Pediatrics Paper 2 - 2024 June

Large for gestational age is not a complication of congenital rubella.

A secundum atrial septal defect (ASD) is associated with right axis deviation on ECG.

Meningoencephalitis is a possible complication of bilateral suppurative conjunctivitis.

Coxsackie A virus is the common cause of hand, foot, and mouth disease, characterized by blisters/sores in the mouth and on hands/feet.

Lead poisoning in children can present with altered mental status and syncope, along with distal motor neuropathy.

Urgent exchange transfusion is the most definitive treatment for a stroke in patients with HbSS disease (sickle cell disease).

Turner syndrome (45,X karyotype) is a possible cause of primary amenorrhea in a girl who is short for her age and has delayed puberty.

Swallowed blood, originating from cracked nipples, is a possible cause of coffee ground vomitus in a healthy infant.

In a child with asthma already on inhaled corticosteroids (ICS) who is now using their rescue inhaler (SABA) daily, adding a long-acting bronchodilator (LABA) is usually the next logical step, rather than increasing ICS.

Characterized by a manic episode lasting more than a week, without a depressive episode, and increased energy, euphoria, and rapid speech.

Involves hypomanic episodes (4 days) followed by a depressive episode, often feeling hopeless and irritable.

Similar symptoms as schizophrenic, lasting 1 month but less than 6 months.

Depressive episodes separated by at least 2 months.

Experiences hypomania and mild depression for at least two years, with periods of euthymia lasting less than 8 weeks.

Characterized by delusions of grandiosity, egotism, and a lack of empathy.

Antibiotic prophylaxis is warranted for patients with high-risk conditions or implanted devices if IE occurs.

A condition marked by decreased mental function and loss of daily task abilities.

10 mcg/kg (0.1 mL/kg of 1 in 10,000 solution).

Every 3-5 minutes.

0.01 mg/kg (max 1 mg) followed by every 3–5 minutes.

Red, swollen, but not pus-filled leg lesion likely due to infection.

Cefuroxime (likely).

Sudden breathlessness, often a serious medical condition.

Heart rate inconsistent and not in a regular pattern.

Rapid, irregular heart rhythm originating from the atria.

Bisoprolol (beta-blocker).

Blood clot in a deep vein (usually in the leg).

Likely iron deficiency anaemia, possibly related.

Colonoscopy (to rule out internal bleeding).

Skin ulcers that are painful, often in association with other conditions.

Crohn's Disease (likely).

High blood sugar levels despite taking metformin and sitagliptin.

Empagliflozin (SGLT2 inhibitor).

Conditions associated with a higher chance of developing infective endocarditis (IE), a serious infection of the heart valves.

Artificial heart valves increasing IE risk.

Repairing heart valves with artificial material, increasing the chance of IE.

Heart assist devices (e.g., ventricular assist devices) making IE possible.

Having infective endocarditis before increases the risk of getting it again.

Specific birth defects which are risk factors for IE, mainly due to damage to heart structures.

Heart condition present at birth that limits oxygen and increases IE risk.

Surgery performed in the first six months after heart defect repair incurs IE risk.

Incomplete repair leading to possible IE complications.

Artificial pulmonary artery valves causing increased risk for IE.

Individuals with a transplanted heart are at a higher risk for valvulopathy, a condition that makes the valves of the heart weaker, increasing their vulnerability to IE.

Implanted devices placed in the left atrial appendage in the first six months of implantation increase risk of IE.

S. viridans (alpha-hemolytic streptococci) is the common bacteria responsible for IE following oral procedures.

A single dose of oral amoxicillin is recommended for this bacteria prevention.

Isoniazid, a TB drug, can lead to numbness and paraesthesia; problems with feeling.

Incorrect dosage; 1 mg, not 0.1 mg, is a corrected dose for adult cardiac arrest in ventricular fibrillation.

The treatment for Ventricular Tachycardia (VT) without a pulse usually involves Defibrillation (shock) and IV vasopressors/antiarrhythmics like epinephrine.