Classic Presentations

Question 1

A child <2 presents with a runny nose, low grade fever, and a dry/wheezy cough. The parent reports reduced oral intake. On examination, the child is tachypnoeic, has increased work of breathing and is using accessory muscles. On auscultation you hear widespread fine inspiratory crackles and a wheeze

Answer 1

Bronchiolitis - most commonly caused by RSV

Question 2

Child < 3 presents with hoarseness, a barking cough, stridor and progressive airway obstruction

Answer 2

Croup/Acute laryngotracheobronchitis

Question 3

A child presents with fever, SOB, lethargy, chest recession and tachypnoea

Answer 3

Pneumonia

Question 4

A 6 week old baby presents with progressively worsening non-billious, projectile vomiting after feeds. The baby is otherwise well. The baby is still interested in feeding despite vomit

Answer 4

Pyloric stenosis

Question 5

5 year old girl referred with failure to gain weight and possible weight loss.
Daily abdominal pain.
Loose stools x 4 daily.
Was completely well until ~ 1 year ago

Answer 5

Coeliac

Question 6

A baby in the first few months of life is brought to clinic for excessive crying. The parents report regular episodes of inconsolable crying, most often in the afternoon/evening. The baby sometimes draws their knees up to their abdomen or arches their back when crying. They are not limp or pale

Answer 6

Colic

Question 7

A baby in its first week of birth vomits green liquid

Answer 7

Malrotation

Question 8

A child presents with a fever and retrosternal chest pain that radiates to the shoulders and neck. It is exacerbated by deep breathing, exercise, swallowing and lying flat. It is relieved by sitting forward.

Answer 8

Pericarditis

Question 9

A child aged 8-14 presents with abdominal pain. It began as early non-specific peri-umbilical pain which localised with time (around 24 hours) to the right iliac fossa (McBurney’s point). The patient is nauseous and pyrexical.

Answer 9

Appendicitis

Question 10

Child aged 2-7 presents with severe airflow obstruction/stridor, high fever, drooling and a severe sore throat

Answer 10

Epiglottitis

Question 11

A 4 month old baby who is of a normal weight is brought to clinic for persistent vomiting. They vomit after every feed and are very irritable, especially when lying flat. When lying flat after a feed, they arch their back. They also have unexplained feeding difficulties (eg. refusing to feed, gagging, or choking)

Answer 11

GORD

Question 12

An child presents with a puritic and erythematous rash on the flexural surfaces

Answer 12

Atopic eczema

Question 13

A child presents with a history of wheeze, non-productive cough and breathlessness that is worse and night and early in the morning. It is made worse with exercise and cold air.

Answer 13

Asthma

Question 14

A few weeks after birth a baby is found to be failing to thrive and and become sweaty, fatigued and tachypnoeic with feeds. On auscultation, a pansystolic murmur can be heard

Answer 14

Ventricular septal defect

Question 15

A 2-4 week old premature infant (<32 weeks gestation) who has a low birth weight (<1500g) becomes lethargic. They experience apnoea, bradycardia and temperature instability. Their stools are bloody. They begin vomiting and on examination you note abdominal distention, tenderness and hypoactive bowel sounds),

Answer 15

Necrotising enterocolitis

Question 16

A breastfed baby who is 2-3 days old is noted to have jaundice. The baby is otherwise well. Bilirubin levels are <200μmol/l

Answer 16

Physiological jaundice

Question 17

A newborn fails to pass meconium in the first 12-24 hours. They have signs of intestinal obstruction, including vomiting that may be bilious and abdominal distention

Answer 17

Meconium ileus (SI obstruction)