Gap Deck - Paed

Question 1

Typical presentation of Kawasaki disease?

Answer 1

high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel

Question 2

Strawberry tongue is a feature of either?

Answer 2

Kawasaki disease or Scarlet Fever

Question 3

hypochloraemic, hypokalaemic alkalosis is a typical presentation of what condition?

Answer 3

Pyloric Stenosis

Question 4

What is Hirschsprung’s Disease?

Answer 4

Congenital condition - nerve plexuses in colon don’t develop - no peristalsis = chronic constipation and distension of colon

Question 5

What is Turners Syndrome

Answer 5

Chromosomal disorder affecting FEMALEs in which one X chr is absent or partially absent

Question 6

Which cardiac abnormalities commonly assoc with Turner’s syndrome

Answer 6

bicuspid valve + aortic coarctation

Question 7

What is Roseola Infantum and how does it commonly present

Answer 7

Common infancy disease (6months-2yrs), caused by Human Herpes Virus 6

High fever lasting few days → followed by maculopapular rash
Diarrhoea + cough commonly seen

Question 8

Tx for patent ductus arteriosus?

Answer 8

Indomethacin (or ibuprofen) - this will inhibit prostaglandin synthesis and, in the majority of cases, close the PDA.

Question 9

Tx for bronchiolitis?

Answer 9

Mainly supportive - admit to provide supportive tx like supplemental O2 if <92% sats or nasogastric feeding

Question 10

Most common cause of Hand, foot & mouth disease?

Answer 10

Caused by intestinal viruses - often coxsackie A16 & enterovirus 71

Question 11

Ebstein’s Anomaly is what?

Answer 11

Congenital heart defect characterised by low insertion of the tricuspid valve resulting in a large atrium and small ventricle.

Question 12

Definitive diagnostic test for Hirschsprung’s disease?

Answer 12

Rectal biopsy - full thickness

Question 13

Scarlet fever is usually caused by which species?

Answer 13

erythrogenic toxins produced by Group A haemolytic streptococci (usually Streptococcus pyogenes).

Question 14

Typical presentation of scarlet fever?

Answer 14

Fever typically lasting 24-48hrs
Malaise, headache, N/V
Sore throat
Strawberry tongue
Rash - ROUGH SANDPAPER texture, pinhead erythema generally first on torso and spares palms & soles

Question 15

Diagnosis of scarlet fever is done by

Answer 15

throat swab taken but abx tx commenced immediately without seeing results

Question 16

Management of scarlet fever

Answer 16

Oral penicillin V (10days)
Azithromycin if pencillin allergy

Can return to school 24hrs after commencing abx

Question 17

Complications of scarlet fever?

Answer 17

Otitis media (MOST COMMON)

• Rhematic fever - 20days after infection
• Acute glomerulonephritis - 10 days after infection
• Invasive complications are rare but present acutely with life-threatening illness (bacteraemia, meningitis. nectrotising fasciitis)

Question 18

Number 1 cause for painless massive GI rectal bleeding needing transfusion in children btwn 1-2yrs old

Answer 18

Meckel’s diverticulum

Question 19

Most common congenital anomaly of GIT

Answer 19

Meckel’s diverticulum

Question 20

Rule of 2’s for Meckel’s diverticulum

Answer 20

2 inches long
2 year old 
2x more likely in males
2 types of ectopic tissue: gastric + pancreatic 
2% population
2ft from ileocaecal valve

Question 21

Major risk factor for SIDS

Answer 21

prone sleeping
parental smoking
bed sharing
hyperthermia and head covering
prematurity