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Medicine Year 4 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

High fever lasting more than 5 days, red palms with desquamation and strawberry tongue with conjunctival infection

A

Kawasaki disease

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2
Q

At what age can a child sit

A

6 months (rounded back)

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3
Q

At what age can a child run

A

16 months - 2 years

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4
Q

At what age can a child ride a tricycle with pedals

A

3 years

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5
Q

4 causes of snoring in children

A

Hypertrophic nasal turbinates
Tonsillitis
Obesity
Downs syndrome

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6
Q

What does VSD increase the risk of?

A

Endocarditis

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7
Q

Obese boy with groin/thigh/knee pain

A

Slipped upper femoral epiphysis

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8
Q

4-8 year old boy with a painless limp, irritable hip and reduced range of motion with no trauma

Xray, epiphyseal sclerosis, a widened joint space and flat femoral head

A

Perthes disease

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9
Q

Joint pain after a recent viral infection with no abnormal radiological findings

A

Transient synovitis

rest and alangesia

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10
Q

What is the newborn screening test and if it is abnormal, what test is next?

A

Otoacoustic emission test
THEN
Auditory brainstem response test

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11
Q

Sore throat, fever, headache, bright red tongue (furred) , coarse red rash (sandpaper) that spares the face

A

Scarlet Fever

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12
Q

How long must a child with scarlet fever remain off school

A

Until 24hrs after the first dose of antibiotics

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13
Q

First line investigation for intussusception

A

Ultrasound

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14
Q

Child presenting in GP with pain in the legs at night with no obvious cause

A

Growing pains

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15
Q

Target sign on ultrasound

A

Intussusception

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16
Q

Management of intussusception

A

Pneumatic reduction under fluoroscopic guidance

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17
Q

Presentation and management of necrotising enterocolitis

A

Premature baby with abdo distention, free fluid, small bowel dilation and septic signs
Laparotomy

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18
Q

Most common childhood leukaemia

A

ALL

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19
Q

Presentation of ITP

A

Purpuric rash

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20
Q

Presentation of ALL

A

Anaemia, neutropaenia, thrombocytopenia

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21
Q

What cardiac condition is turners syndrome associated with

A

Coarctation of the aorta

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22
Q

Features of turners syndrome at birth

A

Widely spaced nipples, webbed neck, peripheral lympoedema (swollen hands and feet)

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23
Q

Achondroplasia inheritance

A

Autosomal dominant

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24
Q

Investigation for slipped upper femoral epiphysis

A

Hip xray

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25
Q

Painful limp for 8 weeks

A

Perthes disease

MRI if X-Ray normal

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26
Q

Child with tonsillitis symptoms but stridor and sitting forward

A

Epiglottitis, do NOT examine

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27
Q

When should you refer a

  • unilateral undescended testis
  • bilateral undescended testes
A
  • unilateral at 3 months

- bilateral in 24 hours

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28
Q

Ejection systolic murmur

A

Pulmonary valve stenosis
Tetralogy of Fallot (associated with ‘tet’ spells)
Aortic valve stenosis (radiates to carotids)

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29
Q

Pansystolic murmur

A

VSD

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30
Q

Mid systolic crescendo-decresendo murmur

A

ASD

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31
Q

Cpntinuous crescendo-decrescendo machinery murmur with a collapsing pulse

A

PDA

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32
Q

Ejection systolic murmur below clavicle

A

Coarctation of the aorta

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33
Q

Salmon pink rash with joint pain

A

Stills Disease (juvenille idiopathic arthritis)

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34
Q

Paediatric BLS

A

5 initial breaths

15:2

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35
Q

Short stature, widely spaced nipples and primary amenorrhoea

A

TURNERS

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36
Q

When should you call an ambulance during a seizure

A

If the seizure persists more than 5 minutes

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37
Q

Treatment of scarlet fever

A

10 days oral Pen V

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38
Q

Treatment of scarlet fever

A

10 days oral Pen V

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39
Q

First line laxative for constipation in childhood

A

Osmotic

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40
Q

4 risk factors for DDH

A

Female
Breech
High birth weight
Oligohydramnios

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41
Q

First step in newborn resus

A

DRY the baby

Then 5 breaths

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42
Q

Causative organism for croup

A

parainfluenza virus

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43
Q

First line management of eczema

A

Topical emollients

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44
Q

How long should a child with whooping cough be kept off school

A

2 days after commencing antibiotics (or 21 days from onset of symptoms if no antibiotics)

