Paediatrics

Question 1

Neonatal heart rate

Answer 1

110-160

Question 2

Neonatal respiratory rate

Answer 2

40-60

Question 3

Neonatal systolic BP

Answer 3

70

Question 4

Heart rate of 1-5yo

Answer 4

95-140

Question 5

Respiratory rate of 1-5yo

Answer 5

25-35

Question 6

Systolic BP of 1-5yo

Answer 6

80-90

Question 7

Heart rate of 5-12yo

Answer 7

80-120

Question 8

Respiratory rate of 5-12yo

Answer 8

20-25

Question 9

Systolic BP of 5-12yo

Answer 9

90-110

Question 10

Respiratory rate of >12yo

Answer 10

12-18

Question 11

Heart rate of >12yo

Answer 11

60-100

Question 12

Systolic BP of >12yo

Answer 12

100-120

Question 13

Causes of Unconjugated jaundice within 1st 24 hours of life

Answer 13

Haemolytic disorders

- ABO incompatibility
- Rh disease
- G6PD deficiency
- spherocytosis
- pyruvate kinase deficiency

Question 14

Causes of conjugated jaundice within 1st 24hours of life

Answer 14

Rare - congenital infections

Question 15

Causes of Unconjugated jaundice after 1st 24 hours but lasting a few weeks only

Answer 15

Physiological jaundice
Breast milk jaundice
Cephalohaematoma
Infection (esp UTI) 
Haemolytic anaemia
Hypothyroidism 
Crigler-Najjar syndrome

Question 16

Causes of conjugated jaundice after 1st 24 hours but lasting a few weeks only

Answer 16

Bile duct obstruction
   - biliary atresia
   - choledochal cyst
Neonatal hepatitis syndrome
   - congenital infection
   - alpha1 anti-trypsin deficiency 
   - galactosaemia
   - inborn error of metabolism
   - CF
Intrahepatic biliary hypoplasia
   - Alagille syndrome

Question 17

Causes of Unconjugated jaundice lasting >2weeks

Answer 17

Physiological jaundice
Breast milk jaundice
Infection
Hypothyroidism
Haemolytic anaemia
High GI obstruction 
    - pyloric stenosis

Question 18

Causes of conjugated jaundice lasting >2weeks

Answer 18

Bile duct obstruction
    - biliary atresia
    - choledochal cyst
Neonatal hepatitis syndrome
   - congenital infection
   - alpha1 anti-trypsin deficiency 
   - galactosaemia
   - inborn error of metabolism
   - CF
Intrahepatic biliary hypoplasia
   - Alagille syndrome

Question 19

Emergency management of asthma

Answer 19

High flow O2
Salbutamol (5mg) nebulised on 02
Ipratropium bromide (0.5mg) nebulised on O2
IV hydrocortisone (100mg) / PO prednisone (40mg)
IV salbutamol or aminophylline
IV Magnesium
ICU - intubate and ventilate

Question 20

Define infantile colic

Answer 20

Distressed/crying infant for :
> 3 weeks 
for >3 hours / day 
for >3 days / week
In an otherwise healthy infant. 
Common.

Question 21

Syx of infantile colic

Answer 21

Inconsolable crying
Red face
Drawing up knees
Flatus

Question 22

DDX of infantile colic - to exclude

Answer 22

Physical discomfort - cold, wet, hungry
Severe nappy rash
Corneal abrasion 
Intussusception
Volvulus
Strangulated hernia
Testicular torsion
NAI

Question 23

Managing infantile colic

Answer 23

Support parent + ease concerns
Advice regarding feeding regieme, room temperature, clothing
Substitute cows milk with soya milk

Simethicone may help syx

Question 24

Congenital cyanotic heart diseases

Answer 24

Tetralogy of fallot

Transposition of the great arteries

Question 25

Congenital non-cyanotic heart disease

Answer 25

``` Coarctation of the aorta Aortic stenosis PDA VSD ASD ```

Question 26

Presentations of croup

Answer 26

``` Starts as viral URTI Progresses to include barking cough Hoarseness. Syx worse at night. Stridor may be heard at rest or when the child is agitated. ```

Question 27

At what age can a newborn smile spontaneously

Answer 27

6 weeks

Question 28

What could cause a child to have peeling skin on the palms and soles

Answer 28

Kawasaki's

Question 29

What is talipes equinovarus

Answer 29

Club foot | Foot is inverted and plantar flexed

Question 30

Commonest cause of recurrent epistaxis in children

Answer 30

Nose picking

Question 31

Risk factors for developmental dysplasia of the hip

Answer 31

``` Family history Breech delivery Spinal abnormality Neuromuscular abnormality Oligohydramnios ```

Question 32

Presentation of developmental dysplasia of the hip

Answer 32

``` Neonatal screening Asymmetrical skin creases Limited abduction Shortening of the limb Limp ```

Question 33

Presentation of posterior urethral valve

Answer 33

Male only | Urinary tract obstruction

Question 34

What bacteria causes meningitis In neonates

Answer 34

Group B streptococcus | Listeria

Question 35

What bacteria causes meningitis In children

Answer 35

Haemophilus Influenza Neisseria meningitidis Streptococcus pneumoniae

Question 36

Genetic inheritance of achondroplasia

Answer 36

autosomal dominant with complete penetrance | but > 80% of cases are spontaneous mutations