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Fifth year revision > General revision > Flashcards

General revision Flashcards

1
Q

S3 heart sound can be d/t

A

normal: pregnancy/young people
path: LV failure

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2
Q

S4 heart sound d/t

A

severe LV hypertrophy and aortic stenosis

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3
Q

petichial rash + unwell infant ddx

A

meningococcal

dengue fever

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4
Q

petichial rash + well infant ddx

A

enteroviral infection
rubella
EBV
HSP

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5
Q

macular and/or papular + unwell infant ddx

A

early meningococcal

travel history for rare causes

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6
Q

macular and/or papular + well infant ddx

A 
measles 
erythema infectosum (fifth disease) from human parvovirus B19
roseola infantum from herpes
adenoviral infection 
EBV
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7
Q

diffuse erythematous rash + unwell infant ddx

A

TSS - toxic shock syndrome
invasive group A streptococcal infection
scarlet fever
Kawasaki disease

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8
Q

diffuse erythematous rash + well infant ddx

A

staphylococcal slapped cheek syndrome

enteroviral infection

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9
Q

vesicular/bullous rash in an infant ddx

A

varicella zoster
herpes simplex
staphylococcal infection

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10
Q

What are the 6 diseases/exanthems of childhood?

A
  1. Measles (morbillivirus)
  2. Scarlet fever (strep. pyogenes)
  3. Rubella (rubivirus)
  4. Filatow-Dukes’ disease (controversial)
  5. Erythema infectiosum (parvovirus B19)
  6. Roseola infantum (HHV-6 and HHV-7)
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11
Q

what is the pathogen which causes erythema infectiosum?

A

parvovirus B19

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12
Q

varicella zoster vaccine type

A

live attenuated

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13
Q

XXY = which chromosomal syndrome?

A

Klinefelter

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14
Q

What syndrome has 45 chromosomes where the missing chromosome is a sex chromosome. i.e. 45, XO

A

Turner’s syndrome

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15
Q

what could cause an infant to have excess androgens

A

congenital adrenal hyperplasia

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16
Q

what could indicate hypopituitarism when doing a newborn examination? why?

A

micropenis. LH and FSH regulate testosterone production in the male foetus

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17
Q

What are two clinical features of Turner Syndrome?

A

Webbing of the neck

widely spaced nipples

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18
Q

how do you measure the bone age of a child?

A

Xray epiphysis of left wrist and hand & compare to atlas of age and sex standards.

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19
Q

Mid parental height calculation for girls

A

mums + (dad’s - 13cm) / 2 +/- 6cm

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20
Q

Mid parental height calculation for boys

A

dads + (mums + 13cm) /2 +/- 7.5cm

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21
Q

spondylolisthesis

A

slippage of a vertebrae (usually forward) and the spine above it relative to the vertebrae below it.

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22
Q

Spondylosis

A

degenerative osteoarthritis of the joints between the centre of the spinal vertebrae and/or neural foramina

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23
Q

spondylolysis

A

defect in the pars interarticularis of the vertebral arch

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24
Q

4 Hs of cardiac arrest

A

Hypovolaemia
Hypothermia
Hypokalaemia/hyperkalaemia/hydrogen ions (acidosis)
Hypoxia

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25
Q

4 Ts of cardiac arrest

A

Tamponade
Tension Pneumothorax/Trauma
Toxins
Thromboembolism

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26
Q

Child has CD19 and CD10 positive on bloods. what have they got?

A

Pre-B cell ALL

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27
Q

what do you see on histo of lymphoblasts?

A

lacy chromatin in nucleus and minimal cytoplasm

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28
Q

Normal Hb of a newborn

A

150

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29
Q

Normal Hb of a 3yo

A

110

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30
Q

Normal Hb of an adult

A

130

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31
Q

Which genetic factor is a good prognostic indicator for ALL?

A

TEL positive

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32
Q

What can you give to patients with a factor VIII deficiency?

A

Cryoprecipitate (Fibrinogen blood component)

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33
Q

what is the first indicator of bone marrow failure?

A

thrombocytopenia. d/t lifespan of platelets is 10-14 days

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34
Q

List 3 causes of thrombocytopenia

A

ITP
infection (e.g. varicella zoster)
bone marrow failure

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35
Q

what is the significance of wet purpura

A

it is associated with serious internal haemorrhage (e.g. ICH)

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36
Q

Tx for acute ITP and wet purpura

A

Prednisolone (IVIG second line if pred fails)

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37
Q

Which factor is involved in Haemophilia A

A

Factor 8

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38
Q

Which factor is involved in Haemophilia B

A

Factor 9

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39
Q

Which factor is involved in Haemophilia C

A

Factor 11

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40
Q

Which inheritance pattern are Haemophilia A and B?

