Mary's teaching

Question 1

when do you use DMSA to investigate UTI?
when? if 3 months, <6

Answer 1

non-e coli (klebsiella)
septicaemia
raised serum creatinine
mass

Question 2

DMSA

Answer 2

function
missing bits
radioactive scan

Question 3

6 week baby boy
projectile vomiting
hungry straight after
mum says looks a lot smaller
what is it?

Answer 3

pyloric stenosis

Question 4

surgical correction of pyloric stenosis

Answer 4

ramstedt procedure

Question 5

cause of bilateral cryptorchidism?

Answer 5

hypopituitarism

Question 6

in cryptorchidism by what age should you do an orchidopexy?

Answer 6

before 2 years old

Question 7

causative agent of HUS

Answer 7

E.coli 01571:H7

Question 8

features of HUS

Answer 8

Microangiopathic haemolytic anaemia
nephropathy
thrombocytopenia

Question 9

HUS investigation?

Answer 9

FBC
clotting
renal function - aki
stool culture and toxin - e coli 0151 h7
BP
fluid balance ( every 8 hours)
daily weight (twice a day)

Question 10

what type of rash is measles?
what spot?

Answer 10

maculopapular rash
koplik

Question 11

subacute sclerosing panencephalitis

Answer 11

complication of measles years after
fatal

Question 12

prolonged jaundice screen ?- 14 days

Answer 12

○ Conjugated and unconjugated bilirubin
§ If conjugated bilirubin is raised what does this mean?
□ Biliary atresia
§ Direct antiglobulin test (coombs)
§ TFT
§ Fbc, blood film
§ Urine for mc&s and reducing sugars
U&e’s and LFTs

Question 13

what enzyme conjugates bilirubin? and where
where does bilirubin go after it becomes conjugated here?

Answer 13

UGT - enzyme
liver
to gallbladder

Question 14

causes of prolonged jaundice?

Answer 14

biliary atresia
hypothyroidism
urinary tract infection
breast milk jaundice
CMV, toxoplasmosis

Question 15

red flag for headaches

Answer 15

new headache
rash
fever
stronger than any other headache

Question 16

visible jaundice before 24 hours is a risk factor of it being pathological
t/f

Answer 16

true

Question 17

management of PDA treating preload / afterload?

Answer 17

furosemide / diuretic reduces demand

Question 18

captopril
afterload reducers why is used in acyanotic heart disease

Answer 18

reduces systemic vascular resistance

Question 19

what is a trendelberg positive mean in gait

Answer 19

weakness in the hip abductor muscles consisting of the gluteus medius and gluteus minimus

Question 20

what is perthes disease?

Answer 20

avascular necrosis of femoral head
femoral epiphyses

Question 21

internal capsule would present issues?

Answer 21

speech

Question 22

what is given in a cyanosed baby
what is the name of this drug?

Answer 22

alprostadil which is a synthetic prostaglandin E1

to keep the PDA open otherwise cyanosed baby will not be able to get oxygen

Question 23

duodenal atresia presents with

Answer 23

duodenum is not patent which causes bowel obstruction

bilious vomiting is happening

Question 24

maintenance fluid in children?

Answer 24

0.9% NaCl +5% glucose

Question 24

do you get bilious vomiting in pyloric stenosis

Answer 24

no

Question 25

shock what do you give?

Answer 25

0.9% NaCl 10ml-20ml/kg

Question 25

bilateral nasal polyp

Answer 25

very uncommon

Question 25

plasmalyte is what ?

Answer 25

isotonic solution but not used routinely

Question 26

what is choanal atresia

Answer 26

nasal choanae is closed congenitally
presents early