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Year 2 Incorrect Questions > Child Health > Flashcards

Child Health Flashcards

1
Q

Presentation of bronchiolitis

A

A non-productive cough, tachypnoea and intercostal recession
Manage supportively

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2
Q

Common deficiency in cystic fibrosis

A

Vitamin A, D, E and K
(impaired absorption of fat soluble vitamins due to reduced pancreatic enzyme secretion)

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3
Q

WHat does double bubble sign indicate?

A

Duodenal atresia
(NOT SEEN IN OESOPHAGEAL)

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4
Q

Presentation of oesophageal atresia

A

Antenatal - Polyhydraminos
Post-natal - Respiratory distress, Distended abdomen, Choking/problems with swallowing, Saliva overflow, No NG tube passage

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5
Q

Baby with APGAR 4, greenish tinge to skin, intercostal recession, poor cry?

A

Meconium aspiration syndrome

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6
Q

Diagnosis of Hirschprung disease

A

Rectal suction biopsy

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7
Q

Grossly distended bowel loops and pneumointestinalis on AXR indicates?

A

Necrotising enterocolitis

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8
Q

ABG findings in pyloric stenosis?

A

Hypokalaemic hypochloraemic metabolic alkalosis

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9
Q

First line investigation in suspected vesicoureteric reflux

A

Micturating Cystourethrogram (MCUG)

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10
Q

First line antibody test for coeliac disease

A

Anti-tissue transglutaminase (tTG) IgA antibody

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11
Q

First line management of gastroenteritis

A

Nasogastric fluid replacement with rehydration sachets

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12
Q

Unvaccinated coughing baby to the point of vomiting, milky vomit, strange sound breathing in?

A

Whooping cough
(test for bordetella via pernasal swab)

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13
Q

What factors can increase risk of Neonatal Respiratory Distress Syndrome?

A

Premature (lack of surfactant)
Diabetic mothers

Presents with:
resents with increased work of breathing shortly after birth, and the chest x-ray demonstrating diffuse granular opacities

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14
Q

What pulses should be felt in an unresponsive child?

A

In the neck (carotid pulse) in children over 1 year
In the inner aspect of the upper arm (brachial pulse) in an infant

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15
Q

Vesicular rash on hands, soles of feet and buccal muscoaa?

A

Coxsackie A
(hand, foot and mouth disease)

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16
Q

Halo sign in oesophagus on CXR after possible foreign object swallow?

A

Button battery
Urgent endoscopy!!!!!!

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17
Q

What is the cause of acute bilirubin encephalopathy?

A

It is caused by a toxic build-up of unconjugated bilirubin

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18
Q

What HR in an unwell child would indicate admission to hospital?

A

HR 160bpm

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19
Q

Adrenaline dose for anaphylaxis in kids

A

Under 6 months - 100-150mg
6m-6y - 150mg
6-12 - 300mg
Adults - 500mg

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20
Q

Test contraindicated in suspected meningitis

A

Lumbar puncture
- risk of coning

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21
Q

Most common congenital heart defect in babies of diabetic mothers

A

Transposition of great arteries

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22
Q

Presentation of acute lymphocytic leukaemia

A

Features of bone marrow failure:
- anaemia
- neutropaenia (resulting in frequent infections)
- thrombocytopaenia (which leads to petechiae and easy bruising)

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23
Q

How is secondary reperfusion injury prevented?

A

Cool newborn to 33-34deg
- slows cerebral metabolism and subsequently slows neurotransmitter and oxygen free-radical release

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24
Q

First line management of meningitis if penicillin allergic

A
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25
Q

Characteristic features of scarlet fever

A

Sandpaper feeling rash
Strawberry tongue
- preceded by non-specific symptoms e.g. sore throat, headache, fever

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26
Q

2/6 pansystolic murmur suggests

A

VSD

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27
Q

Example of macrogol laxative

A

Movicol

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28
Q

Management of Hirschprung’s

A

Surgical removal of the aganglionic segment

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29
Q

What complication of Kawasaki disease does immediate IV immunoglobulin prevent?

A

Coronary artery aneurysm

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30
Q

Widespread scarring rash after tonsillitis managed with antibiotics?

A

EBV infection
- if viral tonsillitis is incorrectly treated with antibios e.g. amoxicillin/ampicillin

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31
Q

Rectal suction biopsy in Hirschprung’s would show….

A

Absence of ganglion cells in the colonic submucosa

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32
Q

How long does fever in Kawasaki have to last?

A

Persistent and for more than 5 days

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33
Q

Presentation of strangulated hernia

A

Generalised tenderness worse on inguinal palpation
Mass in the right inguinal region
Cremasteric reflex present/Prehn’s test negative
Mass is not reducible
Bowel sounds heard on auscultation over the mass

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34
Q

Aspirin given to children can cause which syndrome?

A

Reye’s syndrome

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35
Q

What does neiserria menigitides look like on gram stain?

A

gram-negative intracellular diplococci

36
Q

First line investigation for suspected minimal change/nephrotic syndrome

A

Urine dip for proteinuria
- biopsy if no response to steroids

37
Q

First line investigation of Perthes

A

X-ray
- assess density of femoral head

38
Q

First line management of Perthes

A

Bed rest and analgesia
Physio and reduction in high impact sport

39
Q

Which type of newborn head swelling crosses suture lines?

A

Caput Succedaneum
- Crosses Sutures
- Clears Soon

40
Q

Key bits to remember in child health history taking

A

Birth
Vaccinations
Milestones/school attainment
Family at home
HEADSS for teenagers

41
Q

Most common complication in kids with measles

A

Otitis media

42
Q

Which drug can reduce period of infectivity in pertussis?