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45
Q

How long should a child with roseola be kept off school

A

No exclusion

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46
Q

How long should a child with D+V be kept off school

A

48 hours

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47
Q

Medication given in transposition of the greater arteries

A

Prostaglandin to maintain the PDA

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48
Q

Posterior displacement of the tongue and a cleft palate with no family history

A

Pierre-Robin Syndrome

Place prone due to upper airway obstruction

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49
Q

4 features of tetralogy of fallot

A

pulmonary stenosis
overriding aorta
VSD
right ventricular hypertrophy

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50
Q

Prevention of neonatal distress syndrome

A

Dexamethasone to mother

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51
Q

Treatment of bronchilolitis

A

Supportive management only

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52
Q

Most common cause of ambiguous genitalia in neonates

A

Congenital adrenal hyperplasia

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53
Q

Investigation of choice for reflex nephropathy

A

Micturating cystography

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54
Q

First line treatment for threadworm (and sx)

A

Mebendazole single dose for full family

Itchy bottom

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55
Q

Topical treatment of oral thrush

A

Nystatin

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56
Q

What is the mode of inheritance for prader willi

A

Imprinting

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57
Q

What genetic condition are rocker bottom feel found in

A

Edwards (trisomy 18)

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58
Q

When does a child start to smile

A

6 weeks

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59
Q

Immediate complication of measles

A

Pneumonia

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60
Q

Later complication of meales

A

Subacute sclerosing panencephalitis (5-10 years later)

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61
Q

2 complications following a mumps infection

A

Pancreatitis and infertility

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62
Q

7 features of an atypical UTI

A 
Seriously ill
Poor urine flow
Abdominal or bladder mass
Raised creatinine
Septicaemia
Failure to respond to treatment with suitable antibiotics within 48 hours
Infection with non-E. coli organisms.
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63
Q

Most common reversible cause of cardiac arrest in children

A

Hypoxia (repsiratory)

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64
Q

Child below the 0.4th centile

A

Refer to paeds outpatients for review

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65
Q

Corrected age of a premature baby

A

The age minus the number of weeks they were born early from 40 weeks

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66
Q

treatment of croup

A

Single dose oral dexamethasone

Emergency: High flow oxygen and adrenaline

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67
Q

Appropriate places to check for a pulse in paediatric BLS

A

Brachial and femoral

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68
Q

Dietary advice for ADHD

A

Eat a normal balanced diet unless links have been found between behaviour and certain foods

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69
Q

Vaccinations in pregnant women

A

Pertussis and influenza

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70
Q

Murmur described as a ‘continuous blowing noise’ heard below both clavicles in a child

A

Venous hum (innocent)

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71
Q

Murmur described as a low-pitched sound heard at the lower left sternal edge

A

Stills murmur (innocent)

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72
Q

Difference between gastroschisis and omphalocele

A

Gastroschisis associated with socioeconomic deprivation and presents with a defect left to the umbilicus

Omphalocele refers to a defect in the umbilicus itself

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73
Q

What investigation would you do in kawasakis to screen for potential complications

A

Echo

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74
Q

What is the most common cause of respiratory distress in neonates

A

Transient tachypnoea of the newborn

delayed reabsorption of fluid in the lungs

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75
Q

What is hypospadias and how is it managed

A

Ventral urethral meatus and hooded prepuce

Surgery at 12 months

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76
Q

Heart defect in turners

A

Bicuspid aortic valve

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77
Q

Management of UTI in a child

A

3 day cause of ABx as per local policy

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78
Q

Features and management of biliary atresia

A

first few weeks of life with jaundice, appetite and growth disturbance
surgery

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79
Q

Features of CMV infection in neonate

A

Neonatal jaundice, fever, microcephaly, sensioneural deafness, blueberry muffin skin lesions, hepatosplenomegaly

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80
Q

Hypothyroidism in neonates

A

Jaundice, poor feeding, constipation, hypothermia, rise in unconjugated bilirubin

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81
Q

Components of the APGAR score

A 
Appearance
Pulse
Grimace
Activity 
Respiration
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82
Q

