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MC specialities > Paeds > Flashcards

Paeds Flashcards

1
Q 
Kid with acne. Topical antibiotics don't work. What do you give next?
A oral tetracycline
B bezoyl
C Retinoids
D Oral flucloxacillin
A

A oral teracyclin (lymecycline or doxycycline (for a maximum of 3 months).

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2
Q

Kid with hx of anal fissure. What is your first course of action?
A Inspect anal region
B do DRE with little finger
C panic
D panic
E Send them to ITU cuz you don’t know how the fuck paeds works

A

A inspect anal region

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3
Q 
A level student came back from nigeria recently. He presents with symptoms of jaundice, mild anaemia and fever with malaise and athralgia. What is going on?
A Hep A
B Malaria
C influenza
D others they can't remember
A

?B malaria

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4
Q

Kid with temp 39, cap refill of 6s, generally unwell, bulging fontanelles, no description of rash. What is wrong with him?
A Meningococcal septicaemia
B UTI
C Pneumonia

A

A Meningococcal septicaemia - (bulging fontanelle)

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5
Q

4 yo having acute asthma attack, given IV salbutamol and hydrocortisone. Sats are still low, no chest sounds on ausucultations. What do you do/give next?

A IM adrenaline
B Call senior
C Start atrovent

A

B call senior

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6
Q

Kid with cervical lymphadenopathy, fever, sore throat, red tongue with white spots. What does she have?
A Scarlet Fever
B Measles
C Chickenpox

A

If red tongue with white spots means strawnberry tongue then scarlet fever.
Koplik spots are on oral mucosa not tongue, so if the spots are in the mouth is measles.

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7
Q 
Girl with bulimia. What gave it away?
A dental enamel caries
B striae
C lacerations on the wrist
D weight gain
A

A dental enamel caries

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8
Q 
4 month old, about to have 3rd batch of vaccines. Which would be a complete contraindication to having the vaccine?
A Confirmed past history of pertussis 
B Currently ill with a fever of 38.5 
C Got a rash at the site of vaccination
D Severe cow milk energy
A

B currently ill with a fever of 38.5

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9
Q

Perianal itching especially at night. What is the best treatment option?

A

Mebendazole

Me bendz for that azole because I have thread worms in my ass

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10
Q

5 month old with cough, runny nose, fever. O/E you hear a wheeze. Whats the main pathogen that causes this RTI?
A Strep pneumoniae
B Respiratory syncytial virus
C Mycoplasma pneumoniae

A

B RSV

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11
Q

Unwell kind with indentable mass in left illiac fossa? Whats this?
A Constipation
B Wilm’s tumour

A

They say A constipation but I would guess it depends on the kids symptoms

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12
Q

Kid with URTI and generalised abdo tenderness.

A appendicitis
B mesenteric adenitis
C HSP

A

B mesenteric adenitis

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13
Q

Baby O/E can’t hear heart sounds and has a scaphoid chest. What is this?

A

Diaphragmatic hernia

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14
Q

Baby born at 41 weeks via ECS due to foetal distress. Needed ventilation straight away. X ray shows hyper inflated lungs with areas of consolidation. What does he have?

A

Meconium aspiration (risk due to post term)

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15
Q

Prem baby, resp distress, CXR shows grould glass. What does he have?

A

Surfactant deficiency

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16
Q

Bbay born at 37 weeks via forceps Shows signs of resp distress. CXR shows areas of consolidation throughout what is this?

A

Meconium aspiration

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17
Q

Treatments for paeds rashes repeat

Nappy rash, flexure sparing. How do you treat ?

A

Zinc barrier cream and castor oil

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18
Q

Treatments for paeds rashes repeat

Nappy rash with satellite lesions

A

Clotrimazole

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19
Q

Treatments for paeds rashes

Anal itch, worse at night

A

This is Pruritis ani

Mebendazole if they mean threadworms

symptoms will resolve with self-care measures and symptomatic treatment.

If the perianal skin is excoriated, consider prescribing a soothing cream or ointment containing bismuth subgallate or zinc oxide. See the section on Topical treatments for more information.

