Paeds (ENT, Derm, MSK, Rheum) Flashcards
(41 cards)
Tonsillitis Cause + Sx
S. Pyogenes =>
Fever Sore throat Diff swallowing/talking Drooling SOB
Tonsillitis Scoring
CENTOR Criteria
Abence of Cough
Tender, Cerv LN’s
White Exudate on Tonsils
Temp > 38
Tonsillitis Mx
Analgesia, Rest, Fluids
Delay ABx (Likely Viral)
If Bact confirmed: (CENTOR > 3): PO Phenoxybenzylpenicillin V (10 days)
Tonsillectomy Indications
Recurrent Tonsillitis (> 7/yr in 1yr, > 5/yr in 2yrs, > 3/yr in 3yrs)
Recurrent Tonsillar episodes
Enlarged Tonsils => Diff breathing/swallowing/sleeping (snoring)
Scarlet Fever Cause + Sx
(Group A, beta-Haem S. Pyogenes):
Fever
Sore Throat (Tonsillitis)
Bright Red, Itchy rash over Face + Body (1wk) (+/- Strawberry Tongue)
Scarlet Fever Mx
Rest, Fluids, Analgesia
Abx: Penicillin (Can return to school 24hrs after starting Abx)
Anti-Histamine
Hearing loss (< 3yo) Ix:
SN
CN
Mixed
(Chlidren < 3yo): Audiometry
Basic Resp to Sound (w/ results plotted on Audiogram)
SN loss:
Reduced AC + BC (=> AC > BC)
CN loss:
Reduced AC w/ Normal BC (=> BC > AC)
Mixed:
Reduced AC + BC w/ difference btw AC + BC > 15dB (AC > BC)
Cleft Lip/Palate Mx
Cleft Lip:
Surg at 3mo
Cleft Palate:
Surg at 6-12mo
Viral Examthemas: Chickenpox Measles Scarlet Fever Rubella Slapped Cheek D
Chickenpox (VZV):
Red, Painful, Itchy Vesicles
Measles:
Flat, Red, widespread (w/ Koplik spots - White, Inside of mouth)
Scarlet Fever (S. Pyogenes): Flushed cheeks, Strawberry tongue, Red, Rough vesicles (Sandpaper)
Rubella:
Mild, Erythematous rash
Slapped Cheek D (Parvovirus B19):
Diffuse, Bright red rash on cheeks,
Raised, Reticular (net-like), Itchy rash
Roseola Infantum Patho + Sx
Human Herpes V 6/7 =>
Sudden, High-fever (+/- Febrile Convulsions)
Mild, Erythematous, Non-Itchy rash
Hand, Foot + Mouth D Sx + Warning
Red Blistering spots on Hands/Feet
Small, painful mouth Ulcers
Avoid close-contacts (Highly Contagious)
Impetigo Patho + Sx
Highly contagious Superficial Bact Inf
=> Bullous: Large, Flaccid Bullae/Blisters => Burst leaving Crusty, Golden Patches (Systemic Sx)
=> Non-Bullous (No Systemic Sx)
Impetigo Mx
Self-isolate (Until lesions healed)
Non-bullous:
Antiseptic cream, Top Fusidic Acid
PO Flucloxacillin
Bullous:
PO/IV Flucloxacillin
Pityriasis Rosea Features
Herald patch (Circle/Oval) => Red, Itchy rash (Christmas tree distribution)
Scabies Sx + Mx
Sx:
Extreme Itching (esp at night)
Burrows along palm/soles
Close contact
Mx:
Permethrin cream
PO Ivermectin
Salter-Harris #’s Classification
- Straight Across
- Above
- Below
- Through Everything
- Crush
Limp Referral Criteria - 9
Child < 3yo Duration > 6 months Child > 9yo w/ restricted/painful Hip Unable to weight-bear Severe Pain/Agitation Neurovascular compromise Red Flags (Fever, Fatigue, Weight loss, Night Sweats, Inflamm or Persistent Pain) Suspicion of Abuse Deformity
DDH Patho + Sx
Abnormal development of Fetal (Hip) bones in Preg => Instability (+/- Subluxation/Dislocation)
Asymmetry (Hips, Leg length, Knee Height, Skin folds, Movements), Restricted Hip Abduct, Clicking (No USS needed), Clunking (USS needed) (+) Ortolani: Ant dislocation (+) Barlow: Post dislocation
DDH Ix + Mx
USS,
(If > 6mo: X-ray)
Mx:
Pavlik Harness 6-8wks (Holds Fem head in Acetabulum w/ Hips Flex + Abd)
If > 6mo or Harness failed: Surg w/ Hip spica cast
Transient Synovitis Patho + Sx
(3-10yo)
Temp Inflamm of synovium of Hip (Recent viral URTI) =>
Limp,
Groin/Hip Pain,
Refusal to weight-bear,
Mild low-grade Fever
Transient Synovitis Ix + Mx
Joint Asp (Excl SA, If purulent: Tx as Sepsis)
Mx:
Analgesia + f/up w/in 48hrs,
Self-resolve w/in 1wk),
(If < 3yo: Admit, If > 3yo: Safetynet
Perthes D Patho + Sx
(5-10yo): AVN of Fem Head => Deformity +/- Early OA:
Slow Onset Hip Pain (+/- Referred Pain to Groin/Knee)
w/ no Hx of Trauma
Limp, Restricted movement
Perthes D Ix
X-ray (AVN of Fem head +/- Normal bone),
CRP/ESR (Excl SA, JIA),
Technetium Bone scan
Perthes D Mx
Maintain healthy position (Bed rest, Traction, Crutches) PT (Reduce stress on Bone/Joint, maintain ROM) Reg Xrays (Assess healing) (If Severe/Non-healing/Older: Surg)
