1
Q
by what age would you expect baby to sit unsupported?
A
6-8 months
2
Q
empirical treatment for meningitis if >3 months
A
ceftriaxone or cefotaxime
3
Q
3 most common causes bacterial meningitis >3months
A
N meningitidis
S pneumoniae
H influenzae B
4
Q
contraindication to LP
A
focal neurological signs
papilloedema
bulging fontanelle
DIC
cerebral herniation
signs of raised ICP
5
Q
is LP CI in meningococcal septicaemia?
A
yes - blood cultures and PCR instead
6
Q
antibiotics bacterial meningitis <3 months
A
IV amox and IV cefotaxime
7
Q
when to give dex for bacterial meningitis
A
> 3 months
LP - purulent CSF, bacteria on gram stain
8
Q
prophylaxis for contacts of bacterial meningitis
A
ciprofloxacin
9
Q
milestones
1. no head lag pull to sit
2. walk unsupported
3. crawl
A
3 months
12-15 months
8-10 months
10
Q
most common cause of inherited intellectual disability
A
fragile x
11
Q
gene affected in fragile x
A
FMR1 gene
12
Q
characteristics of fragile x
A
intellectual disability
distinctive physical features
behavioural problems
13
Q
definition microcephaly
A
OFC <2nd centile
14
Q
causes of microcephaly
A
normal variation
familial, congenital infection
HIE
fetal alcohol syndrome
craniosynostosis
15
Q
risk factors DDH
A
female
breech
FH
first born
oligohydramnios
birth weight >5kg
16
Q
DDH more common on left or right?
A
left
17
Q
what newborns require hip USS?
A
1st degree family hip problems
breech >36 weeks
twins
18
Q
clinical exam DDH
A
barlow - dislocate
ortolani - relocate
19
Q
investigations DDH - before and after 4.5months
A
USS
after then Xray
20
Q
cause of hand, foot and mouth disease
A
coxsackie A16 virus
enterovirus
21
Q
presentation hand, foot and mouth
A
low grade fever, reduced appetite
small red spots hands, feet, oral mucosa
22
Q
managing hand, foot and mouth
A
hydration, analgesia
23
Q
school rules hand, foot and mouth
A
unwell - keep off school
do not need excluded
24
Q
What is intussusception?
A
invagination of one portion of bowel into lumen of adjacent bowel
25
what area of bowel most affected about intussusception?
ileo-caecal region
26
age range intususception
6-18 months
27
intususception more boys or girls?
boys
28
intermittent, severe crying, draw knees up, redcurrant jelly stool and suausage shaped mass in RUQ - what condition?
intususception
29
investigations intususception and what it shows
USS
target like mass
30
managing intususception
reduction by air insufflation
surgery
31
what age able to combine 2 words by?
2 years
32
turns towards sounds
3 months
33
says double syllables - adah
6 months
34
says mama and dada
9 months
35
knows and responds to name
12 months
36
Paediatric BLS - if no signs of breathing on initial assessment what to do?
5 rescue breaths
37
ratio for chest compressions
15:2 if 2 or more responders
30:2 if alone
38
common age of perthes disease
4-8 years
39
first line for constipation in children
macrogol
40
red flags constipation in children
distended abdomen
weakness in legs
faltering growth
ribbon stools
41
when should meconium be passed by?
48hrs
42
treating faecal impaction in children
movicol
add stimulant after 2 weeks
add or change to osmotic
43
importance dietary points constipation in children
fluid intake
fibre
do not do this alone - prescribe macrogol too
44
what is osteochondritis dissecans?
fragment of bone detached due to lack of blood supply
45
osteochondiritis dissecans symptoms
pain, swelling and locking
most common in young adults and adolescents
46
treating labial adhesions if recurrent UTIs
oestrogen cream
47
coryzal illness, high fever resolves and then a red rash across trunk and limbs...
roseola infantum
48
cause of roseola infantum
HHV6
49
other name for roseola infantum
6th disease
50
school exclusion for roseola infantum?
no
51
features roseola inflantum
high fever then rash
nagayama spots on uvula
febrile convulsions
52
first line for nocturnal enuresis
enuresis alarm
53
age for definition of nocturnal enuresis
5 years
54
managing nocturnal enuresis - stepwise
underlying triggers
fluid, toilet patterns
reward system
enuresis alarm
desmopressin short term
55
scarlet fever cause
strep pyogenes
56
scarlet fever age
2-6 years
57
features scarlet fever
fever, malaise, sore throat, strawberry tongue
rash - pinpoint, flexures, sandpaper
58
treating scarlet fever
10 days oral antibiotics - penicillin or azithromycin
59
school rules scarlet fever
keep off until 24hrs abx
notifiable disease
60
precocious puberty
secondary sexual characteristics before 8 in girls and 9 in boys
61
first step in neonatal resuscitation
dry baby, remove wet towels and start the clock
62
when to do apgar score?
