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Rashes in Children
General Information Rashes are common in children and babies, with most caused by viral infections. Typically, these rashes are harmless and resolve on their own. Different viruses may produce rashes that appear similar, while others may lead to distinct skin changes. Measles is an example of a virus causing a…
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Petechiae and Purpura
https://www.rch.org.au/clinicalguide/guideline_index/fever_and_petechiae_purpura/ Key Points Background Information Definitions Clinical Assessment History Taking Examination Criteria Differential Diagnoses Causes of petechiae and/or purpura Viral EnterovirusAdenovirusInfluenza Bacterial Neisseria meningitidis (meningococcal disease)Streptococcus pneumoniae Haemophilus influenzaeGroup A streptococcusStaphylococcus aureus Mechanical Vomiting or coughing – occurs in the distribution of the superior vena cava which is above the level of the…
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Bullying in Children and Adolescents (Peer and Sibling)
from – https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/abuse-and-violence/children-and-young-people/sibling-and-peer-bullying General Overview Clinical Practice Recommendations Definitions and Characteristics of Bullying Sibling Bullying vs. Rivalry Prevalence Risk Factors Table 10.1 Risk factors for peer and sibling bullying Risk factors Bullying Peer Reference Sibling Reference Individual Physical (eg overweight, disability, chronic illness) Moderate association 65–68 …
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Behavioral Regression in Children
Key Symptoms to Ask About: Cause Key Features Symptoms to Ask About Psychological/Emotional Stress – Trauma or Abuse Sudden behavioral changesfearfulnesswithdrawal from family and social interactionsbedwettingnightmares – Sudden changes in behavior or mood?– Bedwetting or regression in toilet training?– Fear of certain people or places?– Unexplained injuries or bruises?– Nightmares…
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Challenging Behaviours
gathered from – Ten things I wish you knew about your child’s mental health – Dr Billy Garvey Understanding Behavioural Difficulties: Addressing Behavioural Issues: Long-Term Impact of Emotional Difficulties: Understanding and Addressing Behavioural Issues Role of Paediatrician as a Detective: Behaviour as Communication: Identifying Triggers and Patterns: The Volcano Analogy:…
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Walking’ Pneumonia (Mycoplasma pneumoniae) for GPs
https://www1.racgp.org.au/newsgp/clinical/what-do-gps-need-to-know-about-walking-pneumonia 12 Jul 2024 Overview: Transmission: Symptoms: Complications: Diagnosis: Treatment: Management of Mild Cases: Public Health Data: Clinical Advice for GPs: Practical Considerations:
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Asthma – child aged 1–5 years
gathered from https://www.asthmahandbook.org.au/ -v2.0 Asthma in children is defined clinically as a combination of variable respiratory symptoms (e.g., wheeze, shortness of breath, cough, and chest tightness) and excessive variation in lung function, which indicates variable airflow limitation greater than that seen in healthy children. Key Points Age-specific Diagnostic Considerations Infants…
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Asthma – likelyhood
gathered from https://www.asthmahandbook.org.au/ -v2.0 Checking Whether Current Symptoms Are Due to Asthma Recommendations Likelihood of Asthma Asthma More Likely Criteria Details Symptoms More than one of wheeze, breathlessness, chest tightness, cough Symptom Pattern Recurrent or seasonal, worse at night or early morning History of Allergies Allergic rhinitis, atopic dermatitis Triggers…
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Asthma – Primary School-Aged Children (6-11 Years)
Managing Asthma in Children Overview Children aged 0–12 months: Children aged 1–5 years: Children aged 6 years and over: General Principles of Asthma Treatment in Children Provide Parents/Carers and Children with: Asthma medications and delivery devices include: Frequent use of SABA alone (>3 MDI canisters per year) and infrequent use…
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Asthma – adolescents (12 years and over)
Key Points – from RCH and Asthma guidelines 2.0 Background Assessment Management Stepping Up or Down According to Response Control Level Daytime Symptoms Need for Reliever Limitation to Activity Nighttime Symptoms Good Control ≤2 days per week ≤2 days per week None None Partial Control >2 days per week >2…
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Adolescent Patient
