Paediatrics

Question 1

What is the management for a child < 3 years presenting with an acute limp?

Answer 1

Urgent assessment

Higher risk of septic arthritis & transient synovitis uncommon in this age

Question 2

Should you use bronchodilators in children with bronchiolitis?

Answer 2

No, NICE guidelines do not support the use of bronchodilators in children with bronchiolitis

Question 3

A child presents with:
coryzal symptoms & mild fever which precedes:
dry cough
increasing breathlessness
wheezing (fine inspiratory crackles)
feeding difficulties associated with increasing dyspnoea

What is the diagnosis?

Answer 3

Bronchiolitis

Question 4

What heart condition(s) would you expect in a patient with Turner Syndrome?

Answer 4

Bicuspid aortic valve
Aortic root dilatation
Coarctation of the aorta

Question 5

A multiloculated and heterogenous cyst above the hyoid bone indicates…?

Answer 5

Dermoid cyst

Question 6

A soft lump located in the posterior triangle which transilluminates indicates…?

Answer 6

Cystic hygroma

Question 7

An anechoic neck lump located laterally indicates…?

Answer 7

Branchial cyst

Question 8

Which vaccinations should a 2 month old child receive?

Answer 8

6 in 1
PCV
Oral rotavirus vaccine
Men B

Question 9

What is the most likely diagnosis in a neonate presenting with multiple tiny white papules on their face?

Answer 9

Milia

Common & completely normal in neonates
Resolve spontaneously over a few weeks

Question 10

A continuous blowing noise heard just below the clavicles is indicative of?

Answer 10

Venous hum - innocent murmur due to turbulent blood flow in the great veins returning to the heart

Question 11

A low pitched sound heard at the lower left sternal edge is characteristic of?

Answer 11

Still’s murmur - innocent murmur heard in children

Question 12

A baby with intestinal loops protruding from a hole in the abdomen LATERAL to the umbilicus who was born to a young mother who smoked and drank throughout pregnancy has…?

Answer 12

Gastroschisis

Question 13

In omphalocele - where will the intestinal contents protrude?

Answer 13

Through the umbilicus itself

Question 14

What is the treatment for suspected meningitis in children less than 3 months?

Answer 14

Cefotaxime + IV amoxicillin to cover for listeria

Question 15

A nappy rash which spares the flexural creases is most likely caused by…?

Answer 15

Irritant dermatitis

Question 16

At what age should a child be able to draw a circle?

Answer 16

3 years

Question 17

At what age should a child be competent with a spoon and not spill from a cup?

Answer 17

2 years

Question 18

What age would a child be expected to be able to jump?

Answer 18

36-48 months (3-4 years)

Question 19

From what age does hand dominance become apparent?

Answer 19

18-30 months

Question 20

What limb deformity is pes planus associated with?

Answer 20

Genu valgum (knock-knee)

Question 21

What is the term for a bow-legged limb deformity?

Answer 21

Genu varum

Question 22

What is the gold-standard treatment for transient synovitis?

Answer 22

NSAIDs

Question 23

What type of hip movement is reduced in transient synovitis?

Answer 23

Internal rotation

Question 24

Reossification of the femoral epiphysis on X-ray is suggestive of which condition?

Answer 24

Legg-Calve-Perthe’s disease

Question 25

``` A child presenting with: - sudden onset right leg pain - temperature of 39 degrees - tenderness on palpation - swelling and erythema - refusal to weight bear is a classical history of which condition? ```

Answer 25

Osteomyelitis

Question 26

What is the most common cause of osteomyelitis?

Answer 26

Staph. aureus Rx. with flucloxacillin

Question 27

What is the classic X-ray appearance of osteomyelitis?

Answer 27

Subperiosteal bone formation

Question 28

What is the first-line treatment for juvenile idiopathic arthritis?

Answer 28

NSAIDs

Question 29

What is the likely cause of the rash in a child presenting with: - recent URTI - maculopapular non-blanching rash - temperature 39 degrees - tar-like stools?

Answer 29

Henoch Schonlein Purpura

Question 30

What is the first line management for newborn jaundice?

Answer 30

Phototherapy

Question 31

What does the presence of 'golf-balls' on a blood film indicate?

Answer 31

Thalassaemia

Question 32

Which haematological condition is associated with skeletal abnormalities eg. frontal bossing?

Answer 32

Beta Thalassaemia

Question 33

Which factor is deficient in Haemophilia A?

Answer 33

Factor VIII

Question 34

What is the management for autoimmune thrombocytic purpura?

Answer 34

Platelet transfusion or immunoglobulin

Question 35

Which factor is deficient in Haemophilia B?

Answer 35

Factor IX

Question 36

Which haematological condition would demonstrate an increased APTT and bleeding time?

Answer 36

von Willebrand's disease

Question 37

What clotting factors are deficient in von Willebrand's disease?

Answer 37

von Willebrand Factor (vWF) & Factor VIII

Question 38

What is the treatment for von Willebrand's disease?

Answer 38

Desmopressin (DDAVP) | Desmopressin immediately increases vWF & factor VIII

Question 39

The following are features of which condition: - hyperkalaemia - hyperuricaemia - hyperphosphataemia - hypocalcaemia - elevated serum urea

Answer 39

Acute tumour lysis syndrome

Question 40

Blast cells on blood film are characteristic of which condition?

Answer 40

Acute leukaemia

Question 41

Reed-Sternberg cells on histology are classical of which condition?

Answer 41

Hodgkin's lymphoma

Question 42

Which tumour type accounts for half of all brain tumours in children and arises from astrocytes?

Answer 42

Glioma

Question 43

Which tumour is a benign tumour associated with solid and cystic elements with calcification?

Answer 43

Craniopharyngioma

Question 44

What is the antibiotic of choice in treatment of pneumonia caused by mycoplasma in children?

Answer 44

Erythromycin