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1
Q

Antenatal risk factors for infection of neonate?

A

PROM
Preterm birth
GBS current or past colonisation
Intra-partum fever over 38

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2
Q

How much and what would you give as a fluid bolus to a shocked child?

A

20ml/kg of 0.9% NaCl

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3
Q

Gram +ve, cocci in chains?

A

Group B strep

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4
Q

Long term complications of bacterial meningitis?

A 
Amputation due to necrosis of peripheries
Hearing and visual loss
Learning difficulties, behavioural
Epilepsy
Co-ordination and movement disorders
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5
Q

Causes of respiratory alkalosis? What would blood results show?

A

Hyperventilation (due to anxiety or by excessive mechanical ventilation)

High pH, normal O2, low CO2, normal HCO3 and base excess

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6
Q

What is staphylococcal scalded skin syndrome?

A

Red blistered skin resembling a burn/scald which is caused by S. aureus.

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7
Q

What’s the pathophysiology of SSSS?

A

Certain strains of S. aureus cause skin damage by releasing toxins.

The toxins break the epidermal adhesion molecule (desmoglein 1) which means skin cells can’t stick together. Skin breaks up.

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8
Q

Who gets SSSS?

A

Children under 5

Especially neonates

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9
Q

Clinical features of SSSS?

A

Generalised erythema
Skin tenderness
Prodromal sore throat, conjunctivitis

Tender, large blisters in flexures
These rupture easily to reveal base which gives rise to scalded appearance.

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10
Q

Differential diagnosis for SSSS?

A

Toxic epidermal necrolysis (drug reaction)

Bullous impetigo (blisters without generalised erythema)

Toxic shock syndrome

Scarlet fever

Pemphigus (autoimmune blistering of skin)

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11
Q

Investigations of SSSS?

A

Swabs (identify bug and sensitivities)

Biopsy

Nasal swabs of relatives, carers etc

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12
Q

Management of SSSS?

A

Supportive fluids, electrolytes

Emollient to alleviate tenderness and pruritus

Topical fusidic acid
PO or IV flucloxacillin

Analgesia (Paracetamol, opioid)

Physio to keep them moving despite pain

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13
Q

Complications of SSSS?

A

Dehydration
Cellulitis
Sepsis
Pneumonia

Need for ITU, special treatment in Burns Unit

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14
Q

A child has a seizure, what do you need to know from history?

A

Temperature? Signs of meningitis (rash, meningism)

Recent head trauma

Metabolic disorders (T1DM)

Change in personality, headaches, vomiting (in morning)

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15
Q

List some conditions which you’d find neurological signs?

A

Meningitis (Kernig’s)

Cerebral palsy (Hypertonia, hyperreflexia)

Muscular dystrophy

Chromosomal (Down’s)

SOL: papilloedema

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16
Q

Advice to give parents for if their child has another seizure?

A

Keep child safe (move away sharp objects, anything they could hurt themselves on)

Reassure child

Call 999 if seizure lasts more than 5 mins, there are multiple seizures which she doesn’t recover from between

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17
Q

A neonate with jaundice. What do you want to know from parents?

A

Onset (within or without 24 hrs)

Parents: any genetic conditions in family (G6PD, spherocytosis)

Rh and ABO group of mother and baby

Breast milk fed?

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18
Q

What is the likely cause of jaundice lasting more than 2 weeks in a well child?

How long could this jaundice last?

A

Breast milk jaundice

4 months

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19
Q

When is jaundice an issue with newborns?

A

If onset before 24 hrs or over 2 weeks

20
Q

Group B strep
What does it look like?
What’s its actual name?

A

Gram +ve
Cocci
Chains

Strep. agalactiae

21
Q

Are Neisseria men and gon gram +ve or negative?

A

Negative

22
Q

What systems would you monitor after giving gentamicin?

A

Hearing

Renal

23
Q

Initial investigations for a possible NAI?

A

Full body examination
Bloods: clotting, FBC
Papilloedema: to look for possible cerebral oedema

24
Q

You’ve just intubated and ventilated a patient. What should you do?

A

CXR to ensure correct positioning

25
Q

Resp alkalosis in a ventilated child. Why?

A

Ventilation rate too high

26
Q

Tests for TB?

A

CXR
Interferon gamma release assay
Mantoux test

27
Q

Eye signs in seizures?

A

Repetitive blinking
Staring
Eyes rolling up
Dilated pupils

28
Q

Causes of haematuria (to do with basement membrane nephritis).

A

Good pastures
Post-strep glomerulonephritis
IgA nephropathy

29
Q

Nephrotic vs nephritic?

A

Nephrotic: podocytes, protein

Nephritic: basement membrane, haematuria

30
Q

Causes of nephrotic syndrome?

A

Membranous nephropathy
FSGS
Minimal change disease

31
Q

Causes of microcytic and macrocytic anaemia?

A

Micro: iron deficiency, thalassaemia, sickle cell

Macro: folate, B12 deficiency, alcohol excess

32
Q

What are some haemolytic anaemias?

A

Spherocytosis
G6PD
Thalassaemia
Sickle cell

33
Q

What are some tests to investigate anaemia?

A

Serum iron
Serum ferritin
Hb electrophoresis
Total iron binding capacity

34
Q

Management of ADHD?

A

Methylphenidate (Ritalin)
Atomoxetine
Dexamfetamine

35
Q

Chronic ear and chest infections, dextrocardia. Cause?

A

Primary ciliary dyskinesis

Cilia fail to beat properly, infections and mucus build up

36
Q

Cardiac defect associated with Turner’s syndrome? What are the symptoms?

A

Coarctation of aorta

Often weak femoral pulses, upper limb pulses are fine because coarctation is after sub-clavian has branched off

37
Q

A child presents in acute renal failure after having bloody diarrhoea for a few days?

A

Haemolytic uraemic syndrome

E. coli 0157

38
Q

Investigation of intussusception?

A

USS first line

AXR

39
Q

Complications of intussusception?

A

Paralytic ileus

repeat (30%)

40
Q

Guthrie’s test marker for CF?

A

Immuno-reactive tripsinogen

41
Q

Genetic mutation in CF?

A

CFTR gene on chromosome 7 at position delta f 508

42
Q

Treatment of pancreatic insufficiency in CF?

A

Vit AKED
Pancreatin
Insulin

43
Q

Causes of repeat intussusception?

A

Polyp
Meckel’s diverticulum
Anatomical abnormality

44
Q

What’s a rule that can be used to estimate burns extent?

A

Wallace’s rule of 9s

Head + neck = 9%
Arm = 9%
Anterior leg = 9%, posterior leg = 9%
Anterior chest = 9%, posterior chest = 9%
Anterior abdomen = 9%, posterior abdomen = 9%

Palm size is roughly equal to 1%

45
Q

What is the formula used to calculate fluid requirement in burns patient?

A

Parkland formula

Amount of fluid (ml) = area of burn (%) x weight x 4

46
Q

Different degrees of burns? What do they look/feel like?

A

1st - superficial: epidermis, red, painful

2nd - partial thickness:

  • superficial dermal, pale pink, blisters
  • deep dermal, white, reduced sensation

3rd - full thickness: white, brown, black, no pain

47
Q

Management of burns?

A

First aid: cool water, clingfilm

ABCDE
Fluids, analgesia
Correct electrolytes
Prevent infection
Escharotomies: division of encasing band of burn tissue allows better ventilation

Child Health (17 decks)

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