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Finals Studying - Condensed > Paeds > Flashcards

Paeds Flashcards

1
Q

31 w, PROM, vag delivery, no meconium, resp distress, ventilated, CXR ground glass appearance - Dx?

A

surfactant deficiency

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2
Q

37w, elective csec for PET, no meconium, mild resp distress @ 12h, CXR fluid in horizontal fissure - Dx?

A

TTN

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3
Q

37w, PROM at 35w, spontaneous labour @37w, normal vaginal delivery, increasing resp distress day3 - Dx?

A

neonatal pneumonia

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4
Q

correct position of ET tube

A

2cm above carina, level D2/3

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5
Q

where does air collect in neonatal pneumothorax

A

anteriorly! bcos CXR is taken supine

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6
Q

no. of umbilical veins in baby

A

1

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7
Q

correct position of umbilical vein catheter

A

at or just below R hemidiaphragm

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8
Q

no. of umbilical arteries in baby

A

2

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9
Q

correct position of umbilical artery catheter

A

low tip - lower lumbar (L3/4, below renal arteries)

high tip - between D6-10

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10
Q

cause of bronchioitis

A

RSV

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11
Q

orienation of inhaled foreign body in oesophagus

A

coronal

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12
Q

orientation of inhaled foreign body in trachea

A

sagittal

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13
Q

Ix of UTI in child <6m

A
  1. USS (in acute phase)

then 4-6m later if atypical UTI or recurrent UTI do…

  • VCUG
  • renogram
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14
Q

Ix of UTI in child 6m-3y

A

no imaging if uncomplicated UTI

then 4-6m later if atypical UTI or recurrent UTI do…
- USS + renogram

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15
Q

Ix of UTI in child > 3y

A

no imaging if uncomplicated UTI

then 4-6m later if recurrent UTI do…
- USS + renogram

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16
Q

stepping reflex

A

up to 6w then reappear 8m-1y

baby steps legs when put near ground

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17
Q

moro reflex

A

up to 2m

when baby is startled they throw arms up, clench fists and cry

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18
Q

sucking reflex

A

baby begins to suck when anything touches the roof of its mouth

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19
Q

rooting reflex

A

assists with breast feeding - stroking the corner of baby’s mouth they open it and move towards the direction of the stroke

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20
Q

palmar grasp reflex

A

up to 5-6m

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21
Q

components of APGAR score

A 
Appearance 
Pulse 
Grimace 
Activity 
Resp Effort
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22
Q

no. of umbilical veins in fetus and what does it carry

A

1 umbilical vein

carrys oxygenated blood from placenta to fetus

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23
Q

no. of umbilical arteries in fetus anad what does it carry

A

2 umbilical arteries

carries mixed blood from fetus to placenta

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24
Q

ductus venosus role

A

shunts oxygenated blood away from the liver to the IVC

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25
Q

ductus arteriosus role

A

shunts blood from pulmonary artery through into aorta so that blood bypasses fetal lungs

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26
Q

foramen ovale role

A

R - L shunt

blood to pass through RA to LA

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27
Q

caput succanedum - timing

A

straight after birth

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28
Q

caput succanedum presentation

A

oedema swelling of the head

crosses suture lines

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29
Q

caput succanedum causes

A

ventouse deliveries

mechanical trauma

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30
Q

caput succanedum - how long to resolve

A

a few days

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31
Q

cephalohaematoma presentation

A

swelling of head due to bleed between periosteum and skull

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32
Q

cephalohaematoma timing

A

a few hr after birth

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33
Q

cephalohaematoma causes

A

prolonged deliveries

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34
Q

cephalohaematoma - how long to resolve

A

a few mths

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35
Q

causes of cyanosis in newborn

A

cardiac causes -

  • tricuspid atresia
  • transposition of the great arteries
  • tetralogy of fallot

non-cardiac causes -

  • RDS
  • TTHN
  • tracheo-oesophageal fistula
  • pleural effusion
  • pneumothorax
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36
Q

test for distinguishing between causes of cyanosis in newborn

A

nitrogen wash-out test

  • give 100% O2 to baby for 15 mins
  • pO2 of <15kPa = cyanotic congenital heart disease
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37
Q

causes of neonatal jaundice 2-14d

A

usually physiological

  • due to increased bili production due to shorter RBC lifespan
  • reduced conjugation by the liver due to hepatic immaturity
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38
Q

causes of prolonged neonatal jaundice

A

usually pathological

  • hypothyroidism
  • galactosaemia
  • biliary atresia
  • UTI
  • breast milk jaundice
  • congenital infection
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39
Q

