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Paediatrics Flashcards

1
Q

Neonate with VSD, overriding aorta and infundibular stenosis

A

Tetralogy of Fallot

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2
Q

CXR: reticulonodular shadowing in neonate

A

Bacterial pneumonia

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3
Q

Widespread blanching maculopapular rash with spots of different sizes sparing the head and neck

A

Meningococcal sepsis

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4
Q

Intermittent high fever
Widespread evanescent salmon-pink rash
Can’t weight bear

A

JIA (systemic arthritis)

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5
Q

Quiet systolic murmur best heard at the upper left sternal edge.
The second heart sound is widely split

A

Atrial septal defect

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6
Q

Increased pigmentation of the areolar and nipples bilaterally

A

Congenital adrenal hyperplasia

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7
Q

Most common cause of failure to pass meconium

A

Meconium Plug Syndrome = transient immaturity of gut –> can’t move a plug of meconium along
-Treatment: anal stimulation with glycerine chip

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8
Q

Lactose intolerance caused by deficiency in which enzyme?

A

Lactose dehydrogenase

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9
Q

Puffy feet at birth (with widely-spaced nipples and absent femoral pulses)

A

Turner’s Syndrome

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10
Q

Caused by deficiency in galactose-1-phosphate uridyl transferase

A

Galactosaemia

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11
Q

Ill after drink lactose-containing milks –> recurrent E. coli sepsis and cataracts
Urine-reducing substances in urine

A

Galactosaemia

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12
Q

Dizziness, SOB and fainting –> ECG shows delta wave

A

Wolff-Parkinson-White Syndrome (spontaneous re-entry tachycardia/SVT)

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13
Q

Brain MRI shows subependymal calcifications and hypointense white matter lesions

A

Tuberous Sclerosis

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14
Q

Brain MRI shows many hyperintense, inflammatory white matter lesions

A

MS

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15
Q

Sandpaper skin, erythematous rash

Red tongue

A

Scarlet Fever

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16
Q

Single transverse palmar crease
Almond-shaped eyes
Protruding tongue

A

Down’s Syndrome

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17
Q

Tight Achilles tendon –> clonus

Clasp-knife response (resistance when flex arm, until it suddenly gives way)

A

Spastic Cerebral Palsy

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18
Q

Tiptoe walk

A

Unilateral (hemiplegic) Cerebral Palsy

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19
Q

Scissoring gait

A

Bilateral (quadriplegic) Cerebral Palsy

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20
Q

Formula for mid-parental height

A

Mean of parents height –> +7 for boy/-7 for girl

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21
Q

Short legs, normal torso

A 
Skeletal Dysplasia (achondroplasia)
-->calculate Subischial Leg Length = Total Height - Sitting Height
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22
Q

Commonest cause of delayed puberty

A

Constitutional Delay

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23
Q

Crescent Sign on Abdo X-Ray

Target Sign on Abdo US

A

Intussusception

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24
Q

Appendicitis with generalised guarding

A

Perforation

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25
Q

Colicky abdominal pain – pale around mouth during pain

Redcurrant jelly stool

A

Intussusception

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26
Q

Gram -ve bacillus which causes mesenteric adenitis

A

Yersinia enterocolitica

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27
Q

Olive-like mass in RUQ

A

Pyloric Stenosis

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28
Q

Constipation then diarrhoea –> pass loose, smelly stools without child realising

A

“Overflow soiling” in faecal impaction

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29
Q

Down Syndrome associated with which large bowel disease?

A

Hirschsprung Disease

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30
Q

Main cause of encopresis (soil yourself)

A

Chronic constipation

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31
Q

Cry during defecation

A

Anal fissure

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32
Q

 Periumbilical abdo pain – relieved by pooing
 Alternate between constipation and diarrhoea
 Feeling of incomplete defecation

A

IBS

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33
Q

Epigastric pain wakes them at night and radiates through back

A

Peptic Ulcers

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34
Q

Main diagnostic test for peptic ulcers

A

Carbon-13 urea breath test (swallow urea labelled with 13C–> wait 30 mins –> detected 13CO2 in breath = shows that H. pylori is present, making urease)

Also do stool antigen for H. pylori

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35
Q

Connects right and left atria during pregnancy

A

Foramen ovale

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36
Q

Connects pulmonary artery to aorta during pregnancy

A

Ductus arteriosus

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37
Q
  • Ejection systolic murmur at left sternal edge

- Widely-split S2

A

Atrial Septal Defect

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38
Q
  • Pansystolic murmur at left sternal edge
A

Ventricular Septal Defect

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39
Q
  • Continuous murmur beneath left clavicle

