisis (lack of cortisol) i.e. low glucose and vomiting, hirsuitism, early menarche, large stature
Tx - IV dextrose and hydrocortisone
A
Congenital adrenal hyperplasia
12
Q
Ax - Autosomal dominant
Px - Webbed neck, Pec Excav, short, pulmonary stenosis
A
Noonan’s
13
Q
Px - micrognathia, cleft palate
A
Pierre-Robin
14
Q
Px - Short, LD’s, friendly, aortic stenosis, neonatal hyperCa
A
William’s
15
Q
Jaundice <24hrs
A
Px -
Immune: Rheus/ABO incompatibility
RBC defect: G6PD def, pyruvate kindse def, hered sphere
Infx
16
Q
Jaundice 24hrs-2wks
A
Physiological, breast milk, infx, excess haemolysis
17
Q
Persitant jaundice >2wks
A
Unconjugated: breast mil, infx, ABO incompatibility, hypothyroidism, galactosaemia
Conjugated: biliary atresia, neonatal hepatitis
18
Q
Biliary atresia
A
Px - prolonged jaundice >2ks dark urine, pale stools
Mx - surgical
NB diagnoses after 6wks compromises outcome
19
Q
Group B strep
A
can colonize reproductive tract and can infx baby
20
Q
Px - respiratory distress syndrome, ground glass CXR
Ax - immature T2 pneumocytes
Mx - artificial surfactant, venti
A
Surfactant def
21
Q
Ax - Parvovirus B19
Px - lethargy, fever, headache, slapped-cheek spreading to proximal arms and extensor sufaces
A
erythema infectiosum/slapped cheek/fifth disease
22
Q
Ax - VZV
Px - Multistaged mac/pap/vesicular rash starting on head/trunk before spreading globally
A
Chicken pox
23
Q
Ax - measles virus
Px - prodrome of fever, irritability, conjunctivitis, rash starting behind ears and spreading globally, macpap to confluent
NB Kopliks spots
A
Measles
24
Q
Ax - mumps
Px - fever, muscle pain, pain on eating/earache, parotitis, unilateral and becoming bilateral in 70%
A
Mumps
25
Ax - Rubella virus
| Px - macpap rash spreading globally and usually fades by day 3-5, suboccipital and postauricular LN's
Rubella
26
Ax - toxins produced by GAS
Px - fever, malaise, tonsilitis (strep throat), fine punctate rash sparing peri-oral area (sandpaper texture), strawberry tongue
Scarlet fever
27
Ax - Coxsackie A16
| Px - Vesicles on mouth, hand and feet
Hand, foot and mouth disease
28
Down's diagnosis
karyotyping
29
VACTERL
Vertebral, anal imperforation, cardiac, tracheo-oesophageal fistula, renal, limb anomalies
30
Neonatal cardiology
Cyanotic: transposition of the great arteries, tetralogy of fallot,
Acyanotic: VSD, Aortic stenosis, AVSD, coarction of the aorta
31
Tetralogy of Fallot
VSD, Rt ventricular outflow obstruction, RV hypertrophy, overriding aorta
32
Transposition of the great arteries
PDA sustaining life
| Mx - prostaglandin infusion and surgical intervention
33
Autoimmune hepatitis
Ax - anti -smooth muscle Abs
34
Coeliac's
Px - diarrhoea, malabsorption (buttocks wasting)
35
Acute epiglottitis
Ax - HiB infx
| Px - rapid onset, fever, toxic look, stridor, drooling of saliva
36
Ax - Human herpes virus 6
| Px - 3-5 day high fever, 2 day macpap rash on chest and limbs, cough, D, febrile convulsions
Roseola infantum
37
Meningitis <3mnths
GBS (low birth wt+Prolonged ROM)
| also E.coli+Listeria
38
Meningitis 1mnth-6yrs
N.men
Strep.pneu
Haemophilus.inf
39
Menigitis >6yrs
N.men
| Strep.p
40
Autosomal recessive
Metabolic
| exceptions=inherited ataxia's
41
Autosomal dominant
structural
| exceptions=Gilbert's
42
Ax - parainfluenza infx
Epx - 6mnths-3yrs
Px - Stridor, barking cough, fever, coryzal Sx
Mx - PO dexamethasone, O2+adrenaline in emergency
Croup
43
Adrenaline for anaphylaxis ages and doses
```
<6yrs = 150mcg
6-12 = 300mcg
>12yrs = 500mcg
```
44
Ax - IgA mediated small vessel vasculitis
| Px - Palpable purpuric rash, abdo pain, usually following infx, polyarthritis, haematuria, renal failure
Henoch-Schonlein purpura
45
Develpmental dysplasia of the hip
RF: female, breech, FHx, oligohydramnios, macrosomaly
Ix - Barlow + Ortolani, US
Mx - Spont stabilise by 3-6wks, Pavliks harness, Surgery
46
Rose spots in non bloody diarrhoea
Salmonella typhi
47
BCG vaccine
At birth
48
Hepatitis B
At birth if rsk factors
49
DTap/IPV/Hib
