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Child's health > HB Child Health QP's > Flashcards

HB Child Health QP's Flashcards

1
Q

A 5-month male baby is brought to the clinic by the mother with a history of Convulsions for 1 day. She denies any problems during pregnancy and delivery of this baby. On examination, the baby looks ill. Vitals: 60bpm, temp 38.5°C, a bulging anterior fontanel and grunting are noticed. A diagnosis of Meningitis is considered

Q1
While being examined the child is noted to have Generalized tonic clonic seizure.

  1. 1 What is the immediate management that should be given? (4)
  2. 2 What will be the picture of the CSF analysis if this patient has bacterial Meningitis? (4)
    1. Explain the pathophysiology leading to bulging fontanel in this patient. (5)
A
    1. • Give 0.5 mg per kg diazepam per rectum. To stop convulsions.
  • Give first dose of ceftriaxone IM (p. 35)
  • Test for low blood sugar, then treat or prevent
  • Give one dose of paracetamol for fever 38°C or above.
  • Refer URGENTLY
    1. 1) Appearance - Turbid
      2) WBC- Polymorphs: Increased
      3) Protein- Increased
      4) Glucose- Decreased

1.3. Organisms enter the bloodstream
°Causes inflammatory reaction in the meninges (proliferation of bacteria from brain barrier).
°Causes thrombosis
°Reduced cerebral blood flow
°Purulent exudates spread over the base of the brain and spinal cord
° Inflammation spreads to membranes lining cerebral ventricles
°Inflammatory response-increase permeability of blood-brain barrier
°Leading to cerebral edema, with Bulging fontanel

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2
Q

List 4 predisposing factors of Bacteria meningitis

A
  1. Infection i.e URTI- Otitis media, mastoiditis
  2. Haemoglobinopathies e.g Anemia, immunological defects
  3. Trauma i.e Head injury, recent neurosurgical procedures
  4. Overcrowding- spread by droplet infection
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3
Q

A 6 months old girl was brought to the clinic by her mother who is worried about her cough. The mother reports that the child has been less active than usual for three days. She had a runny nose, decreased appetite, worsening cough, and weakness. On examination, she looks sick. Vitals: Temp=38.8C, RR=65bpm, HR=160bpm. Auscultation revealed reduced breath sounds with diffuse expiratory wheezes. The Clinical Associate on duty suspects Pneumonia.

Q.
what empirical treatment should be prescribed for the child?

A

Amoxicillin oral, 45mg/kg/dose, 12 hourly for 5 days.

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4
Q

A 6 months old girl was brought to the clinic by her mother with a history of cough and fever for 3 days.
After examination the Clinical Associate suspects Pneumonia.

  1. Mention 5 cardinal signs for suspecting the diagnosis of Pneumonia? (5)
A
  1. Fever > 38 C
  2. Tachycardia
  3. Tachypnea
  4. Difficulty breathing
  5. Nasal flaring
  6. Chest indrawing
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5
Q

A 12-year-old girl with a history of loss of energy and feeling tired for 2 weeks

Q1a.
Given the patient’s chief complaint list 5 hypotheses?

A 
Iron deficiency syndrome
TB
?
?
?
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6
Q

A 5-year-old boy came with a history of fits for 1 day

Vitals: BP=100bpm, P=120bpm, RR=36bpm, Temp= 39,8 C. On examination: Febrile on touch and lethargic.

  1. What diagnosis is appropriate for this patient? (2)
  2. Management needed for this patient?
A
  1. Febrile seizures
  2. Reduce fever:
    a) Tepid sponging (use warm water).
    b) Fanning- Use a towel or fan
    c) Increased intake of cold fluids
    d) Bathing the child
    e) Expose the child in an open space.

AND give Paracetamol 15mg/kg/dose

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7
Q

A 12-year-old boy known epileptic on treatment came for review and you noticed that he is on Carbamazepine.

  1. Explain the mechanism of epilepsy? (2)
  2. Give 2 detrimental side effects of carbamazepine (2)
  3. Explain the mode of action and 2 benefits from Carbamazepine. (5)
A
  1. Imbalance between excitatory and inhibitory stimuli resulting in aberrant electrical discharge AND spontaneous synchronous depolarization of both cerebral hemispheres.
  2. Ataxia, Cardiac condition disorders and Pulmonary hypersensitivity
  3. of Action
    Carbamazepine acts by inhibiting the flow of sodium ions through sodium channels on neural cell membranes, thereby causing hyperpolarization and decreased activity of the neuron.
    AND pain relief and seizure control.
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8
Q

A young mother brings her 3-year-old child to the clinic complaining of itchy hands and feet. On closer examination, infected vesicles are visible on the extremities. Describe the information you would give to the mother on the treatment and prevention of the reoccurrence of infected Scabies.

