Paeds Flashcards by Maria Constantinescu

Kid with acne. Topical antibiotics don't work. What do you give next?
A oral tetracycline
B bezoyl
C Retinoids
D Oral flucloxacillin

A oral teracyclin (lymecycline or doxycycline (for a maximum of 3 months).

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Kid with hx of anal fissure. What is your first course of action?
A Inspect anal region
B do DRE with little finger
C panic
D panic
E Send them to ITU cuz you don’t know how the fuck paeds works

A inspect anal region

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A level student came back from nigeria recently. He presents with symptoms of jaundice, mild anaemia and fever with malaise and athralgia. What is going on?
A Hep A
B Malaria
C influenza
D others they can't remember

?B malaria

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Kid with temp 39, cap refill of 6s, generally unwell, bulging fontanelles, no description of rash. What is wrong with him?
A Meningococcal septicaemia
B UTI
C Pneumonia

A Meningococcal septicaemia - (bulging fontanelle)

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4 yo having acute asthma attack, given IV salbutamol and hydrocortisone. Sats are still low, no chest sounds on ausucultations. What do you do/give next?

A IM adrenaline
B Call senior
C Start atrovent

B call senior

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Kid with cervical lymphadenopathy, fever, sore throat, red tongue with white spots. What does she have?
A Scarlet Fever
B Measles
C Chickenpox

If red tongue with white spots means strawnberry tongue then scarlet fever.
Koplik spots are on oral mucosa not tongue, so if the spots are in the mouth is measles.

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Girl with bulimia. What gave it away?
A dental enamel caries
B striae
C lacerations on the wrist
D weight gain

A dental enamel caries

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4 month old, about to have 3rd batch of vaccines. Which would be a complete contraindication to having the vaccine?
A Confirmed past history of pertussis 
B Currently ill with a fever of 38.5 
C Got a rash at the site of vaccination
D Severe cow milk energy

B currently ill with a fever of 38.5

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Perianal itching especially at night. What is the best treatment option?

Mebendazole

Me bendz for that azole because I have thread worms in my ass

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5 month old with cough, runny nose, fever. O/E you hear a wheeze. Whats the main pathogen that causes this RTI?
A Strep pneumoniae
B Respiratory syncytial virus
C Mycoplasma pneumoniae

B RSV

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Unwell kind with indentable mass in left illiac fossa? Whats this?
A Constipation
B Wilm’s tumour

They say A constipation but I would guess it depends on the kids symptoms

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Kid with URTI and generalised abdo tenderness.

A appendicitis
B mesenteric adenitis
C HSP

B mesenteric adenitis

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Baby O/E can’t hear heart sounds and has a scaphoid chest. What is this?

Diaphragmatic hernia

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Baby born at 41 weeks via ECS due to foetal distress. Needed ventilation straight away. X ray shows hyper inflated lungs with areas of consolidation. What does he have?

Meconium aspiration (risk due to post term)

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Prem baby, resp distress, CXR shows grould glass. What does he have?

Surfactant deficiency

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Bbay born at 37 weeks via forceps Shows signs of resp distress. CXR shows areas of consolidation throughout what is this?

Meconium aspiration

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Treatments for paeds rashes repeat

Nappy rash, flexure sparing. How do you treat ?

Zinc barrier cream and castor oil

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Treatments for paeds rashes repeat

Nappy rash with satellite lesions

Clotrimazole

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Treatments for paeds rashes

Anal itch, worse at night

This is Pruritis ani

Mebendazole if they mean threadworms

symptoms will resolve with self-care measures and symptomatic treatment.

If the perianal skin is excoriated, consider prescribing a soothing cream or ointment containing bismuth subgallate or zinc oxide. See the section on Topical treatments for more information.

If the perianal skin is inflamed, consider prescribing a mildly potent topical corticosteroid (such as hydrocortisone 1% cream or ointment) to be used for no longer than 7 days. See the section on Topical treatments for more information.

If there is disturbed sleep due to nocturnal itching, consider prescribing a sedating antihistamine (such as chlorphenamine, off-label use). See the section on Prescribing information for more information.

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Treatments for paeds rashes repeat

Scabies

Permethrin

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Treatments for paeds rashes repeat

Chickenpox

Do nothing?

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Treatments for paeds rashes repeat

Impetigo

Fusidic acid

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Treatments for paeds rashes

Candida nappy rash

Topical imidazole

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Joint problems options
Haemophilia
JIA
Post viral synovitis
Septic arthritis
NAI

Grandma brings boy with swollen knee. Boys brother died young from minor head injury?

Haemophilia

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``` Joint problems options Haemophilia JIA Post viral synovitis Septic arthritis NAI ``` Posterior rib fractures

NAI?

``` Joint problems options Haemophilia JIA Post viral synovitis Septic arthritis NAI ``` Unwell and unable to weight bear, fever

Septic arthritis

``` Joint problems options Haemophilia JIA Post viral synovitis Septic arthritis NAI ``` Recent URTI, not able to weight bear

Post viral synovitis

Kid with fever >39 what do you do next?

