3a ILAs > Paediatric > Flashcards

Paediatric Flashcards

(52 cards)

Study These Flashcards
1
Q

Paediatric red flags

A
  1. Doesn’t wake when roused/won’t stay awake
  2. Looks very unwell to HCP
  3. Weak/high-pitched/continuous cry
  4. Severe tachycardia/pnoea
  5. Brady under 60
  6. Non-blanching rash/mottled/ashen/cyanotic
  7. Temp under 36
  8. If under 3 months, temp over 38
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Amber flags

A
  1. Not responding normally/no smile
  2. Reduced activity/very sleepy
  3. Moderate tachycardia/pnoea
  4. Sp02 under 92 or inc O2 req
  5. Nasal flaring
  6. Cap refil time over 3 seconds
  7. Reduced urine output
  8. Leg pain or cold extremities
  9. Immunocomp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What to do if red flags and amber flags?

A

Paeds septic 6 for red flags. If amber, send bloods, review results, ensure senior clinical review within an hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Septic 6 for paeds (within an hour)

A
  1. Ensure senior clinical attends
  2. Oxygen if required
  3. Obtain IV/IO access
    1. Take bloods
      1. Blood cultures, blood glucose, lactate, FBC, U&Es, CRP, Clotting, Lumbar puncture if indicated
  4. Give IV/IO abx
  5. Consider IV/IO fluids
  6. Consider inotropic support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What would Neisseria Meningitis show on LP, management and cause of purpura

A

Bacterial - mainly neutrophils, low glucose, high protein. Gram film - Gram negative diplococci
Mx: IV Ceftriaxone - if no IV access, IM Benzylpenicillin
Disseminated intravascular coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What first-line treatment is recommended to reduce the risk of the disease in “close contacts”?

A

Rifampicin or ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you diagnose Kawasaki’s

A

American Heart Association Diagnostic Criteria:
Fever over 39C for 5< days + four out of: Mucositis, Bilateral Conjunctivitis without exudate, Peripheral changes, Cervical lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Blood test changes in Kawasaki’s, Management

A

Thrombocytosis and raised ESR
High dose aspirin and IVIg w/supportive care
Echocardiogram due to coronary artery aneurysms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Reye’s

A

progressive encephalopathy w/fatty infiltration affecting Liver, pancreas and kidneys. hypoglycaemia, supportive management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute management of DKA Paeds

A

Immediate: Saline bolus over 15 to 30mins (NaCl 0.9%, 10ml/kg) + Potassium.
Insulin 1-2 hours AFTER fluid. Up saline to 40ml/kg if still in shock
Over 48hrs:
0.45% NaCl - deficit + maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Long term management for paediatric DKA

A

Insulin management. Glucose/ketone monitoring. Nutrition. Education and management by diabetic nurse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to calculate fluid required for dehydrated child

A

Maintenance:
100ml/kg for <10kg
50ml/kg for 11-20kg
20ml/kg for >20kg
Deficit:
(% dehydrated) x (kg) x 10 = fluid for next 48hrs inc. initial bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differentials for unwell neonate

A
  • Sepsis/other infection (UTI, pneumonia, meningitis)
  • Congenital heart abnormalities
  • Metabolic/endocrine
    • CAH
  • GI - obstruction, malrotation with volvulus
  • Intracranial haemorrhage
  • Dehydration, hypoglycaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Likely cause of hyponatremia in neonate? What other changes in electrolyte screen and A/VBG?

A

Congenital adrenal hyperplasia - due to 12-hydroxylase deficiency (Salt wasting crisis)
Hyperkalaemia, Severe HCO3- deficit. Severe metabolic acidosis w respiratory compensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of Salt Losing Crisis

A

5-15days old, shock, hypoglycaemia, vomiting, poor feeding, dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of Salt losing adrenal crisis

A

IV 10% dextrose and 0.9% saline bolus (20ml/kg)
Hyperkalaemia management: Calcium gluconate, salbutamol nebulisers, Insulin.
Monitor ECG
IV/IM hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How could virilisation be prevented antenatally?