A
  1. Advise the mother to wash the child in lukewarm, soapy water and to remove any crustules from the skin.
  2. Dry the skin thoroughly and apply medication over the whole body except the genitalia and face/scalp.
  3. Apply medication of scabicide over the whole body and dress with clean clothes.
  4. Medication i
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9
Q

A 2 year old boy was brought to the hospital by his parents because he was flushed near a Kerosene bottle 45 minutes ago. Mow the patient has tachypnea and cough (5)

(a) What immediate measures should be taken in the management of this patient? (4)
(b) What respiratory complication can you expect in this case? (1)

A

(a) 1. Insert IV line (Normal Saline)
2. Admit to Observe patients for up to 6-8 hours if asymptomatic.
3. Administer Oxygen, if necessary
4. Chest X-ray if respiratory disstress presents
(b) Chemical pneumonitis

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10
Q

A 1 year-old female baby is brought to the clinic, after examinaton a clinical diagnosis of Acute Gastro-enteritis with sever dehydration was made (8 marks)

(a) Describe the signs of severe dehydration using IMCI approach that were considered in making this assessment/diagnosis? (3)
(b) What is the commonest causative agent for water diarrhoea in infants? (1)
(c) State 4 measures that can be undertaken to prevent the Gastroenteritis in children. (4)

A

(a) 1. Sunken eyes
2. Very slow skin turgor >3s
3. Inability to drink
4. Lethargy or unconsciousness
5. Restlessness

(b) Rotavirus

(c) 1. Wash your hands when preparing food and after nappy change.
2. Proper and regular washing or disinfecting baby’s bottle
3. Boiling of water before preparing babies food
4. Disinfecting of surfaces and floors.

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11
Q

State 4 uses of the RTHC in child health (4)

A
  1. Used for documentation of vaccines for children.
  2. Used to monitor health status of children
  3. For growth and nutritional status of the child.
  4. Monitoring developmental milestones of children at certain age.
  5. Used for birth history that may be useful in diagnosing current conditions of the child
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12
Q

What features would be indicative of suspected physical abuse of a child at OPD? (3)

A
  1. Bruises ,scars or wound on the child’s body that do not match the giving hx
  2. A aggressive child or anti-social/withdrawn child
  3. Non-accidental injuries
  4. Abdominal injuries
  5. Burns or scalds
  6. Fractures
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13
Q

Mention 4 complications of allergic rhinitis. (4)

A
  1. Sinusitis
  2. Peritonsillar abscess
  3. Otitis Media
  4. Tonsillitis
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14
Q

Mention 5 triggers of asthma. (5)

A
  1. Stress or emotions
  2. Cold weather
  3. Exposure to dust mites
  4. Animals e.g Cats, dogs
  5. Exposure to pollen or allergic flowers
  6. Exercise
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15
Q

Write 4 complications of blood transfusion. (4)

A
  1. HIV/AIDS
  2. Hepatitis
  3. Transfusion associated circulatory overload (TACO)
  4. Acute hemolytic transfusion reaction
  5. Febrile non-hemolytic transfusion reaction (FNHTR)
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16
Q

Mention 4 causes or risk factors for malnutrition. (4)

A
  1. Low socio-economic status
  2. Being immunosuppressed
  3. Young maternal age
  4. < 5 years of age.
  5. Lack of maternal education on child nutrition
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17
Q

Explain the importance of South African Road to Health Booklet (10 marks)_

A
  1. The road to health booklet is an important document that helps in managing and accounting a child’s health, nutritional and general well-being.
  2. It is used to assess neurodevelopment in the first 5 years of a child.
  3. Helps assess children’s growth and development
  4. It has educates mother to be well aware to the Danger signs
  5. It also helps mother to know how to prevent dehydration in her child by educating her on how to make homemade Oral Rehydrating Solution.
  6. It has immunization schedule for each child to be given, and has information for when a certain vaccine was given and route of administration. This helps health care worker to know if the child IUTD.
  7. Is helps health care workers know the importance of growth monitoring using weight, height, age and MUAC.
  8. It has a section for important Vitamins (Vit A) to be given to the child and Mebendazole for deworming.
  9. Contains Birth Hx.
  10. It has information on proper feeding of the child, according to the age.
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18
Q