- Bounding pulse (pulse pressure increased)

A

Persistent Ductus Arteriosus

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40
Q
  • Hypercyanotic spells: severe SOB, pallor, crying
  • Clubbing in fingers and toes in older kids
  • Harsh ejection systolic murmur at left sternal
A

Tetralogy of Fallot

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41
Q
  • Cyanosis from day 2 (ductal closure = less mixing)
  • Loud 2nd heart sound
  • CXR: narrow upper mediastinum, with “egg on string” appearance of cardiac shadow
A

Transposition of Great Arteries

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42
Q
  • Cyanosis at birth –> heart failure at 2 weeks
  • Superior axis on ECG
  • Common in Down Syndrome
A

Atrioventricular Septal Defect

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43
Q
  • Ejection systolic + click at upper left sternal edge
A

Pulmonary Stenosis

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44
Q
  • Absent femoral pulses

- Shock/cyanosis at 2 days when duct closes

A

Coarctation of Aorta

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45
Q

Strawberry tongue
Peeling skin
Cervical lymphadenopathy

A

Kawasaki Disease

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46
Q

Causes testicular torsion

A

“Clapper Bell” Testis = undescended testis lying transversely

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47
Q

Cottage-cheese discharge on penis glans

A

Smegma

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48
Q

Phimosis (pathologically non-retractile foreskin) caused by?

A

Balanitis Xerotica Obliterans (BSO) = lichen sclerosus in penis!

Treatment: topical betamethasone

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49
Q

Dark patch on armpit of diabetic

A

Acanthosis Nigrans (shows insulin resistance)

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50
Q

Commonest cause of congenital hypothyroidism in UK

A

Maldescent of thyroid

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51
Q

Overlapping fingers
“Rocker-bottom” feet (like rocking chair)
Small chin

A

Edwards Syndrome (Trisomy 18)

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52
Q

Clitoral hypertrophy and fusion of labia

A

Congenital Adrenal Hyperplasia

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53
Q

Faltering growth, large tongue and goitre

A

Congenital hypothyroidism

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54
Q

Polydactyly (extra fingers)
Cleft lip and palate
Small eyes

A

Patau Syndrome (Trisomy 13)

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55
Q

Small testicles
Gynaecomastia
Tall and weak

A

Klinefelter Syndrome (47, XXY)

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56
Q

Prader-Willi affects which chromosome?

A

Chr 15 (imprinting = uniparental disomy)

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57
Q

Diagnostic test for Prader-Willi

A

DNA-methylation testing = absence of paternal PWS region

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58
Q

Wide-spaced and down-slanting eyes
Short stature
Pectus excavatum

A

Noonan Syndrome

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59
Q

Heart murmur in Noonan Syndrome

A

Pulmonary stenosis

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60
Q
  1. Most common all-cause of death <5yrs

2. Most common infectious cause of death <5yrs

A
  1. Prematurity

2. Pneumonia

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61
Q

When would you use electronic thermometer in axilla?

A

<4 weeks (use tympanic for older)

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62
Q

Causes of early-onset sepsis

A

Group B Strep and E. coli

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63
Q

Bulging fontanelle and opisthotonos (hyperextension of neck/back) in neonate

A

Neonatal Meningitis

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64
Q

Treatment of early-onset sepsis

A

IV benzylpenicillin + gentamicin

Add cefotaxime if Gram -ve sepsis

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65
Q

Causes of late-onset sepsis

A

Staph epidermis (coagulase-negative staph)

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66
Q

Treatment of late-onset sepsis

A

Flucloxacillin + gentamicin

add vancomycin for staph epidermis

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67
Q

What is Brudzinski Sign?

A

In meningitis: child supine – neck flexion causes hip/knees flexion

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68
Q

What is Kernig Sign?

A

In meningitis: child supine and hips/knees flexed – back pain when extend knee

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69
Q

Main cause of viral meningitis

A

90% enterovirus (Coxsackie Group B)

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70
Q

Treatment of encephalitis

A

IV aciclovir

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71
Q

Painful white pustules on fingers (esp on broken skin)

A

Herpetic Whitlow

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72
Q

When can kids go back to school after chickenpox

A

5 days after rash onset (infectious until all lesions dry and crusted)

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73
Q

GP gives abx for the fever –> generalised macular rash appears –> he mistakenly thinks it is an allergic reaction

A 
Roseola Infantum (Exanthema Subitum) - caused by HHV6
-get rash after fever subsides, it's nothing to do with the abx!
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74
Q

