paeds Flashcards
(41 cards)
unable to palpate testes, normal penis with no hypospadias anus is patent
normal baby. what do you need to rule out?
21-hydroxylase deficiency. These infants
may present with ambiguous genitalia or bilateral undescended testicles
and are at risk of a salt-losing adrenal crisis (vomiting, weight loss,
floppy unwell infant), typically around 1–3 weeks of age. It is therefore
important to measure urea and electrolytes in addition to chromosomal analysis and a pelvic ultrasound to look for the location of the sex
organs.
status 2 doses of benzo weened off phenytoin recently what next?
IV phenytoin as 2 doses benzo and no longer on pheyntoin
iron overdose presentaiton
2 phases
vomitting diarrhoea gastric irritation + malaena
>24h improvement then deterioraiton with liver failure drowsiness andcoma
neonate with recurrant ecoli. uti/sepsis, vomitting catarcts
Galactosaemia
Phenylketonuria
PKU is an autosomal recessive metabolic condition resulting in a defect
in enzyme phenylalanine hydroxylase, which converts phenylalanine to
tyrosine. Due to the accumulation of phenylalanine and conversion to
phenylketones, unrecognized and untreated PKU can result in seizures
and musty smelling urine and eventually microcephaly and learning
difficulties.
CAH management
IV dextrose IV hydrocortisone and 0.9% saline
neonate with jaundice after 2 weeks from day 5, pale stool dark urine
biliary atresia must be investigated due to risk of cirrhosis
preterm on itu recieving formula milk, billious aspirates from ng, distended abdomen bloody stool, NEC
NBM, IV fluids AXR, surgical review
VACTERL
vertebral, anal imperforation, cardiac, tracheo-oesophageal fistula, renal limb anomalies
symmetrical vs asymetrical IUGR
symmetrical - smoking, alcohol, congenital infection
asymmetrical - maternal diabetes preeclampsia –> placental insufficiency
intersusseption management in DGH
Up to 75 per cent of cases may be reduced by air insufflation rectally,
but if this fails the child will need to be taken directly to theatre as there
is a risk of perforation with the procedure. As it is unlikely that a district
general hospital will be able to take such a young child to theatre, all
procedures should be carried out in a paediatric surgical centre
CMV infection which is not deafness iugr hydrocephalus thrombocytopaenia congenital cardiac
congenital cardiac not associated
SCID B CELLS T CELLS AND iG
LOW B LOW T LOW IG
wiskott aldrich W A T E R
WASP GENE APC'S thrombotcytopaenia eczema recurrant infection
A 3-year-old child presents to the GP with a chronic cough for the last month.
He had previously been fit and well since he suffered a severe pertussis infection
when he was 1 month of age. He has subsequently been fully immunized but
was noted to be on the 0.4th centile for height. What is the most likely cause
for his cough?
severe respiratory infection in early childhood can present later in
life with bronchiectasis. caused by dilatation and poor mucociliary
clearance, predisposing to further infection. Any chronic illness may
impact on the growth and development of a child.
children aged above 5 most common pneumonia?
mycoplasma
strep is less than 4
rheumatic fever major criteria except new murmur swollen right knee geographic shaped rash (erythema marginatum involuntary arm movements fever carditid
fever
duct depedent cardiac disease management
prostoglandin IV + echo
antibiotics to cover for sepsis
12yr old boy not growing past 2 years, classmates overtaken, was tallest in class. developed pubic hair 8-9 and voice changed around that time
congeintal adrenal hyperplasia
isosexual precocious puberty, all changes of pubertal boy in normal order. late onset cah. stunted height due to epiphyseal fusion
hsp triad
+ rare complications
rash (symmetrical rash on buttocks and extensor surfaces purpuric or maculopapular)
arthalgia (knees ankles periarticular oedema)
colicky abdo pain (can vomit from pain+ haematemsis/ malaena),
kidney involvement (40%) haematuria(micro/macro) /nephrotic syndrome
ileus, orchitis CNS involvement , intusussception
periostitis in neonate with jaundice conjugated and unconjugated
neonatal heptatitis due to congenital syphilis
A 10-year-old girl presents to the emergency department with a seizure that
lasted 2 minutes before resolving on its own. Her mother described her as
suddenly collapsing to the ground, going stiff and then shaking all four
limbs. She was ‘drowsy’ for 15 to 20 minutes after the seizure. The girl has no
recollection of the event. Her temperature is 36.2°C, and she was well before
the event. Examination, including a full neurological assessment, is normal.
Blood sugar level was 4.5 mmol/l. Electrolytes were normal.
A. 12-lead ECG B. Electroencephalogram C. Head MRI D. Serum prolactin E. None of the above
All children who have had a ‘convulsive seizure’ (such as in this case)
should have an ECG. The ECG may reveal a cardiac cause for the fit and,
in particular, a prolonged QTc interval needs to be excluded. The girl in
this case collapsed suddenly before fitting, so an ECG is warranted to
exclude a cardiac cause.
An 8-year-old girl with arthritis has some routine blood tests taken
by the general practitioner. She is currently on methotrexate for her
arthritis. Her mother is worried she is a fussy eater and does not enjoy
eating meat. On examination, she has some ulceration at the corners of
her mouth.
Her full blood count reveals:
Hb 8.9 g/dL (range 9.5–14.0)
MCV 109 fL (range 85–105)
What is the best treatment for her? A. Intramuscular vitamin B12 B. Oral ferrous sulphate C. Oral folic acid D. Oral vitamin B12 E. Multivitamin tablet
folic acid due to methotrexate
Vitamin B12
deficiency is treated with intramuscular injections of hydroxocobalamin
(a natural analogue of vitamin B12) rather than oral forms.
CI to MMR
high dose steroids
severe HIV
