Overview

Question 1

When do girls and boys on average enter puberty?

Answer 1

Girls - 11 years old

Boys - 6 months later

Question 2

Name two gonadotrophins

Answer 2

LH

FSH

Question 3

What does LH do?

Answer 3

Stimulates testosterone secretion from Leydig cells

Question 4

What does FSH do?

Answer 4

Stimulates spermatogenesis by acting on sertoli cells

Question 5

What is the function of dihydrotestosterone?

Answer 5

Enlargement of male sex organs
Secondary sexual characteristics
Anabolism

Question 6

Describe true precocious puberty

Answer 6

<8 years old in girls

<9 years old in boys

Question 7

Define puberty delay

Answer 7

Absence of secondary sexual development in a girl aged 13 or boy aged 14

Question 8

What scoring system measures sexual characteristic?

Answer 8

Tanner

Question 9

What are the symptoms of diabetes in children?

Answer 9

Polyuria, nocturnal enuresis, polydipsia, weight loss, fatigue

Question 10

What is a risk of fluid resus in kids with diabetes?

Answer 10

Cerebral oedema

Question 11

Describe congenital adrenal hyperplasia

Answer 11

21 OH enzyme deficiency

• Absent cortisol and aldosterone
• increased androgens

Question 12

How does CAH present?

Answer 12

Addison Crisis

Virilisation

Question 13

Describe an addison crisis how is it managed?

Answer 13

Hyponatraemia
Hyperkalaemia
Hypotension
Urgent salt and cortisol

Question 14

How does increased testosterone present?

Answer 14

Female - ambiguous genitalia

Male - precocious puberty

Question 15

What are the key anatomical differences between kids and adults?

Answer 15

Large head, prominent occiput 
Large surface area compared to volume
High anterior larynx/floppy epiglottis 
More flexible ribs 
Blood volume 80mls/kg
HbF

Question 16

Name the signs of respiratory distress in kids

Answer 16

Prominent inspiratory and expiratory stridor 
Marked intercostal recession 
Significant distress/agitation 
Lethargy 
Restlessness

Question 17

What causes bronchiolitis?

Answer 17

Viral - RSV, parvovirus, adenovirus

Question 18

How does bronchiolitis present?

Answer 18

Cough, wheeze, fever

LRTI

Question 19

How is bronchiolitis treated?

Answer 19

Supportive

Bronchodilators don’t work

Question 20

What causes croup?

Answer 20

Parainfluenza virues

Question 21

Where does croup affect?

Answer 21

Larygotrachobronchitis

Epiglottis

Question 22

How does croup present?

Answer 22

URTI

Barking ‘seal’ cough

Question 23

How is croup treated?

Answer 23

Steroids - dexamethasone

Question 24

What is the classic X-ray sign of croup?

Answer 24

Steeple/wine bottle - tapering of the upper trachea

Question 25

What should be given to kids with viral meningitis?

Answer 25

Steroids - prevent hearing loss

Question 26

What is a classic sign of measles?

Answer 26

Koplik spots - white specs found in the mouth

Question 27

6 week old baby with visible peristalsis, non -bilous vomiting

Answer 27

Pyloric stenosis

Question 28

How is pyloric stenosis treated?

Answer 28

Incision into the sphincter

Question 29

6 month old with green vomit, sausage mass on stomach with red current stool

Answer 29

Intussusception

Question 30

How does intussusception look on US?

Answer 30

Target lesion - coiling of bowel folding in on itself

Question 31

How is intussectpion treated?

Answer 31

Tube up back passage and inflation - air reduction

Question 32

Bile like mossy green vomit

Answer 32

Malrotation with volvulus

Question 33

Describe malrotation with volvulus

Answer 33

SMA obstruction and ischaemia as gut twists on itself

Question 34

What disease is associated with meconium ileus?

Answer 34

CF

Question 35

What is the most common cause of an acute scrotum?

Answer 35

Hydatid of Morgagni

Question 36

What causes hydatid of morgagni?

Answer 36

Persistent mullein duct

Question 37

Describe hydatid of morgagni

Answer 37

Blue dot on testicle - firm bead that can become necrotic

Question 38

How long do you have to save a testicle that has torted?

Answer 38

4 hours

Question 39

Describe idiopathic scrotal oedema

Answer 39

Itchy red scrotum treated with analgesia and anti-histamines

Question 40

What is BXO?