IV cef + admit + arrange investigation whilst on ward Some people said full septic screen Paediatric Sepsis Six The following 6 interventions should be initiated within 1 hour of presentation of suspected sepsis: [48] 1. Supplemental oxygen should be given. 2 Intravenous or intraosseous (IO) access should be obtained within 5 minutes of presentation and blood tests ordered: - including blood cultures, - blood glucose (low blood glucose should be treated) - and arterial, capillary, or venous blood gases. - FBC, serum lactate, and CRP 3 Intravenous or IO antibiotics should be given with broad-spectrum cover as per local policies. 4 Fluid resuscitation should be considered. The aim is to restore normal circulating volume and physiological parameters. Isotonic fluid (20 mL/kg) should be titrated over 5 minutes and repeated as necessary. Caution should be taken to avoid fluid overload by examining the patient regularly (e.g., for pulmonary crepitations and hepatomegaly). 6 Experienced senior clinicians or specialists should be involved and consulted early. Vasoactive-inotropic support should be considered early if normal physiological parameters are not restored after giving ≥40 mL/kg of fluids. It is important to note that adrenaline (epinephrine) or dopamine may be given via peripheral intravenous or IO access.

Mother brings in girl who doesn't speak. What do you do next?

Refer for hearing assessment

Kid fitting for 5 mins, normal glucose, what do you give?

Rectal diazepam

Asthma management. Kid with acute exacerbation, been given salbuatmol and steroids. On listening to the chest you hear a quiet chest. RR is 60. What do you do.

Call PICU ready for intubation

Cross eye kid, what other piece of info would you like?

They say vomiting before breakfast - maybe because you're considering raised ICP from SOL?

Dehydration + ill kid - weight 15 kg what do you give initially?

300 ml bolus IV (20 x 15 = 300) initial bolus

Aspiration pneumonoia - what do you fo?

?Oxygen and NG tube?

Strawberry tongue

Scarlet fever

What is the purpose of debriefing after a childs death in resuscitation?

To address emotional needs of everyone in the team

Child who passess stool every few days, when he goes stools are pellet like and smelly. What's the likely diagnosis?

Overflow constipation

Child with pruritus ani worse at night. what do you give to treat?

Mebendazole

``` Given pictures of reflexes. Which reflex is abnormal? A Moro reflex B Assymetrical neck reflex C palmar and planter grasp D rooting ```

A Moro reflex 3-4 months B Assymetrical neck reflex - 7 months C palmar and planter grasp - 2-4 months D rooting - 4 months they should all be gone by 6 months

Treatments for paeds rashes | Rash involving flexures

``` Name conditions from pictures (all from Liseaurs) NAI Candida albican Moluscum contagiosum HSP Mongolian blue spot ```

Just look it up

By what age would you refer the following kids if they havent achieved the following milestones? Sit without support

normal by 6m, refer by 8m (lisseaurs says 9m)

By what age would you refer the following kids if they havent achieved the following milestones? Walk

normal by 15 m, refer by 18 m

By what age would you refer the following kids if they havent achieved the following milestones? Hops on one leg

Normal by 4 y, refer by 5 y (was the only upper limit option)

By what age would you refer the following kids if they havent achieved the following milestones? Pincer grip

Normal by 10 m, refer by 12 m

By what age would you refer the following kids if they havent achieved the following milestones? Smiles

Normal by 6 w, refer by 8 w

Poisons + investigations Drunk/intoxicated kid

Urine drug screen

Poisons + investigations Dehydrated, seizures, mother been giving some herbal oral rehydration fluid or something

Check plasma sodium

Poisons + investigations Sick kid with fever, vomiting, photophobia

Resp problems Neonate getting progressively worse at breathing over first 3 hrs with opacities?

Group B strep pneumonia

Resp problems Still needs oxygen after delivery

Bronchopulmonary dysplasia

Resp problems Ground glass appearance

Resp distress syndrome/ Surfactant deficiency

Resp problems Nitrogen washout test

Congenital heart disease

Kid with sore throat, cervical lymphadenopathy, been given antbx then rash comes on. What virus caused this?

EBV

Rash that started from behind the ears and spread to trunk, parents are vegetarians and kid goes to school in North london.

Measles

GI Intermittent pain, dehydrated, vomited 3 times

Intrusussception

GI Sudden abdo pain, well child, something indentable on L lower quadrant

L sided wilm's nephroblastoma

GI Scaphoid abdomen

Diaphragmatic hernia

Management of 4yo with enuresis - dry by day. What is your first line managment?

