random bits

Question 1

Tx- child drank bleach

Answer 1

drink milk- curdles in stomach, coats stomach + slows absorption rate
- can present with oral ulceration

Question 2

Management of burns

Answer 2

• remove from source + remove clothes (unless adherent)
• running cool water for 20 mins
• cling film

Question 3

poisoning- presentation and antidote for antifreeze (ethylene gylcol)

Answer 3

• presentation- CN palsy, renal impairment, metabolic acidosis
• tx- fomepizole, ethanol

Question 4

poisoning- presentation and antidote for digoxin

Answer 4

• presentation- bradycardic, blurred vision, xanthopsia
• tx- digoxin specific antibody fragments

Question 5

poisoning- presentation and antidote for benzo’s

Answer 5

presentation- hallucinations, ataxia, slurred speech, blurred vision, sedation, nystagmus
- tx- flumazenil

Question 6

poisoning- presentation and antidote- Iron

Answer 6

• GI haemorrhage
• desferrioxamine

Question 7

poisoning- presentation and antidote- Opioids

Answer 7

• pin point pupils, hypotension, hypoventilation, sedation, bradycardia
• naloxone

Question 8

signs of DDH after the newborn period

Answer 8

• leg dragging when crawling
• uneven leg length
• restricted movement in leg- e.g. when changing nappy
• uneven skin folds of buttocks and thighs
• limping
• tip toe walking/ antalgic gait

Question 9

Investigation in suspected DDH

Answer 9

<6 months- USS
>6 months- x-ray (due to ossification of the proximal femoral epiphysis)

Question 10

most common cause of croup

Answer 10

parainfluenza

Question 11

describe the changes in a haemangioma

Answer 11

• initial pre-cursor lesions (blanched macule/ erythematous/ telangeictasia/ bruised area)
• proliferative growth phase (6-9 months)
• stabilisation and then involution

Question 12

concerns with segmental haemangiomas

Answer 12

• if around the face (cervical/ mandibular)- concerns of airway haemangiomas- may present with stridor
• can also indicate possible haemangiomas of the liver, brain and GI tract
• liver is most common site for haemangiomas

Question 13

management of infantile haemangiomas (if airway or organ compromise)

Answer 13

propranolol

Question 14

describe PHACE syndrome

Answer 14

Posterior fossa brain malformations
Haemangiomas (large segmental facial)
Arterial anomalies
Cardiac/ coarctation
Eye/ endocrine conditions

Nuerocutaneous syndrome
needs MRI+MRA brain and beck
echo
opthal assessment

Question 15

summarise advanced care plans

Answer 15

• Not legally binding
• choronic and life-limiting conditions - - communicates health care wishes
• plans for deterioration

Question 16

Asthma predictive indicator (API)- criteria for use, major and minor criteria

Answer 16

criteria- 2-5 y/o, multiple episodes of wheeze
- major- parental hx asthma, diagnosis of atopic dermatitis
- minor- blood eosiniphils >4%, wheeze unrelated to illness, diagnosis of allergic rhinitis

Question 17

Diagnosis of Trisomys (13- Pateau, 18-Edwards, 21- downs)

Answer 17

Rapid aneuploidy screen
followed by full karyotype

Question 18

Inheritance pattern in Downs

Answer 18

maternal meiotic non-dysjunction

Question 19

screening in downs

Answer 19

Echo- avsd/vsd/asd
Othpal
hypothyroid
Audiology

Question 20

patau syndrome presentation

Answer 20

holproscencephaly (failure of the brain to divide into hemispheres)
orofacial clefts
polydactly

Question 21

Edwards syndrome presentation

Answer 21

prenatal growth deficiency
over riding fingers
CHD

Question 22

Cardiac association of Williams syndrome

Answer 22

supravalvular aortic stenosis

Question 23

Cardiac association of Noonans

Answer 23

dysplastic pulmonary valve

Question 24

Cardiac associations of DiGeorge snydrome (22q deletion)

Answer 24

TOF
Truncus arteriosis

Question 25

Cardiac associations of Holt-Oram syndrome

Answer 25

ASD

Question 26

Murmur: - site heard- cardiac apex - systolic

Answer 26

Mitral regurg

Question 27

Murmur: - site heard- cardiac apex - diastolic

Answer 27

mitral stenosis

Question 28

Murmur: - site heard- LL sternal border - systolic

Answer 28

VSD tricupsid regurg AV valve with regurgitation

Question 29

Murmur: - site heard- UL sternal border - systolic

Answer 29

PS PDA ASD AS

Question 30

Murmur: - site heard- UL sternal border - diastolic

Answer 30

pulmonary regurg aortic regurg

Question 31

Murmur: - site heard- UL sternal border - continuous

Answer 31

PDA

Question 32

Murmur: - site heard- Neck/ aortic area - systolic

Answer 32

AS

Question 33

Murmur: - site heard- Neck/ aortic area - continuous

Answer 33

venous hum

Question 34

Murmur: - site heard- Back - systolic

Answer 34

coarctation PS

Question 35

Murmur: - site heard- Back - Continuous

Answer 35

coarctation AV malformation

Question 36

How to induce remission in Crohns

Answer 36

1- Pred 2- enteral nutrition diet (elemental or polymetric)

Question 37

diagnosis of nephrotic syndrome

Answer 37

clinical oedema Proteinurea >1g/m2/day Hypoalbuminaemia <25g/L

Question 38

surgical management of pyloric stenosis

Answer 38

Ramstedt pylormotomy

Question 39

MODY (Mature onset diabetes of the young) inheritance

Answer 39

autosomal dominant mutation on the HNF gene

Question 40

Diabetic screening- when are the following conditions screened for: - coeliac - thyroid disease - retinopathy - microalbuminurea - BP

Answer 40

- coeliac- Diagnosis - thyroid disease- diagnosis and annually the below- annually from the age of 12 - retinopathy - microalbuminurea - BP

Question 41

Presentation and management of cocaine overdose

Answer 41

- pyrexia, hypertension, tachycardia, tachyarrythmia on ECG, altered concious - benzo's

Question 42

Cushing's triad in raised ICP/ possible herniation

Answer 42

hypertension bradycardia irregular breathing

Question 43

causative organism and presentation of roseola infantum (exanthem subitum)

Answer 43

Human-herpes virus 6 (HHV-6) presents with high fever lasting 3–5 days, during which the child appears relatively well. After the fever resolves abruptly, a blanching maculopapular rash appears, starting on the trunk and often spreading to the neck and proximal limbs. The face is typically spared. This condition is also one of the most common causes of febrile seizures in young children.