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3a Mocks > Peads Mock > Flashcards

Peads Mock Flashcards

1
Q

Components of an APGAR Score

A
  • Appearance/colour
  • Pulse
  • Grimace/reflex irritability
  • Activity/muscle tone
  • Respiratory effort
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2
Q

An absence of fundal reflex could be indicative of what ?

A
  • Congenital cataracts, retinal detachment, vitreous haemorrhage, retinoblastoma
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3
Q

How is developmental dysplasia of the hip investigated ?

A
  • Hip USS
  • Paediatric orthopedics is done if abnormal
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4
Q

RFs for DDH ?

A
  • Female sex
  • FHx
  • Breech presentation after 36 weeks
  • Multiple pregnancy where other foetus was breech after 36 weeks
  • Firstborn child
  • Oligohydramnios
  • Macrosomic baby
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5
Q

What is the pathophysiology of pyloric stenosis ?

A
  • Hypertrophy of the pyloric sphincter resulting in narrowing of the pyloric canal
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6
Q

What would an ABG of a child with pyloric stenosis show ?

A
  • Hypochloremia metabolic alkalosis
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7
Q

What is definitive management of pyloric stenosis ?

A
  • Laparoscopic pyloromyotomy (Ramstedt’s pyloromyotomy)
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8
Q

How does Bronchiolitis present ?

A
  • Coryzal symptoms
  • Signs of respiratory distress
  • Dyspnoea
  • Tachypnoea
  • Poor feeding
  • Mild fever
  • Apnoeas
  • Wheeze and crackles
  • Dry cough
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9
Q

How does viral induced wheeze present ?

A
  • SOB
  • Signs of respiratory distress
  • Expiratory wheeze throughout the chest
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10
Q

What are the differences between bronchiolitis and viral induced wheeze ?

A
  • Bronchiolitis will present with coryzal symptoms and mild fever
  • Crackles on auscultation
  • Dry cough
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11
Q

Red flag symptoms for bronchiolitis ?

A
  • Observed/reported apnoea
  • RR > 70
  • Grunting
  • Central cyanosis
  • O2 sat < 92%
  • Looks unwell to a HCP
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12
Q

What dietary advice would you give to a child with CF ?

A
  • High calorie diet with high fat content and pancreatic enzyme supplementation for every meal
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13
Q

How could congenital adrenal hyperplasia present in females ?

A
  • Tall for their age
  • Facial hair
  • Absent periods
  • Deep voice
  • Early puberty
  • Hyperpigmentation
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14
Q

How could congenital adrenal hyperplasia present in males ?

A
  • Tall for their age
  • Deep voice
  • Large penis
  • Small testicles
  • Early puberty
  • Hyperpigmentation
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15
Q

Why does hyperpigmentation occur in congenital adrenal hyperplasia ?

A
  • The anterior pituitary glands responds to low levels of cortisol by producing increasing amounts of ACTH
  • A by-product of ACTH production is melanocyte simulating hormone which stimulates the production of melanin (pigment) within skin cells
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16
Q

Name electrolyte abnormalities that present with congenital adrenal hyperplasia ?

A
  • Hyponatremia
  • Hyperkalaemia
  • Metabolic acidosis
  • Hyperglycaemia
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17
Q

What is the mode of inheritance of congenital adrenal hyperplasia ?

A
  • Autosomal recessive
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18
Q

What is the most common cause of congenital adrenal hyperplasia ?

A
  • 21-hydroxylase deficiency
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19
Q

How would you treat congenital adrenal hyperplasia ?

A
  • IV fluids, dextrose, hydrocortisone
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20
Q

What are the components of TOF ?

A
  • Overarching aorta
  • VSD
  • Pulmonary hypertension
  • Right ventricular hypertrophy
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21
Q

What are tet spells and how do they present ?

A
  • Intermittent symptomatic periods where the right to left shunt is temporarily worsened, causing cyanosis
  • When the pulmonary vascular resistance increases or the systemic resistance decreases. E.g. if the child is physically exerting themselves they are generating a lot of Co2
  • Co2 is a vasodilator that causes systemic vasodilation and therefore reduces the systemic vascular resistance.
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22
Q

What is the mechanism for how TOF can lead to heart failure ?

A
  • Blood flow through the left-to-right shunt leads to pulmonary hypertension
  • This causes right ventricular hypertrophy and an increase in the right ventricular pressure
  • When the right ventricular pressure exceeds the left ventricular pressure, there is a reversal of blood flow, leading to a right-to-left shunt.
23
Q

How does measles present ?

A
  • Erythematous maculopapular rash that starts on the face and spreads to the trunk
  • Fever
  • Koplik spots
  • Conjunctivitis
  • Rhinorrhoea/nasal discharge
24
Q
  1. Who should be notified of a measles outbreak ?
A
  • The local health protection team
25
Q
  1. What are complications of measles ?
A
  • Otitis media
  • Pneumonia
  • Encephalitis
  • Diarrhoea
26
Q

What are the 2 main features of ADHD ?

