Capsule - Mixed

Question 1

What is included in a baby septic screen?

Answer 1

Bloods, LP, urine dipstick

Question 2

What bacteria level is a UTI confirmed?

Answer 2

> 10^5 colony of urine

Question 3

What is the most common UTI bacteria?

Answer 3

E. coli

Question 4

When is a DMSA scan required in children with UTI?

Answer 4

Klebsiella UTI <6 months old - atypical UTI

Question 5

Ix for UTI in under 6 months old

Answer 5

USS urinary tract

Question 6

Ix for atypical UTI

Answer 6

USS urinary tract acutely
DMSA scan after 4-6 months if under 3
MCUG if under 6 months old

Question 7

Features of atypical UTI

Answer 7

Seriously I’ll
Septic
Poor urine flow
Abdo or bladder mass
Raised serum creatinine
Non E. coli

Question 8

Ix recurrent UTI

Answer 8

USS urinary tract
DMSA 4 to 6 months later
MCUG if under 6 months

Question 9

What is vesicouretic reflux?

Answer 9

Incompetent valve at vesicouretic junction allowing reflux of infected urine to kidneys

Question 10

How common is vesicouretic reflux?

Answer 10

30%

Question 11

Complication of vesicouretic reflux

Answer 11

Pyelonephritis and renal scaring

Question 12

How do you confirm vesicouretic reflux?

Answer 12

Micturating cystourethrogram following uti

Question 13

Mx of vesicouretic reflux

Answer 13

Long term abx and surveillance

Question 14

Age peak of pyloric stenosis

Answer 14

4-6 weeks

Question 15

What is pyloric stenosis

Answer 15

Hypertrophy of pylorus

Question 16

Sx of pyloric stenosis

Answer 16

Projectile vomiting during or just after feeding
Hungry immediately after vomiting
Constipation

Question 17

Sex preference in pyloric stenosis

Answer 17

Male 7:1

Question 18

Physical examination findings of pyloric stenosis

Answer 18

USS prior to Sx
Weight loss, dehydration
Visible peristalsis of stomach
Olive sized tumour in RUQ

Question 19

What blood features are found in pyloric stenosis

Answer 19

Hypocholoraemic alkalosis with low K and Na

Question 20

Mx of pyloric stenosis

Answer 20

Rehydration
Surgical correction

Question 21

What surgery is done in pyloric stenosis s

Answer 21

Ramstedt procedure - slice through pyloric muscle

Question 22

What is the most important thing to remember in testicular torsion Mx?

Answer 22

The other testicle has an increased risk of torsion

Question 23

Ix for testicular torsion?

Answer 23

NONE - do it clinically as quick as possible
Can have USS but do not wait for this

Question 24

Causes of undescended testes?

Answer 24

Incompetent descent of testes
Hypopituartism

Question 25

Sx of cryptorchodism?

Answer 25

No Sx Impalpable testes or high in scrotum / inguinal region

Question 26

Risks of cryptorchidism?

Answer 26

Malignancy and infertility

Question 27

Mx of cryptorchidism?

Answer 27

Orchidoplexy

Question 28

Age peak intussusception ?

Answer 28

3 months to 2 years

Question 29

Most common type of intussusception

Answer 29

Ileo-caecal

Question 30

Sx of intussusception

Answer 30

Episodic screaming but comfort between attacks 20% apathetic or encephalopathy Passage of red current jelly stool

Question 31

Physical examination of intussusception

Answer 31

Pallor Sausage shaped mass on R abdo Blood on PR

Question 32

Ix of intussusception and findings

Answer 32

AXR - dilated small bowel loops USS - invaginated bowel

Question 33

Mx of intussusception

Answer 33

Reduction by air or contract enema Surgery

Question 34

When do you find the red current jelly stool in intussusception

Answer 34

LATE in the course

Question 35

Ddx of intussusception

Answer 35

Any acute painful illness eg otitis media or appendicitis

Question 36

Features of haemolytic uraemic syndrome?

Answer 36

Renal failure / nephropathy Microangiopathic haemolytic anaemia Thrombocytopenia

Question 37

What causes HUS

Answer 37

E. coli 01571 H7 - from petting zoo

Question 38

Sx of HUS

Answer 38

Abdo pain jaundice bloody diarrhoea Anuria oedema

Question 39

Ix of HUS

Answer 39

FBC clotting renal func stool culture BP fluid balance and daily weights

Question 40

Complications of HUS

Answer 40

Encephalopathy and pancreatitis

Question 41

Tx of HUS

Answer 41

Dialysis fluid management red cell transfusion antihypertensives

Question 42

Prognosis of HUS

Answer 42

5% death and 25% long term sequaelae

Question 43

Features of measles

Answer 43

Cough, Coryzz, rash, fever, koplik spots in mouth, conjunctivitis

Question 44

Incubation of measles

Answer 44

10-14 days

Question 45

Measles complications

Answer 45

Otitis media, subacute sclerosing pan encephalitis , pneumonia and encephalitis

Question 46

Molluscum features?

Answer 46

Red bumps with central punctum

Question 47

Age peak for febrile seizures?

Answer 47

6 months to 6 years

Question 48

How long are febrile seizures?

Answer 48

Few minutes

Question 49

3 bacteria that cause otitis media

Answer 49

Streptococcus Haemophilus influenza M. catarrhalis

Question 50

Worrying features of febrile seizures

Answer 50

Unilateral symptoms Long lasting seizure Raised ICP red flags

Question 51

Worrying features of headache suggesting serious intracranial pathology

Answer 51

Deterioration of handwriting New squint Ataxia Waking in night with pain Early morning vomiting with headache

Question 52

How is BR produced?

Answer 52

Breakdown of RBCs

Question 53

How does unconjugated BR circulate?

Answer 53

With albumin

Question 54

Where is BR conjugated?

Answer 54

Liver

Question 55

What does BR cause in body?

Answer 55

Brown poo and yellow wee

Question 56

Is conjugated hyperBR pathological or not?

Answer 56

ALWAYS pathological

Question 57

Is <24hr old with hyperBR pathological or not?

Answer 57

ALWAYS pathological

Question 58

What can hyperBR in baby cause?

Answer 58

Kernicterus

Question 59

What is kernicterus?

Answer 59

Athetosis High risk of CP High risk of sensorineural deafness

Question 60

What signs are present in baby in biliary atresia?

Answer 60

Dark urine, pale stools