PGIM MD Paediatrics flashcards

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

Neonatal physiological jaundice

Jaundice appearing after 24 hours of life, peaking around day 3-5 in term infants and day 5-7 in preterm infants, caused by immature hepatic conjugation and increased red cell turnover.

Kernicterus

Bilirubin-induced neurological damage from unconjugated hyperbilirubinaemia, producing basal ganglia and brainstem injury with lethargy, hypotonia or hypertonia, and sensorineural hearing loss. Prevention relies on timed bilirubin measurement and phototherapy.

Holliday-Segar maintenance fluid

A method calculating daily fluid needs as 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kilogram above 20 kg.

Paediatric maintenance sodium

Maintenance sodium is approximately 2-3 mmol/kg/day and potassium 1-2 mmol/kg/day. Hypotonic maintenance fluids cause hospital-acquired hyponatraemia, so isotonic fluid with glucose is preferred in most sick children.

Paediatric compression-ventilation ratio

Two-rescuer paediatric resuscitation uses 15 compressions to 2 ventilations, while a single lay rescuer uses 30:2. Compressions are delivered at 100-120 per minute to at least one-third of chest depth.

Paediatric adrenaline dose in arrest

Intravenous or intraosseous adrenaline 10 micrograms per kilogram (0.1 mL/kg of 1:10,000 solution), repeated every 3-5 minutes during cardiac arrest in infants and children.

APLS weight formula

An emergency weight estimate for children aged 1-10 years: weight in kilograms equals (age in years + 4) multiplied by 2. It guides drug and fluid dosing when no measured weight is available.

Febrile infant under 28 days

Any infant aged 28 days or less with fever requires a full sepsis evaluation including blood, urine and cerebrospinal fluid cultures, plus empirical intravenous antibiotics and admission, regardless of appearance.

Kawasaki disease diagnostic criteria

Fever for at least five days plus four of five features: bilateral conjunctival injection, oral mucositis, cervical lymphadenopathy, polymorphous rash, and extremity changes. Incomplete disease still risks coronary aneurysms.

Kawasaki disease treatment

Intravenous immunoglobulin 2 g/kg as a single infusion plus high-dose aspirin, with echocardiography at diagnosis and again at two weeks to detect coronary artery dilatation or aneurysms.

Bronchiolitis supportive management

Bronchiolitis is diagnosed clinically and managed with oxygen to maintain saturations above 90-92 percent and adequate hydration. Bronchodilators, steroids, antibiotics and chest physiotherapy are not routinely indicated.

Palivizumab indication

A monoclonal antibody given monthly during respiratory syncytial virus season as prophylaxis for high-risk infants such as those with chronic lung disease of prematurity or significant congenital heart disease; it is not a treatment.

Croup management

Croup presents with barking cough, hoarse voice and inspiratory stridor. Treat with a single dose of oral dexamethasone and nebulised adrenaline for moderate to severe stridor at rest.

Epiglottitis features

Bacterial epiglottitis causes rapid-onset high fever, drooling, muffled voice and tripod positioning in an unwell child. Avoid examining the throat; secure the airway in theatre with anaesthetic support.

Pyloric stenosis presentation

Hypertrophic pyloric stenosis presents at 3-6 weeks with projectile non-bilious vomiting, visible gastric peristalsis and a palpable olive-shaped mass. Hypochloraemic hypokalaemic metabolic alkalosis requires correction before pyloromyotomy.

Intussusception triad

The classic triad is colicky abdominal pain, vomiting and redcurrant-jelly stool in a child aged 6-36 months. Ultrasound shows a target sign; air or contrast enema is both diagnostic and therapeutic if there is no peritonitis.

Malrotation and bilious vomiting

Bilious vomiting in a neonate is a surgical emergency until proven otherwise, suggesting malrotation with midgut volvulus. Urgent upper gastrointestinal contrast study and surgical review are required.

Necrotising enterocolitis

A condition of preterm infants with feeding intolerance, abdominal distension and bloody stools. Management includes stopping feeds, nasogastric decompression, antibiotics and monitoring for perforation, which requires surgery.

Nephrotic syndrome in children

Minimal change disease causes most childhood nephrotic syndrome, presenting with oedema, proteinuria and hypoalbuminaemia. Most respond to corticosteroids; biopsy is reserved for atypical features or steroid resistance.

Post-streptococcal glomerulonephritis

Occurs 1-2 weeks after streptococcal infection with haematuria, hypertension, oedema and low complement C3. Management is supportive with fluid and salt restriction and antihypertensives; prognosis is excellent.

Henoch-Schönlein purpura

IgA vasculitis causing palpable purpura on the buttocks and legs, arthralgia, abdominal pain and renal involvement. Monitor urine for nephritis; most cases resolve with supportive care alone.

Vesicoureteric reflux

Retrograde urine flow from bladder to ureter, graded I to V on micturating cystourethrogram. Higher grades associate with renal scarring and recurrent pyelonephritis, prompting antibiotic prophylaxis in selected children.

Type 1 diabetes presentation

Type 1 diabetes in children presents with polyuria, polydipsia and weight loss, and may debut in diabetic ketoacidosis. Management is lifelong insulin with carbohydrate counting and education for the family.

Congenital hypothyroidism

Screen-detected thyroid hormone deficiency that, if untreated in the first weeks of life, causes irreversible intellectual disability. Treat promptly with levothyroxine and monitor levels and development.

Growth hormone deficiency

Presents with severe short stature, slow growth velocity and delayed bone age, often with midface hypoplasia. Diagnosis uses growth charts, bone age, and stimulation testing before growth hormone treatment.

Constitutional delay of growth

A common cause of short stature with delayed bone age and delayed puberty, often with a family history of late puberty. Growth continues longer and final adult height is usually normal.

Developmental dysplasia of hip

Screening uses Ortolani and Barlow manoeuvres in infants, with ultrasound for those with risk factors or abnormal findings. Untreated dysplasia leads to limp and early osteoarthritis.

Febrile convulsion

A seizure with fever in a child aged 6 months to 5 years without intracranial infection. Simple febrile convulsions are generalised, last under 15 minutes and do not recur within 24 hours; management is supportive.

Infantile spasms

A severe epileptic encephalopathy of infancy with clusters of flexor spasms and a hypsarrhythmia electroencephalogram. Prompt treatment with adrenocorticotropic hormone or vigabatrin improves developmental outcome.

Meningococcal septicaemia

Neisseria meningitidis bloodstream infection causing fever, non-blanching purpura and shock. Give immediate intramuscular or intravenous benzylpenicillin or ceftriaxone and resuscitate with fluids.

Measles clinical features

Measles causes fever, cough, coryza and conjunctivitis, followed by Koplik spots and a descending maculopapular rash. Complications include pneumonia and encephalitis; vaccination is the key preventive measure.

Neonatal resuscitation initial steps

Dry the baby, assess tone and breathing, and provide warmth. If not breathing, give five inflation breaths, then continue ventilation at 30 per minute with 3:1 compression to ventilation if the heart rate remains low.