Acute Child

Question 1

Most common childhood presentation (primary care)

Answer 1

Bronchiolitis

Question 2

Most common acute childhood presentation (secondary care)

Answer 2

Sepsis

Question 3

What is bronchiolitis? What is it called by?

Answer 3

An acute inflammation of the bronchioles

Viral (RSV)

Question 4

What is the X-ray sign for croup?

Answer 4

Steeple sign

Question 5

What is the treatment for croup?

Answer 5

Steroids

Question 6

What are some non-epilepsy causes of seziure

Answer 6

Febrile seizure, vasovagal, reflex, anoxic seizure

Question 7

What age does: congenital pyloric stenosis, volvulus, intussuception, malrotation present?

Answer 7

Infant

Question 8

What age group does appendicitis and testicular torsion present?

Answer 8

Children

Question 9

How does pyloric stenosis present in children?

Answer 9

Projectile vomiting AFTER feeding. Hungry baby. Palpable mass on stomach.

Question 10

How is pyloric stenosis diagnosed and treated?

Answer 10

Diagnosed: USS
Treated: Pyloromyotomy

Question 11

What age does pyloric stenosis occur?

Answer 11

4-6 weeks

Question 12

What age does intussuception present? What are the symptoms?

Answer 12

6 months
Infrequent & absent stools
Sausage shaped mass on abdomen

Question 13

How is intussuception diagnosed?

Answer 13

USS (shows a kidney bean, multi-layered bowel)

Question 14

What age does malrotation present? What are the symptoms?

Answer 14

New-born period.

Presents with green bile vomiting.

Question 15

How is malrotation diagnosed

Answer 15

Upper GI contract with follow through

Question 16

What age does peritonitis / appendicitis usually present?

Answer 16

6 years

Question 17

How does peritonitis present

Answer 17

Acute abdomen pain, worse on driving / bumping/ child will be unable to jump

Question 18

How is early appendicitis pain different from late appendicitis pain?

Answer 18

Early appendicitis is visceral and late is somatic (due to peritonitis)

Question 19

What is the Hydatid of Morgani?

Answer 19

Appendix testis - a remanent of the Mullerian duct

Question 20

What is blue dot sign indicative of?

Answer 20

Appendix testis

Question 21

Where will pain be present in appendix testis torsion?

Answer 21

Top of testis

Question 22

What is the cause of testicular torsion?

Answer 22

Spermatic cord twisting

Question 23

How is testicular torsion confirmed?

Answer 23

USS of scrotum

Question 24

How can epididmytis be differentiated from testicular torsion?

Answer 24

Epididymitis presents with swelling and discoloured scrotum and a fever (note: torsion can sometimes present with a low-grade fever)

Question 25

Undescended testis is a risk factor for which cancer

Answer 25

Testicular

Question 26

Describe some indications for circumcision

Answer 26

Balanitis xerotica obliterans | Severe phimosis

Question 27

Investigation of choice in a new-born child with green vomiting?

Answer 27

Plain AXR (volvulus and malrotation are both possible)

Question 28

Jaundice due to haemolysis will present at what period after birth?

Answer 28

First 24 hours

Question 29

When does breastfeeding jaundice present?

Answer 29

3-12 weeks after birth

Question 30

When does physiological jaundice present?

Answer 30

From 3 days to 2 weeks

Question 31

How long does obstructive jaundice tend to last in the newborn?

Answer 31

Prolonged (14 days in term, 21 in preterm)

Question 32

Causative agent of croup

Answer 32

Viral (often parainfluenzae virus)

Question 33

Spot diagnosis: A 10 month old infant went to bed well but had a mild cough that evening. The infant woke up around midnight severely distressed with a cough associated with a harsh sound while breathing.

Answer 33

Croup

Question 34

What is encopresis?

Answer 34

Normal stools but abnormal places (e.g. smearing on walls)

Question 35

What are the 2 "physiological" reasons for short stature?

Answer 35

1) Familial (short parents) | 2) Constitutional Delay (undernourished, stress)

Question 36

What are the characteristics of a pathological heart murmur?

Answer 36

Any diastolic murmur

Question 37

What's the most common heart murmur in kids?

Answer 37

Innocent

Question 38

Which % of children with functional abdominal pain go on to develop anxiety disorder as an adult?

Answer 38

30%

Question 39

What essential facts should be included in a referral letter (from GP to paediatric outpatient clinic)? (5)

Answer 39

1) All relevant information (PC, PMH, DH.. etc.) 2) General health include: growth, height, weight, OFC with centiles & development history 3) Relevant SH (e.g. is child in care) 4) Parental Concerns 5) School impact (if any)

Question 40

If an infant <1 year old is choking, what is the recommended intervention?

Answer 40

5x back blow then chest thrusts

Question 41

If a child >2 year old is choking, what is the recommended intervention?

Answer 41

Abdominal thrusts

Question 42

Key difference in CPR with infants?

Answer 42

Don't overextend head (this will shut-off airway)