Paediatrics

Question 1

What is seen in U&Es in pyloric stenosis?

Answer 1

Hypochloraemic, hypokalaemic alkalosis due to persistent vomiting

Question 2

What is treatment of malrotation?

Answer 2

Ladd’s procedure

Question 3

What signs are seen in coarctaction of the aorta in kids?

Answer 3

Radio-femoral delay, murmur heard better over the back

Question 4

What is the gold standard for diagnosis of Hirschsprung’s disease?

Answer 4

Rectal biopsy

Question 5

Which gender is more at risk of developing DDH?

Answer 5

Female

Question 6

Pyloric stenosis management

Answer 6

Ramstedt pyloromyotomy

Question 7

Sign seen on examination / Ix in pyloric stenosis

Answer 7

Olive-sized mass in the right upper quadrant

Question 8

Symptoms of intussusception

Answer 8

Episodic crying and drawing of the legs towards the chest

Question 9

USS results of intussusception

Answer 9

Target sign

Question 10

Management of intussusception

Answer 10

Air insufflation

Question 11

Which type of congenital cyanotic heart disease presents earliest?

Answer 11

Transposition of the great arteries. Life-threatening condition

Question 12

What is seen on X-ray in transposition of the great arteries.

Answer 12

Egg on string appearance

Question 13

What’s seen on X-ray in tetralogy of Fallot?

Answer 13

Boot-shaped heart

Question 14

Initial drug management of transposition of the great arteries

Answer 14

Continuous IV prostaglandin infusion to keep PDA patent until surgery

Question 15

Which antibiotics are used in meningococcal disease in < 3 month olds?

Answer 15

Amoxicillin + cefotaxime (amoxicillin for listeria)

Question 16

Which antibiotics are used in meningococcal disease in > 3 month olds?

Answer 16

Just Cefotaxime/ceftriaxome - no need for amoxicillin

Question 17

Where do chickenpox rashes start?

Answer 17

Face and torso

Question 18

Why does cystic fibrosis lead to diabetes?

Answer 18

Thick mucus damaging the pancreas, limiting insulin production

Question 19

Most common complication and cause of death in measles?

Answer 19

Pneumonia

Question 20

Complication of mumps

Answer 20

Orchitis (a common trick option in answers for measles questions)

Question 21

How does measles present?

Answer 21

Fever and a blotchy rash > initially just behind his ears but is now all over his body > clusters of white lesions on the buccal mucosa

Question 22

What is the weight cut-off for macrosomia?

Answer 22

> 4 kg

Question 23

Which drugs are contraindicated in chickenpox and why? (2)

Answer 23

NSAIDs can increase the risk of necrotising fasciitis in patients with chicken pox

Aspirin - Reye’s syndrome

Question 24

Gait in a missed DDH diagnosis

Answer 24

Trendlenberg gait and leg length discrepancy

Question 25

Which murmur is found in Turner's?

Answer 25

aortic coarctation (systolic)

Question 26

Antibiotic used in whooping cough

Answer 26

Azithromycin or clarithromycin if the onset of cough is within the previous 21 days

Question 27

Analgesia of choice in children

Answer 27

Paracetamol

Question 28

Initial management of Hirschprung's

Answer 28

Bowel irrigation/wash-outs

Question 29

Definitive management of Hirschprung's

Answer 29

Anal pull through procedure

Question 30

Follow-up required after 1st seizure in a child

Answer 30

Urgent referral to paediatric neurologist (within 2 weeks)

Question 31

Most common complication of measles

Answer 31

Acute otitis media

Question 32

When is the MMR vaccine given

Answer 32

1 year AND 3 years + 4 months

Question 33

Triad seen in Alport's syndrome

Answer 33

Renal failure, sensorineural hearing loss and ocular abnormalities in a child

Question 34

Why do we give allopurinol in acute lymphoblastic leukaemia?

Answer 34

To prevent hyperuricemia => Tumour lysis syndrome

Question 35

What is the genetic mutation of the Philadelphia chromosome?

Answer 35

Translocation of chromosomes 9 and 22

Question 36

What condition predisposes you to ALL

Answer 36

Trisomy 21 (Down's syndrome)

Question 37

If combined test is suggestive of Down's syndrome, what further testing would you recommend ?

Answer 37

Chorionic Villus Sampling / Amniocentesis

Question 38

Define a hernia

Answer 38

Protrusion of part or whole of an organ or tissue through the wall of the cavity that normally contains it

Question 39

Direct vs indirect inguinal hernia

Answer 39

In direct inguinal hernias, the bowel enters the inguinal canal ‘directly’ through a weakness in the posterior wall of the canal, whereas.. In indirect inguinal hernias, the bowel enters the inguinal canal via the deep inguinal ring

Question 40

Which type of hernia is more common in infants (direct or indirect) and why?

Answer 40

Indirect inguinal hernia (Occur because of a) patent processus vaginalis

Question 41

6 in 1 vaccine

Answer 41

Diphtheria / Hepatitis B / Whooping Cough / Tetanus / Polio / H influenzae B

Question 42

What vaccines do babies receive at 2 months

Answer 42

6 in 1, MenB, rotavirus

Question 43

Pathophysiology of pyloric stenosis

Answer 43

Hypertrophy of the pylorus prevents food travelling from the stomach into the duodenum as normal After feeding, there is powerful peristalsis against the narrow pylorus causing food to be ejected into the oesophagus leading to projectile vomiting

Question 44

Types of jaundice in neonate and causes

Answer 44

Pathological - ABO incompatibility, Rhesus disease, G6PD deficiency, Spherocytosis Prolonged - Biliary atresia, Hypothyroidism, Breast milk jaundice, Infection

Question 45

What happens if jaundice is left untreated in neonate

Answer 45

Kernicterus

Question 46

Tests for DDH in NIPE exam

Answer 46

Ortolani and Barlow tests