If the perianal skin is inflamed, consider prescribing a mildly potent topical corticosteroid (such as hydrocortisone 1% cream or ointment) to be used for no longer than 7 days. See the section on Topical treatments for more information.

If there is disturbed sleep due to nocturnal itching, consider prescribing a sedating antihistamine (such as chlorphenamine, off-label use). See the section on Prescribing information for more information.

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20
Q

Treatments for paeds rashes repeat

Scabies

A

Permethrin

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21
Q

Treatments for paeds rashes repeat

Chickenpox

A

Do nothing?

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22
Q

Treatments for paeds rashes repeat

Impetigo

A

Fusidic acid

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23
Q

Treatments for paeds rashes

Candida nappy rash

A

Topical imidazole

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24
Q 
Joint problems options
Haemophilia
JIA
Post viral synovitis
Septic arthritis
NAI

Grandma brings boy with swollen knee. Boys brother died young from minor head injury?

A

Haemophilia

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25
Q 
Joint problems options
Haemophilia
JIA
Post viral synovitis
Septic arthritis
NAI

Posterior rib fractures

A

NAI?

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26
Q 
Joint problems options
Haemophilia
JIA
Post viral synovitis
Septic arthritis
NAI

Unwell and unable to weight bear, fever

A

Septic arthritis

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27
Q 
Joint problems options
Haemophilia
JIA
Post viral synovitis
Septic arthritis
NAI

Recent URTI, not able to weight bear

A

Post viral synovitis

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28
Q

Kid with fever >39 what do you do next?

A

IV cef + admit + arrange investigation whilst on ward

Some people said full septic screen

Paediatric Sepsis Six
The following 6 interventions should be initiated within 1 hour of presentation of suspected sepsis: [48]

  1. Supplemental oxygen should be given.
    2 Intravenous or intraosseous (IO) access should be obtained within 5 minutes of presentation and blood tests ordered:
    - including blood cultures,
    - blood glucose (low blood glucose should be treated)
    - and arterial, capillary, or venous blood gases.
    - FBC, serum lactate, and CRP

3 Intravenous or IO antibiotics should be given with broad-spectrum cover as per local policies.

4 Fluid resuscitation should be considered. The aim is to restore normal circulating volume and physiological parameters. Isotonic fluid (20 mL/kg) should be titrated over 5 minutes and repeated as necessary. Caution should be taken to avoid fluid overload by examining the patient regularly (e.g., for pulmonary crepitations and hepatomegaly).

6 Experienced senior clinicians or specialists should be involved and consulted early.

Vasoactive-inotropic support should be considered early if normal physiological parameters are not restored after giving ≥40 mL/kg of fluids. It is important to note that adrenaline (epinephrine) or dopamine may be given via peripheral intravenous or IO access.

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29
Q

Mother brings in girl who doesn’t speak. What do you do next?

A

Refer for hearing assessment

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30
Q

Kid fitting for 5 mins, normal glucose, what do you give?

A

Rectal diazepam

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31
Q

Asthma management. Kid with acute exacerbation, been given salbuatmol and steroids. On listening to the chest you hear a quiet chest. RR is 60. What do you do.

A

Call PICU ready for intubation

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32
Q

Cross eye kid, what other piece of info would you like?

A

They say vomiting before breakfast - maybe because you’re considering raised ICP from SOL?

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33
Q

Dehydration + ill kid - weight 15 kg what do you give initially?

A

300 ml bolus IV (20 x 15 = 300) initial bolus

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34
Q

Aspiration pneumonoia - what do you fo?

A

?Oxygen and NG tube?

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35
Q

Strawberry tongue

A

Scarlet fever

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36
Q

What is the purpose of debriefing after a childs death in resuscitation?

A

To address emotional needs of everyone in the team

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37
Q

Child who passess stool every few days, when he goes stools are pellet like and smelly. What’s the likely diagnosis?

A

Overflow constipation

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38
Q

Child with pruritus ani worse at night. what do you give to treat?

