Paediatrics Flashcards
1
Q
High fever lasting more than 5 days, red palms with desquamation and strawberry tongue with conjunctival infection
A
Kawasaki disease
2
Q
At what age can a child sit
A
6 months (rounded back)
3
Q
At what age can a child run
A
16 months - 2 years
4
Q
At what age can a child ride a tricycle with pedals
A
3 years
5
Q
4 causes of snoring in children
A
Hypertrophic nasal turbinates
Tonsillitis
Obesity
Downs syndrome
6
Q
What does VSD increase the risk of?
A
Endocarditis
7
Q
Obese boy with groin/thigh/knee pain
A
Slipped upper femoral epiphysis
8
Q
4-8 year old boy with a painless limp, irritable hip and reduced range of motion with no trauma
Xray, epiphyseal sclerosis, a widened joint space and flat femoral head
A
Perthes disease
9
Q
Joint pain after a recent viral infection with no abnormal radiological findings
A
Transient synovitis
rest and alangesia
10
Q
What is the newborn screening test and if it is abnormal, what test is next?
A
Otoacoustic emission test
THEN
Auditory brainstem response test
11
Q
Sore throat, fever, headache, bright red tongue (furred) , coarse red rash (sandpaper) that spares the face
A
Scarlet Fever
12
Q
How long must a child with scarlet fever remain off school
A
Until 24hrs after the first dose of antibiotics
13
Q
First line investigation for intussusception
A
Ultrasound
14
Q
Child presenting in GP with pain in the legs at night with no obvious cause
A
Growing pains
15
Q
Target sign on ultrasound
A
Intussusception
16
Q
Management of intussusception
A
Pneumatic reduction under fluoroscopic guidance
17
Q
Presentation and management of necrotising enterocolitis
A
Premature baby with abdo distention, free fluid, small bowel dilation and septic signs
Laparotomy
18
Q
Most common childhood leukaemia
A
ALL
19
Q
Presentation of ITP
A
Purpuric rash
20
Q
Presentation of ALL
A
Anaemia, neutropaenia, thrombocytopenia
21
Q
What cardiac condition is turners syndrome associated with
A
Coarctation of the aorta
22
Q
Features of turners syndrome at birth
A
Widely spaced nipples, webbed neck, peripheral lympoedema (swollen hands and feet)
23
Q
Achondroplasia inheritance
A
Autosomal dominant
24
Q
Investigation for slipped upper femoral epiphysis
A
Hip xray
25
Painful limp for 8 weeks
Perthes disease
| MRI if X-Ray normal
26
Child with tonsillitis symptoms but stridor and sitting forward
Epiglottitis, do NOT examine
27
When should you refer a
- unilateral undescended testis
- bilateral undescended testes
- unilateral at 3 months
| - bilateral in 24 hours
28
Ejection systolic murmur
Pulmonary valve stenosis
Tetralogy of Fallot (associated with 'tet' spells)
Aortic valve stenosis (radiates to carotids)
29
Pansystolic murmur
VSD
30
Mid systolic crescendo-decresendo murmur
ASD
31
Cpntinuous crescendo-decrescendo machinery murmur with a collapsing pulse
PDA
32
Ejection systolic murmur below clavicle
Coarctation of the aorta
33
Salmon pink rash with joint pain
Stills Disease (juvenille idiopathic arthritis)
34
Paediatric BLS
5 initial breaths
| 15:2
35
Short stature, widely spaced nipples and primary amenorrhoea
TURNERS
36
When should you call an ambulance during a seizure
If the seizure persists more than 5 minutes
37
Treatment of scarlet fever
10 days oral Pen V
38
Treatment of scarlet fever
10 days oral Pen V
39
First line laxative for constipation in childhood
Osmotic
40
4 risk factors for DDH
Female
Breech
High birth weight
Oligohydramnios
41
First step in newborn resus
DRY the baby
| Then 5 breaths
42
Causative organism for croup
parainfluenza virus
43
First line management of eczema
Topical emollients
44
How long should a child with whooping cough be kept off school
2 days after commencing antibiotics (or 21 days from onset of symptoms if no antibiotics)
45
How long should a child with roseola be kept off school
No exclusion
46
How long should a child with D+V be kept off school
48 hours
47
Medication given in transposition of the greater arteries
Prostaglandin to maintain the PDA
48
Posterior displacement of the tongue and a cleft palate with no family history
Pierre-Robin Syndrome
| Place prone due to upper airway obstruction
49
4 features of tetralogy of fallot
pulmonary stenosis
overriding aorta
VSD
right ventricular hypertrophy
50
Prevention of neonatal distress syndrome
Dexamethasone to mother
51
Treatment of bronchilolitis
Supportive management only
52
Most common cause of ambiguous genitalia in neonates
Congenital adrenal hyperplasia
53
Investigation of choice for reflex nephropathy
Micturating cystography
54
First line treatment for threadworm (and sx)
Mebendazole single dose for full family
| Itchy bottom
55
Topical treatment of oral thrush
Nystatin
56
What is the mode of inheritance for prader willi
Imprinting
57
What genetic condition are rocker bottom feel found in
Edwards (trisomy 18)
58
When does a child start to smile
6 weeks
59
Immediate complication of measles
Pneumonia
60
Later complication of meales
Subacute sclerosing panencephalitis (5-10 years later)
61
2 complications following a mumps infection
Pancreatitis and infertility
62
7 features of an atypical UTI
```
Seriously ill
Poor urine flow
Abdominal or bladder mass
Raised creatinine
Septicaemia
Failure to respond to treatment with suitable antibiotics within 48 hours
Infection with non-E. coli organisms.
