Med Student Finals Category: Paediatrics

MSFinals-4645

A 14 kg 2-year-old girl with a history of vomiting and diarrhea for 4 days is brought to the pediatric emergency department due to increasing fussiness and fatigue. The child has not eaten anything for the past 24 hours and has only been able to tolerate a small amount of fluids. The mother also noticed that the child has been urinating less frequently.

Upon examination, the child appears lethargic and unresponsive. The heart rate is 155 beats per minute (normal range: 90-140/min), respiratory rate is 30 breaths per minute (normal range: 20-30/min), and systolic blood pressure is 88 mmHg (normal range: 80-100 mmHg). The child’s temperature is within normal limits.

There are no skin rashes present. The capillary refill time is 3 seconds, and the child’s extremities are cold and pale. Skin turgor is decreased, and the mucous membranes are dry. What can you conclude about the hydration status of the girl and how would you manage the patient based on your conclusion?

MSFinals-4647

You are working as a Foundation Year 2 in a GP surgery. A mother brings her 4-year-old girl to see you with a cough. You notice an alert on her notes that states she is on a child protection plan.
Which of the following is true regarding a child protection plan?

MSFinals-4648

A 7-year-old girl has been brought to the GP with a 2-day history of fever, malaise, and sore throat. She also has some facial redness that started yesterday evening. On examination, there is flushing of the cheeks and a fine, blanching, erythematosus rash that feels like sandpaper on the anterior aspect of the neck. There is erythema of the tonsils and tongue, without exudate. The GP also notices some erythematosus, non-tender lines in the creases of the elbows. The GP decides to prescribe a 10-day course of antibiotics.

What advice should the mother be given regarding her child’s return to school?

MSFinals-4633

What are the typical vaccines administered to adolescents aged 12-19 years?

MSFinals-4649

A 3-year-old girl presents to her GP with a progressively enlarging neck swelling that has been present for the past 6 months. Upon examination, a smooth midline lesion is noted just below the hyoid bone. The lesion is round, measures 2 cm x 2 cm, and elevates upon protrusion of the tongue. What is the most probable diagnosis?

MSFinals-4634

A 3-month-old girl is presented to the pediatrician by her father. The baby has been struggling with feeding since birth, is frequently fussy, and her lips turn blue after crying for extended periods. She was born at term, weighing 2500 grams. During the examination, the doctor detects an ejection systolic murmur at the left sternal edge.
What is the probable diagnosis?

MSFinals-4635

A 1-month-old infant begins to turn blue and becomes tachypnoeic 10 minutes after feeding. They are administered 100% oxygen for 20 minutes and an arterial blood gas is performed.

pH 7.40 7.36 – 7.42
PaO2 11.5 kPa 10.0 – 12.5
PaCO2 5.8 kPa 5.1 – 5.6

On auscultation, the infant has no murmur but a loud single S2. On palpation, there is a prominent ventricular pulse.

What is the most likely diagnosis?

MSFinals-4636

You are requested to assess a neonate who is 6 hours old and has been experiencing intermittent grunting and occasional nasal flaring. The baby was delivered this morning through an elective Caesarean section at 41 weeks gestation. The respiratory rate and oxygen saturation of the baby are both normal. The mother is worried as her previous child, who was also born through Caesarean section, had a similar presentation. What guidance would you provide to the mother?

MSFinals-4637

Which statement accurately describes Factitious disorder imposed on another (FDIA)?