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Specialties exam > Paeds passmed > Flashcards

Paeds passmed Flashcards

1
Q

Turner’s syndrome associated cardiac abnormalities

A

Bicuspid aortic valve
Coarctation of the aorta
Aortic root dilatation

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2
Q

Raised immunoreactive trypsinogen on heel prick test

A

CF, sweat test to confirm

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3
Q

Features of foetal alcohol syndrome

A 
short ­palpebral fissure
thin vermillion border/hypoplastic upper lip
smooth/absent filtrum
learning difficulties
microcephaly
growth retardation
epicanthic folds
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4
Q

Causes of neonatal hypotonia

A

neonatal sepsis
Werdnig-Hoffman disease (spinal muscular atrophy type 1)
hypothyroidism
Prader-Willi

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5
Q

Features of intussusception

A

Usually 1-2 years old
paroxysmal abdominal colic pain
during paroxysm the infant will characteristically draw their knees up and turn pale
vomiting
blood stained stool - ‘red-currant jelly’
sausage-shaped mass in the right lower quadrant

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6
Q

Clinical features of hand foot and mouth disease

A

mild systemic upset: sore throat, fever
oral ulcers
followed later by vesicles on the palms and soles of the feet

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7
Q

Management of asthma 5-16YO

A

1) SABA
2) SABA + ICS (low dose inhaled corticosteroid)
3) SABA + ICS + LTRA (Leukotriene receptor antagonist)
4) SABA + ICS + LABA
5) SABA + MART (Maintenance reliever therapy) which includes ICS
6) SABA + moderate dose ICS MART (all above was low dose)
7) SABA +:
- high dose ICS or ICS MART
- Trial of additional drug e.g. theophylline
- Seek expert advice

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8
Q

Management of asthma <5YO

A

1) SABA
2) SABA + ICS (Moderate dose, 8 week trial)
- if symptoms didn’t resolve, consider another Dx
- If symptoms resolved, then returned after, start low dose ICS
- If symptoms resolved, then reoccurred after 4 weeks, repeat the trial
3) SABA + low dose ICS + LTRA
4) stop LTRA, refer to expert

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9
Q

Concave abdominal wall, heart sounds displaced medially and reduced breath sounds bilaterally

A

Congenital diaphragmatic hernia

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10
Q

Stridor and cough in 3 year old

A

Croup, caused by parainfluenza

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11
Q

breech baby born at or after 36 weeks, what screening needed

A

USS screening for DDH within 6 weeks old

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12
Q

Signs of kawasaki disease

A

high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel

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13
Q

Delayed passage of meconium, vomiting green bile

Likely diagnosis and confirmatory test

A

Hirschprungs disease

Rectal biopsy

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14
Q

distended abdomen in neonate, not passed meconium, bilious vomiting

A

CF (meconium ileus)

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15
Q

soft lesion located in the posterior triangle that transilluminates.

A

Cystic hygroma

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16
Q

small smooth cyst is identified which is located above the hyoid bone. On ultrasound the lesion appears to be a heterogenous and multiloculated mass.

A

dermoid cyst

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17
Q

immediate and long term complication of measles

A

Pneumonia

Subacute sclerosing panencephalitis 5-10 yrs down

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18
Q

Risk factors for DDH

A 
female sex: 6 times greater risk
breech presentation
positive family history
firstborn children
oligohydramnios
birth weight > 5 kg
congenital calcaneovalgus foot deformity
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19
Q

Vaccine recommended for all new uni students

A

Meningitis ACWY

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20
Q

When to refer baby with undescended testis

A

Refer if still undescended by 3 months old, refer to paediatric surgeon to be seen before 6 months old

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21
Q

normal age for child to run

A

16 months to 2 years

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22
Q

Pulse associated with PDA

A

large volume, bounding, collapsing pulse

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23
Q

Constipated child, movicol hasn’t worked

A

lactulose

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24
Q

vomiting, feeding intolerance and abdo distension.
Watery stools with specs of blood
Gas cysts in bowel wall on X-ray

A

necrotizing enterocolitis

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25
Q

‘anticipation’ in Huntington’s disease

A

Earlier age of onset in successive generations

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26
Q

Age at which kids 1) play alongside other kids and 2) play with other children

A

2 years, 4 years

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27
Q

sandpaper rash

A

scarlet fever

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28
Q

When is rotavirus vaccine given

A

2+3 months

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29
Q

First line medication for ADHD

A

Methylphenidate

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30
Q

commonest cause of meningitis within days of birth

A

GBS
E-col1
Lysteria

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31
Q

Central abdominal pain, febrile, recent URTI

A

mesenteric adenitis, give antibiotics

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32
Q

Kartagener’s syndrome

A

immotile cilia syndrome, causes recurrent episodes of sinitis
Associated with situs inversus

