2014

Question 1

14 year old primary amenorrhoea + ejection systolic murmur

Answer 1

Turner’s

Question 2

Cyclical pain, no heavy menstrual bleed, never sexually active

Answer 2

Ovarian Cyst

Question 3

14 year old pregnant, comes with sister, wants a TOP. What should you do?

Answer 3

Persuade her to tell her parents if she refuses and gillick competent, you can give her TOP

Explore safeguarding

Question 4

What do you test for in Hep B infection antenatally?

Answer 4

HBsAg

Question 5

Women with previous GDM what is the best way to investigation her blood glucose?

Answer 5

OGTT at 28w

Question 6

spotting

Answer 6

rule out ectopic

Question 7

contraception increasing osteoporosis risk

Answer 7

depot

Question 8

admit XS vomiting if

Answer 8

ketouria

Question 9

Mumps orchitis can cause

Answer 9

Azoospermia

Question 10

If want for just bones in menopause

Answer 10

bisphosphonates

Question 11

if no uterus in menopause wanting symptomatic relief

Answer 11

trancutaneous oestrogen HRT

Question 12

Perimenopausal women with menopausal symptoms, irregular menstruation, does swimming and does not patch

Answer 12

cyclical oral HRT

Question 13

Blue dots on cervix

Answer 13

Nabothian cyst

Question 14

47yo women with menorrhagia + dysmenorrhea, US showed multiple fibroids

Answer 14

consider hysterectomy

Question 15

Mother being prepared for CS, sudden tingling around her mouth?

Answer 15

Spinal block

Question 16

Women going away for holiday and would like to delay her periods.

Answer 16

COCP

Question 17

Asthma management. Kid with acute exacerbation, been given salbutamol and steroids. Onlistening to the chest, you hear a quiet chest, respiratory rate 60. What to do?

Answer 17

Call PICU ready for intubation

Question 18

Cross eye kid, what other piece of information would you like?

Answer 18

Vomiting before breakfast … ok then

Question 19

Dehydration + ill kid – weight 15kg what do you give initially?

Answer 19

300ml bolus IV

Question 20

What is the purpose of debriefing after a child’s death in resuscitation?

Answer 20

To address emotional needs of everyone in the team

Question 21

Child who pass stool every few days, when he does go, stools are pellet like and smelly, what is the likely diagnosis?

Answer 21

Overflow constipation

Question 22

Scabies Mx

Answer 22

Management
permethrin 5% is first-line
malathion 0.5% is second-line
give appropriate guidance on use (see below)
pruritus persists for up to 4-6 weeks post eradication

Question 23

Drunk/ intoxicated kid

Answer 23

urine drug screen

Question 24

Dehydrated, seizures, mother been giving some herbal oral rehydration fluid or something

Answer 24

check plasma sodium

Question 25

Neonate getting progressively worse at breathing over first 3h with opacities

Answer 25

GBS

Question 26

GBS then Still needs oxygen

Answer 26

Bronchopulmonary dysplasia

Question 27

Ground grass appearance

Answer 27

Respiratory distress syndrome/ primary surfactant deficiency

Question 28

Nitrogen washout test

Answer 28

congenital heart disease

Question 29

abdominal mass
pallor, weight loss
bone pain, limp
hepatomegaly
paraplegia
proptosis

Answer 29

Neuroblastoma

Investigation
raised urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels
calcification may be seen on abdominal x-ray
biopsy

Question 30

Retinoblastoma Mx

Answer 30

enucleation is not the only option
depending on how advanced the tumour is other options include external beam radiation therapy, chemotherapy and photocoagulation

Question 31

Intermittent pain, dehydrated, vomited 3 times -

Answer 31

Intussesception

Question 32

Sudden abdo pain, well child, something indentable on the L lower quadrant

Answer 32

suspect Wilm’s?…

Question 33

Scaphoid abdomen

Answer 33

diaphragmatic hernia

Question 34

bipolar sudden renal failure

Answer 34

check lithium 0.4-1.0

Question 35

Section 4

Answer 35

72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
a GP and an AMHP or NR
often changed to a section 2 upon arrival at hospital

Question 36

78yo guy has issues with organization, troubles with understanding words

Answer 36

alzheimers (frontotemporal)

Question 37

drug for acute dystonia

Answer 37

procyclidine

Question 38

Woman w confusion

Answer 38

urine dip

Question 39

Learning disability

Answer 39

<70

Question 40

rapid sedation

Answer 40

haloperidol

Question 41

Someone with schizo and need help organizing their activities after they are being discharged?

Answer 41

Occupational therapist