childhealth investigations

Question 1

late jaundice 1st line investigation

Answer 1

split bilurubin (conjugated and unconjugated)

Question 2

diagnostic test for breast abscess

Answer 2

ultrasound

Question 3

diagnostic test for developmental dysplasia of hip (DDH)
(differs with age)

Answer 3

ultrasound if <4.5 months
if infant is >4.5 months then x-ray is first line

Question 4

vesicoureteric reflux diagnostic investigation

Answer 4

micturating cystourethrogram (aka known as voiding cystourethrogram)

how it works: dye is injected into the bladder, then x-ray images are taken to see if the dye moves from the bladder into the kidneys

Question 5

what is the cut off value for hypoglycaemia in neonates

Answer 5

<2.6mmol/L

Question 6

acute epiglottis Ixs

Answer 6

if suspected do NOT examine throat in case of obstruction to airway

diagnosis made by direct visualisation from senior staff who are able to intubate

Question 7

when is the APGAR score used

Answer 7

used twice: 1 min after birth anf 5 mins after birth

Question 8

What does the APGAR score stand for

Answer 8

Appearance
Pulse
Grimace response (reflex irritability)
Activity
Respiration

Question 9

what scores 2 points on APGAR score

Answer 9

2 points: normal colour all over, >100bpm, cries etc, spontaneous movement, normal resp rate and good cry

Question 10

what scores 1 point on APGAR score

Answer 10

normal colour (but hands n feet are blueish),
<100bpm
facial movement only
arms and legs flexed with little movement
slow/irregular breathing, weak cry

Question 11

pyloric stenosis investigation

Answer 11

ultrasound

Question 12

someone having multiple uti’s and there are dilated ureters on imaging what ix should you carry out

Answer 12

micturating cystourethrogram (3 months after uti)

doing this as dilated ureters indicated backed up urine

Question 13

Cystic fibrosis gold standard investigation

Answer 13

Sweat test

Question 14

Ixs for transient synovitis of the hip

Answer 14

X ray to exclude perthes
MRI to exclude osteomyelitis
CRP to rule out septic arthritis

Question 15

Diagnostic test for pyloric stenosis

Answer 15

Ultrasound: Hypertrophic pyloric muscle

Question 16

Malrotation w volvulus Ix
(2)

Answer 16

1st line: abdo x-ray
confirm diagnosis: upper GI contrast and ultraound

Question 17

necrotising enterocolitis Ix

Answer 17

abdo x ray: dilated bowel loops

Question 18

gold standard investigation for coeliac

Answer 18

endoscopy w/ duodenal biopsy

(will show crypt hyperplasia, villi flattening)

Question 19

intussusseption investigation

Answer 19

Ultrasound: target lesion

Question 20

ixs for hirschsprungs disease - inital and gold standard

Answer 20

initial: abdominal x ray with contrast- shows obstruction

confirm diagnosis (gold standard): rectal suction biopsy of intestinal mucosa/submucosa

Question 21

kawasaki disease Ix

Answer 21

urgent echo as coronary anyuresms are a worry

Question 22

describe the ortolani test

Answer 22

attempt to relocate a dislocated femoral head

(ought to come back home)

Question 23

barlow test, decribe

Answer 23

attempt to dislocate femoral head

(out to bar)

Question 24

test for meningitis and when it is contraindicted

Answer 24

lumbar puncture

contraindicted in increased intracranial pressure ie if they have papilloedema (as LP can cause coning when there is raised ICP)

Question 25

neonatal respiratory distress syndrome
ix

Answer 25

CXR- ground glass appearance (rlly just looks more opaque than is should)

Question 26

malrtoation with volvulus ix

Answer 26

corkscrew on x ray