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Phase 3a > Paeds > Flashcards

Paeds Flashcards

1
Q

How do you manage croup?

A

Single dose dexamethasone

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2
Q

How do you manage croup if severe?

A

Oxygen and nebulised adrenaline

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3
Q

How do you manage asthma in those under 5?

A
  1. SABA
  2. Low does corticosteroids
  3. Leukotriene antagonist (Montelukast)
  4. Refer
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4
Q

How do you manage asthma in those 5-12 years?

A
  1. SABA
  2. Low dose corticosteroids
  3. LABA (salmeterol)
  4. Increase corticosteroid & consider montelukast or theophylline
  5. High dose corticosteroid
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5
Q

How do you manage asthma in those over 12 years?

A
  1. SABA
  2. Low dose corticosteroids
  3. LABA (salmeterol)
  4. Increase corticosteroid & consider montelukast or theophylline or LAMA (tiotropium)\
  5. High dose corticosteroid
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6
Q

What are the indications of a life-threatening asthma attack?

A

Peak flow < 33% predicted, hypotension, exhaustion and poor respiratory effort, cyanosis, altered consciousness or silent chest

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7
Q

What are the indications of a severe asthma attack?

A

Peak flow < 50% predicted, sats <92%, respiratory distress, unable to complete sentences in one breath,RR >40 in 1-5 yrs or >30 >5yrs, HR >140 in 1-5 yrs or > 125 in > 5 yrs.

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8
Q

What are the steps in the acute management of a severe asthma attack?

A
  1. Nebulised salbutamol (&ipratropium bromide)
  2. Oral prednisone
  3. IV hydrocortisone
  4. IV magnesium sulphate
  5. IV salbutamol
  6. IV aminophylline
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9
Q

What is the investigation of choice for intussusception?

A

Abdominal US

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10
Q

What causes hand, foot and mouth?

A

Coxsackie A16

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11
Q

What are the features of hand, foot and mouth?

A

Mild systemic upset (sore throat and fever), oral ulcers followed by vesicles on the palms and soles

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12
Q

What are the signs of vitamin D deficiency in children?

A

Poor growth, delayed teeth, swollen wrists and frontal bossing

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13
Q

What blood results are found in a child with rickets?

A

Low calcium, low phosphate, high ALP and high PTH

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14
Q

What is the treatment for bacterial meningitis in babies < 3 months?

A

IV cefotaxime and IV amoxicillin

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15
Q

What is the treatment for bacterial meningitis in children > 3 months?

A

IV cefotaxime (or ceftriaxone)

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16
Q

What are the features of Patau syndrome? - trisomy 13

A

Microcephaly, small eyes, cleft lip/palate, polydactyly, scalp lesion

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17
Q

What are the features of Edward’s syndrome? - trisomy 18

A

Micrognathia, Low-set ears, Rocker bottom feet, Overlapping of fingers

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18
Q

What are the features of Fragile X syndrome?

A

Learning difficulties, Macrocephaly, Long face, Large ears, Macro-orchidism

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19
Q

What are the features of Noonan syndrome?

A

Webbed neck, Pectus excavatum, Short stature, Pulmonary stenosis

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20
Q

What are the features of William’s syndrome?

A

Short stature, Learning difficulties, elfin facies, Friendly, extrovert personality, Transient neonatal hypercalcemia, supravalvular aortic stenosis

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21
Q

What congenital heart condition is associated with Down syndrome?

A

Atrioventricular septal defect

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21
Q

What congenital heart conditions are most commonly associated with Down syndrome?

A

Endocardial cushion defect (AVSD)
Ventricular septal defect

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22
Q

What are the features of Down syndrome?

A

Hypotonia, Brachycephaly, Short neck, Short stature, Flattened face and nose, Prominent epicanthic folds, Single palmar crease, learning disability

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23
Q

What are the features on the combined test that indicate Down syndrome?

A

Nuchal translucency >6mm, increased beta-HCG and low PAPPA

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24
Q

What are the red high-risk signs in a sick child?

A

Mottled/ashen/blue skin, reduced skin turgor, grunting, tachypnoea >60, moderate recessions, non-blanching rash, bulging fontanelle, age <3 months & temp 38℃

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25
Q

What is a venous hum?

A

Is a benign murmur heard in children and sounds like a continuous blowing noise heard below the clavicles

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26
Q

What are the features of measles?

A

Prodromal phase: Fever, conjunctivitis, irritable
Koplik spots
Rash - maculopapular rash starts behind ear then whole body

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27
Q

What is the most common complication of measles?

