Med Student Finals Category: Paediatrics

MSFinals-4632

A 6-year-old girl presents to your clinic with her parents for a follow-up appointment. She has been experiencing nocturnal enuresis for the past eight months. During her last visit four months ago, she was wetting the bed six to seven nights a week. You advised her parents to limit her fluid intake before bedtime, establish a toileting routine before bed, and implement a reward system for positive behavior. Despite following these recommendations, she continues to wet the bed six to seven nights a week. What would be the most appropriate next step in managing her nocturnal enuresis?

MSFinals-4617

A 6-year-old boy is brought in to see his GP by his father, who reports that he has been complaining of a sore throat and has developed a skin rash over the past few days. During examination, you observe erythematous macules and papules measuring 3-4 mm on the dorsum of his hands and feet. You diagnose him with hand, foot and mouth disease. The father inquires if his son should stay home from school. What guidance will you provide regarding school exclusion?

MSFinals-4618

A 6-month-old infant is brought to the Emergency Department with persistent vomiting for the past 2 days. The mother reports that the vomiting is forceful and occurs after every feed. Despite attempts to soothe the baby, the vomiting has not subsided. Upon examination, the infant appears to be in good health. The heart rate is 130 bpm, respiratory rate is 32/min, blood pressure is 95/65 mmHg, capillary refill is 2 seconds, and mucous membranes are slightly dry. The infant has no fever. The paediatric registrar is called to assess the infant and decides to admit the infant for further investigation. Which diagnostic test would be most helpful in determining the cause of the vomiting?

MSFinals-4619

A 4-year-old girl is under your review for idiopathic constipation treatment with Movicol Paediatric Plain. Despite her mother increasing the dose, there has been no improvement. The child is in good health and abdominal examination is unremarkable. What would be the most suitable course of action to take next?

MSFinals-4620

A 5-year-old girl is brought to the emergency department with difficulty breathing. Since yesterday, she has developed a fever (38.5ºC) and become progressively short of breath. On examination, she appears unwell with stridor and drooling. Her past medical history is otherwise unremarkable.
What is the most probable causative organism for this presentation?

MSFinals-4621

A father brings his 7-year-old daughter to the GP. The father reports that he has been struggling to manage his daughter’s behaviour. He describes instances of her not following instructions, arguing frequently, and even getting into physical altercations. The GP refers the daughter to a paediatrician who may consider starting her on methylphenidate. What is a potential side effect of this medication?

MSFinals-4622

A newborn delivered at 36 weeks gestation through a normal vaginal delivery is exhibiting irritability and has experienced a convulsion 72 hours after birth. No visible head trauma or swelling is present. What type of cranial injury is most probable in this case?

MSFinals-4623

A female infant is born prematurely at 32 weeks gestation by emergency cesarean section. She initially appears to be stable. However, over the ensuing 48 hours she develops worsening neurological function. What is the most probable cause of this deterioration?

MSFinals-4624

A mother brings her 6-year-old daughter into your paediatric clinic as her daughter has recently been diagnosed with Fragile X syndrome. During the consultation, you notice that the girl is sitting quietly, avoiding eye contact when you talk to her. Additionally, you observe that she has low-set ears, a long thin face, and an enlarged mandible. The mother is worried about the potential complications of Fragile X syndrome.
What information can you provide her regarding the possible complications of Fragile X syndrome?

MSFinals-4625

As a junior doctor on the neonatal ward, you are asked to assess a premature baby born at 34 weeks gestation who is experiencing respiratory distress. The delivery was uneventful. The baby’s vital signs are as follows:

– Heart rate: 180 bpm (normal range: 100-180 bpm)
– Oxygen saturation: 95% (normal range: ≥ 96%)
– Respiratory rate: 68/min (normal range: 25-65/min)
– Temperature: 36.9°C (normal range: 36.0°C-38.0°C)

The baby is currently receiving 2 liters of oxygen to maintain their oxygen saturation. Upon examination, you notice that the baby is not cyanotic, but there are subcostal recessions and respiratory grunts. There are no added breath sounds on auscultation, but bowel sounds can be heard in the right lung field.

What is the most likely cause of the baby’s symptoms?