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Phase 3a > Paediatrics Questions > Flashcards

Paediatrics Questions Flashcards

1
Q

What is Perthe’s disease?

A

Self-limiting hip disorder caused by varying degrees of ischaemia and subsequent necrosis of the femoral head

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2
Q

Who does Perthe’s disease generally affect?

A

4-8 year old boys

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3
Q

What is the general presentation of Perthe’s disease?

A

Presents with pain in the hip or knee leading to a limp. There is often an effusion from associated synovitis. Antalgic gait. All movements of the hip are limited. No hx of trauma

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4
Q

What does Barlow’s test screen for?

A

Developmental dysplasia of the hip. Done during NIPE

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5
Q

What age should a child be referred to a paediatrician if they have not started walking?

A

18 months

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6
Q

What vitamin deficiency is associated with an increased risk of severe measles infection + why?

A

Vitamin A. Vitamin A deficiency impairs cell-mediated immunity and is associated with severe measles infections, particularly in developing countries. In developing countries, vitamin A should be given as part of the treatment of measles

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7
Q

What are the symptoms of an innocent murmur?

A

Soft, systolic, short, symptomless, standing/sitting

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8
Q

What is the management of unilateral undescended testes in a newborn? When should they be refered?

A

Review again at 3 months. If persistent, refer to paediatric surgeon before 6 months

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9
Q

What leukaemia is associated with down syndrome?

A

History of Down’s

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10
Q

What is the treatment of asymptomatic neonatal hypoglycaemia?

A

Encourage normal feeds and monitor glucose

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11
Q

What is the definition of hypoglycaemia in the newborn?

A

2.6 mmol/L

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12
Q

What are the common causes for persistent/severe hypoglycaemia in neonates?

A
  • preterm birth (<37 weeks)
  • maternal diabetes mellitus
  • IUGR
  • hypothermia
  • neonatal sepsis
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13
Q

What are the possible causes of neonatal hypotonia?

A

Neonatal sepsis, hypothyroidism, Prader-willi

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14
Q

What murmur is heard with patent ductus arteriosus?

A

Machinery murmur at the upper left sternal edge

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15
Q

What is benign rolandic epilepsy? What ages does it affect?

A

Partial seizures occuring at night in an otherwise healthy child. Typically occurs between 4 and 12 years old

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16
Q

What is seen on an EEG in benign rolandic epilepsy?

A

Centrotemporal spikes

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17
Q

What is the typical presentation of necrotising enterocolitis?

A

Abdominal distension, feeding intolerance, bloody stool

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18
Q

What is a common finding in children with hypospadias?

A

Cryptorchidism (around 10%)

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19
Q

What are features of an atypical UTI?

A

Seriously ill, poor urine flow, abdominal or bladder mass, raised creatinine, septicaemia, failure to respond to antibiotics within 48 hours, infection with E.coli organisms

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20
Q

What is a common cause of hand, foot and mouth disease?

A

Coxsackie A16 and enterovirus

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21
Q

What is cephalhaematoma? Expected presentations

A

Swelling on a newborn’s dead. Due to bleeding between the periosteum and the skull. Parietal region most commonly affected. Doesn’t cross suture lines.

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22
Q

What are Chignon’s?

A

Birth traumas due to the use of a ventouse device

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23
Q

What is the rate of chest compressions in infants and children?

A

100-120/min.

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24
Q

What is indicated by hand preference before 12 months?

A

Abnormal. Could be an indicator of cerebral palsy

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25
Q

What investigation must be done and why, for infants born breech at more than 36 weeks?

A

USS for DDH screening; babies in the breech position have increased pressure on hip joints, increased risk

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26
Q

Why is normal pCO2 in an acute asthma attack an issue?

A

Consistent with life threatening attack; suggests exhaustion and declining respiratory effort.

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27
Q

What is the triad commonly seen in shaken baby syndrome?

A

Retinal haemorrages, subdural haematoma, encephalopathy

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28
Q

Where should the pulse be checked for in paediatric BLS?

A

Brachial and femoral arteries

29
Q

What are the differentiating and similar features between Scarlet fever and Kawasaki disease?

A

Similar: both present as child with fever, a form of rash, strawberry tongue

Different: Scarlet Fever has fine punctuate erythmatous rash with ‘Sandpaper’ texture, sparing the mouth. Kawasaki disease has a desquamating rash and cracked lips

30
Q

Name the disease: child presents with fever associated with an itchy, macular rash which becomes vesicular

A

Chickenpox

31
Q

What rash is seen in measles?

A

Blanching erythematous, face and upper chest. Koplik spots

32
Q

At what age can a child sit without support?

A

7-8 months

33
Q

What rash is seen in rubella?

A

Pink maculopapular rash, initially on face before spreading to the whole body.

