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Phase 3A > Passmed Paeds > Flashcards

Passmed Paeds Flashcards

1
Q

What is the first line treatment for whooping cough?

A

Oral Clarithromycin/azithromycin (any oral macrolide) - if presents within 3 weeks

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2
Q

What is the presentation of whooping cough?

A

Paroxysmal cough, inspiratory whoop, post-cough vomiting

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3
Q

How do you diagnose whooping cough?

A

Nasal swab culture for bordetella pertussis, PCR and serology

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4
Q

What is intussusception?

A

The invagination of one portion of the bowel into the lumen of the adjacent bowel - usually in the ileo-caecal region

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5
Q

When does intussusception usually present?

A

6-18 months

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6
Q

What are the clinical features of intussusception?

A

Intermittent abdominal pain, vomiting, bloodstained stool (red-current jelly), sausage-shaped mass in right upper quadrant, target sign on US

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7
Q

What is given to neonates to help promote closure of the ductus arteriosus?

A

Indomethacin or ibuprofen (reduce prostaglandin synthesis)

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8
Q

What are the clinical signs of a patent ductus arteriosus?

A

Left subclavicular thrill, continuous machinery murmur, collapsing pulse, heaving apex beat

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9
Q

What are the initial investigations in a child < 3 months with a fever?

A

FBC, blood culture, CRP, Urine testing, chest radiograph if resp signs, stool culture if diarrhoea

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10
Q

What types of hearing tests are used on different ages of children?

A

Newborn - otoacoustic emission testing
0-6months - auditory brainstem response
6-24months - distraction testing
3 years + - pure tone audiometry

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11
Q

When is an asthma attack classified as life-threatening?

A

When there is a normal pCO2 - due to reduced respiratory effort as the chest is tiring

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12
Q

How does the PCO2 vary in different severity of asthma attacks?

A

Moderate - low PCO2 due to panting -hyperventilating
Severe - low PCO2
Life-threatening - normal PCO2 due to exhaustion
Near-fatal - high PCO2 too tired so hypoventilating

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13
Q

What is the first line treatment for constipation in children?

A

Movicol plus advice on diet and fluid intake

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14
Q

What are the clinical features of hand, foot and mouth disease?

A

Mild systemic upset, fever, sore throat, oral ulcers, vesicles on the palms and soles of feet (can spread to groin)

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15
Q

How do you manage hand, foot and mouth disease?

A

Symptomatic treatment only

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16
Q

What is the first sign of puberty in boys?

A

Increase in testicular volume

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17
Q

What is the first sign of puberty in girls?

A

Breast development

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18
Q

What is the typical presentation of Immune Thrombocytopenia Purpura (ITP) in children?

A

Bruising, petechial rash, following infection

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19
Q

What investigations should be done in children with suspected ITP?

A

FBC, Blood film, (bone marrow examination only if splenomegaly, abnormal WBC)

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20
Q

What are the signs and symptoms of kawasaki disease?

A

Conjunctivitis, Rash, Oedema/erythema of hands and feet, Adenopathy, mucosal involvement (strawberry tongue)

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21
Q

What is the management of Kawasaki disease?

A

High-dose aspirin and IV Ig, regular echocardiograms to look for coronary artery aneurysms

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22
Q

What is the main potential complication of a hydrocele?

A

Indirect inguinal hernia

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23
Q

What is the cause of a hydocele?

A

Failure of the processus vaginalis to obliterate

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24
Q

What are the steps in treating asthma in children?

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + LTRA
  4. SABA + ICS + LABA (remove LTRA if has not helped)
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25
Q

A baby is showing no signs of breathing at 1 minute post delivery, it has a heart rate above 100bpm. What is the most appropriate next step in management?

A

5 breaths of air via face mask

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26
Q

What is the APGAR score?

A

A score used to assess the health of a newborn baby (from 0-10 with 10 being baby in a good state)

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27
Q

Which congenital heart condition causes infants to turn blue and occasionally lose consciousness?

A

Tetralogy of fallot

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28
Q

What are the four features of tetralogy of fallot?

A

VSD, right ventricular hypertrophy, overriding aorta, ventricular outflow obstruction (pulmonary stenosis)

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29
Q

What is the most common malignancy in children?

