Paeds

Question 1

Signs of shock

Answer 1

I SHOCKS

Increased respiratory rate
Sinus tachycardia
Hypotension
Oliguria
Cold
Klammy
Slow cap refill

Question 2

Tetralogy of Fallot

Answer 2

PROVE

Pulmonary stenosis causing
Right ventricular hypertrophy
Overiding aorta, R to L shunt across
VSD
Ejection systolic murmur - pulmonary

Question 3

Down Syndrome facial features

Answer 3

ROSEOLA

Round face
Occipital flattening (and nasal)
Speckled iris (Brushfield spots)
Epicanthic folds
Open mouth (with protruding tongue)
Low set ears
Almond (oval) upward slanting eyes

Question 4

Kawasaki Disease features

Answer 4

CLEAR (excludes 5+ day fever)

Conjunctivitis
Lymphadenopathy and red lips/strawberry tongue
Extremity changes
Anuerysm
Rash on trunk

Question 5

Mnemonic for 5 stage approach to Status epilepticus

Answer 5

Oh My Lord Phone The Anaesthetist

Oxygen (after ABC)
Midazolam buccal/rectal diazepam
Lorazepam IV
Phenytoin
Thiopentone - Anaesthetist

Question 6

Discharge after bronchiolitis advice to parents

Answer 6

DIB

Don’t smoke at home
Immediate advice to be sought if poor fluid intake, worse breathing or no wet nappy for 12 hours
Bring back for review (specify time and place)

Question 7

Asthma assessment

Answer 7

PROPS

Peak flow
Respiratory rate
Oxygen sats
Pulse rate
Sentences

Question 8

Life threatening asthma

Answer 8

33, 92, CHEST

Peak flow <33% of predicted/best
Sats less than 92
Cyanosis
Hypotension
Exhaustion with poor respiratory rate
Silent chest
Tired or confused - (reduced conscious level)

Question 9

Acute severe asthma treatment options (not in order)

Answer 9

O SHIT Me

Oxygen (if sats below 94)
Salbutamol
Hydrocortisone (if can't take oral prednisolone)
Ipratropium Bromide (nebulised)
Theophylline
Magnesium sulphate

Question 10

Acute nephritic syndrome body response

Answer 10

HOST

Hypertension
Oliguria
Smoky brown haematuria
Trace oedema

Question 11

Serious congenital infections

Answer 11

TORCH

Toxoplasmosis
Other (HIV, hepatitis, measles)
Rubella
Cytomegalovirus
Herpes Simplex

Question 12

Management in child abuse

Answer 12

SMACK

Safety of child is absolutely paramount
Manage presenting medical problem appropriately
Always discuss concerns with a senior paediatrician
Contact social care
Keep clear and contemporaneous notes

Question 13

Admission for bronchiolitis

Answer 13

DRAMAS

Dehydration
Respiratory rate >70/marked episodes of grunting/recession
Apnoeic episodes
Milk/fluid intake <50% less than normal
Appearance: ill or exhausted in view of health professional
Sats less than 92 on air or cyanosis