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PassMed Notes Flashcards

1
Q

What are the features of congenital cytomegalovirus?

A
  • Growth retardation
  • Purpuric skin lesions
  • Sensorineural deafness
  • Seizures
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2
Q

What are the features of congenital rubella?

A
  • Sensorineural deafness
  • Congenital cataracts
  • PDA
  • Purpuric skin lesions
  • Salt and pepper chorioretinitis
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3
Q

When is bicuspid aortic valve usually seen?

A

Turner’s syndrome

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4
Q

What are some features of Turner’s syndrome?

A
  • Short stature
  • Shield chest-> widely spaces nipples
  • Webbed neck
  • Bicuspid aortic valve
  • Coarctation of the aorta
  • Primary amenorrhoea
  • Cystic hygromas
  • Lymphoedema in neonates
  • High-arched palate
  • More common-> hypothyroidism, horseshoe kidney, AI disease, Crohn’s
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5
Q

How does chicken pox present?

A
  • Fever
  • Itchy rash-> starts on head/trunk then spreads
  • Macular then papular than vesicular
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6
Q

How does measles present?

A
  • Prodrome-> irritable, fever, conjunctivitis
  • Koplik spots-> on buccal mucosa
  • Rash-> behind ears then whole body, maculopapular
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7
Q

How does mumps present?

A
  • Fever, malaise, myalgia

- Parotitis-> unilateral then bilateral (70%)

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8
Q

How does rubella present?

A
  • Rash-> face then whole body, pink maculopapular, fades by day 3-5
  • Lymphadenopathy-> suboccipital + postauricular
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9
Q

How does erythema infectiosum present?

A
  • AKA slapped cheek syndrome
  • Lethargy, fever, headache
  • ‘Slapped cheek’ rash then spreads to proximal arms + extensor surfaces
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10
Q

What causes erythema infectiosum?

A
  • Slapped cheek syndrome

- Parvovirus B19

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11
Q

What causes scarlet fever?

A
  • Group A haemolytic strep-> erythogenic toxins

- Eg strep pyogenes

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12
Q

How does scarlet fever present?

A
  • Fever, malaise, tonsillitis
  • Strawberry tongue
  • Rash-> fine punctuate erythema, spares area around mouth, ‘sand paper’ on flexural areas
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13
Q

How does hand, foot + mouth disease present?

A
  • Sore throat
  • Fever
  • Vesicles in mouth + palms + soles of feet
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14
Q

What causes hand, foot + mouth disease?

A

Coxsackie A16

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15
Q

What are some clinical features of Down’s syndrome?

A
  • Upslanting palpebral fissures
  • Epicanthic fold
  • Brushfield spots in iris
  • Small, low set ears
  • Flat occiput
  • Single palmar crease
  • Sandal gap between big + first toe
  • Hypotonia
  • Duodenal atresia
  • Hirschprung’s
  • Congenital heart defects
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16
Q

What congenital heart defects are common in Down’s syndrome?

A
  • Endocardial cushion defects (AV septal canal)
  • VSD
  • ASD
  • ToF
  • PDA
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17
Q

What are some complications of Down’s syndrome?

A

-Duodenal atresia
-Hirschprung’s
-Congenital heart defects
-Subfertility
-Learning difficulties
-Short stature
-Recurrent resp infections
-Glue ear
-ALL
-Hypothyroisism
-Alzheimer’s
Atlantoaxial instability

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18
Q

What is chondromalacia patellae?

A
  • Softening in cartilage of patella
  • Teenage girls
  • Anterior knee pain when walking up + down stairs
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19
Q

What is Osgood-Schlatter disease?

A
  • Tibial apophysitis
  • Sporty teens
  • Pain/tender/dwollen tibial tubercle
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20
Q

What is osteochondritis dissecans?

A
  • Intermittent swelling + locking

- Pain after exercise

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21
Q

What is patellar subluxation?

A
  • Lateral subluxation of patella
  • Medial knee pain
  • Can give way
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22
Q

What is patellar tendonitis?

A
  • Chronic anterior knee pain
  • Worse after running
  • Tender below patella on examination
  • More common in athletic teen boys
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23
Q

What are the features of Patau syndrome (trisomy 13)?

A
  • Microcephaly
  • Small eyes
  • Cleft lip/palate
  • Polydactyly
  • Scalp lesions
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24
Q

What are the features of Edward’s syndrome (trisomy 18)?

