paeds

Question 1

nonblanching rash

• ill child
• neck stiffness
• fever

Answer 1

meningococcal disease

Question 2

neck stiffness, bulging fontanella, decreased consciousness, fever

Answer 2

bacterial meningitis

Question 3

focal neuro signs
decreased level of consciousness
focal seizures
fever

Answer 3

encephalitis

Question 4

fever, bilateral conjunctival injection, change in mucous membrane, change in extremities, polymorphous rash, cervical lymphadenopathy

Answer 4

kawasaki disease

Question 5

fever, irritability, dyspnoea, dysphonia, drooling saliva

Answer 5

epiglottitis, h. influenzae type B

Question 6

if think child abuse

Answer 6

do child protection medical assessment. By social services. Hx and exam, growth chart, obs, body map, photos. Child must be questioned away from parents or carers

Question 7

Risk of rapid weight loss eg anorexia

Answer 7

refeeding syndrome, hypoglycaemia, risk of infection, cardiac arrhythmias

Question 8

differentials of rapid weight loss

Answer 8

coeliac disease
T1DM
hyperthyroidism
malignancy
anorexia
IBD
depression

Question 9

treating eating disorder

Answer 9

admit to stabilise physically, start vitamins, regular obs, monitor bloods, contact local eating disorder team. diet plan, IV fluids if needed.

Question 10

diarrhoea in infant

Answer 10

usually rotavirus. could be adenovirus.

Question 11

paroxysmal severe colicky pain, pallor ,red currant jelly stool.

Answer 11

intussusception

Question 12

red flags associated with vomiting

Answer 12

blood, bile, abdo tenderness and distention, blood in stool, bulging fontanelle

Question 13

treatment for campylobacter

Answer 13

erythromycin

Question 14

c. diff treatment

Answer 14

metronidazole or vancomycin

Question 15

haemolytic anaemia, AKI, low platelet count

Answer 15

haemuolytic uraemic syndrome. usually preceded by infection

Question 16

barking cough

Answer 16

croup

Question 17

treatment of croup

Answer 17

consider admission
oxygen
oral dexamethasone
paracetamol

Question 18

hypotension. bronchoconstriction or airway compromise in setting of allergy

Answer 18

anaphylaxis

Question 19

breathless baby esp when feeding

Answer 19

heart failure

Question 20

high chloride in sweat test

Answer 20

cystic fibrosis. sweat test is gold standard

Question 21

most common features of CF

Answer 21

chronic resp infection, malabsorption or failure to thrive, prolonged diarrhoea, infertility, meconium ileus,

Question 22

differentials of abdo pain in children

Answer 22

gastroenteritis, HSP, UTI, IBD, acute appendicitis, DKA, poisoning , intussusception, meckel’s diverticulum, abdominal migraines

Question 23

treatment for meningitis in children

Answer 23

ceftriaxone and if under 3 months give with amoxicillin to cover listeria

Question 24

UTI in children

Answer 24

need to do renal ultrasound scan, micturating urogram, DMSA to detect any structural abnormalities

Question 25

non blanching rash on legs and buttocks
swollen and painful joints
child well
no hepatosplenomegaly or lymphadenopathy

Answer 25

HSP

Question 26

non blanching rash, pallor, lymphadenopathy, hepatosplenomegaly,

Answer 26

ALL

Question 27

white reflex in eyes

Answer 27

retinoblastoma or congenital cataracts

Question 28

lump in abdo. blood in urine

Answer 28

wilms tumour. nephroblastoma

Question 29

Seizure treatment

Answer 29

lorazepam x2

phenytoin

Question 30

causes of delayed walking

Answer 30

global developmental delays, spina bifida, duchenne muscular dystrophy, developmental dysplasia of the hip, cerebral palsy, rickets

Question 31

not sitting or walking by 18 months, floppy, weak arms and legs, speaking problems, scissoring of legs, high tone.

Answer 31

cerebral palsy- ask about infections in pregnancy, difficult birth, head injury, meningitis

Question 32

treatment of cerebral palsy

Answer 32

physio, sspeech therpay, OT, medications for muscle stiffness

Question 33

progressive muscle weakness, loss of walking, scoliosis, resp weakness

Answer 33

Duchenne muscular dystrophy

Question 34

treatment of duchenne muscular dystrophy

Answer 34

steroids can slow progression of weakness but not a cure

Question 35

treatment of DKA

Answer 35

fluids, insulin. slowly correct