Buzzwords + Presentations

Question 1

a 2 week old neonate, born at 34 weeks starts vomiting green fluid and develops bloody stools

Answer 1

Necrotising enterocolitis

Question 2

4 year old with one day hx fatigue and headache. Temperature 38.5. Cool peripheries and non blanching rash on thigh?

Answer 2

Meningitis

Question 3

2 year old can crawl can’t walk yet. Was born at 30 weeks by vaginal delivery. Hypertonia in lower limbs

Answer 3

Cerebral palsy - spastic type affecting pyramidal pathway

Question 4

3 month, floppy when held, large tongue and single palmer crease. Grey spots around iris

Answer 4

Down syndrome

47XX+21

Question 5

3 hour old baby 39weeks in NICU is grunting with RR of 66 but is pink. CXR hyperinflation and fluid line in right horizontal fissure

Answer 5

Transient tachypnoea of the newborn

Question 6

Meconium-Stained Liquour + Respiratory Distress?

Answer 6

Meconium Aspiration Syndrome

Question 7

Baby boy delivered 42 weeks, cyanosed, tachypnoeic CXR patchy infiltrations and atelectasis?

Answer 7

Meconium aspiration syndrome

= because of CXR findings + post term delivery

Question 8

hypotonia, poor growth, prolonged neonatal jaundice, hypreflexia, developmental delay

Answer 8

Congenital hypothyroidism

Question 9

A 34-year-old woman delivers a baby girl at 39 weeks gestation. This is her second baby; both pregnancies have been uncomplicated. A few hours after delivery, she notices her baby’s skin has a slight yellow tinge.

What is the most likely cause of this change in skin colour?

Answer 9

Rhesus haemolytic disease

= pathological jaundice,

(can also be ABO disease, g6pd def, spherocytosis)

Question 10

An 18 year old male presents in the community with a two day history of a mild upper respiratory tract infection. He woke up this morning with yellowing of his skin and sclera. He is otherwise fit and well, and his blood tests are normal.

Answer 10

Gilberts

Mx : Reassurance

Question 11

3 yr old born at 30w has billous vomiting, x ray shows intramural gas

Answer 11

Nec enterocolitis

needs broad spec abx

Question 12

A 3 week old presenting with jaundice and feeding difficulties, no abnormal vital signs

High conjugated bilirubin and weird LFTs

Answer 12

Biliary atresia

Question 13

Infant with billous thick vomiting and no wet nappies for 24 hours, absent bowel sounds

Answer 13

Intestinal malrotation

Question 14

Baby with hepatosplenomegaly, jaundice, fever and microcephaly?

Answer 14

CMV infection from mum

The fever and microcephaly gives it away otherwise you may think biliary atresia

Question 15

Neonate billous vomiting, has palmar crease and passed meconium

Answer 15

Duodenal atresia

= Duodenal atresia in newborns results in bilious vomiting and is characterised by two gas bubbles on an abdominal x-ray. It is commonly associated with Down’s syndrome and requires urgent surgical intervention.

Question 16

Red flag symptom: Bile stained vomit

What conditions come to mind?

Answer 16

Intestinal obstruction:

Intussusception
malrotation
strangulated inguinal hernia
atresia
Necrotising enterocolitis

Question 17

Red flag symptom: Haematemesis

What conditions come to mind?

Answer 17

Oesophagitis
Peptic ulcer
Vitamin K deficiency
Haemorrhagic disease of newborn

Question 18

Red flag symptom: Projective vomiting at 2-7 weeks

What conditions come to mind?

Answer 18

Pyloric stenosis

Question 19

Red flag symptom: Vomiting after paroxysmal cough

What conditions come to mind?

Answer 19

Whooping cough

Question 20

Red flag symptom: Hepatosplenomegaly

What conditions come to mind?

Answer 20

Haemolytic anaemias

Biliary atresia

CMV infection
Syphilis

Metabolic disorders (von gierker’s disease)

Question 21

Red flag symptom: Blood in stool

What conditions come to mind?

Answer 21

Intussusception (red current jelly)
gastroenteritis (salmonella / campylobacter)
Anal fissure
Meckel’s diverticulum

Question 22

Red flag symptom: Severe dehydration/shock

What conditions come to mind?

Answer 22

Systemic infection

DKA

Question 23

Red flag symptom: failure to thrive

What conditions come to mind?

Answer 23

GORD
Coeliac
Chronic GI

Question 24

Red flag symptom: Bulging fontanelle / seizure

What conditions come to mind?

Answer 24

Raised ICP

Question 25

5 week baby projectile vomiting after feeds, looks like uncurdled milk, failing to thrive and BP 90/60

Answer 25

Pyloric stenosis

Question 26

Paediatrics commonly present with this, random inconsolable crying and drawing up on the hands and feet

Answer 26

Infant colic - soothe infant, consider cow milk allergy if persisting -> 2 week trial of whey hydroloysate formular followed by 2 week anti reflux treatment

Question 27

A 3-day-old child has been brought in by his parents after noticing that his tummy looks swollen and he is constantly crying. The parents opted for a home birth and the child has had no healthcare contact as of yet. He has yet to have a bowel movement since birth. There is also difficulty feeding. The patient was born at 39 weeks gestation and his delivery was uncomplicated.

Answer 27

( Cystic fibrosis )+ Meconium ileus

Question 28

Soiling of underwear with stool in children past the age of toilet training e.g. 4?

Answer 28

Encopresis (underlying constipation with overflow)

Question 29

A 5-year-old boy is brought to the GP by his mother due to intense perianal itching, especially at night. His mother has also noticed him scratching frequently and reports that his younger sibling has similar symptoms. The child is otherwise well with no fever, weight loss, or abdominal pain.

Answer 29

Threadworm : enterobius vermicularis Mebendazole for whole household

Question 30

High fever lasting >5 days, red palms with desquamation and strawberry tongue

Answer 30

Kawasaki