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Paeds MCQ Flashcards

(90 cards)

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1
Q

Necrotising enterocolitis?

A

2-4 weks of life, FTT, vomit, lethargy, abdo distension. O/E bile vomit, blood stools, distended/ visable bowel, lactic acidosis, high CRP - complication of abscess/ stricure?
abdo XR - pneumonitis intestinalis, dilated gas filled loops,
TX: NBM, NG to decompress, surgery,
RF: mother chorioamnitis, HIV, drugd, premature, post natal complications

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2
Q

6 weeks milestones:

A

sound startles, smiles at 10, palmer graps, head control,

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3
Q

3 months milestones?

A

held sitting, head control, squeals, quietens to parent’s voice, reaches for object, follows things with eyes, bottle on hand when fed, not shy.

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4
Q

sit without support and put mouth to food? when to refer?

A

refer at 12 months if not sitting without support. 7-8 months puts mouth to food.

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5
Q

9 months milestones?

A

pulls to standing, mama/dada, crawls, points with finger, everything to mouth, understands no, plays peak a boo

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6
Q

12 months mile stones?

A

cruises, walks with 1 hand, pincer grip, bangs toys together, bye bye, drinks from cup, knows their name

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7
Q

when to refer if not walking?
milestones at 13-15 months?

A

refer when 18 months if not walking/ if not speaking
13-15: walks, hand preference (refer if <1), gets dressed/ undressed. looks at book when 15 and builds tower of 2

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8
Q

18 month milestones?

A

squats to pick up toy, tower of 3, scribbles, turn multiple pages, understands simple commands, uses spoon, takes off shoes

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9
Q

2YO milestones?

A

runs, jumps, tower of 6, turns one page at a time, goes upstairs with rail, 2 words combined,
250 words vocab at 2.5 yrs, points to parts of body, puts on hat/ shoes

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10
Q

3YO milestones?

A

tower of 9, copies circle, rides tricycle, stand on 1 leg, spoon and fork, plays with children, knows colours, short sentences, tells stories

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11
Q

4YO milestones

A

hops on 1 leg, draws square, and cross, why, when how qs, dresses alone except laces/ buttons, coutns to 10

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12
Q

5YO milestones?

A

skips, copies triangle, knife and fork, lists address

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13
Q

6 month milestones?

A

rolls front to back, held sitting back straight, pulls to sitting, pass objects between hands, palmer grasp, looks around everywhere,

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14
Q

paeds IX for asthma?

A

spirometry - if obstructive, test for reversibility. If no reversibility, then try FeNO levels - if 35ppb more, refer to specialist.
tests for oesinophilic inflamamtion/ atopy? - skin prick, blood IGe, eosinophils, FeNO

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15
Q

paeds TX asthma steps?

A

PRN SABA (only for short lived wheeze)
trial moderate ICS 8 weeks - if sx start 4 weeks of stopping then start low ICS. IF sx start after 4 weeks of stopping, repeat trial.
low ICS/ <5 trial LTRA
then if >5 add inhaled LABA/ LTRA
then consider increasing dose

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16
Q

drawing legs up, sausage mass, red current jelly stools 3-6 months boy?

A

intussusception - bile vomit, XR dilated bowel, USS - dohnut/ target sign. TX- barium enema, surgery if child < 3months, or 2YO +, peritonitis, dehydration

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17
Q

CMV features?

A

spread through direct body fluid contact, deafness, blueberry rash, chorioretinitis, seizures, microcephaly, intracranial manifestations

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18
Q

trepenoma pallidum features?

A

congenital syphillis - death, deafness, cranial manifestations,

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19
Q

toxoplasmosis features?

A

chorioretinitis, hydrocephalus, intracranial calcifications, rash. CX: uncooked meats, cat faeces toxoplasma gondii
TX: pyrimethamine (antiparasytic,sulfadiane)

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20
Q

TORCH stands for?