```
63
Most common reversible cause of cardiac arrest in children
Hypoxia (repsiratory)
64
Child below the 0.4th centile
Refer to paeds outpatients for review
65
Corrected age of a premature baby
The age minus the number of weeks they were born early from 40 weeks
66
treatment of croup
Single dose oral dexamethasone
| Emergency: High flow oxygen and adrenaline
67
Appropriate places to check for a pulse in paediatric BLS
Brachial and femoral
68
Dietary advice for ADHD
Eat a normal balanced diet unless links have been found between behaviour and certain foods
69
Vaccinations in pregnant women
Pertussis and influenza
70
Murmur described as a 'continuous blowing noise' heard below both clavicles in a child
Venous hum (innocent)
71
Murmur described as a low-pitched sound heard at the lower left sternal edge
Stills murmur (innocent)
72
Difference between gastroschisis and omphalocele
Gastroschisis associated with socioeconomic deprivation and presents with a defect left to the umbilicus
Omphalocele refers to a defect in the umbilicus itself
73
What investigation would you do in kawasakis to screen for potential complications
Echo
74
What is the most common cause of respiratory distress in neonates
Transient tachypnoea of the newborn
| delayed reabsorption of fluid in the lungs
75
What is hypospadias and how is it managed
Ventral urethral meatus and hooded prepuce
Surgery at 12 months
76
Heart defect in turners
Bicuspid aortic valve
77
Management of UTI in a child
3 day cause of ABx as per local policy
78
Features and management of biliary atresia
first few weeks of life with jaundice, appetite and growth disturbance
surgery
79
Features of CMV infection in neonate
Neonatal jaundice, fever, microcephaly, sensioneural deafness, blueberry muffin skin lesions, hepatosplenomegaly
80
Hypothyroidism in neonates
Jaundice, poor feeding, constipation, hypothermia, rise in unconjugated bilirubin
81
Components of the APGAR score
```
Appearance
Pulse
Grimace
Activity
Respiration
```
82
Most common cause of nephrotic syndrome in children
Minimal change disease
83
Children under 3 months with suspected UTI
Non-specific Sx
| Refer to same day paediatric assessment unit
84
At what gestation does a baby have to be breech to get an ultrasound
At or after 36 weeks
85
Management of neonate at risk of hypoxic ischaemic encephalopathy
Therapeutic cooling
86
Asthma not responding to salbutamol inhaler and beclometasone
Add leukotrine receptor antagonist
87
CF diet
high calorie high fat meal with pancreatic enzyme supplementation for every meal
88
The most common complication of roseola
Febrile convulsions
89
What is the inheritance pattern of haemophilia A
X linked recessive
90
Can a male with an x-linked condition pass it onto his son
No, there is no male-male transmission in x-linked recessive conditions
It can only be passed from mothers (carriers)
91
Treatments for CF spasticity
Oral diazepam, baclofen, botox, surgery
92
Child under 3 months with a fever over 38C
Refer for same day paeds assessment
93
Feature of a benign ejection murmur
Varies with posture
94
Can CF cause diabetes
Yes
95
Young boy with learning difficulties, macrocephaly, large ears and macro-orchidism
Fragile X
96
Is school exclusion advised for children with head lice
No
97
At what age will a child start parallel play
2 years
98
Genetic condition associated with supravalvular aortic stenosis and elfin facies
William's syndrome
99
Bowel sounds in a respiratory exam of a neonate
Diaphragmatic hernia
| Intubate if in resp distress
100
When is a bone marrow biopsy needed for children with ITP
Splenomegaly
101
NICE indications for head CT
102
What are infantile spasms
Childhood epilepsy in the first 4-8 months of life in male infants with a poor prognosis
'salaam attacks' progressive mental handicap
EEG shows hypsarrhythia and CT shows a diseases brain
103
When might you prescribe a bronchodilator such as salbutamol
If viral induced wheeze is suspected and the child is over 1 year old
104
Do children with autism spectrum disorder have normal intelligence
no, normally associated with intellectual impairment
105
4 characteristics of autism
Global impairment of language and communication
Children may perform ritualistic behaviour
75% of children are male
Usually develops before 3 years of age
106
At what age do febrile convulsions usually occur?