Engaging with and Assessing the Adolescent Patient Key Points Background Adolescent Health Care Considerations Assessment Psychosocial Interview Examination Management Transition to Adult Services
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Growth Disorders in Adolescents
Normal Growth Phases Measuring Height Effect of Normal Puberty on Growth When to Suspect a Growth Disorder History and Examination Syndromes associated with: Early Puberty Delayed Puberty Before age 8 in girls and before age 9 in boys. No signs of puberty by age 13 in girls and age 14…
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Slow weight gain
Typical Growth Expectations: Average growthAlthough the use of a growth chart is the most accurate indication of overall growth the use of average weekly weight gain for children who are followed up at frequent intervals may be required The rate of weight gain per week is variable The table below…
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Growth in Childhood Development
Normal Growth Patterns Identifying Growth Disorders Assessing Growth Predicting Adult Height Interpreting Growth Data – Normal Variants Interpreting Growth Data Pathological Causes of Short Stature Treatment of Short Stature Tall Stature Conclusion Additional Notes:
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Introducing Solid Foods to Babies for Allergy Prevention
Key Points Include Common Allergenic Foods One Allergenic Food per Meal Regular Introduction Variety of Foods Texture for Development Stage Note on Allergy Development Questions and Answers: from https://www.allergy.org.au/patients/allergy-prevention/ascia-how-to-introduce-solid-foods-to-babies Q1: Why Should Egg and Peanut Be Introduced by 12 Months of Age? Q2: How Should Egg and Peanut Be Introduced?…
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Hypospadias
Definition Hypospadias is a congenital condition affecting the penis where the urethral opening is not located at the tip but somewhere along the underside of the penis. Hypospadias is quite common, and is increasing. It occurs in about 1/250-1/300 boys. It is more common with IVF babies. With a family…
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Urinary Tract Infections (UTI) kids
from RCH and eTG Epidemiology History Examination Assessment of severity Investigation Children with suspected UTI should have a urine sample collected; dipstick and microscopy screening can guide initial management. Check culture results after 24 hours to confirm or adjust management as appropriate Urine samples should be collected prior to starting…
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Juvenile Idiopathic Arthritis (JIA)
Disease course varies greatly; some patients experience mild, self-limiting disease, while others suffer severe, ongoing joint damage. Introduction Etiology Pathophysiology Histopathology Clinical manifestations Investigations extra-articular manifestations of Juvenile Idiopathic Arthritis (JIA), focusing on uveitis and growth disturbances: Uveitis Growth Disturbance Goals of Treatment Common Medications and Patient Monitoring NSAIDs Methotrexate…
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Enuresis (bed wetting)
Enuresis Overview: types Epidemiology: Associated Conditions: Pathophysiology: History Much of the history should focus on voiding habits Examination Evaluation: Treatment/Management: Pharmacological Therapy Desmopressin: MinirinTM melt/tablet DOSING: Intranasal route is not recommended due to higher risk of hyponatraemia Prognosis: Complications: Consider referral to a general paediatrician or continence service when
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Impetigo
Aetiology of Impetigo Approach to Managing Impetigo Preventative measures Outcome Antibiotic Therapy for Impetigo (Including Dosages – from eTG)
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consenting kids
General Consent Principles for Children in Australia Gillick Competence and Mature Minor Doctrine Assessment of Understanding and Maturity Additional Considerations Variability in Consent Based on Treatment Legal Framework and State Variations Special Considerations Legal and Ethical Obligations Conclusion Understanding the nuances of consent in pediatric care is vital for healthcare…
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Stopping the spread of childhood infections
Head Lice Scabies Dust Mites Impetigo Gastroenteritis Glandular Fever (Infectious Mononucleosis) Hand, Foot, and Mouth Disease Hepatitis A Measles Molluscum Contagiosum Mumps Ringworm Scarlet Fever Slapped Cheek (Fifth Disease) Whooping Cough (Pertussis)
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Asperger’s Disorders
