Paeds passmed Flashcards by Sami al-balasmeh

Turner’s syndrome associated cardiac abnormalities

Bicuspid aortic valve
Coarctation of the aorta
Aortic root dilatation

How well did you know this?

Not at all

Perfectly

Raised immunoreactive trypsinogen on heel prick test

CF, sweat test to confirm

How well did you know this?

Not at all

Perfectly

Features of foetal alcohol syndrome

short palpebral fissure
thin vermillion border/hypoplastic upper lip
smooth/absent filtrum
learning difficulties
microcephaly
growth retardation
epicanthic folds

How well did you know this?

Not at all

Perfectly

Causes of neonatal hypotonia

neonatal sepsis
Werdnig-Hoffman disease (spinal muscular atrophy type 1)
hypothyroidism
Prader-Willi

How well did you know this?

Not at all

Perfectly

Features of intussusception

Usually 1-2 years old
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

How well did you know this?

Not at all

Perfectly

Clinical features of hand foot and mouth disease

mild systemic upset: sore throat, fever
oral ulcers
followed later by vesicles on the palms and soles of the feet

How well did you know this?

Not at all

Perfectly

Management of asthma 5-16YO

1) SABA
2) SABA + ICS (low dose inhaled corticosteroid)
3) SABA + ICS + LTRA (Leukotriene receptor antagonist)
4) SABA + ICS + LABA
5) SABA + MART (Maintenance reliever therapy) which includes ICS
6) SABA + moderate dose ICS MART (all above was low dose)
7) SABA +:
- high dose ICS or ICS MART
- Trial of additional drug e.g. theophylline
- Seek expert advice

How well did you know this?

Not at all

Perfectly

Management of asthma <5YO

1) SABA
2) SABA + ICS (Moderate dose, 8 week trial)
- if symptoms didn’t resolve, consider another Dx
- If symptoms resolved, then returned after, start low dose ICS
- If symptoms resolved, then reoccurred after 4 weeks, repeat the trial
3) SABA + low dose ICS + LTRA
4) stop LTRA, refer to expert

How well did you know this?

Not at all

Perfectly

Concave abdominal wall, heart sounds displaced medially and reduced breath sounds bilaterally

Congenital diaphragmatic hernia

How well did you know this?

Not at all

Perfectly

Stridor and cough in 3 year old

Croup, caused by parainfluenza

How well did you know this?

Not at all

Perfectly

breech baby born at or after 36 weeks, what screening needed

USS screening for DDH within 6 weeks old

How well did you know this?

Not at all

Perfectly

Signs of kawasaki disease

high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel

How well did you know this?

Not at all

Perfectly

Delayed passage of meconium, vomiting green bile

Likely diagnosis and confirmatory test

Hirschprungs disease

Rectal biopsy

How well did you know this?

Not at all

Perfectly

distended abdomen in neonate, not passed meconium, bilious vomiting

CF (meconium ileus)

How well did you know this?

Not at all

Perfectly

soft lesion located in the posterior triangle that transilluminates.

Cystic hygroma

How well did you know this?

Not at all

Perfectly

small smooth cyst is identified which is located above the hyoid bone. On ultrasound the lesion appears to be a heterogenous and multiloculated mass.

dermoid cyst

How well did you know this?

Not at all

Perfectly

immediate and long term complication of measles

Pneumonia

Subacute sclerosing panencephalitis 5-10 yrs down

How well did you know this?

Not at all

Perfectly

Risk factors for DDH

female sex: 6 times greater risk
breech presentation
positive family history
firstborn children
oligohydramnios
birth weight > 5 kg
congenital calcaneovalgus foot deformity

How well did you know this?

Not at all

Perfectly

Vaccine recommended for all new uni students

Meningitis ACWY

How well did you know this?

Not at all

Perfectly

When to refer baby with undescended testis

Refer if still undescended by 3 months old, refer to paediatric surgeon to be seen before 6 months old

How well did you know this?

Not at all

Perfectly

normal age for child to run

16 months to 2 years

How well did you know this?

Not at all

Perfectly

Pulse associated with PDA

large volume, bounding, collapsing pulse

How well did you know this?

Not at all

Perfectly

Constipated child, movicol hasn’t worked

lactulose

How well did you know this?

