21 May 2012

Revision Questions (Medical students - 4th Year)

Paediatrics Revision Questions
© 2012-13 Dr Joseph Mizzi

1. A 6 year old girl is brought to A&E complaining of severe earache and fever 103ºF. On inspection the tympanic membrane on the right appears inflamed.

a) What is the diagnosis?
b) What are the likely organisms?
c) How would you treat this child?

2. A child presents to COP with 4 week history of headaches, which are worse in the morning and on coughing. Ophthalmoscopy showed bilateral papilloedema.

a) What is the differential diagnosis?
b) What investigations will you you perform?

3. An 8 year old girl presents with pallor and bruises. Hb 6.3; WBC 28; Plt 12; blood picture: blasts.

a) What is the probable diagnosis?
b) How would you confirm the diagnosis?
c) What are the prognostic factors?

4. A toddler is referred to COP for pallor. Hb 7.0; WBC 5.3; Plt 240; MCV 68.

a) What is the differential diagnosis (two most likely diagnosis)?
b) What two other tests would you perform?
c) What is the management?

5. A boy presents with a rash in his legs and buttocks. He complains of abdominal pain and painful swelling of the right ankle.

a) What is the probable diagnosis?
b) What two investigations would you perform and why?
c) How would you manage this condition?
d) Name one GIT and one renal complication.

6. A 7 year old boy developed increasing difficulty with walking over 2 days. He complained of headache, back and limb pains. He had an acute febrile illness 2 weeks previously. Neurological examination showed weakness in the lower limbs, absent tendon reflexes and sensory loss.

a) What is the likely diagnosis?
b) What would the CSF show?
c) Would you admit to hospital? Why?
d) Would you notify the disease to the Health Department?

7. A 2 year old boy is brought to casualty on Good Friday. He was well the day before. He is weak,  tachypnoeic, pale and jaundiced. He is not febrile. The urine is very dark.

a) What is the likely diagnosis?
b) Why is the urine dark?
c) How would you manage this child?
d) How would you confirm your diagnosis?

8. A pre-school child presents with swelling in his scrotum and lower limbs. Urinalysis showed proteinuria +++; no blood was present. The blood pressure was normal.

a) What is the likely diagnosis?
b) Is a renal biopsy indicated?
c) What investigations would you perform?
d) What is your management?
e) What is the prognosis?

9. A neonate is noted to be centrally cyanosed on the second day of  life.

a) What is the differential diagnosis?
b) How will you confirm that the child is cyanosed?
b) Which two investigations should be performed and how do they help to distinguish between a pulmonary and cardiac cause?

10. A child is brought to your clinic with fever and vomiting.

a) What is the differential diagnosis?
b) How would you assess the state of dehydration in a child with gastroenteritis?
c) If the child requires iv fluids, how would you calculate the hourly rate?

11. A 7 year old boy is brought urgently to casualty with an acute asthmatic attack.

a) How would you assess the severity of his attack?
b) What is the management of acute asthma?
c) What is the long term treatment?

12. A five year old girl is brought to paediatric A&E with fever and a petechial rash.

a) What is the presumptive diagnosis?
b) What is the initial management?

13. An unconscious child is rushed to the casualty department in cardiovascular shock. The child has been vomiting and passing diarrhoea for the past 24.

a) How would you assess his cardiovascular status?
b) What is your acute management?