Lace-like rash on trunk/limbs

A

Erythema Infectiosum (“Slapped-Cheek Syndrome”) = Human Parvovirus B19

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75
Q
  • Maculopapular rash: face –> spreads centrifugally across body
  • Suboccipital and postauricular lymphadenopathy
  • Mild prodrome: fever <39, headache, malaise
A

Rubella

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76
Q

1st-line management of iron-deficiency anaemia

A

Dietary advice and oral iron
• Sytron (sodium iron edetate) or Niferex (polysaccharide iron complex)
–> continue for 3 months after Hb normal – should rise by 10 a week

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77
Q

Genetics of Sickle Cell

A

Mutation in codon 6 of β-globin gene = glutamate to valine

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78
Q

Drug given to kids with recurrent vaso-occlusive crises

A

Hydroxycarbamide (increases HbF)

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79
Q

Easy bruising/bleeding after viral infection

A

Immune Thrombocytopenic Purpura (ITP)

–> most self-resolve within 8 weeks

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80
Q

Adrenaline doses for anaphylaxis

A

IM Adrenaline 1:1000
 0-6yrs: 0.15mL
 6-12yrs: 0.30mL
 12+yrs: 0.5mL

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81
Q

Lactose intolerance caused by deficiency in which enzyme?

A

LACTOSE dehydrogenase

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82
Q

Commonest cause of viral conjunctivitis

A

Adenovirus = 80%

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83
Q

Conjunctivitis with lots of discharge

A

Gonorrhoae

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84
Q

White pupillary reflex (leukocoria) and squint

A

Retinoblastoma

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85
Q

Mutation associated with retinoblastoma

A

RB1 mutation (chr 13)

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86
Q

Difference between Barlow and Ortolani tests?

A

o Barlow Test: push hip forward and in–> it dislocates

o Ortolani Test: pull hip back and out–> it relocates

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87
Q

Asymmetrical skin folds around hip

A

Developmental Dysplasia of the Hip

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88
Q

Osteomyelitis is infection of which part of bone?

A

Metaphysis

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89
Q

Knee pain after exercise in sporty adolescent

A

Osgood-Schlatter Disease = osteochondritis of the patellar tendon’s insertion into knee

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90
Q

Persistent knee pain + local tenderness over femoral condyles in very sporty adolescent

A

Osteochondritis Dissecans = avascular necrosis –> piece of bone and cartilage separates from medial femoral condyle in femur

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91
Q

Blue sclera and bones easily break

A

Oteogenesis imperfecta

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92
Q

How to differentiate between transient synovitis and septic arthritis?

A 
Kocher Criteria 
o	Non weight-bearing on affected side
o	ESR>40
o	Fever >38.5
o	WCC>12,000
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93
Q

Most common cause of joint pain in kids

A

Reactive Arthritis (Reiter’s Syndrome)

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94
Q

Joint pain and salmon-pink macular rash

A

JIA (Systemic Arthritis)

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95
Q

Key diagnostic test for Hypoxic-Ischaemic Encephalopathy

A

Amplitude-integrated EEG

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96
Q

CXR in neonate shows diffuse “ground-glass” appearance

A

Respiratory Distress Syndrome

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97
Q

CXR in neonate shows “widespread opacification”

A

Bronchopulmonary Dysplasia

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98
Q

Antibiotics used in necrotizing enterocolitis

A

Amoxicillin, gentamicin and metronidazole

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99
Q

CXR in neonate shows fluid in horizontal fissure. Baby is term born

A

Transient Tachypnoea of Newborn (TTN)

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100
Q

Central cyanosis in otherwise well baby

A

Congenital Heart Disease

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101
Q

Which type of seizure gives EEG with 3 spike waves per second in all leads?

A

Absence seizure

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102
Q

Epilepsy drug which induces liver enzymes

A

Carbamazepine

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103
Q

Infantile spasms have what EEG appearance?

A

Hypsarrhythmia = chaotic brain activity

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104
Q

Waddling gait, calves very big

A

Duchenne Muscular Dystrophy (big calves = pseudohypertrophy)

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105
Q

What is genetic mechanism underlying Duchenne?