Oppositional Defiant Disorder Patterns of behaviour Conduct Disorder Childhood onset: < 10 yo Adult onset: > 10 yo Developmental co-ordination disorder / dyspraxia Specific learning disorders Dyslexia
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Jaundice – (neonatal)
Background Risk factors Maternal Neonatal Blood group ORhD negativeRed cell antibodiesGenetic: family history, East Asian, MediterreanDiabetesPrevious baby requiring phototherapy Feeding – breastfeeding, reducing intakeHaematoma, bruisingPolycythaemiaHaemolysisBowel obstructionInfectionPre-term, male Assessment History Examination Management Types and Causes Unconjugated hyperbilirubinaemia Conjugated hyperbilirubinaemia Type Causes Investigations Early Onset:( <24 hours) PATHOLOGICALAll should have:FBESBRCoombs Sepsis Please…
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Pulled elbow
NB: do not normally need XR if there is reliable history of traction of elbow, clinical examination suggestive of pulled elbow & child is < 5yrs age XR if there is atypical history or examination Reduction manoeuvres Either of the following methods may be effective Hyperpronation manoeuvre Sit the child…
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Neck MASSES in KIDS
divided into the broad categories of congenital, inflammatory/infective and neoplastic Paediatric cervical masses according to anatomical location Location Aetiology Congenital Inflammatory/infective Neoplastic Submental Thyroglossal cystDermoid cyst SialadenitisLymphadenitisReactive lymphadenopathy Malignant lymphadenopathyBenign connective tissue tumour Submandibular Vascular or lymphatic malformationBranchial cleft cyst SialadenitisLymphadenitisReactive lymphadenopathy Malignant lymphadenopathySalivary gland tumourBenign connective tissue tumour Carotid…
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Hand, foot, and mouth disease
Age Group Affected: Transmission: Causative Agents: Modes of Transmission: Signs and Symptoms: Duration: Complications: Complications in Pregnancy: Complications in Newborns: Rare Complication: Reye Syndrome Management Pain Relief for HFMD Simple Analgesia: Oral Ulcers: Aspirin: Hydration Prevention of Dehydration: Blister Care Management of Blisters: Staying Home and Preventing Spread Home Care:…
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Audiological Assessment and Management
Listening behaviours and warning signs to ask parents about When to refer Diagnostic audiology Hearing assessment is recommended for the following reasons: Speech Path
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Vulval and Vaginal Conditions (kids)
from RCH website Normal anatomy and development Vulval and vaginal pain Vulval and vaginal pain is common in prepubertal children and many conditions affecting the vulva can be painful including Vaginal bleeding Vaginal bleeding in the first week of life can be caused by the normal withdrawal of maternal oestrogens…
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Iron deficiency – kids
Background Risk factors include Symptoms of low ferritin: Investigations Management Suggest iron supplementation and dietary modification if low ferritin, with or without anaemia. Dietary advice Oral iron supplementation Other Treatment Considerations Oral iron formulations Formulation Name Elemental iron content Notes Ferrous sulphate oral mixture Ferro-liquid 6 mg/mL May stain teeth,…
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Joint pains/ swellings – kids
DDx
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Child Abuse
Mandatory Reporting – required to report concerns about a child who may have experienced significant physical or sexual abuse Child Abuse Circumstances suggesting physical NAI Clear Debatable Red Flag History in Child Injury Assessment The “4 Bs” of Non-Accidental Injury (NAI) Risk B: Bruises B: Burns B: Bone Rib Fractures…
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Strabismus (‘squint’)
Common causes of strabismus Primary causes of strabismusRisk factors: – family history of strabismus– premature birth– low birth weight Secondary causes of strabismus often associated with neurological pathology Idiopathic strabismusCongenital syndromes Cranial nerve palsies (CNIII, IV, VI) Orbital fractureIntracranial bleedIntracranial/intraorbital/intraocular mass (benign or malignant)Intracranial infectionGrave’s diseaseMyasthenia gravisDiabetes mellitusAmblyopiaToxins and heavy metal poisoningPost-vaccination…
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Bruising (kids)
Concerning bruising for NAI Investigations
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Head injury (kids)
