Paeds 3

Question 1

B-thal major v minor presentation?

Answer 1

Major = presents 3-6m w/ profound anaemia

Minor = well-tolerated hypochromic microcytic anaemia incidental finding

Question 2

Cardio changes after birth?

Answer 2

L. Atrial pressure rises

Plumonary resistance falls (to increases BF there)

BF to R. Atrium falls –> closure of foramen ovale

Ductus arteriosus closes few days after

Question 3

When to stop CPR in children?

Answer 3

> 60bpm, regular breathing

Question 4

What things can give you erythema nodosum?

Answer 4

Infection - strep throat, herpes, TB and mycoplasma

Drugs - COCP, NSAIDs and Sulphonamides

Systemic - Sarcoid, pregnancy and IBD

Question 5

Who can have medical mx of obesity?

Answer 5

V Obese children >12y w/ significant co-morbidities

Question 6

Most common cause of acute scrotum in children affecting pre-pubertal boys?

Answer 6

Hydatid torsion

Question 7

Blue dot sign on testicle + present cremasteric reflex =

Answer 7

Hydatid torsion

Question 8

What is a accumulation of serous fluid within the tunica vaginalis that presents as an asymptomatic and progressive scrotal swelling
which transilluminates and surrounds the testicle?

Answer 8

Hydrocoele

Question 9

Dilation of the pampiniform venous plexus that may be asymptomatic or cause a dull ache

On examination, the lump may feel like a ‘bag of worms’ and does not
transilluminate.

Answer 9

Varicocoele

Question 10

EEG shows An EEG will show fast generalised spike and wave patterns. It has a good prognosis and tends to go into remission in adolescence - what is the DDx?

Answer 10

Childhood absence epilepsy

Question 11

Mx of person who gets thelarche before 8y (eg. @2y)?

Answer 11

Thelarce in absence of other signs of puberty = non-progressive benign condition w/out complications hence reassure + review in 4-6m to check for signs of precocious puberty

Question 12

What causes prominent calcaneus, midfoot dorsiflexion, and a convexly rounded sole?

Answer 12

Vertical talus (rocker-bottom feet)

Question 13

What causes a fixed defect in which one or both feet point downwards and inwards, with the sole of the foot facing backwards?

Answer 13

Talipes equinovarus (clubfoot)

mx = ponseti method (cast every 5-8w)

Question 14

What is similar to talipes equinovarus but feet

are in an abnormal position due to the cramped conditions in utero but can be corrected with passive manipulation

Answer 14

Positional talipes

Question 15

What occurs occurs when the longitudinal arch in the foot has flattened or collapsed?

Answer 15

Pes planus (flat feet)

Question 16

What is …… is the opposite of pes planus, describing a high-arched claw foot and is associated with Charcot Marie Tooth disease and Friedreich’s ataxi

Answer 16

Pes cavus

Question 17

Eczema drug mx?

Answer 17

1. Mild = Hydrocortison 1%
2. Moderate =Betamethasone valerate 0.025% or Clobetason butyrate 0.05%
3. Potent = Betamethasone valerate 0.1% or Mometasone furoate 0.1%
4. Very potent = clobetasol propionate 0.1%

Question 18

When to admit pts w suspected EBV?

Answer 18

Suspected complications, such as dehydration or splenic rupture

Question 19

What is Choanal atresia?

Answer 19

Is a rare congenital disorder in which the choanal openings (nasal passages) fail to form

Question 20

A 1-week-old boy is brought to the ambulatory care centre by his father
who claims that he often chokes and struggles to breathe when he is
feeding. He explains that he often ‘turns blue’ which resolves when he
starts to cry. He does not have fever or other flu-like symptoms. What is the most likely diagnosis?

Answer 20

Choanal atresia

Question 21

Patients with …………… are at increased risk of epilepsy, gastrooesophageal reflux, chronic constipation, behavioural and learning difficulties,
and impairments of vision and hearing. Patients also tend to have trouble
sleeping and produce excess saliva leading to drooling

Answer 21

Cerebral palsy