A

toxoplasmosis
other - VZV, trepenoma pallidum, parvovirus b19, HIV,
Rubella
CMV
HSV

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21
Q

Rubella features?

A

blueberry rash, deafness, cataracts, cardiac defects,
mother: LN, arthitis, rash

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22
Q

2YO boy, palpable abdo mass iwth fever, HTN, anaemia, haematuria?

A

WIlm’s nephroblastoma (common intrabdo tumour)

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23
Q

painless rectal bleed <2YO

A

meckel’s diverticulum. remnant of the vitellointestinal duct.

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24
Q

pinworm infection tX

A

mebendazole

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25
RDS infant RF?
premature, male, CS, hypothrmia, perinatal asyphixia, maternal diabetes, multipl, FH,
26
2-8YO, drooling, tripod position, muffled voice, cervical LN, odynophagia, stridor, no cough
epiglottitis. CX: haemophilus influenza b. group A strep. thumbpring sign on XR lateral neck.
27
When to suspect coeliac disease?
FTT, diarrhoea, pain, FH, fatigue, anaemia, dermatitis herpetiformis, autoimmune thyroid, IBS, t1dm. tTGA / anti endomesial antibodie - then do biopsy. confirm they have eaten atleast 2 meals a day for 6 weeks.
28
Complications of coeliac?
anameia, OP, fragility fracture, IUGR, BW, cancers (hodgkins and non hodgkins), chronic panc, sarcoid, autoimune, small bowel lymphoma,
29
stridor, steeple sign on XR,
croup - parainfluenza/ rare RSV
30
asylum seeker 14 YO pharyngitis, water nasal discharge then blood stained, enlarged cervical LN, bull's neck, fever?
diptheria. vaccine in uk for kids. adults may need booster. antitoxin within 48 hrs and benpen 4 IV then oral for 10 days
31
HSP complications?
IGA immune complexes, palpable purpuric rash, joint pain, gi pain, complications: renal, MI, pleural effusion, gi bleed, pulmonary haemorrhage, testicular haemorrhage or torsion, seizures, IC heamorrhage
32
recurrent projectile vomits, 2-12 week infant, FTT, olive mass felt in RUQ
pyrloric stenosis. laprascopic pyrlorotomy, hypochloremia, hypokaelaemia met alkalosis
33
scaphoid abdomen, billous vomitting, USS double bubble sign?
duodenal atresia
34
lethargy, good baby, FTT, poor growth, hypotonic, large fontanelle, umbilical hernia?
congenital hypothyroid
35
child shorter than class, tall parents, baby face at 5/6YO, increased fat around trunk.
also delayed puberty/ small phallus. growth hormone delay, do insulin tolerance test and MRI.
36
physiological jaundice?
at day 2 of life, peaks at day 7-15 and then resolves 10. breastmilk jaundice? - could be prolonged
37
what is extracorporeal membrane oxygenation used for?
RDS/ primary pulmonary hypertension
38
UTI in <6 months old Ix?
USS if atypical/ recurrent UTI asap or within 6 weeks. then DMSA after 4-6 months, and MCUG (mictruating urethrocystogram)
39
Jaundice in 24 hrs cx?
haemolysis - ABO/ haematoma/g6pd/spheroytosis, infection
40
atypical UTI features?
ill, poor urine flow, abdnormal bladder mass, raised creatitine, non ecoli, not responding in 48 hrs, scepicaemia
41
cow's milk protein intolerance mx?
comfort milk trial OTC 4 weeks then re-try formula soy milk not for < 6 months hydrolysed milk: nutramigen (2 at 6 months( then aptamil if not working. continue until 2YO or grown out of allergy. 120ml/kg/day 0-6 months 10x 400g per month 6-12 months 12x 400g/ month severe allergy: neocate
42
most common paeds seizures and features?
benign rolandic seizures. 2-3 mins focal, unilaeral face twitching, gurgling, drooling, speech arrest, face numbness/tingling. 7-10 boys. at night or waking, can resolve by age 16
