Paeds 1

Question 1

What Abx do you give for meningitis?
before admission 
on admission (neonates, 1-3m, >3m)

Answer 1

Before admission: benzylpenicillin 
Admission:
Neonate - benzylpenicillin/ amoxicillin + gentamicin 
1-3m - cefotaxime + amoxicillin 
>3m - ceftriaxone

Question 2

What Abx do you give for sepsis?

Answer 2

IV Ceftriaxone

Question 3

What Abx do you give for pneumonia?

Typical & Atypical

Answer 3

Typical: Oral amoxicillin
Atypical: erythromycin/clarithromycin

Question 4

What Abx do you give for UTI?
<3m
>3m & pyelonephritis 
Lower UTI
Prophylaxis

Answer 4

<3m: IV ceftriaxone/cefotaxime + amoxicillin

> 3m with pyelonephritis:
If well - oral cephalexin/co-amoxiclav
If severe - IV co-amox/cefuroxime

Lower UTI:
Trimethoprim 
Nitrofurantoin 
Cephalexin 
Amoxicillin

Prophylaxis:
Low dose trimethoprim/nitrofurantoin (2nd line - amox/cefalxein)

Question 5

What Abx would you give for otitis media?

Answer 5

Amoxicillin/ erythromycin

Question 6

What Abx would you give for tonsillitis?

Answer 6

Phenoxymethylpenicillin/ clarythromycin

Question 7

What Abx would you give in CF for:
prophylaxis
pseudomonas infection

Answer 7

Prophylaxis: flucloxacillin
Pseudomonas: inhaled colistimethate sodium/ Tobramycin

Question 8

What Abx would you give for whooping cough?

Answer 8

Erythromycin

Question 9

What Abx would you give for TB?

Answer 9

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Question 10

What Abx would you give for epiglottitis?

Answer 10

IV cefuroxime

Question 11

Constipation
1st line
2nd line
3rd line

Answer 11

1st - Macrogol
2nd - stimulant (Senna)
3rd - lactulose (osmotic)/ docusate sodium

Question 12

Eczema:

Emollients - 1 thin, 3 thick (ointment)

Steroids - mild, moderate, potent, v potent
SEs of steroids

Answer 12

Emollients (use after washing & 2/3 times in day):
Thin - E45
Thick (ointment) - Diprobase, Hydromol, 50:50 (50% liquid paraffin)

Steroids (apply 1-2/day):
Mild - hydrocortisone 
Moderate - Eumovate 
Potent - betnovate 
V potent - dermovate 

SEs: thinning - more prone to flares, bruising, tearing

Question 13

Croup 
Oral steroids (2)
Nebulised Steroids (1)

Answer 13

Oral:
Dexamethasone/ Prednisolone

Nebulised:
Budesonide

Question 14

Name, onset & duration of:
Rapid acting insulin 
Short acting insulin 
Intermediate insulin 
Long acting

Answer 14

Humalog
- 10min --> 30-90mins
Actrapid, humulin 
- 30-60mins --> 2-5hr
Isophane 
- 1-2hr --> 4-12 hr
Levemic
- 1-2hr --> 20hr

Question 15

What is in a mixed insulin preparation?

Answer 15

Shorting acting & long acting

Question 16

What is a basal bolus regime of insulin?

Answer 16

Long acting in evening

Shorting acting 3x/day before meals

Question 17

Hypoglycaemia management if:

conscious (g of glucose by 10kg, 30kg, 50kg child)

unconscious (3)

Answer 17

Conscious:
sugary snap/ hyostop gel
- 10kg child = 5g glucose
- 30kg = 10g glucose 
- 50kg = 15g glucose 

Unconscious:
- Hypostop gel on buccal mucosa 
- IV 10% dextrose 2mls/kg, followed by glucose infusion 
- SEVERE - glucagon IM
<8yrs = 500mcg, >8yrs = 1mg

Question 18

Antiepileptics for:

Absence seizure

Answer 18

Sodium valproate

Ethosuximide

Question 19

Antiepileptics for:
Myoclonic seizure (1st & 2nd lines)

Answer 19

1st - Sodium Valproate

2nd - Lamotrigine, levetiracetam, topiramate

Question 20

Antiepileptics for:

Tonic clonic seizure (1st & 2nd line)

Answer 20

1st - sodium valproate

2nd - lamotrigine, carbamazepine

Question 21

Antiepileptics for:
Atonic seizure (1st & 2nd line)

Answer 21

1st - sodium valproate

2nd - lamotrigine

Question 22

Antiepileptics for:
focal seizures (1st & 2nd line)

Answer 22

1st - carbamazepine/lamotrigine

2nd - sodium valproate/levetiracetam

Question 23

2 Medications used for west syndrome seizure

Answer 23

Prednisolone

Vigabatrin

Question 24

Desmopressin

• mechanism of action
• indications
• contraindications
• SEs

Answer 24

1) anti-diuretic hormone = increase water reabsorption & reduce urine output 
Increase levels of plasma VIII
2) primary nocturnal enuresis, diabetes insipidus, haemophilia, von Willebrand's disease
3) Diuretics
Cardiac insufficiency 
SIADH
Hx of hyponatraemia 
4) Hyponatraemia

Question 25

What steroid do you give for nephrotic syndrome + how much?

Answer 25

Prednisolone
60mg/m^2 OD 4-6 weeks until proteinuria ceases
Reduce to 40mg/m^2 OD alternate days 4-6weeks
Reduce dose gradually

Question 26

Rickets:
Treatment 
Prevention 
- mechanism of action of each 
- contraindications (same for both)
- SEs (same for both)

Answer 26

Treatment: ergocalciferol
- absorbs Ca & PO4 from intestine, reabsorbs them from kidney, growth of Ca & PO4 in bone
Prevention: cholicalciferol (Vit D3)
- metabolised in liver –> calcidol –> metabolised in kidney –> calcitriol –> maintain Ca & PO4 homeostasis (absorption of Ca & PO4 in small intestine –> bone mineralisation)

• CI: hypercalceamia
• SEs: hypercalcaemia, hypercaliurea, abdo pain, nausea