7&11 - Paediatrics

Question 1

Childhood vaccination schedule:

8 Weeks (3)
12 Weeks (3)
16 Weeks (2)
1 Year (4)

Answer 1

Childhood vaccination - First Year

8 Weeks:

I) 6 in 1
[Dipth, Polio, Pertusis, Tetanus, HiB, HepB]
II) Rotavirus
III) Men B

12 Weeks:

I) 6 in 1
II) Rotavirus
III) PCV

16 Weeks

I) 6 in 1
II) Men B

1 Year

I) Men B
II) Hib/MenC
III) PCV
IV) MMR

Question 2

Vaccination schedule aged 1 - 18

1 Year
2-10 Years
3 Years 4 months
12 Years
14 Years

Answer 2

Vaccinations 1-18

1 Year:
I) Men B/Hib
II) Men C
III) PCV
IV) MMR

2-10 Years:
Flu

3y4m:
I) MMR
II) 4 in 1 boost
[Polio, dipth, pertusis, tetanus]

12-13: HPV

14:
3 in 1 (Td/IPV)
[Tet, Dipth, Polio]
Men ACWY

Question 3

Viral Wheeze (< 3y) RFs

Answer 3

1. 1/3 children
2. Around smoke
3. Premature bronchiolitis

Question 4

Viral wheeze (< 3y) Tx

Answer 4

1. SABA Inhaler

2. SABA Nebulizer + Prednisolone 2-3 days

Question 5

Viral Wheeze DDs

Answer 5

1. Asthma (persistant + triggers)
2. Infection (coarse crackles + productive cough)
3. Foreign body (sudden + choking + voice change)

Question 6

Osgood Schlatter’s Presentation

Answer 6

1. Unilateral knee pain (apophysitis)
2. Growth spurt
3. Tender on exam
4. Exacerbated by exercise

Question 7

Osgood Schlatter Management

Answer 7

Osgood Schlatter’s Management

1. Paracetamol and NSAIDs (swelling)
2. Exercise modification

Question 8

Osgood Schlatter’s DDs

Answer 8

Osgood Schlatter’s DDs

1. Knee injury (trauma hx and S&S)
2. Perthes (Femoral head necrosis, males 4-8, hyper-coagulable)
3. SCFE (Slipped capital femoral epiphysis — groin or knee pain and limp, high BMI, Trendelenburg Gain)

Question 9

Toddler’s Diarrhoea History

Answer 9

Toddler’s Diarrhoea History

1-5 YO
2+ weeks diarrhoea
3+ daily stools
 - Watery
 - Pale
 - Smelly

Normal PR

Question 10

Toddler’s diarrhoea management

Answer 10

Toddler’s diarrhoea management

1. Increase fat eg. Whole milk
2. Avoid fluids
3. Avoid fruit juice

Question 11

Toddler’s diarrhoea DDs

Answer 11

1. Viral GI Infx
2. IBD
3. Intolerance
4. Caeliac

Question 12

Threadworms Treatment

Answer 12

Enterobius vulniculnaris

1. Mebendazole cream
   Twice, 14 days apart
   Whole household
2. Hygiene
3. Clean nails

Question 13

Paediatric GORD Management

Answer 13

1. 4 Weeks PPI
2. Ranitidine
3. Refer

Question 14

Paediatric GORD History

Answer 14

1. Heartburn
2. Vomitting
3. Hicupping
4. Feeding iritability
5. Reduced sleep

Question 15

Paediatric GORD DDs

Answer 15

1. Psych?
   - Reflux w/o pain
2. Migraine
3. Mesenteric adenitis:
   - recent URTI
   - diffuse pain,
   - viral lymphadenopathy (usually cervical)
   - fever

Question 16

Infantile Colic Criteria

Answer 16

Infant Colic:

1. > 3 months
2. 3+ hours of crying daily
3. 3+days of crying per week
4. 3+weeks

Knees-clutched-to-chest pain

Question 17

Infant colic Mx

Answer 17

Infant colic Mx

1. Hold and rock baby
2. Warm baths
3. White noise/TV

Question 18

Four elements of child development?

