Paeds

Question 1

Treatment for whooping cough (bordetella pertusis)?

Answer 1

Azithromycin or clarithromycin

Question 2

What is in the tetralogy of fallot?

Answer 2

ventricular septal defect (VSD)
right ventricular hypertrophy
right ventricular outflow tract obstruction, pulmonary stenosis
overriding aorta

Question 3

Most common cardiac abnorality in babys with Down’s?

Answer 3

ASD

Question 4

What’s Ortolani and Barlow’s tests?

Answer 4

Barlow test: attempts to dislocate an articulated femoral head
Ortolani test: attempts to relocate a dislocated femoral head

B before O

Question 5

When do you get the rotavirus vaccine?

Answer 5

2 MO and 3 MO

Question 6

When do you get the Men B vaccine?

Answer 6

2 Mo, 3Mo, 12Mo

Question 7

When do you get the pneumococcal vaccine?

Answer 7

3Mo, 12 Mo

Question 8

When do you get the MMR vaccine?

Answer 8

12 Mo, 3yrs 4Mo

Question 9

What’s in the 6 in 1 vaccine and when do you get it?

Answer 9

Polio, Whooping, Influenza (Hib), Tetanus, B (hep), Diphtheria

Parents will immunise toddlers because death

2Mo, 3Mo, 4Mo

Question 10

What’s in the 4 in 1 vaccine and when do you get it?

Answer 10

Same as 6 in 1 except the Hs

Polio, whooping cough, tetanus, diphtheria

(no Hib or Hep B )

3yrs 4Mo

Question 11

What’s in the 3 in 1 vaccine and when do you get it?

Answer 11

tetanus, diptheria, polio

13-18 yrs

Question 12

Difference between cephalohaematoma and caput succedaneum?

Answer 12

Cephalohaematoma - doesn’t cross suture lines
Takes months to resolve

Caput succadaneum - does cross suture lines
(succ = succeeds in crossing the line)
Takes days to resolve

Both managed conservatively
More common after difficult/ prolonged deliveries

Question 13

When is the blood spot test done and which diseases does it screen for?

Answer 13

Between day 5-9 of life

Sickle cell disease
Cystic fibrosis, congenital
Hypothyroidism
Phenylketonuria (PKU)
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD)

Question 14

Under which age would you always admit a child with a fever to hospital regardless of if they seem well?

Answer 14

Any child less than 3 months old with a temperature > 38ºC is regarded as a ‘red’ feature in the new NICE guidelines, warranting urgent referral to a paediatrician

Question 15

When is jaundice definitely bad?

Answer 15

When it develops within the first 24 hours post delivery

Physiological jaundice develops 2-3 days post-delivery and should resolve by 14 days.

Question 16

Knee problems in adolescents - what are the features?

Chondromalacia patellae

Osgood-Schlatter disease

Osteochondritis dissecans

Answer 16

Chondromalacia patellae - softening of the cartilage of the patella. Anterior knee pain.
Teenage girls.

Osgood Schlatter disease - anterior knee pain in sporty teenagers. Pain and swelling over the tibial tubercle.

Osteochondritis - pain after exercise with intermittent swelling and locking.

Question 17

Kawasaki versus scarlet fever

Answer 17

Both conditions that cause a rash + fever

Kawasaki - vasculitis
Palms and soles may be involved, cracked lips, conjunctivitis

Scarlet fever - bacterial infection
Spares palms/ soles

Question 18

What are the doses of IM benpen for suspected meningitis?

Answer 18

< 1 year 300 mg
1 - 10 years 600 mg
> 10 years 1200 mg

Question 19

What is Barter’s syndrome?

Answer 19

Inherited (autosomal recessive)

Severe hypokalaemia
Failure to thrive
Polyuria and polydipsia, normotension

Question 20

What is Hirschprung’s disease and how is it managed?

Answer 20

Absence of ganglion cells in the submucosa

Presents with failure or delay to pass meconium, later: constipation and poor feeding

Can be seen in Down’s syndrome

Serial rectal irrigation should be performed before surgery to help prevent enterocolitis

Question 21

What is perthes and when does it present?

Answer 21

AVN of the femoral head

4-8 years

hip pain: develops progressively over a few weeks, limp, stiffness and reduced range of hip movement

x-ray: early changes include widening of joint space, later changes include decreased femoral head size/flattening

Question 22

What is acrocyanosis?

Answer 22

Occurs in the first 24-48 hours of life

Peripheral cyanosis with normal central perfusion and oxygen saturations

Question 23

What is the school exclusion rule for impetigo?

Answer 23

Until lesions are crusted and healed, or 48 hours
after commencing antibiotic treatment

Question 24

What is the school exclusion criteria for measles, mumps and rubella?

Answer 24

Measles/ rubella - 4/5 days from rash onset
Mumps - 5 days from onset of swollen glands

Question 25

What is the school exclusion rule for chickenpox?

Answer 25

Until all lesions are crusted over

Question 26

What is the school exclusion rule for whooping cough?

Answer 26

2 days after commencing antibiotics (or 21 days from onset of symptoms if no antibiotics )

Question 27

What is the shool exclusion rule for scarlet fever?

Answer 27

24 hours after commencing antibiotics

Question 28

Edward Syndrome (Trisomy 18)

Answer 28

Micrognathia (small jaw)
Low-set ears
Rocker bottom feet
Overlapping of fingers

Question 29

Fragile X

Answer 29

Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism

X = Xlarge things

Question 30

Noonan syndrome?

Answer 30

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

Question 31

Pierre Robin syndrome

Answer 31

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

Question 32

William’s syndrome?

Answer 32

Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis

Question 33

Do all kids with suspected transient synovitis need referred?

Answer 33

Yes - because the alternative diagnosis is septic arthritis which you cannot miss