paediatrics

Question 1

4 week old baby with a history of coryzal symptoms followed by violent coughing fits

there are periods where child stops breathing and turns blue

this is highly suggestive of :

Answer 1

bordetella pertussis

infants who develop whooping cough may not have the classic whoop/

they may instead have apnoeas with cyanosis

Question 2

apgar score is used to assess health of a new born baby.

describe the categories it looks at:

Answer 2

Pulse

Respiratory effort

Colour

Muscle tone

Reflex irritiability

Question 3

9 y/o boy collapses.

does not respond to stimulation, no signs of respiration can be found after 10 seconds.

no foreign body in mouth.

next appropriate step according to paediatric basic life support guidelines:

Answer 3

5 rescue breaths

Question 4

6 week old infant

• 4 day hx of poor feeding
• increased difficulty in breathing

OE

• blue tinge to lips
• ejection systolic murmur

underlying diagnosis?

Answer 4

decompensated heart disease with cyanosis (rules out VSD, coarctaction and PDA)

thus could be tetralogy of fallot or transposition of the great arteries.

CYANOTIC Congenital heart disease presenting within the first days of life: TGA

CYANOTIC Congenital heart disease presenting at 1-2 months of age is TOF

Question 5

CYANOTIC Congenital heart disease presenting within the first days of life:

Answer 5

transposition of great arteries

Question 6

CYANOTIC Congenital heart disease presenting at 1-2 months of age is:

Answer 6

tetralogy of fallot

Question 7

components of tetralogy of fallot

Answer 7

• VSD
• right ventricular hypertrophy
• right ventricular outflow obstruction (pulmonary stenosis)
• overriding aorta

Question 8

most common cardiac defect associated with Turner’s syndrome

Answer 8

bicuspid aortic valve

Question 9

Turner’s syndrome is associated with what three heart conditions

Answer 9

• bicuspid aortic valve
• aortic root dilatation
• coarctation of aorta

Question 10

Turner’s syndrome caused by:

Answer 10

• only one X chromosome, or deletion of short arm of one of the X chromosomes
• 45 XO, 45X

Question 11

What is Osgood-Schlatter disease?

Answer 11

• osteochondrosis caused by inflammation at the tibial tuberosity

Question 12

what condition is characterised by:

herniation of abdominal viscera into chest cavity due to incomplete formation of diaphragm

Answer 12

congenital diaphragmatic hernia

- can result in pulmonary hypoplasia and hypertension which caused respiratory distress shortly after birth

Question 13

6 month old baby

• 7 day hx fever & dry cough
• over past 24hrs, refusing milk, very few wet nappies

Obs

• 93% oxygen saturations on air
• RR 58
• HR 160bpm
• BP 85/45
• 38.1 TEMP

OE

• marked intercostal recession
• rapid breathing
• use of accessory muscles
• making a grunting noise

indicative of:

Answer 13

Bronchiolitis

- characterised by acute bronchiolar inflammation

Question 14

most common pathogen present in bronchiolitis

Answer 14

• respiratory syncytial virus

Question 15

average age child attains the ability to:

as ‘what’ and ‘who’ questions

Answer 15

3 years

Question 16

average age child attains the ability to:

combine two words

Answer 16

2 years

Question 17

average age child attains the ability to:

Ask ‘why’, ‘when’ and ‘how’ questions

Answer 17

5 years