Most common cause of nephrotic syndrome in children

A

Minimal change disease

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83
Q

Children under 3 months with suspected UTI

A

Non-specific Sx

Refer to same day paediatric assessment unit

84
Q

At what gestation does a baby have to be breech to get an ultrasound

A

At or after 36 weeks

85
Q

Management of neonate at risk of hypoxic ischaemic encephalopathy

A

Therapeutic cooling

86
Q

Asthma not responding to salbutamol inhaler and beclometasone

A

Add leukotrine receptor antagonist

87
Q

CF diet

A

high calorie high fat meal with pancreatic enzyme supplementation for every meal

88
Q

The most common complication of roseola

A

Febrile convulsions

89
Q

What is the inheritance pattern of haemophilia A

A

X linked recessive

90
Q

Can a male with an x-linked condition pass it onto his son

A

No, there is no male-male transmission in x-linked recessive conditions
It can only be passed from mothers (carriers)

91
Q

Treatments for CF spasticity

A

Oral diazepam, baclofen, botox, surgery

92
Q

Child under 3 months with a fever over 38C

A

Refer for same day paeds assessment

93
Q

Feature of a benign ejection murmur

A

Varies with posture

94
Q

Can CF cause diabetes

A

Yes

95
Q

Young boy with learning difficulties, macrocephaly, large ears and macro-orchidism

A

Fragile X

96
Q

Is school exclusion advised for children with head lice

A

No

97
Q

At what age will a child start parallel play

A

2 years

98
Q

Genetic condition associated with supravalvular aortic stenosis and elfin facies

A

William’s syndrome

99
Q

Bowel sounds in a respiratory exam of a neonate

A

Diaphragmatic hernia

Intubate if in resp distress

100
Q

When is a bone marrow biopsy needed for children with ITP

A

Splenomegaly

101
Q

NICE indications for head CT

A
102
Q

What are infantile spasms

A

Childhood epilepsy in the first 4-8 months of life in male infants with a poor prognosis
‘salaam attacks’ progressive mental handicap
EEG shows hypsarrhythia and CT shows a diseases brain

103
Q

When might you prescribe a bronchodilator such as salbutamol

A

If viral induced wheeze is suspected and the child is over 1 year old

104
Q

Do children with autism spectrum disorder have normal intelligence

A

no, normally associated with intellectual impairment

105
Q

4 characteristics of autism

A

Global impairment of language and communication
Children may perform ritualistic behaviour
75% of children are male
Usually develops before 3 years of age

106
Q

At what age do febrile convulsions usually occur?

A

Children aged 6 months to 5 years

107
Q

Medication for ADHD and side effect

A

Methylphenidate

Stunted growth

108
Q

Define caput seccedaneum

A

puffy swelling that usually occurs over the presenting part and crosses suture lines caused by prolonged delivery/assistance

109
Q

Two features in congenital rubella

A

Sensorineural deafness

Congenital cataracts

110
Q

Treatment for meningitis

A

under 3 months: cefotaxime + amoxicillin (cover listeria)

over 3 months: ceftriaxone

111
Q

two causes of epiglottitis

A

haemophilus influenzae type B

Diptheria

112
Q

Nappy rash: creases spared or not?

A

Spared = irritant dermatitis

Not spared = candida

113
Q

2 month hx of bilateral knee pain worse in the morning with general fatigue

A

Oligoarticular juvenile idiopathic arthritis

114
Q

Is downs syndrome associated with hypothyroidism

A

yes

115
Q

First sign of puberty in girls

A

Breast development

116
Q

Hand foot and mouth features and treatment

A

mild fever and upset with vesicles over the palms and around the mouth (NOT crusty!)
Symptomatic treatment only

