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Past Paper Specialties > 2018 Paper > Flashcards

2018 Paper Flashcards

1
Q

Spiral fracture on kid. What do you worry about and next step?

A
  • NAI
  • You admit and start safeguarding protocol
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2
Q

Clavicle fracture in newborn management

A

great prognosis, no specific treatment needed

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3
Q

Femoral fracture management in
- neonates
- <18 months
- 1-6 years
- > 4 years

A

Femoral shaft fractures:

· Neonates (0-28 days) – padded splints or Pavlik’s harness

· <18 months – Gallows traction

· 1-6 years – straight leg skin traction

· >4 years – intramedullary nail (+ more support if >11y)

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4
Q

Kid given dexamethasone for croup 12 hours ago by GP, was stable and well with good sats but still mild stridor. What else do you give?

A

Repeat steroids

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5
Q

kid that would fall down and scream and stuff but was completely fine afterwards

A

Temper tantrum

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6
Q

After sudden shock (pain, cold food, fright)
Pale or grey turning
Lose consciousness
Become stiff but has rapid recovery
Diagnosis?

A

Reflex anoxic seizure
–> reassure but refer to first seizure clinic if 1st seizure
Seen in infants and toddlers

–> Episodes due to cardiac asystole due to vagal inhibition

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7
Q

Cries forcefully then holds breath then turns blue then LOC

A

Breath holding attack
–> Stop by 4/5 y/o
Behaviour modification

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8
Q
  • Sudden, rapid, tonic contraction of trunk and limb muscles with gradual relaxation over 0.5-2 seconds

Diagnosis and management?

A

Infantile Spasm (West Syndrome)

Peak incidence 3-8 months (90% under 1yo), more common in males

Investigations: EEG (hypsarrhythmia – disordered activity in the brain)

  • Management: Vigabatrin or corticosteroids
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9
Q

Kid with yellow and grey stools and was 4 weeks old. What do you test for?

A

Conjugated bilirubin levels

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10
Q

Kid with bouts of crying and episodes where they flex their knees and hips and red stool.
Hypochloraemic hypokalaemic pH shown, with some clinical information. What is the initial management for it?

A

Correct electrolyte imbalance

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11
Q

Voraciously hungry kid, hypotonia and almond eyes what was the diagnosis?

A

Prader-Willi

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12
Q

7 year old kid has an accident and needs to have his leg amputated below the knee. He says no and wants to wait for his mum to approve first but she’s on a business trip, dad says go for it.
What do you do?

  • Apply to Court to get amputation in best interests
  • Proceed with the dad’s consent (assuming dad is biological and still with the wife)
  • wait for mum to give permission
  • kid is gillick competent don’t operate
A
  • Proceed with the dad’s consent (assuming dad is biological and still with the wife)
    –> contested answer but I think it is right?
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13
Q

14 year old kid who thieves, got into fights (basically conduct disorder). What is 1st Mx?

A

If 11-17 is multisystemic family therapy
If 3-11 is parental training
If mild, 2nd line is cognition problem solving in kids 9-14

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14
Q

Recurrent chest infections / wheeze
+
- Ejection-Systolic Murmur at Upper Left Sternal Edge
- Fixed wide splitting of S2

A

Atrial Septal Defect

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15
Q

Pansystolic murmur at the lower left sternal edge

A

Ventricular septal defect

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16
Q

Harsh ejection systolic murmur at right upper sternal edge

Slow rising pulse

Narrow pulse pressure

Soft S2

A

Aortic Stenosis
- Turner and William’s association
- Risk of sudden death and endocarditis
- May present later on in childhood with chest pain or syncope

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17
Q

Uncle gets TB, kid lives with him, Mantoux test showed a number between 10-14mm for the result. What should you do?

A

Start anti-TB treatment (the kid has TB with those diameters)

It is considered positive if
-Manteaux >5mm = +ve in immunodeficiency
- Manteaux >10mm = +ve in at-risk groups (child <4yo, healthcare workers, IVDU)
- Manteaux >15mm = +ve in normal population

–> Mx: RIPE

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18
Q

3 year old Kid with hypochromic microcytic anaemia and low ferritin. What could be the cause?
Folate deficiency, Thalassaemia
coeliacs,
fussy eater

A

fussy eater common in this age, they take less iron and get anaemia, which explained the hypochromic microcytic anaemia blood film

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19
Q

Most common type of Cerebral Palsy?

A
  • Spastic CP (90%)
  • Dyskinetic CP (6%)
  • Ataxic (hypotonic) CP (4%)
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20
Q

Cerebral Palsy:
hemiplegic weakness with brisk reflexes
‘clasp knife’ rigidity
what area of the brain is affected?

A

Damage to pyramidal (also known as corticospinal) tracts

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21
Q

Cerebral Palsy:
Involuntary, uncontrolled movements
what area of the brain is affected?

A

Dyskinetic CP
Caused due to damage to basal ganglia

22
Q

Cerebral Palsy:
Hypotonia, mal-coordination, delayed motor development ± intention tremor.
What area of the brain is affected?

