The child

Question 1

Name red flag symptoms in a child with abdominal pain

Answer 1

• weight loss
• faltering growth
• right upper / lower quadrant pain
• GI bleeding; family history of IBD
• urinary symptoms
• chronic/ severe vomiting / diarrhoea
• back / flank pain

Question 2

Describe the HR, RR and BP of a <1, 1-2 and 2,5 year old

Answer 2

<1

• HR; 110-160
• RR; 30-40
• Systolic; 70-90

1-2

• HR; 100-150
• RR; 25-35
• Systolic; 80-95

2-5

• HR; 95-140
• RR; 25-30
• Systolic; 80-100

Question 3

Describe the HR, RR and BP of a 5-12 year old and over 12s

Answer 3

5-12

• HR; 80-120
• RR; 20-25
• Systolic; 90-110

> 12

• HR; 60-100
• RR; 15-20
• Systolic; 100-120

Question 4

Encephalitis is usually what in aetiology?

Answer 4

Commonly viral

Question 5

What is the commonest reason for acute illness in children?

Answer 5

Sepsis

Question 6

Describe the equation used to work out a normal BP for a childs age

Answer 6

Systolic BP - 85 + (age in years x 2)

Question 7

Describe the management of shock

Answer 7

• 20mls/kg of 0.9% saline

- reassess and repeat if sill shocked

Question 8

Define overweight and obesity

Answer 8

Abnormal or excessive fat accumulation that may impair health

Question 9

At what centile would a child be 
A) at high risk of overweight
B) at high risk of obesity 
C) overweight 
D) clinically obese

Answer 9

A) >85th centile
B) >95 centile
C) >91st centile
D) >98th centile

Question 10

BMI is the best measure of adiposity in children from the age of what?

Answer 10

2 (when height can be measured accurately)

Question 11

Name risk factors for being overweight at 3 years

Answer 11

• parent overweight
• black ethnicity
• greater birthweight
• smoking during pregnancy
• lone motherhood
• prepregnancy overweight
• maternal employement >21 hrs/week
• solid foods before 4 months

Question 12

Describe prader-willi syndrome

Answer 12

• birth incidence 1:25,000
• at birth; very floppy, ability to suck weak or absent, tube feeding common
• childhood; hyperphagia (food seeking and lack of satiety) and reduced energy requirements due to low muscle tone
• learning difficulties
• hypogonadism
• short stature

Question 13

Describe bardet-biedl syndrome

Answer 13

• birth incidence 1:100,000
• visual impairment, renal abnormalities, polydactyly, learning difficulties, hypogonadism, obesity
• hyperphagia

Question 14

What constitutes a clinical assessment of obesity?

Answer 14

• BMI; plot on centile chart
• eating habits, physical activity patterns, screen time
• social circumstances
• school history
• emotional / psychological issues
• family support
• stature of close family relatives
• family history e.g. obesity / diabetes

Question 15

What are the sugar recommendations for a child?

Answer 15

• 4-6 years; 19g max per day
• 7-10 years; 24g max per day
• > 11 years; 30g max per day

Question 16

What advice can be given to families for children who are overweight?

Answer 16

• use smaller plates
• parent serves meal rather than child serving themselves
• cook only required food quantity
• age appropriate portion sizes

Question 17

Describe the physical activity guidelines for under 5s

Answer 17

• under 5s not yet walking; encourage through floor based play and water based activities in safe environments
• under 5s walking; should be physically active daily or at least 180 mins, spread throughout the day
• all should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods

Question 18

What is a live birth?

Answer 18

Any sign of life after birth irrespective of gestation

Question 19

What are the top 5 causes of under 5 mortality globally?

Answer 19

• preterm birth complications
• pneumonia
• intra-partum related complications
• congenital abnormalities
• diarrhoea