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Question 1
Incorrect
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An 8 year old boy was admitted following a MVA. His BMI is 28 kb/m2 and he's been found to have glycosuria, which resolved after his recovery. Which investigation is necessary to perform as part of the follow-up?
Your Answer: Random blood glucose concentration
Correct Answer: Fasting blood glucose concentration
Explanation:The boy has an increased BMI which implies he is overweight. Possible trauma to his pancreas might have led to a diabetes-like condition, induced by damage to the beta cells. Fasting blood glucose should be measured as a follow-up strategy to see if the damage is reversible or irreversible and to conclude if the glycosuria is related to his metabolic profile or to his accident.
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This question is part of the following fields:
- Emergency Medicine
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Question 2
Correct
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A 2-month-old child is brought to the paediatric emergency by his parents. Which of the following would be a contraindication for the baby's discharge from the hospital?
Your Answer: Any one of the above
Explanation:Any 2-month-old child presenting with any of the above signs, should be assessed and have a history taken and physical examination made before discharge. As these may all be signs and symptoms for a condition requiring hospitalisation.
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This question is part of the following fields:
- Emergency Medicine
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Question 3
Correct
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A 6 year old boy presents with a tibial fracture in a cast and continuous pain. You suspect a compartment syndrome injury. Which of the following represents a late sign of the condition?
Your Answer: Absent distal pulses
Explanation:The Five P’s: pain, pulselessness, paraesthesia, paralysis, and pallor, are the most common symptoms of compartment syndrome. However, late signs of the condition include the absence of distal pulses.
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This question is part of the following fields:
- Emergency Medicine
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Question 4
Incorrect
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An 11-month-old child was given breakfast cereal containing cashew nuts following which he suddenly developed stridor and is struggling to breathe. The patient was brought to the emergency room tired and unable to cough. On examination, he is found to be conscious, and there is no rash. Auscultation did not reveal any abnormal breath sounds.What is the most appropriate next step in the management of this child?
Your Answer: Adrenaline intramuscularly
Correct Answer: Five back blows
Explanation:This clinical presentation is highly suggestive of choking. According to the BLS algorithm, the next step in managing a case of choking in a conscious child with an ineffective cough is five back blows.Other options:- Adrenaline intramuscularly: The history is similar to anaphylaxis, but the absence of a rash or oedema and the acute onset make choking more likely in this situation. Thus, adrenaline will not be of use in this patient.- CPR at a ratio of 15:2: Since the child is conscious, it is not advised. If the child were unconscious, you would commence basic life support.- Five abdominal thrusts: In the given scenario, the child is an infant. Abdominal thrusts are avoided in infants due to the risk of intra-abdominal injury.
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This question is part of the following fields:
- Emergency Medicine
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Question 5
Correct
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A 10-year-old asthmatic boy is brought to the emergency department with severe stridor, wheeze, and lip swelling following the ingestion of a cashew nut at a birthday party.Which of the following can be considered an acceptable treatment option for this child?
Your Answer: Nebulised adrenaline 5ml 1:1,000
Explanation:The patient is suffering from an anaphylactic reaction to the cashew nut he consumed.Anaphylaxis:Anaphylaxis is an acute, rapidly progressing, potentially life-threatening IgE mediated Type I hypersensitivity reaction.It involves the release of mediators from mast cells, basophils and inflammatory cells. It is characterised by oedematous swelling of the airway mucosa giving rise to dyspnoea and respiratory distress.The most common cause of anaphylaxis in children is a food allergy.Risk factors for death in patients with anaphylaxis include asthma, age 11+, peanut allergy, and delay in adrenaline administration.Management of anaphylaxis includes:- Resuscitation – ABCD- Remove the allergen- IM adrenaline is given at ten microgram/kg or Nebulised adrenaline 5ml 1:1,000- IV Hydrocortisone is given at 4mg/kg- pro re nata IV fluid support. – Followed by observation.
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This question is part of the following fields:
- Emergency Medicine
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Question 6
Correct
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A 6 month old baby presents with a sausage-shaped abdominal mass and a history of green vomit a few hours earlier. The baby was born at 38 weeks of gestation and immigrated recently form the Philippines with his parents. What is the most probable diagnosis?
Your Answer: Intussusception
Explanation:Intussusception is the invagination of one segment of the intestine within a more distal segment. It presents with vomiting, abdominal pain, and a palpable abdominal mass.Intussusception usually affects infants between 6-18 months old. Boys are affected twice as often as girls
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This question is part of the following fields:
- Emergency Medicine
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Question 7
Correct
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A child is admitted with a febrile illness. Which of the following is of concern?
Your Answer: A 6 month old with a systolic blood pressure of 60
Explanation:Age (years) Respiratory rate (per minute) Heart rate (per minute) Systolic blood pressure12 15-20 60-100 100-120Adapted from Advanced Paediatric Life Support Manual
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This question is part of the following fields:
- Emergency Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
