Paeds

1. Which of the following would prompt testing for biliary duct disease, cystic fibrosis, alpha tripsin deficiency, Hep C & C?

a) Serum bilirubin < 260 umol/L
b) Jaundice < 24 hours after birth
c) Prolonged jaundice, conjugated bilirubin < 25umol/L
d) Prolonged jaundice, conjugated bilirubin > 25umol/L
e) Jaundice peaking at 3-4 days and resolving by 14 days
2. Characterized by: shortening of the normal red cell life span, increase in unconjugated bilirubin, & a marked increase in erythropoiesis in the bone marrow

a) Microcytic anaemia
b) Haemolytic anaemia
c) Normocytic anaemia
d) Macrocytic anaemia
e) Sickle cell anaemia
3. Has a MCV > 96 femtolitres. The commonest causes are vitamin B12 and folate deficiency. Also hypothyroidism and acute blood loss.

a) Sickle cell anaemia
b) Normocytic anaemia
c) Microcytic anaemia
d) Haemolytic anaemia
e) Macrocytic anaemia
4. A complication of acute tonsillitis, usually due to streptococcal infection. It is a collection of pus arising outside the capsule of the tonsil in close relationship to its upper pole.

a) Croup
b) Quinsey
c) Pneumonia
d) Bronchiolitis
e) Acute epiglottitis
5. With regards to the treatment of diabetic ketoacidosis, which of the following statements is FALSE?

a) Never use more than 10% dehydration in fluid calculations
b) Use 0.9% saline for resuscitation of the circulation
c) Restore the fluid deficit over 48 hours
d) When glucose falls to 14-17 mmol/L add glucose to the fluids
e) There is good evidence for using bicarbonate/phosphate in DKA
6. A condition characterized by a widespread necrotizing vasculitis of arterioles and small capillaries. Classically, children aged 3 to 8 years are affected, boys more than girls, there are gastrointestinal, joint and renal manifestations.

a) Pyelonephritis
b) urticaria
c) Meningitis
d) Idiopathic Thrombocytopenic Purpura (ITP)
e) Henoch-Schonlein purpura
7. This X-linked disorder is the most common type of haemolytic anaemia due to an intrinsic red cell enzyme defect.

a) Coombs anaemia
b) G6PD deficiency
c) Fanconi anaemia
d) megaloblastic anaemia
e) Sickle cell anaemia
8. Common in West Africans, Afro-Caribbeans, and also in Cyprus, Greece, Italy, and the Middle East.

a) Sickle cell anaemia
b) Haemolytic anaemia
c) Normocytic anaemia
d) Microcytic anaemia
e) Macrocytic anaemia
9. Which of the following would be most suggestive of viral meningitis?

a) Kernig's sign present
b) CSF Protein > 1.5
c) CSF Glucose < 1/2 plasma
d) Predominant cell in CSF = polymorphs
e) CSF clear
10. With regards to administering fluids to children, which of the folowing is FALSE?

a) Failure to improve haemodynamic abnormalities following the first bolus requires a second, and perhaps a third 20 ml/kg bolus of saline.
b) When shock is suspected, give a fluid bolus of 20 ml/kg of 0.9% saline.
c) Maintenance requirements: 100 ml/kg for the first 20 kg, 50 ml/kg for the next 10 kg, 20 ml/kg for any weight after 20 kg
d) Correction of deficit: deficit in ml = wt(kg) x %dehydrated x 10.
e) A child's blood volume is approximately 80 ml/kg
11. An URTI occurring in infants and toddlers, usually caused by a parainfluenza virus. There is a characteristic inspiratory stridor caused by laryngeal oedema and thick secretions that block the trachea and airways. Usually preceded by a coryzal prodrome.

