Pastest general

Question 1

What blood condition is associated with Downs

Answer 1

AML

Question 2

Infantile hemangioma (strawberry nave aka capillary haemangioma)

Visible fine telangiectasia, well-demarcated, 4-6 wk life peak incidence, grows fast in first 3 months of life and peak at 5th month, most regress, mainly head and neck, blanching of skin, firm papule with a pale halo

three phases: proliferative, stabilisation, spontaneous resolution

Answer 2

mx = no tx and regress spontaneously → medical photography and reassess child in 3 months time

if troublesome (large, ulcerates, impairs function)

• oral propanolol 1st line
• topical timolol 2nd line

surgery = if rapidly evolving compressing on vital structures

*

Question 3

Idiopathic pulmonary haemosiderosis (IPH)

first decade of life, 4.5 years old, females

alveolar capillary bleeding + haemosiderin accumulation in lungs → IDA, haemoptysis

o/e = atrophic glossitis, angular stomatitis, dyspneic

can undergo spontaneous remission, variable course

repeated haemorrhage → progressive respiratory failure, cor pulmonale

linked to gluten sensitivity

ix: exclusion diagnosis, rule out Goodpastures and SLE first, CXR = irregular infiltrates in both lung fields

Answer 3

mx:

• steroids decrease frequency of haemorrhage
• N-acetylecysteine
• eliminate gluten from diet

Question 4

What is the most common cerebellar neoplasm in children?

Answer 4

Astrocytoma = benign or malignant, type of glioma

cerebellar pathology = headache, vomiting, gait disturbances

ix = CT/MRI

mx = radiotherapy, chemotherapy, surgical intervention

Question 5

Meckel’s diverticulum

Answer 5

congenital abnormality of small intestine from persistence of omphalomesenteric/vitelloinestinal duct

can contain gastric mucosa and can ulcerate from acid produced by parietal cells within this mucosa

2s = 2% of population, 2 feet from ileocaecal valve, 2 inches long

mostly asymptomatic but can present with painless rectal bleeding, signs of obstruction (2o to band, volvulus and intussusception), or in cases of inflammation, it can resemble acute appendicitis with right iliac fossa pain

• most common cause of painless massive GI bleeding requiring a transfusion in children between 1-2 years old

mx = excision of diverticulum ad tis adjacent ideal segment