Paediatrics

Question 1

What are the 4 categories in mile stones?

Answer 1

gross motor skills
fine motor skills and vision
language and hearing
social and play

Question 2

6 week old baby

Answer 2

The surgeon 
head control in vertical
follows light with eyes
stops moving when spoken to 
smiles sociably

Question 3

6 month old baby

Answer 3

curious baby
pushes on forearms, rolls stomach to back, weight bears
hand to hand transfer, palmar grasp, mouths things
babbles (mamama), screams when annoyed
friendly with strangers, plays with feet

Question 4

12 month old baby

Answer 4

drunk 
cruises around furniture, may take first steps
pincer grip, bangs and throws toys
responds to name, mumbles sounds
drinks from cup, waves bye bye

Question 5

18 month old baby

Answer 5

dinner party
runs, climbs on adult chair
builds tower 3-4 blocks, hand preference, picture books
5-20 words, points to body parts
feeds with spoon, imitates adult activities

Question 6

2 year baby

Answer 6

Slow adult
double tread stairs, throws ball
tower 6-7 blocks, scribbles
50 words, talks to self, joins 2 words, simple instructions
hat and shoes, symbolic play

Question 7

4 year baby

Answer 7

Diva
runs up and down stairs, kicks and catches ball, hops
threads beads, copies cross, draws a man
Stories, counts to 20
dresses, takes turns

Question 8

3 year baby

Answer 8

mini me
alternating feet on stairs, pedals trike
tower 9-10 bricks, copies circle, cuts with scissors
name and gender, lots of questions, simple conversation
washes hands, vivid play, sharing

Question 9

What is DTaP/IPV/Hib/HepB?

Answer 9

diphtheria, tetanus and pertussis
polio
haemophilus influenzae B
hepatitis B

Question 10

What does pertussis cause?

Answer 10

whooping cough

Question 11

When is rotavirus immunisation given?

Answer 11

2 months and 3 months

Question 12

What is diphtheria?

Answer 12

bacterial infection that infects mucous membranes
pseudomembranes (grey/white patches) develop that can block the airways
toxin produced that enters the blood stream causing myocarditis, arrhythmias, nerve damage

Question 13

What is tetanus?

Answer 13

bacterial infection (Clostridium tetani commonly found in soil) 
produce toxins that block release of inhibitory neurotransmitters (glycine and GABA)
causing muscle spasms (classically starts as lock jaw)

Question 14

Difference between clostridium botulinum and clostridium tetani?

Answer 14

botulinum affects synapses at neuromuscular junction whereas tetanus affects synapses in the brain

Question 15

What is pertussis?

Answer 15

bacterial infection that starts similarly to URTI but followed by violent coughing attacks in whihc patient gasps for air (whoop)
produces toxins that kill ciliated epithelial cells
can develop pulmonary hypertension (increased white blood cells in lungs) that leads to hypoxia

Question 16

What is polio?

Answer 16

viral infection that attacks the motor neurons and cause permanent muscle paralysis can be fatal if affecting brain or
spread through fecal matter

Question 17

What is haemophilus influenzae type B?

Answer 17

bacterial infection that can cause septicaemia, meningitis, epiglottitis

Question 18

What is pneumococcal infection?

Answer 18

bacterial infection (strep pneumoniae)
commonly causes meningitis

Question 19

What is hepatitis B and what problems can it cause?

Answer 19

virus that affects the liver that can persist for years and cause serious liver damage
spread through blood and body fluids

Question 20

Antibiotic for whooping cough?

Answer 20

macrolide abx: erythromycin

Question 21

Management of HIB?

Answer 21

ceftriaxone

Question 22

Management of epiglottitis?

Answer 22

IV ceftriaxone

Question 23

When is the rotavirus vaccine given?

Answer 23

8 weeks, 12 weeks

Question 24

What 4 vaccines are given at 8weeks?

Answer 24

DTaP/IPV/Hib/HepB
PCV
rotavirus vaccine
MenB

Question 25

What 2 vaccines are given at 12weeks?

Answer 25

DTaP/IPV/Hib/HepB | rotavirus vaccine

Question 26

What 3 vaccines are given at 16weeks?

