Flashcards in Peadiatrics Deck (38):
What is transient synovitis?
Transient inflammation, autoimmune, hips most commonly affected, younger children, recent URTI (triggered by viral infection)
Present with pain and limp
(Need to rule out septic arthritis).
Management:: NSAIDS (may move to prenisolone if not working)
What is Perths disease (legg- calve perths disease)?
Idiopathic avasuclar osteonecrosis of the femoral head.
Younger children, unable to internally rotate hip, hip pain, limp, antalgic gait.
What is development dysplasia of the hip (DDH)?
Easily dislocatable hip joint.
Causes: traumatic birth- breach, multiple birth, digohydromohis (decreased amount of amniotic fluid).
Indicators: see discrepancies of leg lengths, skin folds assymetrical in groin region.
Confirm: Barlow and Attorny test
Treatment: 6 months Pavlik harness
What is Osgood Slaters disease?
Present: might have limp, running/ jumping worsens pain
Happens in pubertal age
Notice swelling and mass of internal tibia.
Treatment: NSAIDs, ice and rest.
What is slipped capital femoral epithesis?
Causes: obese children, sudden growth spurts
Presentation: limp and painful hip, limited internal rotation of hip
Treatment: weight loss, surgically pin in
What is infantile colic?
Baby crying for certain period/ length with no cause
What is Reye's syndrome?
get fatty liver that leads to liver failure.
The reason why you don't give children aspirin.
What is a vesicular rash and some examples?
Raised and filled with clear fluid.
e.g. chicken pox, shingles, herpes simplex
What is a pustular rash and some examples?
Raised and filled with pus
e.g. infective, bacterial process- acne, infected bug bites.
What is a plaque and example?
Large raised rash (bigger than certain diameter to not be papular).
e.g. psoriasis, atopic dermatitis, eczema.
What rashes affect the palms and soles?
Coxsackie A virus (causes hand foot mouth disease)
(you drive CARS with your palms and soles)
But can also get desquamatising rashes in Staph aureys and Strep pyogenes and Kawasaki disease.
What is Kawasaki disease?
Vasculitis of medium vessels.
Give aspirin as risk of devloping cornoary aneurysms (find with ECHO). Also treat with prednisolone.
<5 years, japenese, increased ESR and CRP.
What is the criteria for Kawasaki disease?
First criteria: Fever >38 degrees for 5 days or more.
Second criteria: CRASH &BURN (Conjunctivitis, Rash, cervical Adenopathy, Strawberry tongue, peeling skin Hands, BURN= fever)
For diagnosis have to have first criteria plus four of more of second.
What is epiglotitis?
very severe, acute, paediatric emergency.
Sat still, drooling, trying not to move head.
Stridor, obstruction of large airways.
What are the causes of epilglotits?
H influenzae B (vaccinate against but can still get).
Other causes: staph aureus, strep pneumoniae.
What is the diagnosis and treatment of epiglotitis?
CXR: thumb sign but not always present.
Need to INTUBATE.
Treat with antibiotics and oxygen.
What is laryngomalacia?
Weak larynx so when in positions such as lying down it collapses and causes stridor- but improves when leaning forward.
It is the most frequent cause of stridor in children.
What is croup?
Inflammation of upper airway before vocal cords. Caused by para influenza virus.
Symptoms: inspiratory stridor, 'barking' seal cough.
What do you diagnose and treat croup?
Needs treating incase becomes infected.
CXR: Steeple sign.
Treatment: ABCD supportive mangement, give corticosteroids and nebulised epinephrine.
Five signs of respiratory distress?
Accessory muscle use
Increased resp rate, O2 sats
Intercoastal and subcoastal recessions.
What is bronchiolitis?
Lower resp tract infection (asthma can predispose)
Presents with: expiratory wheeze, 3-5 day history, cough, SOB, fever, disengaged,
What are the causes and treatments of bronchiolitis?
Caused by viral- RSV (most common) influenza, parainfluenza, adenovirus.
Treatment: inhalers- salbutamol, or nebs, or CPAP
What is impitigo?
yellow crusty lesions, school children, caused by strep pyogenes.
What is scarlet fever?
Caused by group A strep- strep pyogenes
Sandpaper rough rash on fleion region of elbow. fever, tonsilitis.
What rashes are caused by strep pyogenes?
steven johnson syndrome.
What are rashes caused by staph aureus?
Scalded skin syndrome (SSS)
Toxic shock syndrome.
(like different ends of spectrum)
What is toxic shock syndrome?
Caused by staph aureus
secretion of super antigen that binds to every inflammatory antibody.
raging fever, rash begins to desquamate. Multisystem failure.
Treatment: give fluids and flucloxacilin.
What is Scolded skin syndrome (SSS)?
Caused by staph aureus
Red rash and blistering then begins peeling and can rub off- Nikolsky sign.
(patient generally stable and organs aren't affected but may progress to toxic shock syndrome).
What is slapped cheek disease?
Rash both cheeks, unhappy child, fever,
Caused by: Parovirus B19
(this virus can also cause viral arthitis, and aplastic crisis in patients with sickle cell).
What are the complications of mumps?
(caused by rna ParaMyxOvirus)
Peritis (swelling of parotids) or Pancreatitis
Orchitis (can cause infertility in men)
what is Waterhouse Friederichson syndrome?
Severe adrenal haemorrhage. Lose mineralcorticosteroids so lose water- hypovolaemic shock.
More unique to meningitis due to severe DIC and sepsis.
What is the presentation of german measles (Rubella)?
Young child presentation: rash spreading from head to trunk, fever, no cough,conjunctivits, no koblik spots. Raised nodes behinf ear 'post oricular lymphadenopathy'.
what are the complications of german measles (Rubella)?
Pregnant women get it/ complication to foetus:
Leading cause of congenital deafness.
Severe intellectual disability
congenital heart conditions.
What is Measles caused by and symptoms?
C: Coryza (cold symptoms)
Koblik sopts +rash that starts at head and goes down.
Very contagious- resp droplets.
what are the complications of measles?
(7.5% experience complications)
giant cell pneumonia
subacute sclerosing panencephalitis (SSE)- developmental regression, 5/6 yrs after measles.
(therefore live attenuated vaccine as child)
What is cystic fibrosis and complications?
screen in new born with blood spot.Autosomal recesive- CFTR egen.
Men infertile- absent vas deferens.
Symptoms: SOB, secretions, recurrent check infecitions, malnutrition.
Present with meconium ileus or recurrent chest infections.
Cant break down ADEk as no pancreatic enzymes.
Diagnose: sweat test
Treatment: supportive (bronchodilators, antimucolytics, replace enzymes, antibiotics)
Causes of delayed meconium?
cystic fibrosis, hirsprungs, atresia of the gut,