A

Otitis media

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28
Q

What are the features of chickenpox?

A

Fever initially
Itchy rash starting on head/trunk - initially maculopapular then vesicular
Mild systemic upset

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29
Q

What are the features of mumps?

A

Fever, malaise, muscular pain
Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral

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30
Q

What are the features of rubella?

A

Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

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31
Q

What causes erythema infectiosum?

A

Parvovirus B19

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32
Q

What are the features of erythema infectiosum?

A

Also known as fifth disease or ‘slapped-cheek syndrome’
Lethargy, fever, headache
‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces

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33
Q

What are the features of scarlet fever?

A

Fever, malaise, tonsillitis
‘Strawberry’ tongue
Sandpaper rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)

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34
Q

What causes scarlet fever?

A

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci

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35
Q

How do you treat scarlet fever?

A

Phenoxymethylpenicillin (penicillin V) for 10 days

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36
Q

What causes roseola infantum?

A

Human Herpes virus 6 (also known as sixth disease)

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37
Q

What are the features of roseola infantum?

A

High-grade fever which resolves before onset of rash. Febrile seizures. Starts on the trunk before spreading to the limbs, maculopapular rash and not itchy.

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38
Q

What causes whooping cough?

A

Pertussis bordetella

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39
Q

How do you test for whooping cough?

A

Nasal swab for Pertussis bordetella

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40
Q

When should whooping cough be considered?

A

Acute cough >2 weeks and has one or more of the following features:
Paroxysmal cough.
Inspiratory whoop.
Post-tussive vomiting.
Undiagnosed apnoeic attacks in young infants.

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41
Q

How should whooping cough be managed?

A

Notifiable disease
School exclusion: 48 hours after commencing antibiotics
Oral macrolide (e.g. clarithromycin or azithromycin)
Household contacts antibiotic prophylaxis
Infants < 6months admitted

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42
Q

What are the notifiable diseases?

A

Scarlet fever, Rubella, Measles

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43
Q

What are the features of Necrotising enterocolitis?

A

Vomiting, diarrhoea, feeding intolerance, abdominal distension, hematochezia and abdominal discolourartion

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44
Q

What investigations should be used for Necrotising enterocolitis and what will they show?

A

Abdominal x-ray - dilated bowel loops, bowel wall oedema, pneumatosis intestinalis, portal vein gas, pneumoperitoneum, Rigler sign (air in & out of bowel)

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45
Q

What are the four features that makeup Tetralogy of Fallot?

A
  1. Ventricular septal defect
  2. Right ventricular hypertrophy
  3. Pulmonary stenosis
  4. Overriding aorta
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46
Q

What is the clinical presentation of Tetralogy of Fallot?

A

Tet spells (cyanotic, tachypnoea, loss of consciousness in first month of life), ejection systolic murmur at left sternal edge, boot-shaped heart on x-ray, low birth weight and poor feeding

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47
Q

What are the clinical features of Transposition of the great arteries?

A

cyanosis, tachypnoea, loud single S2, prominent right ventricular impulse on palpation, ‘egg-on-side’ appearance on chest x-ray

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48
Q

What is Ebstein’s anomaly?

A

Low insertion of the tricuspid valve resulting in a large atrium and small ventricle

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49
Q

What are the feature of coarctation of the aorta?

A

Radio-femoral delay
Mid systolic murmur, maximal over back
Heart failure

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50
Q

What are the features of Ebstein’s anomaly?

A

Cyanosis, hepatomegaly, tricuspid regurgitation
Prominent ‘a’ wave in the distended jugular venous pulse
Pansystolic murmur, worse on inspiration
Right bundle branch block → widely split S1 and S2

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51
Q

What causes Ebstein’s anomaly and what other heart condition is associated with Ebstein’s?

A

Exposure to lithium in-utero

Patent foramen ovale (PFO) or atrial septal defect (ASD) and WPW

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52
Q

What murmur is associated with an atrial septal defect?

A

Ejection systolic murmur, fixed splitting of S2

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53
Q

What murmur is associated with a ventricular septal defect?

A

Pan-systolic murmur

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54
Q

How do you treat a patent ductus arteriosus?

A

Indomethacin or ibuprofen (inhibits prostaglandin synthesis)

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55
Q

What are the features associated with PDA?

A

Left subclavicular thrill, continuous ‘machinery’ murmur
Large volume, bounding, collapsing pulse
Wide pulse pressure and heaving apex beat

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56
Q

Why should aspirin not be given to children?

