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MBBS V > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Skin prick testing vs Serum allergen specific IgE?

A

Use serum allergen if risk of anaphylaxis is high

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2
Q

Risk factors for DDH (4)

A

Female

Frank breech

Family history

First born

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3
Q

What disease is this?

A

Tetraology of Falot (boot shaped heart)

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4
Q

Management of transposition of great arteries? (2)

A

Prostaglandins to maintain PDA

Surgical repair in first two weeks of life

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5
Q

What is Eissenmenger’s syndrome?

A

Chronic pulmonary hypertension caused by a left-right heart shunt, leading to right ventricular hypertrophy that eventually causes the right ventricle to push blood into the left ventricle (bypassing the lungs) -> cyanosis

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6
Q

What infecious disease gives you a high fever THEN a rash?

A

Roseola

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7
Q

Intussuscepion clinical signs (2)?

A

Colicky abdo pain wih relief with child pulling knees to chest

Red current jelly stool (ischemic bowel)

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8
Q

What is this disease?

A

Duodenal atresia

(Double bubble sign)

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9
Q

Toddler with new onse abdo pain, pulls knees to chest to make it better. Dx, physical exam, investigation, Mx?

A

Intussception (bowel teloscoping)

Sausage shaped mass

US: target sign

Air enema

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10
Q

<2 years old child has corzya symptoms and wheezing. Diagnosis? What’s it caused by and mx (3)

A

Bronchiolitis

Respiatory Syncytial Virus

Supportive care (High flow O2, IVT and suction fluids)

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11
Q

What’s this disease?

A

Perthes’ disease

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12
Q

What’s this disease?

A

Omphalocele

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13
Q

What is this disease?

Two associated issues?

A

Congenital diaphragmatic hernia

Lung hypoplasia

Persistant pulmonary hypertension

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14
Q

VSD clinical features? (4)

A

<1 years

Pansytolic murmur over left sternal border

CHF and failure to thrive

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15
Q

What type of fracture is this?

A

Salter-Harris fracture type 3: A physeal fracture that extends through the epiphysis

SALTER

Type I - S: “straight through”

Type II - A: “above” i.e. Proximal

Type III - L: “lower” i.e. Distal

Type IV - TE: “through everything”

Type V - R: “rammed”

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16
Q

Continuous machinery murmur. What is the disease? What other clinical features (1)? How to manage? (1+1)

A

Patent ductus arteriosis

Collapsing pulse

IV indomethicin (prostaglandin antagonist)

If transposition of great arteries present (progressive cyanosis) -> give prostaglandins to maintain until surgical repair

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17
Q

Mx of DDH (3)?

A

<6 months: Pavlik harness

Failure of Pavlick harness -> Spica casts

Older + walking with fixed deformity -> Open reduction

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18
Q

What this disease?

A

Osgood Schlatter’s Disease

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19
Q

Test for cystic fibrosis?

A

Sweat chloride test

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20
Q

Progressive cyanosis in first week of life is what disease?

A

Transposition of great arteries

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21
Q

Best test for intussusception?

A

US

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22
Q

Drooling child, hot potato voice, distress. Two diff dx?

A

Epiglottitis (unvaccineated against Hib)

Quinsy’s peritonsillar abscess: trimus, ipsilateral cervical lymphadenopathy, uvula shifted to contralateral side

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23
Q

Expiratory wheeze diff dx (4)

A

Asthma (>5 years)

Viral induced wheeze (<3 years)

Bronchiolitis (RSV virus < 2 years)

Inhaled foreign object (intrathoracic)

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24
Q

How to treat this condition?

A

Otitis media

Analgesia and review in 72 hours

Consider amoxycillin if: <6 months, indigenous, bilateral ear infections <2 years, systemically unwell (not just fever), otorrhoea (perforated membrane)

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25
Q

Differential diagnosis for lower GI bleeding in children? (5)

A

Premature infant: necrotising enterocolitis

3 months-3 years: Intussusception (acute onset colicky abdo pain)

Merkel’s diverticulum (painless)

> 2 years: Ulcerative colitis (bloody diarrhoea)

Invasive gastroenteritis (E. Coli, Shigella) (fever + bloody diarrhoea)

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26
Q

Most common brain tumour of childhood? Ix?

