passmed

Question 1

lithium in pregnancy, pan systolic murmur and mid-diastolic murmur, and enlarged RA

Answer 1

Ebstein’s anomaly is caused by the use of lithium in pregnancy. It occurs when the posterior leaflets of the tricuspid valve are displaced anteriorly towards the apex of the right ventricle. The creates tricuspid regurgitation (pan-systolic murmur) and tricuspid stenosis (mid-diastolic murmur). There is also enlargement of the right atrium. Ventricular septal defects present with a pan-systolic but not diastolic murmur.

Question 2

girl with haemophilia underlying diagnosis

Answer 2

Haemophilia is a X-linked recessive disorder and would hence be expected only to occur in males. As patients with Turner’s syndrome only have one X chromosome however, they may develop X-linked recessive conditions

Question 3

Unilateral undescended testicle Mx

Answer 3

review at 3 months - if persistent refer

Question 4

hearing test

Answer 4

pure tone audiometry

Question 5

JIA unexpected symptom

Answer 5

pink rash

Question 6

measles vs chicken pox features

Answer 6

It initially presents as a macular rash over the face. Children are often asymptomatic at this point. However, fever and coryza manifest whilst the rash spreads to the trunk and limbs. Koplik spots are white spots seen on the oral mucosa and are pathognomonic of measles.

vesicular rash in mouth and temperature before rash = more likely chickenpox

Question 7

intussusception first step

Answer 7

order abdominal USS

Question 8

Neonatal hypoglycaemia:

Answer 8

if asymptomatic then encourage normal feeds and monitor glucose

Question 9

Ladds vs Kasai procedure

Answer 9

Paediatric intestinal malrotation with volvulus → Ladd’s procedure (includes division of Ladd bands and widening of the base of the mesentery)

Kasai procedure is used to manage cases of biliary atresia, rather than malrotation. It involves creating a connection between the liver and the small intestine to allow for bile drainage.

Question 10

rotavirus type of vaccine

Answer 10

Rotavirus is an oral, live attenuated vaccine

Question 11

(threadworms)

Answer 11

Enterobius vermicularis

Question 12

Undescended testicles are associated with an increased risk of

Answer 12

infertility, torsion and testicular cancer

Question 13

TOF Px

Answer 13

Tetralogy of Fallot: Cyanosis or collapse in first month of life, hypercyanotic spells. Ejection systolic murmur at left sternal edge

Question 14

enuresis alarm if

Answer 14

over 5

Question 15

scarlett fever return to school after

Answer 15

24 hours of Abx

Question 16

A jittery and hypotonic baby in a mother who has taken beta blockers may suggest

Answer 16

may suggest neonatal hypoglycaemia.

Question 17

when is MenB vaccine given

Answer 17

2, 4 and 12 months