Paeds

Question 1

inheritance of fragile X syndrome, main effect and complication

Answer 1

X linked -> mutation in FMR1 gene on X chromosome -> role in cognitive development
mitral valve prolapse

Question 2

continuous crescendo-decrescendo machinery murmur

Answer 2

patent ductus arteriosus

Question 3

ejection systolic murmur

Answer 3

whooOOOoosh dub
Turner’s syndrome; aortic stenosis; pulmonary stenosis -> Tetralogy of Fallot

Question 4

late systolic murmur

Answer 4

mitral valve prolapse and aortic coarctation
Turner’s; Fragile X syndrome???

Question 5

mid-late diastolic, low pitched, rumbling murmur

Answer 5

mitral stenosis - LUB dub durrrrr
(also tapping apex beat, malar flush)
rheumatic fever, infective endocarditis (associated with AF)

Question 6

pan systolic murmur

Answer 6

whooooosh
tricuspid regurgitation,
mitral regurgitation,
ventricular septal defect

Question 7

mitral regurgitation

Answer 7

BURRRR; radiates to axilla,
associated w congestive cardiac failure
causes: idiopathic weakening w age, IHD, etc.

Question 8

aortic stenosis

Answer 8

crescendo-decrescendo
ejection systolic
buUUrr-dub; radiates to carotids
exertional syncope
causes: idiopathic age related calcification; rheumatic heart disease

Question 9

aortic regurgitation

Answer 9

early diastolic soft murmur; lub tarrrrr
collapsing pulse
causes: age related weakness; connective tissue disorders

Question 10

croup presentation and organism

Answer 10

inspiratory stridor, barking cough, SOB
parainfluenza virus

Question 11

whooping cough presentation, organism, management

Answer 11

paroxysmal cough followed by loud high-pitched whooping sound
bordetella pertussis
azithromycin & notify PH, return to school 48h after starting abx

Question 12

scarlet fever presentation, organism, management

Answer 12

fever; malaise; strawberry tongue; fine punctate erythema on torso which spares palms and soles (sandpaper rash)
streptococcus pyogenes (group A haemolytic streptococci)
oral penicillin V for 10 days, notify, return to school 48h after starting abx

Question 13

bronchiolitis presentation and organism

Answer 13

coryza symptoms followed by cough
respiratory syncytial virus
supportive (O2 if sats <92)

Question 14

management of meningitis in <3mo

Answer 14

cefotaxime and amoxicillin

Question 15

management of meningitis in >3mo

Answer 15

cefriaxone and IV corticosteroids

Question 16

macular rash =

Answer 16

small, flat, discoloured spots

Question 17

papular rash =

Answer 17

small raised bumps

Question 18

indications for admission

Answer 18

cyanosis
fluid intake < 50%
nasal flaring
respiratory rate > 70
SpO2 < 94%

Question 19

tetralogy of fallot

Answer 19

large VSD
overriding of the aorta
pulmonary stenosis
RV hypertrophy
= harsh ejection systolic murmur, tet spells, presents at 1-2mo