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Paeds Flashcards

1
Q

Kid with spiral fracture. What do you do?

A

Admit and investigate for NAI

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2
Q

Kid with petechial rashes, low RBC and raised WBC with a limp and sick

A

ALL

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3
Q

On newborn check, inverted ankles and plantar flexed, what sign is this?

A

Talipes equinovarus (clubfoot)

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4
Q

Difficult balance, cannot build block of towers, hyperreflexia. What type of CP and where is lesion?

A

ataxic - cerebellum

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5
Q

Cannot examine ear directly, lump behind ear causing ear to stick out

A

Mastoiditis

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6
Q

Kid with 2cm mass (inframandibular) on left side, painful – blood film shows: toxic left shift with reactive neutrophilia.

A

Lymphadenitis

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7
Q

3 year old Kid with hypochromic microcytic anaemia and low ferritin. What could be the cause? Folate deficiency, Thalassaemia, Coeliac, fussy eater

A

Fussy eater

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8
Q

Girl with abdominal pain only when going to school, not weekends.

A

Functional abdominal pain

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9
Q

Cyanosis in 6 week old with clubbing and systolic stenosis heard at left sternal border

A

Tetralogy of fallot

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10
Q

How should you give influenza vaccine to kid who is allergic to eggs?

A

Hospital IM injection

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11
Q

Kid with bilateral calf hypertrophy - what investigations?

A

Measure creatine kinase - muscular dystrophy

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12
Q

Kid with pellet stools, and loose stool sometimes

A

Overflow diarrhoea secondary to constipation

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13
Q

Maintenance fluid to give to kid with diabetes mellitus - DKA and no DKA

A

In DKA: 0.9% saline, no DKA: 0.9% saline with 5% dextrose

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14
Q

Cerebral Palsy (described hemiplegic weakness with brisk reflexes), what area of the brain is affected?

A

Pyramidal tracts

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15
Q

Child with mild croup symptoms comes to GP. RR of 65. What is your management?

A

Keep child calm and get them urgently to hospital

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16
Q

Premature baby with distended abdomen, vomiting, episode of blood in stool - diagnosis?

A

Necrotising enterocolitis

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17
Q

Voraciously hungry kid, hypotonia, feeding difficulties as a neonate, almond eyes

A

Prader-willi

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18
Q

Neonate, with reduced leg movements and fever

A

Osteomyelitis

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19
Q

Kid with rashes crusted over. He is scratching them and also has a fever and cool peripheries. What is the cause of his acute presentation?

A

Varicella zoster viraemia

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20
Q

Baby who just started solid foods and was being weaned has become constipated. What do you do?

A

Encourage more fluids

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21
Q

Fussy eater (kid), drinks a lot of cow’s milk, tired. What is the cause?

A

Iron deficiency anaemia

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22
Q

Muscle stiffness and tightness, difficulties with fine motor - what kind of cerebral palsy and location of lesion in the brain?

A

Spastic, damage to the motor cortex or pyramidal tracts

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23
Q

Involuntary, uncontrolled movements (athetosis), difficulty controlling posture and balance, facial grimacing or drooling - what kind of cerebral palsy and location of lesion in the brain?

A

Dyskinetic Cerebral Palsy, damage to the basal ganglia or thalamus

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24
Q

Problems with balance and coordination, unsteady movements, tremors or shakiness - what kind of cerebral palsy and location of lesion in the brain?

A

Ataxic Cerebral Palsy - Damage to the cerebellum

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25
Q

Cerebral Palsy (described hemiplegic weakness with brisk reflexes), what area of the brain is affected?

A

spastic CP - Pyramidal tracts or motor cortex

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26
Q

Kid needs fluids, but you can’t get standard IV access. Where do you go?

A

Intraosseous

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27
Q

3 months old baby with signs of HF, systolic murmur that radiates over the praecordium

A

VSD

28
Q

4 year old girl with a high fever that was followed by a rash. What is the most likely diagnosis?

A

Roseola infantum

29
Q

Kid with a temp of 39, cap refill 6s, generally unwell and bulging fontanelles

A

Meningococcal septicaemia

30
Q

Kid with URTI, generalised abdominal tenderness

A

Mesenteric adenitis

31
Q

Mother with cold sores has been kissing her child who has a background of eczema

A

Eczema herpeticum

32
Q

Nappy rash with satellite lesions - diagnosis and treatment?

A

Candida infection, clomitrazole

33
Q

5 y/o presents with widespread non-blanching erythematous rash over her body, after 1 week of cough and coryzal symptoms. Teperature is 37.2, pulse 95bpm, BP 90/60, RR 22, and O2 sats are 98% on room air. Urinanalysis yields no abnormalities, but FBC shows elevated WCC and a platelet count of 7 x 10^9. What is the most likely diagnosis?

