Paediatrics 1

Question 1

A baby is born in breech position.

Barlows and Ortolani tests are normal.

Are there any additional investigations you would carry out?

Answer 1

USS of Hip

child is at risk of developmental dysplasia

Question 2

What will X-rays show in a child with Perthes disease?

Answer 2

• flattened femoral head

Question 3

what should be suspected in a child presenting with a painful limp, present for 8 weeks. Hip X-rays appear to be normal.

Answer 3

Perthe’s disease

can be missed on X-ray

so you’d want to do an MRI

Question 4

what is caput succedaneum?

Answer 4

puffy swelling , oedema of scalp

usually occurs over the presenting part of head

crosses suture lines

usually resolves within a few days

Question 5

What should be given to a child with whooping cough?

Answer 5

• should be prescribed azithromycin or clarithromycin to eradicate the organism

Question 6

what medication is given in a child who has croup?

Answer 6

oral dexamethasone

Question 7

what is croup?

Answer 7

• URTI

- characterised by stridor caused by combo of laryngeal oedema and secretions

Question 8

What is vesicoureteric reflux?

Answer 8

• abnormal backflow of urine from bladder into ureter and kidney
• will see gross dilatation of ureter, pelvis and calyces with ureteral tortuosity.

Question 9

A 9-month-old boy has been referred to you by the out of hours GP. His parents give a 24-hour history of increased work of breathing, coryzal symptoms, lethargy and reduced oral intake. On examination, you note fine inspiratory crackles and subcostal recessions. He is pyrexial (37.9ºC) and oxygen saturations are 91% in air.

diagnosis

Answer 9

bronchiolitis

LRTI

commonly caused by RSV

should be admitted for observation and oxygen therapy

Question 10

benign ejection systolic murmur varies with

Answer 10

posture

Question 11

whooping cough is caused by which organism

Answer 11

bordetella pertussis

Question 12

which type of antibiotics are azithromycin or clarithromycin?

Answer 12

macrolide antibiotics

Question 13

what is first line treatment for all children with pneumonia?

Answer 13

amoxicillin

Question 14

describe what treatment may be tried if there is no response to amoxicillin In pneumonia?

Answer 14

• macrolides such as clarithromycin

- macrolides should also be used if mycoplasma or chlamydia is suspected

Question 15

if pneumonia is associated with influenza what treatment is recommended?

Answer 15

co-amoxiclav

Question 16

what is alport’s syndrome?

Answer 16

characterized by glomerulonephritis, end-stage kidney disease, and hearing loss.

caused by an inherited defect in type IV collagen

Question 17

what is exomphalos?

Answer 17

• abdominal contents protruding through anterior abdominal wall
• covered in an amniotic sac formed by amniotic membrane and peritoneum

Question 18

which of the following suggests life threatening asthma in children?

• difficulty completing sentences
• use of accessory muscle
• RR >30
• Oxygen <92%
• HR > 125bpm

Answer 18

oxygen sats less than 92%

Question 19

precocious puberty in females may be defined as the development of secondary sexual characteristics before;

Answer 19

8 years of age