Paeds

Question 1

Apperance of typical nappy rash

Answer 1

spares the flexures

Question 1

Management of nappy rash?

Answer 1

barrier ointment between nappy changes, keep area clean and dry
- consider antifungal
- may need abx if superimposed bacterial infection

Question 2

redcurrant jelly stool

Answer 2

intusussception

Question 3

intussusception - what age group is commonly affected

Answer 3

3 months to 6 years, usually boys

Question 4

intususception - management?

Answer 4

barium enema

Question 5

Roseola infantum
- when does the rash appear? where does the rash appear?

Answer 5

AFTER the fever
trunk and limbs, less often the face

Question 6

Necrotizing enterocolitis - which pt population is affected?

Answer 6

PREMATURITY
at <1month old

Question 7

Clinical signs of NEC?
Investigations in NEC?

Answer 7

Distended abdomen
Poor feeding/vomiting, fever, blood/mucus in stool

Ix: AXR: distended bowel loops +/- perforation

Question 8

6 examples of infections passed from mother to baby during pregnancy/delivery

Answer 8

Toxoplasmosis
Rubella
CMV
Herpes simplex
HIV
Parvovirus B19
Syphillis

Question 9

Neonatal jaundice - if occurs in <24hrs of age, what is the most likely cause (broadly speaking)

Answer 9

PATHOLOGICAL
- haemolysis

Question 10

Roseola infantum vs Roseola infectiosum
- how do their presentations differ

Answer 10

roseola infantum
- rash AFTER fever resolves, assoc febrile seizures

roseola infectiosum
- aka slapped cheek

Question 11

benign rolandic epilepsy
- what age group
- prognosis?
- typical seizure - what does it look like?

Answer 11

• good! 95% resolve by 16yo
• usually ipsilateral, pt awake throughout (partial), often affects face with grunting/gurgling noise

Question 12

Neurological manifestations of coeliac disease?

Answer 12

Cerebellar ataxia!

intractable epilepsy

Question 13

Haemorrhagic disease of the newborn - which group of babies does it NOT affect and why

Answer 13

Formula fed babies - formula often has vitamin K supplementation

Question 14

What is HSP?

Answer 14

vasculitis

IMMUNE COMPLEX deposition in kidney and skin

Question 15

Congenital Hypothyroidism
3 causes?
Symptoms?
Appearance/examination?

Answer 15

Iodine deficiency
Defect in iodine metabolism
Abnormal thyroid anatomy

Quiet, fatigue, FTT
Coarse features, macroglossia
Hypotonic, large fontanelles

UMBILICAL hernia

Question 16

usual length of symptoms of gastroenteritis in a child?

Answer 16

• diarrhoea avg 1 week, resolves by 2 weeks
• vomiting resolves by 3 days

Question 17

milia vs erythema toxicum neonatorum
- how do they differ?

Answer 17

milia - tiny white spots

erythema toxicum neonatorum
- pustules and papules with a red base which often come and go within hours/days

both resolve by 1 month

Question 18

Stork mark

Answer 18

flat, pink macules at the back of the neck in a neonate - harmless

Question 19

Parvovirus aka …. disease, aka …….

Answer 19

fifth disease
erythema infectiosum

Question 20

Most common cause of gastro in children

Answer 20

Rotavirus

Question 21

In which age group should you always arrange US after a UTI

Answer 21

<6 months

Question 22

What features would inidcate an atypical UTI

Answer 22

Non E Coli bacteria
Abdominal mass
Poor response to abx
Very unwell
Poor urine flow
Raised Cr

Question 23

Treatment of threadworm

Answer 23

Mebendazole - for the whole household

Question 24

6 week check - what milestones are we looking for

Answer 24

head control - lifts head 45 from prone
fixes and follows
startles to loud noise
smiles

Question 25

neonate vomiting with double bubble sign on US

Answer 25

duodenal atresia

Question 26

when to refer if unable to sit unsupported

Answer 26

12 months

Question 27

when to refer if unable to walk unsupported

Answer 27

18 months

Question 28

best test for suspected CMPA

Answer 28

elimination and reintroduction
- patch and allergy testing not useful for non IgE mediated reactions