A

Immune thrombocytopenic purpura

34
Q

Boy born at 40 weeks with male phenotype, but neither testicle can be palpated on examination. What is the most likely diagnosis?

A

Physiological delay in descent

35
Q

22 m/o child had cough and coryza for 2 days, and is now struggling with breathing. She has subcostal and intercostal recessions and widespread wheeze. Her temperature is 37.3, HR 125, RR 45, O2 sats 98% on room air. What is the most appropriate next step in her management?
a. 0.5L/min supplemental oxygen
b. 2 puffs beclomethasone inhaler
c. 10 puffs salbutamol inhaler
d. Intravenous aminophylline
e. Oral prednisolone

A

10 puffs salbutamol inhaler

36
Q

2 y/o girl with loud barking cough and stridor is finding it increasingly difficult to breathe. Temperature 38.3, HR 190bpm, RR 53, O2 sats 92% on room air. Which is the most appropriate immediate treatment?
a. Intravenous salbutamol
b. Intubation and ventilation
c. Nebulised adrenaline
d. Nebulised salbutamol
e. Oral dexamethasone

A

Nebulised adrenaline - emergency croup management

37
Q

A 3 y/o boy has pruritis ani which is worse at night. He has no abdominal pain and bowel movements are normal. He is growing well and his development is normal. What si the most appropriate course of action?
a. Chlorpheniramine solution
b. Hydrocortisone
c. Macrogol sachet
d. Mebendazole solution
e. Miconazole cream

A

Mebendazole - it’s threadworm

38
Q

3 week old baby referred for prolonged jaundice, dark wet nappies, and pale stools. There are no developmental concerns and he is currently breastfed. Birth weight was 3.45kg and he currently weighs 3.2kg, Temperature is 37.1, HR 140, RR 45, O2 sats 98% on room air. Investigations:
Hb 110 (normal)
WCC 6 (normal)
Platelets 430 (slightly high)
Bilirubin 175 (high)
Conjugated bilirubin 100 (high)
ALP 160 (normal)
ALT 35 (normal)
Albumin 25 (lower end of normal)
Sodium 137 (normal
Potassium 4 (normal)
What is the most appropriate next step in management?
a. Feeding advice
b. Inpatient ultrasound
c. I.V. antibiotics
d. Outpatient ultrasound
e. Phototherapy

A

Inpatient ultrasound

39
Q

A 5 year old boy seen in GP with a rash across buttocks on a background of 4 days of cough, coryza, and mild fever, but he is otherwise generally well. Temperature 37.4, HR 105, capillary refill <1s, RR 25, O2 sats 99% on room air. What is the most likely diagnosis?

A

Henoch-Schonlein purpura (its 2-3 days after illness, whereas ITP is 1-2 weeks after)

40
Q

A 2 y/o in GP has worsening painful rash behind the knee for 5 days. He has eczema managed with E45 cream. Temperature 37.2, HR 130, RR 30, O2 sats 98%. What is the most appropriate management?
a. Immediate referral to Paediatric A&E
b. Give oral Aciclovir for 1 week
c. Give oral Flucloxacillin for 1 week
d. Give topical dermovate
e. Give topical fusidic acid

A

AnE referral (eczema herpeticum)

41
Q

Lymphadenitis tx

A

Watch and wait

42
Q

16 hour old baby is jaundiced, has yellow stools, is sleepy, and is not feeding. The mother was positive for Group B Streptococcus in her previous pregnancy. What is the most likely diagnosis?

A

GBS sepsis

43
Q

A baby is born with 45XO karyotype. What is the most likely cardiac abnormality associated with this syndrome?

A

Bicuspid aortic valve, followed by coarctation of aorta

44
Q

2 y/o girl has a fever of 39.7 and a painful, swollen right eye with preserved eye movements (periorbital cellulitis). What is the most appropriate first-line treatment?

A

Co-amoxiclav, oral - fluclox if not near eye

45
Q

Mother with SLE has a baby who is born with a slow heartbeat. What is the most likely diagnosis?

A

Congenital heart block

46
Q

2 month old boy attends GP with fever, rash, and coryza. He is taking 70% of his normal feeds and is producing a normal number of wet nappies. There is a non-blanching petechial rash on his left arm. Temperature 38.9, HR 148, RR 43, and O2 sats 98% on room air. What is the most appropriate pharmacological management to give in the GP surgery?

A

IM benzylpenicillin - community meningococcal sepsis tx

47
Q

2 week old boy in GP has bilateral red eyes with purulent discharge since birth. What is the most likely causative organism?

A

chlamydia trachomatis - bilateral purulent eyes

48
Q

Newborn baby, rash on face and body. Full term.

