Paediatrics

Question 1

Pyloric stenosis: What type of vomit?

Answer 1

Non-bilious
After feeds
May be projectile (buzzword!)

Question 2

Pyloric stenosis: What operation?

Answer 2

Ramstedt’s pyloromyotomy

Question 3

Pyloric stenosis: what bloods and what would it show

Answer 3

U+E’s
V low potassium
Alkalosis (due to vomiting)

Question 4

You find an “olive” on examination of a child, what condition is this?

Answer 4

Pyloric stenosis

Question 5

3 symptoms of Pyloric stenosis except vomiting

Answer 5

Hunger
Weight loss
Dehydration
Lethargy
Infrequent or absent bowel movements

Question 6

What medication do you have to be careful with in early pregnancy to avoid pyloric stenosis

Answer 6

Erythromycin (within the first 2 weeks)

Question 7

Imaging used for pyloric stenosis?

Answer 7

Ultrasound

Question 8

Which parts of stomach affected in pyloric stenosis

Answer 8

Hyperplasia and hypertrophy of smooth muscle in antrum of stomach and pylorus

Question 9

What is the difference between paralytic and non-paralytic squint

Answer 9

Non paralytic: eyes maintain same degree of deviation

Paralytic: Eye deviation changes with gaze direction

Question 10

3 categories of causes of paralytic squint

Answer 10

Nerve
Muscle
Systemic

Question 11

How do children with squint adapt to this problem?

Answer 11

Chin lift or head tilt

This is often a way children are picked up

Question 12

If a child has a squint where each eye works when the other is covered, what type of squint is this?

Answer 12

Non-paralytic

Question 13

When should an intermittent squint settle by?

Answer 13

4 months

Question 14

3 mainstays of examination of a child with strabismus

Answer 14

Eye (gross inspection)
Tool (red reflex test)
Hand (cover test)

Question 15

What age is the cutoff for eye patching with cycloplegic drops?

Answer 15

8 years

Question 16

What type of drug is used in conjunction with patching?

Answer 16

cycloplegic drops

Question 17

2 reasons to admit a child with pneumonia?

Answer 17

Sats below 92

Respiratory distress

Question 18

What percentage of LRTI’s in children are bacterial?

Answer 18

60%

Question 19

Most common pathogen in paediatric pneumonia (>2y)

Answer 19

Strep pneumoniae (same as grown ups)

Question 20

Most common cause of pneumonia in children younger than 2 years

Answer 20

Virus

RSV, influenza A, human metapneumovirus, VZV

Question 21

Name 2 bacteria other than strep pneumoniae that cause LRTI in kids

Answer 21

H. influenzae
Staph aureaus
Klebsiella

Question 22

Name 1 common atypical organism that causes LRTI in kids

Answer 22

Mycoplasma pneumoniae

Question 23

Croup is actually known as

Answer 23

Laryngotracheobronchitis

Question 24

Characteristic cough of croup

Answer 24

Barking cough

Question 25

Differentials of croup

Answer 25

Because of the stridor, you need to consider airway obstruction (i.e. IFB, epiglottitis)

Question 26

Causes of croup

Answer 26

Parainfluenza (80%) | RSV

Question 27

Age to be affected by croup?

Answer 27

6m to 3y

Question 28

Which childhood viral illness is most common in autumn and spring?

Answer 28

Croup | Due to parainfluenza peaks

Question 29

Management for croup

Answer 29

Keep child calm (to reduce effort on respiratory muscles) Paracetamol Fluid intake Steroids (often just a single dose)

Question 30

Steroids for croup?

Answer 30

Yes, normally a single dose at the beginning of the illness

Question 31

Medication that can be used in a child with worsening respiratory distress?

Answer 31

Nebulised adrenaline

Question 32

Rescue pred dose for 2-5 y old?

Answer 32

20mg 5 days

Question 33

Rescue pred dose for 5+ y old?

Answer 33

30-40mg 5 days

Question 34

How often is asthma reviewed?

Answer 34

every year

Question 35

To discharge a patient with asthma, what should their peak flow be?

Answer 35

>75%predicted

Question 36

Name 5 drugs used in the treatment of severe asthma attack

Answer 36

``` Salbutamol Ipratropium bromide Hydrocortisone Aminophylline Magnesium sulphate ```

Question 37

Paeds fluids, resus dose in kids?

Answer 37

20ml/kg in less than 10 mins

Question 38

Fluid resus dose for neonates

Answer 38

10ml/Kg in less than 10 mins

Question 39

Which illicit drug is particular teratogenic?

Answer 39

Cocaine