Children aged 6 months to 5 years
107
Medication for ADHD and side effect
Methylphenidate
| Stunted growth
108
Define caput seccedaneum
puffy swelling that usually occurs over the presenting part and crosses suture lines caused by prolonged delivery/assistance
109
Two features in congenital rubella
Sensorineural deafness
| Congenital cataracts
110
Treatment for meningitis
under 3 months: cefotaxime + amoxicillin (cover listeria)
| over 3 months: ceftriaxone
111
two causes of epiglottitis
haemophilus influenzae type B
| Diptheria
112
Nappy rash: creases spared or not?
Spared = irritant dermatitis
| Not spared = candida
113
2 month hx of bilateral knee pain worse in the morning with general fatigue
Oligoarticular juvenile idiopathic arthritis
114
Is downs syndrome associated with hypothyroidism
yes
115
First sign of puberty in girls
Breast development
116
Hand foot and mouth features and treatment
mild fever and upset with vesicles over the palms and around the mouth (NOT crusty!)
Symptomatic treatment only
117
The only recommended advise to reduce the risk of CF infections
Avoid contact with other CF patients
118
Management of PDA
Give indomethacin to the neonate
119
Neonatal hypoglycaemia
under 1.65 in first 24 hours
| Under 2.5 thereafter
120
Management of neonatal hypoglycaemia
Asymptomatic then encourage feeding and monitor glucose
| Glucose adjuncts if symptomatic
121
Signs of neonatal sepsis
Vague signs and symptoms, poor feeding, grunting, lethargy
122
Most common cause of primary headache in children
Migraine
123
Management of perthes disease
Under 6: observe
| Over 6: surgery
124
Investigation to confirm duchennes
Genetic testing
125
Cause of microcephaly, absent philtrum, pansystolic murmur in neonate
Maternal alcohol use
126
Neonate with jaundice, next step
Measure serum bilirubin within 2 hours
127
Most common complication of measles
Otitis media
128
Diffuse maculopapular rash with small white papules on the inside of cheeks
Measles
129
Management of pneumonia with mycoplasma
Erythromycin
130
High temperature presceding a maculopapular rash
Roseola
131
Mode of inheritance of huntingtons
autosomal dominant
132
What is genetic anticipation?
A phenomenon in which the signs and symptoms of some genetic conditions tend to become more severe and/or appear at an earlier age as the disorder is passed from one generation to the next
e.g. Huntingtons, Myotinic Dystrophy
133
Child 6 years old wanting first MMR dose
Give MMR with repeat dose in 3 months
134
Pyloric stenosis investigation
Abdominal ultrasound
135
Sign of late decompensated shock
Hypotension
| Potentially irreversible
136
Ventral urethral meatus associated condition
Cryptorchidism (hypospadias)
137
Common presentation of neonatal sepsis
Respiratory distress
138
Metabolic disturbance in pyloric stenosis
```
Increased bicarb (alkalosis)
Hypochloraemia, hypokalaemia
```
139
Downs cancer
ALL
140
Ask what and who questions
| Ask why when and how questions
What and who - 3 years
| Why when and how - 4 years
141
Treatment of immune thrombocytopenia with no significant bleeding
No treatment
142
Infant with inspiratory stridor and noisy breathing
Laryngomalacia
143
Hirschsprung disease
Congenital bowel disease
Bilious vomiting, abdo distention, constipation and failure to pass meconium in 1st 24 hours
Might not present until childhood or adolescence
144
Colon biopsy of hirschsprungs
Aganglionic segment of bowel
145
Hepatosplenomegaly and bruising with soft systolic murmur
ALL
146
micrognathia, low-set ears, rocker bottom feet and overlapping of fingers
Edwards
147
Epiglottitis airway protection
Endotracheal intubation
148
```
learning difficulties
large low set ears, long thin face, high arched palate
macroorchidism
hypotonia
autism is more common
mitral valve prolapse
```
Fragile X
149
Dermoid cyst characteristics
Multiloculated and hererogeneous above the hyoid bone
150
Mass in posterior triangle that transilluminates
Cystic hygroma
151
Mass lateral to anterior triangle - fluid filled
Branchial cyst
152
Palmar grasp age
5-6m
153
Tower of 3-4 blocks
18m
154
Management of an infant with GORD
1-2 week trial of alginate therapy
then
4 week trial of PPI
155
Pregnancy complication in a foetus with alpha thalassemia
Hydrops fetalis
156
Colic seizures with change in development and EEG with hypsarrhythmia
West Syndrome (infantile spasms)
157
Cyanosis/collapse in first month of life
Hypercayanotic spells
Ejection systolic murmur at left sternal edge
Tetralogy of Fallot
158
Heart lesion with Duchenne
Dilated cardiomyopathy
159
When is the blood spot test performed in the UK
Between the fifth and ninth day of life
160
When will children with CMPA be tolerant?
