Difficult topic review

Question 1

when is the normal age for responsive smile?

Answer 1

6-8 weeks

Question 2

what is the reference range for the corrected age? if premature

Answer 2

40 weeks

Question 3

what age do you play with others?

Answer 3

4

Question 4

what age contently play alone?

Answer 4

18 months

Question 5

immediate referral in bronch when?

Answer 5

apnoea
seriously unwell (healthcare professional)
severe respiratory distress
central cyanosis
oxygen sat <92%

Question 6

gastroschisis

Answer 6

congenital visceral malformation

defect in anterior abdomen just lateral to umbilical cord

Question 7

omphalocoele defn

Answer 7

also known as exomphalos
abdominal contents protrude through anterior abdominal wall
but are covered in an amniotic sac

Question 8

gastroschisis

associated with?

Answer 8

low SES
maternal age <20
maternal alcohol / tobacco

Question 9

palmar grasp?

Answer 9

6 months

Question 10

early pincer

Answer 10

9 months

Question 11

good pincer

Answer 11

12 month

Question 12

circular scribble?

Answer 12

18 months

Question 13

hand foot and mouth disease is caused by

Answer 13

coxsackie a16

Question 14

Slipped capital femoral epiphyses
mx?

Answer 14

sufe

internal fixation

Question 15

what does a PDA murmur sound like?

Answer 15

machinery murmur at upper left sternal edge

Question 16

hypoglycaemia in neonate signs

Answer 16

visible jittery
reduced foetal movements

irritible

Question 17

neonatal hypoglycaemia

Answer 17

‘inability to regulate glucose / reduced glycogen stores’

a pre-term infant will not yet develop the same glycogen reserves - prematurity

tertubtaline
maternal DM
IUGR
hypothermia
neonatal sepsis

Question 18

mx of neonatal hypoglycaemia

Answer 18

admit
IV infusion 10% dextrose

Question 19

whooping cough
caused by?

confirmed by? why this?

Answer 19

bordetella pertussis

per nasal swab
adheres strongly to ciliated epithelial cells high in nasopharynx

Question 20

whooping cough vaccine

Answer 20

gram negative
2,3,4 months
3-5 years

Question 21

whooping cough features

Answer 21

catarrhal phase

paroxymal phase
vomitng
central cyanosis
inspiratory cough

convalescent phase

Question 22

mx of whooping cough

Answer 22

macrolide

Question 23

GDPP

Answer 23

central precocious puberty
levels of fsh and lh HIGH
testes size LARGE

Question 24

GIPP

Answer 24

symptoms caused by increase sex hormones
testosterone
leads to suppression of LH
FSH

adrenal hyperplasia

Question 25

alprostadil

Answer 25

prostaglandin e1

Question 26

neck masess thyroglossal

Answer 26

located in anterior triangle derived from throglossal duct thin walled and anechoic on USS

Question 27

neck masses branchial cyst

Answer 27

anterior to sternocleidomastoid anechoic on USS

Question 28

dermoid cyst

Answer 28

derived from pluripotent stem cells suprahyoid location heterogenous appearance

Question 29

ladds procedure

Answer 29

intestinal malrotation with volvulus

Question 30

achrondoplasia associated with what physical features?

Answer 30

macrocephaly frontal bossing

Question 31

what can be a cause of microcephaly?

Answer 31

foetal alcohol syndrome trisomy 13 18 21

Question 32

chickenpox mx?

Answer 32

topical calamine lotion

Question 33

scabies mx?

Answer 33

permethrin

Question 34

Spastic cerebral palsy where would damage be?

Answer 34

UMN in the periventricular white matter

Question 35

hypertonia is a sign of damage wherE?

Answer 35

UMN sign

Question 36

13 month unable to pull to stand lower limb is showing hypertonia

Answer 36

spastic cerebral palsy

Question 37

dyskinetic cerebral palsy damage to where?

Answer 37

basal ganglia / substantia nigra > athetoid movements oromotor problems

Question 38

cerebellar signs?

Answer 38

dysdiadokinesia ataxia nystagmus speech intention tremor hypotonia

Question 39

reflux nephropathy

Answer 39

vesicouretral reflux valve problem backflow of urine from bladder into ureter and / or kidney ix? micturating cystourethrogram

Question 40

management of necrotising enterocolitis

Answer 40

total gut rest TPN perforations need laparotomy

Question 41

how is hirschsprung diagnosed? mx>?

Answer 41

full thickness rectal biopsy rectal washouts

Question 42

ladd's procedure is for what?

Answer 42

intestinal malroatation

Question 43

ramstedt procedure is to manage?

Answer 43

pyloric stenosis non bile vomit projectile

Question 44

what is the difference between osmotic and stimulant laxatives?

Answer 44

movicol paediatric plain is an osmotic laxative. these help as the stools tend to be hardened

Question 45

Ebstein anomaly associated with ___ what is it?

Answer 45

maternal lithium use posterior leaflets of the tricuspid valve are displaced anteriorly towards the apex of the right ventricle = tricuspid regurgitation stenosis

Question 46

sepsis in kids

Answer 46

vitals are similar to adults but you should account for age

Question 47

head injury - urgent CT scan request?

Answer 47

LOC lasting more than 5 minutes amnesia abnormal drowsiness 3 or more discrete vomiting episodes NAI seizure GCS<14

Question 48

dangerous mechanism of injury?

Answer 48

high speed road traffic injury fall from height >3m high speed injury from a projectile

Question 49

constipation NICE guidelines

Answer 49

polyethene gycol 3350+electrolytes (movicol paediatric plain) (osmotic laxative) + senna - stimulant after 2 weeks stop MPP