A

Reye syndrome

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57
Q

What are the components of the APGAR score?

A

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

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58
Q

If a newborn has an abnormal hearing screen, what should be done next?

A

Auditory brainstem response test

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59
Q

What is the most common cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

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60
Q

What result does congenital adrenal hyperplasia have on hormone levels?

A

Low cortisol and aldosterone
High ACTH and high testosterone

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61
Q

How might congenital adrenal hyperplasia present?

A

Severe - Ambiguous genitalia, salt wasting (vomiting, dehydration and hypotension), hyponatraemia, hyperkalaemia and hypoglycaemia.
Mild - early puberty

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62
Q

What is Reye syndrome and what causes it?

A

Linked to aspirin use and is characterised by encephalopathy and liver damage

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63
Q

What are the two most common causes of nephritis in children?

A

IgA nephropathy and post-streptococcal glomerulonephritis

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64
Q

What are the differences between IgA nephropathy and post-streptococcal glomerulonephritis?

A

post-streptococcal nephritis associated with low complement levels
main symptom in post-streptococcal glomerulonephritis is proteinuria (although haematuria can occur)
there is typically an interval between URTI & onset of renal problems in post-streptococcal nephritis

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65
Q

What are the 4 features of Henoch-Schonlein purpura?

A
  1. Purpura (palpable)
  2. Arthritis/arthralgia (knees and ankles)
  3. IgA nephritis (haematuria &/or proteinuria)
  4. GI involvement (abdo pain)
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66
Q

What causes Henoch-Schonlein purpura?

A

Often triggered URTI (IgA vasculitis)

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67
Q

What is the cause of post-streptococcal glomerulonephritis?

A

Occurs 1 – 3 weeks post-β-haemolytic streptococcus infection eg. tonsillitis or impetigo

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68
Q

What are the features of post-streptococcal glomerulonephritis?

A

Haematuria, oligouria, cola coloured urine, peripheral or periorbital oedema

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69
Q

What are the features of intussusception?

A

Paroxysmal abdominal colic pain, the infant will draw their knees up & turn pale
Vomiting
Bloodstained stool - ‘red-currant jelly’ - is a late sign
Sausage-shaped mass in the right upper quadrant

70
Q

What investigation should be done for intussusception and what may they show?

A

USS - target sign

71
Q

What is the management of intussusception?

A

Pneumatic (air) reduction under fluoroscopic guidance

72
Q

How do you treat biliary atresia?

A

Kasai procedure

73
Q

What are the main types of cerebral palsy?

A

Spastic - damage UMN
Dyskinetic (Athetoid) - damage to basal ganglia
Ataxic - damage to cerebellum

74
Q

What are infantile spasms and how may it present on EEG?

A

Generalised myoclonic jerks occur in clusters 10-100 usually when the child is waking. Poor prognosis.
Hypsarrhythmia

75
Q

What are the features of Juvenile myoclonic epilepsy?

A

Onset in the teenage years F>M
Infrequent generalized seizures, often in morning//following sleep deprivation
Daytime absences
Sudden, shock-like myoclonic seizures (like jerks)

76
Q

What are the features of Lennox-Gastaut syndrome?

A

onset 1-5 yrs
features: tonic-clonic seizures, atypical absences, falls, jerks
90% moderate-severe mental handicap
EEG: slow spike

77
Q

What is Benign Rolandic epilepsy and how do they appear on EEG?

A

Focal seizures affecting the head and hand.
5 -12 yr olds, usually during sleep, treatment not required as usually outgrown.
Centrotemporal spikes on EEG

78
Q

What changes are seen on microscopy in minimal change disease?

A

None except for in electron microscopy - effacement of podocyte foot processes

79
Q

How do you treat minimal change disease?

A

Corticosteroids

80
Q

What imaging should be used for suspected developmental dysplasia of the hip?

A

USS unless > 4.5 months then x-ray

81
Q

What imaging should be used for suspected developmental dysplasia of the hip?

A

USS unless > 4.5 months then x-ray

82
Q

What treatment should be used for developmental dysplasia of the hip?

A

Pavlik harness in children younger than 4-5 months

83
Q

How does Duchenne muscular dystrophy present?

A

progressive proximal muscle weakness from 5 years
calf pseudohypertrophy
Gower’s sign: child uses arms to stand up from a squatted position
30% of patients have intellectual impairment

84
Q

What causes Duchenne muscular dystrophy?

