Paediatrics Flashcards
1
Q
When is jaundice pathological in the newborn?
A
When within 24hrs
2
Q
What causes Perthe’s disease?
A
More common at 4-8 years
Due to avascular necrosis of the femoral head
3
Q
What causes SUFE?
A
10-15 years - Displacement of the femoral head epiphysis postero-inferiorly
4
Q
What is the most important treatment for prevention of neonatal respiratory distress syndrome?
A
Administer dexamethasone to the mother
5
Q
How does intussuception present, and how do we investigate it?
A
An infant with inconsolable crying, drawing legs up to the abdomen associated with pallor, vomiting → ?intussusception
US
6
Q
What is caput succadaenum?
A
Caput succedaneum is a swelling due to pressure of the presenting part on the cervix. It is present from birth with poor margins and crosses suture lines. It typically resolves in 1-2days and does not usually require treatment.
7
Q
A 6-week-old baby boy presents to his GP with symptoms of regurgitation and vomiting after feeding. His mother also reports ongoing issues with diarrhoea. Formula fed. What should we advise?
A
If a formula-fed baby is suspected of having mild-moderate cow’s milk protein intolerance then a extensive hydrolysed formula should be tried
8
Q
How does acute epiglottitis present?
A
When you attend you find the patient sat on his mothers knee leaning forward and drooling. There is audible stridor from the end of the bed.
9
Q
What causes epiglottitis?
A
Haemophilus influenzae type B
10
Q
How does measles present?
A
Measles is characterised by prodromal symptoms, Koplik spots. maculopapular rash starting behind the ears and conjunctivitis
11
Q
What is Kocher’s criteria?
A
Kocher’s criteria is used to assess the probability of septic arthritis in children using 4 parameters:
Non-weight bearing - 1 point
Fever >38.5ºC - 1 point
WCC >12 * 109/L - 1 point
ESR >40mm/hr
12
Q
How does Kawasaki’s disease presnet?
A
High fever lasting >5 days, red palms with desquamation and strawberry tongue are indicative of Kawasaki disease
13
Q
Define precocious puberty
A
Precocious puberty is the development of secondary sexual characteristics before 8 years in girls and 9 years in boys
14
Q
When is croup most commonly diagnosed?
A
Whereas the peak incidence of croup is 6 months -3 years, bronchiolitis is seen in 1-9 month olds
15
Q
How do we treat croup?
A
Oral dex
16
Q
At what age would the average child acquire the ability to sit without support?
A
6-8m
17
Q
How does TTN and RDS differ?
A
TTN is caused by a delay in the clearance of lung fluid, which is naturally present in utero. It is more commonly seen in babies born via Caesarean section and presents with tachypnoea soon after delivery that settles within a few hours.
RDS presents with features of respiratory distress soon after delivery, which get progressively worse without treatment. It occurs due to surfactant deficiency and causes alveolar collapse after expiration. It is most commonly seen in premature and low birth weight babies.
18
Q
How does necrotising enterocolitis present?
A
Early signs of necrotising enterocolitis: feeding intolerance, abdominal distension and bloody stools
19
Q
What is the inheritance pattern in CF?
A
Autosomal recessive
20
Q
What is pavalizumab?
A
Palivizumab is a monoclonal antibody which is used to prevent respiratory syncytial virus (RSV) in children who are at increased risk of severe disease.
21
Q
What is physiological neonatal vaginal discharge?
A
White vaginal discharge - This occurs as a result of maternal oestrogen crossing the placenta before birth, stimulating the baby’s vaginal mucosa to proliferate and secrete mucus. It usually resolves spontaneously within a few days to weeks after birth without any intervention.
22
Q
A mother brings in her 6-year-old boy who complains of ‘an itchy bottom’ at night. He is otherwise systemically well, developing normally and denies any change in his bowel habit. An external examination of the anus is unremarkable.
Which one of the following is the most likely cause?
A
Threadworm
23
Q
What causes scarlet fever?
A
Scarlet fever, also known as scarlatina, is primarily caused by group A beta-haemolytic streptococci (GABHS), specifically the bacterium Streptococcus pyogenes
24
Q
How does scarlet fever present?
