Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
A healthy 14 month old boy, born at term, presents forroutine assessment with his health visitor. Assuming normal development, up to what milestones is helikely to have attained? A: Rolling, reaching, smiling B: Running, scribbling with a crayon, using simple sentences C: Sitting, transferring bricks, 2 syllable babble D: Taking steps, pincer grasp, saying 1-2 words with meaning E: Walking up stairs, circular scribbles, saying 30-50 word |
Ans: D If you only knew the milestones of sitting at 6 months and walking at 12 months you can narrow down the answer. Learn the basic markers for these age ranges. |
|
|
A healthy 14 month old boy, born at term, presents forroutine assessment with his health visitor. Assuming a normal UK immunisation schedule, which of thefollowing conditions will he not have been immunised against? Chicken Pox Haemophilus Influenzae Type B Meningococcal Disease Type B Polio Tetanus |
Ans = A - Chicken pox Menigiococcal has been added in recently, if they are 7 then they probs wont have Men B immunisation. No vaccine for Chicken pox, only immune once had it |
|
|
A healthy baby girl is born at term via forceps delivery. She isnoted to have 2 small irregular, flat, pink, blanching marks onher left upper eyelid and just below the hair line on theposterior aspect of her neck. What is the most likely diagnosis? Capillary naevi Delivery related bruising Epsteins Pearls Melanotic naevi Mongolian spot |
Ans = A Capillary nevi - with bruising the skin wont blanch, so it is probs capillary nevi |
|
|
A 3 month old baby boy dies suddenly and unexpectedly athome. Concerning Sudden and Unexplained Death in Infants, which ofthe following is true? Most cases are caused by infanticide Most cases do not have an identifiable cause Most cases have a cardiac cause Most cases have a genetic cause Most cases have an infective cause |
Ans = B - No identifiable cause Majority of cases they don't identify the cause (hence unexplained death) - clue is in the title |
|
|
A baby girl is born at 37 weeks gestation weighing 1800grams Which of the following is common during the first few days of lifein babies born small for dates? A. Anaemia B. Hyperthermia C. Hyperkalaemia D. Hypoglycaemia E. Thrombocytosis |
Ans = D Hypoglycemia - common in very small babies at birth because they are likely to have a small reserves of glucose and insulin, can also become thrombocytopeanic or polycytopenaic Aneamia not an option because at birth if anything they have an excess of haemoglobin |
|
|
A baby girl is born at 26 weeks gestation weighing 900 grams(75th centile). What are the correct gestational and weight definitions for thisbaby? Extreme prematurity and Extremely low birth weight Extreme prematurity and Very low birth weight Prematurity and Extremely low birth weight Prematurity and Very low birth weight Prematurity and Low birth weight |
Ans = A Under 28 weeks is extreme premature, if under 1kg then extremely low birth weight |
|
|
A baby boy is born at 26 weeks gestation. He is intubated andventilated for respiratory distress syndrome and transferred toan incubator. His fist recorded temperature is 35.5OC. Which of the following is an adverse effect of cold stress on aneonate? Decreased energy expenditure Decreased oxygen consumption Decreased surfactant production Metabolic alkalosis Pulmonary hypotension |
Ans = C - Decreased surfactant production Think if you were dunked in cold water - energy expenditure would go up and 02 consumption would go up, acid levels would go up so acidotic so you can straight away take out 3 options. In normal babies pulmonary pressure should naturally go down, pulmonary hypertension occurs in stressed babies. *figuring out the answer by process of elimination is key in multiple choice - constantly narrowing your odds* |
|
|
A baby boy is born at 26 weeks gestation. He is intubated andventilated for respiratory distress syndrome and transferred toan incubator. His fist recorded temperature is 35.5OC. Which of the following is not a typical associated complication ofextreme preterm delivery? Brocho-Pulmonary Dysplasia Intra-Ventricular Haemorrhage Necrotising Enterocolitis Neonatal Abstinence syndrome Patent Ductus Arteriosus |
Ans = D - Neonatal abstinence syndrome Neonatal abstinence - typically seen in term babies that have had exposure to opiates in uterus. BPD - due to lungs being battered on premature birth. Necreatorsing enterocolitis - caused by the mature duct being vulnerable to infection. |
|
|
