Paediatrics main flashcards

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jaz_walker
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273953
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Paediatrics main flashcards
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2014-05-10 15:42:31
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paediatrics
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  1. 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. 2. A toddler presents with a severe burn. What surface area indicates poor survival?
    Over 70%
  3. 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. 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. 5. What is the commonest cause of death from house fire?.
    Smoke inhalation
  6. 6. A toddler presents with an electrical burn. What symptoms might you look for?
    VF. Tetanic contractions
  7. 7. A toddler presents with freshwater drowning. What would make you admit them?
    Respiratory distress, inhaled water, cardiac arrhythmias.
  8. 8. What would you look for in the next 3 days?
    Pulmonary oeema, respiratory deterioration
  9. 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. 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. 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. 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. 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. 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. 15. At what age does risk of intussusception peak?.
    2 months - 2 years
  16. 16. A 4 year old presents with painless scrotal swelling. What 3 surgical causes do you want to exclude?
    Inguinal hernia, hydrocoele, varicocoele
  17. 17. A 4 year old presents with painful scrotal swelling. What 2 causes might you consider?
    Torsion of testis, epididymo-orchitis
  18. 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. 19. A 3 year old child presents with a limp. They have an abdominal mass, weight loss and malaise. What might you consider?
    Neuroblastoma
  20. 20. A neonate presents with a systolic murmur. What is it most likely to be?
    VSD
  21. 21. A neonate is known to have persistent truncus arteriosus. What syndrome might you consider?
    diGeorge syndrome
  22. 22. A 4 year old presents with a URTI. What should you examine?.
    Lungs, mouth, ears, FLAP.
  23. 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. 24. A 3 year old has acute otitis media. What viral cause might you consider?
    RSV
  25. 25. A 3 year old has acute otitis media. What bacterial causes might you consider?
    Pneumococcus, haemophilus influenzae, group B strptococci
  26. 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. 27. How do you manage this?
    Manage at home. Admit if under 1 yr old, or fatiguing.
  28. 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. 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. 30. A 4 year old child presents with a 'whooping' cough. What is the causative organism?
    Bordella Pertussis
  31. 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. 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. 33. A 4 year old child presents with a cough and shortness of breath. They're diagnosed with pneumonia. What is first line treatment?
    Penicillin
  34. 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. 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. 36. A baby presents with jaundice within the first 24 hours of life. What do you consider?
    haemolysis, congenital infection. Always pathological.
  37. 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. 38. A 1 year old presents with failure to thrive. What 3 categories of causes mightyou consider?
    inadequate food intake, malabsorption, increased requirements
  39. 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. 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. 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. 42. A child is presented to your clinic with precocious puberty. Are you more concerned in females or males?
    Males
  43. 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. 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. 45. A 5 year old presents with oliguria and malaise. What is the commonest cause of paediatric acute renal failure?
    HUS
  46. 46. A 2 week old female presents with purulent eye discharge. Otherwise well. What's the likeliest caue and management?
    Chlamydia - give erythromycin
  47. 47. A 5 year old presents with painful, swollen joints. What 4 things should you consider?
    JIA, reactive arthiritis, henoch-schonlein purpura, idiopathic
  48. 48. A child presents with a limp. What 4 diagnoses might you consider?
    Transient synovitis, congenital dislocation, perthe's diseae, SUFE
  49. 49. A child presents with a painful limp. What 4 things might you consider?
    Osteomyelitis, septic arthiritis, fracture, sickle cell
  50. 50. A child presents with a limp. What suggests transient synovitis?
    Limited passive abduction and rotation, afebrile
  51. 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. 52. A 6 month old presents with an abnormal hip x ray.. They have DDH. What is management?
    Pavlik harness.
  53. 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. 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. 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
  56. . A baby is born with cataracts. What common diseases might you consider?
    Hypoparathyroidism, Down's, trisomy 13/15, Fabry's syndrome.

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