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MSRA LS > PEDS > Flashcards

PEDS Flashcards

1
Q

triad of the shaken baby syndrome

A

Retinal haemorrhages, subdural haematoma and encephalopathy

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2
Q

Characteristics of an innocent ejection murmur include:

A

DIASTOLIC IS DANGER

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3
Q

hand foot and mouth
virus?
presentation?

A

coxsackie A16 virus
Mild systemic upset: sore throat, fever

Vesicles in the mouth and on the palms and soles of the feet

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4
Q

scarlet fever presentation?
caused by?
tx?

A

‘coarse red rash’ and ‘strawberry tongue’.

10 days of phenoxymethylpenicillin PEN V or azithromycin if there is a suspected allergy to penicillin.

erythrogenic toxins produced by Group A haemolytic streptococci (usually Streptococcus pyogenes)

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5
Q

Kawasaki disease

presentation?

tx?

A

lasts longer then scarlet fever (scarlet is 2-4 days)
FEVER LASTING >5DAYS
erythematous polymorphous rash,
strawberry tongue,
cervical lymphadenopathy,
bilateral conjunctivitis, oedema, erythema, and skin peeling of the hands and feet.

ASPIRIN

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6
Q

Parvovirus B19 aka eythema infectiosum

A

erythematous facial rash appearing on one or both cheeks (resembling a ‘slapped cheek’) in children.

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7
Q

Rubella
rash?

A

non-confluent, maculopapular rash that on face

Lymphadenopathy: suboccipital and postauricular

THINK RUBY EARS

spreads to the face and neck, and then to the trunk and extremities.

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8
Q

preterm baby:
reduced breath sounds bilaterally.
Heart sounds are displaced medially.
The abdominal wall appears concave.
What is the most likely diagnosis?

A

Congenital diaphragmatic hernia presents with scaphoid abdomen, due to herniation of the abdominal contents into the cleft

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9
Q

Cradle cap
name?
tx?

A

Seborrhoeic dermatitis

mild-moderate: baby shampoo and baby oils
severe: mild topical steroids e.g. 1% hydrocortisone

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10
Q

recurrent urinary tract infections
renal ultrasound that showed dilatation of the ureters.
test is most appropriate to grade the severity?

A

Micturating cystography is the investigation of choice for reflux nephropathy

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11
Q

Dimercaptosuccinic acid (DMSA) scan?

A

assessing renal parenchymal defects which may result from vesicoureteral reflux (VUR)

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12
Q

croup
presentation?
tx?
emergency tx?

A

stridor
barking cough (worse at night)
fever
coryzal symptoms
Parainfluenza

tx- dexamethasone

emergency tx- oxygen and nebs adrenaline

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13
Q

7 year old, alot taller, developed pubic hair, large penis but small testes?

A

ADRENAL HYPERPLASIA

Small testes in precocious puberty indicate an adrenal cause of the symptoms

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14
Q

Slipped upper femoral epiphysis (SUFE)
age?
presentation?
ix?
mx?

A

10-15
obese boys
groin/knee/thigh pain

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15
Q

when are new babies risk of vitamin K deficiency

A

Breastfed babies are at risk of vitamin K deficiency

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16
Q

risk factor for sudden infant death syndrome (SIDS)?

A
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17
Q

when and what type food to reintroduce milk protein in children with cows milk protein allergy.

A

The milk ladder can be used after 6 months of age to reintroduce milk protein in children with cows milk protein allergy.

MALTED MILK BISCUITS

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18
Q

IM benzylpenicillin dose for suspected meningococcal septicaemia in the community?
under 1
1 to 10 years
more then 10

A
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19
Q

cardiac ultrasound showed the foetal aorta and pulmonary trunk lying in parallel with an absence of crossing, confirming the suspected diagnosis.

dx? what tx to give?

A

transposition of the great arteries.

