Passmed 2

Question 1

What heart defect and murmer will lithium use in pregnancy cause

Answer 1

Ebsteins anomaly -> pan systolic murmer and mid diastolic murmer

Question 2

when will ebsteins anomaly present

Answer 2

days after birth

Question 3

when will tetralogy of fallot present

Answer 3

1-2 months of age

Question 4

what IV drug is given in bacterial meningitis in <3mo

Answer 4

amoxicillin IV (or ampicillin)

Question 5

what is the most common cause of cardiac arrest in children

Answer 5

respiratory causes - hypoxia

Question 6

how will an umbilical granuloma present

Answer 6

in first few weeks of life
small, red growth of tissue in centre of umbilicus
wet and leaks out small amounts of clear or yellow fluid

Question 7

What are the diagnostic criteria for whooping cough

Answer 7

acute cough lasted 14 days+ with one or more of following features:

• paroxysmal cough,
• inspiratory whoop
• post tussive vomiting
• undiagnosed apnoeic attacks in young kids

Question 8

what features are indicative of childhood sexual abuse

Answer 8

recurrent UTIs, anal fissures, anal bruising, enuresis, behavioral problems

Question 9

how does perthes disease present

Answer 9

progressive hip pain, limp and stiffness

Question 10

what is the inv of choice for Slipped upper femoral epiphysis

Answer 10

plain X-ray of both hips (AP and frog-leg views)

Question 11

what factors would suggest slipped upper femoral epiphysis

Answer 11

boys aged 10-15, obese
hip, groin, medial thigh or knee pain
loss of internal rotation of leg in flexion (presents with externally rotated leg)

Question 12

what tests do breech babies born after 36 weeks require

Answer 12

all require USS for DDH at 6 weeks, regardless of mode of delivery

Question 13

what result on a heel prick test will suggest CF and how should the baby then be testedd

Answer 13

High immunoreactive trypsinogen (IRT)

confirmed with sweat test

Question 14

what are the SSRIs of choice in breastfeeding women

Answer 14

sertraline, paroxetine

Question 15

how does roseola infantum present

Answer 15

typically in 6mo-2y
high fever for a few days followed later by:
-maculopapular rash
-blanching, rose-ink papules on trunk
-diarrhoea and cough

Question 16

what is exomphalon (omphalocele)

Answer 16

foetal abdo wall defect, contents protrude through anterior abdo wall but are covered in an amniotic sac
Csec and staged repair

Question 17

what is the most common cause of nappy rash and how does it present

Answer 17

irritant dermatitis

creases are spared

Question 18

how will candida nappy rash present

Answer 18

erythematous rash that involves flexures and has satellite lesions

Question 19

What should be given alongside antibiotics in suspected bac meningitis, why is it given and who is it not given to

Answer 19

Dexamethasone to prevent hearing loss

not given to younger that 3mo

Question 20

what features are indicative of kawasaki disease

Answer 20

High fever lasting >5 days
red palms with desquamation
strawberry tongue

Question 21

who should not get labetalol

Answer 21

asthmatics - give nifedipine instead

Question 22

how will william’s syndrome present

Answer 22

A boy with learning difficulties is noted to be extremely friendly and extroverted. He has short for his age and has supravalvular aortic stenosis

Question 23

which infection will results in a ‘slapped cheek’ look

Answer 23

Parvovirus B19

Question 24

how will measles present

Answer 24

Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent

Question 25

how will mumps present

Answer 25

Fever, malaise, muscular pain

Parotitis (‘earache’, ‘pain on eating’): unilateral initially

Question 26

how will rubella present

Answer 26

pink maculopapular rash, initially on face before spreading to whole body, usually fades by the 3-5 day

Question 27

how will scarlett fever present

Answer 27

Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth

Question 28

what causes hand, foot and mouth disease

Answer 28

Coxsackie A16 virus`

Question 29

how will coxsackie A16 present

Answer 29

hand foot and mouth disease

Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet

Question 30

what is the most common cause of ambigous genetalia in newborns

Answer 30

congenital adrenal hyperplasia

Question 31

how will coeliac disease present

Answer 31

failure to thrive
diarrhoea
abdominal distension
older children may present with anaemia

Question 32

how is coeliac disease diagnosed

Answer 32

IgA TTG antibodies

Question 33

what will an abdo xray show in hirschsprung’s disease

Answer 33

dilated loops of bowel with fluid levels

Question 34

what will an abdo xray show in meconium ileus

Answer 34

distended coils of bowel and typical mottled ground glass appearance. Fluid levels are scarce

Question 35

how will laryngomalacia present

Answer 35

otherwise well infant with noisy breathing
presents at birth and worsens in first few weeks of life, self resolves after 2y

softening of larynx cartilage -> collapse on insp

Question 36

how will inhaled foreign body present

Answer 36

Sudden onset: coughing, choking, vom, stridor

Question 37

how will croup present

Answer 37

stridor, barking cough (worse at night) fever coryzal symptoms

Question 38

what inf causes acute epiglotitis

Answer 38

Haemophillus influenzae type B

Question 39

how will acute epiglotitis present

Answer 39

rapid onset
toxic unwell child
hypersaliv
stridor