Med Student Finals Category: Paediatrics

MSFinals-4473

A 6-year-old boy has started first grade and is struggling with reading and writing. The teacher has expressed concerns that it may be due to his poor vision as he often squints and complains of headaches. He was a full-term, vaginal delivery infant who had a normal newborn screening, and progressed well throughout infancy on growth charts. He is up-to-date with his immunisations. As part of his school entry, what tests are likely to be conducted to assess the impairment that his teacher is concerned about?

MSFinals-4474

A 7-year-old girl sits close to the TV and watches her mother’s mouth when speaking. Her mother gave the history of child’s irritation due to ear pain along with intermittent fever for the last 5 days. Her teacher reports that her speech is developmentally delayed. There is no past medical history or family history of illness. Audiogram shows conductive hearing loss.
What is the most likely diagnosis?

MSFinals-4475

A 22-year-old woman brings her 8-week-old baby to an emergency GP appointment. The mother reports that her baby is extremely fussy in the evenings, crying incessantly and pulling up their legs. The baby was delivered vaginally at full term and is exclusively breastfed. The baby’s weight is normal and there are no other health concerns. Upon examination, everything appears to be normal. What course of action would you suggest?

MSFinals-4476

A 7-year-old girl presents with a 3-day history of an itchy rash, initially on her abdomen and now spreading across the rest of her torso and limbs. She is usually healthy and is not taking any other medications, and the rest of her family is also healthy. There is a widespread vesicular rash with some papules and crusting, as well as newer papules. Her temperature is 37.6 °C and her other vital signs are normal.
What is the next appropriate step in managing this patient?

MSFinals-4477

Samantha is a 6-year-old girl who has been brought in by her father. He reports that Samantha has had a fever for 3 days and yesterday developed some ulcers in her mouth. Today, he noticed that there are red spots on Samantha’s hands and feet which have now started to worry him.
Which virus is most likely causing Samantha’s symptoms?

MSFinals-4478

You are a junior doctor in paediatrica and have been asked to perform a newborn exam.

Which statement is true regarding the Barlow and Ortolani manoeuvres?

MSFinals-4479

A 19-year-old primigravida is scheduled for induction at 38 weeks due to intrauterine growth restriction. Following a brief labor, a baby girl is born vaginally. The infant has a low birth weight and is diagnosed with microcephaly, moderate hepatosplenomegaly, and a petechial rash upon examination. She experiences a seizure shortly after being admitted to the neonatal intensive care unit. The mother had an uneventful pregnancy, has no medical history, takes no medications, and has received all of her vaccinations. What infection is the baby likely to have been exposed to in utero?

MSFinals-4480

A 16-month-old toddler comes to your primary care clinic after experiencing a seizure. The parents are extremely worried as one of their relatives has epilepsy and they fear that their child may have it too. Upon examination, the child seems alert and has a temperature of 38.4C, which the parents say has been present for four days. They have been giving calpol, which has helped to bring it down from a high of 40.7ºC. You also notice a pink, maculopapular rash on the chest with minimal spread to the limbs, which the mother says she noticed this morning. The child has been eating but has had some diarrhea, and you can feel some enlarged glands on the back of their head. There is no rash in the mouth. Based on your observations, what do you think is the most probable underlying cause of the child’s symptoms?

MSFinals-4481

A 3-year-old girl is brought to the Emergency Department, during the autumn period, with severe dyspnoea at rest. She has been unwell for the past week with a barking cough and inspiratory stridor which are typically worse in the late evening. On examination, intercostal and subdiaphragmatic recessions are noticeable. A chest radiograph shows tapering of the upper trachea.
What is the most probable pathogen responsible for this girl’s condition?

MSFinals-4482

A 3-day-old neonate was discovered to be cyanosed with a PaO2 of 2 kPa on umbilical artery blood sampling. Upon auscultation of the chest, a murmur with a loud S2 was detected, and a chest X-ray revealed a narrow upper mediastinum with an ‘egg-on-side’ appearance of the cardiac shadow. To save the infant’s life, a balloon atrial septostomy was performed. What is the probable diagnosis?