paeds high yield

Question 1

koplik spots

Answer 1

measles
(grey spots on buccal mucosa)

Question 2

raised immuno-reactive trypsinogen in newborn:

Answer 2

cystic fibrosis

Question 3

raised acylcarnitine in newborn:

Answer 3

MCAD

Question 4

raised phenylalanine in newborn:

Answer 4

pheylketonuria

Question 5

CENTOR critera

Answer 5

likelihood of sore throat being due to bacterial infection
1) tonsillar exudate
2) tender anterior cervical lymphadenopathy
3) fever over 38
4) absence of cough

score 0-2 low chance it’s strep
score 3-4 higher chance of strep

Question 6

what is tetralogy of fallot

Answer 6

• vsd
• overriding aorta
• right ventricular outflow tract obstruction (main determinant of severity of cyanosis)
• right ventricular hypertrophy

Question 7

‘double bubble’ sign xray

Answer 7

duodenal atresia

Question 8

newborn heel prick test tests for:

Answer 8

congential hypothyroidism
sickle cell
PKU
CF
MCAD
MSUD, IVA, GA1, HCU

Question 9

what & when do you screen for downs

Answer 9

11-13 weeks
biochemical screening triple test - AFP, hCG, oestriol
+/- uss nuchal translucency

if +ve offer invasive testing (amniocentesis or CVS)

Question 10

congenital abnormality screen: what, when, what for

Answer 10

USS, 18-20 weeks
skeletal abnormality, cns abnormality, neural tube defects, structural heart defects, cleft lip, renal agenesis, congenital lung malformation

Question 11

reduce period of infectivity in pertussis

Answer 11

clarithromycin (or other macrolide) if cough within 21 days (won’t change course of infection tho)

Question 12

croup management

Answer 12

one-off dose of oral dexamethasone 0.15mg/kg

Question 13

congenital adrenal hyperplasia electrolyte imbalance:

Answer 13

hyponatraemia and hyperkalaemia

deficiency of 21-hydroxylase -> reduced cortisol and aldosterone -> reduced sodium absorption and potassium excretion in the kidneys -> hyponatraemia and hyperkalaemia = ‘salt-wasting crisis’

Question 14

management for glandular fever:

Answer 14

supportive
advise against contact sports and heavy lifting for 1 month to minimise risk of splenic rupture

Question 15

NAME THE CONDITION
ladd’s surgical procedure

Answer 15

intenstinal malrotation

Question 16

complications of coeliac

Answer 16

• Anaemia (secondary to iron, B1 or folate deficiency)
• Hyposplenism (and therefore a susceptibility to encapsulated organisms)
• Osteoporosis (a DEXA scan may be required)
• Enteropathy-associated T cell lymphoma (EATL; a rare type of non-Hodgkin lymphoma).
  The likelihood or acquiring this malignancy is directly proportional to the strength of overall adherence to a gluten free diet - i.e. the more a patient breaks adherence, the more likely they are to get EATL

Question 17

management of epiglottitis

Answer 17

do not examine
secure airway (endotracheal intubation)
IV abx (cefuroxime)