Presentations

Question 1

Screening tools for ASD

Answer 1

• Autism Diagnostic Interview, Revised (ADI-R)
• Developmental, Dimensional and Diagnostic Interview (3di)
• Diagnostic Interview for Social and Communication Disorders (DISCO)
• Autism Diagnostic Observation Schedule (ADOS)

Question 2

MDT for autism diagnosis

Answer 2

• Community paediatrician
• Educational psychologist
• Speech and language therapists

Question 3

Criteria for ASD diagnosis ICD-10

Answer 3

• Pervasive
• Manifests before age of 3
• Abnormal functioning in social interaction, communication, restricted/repetitive behaviours

Question 4

Management of ASD

Answer 4

• School support - EHCP
• Speech and language therapist input - ?picture exchange communication systems can be used
• Parents support groups, respite
• Parent managed behavioural interventions - education and training to manage situations

Question 5

Red flags for child with limp

Question 6

RF for DDH

Answer 6

• Female
• FH
• First born
• Foot first

Question 7

Inv for DDH

Answer 7

• USS in younger children
• Older children (older 4.5 months) - x-ray

Question 8

Management of DDH

Answer 8

• Pavlik harness if under 6 months
• Hip spica
• Surgery

Question 9

SUFE RF

Answer 9

• Obesity
• Trauma
• Male

Question 10

Management of SUFE

Answer 10

• Urgent surgery - prevent AVN and malunion

Question 11

Inv for SUFE and Perthes

Answer 11

• AP and frog leg x-ray hip

Question 12

Perthes disease management

Answer 12

• Activity modification
• NSAIDs
• Orthotics
• Surgery if fails

Question 13

JIA

Answer 13

• Under 16
• Arthitiris lasting >6 weeks
• Oligoarticular (few joints) poly (many), systemic (salmon patch), enthesitis, psoriatic

Question 14

Management if JIA

Answer 14

• NSAIDs - naproxen
• Steroids - oral and IV course if severe
• DMARDs eg methotrexate
• Biologics

Question 15

Imaging for osteomyelitis

Answer 15

MRI (x-ray can be normal for first 2 weeks of infection so can’t rule out but can do first)

Question 16

Under 3 causes of limp

Answer 16

• Toddler fracture
• DDH

Question 17

Aged 3-10 for limping child causes

Answer 17

• Transient synovitis
• Fracture or soft tissue
• Perthes

Question 18

Aged 10-19 causes of limp

Answer 18

• SUFE
• Perthes
• OSD
• Chondromalacia patella
• Osteochondiritis dissicans

Question 19

NEC - key features

Answer 19

• Distended and tender abdominal
• Fresh blood in stool
• Premature/LBW
• Formula fed

Question 20

Volvulus due to malrotation key features

Answer 20

• Bilious vomitting
• Absolute constipation
• Abdo pain

Question 21

Meconium ileus

Answer 21

• CF
• Not passing meconium <48hrs

Question 22

Atresia key features

Answer 22

• Polyhydramnios - not swallowing fluid
• No meconium
• Bilious vomiting

Question 23

Hirschsprungs key features

Answer 23

Not passing meconium
Down syndrome
Bilious vomiting

Question 24

Intussusception features

Answer 24

• Red currant jelly stool
• Sausage shaped mass RUQ

Question 25

Colic features

Answer 25

* Crying more than 3hrs / day * Otherwise healthy * Arching in pain

Question 26

CMPA

Answer 26

* Mucus/blood in stool * Poor growth * Eczema/urticaria * Resp symptoms if severe

Question 27

Common cause toddlers diarrhoea

Answer 27

* Large fructose in diet - lots of fruit and juices * Causes osmotic pull of fluid into bowel

Question 28

NICE red flag criteria for a child with fever

Answer 28

Question 29

Lactate and when to give fluids

Answer 29

* If 2-4 give IV fluids * If over 4 - call ITU

Question 30

UHL sepsis guidelines in under 1 month old

Answer 30

Amoxicillin, cefotaxime, gentamicin + aciclovir if concerned re HSV NICE say benzylpenicillin + gentamicin

Question 31

UHL sepsis 1-3 month old

Answer 31

Amoxicillin and ceftriaxone

Question 32

UHL sepsis older 3 months

Answer 32

Ceftriaxone (don't need to cover listeria)

Question 33

Features of DiGeorge syndrome

Answer 33

CATCH 22 * CHD - tetralogy of fallot, pulmonary atresia with VSD * Abnormal face * Thymus underdevelopment - absence of thymic sail sign * Cleft palate * Hypoparathyroidism - hypocalcaemia (chvostek, trousseau) * 22 - microdeletion of 22q11 - need FISH

Question 34

Facial abnormalities of Digeorge

Answer 34

* Small dysmorphic ears * Prominent nose and hypoplastic nares * Small mouth + everted upper lip

Question 35

Inv for DiGeorge

Answer 35

* FBC - with T and B cell differentials * Echo - for heart abnormality * PTH and bone profile - for low parathyroid * Special: FISH

Question 36

Management of DiGeorge

Answer 36

* Abx - prompt treatment and sometimes prophylaxis * Vaccines - monitor titres * IVIG * Calcium and vitamin D * Regular hearing tests * Review educational needs

Question 37

Testing for aged 5-11 for asthma

Answer 37

* PEFR * Spirometry with bronchodilator reversibility * FeNO