A

X-linked recessive condition

85
Q

What investigations can diagnose Duchenne muscular dystrophy?

A

Raised creatine kinase
Genetic testing to confirm the diagnosis

86
Q

What are the features of transient synovitis?

A

Recent viral infection
Limp/refusal to weight bear
Groin or hip pain
Low-grade fever may be present

87
Q

What is Perthes disease?

A

Idiopathic avascular necrosis of the bone.
Linked to repeated minor trauma to bone.

88
Q

What are the features of Perthes disease?

A

Pain in the hip or groin
Gradual limp
Restricted hip movements & stiffness
Referred pain to the knee

89
Q

What investigations should be done in suspected Perthes disease?

A

X-ray
If normal then MRI

90
Q

How should you manage Perthes disease?

A

Conservative - rest, crutches, monitoring
If > 6 yrs → surgery

91
Q

What is slipped capital upper epiphysis?

A

Femoral neck moves away from head

92
Q

What are the features of slipped capital upper epiphysis?

A

Hip, groin, thigh or knee pain
Restricted range of hip movement (internal rotation and abduction)
Painful limp - worse on movement
Restricted movement in the hip
History of minor trauma or growth spurt

93
Q

How do you diagnose slipped capital upper epiphysis?

A

X-ray in AP and lateral (typically frog-leg) view

94
Q

How do you manage slipped capital upper epiphysis?

A

Internal fixation: typically a single cannulated screw placed in the centre of the epiphysis

95
Q

What is Osgood-Schlatter disease?

A

Inflammation at the tibial tuberosity where the patella ligament inserts. Stress from running, jumping and other movements

96
Q

What are the features of Osgood-Schlatter disease?

A

Visible or palpable hard & tender lump at the tibial tuberosity
Pain in the anterior aspect of the knee
Pain worse with physical activity, kneeling & on extension of knee

97
Q

How do you manage Osgood-Schlatter disease?

A

Supportive - rest and NSAIDs

98
Q

Which blood test should be done to investigate JIA?

A

Antinuclear antibody (ANCA) but may be negative

99
Q

What are the features/differences between oligoarticular and polyarticular JIA?

A

Oligoarticular - < 5 joints, medium & large joints, asymmetrical
Polyarticular - ≥ 5 joins, symmetrical

100
Q

What are the features of systemic onset juvenile idiopathic arthritis?

A

Pyrexia, Salmon-pink rash, Lymphadenopathy, Arthritis, Uveitis, Anorexia and weight loss

101
Q

What vaccines should be given at 2 months?

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B

102
Q

What vaccines should be given at 3 months?

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
PCV

103
Q

What vaccines should be given at 4 months?

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Men B

104
Q

What vaccines should be given at 12 months?

A

Hib/Men C
MMR
PCV
Men B

105
Q

What vaccines should be given at 3-4 years?

A

‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio)
MMR

106
Q

How should intestinal malrotation be treated?

A

Ladd’s procedure (includes division of Ladd bands and widening of the base of the mesentery)

107
Q

What are the features of Osgood-Schlatter disease?

A

Visible or palpable hard & tender lump at the tibial tuberosity
Pain in the anterior aspect of the knee
Pain worse with physical activity, kneeling & on extension of knee

108
Q

What is Hirschsprung’s disease?

A

A congenital condition where nerve cells of the myenteric plexus are absent in the distal bowel and rectum. - absence peristalsis

109
Q

What are the features of Hirschsprung’s disease?

A

Delay in passing meconium (more than 24 hours)
Chronic constipation since birth
Abdominal pain and distention
Vomiting
Poor weight gain and failure to thrive

110
Q

How do you treat Hirschsprung’s disease?

A

Initially: rectal washouts/bowel irrigation
Definitive management: surgery Swenson procedure

111
Q

How do you diagnose Hirschsprung’s disease?

A

Abdominal x-ray
Rectal biopsy: gold standard for diagnosis

112
Q

How do you treat Juvenile myoclonic epilepsy?

A

Sodium valproate

113
Q

What is Ebstein’s anomaly?

A

Congenital heart condition - tricuspid valve is set lower in R side of heart (towards the apex) → bigger R atrium & smaller R ventricle.

114
Q

What are the features of Ebstein’s anomaly?

A

Gallop rhythm - tricuspid regurgitation (pan-systolic murmur) and tricuspid stenosis (mid-diastolic murmur)
Cyanosis
HF eg. oedema, SOB, poor feeding
Enlarged R atrium present on imaging

115
Q

What investigation is essential to screen for a potential complication of Kawasaki disease?

