w/c 19/02

Question 1

what is the most specific sign of meningococcal disease?

Answer 1

non blanching rash

Question 2

what is kernigs sign?

Answer 2

inability to fully extend leg flexed at hip- seen in meningitis

Question 3

whencan transcutaneous bilirubin be measured in babies?

Answer 3

GA >35 weeks
>24 hrs old

Question 4

at what level of transcutaeous bilirubin does serum bilirubin need to be checked?

Answer 4

> 250 micromoles/L

Question 5

what 2 tests are done on examination for suspected meningitis?

Answer 5

kernigs
brudzinskis

Question 6

whats the most common cause of precocious puberty?

Answer 6

idiopathic central precocious puberty

Question 7

how much adrenaline IM is given for anaphylaxis to kids of different ages?

Answer 7

under 6= 150 micrograms 1:1000
6-12= 300 micrograms 1:1000
over 12= 500 micrograms 1:1000

Question 8

how many parents consent does a doctor need to provide treatment to a child?

Answer 8

1
they can be a stepparent- married to the other parent either before or after the birth of the child, both ways they have parental responsibility

Question 9

whats gold standard ix for coeliacs and what is seen?

Answer 9

jejunal/duodenal biopsy
villous atrophy, crypt hyperplasia, intraepithelial lymphoycytes

Question 10

what murmur is seen on tetralogy of fallot, where is it auscultated and why?

Answer 10

harsh ejection systolic murmur on upper sternal border left side due to pulmonary stenosis

Question 11

anatomically, what causes an inguinal hernia in children?

Answer 11

a patent processus vaginalis

Question 12

whats the incubation period of chickenpox?

Answer 12

up to 3 weeks

Question 13

what are the first signs of puberty in boys and girls? what age do they happen

Answer 13

boys= enlargement of testes at age 9
girls= development of breasts at age 8.5

Question 14

what is adenomyosis?

Answer 14

presence of endometrial tissue in the myometrium

Question 15

what are rf for adenomyosis?

Answer 15

multiple pregnancies
sustained trauma to uterus- multiple c sections
older reproductive age

Question 16

how is adenomyosis managed?

Answer 16

wanting to concieve: mefanamic acid for analgesia
not wanting to concieve: hormonal contraception

Question 17

what medication can be used to stop breastfeeding and how?

Answer 17

carbergoline
dopamine receptor agonist inhibiting prolactin production

Question 18

what abnormality occurs in baby with maternal lithium use?

Answer 18

ebsteins

Question 19

what is ebsteins abnormality?

Answer 19

congenital heart defect associated with maternal lithium use- 2 leaflets of the tricuspid valve are displaced the long way so blood leaks from the right ventricle to the right atrium leading to right atrial enlargement and congestive heart failure

Question 20

what is lynch syndrome?

Answer 20

a genetic condition causing familial malignancy at a younger age, its associated with ovarian, endometrial and bowel cancer

Question 21

when are women admitted for placenta praevia?

Answer 21

if its symptomatic past 34 weeks

Question 22

what are the 7 layers to get through in a c section

Answer 22

skin
subcut fat
rectus sheath
rectus abdominis
peritoneum
myometrium
amniotic sac

Question 23

how long after delivery is contraception not required?

Answer 23

21 days

Question 24

whats the most common type of fibroid?

Answer 24

intramural

Question 25

what antidepressants cause anticholingeric side effects?

Answer 25

TCAs

Question 26

what are anticholingeric side effects?

Answer 26

falls dry mouth drowsiness blurred vision constipation urinary retention

Question 27

what class of drugs are given for dementia?

Answer 27

acetylcholinesterase inhibitors

Question 28

what is splitting?

Answer 28

a phenomenon seen in EUPD where people regard others as wholly good or wholly bad as their relationships fluctuate between idealisation and devaluation

Question 29

whats given to household contacts for meningitis?

Answer 29

cipro or rifampicin

Question 30

how is mild croup managed?

Answer 30

single dose oral dex

Question 31

how is severe croup managed?

Answer 31

IV dex adrenaline nebs high flow oxygen

Question 32

what type hypersensitivity reaction is asthma?

Answer 32

type 1

Question 33

what is transient tachpnoea in the newborn associated with?

Answer 33

c section prematurity

Question 34

how might you identify an innocent murmur?

Answer 34

soft systolic no diastolic component no radiation, localised no heaves/thrills not symptomatic may vary with posture

Question 35

what age do children with UTIs need to be admitted?

