questions

Question 1

common CVS defect in children with downs

Answer 1

AVSD

Question 2

Roughly what are the asthma treatment guidelines in children under 5

Answer 2

1. low dose ICS + SABA
   review
2. add LTRA (montelukast)

Question 3

roughly what are the asthma guidelines in children between 5-11

Answer 3

1. ICS + SABA
2. low dose MART -> ICS + LABA
3. if cant tolerate the MART then consider adding a LTRA
   never add a LTRA alone

Question 4

when does hand dominance develop and if its any earlier what does this suggest

Answer 4

2 years
if earlier can suggest cerebral palsy or spastic hemiplegia

Question 5

what are the common features of epiglottis

Answer 5

• noisy breathing
• extreme pain
• cant eat
• drooling
  -upright
  -inspiratory stridor

Question 6

what is usually treatment for epiglottis

Answer 6

endotracheal intubation

Question 7

child on methylphenidate starts to develop side effects such as tics what can you start him on

Answer 7

Atomoxetine is a noradrenaline reuptake inhibitor. It is recommended for ADHD refractory to Methylphenidate or in those who it is not appropriate due to risk factors or development of side effects. Development of facial tics is an indication to change medications

Question 8

what Is a sign of congestive heart failure in infants

Answer 8

hepatomegaly
as they are so small it is easy to palpate the edges of the liver

Question 9

which murmer is often heard with turners and what is the cause

Answer 9

ejection systolic murmur
due to radio femoral delay from correction of the aorta

Question 10

what should you do if a child has ingested a foreign object and there is no distress

Answer 10

watch and wait for it to pass
Foreign bodies ingested into the stomach or small intestine will not be visible on a chest X-ray.

Question 11

what are the two main things you should measure if someone is started on a stimulant medication

Answer 11

height and weight and they should be monitored twice a year

Question 12

which is more extreme conduct disorder or oppositional defiant disorder

Answer 12

Conduct disorder is characterised by repetitive and persistent antisocial behaviours, including physical aggression towards people and animals, and destruction of property, often leading to disciplinary problems at school or involvement with the law.
it is more severe than oppositional defiant

Question 13

what abnormality is found with a patent ductus arteriosis

Answer 13

A collapsing pulse arises from the increased pressure gradients and a continuous murmur from turbulent flow across the ductus arteriosus.
machinery murmer

Question 14

what is a blood test marker for bacterial sepsis

Answer 14

Procalcitonin

Question 15

which is the correct dose of adrenaline in children between 6-12

Answer 15

300 micrograms 1:1000 IM adrenaline

Question 16

how can you collect urine in children when its hard to collect

Answer 16

urine pad

Question 17

intususception key features

Answer 17

• abdominal colicky pain - child draws up their legs
• vomiting
• blood stained mucus stool
• sausage shaped mass in right lilac fossa
• distended abdomen
• lethargy and pallor in between episodes

treat:
NG tube and fluids
air enema

Question 18

what is a common sign on X-ray seen with intususseption

Answer 18

target sign

Question 19

A 6 year old girl is brought to A&E by her mother with worsening chickenpox and a painful left leg. She has been recovering from chickenpox over the past week, with a vesicular rash that spread from her torso to her back and both legs. Over the past day, she has been suffering fevers, lethargy and the lesions on her left leg have become blistered with surrounding erythema.
She has a temperature of 39.2ºC. On examination, there is erythema over the left leg which is visibly swollen, extremely tender on palpation and there is evidence of crepitus when palpating surrounding tissues.
what does she have and what is the organism causing this

Answer 19

This child is presenting with features of necrotising fasciitis, a life-threatening soft tissue infection characterised by severe pain, erythema, swelling, and crepitus due to subcutaneous gas. S. pyogenes, a Group A Streptococcus, is a common cause, particularly following skin breaches such as the vesicles of chickenpox, which provide a portal of entry.

Question 20

what is a common cause of mesenteric adenitis

Answer 20

Yersinia enterocolitica is the most common cause of mesenteric adenitis, often following a respiratory infection in adolescents.

Question 21

what condition tends to precede mesenteric adenitis

Answer 21

upper resp tract infection

Question 22

A 1-day-old infant presents with abdominal distension and bilious green vomiting. The infant has not passed stool. Abdomen examination shows distension with no palpable mass. A plain abdominal radiograph demonstrates dilated loops of bowel filled with meconium.

Answer 22

Meconium ileus is a condition in which the meconium becomes thick and sticky and obstructs the distal ileum, causing distension of the proximal bowel. It is most commonly associated with cystic fibrosis.

Question 23

what does perthes disease show on X-ray

Answer 23

Diagnosed via hip X-ray showing sclerosis and fragmentation of the epiphysis

Question 24

if a baby presents with GORD what should be trialed

Answer 24

alginate (gaviscon)
in breastfed babies, or reducing the volume of feeds and increasing their frequency in formula-fed babies, before trialling a thickener and later an alginate.

Question 25

what crisis can paravirus B19 cause

Answer 25

paravirus

Question 26

if children present with global developmental delay what should you do as a first line investigation

Answer 26

genetic karyotyping

Question 27

what is the most common complication of measles

Answer 27

pneumonia in 5-10% of measles cases.

Question 28

The features of life-threatening asthma

Answer 28

33,92 CHEST. Any one of the following:
PEF <33%
SO2 <92% or PO2 <8
Cyanosis
Hypotension
Exhaustion, altered consciousness
Silent chest
Tachyarrhythmias

Question 29

what is the treatment for pyloric stenosis

Answer 29

Laparoscopic pyloromyotomy
to do before: Often infants will have low potassium and low sodium from vomiting and dehydration. This must be corrected. There may be hypochloraemic alkalosis. Definitive treatment is surgical, with division of the hypertrophied pylorus

Question 30

when should you start immunisations in a preterm baby

Answer 30

Preterm infants, regardless of their gestational age at birth, should begin vaccinations according to the routine immunisation schedule at their chronological age, unless contraindicated.

Question 31

if a meningococcal infection is suspected in children what are the immediate options for treatment

Answer 31

you want to try and get antibiotics in them as soon as possible
if they dont have IV access you can give them IM benzylpenicillin

Question 32

how long is measles often infective

Answer 32

usually 4 days after the onset of the rash