Paper 2 - 2024 June Pediatrics Past Paper PDF

Which is not a complication of congenital rubella a. **Large for gestational age** (answer) b. Cataracts. c. Sensorineural deafness d. PDA Boy is an athlete present to paeds for routine check up and found to have murmur... secundum atrial septal defect. What is expected on ecg e. **Right...

Which is not a complication of congenital rubella a. **Large for gestational age** (answer) b. Cataracts. c. Sensorineural deafness d. PDA Boy is an athlete present to paeds for routine check up and found to have murmur... secundum atrial septal defect. What is expected on ecg e. **Right axis deviation** (answer) f. Left Ventricular hypertrophy g. PR lengthening ASD's types: Ostium secundum; defect in fossa ovalis Sinus venosus: defect in posterior aspect of septum Ostium primum: defect in anteroinferior aspect of septum Left to right shunt, Right axis deviation, Right ventricular hypertrophy CXC show cardiomegaly Tx- small \ a. Bilateral suppurative conjunctivitis b. Generalized and bilateral lymiphadenopathy \ A. **Meningoencephalitis** (answer) B. Epilepsy C. Simple febrile seizure D. Complex febrile seizure Menigoenchaplitis: Fever, headach, nuchal rigigity, nuusa/vommiting, altered mental status, Rash starts small red pinpricks before turning into red purple blotches. Does not fade press glass Febrile seziure 6 months- 5 years. Menigitis- photophobia,neck stiffness-if \ a. Scabies b. **Coxsackie A**  Hand,foot and mouth diasese- painful red blisters in throat and tounnge, gums, hard palate, inside cheeks, plams of hands and soles of feet. Spread from unwashed hands, stool. Live in GI tract. Tx minior pain NSAID or Acetaminphen Scabies: Sores, bumps, scabs in finger and wrist. Caused by mites. 4-6 weeks after infestation Aviod skin contact, treat all mmebers of house hold, Topical creams: 5% permethrin cream 0.5% malathiion 6. A 12 year old boy's parents were called by the teacher to discuss his disruptive behavior in school. Dad has an old car battery scrap yard in the backyard.. [[https://www.atsdr.cdc.gov/csem/leadtoxicity/signs\_and\_symptoms.html]](https://www.atsdr.cdc.gov/csem/leadtoxicity/signs_and_symptoms.html) a. Glove and stocking distribution neuropathy( diabeties) b. **Altered mental status and syncope (lead poisoning)- will not get syncope- you get syncope with long term exposure sec to arrhythmias or sec to anemia, its a CNS pathology not a PNS with no motor phenomenon** c. **Distal Motor neuropathy (I feel is this they get a [wrist drop and foot drop])** d. Oral something and paresthesia They also get a neuropathy, A could be the answer 8\. A boy with known HbSS disease presents with stroke symptoms, most definitive management? a. Hydroxyurea ( for sickle cell anemia crisis) b. **Urgent Exchange transfusion** c. Simple top up transfusion d. Antibiotics( for acute chest syndorome)( cephalospornisn e.g ceftriaxone, cefuroxime and macrolides. Discharge home then oral Amoclav, clarithromycine, cefrxime. Exchange tranfusion remove sickle red clood cells andreplace with normal cells to reduce incidience strokes,acute chest synfrome, multi organ failure 9\. A 14 y/o Girl's parents complain that she hasn\'t started her periods yet. She is short for her age. She practices gymnastics 2h per week. She is at sexual maturity stage 2. Karyotype shown below: 10\. What is the cause of her primary amenorrhea? a. **Turner's Syndrome** b. Down syndrome c. Anorexia d. Constitutional Delay in puberty One X chromosome instead of two X chromosomes with total 45 instead of 46.(45X or 45X0) Short strature, ovarian insuffiency. Beast development absent , pubic hair normal, Physical ex; high arched palate, no breast development by 12 and not stated mensene by age 14, elevated FSH and LH confirm ovarian faliure. Pubic hair development is normal Webbed neck, cubitus vulgus, short 4^th^ and 5^th^ metasarl. Ptosis, stribmius, amblopia, cataract,epicantal folds. Inncrase incide of chrons and UC. Corarctation of aorta   10\. A Child has a 1 day history of vomiting blood (coffee grounds). Clinically well, normal bilirubin, no fever, no bruising. Got Vit K shot at birth. No perinatal or postnatal complications. Mum has cracked, sore nipples. Cause of coffee ground vomitus? A. **Swallowed blood from cracked nipples** (similar question from Dr Fernandes paeds mcq review) B. Hemorrhagic disease of new born C. Mallory Weis 11\. Repeat with 7 year old on 200 microgram of ICS for asthma. She was initially responding well but now has to use her (rescue inhaler -SABA) almost everyday. What to do next? A. increase ICS to 400 micrograms. B. **Add LABA** C. Theophylline D. oral corticosteroids Step1: Mild intermittent Asthma- SABA as required, infants inhaled ipratropium bromide Step2: Regular preventer therpy- requre 3 or more SABA per week- Add Inhaled Steriod, \