EFA Session Flashcards
6 year old boy with non blanching rash on extremities with abdo pain and arthritis. Prev URTI. Normal observations but ++ urine. Dx?
IgA vasculitis (HSP)
ITP purpuric rash distribution?
All over body, not confined to one area
What is HSP?
IgA vasculitis
7 year old boy with a 6 week history of limp with no trauma. Reduced range of movement with gluteal wasting and + Trendelenburg. Pain mainly on moving. Dx?
Perthes
What is perthes disease?
Avascular necrosis of femoral head
Age group of SUFE?
Pre pubertal adolescents 10-12
When is perthes worse?
On exertion
7 month old boy not using L arm properly. Hypertonic, hyperreflexia, stiff arm. Also in L leg too. Where is the lesion?
Motor cortex - UMN lesion
Basal ganglia impairment Sx?
Higher cortical function impairment of movement - memory, planning, modulating movements. Eg Parkinson’s
Internal capsule lesion Sx?
Communication between ascending and descending axons. Speech and swallow issues
Pyramidal tract lesion Sx?
Motor and facial function
A fussy eater toddler who only drinks cows milk, what are they most likely to be deficient in?
Iron
One week old baby with pale stool, dark urine and losing weight. She has no fever but is jaundiced. First Ix?
Split BR - conjugated and unconjugated
Why do you want to know split BR figures?
To find out whether it’s obstructive or not, and where the issue is - unconjugated or conjugated
What condition needs urgent attention in a jaundiced newborn?
Biliary atresia
Baby boy born with neither testes palpable. Most likely Dx?
Physiological delay in descent
Is androgen insensitivity syndrome rare or common?
Rare - picked up later on in the baby’s life
Sx of androgen insensitivity?
Inguinal mass in baby girl
6 hour old baby grunting and cyanosed. Loud S2 heart sound with low saturations not improved by oxygen. Dx and Mx?
Transposition of great arteries
Prostaglandin (alprostadil)
3 year old with diarrhoea with food in. Dx?
Toddler diarrhoea
3 year old with diarrhoea with food in. Dx?
Toddler diarrhoea
2 day old Down’s syndrome child with bilious vomiting. Slightly distended tummy but soft. Patent anus. Dx?
Duodenal atresia
Is pyloric stenosis vomit bilious or not?
No
Hearing test for child of deaf mother?
Brain stem evoked response test
Appropriate IV fluid for dehydrated child from gastroenteritis?
0.9% sodium chloride with 5% glucose (add the glucose for a child)
When is just 0.9% chloride used?
Fluid bolus
Cardiac abnormality in downs?
AVSD
Two year old with 4 weeks of smelly discharge from one nostril. Mucous with some blood from it. Sneezing. Dx?
Foreign body
First fluid IV for DKA?
0.9% sodium chloride
2nd IV fluid for DKA?
Insulin 1hr after sodium chloride
Complication of adding insulin for DKA first?
Cerebral oedema
6 year old with L upper tibia pain and no weight bearing. Febrile with no trauma Hx, no swelling. Normal XR but high WCC. Dx and Best initial Ix?
Osteomyelitis
Blood culture
9 month old with vomiting, lethargy, bulging fontanelle. No neck stiffness. Purpuric rash. Febrile. Dx?
Meningococcal disease
Sx suggestive of meningitis in baby?
Bulging fontanelle
NOT neck stiffness, hard to tell in babies
Group B strep disease Hx features?
NEONATES (or up to 3 months max) with ++ maternal Hx
Does viral meningitis have a rash?
Not usually
1st Mx of testicular torsion?
Surgical exploration
11 year old previously well but prev URTI. Nosebleeds and bruises. Low platelets. Dx?
ITP
Scarlet fever Tx?
Phenoxymethylpenecillin
Kawasaki disease Tx?
IV Ig and aspirin
Wheeze in child who is quite well. Tx and method?
Salbutamol via spacer
When is nebulised salbutamol used in asthma?
If child is unwell