Not at all

Perfectly

vomiting, feeding intolerance and abdo distension.
Watery stools with specs of blood
Gas cysts in bowel wall on X-ray

necrotizing enterocolitis

How well did you know this?

Not at all

Perfectly

'anticipation' in Huntington's disease

Earlier age of onset in successive generations

Age at which kids 1) play alongside other kids and 2) play with other children

2 years, 4 years

sandpaper rash

scarlet fever

When is rotavirus vaccine given

2+3 months

First line medication for ADHD

Methylphenidate

commonest cause of meningitis within days of birth

GBS E-col1 Lysteria

Central abdominal pain, febrile, recent URTI

mesenteric adenitis, give antibiotics

Kartagener's syndrome

immotile cilia syndrome, causes recurrent episodes of sinitis Associated with situs inversus

Lymch syndrome

Hereditary Non-Polyposis Colorectal carcinoma

Vaccination schedule

At birth: BGC/HepB if risk factors 2 months: 6in1 (DTaP, Hib, HepB), rotavirus, PCV, men B 3 months: 6in1, oral rotavirus 4 months: 6in1, PCV, men B 12-13 months: Hib/MenC, MenB, MMR, PCV 2-8yrs: Annual flu vaccine 3-4 years: 4in1 preschool booster (DTaP), MMR 12-13 years: HPV for girls 13-18yrs: 3in1 teenage booster (DTaP not pertussis), MenACWY

What is the term we use to describe the mode of inheritance for Prader-Willi syndrome?

Imprinting | - Paternal gene deletion (Prader-willi) and maternal (Angelman) are different phenotyoes

most common brain bleed in neonates

Intreventricular haemorrhage

mainstay of treatment in uncomplicated TTN

No further Rx or investigation needed

Management of croup

Oral dexamethasone or prednisolone if dex not available

time for no or little headlag when pulled up to sit

3 months

Handed baby following C section | You note that the neonate is apnoeic, floppy and blue in colour.

Dry the neonate

Dietary advice for ADHD

Normal balanced diet

repeated flexion of head/arms/trunk followed by extension of arms

Infantile spasms, West syndrome

Fever, THEN rash

Roseola infantum

Diagnosis, initial management and definitive management of Hirschprung's

Full thickness rectal biopsy Bowel irrigation Anorectal pullthrough

Children below 0.4th centile for height

paediatrician review

Classification of squint

Eye deviated... - Medially = esotropia - Laterally = exotropia - Superiorly = hypertropia - Inferiorly = hypotropia

child < 3 years presenting with an acute limp

Urgent hospital assessment

Where does eczema affect kids of different ages

in infants the face and trunk are often affected in younger children eczema often occurs on the extensor surfaces in older children a more typical distribution is seen, with flexor surfaces affected and the creases of the face and neck

nee pain in osgood-schlatter

- Unilateral (but may be bilateral in up to 30% of people). - Gradual in onset and initially mild and intermittent, but may progress to become severe and continuous. - Relieved by rest and made worse by kneeling and activity, such as running or jumping

Investigation NOT to do in suspected meningococcal septicaemia

Lumbar puncture

a small, red growth of tissue in the centre of the umbilicus, covered with clear mucus

umbilical granuloma

Bow legs in a child < 3

Normal variant, usually resolves by age 4

Right knee pain, there most times, antalgic gait and apparent leg shortening

Perthe's disease

infants with symptoms of breathlessness worse on exertion (e.g. feeding), sweating, poor feeding and recurrent chest infections.

heart failure

At what age would the average child start to say 'mama' and 'dada'?

9-10 months

What is the most common cause of headaches in children?

Migraines

On average a child should be competent with a spoon and not spill with a cup at what age

2 years old

Newborn baby, yellow discolouration of skin, next step?

measure bilirubin within 2 hrs

is a benign murmur heard in children and sounds like a continuous blowing noise heard below the clavicles

venous hum

Squats to pick up ball

18 months

when do primitive reflexes normally disappear

Moro, Grasp and Rooting: 4 months | Stepping: 2 months

Management of umbilical hernias in kids

Usually self resolve If large or symptomatic: elective repair at 2-3 yo If small and asymptomatic, repair at 4-5 yo

emergency Rx of severe croup

O2 and nebulised adrenaline

scaphoid abdomen and bilious vomiting

intestinal malrotation

Comonest fractures associated with NAI

- Radial - Humeral - Femoral

Short child, trident hand deformity

Achondroplasia

worsening noisy breathing in baby, especially when eating

Laryngomalacia

General rule on autosomal dominant vs recessive

Autosomal recessive conditions are 'metabolic' - exceptions: inherited ataxias Autosomal dominant conditions are 'structural' - exceptions: Gilbert's, hyperlipidaemia type II