1 and 5 minutes after birth
63
APGAR score
Activity
Pulse
Grimace
Appearance
Resp effort
64
heart condition associated with turners
biscuspid aortic valve, coarctation aorta
65
finds of meconium aspiration
cyanosis
CXR - patchy infiltrations
66
nephrotic syndrome triad
proteinuria
hypoalbuminaemia
oedema
67
most common cause of nephrotic syndrome in children
minimal change disease
68
treating minimal change disease
oral steroids
69
males precocious puberty cause
1. bilateral enlarged testes
2. unilateral enlarged
3. small
1. intracranial lesion
2. gonadal tumour
3. adrenal cause
70
meconium ileus
24-48hrs of life
abdo distension
bilious vomit
71
associated condition meconium ileus
CF
72
low set ears, rocker bottom feet and overlapping fingers
edwards syndrome
trisomy 18
73
when does pyloric stenosis present?
week 2-4
74
features pyloric stenosis
projectile vomiting 30 mins after feed
constipation
palpable mass in upper abdo
75
blood gas pyloric stenosis
hypochloraemic hypokolaemic metabolic alkalosis
76
diagnosis and management of pyloric stenosis
USS
pyloromyotomy
77
organism causing acute epiglottitis
H Influenzae B
78
features epiglottitis
rapid onset, fever, unwell
stridor, drooling
tripod position
79
diagnosis of epiglottitis
by trained staff direct visualisation
xray - thumb sign
80
managing epiglottitis
immediate anaesthetic/ENT support
oxygen, IV abx
81
hand preference before what age is a red flag?
12 months
82
causes of HTN in children
renal paraenchymal disease
coarctation aorta
phaeochromocytoma
CAH
83
most common cause of cyanotic CHD
birth - TGA
overall - fallots
84
most common cause of acyanotic CHD
VSD
85
causes of acyanotic CHD
VSD, ASD, PDA
coarctation aorta
86
VSDs or ASDs more common?
VSD
in adults ASD more likely as new diagnosis
87
first line treatment paediatric migraine
ibuprofen
88
age triptans can be given
12 years but follow up required for nasal
18 years for oral
89
short stature and primary amenorrhoea
turners syndrome
90
caput succedaneum features
forms over vertex
cross suture lines
resolves in days
91
cephalohaematoma
parietal region
does not cross suture lines
resolve in moths
92
polydactyly, microcephaly, small eyes
patau syndrome
trisomy 13
93
why are breastfed babies at risk of haemorrhagic disease newborn
breat milk poor source of vitamin K
94
babies affected by malrotation
<30 days of age
95
genetics of CF
CFTR gene defect
autosomal recessive
1 in 2500
96
inguinal hernia when for surgery?
urgently
if over 1 years can be elective
97
koplik spots are part of which illness
measles
98
what disease has a rash which starts behind the ears then spreads to the whole body?
measles
99
managing measles
supportive care
notifiable disease
100
list 4 complications of measles
otitis media
pneumonia
encephalitis
subacute sclerosing panencephalitis
101
when to give MMR vaccine to child in contact with measles?
within 72 hours
102
klinefelters syndrome karyotype
47 XXY
103
Features of klinefelters syndrome
taller than average
small, firm testes
infertile
gynaecomastia
104
lack of smell in a boy with delayed puberty?
kallman syndrome
105
karyotype AIS
46XY
106
features of AIS
primary amenorrhoea
undescended testes
breast development
107
managing AIS
raise child as female
bilateral orchidectomy
oestrogen therapy
108
what is kochers criteria?
assess probability of septic arthritis in children
109
4 parameters of kochers criteria
non weight bearing
fever >38.5
WCC >12
ESR >40
110
most common affected joints in septic arthritis
hip, knee, ankle
111
barking cough, stridor and hoarse voice..
croup
112
causative organism croup
parainfluenza virus
113
peak age croup
6 months - 3 years
114
managing croup
single dose oral dex
0.15mg/kg
emergency - high flow O2 and neb adrenaline
115
xray in croup
PA - steeple sign
lateral - thumb sign
116
characteristics of innocent murmur
systolic
soft
varies with posture
asymptomatic
no radiation
117
when to refer a baby with fever parameters?
>38 degrees and <3 months
118
4 parameters to record in child with fever
RR, HR, temp, CRT
119
when can pregnant women have pertussis vaccine?
16-32 weeks
120
causative organism pertussis
bortadella pertussis
121
when are infants immunised against pertussis?