A 12-year-old boy was brought to casualty. The CA suspects Organophosphate poisoning. (11)

(a) Mention the effects of the organophosphate poisoning at the muscarinic (4) and nicotinic (4) receptors.
(b) Mention the modes of exposure to organophosphate substances. (3)

A

(a) Muscarinic
1. Bronchospasms
2. Increased Salivation
3. Visual disturbances
4. Lacrimation

Nicotinic

  1. Anxiety
  2. Convulsions
  3. Headache
  4. General weakness

(b)
1. Inhalation
2. Ingestion
3. Direct skin contact

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19
Q

Symptoms of Organophosphate?

A
  1. Increased saliva & tear production
  2. Diarrhea
  3. Vomiting
  4. Small pupils
  5. Sweating
  6. Muscle tremors
  7. Confusion
  8. Muscle weakness
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20
Q

Organophosphate Pathophysiology?

A
  • Effects associated with organophosphate poisoning are as a result of acetylcholine (ACh) present at different nerves & receptors in the body because acetylcholinestrase is blocked.
  • Accumulation of ACh at motor nerves causes overstimulation of nicotinic expression at neuromuscular junction.
  • When the is an accumulation of ACh at autonomic ganglia synapses this causes overstimulation of muscarinic expression in the parasympathetic NS.
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21
Q

Mention 4 classes of drugs that can be used in the management of allergic diseases. (4)

A
  1. Antihistamines (Histamine H1 Antagonists
  2. Glucocorticoids
  3. Anti-Allergic Agents
  4. Bronchodilator Agents
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22
Q

Write down the most appropriate drug management of neurocysticercosis.(2)

A
  1. Albendazole, oral, 7.5mg/kg/dose 12 hourly for 7days.
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23
Q

MB a 7 month old thin, irritable girl, abandoned by her mother at a day care center, was brought in by a caregiver with history of diarrhea for 3 weeks.
(a) Given the patients chief complaint, list 3 hypotheses (3)

A
  1. Malnutrition
  2. Gastro-enteritis
  3. Malabsorption
  4. Lactose intolerance
  5. Inflammatory bowel syndrome
  6. HIV
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24
Q

State how you would test the most likely two hypothesis using Subjective data. (Three pieces of information each). (6)
yiTABLE

A

Malnutrition:
•Hx of feeding-Poor appetite
•Weight loss-Severe
•Abdomen-Distended

Malabsorption:
•Hx of feeding-Good appetite
•Weight loss-Moderate
•Abdomen-Discomfort

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25
Q

State how you would test the most likely two hypothesis using Objective data. (Three pieces of information each). (6)

A

Malnutrition:
•General appearance-Apathy and irritable
•Dehydration-Mild to Moderate
•Anemia- Mild

Malabsorption:
•General appearance- Lethargy
•Dehydration- Severe
•Anemia- Severe

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26
Q

As a CA you are requested to take care of a child who is unable to swallow. Explain the ethical and legal considerations in the management of artificial nutritional support. (5)

A
  1. Care of the sick involves duty of providing adequate fluid and nutrients.
  2. Food and fluid should not be withheld from a patient who expresses desire to eat and drink unless there is a medical contraindication.
  3. Treatment plan should include nutritional issues and should be agreed by all members of the health care team.
  4. Tube feeding is usually regarded as medical treatment; the need for that support should be reviewed on a regular basis.
  5. A competent adult patient who must give consent for any invasive procedures including passage of a nasogastric tube.
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27
Q

A 2 year old boy was brought in by his mother with a history of poor appetite, loss of weight and swollen legs.

(a) What would be the most likely diagnosis? (1)
(b) (b) List 2 investigations you would do for this patient and give reasons (2)

A

(a) Kwashiorkor

(b) 1. Urinalysis-To check for UTI
2. CBC- To check for Urea and Electrolyte imbalance.
3. HIV status

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28
Q

A 6 month old female was brought to OPD by the mother due to cough for 2 days. On examination, she looks sick. Vital signs are: Temperature 38.8C, RR= 65bpm, PR=160bpm

(a) In a child of this age with a cough, list the 1 most important clinical examination finding that indicates the diagnosis of pneumonia. (1)
(b) List 4 signs that would indicate the need to admit this child. (4)

A

A. Difficulty breathing

B.

