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Passmed questions > PEADS PASSMED > Flashcards

PEADS PASSMED Flashcards

1
Q

Hand foot and mouth

A

-Mild systemic upset(fever, sore throat), ulcers, spots on hands and feet
-Cocksackie A16/ enterovirus 71
-Contagious
-Self limiting (hydration and analgesia)
-School exclusion not needed unless child feels unwell

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2
Q

Features of cystic fibrosis in neonatal period

A

-Meconium ileum (bowel obstruction that occurs when meconium is thicker and sticker than normal creating a blockage), prolonged jaundice (less common)
-The thicker stool is secondary to meconium

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3
Q

Mesenteric adenitis vs appendicitis ??

A

-Inflamed lymph nodes within mesentery
-Mesenteric adenitis usually no rebound tenderness or guarding and followed by viral infection

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4
Q

Paediatric BLS - INFANTS

A

-Brachial or femoral pulse
-15:2
-100-120/min
-Two thumb encircling technique for chest compression

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5
Q

What is Turners syndrome?

A

-Chromosomal disorder (FEMALES)
-Caused by presence of one X chromosome( 45, X) or deletion of short arm on X chromosome (45,XO)

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6
Q

Features of Turner’s syndrome

A

-Short stature
-Shielded chest, widely spaced nipples
-Webbed neck
-Primary amenorrhoea (never start period)
-Cystic hygroma (prenatally)
-High arched palate
-Short fourth metacarpal
-Multiple pigmented nave
-Lymphoedema in neonates (especially feet)
-Gonadotrophin levels INCREASED
-Hypothyrodisim in common
-Horseshoe kidney - common renal abnormality

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7
Q

Turners syndrome and heart

A

-Bicuspid aortic valve (15%) - Ejection systolic murmur
-Increased risk of aortic dilatation and dissection
-Regualr monitoring needed

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8
Q

What is a bicuspid aortic valve?

A

Aortic valve only has two leaflets instead of three - congenital defects
- It is associated with dilatation of ascending aorta
-Can cause aortic stenosis or aortic regurgitation
-In heads -valvuloplasty

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9
Q

Febrile convulsions

A

-Occur 6 months - 5 years
-Occur early in viral infection due to rapid rise in temperature
-Can be categorised into SIMPLE (<15 minutes, generalised, no recurrence in 24 hours, complete recovery in hour), COMPLEX (15-30 minutes, Focal seizure, repeat seizure), FEBRILE STATUS EPILEPTICUS (>30 minutes)

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10
Q

When to admit to peads for febrile seizure?

A

-1st seizure
-Any features of complex siezure

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11
Q

Ongoing management of febrile seizure

A

-Parents call ambulance if lasts >5 minutes
-NOTE: antipyretics have not been shown to reduce chance of febrile seizure occurring

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12
Q

What can be given if recurrent febrile convulsions?

A

-Benzodiazepine rescue medication - rectal diazepam or buccal midazolam
-NOTE: SPECIALIST

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13
Q

Future risk of febrile convulsions

A

-1 in 3
-Varies depending on (age of onset <18 months , fever <39, shorter duration before seizure , family history of febrile convulsionns)
-If no risk factors only a 2.5% risk of developing epilepsy
-If family history of epilepsy, complex febrile seizures or background of neurodevelopment disorder - then more likely (50% if all three)

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14
Q

When should testes descend?

A

3 months - prompt referral if not descended by this age

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15
Q

Why is it important to management undescended testes?

A

-Increase risk of testicular cancer and infertility
-Torsion can occur
-Should be repaired at 6-18 months

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16
Q

Management of unilateral undescended testis

A

-Referal from 3 months with baby seeing surgeon before 6 months

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17
Q

Management of bilateral undescended testes

A

-Reviewed by senior paediatrician within 24 hours
-Urgent endocrine or genetic investigation

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18
Q

Tetrology of fallout features

A

-Cyanosis or collapse in first month life
-Ejection systolic murmur - due to pulmonary stenosis

19
Q

What is tetralogy of fallout?

A

-Most common cause of congenital heart disease
-Presents 1-2 months
-Is a result of anterior malalignment of aorticopulmonary septum

20
Q

What are the four characteristics of TOF?

A

-Ventricular septal defect (VSD)
-Right ventricular hypertrophy
-Right ventricular outflow tract obstruction - the severity of right ventricular outflow tract obstruction determines the degree of cyanosis and clinic severity
-Overriding aorta

21
Q

Management of TOF

A

-Surgical repair
-Cyanotic episodes may be helped by beta blockers

22
Q

Intestinal malrotation with volvulus

A

-USS whirlpool sign (midgut volvulus)
-Vomiting (green in colour from bile)
-Ladd’s procedure

23
Q

Congenital diaphragmatic hernia

A

-Herniation of abdominal viscera into chest cavity due to incomplete formation of the diaphragm - can result in respiratory distress syndrome
-only 50% of newborns survive
-CXR bowel loops in chest cavity

24
Q

What does 6-1 vaccine include?

A

Diphtheria, tetanus, whopping cough, polio, Hib, hepB

25
Q

When is 6 in 1 vaccine given?

A

8, 12 , 16 weeks

26
Q

Growing pains

A

-Normal examination
-Normally bilateral pain in legs occurring at night

27
Q

Most common fractures associated with child abuse

A

-Humeral
-Radial
-Femoral

28
Q

Umbiliac hernia

A

-Usually self resolve - if large and symptomatic expletive repair 2-3 years
-If small and asymptomatic perform elective repair 4-5 years

29
Q

Neonatal death

A

death in first 28 days of life

30
Q

Prognosis of CDH

A

1) liver position - lover in thoracic cavity poor prognosis
2) lung to head ratio

31
Q

Medical management of croup

A

Dexamethasone 0.15mg/kg

32
Q

When to admit with croup?

A

-If moderate ( frequent barking cough, easily audible stridor at rest, suprasternal and sternal wall retraction at rest)
-If severe (frequent barking cough, inspiratory stridor at rest, distress, restlessness, tachycardia)

33
Q

What is bronchiolitis

A

-Acute bronchiolar inflammation
-Caused by RSV

34
Q

What are the features of bronchiolitis?

A

-Coryzal symptoms
-De cough
-Increase breathlessness
-Wheezing, fine inspiratory crackles
-Feeding difficulties associated with increasing dyspneoa -REASON TO ADMIT

35
Q

When to consider admission to hospital bronchiolitis?

A

-RR >60
-Clinical dehydration
difficulty breastfeeding or inadequate oral intake

36
Q

Management of bronchiolitis?

A

Supportive

37
Q

Phimosis management - non-retractible foreskin and/or ballooning during micturition in child under two

A

Expectant management - should resolve
NOTE: if over two and recurrent balamoposthisis or UTI then treatment can be considered

38
Q

Causative agent of roseola infantum

A

Herpes virus 6

39
Q

Benign Rolandic epilepsy

A

Seizures that occur at night
Child otherwise normal

40
Q

Age for social smile

A

6 to 8 weeks

41
Q

Risk factors for developmental dysplasia of the hip

A

-Female x6 risk
-Breech presentation

42
Q

what is Barlow and ortolan test used for?

A

Developmental hip dysplasia
Barlow - attempt to dislocate articulated femoral head
Ortolani - attempts to recloate

43
Q
A

Passmed questions (11 decks)

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