passmed w/c 08/01/24

Question 1

patent ductus arteriosus

features

mx?

Answer 1

congenital heart defect

left subclavicular thrill
murmur
bounding, collapsing pulse
wide pulse pressure
hevaing apex beat

PDA pulmonary trunk
descending aorta

indomethicin / ibruprofen inhibits prostaglnadin e2, so the duct

Question 2

roseola infantum
caused by?

Answer 2

herpes simplex virus 6
common
high fever > maculopapular rash

Question 3

vital signs paeds

Answer 3

Age Heart rate Respiratory rate
< 1 110 - 160 30 - 40
1 - 2 100 - 150 25 - 35
2 - 5 90 - 140 25 - 30
5 - 12 80 - 120 20 - 25
> 12 60 - 100 15 - 20

Question 4

neonatal hypoglycaemia

Answer 4

autonomic features irritability and jitteriness

Question 5

rickets - radiological finding

Answer 5

joint widening swelling at costochondral junction

Question 6

scarlet fever mx if penicillin allergy?

Answer 6

azithromycin - 10 days

Question 7

whooping cough mx?

Answer 7

macrolide abx - azithromycin . clarithromycin

Question 8

methylphenidate effect

Answer 8

abdo pain
stunted growth

Question 9

pyloric stenosis

Answer 9

hypocholoraemic
hypokalaemic

Question 10

neonatal sepsis signs

Answer 10

<28 days

GB streptococcus
E.coli

respiratory distress - grunting, nasal flare, tachypnoea

poor reduced feeding
change in mental status / lethargy

Question 11

neonatal sepsis investigations?

Answer 11

blood cultrue
fbc
blood gas
urine MC&S
LP

Question 12

mx of neonatal sepsis?

Answer 12

iv benzylpenicillin with gentamicin
CRP 18-24 hours after presentation

o2
fluid, electrolyte
body weight measurements twice daily
- hypoglycaemia
met acidosis