A

Acute Lymphoblastic Leukaemia

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30
Q

What are the symptoms of ALL?

A

Anaemia - lethargy and pallor
Neutropaenia - frequent or severe infections
Thrombocytopaenia - easy bruising, petechiae

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31
Q

When should an ambulance be called for a febrile seizure?

A

When the convulsions last longer than 5 mins

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32
Q

What is the first line medication for bed wetting in children?

A

Desmopressin

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33
Q

What is the initial management for ADHD?

A

Watch and wait for 10 weeks to see if symptoms change or resolve.
Then refer to a paediatrician or CAMHS.

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34
Q

What is the first line medication used for ADHD in children?

A

Methyphenidate (dopamine and norepinephrine reuptake inhibitor) - S/E: stunted growth, abdo pain, nausea

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35
Q

What is the time limit for a simple febrile convulsion?

A

5 mins (parents are advised to call an ambulance if convulsion lasts more than 5 mins)

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36
Q

What is the most common reason for presentation of early onset neonatal sepsis?

A

Group B strep, from mother to child during vaginal delivery

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37
Q

What is the typical presentation for neonatal sepsis?

A

Respiratory distress, tachycardia, apnoea, jaundice, seizures, reduced feeding, abdo distension, vomiting

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38
Q

What investigations should be done for neonatal sepsis?

A

Blood culture, FBC, CRP, blood gases, urine microscopy, lumbar puncture if concern of meningitis

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39
Q

What is the first line treatment for neonatal sepsis?

A

IV benzylpenicillin with gentamicin

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40
Q

What vaccinations are given at less than 6 months?

A

BCG if risk factors, 6 in 1 - diptheria, tetanus, whooping cough, polo, Hib and hep B (given at 2, 3 and 4 months), Men B, Oral rotavirus vaccine

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41
Q

What vaccines are given to babies at 12 months?

A

HiB, Men C, MMR, Pneumococcal, Men B

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42
Q

When is the flu vaccine given to children?

A

Yearly between the ages of 2 and 8

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43
Q

What vaccines are given at age 3-4 in the pre-school booster?

A

Diptheria, tetanus, whooping cough and polio, MMR

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44
Q

What vaccine is given at age 12/13?

A

HPV

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45
Q

What vaccines are given in children aged 1-18?

A

3 in 1 teenage booster - tetanus, diphtheria, polio, Men ACWY

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46
Q

Which areas are typically affected by eczema in a 10-month-old child?

A

Face and trunk

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47
Q

What is the barlow manouvre?

A

Attempted dislocation of a newborn’s femoral head

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48
Q

What is the otolani manouvre?

A

Attempted relocation of a newborn’s femoral head

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49
Q

Which babies are screened for DDH by ultrasound?

A

first-degree family history if infant hip problems, breech presentation at birth or at 36+ weeks, multiple pregnancy

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50
Q

What is Perthes’ disease?

A

Degenerative condition in children between 4-8yrs. avascular necrosis of the femoral epiphysis at the femoral head.

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51
Q

What is the treatment for perthes’ disease?

A

If under 6yrs - observation
cast/braces/surgical management
- most cases will resolve with conservative management

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52
Q

In which trisomy is Beta-HCG raised?

A

Trisomy 21 (it is lower in 18 -edwards and 13 - patau syndrome)

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53
Q

When is nuchal translucency thickened?

A

In any trisomy

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54
Q

What is the first line treatment for nocturnal enuresis?

A

< 5 advice
> 5 enuresis alarm then desmopressin if no help

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55
Q

What is the most common organism to cause croup?

A

Parainfluenza virus

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56
Q

What are the typical features of a slipped capital femoral epiphysis?

A
  • loss of internal rotation, hip pain, frog leg, usually in obese boys ages 10-15, can present with acute or chronic symptoms
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57
Q

What are the typical features of kawasaki disease?

A

High grade fever than lasts > 5 days
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms and soles that peel

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58
Q

What is the treatment for kawasaki disease?

A

High-dose aspirin
IV IgG
Echo for coronary artery aneurysms

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59
Q

What is the order for basic life support in children?

A

Open airway, feel for breathing, give 5 rescue breaths, then start 15 compressions to 2 rescue breaths

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60
Q

Which congenital heart defects are cyanotic?

