PassMed/Capsule Flashcards by Sarah Abrams

What is a positive Prehn’s sign? Condition with positive Prehn’s

Relief of scrotal pain when scrotum is lifted

- Epididymitis

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Triad of features shaken baby syndrome

Retinal haemorrhages
Encephalopathy
Subdural haematoma

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Which test is used in the newborn hearing screening programme?
What test is used if this is abnormal?

Otoacoustic emission test

If abnormal: brainstem response test

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Which gene is affected in achondroplasia?

FGFR-3 (abnormal cartilage)

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Features of achondroplasia

Short limbs and short fingers
Flattened nasal bridge
Trident hands
Large head with small foramen magnum

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EEG findings West syndrome

Hypsarrhythmia

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Types of spasm in West syndrome

Salaam attacks - flexion of head, neck and trunk followed by extension of arms

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Children to what type of mothers are at a higher risk of transposition of the great arteries?

Diabetic

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Is Hirschsprung’s disease more common in males or females?

Males

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Initial management of Hirschsprung’s disease

Bowel washout/irrigation

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Definitive management of Hirschsprung’s disease

Anorectal pull through

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Diagnosis of Hirschsprung’s disease

Full thickness bowel biopsy

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Is hypotension an early or late sign of shock?

Late

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Average age on onset retinoblastoma

18 months

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Ix for vesicuoureteric reflux

Micturiating cystourethrogram

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Ix for renal scarring

DMSA

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Features of growing pains

Never present after waking 
Intermittent 
Often bilateral 
No limp
Systemically well 
No limitation to functional activity 
Worse after vigorous physical activity

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Features of innocent murmurs

Soft, Systolic, Short, Symptomless, Standing/Sitting (vary with position

No radiation
No thrills
Asymptomatic child
No other sounds, e.g. clicks

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Sandpaper rash
Straeberry tongue
Fever
Lymphadenopathy

Scarlet fever

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What is scarlet fever a reaction to?

Erythrogenic toxins produced by Group A haemolytic strep (e.g. strep pyogenes)

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Common causative organism croup

Parainfluenza viruses

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Age of presentation croup

6 months - 6 years

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Features of croup

Worse at night
95% viral
Barking cough
6 months - 6 years

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In which season is croup most common?

Autumn

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Pharm intervention for NOCTURNAL enuresis

Desmopressin ADH

Pharm intervention for daytime enuresis

Oxybutynin (anticholinergics)

Kawasaki disease initial treatment

High dose aspirin

Complications of Kawasaki disease

Coronary artery aneurysms (monitor with ECHO initially)

Commonest site of metastases Wilm's tumour

Lung

When are APGAR scores assessed?