A

Deletion of dystrophin gene (connects cytoskeleton of muscle fibre to surrounding ECM)

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106
Q

Newborn born with hypotonia

Club foot/talipes (feet point down and in, soles face back)

A

Myotonic Muscular Dystrophy

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107
Q

Head trauma –> lose consciousness, have lucid interval, then lose consciousness again

A

Extradural Haemorrhage

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108
Q

Type of brain haemorrhage with retinal haemorrhages

A

Subdural Haemorrhage

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109
Q

LP shows xanthochromia (yellow CSF)

A

Intraventricular Hamorrhage

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110
Q

Setting-Sun Sign (eyes deviate down)

A

Hydrocephalus

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111
Q

Lisch Nodule

A

Neurofibromatosis Type 1

Lisch Nodule = haemoatoma of iris

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112
Q

Depigmented ash-leaf patches

A

Tuberous Sclerosis

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113
Q

MRI brain shows subependymal calcified nodules

A

Tuberous Sclerosis

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114
Q

Skull X-Ray shows railroad track calcification of gyri

A

Sturge-Weber Syndrome

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115
Q

Neurological disease causing panda eyes

A

Neuroblastoma

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116
Q

CXR shows bowel loops in chest

A

Diaphragmatic Hernia

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117
Q

Important complication of Diaphragmatic Hernia

A

Pulmonary hypoplasia = herniated abdo organs compress lungs during pregnancy –> lung have not developed

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118
Q

Drug class causing cleft lip/palate

A

Anticonvulsants (phenytoin)

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119
Q

Confirmatory diagnostic test of oesophageal atresia

A

Birth: pass wide-calibre feeding tube –> X-Ray shows it doesn’t reach stomach

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120
Q

Down Syndrome associated with which congenital GI abnormality?

A

Duodenal Atresia

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121
Q

Confirmatory diagnostic test of biliary atresia

A

ERCP: abnormal biliary tree

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122
Q

First-line management of biliary atresia

A

Kasai hepatoportoenterostomy (HPE): attach loop of jejunum to porta hepatis (area of liver from which bile drains)

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123
Q

Organism causing UTI in structural abnormality/catheter

A

Pseudomonas

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124
Q

Management of UTI in <3 months/septic

A

Hospital ASAP
o IV co-amoxiclav for 7 days
o Then oral prophylaxis

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125
Q

Periorbital swelling and puffy face on waking

A

Nephrotic Syndrome (also ask for frothy urine!)

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126
Q

What is Alport Syndrome?

A

Familial Nephritis: X-linked recessive-

  1. GBM degeneration –> end-stage renal failure in young men
  2. Sensorineural deafness
  3. Eye changes
127
Q

Kidney tumour with mixed tissue densities (cystic and solid)

A

Nephroblastoma

128
Q

Commonest cause of stridor

129
Q

Main cause of croup

A

Parainfluenza

130
Q

Dose of oral dexamethasone needed for croup

131
Q

Add-on therapy for asthma in

  1. <5yrs
  2. > 5yrs
A
  1. LTRA

2. LABA

132
Q

Dose of prednisolone for acute asthma (and max dose)

A

1-2mg/kg –> max 40mg

133
Q

Cause of Whooping Cough

A

Bordetella Pertussis (bacteria)

134
Q

Treatment of Whooping Cough

A

Clarithromycin (if cough started in last 21 days)

135
Q

What is seen on heel-prick test in CF?

A

Raised immunoreactive trypsinogen (IRT)

136
Q

Omega-shaped larynx

A

Laryngomalacia

137
Q

Sore throat –> red goose pimples rash (punctate “pinhead” erythema) –> strawberry tongue

A

Scarlet Fever (usually strep pyogenes = Group A beta haemolytic strep)

138
Q

Intensely painful throat
Saliva drools down chin (can’t swallow or speak)
Inspiratory stridor –> sit forward to maximise airway

A

Epiglottitis

139
Q

Cause of epiglottitis

A

Haemophilus influenza type B (HiB)

140
Q

Sore throat with hoarseness

A

Laryngitis

141
Q

Lateral neck X-ray shows “thumbprint sign”

A

Epiglottitis

142
Q

Child tugging at ear all the time

A

Acute Otitis Media (ask this in any infection history!)

143
Q

Antibiotic used for otitis media

A

Amoxicillin for 5 days (give if does not improve with analgesia after 3 days)

144
Q

Otoscopy shows dull and retracted ear drum

A

Otitis Media with Effusion (“Glue Ear”)

145
Q

Red, eczematous ear –> pain worse when tragus/pinna moved

A

Otitis Externa (“Swimmer’s Ear”)

146
Q

Have a cold –> increase in symptoms after 5 days/persistence after 10 days

147
Q

Liver US shows echogenic liver

A

Non-Alcoholic Fatty Liver Disease (echogenic = fat infiltration)

148
Q

Treatment of Wilson’s Disease

A

Penicillamine or trientine = increase urine copper excretion

Also zinc reduces copper absorption

149
Q

White pimples on nose, cheeks, eyes in newborn

A

Milia = retention of keratin and sebaceous material in pilosebaceous follicles

150
Q

Nappy rash which spares flexures

A

Irritant contact dermatitis (differentiates from other types of nappy rash)

