Week 3

Question 1

Clin pres of Prader-Willi

Answer 1

At birth – very floppy, weak/absent suck, tube feeding common
Childhood – hyperphagia (food seeking and lack of satiety), reduced energy requirements due to low muscle tone
Learning difficulties
Hypogonadism
Short stature

Question 2

Clin pres of Bardet-Biedl

Answer 2

Visual impairment, renal abnormalities, polydactyly, learning difficulties, hypogonadism, obesity
Hyperphagia

Question 3

Describe Saxenda

Answer 3

GLP-1 agonist, injectable
Approved for adults, licensed for under 16 but not pproved

Question 4

Initial management of child with epigottitis

Answer 4

ET intubation (to prevent resp arrest)

Question 5

Clin pres of pyloric stenosis

Answer 5

Vomiting milk
Abdo mass
Visible peristalsis
(2-12w)

US abdo, pyloromyotomy

Question 6

Clin pres of intussusception

Answer 6

Symptoms
- Severe, colicky abdo pain
- Pale, lethargic, unwell
- Vomiting
- Sound then floppy
Signs
- Dehydration
- ‘Redcurrantjelly stool’
- Right upper quadrant mass
- Concurrent viral illness
- Target lesion/psuedo-kidney on US
Manage
- Air reduction
- If fails, surgical

Question 7

Key feature of appendicitis/peritonitis upon history taking

Answer 7

Bumps/turns in car v painful

Question 8

Describe torsion of Hydatid of Morgagni

Answer 8

Torsion of appendix testes
Conservative or surgical if req

Question 9

Describe testicular torsion

Answer 9

• Testicle rotates, twisting the spermatic cord that brings blood to the scrotum
• Epididymis can become infected and haemorrhagic
• Typically in teenage boys
• Surgery

Question 10

Describe Epididymoorchitis

Answer 10

• Acute bacterial infection of the epididymis progressing to involve the testis
• Occurs as a result of retrograde bacterial colonisation via the ejaculatory ducts and vas deferens
• Manage with analgesia and antibiotic

Question 11

Describe hypospadias

Answer 11

• Congenital defect causing the urethral meatus to be located at an abnormal site, usually on the under side of the penis rather than at the tip
• Cordae of tendons tightening underside of penis
• Surgical correction

Question 12

Red flags for funny turns in kids

Answer 12

Known heart condition/previous surgery
Family history of sudden death including in infancy
Events that happen on exercise
Vagal symptoms when sitting/lying
Events that happen at night

Question 13

Red flags for headache in kids

Answer 13

Rapidly expanding head size
Effortless morning vomiting
Night/early morn headache
Worse coughing/bending over
Change in behaviour/cog ability
Squint/visual change

Question 14

Red flags for heart mumur in kids

Answer 14

Infant
- dymorphic signs
- blue/cyanosis
- signs of HF e.g. poor feeding
- low fem pulses and O2 sats, liver edge, etc
Child
- fatigue
- brethless
- above

Question 15

Red flags for cough in kids

Answer 15

Night time waking with cough, wheeze, SOB or obstructive symptoms
Failure to thrive
Other recurrent infections

Question 16

Red flags for abdo pain in kids

Answer 16

Failure to thrive
Bilious or bloody vomiting
Bloody stools or symptoms of IBD

Question 17

Red flags with poo in kids

Answer 17

Constipation
- symptoms from birth
- abnorm lower limb neurlogy
Diarrhoea
- WL
- bloody stools
- stooling at night
- systemic symptoms e.g. fatigue, rash, mouth ulcers

Question 18

Red flags for growth in kids

Answer 18

Other systemic illness in FTT
Children who are short and obese (most obese children are tall)
Precocious or delayed puberty

Question 19

Red flags with UTIs in kids

Answer 19

Renal scarring (secondary to reflux particularly <2yo)
Renal tract abnormalities abnormal bowel and bladder function (secondary to neuro cause)

Question 20

Causes of fatigue in kids

Answer 20

inflammatory disorders
brain tumours
coeliac
anaemia
thyroid
addisons