A
  • Micrognathia
  • Low-set ears
  • Rocker bottom feet
  • Overlapping of fingers
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25
What are the features of fragile X?
- LDs-> autism more common - Macrocephaly - Long face - Large ears - Macro-orchidism
26
What are the features of Noonan syndrome?
- Webbed neck - Pectus excavatum - Short stature - Pulmonary stenosis - Normal karyotype
27
What are the features of Pierre-Robin syndrome?
- Micrognathia - Posterior displacement of tongue-> upper airway obstruction - Cleft palate
28
What are the features of Prader-Willi syndrome?
- Hypotonia - Hypogonadism - Obesity
29
What are the features of William's syndrome?
- Short stature - LDs - Friendly + extroverted - Elfin facies - Strabismus - Broad forehead - Transient neonatal hypercalcaemia - Supravalvular aortic stenosis
30
What chromosome defect causes cystic fibrosis?
Chromosome 7
31
What causes threadworms?
Enterobius vermicularis
32
How are threadworms managed?
Single dose mebenazole + hygiene measures for all members of the household
33
Which conditions have an X-linked recessive pattern?
- Duchenne muscular dystrophy - Haemophilia - G6PD deficiency
34
Which conditions have an autosomal recessive pattern?
- Cystic fibrosis - Sickle cell anaemia - Haemochromatosis - Gilbert's syndrome
35
What inheritance pattern do the majority of genetic conditions have?
Autosomal dominant
36
How does homocystinuria present?
- Young adult - Lens dislocation - Tall - Arachnodactyly - LD - DVT
37
How is Duchenne muscular dystrophy diagnosed?
Genetic testing
38
How does Duchenne muscular dystrophy present?
- Wasting + weakness of calf muscles | - Positive Gower's test-> walk arms up legs to get up from floor
39
Most common cause of arrest in children?
Respiratory-> hypoxia
40
When are hypospadias surgically corrected?
Around 12 months of age
41
What is a side effect of methylphenidate?
Stunted growth
42
What medication can be used in ADHD?
Methylphenidate
43
What imaging is used in slipped upper femoral epiphysis (SUFE)?
Plan X-ray of both hips (AP + frog legs view)
44
What is a poor prognostic factor for congenital diaphragmatic hernia?
Liver in thoracic cavity
45
How does roseola infantum present?
- High fever for a few days - Then maculopapular rash - Febrile convulsions - Diarrhoea - Cough - Can progress to aseptic meningitis or hepatitis - Often age 6 months to 2 years
46
What causes roseola infantum?
Human Herpes Virus 6
47
What is cryptorchidism?
Undescended testes
48
What should be done when a child presents with acute limp + fever?
Refer urgently for same day assessment-> may need to exclude septic arthritis
49
How does retinoblastoma present?
- Absent red reflex - White pupil (leukocoria) - Strabismus - Visual problems
50
What is the prognosis for retinoblastoma?
90%+ survive to adulthood
51
What is gastroschisis?
Congenital defect in anterior abdominal wall just lateral to umbilical cord
52
How is gastroschisis managed?
- Vaginal delivery if possible | - Immediate repair (within 4 hours)
53
What is exomphalos (omphalocoele)?
Abdominal contents protrude through anterior abdo wall-> covered in amniotic sac (amniotic membrane + peritoneum)
54
How is exomphalos (omphalocoele) managed?
- C-section | - Staged repair
55
What is the most common cause of nappy rash?
Irritant dermatitis
56
What are the features of an innocent murmur?
- Soft - Systolic - Short - Symptomless - Standing/sitting-> vary with position
57
What is used to promote duct closure in PDA?
Indomethacin or ibuprofen
58
How does necrotising enterocolitis present?
- Feeding intolerance - Abdo distention - Bloody stools - Bilious vomiting - Later-> abdo discolouration, perforation, peritonitis
59
What are the abdominal X-ray signs of necrotising enterocolitis?
- Dilated bowel loops (asymmetrical) - Bowel wall oedema - Intramural gas (pneumatosis intestinalis - Portal venous gas - Pneumoperitoneum from perforation - Rigler sign-> air inside + outside of bowel wall - Football sign-> air outlining falciform ligament
60
What is the most common cause of hypothyroidism in children in the UK?
Autoimmune thyroiditis
61
What can cause cleft palate with no other abnormalities?
Maternal anti-epileptic use in pregnancy
62
What is the first sign of puberty in boys?
Testicular growth-> at about 12 years old
63
How is SUFE managed?
Refer to ortho for in situ fixation with cannulated screw
64
What is a rare but serious complication of chickenpox?
Necrotising fasciitis
65
How does pyloric stenosis present?
- More in males - Projectile + non-bile stained vomit - 4-6 weeks old
66
How is pyloric stenosis diagnosed?
- Test feed | - US
67
How is pyloric stenosis treated?
Ramstedt pyloromyotomy
68
How does intussusception present?
- Usually 6-9 months old - Colicky pain - D+V - Sausage shaped mass - Red jelly stools
69
How is intussusception managed?
reduction with air insufflation
70
How does malrotation present?
