Passmedicine

Question 1

When does pyloric stenosis usually present?

Answer 1

1st-4th weeks post-natal; occasionally up to 4 months

Question 2

What is the main presentation of pyloric stenosis?

Answer 2

Projectile vomiting

Question 3

How is pyloric stenosis managed?

Answer 3

Ramstedt pyloromyotomy

Question 4

Describe a typical case of intussusception.

Answer 4

Boy aged 6-18 months old, colicky abdominal pain, vomiting, blood in stool

Question 5

What is the classical ultrasound finding in intussusception?

Answer 5

“Target” sign

Question 6

How does pertussis present?

Answer 6

2/3 days of corzyal symptoms, sustained bouts of coughing, may also be vomiting

Question 7

What are Koplik spots and what are they a feature of?

Answer 7

“Salt-grain” lesions on the oral/buccal mucosa. Feature of measles

Question 8

Describe the rash associated with measles.

Answer 8

Starts behind the ear; initally maculopapular, becoming blotchy and confluent

Question 9

What is the commonest cause of nephrotic syndrome in children?

Answer 9

Minimal change glomerulonephritis

Question 10

What is acute epiglottitis usually caused by?

Answer 10

H. influenzae

Question 11

What is the most common presentation of retinoblastoma in children?

Answer 11

Loss of red reflex in photos; strabismus

Question 12

What is croup characterised by?

Answer 12

Stridor (oedema and secretions)

Question 13

What causes the majority of cases of croup?

Answer 13

Parainfluenza viruses

Question 14

What are the features of croup?

Answer 14

Barking cough worse at night

Stridor

Fever

Corzyal symptoms

Question 15

What is the most common cause of gastroenteritis in children?

Answer 15

Rotavirus

Question 16

What is first-line for constipation in children?

Answer 16

Movicol

Question 17

What does scarlet fever usually follow?

Answer 17

Strep throat

Question 18

Describe the rash seen in rubella.

Answer 18

Pink maculopapular rash initally on face, before spreading

Question 19

When do children normally gain the ability to crawl?

Answer 19

8-10 months

Question 20

What are the guidelines for paediatric asthma management?

Answer 20

1. SABA as required
2. Inhaled steroid
3. Leukotriene antagonist or refer to paeds if <3 years old
4. refer to paeds

Question 21

What kind of hypersensitivity reaction is scabies?

Answer 21

Type 4

Question 22

High grade fever

Conjunctival injection

Red, sore lips

Swollen red hands

“Strawberry” tongue

Answer 22

Kawasaki disease

Question 23

When is MMR first given?

Answer 23

12-15 months

Question 24

When is PCV given?

Answer 24

2 months

Question 26

Abdominal mass + painless haematuria in a child under 5 years of age

Answer 26

? Wilm's nephroblastoma

Question 27

High grade fever + conjunctival injection + cervical lymphadenopathy + "strawberry tongue"

Answer 27

? Kawasaki disease

Question 28

Treatment of Kawasaki disease? (2)

Answer 28

High dose aspirin + IV Ig

Question 29

Commonest cause of nephrotic syndrome in children?

Answer 29

Minimal change disease

Question 30

How is minimal change disease treated?

Answer 30

High dose steroids

Question 31

Why is echocardiography an important investigation in Kawasaki disease?

Answer 31

Rule out coronary artery aneurysm

Question 32

Management of nocturnal enuresis? (4)

Answer 32

Advice on fluid/diet/toilet behaviour Reward charts Enuresis alarm Desmopressin

Question 33

Nasal polyps in a young child should raise suspicion of...

Answer 33

Cystic fibrosis

Question 34

What is the diagnostic test for cystic fibrosis?

Answer 34

Sweat test- muscarinic agonist (pilocarpine) is administered, Cl content of sweat is measured