Reassure - enuresis becomews a problem after 5 yo

``` Child with Downs has NJ tube at home. It comes out and needs reinserting. Who should put it back A community paeds nurse B community paediatrician C hospital nursing staff D GP E healthworker ```

???? I think community paeds nurse can do it????

Child is slow to get dressed. Likes to arrange his toys in a particular way. [ASD; OCD; Oppositional defiant disorder etc]

OCD

o Child is an arsonist. Gets in fights. Attacks teachers. What is he likely to have at age 20? [Conduct disorder; ADHD, Dissocial personality disorder; Oppositional defiant disorder]

Conduct disorder

o Talking about a ~8 month child with cerebral palsy. Which of their milestones is likely to suggest CP

Using right hand more than left apparently

Asthmatic child in A&E. Mother has been giving two puffs of salbutamol with spacer every 4 hours. Description given correlated to severe asthma. What your management? [Inhaled nebs; inhaled adrenaline, Discharge; 10 puffs of salbutamol through spacer]

10 puffs of salbutamol through spacer

Child takes 4 tablets of grandmothers benzodiazepines 4 hours ago. She’s currently asleep, but was fully awake with GCS 15. Your next step? [Activate charcoal; Gastric Lavage; IV flumenazil; admit for monitoring]

IV flumenazil Active charcoal works only after 1 hour

Afebrile child with D+V. Description alludes to shock. She is 15kg. What do you give her initially?

300 ml of initial IV bolus | 0.9% saline

What defines mild learning disability ``` IQ <80 <70 <60 <50 <30 ```

<70

Joint problems | Girl not able to weight bear. Some joints hurt. Mum has rheumatoid arthritis?

JIA?

Paeds milestone - at which age do you expect most children to have achieved this? Smile

6 weeks

Paeds milestone - at which age do you expect most children to have achieved this? Sitting unsupported

6 months with round back | 8 months with straight back

Paeds milestone - at which age do you expect most children to have achieved this? Walking

15 months

Paeds milestone - at which age do you expect most children to have achieved this? 2-3 word sentences

12 months

Paeds milestone - at which age do you expect most children to have achieved this? Pincer grip

10 months

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar) 28 day old with pale stools

Biliary atresia

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar) Baby has blood group AO, mother is group O

ABO incompatibility

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar) Mum has group B strep

Sepsis

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar) Baby has jaundice for a few days (day 2-7), ok now

Physiological

Child with funny turns (options: infantile spasms, reflex anoxic seizure, breath holding attack, absence seizures) child falls, parents pick him up but has tonic clonic seizures. he is completely well afterwards?

Breath holding attack aka anoxic reflex seizure

Child with funny turns (options: infantile spasms, reflex anoxic seizure, breath holding attack, absence seizures) Child at school, complains of unusual smell. Seems to space out. After shes drowsy and sleeps for a few hours in the nurses office. No recolleciton of what happene

Absent seizure

Recurrent jelly stools in childs

Intusussception

7 year old refuses to do homework and stays up late playing Minecraft on his ipad. parents are worried about him. What is the diagnosis?

Normal behaviour for age

7 year old refuses to do homework and stays up late playing Minecraft on his ipad. parents are worried about him. What is the diagnosis?

Normal behaviour for age

Kid given dexamethasone for croup 12 hs ago by GP, was stable and well with good satts but still mild stridor. What else do you give?

Repeat steroids

Kid with yellow and grey stools was 4 weeks old. Whad do you test for? Conjugated bilirubin levels G6PD Coombs test

Conjugated bili 1st

Hypochloraemic hypokalaemic pH shown. what is the initial management for this?

Correct electrolyte imbalance

Premature kid with distended abdo, vomiting, episode of blood in stool.

NEC

Kid on bloods: low platelets, norma WCC, normal RBC

ITP

Very hungry kid, hypotonia, almond eyes

Prader Willi - almond eyes

Kid with nocturnal enuresis where behavioural therapy and enuresis alarm didnt work. Hes going to a sleepover. What is the next management?

Desmopressin

Neonate with cardio problem. Systolic murmur loudest at Left sternal edge 2/6

VSD

Kid with ADHD. What's the management?

Parental training offer meds only after you try conservative measures and its still not working

Kid with ADHD. What's the management?

Parental training offer meds only after you try conservative measures and its still not working

Hip pain on exercise and climbing stairs.

Perthes disease

3 yo female child with intermittent limp, otherwise well

Developmental dysplasia of hip

Uncle gets TB, kid lives with him. Mantoux test showed a number between 10-14 mm for result. What do you do?

Start anti TB treatment

Precocious puberty - 5yo with sparse axillary adn pubic hair as well as breast bud development and high centile growth. Parents are along lower centiles. What definitive diagnostic test do you do?

Gonadotrophin stimulation test from BMJ

Cerebral palsy - what area of brain is affected

Motor cortex

Kid with rough sandpaper like rash on face and trunk and a flushed face

Scarlet fever

Paeds Flashcards

(98 cards)