A 3 week old breast fed Italian baby girl, born at term,presents for assessment of jaundice. Her jaundice was mostvisible on day 4 and is still present on her nose andconjunctivae. She has pale yellow urine and yellow-brownstools. Her investigations show a serum bilirubin of 150micromols/l (Normal 5-40)- 5% of which is conjugated. Herhaemoglobin and blood film are normal. What is the most likely diagnosis? ABO Incompatibility Congenital biliary atresia Glucose-6-phosphate dehydrogenase (G6PD) deficiency Prolonged physiological jaundice/ Breast Milk Jaundice Rhesus Incompatibility |
Ans = D Breast feeding jaundice is the most common cause of jaundice at this age. |
|
|
A 9 month old baby presents with 2 days of increasingepisodic distress. She is described as looking very pale duringthese with colour returning to normal afterwards. She has had3 vomits today that were described as “green.” She has had nostools for 36h. A small mass can be felt in her right iliac fossa. What is the most likely diagnosis? Intussusception Malrotation Pyloric stenosis Tetralogy of Fallot Urinary Tract infection |
Ans = A - Intussusception Intussusception - the episodic pallor the green vomit are the key signs here. Cant be pyloric stenosis they are too old. Pyloric stenosis is more a condition of the new born. |
|
|
A 2 year old boy presents to primary care with a 2 dayhistory of cough and runny nose. On further questioning he hasa 6 month history of foul smelling stools, food refusal andlethargy. His weight has dropped from the 50th to the 2ndcentile over the last 12 months. What is the most likely diagnosis? Coeliac disease Constipation Failure to thrive Food refusal of toddlerhood Psychosocial deprivation |
Ans = A - Coeliac disease Coeliac disease - commonly causes weight loss |
|
|
A 4 y old boy presents after his parents noticed “red stuff”in his urine and were concerned this was blood. He has had arecent upper respiratory tract infection. Mothers grandfatherhad a “kidney problem” but is not sure what type. Which of the following is not typically associated with macroscopichaematuria? IgA Nephropathy Minimal Change Nephrotic Syndrome Post Infectious Glomerulonephritis Renal angle trauma Wilm’s Tumour 26/02/2017 |
Ans = B - Minimal change disease Minimal change disease - typically no blood just protein |
|
|
A 10 year old girl is referred for assessment of short stature Which of the following is not associated with short stature ingirls? Coeliac disease Hypothyroidism Klinefelter ’s Syndrome Prader Willi Syndrome Turner’s Syndrome |
Ans = B - Klinefelters Syndrome Klinefelters syndrome - more to do with boys and causes height not shortness |
|
|
A 10 year old girl has Juvenile Idiopathic Arthritis. Shepresents to her paediatric rheumatologist with parentalconcerns that her mobility remains limited by joint discomfortand swelling in her right knee, despite current NSAIDs and arecent intra-articular steroid injection Which of the following may be considered or advised? Bed rest for 1 week Crutches for 2 weeks Oral Methotrexate Splint application to the knee for 3 weeks Wheelchair use until pain resolved |
Ans = C - Oral methotrexate All the other things they don't use, you want to get the joints mobile DMT are for later disease |
|
|
A 12y girl attends hospital for the first time for assessmentof short stature. Subsequent investigation reveals a 45XOkaryotype What abnormality may be identified following furtherassessment and investigation? Bilateral renal agenesis Coarctation of the aorta Duodenal atresia Imperforate anus Transposition of the great arteries |
Ans = Coarctation of the aorta Turners disease, even if you don't know that you can rule out the other answers because they are problems with the early child and often with these disease they wouldn't be able to make it to later life. |
|
|
A 5y old boy has recently presented to the ward with anabdominal mass. Further investigation reveals a probableneuroblastoma. He is started on chemo therapy. Subsequentblood tests identify elevated blood levels of urea, creatinine,phosphate and urate. Which of the following is correct for his IV fluid management? Fluid Excess (Hyper-hydration, 2.5l/m2) is necessary Fluid restriction (Hypo-hydration, 0.1l/m2) is necessary He should receive oral rehydration solution only Potassium should be infused slowly with his IV fluids Potassium should be infused quickly with his IV fluids |
Ans = A - fluid excess
Never put potassium in fluids for children - especially when potassium is already high, they are acute so oral treatment not good enough, and give excess fluid to flush out the problem (you wouldn't want to restrict) |
|
|
A 4 month old baby boy presents with worseningrespiratory distress secondary to bronchiolitis. Relative to an adult what anatomical or physiological factor mustbe considered in this boy when planning his clinical care? Decreased chest wall compliance Fewer type 1 respiratory muscle fibres Higher systemic vascular resistance Larger area for air tissue interface Smaller surface area to weight ratio |