A
The disease mainly affects children and presents with a sore throat, fever, strawberry tongue and a fine sandpaper-like rash on the trunk.
25
Children under what age are not legally able to consent to sex?
Children under the age of 13 years are not able to consent to sexual intercourse and hence any sexual activity would be regarded as rape under the law. This is one situation under the GMC guidelines where you are compelled to break confidentiality
26
How does Edward's syndrome (trisomy 18) present?
A baby is born with micrognathia, low-set ears, rocker bottom feet and overlapping of fingers - Edward's syndrome
27
How do we treat whooping cough?
Whooping cough - azithromycin or clarithromycin if the onset of cough is within the previous 21 days
28
What causes acute epiglottitis?
Acute epiglottitis is caused by Haemophilus influenzae type B
29
What are Koplik spots?
Koplik spots: white spots ('grain of salt') on buccal mucosa
Seen in measles
30
How does measles present?
Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots ('grain of salt') on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
31
How does mumps present?
Fever, malaise, muscular pain
Parotitis ('earache', 'pain on eating'): unilateral initially then becomes bilateral in 70%
32
How does rubella present?
Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular
33
How does scarlet fever present?
Fever, malaise, tonsillitis
'Strawberry' tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
34
What causes scarlet fever?
Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
35
What is hand, foot and mouth disease?
What organism causes it?
Caused by the coxsackie A16 virus
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet
36
How does cephalohaematoma present?
A cephalohaematoma appears as a swelling due to bleeding between the periosteum and the skull. It is most commonly noted in the parietal region and is associated with instrumental deliveries. The swelling usually appears 2-3 days following delivery and does not cross suture lines. It gradually resolves over a number of weeks.
37
What is caput succadeneum?
Caput succadeneum is commonly seen in newborns immediately after birth. It occurs due to generalised superficial scalp oedema, which crosses suture lines. It is associated with prolonged labour and will rapidly resolve over a couple of days.
C-aput S-uccadaneum -> C-rosses S-uture lines
38
What are Brushfield spots/
Brushfield spots are small grey or brown spots seen on the periphery of the iris. They are associated with Down syndrome.
39
What is the murmur heard in PDA?
Patent ductus arteriosus is associated with a continuous murmur whilst Pulmonary stenosis presents with a systolic murmur.
40
How do we maintain PDA in a neonate?
Maintenance of the ductus arteriosus with prostaglandins is the initial management for duct dependent congenital heart disease
Ensures a route of alternate blood flow. The parallel circulatory systems caused by TGA means that ductus arteriosus closure will result in profound cyanosis and circulatory failure. Prostaglandins maintain the patency of the ductus arteriosus through dilation of vascular smooth muscle
| We may do this in TGA
41
What is the commonest cause of stridor in children?
Laryngomalacia
42
When is hand preference abnormal, and what should you do?
Hand preference before 12 months is abnormal - it could be an indicator of cerebral palsy. Urgent referral to paediatrician.
43
How do innocent murmurs sound?
They are Soft, Systolic, Short, Symptomless, Standing/Sitting (vary with position).
44
Child aged 5-16 years with asthma not controlled by a SABA + paediatric low-dose ICS + leukotriene receptor antagonist asthma management in children 5-16...
add a LABA (salmeterol) and stop the leukotriene receptor antagonist (montelukast)
45
How do we test for developmental dysplasia of the hip?
Barlow manoeuvre: attempted dislocation of a newborns femoral head
46
How does Turner's syndrome present?
Short stature + primary amenorrhoea ?Turner's syndrome
47
How does Patau syndrome present?
Trisomy 13
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions
48
How does Edward's syndrome present?
Trisomy 18
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers
49
How does fragile X syndrome present?
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
50
When do we expect babies to smile by?
Referral points
doesn't smile at 10 weeks
cannot sit unsupported at 12 months
cannot walk at 18 months
51
What is the difference between amino acid based formula and extensively hydrolysed formula?
Amino acid-based formula is appropriate for infants with severe cow's milk protein intolerance. This formula is less palatable, however, it is appropriate for those with severe intolerance as it is composed of free amino acids only.