- Bile stained vomit | - Might have other pathology eg exomphalos or congenital diaphragmatic hernia
71
How is malrotation diagnosed?
- US | - Upper GI contrast study
72
How is malrotation maganed?
- Laparotomy | - Volvulus present-> Ladd's procedure
73
What is Hirschsprung's disease?
Absence of ganglion cells from myenteric and submucosal plexuses
74
How does Hirschsprung's disease present?
- Delayed meconium passage | - Abdominal distention
75
How is Hirschsprung's disease diagnosed?
Full thickness rectal biopsy
76
How is Hirschsprung's disease treated?
- Rectal washouts | - Anorectal pull through procedure
77
What is meconium ileus usually associated with?
Cystic fibrosis
78
What is the main risk factor for necrotising enterocolitis?
Prematurity
79
What causes impetigo?
Staph aureus or strep pyogenes
80
What is the stereotypical appearance of impetigo?
Golden crusted skin lesions around the mouth
81
How might impetigo be treated?
- Hydrogen peroxide 1% cream - Topical fusidic acid - Oral flucloxacillin
82
How long should children with impetigo stay off school for?
Until lesions are crusted and healed OR 48 hours after starting antibiotic treatment
83
How are burns assessed in children?
- Lund and browder chart (most accurate) | - Wallace's rules of nines
84
How does biliary atresia present?
- First few weeks of life - Jaundice - Dark urine + pale stools - Appetite and growth disturbance - High conjugated bilirubin - Hepatomegaly - Raised liver transaminases
85
How long should kids stay off school after developing whooping cough?
- 2 days after commencing antibiotics | - OR 21 days from onset of symptoms
86
How long should kids stay off school after developing roseola?
No need to stay off school
87
How long should kids stay off school after developing slapped cheek syndrome?
No need to stay off school
88
How long should kids stay off school after developing glandular fever?
No need to stay off school
89
How long should kids stay off school after developing scarlet fever?
24 hours after starting antibiotics
90
How long should kids stay off school after developing measles?
4 days fron rash onset
91
How long should kids stay off school after developing rubella?
5 days from rash onset
92
How long should kids stay off school after developing mumps?
5 days from onset of swollen glands
93
How long should kids stay off school after developing scabies?
Until treated
94
How long should kids stay off school after developing influenza?
Until recovered
95
How long should kids stay off school after developing chickenpox?
- Until all lesions crusted over | - Usually 5 days after rash onset
96
What blood results does pyloric stenosis typically give?
- Hypochloraemia - Hypokalaemia - Alkalosis
97
How should phimosis (non-retractable foreskin) be managed?
- If <2 years-> normal + resolves with time | - If >2 with recurrent infections-> consider for treatment
98
What imaging should be done in SUFE?
Hip X-ray
99
What imaging should be done in suspected Perthe's disease when hip X-ray was normal?
MRI scan
100
What is the next investigation of choice in recurrent UTIs (after US)?
Micturating cystography
101
What is the classic presentation of juvenile idiopathic arthritis?
- Joint pain + salmon pink rash | - Can also get pyrexia, lymphadenopathy, uveitis, anorexia, weight loss
102
When should unilateral undescended testicle be referred?
Age 3 months
103
What are the three findings in shaken baby syndrome?
- Retinal haemorrhages - Subdural haematoma - Encephalopathy
104
What would a girl with haemophilia also be likely to have?
Turner's syndrome (only one X chromosome)
105
What are the features of an atypical UTI?
- Seriously ill - Poor urine flow - Abdominal or bladder mass - Raised creatinine - Septicaemia - Failure to respond to antibiotic within 48 hours - Non- E.coli
106
When should kids be referred to paeds for their height/growth?
-If they are below the 0.4th centile
107
When is jaundice always pathological?
<24 hours of life
108
What is the first line investigation in suspected DDH when the patient is >4.5 months old?
X-ray
109
How is whooping cough managed?
- Clarithromycin, azithromycin, erythromycin etc | - Within 21 days of symptom onset
110
What causes whooping cough?
Bordetella pertussis-> gram-negative bacterium
111
What is androgen insensitivity syndrome?
Child with XY chromosomes has 'female' phenotype
112
How does androgen insensitivity syndrome present?
- Primary amenorrhoea - Undescended testes-> groin swelling - Little pubic/axillary hair - Breast development
113
What cardiac pathology is associated with Duchenne muscular dystrophy?
Dilated cardiomyopathy
114
How does cephalohaematoma present?
- Swelling-> bleed between periosteum + skull - Instrumental delivery - 2-3 days after delivery - Doesn't cross suture lines
115
How does caput succedeneum present?
- Immediately after birth - Generalised superficial scalp oedema - Crosses suture lines - Often prolonged labour

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