  1. Tachypnea
  2. Nasal flaring
  3. Lower chest indrawing
  4. Grunting
29
Q

The child is diagnosed with pulmonary TB after further work-up on the ward. The mother confirmed that the father is currently on TB treatment.

(c) State the treatment and duration of the drug which should be given to the 2 children (2 and 4 years old) in the household to prevent TB. (2 marks)

A

(c) Isoniazid 10-15ng/kg/day for 6 months.

30
Q

A 11 year old patient with fever, vomiting and headache for one day.

(a) Identify the possible diagnosis (hypothesis) that has the most serious consequences.
(b) List 2 other hypothesis for these symptoms

A

(a) Bacterial Meningitis

b
1. Encephalitis
2. Brain abscess

31
Q

The child’s condition deteriorates and he develops a purpuric rash and purpura.

(c) State the most likely specific causative organism. (1)
(d) State the prophylaxis medicine which should be given to other members of the household. State the name(s) and route of administrations (2)

A

This is Meningococcal Septicemia

(c) Neisseria Meningitidis

(d)Ceprofloxacin ,oral
OR
Ceftriaxone, IM

32
Q

A 8 year old patient with fever, vomiting and headache for one day. CA diagnosis Bacterial Meningitis

(a) State the most important investigation and findings you would do to confirm/ exclude your hypothesis (5)

The child’s condition deteriorates and he develops a purpuric rash and purpura.

(b) State your initial drug management? (1)

A

(a) Lumbar puncher for CSF analysis
1. CSF color: Turbid
2. Neutrophils: Very high
3. Protein: Very high
4. Glucose: Very low

(b)
1. Ceftriaxone, IV, 50mg/kg/dose 12hrly x7-10 days
2. Dexamethasone IV 0.15 mg/kg 6hrly for 3 days, start before initial antibiotic dose.

33
Q

A 2 year old HIV positive boy is admitted to your ward with a diagnosis of pneumonia. He is growing well and not yet on ARV’s

A. Identify six clinical features you would monitor to assess his response to treatment? (6)

After 3 days of treatment with IV ampicillin and gentamicin he is not improving.
(b) Identify 2 investigations you would now order or perform and give reasons for each. (2marks)

A

A.

  1. Nasal flaring
  2. Tachypnea
  3. Dyspnea
  4. Lower chest indrawing
  5. Apnea
  6. Pulse oximetry measurement < 90% on room air
  7. Altered mental status.

B.
1. If severe pneumonia ask physio to collect sputum for viral PCR screen and shell vial culture for Cytomegalovirus (CMV) : Suspecting CMV Pneumonia

  1. TB investigations: Montoux, CXR, Gastric washings or sputum: suspecting TB
34
Q

A 3 year old girl SM was seen two days ago at your clinic with fever and sore throat, diagnosed with Tonsillitis, and treated appropriately. Her mother has brought her back to the clinic as SM remain febrile and has since developed vomiting, abdominal pain and a headache. SM and her family have recently returned from a visit to Limpopo

(a) List 3 hypothesis (possible explanations) that might account for SM’s new presentation (3)
(b) What additional history should you obtain from SM’s mother to assist in narrowing down the possible diagnosis? (6)

A

a.

  1. Malaria: Fever, headache and recent hx of traveling to Limpopo.
  2. Bacterial Meningitis: Fever, headache, and vomiting.
  3. Hep A: More common in children, and in areas with poor hygiene
B.
1. Immunization schedule UTD
2. ??
3??
4. ??
5.??
6.??
35
Q

A 6 year old is brought into the casualty with difficulty with breathing and stridor of a few hour duration. Oxygen is being administered by face mask. The ClinA suspects Croup with a grade 2 stridor.

1.Outline the utilization of two (2) important drugs in the management of this patient. (2 marks)

A

°Prednisone

°Adrenaline

36
Q

A 10-year-old boy was brought to the hospital because he hasn’t been feeling well and there are several COVID-19 confirmed patients in his classroom. On the examination the patient seems to be in bad shape, is oriented, pink mucosa and hydrated. Vital signs as follows. T:38.5; SpO2: 95% at room air; RR: 28 Breaths/Min; HR: 125 Beats/Min.

