Paeds

Question 1

What age is the average child able to sit without support?

Answer 1

6-8 months

Question 2

what age would a child acquire the ability to walk unsupported?

Answer 2

13-15 months

Question 3

What are the characteristics of William’s syndrome?

Answer 3

• elfin facies
• friendly/social
• learning difficulties
• short stature
• transient neonatal hypercalcaemia
• supravalvular aortic stenosis

Question 4

What is Perthes’ disease?

Answer 4

Avascular necrosis of the femoral head

Question 5

What are the common presenting features of perthes’ disease?

Answer 5

• hip pain - progressive over a few weeks
• limp
• stiffness and reduce ROM
• More likely in boys
• Kids ages 4-8yrs

Question 6

What X-Ray changes are seen in Perthes’ disease?

Answer 6

widening of joint spaces, decreased femoral head size

Question 7

What is the management of Perthes’ disease?

Answer 7

• Cast and braces
• most resolve with conservative management <6yrs old
• if >6 can operate

Question 8

What is the Kocher’s criteria?

Answer 8

Used to assess the probability of septic arthritis in children
- fever > 38.5
- non-weight bearing
- raised ESR
- raised WCC

Question 9

What is the treatment of threadworm?

Answer 9

oral mebendazole (given to all family members)

Question 10

What is the treatment of whooping cough?

Answer 10

oral macrolide - clarithro/erythro/azithromycin
school exclusion for 48hrs after Abx

Question 11

How much adrenaline do you give to a 6-12 year old in anaphylaxis?

Answer 11

300 micrograms (0.3ml of 1 in 1000)

Question 12

What is the management of bed wetting in children under 5?

Answer 12

Reassure

Question 13

What is the first line management of children over 7 with persistent bed wetting?

Answer 13

enuresis alarm

Question 14

What side effect of methylphenidate should be monitored?

Answer 14

Stunted growth

Question 15

What is the management of croup?

Answer 15

single dose of oral dexamethasone
high flow oxygen and nebulised adrenaline

Question 16

What ages do you use different chest compression techniques?

Answer 16

under 1 year - two thumbs circling
1 year to puberty - one hand on lower half of sternum
over puberty - two hands on upper part of sternum

Question 17

What are the features of intussusception?

Answer 17

intermittent, severe, crampy, progressive abdo pain, usually seen between 6-18months. Infant draws up knees and turns pale, may have vomiting. Cries during episode not inbetween. Late sign - red-currant jelly stool

Question 18

What investigation is used to diagnose intussusception and what do you see?

Answer 18

Ultrasound
Target-like mass

Question 19

How do you calculate maintenance fluids for children?

Answer 19

100ml/24hrs for first 10kg
50ml/24hrs for next 10kg
20ml/24hrs for every kilo after