Answer 26

DTaP/IPV/Hib/HepB PCV MenB

Question 27

What 4 vaccines are given at 1year?

Answer 27

Hib/MenC PCV MMR MenB

Question 28

What vaccine is given annually between 2-11 years?

Answer 28

flu

Question 29

What 2 vaccines are given at 3years 4 months?

Answer 29

DTaP/IPV | MMR

Question 30

What vaccine is given to girls aged 11-13?

Answer 30

HPV (16 &18)

Question 31

What 2 vaccines are given at 14years?

Answer 31

Td/IPV | MenACWY

Question 32

Edwards chromosome

Answer 32

18

Question 33

Patau chromosome

Answer 33

13

Question 34

Down's syndrome

Answer 34

21

Question 35

ADHD triad

Answer 35

hyperactive, inattentitive, impulse

Question 36

ADHD treatment

Answer 36

methylphenidate or atomextine

Question 37

Autism

Answer 37

social communication language repetitive behaviour

Question 38

Aspergers

Answer 38

autism but no problem with social communication

Question 39

What is atresia?

Answer 39

absence or abnormal narrowing of a passageway

Question 40

What vaccines are given at birth to at risk babies?

Answer 40

BCG (TB) Flu Heb B (if mother has hep B

Question 41

What is an incubation period?

Answer 41

time of infection to onset of symptoms

Question 42

What do ventral (anterior) horns of spinal cord contain?

Answer 42

cell bodies of motor neurons

Question 43

What do dorsal (posterior) horns of spinal cord contain?

Answer 43

cell bodies of sensory neurons

Question 44

What bilirubin is lipid soluble?

Answer 44

UCB

Question 45

How does UCB get to the liver?

Answer 45

binds to albumin and transported from spleen/lymph nodes to liver

Question 46

What enzyme conjugates bilirubin?

Answer 46

UGT

Question 47

What bilirubin is water soluble?

Answer 47

CB

Question 48

What makes urine yellow?

Answer 48

urobilinogen (CB converted to this by SI microbes)

Question 49

What is gilberts syndrome?

Answer 49

low UGT levels | liver has reduced ability to conjugate UCB

Question 50

What is crigler najjar syndrome?

Answer 50

no UGT | liver cant conjugate any UCB (fatal)

Question 51

What does presence of HBsAg indicate?

Answer 51

active infection (acute or chronic)

Question 52

What does presence of IgGsAg indicate?

Answer 52

cured or vaccinated

Question 53

How do you differentiate between HBV cured or vaccinated?

Answer 53

cured individual also has IgGcAg | Vaccine only has surface antigen present so no antibodies can develop against core

Question 54

What happens in the window period of HBV infection?

Answer 54

HBsAg is so low (due to work of the IgMsAg) that is cant be detected but you are infected (IgMcAg is present and IgGcAg may be present if body is taking longer to clear virus)

Question 55

What hepatitis virus has double stranded DNA oppose to single stranded RNA?

Answer 55

HBV

Question 56

What is the ductus arteriosus?

Answer 56

connects pulmonary artery to descending aorta

Question 57

What is the newest vaccine to be introduced for children?

Answer 57

MenB

Question 58

When is baby first examined and when is the follow up?

Answer 58

examination of the new born within 72 hours | next examination 6-8weeks (GP)

Question 59

Epiglottitis presentation?

Answer 59

sudden onset fever, sore throat, drooling, dysphagia, no cough, muffled voice, inspiratory stridor

Question 60

Thumbprint sign?

Answer 60

epiglottitis

Question 61

Steeple sign?

Answer 61

croup

Question 62

Croup presentation?

Answer 62

barking cough with inspiratory stridor | no drooling

Question 63

Organism commonly causing croup?

Answer 63

viral: parainfluenza

Question 64

Organism commonly causing epiglottitis?

Answer 64

bacterial: HIB, strep pyogenes

Question 65

Managment of epiglottitis?

Answer 65

IV ceftriaxone | ITU, endotracheal intubation

Question 66

management of croup?

Answer 66

serious: O2, nebulised adrenaline, steroids | Non-serious: dexamethasone

Question 67

Whooping cough presentation?