A

Ataxic (hypotonic) CP
Damage to cerebellum

–> most genetically determined

23
Q

Kid having 1st set of primary vaccinations, what would stop you giving it?

A

Previous true anaphylaxis reaction
or
Current fever of >38.5

24
Q

A 3 year old girl has 5 days of fever and a left sided neck lump.
Her temperature is 38.5°C, pulse
140bpm, respiratory rate 25 breaths per minute, oxygen saturation 98% breathing air.

Toxic left shift and reactive neutrophils

Most likely diagnosis?

A

Lymphadenitis

25
Q

Kid needs fluids, but you can’t get standard IV access. Where do you go?

A

Intraosseous access

26
Q

HIV with undetectable viral load. what is contraindicated in labour?

A

foetal blood sampling

27
Q

Woman had an implant inserted but she’s getting it removed. What is the most likely reason why?

A

irregular bleeding
–> never understood this question but apparently this is the answer

28
Q

What cancer are you at increased risk at with HRT?

A

Breast

29
Q

Mother had rupture of membranes at like 32 weeks. What do you give her?

A

Oral erythromycin

30
Q

Post partum haemorrhage with high BP. What do you give

A

Oxytocin is to be preferred initially, especially in women with hypertension or pre-eclampsia

31
Q

Foreign woman has come in and is pregnant. What vaccine should she be offered?

A

dumb question- all women should be recommended whooping cough, but she was foreign so they probably wanted Hep B I think

32
Q

Woman 38/40 has come in for her elective c/s, ECV failed, what do you do now?

A

just carry on with the C/S as planned

33
Q

Woman previously had a abortion cos of severe spina bifida. No other clinical information given. What do you advice her on folic acid doses for her next pregnancy?

A

5mg from before conception to at least 12W

34
Q

Poorly controlled diabetic mother, her newborn has an abnormal asymmetric Moro reflex - what’s wrong?

A

brachial plexus injury
secondary to probably shoulder dystocia coz of diabetes

35
Q

A 26 year old woman at 9 weeks gestation attends midwife antenatal clinic for her booking
bloods.
Which is the routine screening blood test for Hepatitis B infection?

A

Hepatitis B surface antigen

36
Q

A couple in their mid-twenties have been trying to conceive for 2 years. The male partner
has been diagnosed with azoospermia.
Which is the most likely cause of azoospermia?

A

Mumps Orchitis
-> this has come up in so many exams

37
Q

Woman who is exclusively breastfeeding and wants contraception

A

Reassure and give nothing
–> not to sure but seems to be hinting at lactational amenorrhea
–> you need to check she does not have periods and that she is exclusively breatfeeding

38
Q

Alcoholic has cellulitis, given chlordiazepoxide and Abx, what else do you give?

A

thiamine/Pabrinex

39
Q

Girl with anorexia was admitted and she started eating. Then she gets muscle spasms, and abdominal pain. What would be deranged/ what’s the most important thing to check for???

A

Phosphate

40
Q

Drug to give for depression in a guy who had an MI

A

Sertraline

41
Q

A 46 year old male inpatient has recently been initiated on clozapine following relapse of
paranoid schizophrenia. He reports chest pain and tachycardia. ECG demonstrates ST
elevation. Which is the most likely diagnosis?

A

Myocarditis

42
Q

Woman experienced trauma 6 months ago/has PTSD best management?
- trauma focused CBT wasn’t option

A

Eye Movement Desensitisation and Reprocessing

–> could also be cognitive analytical therapy?

43
Q

Woman blushes in public. Diagnosis?

A

social phobia

44
Q

Alcoholic wants to quit and wants something for reducing cravings

A

Acamprosate

45
Q

dilated pupils, urinary retention, obs normal-ish - cause of overdose?

A

TCA

46
Q

Husband brings in wife who has bipolar, who’s taken 20 “white” tablets - has a tremor and other sx. What tablet has she overdosed on?

A

lithium overdose

47
Q

Newborn with portwine stain in trigeminal distribution. What do you need to do?

A

Arrange MRI because of high risk of Sturge-Weber syndrome.

Radiologic imaging (MRI or CT scan) are needed to look for vascular malformations in the eyes and brain. Patients with port wine stains involving the upper face (and particularly the forehead) should be referred to an ophthalmologist to determine if glaucoma or other characteristic eye findings are present.

48
Q

What signifies onset of active labour?

A

dilated >4cm

49
Q

A newborn appears to be in severe respiratory distress and appears blue. Despite being given high flow O2, his saturations remain at 65%.
What is the next best step to take with regards to his management?

A

Infusion of Prostaglandin

50
Q

What is the most important thing to look at in follow up of HSP?

A

Urine Protein

51
Q

15 year old boy with short stature. Passing urine 10 times a day with no dysuria. Pale with heart rate at 78bpm, blood pressure at 158/88 and respiratory rate at 14. What is the likely diagnosis?

A

Chronic renal failure

52
Q

Child with episodes of smelling strange things, hard to communicate with during these episodes, falls asleep for an hour after and doesn’t remember anything

A

Focal seizure

Past Paper Specialties (5 decks)

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