52
What is the Ortolani manoeuvre
Ortolani manoeuvre: attempted relocation of a newborn's femoral head after dislocation due to the Barlow manoeuvre
53
How do we manage severe croup?
NICE recommend giving a single dose of oral dexamethasone (0.15mg/kg) to all children regardless of severity
nebulised adrenaline
54
When is nocturnal enuresis normal?
Under 5y.o.
55
How do we manage hypospadias?
Circumcision should not be performed for infants with hypospadias - the foreskin may be used in the corrective procedure. Procedure performed at 6 months
56
What is roseola infantum?
A coryzal illness with associated high fever that resolves and is followed 1-2 weeks later by an erythematous rash across the trunk and limbs is a classical history of roseola infantum. Associated with febrile seizures
57
What is gastoschisis?
Gastroschisis describes a congenital defect in the anterior abdominal wall just lateral to the umbilical cord. Born with exposed bowel.
Management
vaginal delivery may be attempted
newborns should go to theatre as soon as possible after delivery, e.g. within 4 hours
58
What is seen in tetralogy of fallot?
TOF mnemonic is PROV- pulmonary stenosis, RVH, overriding aorta, vsd
59
How does congestive HF present in neonates?
Presentation of heart failure in neonates: poor feeding, shortness of breath, hepatomegaly
60
How do we treat scarlet fever?
Treated with oral penicillin V, and can go back to school after 24H tx
61
What is the first sign of puberty in girls?
boobs, pubes, grow, flow
62
How does umbilical granuloma present?
An umbilical granuloma is an overgrowth of tissue which occurs during the healing process of the umbilicus. It is most common in the first few weeks of life. On examination, a small, red growth of tissue is seen in the centre of the umbilicus. It is usually wet and leaks small amounts of clear or yellow fluid.
63
How do we treat umbilical granuloma?
It is treated by regular application of salt to the wound, if this does not help then the granuloma can be cauterised with silver nitrate.
64
What is an Epstein pearl? How is it treated?
small white cystic vesicle around 2mm in diameter situation on the hard palate close to the midline. They are common on the hard palate, but may also be seen on the gums where the parents may mistake it for an erupting tooth. No treatment is generally required as they tend to spontaneously resolve over the course of a few weeks.
65
What is seen on the CXR in transcient tachypnoea of the newborn?
. Increased respiratory rate and the chest x-ray findings of hyperinflation and fluid in the horizontal fissure are key findings in transient tachypnoea of the newborn. This patient should be managed with supportive care and supplemental oxygen if required. Symptoms usually resolve spontaneously within a couple of days.
66
What is the most common cause of childhood hypothyroidism in the United Kingdom?
The correct answer is Autoimmune thyroiditis. In the United Kingdom, the most common cause of childhood hypothyroidism is autoimmune thyroiditis, also known as Hashimoto's thyroiditis. This condition occurs when the immune system mistakenly targets and damages the thyroid gland, leading to decreased production of thyroid hormones.
67
What is the Barlow manouevre?
Barlow manoeuvre: attempted dislocation of a newborns femoral head
68
Define maternal mortality
Maternal mortality includes any death in pregnancy and labour as well as up to six weeks post partum
69
What would a CXR show in TTN?
Chest x-ray in transient tachypnoea of the newborn may show hyperinflation and fluid in the horizontal fissure
70
What is croup and how does it present?
Croup, also known as laryngotracheobronchitis, is a common respiratory illness in children aged 6 months to 3 years. It is characterised by a barking cough, stridor (inspiratory), and hoarseness of voice. The fever and coryzal symptoms suggest a viral origin, which is the most common cause of croup.
71
What causes croup?
The most common causative organism is Parainfluenza virus.
72
What is bronchiolitis, and how does its presentation differ to croup?
Bronchiolitis is an incorrect option because it typically presents with wheezing and fast breathing rather than stridor. Bronchiolitis affects infants younger than two years old. While bronchiolitis can present with fever and cough, the presence of inspiratory stridor makes croup more likely.
73
What causes bronchiolitis?
caused by Respiratory Syncytial Virus (RSV)
74
What is congenital diaphragmatic hernia?
