paeds789
A 17-year-old girl presents to the OBGYN after having unprotected. She is found to be 5 days pregnant. The fertilized tissue is at which stage of development?
Archives: MRCPCH FOP/TAS
paeds790
A 23-week-old neonate was delivered in triage following a quick delivery, there was no time for the administration of antenatal steroids. The baby was successfully intubated, and the first dose of surfactant had been given. Despite good chest wall movement and 2 min of chest compressions the heart rate remains very slow. The baby is approximately 18min old when the consultant arrives. Which of the following is the most appropriate next step in the management of this case?
paeds791
A neonate was delivered 24 hours ago at the gestational age of 29 weeks. His birth weight was recorded to be 1 kg. Due to his critical state, the baby was intubated and ventilated. Prior to his intubation, the baby was managed with CPAP, but he seemed to get exhausted. He is now on SiMV (spontaneous intermittent mechanical ventilation). The ventilator settings are as follows: targeted tidal volume 9 ml, maximum PIP 30, PEEP 5, rate 40/min, FiO2 0.3. Baby’s oxygen saturations are 93%. Blood gas shows pH 7.41, CO2 3.9 kPa, BE -4. Which of the following changes need to be made to the ventilator settings initially?
paeds753
A 16 year old previously well male presents with a 4 day history of fever, lethargy and a generalized macular rash. There is no significant previous medical history and the patient has not travelled abroad either. Vitals are as follows: Temp: 38.5BP: 125/75mmHgPulse: 100/min On auscultation the chest was clear and no heart murmur was heard. Examination also reveals a non blanching widespread macular rash over the chest and abdomen. There is swelling of interphalangeal joints of both hands and feet associated with mild tenderness. Lymph nodes are palpable over the supraclavicular, axillary and inguinal areas. Abdominal examination reveals palpable mass on both right and left hypochondrium. Lab results are given below:Haemoglobin (Hb) 13.5 g/dlWhite cell count (WCC) 14.0 x 109/lPlatelets 380 x 109/lSodium 145 mmol/lPotassium 4.8 mmol/lCreatinine 89 ÎĽmol/lRheumatoid factor NegativeAntinuclear antibody NegativeAnti-dsDNA NegativeASO titre Not detectedElectrocardiogram (ECG) Sinus rhythmWhat is the most likely underlying diagnosis?
paeds754
A 14 year old girl suffers from haemophilia A and chronic knee pain with progressive swelling and deformity over the last 4 years. Test results reveal a significantly reduced factor VIII activity. Which of the following is seen in the knee joint space after an acute painful episode?
paeds756
A 17 year old boy presented with complaints of pain in his right lower limb. The pain tends to occur more at night and is not associated with physical activity. The most likely diagnosis would be?
paeds757
A 4-year old boy arrives at the clinic due to sudden onset knee pain that has been occurring over the past 2 days. The pain is associated with mild fever that started on the 2nd day. The patient is able to walk but with a limp. Examination reveals painful and restricted motion of the right knee. Which of the following is the most likely diagnosis responsible for this presentation?
paeds758
A 5 year old boy took a fall on his outstretched hand and presents to the emergency with pain around his elbow. On examination, the radial pulse is found to be absent on the affected side. Which of the following is the most likely diagnosis?
paeds768
Two boys were playing when one of them brought the forearm of the other behind his back. This resulted in a stretching of the lateral rotator of the arm. Which of the following muscles was most likely to have been involved?
paeds769
A 17-year-old boy is brought to the emergency after being stabbed in the upper arm and the median nerve is transected. Impaired function can be demonstrated in which of the following muscle/s?