Module 4 Paediatrics

Question 1

Measles signs

Answer 1

CCCK

Cough, Conjunctivitis, Coryza, Kolpik’s spots

Question 2

Slapped cheek

Answer 2

Eythema infectiosum
Parvovirus
worse in adults with heamoglobinopathies

Question 3

Coxsackie

Answer 3

hand-Foot and mouth disease

Question 4

Primary herpes simplex

Answer 4

aka Herpes stomatitis
Cold sore
Eczema herpeticum around eyes

Question 5

Scalded Skin Syndrome

Answer 5

Staph toxin mediated erythroderma

H.Influenza and staph cause peri-orbital cellulitis

Question 6

Beta-hemolytic strep

Answer 6

significant redness and scaling

Erysipelas - scalded looking

Question 7

Strep throat

Answer 7

Strawberry tongue
Red spots except around mouth and nose
This is scarlet fever
Streptococcus treated using penicillins

Make sure rash isn’t mistaken for antibiotic allergy.

Question 8

Fungal skin infections

Answer 8

•	Tinea capitis
•	Tinea (ringworm)
•	Corporis
•	Unguium
•	Cruris
•	Pedis
Ammoniacal Nappy rash – differentiate by crease sparing and lack of satellite lesions – They indicate Candida. Also in mouth and mother’s nipples

Question 9

Congenital toxoplasmosis

Answer 9

Low birth weight
Retinal lesions
Microcephaly
Lesions
Nerve deafness

Question 10

Urticaria

Answer 10

Looks like nettle stings
Causes by heat/cold – 2-5mm
If IgE mediated response more concerning
Can be caused  by a virus/Bacteria
Papular/cholinergic – exercising child

Question 11

Strawberry mark

Answer 11

Cavernous haemangioma

Question 12

Port-wine stain

Answer 12

Capillary haemangioma

Question 13

Most common childhood RTI

Answer 13

RSV (Respiratory syncytial virus) (90% in first winter)

Question 14

Normal baby fluid volume

Answer 14

150ml/kg/day

Question 15

Causes of underfeeding

Answer 15

Malabsorption

underfeeding

Question 16

Separating CMPT to CMPA

Answer 16

CMPA involves vomiting and blood in vomit/faeces

Question 17

When is early weening?

Answer 17

4 - 6 months

Question 18

Normal neonatal jaundice

Answer 18

1 day - 2 weeks, unless preterm in which case2 weeks can result from fluid loss.

Question 19

Investigations in suspicious fracture

Answer 19

Skeletal survey
CT head
blood screen
Ophthalmoscopy

Question 20

Sign of silent reflux

Answer 20

Back arching

Question 21

infantile spasms are caused by…

Answer 21

Steroids

vigabatrin

Question 22

Types of Left to Right shunt in CHD

Answer 22

ASD
VSD
AVSD
PDA

Question 23

ASD signs and symptoms

Answer 23

Asymptomatic when younger
Fixed and widely split S2
Systolic murmur in pulmonary area

Question 24

What causes the symptoms in ASD?

Answer 24

Right heart failure due to overload

Question 25

PDA presentation

Answer 25

``` Preterm Poor feeding FTT Tachypnoea Active precordium, thrill, galloping rhythm easily palpable femoral pulse ``` Classical Continuous machinery murmur in pulmonary area Hepatomegaly and oedema

Question 26

Classic PDA sign

Answer 26

Continuous machinery murmur in pulmonary area

Question 27

VSD signs and symptoms

Answer 27

May be asymptomatic until pulmonary vascular resistance has fallen poor feeding FTT Tachypnoea Active precordium, thrill, galloping pulse pan-systolic murmur heard in LLSE - transmits to upper sternal edge and axillae Hepatomegaly and oedema

Question 28

AVSD Signs and symptoms

Answer 28

If large, no murmur Can rapidly lead to pulmonary vascular disease Poor feeding, FTT, tachypnoea Active precordium, thrill, gallop rhythm Hepatomegaly, pulmonary oedema Murmur arises from valvular regurg, rather than septal defect itself

Question 29

Common CHD in trisomy 21

Answer 29

AVSD

Question 30

management of L-R shunt conditions

Answer 30

Increase calorie intake NG feeds, Diuretics, ACE-i occlusion, either surgical or catheter

Question 31

Types of stenotic CHD

Answer 31

Coarctation of the Aorta Pulmonary stenosis Aorta stenosis

Question 32

Signs and symptoms of coarctation of the Aorta

Answer 32

Weak femoral pulses - especially compared to brachials Difference in pre- and -post ductal saturations Older children have a murmur across the back if collaterals develop If ductus arteriosus closes/is closing, baby collapses/is acidotic

Question 33

Aortic stenosis signs

Answer 33

Weak pulses Palpable thrill in suprasternal region and carotid area Ejection systolic murmur in aortic area If critical - acidotic and collapsed

Question 34

Pulmonary stenosis signs

Answer 34

ES murmur in LUSE If pulmonary branch stenosed, radiates to the back Right ventricular heave if severe

Question 35

Cyanotic heart conditions

Answer 35

Transposition of the great arteries | Tetralogy of Fallot

Question 36

Signs of Transposition of great arteries

Answer 36

Cyanosis Acidosis collapse/death as FO closes

Question 37

Transposition of great arteries management

Answer 37

atrial septostomy at birth. followed by correction of arteries within 1 week to prevent right heart overload

Question 38

Tetralogy of Fallot Comprises of...

Answer 38

Pulmonary artery muscular thickening VSD RV Hypertrophy (deoxygenated blood into left ventricle and aorta) Over-riding of the Aorta ( shifted right)

Question 39

Tetralogy of Fallot features

Answer 39

Cyanosis collapse acidosis possible 22 q deletion

Question 40

Tetralogy of Fallot management

Answer 40

When hyper cyanotic - propanol, BT shunt surgical repair - 6-9 months