  1. List 4 symptoms you would explore in this patient to declare suspended of COVID-19 (criteria for “person under investigation” PUI). (4 marks).
  2. Mention three (3) aspects of the recommended management of this patient?
A
  1. °Cough
    ° Shortness of breath
    ° Fever
    ° Sore-thorat
  2. ° Home care or Isolation

°Supportive care/ symptomatic treatment: Paracetamol or NSAIDs.

°Caregiver must be given: appropriate information so they can detect deterioration in the condition of their child.

37
Q

A 28-months-old is brought by his mother with a history of diarrhoea. The child has been assessed as having persistent diarrhoea and acute severe malnutrition (SAM).

  1. Mention three (3) criteria for the diagnosis of SAM. (3 marks)
  2. Mention six (6) situations/signs should be assessed for immediate referral and admission. (6marks)
A

1.
° Weight for Age, z-score < - 3 SD
° Mid Upper Arm Circumference < 11.5 cm
° Bilaterally pedal edema or wasting

2.
° Dehydration 
° Bilaterally pedal edema
° Shock 
° Hypothermia
° Diarrhea
° Co-existing infection
38
Q

A 3-month-old is brought from home with three (3) days history of diarrhoea and vomiting. A clinical assessment of Acute gastroenteritis with some dehydration is made, but the child haemodynamically stable.

  1. Outline the practical fluid therapy (solution, dose and time). (2 marks)
  2. The child has one (1) clear vomits of small volume 45 min later. How would you re-challenge the oral rehydration this time. (1 mark)
  3. Mention 1 indication you would give to the parent for the next hour regarding the feeding and drinking of the patient. (1 mark)
A
  1. Oral Rehydration Solution , 80mL/kg over 4 hours
  2. If the child vomits, wait 10 minutes. Then continue, but more slowly.
  3. The mother should continue to breath feed and give ORS if the child wants more.
39
Q

A 4-year old boy was brought to the hospital by his mother because she is concerned about his son’s health. The mother was diagnosed with pulmonary Tuberculosis 15 days ago but she is HIV negative.

  1. Mention three (3) cardinal symptoms for PTB in the baby. (3 marks)
  2. TB was ruled out in the child. Prescribe the drugs for prevention of PTB. (3 marks)
A

1.Cough for more than two weeks?
• Fever for more than seven days?
• NOT GROWING WELL?

  1. Isoniazid,oral, 10mg/kg daily for 6months
40
Q

A HIV positive child on retroviral treatment on Abacavir/lamivudine/Lopinavir/ritonavir (ABC/3TC/LPV/r), was recently diagnosed with PTB. Now was brought to you for TB treatment initiation.

  1. Mention the dose adjustment needed on her retroviral treatment following the TB treatment initiation. (Mention the drug and explain the dose adjusting). (2 marks)
  2. The child has a three year old sibling at home, state the treatment and duration of the drug which should be given to the household sibling to prevent TB. (3 months)
A
  1. Ritonavir should be added at a dose of 0.75 times the volume of the lopinavir/ritonavir dose.
  2. Isoniazid tablets, oral, daily for 6 months.
41
Q

Mention 4 common causes of Anemia in children?

A
  1. Anemia caused by excessive blood loss
  2. Inefficient production of red blood cells
  3. Anemia that results from a chronic disease
  4. Anemia caused by excessive destruction of red blood cells.
42
Q

A 13 year old male patient was brought to OPD with a history of haematuria for one (1) week, the clinical associate suspects Urogenital Schistosomiasis (Schistosoma Haematobium).

  1. Which is the most appropriate drug management for the condition? (2 marks)
A
  1. Praziquantel 40mg/kg oral as a single dose
43
Q

A 2-year-old boy was found near a paraffin bottle and coughing. Now the patient has tachypnoea.

  1. What immediate measures should be taken to manage this patient? (2 marks)
  2. What common respiratory complication leads to respiratory distress in this patient? (1 mark)
A
  1. °Administer Oxygen
    ° Chest X-ray
  2. Chemical Pneumonitis
44
Q

A 1-year-old girl suffering from acute gastroenteritis with severe dehydration is brought to the clinic.

