Formative Flashcards
(25 cards)
A healthy 14-month-old boy, born at term, presents for routine assessment with his health visitor.
Assuming normal development, up to what milestones/skills is he likely to have attained?
A. Rolling, reaching, smiling
B. Running, scribbling with a crayon, using simple sentences
C. Sitting, transferring bricks, 2 syllable babble
D. Taking steps, pincer grasp, saying 1-2 words with meaning
E. Walking up stairs, circular scribbles, saying 30-50 words
D. Taking steps, pincer grasp, saying 1-2 words with meaning
A healthy 14-month-old boy, born at term, presents for routine assessment with his health visitor.
Assuming a normal UK immunisation schedule, which of the following conditions will he not have been immunised against?
A. Chicken Pox B. Haemophilus Influenzae Type B C. Meningococcal Disease Type B D. Polio E. Tetanus
A. Chicken Pox
A healthy baby girl is born at term via forceps delivery. She is noted to have several small irregular, flat, pink, blanching marks on her left upper eyelid and just below the hair line on the posterior aspect of her neck.
What is the most likely diagnosis?
A. Capillary naevi B. Delivery related bruising C. Epsteins pearl D. Melanotic naevi E. Mongolian spot
A. Capillary naevi
A healthy girl is seen for routine review by their health visitor. She can pull herself to stand but does not walk independently. She has a pincer grasp but doesn’t stack bricks or hold a crayon. She has polysyllabic babble and 2 specific words. She will push food to her mouth and is able to waive bye-bye and seems comfortable with strangers.
Assuming a normal pattern of development, how old is this girl likely to be?
A. 3 Months B. 7 Months C. 11 Months D. 15 Months E. 19 Months
C. 11 Months
A baby girl is born at 37 weeks gestation weighing 1800 grams.
Which of the following is common during the first few days of life in babies born small for dates?
A. Anaemia B. Hyperthermia C. Hyperkalaemia D. Hypoglycaemia E. Thrombocytosis
D. Hypoglycaemia
A baby girl is born at 41 weeks gestation weighing 3.2kg. She develops apnoeas on the postnatal ward and has temperature instability. She is admitted to neonatal intensive care. Gram negative bacilli are identified in blood and CSF cultures.
What pathogen is most likely to be responsible for this girl’s symptoms?
A. Escherichia-coli B. Group B Streptococcucs C. Klebsiella pneumoniae D. Neisseria meningitidis E. Pseudomonas aeruginosa
A. Escherichia-coli
A baby boy is born at 26 weeks gestation. He is intubated and ventilated for respiratory distress syndrome and transferred to an incubator. His fist recorded temperature is 35.5OC.
Which of the following is an adverse effect of cold stress on a neonate?
A. Decreased energy expenditure B. Decreased oxygen consumption C. Decreased surfactant production D. Metabolic alkalosis E. Pulmonary hypotension
C. Decreased surfactant production
A baby boy is born at 26 weeks gestation. He is intubated and ventilated for respiratory distress syndrome and transferred to an incubator. His fist recorded temperature is 35.5OC.
Which of the following is not a typical associated complication of extreme preterm delivery?
A. Broncho-Pulmonary Dysplasia B. Intra-Ventricular Haemorrhage C. Necrotising Enterocolitis D. Neonatal Abstinence syndrome E. Patent Ductus Arteriosus
D. Neonatal Abstinence syndrome
A 3 week old breast fed Italian baby girl, born at term, presents for assessment of jaundice. Her jaundice was most visible on day 4 and is still present on her nose and conjunctivae. She has pale yellow urine and yellow-brown stools. Her investigations show a serum bilirubin of 150 micromols/l (Normal 5-40)- 5% of which is conjugated. Her haemoglobin and blood film are normal.
What is the most likely diagnosis?
A. ABO Incompatibility
B. Congenital biliary atresia
C. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
D. Prolonged physiological jaundice/ Breast Milk Jaundice
E. Rhesus Incompatibility
D. Prolonged physiological jaundice/ Breast Milk Jaundice
A 9 month old baby presents with 2 days of increasing episodic distress. She is described as looking very pale during these with colour returning to normal afterwards. She has had 3 vomits today that were described as “green.” She has had no stools for 36h. A small mass can be felt in her right iliac fossa.
What is the most likely diagnosis?
A. Intussusception B. Malrotation C. Pyloric stenosis D. Tetralogy of Fallot E. Urinary Tract infection
A. Intussusception
A 2 year old boy presents to primary care with a 2 day history of cough and runny nose. On further questioning he has a 6 month history of foul smelling stools, food refusal and lethargy. His weight has dropped from the 50th to the 2nd centile over the last 12 months.
What is the most likely diagnosis?
A. Coeliac disease B. Constipation C. Failure to thrive D. Food refusal of toddlerhood E. Psychosocial deprivation
A. Coeliac disease
A 4 y old boy presents after his parents noticed “red stuff” in his urine and were concerned this was blood. He has had a recent upper respiratory tract infection. Mothers grandfather had a “kidney problem” but is not sure what type.
Which of the following is not typically associated with macroscopic haematuria?
A. IgA Nephropathy B. Minimal Change Nephrotic Syndrome C. Post Infectious Glomerulonephritis D. Renal angle trauma E. Wilm’s Tumour
B. Minimal Change Nephrotic Syndrome
A 10 year old girl is referred for assessment of short stature.