151
Q

Nappy rash with satellite lesions

152
Q

Well-defined erythematous scaly patches on scalp

A

Seborrheic Dermatitis

153
Q

Cause of seborrheic dermatitis

A

Malassezia yeast = commensal skin yeast

154
Q

Thick yellow scaly on scalp, eyebrows, behind ears

A

Seborrheic Dermatitis

155
Q

Pearly skin-coloured lesions with central umbilication

A

Molluscum Contagiosum

156
Q

Ring-shaped skin lesions, with central sparing

A

Tinea (ringworm)

157
Q

Separation of nail from nail bed

A

Onychomycosis (tinea of nail)

158
Q

Diagnostic test for tinea capitis (scalp)

A

Examine under Wood’s Light (filtered UV) = infected hairs are fluorescent

159
Q

X-Ray shows “champagne glass wrist”

A

Rickets (cupping/splaying/fraying of metaphysis)

160
Q

Management of malnutrition in alert child with appetite

A

Ready-To-Use Therapeutic Food (RUTF) = peanut butter mixed with dried skimmed milk and vitamins

161
Q

Nutrition deficiency in baby breastfed for long time

A

Vitamin D Deficiency = Nutritional Rickets (formula milk supplemented with vitamin D)

162
Q 
Oedema with distended abdomen
"Flaky-paint" skin rash
Depigmented hair (red in black kids)
A

Kwashiorkor

163
Q

Parietal bones feel like pressing a ping-pong ball
Costochondral junctions palpable

Wrists widened in crawling
Ankles widened in walking

164
Q

Can Gillick-competent child refuse treatment by themself?

A

No - need parental responsibility

165
Q

What age is capacity presumed?

166
Q

What age can you refuse treatment?

167
Q

Child with limp. X-Ray shows increased density in femoral head

A

Perthes Disease (disrupted blood supply to femoral head)

168
Q

Delta wave in all QRS complexes

Slanting upstroke of R wave

A

Wolff-Parkinson-White Syndrome = re-entry tachycardia due to accessory pathway between atria and ventricles

169
Q

Low-set ears, cleft palate, murmur.

With hypocalcaemia

A

Di George syndrome

170
Q

5yo with fever + red tongue, flushed face, “pinhead” erythematous rash with sandpaper texture
(Tongue can have white coating on it)

A

Scarlet Fever

171
Q

Child screaming in pain, drawing up knees to chest

A

Intussusception

172
Q

Upslanting palpebral fissures and flat occiput

A

Down Syndrome

173
Q

Baby who vomits a lot but is still hungry

A

Pyloric Stenosis

174
Q

Neonate not passed meconium –> PR releases liquid stool

A

Hirschprung Disease

175
Q

Child with small head, flattened philtrum and thin upper lip

A

Foetal Alcohol Syndrome

176
Q

Gastroschisis vs Omphalocele

A

Gastroschisis = defect lateral to the umbilicus Omphalocele = defect in the umbilicus itself

177
Q

Cephalohaematoma vs Caput Succedaneum

A

Cephalohaematoma = after birth –> do not cross suture lines (blood confined between skull and outer periosteum lining)

Caput Succedaneum = present at birth –> Crosses Suture lines (as blood on top of periosteum)

178
Q

Pneumatosis intestinalis (gas in bowel wall)

A

Necrotizing Enterocolitis

179
Q

Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis

A

William’s Syndrome

180
Q

Cry like meowing kitten
Microcephaly and small jaw
Eyes far apart

A

Cri du Chat Syndrome (chromosome 5p deletion syndrome)

181
Q

Fever, malaise, muscular pain

Unilateral earache/pain on eating

A

Mumps (earache = parotitis)

182
Q

“Mum has a new boyfriend”

A

Child abuse

183
Q

“Pins and needles” in hands

A

Panic attack

184
Q

Mum unable to let go of your hand when you shake it

A

Myotonic Dystrophy

185
Q

Hip pain in fat teenager

186
Q

Heart appears boot-shaped on CXR

A

Tetralogy of Fallot

187
Q

Sandal-gap deformity (gap between big toe and 2nd toe)

A

Down Syndrome

188
Q

Fever which hasn’t responded to Calpol/ibuprofen

A

Think about Kawasaki Disease

189
Q

Rectal bleeding and offensive stools

A

Meckel Diverticulum

  • -> need technetium-99m pertechnetate scan: increased uptake by ectopic gastric mucosa in the bulge
  • -> surgical resection if symptomatic
190
Q