A

Erythema toxicum

49
Q

A 15 year old boy has 3 weeks of cough, weight loss, night sweats and fever. He moved to the UK from India 3 years ago. His chest x-ray is show in the image (can’t find exact image but showed some left upper zone shadowing I think). Which investigation is regarded as the gold standard for diagnosis for his underlying condition?

A

Sputum culture

50
Q

A term infant born to a diabetic mother is 4 hours old on the postnatal ward and is noted to be jittery. The capillary blood gas result is as follows: pH 7.37 (7.35 - 7.45), PCO2 5.5 kPa (4.6 -
6.4), PO2 4.9 kPa (8 - 12), glucose 2.4 mmol/L (3 - 6), lactate 2.0 mmol/L (1 - 2). Which is the most appropriate treatment for the baby in this scenario?

A

IV Dextrose

51
Q

A 2 year old boy has acute onset of cough and drooling, with inspiratory upper airway noises. His vaccinations are up to date. His examination is otherwise normal. His temperature is 36.8C, pulse 120 bpm, blood pressure 100/60 mmHg, respiratory rate 26 breaths per minute and oxygen saturation 98% breathing air. Which is the most likely diagnosis?

A

Croup

52
Q

A 14 year old girl attends Paediatric Outpatients with ongoing headaches. These are associated with nausea and vomiting and she is missing school. They are occurring once per month and at any time of day. The headaches eventually settle after lying down in a dark room. She has tried NSAIDs, which do not help. Neurological examination is normal. Which is the most appropriate treatment?
a. Aspirin once daily
b. Metoclopramide when required
c. Nasal sumatriptan when required
d. Pizotifen when required
e. Propanolol once daily

A

Nasal sumatriptan

53
Q

A 12 year old girl in GP complains of ongoing headaches for the last 4 months. The headaches are severe and throbbing in nature and often associated with nausea and vomiting. The headaches are worse in the morning. Her father has noticed he is more tired than usual and has been more irritable. Her weight is 62 kg. Which is the most likely diagnosis?
a. Benign intracranial hypertension b. Insomnia
c. Low mood
d. Migraine
e. Tension headaches

A

Migraine - throbbing, nausea and vomiting

54
Q

A 7 year old boy in General Practice has a sore throat, fever and pain on swallowing for 1 day. His temperature is 38.5C, pulse rate 110 bpm, respiratory rate 24 breaths per minute, and oxygen saturation 99% breathing air. He has bilateral tonsillar enlargement with exudate and bilateral cervical lymphadenopathy. He is talking in full sentences without using accessory muscles. Which is the most appropriate management?
a. Admit to hospital
b. Continue supportive measures
c. Prescribe amoxicillin
d. Prescribe phenoxymethylpenicillin
e. Review in 48 hours

A

Prescribe phenoxymethylpenicillin - GP setting, sore throat, abx to give is pen V

55
Q

Neonate had just one episode of billous vomiting. What should be done?

A

Paeds assessment / admit - obstruction until proven otherwise

56
Q

Mum brings 2yo to GP 6 hrs after rolling off sofa onto carpeted floor while playing, happy playing now, interacting normally, no cuts bruising or bleeding, ENT exam normal, best management?

A

Same day paeds assessment

57
Q

Child with bloody diarrhoea, puffy eyes, puffy face, low hb, hi BR, reticulocytes elevated, lo plt. Urine dip; blood 3+, leukocytes 2+, protein 1+, nitrites neg. What the dx?

A

HUS

58
Q

Mum with 2 or 3 yo girl in GP/paeds A&E. Caught her attempting to eat chocolates from a box 30 mins ago, not sure if she ate one, took them away and she started screaming, stopped breathing, turned blue and fell to ground and started jerking arms and legs (unclear description), stopped shortly after. Currently child is running around waiting area and looks fine. Whats the most appropriate mx?

A

Reassure and safety net - breath holding spell

59
Q

Pneumonia management in kids?

A

Oral amox 5 days (or clarithromycin/ cefaclor)

60
Q

Single best bedside investigation for seizure in children?

A

Blood glucose

61
Q

Treatment for haemolytic disease of the newborn?

A

Phototherapy, second line exchange transfusions

62
Q

Scoring system for barking cough and stridor?

A

Westley croup score

63
Q

Epiglottitis management

A

anaesthesia, intubation, IV ceftriaxone

64
Q

Turner vs Kallman LH FSH

A

Turner = High
Kallman = Low

65
Q

Paeds UTI abx - upper/lower uti

A

Upper - Cefelaxin (or co-amoxiclav)
Lower - Nitrofurantoin (or trimethoprim)

66
Q

Red flag - fever under what age?

A

3 months

ppqs (10 decks)

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