Peadiatrics

Question 1

What is transient synovitis?

Answer 1

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)

Question 2

What is Perths disease (legg- calve perths disease)?

Answer 2

Idiopathic avasuclar osteonecrosis of the femoral head.
Younger children, unable to internally rotate hip, hip pain, limp, antalgic gait.
Treatment: surgery

Question 3

What is development dysplasia of the hip (DDH)?

Answer 3

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

Question 4

What is Osgood Slaters disease?

Answer 4

Present: might have limp, running/ jumping worsens pain
Happens in pubertal age
Notice swelling and mass of internal tibia.
Treatment: NSAIDs, ice and rest.

Question 5

What is slipped capital femoral epithesis?

Answer 5

Causes: obese children, sudden growth spurts
Presentation: limp and painful hip, limited internal rotation of hip
Treatment: weight loss, surgically pin in

Question 6

What is infantile colic?

Answer 6

Baby crying for certain period/ length with no cause

Question 7

What is Reye’s syndrome?

Answer 7

get fatty liver that leads to liver failure.

The reason why you don’t give children aspirin.

Question 8

What is a vesicular rash and some examples?

Answer 8

Raised and filled with clear fluid.

e.g. chicken pox, shingles, herpes simplex

Question 9

What is a pustular rash and some examples?

Answer 9

Raised and filled with pus

e.g. infective, bacterial process- acne, infected bug bites.

Question 10

What is a plaque and example?

Answer 10

Large raised rash (bigger than certain diameter to not be papular).
e.g. psoriasis, atopic dermatitis, eczema.

Question 11

What rashes affect the palms and soles?

Answer 11

Coxsackie A virus (causes hand foot mouth disease)
Ricketsia
Secondary syphilis
(you drive CARS with your palms and soles)

But can also get desquamatising rashes in Staph aureys and Strep pyogenes and Kawasaki disease.

Question 12

What is Kawasaki disease?

Answer 12

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.

Question 13

What is the criteria for Kawasaki disease?

Answer 13

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.

Question 14

What is epiglotitis?

Answer 14

very severe, acute, paediatric emergency.
Sat still, drooling, trying not to move head.
Stridor, obstruction of large airways.

Question 15

What are the causes of epilglotits?

Answer 15

H influenzae B (vaccinate against but can still get).

Other causes: staph aureus, strep pneumoniae.

Question 16

What is the diagnosis and treatment of epiglotitis?

Answer 16

CXR: thumb sign but not always present.
Need to INTUBATE.
Treat with antibiotics and oxygen.

Question 17

What is laryngomalacia?

Answer 17

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.

Question 18

What is croup?

Answer 18

Inflammation of upper airway before vocal cords. Caused by para influenza virus.
Symptoms: inspiratory stridor, ‘barking’ seal cough.

Question 19

What do you diagnose and treat croup?

Answer 19

Needs treating incase becomes infected.
CXR: Steeple sign.
Treatment: ABCD supportive mangement, give corticosteroids and nebulised epinephrine.

Question 20

Five signs of respiratory distress?

Answer 20

SOB
Accessory muscle use
Tracheal tug
Increased resp rate, O2 sats
Intercoastal and subcoastal recessions.

Question 21

What is bronchiolitis?

Answer 21

Lower resp tract infection (asthma can predispose)

Presents with: expiratory wheeze, 3-5 day history, cough, SOB, fever, disengaged,

Question 22

What are the causes and treatments of bronchiolitis?

Answer 22

Caused by viral- RSV (most common) influenza, parainfluenza, adenovirus.
Treatment: inhalers- salbutamol, or nebs, or CPAP

Question 23

What is impitigo?

Answer 23

yellow crusty lesions, school children, caused by strep pyogenes.

Question 24

What is scarlet fever?

Answer 24

Caused by group A strep- strep pyogenes

Sandpaper rough rash on fleion region of elbow. fever, tonsilitis.

Question 25

What rashes are caused by strep pyogenes?

Answer 25

scarlet fever impetigo steven johnson syndrome.

Question 26

What are rashes caused by staph aureus?

Answer 26

Scalded skin syndrome (SSS) Toxic shock syndrome. (like different ends of spectrum)

Question 27

What is toxic shock syndrome?

Answer 27

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.

Question 28

What is Scolded skin syndrome (SSS)?

Answer 28

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).

Question 29

What is slapped cheek disease?

Answer 29

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).

Question 30

What are the complications of mumps?

Answer 30

(caused by rna ParaMyxOvirus) POM POMS Peritis (swelling of parotids) or Pancreatitis Orchitis (can cause infertility in men) Meningitis

Question 31

what is Waterhouse Friederichson syndrome?

Answer 31

Severe adrenal haemorrhage. Lose mineralcorticosteroids so lose water- hypovolaemic shock. More unique to meningitis due to severe DIC and sepsis.

Question 32

What is the presentation of german measles (Rubella)?

Answer 32

Young child presentation: rash spreading from head to trunk, fever, no cough,conjunctivits, no koblik spots. Raised nodes behinf ear 'post oricular lymphadenopathy'.

Question 33

what are the complications of german measles (Rubella)?

Answer 33

``` Pregnant women get it/ complication to foetus: Leading cause of congenital deafness. Severe intellectual disability congenital heart conditions. Catarax, glaucoma. ```

Question 34

What is Measles caused by and symptoms?

Answer 34

RNA paramyovirus. C: conjunctivits C: Coryza (cold symptoms) C: cough Koblik sopts +rash that starts at head and goes down. Very contagious- resp droplets.

Question 35

what are the complications of measles?

Answer 35

``` (7.5% experience complications) giant cell pneumonia otitis media encephalitis subacute sclerosing panencephalitis (SSE)- developmental regression, 5/6 yrs after measles. ``` (therefore live attenuated vaccine as child)

Question 36

What is cystic fibrosis and complications?

Answer 36

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)

Question 37

Causes of delayed meconium?

Answer 37

cystic fibrosis, hirsprungs, atresia of the gut,

Question 38

What is Kernicterus?

Answer 38

Kernicterus is a complication of neonatal jaundice. Acute bilirubin encephalopathy