MCQ bank Flashcards
Kid with UTI, still febrile after 5/7 ABx, now has palpable painful flank mass. What investigation?
- Renal USS
- CT Abdomen
- DMSA
- DTPA
Renal USS
Could be a renal abscess
Kid presenting for 5 month immunisations with temperature of 37.6 and URTI for the past 2days. What do you do?
1. Give vaccines
2. Withhold vaccines until better
Give vaccines
Mild illness, temp not >38
Kid with rash on face - red cheeks, sweating and fever. Most likely diagnosis + cause?
Slapped cheek/erythema infectiosum/fifth disease
Caused by parvovirus
Otitis media spreading to meningitis. What is the most likely organism?
Strep pneumoniae
10 month old child recovering from viral gastroenteritis, on formula + solids. Gets diarrhoea 10days later. What do you do?
1.Lactose free diet
2.Soy formula
3 .Gluten free diet
4.Revert to clear fluids for 48 hours
5.Metronidazole
Lactose free
Post-viral lactase deficiency, damage to villi
4 year old child with fever (39), looking toxic, respiratory distress and high pitched inspiratorystridor, what do you do first? He had already had neb adrenaline
- IV hydrocortisone
- Inhaled corticosteroids
- Nebulised salbutamol
- Inhaled adrenaline
- Intubation
Intubation - he could have epiglottitis
Kiddy brought in w/ seizure. No obvious problems but you find retinal haemorrhages. Pale andlethargic. Parents say he cries a lot.
Non-accidental injury
Baby who can turn over on tummy but needs help sitting up on it’s own, passes hand tohand, doesn’t have a pincer grip, no words but babbles, responds to name, holds bottle to feed. How old are they?
6 months
Little Māori boy with haematuria, proteinuria and oedema. Told that he gets a “cold” every winterbut previously well. Broke his clavicle once. Normal JVP, BP 124/80ish (not raised - I would consider this a bit elevated for a child), C3 was low. Electron Microscopy = subepithelial humpsand fused podocyte foot processes
1.Post-infectious glomerulonephritis
2.Minimal change
PSGN - C3 low shows immune system activation
Min change causes nephrotic syndrome, PSGN causes nephritic.
Kid with a spot that looked utterly bizarre, mum said previous spots on back had disappeared leaving white zones behind.
1.Reassure
2.Excise with 2cm margins
3.Genetic testing
4.Topical antifungals
5.Biopsy
Reassure
Halo naevus
Periorbital hemangioma management
Observe, only excise if obstructing vision
Boy playing cricket with pain, sounded like testicular torsion, too tender to examine. Afebrile. Management?
- Exploratory surgery
- USS testes
- Antibiotics
Exploratory surgery
Child had GTCS on waking. Has twitches in arms and legs occasionally. ?had febrile seizure when younger. EEG showed generalised spike and wave when sleep deprived and with photostimulation. Diagnosis?
Juvenile myoclonic seizures
5yo Maori boy with viral sx and wheeze. No sx any other time.
1.Viral induced wheeze
2.Asthma
3.Bronchiolitis
VIW
Drooling kid
1.Emergency endotracheal intubation 2.Tracheostomy
3.Salbutamol
4.Adrenaline
5.IV hydrocortisone
Intubation, croup
would give nebulised adrenaline first btw
Baby with a coupley arm lesions. When can she go back to kindy?
1.When they’ve dried (were these chicken pox?)
2.Immediately - as they were already crusted over? (Shit quality image)
3. 2 days antibiotics first
4. Wait 7 days
When dry
Baby with stridor that goes away when they sleep
1.Laryngomalacia
2.Vascular ring LOL
3.Subglottic stenosis
4.Croup
Laryngomalacia (soft larynx tissues which fall down over airway opening)
Kid with petechiae and bruises, what investigation do you do first
1. FBC
2. Coagulation studies
3. Skeletal survey
FBC first to rule out meningococcal
6 mo with wheeze, increased work of breathing etc, had sibling who was sick last week.On exam had diffuse crackles. Diagnosis?
1.Bronchiolitis
2.Bronchiectasis
3.Asthma
4.Viral induced wheeze
Bronchiolitis (diffuse crackles)
NZ European kid with the sniffles , sore red throat, low grade fever, what organism is responsible
1.Rhinovirus
2.S. pyogenes
3.EBV
4.RSV
Rhinovirus
Woman with gestational diabetes, what is most likely complication for baby?1.Hypoglycemia 2.Macrosomia
3.Respiratory distress
Hypoglycemia
Child in severe resp distress, probably bronchiolitis, what investigation do you do?
1.Blood culture
2. Blood gas
3. FBC
4.Nasopharyngeal aspirate
5.Echo
Blood gas? FBC?
Morning twitches in kid
1. Juvenile myoclonic epilepsy
2. Hypnic myoclonus
Juvenile myoclonic epilepsy
Parents check on girl in the night during a ‘turn’ and she’s all confused and then doesn’tremember it in the morning
Night terrors
Kid with sore tibia, not worse on walking. Still fine moving joints. Normal X-ray. Neutrophilia +fever
1.Osteomyelitis
2.Osgood-Schlatter
3.Acute leukaemia
4.Septic arthritis
Osteomyelitis
Kid with sniffles, harsh cough, and fever (38°) moderate indrawing. Wheeze (actually don’t thinkthey mentioned wheeze) with ‘streaming’. Treatment?
Nebulised salbutamol
Baby born at term with no complications, normal weight. Rapid breathing, diagnosis?
Transient tachypnea of newborn
6 week old baby, well, still feeding and gaining weight, has a 3/6 pansystolic murmur at theleft lower sternal border that radiates to the axilla. What initial investigation would you do?
ECHO
Girl with no period yet but cyclical pain and full feeling. Normal secondary sex characteristics.Fluid in uterus and abdomen. Diagnosis?
Imperforate hymen
Strawberry tongue, fever, rash after sore throat
Scarlet fever
Small, irregular spots on buccal/lingual mucosa with blue-white centres
Koplik spots of measles or rubella