A

X-linked

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41
Q

What would you use in minor bleed in someone with haemophilia

A

Desmopressin

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42
Q

Which way is the shunt in a VSD if the baby is cyanosed and minimal heart failure signs?

A

R –> L

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43
Q

Which way is the shunt in a VSD if the baby has heart failure signs and minimal cyanosis

A

L–> R

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44
Q

What does tetralogy of fallot look like on CXR?

A

boot-shaped heart with upturned apex and dark lung fields

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45
Q

what arrhythmia is present in the child population?

A

SVT

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46
Q

Tx for acute episode of SVT in an infant/child?

A

Diving Seal reflex - ice cold water, immerse face.

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47
Q

Is verapamil or adenosine used for SVT tx in infants/children?

A

adenosine.

Verapamil should NEVER be given (fatal)

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48
Q

What is the cause of a pulmonary branch murmur in an infant?

A

d/t change in amount of blood going through lungs after birth. More commonly in premature infants.

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49
Q

What is the name of the murmur in babies which is short, mid-systolic ejection murmur, low-pitched, vibratory, musical, best heard between LLSE and apex?

A

Still’s murmur.

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50
Q

If a child is obese with a fast growth velocity what is the likely cause of their obesity?

A

Nutrition

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51
Q

If a child is obese with a slow growth velocity what is the likely cause of their obesity?

A

Hormonal/genetic

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52
Q

what are the biochemical criteria for DKA?

A

Venous pH

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53
Q

what bedside test would you perform for a patient with BGL >11.1mmol/L?

A

blood ketones on a capillary sample.

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54
Q

What clinical signs would you get for dehydration of

A

none

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55
Q

What clinical signs would you get for dehydration of 4-7% blood volume in paeds?

A

reduced skin turgor

poor capillary return

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56
Q

What clinical signs would you get for dehydration of >7% blood volume in paeds?

A

poor perfusion, rapid pulse, reduced blood pressure, shock.

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57
Q

Features of BWS (Beckwith-Wiedemann Syndrome)

A

overgrowth, macroglossia, anterior abdominal wall defects, organomegaly, hemihypertrophy, ear lobe creases, helical pits, renal tract abnormalities

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58
Q

What developmental syndrome is most commonly associated with HH (Hyperinsulinaemic Hypoglycaemia)

A

BWS (Beckwith-Wiedemann Syndrome)

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59
Q

What is the most common cause of Hyperinsulinaemic hypoglycaemia?

A

“Dumping syndrome” after gastro-oesophageal surgery.

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60
Q

What genetic abnormality are insulinomas associated with?

A

MEN1 (multiple endocrine neoplasia type 1)

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61
Q

what is the most important complication of hyperinsulinaemic hypoglycaemia

A

hypoglycaemic brain injury (glucose and ketone production stopped by insulin so no fuel for brain)

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62
Q

at what level of BGL is insulin secretion suppressed?

A

4mmol/L

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63
Q

HEADSS

A 
Home and Environment
Education and Employment 
Activities 
Drugs 
Sexuality
Suicide/Depression
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64
Q

what are the biochemical criteria for DKA?

A

Venous pH

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65
Q

what blood tests should be performed on patients with newly diagnosed diabetes?

A

Insulin antibodies
GAD antibodies
Coeliac screen (total IgA, anti-gliadin Ab, tissue transglutaminase Ab)
Thyroid function tests (TSH, FT4)

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66
Q

ECG signs of hyperkalaemia

A

peaked T-waves

Widened QRS

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67
Q

ECG signs of hypokalaemia

A

flattened or inverted T- waves
ST depression
wide PR interval

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68
Q

what is the BGL aim during insulin infusion in treatment of DKA?

A

5-12mmol/L

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69
Q

Corrected sodium for DKA

A

Measured Na + 0.3 (glucose - 5.5)

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70
Q

Why should patients with DKA be nursed with head up?

A

Risk of cerebral oedema

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71
Q

how much weight should a term neonate gain per day?

A

20-30g/d

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72
Q

how much is an accepted weight loss in the first week after birth?