A

tetralogy of Fallot, transposition of the great arteries, tricuspid atresia

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61
Q

Describe the classical presentation of measles

A

Initial prodrome of cough, coryza, koplik spots (white spots on oral mucosa) before maculopapular rash which starts behind ears and spreads - notifiable disease

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62
Q

What is the most common complication of measles?

A

otitis media
pneumonia, encephalitis also common

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63
Q

What is the classical presentation of impetigo?

A

Vesicles around the mouth that form yellow-crusted lesions. Can be lymph node involvement

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64
Q

What is the classical presentation of Parvovirus B19?

A

Causes slapped cheek syndrome. Viral prodrome, followed by a break for 7-10 days, followed by the erythematous rash over the cheeks. morbilliform rash then appears over the extremities.

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65
Q

What is the classical presentation of rubella?

A

Flu-like prodrome. Pink rash is macular and not usually itchy. Rash starts behind the ears and then spreads to the trunk. rubella is a notifiable disease in the UK

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66
Q

What is the classical presentation of chickenpox?

A

Fever initially, itchy, rash starting on head and trunk before spreading. Initially macular then papular then vesicular, systemic upset is usually mild

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67
Q

How is chickenpox spread?

A

Through the respiratory route

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68
Q

How long is someone with chickenpox infectious?

A

From 4 days before rash until all the lesions are dry and have crusted over

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69
Q

What causes respiratory distress syndrome?

A

Surfactant deficiency

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70
Q

What is the typical presentation of neonatal sepsis?

A

Respiratory distress - grunting, nasal flaring, tachypnoea

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71
Q

What is the treatment for neonatal sepsis?

A

IV Benzylpenicillin with gentamicin
Maintain adequate oxygen, fluid and electrolyte status

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72
Q

Which two organisms are more likely to increase morbidity in CF patients?

A

Burkholderia cepacia and psuedomonas aeruginosa

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73
Q

What is the management of cystic fibrosis?

A

regular chest physio and postural drainage, high calorie diet, vitamin supplementation, pancreatic enzyme supplementation. Ivacaftor/lumacaftor for CF patients who are homozygous for the delta F508 mutation

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74
Q

Which vaccination should students starting university get if they have not had it before?

A

Men ACWY vaccine

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75
Q

Which feature of a febrile seizure should prompt referral to paediatrics?

A

A child still being drowsy 1 hour after a seizure

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76
Q

What are the common causes of jaundice within the first 24hrs?

A

rhesus haemolytic disease, ABO haemolytic disease, hereditary spherocytosis, G-6DP deficiency

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77
Q

What is the common cause of jaundice in the neonate of 2-14 days?

A

Physiological - present in 40% of babies. more common in breastfed babies

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78
Q

What are the common causes of prolonged jaundice (14 days +)?

A

biliary atresia, hypothyroidism, galactosaemia, UTI, prematurity

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79
Q

What is the management of a child under 3 with an acute limp in primary care?

A

Urgent referral to secondary care

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80
Q

What are the typical features of scarlet fever?

A

typically aged 2-6
fever for 1-2 days
malaise, sore throat, strawberry tongue, sandpaper rash - usually on torso

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81
Q

What is the management of scarlet fever?

A

Oral penicillin 10 days (caused by group A strep - pyogenes)
children can return to school 24 hours after starting Abx
Notifiable disease

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82
Q

What is the treatment of a mild-moderate asthma attack?

A

Oral prednisolone and salbutamol via a spacer - one puff every 30-60 seconds up to 10 puffs

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83
Q

What is the management of neonatal hypoglycaemia?

A

If asymptomatic, encourage normal feeds and monitor glucose
Admit to neonatal unit for IV dextrose if glucose < 1 mmol/L or symptomatic

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84
Q

What is the most common cause of cardiac arrest in toddlers?

A

Hypoxia - usually from choking

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85
Q

A three year old presents with a Trendelenburg gait (waddling) and leg length discrepancy, what is the most likely diagnosis?

A

Developmental dysplasia of the hip

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86
Q

What causes hand, foot and mouth disease?

A

Coxsackie A16

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87
Q

What is the management of a child with chronic constipation?