Primary survey and resuscitation: A Alert V Responds to voice P Responds to pain U Unresponsive Assess pupil size, equality and reactivity Initial management flowchart: Secondary survey: Perform a formal Glasgow Coma Score (GCS) Neck and cervical spine Head Eyes Ears Nose Mouth Face Motor function * suspect basal skull fracture if these signs present Features…
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Concussion
A concussion is a mild traumatic brain injury (mTBI) A concussion occurs after a strong blow to the head or significant shaking and the brain has been injured. Advice for Patients Regarding Concussions: Immediate Action Post-Injury:– Rest: Take it easy for the first 24-48 hours after the injury. Avoid physical…
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Reye’s syndrome
aetiology Symptoms Treatment
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Plagiocephaly
literally meaning ‘oblique head’. Deformational plagiocephaly, also known as ‘positional plagiocephaly’, refers to a misshapen (asymmetrical) head shape. Craniosynostosis
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Meningitis
Epidemiology Overview Asymptomatic Carriage Invasive Meningococcal Disease (IMD) Age Distribution Pathogens in Infants Under 2 Months Common Causative Organisms in Children Over 2 Months Neisseria meningitidis Special Populations Encephalitis Etiology Long-Term Complications Vaccination Developments Risk Factors for Meningitis Neonates Older Children Differentials for Headache and Fever Intracranial Infections Systemic Infections/Other…
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Pharyngitis / Sore Throat
causes Condition Details conditions associated with airway obstruction or deep neck space infection Acute epiglottitisPeritonsillar abscess (quinsy)Retropharyngeal abscessParapharyngeal abscesspharyngeal diphtheriaEpstein–Barr virus (EBV) infection – severeCroup – severeBacterial Tracheitis – severeSpreading odontogenic infections (including Ludwig angina)Septic jugular thrombophlebitis (part of Lemierre syndrome) viral pharyngitis and tonsillitis Most common cause of sore…
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Strep Infections (GAS)
Infections Caused by Group A Beta Hemolytic Streptococcus Complications: Suppurative Non-Suppurative
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Febrile convulsions (kids)
Definitions Causes: New Onset Secondary Seizure – Causes by age Causes: Non-Epileptic Causes of Seizure Distinguish Pediatric Seizures vs. Pediatric Seizure mimics Distinguish Simple vs. Complex Febrile Seizure Focal features Focal Motor Signs: Focal Sensory Symptoms: Autonomic Symptoms: Focal Cognitive or Emotional Symptoms: Focal Behavioral Symptoms: Note: Assessment Febrile Convulsion…
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Kawasaki Disease
Background Assessment Epidemiology Etiology and Pathogenesis Clinical Presentation Diagnostic Criteria Kawasaki disease: Diagnostic criteriaFever persisting for 5 days, PLUS 4 of the 5 following criteria: A diagnosis earlier than 5 days can be made with a typical presentation in consultation with an experienced clinician KD can be diagnosed with less than…
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Henoch-Schönlein purpura (HSP)
Examination Assess for Features Vitals Hypertension Skin Palpable purpura, petechiae and ecchymoses Usually symmetrical Gravity/pressure-dependent areas (buttocks and lower limbs in ambulatory children) Painful subcutaneous oedema Periorbital area Dependent areas (hands, feet, scrotum) Joints Arthritis/arthralgia Usually affects large joints of lower limbs Occasionally upper limbs Usually no significant effusion…
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Fever (in a child)
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Rashes (kids)
LESION DESCRIPTION PATHOGENS ORINFECTION a)Maculopapular rash macules – red/pink discrete flat areas, blanch on pressure papules – solid,raised hemispherical lesions, tiny, blanch on pressure VRS – Measles, rubella, roseola, erythema infectiosum, EBV, echovirus, HBV, HIV BACT – Erythema marginatum, scarlet fever, erysipelas, 2° syphilis, leptospirosis, Lyme dzs, RICK – Rocky…
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Scarlet fever
Treatment
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Infectious Mononucleosis (EBV)
Transmission Clinical features Complications Investigations Management
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Varicella/Chickenpox
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Erythema Infectiosum (Fifth Disease)
Fetal effects of Parvovirus B19 Antenatal diagnosis and management IgM is detectable within 1-3 weeks of exposure and usually remains detectable for 2-3months, but sometimes longer Management plan for recent maternal Parvovirus infection