Mx neonatal jaundice

A

phototherapy +/- exchange transfusion

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40
Q

kernicterus

A

acute bilirubin encephalopathy

  • consequence of untreated neonatal jaundice
  • presentation - hypotonia, shrill cry
  • reduced IQ, deafness (long term)
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41
Q

RF for haemorrhagic disease of the newborn

A

maternal use of epileptics

breast feeding

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42
Q

prevention of haemorrhagic disease of the newborn

A

Im or Oral vit K at birht (offered to all babies)

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43
Q

what group of babies is meconium aspiration syndrome more common in

A

post-term deliveries

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44
Q

calculation for corrected gestational age

A

(no. of weeks old) - (term(40)-gestational age)

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45
Q

1st line for neonatal sepsis

A

IV benzylbenicillin + gentamicin

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46
Q

2nd line for neonatal sepsis

A

IV flucloxacillin + gentamicin

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47
Q

3rd line for neonatal sepsis

A

IV vancomycin + gentamicin

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48
Q

Mx apnoea of prematurity

A

caffeine citrate
ventilation
- also find cause

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49
Q

Mx retinopathy of prematurity

A

laser diode therapy

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50
Q

neonate born v agitated - what has mum taken during pregnancy -

A

alcohol

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51
Q

neonate born v quiet and inactive - what has mum taken during pregnancy

A

opiates

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52
Q

diabetic mother - most likely complication in baby

A

neonatal hypoglycaemia

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53
Q

cause of croup

A

parainfluenza

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54
Q

Mx croup

A

severe croup - O2 and nebulised adrenaline 5ml of 1:1000

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55
Q

cause epiglottitis

A

haemophilus influenze B

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56
Q

Mx epiglottitis

A 
give O2 via mask until anaesthetist arrives 
nasopharyngeal intubation 
nebulised adrenaline 
IV dexamethasone 
IV cefotaxime
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57
Q

cause whooping cough

A

bordatella pertussis

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58
Q

Mx whooping cough

A

usually self resolves in around 8w

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59
Q

Dx asthma children 5-16y

A

spirometry and bronchodilator reversibillity test

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60
Q

Dx asthma children <5y

A

clinical Dx

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61
Q

Mx asthma children 5-16y

A
  1. SABA
  2. SABA + paed low dose ICS
  3. SABA + paed low dose ICS + LTRA
  4. SABA + paed low dose ICS + LABA +/- LTRA (stop it if no response)
  5. SABA + MART (has LABA + ICS in one)
  6. SABA + moderate dose MART
  7. SABA + any of:
    - add theophylline
    - high dose ICS
    - refer to specialist
62
Q

Mx asthma children <5y

A
  1. SABA
  2. SABA + 8w trial of mod dose ICS
    - if symptoms not resolved - alt diagnosis
    - if symtpoms resolved & return <4 w - start low-dose maintenance ICS
    - if symptoms resolved & return >4 - redo trial
  3. SABA + low dose paed ICS + LTRA
  4. Stop LTRA and refer
63
Q

Mx acute asthma attack children

A

B2 agonist via spacer - 1 puff every 30-60 secs for 10 puffs
- can repeat if not controlled
+
Steroids - 3-5d course

64
Q

cause bronchiolitis

A

RSV

65
Q

Mx bronchiolitis

A

Supportive

  • O2 by head box if sats <92%
  • NG tube if poor oral intake/not drinking
  • suction if excess upper airway secretions
66
Q

causes of neonatal jaundice 1st 24h

A

always pathological

  • G6PD deficiency
  • hereditary spherocytosis
  • rhesus haemolytic disease
  • ABO haemolytic disease
67
Q

9 month old baby with striodr, better with crying - Dx and Ix?

