Mock 2 Flashcards
What is the initial treatment for DKA if the child who presented to A&E with nausea and vomiting, is clinically dehydrated and is now not alert?
IV fluids (0.9% NaCl 10 ml/kg) + SC insulin (0.2units/kg/hr)
Aside from hyperglycaemia, acidosis and ketonaemia, which other abnormality may be seen on blood investigation of DKA prior to treatment?
Mildly raised creatinine
Why does hyperkalaemia occur in DKA ?
Acidosis and lack of insulin means K+ is not moved into cells
Note once insulin and IV fluids have been given K+ levels will fall and should be monitored to avoid hypos
A 9-year-old, has been experiencing a fever, cough and runny nose for the last few days. However, this morning, his dad said that he noticed a rash that started behind his ears and has spread down over his body. He seems very unsettled, and his fever has been getting progressively higher and is now at 39 degrees. What is the likely diagnosis?
Measles
Clinical features of Turner Syndrome
Hypothyroidism
Congenital heart defects
Short statue
Webbed neck
Widely spaced nipples
Which three vaccines should a baby receive at 8 weeks old?
6 in 1 + rotavirus + MenB
Which vaccines should an infant receive at 12 weeks
6 in 1 (again) rotavirus (again), pneumococcal
Which vaccines should an infant receive at 16 weeks
6 in 1 (again) Men B (again)
Which vaccines should an infant receive at 1 year
Men B (again), pneumococcal (again), HiB, Men C and MMR
First line treatment for oligoarticular JIA
Intra-articular steroid injection
Used as a bridging agent when starting methotrexate
When is methotrexate more effective ?
Polyarthritis (useful)
What should be monitored for a child of methotrexate ?
Liver function
Bone marrow suppression
What is chronic anterior uveitis a complication of ?
Junior idiopathic arthritis
Seen in 33% of cases
Child with JIA are screened every 3 months as hard to pick up
What drugs can cause Stephen-Johnson syndrome?
Allopurinol
Lamotrigine
Penicillin
Phenytoin
What is Stephen-Johnson syndrome ?
A rare condition arising from ‘over-reaction’ of the immune system to a trigger such as a mild infection or a medicine, leading to blistering and peeling of the skin and surfaces of the eyes, mouth and throat.
Associated with a red/purple target like rash that spread and forms blisters
The mucous membranes of the mouth may also become blistered and ulcerated
At what age will a baby raise its head to 45 degrees from horizontal, follow moving objects by turning their head and smile responsively?
6 weeks
A 13-year-old male presents to his GP along with his mother. His mother describes her son appearing distant at times and falling behind at school, despite being very bright. She reports his attention as being generally poor. She describes him being clumsy in the morning and often dropping his breakfast. She noticed him jerking this morning and decided to get it checked out. What is the most likely diagnosis?
Juvenile Myoclonic epilepsy
Typical age of onset for juvenile myoclonic epilepsy ?
10–20 years
Typical features of juvenile myoclonic epilepsy
Myoclonic jerks up to 2 hours after waking up
Period of absence which disrupt school but learning is normal
You assess an 8-year-old boy in your paediatrics clinic who was referred by his GP. The referring letter states his mother has described a classic presentation of seizures, having had 3 to date. There is also a family history of epilepsy. You take a history and perform a thorough neurological examination, which is all normal. You agree that he is likely to be having seizures. What is the most appropriate first step?
Request an EEG and follow up when results are back
Complications of chickenpox
Bacterial superinfection
Cerebellitis
Disseminated intravascular coagulation
Progressive disseminated disease
How would the CSF appear in bacterial meningitis
Turbid appearance, raised polymorphs, raised protein and low glucose
How would the CSF appear in viral meningitis
Clear appearance, raised lymphocytes, raised or normal protein, normal/low glucose
How would the CSF appear in encephalitis
Clear appearance, normal/raised lymphocytes, normal/raised protein, normal/low glucose