End of block assessment

Question 1

10yrs boy has acute onset of scrotal pain. O/E the scrotum looks erythematous and swollen and is very tender on palpation. The testicle is higher and has a transverse lie on comparison to the other testicle. what is the diagnosis?

Answer 1

torsion of the testicle

Question 2

a 10months female is ill. They are fully up to date their immunisation. Which of the following will they not have received ?
Diptheria 
polio
measles
H. influenzae 
Men B
pneumococcal

Answer 2

measles

• MMR is given at 12months
• it is a live vaccine

Question 3

what vaccines are included in the 6in1 vaccine?

Answer 3

diphtheria, tetanus, whooping cough, polio, Hib (Haemophilus influenzae type b) and hepatitis B

Question 4

when is rotavirus given?

Answer 4

2 and 3 months

Question 5

what vaccines are given at the school boosters?

Answer 5

diphtheria, tetanus, whooping cough and polio

Question 6

4month M who didnt pass meconium in the first 24hrs of life has been treated with laxatives but they have not worked. The abdo is distended and abdo Xray shows dilated bowel loops. What is the diagnosis?

Answer 6

Hirsprungs disease

Question 7

what is hirsprungs disease?

Answer 7

absence of ganglion cells in rectum and sigmoid colon

Question 8

how is a diagnosis of hirsprungs disease made?

Answer 8

rectal biopsy

Question 9

what is the management of hirsprungs disease?

Answer 9

sigmoid colonostomy

resection of aganglionic section with end to end anastomosis

Question 10

what is 1st and 2nd line for GORD?

Answer 10

1 = feed thickener 
2 = oral ranitidine

Question 11

what is the treatment for ADHD?

Answer 11

methylphenidate

Question 12

what are the risks of premature low birth weight?

Answer 12

RDS, surfactant deficiency, hypoglycaemia, hypothermia, sepsis, jaundice

Question 13

what is the initial management for premature low birth weight?

Answer 13

transfer to neonatal unit for further observations

Question 14

what level of WCC and organism is required for UTI diagnosis confirmation?

Answer 14

WCC 500 
E coli (single organism) 10^5 cf./ml

Question 15

what is the diagnosis of a child with excessive crying/vomiting/blood stained stool. Unwell with poor perfusion with a mass on the R side and tender abdo?

Answer 15

intussusception

Question 16

what is the initial treatment for intussusception ?

Answer 16

fluid resuscitation

20ml/kg

Question 17

what is the diagnosis of a 5 week old child with vomiting, loosing weight and gavisicon hasn’t worked?

Answer 17

pyloric stenosis

Question 18

what is the commonest heart lesion?

Answer 18

VSD

Question 19

what is the commonest cyanotic heart lesion?

Answer 19

TOF

Question 20

what are the normal O2 sats for a child?

Answer 20

> 95%

Question 21

A child is well and non dysmorphic. O2 sats = 85% with normal pulses, grade 3/6 long ejection systolic murmur.
What is the most likely heart lesion?

Answer 21

TOF

- pulmonary stenosis causing cyanosis and murmur

Question 22

what murmur is heard with VSD?

Answer 22

pan systolic

Question 23

what murmur is heard with PDA?

Answer 23

machinery continuous murmur

Question 24

what murmur is heard with ASD?

Answer 24

wide fixed split S2, pulmonary ejection systolic murmur

2nd intercostal space L

Question 25

after SABA what medication should be used to step up on asthma management?

Answer 25

low dose inhaled corticosteroid (beclometasone)

Question 26

at what age should a child have pincer grip?

Answer 26

9months

Question 27

at what age should a child smile?

Answer 27

6 weeks

Question 28

at what age should a child have head control ?

Answer 28

4months

Question 29

a 5year M has a purple non blanching rash along the back of his thighs and ankle pain. Temp = 36.5. Urine dipstick shows proteinuria and haematuria. what is the diagnosis?

Answer 29

henoch schonlein purpura

Question 30

what systems does henoch schonlein purpura affect?

Answer 30

``` joint pain interstitial nephritis vascular colitis (require steroids) ```

Question 31

what is the body feature called when a newborn has 0.4th centile weight and 50th centile?

Answer 31

asymmetrical intrauterine growth restriction

Question 32

what at trimester insult causes asymmetrical intrauterine growth retardation ?

Answer 32

3 trimester

Question 33

what at trimester insult causes symmetrical intrauterine growth retardation ?

Answer 33

1 trimester

Question 34

what are some complications of IUDR?

Answer 34

hypoglycaemia, hypothermia, jaundice

Question 35

what is the management of IUGR?

Answer 35

temperature monitoring | temperature control

Question 36

what is the management for febrile convulsion?

Answer 36

antipyretics, fans to cool down | doesn't require investigations if the diagnosis is clear

Question 37

what advice can be given to parents about febrile convulsions?

Answer 37

may have further convulsions should given antipyretics to reduce chances of convulsion doesn't necessarily increase risk of epilepsy very common benign condition not meningitis