General pads

Question 1

Triad of autism spectrum disorder

Answer 1

• Impaired communication
• Impaired social relationships
• Ritualistic behaviour

Question 2

Triad for ADHD

Answer 2

Inattention
Impulsive behaviour
Hyperactivity

Question 3

Gross motor milestone: crawling + walking

Answer 3

9 months
18 months (refer if not walking by 18 months)

Question 4

Slapped cheek syndrome: cause and pattern

Fifth syndrome

Answer 4

• Parovirus

- Spreads to arms and extensor surfaces

Question 5

How does rubella present? (German measles)

Answer 5

Pink maculopapular rash on face initially, then spreads to rest of body, fades after 3-5 days.
Lymphadenopathy (posterior auricular and sub occipital)

Question 6

How does measles present?

Answer 6

Prodrome: ill, fever, conjunctivitis
Initially: koplik (white) spots in mouth + rash behind ears
Progression: spreads to rest of body, discrete maculopapular rash becomes confluent and blotchy.

Question 7

Symptoms of scarlet fever

Answer 7

Fever, tonsillitis, strawberry tongue, punctuate erythema except around the mouth.
Caused by group A strep toxins.

Question 8

Precocious puberty: types and causes

Answer 8

Either gonadotropin independent or dependent.
Test FSH and LH. If low, it’s independent and due to adrenal hyperplasia.
Dependent is related to early HPA axis activation.

Question 9

Inv and mx of intusussception

Answer 9

US (avoid CT in kids because radiation, X-ray doesn’t show cause).

Mx = air insufflation

Question 10

Sx of intusussception

Answer 10

Colicky pain, drawing up knees, vomiting, red-currant stools

Question 11

What drug should you give in preterm labour to prevent neonatal respiratory distress?

Answer 11

Dex to mum induces fetal lung maturation, otherwise will be deficient in surfactant.

Question 12

Mx of meningitis in children

Answer 12

< 3 months = IV cefotaxime
> 3 months = IV cef + IV amox

Treat with fluids if shock

Question 13

When is jaundice pathological in an infant?

Answer 13

First 24 hours then beyond 14 days

Question 14

Causes of jaundice

Answer 14

First 24 hours: ABO or rhesus haemolytic disease, g6p deficiency

Prolonged jaundice: biliary atresia, hypothyroid

Question 15

Inv for jaundice

Answer 15

Routine bloods with TFTs
Conj and unconj (conj can indicate atresia)
Coombs test (direct)

Question 16

Mx of ADHD

Answer 16

Watch and wait then methylphenidate (Ritalin).

Can be cardiotoxic and reduce appetite, so do ECG and regular weight and height.

Question 17

Mx for nocturnal enuresis

Answer 17

Rule out DM, constipation and UTI.

Advice on fluid intake, healthy diet with no caffeine, toileting behaviour (going to toilet before bed).

Can use alarm, if over 7 years and alarm is ineffective, trial desmopressin.

Question 18

Define enuresis

Answer 18

Enuresis (day or night) aged 5 or over, in the absence of neuro/urological defects.

Primary (never continent), or secondary (previously dry for 6 months).

Question 19

Presentation and mx of GE

Answer 19

Diarrhoea up to a week. Can simultaneously have fever and vomiting initially.

ORS. Avoid fruit juice and carbonated drinks. Don’t use anti-motility/anti-diarrhoeals in kids under 5.

Question 20

Inv and mx of p.stenosis

Answer 20

US and pyloromyotomy

Question 21

Pattern of eczema in infants/young kids and older children

Answer 21

Infants: face and trunk
Young kids: extensor surfaces
Older kids: flexors, creases of face and necks

Question 22

Mx of eczema in children

Answer 22

Topical emollients, can add topical steroid later (30 mins after).

Question 23

Features of Edward’s

Answer 23

Micrognathia, low set ears, rocker bottom feet.

May present with low APGAR.

Question 24

Normal APGAR

Answer 24

7-10.

Lower = concerning

Question 25

Features, signs and risk factors for Ebstein’s anomaly

Answer 25

Tricuspid valve is AT to RV wall and septum instead of RA.
Tricuspid regurgitation = pan systolic murmur
Lithium in first trimester = RF

Question 26

Androgen insensitivity syndrome presentation

Answer 26

Phenotypically female, genetically male.

Undescended testes = bilateral groin swellings. Primary amenorrhoea. Presents around puberty.

Question 27

Cause of ambigious genitalia

Answer 27

Congenital adrenal hyperplasia, presents at birth.

Question 28

Presentation and mx of transient synovitis

Answer 28

2-10 year old boys.
Acute hip pain associated with virus (fever, infective sx). Can develop small effusion.

Bed rest and analgesia- self limiting

Question 29

What does bilious vomiting indicate?

Answer 29

Obstruction is at the level or distal to the second part of the duodenum, where bile enters. (malrotation, duodenal atresia)

Question 30

Sx of pyloric stenosis

Answer 30

Non-bilious vomiting, visible abdominal peristalsis (trying to push food past obstruction), projectiles 30mins after feeding. 2-4 week olds.

Question 31

Characteristic pulse of PDA

Answer 31

Collapsing pulse

Question 32

Perth’s presentation, inv and mx

Answer 32

4-8 year old boys.
Hip pain develops over weeks. Limp, reduced range.
X-ray.
Mx = casts/braces to keep f.head in acetabulum. Older children can have surgery, younger = observe.

Question 33

What viruses cause hand foot and mouth?

Answer 33

Coxsackie + enterovirus.

Oral ulcers and vesicles on hands and feet.

Question 34

Slipped upper femoral epiphysis demographic, sx and mx

Answer 34

10-15 year old overweight boys.
Pain in hip, groin or knees. Loss of internal rotation in flexion. Usually unilateral, can be bilateral.

X-rays.
Surgical internal fixation.

Question 35

What common drug is contraindicated in breastfeeding mums?

Answer 35

Aspirin- increases risk of Reye’s (swollen liver and brain)

Question 36

What condition is neonatal hypotonia associated with?

Answer 36

Prader-Willi

Question 37

How does heart failure present in infants?

Answer 37

Breathlessness, particularly on exertion (feeding), poor feeding, sweating, recurrent chest infections.

Question 38

What CO2 is concerning in asthma?

Answer 38

Normal CO2. Initially, hyperventilate so CO2 is low. When it becomes normal, this indicates failure to compensate.

Question 39

What is capacity?

Answer 39

Time and decision dependant.

Lack of capacity in the past does not impact ability to consent now.