A

10%

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73
Q

Normal birth weight

A

3.25kg

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74
Q

Normal length of a term newborn

A

50cm

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75
Q

Weight at 4-5months old

A

2 x birth weight

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76
Q

weight at 1yo

A

3 x birth weight

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77
Q

weight at 2yo

A

4 x birth weight

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78
Q

how much should an infant grow in it’s 1st year

A

25cm

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79
Q

how much should an infant grow in it’s 2nd year

A

12cm

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80
Q

how much should an infant grow in it’s 3rd year

A

8cm

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81
Q

how much should an child grow between 4yo and puberty

A

4-7cm per year.

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82
Q

normal head circumference

A

35cm

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83
Q

describe the galant reflex

A

infant held in ventral suspension and one side of back is stroked along paravertebral line. The pelvis should move in the direction of stimulated side.

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84
Q

when does Babinski become abnormal?

A

after aged 2yo

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85
Q

Moro reflex, describe

A

infant placed semi-uprght, head supported by examiner’s hand, sudden withdrawal of supported head with immediate return of support –> results in abduction and extension of the arms, opening of the hands, followed by flexion and adduction of arms.

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86
Q

what do you call the fencing reflex in a baby?

A

asymmetric tonic neck reflex

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87
Q

Placing reflex

A

dorsal surface of foot against edge of table –> infant appears to step onto table.

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88
Q

Name the reflex where you stroke the infants face and they turn towards the stimulated side?

A

rooting reflex

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89
Q

describe the parachute reflex

A

ipsilateral arm extension when a sitting infant is tilted to one side.

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90
Q

what is the name of the congenital abnormality where the end of the urethra is situated further down the shaft of the penis not at the tip.

A

hypospadias.

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91
Q

pathophys neuroblastoma

A

persisting embryonal immaturity of neural crest cells (adrenals, thoracic, abdominal ganglia)

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92
Q

marker for neuroblastoma

A

catecholamines (urine and blood)

93
Q

radionuclide scan for neuroblastoma uses what labelled compound

A

labelled MIBG

94
Q

bounding pulses due to a wide pulse pressure could signify what congenital abnormality

A

patent ductus arteriosus

95
Q

What would cause a bounding pulse in a child/infant (3)

A

patent ductus arteriosus
severe aortic regurg
high cardiac output states

96
Q

how do you choose a BP cuff size?

A

largest cuff which does not cover the antecubital fossa or one which covers 2/3 of the arm.

97
Q

what could you expect to find on auscultation of an infant with atrial septal defect?

A

fixed splitting of the second heart sound (does not vary with inspiration or expiration)

98
Q

What is the characteristic which makes second heart sound splitting most likely physiological and not pathological?

A

variation (widened splitting with inspiration)

99
Q

what would you notice on cardiac examination of a patient with pulmonary hypertension

A

loud second heart sound with no definite splitting. it may be palpable at the upper left sternal border.

100
Q

what would you expect to be the pathology if you hear an ejection click in a newborn?

A

bicuspid aortic valve or aortic valve stenosis

could be pulmonary valve stenosis if heard at the left sternal edge and louder on expiration

101
Q

what is the treatment for hepatoblastoma?

A

complete surgical resection of the primary +/- neoadjuvant chemo

102
Q

how much fluid should be given in boluses for correction of intravascular depletion/hypovolaemia in children?

A

10-20ml/kg of 0.9% sodium chloride. Can be repeated

103
Q

how much should maintenance fluids in unwell children be?

A

2/3 of maintenance rate (dependant on weight). need less because of ADH secretion.

104
Q

what is the danger of being overaggressive in rehydration of children (especially in meningitis)

A

cerebral oedema

105
Q

when should 4% dextrose 1/5 NS be given in paediatrics

A

never. risk of hyponatraemia from the hypotonic saline

106
Q

how much is full maintenance in mls/day for a child weighing 3-10kg?

A

100 x weight

107
Q

how much should be given for maintenance fluids per day for a child weighing 6kg?

A

400mls

108
Q

how much is full maintenance fluids per day for a patient weighing 10-20kg

A

1000mls + 50 x (wt-10)

109
Q

what is the most accurate way to assess the degree of dehydration in a neonate/infant?

A

weight loss

110
Q

what signs would you expect for an infant with mild (3-5%) dehydration

A

none

111
Q

what signs would you expect for an infant with moderate (6-9%) dehydration?

