The ill child

Question 1

as a child ages their hr, rr and sbp __ (increase/decrease?)

Answer 1

hr and rr decrease

sbp increase

Question 2

blood volume of kids =

Answer 2

80ml/kg

Question 3

3 common things kids present with

Answer 3

bronchiolitis/URTI/croup
gastroenteritis
seizures

Question 4

commonest reason for child’s acute illness =

Answer 4

sepsis

Question 5

febrile seizures are seen in this age group
why do they happen?
how do they present?

Answer 5

2,3,4yo
minor infection => brain temperature increases rapidly
tonic clonic seizures and possibly lack of consciousness

Question 6

in a child - brief asystole and then turn white and faint usually due to fright/injury =

Answer 6

reflex anoxic seizures

Question 7

breath holding attacks =

Answer 7

child will hold breath and turn blue until they faint

Question 8

most common arrhythmia in kids =

Answer 8

SVT

Question 9

6 wk old will milky vomit, projectile shortly after gettin fed
sunken fontanelle
abdo lumps that are transient =

Answer 9

congenital pyloric stenosis

Question 10

why do you get transient abdominal lumps with pyloric stenosis

Answer 10

stomach peristalsis against closed pylorus

Question 11

olive that glances off of hand on abdo exam=

Answer 11

pyloric stenosis

Question 12

how to feel pyloric stenosis

Answer 12

feel left side of abdomen with left hand

= olive glancing off of hand

Question 13

US result for pyloric stenosis

Answer 13

thin channel and very thickened pyloric muscle

Question 14

treatment for pyloric stenosis

Answer 14

fix metabolic alkalosis

Sx - Bransted’s pylorothyrotomy (cut circular muscle)

Question 15

sausage shaped abdo mass in 6m old

Answer 15

intususception

Question 16

redcurrent jelly in nappy =

caused by

Answer 16

late stage intususception

mucosal layer falling off and haemorrhage

Question 17

target lesion and pseudokidney seen on abdo US -

Answer 17

intususception

Question 18

signs of intususception

Answer 18

6m old
sausage shaped abdo mass
vomit
temperature
waves of pain
redcurrent jelly in nappy

Question 19

treatment for intususception

Answer 19

air enema reduction (works 80% of the time ) => Sx

Question 20

6yo with acute abdomen =

Answer 20

appendicitis

Question 21

bumps to hospital were sore =

Answer 21

peritonitis

Question 22

treatment of appendicitis in kids =

Answer 22

appendectomy

Question 23

vomit bile - mossy green =

Answer 23

malrotation causing SMA occlusion = emergency

Question 24

most malrotation is picked up at age

Answer 24

1m-6k 60%

<1yo 95%

Question 25

investigaion for malrotation -

Answer 25

upper GI contrast with follow through

Question 26

treatment for malrotation

Answer 26

Sx

Question 27

red and painful scrotum with possibly a black dot visible | sore only at top of testicle =

Answer 27

mullerian dot structures (remnants of femal parts - may lead to torsion)

Question 28

treatment of mullerian dot structures =

Answer 28

Sx to remove appendages

Question 29

whole testicle is blue =

Answer 29

torsion

Question 30

red and painful scrotum

Answer 30

infected epididymis

Question 31

swollen and red bilateral testicles spreading up groin and perineum - not usually sore =

Answer 31

idiopathic scrotal oedema

Question 32

treatment for idiopathic scrotal oedema =

Answer 32

antihistmaines and analgesia

Question 33

phimosis =

Answer 33

prepuce cant retract

Question 34

if phimosis is causing scarring treatment -

Answer 34

Sx - circumcision

Question 35

benign phimosis treatment =

Answer 35

steroids, daily bathe it and stretch prepuce

Question 36

paraphimosis =

Answer 36

prepuce stuck and glans fills with fluid

Question 37

hypospadias = | Rx =

Answer 37

congenitally urethral opening is on underside of penis | extensive Sx

Question 38

scrotal swelling that you can get above and transilluminates, usually gets bigger when standing up

Answer 38

hydrocele

Question 39

treatment for hydrocele

Answer 39

Sx - close PPV

Question 40

gubernaculum =

Answer 40

white tissue that guides testicle down into the scrotum normally

Question 41

treatment for undescended testicle

Answer 41

orchioplexy Sx

Question 42

if can't feel undescended testicle after sweeping the groin next Ix =

Answer 42

scope the abdomen

Question 43

loss of continence in previously continent child suggests

Answer 43

UTI

Question 44

most common cause of uncomplicated UTI in kids

Answer 44

E. coli

Question 45

poor urinary flow in a young male suggests

Answer 45

posterior urethral valve

Question 46

red flag for Hirschsprung's

Answer 46

no meconium >24hrs after birth

Question 47

encopresis =

Answer 47

normal stool but in abnormal place eg in classroom | a behavioural problem

Question 48

signs of an innocent heart murmur

Answer 48

``` systolic low density 2nd intercostal space medial to apex beneath either clavicle venous hum - disappears when supine ```

Question 49

red flags for a heart murmur

Answer 49

``` diastolic loud >=grade 3 harsh thrill radiate widely FH ```

Question 50

fluid loss or maldistribution => ___ failure => __ arrest

Answer 50

circulatory failure | cardiac arrest

Question 51

respiratory diistress or depression can lead to __>__>__

Answer 51

resp failure resp arrest cardiac arrest

Question 52

sbp = __+ 2x___

Answer 52

85 | 2x age in years

Question 53

due to a high larynx what should you not do in airway management of a paed

Answer 53

overextend the neck

Question 54

stridor indicates ___ airway obstruction

Answer 54

>70%

Question 55

____ = 25% of circulating volume in a kid => point at which clinical __ is detected

Answer 55

20ml/kg | shock

Question 56

posture __ to __ = patients condition is deteriorating (D in ABCDE for kids)

Answer 56

decorticte ( hands curled up to face) | decerebrate ( hands down by sides straight out)

Question 57

if born on or after ___ in Scotland then both parents are on birth certificate irrespective of whether they are married or not

Answer 57

4th may 2006

Question 58

Centor criteria is used to __ | =

Answer 58

``` determine if the likely cause of tonsillitis is bacterial Tonsilar exudate Tender anterior cervical lymph nodes History of fever Absence of cough ```

Question 59

immediate Abx are given if have a centor score of

Answer 59

>=3

Question 60

Indications for a tonsillectomy

Answer 60

7 episodes of tonsillitis in the past year 5 episodes of tonsillitis each year in 2 consecutive years 3 episodes of tonsillitis per year for 3 consecutive years

Question 61

most cases of tonsillitis are ___ in origin

Answer 61

viral