A

Mebendazole

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39
Q 
Given pictures of reflexes. Which reflex is abnormal? 
A Moro reflex
B Assymetrical neck reflex
C palmar and planter grasp
D rooting
A

A Moro reflex 3-4 months
B Assymetrical neck reflex - 7 months
C palmar and planter grasp - 2-4 months
D rooting - 4 months

they should all be gone by 6 months

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40
Q

Treatments for paeds rashes

Rash involving flexures

A

`

41
Q 
Name conditions from pictures (all from Liseaurs) 
NAI
Candida albican 
Moluscum contagiosum
HSP
Mongolian blue spot
A

Just look it up

42
Q

By what age would you refer the following kids if they havent achieved the following milestones?

Sit without support

A

normal by 6m, refer by 8m (lisseaurs says 9m)

43
Q

By what age would you refer the following kids if they havent achieved the following milestones?

Walk

A

normal by 15 m, refer by 18 m

44
Q

By what age would you refer the following kids if they havent achieved the following milestones?

Hops on one leg

A

Normal by 4 y, refer by 5 y (was the only upper limit option)

45
Q

By what age would you refer the following kids if they havent achieved the following milestones?

Pincer grip

A

Normal by 10 m, refer by 12 m

46
Q

By what age would you refer the following kids if they havent achieved the following milestones?

Smiles

A

Normal by 6 w, refer by 8 w

47
Q

Poisons + investigations

Drunk/intoxicated kid

A

Urine drug screen

48
Q

Poisons + investigations

Dehydrated, seizures, mother been giving some herbal oral rehydration fluid or something

A

Check plasma sodium

49
Q

Poisons + investigations

Sick kid with fever, vomiting, photophobia

A

LP

50
Q

Resp problems

Neonate getting progressively worse at breathing over first 3 hrs with opacities?

A

Group B strep pneumonia

51
Q

Resp problems

Still needs oxygen after delivery

A

Bronchopulmonary dysplasia

52
Q

Resp problems

Ground glass appearance

A

Resp distress syndrome/ Surfactant deficiency

53
Q

Resp problems

Nitrogen washout test

A

Congenital heart disease

54
Q

Kid with sore throat, cervical lymphadenopathy, been given antbx then rash comes on. What virus caused this?

A

EBV

55
Q

Rash that started from behind the ears and spread to trunk, parents are vegetarians and kid goes to school in North london.

A

Measles

56
Q

GI

Intermittent pain, dehydrated, vomited 3 times

A

Intrusussception

57
Q

GI

Sudden abdo pain, well child, something indentable on L lower quadrant

A

L sided wilm’s nephroblastoma

58
Q

GI

Scaphoid abdomen

A

Diaphragmatic hernia

59
Q

Management of 4yo with enuresis - dry by day. What is your first line managment?

A

Reassure - enuresis becomews a problem after 5 yo

60
Q 
Child with Downs has NJ tube at home. It comes out and needs reinserting. Who should put it back
A community paeds nurse
B community paediatrician
C hospital nursing staff
D GP
E healthworker
A

???? I think community paeds nurse can do it????

61
Q

Child is slow to get dressed. Likes to arrange his toys in a particular way. [ASD; OCD; Oppositional defiant
disorder etc]

A

OCD

62
Q

o Child is an arsonist. Gets in fights. Attacks teachers. What is he likely to have at age 20? [Conduct
disorder; ADHD, Dissocial personality disorder; Oppositional defiant disorder]

A

Conduct disorder

63
Q

o Talking about a ~8 month child with cerebral palsy. Which of their milestones is likely to suggest CP

A

Using right hand more than left apparently

64
Q

Asthmatic child in A&E. Mother has been giving two puffs of salbutamol with spacer every 4 hours.
Description given correlated to severe asthma. What your management? [Inhaled nebs; inhaled
adrenaline, Discharge; 10 puffs of salbutamol through spacer]

A

10 puffs of salbutamol through spacer

65
Q

Child takes 4 tablets of grandmothers benzodiazepines 4 hours ago. She’s currently asleep, but was fully
awake with GCS 15. Your next step? [Activate charcoal; Gastric Lavage; IV flumenazil; admit for
monitoring]

A

IV flumenazil

Active charcoal works only after 1 hour

66
Q

Afebrile child with D+V. Description alludes to shock. She is 15kg. What do you give her initially?

