child health

Question 1

scarlet fever typical presentation

Answer 1

children aged 2-6
- fever
- malaise, headache, N/V
- sore throat
- bright red and bumpy ‘strawberry’ tongue
- coarse erythematous ‘sandpaper’ rash: fine punctuate erythema which generally appears first on torso and spares palms and soles, more obvious (confluent) in flexures - often have flushes appearance + circumoral pallor

Question 2

scarlet fever management

Answer 2

oral penicillin V for 10 days
azithromycin if allergic
can return to school within 24hrs after commencing abx

Question 3

DKA - when should senior review be sought

Answer 3

if ketonaemia and acidosis have not been resolved within 24hrs of admission (senior endocrinologist)

Question 4

initial insulin therapy in DKA

Answer 4

IV FRII at 0.1 unit/kg/hr

Question 5

DKA: when blood glucose __ what should be done

Answer 5

once blood glucose is < 14 mmol/l an infusion of 10% dextrose should be started at 125 mls/hr in addition to the 0.9% sodium chloride regime

Question 6

West’s syndrome / infantile spasms typical presentation + EEG finding

Answer 6

typically first 4-8mo of life
often assoc with a serious underlying condition - poor prognosis

features
characteristic ‘salaam’ attacks: flexion of the head, trunk and arms (forward bending/nodding motion) followed by extension of the arms - can look like other benign movements e.g. startle reflex / colic
developmental delay

EEG - HYPSARRHYTHMIA

CT/MRI - abnormal