Answer 67

cold like symptoms | attacks of whooping cough with gasps for air

Question 68

Management of whooping cough?

Answer 68

erythromycin

Question 69

Organism in whooping cough?

Answer 69

bordetella pertussis bacteria

Question 70

inheritance of CF?

Answer 70

AR

Question 71

What causes CF?

Answer 71

inherited mutation in CFTR gene that codes for NaCl channel | Decreased Cl into secretions which usually draws water in to help thin

Question 72

fat soluble vitamins?

Answer 72

ADEK

Question 73

Test for CF?

Answer 73

IRT screening in newborn Sweat test NaCl >60 Genetic testing for CFTR mutations

Question 74

Where is CFTR gene found?

Answer 74

chromosome 7

Question 75

What is cerebral palsy?

Answer 75

group of movement disorders

Question 76

Overall function of the cerebellum?

Answer 76

balance and coordination

Question 77

Overall function of the basal ganglia?

Answer 77

helps initiate and prevent certain movements habits eye movements cognition, emotion

Question 78

Function of the motor cortex?

Answer 78

motor function

Question 79

What is chorea?

Answer 79

irregular movements that flow from one part to another producing dance like movements

Question 80

What is dystonia?

Answer 80

sustained muscle contraction

Question 81

Where does PD affect?

Answer 81

substantia nigra in basal ganglia

Question 82

What are the three main types of cerebral palsy and what area of the brain is affected in each?

Answer 82

spastic (cerebrum) dyskinetic (basal ganglia) ataxic (cerebellum)

Question 83

What is baclofen?

Answer 83

muscle relaxant

Question 84

What is juvenille myoclonic syndrome?

Answer 84

brief episodes of involuntary muscle twitchin (myoclonic seizures) +/- absence +/- tonic clonic common in 12-18yrs

Question 85

management of generalised epilepsy?

Answer 85

na valproate 2nd line/chil-bearing age lamotrigine

Question 86

management of focal/partial seizures?

Answer 86

carbamazapine, 2nd line lamotrigine

Question 87

For infants having repeat febrile convulsions what can you teach the mother?

Answer 87

rectal diazepam buccal midazolam ambulance if >5mins

Question 88

What are the risk factors for febrile convulsions?

Answer 88

age (6months to 5 years) FH rapid onset fever >38 vaccines (benefits outweigh risks)

Question 89

What is the classic presentation for febrile convulsion?

Answer 89

occurs early in viral infection brief <5mins generalised tonic-clonic

Question 90

Do antipyretics reduce chance of febrile seizures?

Answer 90

no

Question 91

What is a simple febrile seizure?

Answer 91

<15 mins normal in 1hr symmetrical generalised tonic-clonic no repeat in 24hrs

Question 92

What is a complex febrile seizure?

Answer 92

15-30mins repeat in 24 hrs focal

Question 93

Who gets admitted with febrile seizures?

Answer 93

1st one | any features of complex seizure

Question 94

What are the chances of a repeat seizure and when does this increase?

Answer 94

``` 1 in 3 increased if <18 months fever <39 onset shortly after fever began FH ```

Question 95

What is the childhood chance of developing epilepsy and what are the risk factors that increase this chance?

Answer 95

2.5% complex febrile seizures FH neurodevelopmental disorders

Question 96

Common cause of meningitis in 0-3months?

Answer 96

listeria e-coli GBS

Question 97

Common cause of meningitis 3months to 6 years?

Answer 97

h. influenzae (gram -ve rods) n. meningitidis (meningococcus) s. pneumoniae (pneumococcus)

Question 98

Common cause of meningitis in >6year olds?

Answer 98

neisseria meningitis (meningococcal) gram -ve diplococci s.pneumoniae

Question 99

What is a positive kernigs sign?

Answer 99

lie on back knee at 90degrees and straighten causes back pain

Question 100

What is a positive brudzinskis sign?

Answer 100

lie on back and flex neck causes knees to automatically flex

Question 101

Management of bacterial meningitis?

Answer 101

<3months: cefotaxime and amoxicillin | >3monhts: cefotaxime 1st dose then ceftriaxone

Question 102

Where is a lumbar puncture done?

Answer 102

between L3 and L4