2,3,4 months and 3-5yrs
122
diagnostic criteria croup
cough >14 days with
- paroxysmal cough
- inspiratory whoop
- post tussive vomit
- apnoeic attacks
123
managing pertussis
<6 months - admit
notifiable disease
oral macrolide
household contact prophylaxis
school exclusion
124
when to give oral macrolide for pertussis?
onset of cough within last 21 days
125
school exclusion pertussis
48hrs after antibiotics
126
complications pertussis
subconjunctival haemorrhage
pneumonia
bronchiectasis
seizures
127
treatment for threadworm
mebendazole (single dose) for child and household
hygiene advice
128
threadworm features
perianal itching, particulary at night
129
infant with coryza, cough, bilateral crackles and fever
bronchiolitis
130
age for bronchiolitis
3 months - 6 months
131
causative organism bronchiolitis
RSV
132
investigation for bronchiolitis
immunofluorescence of nasopharyngeal secretions
133
management of bronchiolitis
supportive
can give humidified O2, NG feed, suctioning
134
school aged child fever, bright red cheek rash with lacy appearance
erythema infectiosum
135
cause of erythema infectiosum
parvovirus B19
136
other name for erythema infectiosum
fifth disease
slapped cheek
137
severe asthma criteria
sats <92%
PEF 33-50
HR >125 or 140
RR >30 or 40
138
life threatening asthma signs
silent chest
altered consciousness
cyanosis
sats <92%
PEF <33
139
opening of urethra most common in hypospadias
distal ventral surface
140
managing hypospadias
refer
surgery at 12 months
essential not to circumcise before op
141
when is blood spot screening test done?
between day 5 and 9 of life
142
blood spot test conditions tested for
CF
PKU
congenital hypothyroidism
MCADD
sickle cell
143
managing surfactant deficienct lung disease
steroids to mother
oxygen, ventilation, exogenous surfactant
144
acrocyanosis
peripheral cyanosis
common in neonates
145
test to differentiate cardiac and non-cardiac cyanosis
nitrogen washout test
146
initial management cyanotic CHD
prostaglandin E1
147
nappy rash with creases spared
irritant dermatitis
148
managing nappy rash
expose to air, barrier cream
mild HCT 1% cream
149
jaundice in first 24 hours is..
always pathological
150
causes of jaundice in first 24 hours
rhesus haemolytic disease
ABO haemolytic disease
spherocytosis, G6PD
151
jaundice with raised conjugated bilirubin
biliary atresia
152
features of growing pains
never present in morning, no limp, no limit to activity, systemically well, normal exam
153
when can mild ladder be used?
after 6 months of age
children with CMPA
154
managing CMPA
extensive hydrolysed formula
AAF
if breastfeeding mother eliminate cow milk from diet
155
treating asthma exacerbation in children
beta 2 agonist via spacer - max 10 puffs
steroids for 3-5 days
156
what age hop on one leg
3-4 years
157
what age squat to pick up a ball
18 months
158
most common cause of headache in children
migraine
159
children under what age are not able to consent to sexual intercourse?
13
160
number 1 cause of painless massive GI bleeding in children 1-2 years
meckels diverituclum
161
meckels diverticulum rule of 2
2% of population
2 feet from ileocaecal valve
2 inches long
162
rocker bottom feet, clenched hands, low set ears
trisomy 18 - edwards syndrome
163
neonatal meningitis organisms
GBS
E coli and listeria
164
gap between live attenuated vaccines in time
4 weeks
165
contraindication to MMR
severe immunosuppression
neomycin allergy
live vaccine within 4 weeks
166
intestines exposed not in a sac
gastrochisis
167
exomphalos
abdominal contents protrude covered by amniotic sac
cardiac and kidney malformations
168
management of undescended testes
review at 3 months
169
complications of undescended testes
infertility
torsion
testicular ca
psychological
170
when should oral rotavirus vaccine not be given after?
15 weeks
171
rotavirus vaccine
oral, live attenuated vaccine
2 doses at 2 months and 3 months
172
why can oral rotavirus vaccine not be given after 15 weeks?
risk intussusception
173
features wilms tumour
abdo mass
haematuria, flank pain
174
cause of perthes disease
AVN femoral head
175
necrotising enterocolitis symptoms
feeding intolerance
abdo distenstion
bloody stools
176
necrotising enterocolitis XR
rigler and football sign
bowel wall oedema, dialted loops
177
hearing test done before school
pure tone audiometry
178
type of hearing test newborn
otoacoustic emission test
179
what could hand preference before 12 months be a sign of?
