Pass med 29/03/24 peads

Question 1

What to do if hand preference <12 months?

Answer 1

This is abnormal - could indicate cerebral palsy - refer urgently to peads

Question 2

What is a key feature of NEC on abdominal X-Ray?

Answer 2

pneumatosis intestinalis (intramural gas)

Question 3

What is the investigation of choice for intussusception?

Answer 3

Abdominal ultrasound

Question 4

What are the presenting features of cystic fibrosis?

Answer 4

Neonatal peridod: meconium ileus (can get stuck as it is thicker than normal), prolonged jaundice (less common)
Recurrent chest infection
Malabsorption: steatorrhoea - due to pancreatic insufficiency , failure to thrive
Other features - liver disease

Question 5

What is seborrhoeic dermatitis?

Answer 5

Also known as cradle cap - it is characterised by an erythematous rash with coarse yellow scales
also found on nappy, flexures and face

Question 6

How is cradle cap or seborrhoeic dermatitis treated?

Answer 6

-doesn’t affect the baby and resolves within a few weeks
-Massage a topical emollient onto the scalp to loosen scales, brush gently with a soft brush and wash off with shampoo
-If severe/persistent a topical imidazole cream may be tried

Question 7

What is the most common heart condition associated with DMD?

Answer 7

Dilated cardiomyopathy

Question 8

What is the most common organism that causes meningitis in <3 months ?

Answer 8

-Group B streptococcus - usually acquirted from mother at birth - most common in low birth weight babies and prolonged rupture of membranes
-E.coli and other gram - organisms
-Listeria monocytogenes

Question 9

What is the most common organism that causes meningitis in 1month -6 years?

Answer 9

-Neisseria meningitidis (meningococcus)
-Streptococcus pneumoniae (pneumococcus)
-Haemophilus influenzae

Question 10

What is the most common organism that causes meningitis in >6 years?

Answer 10

Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)

Question 11

What is the prognosis like for infantile spasms?

Answer 11

Poor prognosis - often associated with serious underlying health condition

Question 11

What are infantile spasms?

Answer 11

Also known as west syndrome - is a type of epilepsy that presents in first 4-8 months of life
-It is more common in males

Question 12

What are the features of infantile spasm?

Answer 12

-“Salaam attack” - flexion of head, trunk, arms, followed by extension of arms
-Only lasts 1-2 seconds

Question 13

What do the chosen investigations show in infantile spasms?

Answer 13

-EEG - 2/3 infants show hypsarrhythmia
-CT demonstrates diffuse or localised brian disease in 70%

Question 14

What is the management for infantile spasms?

Answer 14

-vigabatrin is 1st line
-ACTH is also used
-Poor prognosis

Question 15

What is the management used to reduce chances of severe brain damage in neonates with hypoxic injury?

Answer 15

Therapeutuc cooling

Question 16

What organism causes Roseola infantum?

Answer 16

human herpes virus 6 (HHV6)

Question 18

What age is roseola infantum most common in?

Answer 18

6 months to 2 years

Question 18

What are the features of roseola infantum?

Answer 18

-Fever then rash - child can present with “cold”
-Maculopapular rash
-Associated with febrile convulsions (10-15%)
-diarrhoea and cough are also commonly seen

Question 18

School exclusion with roseola infantum?

Answer 18

No not needed

Question 18

What investigation is done to screen for complciation of Kawasaki disease

Answer 18

Echocardiogram

Question 19

What heart condition is associated with Fragile X syndrome?

Answer 19

Mitral valve prolapse

Question 20

What does Ortolani’s test do?

Answer 20

attempts to relocate a dislocated femoral head

Question 21

What does the Barlows test do?

Answer 21

attempts to dislocate an articulated femoral head

Question 22

What is the most common complication of measles?

Answer 22

Otis media

Question 23

How do migraines present in children?

Answer 23

Unilateral headache
Pulsating in nature
Nausea
Often a trigger or exacerbating by stress

Question 24

Where are thyroglossal cysts located?

Answer 24

Anterior triangle
-Usually in the midline and below the hyoid

Question 25

What treatments can be used for spasticity in cerebral palsy?

Answer 25

oral diazepam
oral and intrathecal baclofen
botulinum toxin type A
orthopaedic surgery
selective dorsal rhizotomy

Question 26

When do you give treatment in neonatal hypoglycaemia?

Answer 26

If neonate is symptomatic
If glucose is very low

Question 27

What is the treatment for neonatal hypoglycaemia?

Answer 27

Admit to neonatal unit and give IV 10% dextrose

Question 28

What maternally can cause neonatal hypoglycameia?

Answer 28

labetalol

Question 29

What is immune thrombocytopenia?

Answer 29

-An immune mediated reduction in the platelet count
-Antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex
-It is a type II hypersensitivity reaction

Question 30

Difference between ITP in adults and children?

Answer 30

ITP is more acute in childrena dn usually follows after illness or vaccination

Question 31

What is the treatment for ITP ?

Answer 31

• Usually no treatment resolves within 6 months in 80% of cases
  -Advised to avoid activies that result in trauma

Question 32

How to treat ITP if platelet count very low (<10*109/L) or significant bleeding?

Answer 32

-Oral/IV corticosteroid
-IV immunoglobulins
-Platelet transfusions only in an emergency and temporary as they are destoryed quickly by curculating antibodies

Question 33

WHat should you not give to children <3 months with suspected bacterial meningtis?

Answer 33

Corticosteriods

Question 34

Why is are corticosteroids such as dexamethasone given to children with bacterial meningitis?

Answer 34

Reduce the risk of neurological sequelae

Question 35

What age is infantile colic common and when do you expect it to resolve?

Answer 35

-Common in infants less than 3 months old
-Improves 3-4 months
-Resolves 6 months

Question 36

When do babies start to smile?

Answer 36

6 weeks

Question 37

What are the causes of jaundice in the first 24 hours of life?

Answer 37

-Jaundice is always pathological
-rhesus haemolytic disease
-ABO haemolytic disease
-hereditary spherocytosis
-glucose-6-phosphodehydrogenase

Question 38

What is the inherintence pattern of huntington’s disease?

Answer 38

Autosmonal dominant