A

Dexamethasone started at 9wks if both parents are carriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Difference between stridor and wheeze

A

Stridor is upper airway and on expiration
Wheeze is lower airway and inspiration almost always
Both due to obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

2 infective causes of stridor and their pathogens

A

Croup - Parainfluenza (6mos -3 years, winter)
Acute epiglottitis - Haemophilus influenzae b (2-7 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Croup first line treatment and management if patient desaturates

A

Oral/IM Dexamethasone or budesonide nebs in severe hypoxia
Then:
Nebulised adrenaline, high flow oxygen, IV fluids, CSx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features of heart failure as a result of VSD

Study These Flashcards
A

HF: Displaced apex (5th left IC space), sweating, liver palpable 3cm below margin (hepatomegaly)
VSD: Poor feeding, poor weight gain, SoB when feeding. Soft pansystolic murmur

22
Q

Investigations for likely paediatric HF w/VSD

Study These Flashcards
A

Echocardiogram - large hole between ventricles (left to right)
CXR - Cardiomegaly w/increased pulmonary vascular markings
ECG - Biventricular hypertrophy

23
Q

Paediatric Heart Failure medications

Study These Flashcards
A

Diuretics - furosemide
ACEi
Nutritional support - high caloric feeds

24
Q

Possible causes of faltering growth

Study These Flashcards
A
  • Inadequate intake
  • Malabsorption
  • Increased metabolic demands/ chronic illness
  • Failure of nutrient utilisation
  • Psychosocial environment
25
When can you give additional formula feeds? (faltering growth)
After underlying cause is identified and treated
26
Likely cause of UTI in 4 month old?
E.Coli or Klebsiella (both are Gram-negative rod shaped bacteria)
27
What investigations could you do for recurrent UTIs?
Renal and Bladder USS for structural abnormalities Micturating cystogram to check for Vesicoureteric reflux DMSA scan to check for renal scarring
28
When should children be referred for a UTI and management
<3 months -> paediatrician 3+ months w/UUTI or give 7 days cephalosporin/co-amoxiclav 3months+ w/LUTI - 3 days trimethoprim/cephalosporin
29
When to do urine sample in paediatric UTI and how?
If any symptoms/signs of UTI, unexplained fever +38C No later than 24hrs - clean catch, or urine collection pads Suprapubic aspiration if needed
30
Factors affecting choice of investigation for paediatric UTI
Age, severity, if it's recurrent, response to treatment, local guidance, finding on image, signs of UUTI (loin pain, +38C)
31
What is overflow soiling/diarrhoea?
When child has chronic constipation and faecal impaction builds in rectum or colon, and diarrhoea passes through. Small amounts of foul smelling faeces pass through
32
Constipation definition and common clinical features
Delay or difficulty ind efaecation for 2+ weeks and sufficient to cause distress to patient Features: <3 stools per week Hard or painful stools Straining/withholding behaviour Abdo pain or distension Soiling 2ndary to overflow Large stools that may block the toilet
33
Red flags in diagnosing constipation
Delayed meconium Faltering growth/Weight loss Vomiting/Severe abdo distension Abnormal lower limb neurology, sacral dimple or tuft of hair, spinal lesion Anal stenosis, anteriorly placed anus, perianal fistula Bloody stools w/o fissue, systemic illness, FHx of Hirschprung's Very early onset
34
Management of overflow soiling
1. Education and explanation to family and child 2. Oral macrogol - gradually increase until disimpaction achieved 3. Behavioural and lifestyle measures 4. Review in a week
35
Laxative types and names used in paediatrics
Osmotic - soften stool by drawing water into bowel Macrogols (Movicol, Laxido), lactulose Stimulant - increase intestinal motility and colonic contractions Senna, sodium picosulfate, bisacodyl
36
Differential diagnoses for 4yr M w/swelling around face, scrotum and ankles. No fever, slight abdo distension, proteinuria, and previous infection 2 months ago
