Paeds

Question 1

indications for abx otitis media paeds

Answer 1

tympanic membrane perforated
< 3-months old
<2 years & infection bilateral
symptoms present >= 4 days

Question 2

anaphylaxis adrenaline doses for children < & >6

Answer 2

150 microgram 1:1000
3000 microgram

Question 3

CIs lumbar puncture (coning risk)

Answer 3

men sept
raised ICP
focal neurological signs
coagulation disorders
cardiovascular instability
delay abx deliver

Question 4

jaundice with a conjugated hyperbilirubinaemia

Answer 4

biliary atresia

dark urine and chalky white stool

Question 5

cause of prolonged jaundice in infants.

Clinical features include dry skin, constipation, coarse facial features including a large tongue as in the figure, umbilical hernia and a hoarse cry.

In the UK it is usually identified on newborn biochemical screening (Guthrie test).

Answer 5

Hypothyroidism

Question 6

whilst neonatal hypoglycaemia is often under ….

it’s often treated if under …

Answer 6

2.5

1 (10% dextrose)

Question 7

most common finding of neonatal sepsis

Answer 7

respiratory distress

Question 8

when are bowed legs normal and when do they resolve

Answer 8

<3
by 4

Question 9

prem babies immunisation changes

Answer 9

as per chronological age
if <28 –> 1st set in hospital due to apnoea risk

Question 10

airway suction should not be performed in neonates unless there is …. because it can cause …..

Answer 10

meconium
reflex bradycardia

Question 11

initial Ix for febrile child

Answer 11

Full blood count
Blood culture
C-reactive protein
Urine testing for urinary tract infection
Chest radiograph only if respiratory signs are present
Stool culture, if diarrhoea is present

Question 12

intesessuption is often associated with (2)

Answer 12

exophalos
diaphragmatic hernia

Question 13

what is seen on blood films in TTP

Answer 13

schistocytes

Question 14

mx limp in <3

Answer 14

urgent paeds assessment

Question 15

milestone calculation in prem baby

Answer 15

normal milestone - (40 - gestational age)

Question 16

in child with fever remember

Answer 16

NICE traffic light system

Question 17

threadworms name

Answer 17

Enterobius vermicularis

Question 18

ix if FTT baby

Answer 18

FBC // TFTs // coeliac screen // sweat test

Question 19

key facts on each type of idiopathic arthritis

Answer 19

oligo - <=4 joints // girls<6
poly - 5>= // +ve RF
systemic - fever // rash

Question 20

chest compressions on a child can also be commenced if

Answer 20

bradycardic (<30)

Question 21

parkland formula for paeds fluid for 1st 24hrs after a burn

Answer 21

4mL/kg/%BSA burn of Hartmann’s

give half in 1st 8 hours (other half in remaining 16hrs)

Question 22

most common cause pathological neonatal jaundice

Answer 22

biliary atresia

Question 23

tx vs prevention choices for NEC

Answer 23

prevention erythromycin
tx BSAbx

Question 24

Pancreatitis and infertility may follow … infection

Answer 24

mumps

Question 25

loud single S2 is audible and a prominent right ventricular impulse

Answer 25

TGAs

Question 26

differentiate infantile spasm from colic

Answer 26

In infantile spasms the child will become distressed between spasms, whereas in colic the child will become distressed during the 'spasms'

Question 27

common transient problem post gastroenteritis

Answer 27

lactose intolerance Removal of lactose from the diet for a few months followed by a gradual reintroduction

Question 28

intracranial haemorrhages in neonates

Answer 28

Subarachnoid: common // irritability + convulsions over the first 2 days of life Subdural: following use of forceps Intraventricular: pre-term infants // ultrasound

Question 29

undescended testes vs hyposdpadias mx

Answer 29

undescended: in 3m (ideally operation <6) hypospadias: 12m

Question 30

undescended testes vs hyposdpadias complications

Answer 30

undescended: infertility & testicular torsion hypospadias: cryptochidism & inguinal hernia

Question 31

The major risk factors for SIDS are:

Answer 31

prone sleeping parental smoking bed sharing hyperthermia and head covering prematurity

Question 32

if NEC deteriorates then manage with

Answer 32

laparotomy

Question 33

fluid levels in meconium ileus vs Hirschsprung

Answer 33

meconium --> no fluid levels

Question 34

maternal partum ICS use ++ risk of

Answer 34

DDH (lol!)

Question 35

when is PDA closed

Answer 35

1 week post delivery

Question 36

give abx in otitis media if

Answer 36

systemically unwell // immunocompromised

Question 37

DDx thalassaemia & sickle cell

Answer 37

- first year of life with severe anemia and failure to thrive. Extramedullary haemopoiesis results in frontal bossing of the skull. Haemolysis results in hepatosplenomegaly - later in line, recurrent bone & chest pain, proliferative retinopathy

Question 38

gold standard test for streptococcal pharyngitis

Answer 38

Throat cultures (since centor isnt good enough)

Question 39

why do we defer giving antibiotics in the community if men sept is suspected (unless hospital tx is gonna be delayed or px is too sick)

Answer 39

abx can interfere with LP results

Question 40

freidrich's ataxia inheritance pattern

Answer 40

autosomal recessive

Question 41

genetic disease common in children with consanguineous parents characterised by fatty substances, gangliosides, build up to toxic levels in the brain and spinal cord and affect the function of the nerve cells

Answer 41

Tay-Sachs disease

Question 42

immunisation associated with febrile convulsions

Answer 42

menB

Question 43

bruising that is more pronounced over bony prominences

Answer 43

ITP

Question 44

A 10 year old presents to his GP with several episodes of dizziness which have occurred on exercise over the past 3 months. On examination, he has a harsh grade 4/6 ejection systolic murmur which is loudest in the second right intercostal space. There is an ejection click. From the list below which is the most likely diagnosis?

Answer 44

aortic stenosis

Question 45

1. What is the most common symptom of a UTI in a child aged <2 years?

Answer 45

unexplained fever

Question 46

UTI abx duration for boys and girls

Answer 46

boys - 7days girls - 3days

Question 47

x-linked recessive conditions

Answer 47

haemophilia DMD G6PD deficiency

Question 48

x-linked dominant condition

Answer 48

fragile x (CGG // huntington's GAG)

Question 49

autosomal dominant

Answer 49

marfan ehler's danlos syndrome ryanodine deficiency

Question 50

autosomal recessive

Answer 50

cystic fibrosis sickle cell

Question 51

MMR vaccine is contraindicated in what allergy

Answer 51

neomycin