A
  • Inattention
  • Hyperactivity
27
Q

What is first line medication for ADHD ?

A
  • Methylphenidate
28
Q

How and how often should the side effects of methylphenidate be monitored ?

A
  • BMI
  • Every 6 months
29
Q

What is the mode of inheritance of muscular dystrophy ?

A
  • X linked recessive
30
Q

Explain the pathology of muscular dystrophy ?

A
  • Gene mutation on Xp21
  • Dystrophin is absent which is important for architecture
  • Muscle is lost and replaced by adipose tissue
31
Q

What is Growers sign ?

A
  • The child assumes the hands-and-knees position and then climbs to a stand by “walking” his hands progressively up his shins, knees, and thighs.
32
Q

Give options for MDT management of muscular dystrophy ?

A
  • Medical – corticosteroids
  • Surgical – Scoliosis surgery
  • Respiratory ventilation
  • Physiotherapy
  • Exercise
  • Education
  • Counselling
  • Palliative care
33
Q

At what time does physiological jaundice typically resolve in a pre-term and term baby ?

A
  • At term = 14 days
  • Preterm = 21 days
34
Q

What could differentials be for a child presenting with jaundice in the first 24 hours after birth ?

A
  • Rhesus haemolytic disease
  • ABO haemolytic disease
  • Hereditary spherocytosis
  • Glucose-6-phosphodehydrogenase
35
Q

What are the 2 main management options for jaundice in neonates ?

A
  • Phototherapy
  • Exchange transfusion
36
Q

What is the surgical procedure used to treat biliary atresia?

A
  • Kasai procedure
37
Q

A 5-year-old boy, presents to your paediatric ENT clinic with a complaint of persistent ear pain and hearing difficulties. His parents mention that he has a history of recurrent ear infections since infancy. Upon examination, you notice fluid behind both tympanic membranes and mild hearing loss. What is the most likely diagnosis ?

A
  • Otitis media with effusion
38
Q

RFs for recurrent ear infections in children ?

A
  • Age 6m to 2 years (shorter eustachian tubes)
  • Bottle feeding when lying down
  • Allergies
  • Genetic predisposition (FHx)
  • Cleft palate
  • Respiratory infections
39
Q

Primary treatment for recurrent ear infections ?

A
  • Conservative measures such as nasal saline irrigation, and medical
  • options like antibiotics in cases of acute exacerbations. Tympanostomy tube insertion
  • may be considered in persistent cases.
40
Q

What is Noonan’s syndrome ?

A
  • Can be thought of as male Turner’s syndrome
  • An autosomal dominant condition associated with a normal karyotype caused by a gene defect on CH:12
41
Q

How does Noonan’s present ?

A
  • Webbed neck, widely spaced nipples, short stature, pectus carinatum and excavatum (similar to Turner’s)
  • Pulmonary valve stenosis
  • Ptosis
  • Triangular-shaped face
  • Low-set ears
  • Coagulation problems e.g. factor XI deficiency
42
Q

What cardiovascular abnormalities is the patient at risk of ?

A
  • Pulmonary stenosis
  • Hypertrophic cardiomyopathy
  • ASD
43
Q
  1. What cancers do patients with Noonan’s have a increased risk of developing ?
A
  • Leukaemia
  • Neuroblastoma
44
Q

Management for a 2-year-old with a UTI ?

A
  • Nitrofurantoin or Trimethoprim
  • 3 days
  • Infant less than 3 months old should be referred immediately to a pediatrician
  • Upper UTI should be considered for admission
45
Q

A patient has been given ABs for a UTI and they have not worked. How do you follow up ?

A
  • Ultrasound of the urinary tract
46
Q

How do you investigate a child who has recurrent UTIs ?

A
  • DMSA (dimercaptosuccinic acid scintigraphy) scan
47
Q

What is the MCC of a UTI in children ? What are less common causes ?

A
  • E.coli
  • Proteus
  • Klebsiella
48
Q

Why are UTIs more common in females ?

A
  • The female urethra is shorter than the male urethra, so it is easier for bacteria to
  • enter and cause infection.
49
Q

What is vesicoureteral reflux ?

A
  • Abnormal backflow of urine from the bladder into the ureter/kidney
50
Q

RFs for UTIs in children

A
  • Female sex
  • Sexual abuse
  • Immunosuppressed
  • Malnourishment
  • Age < 1 year
    Not breast fed
51
Q

DDs for a 2 year old with a new limp

A
  • Septic arthritis
  • Transient synovitis
  • Malignancy
  • Fracture/sprain
  • Abuse
  • Developmental dysplasia of the HIP
  • Perthes’s disease
  • Juvenile idiopathic arthritis
  • ALL
52
Q

What is the initial management of a child with a new onset limp ?

A
  • Refer to pediatrics for urgent specialist review
53
Q

What red flags could indicate septic arthritis

A
  • Fever > 38 degrees
  • Non-weight bearing
  • Raised ESR
  • Raised CRP
  • Swollen red joint
54
Q

What is a toddler’s facture ?

A
  • Spiral fracture of the tibia

3a Mocks (6 decks)

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