A

300 ml of initial IV bolus

0.9% saline

67
Q

What defines mild learning disability

IQ <80
<70
<60
<50
<30
A

<70

68
Q

Joint problems

Girl not able to weight bear. Some joints hurt. Mum has rheumatoid arthritis?

A

JIA?

69
Q

Paeds milestone - at which age do you expect most children to have achieved this?

Smile

A

6 weeks

70
Q

Paeds milestone - at which age do you expect most children to have achieved this?

Sitting unsupported

A

6 months with round back

8 months with straight back

71
Q

Paeds milestone - at which age do you expect most children to have achieved this?

Walking

A

15 months

72
Q

Paeds milestone - at which age do you expect most children to have achieved this?

2-3 word sentences

A

12 months

73
Q

Paeds milestone - at which age do you expect most children to have achieved this?

Pincer grip

A

10 months

74
Q

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar)

28 day old with pale stools

A

Biliary atresia

75
Q

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar)

Baby has blood group AO, mother is group O

A

ABO incompatibility

76
Q

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar)

Mum has group B strep

A

Sepsis

77
Q

Jaundice (options ABO incompatibility, biliary atresia, physiological, sepsis, criggler najjar)

Baby has jaundice for a few days (day 2-7), ok now

A

Physiological

78
Q

Child with funny turns (options: infantile spasms, reflex anoxic seizure, breath holding attack, absence seizures)

child falls, parents pick him up but has tonic clonic seizures. he is completely well afterwards?

A

Breath holding attack aka anoxic reflex seizure

79
Q

Child with funny turns (options: infantile spasms, reflex anoxic seizure, breath holding attack, absence seizures)

Child at school, complains of unusual smell. Seems to space out. After shes drowsy and sleeps for a few hours in the nurses office. No recolleciton of what happene

A

Absent seizure

80
Q

Recurrent jelly stools in childs

A

Intusussception

81
Q

7 year old refuses to do homework and stays up late playing Minecraft on his ipad. parents are worried about him. What is the diagnosis?

A

Normal behaviour for age

82
Q

7 year old refuses to do homework and stays up late playing Minecraft on his ipad. parents are worried about him. What is the diagnosis?

A

Normal behaviour for age

83
Q

Kid given dexamethasone for croup 12 hs ago by GP, was stable and well with good satts but still mild stridor. What else do you give?

A

Repeat steroids

84
Q

Kid with yellow and grey stools was 4 weeks old. Whad do you test for?
Conjugated bilirubin levels
G6PD
Coombs test

A

Conjugated bili 1st

85
Q

Hypochloraemic hypokalaemic pH shown. what is the initial management for this?

A

Correct electrolyte imbalance

86
Q

Premature kid with distended abdo, vomiting, episode of blood in stool.

A

NEC

87
Q

Kid on bloods: low platelets, norma WCC, normal RBC

A

ITP

88
Q

Very hungry kid, hypotonia, almond eyes

A

Prader Willi - almond eyes

89
Q

Kid with nocturnal enuresis where behavioural therapy and enuresis alarm didnt work. Hes going to a sleepover. What is the next management?

A

Desmopressin

90
Q

Neonate with cardio problem. Systolic murmur loudest at Left sternal edge 2/6

A

VSD

91
Q

Kid with ADHD. What’s the management?

A

Parental training

offer meds only after you try conservative measures and its still not working

92
Q

Kid with ADHD. What’s the management?

A

Parental training

offer meds only after you try conservative measures and its still not working

93
Q

Hip pain on exercise and climbing stairs.

A

Perthes disease

94
Q

3 yo female child with intermittent limp, otherwise well

A

Developmental dysplasia of hip

95
Q

Uncle gets TB, kid lives with him. Mantoux test showed a number between 10-14 mm for result. What do you do?

A

Start anti TB treatment

96
Q

Precocious puberty - 5yo with sparse axillary adn pubic hair as well as breast bud development and high centile growth. Parents are along lower centiles. What definitive diagnostic test do you do?

A

Gonadotrophin stimulation test from BMJ

97
Q

Cerebral palsy - what area of brain is affected

A

Motor cortex

98
Q

Kid with rough sandpaper like rash on face and trunk and a flushed face

A

Scarlet fever

MC specialities (3 decks)

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