34
Q

What is slapped cheek syndrome, and what causes it?

A

Erythema infectiosium (5th disease). Parvovirus B19

35
Q

What is the typical presentation of shingles?

A

Elderly patient presenting with a painful, ‘burning’ rash

36
Q

What bacteria causes Scarlet fever?

A

Group A haemolytic streptococci: S.Pyogenes

37
Q

What age do children learn to turn towards sound?

A

3 months

38
Q

Under what age should a child be referred to child protection, if they are planning to engage in sexual activity?

A

Under 13: this is rape under the law. You can break confidentiality

39
Q

What are the 8 S’s of innocent murmurs?

A
  • soft
  • systolic
  • short
  • sounds (S1 and S2) normal
  • symptomless
  • special test normal
  • standing/sitting (vary with position)
  • sternal depression
40
Q

What sort of murmur is never innocent in children?

A

Diastolic

41
Q

How should SUFE be diagnosed?

A

Hip x-ray

42
Q

What should be suspected in boys over 4 years old with a limp? Diagnostic test?

A

Perthes’. X-ray

43
Q

What are the criteria for immediate request for CT scan of the head in children?

A

Loss of consciousness (>5 mins), amnesia (>5 mins), abnormal drowsiness, 3 or more discrete episodes of vomiting, post trauma seizure, GCS <14, any sign of basal skull fracture, dangerous mechanism of injury, focal neurological defect

44
Q

How is patent ductus arteriosus treated?

A

Indomethacin or ibuprofen. Inhibits prostaglandin synthesis. Given to the neonate in the postnatal period

45
Q

What is assessed using an apgar score?

A

Pulse, respiratory effort, colour, muscle tone, reflex irritability

46
Q

What ages do febrile convulsions typically occur between?

A

Between 6 months and 5 years

47
Q

What is distended abdomen and bilious vomiting indicative of?

A

Intestinal malrotation and volvulus

48
Q

What is the inheritance of Prader Willi syndrome?

A

Imprinting

49
Q

What is the causative organism of threadworms?

A

Enterobius vermicularis

50
Q

What is the first line response if a neonate is apnoeic, floppy and blue?

A

Dry the baby, then reassess APGAR

51
Q

What resp rate in children is a red flag (at any age)

A

> 60/min

52
Q

If a child is under 3 months old and has a UTI, what should be immediate management?

A

Immediately refer to a paediatrician

53
Q

What are features suggestive of hypernatraemic dehydration?

A

Jittery movements, increased muscle tone, hyperreflexia, convulsions, drowsiness/coma

54
Q

What is undigested vegetables in frequent diarrhoea a sign of?

A

Toddler’s diarrhoea

55
Q

What is osteochondritis dissecans?

A

Fragment of the bone in the knee becomes detached due to lack of blood supply. Fragment and overlying cartilage can move around inside the joint, causing pain, swelling, locking. Common in sporty young adults

56
Q

What is the best predictor of clinical severity of tetralogy of fallot?

A

Severity of the right ventricular outflow tract obstruction (pulmonary stenosis). This determines degree of cyanosis and clinical severity.

57
Q

What can ritalin affect as a s/e? What should be monitored and how often?

A

Weight and height. Should be monitored every 6 months

58
Q

What is included in the 6-in-1 vaccine?

A

Diphtheria, tetanus, pertussis, polio, haemophilus influenzae type b, hepatitis B

59
Q

When is the heel prick blood test done in the UK?

A

Between the fifth and ninth day of life

60
Q

What congenital abnormalities can be caused by the use of lithium in pregnancy?

A

Ebstein’s abnormality

61
Q

If diarrhoea persists following an episode of gastroenteritis, what is the likely cause?

A

Lactose intolerance

62
Q

What is the triad of shaken baby syndrome?

A

Retinal haemorrhages, subdural haematoma, encephalopathy

63
Q

What type of bilirubin is raised in biliary atresia?

A

Conjugated

64
Q

What is characteristic of necrotising enterocolitis? What is seen on AXR?

A

Characterised by inflammation and necrosis of the bowel wall. Abdominal X-rays can show dilated bowel loops, portal venous gas, as well as the pathognomonic sign of intramural gas (pneumatosis intestinalis)

65
Q

What syndrome is duodenal atresia closely associated with?

A

Downs

66
Q

What population does necrotising enterocolitis mostly affect?

A

Premature infants

67
Q

What are the symptoms of necrotising enterocolitis?

A

Feeding intolerance, abdominal distension, bloody stools, abdominal discoloration, perforation, peritonitis

68
Q

What is the most common cause of paediatric arrest?

A

Respiratory: hypoxia common (choking), hypothermnia, hypovolaemia, hypo/hyper electrolytes

69
Q
A

Phase 3a (19 decks)

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