Congenital diaphragmatic hernia (CDH) occurs in around 1 in 2,000 newborns. It is characterised by the herniation of abdominal viscera into the chest cavity due to incomplete formation of the diaphragm. This can result in pulmonary hypoplasia and hypertension which causes respiratory distress shortly after birth.
75
What is the difference between measles and rubella?
Measles - x2E's = Starts behind Ears.
Rubella - x2 L's = Lymphadenopathy
76
What is Osgood-Schlatter disease?
This condition is a common cause of knee pain in growing adolescents, typically aged between 10 and 15 years old. It is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia). The symptoms usually include pain and swelling over the tibial tubercle, which can be exacerbated by physical activity such as hockey. The condition tends to resolve itself with time, once the child has stopped growing.
77
When do we offer the pertussis vaccine?
Women who are between 16-32 weeks pregnant are offered the pertussis vaccine
78
How quickly does caput succedaneum resolve?
Caput succedaneum is a puffy swelling that usually occurs over the presenting part and crosses suture lines
79
At what age would the average child acquire the ability to crawl?
9m
80
When Little or no head lag on being pulled to sit?
3m
81
When walk unsupported?
12-15m
82
When can children with mumps go back to school?
If a child has mumps they need to be excluded from school for 5 days from the onset of swollen glands
83
What is a Wilms tumour?
Wilms tumour, also known as nephroblastoma, is the most common paediatric renal malignancy. The most common presenting feature is an asymptomatic abdominal mass which is often discovered incidentally by a parent or caregiver while bathing or dressing the child. It typically presents as a smooth, firm and non-tender mass.
84
What is the classic finding in congenital diaphragmatic hernia?
classical concave abdominal appearance
85
When will a child be able to Sits without support, with a straight back?
7-8m
86
When will a child be able to run?
16m-2y
87
When will a child be able to ride a tricycle?
3 years
88
What is irritant dermatitis?
This condition, also known as nappy rash or diaper dermatitis, is the most common cause of nappy rash in infants. It is caused by prolonged exposure to urine and faeces that irritates the skin, leading to an erythematous rash in the nappy area with flexural sparing (as these areas are less likely to be in contact with irritants). The rash often appears abruptly and can vary from mild (with only slight redness) to severe (with bright red, shiny inflammation).
89
How does ALL present?
Features may be divided into those predictable by bone marrow failure:
anaemia: lethargy and pallor
neutropaenia: frequent or severe infections
thrombocytopenia: easy bruising, petechiae
And other features
bone pain (secondary to bone marrow infiltration)
splenomegaly
hepatomegaly
fever is present in up to 50% of new cases (representing infection or constitutional symptom)
testicular swelling
90
Why does maternal diabetes mellitus lead to surfactant deficient lung disease in a newborn?
Surfactant deficient lung disease, also known as neonatal respiratory distress syndrome (RDS), is more common in infants born to mothers with diabetes mellitus. This is because insulin, which is increased in diabetic mothers, inhibits surfactant production and maturation of the fetal lungs.
91
What is penetrance?
Penetrance describes the severity of a particular genotype's presenting phenotype.
92
Why do you get an ES murmur with Turner's syndrome?
Bicuspid aortic valve
| Normally tricuspid
93
When would you expect a child to be able to hop on one leg?
3-4 years
94
When would you expect a child to be able to pull to standing?
8-10m
95
When would you expect a child to squat to pick up a ball?
18m
96
How does whooping cough present? Tx?
Child with a persistent cough, worse at night, possibly associated with vomiting → ?whooping cough
Oral azithromycin
97
What do undescended testes increase the risk of?
Undescended testicles are associated with an increased risk of infertility, torsion and testicular cancer
Need referral to paediatric surgeron
98
What is the carrier rate of cystic fibrosis in the UK?
1 in 25
99
How is homocystinuria inherited
Autosomal recessive
| Stops you processing methionine - homocysteine + methionine build-up
100
What is the triad in shaken baby syndrome?
Retinal haemorrhages, subdural haematoma and encephalopathy
101
Which rash is seen in JIA?
Systemic onset JIA (AKA Still's disease) has a characteristic salmon-pink rash
102
How does HSP present?