Ans = B - fewer type 1 (slow twitch) muscle fibres They tend to have increased chest compliance, there systemic pressure tends to be lower, they tend to have a small areas for tissue (small lungs), there surface to weight area is higher because there total mass is low. |
|
|
A 12-month-old girl presents to primary care with a 3 dayhistory of sneezing, runny nose and cough. She has atemperature of 37.8OC, mild sub-costal recession and bilateralwheeze with scattered crepitations. She has bilateral pinktympanic membranes and mildly erythematous fauces. What is the most appropriate initial treatment? Intravenous Cefotaxime Intravenous Benzlypenicillin No Medical therapy Oral Amoxicillin Oral Trimethoprim |
Ans = C - no medical therapy Diagnosis is probs bronchitis and the most common cause of bronchiolitis is RSV - watchful waiting is first line management. |
|
|
A 12 month old girl presents to A+E with fever, vomitinglethargy and a non-blanching rash. She is pale, clammy andperipherally shut down. It is decided to initiate immediateantibiotic therapy. What weight should be estimated to guide initial treatment? A. 5kg B. 10kg C. 15kg D. 20kg E. 25kg |
Ans = B - 10kg Use 10kg to gauge rough treatment (5kg is a big new born) (15kg is an average 2 year old) |
|
|
A 4-year-old boy is brought in to the Accident andEmergency department following a witnessed episode ofchoking. He is unconscious with no evidence of any respiratoryeffort or cough. What is the most appropriate action? Administer 5 back blows Administer 5 abdominal thrusts Administer 15 chest compressions Encourage cough and continue to check for deterioration Open the airway and administer 5 rescue breaths |
Ans: E - rescue breaths They are unconscious and not showing effort and not coughing then it is the last option. |
|
|
A male child is found to have an injury. Which of the following does NOT suggest non-accidental injury? A 3 hour old baby with a clavicle fracture A 3 week old baby with a bruise on the right ear A 6 week old baby with a torn frenulum A 3 month old infant with a humeral fracture A 3 month old infant with a rib fracture |
A = A - fractured clavicle The most common cause of clavicle fracture is injury during delivery, the rest are unlikely. |
|
|
A 9 month old girl is admitted following a febrile UTI. She istreated with IV antibiotics. The consultant wants to know if shewill develop renal scarring. Which the following investigations would be most useful for this? Abdominal Computerised Tomography (CT) DMSA (Isotope scan) MAG3 Renogram Micturating Cystourethrogram (MCUG) Renal Ultrasound |
Ans = B - DMSA (isotope scan) DMSA is the best test for renal scarring. MCUG tells you about reflux. |
|
|
A 3 day old baby presents with bilious vomiting for 2 days. Examination shows she is lethargic. Her heart rate is 180. Shehas cold peripheries and a respiratory rate of 70. Which is the most appropriate type of fluid to use immediately? 0.45% Sodium Chloride + 5% Dextrose with potassium 0.45% Sodium Chloride + 5% Dextrose without potassium 0.9% Sodium Chloride without potassium 5% Dextrose with potassium 10% Dextrose with potassium |
Ans = C - 0.9% saline The most common one, HR is high and cold peripheries you are thinking they are undergoing shock - they need volume replacement and out of all of these the best one for volume replacement is saline. |
|
|
A 6y old boy is being reviewed on the ward round afterpresenting the previous day following a first afebrilegeneralised tonic-clonic seizure. He has fully recovered and iscurrently playing. His blood sugar was not checked on arrival. Which of the following is correct regarding further investigation? A blood sugar should be performed immediately A normal EEG excludes epilepsy An ECG should be performed before discharge Blood for genetic and metabolic studies should be sent Performing an EEG will be diagnostic for epilepsy |
Ans = C - EC A heart condition (long QT) can be a cause of seizures in children, if they are fitting at the time and not woken up then blood sugar is reasonable EEG doesn't exclude epilepsy so can rule these out |
|
|
A 4y old girl who is a type 1 diabetic is noticed to be pale,quiet and complaining of being dizzy. Her parents check herblood glucose and note it to be 2.9 mmol/l Which of the following would not be appropriate initial treatment? 3-6 Lucozade glucose tablets 50g of Dairy Milk Chocolate 50ml of Lucozade 60ml of Berry Burst Glucojuice 100ml of Lemonade |
Ans = B - 50g of dairy milk Is fat and so not appropriate. |