- '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

Pyloric stenosis

6 weeks post viral gastroenteritis, presenting with loose stools

Transient lactose intolerance

feeding intolerance, abdominal distension and bloody stools, Abdo X ray shows dilated loops of bowel (asymetrical)

necrotising enterocolitis

Gastroschisis vs omphalocele

gastroschisis refers to a defect lateral to the umbilicus whereas omphalocele refers to a defect in the umbilicus itself.

precipitating factor for a more severe episode of bronchiolitis and not just an increased risk of developing bronchiolitis?

underlying congenital heart disease

On examination the baby appears jittery and hypotonic. What is the most appropriate next step?

Measure blood glucose

A 9-year-old boy is diagnosed as having Attention Deficit Hyperactivity Disorder and started on methylphenidate. Which one of the following should be monitored during treatment?

growth, monitor every 6 months

GI complication of CF

Steatorrhoea

Age at which kids can draw a circile

3 years

On examination there is tenderness and swelling of the scrotum and left testicle, with absence of the cremaster reflex on the left side. Elevation of the affected testicle causes increased pain.

testicular torsion

A 4-week-old child is brought to clinic with a red rash on her scalp associated with yellow flakes. What is the most likely diagnosis?

Seborrhoeic dermatitis

A 4-week-old child is brought to clinic with a red rash on her scalp associated with yellow flakes. What is the most likely diagnosis? management

Seborrhoeic dermatitis | Rx: baby shampoo and baby oil

neonate with white-coloured nodule at the roof of the mouth.

Epstein's pearl. No Rx needed

phimosis in <2 year old

Reassurance, review then 2 years old

best practice in neonatal vitamin K?

One-off IM injection

When to measure APGAR scores post-delivery

1,5,10 minutes

Hearing assessment of newborns

All babies have otoacoustic emission test at newborn | Any who have an abnormal test then get an Auditory Brainstem Response test as newborn

Features of hypernatraemia

``` Jittery Increased muscle tone Hyperreflexia Convulsions Drowsiness or coma ```

Risk of down's with age

``` 20 = 1/1500 30 = 1/800 35 = 1/270 40 = 1/100 45 = 1/50 ```

Time off school for hand, foot and mouth disease

none if child feels well

live attenuated vaccine that isn't SM BOY

oral rotavirus

What is the recommended compression: ventilation ratio for the newborn?

3:1

peak incidence age for bronchiolotis

3-6 months

management for meningitis at different ages

<3 months old: IV cefotaxime and amoxicillin (for listeria) | >3 months old: IV cefotaxime

16YO, chronic left knee pain worse after jogging

osteochondritis dissecans

At what age would the average child acquire the ability to crawl?

9 months

Rubella rash pattern

Face then rest of bodu

EEG findings in West's syndrome

Hypsarrhythmia

Cyanosis, worse when feeeding, better when baby cries

Choanal atresia

2YO, diarrhoea, sometimes has undigested food. no other symptoms, growth is fine

Toddler's diarrhoea

When do Growing pains NOT usually affect the child

When waking up in the morning

1 hour old, heelprick shows low glucose. next step

Observe and encourage normal feeding, this is normal for first few hours after birth

Talk in short sentences (e.g. 3-5 words)

2.5-3 years

Poor prognostic markers for ALL

being male presenting <2 years or >10 years; having B or T cell surface markers; having a WCC > 20 * 10^9/l at diagnosis.

In the UK, what is the most common cause of death in children greater than one-year-old?

accidents

most common cause of ambiguous genitalia in newborns

Congenital adrenal hyperplasia

Investigation for Perthe's

USS knee, then MRI scan

When to consider a diagnosis of pneumonia in suspected bronchiolitis

``` high fever (over 39°C) and/or persistently focal crackles. ```

newborn baby <10 mins old, O2 sats of 73%, next step

observe and reassess at next interval, can be normal

Time off school for roseola infantum

None

Paeds passmed Flashcards

(108 cards)