Medical Paediatrics

Question 1

What is the difference between an allergy and an intolerance?

Answer 1

Allergy is immune-mediated reaction while intolerance is direct effect of the protein on you

Question 2

Which kind of allergic reaction may be difficult to differentiate from a food intolerance?

Answer 2

Delayed (Type 4) hypersensitivity

Question 3

What investigations may be carried out in suspected immediate food allergy?

Answer 3

Specific IgE
Skin prick tests
Food challenge

Question 4

Give some treatment options for food allergy.

Answer 4

Avoid allergen
Anti-histamines
Adrenaline
Immunotherapy

Question 5

Children tend to grow out of egg allergy by age…

Answer 5

3

Question 6

How are immediate food allergies mediated?

Answer 6

IgE

Question 7

How are delayed food alleries mediated?

Answer 7

Cell

Question 8

Give common symptoms of immediate allergy.

Answer 8

Angio-oedema, urticaria

Question 9

Give common symptoms of delayed food allergy.

Answer 9

GI symptoms, rash

Question 10

Give an example of a delayed food allergy.

Answer 10

Cow’s Milk Protein allergy

Question 11

What is the prevalence of Cystic Fibrosis?

Answer 11

1 in 2500 live births

Question 12

What is the defect in CF?

Answer 12

Faulty CFTR protein

Question 13

What are the main symptoms experienced by patients with CF?

Answer 13

Recurrent resp infection
Pancreatic insufficiency
Liver disease
Portal hypertension
Gallstones

Question 14

What infection control measures are needed for patients with CF?

Answer 14

Need to stay away from other with CF and be nursed in a side room when in hospital

Question 15

What is the most common presentation of CF?

Answer 15

Newborn screening

Question 16

How may CF present in neonates?

Answer 16

Meconium ileus

Question 17

What is the gold-standard test for CF?

Answer 17

Sweat test

Question 18

What are children with CF treated with?

Answer 18

Trikafta

Question 19

Can people with CF have children?

Answer 19

Males cannot but women can

Question 20

Most likely cause of loss of red reflex in 2 y/o…

Answer 20

Retinoblastoma

Question 21

What is the next step in asthma treatment for children if SABA + ICS does not control symptoms?

Answer 21

Leukotriene Receptor Antagonist

Question 22

What are the 3 shunts of foetal circulation?

Answer 22

Ductus venosus
Foramen ovale
Ductus arteriosus

Question 23

What kinds of shunt do the ductus arteriosus and foramen ovale create?

Answer 23

R –> L

Question 24

What kind of shunt is found in normal neonatal circulation?

Answer 24

L –> R

Question 25

What kind of shunt is found in cyanotic congenital heart conditions?

Answer 25

R --> L (bypasses lungs, hence cyanosis)

Question 26

Give examples of cyanotic congenital heart defects.

Answer 26

5T's: - Truncus arteriosus - Transposition of the great vessels - Tricuspid atresia - Tetralogy of Fallot - Total Anomalous Pulmonary Venous Connection

Question 27

Cyanosis from birth suggests...

Answer 27

Transposition of the great vessels

Question 28

Cyanosis from a few months old suggests...

Answer 28

Tetralogy of Fallot

Question 29

Which abnormalities make up Tetralogy of Fallot?

Answer 29

Pulmonic stenosis, RVH, VSD and over-riding aorta

Question 30

Acyanotic CHD may present with...

Answer 30

signs of heart failure eg. SOB, poor feeding, failure to thrive

Question 31

Give examples of acyanotic CHD.

Answer 31

ASD, VSD, PDA, coarctation of the aorta

Question 32

Petechial rash, no fever after respiratory infection suggests...

Answer 32

ITP

Question 33

Joint pain and 'salmon pink rash' suggests...

Answer 33

Juvenille Idiopathic Arthritis (Still's Disease)

Question 34

Young adult with knee pain after exercise with swelling/locking suggests,,,

Answer 34

Osteochondritis dissecans

Question 35

Microcephaly, cleft lip/palate and polydactyly suggests...

Answer 35

Patau Syndrome (Trisomy 13)

Question 36

What is the prognosis for Patau Syndrome?

Answer 36

Life-limiting - usually before 5

Question 37

Micrognathia, Low-set ears, Rocker-bottom feet | and Overlapping of fingers suggests...

Answer 37

Edward's Syndrome (Trisomy 18)

Question 38

What is the prognosis for Edward's Syndrome (Trisomy 18)?

Answer 38

Usually die before or shortly after birth

Question 39

Upslanting palpebral fissures, single palmar crease | and small, low-set ears suggests...

Answer 39

Down's Syndrome

Question 40

LD, long face, macrocephaly, large ears suggests...

Answer 40

Fragile X Syndrome

Question 41

Webbed neck, pectus excavatum, short stature, pulmonary stenosis suggests...

Answer 41

Noonan Syndrome

Question 42

Which cardiac complications are associated with Marfan Syndrome?

Answer 42

Mitral valve prolapse and aortic aneurysm/dissection

Question 43

Karyotype = 45 X suggests...

Answer 43

Turner's Syndrome

Question 44

Short stature, premature ovarian failure (in childhood) suggests...

Answer 44

Turner's Syndrome

Question 45

Delay/absence of puberty with anosmia suggests...

Answer 45

Kallmann syndrome

Question 46

Which condition is associated with ambiguous external genitalia in females?

Answer 46

Congenital Adrenal Hyperplasia

Question 47

Which cardiac abnormality is associated with Turner's syndrome?

Answer 47

Aortic coarctation

Question 48

Dyskinetic cerebral palsy occurs due to damage of...

Answer 48

Basal ganglia

Question 49

What is first-line in children for constipation?

Answer 49

Movicol

Question 50

Rash with satellite lesions in nappy area suggests...

Answer 50

Candidiasis

Question 51

What is the cause of HSP?

Answer 51

IgA-mediated vasculitis, usually following viral illness

Question 52

How long do molluscum typically take to recede?

Answer 52

9 months

Question 53

'Trident hand deformity' suggests...

Answer 53

Achondroplasia

Question 54

Is school exclusion recommended for children with head lice?

Answer 54

no

Question 55

Give differentials for unexplained bruising on a child.

Answer 55

NAI Genuine accident Coagulopathy eg. Von Willibrand’s, ITP, bone marrow failure Osteogenesis imperfecta

Question 56

Which investigations would be indicated for suspected NAI?

Answer 56

Coagulation screen | Skeletal survey

Question 57

What is the prognosis for a child with febrile convulsions?

Answer 57

2/3 will never have a convulsion again, 1/3 will. Slightly increased risk of epilepsy