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Past-Test exam questions > Paeds > Flashcards

Paeds Flashcards

1
Q

outpouching of ileum due to peristence of vitelline duct is known as:

A

meckel’s diverticulum

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2
Q

absence of ganglionic cells in submucosa is known as :

A

hirschsprungs disease

infants

  • fail to pass meconium
  • abdo distention
  • vomiting
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3
Q

6 features of cystic fibrosis:

A

MRS SEW

M- meconium ileus

R- recurrent pneumonia

S- steatorrhoea

S- short stature

E- extra energy needed

W- weight gain poor

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4
Q

which manoeuvre is contraindicated in patients with suspicion of cervical spine injury?

A

head tilt and chin lift

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5
Q

telescoping of one bowel segment into distal segment:

A

intussusception

- red current jelly stools

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6
Q

palpable ‘olive’ mass in epigastric region.

non bilious projectile vomiting at 2-6 weeks of life

A

congenital hypertrophic pyloric stenosis

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7
Q

ileus caused by

A

aperistaltic bowel

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8
Q

what sign is seen on x-ray in a child with duodenal atresia

A

double bubble sign

association with downs.

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9
Q

4 y/o ran into a door.
crying. vomited three times.

OE: swelling on forehead, CNS and PNS examination normal.

next best course of action?

options:

a) CT within 1 hr
b) CT within 8 hrs
c) observe 4 hrs
d) discharge now
e) social service involvement

A

observe for atleast 4 hrs.

CT within one hour if more than one of the following features

  • loss of consciousness > 5mins
  • abnormal drowsiness
  • 3 episodes vomitting
  • high impact injury
  • amnesia

the child in this case only has one feature!

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10
Q

supplementation with what prior to conception can help prevent neural tube defects

A

folate

  • necessary in nucleic acid synthesis
  • 400 micograms a day

however if +FH
- 5mg folic acid

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11
Q

which vitamin prevents keratinised squamous metaplasia

A

vitamin A supplementation

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12
Q

which vitamin is necessary for pyruvate dehydrogenase function:

A

thiamine

thiamine deficiency can cause beriberi and wernickes-korsakoffs syndrome observed in alcoholics

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13
Q

11 month old

pc: failure to thrive, weight loss. recurrent diarrhoea, recurrent fevers, breathing difficulties
oe: generalised lymphadenopathy + eczema

likely diagnosis:

A

HIV

mothers with low viral load can have vaginal delivery, otherwise pre labour C-section done to reduce vertical transmission risk

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14
Q

neonate with

  • low birthweight
  • jaundice
  • small head
  • seizures
  • acutely unwell

could be due to:

A

congenital cytomegalovirus

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15
Q

2 day old neonate

pc:

  • refusing to feed
  • irritable

oe

  • hypotonic
  • non blanching petechial rash over lower limbs

diagnosis:

A

early onset neonatal sepsis.

common organism: GBS

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16
Q

treatment of GBS neonatal sepsis

A

IV benzylpenicillin

gentamicin

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17
Q

10 day old neonate:

pc: blistering rash on scalp and face
oe: jaundice, hepatomegaly, vesicular rash

indicative of:

A

herpes simplex virus

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18
Q

tx herpes simplex virus

A

IV aciclovir

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19
Q

conjunctivitis (bilateral purulent discharge from eye) + respiratory distress

likely due to:

A

chlamydia infection

- can cause pneumonia and conjuctivitis

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20
Q

treatment of chlamydia trachomatis ?

A

erythromycin

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21
Q

6 week old

pc:

  • struggling to feed
  • increased work of breathing
  • not gained weight in 2 weeks

oe:

  • parasternal heave
  • loud systolic murmur at left sternal border

indicative of :

A

ventral septal defect

spontaneous closure common < 1 years.

after 2 years VSD unlikely to close.

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22
Q

what is a common method of diagnosing VSD?

A

Echocardiography

23
Q

when is surgical repair indicated in child with VSD?

A
  • poor growth

- uncontrolled heart failure

24
Q

most appropriate investigation for child with suspicion of meningitis

A

lumbar puncture

csf fluid for gram staining and microscopy

25
Q

2 month old

pc: fever + grunting, tacypnoeic, cough, nasal flaring

investigation:

A

signs of respiratory distress

+ fever –> pneumonia

Ix = CXR

26
Q

child under 5 with signs of gastroenteritis.

investigation:

A

only <5% due to bacterial cause.

so need to do electron microscopy of stool
- demonstrates viruses

27
Q

6 month old

4 day hx paroxysmal cough + fine purpuric eruptions around eyes and neck.

missed her diptheria, tetanus and pertussis vaccinations.

indicative of:

A

patient have pertussis –> forceful coughing

can lead to traumatic petechiae.

traumatic petechiae

  • in periorbital areas
  • subconjunctival haemorrhage
28
Q

which commonly presents with

  • palpable purpuric rash
  • abdominal pain
  • arthralgia
  • glomerulonephritis
A