Prostaglandin E1 is given intravenously to neonates with transposition of the great arteries (TGA) to maintain the ductus arteriosus,

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20
Q

hand foot and mouth
virus?
presentation?

A

coxsackie A16 virus
Mild systemic upset: sore throat, fever

Vesicles in the mouth and on the palms and soles of the feet

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21
Q

Measles

A

Prodrome: irritable, conjunctivitis, fever

Koplik spots: white spots (‘grain of salt’) on buccal mucosa

Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent

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22
Q

Gastroschisis vs exomphalos

A

exomphalos: kidney issues

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23
Q

10-month-old
days ago he developed a fever
following this he developed a rash
blanching, rose pink macules present on his trunk.

A

Roseola infantum - fever followed later by rash

common 6 months - 2 years
fever followed later by rash
febrile seizures common

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24
Q

What is the role of caffeine in neonates?

A

Caffiene can be used as a respiratory stimulant in newborn babies

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25
Q

10-month male infant
over using his right hand in preference to the left.
mx?

A

Hand preference before 12 months is abnormal - it could be an indicator of cerebral palsy

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26
Q

cephalohaematoma
presentation?

A

swelling due to bleeding between the periosteum and the skull.

most commonly noted in the parietal region and is associated with instrumental deliveries.

usually appears 2-3 days following delivery and does not cross suture lines. It gradually resolves over a number of weeks.

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27
Q

Caput succadeneum

A

newborns immediately after birth
occurs due to generalised superficial scalp oedema, which crosses suture lines
It is associated with prolonged labour and will rapidly resolve over a couple of days.

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28
Q

Hypospadias surgery?

A

Corrective surgery at around 12 months of age is required

children should not be circumcised

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29
Q

tuberous sclerosis inherited in…?

A

AD

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30
Q

NEW BORN BABY VIA C-section

Chest x-ray may show hyperinflation of the lungs and fluid in the horizontal fissure.

dx?

A

transient tachypnoea of the newborn (TTN) is the commonest cause of respiratory distress in the newborn period.

caused by delayed resorption of fluid in the lungs

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31
Q

Palivizumab for? what is it?

A

monoclonal antibody which is used to prevent respiratory syncytial virus (RSV) in children who are at increased risk of severe disease.

Those at risk of developing RSV include
Premature infants
Infants with lung or heart abnormalities
Immunocompromised infants

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32
Q

IgE-mediated allergy vs non-IgE-mediated allergy

A
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33
Q

Chondromalacia patellae

A
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34
Q

Osgood-Schlatter disease
(tibial apophysitis)

A
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35
Q

Osteochondritis dissecans

A
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36
Q

Patellar subluxation

A
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37
Q

Patellar tendonitis

A
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38
Q

when to refer fever seen in gp- peds

A
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39
Q

pertussis vaccine pregnancy?

A
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40
Q

What is the time frame that defines maternal mortality?

A

Maternal mortality includes any death in pregnancy and labour as well as up to six weeks post partum

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41
Q

first-line for nocturnal enuresis if general advice has not helped

when to use meds, what med?

A

enuresis alarm

desmopressin
particularly if short-term control is needed (e.g. for sleepovers) or an enuresis alarm has been ineffective/is not acceptable to the family

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42
Q

Congenital heart disease: types
acyanotic vs cyanotic

A

cyanotic- think 3 T’s!!

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43
Q

4-month-old baby girl
Four weeks ago you started a trial of alginate therapy (Gaviscon) for frequent regurgitation associated with distress.

now now reports she appears to be refusing feeds.

what next?

A
44
Q

Tetralogy of Fallot: features?

A

ventricular septal defect (VSD)
right ventricular hypertrophy
right ventricular outflow tract obstruction, pulmonary stenosis
overriding aorta

45
Q

bronchiolitis is seen in (age)?

A

1 to 9 months old
in stems look at the age! if this then supportive mx

46
Q

Friedreich’s ataxia inheritance pattern?

