Paediatrics

Question 1

When is jaundice pathological in the newborn?

Answer 1

When within 24hrs

Question 2

What causes Perthe’s disease?

Answer 2

More common at 4-8 years
Due to avascular necrosis of the femoral head

Question 3

What causes SUFE?

Answer 3

10-15 years - Displacement of the femoral head epiphysis postero-inferiorly

Question 4

What is the most important treatment for prevention of neonatal respiratory distress syndrome?

Answer 4

Administer dexamethasone to the mother

Question 5

How does intussuception present, and how do we investigate it?

Answer 5

An infant with inconsolable crying, drawing legs up to the abdomen associated with pallor, vomiting → ?intussusception

US

Question 6

What is caput succadaenum?

Answer 6

Caput succedaneum is a swelling due to pressure of the presenting part on the cervix. It is present from birth with poor margins and crosses suture lines. It typically resolves in 1-2days and does not usually require treatment.

Question 7

A 6-week-old baby boy presents to his GP with symptoms of regurgitation and vomiting after feeding. His mother also reports ongoing issues with diarrhoea. Formula fed. What should we advise?

Answer 7

If a formula-fed baby is suspected of having mild-moderate cow’s milk protein intolerance then a extensive hydrolysed formula should be tried

Question 8

How does acute epiglottitis present?

Answer 8

When you attend you find the patient sat on his mothers knee leaning forward and drooling. There is audible stridor from the end of the bed.

Question 9

What causes epiglottitis?

Answer 9

Haemophilus influenzae type B

Question 10

How does measles present?

Answer 10

Measles is characterised by prodromal symptoms, Koplik spots. maculopapular rash starting behind the ears and conjunctivitis

Question 11

What is Kocher’s criteria?

Answer 11

Kocher’s criteria is used to assess the probability of septic arthritis in children using 4 parameters:
Non-weight bearing - 1 point
Fever >38.5ºC - 1 point
WCC >12 * 109/L - 1 point
ESR >40mm/hr

Question 12

How does Kawasaki’s disease presnet?

Answer 12

High fever lasting >5 days, red palms with desquamation and strawberry tongue are indicative of Kawasaki disease

Question 13

Define precocious puberty

Answer 13

Precocious puberty is the development of secondary sexual characteristics before 8 years in girls and 9 years in boys

Question 14

When is croup most commonly diagnosed?

Answer 14

Whereas the peak incidence of croup is 6 months -3 years, bronchiolitis is seen in 1-9 month olds

Question 15

How do we treat croup?

Answer 15

Oral dex

Question 16

At what age would the average child acquire the ability to sit without support?

Answer 16

6-8m

Question 17

How does TTN and RDS differ?

Answer 17

TTN is caused by a delay in the clearance of lung fluid, which is naturally present in utero. It is more commonly seen in babies born via Caesarean section and presents with tachypnoea soon after delivery that settles within a few hours.

RDS presents with features of respiratory distress soon after delivery, which get progressively worse without treatment. It occurs due to surfactant deficiency and causes alveolar collapse after expiration. It is most commonly seen in premature and low birth weight babies.

Question 18

How does necrotising enterocolitis present?

Answer 18

Early signs of necrotising enterocolitis: feeding intolerance, abdominal distension and bloody stools

Question 19

What is the inheritance pattern in CF?

Answer 19

Autosomal recessive

Question 20

What is pavalizumab?

Answer 20

Palivizumab is a monoclonal antibody which is used to prevent respiratory syncytial virus (RSV) in children who are at increased risk of severe disease.

Question 21

What is physiological neonatal vaginal discharge?

Answer 21

White vaginal discharge - This occurs as a result of maternal oestrogen crossing the placenta before birth, stimulating the baby’s vaginal mucosa to proliferate and secrete mucus. It usually resolves spontaneously within a few days to weeks after birth without any intervention.

Question 22

A mother brings in her 6-year-old boy who complains of ‘an itchy bottom’ at night. He is otherwise systemically well, developing normally and denies any change in his bowel habit. An external examination of the anus is unremarkable.

Which one of the following is the most likely cause?

Answer 22

Threadworm

Question 23

What causes scarlet fever?

Answer 23

Scarlet fever, also known as scarlatina, is primarily caused by group A beta-haemolytic streptococci (GABHS), specifically the bacterium Streptococcus pyogenes

Question 24

How does scarlet fever present?

Answer 24

The disease mainly affects children and presents with a sore throat, fever, strawberry tongue and a fine sandpaper-like rash.

Question 25

Children under what age are not legally able to consent to sex?

Answer 25

Children under the age of 13 years are not able to consent to sexual intercourse and hence any sexual activity would be regarded as rape under the law. This is one situation under the GMC guidelines where you are compelled to break confidentiality

Question 26

How does Edward’s syndrome (trisomy 18) present?

Answer 26

A baby is born with micrognathia, low-set ears, rocker bottom feet and overlapping of fingers - Edward’s syndrome