43
most common cx of viral GE?
rotavirus - in children norovirus in the UK bacterial - campylobacter
44
can females have haemophia b?
no because this is x linked recessive
45
what is haemorrhagic disease of newborn?
vitamin K deficiency bleeding. common bleeding site - umbilical chord, mucous mebrane, gi bleed, haematomas, venepunctures, circumsicison. RF: breast fed.
46
10 YO, salmon punk rash on trunka dn extremtitis, fatigue, pain in joints for 3 months
juvenile chronic arthritis : <16YO and 3 months +
47
8YO boy, bleeding gums, nose, platelets 30, bruises, no organomegaly
ITP: destruction of platelets atuoimmune. acute is <6 months.
48
Tx whooping cough?
women who are between 16-32 weeks pregnant will be offered the vaccine. oral macrolgide - clarithomycin if presents within 21 days DX:Paroxysmal cough. Inspiratory whoop. Post-tussive vomiting. Undiagnosed apnoeic attacks in young infants.
49
Measles school exclusion?
4 days from rash
50
small head, flattened philtrum and thin upper lip.
Fetal alcohol syndrome
51
Gastroshisis?
Congenital defect of abdo wall lateral to umbicicus. Not covered. Trial Vaginal delivery surgery within 4 hrs
52
Contents potruding through anterior abdo wall covered by sack. AF cardiac/ renal defects and downz syndrome?
Exomphalos - do c section delivery. Sack can granulose and then be closed up
53
Cyanotic congenital heart conditions? Most common?
tetralogy of Fallot - VSD, RVH, overriding aorta, pulmonary stenosis transposition of the great arteries (TGA) tricuspid atresia Fallot's is more common than TGA. However, at birth TGA is the more common lesion as patients with Fallot's generally presenting at around 1-2 months
54
Acyanotic congenital HD?
(VSD) - most common - pansystolic, lower left sternal edge , (ASD - systeolic murmur upper left sternal edge ), (PDA) - machine like murmur lef tupper SE , COA,- late systolic murmur L uSE aortic valve stenosis VSDs are more common than ASDs. However, in adult patients ASDs are the more common new diagnosis as they generally presents later.
55
TTN?
Tranzient tachypnoea of newnborn resolves within 2 days. Fluid in lungs, cxr shows fluid in horizontal fissure and hyperinflation. Common.
56
Emergency doses for meningococcal scepticaemia?
<1yr 300 mg benpen im, 1 - 9 Yo 600mg benpen, 10 yrs + 1200mg
57
early changes include widening of joint space, later changes include decreased femoral head size/flattening. Dx? Age range? TX?
4 to 9 YO perthes disease. <6YO - only observe, good prognosis
58
Heel prick test?
Heel-prick test day 5-9 - hypothyroidism, PKU, metabolic diseases, cystic fibrosis, medium-chain acyl Co-A dehydrogenase deficiency (MCADD)
59
Meningitis child causes?
Neonatal to 3 months - add amoxicillin/ ampicillin to cover listeria Group B Streptococcus: (from mum, Rf LBW. PROM) E. coli and other Gram -ve organisms Listeria monocytogenes 1 month to 6 years Neisseria meningitidis Streptococcus pneumoniae Haemophilus influenzae Greater than 6 years Neisseria meningitidis (meningococcus) Streptococcus pneumoniae (pneumococcus tx - cefotaxime/ceftriaxone
60
FTT, poly uria, polydipsia, normal BP, hypokalaemia?
Bartter's syndrome is an inherited cause (usually autosomal recessive) of severe hypokalaemia due to defective chloride absorption at the Na+ K+ 2Cl- cotransporter in the ascending loop of Henle.
61
Raised INR in newborn from out of UK?
Vitamin K deficiency, breast feeding. Breast milk has low vit K
62
6week baby, E-S murmur, right IC space, radiating to neck, long philtrum, small chin, puffy eyes,
William's syndrome
63
