extra passmed questions 2 Flashcards
likely cause of ambiguous genitalia in a neonate
congenital adrenal hyperplasia
gross dilatation of the ureter, pelvis and calyces with ureteral tortuosity
this indicates:
vesicouretic refux
- abnormal backflow of urine from bladder into ureter and kidney
1st line for Constipation in children:
movicol
this is a simple fracture to the bottom part of the fibula (bone on the outer part of your leg).
Weber A fracture
may weight bear as tolerated in a CAM boot
An 8-year-old boy presents to the emergency department severely short of breath and wheezy. He is extremely short of breath and cannot complete sentences fully. His peak expiratory flow rate is 300 l/min (40% of normal). His oxygen saturations are 93%. His pCO2 is 4.9 kPa.
normal pco2 (4.5-6kpa)
which feature is most concerning?
normal CO2
- indicative of reduced respiratory effort
specific indicators of life threatening asthma
- cyanosis
- poor resp effort
- peak exp flow rate < 33%
- silent chest
- altered level of consciousness
A 4-year-old boy presents to the emergency department with a suspected fractured femur. He has had several visits over the past few months. On examination, his teeth appear abnormal and he is very skinny. His father is also concerned about the boys hearing.
What is the most likely diagnosis?
Osteogenesis imperfecta
characteristically presents in childhood with features such as bone fractures and deformities, blue sclera and hearing/visual problems
The most common form is type 1, which is a mild form. Presenting features include fractures following minor trauma, blue sclera, deafness secondary to otosclerosis and dental imperfection.
difference between nephrogenic diabetes insipidus and diabetes insipidus?
- kidneys inabiltiy to respond to vasopressin
- thus can’t give vasopression as will be infective
- need to give a thiazide like diuretic instead
A 60-year-old man presents with visible haematuria for the past three weeks. He has an ache in the left loin but examination is unremarkable other than a left varicocele. He also notes to feeling intermittently hot and sweaty.
likely diagnosis :
renal cell carcinoma
classical triad:
- haematuria
- loin pain
- abdominal mass
- pyrexia of unknown origin
- left varicocele due to occlusion of left testictular vein
A 14 year-old boy develops visible haematuria following an upper respiratory tract infection
most likely
IgA nephropathy
what is perthe’s disease?
- avascular necrosis of femoral head
- typically 4-8 y/o
- 5x more common in boys
4 y/o male
pc: urine dark reddish colour, eating less over past couple weeks
OE: afebrile , distended abdomen soft and non-tender. palpable mass in right flank.
FHx: father and grandfather both had kidney trouble
likely diagnosis?
Wilms tumour
- given boys age, haematuria with no pain and reduction in appetite.
describe the combined test for down’s syndrome in pregnancy?
- occurs at 10-14 weeks gestation
- USS for nuchal translucency
- and blood test for beta-HCG & pregnancy associated plasma protein A (PAPP-A)
- In pregnancies with Down Syndrome, PAPP-A is low and beta-hCG raised.
A 65-year-old woman presents to her GP complaining of 2 weeks of fatigue and lethargy. She has also been experiencing difficulty with dressing herself in the morning due to stiffness in her shoulders.
Routine blood tests are normal. ESR raised.
indicative of:
polymyalgia rheumatica
- symmetrical aching and stiffness of shoulders, hip girdle, neck and torso
baby girl born 4 weeks ago has had persistent jaundice since 48hrs post birth.
reluctant to breastfeed, has dark urine.
OE: jaundiced, notice firm, enlarged liver.
blood show conjugated hyperbilirubinemia.
serum A1A levels and electrophoresis normal. neonatal heal prick normal.
likely condition?
Biliary atresia
- obliteration or discontinuity within extrahepatic biliary system
- obstruction in flow of bile
early surgical treatment required
24 y/o male
pc: 3 month hx lower back pain radiating to buttocks, symptoms worst in morning. improve with exercise. occasionally wake him up from sleep.
diagnosis?
ankylosing spondylitis
- HLA-B27
IX - Plain XRay
- sacroilitis (subcondral erosions, sclerosis)
- syndesophytes (ossification of outer fibers of annulus fibrosis)
- squaring of lumbar vertebrae
Hashimoto’s thyroiditis is associated with what lymphoma
MALT
- mucosa assocaited lymphoid tissue
hashimoto’s
- autoimmune disorder of thyroid
- antiTPO, antiTTg
Seen in sporty teenagers
Pain, tenderness and swelling over the tibial tubercle
Osgood-Schlatter disease
Bronchiectasis: most common organism
Haemophilus influenzae
what is given in the prophylaxis of oesophageal bleeding
propanolol
the normal age when a child should show a responsive smile:
14 - 16 weeks
Metabolic ketoacidosis with normal or low glucose cause:
alcoholic ketoacidosis
70 y/o female
pmh: T2DM, alchohol abuse , non smoker
pc: productive cough and fever
OE: crackles in right upper lobe
CXR: consolidation which is cavitating in right upper lobe
diagnosis:
pneumonia
- klebsiella pneumonia is common cause of cavitating pneumonia in upper lobe
Klebsiella – KlebSTELLA (common in alcoholics)
57 y/o female presents with the following symptoms:
These include bilateral swelling of her metacarpophalangeal joints
early morning stiffness of around an hour’s duration
raised nodule on the extensor surface of her left forearm
likely to be:
rheumatoid arthritis
what test should be done in all women with recurrent episodes of vaginal candidiasis?
blood glucose
Recurrent thrush is likely due to some form of immunosuppression. The most common form of immunosuppression seen in recurrent thrush is diabetes, and this is the most likely in this woman as she is not sexually active and has no significant past medical history. Therefore, it would be appropriate for her GP to perform a random blood glucose test.