Murmur: continuous blowing noise heard below the clavicles

A

Venous hum (turbulent blood flow in the great veins returning to the heart)

191
Q

Murmur: low-pitched sound heard at the lower left sternal edge

A

Still’ murmur

192
Q

Maculopapular rash, starts on face and then moves to whole body –> gone by 5 days!
Suboccipital and postauricular lymphadenopathy

193
Q

X-Ray shows flattening of femoral head

A

Perthes Disease

194
Q

Knee pain after exercise – can have intermittent swelling and locking of knee

A

Osteochondritis Dissecans

195
Q

Continuous machinery murmur at the left upper sternal edge

A

Persistent Ductus Arteriosus

196
Q

Systolic murmur below left clavicle and left scapula

A

Coarctation of Aorta

197
Q

Murmur which varies with position

A

Innocent murmur

198
Q

Bounding and collapsing pulse

A

Persistent Ductus Arteriosus

199
Q

Severe coughing fits that make child blue

A

Whooping Cough

200
Q

Posterior displacement of tongue

Cleft palate

A

Pierre-Robin syndrome

201
Q

Short palpebral fissure (opening of eyes)
Smooth philtrum (bump in the middle above upper lip)
Hypoplastic thin upper lip
Epicanthic fold (folds in medial corners of eyes)

A

Foetal Alcohol Syndrome

202
Q

Fever, then blanching macular rash appears a few days later

Rash starts on trunk and moves outward

A

Roseola Infantum (HHV6)

203
Q

Symptoms start after switching to formula

A

Cow’s Milk Protein Allergy

–>need to switch to Extensive Hydrolysed Formula

204
Q

Vomit after coughing fit

A

Whooping Cough (bordetella pertussis)

205
Q

Most common childhood malignancy

206
Q

Baby with cataract, deafness, cardiac abnormalities

A

Congenital Rubella Syndrome

207
Q

Baby with saddle-shaped nose, notched incisors and deafness (sensorineural hearing loss)

A

Maternal Syphillis infection

208
Q

Virus –> low platelets –> self-resolves in 12 weeks

A

Idiopathic Thrombocytopenic Purpura (ITP)

-Antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex.

209
Q

When are AGPAR scores measured?

A

1, 5, 10mins

210
Q

Lack of smell (anosmia) in a boy with delayed puberty

A

Kallman’s syndrome = hypogonadotrophic hypogonadism (X-linked recessive)

211
Q

Girl with delayed puberty (including primary amenorrhoea) and bilateral “marble-sized” groin swellings

A

Androgen Insensitivity = genetically male (46XY) but phenotypically female, as end-organs are resistant to testosterone

  • undescended testes are the groin swellings!
  • Treatment: remove testes and oestrogen therapy
212
Q

Tricuspid valve leaflets are attached to the walls and septum of the right ventricle

A

Ebstein’s anomaly = lithium in pregnancy

–> tricuspid regurg and Wolff-Parkinson-White in 50%

213
Q

Infectious rash which starts behind ears, but then spreads down body

214
Q

Measles:

  1. Most common complication
  2. Most common cause of death
A
  1. Otitis media

2. Pneumonia

215
Q

Fixed split S2 sound

A

ASD (increased venous return overloading the right ventricle during inspiration and delaying closure of the pulmonary valve)

216
Q

Pansystolic murmur

217
Q

“Continuous murmur”, heard loudest under left clavicle

218
Q

Hip pain in hyperactive and short child

A

Perthes Disease

219
Q

Neonate with concave abdomen and heart sounds displaced medially

A

Congenital diaphragmatic hernia

220
Q

Multiloculated and heterogeneous cyst, above hyoid bone

A

Dermoid cyst

221
Q

Compression: ventilation ratio in neonates

222
Q

Right ventricle looks like right atrium

A

Ebstein’s anomaly

223
Q

Itchy bum, worse at night

A

Threadworm

224
Q

Cut-off for complete recovery after febrile seizure (any longer and it is a complex seizure)

225
Q

Precocious puberty with both testes enlarged

A

Brain lesions releasing gonadotrophins

226
Q

Precocious puberty with one testis enlarged

A

Gonadal tumour (e.g. sex cord-gonadal stromal tumour)

227
Q

Precocious puberty with small testes

A

Adrenal cause (e.g. adrenal hyperplasia)

228
Q

DDH more common in which gender?

229
Q

What do you use to screen for coronary aneurysm in Kawasaki - echo or coronary angiogram?