Answer 40

Lichen sclerosis in boys aged 9/10

Question 41

How can phimosis be managed?

Answer 41

Dab urine, stretch under bath, steroid cream - if it looks scarred surgery can be done

Question 42

What is paraphimosis?

Answer 42

Retracted irreplaceable foreskin

Question 43

How do you treat paraphimosis?

Answer 43

Ice Squeeze Surgery - circumcision

Question 44

What is hypospadias?

Answer 44

Urethra on underside of penis

Question 45

What causes hydrocele?

Answer 45

Patent tunica vaginalis

Question 46

Describe hydrocele

Answer 46

Transiluminates, oedema comes and goes tend to drain at night and then fill up

Question 47

What are the key risks of undescended testes?

Answer 47

Testicular cancer | Infertility

Question 48

Bag of worms

Answer 48

Varicocele

Question 49

Which side is varicocele most common on?

Answer 49

Left - obstruction of renal vein

Question 50

Describe febrile seizures

Answer 50

Fever induced tonic clonic >5 mins - buccal midazolam Small increased risk of epilepsy

Question 51

What are the components of APGAR?

Answer 51

``` Activity Pulse Grimace Appearance Respiration ```

Question 52

What are the three symptoms of ADHD?

Answer 52

Impulsivity Hyperactivity Inattentive

Question 53

Name three main chromosome abnormalities screened for antenatally

Answer 53

Downs - 21 Patau - 13 Edward - 18

Question 54

What is the autism triad?

Answer 54

Language Repetitive behaviour Communication

Question 55

What is small/large for gestational age?

Answer 55

SGA <10th centile | LGA >90th centile

Question 56

How can low birthweight be described?

Answer 56

LBW - <2.5kg VLBW <1.5kg ELBW <1kg

Question 57

Describe TTN

Answer 57

Transient tachypnoea of the newborn Often seen with C section due to left over amniotic fluid Self-limiting but observe in NICU

Question 58

Describe RDS

Answer 58

Preterm babies <28 weeks in particular Surfactant deficiency produced by type 2 alveolar epithelial cells Treat with maternal steroids

Question 59

What is a serious neonatal infection?

Answer 59

Necrotising enterocolitis

Question 60

Describe NEC

Answer 60

GI tract - bile in vomit, bloating and bloody stools can lead to necrosis and perforation Rest bowels and antibiotics

Question 61

Name the features of a innocent paeds murmur

Answer 61

Soft systolic Left sternal edge No radiation

Question 62

Name six congenital heart diseases

Answer 62

``` Coarction of aorta Atrial septal defect Ventricular septal defect AVSD Transposition of great arteries Tetralogy of Fallot ```

Question 63

What is Tetralogy of Fallot?

Answer 63

Pulmonary stenosis VSD RVH Overriding aorta

Question 64

Describe androgen insensitivity syndrome

Answer 64

XY X linked recessive condition in androgen receptor causing testosterone insensitivity in end organs Female phenotype no uterus

Question 65

Describe 5 alpha reductase deficiency

Answer 65

46 XY autosomal recessive condition leading to inability to covert testosterone to DHT Ambiguous

Question 66

What are red flags for developmental delay?

Answer 66

``` Asymmetry of movement Loss of skills No speech by 18 months Not walking by 18 months Parental concerns of hearing/vision ```

Question 67

How does cerebral palsy present?

Answer 67

Increased spasticity Hemiplegic, paraplegic, quadriplegic Often global delay

Question 68

How is CF inherited?

Answer 68

Autosomal recessive - CFTR gene in epithelial cells leading to sticky, thick mucus

Question 69

How does Klienfelters present?

Answer 69

XXY | Weak muscles, less body hair, small genitals, breast growth, less sex interest

Question 70

What is the genotype of turners?

Answer 70

45X - missing X chromosome

Question 71

What causes whooping cough?

Answer 71

Bordetella Pertussis

Question 72

What is reactive attachment disorder?

Answer 72

Difficulty forming lasting relationships - inhibited - disinhibited

Question 73

Describe inhibited RAD

Answer 73

Continually fail to initiate and respond to social interactions - met with resistance and avoidance

Question 74

Describe disinhibited RAD

Answer 74

Inability to display appropriate selective attachments - overfamiliar child

Question 75

Describe conduct disorder

Answer 75

Repetitive, persistent violation of rules | Aggression, destruction of property, deceitful