Pastest - wrong answers Flashcards
S/e of phenytoin
Balance - cerebellar like symps
Mental slowing
Nystagmus
liver dysfunction
How is Caeruloplasmin affected in Wilsons
LOW
Accelerated Hep B vaccination schedule in neonates
Birth
1 month
2 months
12 months
Most common cause of HFMD
Coxsackie A
Then enterovirus
Complications of VZV
Pneumonia
Encephalitis
Cerebellar ataxia
Sepsis
Congenital VZV infection
Limb hypoplasia
Microcephaly
Cataracts
Growth retardation
Skin scarring
What is purpura fulminans & causes of it
Thrombotic disorder with haemorrhagic skin infarction & DIC
Meningococcus
Strep
VZV
Gram -ve bacilli
ECG appearance in rheumatic fever
Prolonged PR interval ie 1st degree HB
Presentation rheumatic fever
2-4w after Group A strep infection
Diagnostic criteria for Rheumatic fever
Jone’s criteria =
Need 2x major or
1x major and 2x minor
Major diagnostic criteria for rheumatic fever
Polyarthritis
Carditis
Sydenham’s chorea
Erythema marginatum
Subcutaneous nodules
Minor diagnostic criteria for rheumatic fever
Fever
Prolonged PR interval on ECG
Raised inflammatory markers
Most common heart problem after rheumatic fever
Mitral valve problems
How long do joint Sx need to be present for diagnosis of JIA
> 6w
Role of diuretics in heart failure secondary to VSD
Help to relieve pulmoanry congestion caused by L>R shunting
‘Dancing eyes, dancing feet’ syndrome
Paraneoplastic syndrome associated with NEUROBLASTOMA
Aka opsoclonus-myoclonus > rapid involuntary horizontal and vertical eye movements
Prognostic sign for opsoclonus-myoclonus in neuroblastoma
GOOD prognostic sign
Appearance of toxoplasmosis on Fundoscopy
White-yellow Chorioretinitis lesions
Sources of toxoplasmosis infection
Contaminated or undercooked meat and dairy products, cat faeces
Role of Hb electrophoresis
Separates subsets of Hb into bands to determine the presence of abnormal subsets e.g. HbS - used to diagnose haemoglobinopathies
What does a gallop rhythm indicate
Sign of acutely impaired ventricular function, resulting in pulmoanry and venous congestion
S/e of carbamazepine
Vit k deficiency
S/e phenytoin
Congenital malformations
Vit k deficiency
Which anti-epileptic is considered safest in pregnancy
Keppra
MOA metoclopramide
Dopamine antagonistw
Why is metoclopramide not liceneced in paeds
Can cause a dystonic reaction
GI complication of CF and how is it caused
Distal intestinal obstruction syndrome - increased level of dehydration and poor pancreatic enzyme compliance > sticky faeces > blocked gut
Asthma stepwise Rx
- SABA prn
- very low dose ICS or LRTA (if < 5 y)
- Very low dose ICS
+ LABA or LRTA (5 years or up)
+ LRTA (< 5y) - Low dose ICS or + LABA or LRTA
Central vs peripheral precious puberty
Central will present in the same order as normal puberty but early
peripheral will present in an abnormal order
What can sometimes be the first presentation of T cell lymphoma
Upper airway obstruction ‘widened mediastinum’
How many mutations needed for a CF diagnosis
2
Level of sweat chloride test for a diagnosis of CF
> 60 mmol/lmos
Most common location for a coarctation
Just distal to the left subclavian artery
Presentation of aortic stenosis
Systolic murmur with ejection click, radiates to the carotids
Presentation of mitral regurgitation
Pan systolic murmur
High-pitched
Loudest of apex
Radiation to left axilla
Rx for shigella
Ciprofloxacin
Rx for giardia
Metronidazole
Rx for severe campylobacter
Azithromycin
Definition latent TB
No clinically active TB
Asymptomatic and not infectious
State of immune response to stimulation by TB antigens
Samples to send to micro for TB diagnosis
Sputum
Gastric aspirates
BAL
Ix for TB
CXR
tuberculin skin tests
Microbiology (3x samples)
Limitation of interferon test for TB
Doesn’t distinguish between active and latent TB so is normally done with tuberculin skin tests
Management of neonatal contact with TB
If no clinical signs of TB
Then give
Isoniazid prophylaxis
And do tuberculin skin test at 3 MONTHS
If TST -ve, then repeat with interferon text and if this is negative then stop Abx
Bacterial cause of toxic shock syndrome
Toxin producing strains of S. aureus or Group A strep (strep pyogenes)
‘Super antigens’ that can non-specifically bind to T-cell receptors and cause increased inflammatory response
Presentation toxic shock syndrome
Red palms & soles with desquamation
‘Sand-paper’ maculopapular rash
High fever
Vomiting diarrhoea
Mucositis
Myalgia (high high CK)
Adult Hb
Alpha and beta
Rx salicylate poisoning
Urinary alkalinisation : 1L NaBic over 2hc
Impetigo - school rules
Keep off until affected areas are crusted and healed OR 48h after starting Abx
Why can low Ca cause stridor
Laryngeal collapse due to loss of ridigity
What is a laryngeal web
The larynx contains web-like tissue that partially constricts the trachea and causes a CHRONIC stridor
Inheritance of epidermolysis bullosa simplex and layer of skin affected
AD
Within the epidermis
Inheritance of junctional epidermolysis bullosa
AP
Lamina Lucida of the basement membrane
Inheritance of dystrophic epidermolysis bullosa
AD (mild), AR (severe)
Uppermost dermis
Affected arches in DiGeorge
3rd and 4th pharyngeal arches
Which is more severe and how do the presentations differ between ABO incompatibility and Rh disease
ABO incompatibility generally milder disease than Rh
Liver and spleen not normally enlarged in ABO but are in RhD
Presentation of tinea rash
Annular erythema with central clearing
IX dermatomyositis
Muscle biopsy
MRI
Type of anaemia in hypothyroidism
Macrocytic
How unwell are patients with IgA deficiency
Recurrent infections but well in between
No faltering growth
Usually found incidentally, can have no clinical Sx
What is Bruton’s disease
Aka X-linked agammaglobulinaemia
Presents as a male with recurrent infections and faltering growthw
What is sprengel’s shoulder
Failure of the scapula to descend secondary to fibrosis
Renal conditions associated with Turners
Horseshoe kidney
Renal agenesis
Coagulation problem associated with Noonan’s
Factor XI deficiency
Causes of acute interstitial nephritis
Drugs (cipro, erythromycin, phenytoin, PPIs, NSAIDS)
Infection
Ix for acute interstitial nephritis
Urinary eosinophils raised
Red cell casts
Hyperkalaemia
Metabolic acidosis
AIN - type of hypersensitivity
Type IV
Presentation carbamazepine toxicity
Cerebellar Sx
Triad for HUS diagnosis
Microangiopathic haemolytic anaemia with red cell casts
Thrombocytopenia
AKI
Why are patients with sickle cell more likely to get sepsis
Repeated splenic infarcts causes splenic malfunction
Rx tinea capitis
SYSTEMIC griseofulvin
(Topical isn’t effective in penetrating hair follicles)
What is Wiskott-Aldrich syndrome
A primary immunodeficiency
Affects B and T cell lymphocytesWha