Paediatrics

Question 1

What may cause bilious vomiting on the first day of life?

Answer 1

Duodenal atresia

Common in Down’s patients

Question 2

X-ray findings of Duodenal atresia?

Answer 2

Neonatal bilious vomiting with double bubble sign on AXR

Question 3

2 week-old with abdominal pain exacerbated by palpation, distended abdomen and bilious vomiting that is not projectile, what is the most likely diagnosis?

Answer 3

Intestinal malrotation

Question 4

Painful defaecation and bright red rectal bleeding in 4-year old, what is the most likely diagnosis?

Answer 4

Anal fissure

Question 5

Treatment of anal fissure?

Answer 5

Stool softeners and lifestyle advice

Question 6

Cherry red lesion at the anal verge is indicative of?

Answer 6

Juvenile polyp

Question 7

Management of inguinal hernia in infant?

Answer 7

Herniotomy (surgery)

Whereas umbilical hernias spontaneously resolve

Question 8

What scoring system is used to assess the health of a newborn immediately after birth?

Answer 8

AGPAR

Question 9

What metabolic abnormality is associated with pyloric stenosis?

Answer 9

HYPOchloremic, HYPOkalemic, metabolic alkalosis

Vomiting of HCl = loss of H+ (alkalosis) and Cl

Question 10

Appropriate management for croup?

Answer 10

Single dose of oral dexamethasone

Question 11

What is a feature of a benign ejection murmur?

Answer 11

Varies with posture

Question 12

At what age would the average child acquire the ability to sit without support?

Answer 12

6-8 months

Question 13

Most important investigation in Kawasaki disease?

Answer 13

Echocardiogram

Coronary artery aneurysms are a complication and should be screened

Question 14

What is the most important treatment for the prevention of neonatal respiratory distress syndrome?

Answer 14

Administer dexamethasone to the mother

Question 15

What organism is responsible for scarlet fever?

Answer 15

Group A haemolytic streptococci

Question 16

What is the most causative agent of bacterial pneumonia in children?

Answer 16

Strep. pneumoniae

Question 17

Most appropriate management in bronchiolitis?

No signs of increased breathing, symmetrical chest expansion. Temperature 37.5 and oxygen sats 98%

Answer 17

Continue observation and discharge with safety-netting advice

Question 18

Life-threatening feature of asthma in children?

Answer 18

Oxygen saturations <92%

Question 19

When would you admit a child for bronchiolitis?

Answer 19

• Apnoea
• Persistent oxygen saturation of <92% in air
• Inadequate oral fluid intake
• Persistent respiratory distress: grunting, marked chest recession, respiratory rate of >70

Question 20

Causative organism of croup?

Answer 20

Parainfluenza virus

Question 21

What medication would you give to prevent RSV infection and in which children?

Answer 21

Monoclonal antibodies

• Premature infants
• Infants with lung or heart abnormalities
• Immunocompromised infants

Question 22

Causative organism for acute epiglottitis?

Answer 22

Haemophilus influenzae type B

Question 23

Most appropriate places to check for a pulse in paediatric BLS?

Answer 23

• Femoral

- Brachial

Question 24

Identifiable sing of intususseption on X-ray?

Answer 24

Target sign

Question 25

At what times are AGPAR score assessed?

Answer 25

1, 5, 10 minutes

Question 26

First line treatment of whooping cough?

Answer 26

Azithromycin or clarithromycin if the onset of the cough is within 21 days