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MBBS V > Paediatrics > Flashcards

Paediatrics Flashcards

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1
Q

Skin prick testing vs Serum allergen specific IgE?

A

Use serum allergen if risk of anaphylaxis is high

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2
Q

Risk factors for DDH (4)

A

Female

Frank breech

Family history

First born

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3
Q

What disease is this?

A

Tetraology of Falot (boot shaped heart)

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4
Q

Management of transposition of great arteries? (2)

A

Prostaglandins to maintain PDA

Surgical repair in first two weeks of life

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5
Q

What is Eissenmenger’s syndrome?

A

Chronic pulmonary hypertension caused by a left-right heart shunt, leading to right ventricular hypertrophy that eventually causes the right ventricle to push blood into the left ventricle (bypassing the lungs) -> cyanosis

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6
Q

What infecious disease gives you a high fever THEN a rash?

A

Roseola

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7
Q

Intussuscepion clinical signs (2)?

A

Colicky abdo pain wih relief with child pulling knees to chest

Red current jelly stool (ischemic bowel)

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8
Q

What is this disease?

A

Duodenal atresia

(Double bubble sign)

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9
Q

Toddler with new onse abdo pain, pulls knees to chest to make it better. Dx, physical exam, investigation, Mx?

A

Intussception (bowel teloscoping)

Sausage shaped mass

US: target sign

Air enema

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10
Q

<2 years old child has corzya symptoms and wheezing. Diagnosis? What’s it caused by and mx (3)

A

Bronchiolitis

Respiatory Syncytial Virus

Supportive care (High flow O2, IVT and suction fluids)

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11
Q

What’s this disease?

A

Perthes’ disease

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12
Q

What’s this disease?

A

Omphalocele

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13
Q

What is this disease?

Two associated issues?

A

Congenital diaphragmatic hernia

Lung hypoplasia

Persistant pulmonary hypertension

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14
Q

VSD clinical features? (4)

A

<1 years

Pansytolic murmur over left sternal border

CHF and failure to thrive

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15
Q

What type of fracture is this?

A

Salter-Harris fracture type 3: A physeal fracture that extends through the epiphysis

SALTER

Type I - S: “straight through”

Type II - A: “above” i.e. Proximal

Type III - L: “lower” i.e. Distal

Type IV - TE: “through everything”

Type V - R: “rammed”

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16
Q

Continuous machinery murmur. What is the disease? What other clinical features (1)? How to manage? (1+1)

A

Patent ductus arteriosis

Collapsing pulse

IV indomethicin (prostaglandin antagonist)

If transposition of great arteries present (progressive cyanosis) -> give prostaglandins to maintain until surgical repair

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17
Q

Mx of DDH (3)?

A

<6 months: Pavlik harness

Failure of Pavlick harness -> Spica casts

Older + walking with fixed deformity -> Open reduction

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18
Q

What this disease?

A

Osgood Schlatter’s Disease

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19
Q

Test for cystic fibrosis?

A

Sweat chloride test

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20
Q

Progressive cyanosis in first week of life is what disease?

A

Transposition of great arteries

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21
Q

Best test for intussusception?

A

US

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22
Q

Drooling child, hot potato voice, distress. Two diff dx?

A

Epiglottitis (unvaccineated against Hib)

Quinsy’s peritonsillar abscess: trimus, ipsilateral cervical lymphadenopathy, uvula shifted to contralateral side

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23
Q

Expiratory wheeze diff dx (4)

A

Asthma (>5 years)

Viral induced wheeze (<3 years)

Bronchiolitis (RSV virus < 2 years)

Inhaled foreign object (intrathoracic)

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24
Q

How to treat this condition?

A

Otitis media

Analgesia and review in 72 hours

Consider amoxycillin if: <6 months, indigenous, bilateral ear infections <2 years, systemically unwell (not just fever), otorrhoea (perforated membrane)