| Diptheria, tetanus, acellular pertussis/inactivated polio vaccine/Haemophilus influenza B vaccine
2mnths
3mnths
4mnths
50
PCV
| Pneumococcal conjugate vaccine
2mnths
4mnths
12-13mnths
51
Oral rotavirus vaccine
2mnths
| 3mnths
52
Men B
2mnths
4mnths
12-13mnths
53
Hib
2mnths
3mnths
4mnths
12-13mnths
54
Men C
12-13mnths
55
Flu vaccine
2-7yrs
56
MMR
12-13mnths
| 3-4yrs
57
DTaP/IPV
```
2mnths
3mnths
4mnths
3-4yrs
13-18yrs
```
58
HPV vaccination
12-13yrs
59
Thx for impetigo
Fusidic acid
60
Grey coating on tonsils and cervical lymphadenopathy
Diphtheria
61
Irritability and convulsion in premmie w/ no head trauma or swelling
Intraventeicular haemorrhage
62
Methods of catching urine sample
Adhesive bags
Clean catch
Catheter insertion
Suprapubic aspiration
63
Px - Tall, obese, hirsute, high LH, high insulin, subfertility, menstrual abnormalities, acanthosis nigracans (Hyperpig skin folds)
PCOS
64
Pansytolic left 4th ICS
VSD most common congenital heart abnormality
65
Diastolic apex
Mitral stenosis
66
Howell-Jolly bodies
Splectomy, splenic atrophy
67
Auer rods
AML
68
Infants intake mL/kg/day
150-180mL/kg/day
69
2 feet proximal to ileo-caecal valve, 2 inches in length , 2% of ppln
Painless PRB
Meckel's diverticulum
70
Px - Obese, tall adolescents, shortened and externally rotated, referred pain to knee
Ax - Posterolateral displacement of the femoral head
Silpped upper femoral epiphysis
71
Ax - degenerative disease of the hip
Epidx - 2-10yo, boys,
Px - Insidious-onset hip pain, limp,
Perthe's disease
| Legg-Calve-Perthes disease
72
Px - Acute hip pain following viral infx, no pain at rest, reduced ROM
Epix - Most common cause of acute hip pain 3-8yo,
Transient synovitis
73
Px - Neonate w/ swollen hands and feet, difficult to palpate femoral artery, short stature, wide carrying angle, widely spaced nipples, coarction of aorta
Turner's syndrome 45XO
74
Px - Delayed puberty, tall for age, small firm testes, shy
Klinefelter's 47XXY
75
Major Duckett Jones criteria for Rheumatoid fever (5)
Pancarditis, Polyarthritis, Erythema marginatum, nodules, Chorea
76
Minor Duckett Jones criteria for Rheumatoid fever (4)
Fever, arthralgia, high ESR/WCC, heart block
77
HTN, renal impairment, wt loss reduced appetitie, lethargy, abdo mass, haematuria
Wilm's tumour
78
Purpruic non blanching rash, arthralgia, abdo pain, renal involvement (nephrotic syndrome), +/-vomiting
Usually following viral illness
Henoch-Schonlein purpura
79
Tx of ITP
Conservative, ITP is self limiting
80
Tx of AML prevention
Tumour lysis syndrome
Ax - large number of cells break down
Px - HyperK, fluid overload, raised urea
81
Complications of childhood oncological disease (4)
Secondary malignancies, LD, growth problems, infertility
82
Causes of erythema nodosum (4)
OCP, TB, strep infx, sarcoidosis
83
3wo baby, floppy, jaundice, large tongue hoarse cry no dysmorphic features
Congenital hypothyroidism
84
Graves Tx
Optimize carbimazole
| Add propanolol for Sx relief
85
Corticosteroids SE (4)
HTN, glucose intolerance (hyperglycaemia), wt gain, short, osteoporosis
86
Delayed puberty
No pubertal development by 15yo
87
Tall, gynaecomastia, microorchidism, delayed puberty
Klinefelter's 47XXY
88
```
Age 2-13
Pain symmetrical in lower limbs and not limited to joints
Pains never present at start of day
Physical activities not limited
No limp
Examination normal
```
Rules of growing pains
89
Immobile child, apyrexial, following URTI (1-2wks), normal xray, joint may be red/hot/swollen
Reactive arthritis
90
Limp, apyrexial, accompanied by viral infx, referred knee pain, reduced ROM internal rotation
Transient synovitis
91
Px - obese boys, shortened externally rotated
| Mx - internal fixation
Slipped femoral epiphysis
92
Acute illness, daily fevers, malaise, failure to thrive, rash, muscle/joint aches, >6wk duration, raised inflammatory markers
Juvenile idiopathic arthritis
93
Erythematous, warm, acutely tender joint, reduced ROM, febrile child, <2yo
Septic arthritis
