PassMed Qs Flashcards
What is the first line for Mycoplasma pneumonia?
Erythromycin - a macrolide
What is the heart murmur seen in Turner’s and why?
Ejection systolic
Due to bicuspid aortic valve
What drug class is associated with long QT?
Macrolides e.g. clarithromycin
Should either change or have regular ECGs
What is the requirement to step up to prescribing an inhaled corticosteroid for asthma?
Symptoms more than 3 times a week, or
night time waking
What are acute causes of hydrocephalus?
Meningitis - look out for febrile, poor feeding etc
Traumatic brain injury
Haemorrhage - intraventricular or subarachnoid
When are antibiotics indicated for acute otitis media?
Eardrum perforated
<2 years old and bilateral infection
Present for >4 days
<3 months old
What is the most common side effect of salbutamol?
Tachycardia
How might maternal bipolar disorder be relevant in a presentation of a heart murmur heard in both systole and diastole, and heard best on the left sternal border?
Ebstein’s anomaly
Caused by the use of lithium in pregnancy
Occurs when the posterior leaflets are displaced anteriorly towards the apex, creates tricuspid regurgitation and a pan systolic murmur
Enlargement of the right atrium
What are some causes of clubbing in children?
Hereditary clubbing Cyanotic heart disease Infective endocarditis Cystic fibrosis Tuberculosis Inflammatory bowel disease Liver cirrhosis
Why do patients with cystic fibrosis take long term prophylactic flucloxacillin?
To prevent staph aureus infection
Pseudomonas is a troublesome coloniser
What is the step up from a SABA and ICS in asthma management for children?
Child aged 5-16 years with asthma not controlled by a SABA + paediatric low-dose ICS
add a leukotriene receptor antagonist
Also less than 5 years
What is the management of a viral induced wheeze?
first-line is treatment with short acting beta 2 agonists (e.g. salbutamol) or anticholinergic via a spacer
next step is intermittent leukotriene receptor antagonist (montelukast), intermittent inhaled corticosteroids, or both
there is now thought to be little role for oral prednisolone in children who do not require hospital treatment
What are the complications of measles?
Otitis media most common
Pneumonia
Encephalitis
What are the features of PDA?
left subclavicular thrill continuous 'machinery' murmur large volume, bounding, collapsing pulse wide pulse pressure heaving apex beat
What is the most common cause of RDS in the newborn period, if not premature?
Transient tachypnoea of the newborn (TTN)
What are the diagnostic features of Kawasaki disease?
fever >5d with 4 of the following criteria:
A) Conjunctival injection
B) Mucous membrane changes (dry cracked lips, strawberry tongue)
C) Cervical lymphadenopathy
D) Polymorphous rash
E) Red and oedematous palms/soles, peeling of fingers and toes.
What is included in APGAR scoring?
pulse, respiratory effort, colour, muscle tone and reflex irritability.
How should coronary artery aneurysms be screened for?
With an echocardiogram
What is the triad in haemolytic uraemic syndrome?
acute kidney injury
microangiopathic haemolytic anaemia
thrombocytopenia
What is the treatment of nocturnal enuresis if an alarm has been ineffective?
Desmopressin for children over 7
What is the investigation of choice for reflux nephropathy?
A micturating cystourethrogram
When is nocturnal enuresis not considered normal?
Any child over the age of 5
Use of anti-epileptics in pregnancy can cause what facial feature?
Orofacial clefts
What are the characteristics of an innocent ejection murmur?
soft-blowing murmur in the pulmonary area
or short buzzing murmur in the aortic area
may vary with posture localised with no radiation no diastolic component no thrill no added sounds (e.g. clicks) asymptomatic child no other abnormality
Who should doxycycline not be prescribed to?
Children under 12 years
Due to risk of dental hypoplasia and permanent discolouration of teeth
What pulses do you check for in PBLS?
Brachial and femoral pulses
What are high risk signs/red traffic light signs prompting urgent assessment?
Pale/mottled/blue No response to social cues Appears to be ill by health professionals Does not wake/stay awake Weak, high pitched or continuous cry
Grunting
Tachypnoea, more than 60 breaths per minute
Moderate/severe chest indrawing
Reduced skin turgor
Age < 3 months with temp > 38 Non-blanching rash, bulging fontanelle Neck stiffness Status epilepticus Focal neurological signs or seizures
What is acute chest syndrome in sickle cell disease?
Vaso-occlusive crises of the pulmonary vasculature
Shown with new opacification on chest x-ray
What is Gower’s sign?
Child using hands on thighs to stand up
Weakness of the proximal muscles
When does the moro reflex typically disappear?
4 months of age
Startle reflex - parachute
What is it important to remember in the antibiotic treatment for meningitis?
Give IV amoxicillin in children less than 3 months to cover for listeria
What are the main risk factors for SIDS?
prone sleeping parental smoking bed sharing hyperthermia and head covering prematurity
