Paeds.

Question 1

Why should you not give aspirin in children < 16yrs? [1]

Answer 1

Risk of Reye’s syndrome

Question 2

How do you calculate doses. for children? [1]

Answer 2

Question 3

In an emergency, how would you estimate a child’s weight [3]

Answer 3

1. Body-length tape - Broselow emergency paediatric tape
   - Laid under child and allows estimation of the weight depending on the length
2. Paediatric emergency drug charts
3. Formula: Weight = (age in yrs + 4) x2

Question 4

Answer 4

Question 5

What are usual routine maintenance fluids in paediatrics? [1]

Answer 5

Question 6

Describe how you calculate maintenance fluids over 24 hrs for children [+]

Answer 6

Question 7

What do you give as a bolus to a child in shock? [1]

Answer 7

Question 8

What rate do you correct dehydration in children not in shock? [1]

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

Question 12

Answer 12

Question 13

Answer 13

Question 14

Answer 14

Question 15

Answer 15

2-16

Question 16

Answer 16

Question 17

Answer 17

Question 18

Answer 18

Question 19

At what age should a child receive their first dose of the meningococcal B vaccine as part of the routine childhood immunisation schedule? You may wish to refer to the routine childhood immunisation schedule for this.

8-weeks-old
12-weeks-old
16-weeks-old
20-weeks-old
1-year-old

Answer 19

8-weeks-old

Question 20

Which ONE of the following antiseizure medicines is recommended by the Resus Council UK as a second line agent in the treatment of convulsive status epilepticus in children? You may require access the Paediatric emergency algorithms and resources from the Resuscitation Council UK.

Carbamazepine
Clonazepam
Levetiracetam
Lamotrigine
Sodium valproate

Answer 20

Levetiracetam

Question 21

In the emergency treatment of anaphylaxis, adrenaline should be administered intramuscularly for a 2-year-old child at which ONE of the following doses?

75 micrograms
150 micrograms
300 micrograms
450 micrograms
500 micrograms

Answer 21

A dose of 150 micrograms is recommended for children 6-months to 5-years-old.

Question 22

A 4-year-old girl is clinically dehydrated. She is having ongoing episodes of watery diarrhoea but has no evidence of shock or any red flag symptoms. She requires fluid replacement. Which ONE of the following statements relating to her fluid management is CORRECT?

Maintenance fluids over 24 hours should prevent further dehydration and would be adequate in this case.
Oral rehydration should be started initially.
Resuscitation fluids are required in addition to maintenance fluids.
The fluid deficit in this case should be replaced with intravenous fluids.
The dehydration should be corrected over 48 hours.

Answer 22

Question 23

Which ONE of the following statements BEST explains why children are more vulnerable to medication errors?

Children have higher rates of drug absorption
Children have less predictable responses to medicines
Children metabolise medicines quicker
Children often have a lower tolerance for medicines
Children often require individualised dosing

Answer 23

Question 24

A critically ill 1-year-old baby is brought into the Emergency Department. The team are unable to obtain the baby’s weight and therefore estimate their weight. Which ONE of the following options does the Resuscitation Council UK guideline on Paediatric Advanced Life Support recommend is used as first preference for body weight estimations?

Age-based weight calculation formula
Body length tape with pre-calculated doses
Paediatric emergency drug chart
Rule of thumb estimate
Weight estimation from parents

Answer 24

Question 25

A 2-year-old girl weighing 12 kg has mild croup. You are asked to prescribe dexamethasone treatment. Which ONE of the following treatment options for treatment of croup with dexamethasone is MOST appropriate? You may require access to the BNFC for this.

Oral dexamethasone 120 micrograms as a single dose
Oral dexamethasone 1.2 mg as a single dose
Oral dexamethasone 180 micrograms as a single dose
Oral dexamethasone 1.8 mg as a single dose
Oral dexamethasone 18 mg as a single dose

Answer 25

Oral dexamethasone 1.8 mg as a single dose
The BNFC states for mild croup, oral dexamethasone should be given at a dose of 150 micrograms/kg.
12 (kg) x 150 (micrograms) = 1800 micrograms = 1.8 mg.

Question 26

Which ONE of the following scenarios requires the dose to be calculated based on the patient’s body surface area. You may require access to the BNF© for this.

Aciclovir via intravenous infusion for treatment of herpes simplex in a 7-year-old child
Dopamine via intravenous infusion as an adjunct following cardiac surgery in a 2-year-old child
Fluconazole by intravenous infusion for severe mucosal candidiasis in a 12-year-old child
Gentamicin via intravenous infusion for sepsis in a 10-year-old child
Ondansetron by intravenous injection for prevention of postoperative nausea and vomiting in a 4-year-old child

Answer 26

Aciclovir via intravenous infusion for treatment of herpes simplex in a 7-year-old child