PAEDS

Question 1

Bordetella Pertussis (Whooping cough) presentation

Answer 1

Afebrile, cough ,coryza, vomiting after cough

Question 2

Pertussis investigation + management

Answer 2

Nasopharyngeal swab

Azithromycin or clarithromycin

Question 3

Epiglottitis pathogen?

Answer 3

Hib

Question 4

Epiglottitis ix + mx

Answer 4

Xray (avoid tongue depressor - elicit muscle spasm)

IV Ceftriaxone, intubation if severe resp distress

Question 5

Rhinitis allergic vs non-allergic

Answer 5

Allergic: pollen, dust mites, mould
Non-allergic rhinitis: animals, food, drugs (aspirin), chemicals, infection, vasomotor (tobacco smoke, exercise, weather, perfume)

Question 6

Rhinitis ix + mx

Answer 6

skin prick testing or IgE blood test

Mx: IN steroids (Beclamethasone, budenoside); antihistamines (loratidine, certirizine)

Question 7

EBV presentation

Answer 7

Malaise, anorexia → fever, tonsillar exudate, generalised lymphadenopathy → fatigue
+/- hepatosplenomegaly, rash (amoxicillin-induced), arthritis

Question 8

EBV ix + mx

Answer 8

Monospot test.

Supportive care.

Question 9

Peritonsillar abscess clinical features

Answer 9

Unilateral sore throat, odynophagia, “hot potato” voice, drooling, fever, referred ear pain, trismus (lock jaw), contralateral deviation of uvula

Question 10

Peritonsillar abscess mx

Answer 10

Penicillin + drainage

Question 11

Retropharyngeal abscess

Answer 11

Torticollis (stiff neck), fever, odynophagia, drooling, palpable neck pain, stridor
Ix: CT with IV contrast
Mx: Antibiotics (Timentin IV)

Question 12

Hand foot and mouth disease (coxsackie virus) presentation

Answer 12

high fever, fatigue, non-itchy blisters (side of tongue, palate, nappy area, soles, palms), sore throat

Question 13

Rubella presentation

Answer 13

Respiratory symptoms + suboccipital adenopathy → maculopapular rash (initially face, then spread to entire body; pruritic), pink eye

Question 14

Pregnancy + rubella. Complications and when to give vaccine?

Answer 14

Mother infected in first 4 months pregnancy may result in congenital rubella syndrome (deafness, blindness, heart disease).
Do not give rubella vaccine in pregnancy, or 1 month before

Question 15

Mumps presentation and ix

Answer 15

Fever, headache, PAROTITIS (bilateral inflammation of parotid glands - pushes earlobes up and out; ear pain; pain on chewing), myalgia
Ix: urine or saliva viral serology

Question 16

Measles clinical features. 3Cs

Answer 16

Cough, coryza, conjunctivitis.
Fever, eyelid oedema, Koplik spots.
Maculopapular rash spreads from face + hairline, in descending fashion

Question 17

Varicella Zoster presentation.

Answer 17

Fever, resp symptoms → rash (pruritic, vesicles, erythematous) → vesicles burst + crust over

Question 18

WHy should pregnant women be careful of VZV infection and what should be done?

Answer 18

Maternal infection in first trimester can cause congenital varicella syndrome (low birth weight, CNS abnormality, limb abnormality, eye defects). If mother develops VZV 2-5d after delivery, high risk of neonatal varicella = must give VZIg

Question 19

Jones criteria of Rheumatic fever

Answer 19

SPACE: s/c nodules, pancarditis, arthritis, chorea, erythema marginatum

Question 20

Antibiotics for Rheumatic fever

Answer 20

Penicillin

Question 21

Scarlet fever clinical presentatoin

Answer 21

Acute onset fever (>38C), sore throat, strawberry tongue → pharyngitis, ‘sandpaper’ rash (perioral sparing, non-painful) → peeling

Question 22

Scarlet fever pathogen + abx

Answer 22

GABHS - penicillin

Question 23

CENTOR criteria for bacterial pharyngitis

Answer 23

No cough, tonsillar exudate, fever, cervical lymphadenopathy

Question 24

What is glue ear and how to treat

Answer 24

persistent serous otitis media causing conductive hearing loss. can cause long term language deficits. Do not treat if hearing not affected. Grommets if fluid persists.

