Corrections - 3

Question 1

Average age for the following milestones:

a) sit without support with a straight back

b) run

c) ride a tricycle

Answer 1

a) 7-8m
b) 16m-2y
c) 3y

Question 2

Mx of a diaphragmatic hernia?

Answer 2

1) insertion of NG tube (with the aim of keeping air out of the gut)

2) intubate & ventilate in cyanosed patients

3) surgical repair

Question 3

Is whooping cough a notifiable disease?

Answer 3

Yes

Question 4

Head size in Fragile X?

Answer 4

Macrocephaly

Question 5

Testes size in Fragile X?

Answer 5

Large testes (macro-orchidism)

Question 6

Mx of small umbilical hernias in babies?

Answer 6

tend to resolve by 12 months of age –> reassurance

Question 7

What heart defect is most commonly associated with Fragile X?

Answer 7

Mitral valve prolapse

Question 8

Mx of scarlet fever?

Answer 8

oral penicillin V for 10 days

Question 9

Is scarlet fever a notifiable disease?

Answer 9

Yes

Question 10

What is HSP?

Answer 10

IgA vasculitis

The most common form of systemic vasculitis in children.

Question 11

Classic 4 features of HSP?

Answer 11

1) rash
2) abdo pain
3) arthritis/arthralgia
4) glomerulonephritis

Question 12

What do about 50% of cases of HSP follow?

Answer 12

URTI (mainly strep)

Question 13

Describe rash in HSP

Answer 13

Typically symmetrically distributed, non-blanching palpable purpura, especially on the lower legs, buttocks, knees and elbows.

Question 14

What joints are most affected by arthritis/arthralgia in HSP?

Answer 14

The knees and ankles are most often affected.

Question 15

What is a common GI complication in HSP?

Answer 15

Intussusception

Question 16

Renal features of HSP?

Answer 16

Vary from mild (i.e., asymptomatic haematuria and/or proteinuria) to severe (i.e., rapidly progressive nephritis, nephrotic syndrome, and renal failure).

Question 17

Diagnosis of HSP?

Answer 17

Clinical

Question 18

Whwat monitoring is required in HSP?

Answer 18

Patients should be followed for at least 6 months with periodic urinalysis and BP monitoring.

Question 19

Average age that a child would pull to stand?

Answer 19

8-10 months

Question 20

Average age that a child would squat to pick up a ball?

Answer 20

18m

Question 21

Average age that a child would hop on one leg?

Answer 21

3y-4y

Question 22

In X-linked recessive conditions, what is the chance of a female child of a heterozygous female carrier being a carrier?

Answer 22

50%

Question 23

Inheritance of thalassaemia?

Answer 23

Autosomal recessive

Question 24

What genetic syndrome can cause a small chin, posterior displacement of the tongue and cleft palate?

Answer 24

Pierre-Robin syndrome

Question 25

1st & 2nd line mx of a viral-induced wheeze?

Answer 25

1st --> SABA 2nd --> LTRA (oral montelukast) or ICS

Question 26

Role of abx in whooping cough?

Answer 26

Does not alter the course of the illneess, but has been shown to reduce the spread.

Question 27

Mx of children below the 2nd centile for height?

Answer 27

Should be reviewed by their GP

Question 28

Mx of children below the 0.4th centile for their height?

Answer 28

Should be reviewed by a paediatrician

Question 29

Location of eczema in: a) infants b) younger children c) older children

Answer 29

a) face and trunk b) extensor surfaces c) flexor surfaces (typical distribution)

Question 30

1st line investigation in asthma in children aged 5-16 y/o?

Answer 30

FeNO Diagnose asthma if FeNO ≥35

Question 31

2nd line investigation in asthma in children aged 5-16 y/o if FeNO is normal?

Answer 31

measure bronchodilator reversibility (BDR) with spirometry

Question 32

What translocation is Burkitt's lymphoma often associated with?

Answer 32

c-myc gene translocation

Question 33

Poor prognostic features of ALL?

Answer 33

1. age < 2 years or > 10 years 2. WBC > 20 * 109/l at diagnosis 3. T or B cell surface markers 4. non-Caucasian 5. male sex

Question 34

Mx of otitis media with effusion if symptoms persist following 3m period of active observation?

Answer 34

Refer to ENT for further mx 'Refer a child with glue ear to ENT if they have persisting significant hearing loss on two separate occasions (usually 6-12 weeks apart)'

Question 35

Mx of chickenpox?

Answer 35

Supportive & calamine lotion for itch Only consider aciclovir in immunodeficient children.

Question 36

Presentation of migraines in paeds vs adults

Answer 36

Migraines in children often present with bilateral pain rather than the unilateral pain more commonly seen in adults.

Question 37

Mx of pityriasis versicolor?

Answer 37

Ketoconazole 2% shampoo

Question 38

Descriibe prodrome in measles

Answer 38

irritability, conjunctivitis & fever

Question 39

Eczema herpeticum is a primary infection of the skin caused by HSV and uncommonly what?

Answer 39

Coxsackie virus

Question 40

FBC features of ALL?

Answer 40

1) anaemia 2) neutropenia (frequent or severe infections) 3) thrombocytopenia

Question 41

How is a diagnosis of epiglottitis made?

Answer 41

direct visualisation of inflamed tissue performed by senior, airway trained staff

Question 42

CPR technique in children <1 y/o & >1y/o?

Answer 42

<1 y/o: two thumb encircling >1 y/o: compress the lower half of the sternum

Question 43

What is the limit age for smiling responsively?

Answer 43

8 weeks

Question 44

Inheritance of androgen insensitivity syndrome?

Answer 44

X-linked recessive

Question 45

How long before being able to draw a shape are children able to copy it?

Answer 45

Usually 6 months

Question 46

What is the most common cause of 1ary amenorrhoea?

Answer 46

Turner's

Question 47

What genetic syndrome might you see polydactyly?

Answer 47

Patau (18)

Question 48

What are the 4 key features of Edward’s syndrome (trisomy 18)?

Answer 48

1) Rocker bottom feet 2) Overlapping fingers 3) Micrognathia 4) Low set ears

Question 49

How can you distinguish Down’s syndrone and Edwards/Patau syndrome on combined test?

Answer 49

Similar results but lower hCG

Question 50

Typical feed requirements after first week until weaning?

Answer 50

150 mls/kg/day

Question 51

Define overweight & obese regarding centiles

Answer 51

Overweight: >91st Obese: >98th

Question 52

Key investigations in precocious puberty? (2)

Answer 52

1) MRI brain 2) Scan pelvis & adrenals

Question 53

Inheritance of Kallman’s?

Answer 53

X-linked recessive