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passmed qs > 22/06 > Flashcards

22/06 Flashcards

1
Q

what causes acute epiglottitis

A

haemophilus influenza B

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2
Q

APGAR

A

Activity (muscle tone)
Pulse
Grimace (reflex irritability)
Appearance (skin colour)
Respiratory effort

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3
Q

when should apgar be assessed

A

1 and 5 mins
again at 10 mins if abnormal

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4
Q

adverse effect of methyphenidate

A

cardiotoxicity - perform a baseline ECG

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5
Q

benign rolandic epilepsy EEG

A

centrotemporal spikes

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6
Q

jaundice extending beyond physiological 2 weeks
conjugated bilirubin abnormally high

A

biliary atresia

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7
Q

crosses suture lines

A

caput succedaneum

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8
Q

doesnt cross suture lines

A

cephalohaematoma

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9
Q

cause of erythema infectious/slapped cheek/fifth disease

A

parvovirus b19

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10
Q

‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)

A

scarlet fever

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11
Q

what causes scarlet fever

A

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci

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12
Q

what causes hand foot and mouth disease

A

coxsackie A16 virus

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13
Q

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

A

Patau syndrome (trisomy 13)

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14
Q

Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

A

Edward’s syndrome (trisomy 18)

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15
Q

Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism

A

fragile X

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16
Q

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

A

noonan syndrome

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17
Q

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

A

pierre-robin syndrome

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18
Q

Hypotonia
Hypogonadism
Obesity

A

Prader-Willi syndrome

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19
Q

Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis

A

williams syndrome

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20
Q

Characteristic cry (hence the name) due to larynx and neurological problems
Feeding difficulties and poor weight gain
Learning difficulties
Microcephaly and micrognathism
Hypertelorism

A

cri du chat syndrome (chromosome 5p deletion syndrome)

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21
Q

drug use increasing risk of cleft lip/palate

A

anti-epileptics

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22
Q

Sensorineural deafness
Congenital cataracts
Congenital heart disease (e.g. patent ductus arteriosus)
Glaucoma

A

rubella

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23
Q

Cerebral calcification
Chorioretinitis
Hydrocephalus

A

toxoplasmosis

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24
Q

Low birth weight
Purpuric skin lesions
Sensorineural deafness
Microcephaly

A

cytomegalovirus

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25
Q

heart defect DMD

A

dilated cardiomyopathy

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26
Q

turners syndrome murmur

A

ejection systolic due to bicuspid aortic valve

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27
Q

peak incidence at 6 months - 3 years
more common in autumn

A

croup (parainfluenza virus) -> give dex

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28
Q

<1 year old
winter

A

bronchiolitis (RSV) -> supportive tx

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29
Q

differentiate cardiac and non-cardiac cyanosis

A

nitrogen washout test

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30
Q

acrocyanosis

A

cyanosis of the peripheries
normal finding and may persist 24-48hr

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31
Q

CF colonising organisms

A

Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia cepacia*
Aspergillus

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32
Q

cystic fibrosis diagnosis

A

sweat test, CF indicated by > 60 mEq/l

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33
Q

developmental referral

A

doesn’t smile at 10 weeks
cannot sit unsupported at 12 months
cannot walk at 18 months

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34
Q

diagnosis of DDH

A

USS unless >4.5 months, then xray

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35
Q

tx of DDH

A

pavlik harness in children younger than 4-5 mo.
older -> surgery

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36
Q

Holds in palmar grasp

A

6 months

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37
Q

Points with finger

A

9 months

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38
Q

reaches for object

A

3 months

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39
Q

good pincer grip

A

12 months

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40
Q

head control

A

3 months

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41
Q

sits without support

A

7-8 months

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42
Q

crawls

A

9 months

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43
Q

walks unsupported

A

13-15 months

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44
Q

runs

A

2 years

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45
Q

tricycle

A

3 years

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46
Q

hops on 1 leg

A

4 years

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47
Q

not shy

A

6 months

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48
Q

shy

A

9 months

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49
Q

turns towards sound

A

3 months

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50
Q

mama dad

A

9 months

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51
Q

knows and responds to own name

A

12 months

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52
Q

2-6 words

A

18 months

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53
Q

combine two words

A

2 years

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54
Q

talks in short sentences

A

3 years

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55
Q

Primary hypogonadism (Klinefelter’s syndrome)