A 
thirsty/irritable 
slightly sunken eyes
sticky tongue 
decreased tears
2-3sec cap refill
increased RR
pulse fast, still strong 
hands and feet normal perfusion
112
Q

what signs would you expect for an infant with severe (>10%) dehydration?

A 
drowsy, floppy, limp +/- comatose 
very sunken eyes
dry tongue 
absent tears
slow >3 sec cap refill
fast RR
skin pinch goes back v. slowly
fast, weak pulse 
cool peripheries +/- blue nail-beds
113
Q

what is the difference between plasmalyte148 solution and normal saline?

A

plasmalyte 148 has K+ and Mg2+

114
Q

hourly maintenance requirement in an infant/child?

A

4mL/kg first 10kg
2mL/kg second 10kg
1ml/kg for subsequent kg.

115
Q

how do you calculate the fluid deficit in an infant?

A

%dehydration x weight (kg) x 10 = mL of fluid loss

if premorbid recent weight available then fluid loss (mLs) is equal to the weight loss in grams

116
Q

What is Kawasaki disease?

A

systemic vasculitis with unknown aetiology.

117
Q

Which nationality does Kawasaki disease most commonly affect?

A

Japanese and Korean

118
Q

what is the major complication of kawasaki disease?

A

aneurysm of major arteries (including coronary arteries.

119
Q

what age group does kawasaki disease most commonly affect?

A

6months –> 4yo

120
Q

3yo, fever for 5 days, polymorphous rash, strawberry tongue, swollen feet, bilateral conjunctivitis, and raised CRP. What is the diagnosis?

A

Kawasaki disease.

121
Q

DDx for diarrhoea/vomiting in an infant?

A 
intussusception 
gastroenteritis 
volvulus secondary to malrotation
band from a Meckel diverticulum 
duplication cyst 
strangulated inguinal hernia
122
Q

Which toxin is implicated in HUS?

A

verocytotoxin

123
Q

what are the features of the HUS clinical triad?

A

microangiopathic haemolytic anaemia
thrombocytopenia
acute renal insufficiency

124
Q

What is the treatment for pyloric stenosis?

A

Ramstedt’s Pyloromyotomy

125
Q

what acid base disturbance is associated with pyloric stenosis?

A

hypokalaemic hypochloraemic metabolic alkalosis

126
Q

what are the two key OE findings in a pt with pyloric stenosis?

A

pyloric tumour/mass/olive mass

“golf-ball waves”/peristaltic waves from L) to R)

127
Q

2 yo infant presents with bloody diarrhoea. The CBE shows thrombocytopenia and anaemia. what 2 inv would you do next and what are the results?

A

blood smear: fragmented RBC and thrombocytopenia.
EUC: raised creatinine

(dx is HUS)

128
Q

which enzyme is implicated in congenital adrenal hyperplasia

A

deficiency of 21-hydroxylase.

129
Q

what are some dysmorphic features of Down Syndrome?

A

flat midface, flat occiput, upward slanting eyes with medial epicanthic folds, Brushfield spots in the iris, palpebrae on laughing, small down turned mouth, protruding tongue, small ears, excess nuchal skin in neonatal period.
single palmar creases, clinodactyly of the fifth digit, widened gap between first and second toes.

130
Q

what are the three most common birth defects in patients with trisomy 21

A

congenital heart disease
duodenal atresia
anal atresia

131
Q

what are some common medical problems in patients with trisomy 21

A 
cataracts, strabismus
leukaemia 
hypothyroidism
obesity
dental problems 
OSA
atlantoaxial instability
132
Q

features of an infant with trisomy 19 (Edwards syndrome)

A 
low birth weight 
prominent occiput
dysplastic low set ears
micrognathia (small chin)
short palpebral fissures (space between eyelids)
small mouth
clenched hand posture
prominent heels
133
Q

trisomy 13

A

Patau syndrome

134
Q 
low birth weight 
microcephaly with sloping forehead 
scalp defects 
cleft lip and palate
broad flat nose 
polydactyly

what is the genetic abnormality?

A

trisomy 13 Patau

135
Q

OE findings in Turner’s

A 
short stature 
webbed neck 
broad chest with widely spaced nipples
increased carrying angle of elbows 
pigmented naevi 
narrow, deep-set hyperconvex nails 
idiopathic HTN
136
Q

what are three medical consequences of turner’s syndrome?