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Roseola (Sixth Disease)
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Mumps
Infectious agent: Mumps virus
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Rubella (German measles)
Rubella reinfection Congenital rubella syndrome despite maternal antibodies = Anna Banerji, Elizabeth Lee Ford-Jones, Edmond Kelly and Joan Louise Robinson, CMAJ June 21, 2005 172 (13) 1678-1679; DOI: https://doi.org/10.1503/cmaj.050230 Congenital rubella syndrome Classic Triad Congenital rubella syndrome is characterised by: Rubella (non-congenital) lab definitive evidence lab suggestive evidence clinical evidence…
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Measles
Investigations Complications TREATMENT PREVENTION
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Alopecia (kids)
Tinea capitis presenting with a solitary circular area of hair loss. Note there is a short stubble of broken hairs and the skin is inflamed. Tinea capitis presenting with a solitary circular area of hair loss. Note there is a short stubble of broken hairs and the skin is…
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limp (kids)
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murmurs (kids)
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Depression (kids)
Presentation MDD symptoms How symptoms may present in a child Depressed mood Irritable, temper outburst, cranky, unhappy, miserable Anhedonia/lack of interest Loss of interest in pleasurable activities (eg does not want to see friends, do usual activities) Somatic symptoms Stomach ache, headache, musculoskeletal pain, fatigue Sleep disturbance Change in sleep…
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Developmental dysplasia of hip
– How to Treat article “ A GP guide to paediatric orthopaedics” Dec 2019, SCHP notes = spectrum of conditions where the femoral head has abnormal relationship to acetabulum 🡪 unstable hip Diagnosis Clinical examination Other: Neuro (movement of all limbs, spasticity, ROM, foot abnormality) Risk factors: Other: underlying NM…
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Slipped capital femoral epiphysis (SCFE aka SUFE)
– = physeal disruption & slippage of femoral neck in relation to the femoral head, which remains enlocated in acetabulum Aetiology Symptoms Signs Investigation Management Complications
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Perthes disease
How to Treat article “ A GP guide to paediatric orthopaedics” Dec 2019; Orthobullets; RCH ortho fact sheet = idiopathic avascular necrosis of epiphysis of the femoral head Epidemiology 4 Stages of disease Stage Appearance 1. Sclerosis Femoral head appears dense & smallerMedial joint space widening 2. Fragmentation Subchondral lucencyMottled…
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Toddler fracture
A toddler fracture is a minimally displaced or undisplaced spiral fracture, usually of the tibia, typically encountered in toddlers. It is a potentially difficult diagnosis to establish on account of both the symptoms and imaging findings being subtle The term has sometimes also been used to describe occult fractures of…
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Worms – pinworm, hookworm, roundworm, whipworm
Pin Worm Thread worm/pinworm/Entrobius vermicularis Care at home: You can talk to a pharmacist about over-the-counter treatment options. Drugs such as pyrantel (Combantrin) or mebendazole (Banworm) are very safe and often recommended. Follow the instructions on the packet, bearing in mind special precautions may be given for children under…
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Gastroenteritis (kids)
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Faecal incontinence/Encopresis
Diseases which mimic faecal incontinence 80% is retentive (secondary to constipation) and of this 95% functional and 5% organic (as below) Differentials retentive/ constipation: non-retentive Assessment Investigations Management
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Constipation (kids)
Clinical diagnosis Organic causes to consider Key points in the history Physical examination abdominal exam – assess for faecal masses inspect the anus – look for patency, fissures, patulous anus, anteriorly placed anus neurological exam – assess the back, gait, lower limb tone, power, reflexes and…
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Gastro-oesophageal reflux disease (GORD) – kids
Acid suppression medication use in infants with reflux How to know when it’s GORD or something else: AWESOME LINK: https://www.rch.org.au/uploadedFiles/Main/Content/hsru/Parent_Managing%20Unsettled%20Babies_public.pdf
