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OSCE > Paeds > Flashcards

Paeds Flashcards

1
Q

What gross and fine motor skills should a child of 6 months be able to achieve?

A

Pushes up on arms in prone, can roll from front to back / transfers objects using palmar grasp

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2
Q

A weight on what centile corresponds to a child being obese?

A

98th centile

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3
Q

Which formula is best- whey or casein based?

A

Whey

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4
Q

What gross and fine motor skills should a child of 18 months be able to achieve?

A

Runs, climbs onto adult chair / builds tower of 3-4 blocks, develops hand preference

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5
Q

Other than general inspection, what should you do during assessement of the back and CNS in a newborn examination?

A

Palpate down the spine

Listen to the mid-scapular area

Check the anus is patent

Check the Moro and grasp reflexes

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6
Q

What defines precocious puberty in girls and boys?

A

< 8 years in girls, < 9 years in boys

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7
Q

What are some potential underlying causes of a delay in social skills?

A

Autism

Secondary to abuse or neglect

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8
Q

Other than general inspection, what additional test should you do during assessment of the legs and hips in a newborn examination?

A

Barlow and Ortolani’s test

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9
Q

What are some good ways to tell that a baby is taking enough milk during feeds?

A

They are gaining weight

They are having 6 wet nappies per day

They are passing 2 yellow stools per day

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10
Q

When is calculation of a child’s BMI required?

A

If the weight is above the 75th centile or if the weight and height centiles differ

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11
Q

What social skills should a child of 9 months be able to achieve?

A

Anxious around strangers

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12
Q

From 4 years to puberty, how much should a child’s height increase by each year?

A

5cm

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13
Q

What extra things should you always enquire about in a paediatric history?

A

Birth history, growth and developmental history, vaccination history

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14
Q

Explain how the grimace in response to plantar stimulation section of APGAR is scored?

A

Absent = 0

Grimace/feeble cry = 1

Strong cry/pull away when stimulated = 2

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15
Q

What language skills should a child of 24 months be able to achieve?

A

Joins two words together, follows simple instructions

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16
Q

What are some potential underlying causes of a fine motor/visual delay?

A

Squint

Refractory error

Cataract

Glaucoma

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17
Q

What happens to a baby’s weight in the first week after birth?

What is the reason for this?

A

The baby will lose 5-10% of its birthweight

Loss of extracellular fluid

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18
Q

What social skills should a child of 12 months be able to achieve?

A

Waves bye-bye, drinks from a cup

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19
Q

By what age should the majority of children have achieved day and night time continence?

A

3-4 years

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20
Q

What are some specific symptoms to ask about in a paediatrics systemic enquiry?

A

Cough/cold symptoms/difficulty breathing, vomiting, rashes, fever, any evidence of pain

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21
Q

When should routine examination of the newborn take place?

A

Ideally within 24 hours of birth, must be within 72 hours

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22
Q

What growth variables are plotted in children aged < 2 years?

A

Head circumference, length and weight

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23
Q

At what ages are childhood vaccinations usually given?

A

2, 3 and 4 months

12-13 months

3 years 4 months

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24
Q

What are some risk factors for child abuse that you should try to address in a history where this is suspected?

A

Was the child premature or does it have any physical/mental disability?

Are there any mental health or substance misuse issues with the parents?

Is there domestic violence or social deprivation?

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25
Q

Exclusive breastfeeding is recommended for how long?

A

6 months

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26
Q

A weight on what centile corresponds to a child being overweight?

A

91st centile

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27
Q

What social skills should a child of 6 months be able to achieve?

A

Friendly with strangers, plays with their feet

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28
Q

Explain how the activity (tone) section of APGAR is scored?

A

Absent = 0

Some flexion = 1

Flexed arms and legs that resist extension = 2

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29
Q

Explain how the pulse section of APGAR is scored?

A

No pulse = 0

< 100 = 1

> 100 = 2

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30
Q

What gross and fine motor skills should a child of 12 months be able to achieve?

A

Cruising, walking / bangs toys together

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31
Q

What extra question should you always ask in a social history in paediatrics?

A

Has social work ever been involved with the child?

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32
Q

A baby’s weight should double by when?

A

4-6 months

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33
Q

What are some potential underlying causes of a speech delay?

A

Hearing impairment

Autism

Part of a wider global developmental delay

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34
Q

What social skills should a child of 3 years be able to achieve?

A

Vivid pretend play, understands sharing

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35
Q

If a child who is in or completing puberty has a height measurement plotted within the shaded area, what action is required?

A

Referral to paediatrics (below 0.4th centile)

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36
Q

If a child who is pre-pubertal has a height measurement plotted within the shaded area, what intervention is required?

A

Compare with the mid-parental height- only consider referral to paediatrics if there is a significant discrepancy

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37
Q

At what age can a child drink full fat cow’s milk?