Answer 18

Child development

1. Gross motor
   Sitting/support
   Walking
2. Fine motor + Vision
3. Speech and language
4. Social interaction

Question 19

Child development milestones?

Answer 19

Child development milestones:

Newborn:
Symmetrical flexed posture
Head-lag on pulling-up

6-8 weeks:
Raises head when prone

6-8 months:
Sits

10months
Stands

12-18 months
Walks

2-2.5 years
Walks steadily, runs, jumps

Question 20

Baby bac meningitis

- Mx

Answer 20

NICE - Bacterial Meningitis

1. Older than 3/12
   - IV Ceftriaxone
2. Younger than 3/12
   - IV Amoxicillin or ampicillin
3. Travelled outside UK
   - Vancomycin in addition
4. If on calcium-containing infusions
   - Cefotaxime

Question 21

Baby rash

- Red Flags

Answer 21

Baby rash - red flags

1. Fever
2. Drowsy
3. Meningism

Question 22

Child cough

- Red flags

Answer 22

Child cough: red flags

1. High fever
2. Unwell
3. ‘Up and down’
4. Not eating or drinking

Question 23

Baby Crying - ICON

1. Acronym
2. Aims

Answer 23

1. ICON

I Infant crying is normal
C Comforting can help
O Ok to walk away
N Never, ever shake a baby

2. Prevention of abusive head trauma

Question 24

Infant development

- 0-3 months

Answer 24

0-3 months development

GM

1. Raise head
2. Hands to mouth

FM

3. Grip objects
4. Swipe at objects

Social

5. Smile and return smile
6. Track objects

Question 25

Infant development | - 4-6 months

Answer 25

4-6 months development 1. Roll front-to-back - and back-to-front 2. Speech-like sounds 3. Laugh 4. Grab objects 5. Sit up with support

Question 26

Infant development | - 7-9 months

Answer 26

7-9 months development 1. Start to crawl - Shuffle, army, hands and knees 2. Sit unsupported 3. Respond to name 4. Mama and Dada 5. Clap and play peekaboo 6. Pull up into standing

Question 27

Infant development | - 10-12 months

Answer 27

10-12 months development 1. Pincer grasp 2. Feeding 3. Moving around on foot 4. Three-ish words 5. Point 6. Pretend-play actions 7. First steps

Question 28

Bronchiolitis | - S&S

Answer 28

Bronchiolitis S&S < 3YO, prematurity, Winter 1. Cough 2. Tachypnoea 3. Wheezing 4. Retractions, grunting, flaring 5. Fever/rhinitis

Question 29

Infantile colic | - S&S

Answer 29

Infantile colic S&S 1. RFs - 5mo, food sensitive - cigarette smoke, psychosocial 2. Generally well - Normal urine - No recurrent vomiting - Normal temperature - No diarrhoea - Normal abdomen and ear

Question 30

Infantile colic | - Mx

Answer 30

Infantile Colic Mx 1. Upright feeding - Burping after feeding - Well fitting bottle 2. Elimination diet 3. Reassurance

Question 31

Mesenteric adenitis | - S&S

Answer 31

Mesenteric adenitis S&S 1. Diffuse abdo pain 2. Recent URTI 3. Fever 4. Abdo tenderness 5. Rhinorrhoea 6. Hyperaemic pharynx

Question 32

Pediculosis capitis | - Mx

Answer 32

Headlice management <2 mo 1. Mechanical removal 2. Treatment of contacts >2mo 1. Pediculicide - Dimeticone (physical) - Permethrin/Pyethrin 2. Benzyl alcohol/ivermectin 3. Contacts 4. Mechanical/occlusive - Combing + Petrolium Jelly