Paeds Key Points 1

Question 1

Threadworms

Answer 1

Perianal itching at night

Mx
- single dose of mebendazole for whole family and hygeine advice

Question 2

ASD

Answer 2

Fixed splitting of 2nd heart sound

Question 3

VSD

Answer 3

Pansystolic murmur in lower left sternal edge

Question 4

Coarctation of the aorta

Answer 4

Crescendo-decrescendo murmur in upper left sternal edge

Question 5

PDA

Answer 5

Continuous machinery murmur in upper left sternal edge

Question 6

Pulmonary stenosis

Answer 6

Ejection systolic murmur in upper left sternal edge

Question 7

Venous hum (Innocent murmur)

Answer 7

Sounds like blowing through nose below both clavicles

Question 8

Still’s murmur (Innocent murmur)

Answer 8

Low pitched heart sound at lower left sternal edge

Question 9

Roseola infantum

Answer 9

HHV6
6 months - 2 years
High fever comes and then goes and then a maculopapular rash develops
Diarrhoea, cough
Associated with aseptic meningitis and hepatitis

Question 10

Laryngomalacia

Answer 10

4 weeks old with stridor

Mx

• self resolves by 2 years old
• if failure to thrive or breathing problems then surgery

Question 11

Commonest cause of headaches in children

Answer 11

Migraine without aura

Mx

• ibuprofen, sumitriptan nasal spray
• pizotifen and propranolol prophylaxis

Question 12

Infantile spams (West syndrome)

Answer 12

4-8 month old boy
Flexion of head trunks and arms followed by extension of arms (salaam attack) and hypsarrythmia on EEG

Poor prognosis
Mx
- vigabatrin

Question 13

CF + Hirschprung

Answer 13

Meconium ileus

Question 14

Infantile colic

Answer 14

Inconsolable crying, drawing up knees, flatus

Crying starts and stops for no reason that lasts for >3 hrs a day for >3 days a week for >1 week

Question 15

Congenital cataract

Answer 15

No red reflex at birth

Question 16

Retinoblastoma

Answer 16

Red reflex present at birth but not at around 18 months

Question 17

Seborrhoeic dermatitis

Answer 17

Scalp (cradle cap), nappy area, flexures
Mx
- mild - baby shampoo/oils
- severe - mild topical steroids (1% hydrocortisone)

Question 18

Hand Foot and Mouth Disease

Answer 18

Coxsackie A16
Maculopapular rash in mouth, palms and soles, groin and buttocks
Sore throat and low-grade fever

Question 19

Paediatric BLS

Answer 19

Patient not breathing –> 5 rescue breaths –> assess circulation –> not breathing + no pulse –> CPR at 15:2

Question 20

Jaundice

Answer 20

<24 hours - always pathological - ABO/rhesus haemolytic disease, hereditary spherocytosis, G6POD deficiency
2-4 days - common - physiological
>14 days - biliary atresia (high conjugated bilirubin), hypothyroidism, galactosaemia, UTI, congenital infection, breast milk jaundice
Ix for >14 days - conjugated and unconjugated bilirubin, direct antiglobulin test, TFTs, FBC, blood film, urine for MC&S and reducing agents, U&Es and LFTs