230
Q

Broad-spectrum antibiotic used in <3 months

A

Cefotaxime

231
Q

Tumour suppressor gene associated with Wilm’s Tumour

232
Q

Tumour suppressor gene associated with Burkitt Lymphoma

233
Q

Bicuspid aortic valve in which genetic disease?

A

Turner Syndrome (causes aortic stenosis)

234
Q

Girl with haemophilia, what other condition do they have?

A

Turner Syndrome - because haemophilia is X-linked recessive, so should only occur in males … but can happen in Turner as just have one X chromosome!!

235
Q

Treatment of pneumonia and influenza simultaneously

A

Co-amoxiclav

236
Q

Genetic condition causing neonatal hypotonia

A

Prader-Willi

Neonatal hypotonia also:

  • Sepsis
  • Hypothyroidism
  • Spinal Muscular Atrophy
237
Q

Mode of inheritance of Prader-Willi

A

Inprinting (absence of paternal copy of PWS region on chromosome 15q11-13)

238
Q

Hereditary condition associated with glomerulonephritis and hearing loss

A

Alport Syndrome

239
Q

Muscle weakness after GI infection, which starts in legs and ascends

A

Guillain-Barre Syndrome (GI infection = campylobacter)

240
Q

Scaphoid abdomen and bilious vomiting in newborn

A

Intestinal malrotation/volvulus (scaphoid = sucked in)

241
Q

Calculation for corrected age of premature

A

Age - number of weeks born before 40

– use this for milestones up til 2yrs

242
Q

Born before 28 weeks – what special thing should you do with their vaccinations?

A

First set at hospital (apnoea risk)

243
Q

Cause of mitral stenosis

A

Rheumatic Fever = vanishingly rare in UK

244
Q

Indications for antibiotics in bacterial gastroenteritis

A

 Sepsis
 Extra-intestinal spread
 Salmonella in under 6 months

245
Q

Boy with hip/knee pain and limp – also have groin pain, which is worse after exercise

A

Perthes Disease

246
Q

First-line imaging in septic arthritis

A

Ultrasound (because X-Ray normal initially)

247
Q

DDH more common in males or females?

A

6x more common in females! Also more common in left hip

248
Q

Fever and resp rate >50 in child under 3

A

Pneumonia (normal resp rate 25-40)

249
Q

Brushfield’s spots

A

Spots on iris in Down’s Syndrome

250
Q

X-linked recessive disease with many CGG trinucleotide repeats on X chromosome

A

Fragile X Syndrome

251
Q

GI infection –> swollen joints

A

Reactive Arthritis

252
Q

ASO titres indicate what?

A

Streptococcal infection (ASO = anti-streptolysin O)

253
Q

IBD + asymmetrical oligoarthritis

A

Enteropathic Arthritis

254
Q

Jaundice with low birth weight, small heads, seizures (encephalitis)

A 
Toxoplasmosis
Other (syphillis)
Rubella
CMV
Herpes simplex
255
Q

Newborn with limb hypoplasia, microcephaly, cataracts and skin scarring

A

Foetal Varicella Syndrome

256
Q

Haematuria after start COCP

A

Acute Intermittent Porphyria (AIP)

257
Q

Haematuria after surgery

A

Rhabdomyolysis (long period of inertia, with pressure on muscles)

258
Q

Treatment of meconium ileus

A

Gastrograffin Enema (diagnostic and therapeutic)

259
Q

Newborn with microcytic anaemia, hepatosplenomegaly and failure to thrive

A

Beta thalassaemia (hepatosplenomegaly = intramedullary haematopoiesis)

260
Q

Blood pressure higher in arm vs leg

A

Coarctation of Aorta

261
Q

Shocked neonate – can’t palpate radial, brachial or femoral pulses

A

Critical aortic stenosis

262
Q

Baby with lots of hiccups (also vomiting, failure to thrive)

263
Q

Scrotal swelling that feels like “bag of worms”

A

Varicocele

264
Q

Acute scrotal pain –> elevating testes relieves the pain

A

Epididymo-Orchitis

265
Q

Sore throat with grey coating on tonsils/pharynx

A

Diphtheria

266
Q

Sore throat –> GP prescribes amoxicillin –> widespread maculopapular rash

A

Infectious Mononucleosis

267
Q

Flu-like illness –> acute-onet flaccid paralysis in a single limb

268
Q

Febrile illness with “painful purple rash on legs”

A

Erythema nodosum in TB

269
Q

Widespread painless lymphadenopathy

270
Q

Autoantibodies against this in ITP

A

IIb/IIIa glycoprotein on platelets

271
Q

How much dehydration (% weight loss) needed to get dry mucous membranes and reduced urine?