  1. Mention three signs of severe dehydration using IMCI approach. (3 marks)
  2. What is the commonest causative agent for watery diarrhea in infants. (1 mark)
  3. State 4 preventive measures of Gastroenteritis in children. (4 marks)
A 
1.
° Lethargic or unconscious.
• Sunken eyes.
• Not able to drink or drinking poorly.
• Skin pinch goes back very slowly
  1. Rotavirus
3. 
° GOOD HYGIENE
° SAFE WATER SUPPLY
° COMPLETE COOKED FOOD
° ADEQUATE SANITATION
° ROTAVIRUS VACCINATION
° EXCLUSIVE BREAST FEEDING THE FIRST 6 months
45
Q

A 4 year old girl was brought to casualty because she was bitten by a snake on her leg 2 hours ago. Right now the girl is fine, and there are no signs of systemic poisoning. (3 marks)

  1. Mention 3 measures that should be taken in the management of this patient? (3 marks)
A
  1. ° Tetanus immunoglobulin, IM, 75 IU
    ° Clean wound: Chlorhexidine 0.05% solution in water.
    ° Antivenom therapy
46
Q

Mention any 5 preventative measures of child malnutrition? (5 marks)

A

° Growth monitoring
°Breastfeeding, immunization
° Good nutrition for children under five years of age and are able to eat solids.
° Give young mothers support, so as to avoid child neglect
° Eat a healthy, balanced diet.

47
Q

Mention 4 risk factors of Pneumonia in infants. (4 marks)

A
  1. Aspiration
  2. Septicaemia
  3. Measles
  4. Immunosuprresion
  5. Malnutrition

Abnormalities in clearance of mucus/secretions e.g cystic fibrosis, foreign body

48
Q

A 14 months old child is brought with a 2 days history of diarrhoea. List the 4 questions one should ask to assess the presence of general danger signs for dehydration, according to IMCI.

A

° Lethargic or unconscious.
• Sunken eyes.
• Not able to drink or drinking poorly.
• Skin pinch goes back very slowly.

49
Q

Mention 4 complications of AOM

A
  1. Perforated ear
  2. Mastoiditis
  3. Bacterial Meningitis
  4. Decreased hearing
50
Q

A 10-year-old patient was counselled to have HIV test and consented. The initial rapid test was positive. Therefore a second rapid test was done to confirm but it becomes negative.

  1. What is term used to describe the final result of the above scenario. (1 mark)
  2. What is the next test needed to ascertain the status? (1 mark)
A
  1. False negative results

2. ELISA test

51
Q

Child with Measles

List 4 possible findings which would require Referring the child to hospital

A
  1. Any general danger signs
  2. Pneumonia
  3. Clouding of Cornea
  4. Deep or extensive mouth ulcer
52
Q

Describe 4 ways you would screen a 2 year old for TB

A
  1. Ask about features of TB
  2. Send sputum or Gastric aspirate for Genexpert and Culture
  3. Do Tuberculin skin test
  4. CXR
53
Q

List 3 baseline laboratory bloods to be done and explain the reason in TB. (6marks)

A
  1. CD4 count and FBC/Hb- All children starting ART
  2. Creatinine and eGFR- children/adolescents starting ART
  3. Alanine Aminotransferase (ALT) - On TB treatment or starting Nevirapine (NVP)
54
Q

ART INITIATION 6 STEPS

A
  1. Record patient details and history
  2. Decide if the child has confirmed HIV infection
  3. Decide if the Caregiver is able to give ART
  4. Decide if a IMCI nurse should initiate ART
  5. Assess and record baseline information
  6. START ART
55
Q

A 23 year old boy was brought to OPD with a history of haematuria for one week the ClinA suspects Urogenital Schistosomiasis (Schistosoma Haematobium)

  1. Describe the way of transmission of the parasite (3 marks)
  2. Which is the most appropriate management for the condition. (2marks)
A

1.Transmission occurs through skin contact with infected fresh water.

Cercariae penetrate human skin → become schistosomulae after shedding their forked tails
Migration into the bloodstream.

  1. Praziquantel, oral, 40mg/kg as a single dose or in 2 divided doses on the same day.
56
Q

List the route of exposure to organophosphate substances? (3 marks)

A
  1. Skin
  2. Orally
  3. Inhalation
57
Q

Mention 3 principles of management for corrosive poisoning. (3 marks)

A

1.Limit further exposure, get appropriate history and present with evidence(container).