A

12 months

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38
Q

How do you gestationally correct on a growth chart?

A

Plot the measurements at the child’s chronological age, then draw a line back the number of weeks the infant was preterm

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39
Q

What language skills should a child of 3 years be able to achieve?

A

Knows name and sex, asks lots of questions

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40
Q

What are three questions to always ask as part of your systemic enquiry in paediatrics?

A

Is the child eating/drinking normally? Is the child still having wet/dirty nappies or going to the toilet as normal? Is the child acting like their normal self or are they out of character?

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41
Q

Short stature is defined as a height below what centile?

Tall stature is defined as height above what centile?

A

2.5th centile

98th centile

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42
Q

What language skills should a child of 12 months be able to achieve?

A

Responds to name, jargons

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43
Q

What are some investigations you may want to do in a situation where child abuse is suspected?

A

Blood tests

Skeletal survey

Head CT

Fundoscopy

Medical photography

44
Q

How long should milestones and growth charts be corrected for premature babies?

A

2 years

45
Q

What social skills should a child of 6 weeks be able to achieve?

A

Social smile

46
Q

When do the primitive reflexes typically disappear?

A

5-6 months

47
Q

How should you plot growth for a baby who was < 32 weeks premature?

A

Use an infant and neonatal close monitoring chart

48
Q

What language skills should a child of 6 weeks be able to achieve?

A

Stills to voice

49
Q

What social skills should a child of 24 months be able to achieve?

A

Puts on hat and shoes, developing symbolic play

50
Q

Explain how the respiratory effort section of APGAR is scored?

A

No effort = 0

Weak, slow gasps = 1

Strong cry = 2

51
Q

What are the 5 features of APGAR?

A

Appearance (colour)

Pulse

Grimace (response to stimulation)

Activity (tone)

Respiratory effort

52
Q

A baby’s head circumference should treble by when?

A

One year

53
Q

How should head circumference be measured?

A

Above the child’s ears, measure the head from midway between the eyebrows and hairline to the occipital prominence

54
Q

What is one of the most important things to ask about in a history where abuse is suspected, in order to be safe?

A

Ask if there are any other children at home

55
Q

A baby’s weight should treble by when?

A

1 year

56
Q

What is the target height for a child based on mid-parental height?

A

Within two centile spaces above or below the mid-parental height

57
Q

After the first few days of life, how much milk should babies be consuming?

How many feeds should this be spread over?

A

150ml/kg/day spread over 4-6 feeds

58
Q

What are some things to ask for in a family history of a child where abuse is suspected to rule out potential differentials?

A

Bleeding disorders, ostoegenesis imperfecta

59
Q

At what age should a baby begin to be weaned onto solid foods?

A

6 months

60
Q

Describe how to perform Ortolani’s test?

A

Flex the hips and knees of the infant, place your index finger on the greater trochanter and apply pressure while abducting the hip- this relocates a dislocated hip

61
Q

What social skills should a child of 4 years be able to achieve?

A

Dresses and undresses, understands turn-taking

62
Q

When should a child have their length measured in a supine position as opposed to standing height?

A

If they are < 2 years old or they are unable to stand

63
Q

When are APGAR scores calculated?

A

Routinely at 1 and 5 minutes after birth

Additional checks every 5 minutes until the score is > 6

64
Q

What gross and fine motor skills should a child of 3 years be able to achieve?

A

Stairs with alternating feet, rides tricycle / copies a circle, cuts with scissors

65
Q

How accurate is the adult height predictor section of growth charts?

A

4/5 children will be within +/- 6cm of this value

66
Q

What gross and fine motor skills should a child of 4 years be able to achieve?

A

Runs up and down stairs / threads beads, draws man

67
Q

What is a good way of explaining that you are going to refer their child to social services for assessment?

A

All children with these injuries are referred for further assessment. Some injuries like this are not accidental and it can be very difficult to tell, so we have to refer all cases in order to be safe.

(Explain the process and emphasise that you are doing this to keep the child safe and protected)

68
Q

What are some specific milestones that are useful to ask about?

A

When did the child start to walk and talk?

69
Q

What gross and fine motor skills should a child of 3 months be able to achieve?

A

No head lag / regards hands held in midline

70
Q

What language skills should a child of 3 months be able to achieve?

A

Laughs and coos

71
Q

What gross and fine motor skills should a child of 9 months be able to achieve?

A

Crawls, stands holding onto furniture / picks up objects between thumb and hand, points with index finger

72
Q

What is the definition of faltering growth (failure to thrive)?

A

A sustained drop down 2 centiles on a growth chart

73
Q

Before performing a newborn examination, what information should you obtain?

A

Information about the maternal health, pregnancy and delivery, family history

74
Q

What would be your immediate management for a case where child abuse was suspected?

