Primary Care paediatrics

Question 1

name 5 common presentations to primary care in the neonatal period (up to 4 weeks)?

Answer 1

jaundice
vomiting
sepsis
failure to thrive
"trivia" (e.g milk spots, rash etc)

Question 2

what can cause jaundice in the neonate?

Answer 2

UTI
hypothyroid
galactosaemia
breast milk jaundice
biliary atresia (thickening of walls of biliary tract?)

Question 3

what can cause vomiting in the neonate?

Answer 3

reflux
Cows milk protein (CMP) intolerance
pyloric stenosis
sepsis
duodenal atresia

Question 4

name 5 common respiratory problems in children

Answer 4

bronchiolitis (RSV)
croup
viral URTI
asthma (new or exacerbation)
acute tonsilitis

Question 5

name 6 rarer causes of respiratory problems in children

Answer 5

CF
acute epiglottitis
foreign body
pneumonia
cardiac causes
malignancy

Question 6

how does respiratory rate differ in adults and children?

Answer 6

adults should be <20 bpm
children = must faster
<1 y/o = 30-40 bpm
2-5 = 25-30 bpm
>12 = 15-20 bpm

Question 7

3 common medical causes of abdominal pain in children?

Answer 7

gastroenteritis
UTI
constipation

Question 8

3 common surgical causes of abdominal pain in 0-5 y/o?

Answer 8

intussusception
volvulus
incarcerated hernia

Question 9

4 common causes of abdominal pain in 6-18 y/o?

Answer 9

appendicitis
trauma
testicular torsion
ovarian torsion (12+)

Question 10

how do MSK problems common present to the GP?

Answer 10

painful joints
limp
trauma

Question 11

common causes of joint pain in children?

Answer 11

inflammatory arthritis
perthes disease
SUFE
Osgood schlatters
growing pains
bone tumours

Question 12

common causes of limp in children?

Answer 12

DDH

perthes

Question 13

common cause of trauma presentation in children?

Answer 13

sprain
fracture
NAI

Question 14

how is impetigo managed?

Answer 14

usually topical antibiotics

can need oral if severe

Question 15

what is slapped cheek?

Answer 15

viral infection causing cold like symptoms and a red rash over both cheeks which can/might then progresses to a pink rash over the body after a few days

Question 16

how is slapped cheek managed?

Answer 16

no specific treatment
only supportive
rash should clear after 2 weeks

Question 17

how does molluscum contagiosum present?

Answer 17

lots of small spots/papules

will go away but may take up to 2 years

Question 18

how does scarlet fever present?

Answer 18

white tongue which then becomes red (strawberry tongue)
red rash over chest and trunk
red face

Question 19

painful lesions in the mouth and hands (may cause lack of desire to eat in children)?

Answer 19

hand, foot and mouth

coxakie virus

Question 20

what is involved in development screening at 6-8 weeks old?

Answer 20

red light reflex
hips (barlows/ortolanis)
genitalia
femoral pulses

Question 21

what diseases are vaccinated against <1 year old?

Answer 21

diphtheria, pertussis, tetanus, polio, haemophilus influenza (Hib) = 3 doses
pneumococcal disease = 2 doses
meningococcal type C = 1 dose
meningococcal type B = 2 doses
rotavirus = 2 doses

Question 22

name 10 red flags for sepsis in children

Answer 22

unresponsive to social clues/difficult to rouse
health professionals very worried
weak, high pitched or continuous cry
grunting respiration or apnoeic episodes SpO2 <90%
severe tachypnoea
severe tachycardia
no wet nappies/not passed urine in last 18 hrs
non-blanching rash or mottled/ashen/cyanotic
temp <36
temp >38 in under 3 months old

Question 23

what defines moderate and severe tachypnoea in <1 y/o?

Answer 23

moderate = 50-59
severe = >60

Question 24

what defines moderate and severe tachycardia in <1 Y/o?

Answer 24

moderate = 150-159
severe = >160

Question 25

what defines moderate and severe tachypnoea in 1-2 y/o?

Answer 25

``` moderate = 40-49 severe = >50 ```

Question 26

whatd efines moderate and severe tachycardia in 1-2 y/o?

Answer 26

``` moderate = 140-149 severe = >150 ```

Question 27

what defines moderate and severe tachypnoea in 3-4 y/o?

Answer 27

``` moderate = 35-39 severe = >40 ```

Question 28

what defines moderate and severe tachycardia in 3-4 y/o?

Answer 28

``` moderate = 130-139 severe = >140 ```

Question 29

name 11 amber flags for sepsis in children?

Answer 29

``` parent or clinician very concerned abnormal response to social cues/not smiling reduced activity, very sleepy parent/carer reports abnormal behaviour moderate tachypnoea SpO2 <91 or nasal flaring moderate tachycardia cap refill >3 seconds reduced urine output pale or flushed leg pain or cold extremities ```

Question 30

what diseases are vaccinated against age 1?

Answer 30

Hib and meningococcal type C pneumococcal MMR meningococcal type B

Question 31

what diseases are vaccinated against age 2-11?

Answer 31

influenza (annually)

Question 32

what diseases are vaccinated against at 3yrs, 4 months old?

Answer 32

``` diphtheria tetanus pertussis polio MMR ```

Question 33

what diseases are vaccinated against in girls aged 11-13?

Answer 33

cervical cancer (HPV)

Question 34

what diseases are vaccinated against around age 14?

Answer 34

tetanus, diphtheria and polio | meningococcal types YWCA