A

Usually a dietary cause - increase fibre and fluids. Can give an osmotic laxative to increase water in stools. Stimulant laxative can be given after stools are soft.

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88
Q

What age does the average child start to crawl?

A

9 months

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89
Q

What motor milestones should be achieved by 6 months?

A

Pulls self to sitting, rolls front to back, lying on back, lifts and grasps feet

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90
Q

At what age should children sit unsupported?

A

7-8 months (refer at 12 months)

91
Q

What age do children typically walk?

A

13-15 months (refer at 18 months)

92
Q

What age do children typically run?

A

2 years - can also walk up and downstairs holding onto something at this age

93
Q

What is the treatment for meningitis in children over 3 months?

A

IV ceftriaxone or ceftotaxime

94
Q

Which fluid is used for fluid resuscitation in shock?

A

Colloid

95
Q

What is the management for young children with in-toeing? (pigeon toes)

A

Advise parents to monitor - should resolve by 8-10 years

96
Q

What are the typical features of benign rolantic seizures?

A

Usually aged 4-12, focal seizure typically involving face, usually at night, EEG shows centrotemporal spikes

97
Q

What is the initial test for coeliac disease?

A

IgA TTG

98
Q

What are the signs of a life-threatening asthma attack?

A

SpO2 < 92%, PEV < 33% of best, silent chest, poor resp effort, altered consciousness, cyanosis

99
Q

What are the clinical findings in ALL?

A

thrombocytopenia, anaemia, neutropaenia

100
Q

What virus causes roseola infantum?

A

HHV6

101
Q

What is the management of GORD in infants?

A

Thickened formula, head position up after feeds.
Alginates (gaviscon)
Can give PPI if unexplained feeding difficulties, distressed behaviour, faltering growth

102
Q

What is a Wilms’ tumour?

A

A nephroblastoma - usually presents in children under 5 with an abdominal mass/flank pain/painless haematuria

103
Q

What is the typical presentation of Meckel’s diverticulum?

A

Abdo pain mimicking appendicitis, rectal bleeding, intestinal obstruction

104
Q

What is the classical presentation of epiglottitis?

A

Rapid onset, high temperature, stridor, drooling, tripod position

105
Q

What are the features of androgen insensitivity syndrome?

A

primary amenorrhoea, undescended testes causing groin swelling, breast development

106
Q

What are the features of klinefelters syndrome?

A

tall, lack of secondary sexual characteristics, small firm testes, infertile, gynaecomastia, elevated gonadotrophin levels

107
Q

What features of bronchiolitis necessitate immediate referral to hospital?

A

apnoea, grunting, RR> 70, O2 < 92%, central cyanosis

108
Q

At what age should a child walk unsupported?

A

12-15 months

109
Q

At what age should a child crawl?

A

8-10 months

110
Q

What is the initial management of hischprungs disease?

A

rectal washouts/bowel irrigation
anorectal pullthrough is definitive management

111
Q

When do you refer for an undescended teste?

A

3 months

112
Q

A baby is born breach. Barlows and otolanis tests are normal. What do you do?

A

US hips

113
Q

What are the X-Ray features of Perthes disease?

A

Flattened femoral head
Between ages 5-12

114
Q

What is Osgood-Shlatter disease?

A

Seen in sporty teenagers, pain tenderness and swelling over the tibial tuberosity. Relieved by rest, made worse by kneeling and activity

115
Q

What is the treatment of a patent ductus arteriosus?

A

Indomethacin

116
Q

What is the most common cause of milky vomiting after feeds in infants under 8 weeks?

A

GORD

117
Q

What is the management of a child <3yrs presenting with an acute limp?

A

Immediate specialist assessment

118
Q

What is the first line treatment of ADHD in children?

A

Methylphenidate - in kids over 5. Can cause abdo issues and stunted growth - plot growth every 6 months

119
Q

At what age is child able to refuse treatment?

A

16 if competent

120
Q

What is beckers muscular dystrophy?

A

muscular dystrophy that presents usually after 10yrs and is less severe

121
Q

What is the difference between Gastroschisis and omphalocele (exomphalos)?

A

Gastroschisis is a bowel coming through a hole lateral to the umbilicus
Omphalocele is bowel coming through the umbilicus

122
Q

What are you worried about in a child with a limp and fever?

