Czech Paediatrics Board Examination flashcards

34 cards. Read the term and the definition here. The deck at the top of this page is optional.

Apgar score components

Five items scored 0–2 each: appearance (colour), pulse, grimace (reflex irritability), activity (muscle tone), and respiration. Assessed at 1 and 5 minutes; the 1-minute score guides resuscitation, not long-term prognosis.

Surfactant therapy indication

Administered to preterm infants with respiratory distress syndrome, especially below 30 weeks' gestation, as early rescue therapy. Repeat doses are given at intervals if oxygen requirements remain high despite initial treatment.

Physiological vs pathological jaundice

Physiological jaundice appears after 24 hours, peaks at days 3–5, and is unconjugated. Jaundice within the first 24 hours, a rise above 85 µmol/L/day, or conjugated hyperbilirubinaemia is always pathological and requires investigation.

Therapeutic hypothermia for HIE

Cooling to 33.5 °C for 72 hours, started within 6 hours of birth, improves outcomes in term infants with moderate-to-severe hypoxic-ischaemic encephalopathy staged by Sarnat criteria.

Growth velocity norms

Expected growth is about 25 cm in the first year, 10–12 cm in the second, and 5–7 cm/year from age 3 to puberty, with a pubertal spurt of 8–10 cm/year.

Developmental red flags

No head control by 4 months, no sitting by 9 months, no walking by 18 months, no words by 18 months, or loss of any previously acquired skill. Regression always requires investigation.

Czech vaccination schedule

Hexavalent vaccine at 2, 3, 4, and 11–12 months; MMR at 13–15 months and 5–6 years; varicella at 15–18 months and 5–6 years; HPV at 13–14 years.

Vitamin D supplementation in infants

400 IU/day from birth or within the first weeks through at least 12 months for all infants, continued in at-risk groups. Vitamin K 1 mg IM is given at birth to prevent haemorrhagic disease of the newborn.

Measles vs rubella rash

Measles shows Koplik spots and a descending rash; rubella shows postauricular lymphadenopathy with a rash spreading from the face. Scarlet fever has a sandpaper rash and strawberry tongue from group A streptococcus.

SCID presentation

Severe combined immunodeficiency presents with severe infections, chronic diarrhoea, failure to thrive, and an absent thymic shadow. Live vaccines are contraindicated; treatment is haematopoietic stem cell transplantation.

Meningococcal disease management

Purpura fulminans with rapid progression and high mortality. Give immediate parenteral benzylpenicillin or ceftriaxone; provide chemoprophylaxis with rifampicin or ciprofloxacin for close contacts.

Lyme borreliosis treatment

Erythema migrans is a clinical diagnosis treated with amoxicillin in children or doxycycline from 8 years. Neuroborreliosis requires ceftriaxone or cefotaxime.

Tetralogy of Fallot components

Ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. Hypercyanotic spells are treated with knee-chest position, oxygen, morphine, and beta-blockers or phenylephrine.

Kawasaki disease diagnostic criteria

Fever for at least 5 days plus at least 4 of conjunctivitis, mucosal changes, extremity changes, rash, and cervical lymphadenopathy. Risk of coronary aneurysms; treat with IVIG 2 g/kg plus aspirin.

Acute asthma exacerbation treatment

Salbutamol inhaled or nebulised, ipratropium for severe cases, systemic corticosteroids (prednisolone 1–2 mg/kg/day for 3–5 days), oxygen to keep SpO2 at least 94%, and magnesium sulphate for severe unresponsive cases.

Croup treatment

Laryngotracheobronchitis presents with barking cough, inspiratory stridor, and hoarseness. Treat with a single dose of dexamethasone (0.15–0.6 mg/kg) and nebulised adrenaline for moderate-to-severe cases.

Coeliac disease diagnosis

Screen with tissue transglutaminase IgA and total IgA; confirm by duodenal biopsy showing villous atrophy, crypt hyperplasia, and intraepithelial lymphocytosis. A no-biopsy pathway is possible with high titres and positive EMA or genetics.