A

Laryngomalacia

Ix - flexible laryngoscopy

68
Q

heart disease associated with Trisomy 21

A

VSD, AVSD

69
Q

Trisomy 18

A

Edward’s syndrome

70
Q

heart disease associated with Trisomy 18

A

VSD, DORV

71
Q

Trisomy 13

A

Patau syndrome m

72
Q

heart disease associated with Trisomy 13

A

VSD, DORV

73
Q

heart disease associated with Turner’s syndrome

A

Coarctation of the aorta

74
Q

heart disease associated with DiGeorge Syndrome

A

Truncus arteriosus
Tetralogy of Fallot
Interrupted Aortic Arch

75
Q

innocent murmur presentation

A

always systolic

gets more prominent when high CO - fever

76
Q

acyanotic congenital HD

A

VSD, ASD, AVS, PDA, coarctation of the aorta

77
Q

cyanotic congenital HD

A

Tetralogy of Fallot

Transposition of the Great Arteries

78
Q

what is the problem in systemic duct-dependent lesions (congenital HD)

A

Obstruction of blood out of the left side of the heart

79
Q

examples of systemic duct-dependent lesions in congenital HD

A

Hypoplastic Left Heart Syndrome
Critical Aortic Stenosis
Interrupted Aortic Arch

80
Q

what is the problem in cyanotic duct-dependent lesions (congenital HD)

A

Obstruction to pulmonary blood flow OR lack of oxygenation of systemic blood

81
Q

ASD pathology

A

hole connecting atria
L - R shunt
blood still gets to lungs for oxygenation

82
Q

ASD presentation

A

asymptomatic until adulthood
splitting of S2
ejection systolic murmur

83
Q

presentation VSD

A

pansystolic murmur, lower left sternal edge

84
Q

pathology of PDA

A

PDA usually closes within the first few weeks of life.

There is a L-R shunt because the pressure in the left side of the heart has increased.

85
Q

presentation PDA

A 
continuous machinery murmur 
crescendo-descrescendo 
poor wt gain 
SOB difficulty feeding 
LTRI
86
Q

Presentation of Tetralogy of Fallot

A

cyanosis
SOB on feeding /crying/exertion
Failure to thrive

87
Q

“Tet Spells”

A

occurs when there is increased venous return to the heart

  • sudden onset SOB
  • triggered by slight decrease in O2 conc
  • toddler squats to decrease venous return to heart and increase blpood O2
88
Q

presentation coarctation of aorta

A 
weak femoral pulses
grey and floppy baby 
hepatosplenomegaly 
tachypnoea 
poor feeding
89
Q

Ix coarctation of aorta

A

pre-ductal & post-ductal pressures (upper body HTN, lower body hypotension)

90
Q

Mx coarctation of aorta

A

Iv prostaglandin - keep PDA open until surgery

91
Q

pathology of transposiition of the great arteries

A

aorta arises from R ventricle - delivers unoxygenated blood to body

pulmonary artery arises from L ventricle - delivers oxygenated blood back to lungs

92
Q

Mx transposiition of the great arteries

A

Iv prostaglandins - keep PDA open until surgery

93
Q

pathology hypoplastic left heart syndrome

A

hypoplastic left ventricle, ascending aorta and aortic arch

94
Q

Mx hypoplastic left heart syndrome

A

IV prostaglandins - to keep PDA open until surgery

95
Q

presentation orofacial granulomatosis

A

lip swelling
facial rash
no Crohn’s features

96
Q

inheritance of peutz jegher’s syndrome

A

AD

97
Q

presentation of GORD in baby

A

incessant crying
back arching
vomiting
red colour change

98
Q

Mx GORD in baby

A
  1. Gaviscon

2. + Ranitidine

99
Q

presentation tracheo-oesophageal fistula

A

cough
aspiration pneumonia
choking
cyanosis on feeding

100
Q

presentation oesophageal atresia

A

unable to swallow own saliva
gastric distension
cyanosis
unable to pass NG tube

101
Q

presentation choanal atresia

A

difficulty breathing

unable to nurse and breathe at same time - more pronounced when feeding

102
Q

Ix coeliac in a child

A

can Dx by blood tests only if: clinical symptoms + tTG >10x upper limit of normal

Gold-standard: endoscopy + duodenal biopsy

103
Q

vomiting green bile

A

malrotation

104
Q

Ix malrotation

A

upper GI contrast enema

105
Q

presentation biliary atresia

A

symptoms of cholestasis

  • pale stools
  • dark urine
  • jaundice
106
Q

Mx biliary atresia

A

Kasai operation - connect liver to small intestine

107
Q

presentation of toddler’s diarrhoea

A

up to 10 stools x day
undigested food in stool
otherwise well and thriving

108
Q

Ix pyloric stenosis

A

abdo US

109
Q

ABG in pyloric stenosis

A

hypochloraemia hypokalaemic metabolic alkalosis

110
Q

Mx constipation in child

A
  1. Magrocol (laxido) - a softener

+/- Senna (stimulant) - DON’t give if stools hard

111
Q

Ix intussception

A

abdo USS

112
Q

presentation NEC

A

abdo distension
blod/mucus PR
tenderness
shock

113
Q

Ix NEC

A

plain abdo xray - shows portal venous gas

114
Q

Mx NEC

A

supportive - gastric aspiration, NBM

115
Q

presentation meconium ileus

A

not wanting to feed
not passing bowels
fullish stomach

116
Q

Ix meconium ileus

A

contrast enema (will show loops of bowel that are impacted and parts that haven’t been used)