A

high LH
low testosterone

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56
Q

hypogonadotrophic hypogonadism (kALlmans)

A

ALL LOW
low LH
low testosterone

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57
Q

Androgen insensitivity syndrome

A

high LH
normal/high testosterone

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58
Q

Testosterone-secreting tumour

A

low LH
high testosterone

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59
Q

often taller than average
lack of secondary sexual characteristics
small, firm testes
infertile
gynaecomastia - increased incidence of breast cancer
elevated gonadotrophin levels

A

klinefelters

60
Q

‘delayed puberty’
hypogonadism, cryptorchidism
anosmia
sex hormone levels are low
LH, FSH levels are inappropriately low/normal
patients are typically of normal or above average height

61
Q

DMD diagnosis

A

genetic testing

62
Q

low insertion of the tricuspid valve resulting in a large atrium and small ventricle
atrilisation of the right ventricle

A

ebsteins anomaly

63
Q

cause of ebsteins anomaly

A

exposure to lithium in utero

64
Q

ebsteins anomaly murmur

A

tricuspid regurgitation
pansystolic murmur, worse on inspiration

65
Q

steroid + emollient application

A

emollient should be applied first followed by waiting at least 30 minutes before applying the topical steroid

66
Q

congenital cyst found in the mouth

A

epsteins pearl

67
Q

when should a PPI be used for GORD in kids

A

unexplained feeding difficulties (for example, refusing feeds, gagging or choking)
distressed behaviour
faltering growth

68
Q

gastroschisis

A

no sac -> vaginal delivery -> straight to theatre

69
Q

omphalocele

A

sac -> C section -> staged repair

70
Q

paed migraine management

A

ibuprofen
nasal triptan

71
Q

bupronion CI

72
Q

varenicline CI

A

depression

73
Q

hypospadius

A

distal ventral urethral meatus

74
Q

ITP in kids mx

A

usually conservative
if platelet count <10 or sig bleeding;
oral/IV corticosteroid
IV immunoglobulins

75
Q

BCG if risk factors

76
Q

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B

77
Q

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
PCV

78
Q

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Men B

79
Q

Hib/Men C
MMR
PCV
Men B

A

12-13 months

80
Q

Flu vaccine (annual)

81
Q

‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio)
MMR

82
Q

HPV vaccination

A

12-13 years

83
Q

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)
Men ACWY

A

13-18 years

84
Q

EEG shows hypsarrhythmia

A

infantile spasms

85
Q

most common loc of intussecption

A

ileo-caecal region

86
Q

jaundice in first 24 hours

A

pathological

87
Q

jaundice from 2-14 days

A

physiological

88
Q

Pauciarticular JIA

A

less than 4 joints affected

89
Q

high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel

A

kawasaki disease -> treat with aspirin

90
Q

precocious puberty
cafe-au-lait spots
polyostotic fibrous dysplasia
short stature

A

mccune albright syndrome

91
Q

when does meconium aspiration syndrome occur

A

post term deliveries

92
Q

neck lump anterior to the sternocleidomastoid near the angle of the mandible

A

branchial cyst

93
Q

neck lump midline/suprahyoid location

A

dermoid cyst

94
Q

neck lump posterior to the sternocleidomastoid

A

lymphatic malformation/cystic hygroma

95
Q

when is neonatal blood spot test performed

96
Q

confirmed neonatal sepsis tx

A

intravenous benzylpenicillin with gentamicin

97
Q

nephrotic syndrome kids

A

minimal change glomerulonephritis

98
Q

Projectile non bile stained vomiting at 4-6 weeks of life

A

pyloric stenosis

99
Q

Colicky pain, diarrhoea and vomiting, sausage-shaped mass, red jelly stool.