A

Echocardiogram to screen for coronary artery aneurysms are a complication

116
Q

How may a congenital diaphragmatic hernia present?

A

Dyspnoea and tachypnoea at birth
Scaphoid abdomen, due to herniation of the abdominal contents into the cleft

117
Q

What are the 5 components of the APGAR score?

A

Pulse, Respiratory effort, Colour, Muscle tone, Reflex irritability

118
Q

What screening do breech babies need regardless of the mode of delivery?

A

All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks

119
Q

How should a threadworm infection be treated?

A

A single dose of oral mebendazole for entire household and hygiene advice

120
Q

What auditory screening test is done in newborns?

A

Otoacoustic emission test
If abnormal - Auditory Brainstem Response test

121
Q

What auditory screening test is done in children starting school?

A

Pure tone audiometry

122
Q

What is the first and second-line treatment for ADHD?

A

1st Methylphenidate
2nd Lisdexamfetamine

123
Q

What are the features of fetal alcohol syndrome?

A

short ­palpebral fissure
thin vermillion border/hypoplastic upper lip
smooth/absent filtrum
learning difficulties
microcephaly

124
Q

What antibiotics should be given for meningitis in children > 3 months?

A

Intravenous ceftriaxone

125
Q

What antibiotics should be given if a diagnosis of meningitis is made in the community?

A

Intramuscular benzylpenicillin

126
Q

What antibiotics should be used as prophylaxis for close contacts of patients with meningococcal meningitis?

A

Ciprofloxacin

127
Q

What is Meckel’s diverticulum?

A

Common congenital GI condition. Remnant of the omphalomesenteric duct & contains ectopic ileal, gastric or pancreatic mucosa.

128
Q

How might Meckel’s diverticulum present?

A

Abdominal pain mimicking appendicitis
Rectal bleeding - massive painless GI bleed
Intestinal obstruction

129
Q

What investigation should be done in Meckel’s diverticulum (if hemodynamically stable)?

A

Meckel’s scan - 99m technetium pertechnetate, which has an affinity for gastric mucosa

130
Q

What is the most common cause of epiglottitis?

A

In unvaccinated - Haemophilus influenza B
Vaccinated - Streptococcus group A

131
Q

What are the features of epiglottitis?

A

Pyrexia, generally unwell, inspiratory stridor, drooling of saliva, tongue out, muffled voice, ‘tripod’ position, sore throat.

132
Q

What features can be seen on an x-ray in epiglottitis?

A

Lateral view - thumb sign
Posterior-anterior view - steeple sign

133
Q

What cardiac conditions are associated with Turner syndrome?

A

Bicuspid aortic valve and aortic coarctation.

134
Q

What are the possible causes of prolonged neonatal jaundice (>14 days)?

A

Biliary atresia
Hypothyroidism
G6PD deficiency
UTI or prematurity

135
Q

What are the possible causes of neonatal jaundice in the first 24hrs?

A

ALWAYS pathological
Haemolytic disease (rhesus or ABO)
Hereditary spherocytosis

136
Q

Which metabolic abnormality would a patient with pyloric stenosis most likely present with?

A

Hypochloremic hypokalemic metabolic alkalosis

137
Q

What are the features of Kawasaki disease?

A

High-grade fever lasts for > 5 days, Conjunctivitis, Bright red, cracked lips, strawberry tongue, cervical lymphadenopathy, red palms of the hands & the soles of the feet

138
Q

How do you treat Kawasaki disease?

A

High dose aspirin and immunoglobulins

139
Q

Should you prescribe antibiotics for otitis media?

A

Only prescribe if:
Symptoms > 4 days or not improving
Systemically unwell
Immunocompromise
< 2 years with bilateral otitis media
Otitis media with perforation and/or discharge

140
Q

What antibiotics should you prescribe for otitis media?

A

5-7 day course of amoxicillin

141
Q

What is glue ear?

A

Otitis media with an effusion, and hearing loss is usually the presenting feature.

142
Q

How is glue ear treated?

A

Grommet insertion - to allow air to pass through into the middle ear and hence do the job normally done by the Eustachian tube.

143
Q

Which bacteria commonly cause otitis media?

A

Strep pneumoniae and Haemophilus influenzae

144
Q

What checks should be done for the use of Methylphenidate in ADHD?

A

Potentially cardiotoxic - perform a baseline ECG
Weight and height should be monitored every 6 months

145
Q

How should lower UTIs in children be managed?

