Questions Flashcards
See learning guide for practice SAQs
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Child presents to you with the following skills, how old are they:
- Can roll from back to belly
- Can sit upunaided
- Scooting on bum
- Is grasping toys with the whole hand
- Making simple sounds
- Responding to mums voice
- Enjoys rhythmic music
Probably 6 months
Maybe a little older as sitting without a hand and enjoying music are a few months beyond 6
Most of these skills develop around 6 except responding to mums voice which they should be able to do about 4months
little boy presents with the following skills, how old is he?
- running
- picking things up with finger and thumb
- points when simply requested
- takes off his top
- Can say “Ball, mum!”
- Smiles when praised
Around 2yrs
using simple words together is a 2 yr skill as well as being praised, taking off clothes and pointing when requested
Running is common by 2 and grasping with thumb and forefinger comes around 18months
A wee Girl presents with the following skill, how old is she?
- Says “Mama” & comes when called
- Imitates mum
- Drinks from her cup alone
- focusses on you from across the ward
- Mum says she takes some steps at home while holding her hand
1yr
using single words and responding to very simple requests like “come here” are 1 yr skills
Being able to drink from a glass shows 1 yr fine motor skills & self care
Imitating people is a 1 yr social skill
Being able to focus on distant objects comes about 9months to a year
First steps occur on avg by 12 months`
Another wee Girl presents with the following skills, how old is she?
- She can see shapes at 6m
- she seems to understand most of what you say
- She can walk on tiptoes and heels but falls over walking backwards
- “Mostly” toilet trained
- She plays with another child (but only when prompted)
- Brings things when mum asks
probably just under 3 yrs
seeing 6m clearly and understand most simple language is normal at 3yrs
toilet training should be good by 3yrs
Playing with other kids starts around 18months but often they don’t do it independently until 3yrs
Walking backwards develops around 3yrs, shes trying but not got it yet
following simple instructions is normal by 3
Case 1)
A 6yr old boy called Marvin comes in to see you
Mum says he’s suffered for 12 months from abdo pain and passes 1 stool/week with occasional blood
On exam you notice small soft masses in LLQ.
What else would you want to know about his history?
1) Is it always 1 stool/week
2) Consistency & size of stool
3) Any pain defecating
4) How often/much blood
5) Toilet training
6) Soiling
7) Withholding
8) Diet
9) Appetite
10) Fluid intake
11) Activity
12) School routine
Case1)
What else would you want to examine on Marvin?
Inspect lower spine (Spinal damage)
Inspect Anus (Perianal disease)
Lower Limb Neurology (spinal problems)
Measurments and centiles (growth)
Don’t do DREs on kids
Case 1)
Based on the initial presentation (1stool/wk, abdo pain and occasional blood) what do you think Marvin has?
Chronic Constipation
Case 1)
How would you manage Marvin’s constipation? (Clue theres atleast 4 non-medical ways)
1) Increase fruit, veg & fibre
2) decrease milk and sweets
3) Increase fluid intake
4) Improve toilet comfort and reward it
5) Laxatives (Lactulose, Senna or Movicol)
Case 2)
8wk old Eryk is brought to the GP by his dad for a routine exam.
You notice he has a murmur.
What else would you want to ask the dad?
1) Breathless & Colour Changes
2) Poor feeding & weight change
3) Sweating
Case 2)
What else would you look for on baby Eryk?
1) Tachycardia/Tachypnoea
2) Hepatomegaly
3) Peripheral Pulses
4) Measurments & Centiles
Case 2)
Assuming you find something on Eryk’s exam/history to suggest this is not a simple innocent murmur, how would you manage it?
1) Refer to paediatrics
2) Sats, 4 limp BP, Echo, EXG and/or CXR
Case 2)
What features of baby Eryk’s murmur would suggest it’s innocent?
1) Systolic
2) Soft (Grade 1 or 2)
3) Vibratory
4) Very localised (oft to L SB)
5) It varies with activity, position or respiration
Bonus point if Eryk’s otherwise asymptomatic
Case 3)
12hr old baby Lucca is noted to be blue in the face, tongue and limbs.
Her peripheral pulses are present along with a loud systolic murmur
DDx?
Heart disease causing cyanosis in a baby is not a big list:
1) Transposition of Great Arteries!
2) Tetralogy of Fallot
3) Pulmonary Atresia
4) Truncus Arteriosus
5) TAPVD
Case 3)
An angiogram confirms little Lucca has Transposition of her Great Arteries. How do you manage her?
Prostaglandin Infusion to reopen/maintain her DA
Then do a Switch procedure
