The acutely ill child

Question 1

What is bronchiolitis?

Answer 1

Acute inflammatory injury to the bronchioles commonly seen in infants

Question 2

What causes most cases of bronchiolitis?

Answer 2

Respiratory syncytial virus

Question 3

How is bronchiolitis managed?

Answer 3

Supportively- referral if signs of severe illness

Question 4

What is croup otherwise known as?

Answer 4

Laryngotracheobronchitis

Question 5

What is the characteristic symptom of croup?

Answer 5

Harsh “barking” cough due to airway constriction

Question 6

How is croup managed?

Answer 6

Supportive + steroids + referral if necessary

Question 7

What are two important differential diagnoses of croup?

Answer 7

Foreign body

Epiglottitis

Question 8

What are five common causes of faints, fits and “funny turns” in children?

Answer 8

Vasovagal attacks
Febrile convulsions
Breath-holding attacks
Epilepsy
Reflex anoxic seizures

Question 9

What is the most common cause of vomiting and diarrhoea in children?

Answer 9

Gastroenteritis (usually viral- rotavirus)

Others- campylobacter, salmonella, shigella, E. coli

Question 10

What is an important consideration when a child develops bloody diarrhoea following gastroenteritis?

Answer 10

Haemolytic uraemic syndrome

Question 11

What is pyloric stenosis and how does it present?

Answer 11

Thickening of the pylorus causing an obstruction and vomiting, seen in children usually around 2-6 weeks

Question 12

What are the common causes of bowel obstruction in children up to age 6 months?

Answer 12

Intussusception
Volvulus
Malrotation

Question 13

What is Hirchsprung’s disease?

Answer 13

Absent nerve supply to a section of the large bowel causing severe constipation and sometimes bowel obstruction

Question 14

What is the overall effect of the Tetralogy of Fallot?

Answer 14

Right-to-left shunt causing restriction of blood flow to the lungs

Question 15

What name is given to the condition where the
a) connection between pulmonary artery and descending aorta
and b) connection between the right atrium and left atrium fails to close at birth?

Answer 15

a) Patent ductus arteriosus

b) patent foramen ovale

Question 16

Commonest cause of infective diarrhoea and vomiting in children?

Answer 16

Rotavirus

Question 17

Features which suggest a child is dehydrated? (5)

Answer 17

Decreased urine output
Irritable/lethargic
Tachycardia/tachypnoea
Dry mucous membranes
Reduced skin turgor

Question 18

Features which suggest a child is shocked? (6)

Answer 18

GCS less than 14
Cold extremities
Pale/mottled skin
Tachycardia + hypotension
Tachypnoea
Weak peripheral pulses

Question 19

Features which suggest hypernatraemic dehydration? (4)

Answer 19

Jittery movements
Increased muscle tone
Hyper-reflexia
Convulsions