Peads

Question 1

Drug and dose for suspected meningitis

Answer 1

Age 1-10: 600mg IM BenPen

>10: 1200mg

Question 2

Mx of asthma in >15 y

Answer 2

Same as 5-15, theophylline at end

Question 3

Drug treatment protocol in ADHD, side effects

Answer 3

Last resort, age 5 and over only.

6 week trial of methylphenidate

Side effects: abdo pain, nausea, cardio toxic

Question 4

Rubella features

Answer 4

Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

Question 5

Scarlett fever

Answer 5

Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)

Question 6

Definition of precocious puberty

Answer 6

<8 in girls

<9 in boys

Question 7

Autosomal dominant vs recessive

Answer 7

Autosomal recessive: metabolic (except at ataxia)

Autosomal dominant: structural (except Gilbert’s, hyperlipidaemia)

Question 8

tetralogy of fallot vs transposition of great arteries age of presentation

Answer 8

TOF: 1-2 months
TGA: first 24-48hours of life

Question 9

Management of reflux in babies

Answer 9

1. Trial little and often feeds
2. Trial thickened feeds
3. Gaviscon (not together with thickening agents)
4. PPI

Question 10

age of knowing ‘mama, dada’ and 2-6 words

Answer 10

9 months; mama, dada

12-15 months. 2-6 words (Refer at 18 months)

Question 11

When to immediately refer a fever child to paediatrics

Answer 11

<3 months and pyrexial > 38.0

Question 12

Presentation and treatment of PDA

Answer 12

• continuous ‘machinery’ murmur
• large volume, bounding, collapsing pulse
• wide pulse pressure
• heaving apex beat

Tx: indomethacin or ibuprofen

Question 13

When to admit in bronchiolitis

Answer 13

apnoea 
child looks seriously unwell
severe respiratory distress, eg grunting, marked chest recession, or a RR> 70 breaths
central cyanosis
persistent o2 sats <92%

Question 14

Major risk factors for SIDS

Answer 14

prone sleeping
parental smoking
bed sharing
hyperthermia and head covering
prematurity

Question 15

TOF presentation in newborns

Answer 15

Cyanotic episodes, boot shaped heart (coer en sabot), clubbing

Question 16

at what age is hand preference abnormal

Answer 16

<12 months, could indicate cerebral palsy

Question 17

Fragile X presentation

Answer 17

Learning difficulties, macro orchidism, macrocephaly

Question 18

Kawasaki presentation

Answer 18

High fever lasting >5 days
red palms with desquamation
strawberry tongue

“Japanese expensive strawberries causing red peeling palms”

Question 19

Tx of croup

Answer 19

Stat dose dexamethasone

Question 20

Webbed neck and pectus excavatum

Answer 20

Noonan’s syndrome

Question 21

Low set ears, cleft palatte, polydactyly, micro ophthalmia

Answer 21

Patau syndrome

Question 22

Most common cause of hypothyroidism in children

Answer 22

Autoimmune thyroiditis

Question 23

Meningitis vaccine schedule

Answer 23

2, 4 and 12 months

Question 24

Emergency management of severe croup

Answer 24

Oxygen and nebulised adrenaline

Question 25

Age of presentation of Perthes disease

Answer 25

4-8

Question 26

TOF features

Answer 26

``` ventricular septal defect (VSD) right ventricular hypertrophy right ventricular outflow tract obstruction pulmonary stenosis overriding aorta ``` VRROP

Question 27

Management of Kawasaki

Answer 27

High dose aspirin IV Ig Echo to screen for coronary artery aneurysm

Question 28

Schedule for MMR vaccine

Answer 28

1 year | 3-4 years

Question 29

Tx of whooping cough

Answer 29

azithromycin or clarithromycin if the onset of cough is <21 days

Question 30

micrognathia, low-set ears, rocker bottom feet and overlapping of fingers

Answer 30

Edwards syndrome

Question 31

Sit without support milestone

Answer 31

7-8 months

Question 32

Knows own name milestone

Answer 32

9-12 months

Question 33

Talk in short sentences

Answer 33

2-5-3 years

Question 34

small upturned nose, long philtrum (upper lip length), wide mouth, full lips, small chin, and puffiness around the eyes, aortic stenosis

Answer 34

Williams syndrome

Question 35

6 in 1 vaccine

Answer 35

2, 3 and 4 months | diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B

Question 36

MMR vaccine age

Answer 36

1 year | 3-4 years

Question 37

Risk factors for surfactant deficient lung disease

Answer 37

male sex diabetic mothers Caesarean section second born of premature twins

Question 38

Micrognathia Posterior displacement of the tongue (may result in upper airway obstruction) Cleft palate

Answer 38

Pierre robin syndrome

Question 39

Whooping cough vaccine in pregnancy

Answer 39

16-32 weeks

Question 40

Jaundice in babies

Answer 40

First 24hours, always pathological Day 3-day 14; physiological If doesn’t resolve, jaundice screen

Question 41

Palmar grasp

Answer 41

5-6 months

Question 42

Tower of 3-4 blocks

Answer 42

18months

Question 43

Crawls and walks unsupported

Answer 43

Crawls: 8-10 months Walks: 12-15 months

Question 44

Tx for meningitis in children <3

Answer 44

Cefotaxime and amoxicillin

Question 45

Age of day and night time continence

Answer 45

3-4

Question 46

Characteristically anterior knee pain on walking up and down stairs and rising from prolonged sitting

Answer 46

Chondromalacia patellae

Question 47

Life threatening asthma attack

Answer 47

``` SpO2 <92% PEF <33% best or predicted Silent chest Poor respiratory effort Agitation Altered consciousness Cyanosis ```

Question 48

Perthes age of presentation

Answer 48

4-8

Question 49

Contraindications to MMR

Answer 49

severe immunosuppression allergy to neomycin children who have received another live vaccine by injection within 4 weeks pregnancy should be avoided for at least 1 month following vaccination immunoglobulin therapy within the past 3 months

Question 50

Initial mx of cyanotic heart disease

Answer 50

Prostaglandin E1