A

AR

47
Q

pneumonia …..abx…?.. is first line for all children who are not allergic to penicillin

A

amoxicillin

Macrolides may be added if there is no response to first line therapy

48
Q

Turner’s syndrome is associated with an …murmur??

A

EJECTION SYSTOLIC MURMUR

49
Q

Meningitis in children

0 TO 3MONTHS?

1 MONTH TO 6 YEARS?

GREATER THEN 6 YEARS?

A
50
Q

Acute epiglottitis is caused by ?
Features?

A

Haemophilus influenzae type B

rapid onset
high temperature, generally unwell
stridor
drooling of saliva
‘tripod’ position: the patient finds it easier to breathe if they are leaning forward and extending their neck in a seated position

51
Q

most common cause of primary headache in children

A

migraine

52
Q

Measles complication

A

pneumonia and otitis media

53
Q

most common congenital cardiac abnormality in Down’s syndrome

A

Atrioventricular septal defects

54
Q

new born baby check
babys peripheries are blue with cyanosis.

dx?

A

Acrocyanosis (peripheral cyanosis around the mouth and extremities) is common in neonates

54
Q

new born baby check
babys peripheries are blue with cyanosis.

dx?

A

Acrocyanosis (peripheral cyanosis around the mouth and extremities) is common in neonates

55
Q

Crawls age?

A

8 to 10 months

56
Q

9-year-old daughter
mum concerned because she noticed that for the last 2 months, her daughter has been showing signs of breast development.

what to do?

A

reassure
Precocious puberty is the development of secondary sexual characteristics before 8 years in girls and 9 years in boys

57
Q

ear condition common in down syndrome?

A

otitis media

58
Q

when and how to screen for (developmental dysplasia of the hips) DHH?

risk factors

A

the baby requires ultrasound

breech baby

risk factors:
female sex: 6 times greater risk
breech presentation
positive family history
firstborn children
oligohydramnios
birth weight > 5 kg
congenital calcaneovalgus foot deformity

59
Q

unobstructed umbilical hernia in 1yo. mx?

A

reassure

Umbilical hernias in newborns typically self-resolve by 3 years of age

60
Q

formula-fed baby is suspected of having mild-moderate cow’s milk protein intolerance … what to do next?

A

a extensive hydrolysed formula should be tried

61
Q

When is the neonatal blood spot screening test typically performed in the United Kingdom

A

5th and 9th day of life

heel prick test

62
Q

Persistent vitello-intestinal duct

A

umbilical discharge that discharges small bowel content.

63
Q

carrier rate of cystic fibrosis in the UK?

A

1/25

64
Q

11-year-old Nigerian girl
complaining of a sore throat, pain on swallowing and this morning, her father has noticed swellings on both sides of her lower face and upper neck.
can she go to shcool?

A

If a child has mumps they need to be excluded from school for 5 days from the onset of swollen glands

65
Q

most common congenital defect after birth?

A

TGA

cyanotic: TGA (transposition of the great arteries) most common at birth, Fallot’s most common overall

acyanotic: VSD most common cause

66
Q

…?….. a complication of Kawasaki disease

how can this be screened?

A

Coronary artery aneurysms are a complication of Kawasaki disease and this should be screened for with an echocardiogram

66
Q

…?….. a complication of Kawasaki disease

how can this be screened?

A

Coronary artery aneurysms are a complication of Kawasaki disease and this should be screened for with an echocardiogram

67
Q

7-year-old girl
itching around her vulva and anus

A

threadworm

Prescribe a single dose of mebendazole for the household and give hygiene advice

68
Q

Haemophilia A is an X-linked recessive disease.

how can it be passed?

A

all female offspring of affected men will be carriers. There is then a 50% chance of these females passing the gene on.

69
Q

fragile x?

A

earning difficulties, macrocephaly, large ears and macro-orchidism

70
Q

Whooping cough (pertussis) tx?

