paeds

Question 1

Small testes in precocious puberty indicate_________________________

Answer 1

an adrenal cause of the symptoms

Question 2

____________would cause unilateral enlargement of the affected testicle

Answer 2

A sex cord-gonadal stromal tumour

Question 3

hypoglycaemia in neonates is defined as _____. what is a RF?

Answer 3

blood glucose level of less than 2.5 mmol/L

Maternal gestational diabetes

Question 4

Perianal itching in children, possibly affecting other family members → which organism?

Answer 4

Enterobius vermicularis (threadworms)

Question 5

‘Examination reveals a positive head impulse test’ –> ?

Answer 5

Vestibular neuritis
not typically seen in a posterior circulation stroke

Question 6

_______________________ is the number one cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years

Answer 6

Meckels diverticulum

Question 7

CAH vs AIS - how to differentiate?

Answer 7

AIS causes primary amenorrhea while CAH causes precocious pubic hair

AIS: female presenting, firm palpable masses in groin (undescended testes)

CAH: ambiguous genetilia and virilisation (in F)

Question 8

______________ is the triad of the shaken baby syndrome

Answer 8

Retinal haemorrhages, subdural haematoma and encephalopathy

Question 9

distended abdomen and bilious vomiting =

Answer 9

intestinal malrotation

Question 10

Pansystolic murmur in lower left sternal border

Answer 10

Ventricular septal defect

Question 11

Crescendo-decrescendo murmur in the upper left sternal border

Answer 11

Coarctation of the aorta

Question 12

Diastolic machinery murmur in the upper left sternal border

Answer 12

Patent ductus arteriosus

Question 13

Ejection systolic murmur in the upper left sternal border

Answer 13

Pulmonary stenosis

Question 14

which abdo condition is associated with fluid levels?

Answer 14

Hirchsprung’s

Question 15

Infant with bilious vomiting & obstruction →

Answer 15

?intestinal malrotation

Question 16

Parents should be advised to call an ambulance if a febrile convulsion lasts _____________

Answer 16

> 5 minutes

Question 17

Exomphalos and diaphragmatic herniae are commonly associated with

Answer 17

malrotation

Question 18

paeds seizures
1. generalised tonic-clonic seizures, myoclonic episodes in morning, 12-16 Y.O. occasional episodes of absence seizures:

2. centrotemporal spikes on EEG, 3-13 Y.O. short seizures involving twitching and parraesthesia of one side of face and tongue:

Answer 18

1. generalised tonic-clonic seizures, myoclonic episodes in morning, 12-16 Y.O. occasional episodes of absence seizures: juvenile myoclonic epilepsy
2. centrotemporal spikes on EEG, 3-13 Y.O. short seizures involving twitching and parraesthesia of one side of face and tongue: benign rolandic epilepsy

Question 19

Coronary artery aneurysms are a complication of Kawasaki disease and this should be screened for with an

Answer 19

echocardiogram

Question 20

murmur in Turner’s syndrome

Answer 20

ejection systolic murmur due to bicuspid aortic valve

Question 21

definitve Mx of SCFE

Answer 21

Refer to orthopaedics for in situ internal fixation with a cannulated screw

Question 22

ITP vs TTP?

Answer 22

In TTP, schistocytes are often seen on blood smears.

Question 23

____________ is used as prophylaxis for contacts of patients with meningococcal meningitis

Answer 23

Oral ciprofloxacin or rifampicin

Question 24

Croup:_______________ is an indication for admission

Answer 24

audible stridor at rest

Question 25

what causes roseola

Answer 25

HHV6

Question 26

chickenpox rash vs roseola rash

Answer 26

roseola rash typically starts on the trunk and limbs (this is different to chickenpox which is typically a central rash)

Question 27

Neonatal sepsis - early onset cause: - late onset cause: - most characteristic feature: - Tx:

Answer 27

- early onset cause: Group B Strep - late onset cause: Staph epidermidis - most characteristic feature: grunting/resp distreess - Tx: IV benpen and gentamicin

Question 28

ASD in children is associated with

Answer 28

- Downs - FA - Ebsteins anomaly

Question 29

Live attenuated vaccines

Answer 29

BCG MMR oral polio yellow fever oral typhoid

Question 30

adrenaline dose for children under 6 years

Answer 30

150mcg 6-12: 300mcg adults: 500mcg in cardiac arrest: 1mg

Question 31

Ix for bronchiolitis?

Answer 31

immunofluorescence of nasopharyngeal secretions

Question 32

emergency Tx for croup

Answer 32

dexamethasone, O2, adrenaline (nebulised)

Question 33

CF-specific contraindication for lung transplantation

Answer 33

chronic infection with Burkholderia cepacia

Question 34

referral points for milestones

Answer 34

Referral points - doesn't smile at 10 weeks - cannot sit unsupported at 12 months - cannot walk at 18 months Fine motor skill problems - hand preference before 12 months is abnormal and may indicate cerebral palsy

Question 35

which infants need routine US examination for DDH

Answer 35

- first-degree family history of hip problems in early life - breech presentation at or after 36 weeks gestation, irrespective of presentation at birth or mode of delivery - multiple pregnancy

Question 36

DDH Ix

Answer 36

US XRAY if >4.5m

Question 37

motor milestones

Answer 37

3 months = fix and follow 6 months = palmar grasp 9 months = points 12 months = pincer group

Question 38

Play milestones

Answer 38

9m = peek a boo 12m = waves bye 18m = plays alone 2 years = plays near children 4 years = plays with children

Question 39

inheritance of Duchenne's muscular dystrophy

Answer 39

X-linked recessive

Question 40

Definitive Ix for Duchenne's muscular dystrophy

Answer 40

genetic testing

Question 41

vaccination schedule

Answer 41

Question 42

Ix of choice in NE and what does it show

Answer 42

Abdo XRAY: shows dilated bowel loops + pneumatosis intestinalis

Question 43

do you treat whooping cough?

Answer 43

Whooping cough - azithromycin or clarithromycin if the onset of cough is within the previous 21 days

Question 44

Newborn with intermittent grunting and nasal flaring, normal RR and O2 sats, born after C-section - Dx? Mx?

Answer 44

Dx: transient tachypnoea of the newborn Mx: no further investivations just monitor It is more common following caesarean sections, possibly due to the lung fluid not being 'squeezed out' during the passage through the birth canal Chest x-ray may show hyperinflation of the lungs and fluid in the horizontal fissure.

Question 45

For a child with a palpable abdominal mass or unexplained enlarged abdominal organ:

Answer 45

refer very urgently (<48hr) for specialist assessment for neuroblastoma and Wilms' tumour

Question 46

Unilateral undescended testicle -

Answer 46

review at 3 months - if persistent refer bilateral - review in 24h

Question 47

____ is associated with seborrhoeic dermatitis

Answer 47

HIV

Question 48

increased nuchal thickness on combined scan =

Answer 48

1. Down's syndrome 2. Congenital herat defects