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33
Q

Lymch syndrome

A

Hereditary Non-Polyposis Colorectal carcinoma

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34
Q

Vaccination schedule

A

At birth: BGC/HepB if risk factors
2 months: 6in1 (DTaP, Hib, HepB), rotavirus, PCV, men B
3 months: 6in1, oral rotavirus
4 months: 6in1, PCV, men B
12-13 months: Hib/MenC, MenB, MMR, PCV
2-8yrs: Annual flu vaccine
3-4 years: 4in1 preschool booster (DTaP), MMR
12-13 years: HPV for girls
13-18yrs: 3in1 teenage booster (DTaP not pertussis), MenACWY

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35
Q

What is the term we use to describe the mode of inheritance for Prader-Willi syndrome?

A

Imprinting

- Paternal gene deletion (Prader-willi) and maternal (Angelman) are different phenotyoes

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36
Q

most common brain bleed in neonates

A

Intreventricular haemorrhage

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37
Q

mainstay of treatment in uncomplicated TTN

A

No further Rx or investigation needed

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38
Q

Management of croup

A

Oral dexamethasone or prednisolone if dex not available

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39
Q

time for no or little headlag when pulled up to sit

A

3 months

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40
Q

Handed baby following C section

You note that the neonate is apnoeic, floppy and blue in colour.

A

Dry the neonate

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41
Q

Dietary advice for ADHD

A

Normal balanced diet

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42
Q

repeated flexion of head/arms/trunk followed by extension of arms

A

Infantile spasms, West syndrome

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43
Q

Fever, THEN rash

A

Roseola infantum

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44
Q

Diagnosis, initial management and definitive management of Hirschprung’s

A

Full thickness rectal biopsy
Bowel irrigation
Anorectal pullthrough

45
Q

Children below 0.4th centile for height

A

paediatrician review

46
Q

Classification of squint

A

Eye deviated…

  • Medially = esotropia
  • Laterally = exotropia
  • Superiorly = hypertropia
  • Inferiorly = hypotropia
47
Q

child < 3 years presenting with an acute limp

A

Urgent hospital assessment

48
Q

Where does eczema affect kids of different ages

A

in infants the face and trunk are often affected
in younger children eczema often occurs on the extensor surfaces
in older children a more typical distribution is seen, with flexor surfaces affected and the creases of the face and neck

49
Q

nee pain in osgood-schlatter

A
  • Unilateral (but may be bilateral in up to 30% of people).
  • Gradual in onset and initially mild and intermittent, but may progress to become severe and continuous.
  • Relieved by rest and made worse by kneeling and activity, such as running or jumping
50
Q

Investigation NOT to do in suspected meningococcal septicaemia

A

Lumbar puncture

51
Q

a small, red growth of tissue in the centre of the umbilicus, covered with clear mucus

A

umbilical granuloma

52
Q

Bow legs in a child < 3

A

Normal variant, usually resolves by age 4

53
Q

Right knee pain, there most times, antalgic gait and apparent leg shortening

A

Perthe’s disease

54
Q

infants with symptoms of breathlessness worse on exertion (e.g. feeding), sweating, poor feeding and recurrent chest infections.

A

heart failure

55
Q

At what age would the average child start to say ‘mama’ and ‘dada’?

A

9-10 months

56
Q

What is the most common cause of headaches in children?

A

Migraines

57
Q

On average a child should be competent with a spoon and not spill with a cup at what age

A

2 years old

58
Q

Newborn baby, yellow discolouration of skin, next step?

A

measure bilirubin within 2 hrs

59
Q

is a benign murmur heard in children and sounds like a continuous blowing noise heard below the clavicles

A

venous hum

60
Q

Squats to pick up ball

A

18 months

61
Q

when do primitive reflexes normally disappear

A

Moro, Grasp and Rooting: 4 months

Stepping: 2 months

62
Q

Management of umbilical hernias in kids

A

Usually self resolve
If large or symptomatic: elective repair at 2-3 yo
If small and asymptomatic, repair at 4-5 yo

63
Q

emergency Rx of severe croup

A

O2 and nebulised adrenaline

64
Q

scaphoid abdomen and bilious vomiting

A

intestinal malrotation

65
Q

Comonest fractures associated with NAI

A
  • Radial
  • Humeral
  • Femoral
66
Q

Short child, trident hand deformity

A

Achondroplasia

67
Q

worsening noisy breathing in baby, especially when eating

A

Laryngomalacia

68
Q

General rule on autosomal dominant vs recessive

A

Autosomal recessive conditions are ‘metabolic’ - exceptions: inherited ataxias

Autosomal dominant conditions are ‘structural’ - exceptions: Gilbert’s, hyperlipidaemia type II

69
Q
  • ‘projectile’ vomiting, typically 30 minutes after a feed
  • constipation and dehydration may also be present
  • a palpable mass may be present in the upper abdomen
  • hypochloraemic, hypokalaemic alkalosis due to persistent vomiting
A

Pyloric stenosis

70
Q

6 weeks post viral gastroenteritis, presenting with loose stools

A

Transient lactose intolerance

71
Q

feeding intolerance, abdominal distension and bloody stools, Abdo X ray shows dilated loops of bowel (asymetrical)

A

necrotising enterocolitis

72
Q

Gastroschisis vs omphalocele

A

gastroschisis refers to a defect lateral to the umbilicus whereas omphalocele refers to a defect in the umbilicus itself.

