Med Student Finals Category: Paediatrics

MSFinals-4496

A 3-year-old girl with several small bruise-like lesions is brought to the emergency department by her father. He reports first noticing these lesions on his daughter’s arm when dressing her three days ago, despite no obvious preceding trauma. The bruising does not appear to be spreading.
Notably, the child had mild cough and fever symptoms two weeks ago, though has now recovered.
On examination, the child appears well in herself and is playing with toys. There are 3 small petechiae on the patient’s arm. The examination is otherwise unremarkable.
What would be an indication for bone marrow biopsy, given the likely diagnosis?

MSFinals-4497

A mother brings her 6-year-old daughter to see you at the General Practice surgery where you are working as a Foundation Year 2 doctor. The daughter had a runny nose and sore throat for the past few days but then developed bright red rashes on both her cheeks. She now has a raised itchy rash on her chest, that has a lace-like appearance, but feels well. She has no known long-term conditions and has been developing normally.
What is the most likely diagnosis?

MSFinals-4498

Which diagnostic test is most effective in identifying the initial stages of Perthes’ disease?

MSFinals-4499

A 14-year-old boy comes to the GP complaining of gradual onset right groin pain and a limp. He has no significant medical or family history. During the examination, the right leg appears shortened and externally rotated, with limited range of motion. No joint swelling or warmth is detected. The patient’s vital signs are normal, and he is in the 50th percentile for height and 90th percentile for weight. What is the most suitable initial investigation to perform?

MSFinals-4468

A 9-year-old girl presents with symptoms of left knee pain. The pain has been present on most occasions for the past four months and the pain typically lasts for several hours at a time. On examination; she walks with an antalgic gait and has apparent left leg shortening. What is the most likely diagnosis?

MSFinals-4484

A 7-year-old girl arrives at the emergency department with severe wheezing and shortness of breath. She is struggling to speak in full sentences and her peak expiratory flow rate is 320 l/min (45% of normal). Her oxygen saturation levels are at 92%. Her pCO2 is 4.8 kPa.

What is the most concerning finding from the above information?

MSFinals-4469

A 5-year-old girl presents to the emergency department with a fever and a blotchy rash. According to her mother, the rash started behind her ears and has now spread all over her body. During the examination, you observe clusters of white lesions on the buccal mucosa. The child has not received any vaccinations. What is the potential complication that this child may face?

MSFinals-4470

A 16-month-old boy has been diagnosed with roseola infantum. What is the most frequent complication associated with this illness?

MSFinals-4471

A 6-year-old girl has recently started primary school in the UK. Her father has been informed that she can undergo school entry health screening, which will involve a hearing test. She had undergone the full newborn screening program and is up to date on her vaccinations. Her father has no health concerns and agrees to her participation in the school entry health screening program.
What technique will be employed to test the child’s hearing as part of the screening program?

MSFinals-4472

A paediatrician is conducting a ward round and comes across a 20-hour-old neonate without apparent issues. During the round, the mother expresses concern about her child’s hearing, citing her own deafness as a potential risk factor. Which screening tool would be most suitable for this patient?