117
Q

The only recommended advise to reduce the risk of CF infections

A

Avoid contact with other CF patients

118
Q

Management of PDA

A

Give indomethacin to the neonate

119
Q

Neonatal hypoglycaemia

A

under 1.65 in first 24 hours

Under 2.5 thereafter

120
Q

Management of neonatal hypoglycaemia

A

Asymptomatic then encourage feeding and monitor glucose

Glucose adjuncts if symptomatic

121
Q

Signs of neonatal sepsis

A

Vague signs and symptoms, poor feeding, grunting, lethargy

122
Q

Most common cause of primary headache in children

A

Migraine

123
Q

Management of perthes disease

A

Under 6: observe

Over 6: surgery

124
Q

Investigation to confirm duchennes

A

Genetic testing

125
Q

Cause of microcephaly, absent philtrum, pansystolic murmur in neonate

A

Maternal alcohol use

126
Q

Neonate with jaundice, next step

A

Measure serum bilirubin within 2 hours

127
Q

Most common complication of measles

A

Otitis media

128
Q

Diffuse maculopapular rash with small white papules on the inside of cheeks

A

Measles

129
Q

Management of pneumonia with mycoplasma

A

Erythromycin

130
Q

High temperature presceding a maculopapular rash

A

Roseola

131
Q

Mode of inheritance of huntingtons

A

autosomal dominant

132
Q

What is genetic anticipation?

A

A phenomenon in which the signs and symptoms of some genetic conditions tend to become more severe and/or appear at an earlier age as the disorder is passed from one generation to the next
e.g. Huntingtons, Myotinic Dystrophy

133
Q

Child 6 years old wanting first MMR dose

A

Give MMR with repeat dose in 3 months

134
Q

Pyloric stenosis investigation

A

Abdominal ultrasound

135
Q

Sign of late decompensated shock

A

Hypotension

Potentially irreversible

136
Q

Ventral urethral meatus associated condition

A

Cryptorchidism (hypospadias)

137
Q

Common presentation of neonatal sepsis

A

Respiratory distress

138
Q

Metabolic disturbance in pyloric stenosis

A 
Increased bicarb (alkalosis)
Hypochloraemia, hypokalaemia
139
Q

Downs cancer

A

ALL

140
Q

Ask what and who questions

Ask why when and how questions

A

What and who - 3 years

Why when and how - 4 years

141
Q

Treatment of immune thrombocytopenia with no significant bleeding

A

No treatment

142
Q

Infant with inspiratory stridor and noisy breathing

A

Laryngomalacia

143
Q

Hirschsprung disease

A

Congenital bowel disease
Bilious vomiting, abdo distention, constipation and failure to pass meconium in 1st 24 hours
Might not present until childhood or adolescence

144
Q

Colon biopsy of hirschsprungs

A

Aganglionic segment of bowel

145
Q

Hepatosplenomegaly and bruising with soft systolic murmur

A

ALL

146
Q

micrognathia, low-set ears, rocker bottom feet and overlapping of fingers

A

Edwards

147
Q

Epiglottitis airway protection

A

Endotracheal intubation

148
Q 
learning difficulties
large low set ears, long thin face, high arched palate
macroorchidism
hypotonia
autism is more common
mitral valve prolapse
A

Fragile X

149
Q

Dermoid cyst characteristics

A

Multiloculated and hererogeneous above the hyoid bone

150
Q

Mass in posterior triangle that transilluminates

A

Cystic hygroma

151
Q

Mass lateral to anterior triangle - fluid filled

A

Branchial cyst

152
Q

Palmar grasp age

A

5-6m

153
Q

Tower of 3-4 blocks

A

18m

154
Q

Management of an infant with GORD

A

1-2 week trial of alginate therapy
then
4 week trial of PPI

155
Q

Pregnancy complication in a foetus with alpha thalassemia

A

Hydrops fetalis

156
Q

Colic seizures with change in development and EEG with hypsarrhythmia

A

West Syndrome (infantile spasms)

157
Q

Cyanosis/collapse in first month of life
Hypercayanotic spells
Ejection systolic murmur at left sternal edge

A

Tetralogy of Fallot

158
Q

Heart lesion with Duchenne

A

Dilated cardiomyopathy

159
Q

When is the blood spot test performed in the UK

A

Between the fifth and ninth day of life

160
Q

When will children with CMPA be tolerant?