A

septic arthritis - refer all kids for same day assessment

123
Q

What is transient synovitis?

A

Joint pain following a viral infection, usually in 3-6 year olds. Treat with rest and analgesia

124
Q

What are the features of a baby with foetal alcohol syndrome?

A

IUGR, microcephaly, midfacial hypoplasia, micrognathia, smooth philtrum, microphthalmia, short palpebral fissures, thin upper lip, irritability, ADHD.

125
Q

What are the features of fragile X syndrome?

A

learning difficulties
large low set ears, long thin face, high arched palate
macroorchidism
hypotonia
autism is more common
mitral valve prolapse
CGG trinucleotide repeat

126
Q

In what two conditions do you not examine a child’s throat?

A

Croup and epiglottitis

127
Q

What is the most common cause of ambiguous genitalia in newborns?

A

Congenital adrenal hyperplasia

128
Q

What is a management of a child with croup in respiratory distress?

A

Oxygen and nebulised adrenaline. give dexamethasone

129
Q

What is the treatment for immune thrombocytopaenia in children?

A

Usually no treatment is required and it resolves on its own - if platelet count is not less than 10 and there is no active bleeding

130
Q

What is the management of whooping cough?

A

Azithromycin, or clarithromycin if onset of cough is within 21 days, advice only after

131
Q

What is the presentation of androgen insensitivity syndrome?

A

primary amenorrhoea, little axillary and pubic hair elevated testosterone

132
Q

What is the most common cause of massive painless GI bleed in kids between 1-2?

A

Meckel’s diverticulum

133
Q

What is the initial management of Hirshprung’s disease?

A

Rectal washouts and bowel irrigation

134
Q

When can a child with scarlet fever return to school?

A

24hrs after commencing antibiotics

135
Q

What is the triad of shaken baby syndrome?

A

Retinal haemorrhages, subdural haematoma and encephalopathy

136
Q

What types of analgesia do you not give kids with chickenpox?

A

aspirin - reyes syndrome
NSAIDS - necrotising fascitis risk

137
Q

What hormonal changes are seen in turners syndrome?

A

high FSH and LH

138
Q

What is the characteristic rash in Juvenille idiopathic arthritis?

A

salmon-pink rash

139
Q

What is the management of exomphalos and gastroschisis?

A

Exomphalos should have a gradual repair to prevent respiratory complications. Gastroschisis requires urgent correction

140
Q

What medications should be prescribed following an asthma attack?

A

salbutamol inhaler, 3 days prednisolone PO

141
Q

What is the presentation of CMV exposure in utero?

A

hearing loss, low birth weight, petechial rash, microcephaly and seizures

142
Q

What is the chest compression to ventilation ratio in newborns?

A

3:1

143
Q

Is whooping cough a notifiable disease?

A

yes

144
Q

What are the features of congenital rubella syndrome?

A

sensorineural deafness and congenital cataracts

145
Q

What are the features of congenital toxoplasmosis infection?

A

cerebral calcification, hydrocephalus, chorioretinitis

146
Q

What is the classical presentation of dyskinetic cerebral palsy?

A

difficulty holding objects due to fluctuating muscle tone and oro-motor issues e.g. drooling

147
Q

At what age are competent children deemed capable of consenting to sex?

A

13

148
Q

What is the management of faecal impaction?

A

Movicol Paediatric Plain
Then add stimulant laxative - like lactulose

149
Q

How old is a child who can do a pincer grip?

A

12 months

150
Q

If a newborn has an abnormal hearing test at birth (otoacoustic emission test) what follow up test are they offered?

A

auditory brainstem response

151
Q

What is the management of eczema?

A

emollients - 250g/weeks
topical steroids - applied 30 mins after emollients
wet wrapping - large amounts of emollients covered by bandages

152
Q

What is the classical presentation of intussuseption?

A

lethargy, vomiting, intermittent crying while drawing knees to chest
recent infection is a risk factor for intussusception, red-current jelly stools

153
Q

What investigations are used for suspected intussusception?

A

abdominal ultrasound - target or doughnut signs

154
Q

What is the first line management of intussusception?

A

Air insufflation

155
Q

What might cause a baby to have a tremor?