A

azithromycin or clarithromycin if the onset of cough is within the previous 21 days

71
Q

3-week old male baby
PREMATURE
Refusing feed
noticed that he passed some bloody stools.

WHAT IS IT?
DX?

A

Early signs of necrotising enterocolitis: feeding intolerance, abdominal distension and bloody stools

Abdominal x-ray

72
Q

keep PDA open?

A

prostagladins

73
Q

first-line treatment for paediatric migraine?

A

Ibuprofen is the first-line treatment for paediatric migraine

74
Q

Patau syndrome

A

13

microcephaly, small eyes, low-set ears, cleft lip and polydactyly

75
Q

William’s syndrome?

A

aortic stenosis- loud systolic murmur

small upturned nose, long philtrum, a small chin and puffy eyes.

76
Q

Barlow vs ortolani?

A

Barlow manoeuvre is an attempted dislocation of a newborns femoral head. After performing this the Ortolani manoeuvre is used to attempt to relocate a dislocated femoral head.

you smell of BO

77
Q

meconium aspiration syndrome.
findings? presentation?

A

during delivery thick meconium-stained amniotic fluid.

Chest X-ray shows patchy infiltrations and atelectasis.

78
Q

Surfactant deficient lung disease on chest x ray baby?

A

ground glass opacities

79
Q

3-year-old daughter
discomfort every time she is passing urine
semitranslucent adhesions completely covering the vaginal opening between the labia minora

dx?
tx?

A

Labial adhesions: prescribe trimethaprim for UTI
if recurrent urinary tract infections, oestrogen cream may be tried

80
Q

Noonan syndrome

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

81
Q

common cause of cyanotic congenital heart disease typically presenting at around 1-2 months

A

TOF

82
Q

Pyloric stenosis typically presentATION AGE?

A

2-6 weeks
vomiting

83
Q

child
partial seizures at night
name?

A

Benign rolandic epilepsy

84
Q

Paediatric BLS:?

A

5 rescue breaths if there are no signs of breathing on initial assessment

85
Q

18 year-old
moves to University.
Which of the following vaccinations should he receive if he has not had it previously?

A

Meningitis ACWY

86
Q

What is the most important treatment for prevention of neonatal respiratory distress syndrome?

A

Administer dexamethasone to the mother

87
Q

loss of the red-reflex

A

Retinoblastoma

88
Q

Constipation in children:

A

macrogols (e.g. Movicol) is first-line

89
Q

Meningitis in children: investigation and management

A

Antibiotics
< 3 months: IV amoxicillin (or ampicillin) + IV cefotaxime
> 3 months: IV cefotaxime (or ceftriaxone)

90
Q

contraindications for MMR vaccine

A

vaccination of yellow fever in last week
pregant
immunocompromised
anaplylaxisi to the vaccine, neomycin, gelatin

91
Q

classic rash and description in juvenile idiopathic arthritis JIA

A

salmon pink rash!!

92
Q

DDH age

A
93
Q

what electrolyte inbalance for IUGR?

A

hypoglcemia, necrotising entercolitis, polycythemia, thrombocytopenia

94
Q

which is more common
Non hogkins or hodgkins

A

NON-HOGKINS

95
Q

eye condition linked to NF1?

A

optic glioma

96
Q

child murmur that may be suspicious give example

A

pansystolic murmur

97
Q

drooling- epiglititis

tx?

A

caused by haemophilus B
nebulised adrenaline, iv cefotaxime

98
Q

bronchiolitis virus

A

RSV

99
Q

CAP in child- starts off with a headache most likely by mycoplasma pneumonia

tx

A

oral clarthithromycin

100
Q

second line tx for absense seizure

A

SODIUM VALPORATE

101
Q

INDICATION TO REMOVE TONSILS

A
102
Q

DiGeorge features

A

short
immune issues

103
Q

official name for croup

A

MSRA LS (22 decks)

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