Henoch-Schonlein purpura can cause joint pain, but the rash is palpable and purpuric.
103
How does SLE present?
. Systemic lupus erythematosus can cause joint pain and rash but is unusual in children and the rash is usually on the face.
104
How long should the gap be after having another live attenuated vaccine?
4 weeks in children
105
When does TOF present?
Tetralogy of Fallot (TOF) is the most common cause of cyanotic congenital heart disease typically presenting at around 1-2 months
106
Which are the most common cardiac abnormalities in babies with Down syndrome?
Atrioventricular septal defects are the most common congenital cardiac abnormality in Down's syndrome
107
How does Down syndrome present OE?
On examination, he has upslanting palpebral fissures, prominent inner epicanthal folds, a protuberant tongue and single palmar creases. An atypical murmur is heard.
108
How do we treat Perthe's disease under 6y.o.?
Observation - good chance it will recover itself
109
How do we manage congenital hip dysplasia (DDH)?
Pavlik harness
110
What is Bartter's syndrome?
Bartter's syndrome is an inherited cause (usually autosomal recessive) of severe hypokalaemia due to defective chloride absorption at the Na+ K+ 2Cl- cotransporter in the ascending loop of Henle. It should be noted that it is associated with normotension (unlike other endocrine causes of hypokalaemia such as Conn's, Cushing's and Liddle's syndrome which are associated with hypertension)
111
How does Bartter's syndrome present?
Features
usually presents in childhood, e.g. Failure to thrive
polyuria, polydipsia
hypokalaemia
normotension
weakness
112
How does patent ductus arteriosus present?
Left subclavicular thrill
Continuous 'machinery-like' murmur.
Bounding pulse
Widened pulse pressure.
There is no evidence of cyanosis, nor crackles on auscultation.
113
How do we treat PDA?
Indomethacin or ibuprofen is used in patent ductus arteriosus to promote duct closure
| Prostoglandin - P for remaining Patent
ENdomethacin- ENcourages to close
114
A mother comes to see you with her 3-month-old baby who is currently breastfed. She reports that he occasionally refuses feeds, is often sick and cries for long periods following feeds. Her child's weight was on the 50th centile when he was born, however, is now on the 40th centile.
What should you advise?
NICE advise that breastfed infants who have persisting symptoms of frequent regurgitation associated with marked distress should be given a 1-2 week trial of alginate therapy (eg. Gaviscon) following every feed.
If symptoms persist following this then a 4-week trial of a proton pump inhibitor (such as oral omeprazole) or a histamine-2 receptor antagonist (such as oral ranitidine) should be given.
If symptoms still persist despite this then a referral to paediatrics should be considered.
115
A 6-week old baby presents with profuse vomiting and constipation. The mother states he has vomited on multiple occasions but generally, he has been happy feeding. The baby looks visibly dehydrated. On examination, there is a small mass located in the abdominal region. Dx?
Pyloric stenosis
116
How does SUFE present?
Obese boy with groin/thigh/knee pain
117
How do we manage Hirschprung's disease?
Serial rectal irrigation should be performed before surgery to help prevent enterocolitis.
Surgery is the definitive treatment, serial rectal irrigation should be performed before surgery to help prevent enterocolitis.
118
What is diagnostic for Hirschprung's disease?
Absence of ganglion cells in the submucosa is diagnostic for Hirschprung's disease
119
How do we treat recurrent UTIs with labial adhesions?
Topical oestrogen cream
120
How does Osteochondritis dissecans present?
This condition is characterised by a fragment of bone in the knee joint that becomes detached due to a lack of blood supply. The fragment and its overlying cartilage can then move around inside the joint, causing symptoms such as pain, swelling, and locking - all symptoms described by this patient. It's most common in adolescents and young adults, particularly those who are active or participate in sports.
121
What is the first-line tx for paediatric migraine?
Ibuprofen
122
Initial empirical therapy for meningitis if > 3 months of age:
IV ceftriaxone
If <3m.o. include amoxicillin to cover listeria
123
What is transient synovitis?