3 years
161
Hand foot and mouth organism and Sx
Mild systemic upset then oral ulcers then vesicles on palms and soles
Cosackie A16
162
Webbed neck and pectus excavatum with widely spaced nipples and short stature
Noonan
163
Small eyes and polydacytly with cleft palate and microcephaly
Patau (trisomy 13)
164
learning difficulties and macrocephaly
Fragile X
165
Haemophilia A genetics
x linked recessive
166
Talk in short sentences (3-5 words)
2.5-3yrd
167
Vocab of 2-6 words
12-18 m
168
Responds to name
9-12m
169
formula fed baby with suscpedted CMPI
Extensive hydrolysed formula trial
170
Risk factor for DDH
Female sex
| Firstborn
171
7 features of growing pains
never present at the start of the day after the child has woken
no limp
no limitation of physical activity
systemically well
normal physical examination
motor milestones normal
symptoms are often intermittent and worse after a day of vigorous activity
172
Amber and red flag for increased work of breathing
Amber: nasal flaring
Red: IC recession
173
2 features of measles
Fever, irritable and conjunctivitis in prodrome
| White spots in mouth
174
Triad of shaken baby syndrome
retinal haemorrhages
subdural haematoma
encephalopathy
175
Osgood schlatter vs Osteochondtitis dissecans
O-S: pain, tender and swelling over tibial tuberosity (sporty teens)
O-D: Swelling/locking after exercise
176
Bronchiolitis organism
RSV
177
What type of vaccination is rotavirus
Oral live attenuated vaccine
178
Coryza and fever followed by red rash on both cheeks and pallor surrounding the mouth
Slapped cheek syndrome
| Parvovirus
179
Fever malaise, pink maculopapular rash on face that spreads with suboccipital lymph nodes
Rubella
180
Investigation for necrotising enterocolitis
Abdo x-ray (premature, bilious vomiting)
181
When is indomethacin given
To newborn if ECHO shows PDA 1 week after delivery
182
Infantile colic vs spasms
Spasms (west): repeated flexion of head/arms/trunk followed by extension of arms
Colic: drawing up of legs but not repeated
183
What happens in Ebstein's anomaly
Tricuspid valve leaflets attached to walls and septum of right ventricle
184
Management of a small umbilical hernia in neonate
Watch and wait
185
Management of necrotising enterocolitis
Bacterial infection
| Broad spectrum ABx
186
Most common complication of measles
Otitis media
187
Constipation medical management
Movicol then add senna
188
4 causes of hypotonia
Acutely unwell child
Prader-Willi
Downs
Cerebral palsy
189
What is fragile X - what does it increase the risk of
trinucleotide repeat disorder on x chromosome - autism
190
5 signs of hypernatraemic dehydration
```
jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness or coma
```
191
Small testes in precocious puberty
Adrenal hyperplasia
192
Rare complication of chicken pox
Necrotising fascitis (increased with NSAIDs)
193
Congenital CMV presents with...
Hearing loss, low birth weight, petechial rash, microcephaly and seizures
194
Congenital rubella syndrome presents with...
sensorineural deafness, eye abnormalities (e.g. retinopathy and cataracts) and congenital heart disease (especially pulmonary artery stenosis and patent ductus arteriosus)
195
Failed enuresis alarm
Desmopressin
196
Define precocious puberty in males and females
Secondary sex characteristics before 9 years in males and before 8 years in females
197
cephalhaematoma
Small haematoma over the parietal bone that develop after birth
198
Genetic condition associated with hirschsprungs
Downs
199
2 month old with UTI
admit
200
Bronchiolitis referred to hospital if (3)
RR above 60
50% less feed
clinical drhydration
201
RF for surfactant deficient lung disease in newborn
MaternL DM
202
Define neonatal death
0-28 days
203
Define simple and complex febrile seizure
Simple: less than 15 mins, generalised, recovery in 1 hour
Complex: 15-30 mins, focal, repeats
Status epilepticus: over 30 mins
204
Pincer grip
12 m
205
Pulls to standing
8-10 months
206
Squats to pick up a ball
18m
207
Bow legs in a child < 3
a normal variant and usually resolves by the age of 4 years
