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Paediatrics (Y4) > Revisions deck (VERY HELPFUL) > Flashcards

Revisions deck (VERY HELPFUL) Flashcards

1
Q

sources of fever

A

otitis media
viral illness:
- viral exanthum e.g. measles
- sesonala influenza
- covid-19
uti
meningitis
pneumonoa
cellulitis
sepsis

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2
Q

how to screen if a chuld is unwell

A

A to E
- RR is the most important first sign to look for

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3
Q

PEWS

A

nursing/parent concern
RR
resp distress
oxygen
heart rate
level of cosncpusness

not temp or BP

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4
Q

point of care tests - remember

A

capillary blood gas
blood glucose
urine dipstix
nasopharngeal aspirate e.g. flu, cobid rsb

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5
Q

complifcations of otitits media

A

hearing loss
balance problem
perforation
mastoiditis
venous sinus thrombosis

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6
Q

maculopapular rashes

A

roseola infantum
slapped cheek
measles (cough, coryza, conjunctivitis)
scarlet fever

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7
Q

vesicular rahses

A

chicken pox - herpes varicella zoster
hand foot and mouth disease
herpes simplex virus- herpes 1
erythema multiform- herpes 1

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8
Q

petechial (<2mm)/ pupuric (>2mm) rash

A

Non blanching
- meningococcal
- Henoch-Schönlein purpura (HSP) - lower limbs due to gaviravity

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9
Q

management of possible sepsis

A
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10
Q

management of possible sepsis

A
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11
Q

kawasaki

A
  • One of the most common vasculitides in children; also occurs in adults.
  • Acute self-limiting an acute self-limiting inflammatory disorder affecting predominantly medium sized arteries, particularly coronary arteries causing aneurysms in 15-25% if untreated.
  • Commonest causes of acquired heart disease in children in developed countries.

Presentation
CRASH AND BURN

Management: (no laboratory investigation included in diagnostic criteria):
Systemic inflammation with mild anaemia, leucocytosis with left shirt and thrombocytosis (end of week 2).
Raised ferritin (acute phase reactant). Needs ECG, CXR and cardiac ECHO.
Treatment: IV Ig; Aspirin - high dose in acute phase followed by low dose maintenance.

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12
Q

viral vs bacterial meningitits

A

viral:
- entervorus
- herpes virus

bacterial
- younger: Neisseria meningiditis (meningococcal), E.coli, Group B strep
- adults: Haemophilus influnzae and streptococcus pneumoniae

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13
Q
A

neisseria meningiditis

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14
Q

cough type. andspecific causes summary

A
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15
Q

examples of increased work of breathing

A

Nasal flaring

Expiratory grunting – increase PEEP

Use of accessory muscles - sternomastoids

Retractions – suprasternal, SC and IC

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16
Q

features of

A

bacterial
- high fever
- pain- pleurisy
- no whezze

viral
- coryzal
- young
- wheeze

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17
Q

features of

A

bacterial
- high fever
- pain- pleurisy
- no whezze

viral
- coryzal
- young
- wheeze

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18
Q

summary of LRTI management

A
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19
Q

UTI urine dipstix and MCS findings

A
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20
Q

management of UTI

A
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21
Q

indication for urianry tract Ultrasound

A

Under 6 months with first-time UTI that responds to treatment – US within 6 weeks.

6 months to 3 years:

  • Atypical UTI- organism
  • Seriously ill.
  • Septicaemia.
  • Failure to respond to suitable antibiotics within 48 hours.
  • Infection with non-E.coli organisms.
  • Poor urine flow.
  • Abdominal mass.
  • Raised creatinine.

Recurrent UTIs

  • 3 or more UTIs with lower UTI.
  • 2 or more UTIs with acute upper UTI (acute pyelonephritis).
  • 1 episode of acute upper UTI and 1 episode of acute lower UTI.
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22
Q