Transient synovitis is sometimes referred to as irritable hip. It generally presents as acute hip pain following a recent viral infection. It is the commonest cause of hip pain in children. The typical age group is 3-8 years.
124
How does transient synovitis present?
Features
limp/refusal to weight bear
groin or hip pain
a low-grade fever is present in a minority of patients
high fever should raise the suspicion of other causes such as septic arthritis
125
Which conditions are autosomal dominant and autosomal recessive?
Autosomal recessive conditions are 'metabolic' - exceptions: inherited ataxias
Autosomal dominant conditions are 'structural' - exceptions: Gilbert's, hyperlipidaemia type II
126
Which dose of benzylpenicillin should we give in suspected meningitis?
< 1 year 300 mg
1 - 10 years 600 mg
> 10 years 1200 mg
127
How does HSP present?
Features of Henoch-Schonlein purpura are typically a non-blanching rash affecting the legs and buttocks, arthralgia and abdominal pain. This child has presented with a non-blanching rash but not in the distribution of HSP and has not experienced any other symptoms of HSP
128
A 10-year-old boy presents to the emergency department with his mother who is very concerned as she has noticed a non-blanching petechial rash on his arms and legs. The child has had a recent cold but today his observations are normal and he appears well otherwise.
What is the most likely diagnosis?
ITP is correct as it is a differential in any child presenting with petechiae and no fever and is usually preceded by a viral illness. We need blood results to confirm the diagnosis but these typically present with isolated thrombocytopenia and this low platelet count causes the classic petechial rash.
129
What is Acrocyanosis?
a completely normal finding in newborn babies within the first 24-48 hours of life. It is characterised by peripheral cyanosis (bluish discolouration of the hands and feet) with normal central perfusion and normal oxygen saturations. This physiological phenomenon occurs due to peripheral vasoconstriction and the normal transition from fetal to newborn circulation.
130
How does Noonan syndrome present?
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
131
How does Pierre-Robin syndrome present?
Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate
132
How does Prader-Willi syndrome present?
Hypotonia
Hypogonadism
Obesity
133
How does Williams syndrome present?
Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis - supraWalvular aortic stenosis
134
How do we treat threadworm?
Family get single dose mebendazole
135
When is the neonatal blood spot screening test typically performed in the United Kingdom
Between fifth and ninth day of life
136
What is cradle cap?
The image provided shows a rash that is likely to be cradle cap (seborrhoeic dermatitis), which is a common condition in newborns. It typically presents as greasy, yellow scales on the scalp but can also affect the face, ears and neck.
137
How do we treat cradle cap?
Management primarily involves gentle washing with baby shampoo followed by soft brushing to loosen scales, and application of baby oil or emollients to soften the scales. This approach is safe, simple and effective for most cases.
138
At what age do the majority of children achieve day and night time urinary continence?
Three to four no pee on the floor
139
When is bowing of the legs normal?
Bow legs in a child < 3 is a normal variant and usually resolves by the age of 4 years
140
Give a common complication of measles
Pneumonia
Subacute sclerosing panencephalitis is seen but develops 5-10 years following the illness.
141
What can cause Early neonatal jaundice presenting less than 24 hours after birth?
hameolytic disease (rhesus incompatibility, ABO incompatibility, G6PD deficiency, spherocytosis), infection, autoimmune haemolytic anaemia, Crigler-Najjar syndrome, Gilbert's syndrome.
142
What can cause early neonatal jaundice 24hrs-3 wks post delivery?
physiological jaundice, breast milk jaundice, infection, haemolysis, bruising, polycythaemia, Crigler-Najjar syndrome
143
What can cause prolonged jaundice (>3wks)
physiological jaundice, breast milk jaundice, infection, hypothyroidism, haemolytic anaemia, gastro-intestinal obstruction, biliary atresia, neonatal hepatitis.
144
WHen does TOF usually present?
Within 1-2months of delivery - if within days, transposition of the great arteries
145
What are the most common causes of meningitis?
Neonatal to 3 months: LEG
Listeria monocytogenes
E. coli and other Gram -ve organisms
Group B Streptococcus
1 month to 6 years: NHS
Neisseria meningitidis
Haemophilus influenzae
Streptococcus pneumoniae
146
What is the investigation of choice for reflux nephropathy?
