Paediatrics main flashcards
Card Set Information
Paediatrics main flashcards
1. A toddler presents with a severe burn. How would you examine / investigate this child?
ABC, assess depth and surface area of burn and involvement of special sites
2. A toddler presents with a severe burn. What surface area indicates poor survival?
3. A toddler presents with a severe burn. How would you manage them (5 things).
Treat pain, shock. Wound care: plastic wrapping and brief irrigation. Tetanus immunisation. Consider referral.
4. A toddler presents with a severe burn. What would make you refer them?
More than 5% full thickness, more than 10% partial thickness, or significant burns ot special sites
5. What is the commonest cause of death from house fire?.
6. A toddler presents with an electrical burn. What symptoms might you look for?
VF. Tetanic contractions
7. A toddler presents with freshwater drowning. What would make you admit them?
Respiratory distress, inhaled water, cardiac arrhythmias.
8. What would you look for in the next 3 days?
Pulmonary oeema, respiratory deterioration
9. A toddler on your ward is witnessed to have inhaled a foreign object. They have an ineffective cough and are unconscious. What do you do?
Start CPR (5 rescue breaths and chest compressions)
10. A toddler on your ward is witnessed to have inhaled a foreign object. They have an ineffective cough and are conscious. What do you do?
5 back blows and 5 thrusts (abdo for child, chest for infant)
11. A toddler on your ward is witnessed to have inhaled a foreign object. They have an effective cough and are conscious. What do you do?
Encourage and check for deterioration
12. A 3 month old male dies suddenly in their sleep. What 3 pieces of advice prevent SIDS?
Feet to foot, back to sleep, avoid overheating
13. A 4 month old presents with a neck lump. What 3 differentials should you consider?
Cervical lymphadenitis, congenital thyroglossalcysts, malignancy (non-Hodgkin's).
14. A 7 year old present with abdominal pain. What 4 surgical causes do you want to exclude?
Acute appendicitis, mesenteric adenitis (after RTI), intussusception, volvulus
15. At what age does risk of intussusception peak?.
2 months - 2 years
16. A 4 year old presents with painless scrotal swelling. What 3 surgical causes do you want to exclude?
Inguinal hernia, hydrocoele, varicocoele
17. A 4 year old presents with painful scrotal swelling. What 2 causes might you consider?
Torsion of testis, epididymo-orchitis
18. A 7 year old female presents with an abdominal mass. What is the most common cause and what other causes might you consider?
Constipation is most common. Also hydronephrosis, neuroblastoma, nephroblastoma
19. A 3 year old child presents with a limp. They have an abdominal mass, weight loss and malaise. What might you consider?
20. A neonate presents with a systolic murmur. What is it most likely to be?
21. A neonate is known to have persistent truncus arteriosus. What syndrome might you consider?
22. A 4 year old presents with a URTI. What should you examine?.
Lungs, mouth, ears, FLAP.
23. A 6 year old has otitis media with effusion. What treatment might you consider?
Usually resolves itself. If persists, consider grommets and surgical development. Grommets don't always help hearing and speech.
24. A 3 year old has acute otitis media. What viral cause might you consider?
25. A 3 year old has acute otitis media. What bacterial causes might you consider?
Pneumococcus, haemophilus influenzae, group B strptococci
26. A 2 year old child presents at night in winter with a 'sea lion' barking cough. They've had a cough for 2 days. What organism causes this?
Croup - parainfluenza virus
27. How do you manage this?
Manage at home. Admit if under 1 yr old, or fatiguing.
28. A 4 week old presents with a cough and breathlessness in Winter. There are bilateral fine crackles. CXR shows hyperinflation. What may be the organism?
Bronchiolitis - RSV
29. A 4 week old presents with a cough and breathlessness in Winter. There are bilateral fine crackles. CXR shows hyperinflation. What is management?
Supportive - of hypoxia and hydration.
30. A 4 year old child presents with a 'whooping' cough. What is the causative organism?
31. A 4 month old child presents with a 'whooping' cough. What is management?
Erythromycin early on eradicates organism and infectivity, but not length of convelescence.
32. A 4 year old child presents with a cough and shortness of breath. What 3 investigations indicate pneumonia?
PMN leukocytes, lobar consolidation, pleural effusion
33. A 4 year old child presents with a cough and shortness of breath. They're diagnosed with pneumonia. What is first line treatment?
34. A toddler presents with diarrhoea. They are otherwise well. What is the most likely cause and management?
Toddler diarrhoea - they'll grow out of it, but a good diet might help.
35. A child presents with constipation. What are the 6 red flag signs?
within a few weeks of life, meconium passage abnormal, growth falter, lower limb neurology, abdo distension/vomiting, child protection
36. A baby presents with jaundice within the first 24 hours of life. What do you consider?
haemolysis, congenital infection. Always pathological.
37. A 1 year old presents with failure to thrive. What malabsorptive causes might you consider?
coeliac disease, cystic fibrosis, cow's milk protein allergy
38. A 1 year old presents with failure to thrive. What 3 categories of causes mightyou consider?
inadequate food intake, malabsorption, increased requirements
39. A father comes with his 4 year old, concerned about short stature. How would you define short stature?
Below 0.4th centile, less than mid parental target and changing more than 1 centile over 1-2 years.
40. A father comes with his 4 year old, concerned about short stature. What 5 categories of causes might you consider?
Familial, endocrine, chromosomal, skeletal, emotional, chronic illness
41. A child is presented to your clinic with precocious puberty. How would you define this?
Secondary sexual characteristics before 8 in girls and 9 in boys.
42. A child is presented to your clinic with precocious puberty. Are you more concerned in females or males?
43. A child is presented to your clinic with late puberty. How would you define this?
Absence of secondary sexual characteristics at 13 years (girls) or 14 years (boys)
44. A 4 year old male presents with dysuria and frequency, with loin pain. What else might you ask about / examine?
Fever, oedema, hypertension, rash, joints, bruises, abdo mass
45. A 5 year old presents with oliguria and malaise. What is the commonest cause of paediatric acute renal failure?
46. A 2 week old female presents with purulent eye discharge. Otherwise well. What's the likeliest caue and management?
Chlamydia - give erythromycin
47. A 5 year old presents with painful, swollen joints. What 4 things should you consider?
JIA, reactive arthiritis, henoch-schonlein purpura, idiopathic
48. A child presents with a limp. What 4 diagnoses might you consider?
Transient synovitis, congenital dislocation, perthe's diseae, SUFE
49. A child presents with a painful limp. What 4 things might you consider?
Osteomyelitis, septic arthiritis, fracture, sickle cell
50. A child presents with a limp. What suggests transient synovitis?
Limited passive abduction and rotation, afebrile
51. A child presents with a limp. What warns you that this might be DDH?
painless limp, delayed walking, waddling gait, limited abduction, shortened femur. You can x ray after 4-5 months.
52. A 6 month old presents with an abnormal hip x ray.. They have DDH. What is management?
53. A 4 year old presents wtih a limp. What suggests this might be Perthes' disease?
Abduction and rotation is limited. Intermittent pain. Hip x ray is diagnostic.
54. An obese 12 year old boy presents with a limp. What are you wary of and how do you diagnose it?
SUFE - plain radiography
55. A 3 year old is brought by her mother to see the paediatrician, concerned about autism. What 4 features are key to diagnosing autism?
impaired social interaction, communication, before age 3, restricted pattern of behaviour and interests
. A baby is born with cataracts. What common diseases might you consider?
Hypoparathyroidism, Down's, trisomy 13/15, Fabry's syndrome.