Miscellaneous

Question 1

what % of cleft lip/palate is lip, palate and both?

Answer 1

40% lip
15% palate
45% both

Question 2

What are some causes of cleft lip/palate?

Answer 2

Pierre Robin Sequence
Treacher collins
Patau’s
Di George syndrome

Question 3

What is Pierre robin syndrome and the triad of Sx?

Answer 3

Congenital anomaly
1. Micognathia (smaller than normal lower jaw)
2. Glossoptosis (downward displacement of tongue)
3. Cleft palate

Question 4

What is treacher collins?

Answer 4

Auto dominant severe Pierre robin

Question 5

What is Tx for cleft lip/palate?

Answer 5

Staged delayed repair
Lip 3m
palate 6-12m

Question 6

complications of cleft lip/palate?

Answer 6

poor feeding
milk aspiration
speech delay

Question 7

what is hypoglycaemia?

Answer 7

a BM of <2mmol/L

Question 8

When is transient hypoglycaemia common?

Answer 8

Transient hypoglycaemia in first few hrs of birth is common

Question 9

Sx of hypoglycemia?

Answer 9

Jittery
Irritable
cyanotic
Floppy
tremor
lethargic - permanent neurological disability

Question 10

Dx of hypoglycaemia?

Answer 10

heel prick blood test

Question 11

Tx for hypoglycaemia if:
ASx, >2mmol/L?
Sx or 2 or less mmol/L?

Answer 11

encourage feed
IV 10% dextrose

Question 12

What is hypoxic ischemic encephalopathy (HIE) ?

Answer 12

Perfusion reperfusion injury
Brain damage due to antenatal or perinatal hypoxia - brain ischemia

Question 13

Causes of hypoxic ischemic encephalopathy?

Answer 13

Placental abruption
cord compression
Nuchal cord*
Intrapartum haemorrhage*
prolapsed cord

Question 14

What part of the brain is affected by the perfusion reperfusion injury?

Answer 14

Subependymal germinal matrix

Question 15

What staging is used for HIE?

Answer 15

Sarnat staging

Question 16

What Sx are seen in mild HIE?

Answer 16

Resolved in <1day
poor feed
irritability

Question 17

What Sx are seen in moderate HIE?
what % develop cerebral palsy?

Answer 17

Floppy/hypotonic
seizures
40%

Question 18

What Sx are seen in severe HIE?
% develop Cerebral palsy and mortality?

Answer 18

comatose
flaccid
90% CP
5% mortality

Question 19

Dx of HIE?

Answer 19

ABG
Glucose
USS/MRI head

Question 20

Tx of HIE?

Answer 20

ABCDE
Therapeutic hypothermia (<35C for 72hrs)

Question 21

what is criteria A + B for therapeutic hypothermia?

Answer 21

A = APGAR <5 after 10 mins, pH<7
B = Seizures, abnormal tones/reflexes

Question 22

What is a complication of HIE?

Answer 22

Intraventricular haemorrhage (IVH)
may cause focal neurology

Question 23

Tx for intraventricular haemorrhage and long term cognition?

Answer 23

VP shunt
Bad, developmental delay, epilepsy, cerebral palsy

Question 24

what features are seen in fetal alcohol syndrome?

Answer 24

Smooth Philtrum (no ridge on upper lip
Microcephaly (small head)
Hypoplastic upper lip
Small eyes
+/- learning difficulties

Question 25

What is a non accidental injury known as?

Answer 25

child abuse

Question 26

Signs of a non accidental injury?

Answer 26

Multiple bruises at diff healing stages (esp tummy + thighs)
Bruising in non mobile child
Anal fissures
Recurrent UTIs
child/parent behaviour
delayed presentation

Question 27

What Sx are seen in a shaken baby?

Answer 27

Retinal haemorrhages
SDH
Encephalopathy

Question 28

investigations in non accidental injury?

Answer 28

FBC, Clotting screen

Question 29

what is a Ddx for non accidental injury?

Answer 29

ALL
Bleed disorder
ITP

Question 30

what does the child act 2004 state?

Answer 30

child can speak to a Dr without guardian in room

Question 31

If non accidental injury is suspected, what should be done?

Answer 31

Notify child protective services stat