EFA Session

Question 1

6 year old boy with non blanching rash on extremities with abdo pain and arthritis. Prev URTI. Normal observations but ++ urine. Dx?

Answer 1

IgA vasculitis (HSP)

Question 2

ITP purpuric rash distribution?

Answer 2

All over body, not confined to one area

Question 3

What is HSP?

Answer 3

IgA vasculitis

Question 4

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?

Answer 4

Perthes

Question 5

What is perthes disease?

Answer 5

Avascular necrosis of femoral head

Question 6

Age group of SUFE?

Answer 6

Pre pubertal adolescents 10-12

Question 7

When is perthes worse?

Answer 7

On exertion

Question 8

7 month old boy not using L arm properly. Hypertonic, hyperreflexia, stiff arm. Also in L leg too. Where is the lesion?

Answer 8

Motor cortex - UMN lesion

Question 9

Basal ganglia impairment Sx?

Answer 9

Higher cortical function impairment of movement - memory, planning, modulating movements. Eg Parkinson’s

Question 10

Internal capsule lesion Sx?

Answer 10

Communication between ascending and descending axons. Speech and swallow issues

Question 11

Pyramidal tract lesion Sx?

Answer 11

Motor and facial function

Question 12

A fussy eater toddler who only drinks cows milk, what are they most likely to be deficient in?

Answer 12

Iron

Question 13

One week old baby with pale stool, dark urine and losing weight. She has no fever but is jaundiced. First Ix?

Answer 13

Split BR - conjugated and unconjugated

Question 14

Why do you want to know split BR figures?

Answer 14

To find out whether it’s obstructive or not, and where the issue is - unconjugated or conjugated

Question 15

What condition needs urgent attention in a jaundiced newborn?

Answer 15

Biliary atresia

Question 16

Baby boy born with neither testes palpable. Most likely Dx?

Answer 16

Physiological delay in descent

Question 17

Is androgen insensitivity syndrome rare or common?

Answer 17

Rare - picked up later on in the baby’s life

Question 18

Sx of androgen insensitivity?

Answer 18

Inguinal mass in baby girl

Question 19

6 hour old baby grunting and cyanosed. Loud S2 heart sound with low saturations not improved by oxygen. Dx and Mx?

Answer 19

Transposition of great arteries
Prostaglandin (alprostadil)

Question 20

3 year old with diarrhoea with food in. Dx?

Answer 20

Toddler diarrhoea

Question 20

3 year old with diarrhoea with food in. Dx?

Answer 20

Toddler diarrhoea

Question 21

2 day old Down’s syndrome child with bilious vomiting. Slightly distended tummy but soft. Patent anus. Dx?

Answer 21

Duodenal atresia

Question 22

Is pyloric stenosis vomit bilious or not?

Answer 22

No

Question 23

Hearing test for child of deaf mother?

Answer 23

Brain stem evoked response test

Question 24

Appropriate IV fluid for dehydrated child from gastroenteritis?

Answer 24

0.9% sodium chloride with 5% glucose (add the glucose for a child)

Question 25

When is just 0.9% chloride used?

Answer 25

Fluid bolus

Question 26

Cardiac abnormality in downs?

Answer 26

AVSD

Question 27

Two year old with 4 weeks of smelly discharge from one nostril. Mucous with some blood from it. Sneezing. Dx?

Answer 27

Foreign body

Question 28

First fluid IV for DKA?

Answer 28

0.9% sodium chloride

Question 29

2nd IV fluid for DKA?

Answer 29

Insulin 1hr after sodium chloride

Question 30

Complication of adding insulin for DKA first?

Answer 30

Cerebral oedema

Question 31

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?

Answer 31

Osteomyelitis
Blood culture

Question 32

9 month old with vomiting, lethargy, bulging fontanelle. No neck stiffness. Purpuric rash. Febrile. Dx?

Answer 32

Meningococcal disease

Question 33

Sx suggestive of meningitis in baby?

Answer 33

Bulging fontanelle
NOT neck stiffness, hard to tell in babies

Question 34

Group B strep disease Hx features?

Answer 34

NEONATES (or up to 3 months max) with ++ maternal Hx

Question 35

Does viral meningitis have a rash?

Answer 35

Not usually

Question 36

1st Mx of testicular torsion?

Answer 36

Surgical exploration

Question 37

11 year old previously well but prev URTI. Nosebleeds and bruises. Low platelets. Dx?

Answer 37

ITP

Question 38

Scarlet fever Tx?

Answer 38

Phenoxymethylpenecillin

Question 39

Kawasaki disease Tx?

Answer 39

IV Ig and aspirin

Question 40

Wheeze in child who is quite well. Tx and method?

Answer 40

Salbutamol via spacer

Question 41

When is nebulised salbutamol used in asthma?

Answer 41

If child is unwell