Paeds Key Points 5

Question 1

VACTERL association

Answer 1

Vertebral defects, anal atresia, cardiac defects, tracheo-oesophageal fistula, renal anomalies, and limb abnormalities
Usually have at least 3

Question 2

Management for a child < 3 years presenting with an acute limp

Answer 2

Urgent referral to hospital for septic arthritis/NAI

Question 3

Coeliac disease

Answer 3

Failure to thrive, gluteal muscle wasting, steatorrhoea
Ix - anti-tTG/endomysial/DGP
Mx - gluten free diet

Question 4

Viral induced wheeze

Answer 4

URTI causing an expiratory wheeze
Mx - salbutamol via spacer –> intermittent leukotriene receptor antagonist (montelukast) or intermittent inhaled corticosteroids or both

Question 5

Outpatient asthma management

Answer 5

1 - salbutamol inhaler
2 - low dose inhaled steroid
3 - >5 - long acting beta agonist; <5 - leukotriene receptor antagonist (montelukast)
4 - increase inhaled steroid dose ± continue long acting beta agonist + stop leukotriene receptor antagonist
5 - Oral steroids

Question 6

Inpatient asthma management

Answer 6

1 - burst therapy - salbutamol (10 puffs with 10 breaths per puff) 3 times, ipratropium bromide 2 times, prednisolone 1 dose
2 - IV bolus of magnesium sulphate, salbutamol, aminophylline
3 - IV infusion of aminophylline and salbutamol
4 - intubate and ventilate