  1. Remove clothes in skin and shower
  2. Gastric larvage is indicated if done within 1 hour of ingestion. But contraindicated in volatile hydrocarbons (Parrafin).
58
Q

Mention 6 classes of drugs that can be used in the management of allergic diseases. (4 marks)

A
  1. Antihistamines
  2. Glucocorticoids
  3. Anti-Allergic Agents
  4. Bronchodilator Agents
  5. Decongestants
  6. Adrenergic agonist
59
Q

Write down the most appropriate drug management of neurocysticerosis.

A

Albendazole, oral, 7.5mg/kg/dose 12 hourly for 7 days.

60
Q

A 18 month old girl was diagnosed with pulmonary Tuberculosis and HIV in her clinic 2 months ago. She has been on TB treatment since then and referred to you for ART initiation.

  1. What drug combination would you prescribe? (3 marks)
  2. Since she will be in TB and ART treatment at the same time for the next 4 months, what drug adjustment you need to do for this patient? (1 mark)
A
  1. Abacavir (ABC) + Lamivudine (3TC) + Lopinavir/ritonavir (LPV/r)

2.

61
Q

Encephalitis dose in children

Aciclovir

A

???

62
Q

What are the complications of Measles?

A
  1. Pneumonia
  2. Difficulty feeding
  3. Croup
  4. Diarrhea
  5. Encephalitis
63
Q

What are the cardinal symptoms of Measles

A 
Duration 3-5 days
1. Fever
2. Maculopapular rash
3. Cough
4. Runny nose
5. Conjunctivitis
Koplik's spot
64
Q

Mention 6 Behavioural & Physical indicators of child abuse

A
  1. Poor child- patient interaction/ scared of parents
  2. Nightmares
  3. Wary of adult contact
  4. Agression
  5. Withdrawn/sad/ depressed child
  6. Poor self-concept, reluctance to undress
  7. Developmental delay/ regression of milestones
  8. Decreased school performance
  9. Secondary enuresis/ encopresis
  10. Sexual behaviour, including excessive inappropriate masturbation
  11. Recurrent Genito-urinary tract infections (bladder infections, vaginal discharges)
65
Q

What advice would you give to parents on how to prevent Pneumonia

A
  1. Keep vaccinations up to date
  2. Teach children proper etiquette for coughing and sneezing
  3. Teach and practise good hand washing
  4. Wash surfaces that are regularly touched often (like toys, tables, and doornobs) with disinfectants
  5. Keep home smoke free
  6. Optimal nutrition for all age groups
  7. Breast feeding for at least 2 years
66
Q

A 10 year-old female patient presented with a history of skin rash. The mother reports that she has had an itchy rash since she was a small kid. It becomes worse when she eats certain foods including fish and mutton. The neck, armpits, and elbows are most affected. The mother reports that the child’s father has got Asthma.

List 5 findings that are likely to be found on physical examination of this patient in line with history

A
  1. Erythema
  2. Papules
  3. Vesicles overlying erythematous skin
  4. Excoriations and erosions with serious exudates
  5. Scaling
  6. Thickened plaques of skin
  7. Linchenification
  8. Fibrotic papules
  9. Typical locations of lesions on Wrists, ankles,antecubital fossae, popliteal fossae and neck
67
Q

Mention the 3 common complications of epilepsy in children

A
  1. Difficulty learning
  2. Broncho aspiration
  3. Injury from falls, bumps, self-inflicted bites
  4. Psychosocial problems (Depression, anxiety)
  5. Brain damage
  6. Sudden unexpected death in epilepsy
68
Q

A one-year-old boy was brought to casualty by mother with a complaint of generalized body swelling for one month. Physical examination findings include bilateral pitting oedema, MUAC <11.5cm and body weight is 6kg

Explain 5 causes of this child condition

A
  1. Chronic infections
  2. Poor-socio-economic status leads to inadequate provision of food to the child.
  3. Twin children or many children in the family increase the demand for food
  4. Reduced absorption of macro-and/or micronutrients leads to underutilization of the food that is taken in.
  5. Limited knowledge of the caretaker about nutrition leads to imbalanced diet
  6. Neglected children, orphans and those living in care homes do not have adequate balanced diet.
    5.
69
Q

Malaria

management

A

Artemether + Lumefantrine (Co-ArtemR), (20mg/120mg), oral, with fat-containing food/milk to ensure adequate absorption. food.
•Give the first dose immediately
• Second dose should be taken at home 8 hours later.
• Then twice daily for two more days

Child's health (12 decks)

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