cerebral palsy
180
JIA symptoms
salmon pink rash, LN, arthritis, uveitis
181
complication of kawasaki disease and how to screen for this
coronary artery aneurysm
echo
182
features of kawasaki disease
fever >5 days
bilateral conjunctivitis
cervical LN
polymorphic rash
cracked lips/strawberry tongue
oedema/desquamation
183
management of kawasaki disease
high dose aspirin
IVIG
Echo
184
why is aspirin usually CI in children?
risk of reye's syndrome
185
maculopapular rash on face, spread to body and LN
Rubella
186
murmur in PDA
continuous machinery murmur
187
treating PDA
ibuprofen/indomethacin/paracetamol
if other CHD prostaglandin E1
188
use of prostaglandin E1 in CHD
keep ductus arteriosus open until surgery
189
school exlcusion - influenza and scabies
flu - until recovered
scabies - until treated
190
scarlet fever school exclusion
24 hours after antibiotics
191
CXR in transient tachypnoea newborn
hyperinflation of lungs
fluid in horizontal fissure
192
management of TToN
observe, supportive care, O2 may be required
193
inheritance of CF
autosomal recessive
194
4 features of tetralogy of fallot
pulmonary stenosis
VSD
overriding aorta
RVH
195
age of presentation of TOF
1-2 months
TGA more common to pick up at birth
196
neonate with poor feeding, shortness of breath and hepatomegaly
heart failure
197
prodrome irritable, conjuctivitis and fever
measles
198
investigation for reflux nephropathy
micturating cystography
199
when to consider diagnosis of pneumonia instead of bronchiolitis
fever >39
persistent focal crackles
200
complications of gastroschisis
heat and fluid loss
201
bow legs in child <3 years
normal variant
usually resolves by 4
202
cyanotic heart disease
- first days of life
- 1-2 months
TGA
TOF
203
treatment seborrhoeic dermatitis
baby shampoo and baby oil
204
When to consider adding dexamethasone - meningitis
>3 months old
LP - purulent CSF, WCC high, bacteria on gram stain
205
maternal mortality
any death in pregnancy, labour or 6 weeks post partum
206
stillbirth
after 24 weeks
207
webbed neck, pectus excavatum and pulmonary stenosis
noonan syndrome
208
managing reflux
positioning when feeding
not overfed - small and frequent feeds
thickened formula
gaviscon
209
kawasaki disease treatment
high dose aspirin
210
management of perthes
<6 years observe
older - surgery
211
first line pneumonia in children
amoxicillin
212
obesity in children - how to ascertain this
BMI adjusted to age and gender
213
benign rolandic epilepsy
seizures - partial, at night
214
use of caffeine in a neonate
aiding weaning off ventilator - resp stimulant
215
use of sildenafil in neonate
pulmonary HTN
216
umbilical hernia management
watch and wait
usually resolve by 3 years
217
CXR - transient tachypnoea of the newborn
hyperinflation
fluid in horizontal fissure
218
3 week old with sticky eyes, purulent discharge
refer to ophthalmology
219
medication for ADHD
children >5 years
last resort
methylphenidate
220
childhood syndromes - small eyes and polydactyly
patau
221
mumps school exclusion
5 days from onset swollen glands
222
associations with hirschprings
downs syndrome
males
223
managing hirschprings
rectal washouts/irrigation
surgery
224
trid of shaken baby syndrome
retinal haemorrhage
subdiral haematoma
encephalopathy
225
diagnosing bronchiolitis
immunofluorescence nasopharyngeal secretions for RSV
226
what is Epstein's pearl?
congenital cyst roof of mouth
no treatment required
227
inguinal hernia in infants
urgent surgery
over 1 year - elective
228
CHD - downs syndrome
AVSD
229
causes of snoring in children
obesity
nasal problems
recurrent tonsillitis
downs syndrome
hypothyroidism
230
age for perthes
4-8 years
231
risk factors surfactant deficient lung disease
male
diabetic mother
C-section
second born of prem twins
232
premature babies - when to give vaccines?
no adjustment - give according to gestational age
MSRA
flashcards
Decks in class (24)
# Cards
-
Gynae148
-
Obstetrics226
-
Dermatology193
-
Breast surgery28
-
Respiratory173
-
Renal125
-
Urology65
-
Psychiatry122
-
Neurology219
-
Anaesthesia/pre-op28
-
Pharmacology and therapeutics84
-
cardiovascular243
-
Paediatrics232
-
Rheumatology112
-
Orthopaedics78
-
Imm/allergy/genetics17
-
Haematology79
-
Infectious diseases131
-
Colorectal/gensurg/upper GI40
-
Gastro94
-
Endocrine/metabolic45
-
MCQ Bank18
-
ENT44
-
Eyes39