A

Failure of onset of puberty
coarctation of the aorta
renal anomalies

137
Q

clinical features of Kleinfelter Syndrome

A 
tall stature 
long limbs 
small testes 
undescended testes
gynaecomastia 
female fat distribution with age 
infertility 
behaviour problems
138
Q

Features of triple X syndrome

A 
tall stature 
few dysmorphic features 
IQ in normal range but lower than siblings
delayed speech and motor milestones 
poor coordination 
normal puberty and fertility
139
Q

what genetic abnormality is implicated in fragile X syndrome?

A

unstable triplet repeat of DNA next to the FMR1 gene –> switches off the FMR1 gene on the X chromosome

140
Q

what is the most common cause of acidosis in ill children?

A 
lactic acidosis (metabolic acidosis)
secondary to tissue hypoxia/dehydration/shock.
141
Q

causes of metabolic acidosis with increased anion gap (normochloraemic) in children?

A

lactic acidosis
ketoacidosis (DM, ethanol, starvation, inborn errors in metabolism of amino acids)
uraemia (renal failure)
toxins (paraldehyde, methanol, salicylate)

142
Q

causes of metabolic acidosis with normal anion gap (hyperchloraemic) in children

A

intestinal losses (diarrhoea, pancreatic fistula)
renal tubular acidosis
ureteral diversion with bowel
exogenous Cl- containing compounds
dilutional (ECF expansion with bicarbonate-free isotonic solution)
mineralocorticoid deficiency

143
Q

causes of resp acidosis in children

A

pneumonia/pulm oedema/interstitial fibrosis
acute airway obstruction (foreign body/aspiration/croup/epiglottitis)
thoracic cage disorders (pneumothorax, flail chest, kyphoscoliosis).
ms defects (myasthenia gravis, hypokalaemia, muscular dystrophy)
nervous (polio, GBS, botulism, tetanus)
resp centre depression (anaesthesia, narcotics, sedatives)
CF

144
Q

Causes of metabolic alkalosis in children, chloride responsive.

A 
vomiting 
NGT suction 
diuretics 
posthypercapnic alkalosis 
stool losses (laxatives, CF, villous adenoma)
massive blood transfusion 
exogenous alkali administration
145
Q

causes of metabolic alkalosis in children, chloride unresponsive

A

hyperadrenocorticoid states (Cushing’s syndrome, primary hyperaldosteronism, secondary mineralocorticoidism (chewing tebacco)
hypokalaemia
Bartter’s syndrome

146
Q

causes of respiratory alkalosis

A 
fever 
sepsis 
hypoxaemia (pneumonia, PE, atelectasis)
drugs (salicylates, xanthines, progesterone, adrenalin)
CNS disorders (tumour, CVA, trauma, infection)
psychogenetic hyperventilation 
hepatic encephalopathy
mechanical ventilation
147
Q

what is the most common primary acid-base disturbance in children?

A

respiratory alkalosis

148
Q

what medical treatment is available for children with cerebral palsy?

A

baclofen (gamma-aminobutyric acid antagonist)

botulinum toxin

149
Q

what are some risk factors for cerebral palsy?

A 
infection (CMV, group B strep, HSV) 
intraventricular haemorrhage (periventricular leukomalacia)
kernicterus 
stroke 
brain trauma
150
Q

characteristic features of a scarlet fever rash

A

“sandpaper” texture

accentuation in flexural creases (Pastia lines)

151
Q

measles clinical features

A

enanthem (Koplik spots)
cough
coryza

152
Q

what bug is implicated in scarlet fever?

A

group A streptococcus (GAS)

153
Q

what bug causes impetigo?

A

staph aureus in developed countries
Group A Beta Haemolytic Streptococcus in developing countries

s. aureus = bullous
strep = crusted, honeycomb yellow non-bullous

154
Q

treatment for anaphylaxis

A

remove trigger
Oxygen 100%
adrenaline IM 0.01mL/kg (repeat 3-5minutes if symptoms persist)
fluids, adrenaline infusion if hypotensive, airway management

155
Q

most common bacterial causes of meningitis in a neonate?

A

group B strep
Listeria
Klebsiella

156
Q

Most common bacterial causes of meningitis in an infant?

A

Neisseria meningitides
Strep pneumoniae
Haemophilus influenzae

157
Q

most common viral causes of meningitis in paeds?

A

enterovirus
adenovirus
HSV

158
Q

gram negative diplococci in CSF. most likely pathogen?

