Paeds

Question 1

School exclusion for measles

Answer 1

Until 4 days after onset of rash

Question 2

Dx?: high fever, white spots on the mouth (Koplik), conjunctival injection, and a blotchy red rash

Answer 2

measles

Question 3

School exclusion for impetigo?

Answer 3

Children should be excluded from school until lesions have crusted or healed, or for 48 hours after starting antibiotics

Question 4

IgE vs non IgE mediated Cows milk protein allergy differences

Answer 4

With non IgE children often develop loose stools, abdominal discomfort, eczema and general irritability/colic.
In IgE mediated cow’s milk allergy the reaction is much sooner after ingestion, more severe and can include angioedema or even anaphylaxis.

Question 5

A four-year-old boy attends with his mother. They have recently joined the practice and you have no previous records available. The mother expresses concern about her son’s behaviour, describing him as over-active. He is doing poorly at school. You note that the boy looks small for his age, has small widely-spaced eyes, short palpebral fissures, a thin upper lip and his nose looks low set.
What is the most likely diagnosis?

Answer 5

fetal alcohol syndrome

Question 6

persistent paroxysmal cough and associated vomiting in a child - Dx?
Treatment?

Answer 6

whooping cough
if within 21 days - treat w azithromycin (/macrolide abx)

Question 7

sandpaper-like rash’ or a ‘strawberry tongue’
5-year-old girl whose mum has been concerned about a rash. This initially started on the trunk before spreading to the rest of the body. Mum thinks she has had a temperature for 1 or 2 days prior to this.

On examination, you note a generalised, rough-textured, pin-point rash. Her tongue has a white coating through which you can see some red papillae.

Dx, causative agent and Tx?

Answer 7

Dx = scarlet fever
causative agent: group A strep (Strep pyogenes)
Tx = Pen V OR if allergic azithromycin
NOTIFIABLE DISEASE