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Year 4 > Paeds Presentations > Flashcards

Paeds Presentations Flashcards

1
Q

What is the acute management of seizures?

A

Buccal midazolam, rectal diazepam, or IV lorazepam

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2
Q

How is a headache managed in paeds?

A

Paracetamol, ibuprofen, or triptans can be used

Treated differently if there are red-flag features

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3
Q

What are visual field defects?

A

When any part of the visual pathway is damaged because of a disease or an injury, part of the visual field may disappear

Eg,
- Bitemporal hemianopia: loss of all or part of lateral half of visual field
- Blind-spot enlargement: enlargement of the normal blind spot at the optic nerve head
- Central scotoma: loss of visual function in the middle of the visual field

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4
Q

What are peripheral nerve injury palsies?

A

Result from trauma, injury, nerve compression, genetic disorder, or disease like diabetes

Eg. carpal tunnel syndrome

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5
Q

What are the different types of brain haemorrhage?

A
  • Epidural: between the skull and dura mater. usually very acute
  • Subdural: between dura mater and arachnoid mater
  • Subarachnoid: between arachnoid and pia mater
  • intraparenchymal
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6
Q

What is the treatment for a squint?

A

When the eyes point in different directions

Treatment: operation to move the muscles that control eye movement

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7
Q

What are some causes of hearing loss in children?

A

Otitis media, genetic disorders, exposure to loud noise, and certain diseases (such as meningitis)

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8
Q

What are some causes of vision loss in children?

A
  • Glaucoma: when the retinal nerve becomes damaged
  • Retinal diseases
  • Refractive errors: when the shape of your eye prevents the light from hitting the retina
  • Cataract: when the transparent disc in the eye gets cloudy
  • Amblyopia: reduced vision in one eye caused by abnormal visual development early in life
  • Retinblastoma: a cancer that starts in the retina
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9
Q

Why is a CT always done when children come in the migraines?

A

Because early onset migraines could suggest a pituitary tumour

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10
Q

What are some causes of abnormal movements in children?

A
  • Chorea: involuntary movements
  • Myoclonus: sudden brief twitching of muscle groups
  • Tremor
  • Ataxia: lack of coordination and balance
  • Cerebral palsy
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11
Q

How does inflammatory bowel disease present in children?

A

Abdominal pain, cramping, blood in the stools, and chronic diarrhoea

Eg. Crohn’s or Ulcerative colitis

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12
Q

How does GORD present in children?

A

Vomiting
Gagging
Coughing
Trouble breathing

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13
Q

How does a cow’s milk allergy present?

A

It’s an IgE-mediated allergy causing urticaria, itching, cough, wheeze, diarrhoea, colic, constipation

Usually presents within 6 months of life

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14
Q

How does malnutrition present in children?

A

Short for their age
Thin or bloated
Weakened immune system
Tiredness

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15
Q

How does hepatitis present in children?

A

Same as adults but with developmental delays

Vomiting
Jaundice
Abdo pain
Diarrhoea

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16
Q

What are some causes of bloody stool in children?

A

Intestinal infection
Inflammatory bowel disease
Juvenile polyp

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17
Q

What is the treatment of peptic ulcers in children?

A

Antibiotics for H-pylori and an antacid

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18
Q

Why is BP not a good indicator of health in children?

A

Because they compensate very well and the plumet rapidly

Use respirate and 02 sats instead

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19
Q

In which cases in charcoal used in overdose?

A

Used shortly after ingestion if the toxin is still in the GI tract as charcoal stops it’s absorption

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20
Q

What is a Wilms tumour?

A

A nephroblastoma (the most common type of paediatric renal caner)

Typically in children under 5

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21
Q

What is biliary atresia?

A

A congenital condition when the bile ducts inside or outside the liver don’t develop normally

Causes blockages in the bile ducts

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22
Q

What is a hydrocele?

A

A fluid collection in the scrotum that can lead onto an inguinal hernia

They often go away without treatment by age 1. More common in premature babies

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23
Q

What causes intestinal obstructions in children?

A

Telescoping of the intestine (intussusception) most commonly

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24
Q

What is an ileus?

A

The intolerance of oral intake due to inhibition of the gastrointestinal propulsion without signs of mechanical obstruction

Often associated with surgery, medications, trauma, peritonitis, or severe illness

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25
Q

What is Henoch-Schoenlein purpura?