Pyloric stenosis features

Projectile non-bilious vomiting at 3–6 weeks, visible peristalsis, and an olive-shaped mass. Ultrasound shows pyloric muscle thickness above 3 mm and length above 15 mm; treatment is pyloromyotomy.

Biliary atresia presentation

Conjugated hyperbilirubinaemia in the first weeks of life with pale stools and dark urine. Diagnosed by ultrasound, HIDA scan, and liver biopsy; Kasai portoenterostomy is ideally performed before 60 days of life.

Diabetic ketoacidosis management

Fluid resuscitation with isotonic saline, insulin infusion 0.05–0.1 U/kg/h started after 1 hour of fluids, and potassium replacement. Cerebral oedema is the leading cause of death; treat with mannitol or hypertonic saline.

Congenital adrenal hyperplasia crisis

21-hydroxylase deficiency causes a salt-wasting crisis in the second week of life with hyponatraemia, hyperkalaemia, and hypotension. Treatment is hydrocortisone and fludrocortisone.

Nephrotic syndrome triad

Proteinuria above 3.5 g/day/1.73 m² or urine protein/creatinine ratio above 200 mg/mmol, hypoalbuminaemia below 25 g/L, and oedema. Minimal change disease is the most common cause in children; treat with corticosteroids.

Haemolytic uraemic syndrome

Microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury, usually caused by Shiga toxin-producing E. coli. Treatment is supportive; antibiotics and antimotility drugs are avoided.

Febrile seizure classification

Simple seizures are generalised, last under 15 minutes, and occur once in 24 hours. Complex seizures are focal, last over 15 minutes, or recur within 24 hours. Simple febrile seizures need no routine EEG or imaging.

Status epilepticus treatment

Benzodiazepines first-line (IV lorazepam or diazepam, or buccal midazolam), followed by phenytoin, levetiracetam, or valproate; anaesthesia with midazolam, propofol, or thiopental for refractory cases.

Bacterial meningitis treatment

Fever, headache, neck stiffness, and altered consciousness require immediate IV ceftriaxone, plus ampicillin in neonates for Listeria, and dexamethasone before or with the first antibiotic dose.

Immune thrombocytopenia in children

Isolated thrombocytopenia with petechiae and ecchymoses in an otherwise well child. Treatment is observation, or IVIG and corticosteroids for significant bleeding.

Acute lymphoblastic leukaemia presentation

The most common childhood malignancy, presenting with pallor, fatigue, fever, bone pain, lymphadenopathy, and hepatosplenomegaly. Diagnosis is by bone marrow aspirate with at least 20% blasts; treatment is multi-agent chemotherapy with CNS prophylaxis.

Juvenile idiopathic arthritis definition

Arthritis in at least one joint for at least 6 weeks in a child under 16 years. Subtypes include oligoarticular, polyarticular, systemic, and enthesitis-related; treatment is NSAIDs, intra-articular steroids, and methotrexate.

Anaphylaxis treatment

Immediate intramuscular adrenaline 0.01 mg/kg (maximum 0.5 mg) into the anterolateral thigh, repeated every 5–15 minutes if needed. Adjuncts include oxygen and IV fluids; observe 4–6 hours for biphasic reactions.

Paediatric basic life support ratio

Five rescue breaths, then 15 chest compressions to 2 breaths for two rescuers. Compression depth is one-third of chest diameter at a rate of 100–120/min.

Paediatric defibrillation energy

Adrenaline 10 µg/kg IV/IO (0.1 mL/kg of 1:10,000) every 3–5 minutes; defibrillation at 4 J/kg for shockable rhythms.

Informed consent for minors

In the Czech Republic, a minor aged 15–18 can consent to certain medical procedures; for younger children, consent is given by the legal guardian. Emergency treatment can be provided without consent if life-threatening.

Mandatory vaccination in Czech Republic

Vaccination is mandatory for diphtheria, tetanus, pertussis, polio, Hib, hepatitis B, measles, mumps, rubella, and others; exemptions exist for medical contraindications.