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Colic (infantile)
Differential diagnoses to consider Acute management Investigations Management Parental Education
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Pneumonia (kids)
[display-posts category=”paediatrics”] Protracted bacterial bronchitis
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Pertussis / Whooping Cough
Assessment Catarrhal Phase (1-2 weeks, sometimes as short as a few days in infants <3 months) Paroxysmal Cough Stage (2-4 weeks with a peak at 2 weeks, may persist up to 10 weeks) Recovery Phase Complications Investigations Management Prophylaxis Recommended antibiotic for post-exposure prophylaxis for pertussis – Australian Prescriber – VOLUME…
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Obstructive sleep apnoea (OSA – KIDS)
upper airway dysfunction causing complete or partial airway obstruction during sleep leading to decreased oxygen saturation or arousals from sleep. Peaks in pre-school years pediatric OSA peaks between 2- 8 years of age due to the increased growth of tonsils and adenoids relative to the size of the upper airway…
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inhaled Foreign body
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CAUSES of Stridor
History Examination Age Frequency Tests Management Croup Associated URTIBarking cough +/ fever, not toxichigh pitched stridor 6 m6y mean 18m Common Nil Supportive SteroidsAdrenaline Epiglottitis Sudden onsetRapid progressionNo preceding coughURTI 2550% Sitting upToxic, pale, droolingLow pitched stridor 90% 2yr Rare in immunised children XrayBlood culture AntibioticsSupportive Foreign body Possible choking…
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Epiglottitis
Causes Group A beta hemolytic Streptococcus (Streptococcus Pyogenes) Streptococcus Pneumoniae Staphylococcus aureus Moraxella catarrhalis HaemophilusInfluenzae type B Previously most common cause of Epiglottitis in children No longer a common cause in due to Hib Vaccine More common in adults than children now with waning Vaccination/Immunity and failed Herd Immunity Risks…
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Croup
Key Points Pathophysiology Pathology Assessment History Examination Investigations Minimal Wheezing (Inspiratory Stridor instead), Minimal rhonchi and no rales Assessment “Sound worse than they look” (Opposite of Epiglottitis) – However, severe croup can cause complete airway obstruction Mild Moderate Severe Behaviour Normal Able to talk normally Some / intermittent irritability Some limitation…
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Newborn examination
General Assess Growth Head to Toe Exam Scalp lesions/swelling/bruising/ lacerations If this is not corrected early it can lead to blindness. Proper coordination of eye movements should be achieved by 3-6 months; persistent eye deviation requires evaluation. Isolated abnormalities The following anomalies are usually of no concern when isolated (3…
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Neonatal Rashes
Erythema toxicum Milia neonatal pustular melanosis Acropustulosis of infancy
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Signs and symptoms of Neonates
Unwell – Vital signs Heart rate (bradycardia <110 beats/minute and tachycardia >170 beats/minute) Temperature (fever >38°C; hypothermia <36.5°C) can be the first indicator of a serious invasive infective illness Rectal temperature most accurate hypothermia <36.5 can also be a sign of sepsis, as neonates have difficulty regulating temperatures The health…
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Neonatal assessment
Neonate = first 28 days of life post-term Discuss and advise Promote immunisation Vitamin K Universal hearing screen Newborne Baby care Hygiene Bathing Eye and mouth care Umbilical cord care Nappy changing including skin care Feeding Feeding cues and behaviour Promote and support breastfeeding Refer to Queensland Clinical Guideline:…
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Syndromes
Down syndrome Fragile X syndrome Prader-Willi syndrome Turner’s syndrome
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Developmental milestones
https://www.childrens.health.qld.gov.au/wp-content/uploads/PDF/red-flags-a3.pdf HEIGHT
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Tourette’s
Management
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Tic Disorder
Sudden, non-rhythmic & repetitive movements and/or vocalisations >1 year Persistent tick disorder – either motor or vocal Provisional < 1 year Often mimic some aspect of normal behaviour ↑ if stressed or excited ↓ when calm or focused activities, & asleep Average onset 5-6 years Risks – genetics, ADHD< OCD,…