Answer 35

under 3 months

Question 36

what is galaezzi test?

Answer 36

the test used to indicate wether shortening is femoral or tibial

Question 37

when is jaundice abnormal in neonates?

Answer 37

first 24 hrs of life

Question 38

when does physiological jaundice usually present?

Answer 38

after 24 hrs

Question 39

how is foreign body ingestion managed?

Answer 39

is patient is asymptomatic and theres no evidence of obstruction they can be discharged

Question 40

what mutation is associated with digeorge syndrome?

Answer 40

22q 11.2 deletion

Question 41

what heart defects are seen in digeorge syndrome?

Answer 41

interrupted aortic arch VSD

Question 42

what is salmon pink rash in paediatric MSK indicative of?

Answer 42

JIA

Question 43

what are other features of JIA?

Answer 43

salmon pink rash lymphadenopathy uveitis pyrexia anorexia weight loss

Question 44

describe wilms tumor

Answer 44

most common primary renal tumor in kids nephroblastoma usually unilateral painless mass in abdomen with distention fever and haematuria

Question 45

how is wilms tumor imaged?

Answer 45

ultrasound

Question 46

how do you recognise croup?

Answer 46

high pitched barking cough and hoarse voice

Question 47

how is severe croup managed in the community

Answer 47

give steroids (oral dex or budesonide nebs) and transfer to hospital

Question 48

what are features of severe croup?

Answer 48

stridor resp distress hypoxia

Question 49

what is otitis media with effusion?

Answer 49

presence of fluid behind in the ear without infection

Question 50

what are the causes of conjugated vs unconjugated hyperbilirubinaemia?

Answer 50

conjugated: biliary atresia, CF unconjugated: breast milk jaundice, gilberts syndrome, crigler-najjar syndrome

Question 51

how does cerebral palsy affect development?

Answer 51

delay in one specific developmental region

Question 52

what chromosome and gene are affected in cystic fibrosis?

Answer 52

CTFR gene on chromosome 7

Question 53

what sign do you see on x ray in croup?

Answer 53

steeple sign- due to subglottic narrowing

Question 54

how do you differentiate croup and whooping cough

Answer 54

croup= barking cough, inspiratory stridor whooping cough= severe bouts of coughing, cant breath during so inspiration when cough ends

Question 55

how is croup managed?

Answer 55

supportive responds well to steroids- dexamethasone especially

Question 56

how is whopping cough managed

Answer 56

supportive care macrolide abx

Question 57

how does clomiphine work?

Answer 57

selective oestrogen receptor modulator reduced negative feedback from oestrogen so increases fsh and lh to encourage ovulation

Question 58

when is clomiphine given/

Answer 58

day 2 and 6 of the cycle

Question 59

what weight is defined as macrosomia?

Answer 59

over 4 kg

Question 60

in what patients is ergometrine contraindiciated?

Answer 60

hypertension PVD heart disease

Question 61

when is ECV performed?

Answer 61

nulliparous= 36 weeks multiparous= 37 weeks

Question 62

regarding the cervix, when can you perform artificial rupture of membranes?

Answer 62

when the cervix is ripe and dilated to 4cm

Question 63

how do you differentiate postpartum blues and depression

Answer 63

blues= presents 3-7 days post delivery depression= presents after 6 weeks/present for 6 weeks

Question 64

what is capgras delusion?

Answer 64

a belief that close people (friends/family) have been replaced by clones

Question 65

what is the belief that close people (friends/family) have been replaced by clones?

Answer 65

capgras delusion

Question 66

when can therapy be started after a traumatic event?

Answer 66

immediately a diagnosis of ptsd is not needed, trauma focused cbt can be given in acute stress disorder

Question 67

what medication is used for extrapyramidal side effects of antipsychotics? whats the moa

Answer 67

procyclidine- anticholinergic

Question 68

what extrapyramidal side effects does procyclidine improve vs not?

Answer 68

improves: tremor, akithesia, dystonia doesnt improve: bradykinesia and rigidity

Question 69

whats the tetrad for neuroleptic malignant syndrome?

Answer 69

hypertonia hyperthermia autonomic instability mental state change

Question 70

what medication is neuroleptic malignant syndrome associated witgh?

Answer 70

antipsychotics

Question 71

what is lewy body dementia associated with?

Answer 71

visual hallucinations- often small/non harmful creatures/animals REM sleep disorder falls