A

Pilocytic astrocytoma

Stains with glial fibrillary acidic protein

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27
Q

Clinical features of coarctation of aorta?

A

Upper limb HTN, lower limb hypotension

Brachial-femoral delay

Claudication of lower limbs

Absent femoral pulses

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28
Q

Dx (2) and Mx (2) for pathological jaundice?

A

Bilirubin - conjugated riased usually

Plot total bilirubin on normogram

Phototherapy

Exchange transfusion

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29
Q

What’s this disease?

A

Slipped Capital Femoral Epiphysis

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30
Q

Feature of duodenal atresia (3)?

A

Polyhydramnios

Biliary projectile vomiting

Double bubble xray

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31
Q

Acid/base balance in pyloric stenosis?

A

Hypochloremic, hypokalaemic metabolic alkalosis

32
Q

Two aetiologies of otitis externa ?

A

Exposure to water -> psuedomonas aeruginosa

Digital trauma -> Staph epidermidis

33
Q

Atiology for croup?

A

Parainfluenza virus

34
Q

Physical exam finding for intussusception?

A

Sausage mass RUQ

35
Q

Risk factor for coarctation of aorta?

A

Turner’s syndrome

36
Q

Flow of PDA?

A

Desceding aorta to pulmonary artery

37
Q

What type of fracture is this?

A

Salter-Harris type 2: physeal fracture that extends through the metaphysis

SALTER

Type I - S: “straight through”

Type II - A: “above” i.e. Proximal

Type III - L: “lower” i.e. Distal

Type IV - TE: “through everything”

Type V - R: “rammed”

38
Q

What’s this?

A

DDH

39
Q

Risk factors for transposition of great arteries? (1)

A

Diabetic mothers at conception (not GDM)

40
Q

What type of fracture is this?

A

Salter Harris Type 1: complete physeal fracture +/- displacement

SALTER

Type I - S: “straight through”

Type II - A: “above” i.e. Proximal

Type III - L: “lower” i.e. Distal

Type IV - TE: “through everything”

Type V - R: “rammed”

41
Q

What’s this disease and give three clinical features?

A

Osteosarcoma

Metaphysis of bones (particularly proximal tibia and distal femur)

Sunburst appearance

Atraumatic pin point bony tenderness

42
Q

What type of fracture is this?

A

Salter-Harris type 4: A physeal fracture extended through both the metaphysis and epiphysis

SALTER

Type I - S: “straight through”

Type II - A: “above” i.e. Proximal

Type III - L: “lower” i.e. Distal

Type IV - TE: “through everything”

Type V - R: “rammed”

43
Q

What’s this?

A

DDH

44
Q

Fixed splitting of S2 in a child indicated what heart defect?

A

Atrial Septal Defect

45
Q

Four complications of prematurity?

A

Bronchiopulmonary dysplasia

Retinopathy of prematurity

Intraventricular haemorrhage

Necrotising Entero Colitis

46
Q

What is this disease?

What other associations does it have?

A

Oesophageal atresia

VACTERL

Vertebra

Anus

Cardiac

Tracheo-oesophageal fistula

Esophageal atresia

Renal

Limbs

47
Q

Management for pertussis?

A

Azithromycin

48
Q

What’s this disease and give three clinical features.

A

Ewing’s sarcoma

Mid shaft

Onion skin appearance

Atraumaic point bone tenderness

49
Q

Projectile non billary vomiting straight after feeding. Dx, physical exam finding, investigation, mx?

A

Pyloric stenosis

Olive lump epigastrium

EUC: hypokalaemic, hypochloraemic metabolic alkalosis

NG tube, correct electrolytes, pyloromyotomy

50
Q

4 hours post birth. Dx?

A

Cephalohaematoma (does not cross midline)

51
Q

Physical exam finding in pyloric stenosis?

A

Olive shaped lump in abdomen

52
Q

Trisomy 21 associated with what paediatic conditions?

