PEADS 4

Question 1

bronchiolitis causes
who
symptoms

Answer 1

RSV, mycoplasma, adenovirus
<18m
flu like symp first, cough, SOB, wheeze, fine crep, feeding difficulties

Question 2

bronchiolitis investigations
treatment
prophylaxis

Answer 2

clinical dx
CXR: hyperinflation, patchy infiltrates. nasopharyngeal aspirate. IF - RSV

oxygen, NG feeds, severe CPAP, ventilation, ipratropium neb

Palivizumab RVS monoclonal AB given monthly as proph to CL disease, congenital heart disease babies

Question 3

croup caused by what in who and when
symtoms
rx

Answer 3

PI, 6m-3y, autumn
flu like sym[toms, strider, hoarse voice, difficulty breathing
oral dex 0.15mg/kg, severe: oxygen, nebulaised adrenaline

Question 4

epiglottis causes
who and symp
rx

Answer 4

HIB, strep pneumonia
2-6yo
fever, ill looking child, sudden onset stridor, drooling
IV ABs, emergency trachaeostomy

Question 5

foreign body where and rx

Answer 5

right main bronchus

bronchosopcy to remove

Question 6

laryngomalacia is what
symptoms
rx

Answer 6

floppy larynx
stridor varies with position and excerpted when feeding and exertion

conservatve rx

Question 7

whooping cough cause
symptoms
ix
rx

Answer 7

bordetella pertussis
coryza then bouts of inspiratory whoop lasts 10-12w and lymphocytosis

nasal swabs, PCr and serology

supportive macrocodes if onset of cough within 21d

Question 8

whooping cause infectious

proph

Answer 8

can return to school 5d after starting antibiotics

proph macrolide

Question 9

asthma

Answer 9

SABA
SABA and becloside
SABA and ICS and LTRA

Question 10

pneumonia cause
CAP severe
CAP non severe
HAP

Answer 10

strep pneumonia, HI, mycoplasma
<1y co-amox PO >1y amor PO 7d (clarithro)
coax IV then PO 10d

amo amox IV/PO for 7d

Question 11

cystic fibrosis genetics
symptoms
ix

Answer 11

AR NaCl channel dysfunction leading to thick secretions in lungs and pancreas
1/25 in caucasians

failure to thrive, recurrent chest infection

sweat test >=60mmol/L of chloride, genetic studies, CXR - bronchiectasis

Question 12

risk factors of reflux 
symp
ix
rx
cx

Answer 12

prem, neuro, post oesophageal atresia
heartburn, back arching, nom, failure to thrive, apnoea, uncomfortable during feeds

pH, upper GI contrast study

resolves by 6m/1y. unsure baby is not overfed, gavascon, rinatidine, omeprazole, surgery

pulmonary aspiration, oesophageal stricture

Question 13

pyloric stenosis when who
symptoms/signs
ix
rx

Answer 13

2-8w M>F
projectile milky nom after feeds, olive mass in RU abdomen, peristaltic wave after feeding
abd USS, met alk, decreased K, decreased chloride
NBM, IV rehydration, NGT, pylorectomy - surgery

Question 14

coeliac disease symptoms

treatment

Answer 14

failure to thrive, non specific, and pain, nom, constipation

elemental diet/pred to achieve remission for maintenance aizthroymycin, metho, inflixumab

Question 15

interception is what
symptoms
rx

Answer 15

telescoping of bowel
red current jelly on PS,palpable sausage, shock
reduction with air enema, surgery

Question 16

meconium ilius 1/3 what 
symptoms 
where
ix
rx

Answer 16

Cf in 1/3
not keen to feed, nom, not emptying bowels, slightly distended abd, not passed meconium 
gets stuck in terminal ileum
contrast enema
^ can treat

Question 17

malrotation who
symptoms
cx
ix

Answer 17

<1y
fairy liquid vom
SMA can be pinched
contrast enema corkscrew diverticulum in volvulus

Question 18

hirsprings is whar
symp
AXR
cx
rx

Answer 18

absent ganglion cells in anorectic - absent nerve supply to large intestine preventing contractions

severe constipation, vom, delayed passage of meconium, spisode severe colicky pain and pallor with knees drawn up

dilated bowel loops, absent rectal air
USS - doughnut sign

enterocolitis

surgery

Question 19

biliary atria symptoms and signs

ix

rx

cx

Answer 19

prolonged jaundice, pale stools, dark urine, organomegaly

conjure bilirubin increased alk phos, USS absent / contracted GB, liver biopsy

karai procedure

liver cirrhosis/transplant