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25
Differential diagnosis for lower GI bleeding in children? (5)
Premature infant: necrotising enterocolitis 3 months-3 years: Intussusception (acute onset colicky abdo pain) Merkel's diverticulum (painless) \> 2 years: Ulcerative colitis (bloody diarrhoea) Invasive gastroenteritis (E. Coli, Shigella) (fever + bloody diarrhoea)
26
Most common brain tumour of childhood? Ix?
Pilocytic astrocytoma Stains with glial fibrillary acidic protein
27
Clinical features of coarctation of aorta?
Upper limb HTN, lower limb hypotension Brachial-femoral delay Claudication of lower limbs Absent femoral pulses
28
Dx (2) and Mx (2) for pathological jaundice?
Bilirubin - conjugated riased usually Plot total bilirubin on normogram Phototherapy Exchange transfusion
29
What's this disease?
Slipped Capital Femoral Epiphysis
30
Feature of duodenal atresia (3)?
Polyhydramnios Biliary projectile vomiting Double bubble xray
31
Acid/base balance in pyloric stenosis?
Hypochloremic, hypokalaemic metabolic alkalosis
32
Two aetiologies of otitis externa ?
Exposure to water -\> psuedomonas aeruginosa Digital trauma -\> Staph epidermidis
33
Atiology for croup?
Parainfluenza virus
34
Physical exam finding for intussusception?
Sausage mass RUQ
35
Risk factor for coarctation of aorta?
Turner's syndrome
36
Flow of PDA?
Desceding aorta to pulmonary artery
37
What type of fracture is this?
Salter-Harris type 2: physeal fracture that extends through the metaphysis SALTER Type I - S: "straight through" Type II - A: "above" i.e. Proximal Type III - L: "lower" i.e. Distal Type IV - TE: "through everything" Type V - R: "rammed”
38
What's this?
DDH
39
Risk factors for transposition of great arteries? (1)
Diabetic mothers at conception (not GDM)
40
What type of fracture is this?
Salter Harris Type 1: complete physeal fracture +/- displacement SALTER Type I - S: "straight through" Type II - A: "above" i.e. Proximal Type III - L: "lower" i.e. Distal Type IV - TE: "through everything" Type V - R: "rammed”
41
What's this disease and give three clinical features?
Osteosarcoma Metaphysis of bones (particularly proximal tibia and distal femur) Sunburst appearance Atraumatic pin point bony tenderness
42
What type of fracture is this?
Salter-Harris type 4: A physeal fracture extended through both the metaphysis and epiphysis SALTER Type I - S: "straight through" Type II - A: "above" i.e. Proximal Type III - L: "lower" i.e. Distal Type IV - TE: "through everything" Type V - R: "rammed”
43
What's this?
DDH
44
Fixed splitting of S2 in a child indicated what heart defect?
Atrial Septal Defect
45
Four complications of prematurity?
Bronchiopulmonary dysplasia Retinopathy of prematurity Intraventricular haemorrhage Necrotising Entero Colitis
46
What is this disease? What other associations does it have?
Oesophageal atresia VACTERL Vertebra Anus Cardiac Tracheo-oesophageal fistula Esophageal atresia Renal Limbs
47
Management for pertussis?
Azithromycin
48
What's this disease and give three clinical features.
Ewing's sarcoma Mid shaft Onion skin appearance Atraumaic point bone tenderness
49
Projectile non billary vomiting straight after feeding. Dx, physical exam finding, investigation, mx?
Pyloric stenosis Olive lump epigastrium EUC: hypokalaemic, hypochloraemic metabolic alkalosis NG tube, correct electrolytes, pyloromyotomy
50
4 hours post birth. Dx?
Cephalohaematoma (does not cross midline)
51
Physical exam finding in pyloric stenosis?
Olive shaped lump in abdomen
52
Trisomy 21 associated with what paediatic conditions?
AtrioVentricular Septal Defect VSD ASD ToF
53
Tx for GAS?
Phenoxymethylpenicillin
54
Screning for DDH (3)?
Barlow' test (\<3 months): attempt to dislocate with hip flexion an adduction with posterior force Ortolani' test (already dislocated hip): attemt to relocate with hip adbuction and use fingers on bum to push back in socket USS at 4 weeks
55
Neonatal jaundice in first 24 hours. Pathological or physiological? 3 differential diagnoses?
Pathological APO incompatability Rh incompatability Sepsis
56
Hours after birth. Dx?
Caput succedaneum: croses midline
57
What's tested on a Guthrie card? (4)
Cystic fibrosis Congenital hypothyroidism Phenylketouria (PKU) Galactosaemia (unable to process milk)
58
Mx of absence seizures? (2)
Ethosuximide Valporate
59
What type of fracture is this?
Salter-Harris type 5: physeal fracture which is compressed SALTER Type I - S: "straight through" Type II - A: "above" i.e. Proximal Type III - L: "lower" i.e. Distal Type IV - TE: "through everything" Type V - R: "rammed”
60
Barking cough and this CXR. Dx?
Croup (Steeple sign) \<- didn't need to do CXR for diagnosis
61
Conditions as a part of imperforate anus syndrome? (7)
VACTERL Vertebra Anus Cardiac Trachea-oesophagus fistula Esophageal atresia Renal Limbs
62
What's this disease?
Gastroschisis
63
Tx for pertussis?
Azithromycin
64
Failure to pass meconium differentials (2)?
Imperforate anus Meconium ileus in cytic fibrosis
65
Most sensitive indicator of successful newborn resuscitation?
HR
66
Risk factor for patent ductus arteriosis?
Maternal rubella
67
Ambigous genitalia + raised serum 17-hydroxyprogesterone levels
Congenital adrenal hyperplasia
68
Limping child differential dx? (5)
Missed developmental dysplasia of the hip (long standing since they could walk) Perthe's disease (slow onset develops limp) Slipped Capital Femoral Epiphysis (gradual onset pain, usually obese child in early teens) Transient synovitis (post URTI hip pain) Septic joint (will not weight bere or move)
69
Young child with sore throat, lymphadenopathy, odynophagia, no cough. Two diff dx?
Group A Strep EBV (+ splenomegaly)
70
What is this condition?
Duodenal atresia | (Double bubble sign)
71
Differential dx for neonatal respiratory distress (5)?
Transient tachyopnoea of the newborn (TTN): full term baby via C section Neonatal Respiratory Distress Syndrome/ Hyaline membrane disease: premature baby or maternal GD Meconium aspiration syndrome: post term baby Sepsis: GBS positive mother or chorioamnionitis Hypoglycaemia: LGA, SGA, maternal GD
72
Coughing spasms and vomiting afterwards in young children?
Pertussis
73
Child with recurrent bacterial nasal infections, further investigations?
Look for foreign object
74
2 Complications from this disease?
Parvovirus B19 (slapped cheek) Aplastic crisis in sickle cell disease Threat to pregancy (keep away from pregnant ladies)
75
Gastro-illness followed by anaemia, thrombocytopenia + petechiae, renal impairment?
HUS Can have jaundice due to haemolytic anaemia. TTP is usually in adults (altered mental status, renal impairment, fever, haemolytic anaemia, thrombocytopenia)
76
Young child with distal extremity muscle weakness, loss of pain/temp and vibration. Dx, Ix?
Charot-Marie-Tooth disease Autosomal dominant condition Ix with nerve conduction studies and genetic testing (defintive)

MBBS V (6 decks)

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