A

n meningitides

159
Q

what investigations are available for dx of duchennes muscular dystrophy

A

Genetic testing: dystrophin gene
Muscular biopsy: no staining of dystrophin
EMG
CK (levels 10-100x normal)

160
Q

what would you expect to see on MRI of someone with cerebral palsy?

A

previous stroke
periventricular leukomalacia
cortical malformations
lesions in basal ganglia

161
Q

how would you test for myasthenia gravis?

A

EMG: would show diminishing action potentials with repetitive stimulation until it becomes refractory to further stimulations.

162
Q

what is the name of the sign in Duchennes where the child walks their hands up their legs when standing?

A

Gower’s sign

163
Q

what are the characteristic facial features of someone with Down’s syndrome?

A 
flat midface
epicanthic folds 
upslanting palpebral fissures
Brushfield's spots on the iris
short neck 
macroglossis
164
Q

what are some deformities commonly associated with downs syndrome?

A

TOF
VSD/ASD/PDA
duodenal atresia
atlantoaxial instability

165
Q

what is Todd’s paralysis

A

Post-ictal paralysis

Focal weakness in a part of the body after a seizure

166
Q

how common are febrile convulsions?

A

2-5% of children

167
Q

what is the risk of a sibling having a febrile convulsion?

A

10%

168
Q

what is the risk of a second febrile convulsion?

A

30-50%

169
Q

chance of developing epilepsy after complex febrile convulsions?

A

4-12%

170
Q

What are the TORCH infections?

A 
Toxoplasmosis
Other (syphilis, VZV, Parvovirus B19)
Rubella 
CMV
Herpes
171
Q

what are the two most common causes of nephritic syndrome in the paediatric patient?

A 
IgA nephropathy (Berger's nephropathy) (common>10yo)
Post-streptococcal glomerulonephritis (mean 7yo)
172
Q

what is goodpasture’s disease?

A

anti-GBM disease.
autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and kidney failure

173
Q

complications of post-strep glomerulonephritis

A 
hypertension (60%)
- hypertensive encephalopathy (10%)
AKD
Heart failure 
Electrolytes: hyperkalaemia, hyperphosphataemia, hypocalcaemia
seizures
174
Q

Forcheimer spots are assoc with what condition

A

rubella

175
Q

complications of rubella?

A 
arthritis
myocarditis 
secondary bacterial infection
thrombocytopenia 
pan encephalitis
176
Q

when is the risk highest for congenital rubella syndrome

A

exposure in the first 6 weeks of pregnancy is highest.

first trimester risk is high

177
Q

what are the features of congenital rubella syndrome?

A 
deafness
ocular - cataracts
blueberry muffin appearance
heart disease
patent ductus arteriosus 
right pulmonary artery stenosis 
low birthweight 
psychomotor retardation 
death
178
Q

4 possible abdominal malignancies in a 6month old baby

A

neuroblastoma
nephroblastoma
hepatoblastoma
rhabdomyosarcoma

179
Q

what investigations would do for neuroblastoma

A

urine catecholamines

biopsy

180
Q

baby born with intestines out, not in peritoneum sac

A

gastroschisis

181
Q

omphalocoele vs gastroschisis

A

omphalocoele is covered by sheath of peritoneum, can include ovaries, liver, bladder, midline/umbilical in origin.

gastroschisis is not encased in sheath, only involves bowel, and is lateral to the midline.

182
Q

what does gastroschisis look like on USS at 12 weeks

A

cauliflower lesion

183
Q

what are the coeliac antibodies?

A

Tissue transglutaminase
Endomysial
Anti-gliadin

184
Q

if someone has an elbow injury and then one day later present with a claw-like deformity with volar tilt of the hand at the wrist, what is this complication called?

A

Volkmann’s Ischaemic Contracture

185
Q

what is the treatment for Volkmann’s ischaemic contracture?

A

emergency fasciotomy

186
Q

what nerve is likely to be damaged in volkmann’s ischaemic contracture?

A

median

187
Q

what is the medical term for webbing of the fingers or toes? and what is the classification?

A

syndactyly

incomplete or comlete (to tip),
simple (skin only) or complex (skin, tendon, bone)

188
Q

what are the clinical findings of Talipe’s equinovarus?

A

Cavus
Adducted forefoot
Varus deformity of hindfoot
Equinus deformity of heel.