Nephrotic (minimal change, focal segmental glomerulosclerosis, membranoproliferative GN) Liver disease, Cardiac failure, Hydrocele
37
Criteria for minimal change disease
1. Heavy proteinuria 2. Hypoalbuminemia 3. Oedema 4. Normal renal function
38
Initial investigations (suspect minimal change)
Urine dip/microscopy Protein:Creatinine Ratio Urine Culture Bloods - U+E, eGFR, Creatinine, total protein, FBC HIV serology, HepB Renal US
39
Management and prognosis of minimal change disease
Steroids (pred) without biopsy 80-90% respond but relapses are common
40
2wk male infant with immobile leg, and inconsolable crying - FHx of osteoporosis and several fractures. Diff Diagnoses and what to look for on examination
DD: Birth related fracture, NAI, Osteogenesis imperfecta Ex: Blue sclerae, Full head to toe for other bone deformities, Local limb: swelling, bruising, deformity, asymmetry, point tenderness, warmth, cap refill. Deafness, dental imperfections
41
Investigations with symptoms of OI
1. AP + lateral X-ray of affected limb 2. Full skeletal survey : adjusted calcium, phosphate, PTH, ALP 3. Cranial CT or X Ray 4. Baseline bloods : FBC, CRP, ESR, U+Es, LFTs
42
Osteogenesis imperfecta: mode of inheritance, analgesia, agencies involved if NAI not excluded
Autosomal dominant - parents may need genetic counselling Analgesia: paracetamol/calpol (oral/rectal). Morphine if in hospital and pain severe. Agencies: Social services, CPS, Police
43
Referral points for development
No smile at 10wks Can't sit unsupported at 12 months Can't walk at 18 months
44
4 fields of development
1. Social, emotional and behavioural 2. Fine motor and vision 3. Gross motor 4. Speech, language and hearing
45
Developmental milestones expected in 6 month old
Eye contact, social smile, sitting, rolls front to back, bears weight on legs with support Hand to hand, palmar grasp Turns at sound, recognises faces, babbles, enjoys play
46
Developmental milestones expected in 12 month old
Crawl, pull to stand, standing assisted, cruising Pinch grasp, finger food, speaking a word or more, waves, understands simple commands
47
Cerebral palsy: Definition and causes
D: permanent disorder of movement and posture causing activity limitation due to a non-progressive lesion of motor pathways in the developing brain (<2) C: Antenatal: congenital infection (TORCH), cerebral malformation Intrapartum: birth asphyxia/trauma Postnatal: meningitis, head trauma, intraventricular haemorrhage
48
Types of Classification
Motor : Spastic (hypertonia, hyperreflexia, pyramidal tracts), Dyskinetic (involuntary, uncontrolled movements more evident during voluntary movements, BG injury), Ataxia (disturbed coordination, hypotonia, intention tremor, cerebellar), Mixed Topographical : Hemiplegia (Upper more), Diplegia (all four limbs, Lower more) , Quadriplegia (all four with equal or upper more. bulbar involvement), Monoplegia, Triplegia
49
Why do clinical signs of CP change over time?
Abnormal muscle tone and spasticity become more evident. MSK contractures and deformities develop. Early floppiness progresses to spasticity as pyramidal tracts develop
50
Investigations and Management for Cerebral Palsy
Clinical mainly MRI Metabolic/genetic testing EEG if seizures present Hearing and visual assessment Management: MDT. Treatments for spasticity include oral diazepam, oral and intrathecal baclofen, botulinum toxin type A for focal spasticity
51
What professionals involved in care of children with Cerebral Palsy
Neurologist, SALT, dietician, paediatrician, occupational therapists
52
Effects of CP on mobility, family, school, and help available
Mobility - reduced mobility, walking aids/braces Family - financial impact of equipment, transport, therapy, respite is high. Emotional stress, caregiver burnout, parentification. Missing work, reliance on others. Support groups - Day centres, Respite care facilities, community paediatric and physiotherapy services, social prescribing
3a ILAs
flashcards
Decks in class (5)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions