Med Student Finals Category: Paediatrics

MSFinals-4518

Sophie is a 15-year-old who has visited her GP seeking advice on contraception. She discloses that she has been sexually active with a 15-year-old male partner for the past 3 months. Sophie has done her research on various contraceptive methods and expresses her interest in trying the combined oral contraceptive pill (COCP). She has a history of depression due to childhood abuse and is currently receiving treatment from the Child and Adolescent Mental Health Services. However, she reports feeling much better since starting her relationship with her partner. Sophie’s parents are unaware of the situation, and she is unwilling to inform them. What is the appropriate course of action?

MSFinals-4519

You are working at a Saturday morning clinic and a mother brings in her 10-year-old daughter who has developed new pustular, honey-coloured crusted lesions over her chin. She is systemically well with all observations in the normal range and no evidence of lymphadenopathy on examination. She has no allergies to any medications and is normally fit and well.
You diagnose localised non-bullous impetigo.
The daughter is due to go on a school trip to the Natural History Museum in London the following day and is extremely excited about this. The mother asks if she is allowed to go on this school trip.
What is your management plan?

MSFinals-4504

A 12-year-old girl visits the doctor with her mother, worried about not having started her periods yet. During the examination, it is observed that she has normal female genitalia but bilateral inguinal hernias. Additionally, she has breast buds and minimal pubic and axillary hair. The girl’s weight and IQ are both within the normal range for her age. What is the probable underlying reason for her concern?

MSFinals-4520

During your ward round on the paediatric unit you review a 7-year-old African American male who has been admitted for chemotherapy as he has recently been diagnosed with acute lymphoblastic leukaemia (ALL). His father anxiously asks you what his chance of survival is and how you determine this.

Upon reviewing the patient’s medical records, you notice that he is on the 10th percentile for weight and the 25th percentile for height. His white cell count at diagnosis was 15 * 10^9/l and there were no noted T or B cell markers on his blood film.

What is the poor prognostic factor in this case?

MSFinals-4506

You are asked to assess a male infant born 18 hours ago, at 35 weeks gestation, due to concerns raised by the nursing staff. Upon conducting a comprehensive examination and taking note of the mother’s positive group B streptococcus status, you tentatively diagnose the baby with neonatal sepsis and commence treatment. What is the most frequently observed feature associated with this condition?

MSFinals-4507

A 4-month-old is brought to the emergency department with a suspected UTI and responds well to antibiotics within 48 hours. An ultrasound may be necessary to determine if this is a typical or atypical UTI. What is the most common indicator of an atypical UTI?

MSFinals-4508

A 6-week-old infant is experiencing projectile vomiting after feeds and is always hungry despite vomiting. What is the most effective approach to managing this condition?

MSFinals-4509

A 15-year-old boy is presented to the General Practitioner by his mother who reports that he has been having difficulties at school for the past year. The patient has a medical history of recurrent otitis media. The mother mentions that her nephew and niece have both required extra assistance at school, and the latter has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). The patient had a normal birth history and early childhood development. On examination, he has an elongated face and protruding ears. What is the most probable diagnosis?

MSFinals-4510

Which of the following does not result in feeding challenges during the neonatal phase?