MLA Child health

Question 1

Which inherited diseases cause anaemia?

Answer 1

Sickle cell
Fanconi anaemia (bone marrow failure)
Thalassemia (haemoglobin deficiency)

Question 2

What is the dose on adrenaline for anaphylaxis compared to cardiac arrest?

Answer 2

Anaphylaxis (IM)
- 1:1000 solution
- If persistent, can be given as IV infusion

Cardiac arrest (IV)
- 1mg of 1:10,000 solution dose every 3-5 minutes

Question 3

How does IM Adrenaline resolve anaphylaxis?

Answer 3

It improves circulation, reduces swelling, and improves general symptoms through the fight or flight response

Question 4

What is the management of ADHD in children?

Answer 4

Combination of meds and talking therapy

1st line: methylphenidate
2nd line: Lisdexamfetamine

Question 5

What are some side effects of medications for ADHD?

Answer 5

Low mood
Low BP
Nausea/vomiting
Decreased appetite
Headaches

Question 6

What are the symptoms of ADHD?

Answer 6

Inattention, hyperactivity. and impulsivity

Question 7

What is biliary atresia?

Answer 7

Blockage in the bile ducts because they didn’t form properly during pregnancy

Presents as jaundice and pale stool in the first 4-8 weeks of life

Question 8

What is the management of biliary atresia?

Answer 8

1st line: Kasai procedure which restores bile flow. Done before 8 weeks old

May need liver transplant if there is cirrhosis

Cannot be managed conservatively

Question 9

What are some complications of biliary atresia?

Answer 9

Liver damage (cirrhosis) then failure
Portal hypertension
Ascites
Malnutrition
Sepsis

Question 10

What is bronchiectasis?

Answer 10

Chronic lung disease that causes lungs to be widened and damaged causing mucus build up and increased risk of infection

Symptoms: chronic cough, recurrent chest infections, fatigue

Caused by infections, allergies, autoimmune diseases, cystic fibrosis

Question 11

What is bronchiolitis?

Answer 11

Inflammation of the bronchi

<2, most commonly RSV

Question 12

What are the different types of cerebral palsy?

Answer 12

4 types:
- spastic (most common). Causes awkward movements due to increased muscle tone
- Dyskinetic. Difficulty controlling movements
- Ataxic (least common). Loss of balance and coordination
- Mixed cerebral palsy

Question 13

What is cerebral palsy?

Answer 13

Non-progressive, permanent difficulty controlling muscles due to abnormal brain development or brain damage

Causes: prematurity, infections, lack of oxygen, injury, haemorrhage, toxins

Question 14

What is the management of cerebral palsy?

Answer 14

MDT approach
- Physiotherapy
- SALT
- Dieticians
- Drug treatment for symptoms
- Surgical correction of hip displacement

Question 15

Which medications are used to manage symptoms of cerebral palsy?

Answer 15

• Hyoscine hydrobromide or glyclopyrronium bromide for drooling
• Diazepam for pain
• Baclofen for hypertonia
• Botox for spasticity

Question 16

What are the clinical features of cerebral palsy?

Answer 16

Delayed motor mile stones
Floppiness or stiffness
Abnormal movements
Feeding issues
Persistent toe walking

Doesn’t progress so consider alterative diagnosis of symptoms are getting worse

Question 17

Which scoring systems are used to classify cerebral palsy?

Answer 17

Gross motor function classification system (GMFCS) and bimanual fine motor function (BFMF) test for upper limbs

Question 18

What is the definitions of hypertonia?

Answer 18

Increased resistance in muscles

Question 19

What is the definition of spasticity?

Answer 19

Stiffness that is velocity dependent

The faster you move the limb, the more stiff it will become

Question 20

What is the definition of dystonia?

Answer 20

Abnormal postures that are worse with intention. It can be observed

Question 21

What are some complications of cerebral palsy?

Answer 21

It’s non-progressive but some will become more apparent with age

• Feeding and aspiration issues
• Drooling
• Constipation
• Visual/hearing impairment
• Epilepsy
• Learning disability
• Speech problems
• Osteopenia and osteoporosis especially if non-mobile
• Sleep disturbance

Question 22

What is hypoxic-ischaemic encephalopathy?

Answer 22

When the babies brain is not receiving enough oxygen or blood flow at the time of birth
- Common cause of cerebral palsy

Question 23

What causes chronic kidney disease in children?

Answer 23

• Congenital urological abnormalities
• Haemolytic uremic syndrome (HUS)
• Glomerular disease
• Sepsis
• Autoimmune diseases

Question 24

What is the clinical presentation of cystic fibrosis?

Answer 24

Resp: chronic cough, wheezing, SOB, frequent lung infections

Digestive: chronic diarrhoea, constipation, intestinal blockage, greasy stool, inability to gain weight

Skin: salty skin and sweat

Growth: slow growth, short stature

Other: clubbing, delayed puberty, fertility problems, muscle and joint pain