Paediatrics - Misc

Question 1

Name 3 causes of Acute Compartment Syndrome

Answer 1

Fracture, Burn, Infection, Limb compression, Vascular (Haemorrhage), Iatrogenic (IM injection)

Question 2

The medical name for a birth mark

Answer 2

Cavernous hemangioma

Question 3

Explain a formula used for calculating maintenance fluids in paediatrics

Answer 3

1. ) 4-2-1 rule (ml’s per hour) => 4ml/kg/hr first 10kg, 2ml/kg/hr next 10kg, 1ml/kg/hr every kg above 20kg
2. ) 100-50-20 rule (ml’s per 24hr) => 100ml for first 10kg, 50ml for next 10kg, 20 ml/kg above 20kg

Question 4

What is the formula for calculating rehydration fluids over 24 hours?

Answer 4

Weight (kg) X %Dehydration X 10 = Total ml over 24 hours

Question 5

Name a condition for which bolus fluids would be used?

Answer 5

Any type of shock

Question 6

What fluids are used as bolus in paediatrics and how much per Kg (give percentage)

Answer 6

0.9% NaCl 20ml/Kg given stat

Question 7

The external ear develops from what structure of the embryo

Answer 7

6 Hillocks of His (mesoderm)

Question 8

The nose develops in which week for the embryo and from what?

Answer 8

Week 5 from olfactory placodes (thickening of ectoderm above stromodeum)

Question 9

Name one type of manifest Strabismus

Answer 9

Esotropia (inwards); Exotropia (outwards); Hypertropia (upwards); Hypotropia (downwards)

Question 10

Name one type of latent Strabsimus

Answer 10

Esophoria; Exophoric; Hyperphoria; Hypophoria

Question 11

Name an investigation for childhood strabismus

Answer 11

Corneal reflection; Cover test; Visual acuity

Question 12

Name a treatment for Amblyopia (lazy eye)

Answer 12

refractive adaptation (glasses; Occlusion of better eye (patch); Atropine drops in better seeing eye (blur vision)

Question 13

What does WHODAS 2.0 assess and name 2 of the 6 areas assessed

Answer 13

WHO Disability Assessment Schedule => generic assessment for health + disability
6 areas: Cognition, Mobility, Self-care, Social, Life activities, Participation

Question 14

Name an investigation for splenomegaly/hypersplenism

Answer 14

Liver biopsy, Bone marrow biopsy, Lymph node biopsy, MRI or PET scan may be required, Splenic biopsy

Question 15

Name a cause of splenomegaly in children for each of the following headings: 1.) Infection 2.) Autoimmune 3.) Haemolysis 4.) Neoplasia 5.) Inherited

Answer 15

Infection: glandular fever, cytomegalovirus (CMV), other viral infections, often accompanied by lymphadenopathy; bacterial, protozoal, and fungal infections
Autoimmune: Juvenile rheumatoid arthritis
Haemolysis: hereditary spherocytosis, sickle cell anaemia, thalassaemia
Neoplasia: acute lymphoblastic leukaemia (ALL), Hodgkin’s disease and non-Hodgkin’s lymphoma (NHL), acute or chronic myeloblastic leukaemia, neuroblastoma
Inherited: Hereditary spherocytosis, Gaucher disease, Niemann-Pick disease

Question 16

A crisis which may develop in young children with sickle cell anaemia, which can precipitate hypovolaemic shock and death, and is an indication for splenectomy

Answer 16

Splenic sequestration crisis

Question 17

Name 3 investigations for a neck lump/bump

Answer 17

FBC and ESR, TFTs, Viral serology (eg, EBV, cytomegalovirus, toxoplasmosis), Throat swab, CXR/CT/MRI, USS (for thyroid swellings), Radionucleotide scanning (if masses of parathyroid or thyroid glands)

Question 18

Name a cause of lymphadenopathy in children for each of the following headings: 1.) Viral 2.) Bacterial 3.) Protozoal 4.) Fungal 5.) Autoimmune 6.) Neoplasia

Answer 18

Viral: upper respiratory infections, mononucleosis, cytomegalovirus (CMV), Rubella, varicella, measles, HIV, Hepatitis A and hepatitis B, Roseola infantum, Dengue, Adenovirus
Bacterial: Septicaemia, Typhoid, TB, Syphilis, Plague, Lyme disease, Tularaemia, Brucellosis.
Fungal: Histoplasmosis, coccidioidomycosis, blastomycosis and tinea
Autoimmune: systemic lupus erythematosus, juvenile idiopathic arthritis, and dermatomyositis
Neoplasia: Lymphoma, Leukaemia,

Question 19

What is the triad of Shaken Baby Syndrome?

Answer 19

Retinal haemorrhages + Subdural haematoma + Encephalopathy

Question 20

Which one of the following is least associated with constipation in children?

• Dehydration
• Addison’s disease
• Hirschprung’s disease
• Hypercalcaemia
• Anal fissure

Answer 20

Addison’s disease

Question 21

Does a 15-year-old patient have capacity to consent to a procedure?

Answer 21

Children under the age of 16 can consent to their own treatment if they’re believed to have enough intelligence, competence and understanding to fully appreciate what’s involved in their treatment. This is known as being Gillick competent. Otherwise, someone with parental responsibility can consent for them.

Question 22

Age-appropriate HR and RR for ages:

<1, 1-2, 2-5, 5-12, >12

Answer 22

< 1	       110 - 160	   30 - 40
1 - 2	       100 - 150	   25 - 35
2 - 5       90 - 140	   25 - 30
5 - 12      80 - 120	   20 - 25
> 12	       60 - 100	   15 - 20

Question 23

Paediatric BLS: In an infant, which 2 pulses are the most appropriate places to check for a pulse?

Answer 23

Brachial + Femoral