MSRA Category: Paediatrics

MSRA-1819

A mother brings her 10-month-old son to the Emergency Department (ED). She is very concerned as she reports that he has been unsettled and crying all night, which is unusual for him. The patient was born at 40+1 weeks by normal vaginal delivery; the mother developed gestational diabetes, but there were no other complications during the pregnancy or birth. The child has had all his vaccinations. The mother reports that he has been crying non-stop since the early hours of this morning. She tried to feed him, but he vomited twice, minutes after the feed.
On examination, he is crying, warm and well perfused, with a pulse of 150 beats per minute (bpm). His abdomen appears distended with tinkling bowel sounds. The mother mentions that she noticed a dark red jelly-like substance in his nappy when she changed it earlier.
What is the most likely diagnosis?

MSRA-1820

A mother brings her 10-month-old child to surgery, worried that he is not meeting developmental milestones compared to her friends’ children. Upon observation, the child is able to sit without support but shows minimal interest in exploring his surroundings. He has a basic pincer grip, seems hesitant to engage with others, and only says mama. How would you describe his developmental progress?

MSRA-1821

A 6-month-old girl has been brought in to the Emergency Department after an episode of rectal bleeding. Her parents tell you that she appears to be suffering from abdominal pain since this morning, drawing her legs up into the fetal position, and has eaten very little, which is unlike her. She vomited about three times and then passed bloody stools. When you ask for further details, the parents tell you that the stool was jelly-like red and very slimy. The parents started weaning the child one month ago and only give her baby food.
On examination, the child has right lower abdominal tenderness and her mucous membranes look dehydrated. Her capillary refill time is four seconds and you can vaguely feel some sort of mass in her right lower abdomen.
What is the most likely diagnosis?

MSRA-1822

A 16-year-old complains of left knee pain that has been present for the last 4 weeks. No injury history is reported. The pain is located in the front of the joint and is aggravated when ascending or descending stairs. Physical examination reveals no significant findings. What is the probable diagnosis?

MSRA-1823

A 14-year-old girl comes to the clinic complaining of right knee pain. She is an avid hockey player but has not experienced any recent injuries. During the examination, a painful swelling is observed over the tibial tubercle. What is the probable diagnosis?

MSRA-1808

What is a not a cause of hypertension in adolescents?

MSRA-1809

A 6-year-old girl is seen in surgery. Her father is concerned about her temperature, which she has had for the past 72 hours. He reports that she is eating and drinking around 75% of usual. She is still producing wet nappies and does not have any vomiting or diarrhoea. Examination reveals a temperature of 38.5°C, heart rate 120 beats/min, a capillary refill time <2 s, no rash, no cough, tender cervical lymphadenopathy, and a red exudative throat with pus on the right tonsil.
Which of the following is the best action to take?
Select the SINGLE best action from the list below.

MSRA-1801

A healthy toddler is 18 months old and was born in the breech position. The toddler’s mother is concerned about developmental dysplasia of the hip (DDH), as she has heard that this can be associated with breech delivery.
Which of the following is the most appropriate investigation for this toddler?

MSRA-1802

A mother brings her 6-week-old newborn baby to see you. She reports that she has noticed that his belly button is always wet and leaks out yellow fluid. On examination, you note a small, red growth of tissue in the centre of the umbilicus, covered with clear mucus. The child is otherwise well, apyrexial and developing normally.
What is the most probable diagnosis for this infant’s condition?