Kocher Criteria for Septic Arthritis

A
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23
Q

transient synovitis vs septic arthritis

A
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24
Q

differential diagnosis of an autrauamtic limp

A
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25
antibiotic prescribing
26
antibiotic prescribing
27
typical clinical features of croup
hoarseness barking cough stridor
28
infectious differential for croup
Acute epiglottitis Bacterial tracheitis Severe LN swelling Tonsillar abscess Retropharyngeal abscess
29
non infectious differential for croup
Acute laryngeal oedema (allergy) Inhaled foreign body Inhalation of smoke or hot fumes Trauma to throat Hypocalcaemia Psychological (VCD)
30
investigations for bronchiolitis
* Naso-pharyngeal aspirate PCR. * Blood gas: assess respiratory status. * Blood tests: FBC, CRP rarely helpful. U&E to assess hydration. * CXR: only to exclude complications. clinical diagnosis!
31
complications of bronchiolitis
Acute: dehydration, lung collapse, pneumonia, respiratory failure. Chronic: persistent bacterial bronchiti, bronchiolitis obliterans (adenov) (Scarring and fibrosis of small airways
32
manaagment of bronchiolitis
- supportive: oxygen, nutirtion, IV fluids NO SALBUTAMOL
33
management of viral induced wheeze
-nebulised salbutamol
34
differentials for wheeze
35
examples of chronic asthma treatment drugs
LTRA- suidical ideation theophylline- awful drug
36
causes of central cyanosis in neonates
**Airway obstruction** - choanal atresia - larygomalacia - macroglossia - micrognathia or rethrognathia (Pierre-Robin syndrome) **Pulmonary** - alveolar capillary dysplasia - lobar emphysema - pneumonoa/PE/ pneumo - perissdtent pulmonary hypertension of newborn - pulmonary hypoplasia - resp distress syndrome - transient tachypnoea of the newborn**
37
chonal atresia
38
laryngomalacia
39
micrognathia (pairee robin sequence)
40
congential lobar emphysema
41
congenital diaphragmatic hernia
42
congneital diaphagmatic hernia
43
congenital heart disease presentations at birth
44
heart murmurs
45
intussusception
46
red flags for constipation
47
constipation summary
: <3 complete stools/week. Large, infrequent stools (Bristol 3/4). ‘Rabbit droppings’ (Bristol 1) Overflow soiling: very loose/smelly. unaware passed.
48
dehyration summary
49
presentation of dehydration
50
dehydration risk factors
51
diarrhoea management
52
causes of vomiting in infants
Gastro-oesophageal reflux Feeding problems Infection: Gastroenteritis Upper/lower respiratory tract infection Whooping cough Urinary tract infection Meningitis Intestinal obstruction Pyloric stenosis Atresia – duodenal and other sites Intussusception Malrotation/Volvulus Strangulated inguinal hernia Hirschprung disease Inborn error or metabolism Congenital adrenal hyperplasia Renal failure
53
causes of vomiting in older children
Gastroenteritis Appendicitis Intestinal obstruction¶ Intussusception/malrotation/volvulus Adhesions/foreign body (bezoars) Coeliac disease Cyclical vomiting syndrome§ Torsion of the testis Infection: upper/lower UTI/RTI septicaemia, meningitis Migraine§ Raised intracranial pressure Renal failure Diabetic ketoacidosis § Inborn errors of metabolism¶ Alcohol/drug ingestion§ Bulimia/anorexia nervosa§ (¶ - pre-school; § school aged/adolescents)
54
presentation of pyloric stenosis
Vomiting is non-bilious and forceful; may become more forceful over time. Vomiting immediately after feeds; GOR vomiting not forceful and later after feeds. Infants have strong appetite; hungry after vomiting. Peristaltic waves in upper abdomen from left to right immediately before vomiting. Palpable hypertrophied pylorus (known as ‘olive’) – pathognomonic.
55
investigation findigns for pyloric stenosis
Blood gas: Metabolic alkalosis **Hypochloraemia Hypokalaemia** ± hyponatraemia.
56
management of pylorisic stenosis
NBM rehdyration Ramstedt pyloromyotomy
57
options for cows milk protein allergy
58
assessment for child who is short of age
**Predicted height:**- - (Father’s + Mother’s height/2) + 7cm (boys) or -7cm (girls). - 9th to 91st centile range: ± 10cm (boys) or 7.5cm (girls). Screening tests: * FBC, U&E, LFT. * Vitamin D * Coeliac screen * Thyroid function * Karyotype (in girls)- Turners * Bone age – x-ray left wrist and hand * (Delayed bone maturity: endocrine disorders e.g., growth hormone deficiency * constitutional delay of growth and puberty) *
59
cuases of short stature in children
60
presentation of down syndrome
61
presentation of Turner Syndrome
62
classification of headache
63
red flags for SoL
64
differnntials for suspected seizure
Seizures Pyrexial convulsion Apyrexial convulsion Epilepsy Associated/triggering conditions Inflammation (meningitis/encephalitis) Trauma (accidental/non-accidental) Intoxication/poisoning Medication/drug withdrawal Metabolic (hypo-glycaemia, -calcaemia) Hypoxia/Stroke Paroxysmal disorders Breath-holding spells Reflex anoxic seizures Syncope Migraine Benign paroxysmal vertigo Reflux (Sandifer Syndrome) Cardiac arrhythmias
65
status epilpeticus
Generalised convulsive SE defined as: ‘generalised convulsion lasting ≥30-minutes’ – or – ‘successive convulsions over 30-minutes so frequent that patient does not recover consciousness between them’
66
investigations for seizures
Bedside glucose monitoring in all children. FBC, U&E, LFT, CRP, BG, Blood culture. Anticonvulsant levels (if epilepsy). Toxicology screen (if appropriate). Plasma ammonia and lactate, serum amino-acids and urine amino- and organic-acids (seek metabolic disorder). CT head (if NAI/SOL suspected). ECG in all with prolonger seizures – rule out prolonged QT-syndrome.
67
epilepsy syndromes
68
immune thrombocytopaenic purpura - no need for treatment
69
nephrotic syndrome
70
neonatal jaundice classification
71
aetiology of neonatal jaundice
72
phototherapy for jaundice

Paediatrics (Y4) (42 decks)

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