A

Admit to paediatrics for further investigation

Contact your senior and contact safeguarding lead

Refer to social services

75
Q

Between the ages of 1 and 5, the average child should gain how much weight per year?

A

2kg

76
Q

What are some potential underlying causes of a gross motor delay?

A

Cerebral palsy

Muscular dystrophy

Part of a wider global developmental delay

77
Q

What language skills should a child of 9 months be able to achieve?

A

Polysyllabic babble, imitates adult sounds

78
Q

For children up to the age of 5 who are walking, how much exercise should they be doing in a day?

For children aged 5-18 years, how much exercise should they be doing in a day?

A

180 minutes

60 minutes of moderate-vigorous intensity exercise

79
Q

What is the triad of symptoms that forms shaken baby syndrome?

A

Retinal haemorrhages, subdural haematoma, encephalopathy

80
Q

How should you plot growth for a baby that was premature, but more than 32 weeks gestation at birth?

A

Plot measurements on the preterm section until 42 weeks’ gestation

After this, plot on the 0-1 chart at the chronological age but with gestational correction

81
Q

What should you do during assessment of the abdomen and external genitalia in a newborn assessment?

A

Check the umbilical stump and feel the abdomen, softly then firmly

Palpate the testes and inspect for hypospadias (boys)

Check the labia and introitus and warn patients to expect some spotting (girls)

82
Q

What growth variables are plotted in children aged > 2 years?

A

Weight, height +/- BMI

83
Q

What gross and fine motor skills should a child of 6 weeks be able to achieve?

A

Head control in vertical / follows torch with eyes

84
Q

What are some benefits of breastfeeding to the mother?

A

Decreased risk of breast and ovarian cancer

Decreased risk of cardiovascular disease

Helps with post-natal weight loss

Improves bonding

More affordable

85
Q

What defines pubertal delay in boys and girls?

A

13+ for girls, 14+ for boys

86
Q

If a teenage child’s height is plotted in the shaded area, what further information do you need to acquire?

A

Pubertal status and mid-parental height centil

87
Q

What are some benefits of breastfeeding to the child?

A

More proteins, antibodies and probiotics to prevent infection

Decreases risk of type 1 diabetes, obesity, SUDI and cardiovascular disease in adulthood

88
Q

When should a skeletal survey be repeated?

A

After 11-14 days

89
Q

What language skills should a child of 18 months be able to achieve?

A

5-20 words, points to body parts

90
Q

A baby’s head circumference should double by when?

A

4-6 months

91
Q

What language skills should a child of 6 months be able to achieve?

A

Screams when annoyed, babbles tunefully

92
Q

What is the average age of puberty in boys and girls?

A

10 years in girls, 11 years in boys

93
Q

What gross and fine motor skills should a child of 24 months be able to achieve?

A

Stairs two feet at a time / builds tower of 6-7 blocks, circular scribble

94
Q

What does dropping centiles on a chart actually correlate to in terms of growth?

A

The child isn’t growing

95
Q

What should be done as part of assessment of the head and skull during the newborn examination?

A

Examine the size and shape of the skull

Feel the fontanelles

Measure the head circumference

96
Q

What should you do during assessment of the heart and peripheral pulses in the newborn examination?

A

Feel the femoral pulses (normally 110-160 bpm)

Palpate the four areas with bell and diaphragm

Feel for the apex beat and any heaves/thrills

97
Q

Other than general inspection, what are some additional things you should do during the assessment of the face, eyes, ears, mouth during the newborn examination?

A

Check the red reflex

Feel the palate while assessing for the suckling reflex

98
Q

What should you do during assessment of the lungs in the newborn examination?

A

Assess the respiratory rate (30-60) and pattern of breathing

Listen to air entry

99
Q

What APGAR score would be considered normal?

A

8-10

100
Q

What language skills should a child of 4 years be able to achieve?

A

Recount stories of recent experiences

101
Q

What social skills should a child of 18 months be able to achieve?

A

Feeds with a spoon, imitates adult activities

102
Q

From 1 to 4 years, how much should a child’s length increase by each year?

A

25cm

103
Q

Explain how the ‘appearance’ section of APGAR is scored?

A

Blue/pale = 0

Pink body with blue extremities = 1

Pink = 2

104
Q

A specialised growth chart is required for children with what condition?

A

Down’s syndrome

105
Q

Before performing a newborn examination you should ask whether the baby has peed or pood- within what timeframe should each of these events occur?

A

Should urinate within the first 24 hours and pass meconium within the first 48 hours

106
Q

Describe how to perform Barlow’s test?

A

Adduct the hip and apply posterior pressure through the knee, this may dislocate a hip (positive test)

107
Q

What social skills should a child of 3 months be able to achieve?

A

React pleasurably to familiar situations

OSCE (14 decks)

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