A

hypoglycaemia - prematurity

156
Q

What blood glucose level warrants 10% dextrose infusion in a neonate?

A

< 1mmol/L
or <2.6mmol/L and symptomatic

157
Q

what are macules?

A

Flat, non palpable lesions <1cm

158
Q

What are papules?

A

small elevated lesions <1cm

159
Q

5 y/o, 2 weeks ago cough and coryza. now has a maculopapular rash from hairline down and koplik spots?

A

CCCK - cough, coryza, conjunctivitis and koplik spots
MEASLES

160
Q

What causes measles?

A

RNA paramyxovirus

161
Q

How long does the child stay of school for with measles?

A

5 days - notifiable disease

162
Q

What are the distinctive features of scarlet fever?

A

strawberry tongue, sandpaper rough rash, fever, vomiting, abdo pain

163
Q

What are the key features of rubella?

A

low grade fever, rash beginning in face and spreading across whole body. suboccipital and postauricular lymphadenopathy

164
Q

What are the features of foetal rubella syndrome?

A

sensorineural hearing loss, cataracts, congenital heart defects

165
Q

7 y/o, headache, fever, runny nose 1 weeks ago. red rash on face and hands. diagnosis?

A

slapped cheek disease (parvovirus B19)

166
Q

1 y/o boy, high grade fever for 3 days. rash on trunk that starts on trunk and spreads peripherally, spots on uvula and soft palate (nagayama spots). Diagnosis?

A

Roseola Infantum

167
Q

What are the symptoms of kawasaki disease?

A

CRASH and BURN - conjunctivitis, rash, adenopathy, strawberry tongue, hands, fever (>5 days)

168
Q

How often must kids with chicken pox stay off school?

A

5 days from skin eruption

169
Q

What is the definition of shock?

A

The inadequacy of circulation to meet tissue demands leading to end-organ damage

170
Q

What is the most common viral cause of meningitis?

A

HSV-1

171
Q

What are kernig and brudinski signs?

A

kernig - knee extension is painful
brudinski - neck flexion leads to knee flexion
For meningitis

172
Q

How do you calculate maintenance fluids?

A

<10kg - 100ml/kg
10kg-20kg - 100ml/kg for first 10kg + 50ml/kg for each 1kg over 10kg
+ 20ml/kg for each 1kg over 20kg

173
Q

What is the max amount of maintenance fluid you give?

A

2L in girls, 2.5L in boys

174
Q

What maintenance fluids do you give in kids?

A

0.9% NaCl + 5% dextrose

175
Q

How do you work out replacement fluids?

A

% dehydration - (well weight-ill weight)/ well weight x 100
fluid deficit = %dehydration x well weight (kg) x 10
give fluid replacement and maintenance

176
Q

How much do you give in resus fluids?

A

10ml/kg IV bolus fluids over 5-10 mins - repeat up to 40ml/kg

177
Q

What fluids do you give for resuscitation?

A

0.9% saline

178
Q

How do you work out the rate of influsion?

A

Total fluid maintenance / 24 to give it per hour

179
Q

A child has swollen legs and eyes, this has happened before and usually self resolves. diagnosis?

A

nephrotic syndrome - usually minimal change disease

180
Q

What are the features of minimal change disease?

A

periorbital oedema, leg oedema, SOB, frothy urine, pallor

181
Q

How do you diagnose minimal change disease?

A

Urine dip and urinary protein:creatinine ratio

182
Q

What are the features of nephritic syndrome?

A

reduced kidney function, haematuria, proteinuria. usually occurs post strep infection

183
Q

4 y/o m, pain when going for a wee and history of fever. diagnosis?

A

UTI, pyelonephritis

184
Q

What is the treatment for a UTI in kids?

A

< 3months - IV cefotaxime
upper UTI - oral cefotaxime/co-amox
lower UTI - trimethoprim/nitrofurantoin

185
Q

What investigations do kids with atypical or recurrent UTIs?

A

DMSA scan. MCUG scan for vesicoureteric reflux

186
Q

What is the treatment of absence seizures?

A

ethosuximide

187
Q

What is the treatment of focal seizures?

A

lamotrigine, levetiracetam

188
Q

When do kids at risk of developmental dysplasia of the hip get ultrasounds?

