GP Paediatrics

Question 1

What are the main disadvantages to dealing with paediatric problems in a GP setting?

Answer 1

Undifferentiated illness
Lack of access to Investigations
Lack of team
10 minute chance to get it right

Question 2

What specific enquiries should be made in any paediatric history taking?

Answer 2

Eating/drinking
Bowels/urine
Family History
Immunisation History

Question 3

What usually presents to GP in the neonatal period?

Answer 3

(Neonatal period = first 28 days)
Jaundice
Vomiting
Failure to thrive 
Sepsis

Question 4

What are the most common causes of neonatal jaundice?

Answer 4

UTI
hypothyroidism
galactosaemia
breast milk jaundice
biliary atresia

Question 5

Why would neonates present to the GP with vomiting?

Answer 5

reflux
Cows Milk Protein intolerance
pyloric stenosis (PROJECTILE VOMITING)
sepsis
duodenal atresia

Question 6

How do children present to the GP with respiratory problems?

Answer 6

Cold
Infant not feeding
Cough
Wheeze

Question 7

What are the most common respiratory presentations in children?

Answer 7

Bronchiolitis
Croup
Viral URTI
Asthma (new or exacerbation)
Acute tonsillitis

Question 8

What are the rarer causes of respiratory symptoms in children presenting to the GP?

Answer 8

Cystic fibrosis
Acute Epiglottitis
Foreign Body 
Pneumonia 
Cardiac causes 
Malignancy

Question 9

What signs and symptoms should be looked for if you suspect a respiratory problem in a child

Answer 9

Cyanosis
Tachypnoeic (RR)
Nasal flaring
Intercostal/subcostal recession
Wheeze/stridor/cough
Pulse oximetry

Question 10

If a child is under the age of 1, a respiratory rate of 30-40 breaths per minute is normal. TRUE/FALSE?

Answer 10

TRUE
Resp rate decreases as children get older
<1 = 30-40
1-2 = 25-35
2-5 = 25-30
5-12 = 20-25
>12 = 15-20

Question 11

How do children’s GI problems usually present to the GP?

Answer 11

Abdominal Pain
Vomiting
Diarrhoea
Nausea 
Constipation

Question 12

What are the largest non-surgical causes of abdominal pain in children?

Answer 12

Gastro-enteritis
UTI
Constipation

Question 13

What are the most common surgical causes of abdominal pain between birth and the age of 5?

Answer 13

Intussusception

Volvulus

Question 14

What are the most common surgical causes of abdominal pain from the age of 6-18?

Answer 14

Appendicitis
Trauma
Testicular/Ovarian Torsion

Question 15

What MSK problems do children most commonly present to the GP with?

Answer 15

Painful joint(s)
Limp
Trauma

Question 16

What conditions can cause the painful joint(s) that children present with?

Answer 16

Inflammatory arthritis
Perthes  (AVN of Hip)
Slipped Femoral Epiphyses
Osgood Slatters
Growing Pains
Bone Tumours

Question 17

What are the main causes of a limp in a child?

Answer 17

DDH

Perthes

Question 18

What are the main traumas which children present with to their GP?

Answer 18

sprain
fracture
NAI

Question 19

What other problems do children present to the GP with?

Answer 19

Skin problems
ENT
Ophthalmology 
Mental health problems
Behavioural problems 
Haematology

Question 20

Name two dermatological infections that can present on a child’s face?

Answer 20

Impetigo

Slapped Cheek

Question 21

How does scarlet fever usually present in a child?

Answer 21

widespread rash on trunk and face
white patches on tongue that go red once white is lost
(Strawberry tongue)

Question 22

What is involved in the 6-8 weeks GP health check for babies?

Answer 22

Red light reflex
Hips (barlows/ortolanis)
Genitalia
Femoral pulses

Question 23

What are the common red flags in a child which can indicate a potential sepsis?

Answer 23

Unresponsive/difficult to rouse
Weak, high pitched or continuous cry
Grunting respiration or apnoeic episodes
Severe tachypnoea
Severe tachycardia/ bradycardia
No wet nappies/ not passed urine in last 18 h
Non-blanching rash or mottled/ ashen/ cyanotic
Temperature < 36oC
If under 3 months, temperature > 38oC