Androgen insensitivity syndrome?
genetically 46XY, but raised feminine. groin swellings, primary amenhorrhea, no pubic hair. x linked recessive
64
labial adhesions with recurrent UTI?
trial oestrogen cream
65
primary amenorrhea, high FSH 30+, low oestrodil? hypothryoidism?
turner's. also horseshoe kidney. 45XO
66
webbed neck, pulmonary stenosis, ptosis, pectus excavatum?
noonan syndrome
67
child knee pain: Pain after exercise, sport teen. Intermittent swelling and locking
Osteochondritis dissecans. fragment of bone in the knee becomes detached due to a lack of blood supply. The fragment and its overlying cartilage can then move around inside the joint, causing symptoms
68
5 day fever, cracked lips, red tongue, cercical ln,
kawasaki = do eCHO, coronary A aneyrusm. Bilateral conjunctivitis Cervical lymphadenopathy Polymorphic rash Cracked lips/strawberry tongue Oedema/desquamation of the hands/feet
69
genetic anticipation?
earlier presentation with successive generation/ huntingtons, myotonic dystrophy
70
bronchiolitis peak age?
1-9 months RSV cause
71
croup peak age?
6 months to 3 yrs. parainfluenza cx.
72
scarlet fever complications? most common? 20 days after? 10 days after? presentation?
otitis media: common rheumatic fever: 20 days after glomerulonephritis: 10 days after complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) rash sapres oral area,
73
partial child seizures at night?
benign rolandic epilepsy
74
4YO progressive hip pain with reduced ROM
Perthes
75
small umbicial hernia?
resolved by 12 months, if not by 2YO, refer. AF: afrocarribean, downs, mucopolysaccharide storage diseases
76
macrocephaly and learning difficulties, large ears, macro-orchidism dx?
fragile X. everything is larger
77
jaundice in first 24 hrs?
rhesus haemolytic disease ABO haemolytic disease hereditary spherocytosis glucose-6-phosphodehydrogenase
78
14 day + jaundice? IX? cuases?
CB/ UCB. raised CB-biliary atresia (surgery) direct antiglobulin test (Coombs' test) TFTs FBC and blood film urine for MC&S and reducing sugars U&Es and LFTs Causes: biliary atresia,hypothyroidism galactosaemia, UTI breast milk jaundice prematurity due to immature liver function increased risk of kernicterus congenital infections e.g. CMV, toxoplasmosis
79
teen girl, painful anterior knee when walking up and down stairs, rising from prolonged sitting?
chrondomalacia patellae
80
croup age prevalence?
6 months to 3 yrs. dex 0.15ml/kg
81
hearing tests in children? newborn/ school entry/ 3 YO?
O = Otoacoustic emission:out of womb (newborn) P = Pure tone audiometry: Prior school entry A = Auditory Brainstem: abnormality in other tests (for newborn) 6 months - distraction test
82
RF for SIDS
prone sleeping parental smoking bed sharing hyperthermia and head covering prematurity
83
2 week old baby with raised INR?
exclusively breast fed - deficiency of vitamin K if missed vitamin K injection at birth
84
cyanotic HD after the first 2 days of life? in the first 2 days?
TOF TPOA (at birth)
85
poor feeding, SOB, hepatomegaly?
heart failure
86
cx of HTN in children?
renal parenchymal disease renal vascular disease COA phaeochromocytoma congenital adrenal hyperplasia older - essential htn
87
FTT, polyuria, polydipsia, hypo kalaemia, weakness with normal BP?
BArtter's - inherited autosomal recessing
88
CXR for meconium aspiration syndrome?
RF 42weeks birth CXR - patchy infiltrations and atelectasis, cyanosis, mum had GBS
89
irritant dermatitis vs candidia dermatitis?
irritant - creases spares normally. common candida - involves flexures and satellite lesions
90

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