Peds 2 Flashcards
(170 cards)
What is the management of breast milk jaundice?
Temporary cessation of breast feeding for 2 days then resume breast feeding.
Describe the first step in the management of neonatal jaundice.
Check total and direct bilirubin levels.
How is neonatal hypoglycemia initially treated?
With IV glucose.
Define the term ‘choanal atresia’.
A condition where there is a blockage of the back of the nasal passage.
What is the test of choice if choanal atresia is suspected?
Catheter test.
Describe the management of innocent murmur.
Reassure, but refer to a pediatrician if necessary.
Management:
- Regular Monitoring: Monitor during routine check-ups.
- Parental Reassurance: Reassure parents about the benign nature of the murmur.
| Criteria | Details |
|————–|————-|
| Loud or Harsh Murmur | Grade ≥3/6, harsh, or long-lasting. |
| Diastolic or Continuous Murmur | Murmurs that occur during diastole or are continuous. |
| Unaffected by Position | Murmurs that do not change with position. |
| Radiating Murmurs | Radiate to the neck or back. |
| Associated Symptoms | Presence of shortness of breath, chest pain, fatigue, syncope. |
| Abnormal Signs | Clubbing, cyanosis, ejection clicks, added heart sounds, tachycardia, hypertension. |
| Family History | Family history of congenital heart disease or sudden cardiac death. |
| Syndromic Features | Other congenital anomalies present. |
Referral:
- Refer to a pediatric cardiologist for further evaluation and management if any of the above suspicious or pathological characteristics are present.
- RACGP Guidelines: Cardiac Murmurs in Children
- American Family Physician: Evaluation and Management of Heart Murmurs in Children
Criteria | Details |
|————–|————-|
| Soft and Low-Pitched | Typically Grade 1-2/6. |
| Systolic Murmurs | Occur during systole. |
| Position Dependent | Murmurs often change or disappear when the child is upright. |
| Localized | Heard best at the left lower sternal border or apex. |
| No Associated Symptoms | No shortness of breath, chest pain, fatigue, cyanosis. |
| No Abnormal Signs | Absence of clubbing, cyanosis, clicks, added sounds, tachycardia, hypertension. |
What is the most important complication of measles?
Otitis media.
How is bronchiolitis diagnosed in a child under 2 years old?
By the presence of wheezes.
What is the course of action in mild to moderate croup?
Inhaled cortisone
mild: no treatment
moderate/severe:
-Dexamethasone 0.3 mg/kg orally (first-line);
- Prednisolone 1mg/kg orally, or
- Budesonide 2mg by nebulizer
most severe with significant airway obstruction/fatigue: Adrenaline 1% (1:100, 10mg/ml) solution 0.05ml/kg/dose
How is severe croup treated?
With inhaled nebulized adrenaline.
mild: no treatment
moderate/severe:
-Dexamethasone 0.3 mg/kg orally (first-line);
- Prednisolone 1mg/kg orally, or
- Budesonide 2mg by nebulizer
most severe with significant airway obstruction/fatigue: Adrenaline 1% (1:100, 10mg/ml) solution 0.05ml/kg/dose
Describe the clinical presentation of a child with epiglottitis.
Symptoms include fever, sore throat, difficulty swallowing, and a characteristic with the neck extended and the chin pointing upwards.
What is the causative organism of epiglottitis?
Haemophilus influenzae.
What is the recommended treatment for epiglottitis?
Hospital admission and intubation.
Define Kawasaki disease.
A condition characterized by prolonged fever and a specific set of clinical criteria including conjunctivitis, rash, erythema, adenopathy, and mucous membrane involvement.
How is Kawasaki disease diagnosed?
Fever for 5 days or more plus 4 of the following criteria (CREAM): Conjunctivitis, Rash, Erythema, Adenopathy, and Mucous membrane involvement.
Describe the most important investigation in Kawasaki disease.
Echocardiogram (echo) to assess for cardiac complications.
What are the most serious complications of Kawasaki disease?
Myocarditis and coronary aneurysm.
Do you know the first-line treatment for Kawasaki disease?
Intravenous immunoglobulin (IVIG) is the first line, followed by aspirin as the second line.
Describe the presentation of a child with otitis media.
A child with fever, crying, and pulling on their ear.
What is the most common causative organism of otitis media?
Streptococcus pneumoniae.
How is otitis media treated according to current updates?
Initially with paracetamol, then amoxicillin if no response, and amoxicillin-clavulanate if still no response.
Define mastoiditis.
Inflammation of the mastoid bone typically presenting with swelling behind the ear.
What is the recommended imaging modality for diagnosing mastoiditis?
CT scan.
Describe the treatment of chronic otitis media.
Management includes aural toilet and the use of ciprofloxacin ear drops.
