Paediatrics

Question 1

When in pregnancy to you check for anti D in rh-ve women?

Answer 1

at booking, 28 & 34 weeks’ gestation.

Question 2

Biliary atresia

Answer 2

Apparently healthy term babies
Week 3 - jaundice, yellow urine and pale stools due to biliary tree occlusion by angiopathy
spleen palpable, liver hard and enlarged.
Kasai procedure = hepatoportoenterostomy
20% have associated cardiac malformations: polysplenia and situs inversus.
Babies may be excessively hungry.
US may help with diagnosis.
Percutaneous liver biopsy may show bile duct proliferation and bile plugs.
Liver unit

Question 3

Meningococcal prophylaxis

Answer 3

ciprofloxacin

Question 4

Antenatal CMV infection effects to neonate

Answer 4

cerebral calcification, microcephaly and sensorineural deafness.

Question 5

Parvovirus B19 effects to neonate

Answer 5

hydrops fetalis

Question 6

effects to neonate VZV

Answer 6

greatest risk to foetus is before 20 weeks gestation and can result in scarring of the skin, limb hypoplasia, microcephaly and eye defects

Question 7

ADHD treatment

Answer 7

Methylphenidate
(dopamine/NE reuptake inhibitor)
BP, pulse,, BMI 6 monthly, ECG

Question 8

Anaphylaxis doses

Answer 8

Adrenaline 1:1000
< 6 years - 150ug
6-12 - 300ug
12+ 500ug

Hydrocortisone
< 6months - 25mg 
6mo - 6yrs - 50mg 
6-12 - 100mg 
12+ 200mg

Chlorphenamine???

RPT 5 mins adrenaline

Question 9

Osmotic laxative

Answer 9

Movicol and lactulose

Question 10

Stimulant

Answer 10

Senna/ glycerol supp

docusate

Question 11

Prophylaxis for home people in epiglottitis

Answer 11

Rifampicin

Question 12

When do present with laryngomalacia?

Answer 12

4 weeks

Question 13

Bronchiolitis - most common cause

Answer 13

RSV

Question 14

Notes on whooping cough

Answer 14

Bordatella pertussis
Infectious 3 weeks post sx
lymphocytosis
erythromycin and prophylaxis for contacts
Notifiable
Isolate until 2 days after tx

Question 15

Treatment croup

Answer 15

Stat steroids
If moderate > hospital
Modified Westley score

Question 16

Hand foot and mouth

Answer 16

vesicular rash
Coxsackie A16
sore throat, fevers

Question 17

Chickenpox during pregnancy

Answer 17

If contact - (for PEP)
And unsure if immune - check varicella antibodies
If < 20/40 and no antibodies = VZIG within 10 days of contact. Infectious > 1/12#
If > 20/40 and no antibodies = VZIG or acicolovir BUT on days 7-14 post exposure **

If rash - ie has chickenpox
Specialist advice
>20/40 - ora aciclovir if presented within 24 hours
If <20/40 consider aciclovir with caution

Last 7 days
delivery after 7 days
Give baby VZIG
Monitor 1/12

Question 18

Rubella in pregnancy

Answer 18

Sensorineural hearing loss’
Cataracts, glaucoma
Heart defects

Question 19

Fragile X

Answer 19

Trinucleotide CCG repeat disorder

Long face, low set ears, autism, LD, macroorchidism, hypotonia, mitral valve prolapse

Question 20

Patau syndrome

Answer 20

Trisomy 13
Microcephaly
Small eyes
Cleft palate
Scalp lesions
Polydactly

Question 21

William’s syndrome

Answer 21

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

Question 22

Prader-Willi syndrome

Answer 22

Hypotonia
Hypogonadism
Obesity

Question 23

Pierre-Robin syndrome

Answer 23

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

Question 24

Noonan syndrome

Answer 24

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

Question 25

Edward’s syndrome (trisomy 18)

Answer 25

Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

Question 26

Cri du chat syndrome (chromosome 5p deletion syndrome)

Answer 26

Characteristic cry (hence the name) due to larynx and neurological problems
Feeding difficulties and poor weight gain
Learning difficulties
Microcephaly and micrognathism
Hypertelorism

Question 27

When to give anti D in rhesus negative Mums

Answer 27

28 and sometimes 34 weeks

if event is in 2nd/3rd trimester give large dose of anti-D and perform Kleihauer test - determines proportion of fetal RBCs present

Question 28

Coombs test

Answer 28

Direct antiglobulin detects antibodies on bloods cells

Question 29

Meningitis prophylaxis close contacts

Answer 29

Ciprofloxacin (1 dose)

Rifampicin