A

3 years

161
Q

Hand foot and mouth organism and Sx

A

Mild systemic upset then oral ulcers then vesicles on palms and soles
Cosackie A16

162
Q

Webbed neck and pectus excavatum with widely spaced nipples and short stature

A

Noonan

163
Q

Small eyes and polydacytly with cleft palate and microcephaly

A

Patau (trisomy 13)

164
Q

learning difficulties and macrocephaly

A

Fragile X

165
Q

Haemophilia A genetics

A

x linked recessive

166
Q

Talk in short sentences (3-5 words)

A

2.5-3yrd

167
Q

Vocab of 2-6 words

A

12-18 m

168
Q

Responds to name

A

9-12m

169
Q

formula fed baby with suscpedted CMPI

A

Extensive hydrolysed formula trial

170
Q

Risk factor for DDH

A

Female sex

Firstborn

171
Q

7 features of growing pains

A

never present at the start of the day after the child has woken
no limp
no limitation of physical activity
systemically well
normal physical examination
motor milestones normal
symptoms are often intermittent and worse after a day of vigorous activity

172
Q

Amber and red flag for increased work of breathing

A

Amber: nasal flaring
Red: IC recession

173
Q

2 features of measles

A

Fever, irritable and conjunctivitis in prodrome

White spots in mouth

174
Q

Triad of shaken baby syndrome

A

retinal haemorrhages
subdural haematoma
encephalopathy

175
Q

Osgood schlatter vs Osteochondtitis dissecans

A

O-S: pain, tender and swelling over tibial tuberosity (sporty teens)
O-D: Swelling/locking after exercise

176
Q

Bronchiolitis organism

A

RSV

177
Q

What type of vaccination is rotavirus

A

Oral live attenuated vaccine

178
Q

Coryza and fever followed by red rash on both cheeks and pallor surrounding the mouth

A

Slapped cheek syndrome

Parvovirus

179
Q

Fever malaise, pink maculopapular rash on face that spreads with suboccipital lymph nodes

A

Rubella

180
Q

Investigation for necrotising enterocolitis

A

Abdo x-ray (premature, bilious vomiting)

181
Q

When is indomethacin given

A

To newborn if ECHO shows PDA 1 week after delivery

182
Q

Infantile colic vs spasms

A

Spasms (west): repeated flexion of head/arms/trunk followed by extension of arms
Colic: drawing up of legs but not repeated

183
Q

What happens in Ebstein’s anomaly

A

Tricuspid valve leaflets attached to walls and septum of right ventricle

184
Q

Management of a small umbilical hernia in neonate

A

Watch and wait

185
Q

Management of necrotising enterocolitis

A

Bacterial infection

Broad spectrum ABx

186
Q

Most common complication of measles

A

Otitis media

187
Q

Constipation medical management

A

Movicol then add senna

188
Q

4 causes of hypotonia

A

Acutely unwell child
Prader-Willi
Downs
Cerebral palsy

189
Q

What is fragile X - what does it increase the risk of

A

trinucleotide repeat disorder on x chromosome - autism

190
Q

5 signs of hypernatraemic dehydration

A 
jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness or coma
191
Q

Small testes in precocious puberty

A

Adrenal hyperplasia

192
Q

Rare complication of chicken pox

A

Necrotising fascitis (increased with NSAIDs)

193
Q

Congenital CMV presents with…

A

Hearing loss, low birth weight, petechial rash, microcephaly and seizures

194
Q

Congenital rubella syndrome presents with…

A

sensorineural deafness, eye abnormalities (e.g. retinopathy and cataracts) and congenital heart disease (especially pulmonary artery stenosis and patent ductus arteriosus)

195
Q

Failed enuresis alarm

A

Desmopressin

196
Q

Define precocious puberty in males and females

A

Secondary sex characteristics before 9 years in males and before 8 years in females

197
Q

cephalhaematoma

A

Small haematoma over the parietal bone that develop after birth

198
Q

Genetic condition associated with hirschsprungs

A

Downs

199
Q

2 month old with UTI

A

admit

200
Q

Bronchiolitis referred to hospital if (3)

A

RR above 60
50% less feed
clinical drhydration

201
Q

RF for surfactant deficient lung disease in newborn

A

MaternL DM

202
Q

Define neonatal death

A

0-28 days

203
Q

Define simple and complex febrile seizure

A

Simple: less than 15 mins, generalised, recovery in 1 hour
Complex: 15-30 mins, focal, repeats
Status epilepticus: over 30 mins

204
Q

Pincer grip

A

12 m

205
Q

Pulls to standing

A

8-10 months

206
Q

Squats to pick up a ball

A

18m

207
Q

Bow legs in a child < 3

A

a normal variant and usually resolves by the age of 4 years

Medicine Year 4 (13 decks)

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