73
Q

precipitating factor for a more severe episode of bronchiolitis and not just an increased risk of developing bronchiolitis?

A

underlying congenital heart disease

74
Q

On examination the baby appears jittery and hypotonic. What is the most appropriate next step?

A

Measure blood glucose

75
Q

A 9-year-old boy is diagnosed as having Attention Deficit Hyperactivity Disorder and started on methylphenidate. Which one of the following should be monitored during treatment?

A

growth, monitor every 6 months

76
Q

GI complication of CF

A

Steatorrhoea

77
Q

Age at which kids can draw a circile

A

3 years

78
Q

On examination there is tenderness and swelling of the scrotum and left testicle, with absence of the cremaster reflex on the left side. Elevation of the affected testicle causes increased pain.

A

testicular torsion

79
Q

A 4-week-old child is brought to clinic with a red rash on her scalp associated with yellow flakes. What is the most likely diagnosis?

A

Seborrhoeic dermatitis

80
Q

A 4-week-old child is brought to clinic with a red rash on her scalp associated with yellow flakes. What is the most likely diagnosis?
management

A

Seborrhoeic dermatitis

Rx: baby shampoo and baby oil

81
Q

neonate with white-coloured nodule at the roof of the mouth.

A

Epstein’s pearl. No Rx needed

82
Q

phimosis in <2 year old

A

Reassurance, review then 2 years old

83
Q

best practice in neonatal vitamin K?

A

One-off IM injection

84
Q

When to measure APGAR scores post-delivery

A

1,5,10 minutes

85
Q

Hearing assessment of newborns

A

All babies have otoacoustic emission test at newborn

Any who have an abnormal test then get an Auditory Brainstem Response test as newborn

86
Q

Features of hypernatraemia

A 
Jittery
Increased muscle tone
Hyperreflexia
Convulsions
Drowsiness or coma
87
Q

Risk of down’s with age

A 
20 = 1/1500
30 = 1/800
35 = 1/270
40 = 1/100
45 = 1/50
88
Q

Time off school for hand, foot and mouth disease

A

none if child feels well

89
Q

live attenuated vaccine that isn’t SM BOY

A

oral rotavirus

90
Q

What is the recommended compression: ventilation ratio for the newborn?

A

3:1

91
Q

peak incidence age for bronchiolotis

A

3-6 months

92
Q

management for meningitis at different ages

A

<3 months old: IV cefotaxime and amoxicillin (for listeria)

>3 months old: IV cefotaxime

93
Q

16YO, chronic left knee pain worse after jogging

A

osteochondritis dissecans

94
Q

At what age would the average child acquire the ability to crawl?

A

9 months

95
Q

Rubella rash pattern

A

Face then rest of bodu

96
Q

EEG findings in West’s syndrome

A

Hypsarrhythmia

97
Q

Cyanosis, worse when feeeding, better when baby cries

A

Choanal atresia

98
Q

2YO, diarrhoea, sometimes has undigested food. no other symptoms, growth is fine

A

Toddler’s diarrhoea

99
Q

When do Growing pains NOT usually affect the child

A

When waking up in the morning

100
Q

1 hour old, heelprick shows low glucose. next step

A

Observe and encourage normal feeding, this is normal for first few hours after birth

101
Q

Talk in short sentences (e.g. 3-5 words)

A

2.5-3 years

102
Q

Poor prognostic markers for ALL

A

being male
presenting <2 years or >10 years;
having B or T cell surface markers;
having a WCC > 20 * 10^9/l at diagnosis.

103
Q

In the UK, what is the most common cause of death in children greater than one-year-old?

A

accidents

104
Q

most common cause of ambiguous genitalia in newborns

A

Congenital adrenal hyperplasia

105
Q

Investigation for Perthe’s

A

USS knee, then MRI scan

106
Q

When to consider a diagnosis of pneumonia in suspected bronchiolitis

A 
high fever (over 39°C) and/or
persistently focal crackles.
107
Q

newborn baby <10 mins old, O2 sats of 73%, next step

A

observe and reassess at next interval, can be normal

108
Q

Time off school for roseola infantum

A

None

Specialties exam (4 decks)

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