A

6-9%

>10% = haemodynamically compromised

272
Q

Isolated hyponatraemia in pneumonia

273
Q

Type of JIA with ANA +ve and anterior uveitis

A

Oligoarthritis

274
Q

Type of JIA with Rheumatoid Factor +ve

A

Polyarticular (seen in older kids)

275
Q

Type of JIA with nail changes = dystrophy (thickened), pitting and onycholysis

276
Q

Normal growth until 1yr, then rapidly fall off

-associated with doll-like face and neonatal hypoglycaemia/jaundice

A

Growth Hormone Deficiency

277
Q

Ejection systolic murmur that radiates to back

A

Pulmonary Stenosis

278
Q

First-line investigation in delayed puberty in a girl

A

Gonadotrophins

279
Q

Delayed puberty and can’t smell

A

Kallman Syndrome = decreased gonadotrophin-releasing hormone

280
Q

If child already on phenytoin for epilepsy, what should be used instead in status epilepticus?

A

Phenobarbitone

281
Q

Testicular pain – “blue dot” on scrotum when transilluminated

A

Torsion of the hydatid of Morgagni (blue dot = torted hydatid)

282
Q
  • Daily seizures, with recurrent status epilepticus

- EEG: slow spike-waves with many abnormalities

A

Lennox-Gastaut Epilepsy

283
Q
  • Twitching on one side of face (at night)

- EEG: high-amplitude spikes in left centrotemporal region

A

Rolandic seizures

284
Q

Sore throat –> scaly papules on torso and limbs

A

Guttate Psoriasis

285
Q

Sore throat –> red rash that feels like goose-pimples

A

Scarlet Fever

286
Q

Imaging of choice in brain tumours

287
Q

Most common cause of erythema multiforme

A

Herpes Simplex

288
Q

Red nodules on legs = symmetrical, tender, hot

A

Erythema Nodosum = Group A Strep, COCP, IBD

289
Q

Anticonvulsant causing hair loss

A

Sodium Valproate

290
Q

Anticonvulsant which induces hepatic enzymes

A

Carbamazepine

291
Q

Child with bone pain/limp – always look out for…

292
Q

Undergoing leukaemia treatment –> hyperkalaemia, high phosphate, gout, raised U&Es…

A

Tumour Lysis Syndrome (cancer cells break down)

–>need hydration and allopurinol

293
Q

“Prominent forehead” and jaundice

A

Beta thalassaemia

294
Q
  • High arched palate
  • Arm span > height
  • Myopia/lens dislocation
A

Marfan’s Syndrome

295
Q

“Bamboo-spine” on X-Ray

A

Enthesitis-related arthritis

296
Q

Bounding peripheral pulses

297
Q

Newborn with retinitis and periventricular calcifications on CT

298
Q

Newborn with chorioretinitis, hydrocephalus and tram-like calcifications on CT

A

Toxoplasmosis

299
Q

Congenital infection causing hydrops fetalis

A

Parvovirus

300
Q

“Blistering rash” in newborn (with jaundice and hepatomegaly)

A

Herpes Simplex

301
Q

Treatment of Scarlet Fever

A

10 days penicillin

302
Q

Mode of inheritance in retinoblastoma

A

Autosomal dominant (chr 13)

303
Q

Type of Polycystic Kidney Disease which presents in newborns vs in teens

A

Newborns: autosomal recessive (oligohydramnios, pulmonary hypoplasia)
Teens: autosomal dominant (Berry aneurysm, mitral prolapse)

304
Q

Mechanism of cleft lip

A

Medial nasal and maxillary processes do not fuse during development

305
Q

Infection causing acute demyelinating encephalitis

306
Q

Violaceous rash on eyelids

Red papules on finger joints

A

Dermatomyositis

  • Violaceous = heliotrope rash
  • Red papules = Gottron’s papules
307
Q

Defect in alpha-ketoacid dehydrogenase

A

Maple Syrup Urine Disease

308
Q

Itching on palms/soles – see burrows in finger webs

A

Scabies (sarcoptes scabei)

309
Q

Treatment of scabies

A

Permethrin

310
Q

Transilluminating cyst, found in posterior triangle

A

Cystic hygroma

311
Q

Non-transilluminating cyst, found in anterior triangle

A

Brachial cyst

312
Q

Abnormal opening of urethra on ventral surface of penis

A

Hypospadias

313
Q

Total fluid requirement calculation

A

Maintenance + deficit + ongoing losses

314
Q

Fluid deficit calculation

A

% dehydration x weight x 10

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