A

6 weeks of age

189
Q

what movement is lost in SCFE?

A

Internal rotation - is painful, so kids in frog legs

190
Q

What do you give kids under 3 months with bacterial meningitis?

A

cefotaxime and amoxicillin

191
Q

What medication is sued to maintain patency of the ductus arteriosus?

A

Prostaglandin e1 (prostaglandin = patent)
(NSAIDs to close )

192
Q

What is the management of croup?

A

single oral dose of Dexamethosone

193
Q

What are the symptoms of croup?

A

coryzal symptoms followed by stridor and a barking cough

194
Q

What biochemical signs are seen in babies with pyloric stenosis?

A

hypochloraemic, hypokalaemic, alkalosis (due to persistent vomiting)

195
Q

What are the signs of late/decompensated shock?

A

hypotension, bradycardia, acidotic (kussmaul breathing), absent urine output

196
Q

What are the signs of early/compensated shock?

A

tachycardia, tachypnoea, weak pulses, reduced urine output, normal BP

197
Q

What is the management of bacterial meningitis?

A

<3months. IV amoxicillin + IV cefotaxime
>3months. IV cefotaxime + corticosteroids

198
Q

Meconium Ileus is a common neonatal feature of what condition?

A

Cystic fibrosis

199
Q

What are the features of rickets?

A

Aching bones and joints, kyphoscoliosis, bow legged, knock knees, joint widening

200
Q

What investigation is the best for diagnosing necrotising enterocolitis?

A

Abdominal X-Rays - intestinal gas is seen on X-Ray and dilated bowel loops

201
Q

what is the typical presentation of biliary atresia?

A

jaundice, loss of appetite and growth disturbance within the first few weeks of life

202
Q

How do you treat biliary atresia?

A

Early surgical intervention

203
Q

What electrolyte abnormalities are associated with pyloric stenosis?

A

high bicarb, hypokalaemia and hypochloraemia

204
Q

What can you give in a baby with bad croup/stridor?

A

Nebulised adrenaline

205
Q

What are the common features of foetal alcohol syndrome?

A

microcephaly (small head)
short palpebral fissures (small eye opening)
hypoplastic upper lip (thin)
absent philtrum
reduced IQ
variable cardiac abnormalities.

206
Q

When do different cyanotic heart conditions typically present?

A

first days of life is TGA.
1-2 months of age is TOF

207
Q

What biochemistry results are seen in biliary atresia?

A

raised conjugated bilirubin

208
Q

What is the gold standard investigation to look for scarring in vesicoureteric reflux?

A

Radionuclide scan using dimercaptosuccinic acid (DMSA)
Micturating cystoureterogram is first line

209
Q

When is the heel-prick test typically done?

A

between the 5th and 9th day of life

210
Q

What kind of vaccine is the rotavirus vaccine?

A

A life attenuated vaccine given orally - at 2 and 3 months of age

211
Q

What is the management of bilateral undescended testes?

A

Urgent referral to paeds within 24hrs for endocrine and genetic testing

212
Q

What type of inheritance pattern is haemophilia A?

A

X-linked recessive

213
Q

What kind of defect causes a continuous machinery murmur at the upper left sternal edge?

A

patent ductus arteriosus

214
Q

What is the next test offered if the heel-prick test is positive?

A

sweat test

215
Q

What signs present in children may indicate sexual abuse?

A

Recurrent UTIs and anal fissures

216
Q

In paediatric life support which pulses do you check?

A

Femoral or brachial

217
Q

What heart condition is associated duchenne muscular dystrophy?

A

Dilated cardiomyopathy

218
Q

What is the treatment of threadworms?

A

A single dose of mebendazole to the whole household

219
Q

What is noonan syndrome?

A

The same as turners syndrome symptoms but in a boy. Wide-spaced nipples, webbed neck etc

220
Q

What cardio issues do you get with turner’s syndrome?

A

bicuspid aortic valve - which leads to aortic dissection

221
Q

What is the first line treatment of DDH in kids under 6 months?

A

Pavlik Harness

222
Q

What do you do in a newborn with jaundice?

A

Measure serum bilirubin

223
Q

What investigation should be used in Meckel’s diverticulum?

A

Technetium scan

Phase 3A (14 decks)

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