117
Q

Mx meconium ileus

A
  1. rpt contrast enema

2. laparotomy

118
Q

Ix Hirschsrungs

A

rectal biopsy

119
Q

Mx Hirschprungs

A

remove uninnervated bowel

120
Q

presentation of congenital diaphragmatic hernia

A

bowel in one hemithorax

resp distress

121
Q

Ix congenital diaphragmatic hernia

A

pre-natal: USS

post-natal: CXR

122
Q

Mx umbilical hernia in baby

A

can leave alone - will resolve spontaenously by age 4-5

123
Q

Mx inguinal hernia in baby

A

urgent repair - strangulation risk

124
Q

presentation measles

A

prodromal illness
Koplick spots - white spots on buccal mucosa
then
maculopapular rash starting behind ears, spreads to whole of body & becomes confluent

125
Q

complications of measles

A 
otitis media
pneumonia 
encephalitis 
keratoconjunctivitis sicca
increased incidence of appendicitis 
myocarditis
126
Q

presentation mumps

A

fever, muscular pain, parotitis

127
Q

complications of mumps

A

orchitis
hearing loss
meningoencephalitis
pancreatitis

128
Q

presentation rubella

A

prodromal illness
rash starting on face then spread to whole of body
lymphadenopathy

129
Q

cause of scarlet fever

A

reaction to toxins produced by Group A strep

130
Q

presentation scarlet fever

A 
fever, malaise, N+v, headache 
strawberry tongue 
rash
- sandpaper texture
- torso first, spares palms and soles
131
Q

Ix scarlet fever

A

throat swab

132
Q

Mx scarlet fever + when kid can go back to school

A

oral pen V for 10d

can go back 24h after starting Abx

133
Q

complications scarlet fever

A

otitis media
rheumatic fever
glomerulonephritis

134
Q

what is cytolomegalovirus

A

one of the herpes viruses

135
Q

presentation congenital CMV

A 
pinpoint blueberry muffin rash 
microcephaly 
sensorineural deafness 
seizures
hepatosplenomgaly
136
Q

mneumonic for kawasaki disease presentation

A

CRASH & Burn

C - conjunctivitis 
R - rash 
A - adenopathy 
S - strawberry tonue 
H - hands &amp; feet - burning and peeling
137
Q

Mx kawasaki disease

A

high dose aspirin

IVIG

138
Q

What is HSP

A

IgA vasculitis

139
Q

cause of HSP

A

triggered by infection (e.g. tonsilitis or gastroenteritis)

140
Q

presentation HSP

A

4 classic features

  1. abdo pain
  2. joint pain
  3. purpura
  4. renal involement (IgA nephritis)
141
Q

hypospadius

A

urethral meatus located ventally on undersurface of penis

142
Q

renal agenesis presentation

A

oligohydramnios

Potter’s facies

143
Q

when is undescended testis considered congenital

A

if testis not descended by 3m

144
Q

Mx cryptorchidism

A

orchidopexy (6-18m)

orchidectomy - if presents in teenage y

145
Q

Mx nocturnal enuresis

A
  1. Reward systems
  2. Enuresis alarams (<7y)
  3. Desmospression (>7y)
146
Q

what is horseshoe kidneys

A

fusion of the lower poles of the kidneys

147
Q

presentation wilm’s nephroblastoma

A
  • abdo pain - most common
    painless haematuria
    flank pain
    anorexia
148
Q

Mx phimosis

A

Can leave alone - most resolve by 2y

149
Q

presentation juvenile polyp

A

rectal bleeding

prolapsing cherry red mass post defecation

150
Q

Ix always needed in Kawasaki disease & why

A

Echo

- can get coronary artery aneurysms

151
Q

meconium ileus associated with what condition

A

cystic fibrosis

Finals Studying - Condensed (22 decks)

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