Paediatrics

Question 1

Kawasaki Disease
Complete

Answer 1

Commonest cause of acquired heart disease in Western World

Predominantly 6 mo to 4yrs
- 75% cases < 5yrs old
Infants and adolsecents may present with incomplete -> higher risk of dvp’ing coronary artery aneurysms

Fever for 5 days +

Complete - 4/5 of the following

• Conjuntivitis
• Rash - Maculo-papular
• Extremity Changes - Hyperaemia, painful oedema progressing to desquamation (2nd week)
• Adenopathy - anterior cervical nodes and at least one >1.5cm
• Mucous membrane changes - Strawberry tongue, oropharyngeal oedema

Mangement
* Admit
* Echo - presentation, 2 and 6 weeks
* IVIG 2g/kg within first 10 days
* Aspirin - 3-5mg/kg until normal echo

Question 2

Cyanotic Heart Disease

Answer 2

1. Transposition of great vessels
2. Tetralogy of Fallot
3. Total anomalous pulmonary venous return
4. Truncus arteriosus
5. Tricuspid atresia
6. Severe pulmonary stenosis

Present in first 2-3 weeks of life when the DA closes

Question 3

Kawasaki Incomplete

Answer 3

Incomplete - prolonged fever and

• 2-3/5 prinicipal clinical features
• Infant with fever 7 days and irritability
• Cervical adenitis not responding to antibiotics