A

An autoimmune often triggered by an URTI where blood vessels become inflamed

It can affect blood vessels in the intestines and kidneys and small blood vessels causing a rash called purpura

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26
Q

What is the difference between nephrotic and nephritic?

A

Nephrotic: affects glomeruli and causes lots of proteins in urine

Nephritic: caused by inflamed glomeruli and causes haematuria

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27
Q

What causes DIC in paeds?

A

Disseminated intravascular coagulation causes abnormal clotting in the body

It’s always a secondary process caused by a variety of underlying disorders (eg, sepsis, trauma, or malignancy)

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28
Q

What causes hyposplenism?

A

Eg. sickle cell disease, celiac disease, alcoholic liver disease, hepatic cirrhosis, lymphomas and autoimmune disorders

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29
Q

How is hyposplenism diagnosed?

A

Pitted RBC counts or a 99Tc-labelled radiocolloid scan of the spleen

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30
Q

What is Kawasaki’s disease?

A

Swelling of blood vessels throughout the body

Full recovery after 6-8 weeks, treatment offered if the fever lasts 5+ days

Treatment: gamma globulin

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31
Q

What is the difference between Duchenne’s and Becker’s muscular dystrophy?

A

Both caused by mutations in dystrophin

In Duchenne’s, there is no dystrophin present and in Becker’s there is still some present making it less severe

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32
Q

What is idiopathic arthritis?

A

It affects children between 6 months-16 years. There’s no cure

Caused by combinations of genes and environment

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33
Q

What causes croup?

A

Parainfluenza virus

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34
Q

What is Cushing’s syndrome in paeds?

A

A multisystem disorder that results from the prolonged exposure to excess glucocorticoids

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35
Q

What are some causes of cardiac arrest in children?

A

Most commonly hypoxia and hypovolaemia

Toxins
Tamponade
Tension pneumothorax
Thromboembolic event
Trauma

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36
Q

What are some causes of respiratory arrest in children?

A

Infections
Asthma
Anaphylaxis
Foreign body
Airway anomalies
Pulmonary oedema
Chest wall and thoracic cavity abnormalities

37
Q

What is epiglottitis?

A

Inflammation of the epiglottis caused by haemophilus influezae type B (HiB)

Rare now because of the vaccine

38
Q

What are some presentations of diabetic ketoacidosis in children?

A

Abdominal tenderness, abdominal pain, nausea, and vomiting

Often misdiagnosed as gastroenteritis

39
Q

What are some caused or raised ICP in children?

A

Brain injury
Intracranial infections
Hepatic encephalopathy
hydrocephalus

40
Q

What are some musculoskeletal deformities seen in children?

A
  • Hip dysplasia: the hip socket doesn’t fully cover the ball portion
  • Legg-Calvé-Perthes disease: when the ball bit of the femur temporarily looses blood supply causing it to become inflamed and irritated
  • Slipped capital femoral epiphysis: when the femoral epiphysis is abnormally displaced relative to the neck and head of femur
  • Osgood-Schlatter disease: an overuse injury to the patellar tendon causing pain below the knee joint
  • Patellofemoral syndrome: overuse injury causing pain behind and around the patella
  • Radial head subluxation: when the radial head slips causing inability to supinate the forearm
41
Q

What are some causes of AKI in children?

A

Most commonly Haemolytic uraemic syndrome (HUS)

Can be infections, toxins, disruption to blood flow

42
Q

What are some causes of CKD in children?

A

5-14 yrs: birth defects and genetics
15-19 yrs: nephrotic syndrome and lupus

43
Q

What are some causes of haematuria in children?

A

Bladder/kidney infections
Kidney stones
Problems with urinary tract
Medication

44
Q

What are some causes of hypertension in children?

A

Overweight
Hyperthyroidism
Kidney disease
Cardiac disease
Coarctation of the aorta

45
Q

What are some causes of oedema in children?

A

Heart disease
venous obstruction
Nephrotic syndrome
Lymphatic dysfunction/obstruction

46
Q

What is a neuroblastoma?

A

Cancers that start in early nerve cells (called neuroblasts) of the sympathetic nervous system

90% of cases happen <10yrs

47
Q

What causes sickle cell anaemia?

A

Caused by a mutation to haemoglobin causing a deformed shape

48
Q

When do clinical features of sickle cell anaemia first appear?

A

3-6 months of age
(When the foetal haemoglobin fall in proportion to adult haemoglobin)

49
Q

What are some signs and symptoms of sickle cell anaemia?

A
  • Acute or chronic pain: due to vaso-occlusion
  • Pallor, weakness and lethargy: due to chronic haemolysis, transient red cell aplasia or splenic sequestration
  • Growth restriction
  • Delayed puberty
  • Splenomegaly: due to increased haemolysis in the spleen. Notably recurrent splenic infarcts usually cause asplenism by two years of age
  • Recurrent infections: as there is an increased risk of infection from encapsulated bacteria including pneumococcus, Haemophilus influenzae type b, meningococcus and salmonella species.
  • Jaundice: due to increased haemolysis
50
Q

What are some reasons for hospitalisation with sickle cell anaemia?

A
  • vasoocclusive crisis
  • Acute chest syndrome (leading cause of death): fever, cough, tachypnoea, dyspnoea, sputum production, new-onset hypoxia
  • Aplastic crisis: temporary cessation of erythropoiesis usually precipitated in parvovirus B19 infection
  • Sequestration: sudden enlargement of the spleen due to haemorrhage within it
51
Q

What is a sickle solubility test?

A

When blood with HbS is mixed with sodium dithionite a precipitate is formed and the solution becomes turbid.

When blood with normal haemoglobin is mixed with sodium dithionite the solution remains clear

51
Q

Which tests are required for diagnosis of sickle cell anaemia?

A

Haemoglobin electrophoresis
- measures haemoglobin levels and looks for abnormal types

Sickle cell anaemia: there is no HbA, 80-95% HbSS and 1-20% HbF

Sickle cell trait: both HbA and HbS are present on electrophoresis

51
Q

What are some triggers for sickle cell complications?

A

Cold temperatures
Dehydration
Exhaustion: may lead to lactic acidosis
Alcohol: may cause dehydration
Smoking: may cause the acute sickle chest syndrome

52
Q

What preventative measures are put in place for sickle cell anaemia complications?

A

Oral penicillin prophylaxis
Vaccinations
Folic acid supplementation
Hydroxycarbamide (increase HbF)

Gene therapy and bone marrow transplants are sometimes an option

53
Q

What is pancytopaenia?

A

Low levels of RBC’s, WBC’s, and platelets

54
Q

What are some causes of short stature in children?

A

Growth hormone deficiency
Genetics
Malnutrition (or GI Diseases)
Delayed puberty
Syndromes

55
Q

What is Prader-Willi syndrome?

A

Causes hypotonia, feeding difficulties, poor growth, delayed development, learning difficulties

56
Q

What is Russell-Silver syndrome?

A

Characterized by intrauterine growth restriction (IUGR), poor growth after birth, a relatively large head size, a triangular facial appearance, a prominent forehead, body asymmetry and significant feeding difficulties

Often needs growth hormone supplements

57
Q

What is meant by failure to thrive?

A

When the child has failed to develop and grow normally
Eg. weight and height

58
Q

What causes tall stature in children?

A
  • Excessive growth hormone
  • Hyperthyroidism
  • Precocious puberty
  • Lipodystrophy
  • Chromosome disorders, such as Trisomy X (47, XXX female), Klinefelter Syndrome (47, XXY), XYY syndrome (47, XYY male)
  • Fragile X syndrome
59
Q

What are the some consequences of starting your period early?

A

Early menstruation causes shorter and more irregular menstrual cycles, bleeding between cycles and results in a higher risk of suffering from primary dysmenorrhea

60
Q

What are some causes of urinary incontinence in children?

A
  • Anxiety
  • ADHD
  • Genetics
  • Constipation putting pressure on the bladder
  • Diabetes
  • Antidiuretic hormone (ADH) deficiency
  • Obstructive sleep apnoea (OSA)
  • Overactive bladder
61
Q

What is an overactive bladder?

A

When someone regularly gets a sudden and compelling need or desire to pass urine

Treated with pelvic floor exercises, scheduled toilet trips, healthy weight, bladder training

62
Q

What is the difference between polyuria and polydipsia?

A

Polydipsia: an increase in thirst
Polyuria: frequent urination

63
Q

What causes polydipsia?

A

Diabetes mellitus
Diabetes insipidus
Medications
Pregnancy

64
Q

What are some causes of learning difficulties?

A

Hypoxia during pregnancy, head trauma, early childhood illness, seizures, certain syndromes, prematurity

65
Q

What are the different types of developmental delay?

A

Cognitive
Motor
Social
Emotional
Speech

66
Q

What are dysmorphic features?

A

Abnormal differences in body structure

67
Q

What is cerebral palsy?

A

A group of disorders that affect a person’s ability to move and maintain balance and posture

Decreases life expectancy

68
Q

What is the pathophysiology behind asthma?

A

Bronchoconstriction, airway inflammation, and mucous impaction

69
Q

What is bronchiolitis?

A

An infection that causes inflammation and mucous build up in the airways

Most common cause: respiratory syncytial virus (RSV)

70
Q

What is the pathophysiology of cystic fibrosis?

A

Causes changes in how a Cl- moves in and out of cells, resulting in thick, sticky mucus in the respiratory, digestive and reproductive systems

Causes obstruction and atrophy of ducts and tubes

71
Q

What is bronchiectasis?

A

A chronic condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection

Most often linked to cystic fibrosis or COPD

72
Q

What are the main causes of pneumonia in children?

A

1st: Streptococcus pneumoniae
2nd: Haemophilus influenzae b (HiB)
3rd: RSV

73
Q

What are the most common causes of pneumothorax in children?

A

Diseases like cystic fibrosis, whooping cough, and asthma increase the chances

74
Q

What is obstructive sleep apnoea?

A

When the walls of the throat relax and narrow during sleep, interrupting normal breathing

Most common if children have large tonsils or glands

75
Q

What causes stridor in children?

A

An upper airway obstruction

Laryngomalacia is the most common cause of inspiratory stridor in the neonatal period and early infancy and accounts for as many as 75% of all cases

76
Q

What is parasuicide?

A

Apparent attempted suicide without the actual intention of killing yourself

77
Q

What causes feeding difficulties?

A

Prematurity
Oral-motor difficulties
Reflux
Allergies
Developmental delay

78
Q

What is a ventricular-septal defect?

A

When there is a hole in the septum that divides the ventricles

79
Q

What is respiratory distress syndrome?

A

Occurs in premature babies whose lungs are not fully developed and lack surfactant

80
Q

What causes jaundice in babies?

A

Too much bilirubin because babies have more blood cells that don’t live as long so are broken down

81
Q

What causes palpitations in children?

A

Premature babies have an irregular hart beat

82
Q

What’s included in the newborn examination?

A
  • Height, weight, and head circumference and calculate percentiles
  • Review HR (90-160)
  • Review RR (30-60)
  • Pulse oximetry (60%-90%)
  • Feel the head sutures and fontanelles for asymmetries
  • Eyes: Red reflex, coloboma
  • Ears: normally developed?
  • Mouth: abnormalities? palpate top of mouth for cleft palate. Check babies suck
  • Assess patency of nose if resp distress
  • Neck: thyroglossal cyst?, Clavicular fractures
  • Listen to heart and lungs
  • Liver: normal to fell liver and kidneys
  • Check for patient rectum
  • Inspect genitalia
  • Inspect hip stability, spine, fingers, and toes
  • Neuro exam: overall tone (should be balled up), check suck, rooting reflex, grasp reflex, moro reflex, deep tendon reflexes
83
Q

What is a coloboma?

A

When the pupil isn’t contained roundly but leaks into the iris
Can be genetic, environmental, result of pregnancy problems like alcohol intake

Associated with CHARGE syndrome

84
Q

What is CHARGE syndrome?

A

Coloboma
Heart defects
Atresia choanae (also known as choanal atresia)
Growth retardation
Genital abnormalities
Ear abnormalities

70% survive to age 5

85
Q

What is the moro reflex?

A

Suddenly lower infant and the arms will come up and spread and shake and come back in again

If there is asymmetry, can indicate nerve damage

85
Q

What is a rooting reflex in babies?

A

Involuntary muscle response to stimulation of their mouth

If you stroke the mouth, the baby will follow the sensation

Year 4 (84 decks)

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