Med Student Finals Category: Paediatrics

MSFinals-4626

A 6-month-old Caucasian baby girl is brought to her general practitioner, as her parents are concerned about a skin lump that has appeared on the left side of her neck. It is non-tender and does not seem to bother her, but it is growing in size. She is feeding well and is otherwise healthy. On examination, there is a 2 x 2 cm, firm and well-demarcated lesion in the left posterior triangle of the neck, with visible telangiectasia. There are no other skin lesions. The abdomen is soft, without masses.
What would be the next step in management?

MSFinals-4627

A mother brings her 18-day old baby to the emergency department with visible jaundice and distress. The baby has been feeding poorly since yesterday. Upon examination, hepatomegaly and splenomegaly are observed. The newborn jaundice screen shows no infection, normal thyroid function tests, raised conjugated bilirubin, liver transaminases, and bile acids. Reducing substances are absent in the urine. What is the initial management option for the most probable diagnosis?

MSFinals-4612

A 27-year-old man presents with a persistent cough for the past 20 days which initially started with a few days of cold symptoms. He describes it as ‘the worst cough I’ve ever had’. He has bouts of coughing followed by an inspiratory gasp. This is usually worse at night and can be so severe that he sometimes vomits. He is otherwise fit and well and confirms he completed all his childhood immunisations. Examination of his chest is unremarkable.
What is the most suitable initial management for this likely diagnosis?

MSFinals-4613

You come across an 11-year-old boy with asthma who has been using a salbutamol inhaler for the past year. He reports needing it when he plays sports outside, especially in colder weather. His mother is worried as he has been using it more frequently in the last 6 months and has had to use it at night. She has also noticed that he sometimes wakes up coughing and his wheezing is worse in the morning. On average, he uses his inhaler 3-4 times a week. After examining the patient and finding no abnormalities, what would be the most appropriate next step to step up his treatment?

MSFinals-4614

A 25-year-old man with cystic fibrosis is scheduled for a follow-up appointment with his respiratory specialist. He has been experiencing more frequent respiratory infections and is seeking advice on how to minimize his risk of contracting further infections.

What is the most suitable answer?

MSFinals-4615

A 5-year-old girl is discovered unresponsive and not breathing. There are no apparent obstructions in her airway. A paramedic administers 5 rescue breaths using a bag-valve-mask connected to 100% oxygen. She has a heart rate of 30 beats per minute and is cold to the touch in her extremities. Despite the rescue breaths, she is not making any effort to breathe on her own.

What is the best course of action in this situation?

MSFinals-4616

A 5-year-old girl presents with a 3-day history of passing loose stools and non-bilious vomiting. She has passed 6 loose stools and vomited 3 times over the last 72 hours. No visible mucous or blood seen in the stool, and urine output has not changed according to her mother. She is able to tolerate oral fluid and liquid food.

She has not travelled abroad recently and there are no sick contacts. Her vaccination schedule is up-to-date and there are no concerns regarding her growth and development.

On examination, she appears well and is alert and responsive. She has warm extremities and capillary refill time is <2 seconds. Her vital signs are normal. Peripheral pulses are strong and regular. There is normal skin turgor and there are no sunken eyes. What is the appropriate management for this patient?

MSFinals-4602

A 6-year-old male is brought to his pediatrician by his father who is worried that he may have an infection. He reports that for the past 5 days his son has been scratching his anal and genital area, especially at night. He has also noticed some ‘white threads’ in his son’s stool which he is very concerned about.

What is the most suitable course of action based on the probable diagnosis?

MSFinals-4603

A 24-month-old child is brought to see you with concerns about his development.
Which of the following sets of findings on history and examination reflects age-appropriate development for this child?

MSFinals-4604

A toddler is brought to the emergency department after a near-drowning incident in a swimming pool. The child is unresponsive and requires intubation for airway management. Upon examination, the child is found to have global hypotonia and abnormal reflexes, indicating possible hypoxic brain injury. What is the most crucial intervention for this child?