Specialities Qs answered poorly Flashcards
(9 cards)
A 3-year-old boy has just started fitting in A+E. You are the F1 doctor. The nurses are all busy with other children. Of the following actions which should you do first?:
a. Administer oral midazolam b. Do a blood gas c. Gain iv access d. Give him high-flow oxygen e. Measure his blood sugar
a. Administer oral midazolam b. Do a blood gas c. Gain iv access d. Give him high-flow oxygen - correct e. Measure his blood sugar
One evening a 4-month-old boy is brought into A+E by his step-father because of a prolonged nose bleed. This has now stopped. The examination is normal apart from some irregular bruising on his abdomen and small, well circumscribed marks on his back. The next most appropriate step from the options below would be to:
a.
Admit him and arrange a full skeletal survey, clinical photographs and clotting studies
b.
Check his full blood count and clotting studies, and discharge him if they are normal for follow up in OPD
c.
Discharge him and discuss the case the next day with the child protection team
d.
Discuss the case with the child protection team now
e.
Reassure the step-father that since the nose bleed has stopped, no further treatment is required
a.
Admit him and arrange a full skeletal survey, clinical photographs and clotting studies
b.
Check his full blood count and clotting studies, and discharge him if they are normal for follow up in OPD
c.
Discharge him and discuss the case the next day with the child protection team
Correct = d.
Discuss the case with the child protection team now
e.
Reassure the step-father that since the nose bleed has stopped, no further treatment is required
A 5-year-old girl who never received MMR was exposed to chicken pox last week at school. She now presents with a 12 hour history of rash and abdominal pain and is reluctant to walk. On examination, she is unwell with cold hands and feet, and a widespread blanching maculopapular rash with spots of different sizes sparing the head and neck. What is the most likely diagnosis?
a. Chicken pox (Varicella zoster) b. Measles Correct = c. Meningococcal sepsis d. Roseola infantum e. Rubella
A 3 year old girl’s parents have noted that her urine has gone very dark and she has had puffy eyes. She has been unwell recently with a fever and sore throat. Urine shows blood ++++, protein +++. BP 110/65. Which investigation is most likely to indicate the underlying diagnosis?
a. 24-hour urine protein quantification b. Blood culture c. Complement C3 and C4 levels d. Ultrasound scan of the abdomen e. Urine M,C&S
a.
24-hour urine protein quantification
b.
Blood culture
Correct = c. Complement C3 and C4 levels d. Ultrasound scan of the abdomen e. Urine M,C&S
A 5 year old who has recently returned from Nigeria, has had 3 days of swinging high fevers. His urine is noted to be dark red. On examination he has an enlarged liver, but no other abnormal findings. A urine dipstick is positive for blood +++. Which investigation is most likely to reveal the underlying diagnosis?
a. Blood culture b. G6PD level, now and in one month's time c. Hb electrophoresis d. Thick and thin blood film e. Urine M,C&S
a. Blood culture b. G6PD level, now and in one month's time c. Hb electrophoresis Correct = d. Thick and thin blood film e. Urine M,C&S
A 14-year-old girl presents with a 5 day history of abdominal pain, submandibular and parotid gland enlargement, low grade fever and severe headaches. She has not received any antibiotics. On examination she is photophobic with neck stiffness, but is well perfused. She has no rash. On lumbar puncture the cerebrospinal fluid has normal protein and glucose, 50 WBC/ml (95% lymphocytes) and no RBC. What is the most likely diagnosis?
a. Bacterial meningitis b. HIV infection c. Measles d. Mumps e. Tuberculosis
a. Bacterial meningitis b. HIV infection c. Measles Correct = d. Mumps e. Tuberculosis
A 2 year old presents with frank haematuria, some abdominal pain and rigors. Which investigation is most likely to reveal the underlying diagnosis?
a. 24-hour urine protein quantification b. Blood culture c. Renal biopsy d. Ultrasound scan of the abdomen e. Urine M,C&S
a. 24-hour urine protein quantification b. Blood culture c. Renal biopsy d. Ultrasound scan of the abdomen Correcte. Urine M,C&S
A two year old boy is brought into A+E by ambulance having a generalised tonic-clonic seizure. Over the last 24 hours he has had a slightly runny nose, and his mum has been giving him regular Paracetamol for a low grade fever. Mum also comments that she herself had a cold sore recently. On arrival at A+E he is still having the seizure. What would be the most appropriate immediate action?
a. Do a lumbar puncture b. Give buccal midazolam c. Give IV acyclovir d. Give IV phenytoin e. Organise a CT head
a. Do a lumbar puncture Correctb. Give buccal midazolam c. Give IV acyclovir d. Give IV phenytoin e. Organise a CT head
A one week old term baby presents to A+E. He is tachypnoeic, tachycardic and has an enlarged liver. Feeding and weight gain have been poor. On examination the infant is acyanotic with a quiet systolic murmur best heard at the upper left sternal edge. The second heart sound is widely split, the split not varying with respiration. What is the most likely diagnosis?
a. Aortic stenosis b. Atrial septal defect c. Interruption of the aortic arch d. Patent ductus arteriosus e. Pulmonary stenosis
a. Aortic stenosis Correctb. Atrial septal defect c. Interruption of the aortic arch d. Patent ductus arteriosus e. Pulmonary stenosis