a) Pneumonia
b) Bronchiolitis
c) Croup
d) Quinsey
e) Acute epiglottitis
12. Defined by: a combination of heavy proteinuria, hypoalbuminemia, and generalized oedema (particularly periorbital oedema)

a) Pyelonephritis
b) Meningitis
c) Henoch-Schonlein purpura
d) Nephrotic syndrome
e) Idiopathic Thrombocytopenic Purpura (ITP)
13. In which step of management of chronic asthma in children aged 5-12 years are inhaled steroids increased to 800mcg/day (beclomethasone diproprionate or equivalent).

a) Step 1
b) Step 5
c) Step 3
d) Step 2
e) Step 4
14. Belongs to the group of medicines known as antimuscarinic bronchodilators

a) Ipratropium
b) Monteleukast
c) Salbutamol
d) IV aminophylline
e) Prednisolone
15. Inflammation of the lung parenchyma characterised by exudation and consolidation into the alveoli.

a) Acute epiglottitis
b) Pneumonia
c) Croup
d) Quinsey
e) Bronchiolitis
16. Should only be considered in children with severe or life threatening bronchospasm who have not responded to other treatment, in a HDU or PICU setting.

a) Salbutamol
b) Monteleukast
c) IV aminophylline
d) Ipratropium
e) Prednisolone
17. A genetic disorder in globin chain production

a) Microcytic anaemia
b) G6PD deficiency
c) Thrombocytopaenia
d) Thalassaemia
e) Fanconi anaemia
18. Which of the following is NOT a cause of macrocytic anaemia?

a) myleloproliferative disease
b) reticulocytosis
c) lead poisoning
d) hypothyroidism / myxoedema
e) marrow infiltration
19. The mean cell volume (MCV) is less than 76 femtolitres. The most common cause is iron deficiency.

a) Macrocytic anaemia
b) Normocytic anaemia
c) Haemolytic anaemia
d) Microcytic anaemia
e) Sickle cell anaemia
20. Epidemics occur in winter, when it may account for half of paediatric hospital admissions. Often occurs in atopic individuals, and may predict the later development of asthma. 90% of cases are caused by RSV.

a) Pneumonia
b) Acute epiglottitis
c) Quinsey
d) Bronchiolitis
e) Croup
21. The Guthrie test has been replaced by the Newborn Blood spot test. Which of the following does it screen for?

a) Medium Chain Acyl Co-A Dehydrogenase Deficiency (MCADD)
b) Sickle Cell disorders & Cystic Fibrosis (CF)
c) Phenylketonuria (PKU) & Congenital Hypothyroidism (CHT)
d) Phenylketonuria (PKU), Congenital Hypothyroidism (CHT) & Sickle Cell disorders & Cystic Fibrosis (CF)
e) All of these
22. Belongs to a group that have anti-inflammatory and bronchodilator properties. They block the effects of cysteinyl leukotrienes in the airways which can get released in response to antigens, aspirin or exercise.

a) IV aminophylline
b) Salbutamol
c) Monteleukast
d) Prednisolone
e) Ipratropium
23. A decrease in the number of platelets in the blood, reducing clotting ability Defined as a platelet count less than 100 x 10^9/L (<100,000 per cubic mm).

a) Microcytic anaemia
b) Fanconi anaemia
c) Thrombocytopaenia
d) G6PD deficiency
e) Thalassaemia
24. Causes bronchodilatation, diuresis, CNS and cardiac stimulation, and gastric acid secretion by blocking phosphodiesterase which increases tissue concentrations of cyclic adenine monophosphate (cAMP) which in turn promotes catecholamine stimulation of lipolysis, glycogenolysis, and gluconeogenesis and induces release of epinephrine from adrenal medulla cells.

a) Prednisolone
b) Monteleukast
c) Salbutamol
d) IV aminophylline
e) Ipratropium
25. Seen predominantly in children following a viral infection - most commonly varicella. General features include: mucosal or skin bleeding, afebrile, spleen and liver are usually not enlarged, fundal haemorrhage, persistent headache and other signs of raised intracranial pressure.

a) Henoch-Schonlein purpura
b) urticaria
c) Meningitis
d) Idiopathic Thrombocytopenic Purpura (ITP)
e) Pyelonephritis
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