LIMPING CHILD

Question 1

A male child 2-12 years old with pain that has just started. Last week he had a cold with grey stuff on his tongue now he has a mild fever

Answer 1

transcient synovitis

Question 2

Child is febrile and looks unwell and has a limp

Answer 2

septic athritis

Question 3

child has developed a limp which appears to be painless for more than 6 weeks there is leg length discrepancy and systemically macular rash

Answer 3

juvenile idiopathic arthritis

Question 4

how does developmental displasia present

Answer 4

detected in nenonates 6 times more common in girls

Question 5

A 4 year old with gradual onset knee pain and limp sometimes radiates to buttock and thigh and is worse with acitiity. Appeared after a cold a month ago.

Answer 5

legg perthes disease - can be transcient synovitits but this goes away in 2 weeks

Question 6

10-16 year old boyr with a bit of a big belly that have a limp with pain in groin thigh and knee. onset is gradual but can be acute and very painful on x ray there is a frog leg lateral displacement of femoral head

Answer 6

slipped upper femoral epiphysis

Question 7

Mnagment for JIA

Answer 7

1. NSAIDS
2. STEROIDS
3. DMARDs
   4.

Question 8

MANAGMENT for slipped femoral epiphysis

Answer 8

surgical fixation

Question 9

management with perthes disease

Answer 9

alagesia if mild

plaster or surgery to secure femoral head

Question 10

DDH TREATMENT

Answer 10

1. < 6 months pavlik harness - effective if started early

2. > 6 months surgery

Question 11

Describe barlows and ortholini?

Answer 11

ortholini leg elevated and abducted and brlrlows leg depressed and adducted to dislocate

Question 12

Acute lymphoid leukaemia presentation and signs

ANT

Answer 12

anaemia - lethargy pallor
neutropenia - frequent or severe infections
thrombocytopenia - easily bruising petechiae

hepatosplenomegaly
bruising
symptoms of anaemia

Question 13

Thrombotic thrombocytopenia purpura is common in what age adn how does it present

Answer 13

30-50 year olds

neuro and renal symptoms

Question 14

Idiopathic thrombocytopenia purpura how does it present

Answer 14

petechiae due to bleeding

low platelets seen ONLY

Question 15

dic how does it caused

Answer 15

by burns/trauma or sepsis

Question 16

sequalea of measles

Answer 16

pneumonia then much later on subacute sclerosising panencephalitis

Question 17

sequalea of mumps

Answer 17

pancreatitis and infertility

Question 18

Kosher criteria what is it used for and what does it contain

Answer 18

used for identifyin septic artheritis and it contains

• fever
• inability to weight bear
• raised ESR

Question 19

The two types of innocent murmus and how they present

Answer 19

Both are due to the turbulence of the blood flow in the heart - noise heart makes as blood flows through it.

1. venous hum - continuous blowing noise heard below the clavicles
2. Stills murmur - low pitches sound at the LLSE

Question 20

signs of malrotation
management
treatment

Answer 20

exophthalmus congenital diaphragmatic hernia and intrinsic duodenal atresia
volvulus and bile stained vom
Diagnosis - upper go contrast and USS
Rx- laparotomy if volvulus and ladds is risk of reoccurrence

Question 21

Kawasaki

Answer 21

crash burn 
c- conjunctivitis 
r - rash 
a - adenopathy cervical 
s- strawberry tongue 
h- hands and feet swollen and peeling 

burn - high fever that doesnt respond to antipyretics

Question 22

what renal disease is associated beckwith wiedermann syndrome

Answer 22

wilms tumour

Question 23

GIrl is urinating more she feeling tired and skinny likely underlying cause is ….

Answer 23

diabetes causes this but the diabetes can be caused by cystic fibrosis so answer is CF

Question 24

girl 12 years old consentual sex with 17 year old whats the first thing you should do

Answer 24

disclose to relevent authority cause she is underage it is a doctors to do so and you cannot expect the child to disclose herself or

Question 25

thyroglossal cyst presentation

Answer 25

ant triangle where thyroid is

aneichoic on USS echogenicity would suggest infection

Question 26

brachial cyst

Answer 26

ant to SCM near angle of mandible

unless infected it has a similar consistency to water and anechoic on USS

Question 27

WAHT IS A dermoid cyst and where

Answer 27

in the midline suprahyoid are heterogenous and contain calcium and fat on imaging

Question 28

thyroid gland tumours are they rare in chilren

Answer 28

yep rare

Question 29

lymphatic malformations

cause:

Answer 29

post, to SCM and result form occlusion of lymphatic channels
cause: painless fluid filled lesions from age 2 closely linked to surrounding structures and removal is difficult
hyperanchoic on USS

Question 30

INFANTILE HAEMANGIOMA

Answer 30

ANY triangle in neck

grow rapidly then regress

x ray mass lesion with calcified phleboliths

involution occurs the fat ocntent of lesions increase

Question 31

lymphadenopathy

Answer 31

generalised is secondary to infection and can be any triangle

Question 32

less than 3 months treatment for meningitis

Answer 32

IV amoxicillin and IV cefotaxime