Paediatrics

Question 1

When can most children undress themselves?

Answer 1

4y

Question 2

When can most children jump by?

Answer 2

2y

Question 3

When can most children roll from front to back?

Answer 3

4/12

Question 4

How do we dx CF?

Answer 4

Sweat test

Question 5

How does cow’s milk protein allergy present?

Answer 5

Combination of skin and GI sx

E.g. severe eczema + N&V

Question 6

Tx cow’s milk protein allergy?

Answer 6

Extensively hydrolysed forula

Question 7

What is an atypical UTI in children?

Answer 7

Seriously ill
Poor urine flow
Abdominal or bladder mass
Raised creatinine
Septicaemia
Failure to respond to tx with abx by 48h
Infection by non-E .coli organisms

Question 8

How do we tx UTI in 5y.o.

Answer 8

Trimethoprim first-line
Or nitro

Amoxicillin has high levels of resistance so +ve culture needed

Question 9

What is a common cause of nappy rash? Tx?

Answer 9

Candida albicans
Topical antifungal

Question 10

How do we treat impetigo?

Answer 10

Topical hydrogen peroxide
Second line fusidic acid

Question 11

How do we estimate weight in <=10y.o.?

Answer 11

Weight = (age+4) * 2

Question 12

What is fifth disease otherwise known as?

Answer 12

Erythema infectiosum or slapped cheek syndrome

Question 13

What causes fifth disease?

Answer 13

Parvovirus B19

Question 14

How does fifth disease present?

Answer 14

Rash sparing nasolabial folds
Rash on arms and trunk following sore throat and fevers sx the week before

Question 15

What is acute splenic sequestration?

Answer 15

Life-threatening complication of sickle cell disease
Sudden enlargement of the spleen with a decrease in Hb concn and substanial reticulocytosis

Question 16

How does acute splenic sequestration present?

Answer 16

Shocked, sudden abdo pain and distension, large mass from the left costophrenic angle to the umbilicus

Question 17

How does congenital hypothyroidism present?

Answer 17

Lethargy, poor feeding, constipation, symmetrically poor weight gain, length and head circumference
Sometimes umbilical hernia

Question 18

How does growth hormone deficiency present?

Answer 18

Standing height and growth velocity reduced
Increased subcutaneous fat around the trunk
Pubertal onset delayed

Question 19

How do we test for growth hormone deficiency?

Answer 19

Insulin tolerance test for dx
MRI head to r/o tumour

Question 20

Give a risk factor for necrotizing enterocolitis

Answer 20

Formula feed

Question 21

Where may you see redcurrant stool?

Answer 21

Intussusception

Question 22

What is screened for in the bloodspot test?

Answer 22

Phenylketonuria
Congenital hypothyroidism
Sickle cell
CF
Medium chain acyl-CoA dehydrogenase deficiency

Maple syrup urine disease
Homocystinuria
Glutaric acidaemia type 1
Isovaleric acidaemia

Question 23

Where do you see blast cells?

Answer 23

ALL

Question 24

What is a stork mark?

Answer 24

Pink, flat and irregularly shaped mark on the back of the neck, and/or the forehead, eyelids and sometimes the top lip

Question 25

What is protozoal gastroenteritis?

Answer 25

Consider this if the diarrhoea lasts most than 14 days

Question 26

How does hand, foot and mouth disease present?

Answer 26

Sore throat, dysphagia, pyrexia (up to 39deg), vesicles in oral cavity, hands and feet

Question 27

What are the TORCH infections?

Answer 27

Pass from mother to foetus during childbirth Toxoplasma gondii Other agents Rubella Cytomegalovirus (CMV) Herpes simplex virus Other agents incl. treponema pallidum, VZV, parvovirus B19, Zika virus

Question 28

What is the most common childhood epilepsy?

Answer 28

Benign rolandic epilepsy - partial - usually resolve by adolescence

Question 29

Why do we treat neonatal jaundice?

Answer 29

Avoid neurotoxicity

Question 30

What is ECMO? What is it used for?

Answer 30

Extracorporeal membrane oxygenation Technique to provide both cardiac and respiratory support oxygen to pts whose lungs are severely dysfunctional e.g. in RDS or Primary Pulmonary Hypertension

Question 31

What causes roseola infantum?

Answer 31

HHV-6 - supportive tx

Question 32

Where would you see abdominal breathing?

Answer 32

Normal in infants

Question 33

How do we initially support newborn babies after delivery?

Answer 33

Warm and stimulate by rubbing (vast majority of infants respond to just these two manouvres)

Question 34

What is Riedel's lobe?

Answer 34

Downward tongue-like projection of the anterior edge of the right liver lobe to the right of the gallbladder, seen most frequently in the liver. Sometimes can extend down to the RIF! Normal variant

Question 35

In which population is RDS more common in?

Answer 35

Males

Question 36

Where do you see the double bubble sign?

Answer 36

Duodenal atresia

Question 37

How does duodenal atresia present?

Answer 37

Vomiting within first 24hrs of life, absence of breath sounds, scaphoid abdomen

Question 38

How does Hirschsprung disease present?

Answer 38

One year old child with a PMH of delayed passage of meconium presents with constipation and vomiting

Question 39

Where do you see a thumbprint sign on CXR?

Answer 39

Epiglottitis

Question 40

How do we treat epiglottitis?

Answer 40

Third gen cephalosporin e.g. cefotaxime

Question 41

How do we catch a urine sample in a young child?

Answer 41

Clean catch urine

Question 42

What is erythema toxicum neonatorum?

Answer 42

Toxic erythema of the newborn Harmless red rash that occurs on the skin of newborns

Question 43

How do we treat erythema toxicum neonatorum?

Answer 43

Self-limiting

Question 44

How do we investigate henoch-schonlein purpura?

Answer 44

Urine dipstick looking for blood or protein in urine Refer to secondary care

Question 45

What is haemorrhagic disease of the newborn?

Answer 45

Vitamin K deficiency bleeding

Question 46

Where do you see dermatitis herpetiformis?

Answer 46

Coeliac disease - it results as a form of gluten causes inflammation

Question 47

What is DIC?

Answer 47

Activation of the coagulation system leads to deposition of fibrin throughout the circulation, further compromising organ and tissue perfusion. It also leads to consumption of platelets and clotting factors, as they are being used up to form the blood clots. This leads to thrombocytopenia, haemorrhages and an inability to form clots and stop bleeding. This is called disseminated intravascular coagulopathy (DIC).