A

intussuseption

100
Q

pyloric stenosis diagnosis and tx

A

USS and Ramstedt pyloromyotomy

101
Q

intussuception diagnosis and tx

A

USS and reduction via air insufflation

102
Q

intestinal malrotation diagnosis

A

upper GI contrast study and USS

103
Q

intestinal malrotation tx

A

laparotomy, if volvulus is present (or at high risk of occurring) then a Ladd’s procedure is performed

104
Q

tx hirshsprungs

A

rectal washouts initially, after that an anorectal pull through procedure

105
Q

meconium ileus diagnosis

A

X-Rays will not show a fluid level as the meconium is viscid
PR contrast studies may dislodge meconium plugs and be therapeutic –> surgery

106
Q

biliary atresia tx

A

surgery - Kasai procedure

107
Q

necrotising enterocolitis diagnosis

A

XRAY - pneumatosis intestinalis and evidence of free air

108
Q

necrotising enterocolotis tx

A

total gut rest and TPN
babies with perforations will require laparotomy

109
Q

which fractures is compartment syndrome most assoc with

A

supracondylar and tibial shaft fractures

110
Q

splenic flexure tumour

A

left hemocolectomy

111
Q

upper rectum tumour

A

anterior resection

112
Q

lower rectal tumour

A

abdominoperineal resection

113
Q

umbilical hernia

A

majority close spontaneously

114
Q

patent ductus arteriosus

A

left subclavicular thrill
continuous ‘machinery’ murmur
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat

115
Q

perthes disease mx

A

If less than 6 years: observation
Older: surgical management with moderate results

116
Q

precocious puberty

A

before 8 in females
before 9 in males

117
Q

pyloric stenosis

A

hypochloraemic, hypokalaemic alkalosis

118
Q

Roseola infantum cause

A

human herpes virus 6

119
Q

roseola infantum

A

high fever
followed a few days later by maculopapular rash

120
Q

scarlet fever tx

A

oral penicillin V for 10 days

121
Q

seb dermatitis

A

topical emollient
topical imidazole cream

122
Q

shaken baby syndrome

A

retinal haemorrhages
subdural haematoma
encephalopathy

123
Q

TOF

A

ventricular septal defect
right ventricular hypertrophy
right ventricular outflow tract obstruction, pulmonary stenosis
overriding aorta

124
Q

loud single S2
prominent right ventricular impulse
‘egg-on-side’ appearance on chest x-ray

A

transposition of the great arteries

125
Q

undescended testes mx

A

refer at 3 mo.
repair at 1 year

126
Q

bilateral undescended testes

A

senior paediatrician within 24hours

127
Q

diagnosis of vesicoureteric reflux

A

micturating cystourethrogram
look for renal scarring - DMSA scan

128
Q

5 Ws of post-op pyrexia

A

-Wind (1day): atelectasis
-Water(3days): UTI
-Wound(5days): surgical site infection/abscess
-Walking(7days): DVT/PE
-Wonder-drugs(Anytime): adverse drug reaction

129
Q

differentiate between true seizure and pseudoseizure

130
Q

Sudden heart failure, raised JVP, pulsus parodoxus, recent MI

A

left ventricular free wall rupture

131
Q

Weber result: Lateralises to unaffected ear

A

sensorineural hearing loss

132
Q

c diff

A

gram +ve rods

133
Q

posterior MI ECG

A

tall R waves V1-2

134
Q

lidocaine MOA

A

blocking sodium channels

135
Q

Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller

A

dengue fever

136
Q

Management of placental abruption when the fetus is alive, <36 weeks and not showing signs of distress

A

admit and administer steroids

137
Q

indapamide

A

THIAZIDE DIURETIC

138
Q

personality disorder tx

A

dialectal behavioural therapy

139
Q

diarrhoea

A

normal anion gap acidosis

140
Q

vomiting

A

metabolic alkalosis

141
Q

COPD

142
Q

OSA

143
Q

type 1 resp failure

144
Q

Patients with suspected visual loss secondary to temporal arteritis

A

IV methyprednisolone

145
Q

long term mx MS

A

natalizumab

passmed qs (18 decks)

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