Micturating cystography is the correct answer. 25% of children <6 years of age with a urinary tract infection (UTI) have vesicoureteral reflux (VUR).
It is important to detect VUR early, as it can result in scarring of the kidneys (reflux nephropathy).
147
Where in the childhood immunisation schedule is the Meningitis B vaccine given?
2, 4 and 12 months
148
Which vitamin deficiency of breastfed babies at risk of?
This baby is likely to have idiopathic vitamin K deficiency. Breastfeeding is the only risk factor as the breast milk is deficient in vitamin K. This baby was born in Ukraine hence may not have had the vitamin K injection following birth.
149
How does congenital adrenal hyperplasia present?
Congenital adrenal hyperplasia would likely be diagnosed much earlier than puberty and is typically characterised by ambiguous genitalia and other symptoms of adrenal insufficiency, such as arrhythmias and vomiting.
150
How does androgen insensitivity present?
The key symptom here is the groin swellings, which combined with 'primary amenorrhoea' and no pubic hair points towards a diagnosis of androgen insensitivity (previously testicular feminisation syndrome). The groin swellings here are undescended testes. This is a condition in which the patient is genetically male (46XY), but phenotypically female. Feminisation is a result of increased oestradiol levels, which lead to breast development.
151
What is Ophthalmia neonatorum?
Ophthalmia neonatorum is defined as conjunctivitis under 30 days old. Prompt treatment is necessary to prevent serious illness and may require systemic antibiotics - urgent referral to ophth
152
When would expect children to Talk in short sentences (e.g. 3-5 words)?
2.5 - 3 years
153
When would you expect chidlren to have Vocabulary of 2-6 words?
12-18 months
154
When would you expect children to respond to their own name?
9-12m
155
What is the most common cause of primary headache in children?
Migraine is the most common cause of primary headache in children
156
Why can we not give rotavirus vaccination after 15w?
The reason for this specific timing is due to safety concerns associated with a rare but serious condition called intussusception
157
Which hearing test is done at school entry in the UK?
Pure tone audiometry
158
What is spared in scarlet fever?
Palms and soles
159
At what age would the average child start to say 'mama' and 'dada'?
9-10m
160
Which congenital heart conditions are cyanotic?
Trulmonary valve stenosis
Pulmonary valve stenosis
TGA
TGF
Tricuspid atresia
161
Which screening do we offer for all breech babies?
All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery
162
What is phenylketonuria?
Phenylketonuria (PKU) is a rare genetic condition where the body cannot break down phenylalanine, an amino acid vital for brain development but toxic in high levels. Early detection through newborn screening allows immediate dietary modifications which can prevent severe intellectual disability
163
What is galactosaemia?
Galactosaemia is a rare genetic metabolic disorder that affects an individual's ability to metabolise the sugar galactose properly.
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What is caffeine used for in neonates?
Caffiene can be used as a respiratory stimulant in newborn babies - aid weaning off a ventilator
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How does Chondromalacia patellae present?
This condition, also known as 'runner's knee,' is a common cause of anterior knee pain in adolescents and young adults. It occurs when the cartilage on the underside of the patella (kneecap) becomes softened and irritated, often due to overuse or poor alignment of the patella. The pain typically worsens with activities that involve bending the knee, such as walking up and down stairs, squatting, or running.
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How does benign rolandic epilepsy present?
Benign rolandic epilepsy is a form of childhood epilepsy that typically occurs between the age of 4 and 12 years.
Features
seizures characteristically occur at night
seizures are typically partial (e.g. paraesthesia affecting the face) but secondary generalisation may occur (i.e. parents may only report tonic-clonic movements)
the child is otherwise normal
Excellent prognosis, with seizures stopping at adolescence
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When can children with hand, foot and mouth disease go back to school?
No exclusion
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What inheritance pattern is seen in Myotonic dystrophy?
With genetic anticipation, hereditary diseases have an earlier age of onset through successive generations.
Trinucleotide repeat disorders, including Huntington's disease and Myotonic dystrophy (CTG repeat sequence) can exhibit genetic anticipation.
