Paediatric 3

Question 1

Severe asthma paeds criteria (5)

Life-threatening criteria (7)

Answer 1

Severe
1. < 92%
2. PEFR 33-50%
3. Cant finsh sentence/ cant feed
4. HR
- >5yo > 125
- 1-5yo > 140
5. RR
- >5yo > 30
- 1-5yo > 40

Life-threat
1. Silent chest
2. < 92%
3. Cyanosis
4. Confusion
5. <33% PEFR
6. Poor resp effort
7. Agitation

Question 2

6 week presents with weak femoral pulses bilaterally what should you do?

Answer 2

Same day discussion- Babies with absent or weak femoral pulses at 6-8 week baby check should be discussed immediately with paediatrics

coarctation of the aorta

Question 3

osteogenesis imperfecta

Question 4

Abdominal x-rays are useful when diagnosing necrotising enterocolitis, as they can show:

Answer 4

dilated bowel loops (often asymmetrical in distribution)
bowel wall oedema
pneumatosis intestinalis (intramural gas)
portal venous gas
pneumoperitoneum resulting from perforation
air both inside and outside of the bowel wall (Rigler sign)
air outlining the falciform ligament (football sign)

Question 5

bacterial meningitis in < 3 months (2)

Bacterial meningitis management in > 3 months (2)

Answer 5

< 3 months
- IV cefotaxime (covers pneumococcal and h.influenza
- Amoxacillin (covers Listeria)
- NO DEX GUVEN IN < 3months!

> 3 months
- IV cefotaxime (covers GBS and h.influenza
= Dexamethasone to decrease ICP

Question 6

What is Ebsteins anomoly?

What drug can cause it in preg?

Answer 6

the posterior leaflets of the tricuspid valve are displaced anteriorly towards the apex of the right ventricle.
- tricuspid regurgitation (pan-systolic murmur) and tricuspid stenosis (mid-diastolic murmur)
-enlargement of the right atrium

Lithium

Question 7

croup pathogen =

acute epiglottitis pathogen =

Answer 7

croup pathogen = Parainfluenza

acute epiglottitis pathogen = Haemophilus influenzae B (HiB) bacteria

Question 8

Women who are between 16-32 weeks pregnant are offered what vaccines?

Answer 8

pertussis and influenza

Question 9

what murmur does TOF have?

Answer 9

Ejection systolic murmur at left sternal edge

Question 10

Whooping cough mangement

Answer 10

azithromycin or clarithromycin if the onset of cough is within the previous 21 days

Question 11

Features of systemic onset JIA (6)

Answer 11

pyrexia
salmon-pink rash (Still’s disease)
lymphadenopathy
arthritis
uveitis
anorexia and weight loss

Question 12

genetic pattern of haemophilia A

Answer 12

There is no male-to-male transmission in X-linked recessive conditions

Question 13

Hand, foot and mouth disease managment

pathogen

Answer 13

symptomatic treatment only, general advice about hydration and analgesia

coxsackie virus A16

Question 14

Umbilical hernias in kids should self resolve by 2-3yo but if they don’t what should you do?

Answer 14

if large or symptomatic perform elective repair at 2-3 years of age. If small and asymptomatic peform elective repair at 4-5 years of age.

Question 15

What is the most common cardiac pathology associated with Duchenne muscular dystrophy

Answer 15

dilated cardiomyopathy

Question 16

Definitions
Neonatal death
Early neonatal death

Stillbirth

Perinatal death

Answer 16

Neonatal death : death within 28 days
Early neonatal death : death within 7 days

Stillbirth : intrauterine death of atleast 24weeks old gestation

Perinatal death : (early neonatal death) + (stillbirth)

Question 17

necrotizing fasciitis secondary to Chickenpox, but what pathogen causes the nec fasc?!

Answer 17

B- haemolytic Group A strep

Question 18

The 6 Fs for develpoment hip dysplasia risk factors

Answer 18

Fat (macrosomia), Female, First Born, Foot-first (Breech), Family history (First-degree) and Fluid low (oligohydramnios)

Question 19

type of vaccine is rota virus?

Answer 19

Rotavirus is an oral, live attenuated vaccine

Question 20

DDH imaging
first-line

if normal age at 6 weeks etc
if child >4.5 months (older) -

Answer 20

if normal age at 6 weeks etc = USS
if child >4.5 months (older) = XRAY