Which of the following is not associated with short stature in girls?
A. Coeliac disease B. Hypothyroidism C. Klinefelter’s Syndrome D. Prader Willi Syndrome E. Turner’s Syndrome
C. Klinefelter’s Syndrome
A 13 year old boy presents with a 2 month history of right sided limp and knee pain whilst exercising. There is no fever and he is otherwise well. Examination shows limited internal rotation of his right hip. His full blood count and ESR are normal.
What is the most likely diagnosis?
A. Congenital hip dysplasia B. Perthe’s disease C. Reactive arthritis D. Septic arthritis E. Slipped upper femoral epiphysis
E. Slipped upper femoral epiphysis
A 12y girl attends hospital for the first time for assessment of short stature. Subsequent investigation reveals a 45XO karyotype.
What abnormality may be identified following further assessment and investigation?
A. Bilateral renal agenesis B. Coarctation of the aorta C. Duodenal atresia D. Imperforate anus E. Transposition of the great arteries
B. Coarctation of the aorta
A 5y old boy has recently presented to the ward with an abdominal mass. Further investigation reveals a probable neuroblastoma. He is started on chemo therapy. Subsequent blood tests identify elevated blood levels of urea, creatinine, potassium, phosphate and urate.
Which of the following is correct for his IV fluid management?
A. Fluid Excess (Hyper-hydration, 2.5l/m2) is necessary
B. Fluid restriction (Hypo-hydration, 0.1l/m2) is necessary
C. He should receive oral rehydration solution only
D. Potassium should be infused slowly with his IV fluids
E. Potassium should be infused quickly with his IV fluids
A. Fluid Excess (Hyper-hydration, 2.5l/m2) is necessary
- A 4 month old baby boy presents with worsening respiratory distress secondary to bronchiolitis.
Relative to an adult what anatomical or physiological factor must be considered in this boy when planning his clinical care?
A. Decreased chest wall compliance B. Fewer type 1 respiratory muscle fibres C. Higher systemic vascular resistance D. Larger area for air tissue interface E. Smaller surface area to weight ratio
B. Fewer type 1 respiratory muscle fibres
A 12-month-old girl presents to primary care with a 3 day history of sneezing, runny nose and cough. She has a temperature of 37.8OC, mild sub-costal recession and bilateral wheeze with scattered crepitations. She has bilateral pink tympanic membranes and mildly erythematous fauces.
What is the most appropriate initial treatment?
A. Intravenous Cefotaxime B. Intravenous Benzlypenicillin C. No Medical therapy D. Oral Amoxicillin E. Oral Trimethoprim
C. No Medical therapy
A 12 month old girl presents to A+E with fever, vomiting lethargy and a non-blanching rash. She is pale, clammy and peripherally shut down. It is decided to initiate immediate antibiotic therapy.
What weight should be estimated to guide initial treatment?
A. 5kg B. 10kg C. 15kg D. 20kg E. 25kg
B. 10kg
A 4-year-old boy is brought in to the Accident and Emergency department following a witnessed episode of choking. He is unconscious with no evidence of any respiratory effort or cough.
What is the most appropriate action?
A. Administer 5 back blows
B. Administer 5 abdominal thrusts
C. Administer 15 chest compressions
D. Encourage cough and continue to check for deterioration
E. Open the airway and administer 5 rescue breaths
E. Open the airway and administer 5 rescue breaths
A male child is found to have an injury.
Which of the following does NOT suggest non-accidental injury?
A. A 3 hour old baby with a clavicle fracture
B. A 3 week old baby with a bruise on the right ear
C. A 6 week old baby with a torn frenulum
D. A 3 month old infant with a humeral fracture
E. A 3 month old infant with a rib fracture
A. A 3 hour old baby with a clavicle fracture
A 9 month old girl is admitted following a febrile UTI. She is treated with IV antibiotics. The consultant wants to know if she will develop renal scarring.
Which the following investigations would be most useful for this?
A. Abdominal Computerised Tomography (CT) B. DMSA (Isotope scan) C. MAG3 Renogram D. Micturating Cystourethrogram (MCUG) E. Renal Ultrasound
B. DMSA (Isotope scan)
- A 3 day old baby presents with bilious vomiting for 2 days. Examination shows she is lethargic. Her heart rate is 180. She has cold peripheries and a respiratory rate of 70.
Which is the most appropriate type of fluid to use immediately?
A. 0.45% Sodium Chloride + 5% Dextrose with potassium
B. 0.45% Sodium Chloride + 5% Dextrose without potassium
C. 0.9% Sodium Chloride without potassium
D. 5% Dextrose with potassium
E. 10% Dextrose with potassium
C. 0.9% Sodium Chloride without potassium
A 6y old boy is being reviewed on the ward round after presenting the previous day following a first afebrile generalised tonic-clonic seizure. He has fully recovered and is currently playing. His blood sugar was not checked on arrival.
Which of the following is correct regarding further investigation?
A. A blood sugar should be performed immediately
B. A normal EEG excludes epilepsy
C. An ECG should be performed before discharge
D. Blood for genetic and metabolic studies should be sent
E. Performing an EEG will be diagnostic for epilepsy
C. An ECG should be performed before discharge