A

Clarithromycin
- give booster vaccine to any contacts

43
Q

Clin pres of Turner syndrome

A

Short stature
Spoon nails, webbed neck
Shield chest, wide nipples
Wide carrying angle
Delayed puberty, amennorhoea
Hypothyroidism
Bicuspid aortic valve

44
Q

Medical management of ADHD

A

Methylphenidate

45
Q

Virus presenting with facial rash an flu-like symptoms causing hydrops fetalis

A

Parvovirus B19 (slapped cheek syndrome)

46
Q

When are kids with slapped cheek syndrome not infectious anymore?

A

When the rash appears

47
Q

Severe complication of bronchiolitis requiring lots of hospital care presenting with seizure, resp distress, pneumonia, terminal bronchiolar dilatation with areas of air trapping?

A

Bronchiolitis obliterans
- caused by adenovirus

48
Q

Complication resulting from failure to operate on hydrocele in baby

A

Indirect inguinal hernia

49
Q

Prescribing amoxicillin in glandular fever can result in what kind of drug reaction?

A

Mobiliform

50
Q

Describe TTN

A

Caused by: delayed resorption of fluid in the lungs
Strongly associated with caesarean section and prematurity
X-ray signs: hyperinflation, and fluid in the horizontal fissure

51
Q

Which test can determine whether leg length discrepancy is a femoral or tibial cause?

A

Galeazzi

52
Q

Most common cause of neonatal sepsis

A

Group B strep (from genital tract)
- risk factors include prolonged prelabour rupture of membranes, intrapartum fever and suspected or confirmed bacterial infection

53
Q

First line management of precocious puberty

A

Ref to peds

54
Q

Low-set ears, microcephaly and omphalocele are characteristic of which genetic condition?

A

Edward’s syndrome

55
Q

Management of HSP

A

Analgesia
Steroids if severe
Potentially anti-HT if hypertensive

56
Q

What is the most common cause of rectal bleeding in kids and how is it investigated?

A

Meckel’s diverticulum (embryological remnant)
- investigate with Technetium scan

57
Q

Managment of perforated eardrum assoc with otitis media

A

<4 day history - reassure and discharge
>4 day history - oral amoxicillin

58
Q

When should you not prescribe antibiotics in whooping cough?

A

After 21 days of persistent symptoms

59
Q

Most common causative organism of osteomyelitis in sickle cell

A

Salmonella typhi

60
Q

How is Prader-Willi inherited?

A

Genomic imprinting

61
Q

Midwife home visit finds baby to be jaundiced but otherwise well, what action should they take?

A

Check serum bilirubin with transcutaneous bilirubinometer if bilirubin level is >250 micromoles/L

62
Q

Investigation of child with recurrent UTI after positive cultures

A

Request an ultrasound scan within 6 weeks and a DMSA scan 4-6 months later

63
Q

What is roseola infantosum?

A

Benign illness characterised by several days of high temperatures followed by a widespread rash that starts on the torso/neck

64
Q

After starting bilirubin phototherapy, when should levels be rechecked?

A

4-6 hours

65
Q

Presentation of cogenital hypothyroidism

A

Hypotonia, macroglossia, an umbilical hernia, reduced feeding and constipation (mild soft abdominal distention)

66
Q

Reed Sternberg cells on lymph node biopsy suggest…

A

Hodgkin’s lymphoma

67
Q

What medication can be used to encourage patent ductus arteriosus in ToF?

A

Prostaglandins e.g. alprostadil

68
Q

Management AOM with sudden otorrhoea and perforated tympanic membrane?

A

Immediate oral antibiotic prescription

69
Q

Initial management of UTI in suspected urosepsis

A

Tazocin

70
Q

First line for chronic constipation in kids

A

Movicol
- senna second line

71
Q

CFTR mutation in cystic fibrosis is found on which chromosome?

A

Chromosome 7

72
Q

Baby with stridor and coryzal symptoms…

A

Bronchiolitis

73
Q

Management of choking infant after back blows

A

Chest thrusts

74
Q

First line investigation of child with recurrent UTIs

A

Abdominal US

75
Q

If a mother has preeclampsia, what type of jaundice does baby most likely have?

A

Haemolytic jaundice

76
Q

4h old baby with jaundice and sick mum is physiological or pathological?

A

Pathological (less than 24h old)

77
Q

ST elevation in leads V2-5 suggests infarct where?

A

Anterior infarct

78
Q

What HIV viral load is acceptable for breastfeeding?

A

<20

79
Q

Diagnostic investigation for eosophageal atresia

A

NG tube and a chest X-ray

80
Q

Complication of coarctation of aorta

A

Cerebral aneurysm

81
Q

Investigation for child under 3 months with high fevers…

A

Blood cultures, urine cultures and CSF cultures
- always suspect sepsis first

82
Q

Key marker of biliary atresia on LFTs

A

Abnormally high levels of conjugated bilirubin
- also jaundice, pale stools, palpable masses in upper quadrants

83
Q

Premature babies who are approaching bronchiolitis season should be started on which prophylactic therapy?

A

Palivisumab

84
Q

How to tell if a rash is HSP not Kawasaki?

A

Bum and leg rash
Bloody diarrhoea
Abdo joint pain
Recent URTI

Kawasaki has strawb tongue

85
Q

Breast cancer difficult to see on mammogram

A

Invasive lobular carcinoma
- most have MRI to ID and stage

86
Q

Drugs lowering seizure threshold

A

“I am Tramadol’s friend, keeping life less anxious”
I for imipenem
AM for abx:penicillins, cephalosporins, metronidazole, isoniazid
Tramadols for tramadol
Friend for fentanyl
Keeping for ketamine
Life for lidocaine
Less for lithium
Anxious for antihistamines

87
Q
A

Year 2 Incorrect Questions (9 decks)

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