A

< 3 months old = referred immediately to a paediatrician
> 3 months old with a lower UTI = 3 days either trimethoprim (first line) or nitrofurantoin

146
Q

How should upper UTIs in children be managed?

A

< 3 months old = referred immediately to a paediatrician
> 3 months with upper UTI = consider admission & Cefalexin

147
Q

What imaging should babies < 6 months have following a UTI?

A

Atypical or recurrent infections = DMSA & Micturating cystourethrogram
If just normal UTI = US within 6 weeks

148
Q

What antibiotic should be used for pneumonia in children?

A

Amoxicillin

149
Q

When should Erythromycin be used in paediatric pneumonia?

A

If mycoplasma or chlamydia is suspected

150
Q

What causes androgen insensitivity syndrome?

A

X-linked recessive condition, defect in androgen receptor results in end-organ resistance to testosterone causing genotypically male children (46XY) to have a female phenotype.

151
Q

What are the hormone levels in androgen insensitivity syndrome?

A

Testosterone, oestrogen and LH levels are elevated

152
Q

What is Kallman’s syndrome?

A

Delayed puberty secondary to hypogonadotrophic hypogonadism, due to failure of GnRH-secreting neurons to migrate to the hypothalamus

153
Q

What are the features of Kallman’s syndrome?

A

‘delayed puberty’
hypogonadism, cryptorchidism
anosmia
sex hormones & LH/FSH levels are low

154
Q

How do you manage constipation?

A
  1. Polyethylene glycol 3350 + electrolytes (Movicol Paediatric Plain)
  2. Stimulant laxative (Senna)
  3. Osmotic laxative (lactulose)
155
Q

How should exomphalos and gastroschisis be repaired?

A

Exomphalos should have a gradual repair to prevent respiratory complications. Gastroschisis requires urgent correction

156
Q

What are red flags in gross motor skill development?

A

Not sitting unsupported @ 12 months
Not walking @ 18 months
Hand preference before 18 months

157
Q

What are the 4 main causes of inspiratory stridor in children?

A

Croup
Inhaled foreign body
Acute epiglottis
Laryngomalacia (baby’s larynx is soft & floppy

158
Q

What is tested for in the Guthrie test or ‘heel-prick test’?

A

Congenital hypothyroidism
Cystic fibrosis
Sickle cell disease
Metabolic conditions such as maple syrup urine disease, MCADD and phenylketonuria

159
Q

What are the two most common congenital heart defects associated with Turner’s syndrome?

A

Bicuspid aortic valve
Coarctation of the aorta

160
Q

What vaccine is available against bronchiolitis and who is it available for?

A

Palivizumab
All childen < 24 months immunocompromised

161
Q

What antibiotics should be given in suspected neonatal sepsis?

A

Benzylpenicillin + Gentamicin

162
Q

What would a blood gas in congenital adrenal hyperplasia salt crisis show?

A

Hyponatraemia Hyperkalaemia
Metabolic acidosis

163
Q

What is the classic triad of haemolytic uraemic syndrome?

A

Haemolytic anaemia
Acute kidney injury
Low platelet count (thrombocytopenia)

164
Q

What causes haemolytic uraemic syndrome?

A

Shiga toxin produced by e.coli or shigella

165
Q

What are the features of Wilm’s tumour?

A

abdominal mass (most common presenting feature)
painless haematuria
flank pain
anorexia, fever
hypertension

166
Q

What is Infectious mononucleosis?

A

Epstein Barr virus (EBV). It is commonly known as the “kissing disease”, “glandular fever” or “mono”

167
Q

What advice should be given to patients with Infectious mononucleosis?

A

Avoid alcohol & contact sport (splenic rupture)

168
Q

What tests should be done in suspected coeliac?

A

Tissue transglutaminase (TTG) antibodies (IgA) are first-choice
Endomyseal antibody (IgA)
Check IgA deficiency if negative

169
Q

How do you diagnose mononucleosis?

A

heterophil antibody test (Monospot test)

170
Q

How do you treat impetigo?

A

Hydrogen peroxide (topical)

171
Q

How do you treat scabies?

A

Permethrin

172
Q

What fluid bolus should be given to children in shock?

A

20ml/kg bolus is administered in shock, however in DKA and HF give 10ml/kg

173
Q

How can faecal impaction be managed?

A
  1. Macrogol and electrolytes (Movicol Paediatric Plain)
  2. Stimulant laxative e.g. senna

Phase 3a (6 decks)

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