94
Immobile limb, acute febrile illness, distal femur, proximal tibia
Osteomyelitis
95
Clumsy, quadriceps wasting, Gower's sign, waddling gait, raised CK
Muscular dystrophy
96
Maternal haemorrhage, poor feeding, altered tone, seizure activity in neonate
Hypoxic ischaemic encephalopathy (moderate)
97
Hyperintense, inflammatory white matter lesions
MS
98
UMN lesion signs (4)
Increased reflexes
Decreased power
Increased Tone
Up going plantar reflexes
99
Leg weakness in SCCC
Stroke
100
SE profile:
| Inc appetite, wt gain, hair loss, liver failure
Sodium valproate
101
SE profile:
| dizziness, visual distrubance, lupus erythematosus syndrome
Carbemazipine
102
SE profile:
| Behavioural change, irritability rash
Lamotrigine
103
SE profile:
| Behavioural changes, retinopathy, sleep disturbance, wt gain
Vigabatrin
104
SE profile:
| Anorexia, abdo pain, vomiting, diarrhoea,
Levetiracetam (Keppra)
105
Ash leaf macule under Wood's light, subendymal nodules, hypsarrythmia on EEG
Tuberous sclerosis
106
Port wine stain
Sturge-Weber syndrome
107
```
Status epilepticus Mx
0min
5min
15min
25min
45min
```
0mins: ABC + glucose. O2
5mins:
IV access = lorazepam
No IV buccal midazolam/rectal diazepam
15mins: Lorazepam IV/IO senior help, prepare phenytoin
25mins: Rectal paraldehyde, phenytoin infusion
45mins: Rapid sequence induction of anaesthesia w/ thiopental and intubation, transfer to PICU
108
GORD Mx
Cons: Feed thickeners, positioning
Med: Antacids, PPI, hypermotility drugs (metoclopramide)
Surg: fundoplication
109
PDA Mx
Cath lab plugging
110
Exercise + haematuria
Stress haematuria
111
OCP + red urine, bld -ve
Porphyria
112
Fluid maintenance
```
0-10kg = 100ml/kg
10-20kg = 50ml/kg
>20kg = 20ml/kg
```
113
Undigested food w/ diarrhoea, healthy child
Toddler's diarrhoea/chronic non specific
114
IDA, polyps, pigmented palms and soles
Peutz-Jeghers
115
Small red growth in centre of umbilicus, covered w/ clear mucous
Umbilical granuloma
Salt the wound
resolve by 2
116
Boot shaped heart
ToF
117
Frequent yawning, irritable, no fever
Maternal opiod use
118
Becwith-Wiedemann
Macrosomaly, large tongue hypoglycaemia
119
Resp rate infants
30-40
120
Resp rate young children
25-35
121
Resp rate older children
20-25
122
HR infants
110-160
123
HR young children
95-150
124
Older children
80-120
125
Systolic BP infants
80-90
126
Systolic BP young children
85-100
127
Systolic BP Older children
90-110
128
Neonate
<4wks
129
Infant
<1yr
130
Young child
2-5
131
Older child
6-12
132
Severe asthma assessment
| O2 sats
O2: <92% for <12yo
133
Severe asthma assessment
| Resp rate
Resp rate:
>40 (2-5)
>30 (5-12)
>25 (12-18)
134
Severe asthma assessment
| Peak flow
Peak flow:33-50%
135
Severe asthma assessment
| HR
>140 (2-5)
>125 (5-12)
>110 (12-18)
136
Px - Generalised abdo pain, fever, recent viral URTI
| Ax - Inflammation of mesenteric lymph nodes that occur following a viral URTI
Mesenteric adenitis
137
RF for hypoglycaemia
<37wks, <2.5kg
138
Acquired vs congenital hypothyroidism
Congenital presents earlier in life w/ coarse facial features, macroglossitis, umbilical hernia
139
Sever dehydration (Wt)
>10% wt loss
140
Juvenile idiopathic arthritis. Define:
Monoarticular
Pauciarticular
Multiarticular
Single joint
<4
>4
141
Supravalvular aortic stenosis
Williams
142
UTI Mx:
<3mnths
Upper UTI >3mnths
Lower UTI <3mnths
<3mnths = Referred immediately to specialist. Admitted IV Abx
>3mnths Upper = Considered for admission. If not admitted PO Abx for 7-10 days (cephalosporin/co-amox)
>3mnths Lower = PO Abx for 3 days (Trimethoprim/nitro)
143
CF Mx at birth
Gastrograffin enema - diagnostic and therapeutic
| Prophylactic flucloxacillin and sweat test at 6wks
144
Anaphylaxis
PO antihistamines (chlorphenamine)
IV Adrenaline
IV hydrocortisone
145
Risk of hydrops feotalis
Parvovirus B19
146
Simple nappy rash Tx
Castor oil, zinc
147
Threadworm Tx
Mebendazole
148
Impetigo Tx
Fusidic acid
149
Kid w/ acne, topical Abx don't work
Benzoyl peroxide