Henoch-schonlein purpura
- immune complex small vessel vasculitis

glomerulonephritis –> nephritic syndrome –> swelling of ankles and feet

29
Q

Henoch-schonlein purpura results from:

A
  • IgA deposition

- post URTI or other infection

30
Q

bacterial cause sof meningitis

A

NHS

N- neisseria menpngitidis (child and adult; meningococcus)

H- haemophillus influenza

S- strep pneumoniae (adults and elderly)

31
Q

acute lymphoblastic leukaemia presents with

A
  1. progressive anaemia (lethargy + pallor)
  2. neutropenia (recurrent infections)
  3. thrombocytopenia (spontaneous bruising, purpura, mucosal bleeding)

may be lymphadenopathy, hepatosplenomegaly –> organ infiltration

32
Q

what presents with :

  • abrupt onset platelet type bleeding
  • spontaneous bruising
  • petechiae
  • mucosal bleeding
A

idiopathic thrombocytopenic purpura

33
Q

management of idiopathic thrombocytopenic purpura is:

A

corticosteroids OR intravenous immunoglobulin

34
Q

where is a patent ductus arteriosus best heard?

A

left upper chest , pulmonary area

35
Q

what is the tetralogy of fallot?

A

SHOP

S- ventricular septal defect

H- hypertrophy of RV

O- overriding aorta

P- pulmonary stenosis

36
Q

causes of aortic stenosis:

A

REC

R- rheumatic heart disease

E- elderly calcification of tricuspid

C- congenital calcification of bicuspid aortic valve

37
Q

newborn:

cyanotic at birth

CXR : boot shaped heart, holosystolic murmur audible at left lower sternal border

indicative of:

A

tetralogy of fallot

38
Q

3 y/o boy

pc:
- cough (dry/ nocturnal/ worse with exercise)
- wheeze
- sob

pmh
- mild excema

indicative ofL

A

asthma
- intermittent attacks of wheese

pmh of hay fever or eczema is also suggestive of asthma

39
Q

7 month old

  • chronic resp symptoms
  • offensive diarrhoea
  • failure to thrive

indicative of:

A

cystic fibrosis

steatorrhoea - malabsorption from pancreatic insufficiency

40
Q

15 y/o

pc

  • intermittent abdo pain + diarrhoea for 2 years
  • blood + mucus in stools
  • weight loss, periodic fevers

oe
- erythema nodosum on shins

A

ulcerative colitis

extraintestinal manifestations of IBD involve

  • monoarticular arthritis
  • erythema nodosum
41
Q

posititive anti-TTG and anti- EMA antibodies are characteristic of:

A

coeliacs disease

association with HLA-DQ2, HLA-DQ8

42
Q

neonate
- forceps delivery

oe

  • reduced tone in left arm
  • reduced moro reflex (splaying arms and legs in front of their body)
  • arm in waiter tip position

classical signs of:

A

erbs palsy

management: physio

43
Q

14 y/o, started to limp, in pain, overweight

diagnosis:

A

slipped femoral epiphysis

secondary school

44
Q

deficiency in G6PD leads to:

A

G6PD enzyme needed in RBCs.

Cells become more vulnerable to damage from reactive oxygen species (ROS)

–> leads to haemolysis

45
Q

G6PD deficiency often presents with:

A

neonatal jaundice!

  • anaemia
  • gall stones
  • splenomegaly

more common in mediterranean, middle eastern and african parents

X-linked

46
Q

15 y/o

pc:
- recurrent abdo pain
- bloody diarrhoea

oe

  • small for her age
  • delayed puberty
  • oral and perianal ulcers

indicative of:

A

Crohn’s disease

notes

  • transmural
  • skip lesions

perianal fistulae and oral apthous ulcers are not classically seen in UC.

47
Q

3 key signs of intussusception

A

SSS

S- screaming, pallor

S-stool, red current jelly

S-sausage shaped palpable abdo mass in RHS abdomen

48
Q

inheritance of haemophilia A

A

X-linked recessive

49
Q

haemophilia A characterised by deficiency in what

A

factor VII

50
Q

haemophilia B characterised by deficiency in what

A

clotting factor IX

51
Q

5 month old

pc: respiratory distress
hpc: coryzal symptoms 5 day hx

oe: 37.8 temp
- nasal flaring
- intercostal recession
- cyanosis

widespread wheeze and crackles through lung fields

indicative of:

A

acute bronchiolitis

52
Q

what syndrome is characterised by deafness and renal failure?

A

alport syndrome

53
Q

child has difficulty in hearing, several fractures after minor falls, sclera appear blue, legs short and deformed

indicative of:

A

osteogenesis imperfecta

54
Q

18 month old

pc: 4 day hx high fever + coryza
oe: pink blanching maculopapular rash, now spread to arms , fever now settled

indicative of:

A

Roseola infantum

Past-Test exam questions (7 decks)

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