Paeds

Question 1

what hip condition affects 0-5s?

Answer 1

DDH
cancer
sepsis

Question 2

risk factors for DDH

Answer 2

family history

breech/transverse

Question 3

DDH ix

Answer 3

ortolani and barlows

no abnormality will be seen on XR until 4 months

Question 4

what condition affects 4-10 year old hips

Answer 4

sepsis
cancer
perthes (fluctuating avascular necrosis)

Question 5

treatment for perthes

Answer 5

rest when it is painful

Question 6

where can hip pain be referred from?

Answer 6

knee

Question 7

what affects 10-15 year old hips

Answer 7

sepsis
cancer
slipped upper femoral epiphysis

Question 8

who is at risk of SUFE

Answer 8

obese
hypogonadal
tall
boys
afro-carribean
hypothyroid
hyperparathyroid

Question 9

what XR views should you order for SUFE?

Answer 9

AP and frog leg (a lateral view)

Question 10

what is the risk of the other side being affected in SUFE?

Answer 10

10-15%

Question 11

what are the symptoms of prader willi?

Answer 11

hypotonia, feeding problems, excessive weight gain, behavioural difficulty, hypogonadism

Question 12

what are the causes of bruising in infants?

Answer 12

non accidental injury
haemophilia
ITP
vWF deficiency
vit K deficiency
liver disease

Question 13

what investigations would you do in a child with abnormal bleeding?

Answer 13

FBC, LFTs, clotting screen-factors VIII and IX, vWF

Question 14

how does ITP present in children?

Answer 14

asymptomatic to intracranial haemorrhage, in between is petichae, nosebleeds
follows viral infection
is self limiting

Question 15

how does HUS present in children?

Answer 15

profuse diarrhoea that turns profuse 1-3 days in
abdo pain, worse on defecation
fever-though in hospital many are afebrile

Question 16

what is HUS?

Answer 16

haemolytic anaemia
uraemia so AKI
thrombocytopenia

Question 17

what will HUS bloods show?

Answer 17

fragmented red cells, low platelets

high creatinine

Question 18

how does measles present?

Answer 18

fever
rash that spreads from face to trunk a few days later
cough/coryza/conjunctivitis
coryzal prodrome
Koplick spots
very unwell

Question 19

what is tuberous sclerosis

Answer 19

multisystem disorder of haematomas that usually presents in childhood with skin changes and epilepsy

Question 20

what infections will a child not have if they have been fully immunised

Answer 20

MMR, Haemophilus influenzae-epiglottidis, pertussis, diptheria, tetanus, polio, hep B, men B, rotavirus

Question 21

what is the most common cause of meningitis in young children?

Answer 21

strep pneumoniae or a N. meningitidis strain which has not been vaccinated against

Question 22

what is henoch sconlein purpura?

Answer 22

a vasculitis that only occurs in children, it is autoimmunity that leads to purpura, orchitis, gastritis, abdo pain and arthritis

Question 23

presentation of HSP?

Answer 23

preceding URTI
symmetrical erythematous macular rash that is mostly on legs, bum and ulnar side of arms
mild illness with low grade fever
abdo pain and bloody diarrhoea may precede the rash
arthritis-joint pain but full range of movement, especially knees and ankles
microscopic haematuria and proteinuria

Question 24

investigations for hsp

Answer 24

FBC-platelets normal (rules out itp)

urinalysis-proteinuria and microscopic haematuria

Question 25

what do you need to test for in coeliac disease

Answer 25

anti-transglutaminase IgA

anti-endomysial

Question 26

what are the findings on coeliac duodenal biopsy?

Answer 26

villous atrophy and crypt hyperplasia and lymphocyte infiltration

Question 27

what rash is associated with coeliac disease?

Answer 27

dermatitis herpetiformis