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Year 5: Specialities COPY > Paeds > Flashcards

Flashcards in Paeds Deck (1990)
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1

Gross motor milestones

 

3 months

Little or no head lag on being pulled to sit

Lying on abdomen, good head control

Held sitting, lumbar curve

2

Gross motor milestones

 

6 months

Lying on abdomen arms extended

Lying on back, lifts and grasps feet

Pulls self to sitting

Held sitting, back straight

Rolls front to back

3

Gross motor milestones

 

7-8m

Sits without support

 

(Refer at 12m)

4

Gross motor milestones

 

9 months

Pulls to standing

Crawls

5

Gross motor milestones

 

12m

Cruises

 

Walks with one hand held

6

Gross motor milestones

 

13-15m

Walks unsupported

 

(Refer at 18m)

7

Gross motor milestones

 

2y

Runs

 

Walks upstairs and downstairs holding onto rail

8

Gross motor milestones

 

3y

Rides a tricycle using pedals

 

Walks up stairs without holding a rail

9

Gross motor milestones

 

4y

Hops on one leg

10

Pyloric stenosis presentation:

Pyloric stenosis typically presents in the second to fourth weeks of life with vomiting, although rarely may present later at up to four months. It is caused by hypertrophy of the circular muscles of the pylorus

11

Features of Py Sten

'projectile' vomiting, typically 30 minutes after a feed

constipation and dehydration may also be present

a palpable mass may be present in the upper abdomen

hypochloraemic, hypokalaemic alkalosis due to persistent vomiting

12

Dx of py sten

USS

13

Ramstedt pylorotomy

Used in management of py sten

Excision of the hypertrophied circular muscles of the pylorus

14

Def intussuception

Intussusception describes the invagination of one portion of bowel into the lumen of the adjacent bowel, most commonly around the ileo-caecal region.

Intussusception usually affects infants between 6-18 months old. Boys are affected twice as often as girls

15

Features of intussuception

paroxysmal abdominal colic pain

during paroxysm the infant will characteristically draw their knees up and turn pale

vomiting

blood stained stool - 'red-currant jelly'

sausage-shaped mass in the right lower quadrant

16

Ix intussuception

USS

17

Mx of intussuception

Air insuffation under radiological control

If the child has signs of peritonitis or the air insufflation fails, Sx

18

A 2-month-old boy is brought to the afternoon surgery by his mother. Since the morning he has been taking reduced feeds and has been 'not his usual self'. On examination the baby appears well but has a temperature of 38.7ºC. What is the most appropriate management?
 

Advise regarding antipyretics, to see if not settling

IM benzylpenicillin

Advise regarding antipyretics, booked appointment for next day

Admit to hospital

Empirical amoxicillin for 7 days

Any child less than 3 months old with a temperature > 38ºC is regarded as a 'red' feature in the new NICE guidelines, warranting urgent referral to a paediatrician. Although many experienced GPs may choose not to strictly follow such advice it is important to be aware of recent guidelines for the exam

19

Assessment of febrile children?

T: electronic thermometer in the axilla if <4w or with infra-red tympanic thermometer

HR

RR

CRT

Signs of dehydration: skin turgor

20

What are the categroies on the feverish illness guidelines

Colour

Activity

Respiratory

Circulation and hydration

Other

21

Mx of child at "green" on risk stratificiation for feverish illness?

Managed at home with appropriate care advice, including when to seek further help

22

Mx of child at "amber" on risk stratificiation for feverish illness?

Safety net or refer to paediatric specialist for further assessment

Safety net: verbal/written info about warning symptoms and how to access further care

23

Mx of child at "red" on risk stratificiation for feverish illness?

Admit to hospital

24

Key points for Mx of fever in child

Oral antibiotics should not be prescribed without identification of an apparent source of fever

25

CXR in ?pneumonia in children?

Not routinely performed

26

Green

 

Colour

Normal

27

Green

 

Activity

Responds normally to social cures

Content/smiles

Stays awake or wakens quickly

Strong normal cry/not crying

28

Green

 

Circulation and hydration

Normal skin and eyes

 

Moist mucous membranes

29

Important for Green risk stratification

No amber or red signs present

30

Amber

 

Coour

Pallor reported by patient/carer