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Autism spectrum disorders
is a lifelong neurodevelopmental condition features of which become evident in early childhood They can be more difficult to assess because they communicate differently and may not tolerate an unfamiliar clinical environment Behavioural and communication difficulties act as significant barriers to these children accessing hospital care. Children with autism and…
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ADHD
Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder and is estimated to affect approximately 10% of children and 5% of adults. Males 5-10X in clinic referrals 2-3X in community settings Mean age at diagnosis 9 yrs (boys < girls) Heritability > 70% 1st degree relatives – 4-8…
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Pediatric Oncology
Lymphadenopathy Leukemia Lymphoma Wilms’ Tumour (Nephroblastoma)
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Neck masses
Paediatric cervical masses according to anatomical location Location Aetiology Congenital Inflammatory/infective Neoplastic Submental Thyroglossal cystDermoid cyst SialadenitisLymphadenitisReactive lymphadenopathy Malignant lymphadenopathyBenign connective tissue tumour Submandibular Vascular or lymphatic malformationBranchial cleft cyst SialadenitisLymphadenitisReactive lymphadenopathy Malignant lymphadenopathySalivary gland tumourBenign connective tissue tumour Carotid triangle Vascular or lymphatic malformationBranchial cleft cyst LymphadenitisReactive lymphadenopathySternocleidomastoid tumour…
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Airway Obstruction
Airway obstruction can be incomplete or complete Upper airway obstruction can be due to the following factors: CAUSES ASSESSMENT History Examination Investigation MANAGEMENT Basic life support Assess Severity Effective Cough (Mild Airway Obstruction) Ineffective Cough (Severe Airway Obstruction) Conscious Person Unconscious Person Supraglottic & Laryngeal Lesions
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Paediatric Resusatation:
START A – Airway Airway – Background info B – Breathing Premature infant 0 Miller Infant 1 Miller Child 2-6 yrs 2 Miller Child 6-12 2 Macintosh > 12yrs 3 Macintosh As per The Emergency Medicine Manual;Dunn Select the correct tube size: neonatal trachea is only 4cm in length Older…
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WETFLAG
Weight Use Broselow Tape Ask Parents the weight of their child Original APLS formula : (age [years] + 4) × 2 for 1–12 years UPDATED APLS FORMULA: Age Weight (Kg) 1–12 months 0.5 × age [months] + 4 1–5 years 2 × age [years] + 8 6–12 years…
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Paediatric Sepsis and Shock
Red Flags in the Recognition of Pediatric Sepsis Systemic inflammatory response syndrome (SIRS) Severe sepsis/Shock Cold vs. Warm shock Acute Management of Pediatric Sepsis
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Peritonsillar abscess (quinsy)
Epidemiology Pathophysiology Symptoms Physical Exam Findings Clinical features associated with airway obstruction or deep neck space infection Conditions associated with airway obstruction or deep neck space infection Initial Management: Abscess drainage Antibiotics OR continue intravenous therapy for 1 to 2 days following successful abscess drainage, then switch oral therapy Antibiotics…
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Stridor Differentials
Stridor: History Examination Age Frequency Tests Management Croup Associated URTI Barking cough +/ fever, not toxic high pitched stridor 6 m6y mean 18m Common Nil Supportive Steroids Adrenaline Epiglottitis Sudden onset Rapid progression No preceding cough URTI 2550% Sitting up Toxic, pale, drooling Low pitched stridor 90% 2yr Rare…
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Bronchiolitis
Overview VIRAL INFLAMMATION OF THE BRONCHIOLES produces small airway obstruction with air trapping and respiratory difficulty in infants Age: 0-1 years An infant or child less than 18 months of age presenting with initial symptoms and signs of upper respiratory tract infection followed by cough, tachypnoea, inspiratory crepitations and wheeze…
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Coughing, Wheezy and Stridulous Children
LRTI vs URTI – Key Learning Points Pneumonia in Children (LRTI) URTI in Children Wheeze in Children Bronchiolitis in Children Case Example: Perplexing Case – A Wheezy 6-week-old Viral Wheeze in Children Understanding the distinctions between bronchiolitis and viral wheeze is essential for appropriate management and treatment to ensure the…