189
Q

treatment for Talipe’s Equinovarus

A

serial casts

achilles tenotomy if casts unsuccessful

190
Q

treatment for undescended testes

A

orchidopexy at 6-12 months old

191
Q

what is the tumour marker for colon cancer

A

CEA

192
Q

what is the tumour marker for ovarian cancer

A

CA125

193
Q

causative organisms for acute otitis media

A

strep pneumoniae
haemophilus influenzae
moraxella catarrhalis

194
Q

what is an autoimmune cause of oesophageal strictures

A

eosinophilic oesophagitis

195
Q

3 most common secondary causes of raynauds

A

SLE
Scleroderma
RA

196
Q

normal range for blood creatinine

A

50-120 mmol/L

197
Q

strep pyogenes type and gram

A

Group A strep

gram positive

198
Q

gram status listeria monocytogenes

A

gram positive

199
Q

what bacteria causes gas gangrene

A

clostridium perfringens

200
Q

best treatment for gas gangrene

A

debridement

201
Q

tx of listeriosis in pregnancy

A

ampicillin IV + gentamicin

if penicillin allergic then erythromycin + gent

202
Q

E. coli gram status

A

gram negative

203
Q

pseudomonas aeruginosa gram status

A

negative

204
Q

moraxella catarrhalis gram status

A

gram -ve diplococci

205
Q

HIB gram status

A

gram negative

206
Q

bacteria involved in cat-scratch disease

A

bartonella henselae

207
Q

name for sign of arching of body with neck hyperextension from tetanus or kernicterus

A

opisthotonus

208
Q

ECG changes with Brugada syndrome

A

RBBB

raised ST segmets in V1-3

209
Q

autosomal dominant condition with faulty sodium channels –> sudden death from fatal arrhythmias

A

Brugada Syndrome

210
Q

eponymous name for IgA nephropathy

A

Berger’s disease

211
Q

time of onset of IgA nephropathy

A

24-48 hours from onset of URTI or same time

212
Q

time of onset of Post-strep glomerulonephritis

A

1-4 weeks

213
Q

histo of renal biopsy in IgA nephropathy

A

mesangial IgA deposition with immunofluorescence

214
Q

histo of renal biospy in post strep glomerulonephritis

A

mesangeal proliferation and neutrophil infiltration. may see crescents.
immunofluorescence shows IgG and C3.

(renal biopsy only indicated if lasts longer than 3 weeks or uncertain dx)

215
Q

bloods in post strep glomerulonephritis

A

low serum levels of C3 due to activation of complement pathway –> deposition.

ASOT (antistreptolysin O titre) and anti-stre DNase B are raised in 90%

216
Q

child presents with macroscopic haematuria, fluid overload and hypertension 2 weeks after having a sore throat. most likely ddx

A

post-strep glomerulonephritis

217
Q

tx for post-strep glomerulonephritis

A

frusemide
fluid and salt restrict
penicillin for strep

if required, oral nifedipine or prazosin for uncontrolled HTN.

218
Q

causes of acute nephritis in children

A
  • post-strep glomerulonephritis
  • HSP
  • IgA nephropathy
  • SLE
  • membranoproliferative
    gloerulonephritis
  • vasculitis
219
Q

IgA nephropathy presentation

A

recurrent episodes of macroscopic haematuria coinciding with viral infections.

220
Q

4 immunosuppressant meds sometimes used in SLE

A

prednisolone
azathioprine
cyclophosphamide
mycophenolate

221
Q

Alport Syndrome

A

X linked dominant
disorder of production of type IV collagen
presents c microscopic or macroscopic haematuria and proteinuria
renal failure in teenage years

222
Q

HUS triad

A

microangiopathic haemolytic anaemia
thrombocytopenia
acute renal insufficiency

223
Q

4 Hs 4 Ts

A

Hypovolaemia
Hypoxia
Hypothermia
Hypoglycaemia/Hyperkalaemia/H+ (acidosis)

Tension pneumothorax
Tamponade
Toxins
Thromboembolism

224
Q

definitive tx of pyloric stenosis

A

Ramstedt’s pyloromyotomy

225
Q

initial tx for Crohn’s

A

5-aminosalicylic acid (e.g. sulphasalazine)
abx (e.g. metro)
nutritional therapy

226
Q

triad of AAA

A

back pain
hypotension
pulsatile abdominal mass

227
Q

test to confirm Addisons

A

Short Synacthen test (synACTHen)

228
Q

test to confirm Conns

A

renin-aldosterone ratio: get high aldosterone and high renin

Fifth year revision (2 decks)

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