Question 25

CSOM complications

Answer 25

hearing loss, mastoiditis, cholesteatoma, facial nerve paralysis, meningitis, brain abscess and sigmoid sinus thrombosis

Question 26

CSOM management

Answer 26

Ciprofloxacin. Do not use aminoglycosides e.g. gentamicin (ototoxic)

Question 27

Common cause of AOM

Answer 27

Viral, Strep pneumoniae, M. catarrhalis, H. influenzae

Question 28

Management of impetigo

Answer 28

Staph aureus - mupirocin (bactroban) or cephalexin

Question 29

Giardiasis

Answer 29

Metronidazole

Question 30

Meningitis vs encephalitis management

Answer 30

Meninigitis: Ceftriaxone + Dexamethasone Encephalitis: aciclovir

Question 31

Danger signs of paediatric illness

Answer 31

Convulsions, poor feeding, poor social interaction, poor sleep, non-responsive, chest indrawing, non-blanching rash, RR >40, stiff neck

Question 32

Croup presentation + mx

Answer 32

Barking cough + stridor. Consider prednisolone.

Question 33

Signs and symptoms of meningitis

Answer 33

photophobia, purpura (non-blanching rash - may be HSP), neck stiffness, confusion, full fontanelle, Kernig’s sign, signs of encephalitis (focal neuro)

Question 34

Bacterial meningitis pathogens

Answer 34

Strep pneumoniae (GP diplococci), Neisseria meningitides (GN diplococci), Hib (GN coccobacilli), Listeria monocytogenes (GP rods)

Question 35

List 5 examinations and conditions to look for on 6 week GP check

Answer 35

1) Undescended testes 2) Hip dysplasia 3) Heart defects 4) Cerebral palsy 5) oral thrush/ cleft palate

Question 36

What is blanitis + causal organism

Answer 36

Inflammation of glans penis resulting in rash over glans + under foreskin. May have discharge/odor. Candida (not STI).

Question 37

DDx for nappy rash

Answer 37

Threadworms Seborrheic dermatitis - non-itchy, salmon pink flaky patches Eczema, psoriasis Zinc deficiency - sharply defined, red, anogenital rash. Perioral dermatitis, failure to thrive, alopecia, diarrhoea Langerhan’s cell histiocytosis - chronic anogenital + scalp erosive rash unresponsive to treatment. Purpura, fever, hepatosplenomegaly, diarrhea, bone pain, pancytopenia.

Question 38

Testicular torsion clinical features + mx

Answer 38

Discolouration of scrotum; tender and swollen testis, high riding. Cremasteric reflex absent. Keep fasted. Urology referral for surgical consultation

Question 39

Torsion of the appendix testis clinical features + mx

Answer 39

Focal tenderness at upper pole of testis; "blue dot" sign | Analgesia, rest.

Question 40

Epididymoorchitis clinical features + mx

Answer 40

Onset may be insidious; fever, vomiting, irritative LUTS; penile discharge, dysuria. Red, tender, swollen hemiscrotum. First-pass urine sample (first morning urine) for chlamydia and gonococcus PCR Co-trimoxazole

Question 41

Idiopathic scrotal oedema | clinical features

Answer 41

Rapid onset of painless but notable oedema

Question 42

Hydrocele clinical features

Answer 42

Soft, non-tender swelling adjacent to testis; transilluminates (often self-resorbs)

Question 43

Varicocele clinical features

Answer 43

Mass of varicose veins ("bag of worms") above testicle, non-tender, more prominent when standing.

Question 44

Henoch Schonlein purpura triad

Answer 44

1) purpura over butt + lower limbs extonsor surfaces, 2) arthralgia, 3) abdo pain with GI bleeding (4) haematuria)

Question 45

What is dyschezia and is it normal in

Answer 45

Healthy infants (

Question 46

Laxatives for paediatric constipation

Answer 46

Movicol or paraffin oil. | If