1, 5, 10 minutes

Fetal alcohol syndrome features

``` Short palpebral fissure Thin vermillion border/hypoplastic upper lip Smooth/absent filtrum Learning difficulties Microcephaly Growth retardation Epicanthic folds Cardiac malformations ```

Ix for necrotising enterocolitis

AXR

AXR sign - necrotising enterocolitis

Pneumatosis intestinalis (gas in bowel wall)

Signs necrotising enterocolitis

Distended, tender abdomen Bilious vomiting Blood in stool Reduced movement

Why do girls with Turner's syndrome have an ejection systolic murmur?

Bicuspid aortic valve

Commonest renal abnorality in Turner's syndrome

Horseshoe kidney

Is biliary atresia more common in males or females?

Females

Cause of transient tachypnoea of the newborn

Delayed resorption of fluid in the lungs

Features of caput succedanum

Bruising and bleeding around presenting part Extends beyond margins of skull bones Resolves spontaneously in a few days Associated with SVD

Features of cephalohaematoma

Bleeding Confinded within margins of skull bones (because beneath the periosteum) Often associated with the parietal bone Resolves within several weeks-months Associated with SD/forceps/ventouse deliveries

Features of subaponeurotic haemorrhage

Diffuse, boggy swelling of the scalp Traumatic birth Significant bleeding may lead to hypovolaemic shock

Which type of damage to the head of a newborn remains confined withi the margins of the skull bones? Why?

Cephalohaematoma - bleeding occurs beneath the periosteum

Which brain injury is most common in preterm infants?

Intraventricular haemorrhage

How soon after birth does an intraventricular haemorrhage usually occur?

Within 72 hours

Why is aspirin generally contraindicated in children?

Increased risk of Reye's syndrome

Diagnosis of pertussis

Nasal swab

Are male or female infants more likely to suffer from developmental dysplasia of the hip? By how much

Females 6x

The following are all RFs for the following disease in infancy: - female sex: 6 times greater risk - breech presentation - positive family history - firstborn children - oligohydramnios - birth weight > 5 kg - congenital calcaneovalgus foot deformity

DDH

What may a child showing hand preference before 12 months indicate?

Celebral palsy

What percentage of IUGR babies never catch up?

10-15%

Russell silver

Tiny body, normal head. Protruding forehead

Approach to analysing a tantrum

ABC Antecedent - what happened before the tantrum? Behaviour - exactly what the episode consisted of Consequences - what happened as a result, including parental response

Investigations for suspected haemolytic jaundice

FBC and film Serum bilirubin Coomb's DAT

Long term sequelae of kernicterus

CP | Deafness

Mx haemolytic jaundice (<24 hours after birth)

1. Phototherapy 2. IVIG 3. Exchange transfusion

Treatment for PKU

Low phenylalanine diet with amino acid supplementation

Inheritance pattern PKU

Can phenylalanine cross the placenta?

Yes - so it is important for women hoping to get pregnant to have a well controlled diet

3 physical features associated with PKU

Microcephaly Epilepsy Eczema

Is Hirschsprung's more common in males or females?

Males 4:1

What type of obstruction occurs in hirschsprung's?

Functional

Definitive diagnosis Hirschsprung's

Full thickness rectal biopsy (contrast enema can also be useful but radiological changes might not be best seen until weeks or months after)

CXR changes in RDS

Ground glass appearance

Is RDS more severe in male or female infants?

Male

When does NEC present in preterm infants?

Commonly around 32 weeks corrected gestation (i.e. delayed from birth)

How long are preterm babies followed up for?

2 years

When does separation anxiety start to show?

6-8 months

Three stages of separation response (separation anxiety)

Protest Despair Detachment

Majority of causes of FTT are organic or inorganic?

Inorganic | Only approx 5% organic

Are obese children normally tall or short?

Tall (over nutrition = acceleration of growth) Be suspicious if they are short: cushing's, prader willi

Swollen hands and feet at birth (lymphoedema) may be indicative of ?

Turner's / Noonan's Trisomy 13/18/21 Inborn errors of lymphadenopathy

What are all girls with unexplained short stature offered?

Karyotyping, chromosomal analysis

When does growth rate begin to fall off in Turner's syndrome?

3-5 years (before then is normal)

Management of Turner's syndrome

Daily s/c HCG injections (improve growth) or GH Oral oestrogen at pubertal age to induce puberty Fertility treatment

Is an intellectual disability more common in Turner's or Noonan's?

Noonan's

Are Asian children genetically smaller or larger than other ethnic groups?

Smaller

Causes of jittery baby

Hypoglycaemia Withdrawal Metabolic problem Sepsis

Hypoglycaemia cut off for term babies and preterm babies

Term: <2 | Pre term: <2.6

Indications for a BM in a neonate

SGA GDM Mum on beta blocker

Ddx neonate seizures

``` HIE Hypoglycaemia Sepsis Polycthaemia Electrolyte imbalance Inborn errors of metabolism Kernicterus ```

Medication septic baby

Benpen Gent Aciclovir

Recommended diet for CF

High calorie, high fat, | Pancreatic enzyme supplementation

Management threadworms

Hygiene measures | Single dose mebendazole for whole family

Who might a ketogenic diet be particularly useful for?

Children with difficult to control seizures

Vomiting Cataracts Recurrent E.coli infections (sepsis)

Galactosaemia