A

AtrioVentricular Septal Defect

VSD

ASD

ToF

53
Q

Tx for GAS?

A

Phenoxymethylpenicillin

54
Q

Screning for DDH (3)?

A

Barlow’ test (<3 months): attempt to dislocate with hip flexion an adduction with posterior force

Ortolani’ test (already dislocated hip): attemt to relocate with hip adbuction and use fingers on bum to push back in socket

USS at 4 weeks

55
Q

Neonatal jaundice in first 24 hours. Pathological or physiological? 3 differential diagnoses?

A

Pathological

APO incompatability

Rh incompatability

Sepsis

56
Q

Hours after birth. Dx?

A

Caput succedaneum: croses midline

57
Q

What’s tested on a Guthrie card? (4)

A

Cystic fibrosis

Congenital hypothyroidism

Phenylketouria (PKU)

Galactosaemia (unable to process milk)

58
Q

Mx of absence seizures? (2)

A

Ethosuximide

Valporate

59
Q

What type of fracture is this?

A

Salter-Harris type 5: physeal fracture which is compressed

SALTER

Type I - S: “straight through”

Type II - A: “above” i.e. Proximal

Type III - L: “lower” i.e. Distal

Type IV - TE: “through everything”

Type V - R: “rammed”

60
Q

Barking cough and this CXR. Dx?

A

Croup

(Steeple sign) <- didn’t need to do CXR for diagnosis

61
Q

Conditions as a part of imperforate anus syndrome? (7)

A

VACTERL

Vertebra

Anus

Cardiac

Trachea-oesophagus fistula

Esophageal atresia

Renal

Limbs

62
Q

What’s this disease?

A

Gastroschisis

63
Q

Tx for pertussis?

A

Azithromycin

64
Q

Failure to pass meconium differentials (2)?

A

Imperforate anus

Meconium ileus in cytic fibrosis

65
Q

Most sensitive indicator of successful newborn resuscitation?

A

HR

66
Q

Risk factor for patent ductus arteriosis?

A

Maternal rubella

67
Q

Ambigous genitalia + raised serum 17-hydroxyprogesterone levels

A

Congenital adrenal hyperplasia

68
Q

Limping child differential dx? (5)

A

Missed developmental dysplasia of the hip (long standing since they could walk)

Perthe’s disease (slow onset develops limp)

Slipped Capital Femoral Epiphysis (gradual onset pain, usually obese child in early teens)

Transient synovitis (post URTI hip pain)

Septic joint (will not weight bere or move)

69
Q

Young child with sore throat, lymphadenopathy, odynophagia, no cough. Two diff dx?

A

Group A Strep

EBV (+ splenomegaly)

70
Q

What is this condition?

A

Duodenal atresia

(Double bubble sign)

71
Q

Differential dx for neonatal respiratory distress (5)?

A

Transient tachyopnoea of the newborn (TTN): full term baby via C section

Neonatal Respiratory Distress Syndrome/ Hyaline membrane disease: premature baby or maternal GD

Meconium aspiration syndrome: post term baby

Sepsis: GBS positive mother or chorioamnionitis

Hypoglycaemia: LGA, SGA, maternal GD

72
Q

Coughing spasms and vomiting afterwards in young children?

A

Pertussis

73
Q

Child with recurrent bacterial nasal infections, further investigations?

A

Look for foreign object

74
Q

2 Complications from this disease?

A

Parvovirus B19 (slapped cheek)

Aplastic crisis in sickle cell disease

Threat to pregancy (keep away from pregnant ladies)

75
Q

Gastro-illness followed by anaemia, thrombocytopenia + petechiae, renal impairment?

A

HUS

Can have jaundice due to haemolytic anaemia.

TTP is usually in adults (altered mental status, renal impairment, fever, haemolytic anaemia, thrombocytopenia)

76
Q

Young child with distal extremity muscle weakness, loss of pain/temp and vibration. Dx, Ix?

A

Charot-Marie-Tooth disease

Autosomal dominant condition

Ix with nerve conduction studies and genetic testing (defintive)

MBBS V (6 decks)

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