Paediatrics - Questions and Problems
1. The current routine immunisation schedule given at 2 months of age includes
immunisation against:
Select one or more:
a. Pertussis (Whooping cough)
b. Meningitis C
c. Haemophilus influenzae B
d. Diptheria
e. Polio
f. Tetanus
g. Measles
h. Pneumococcus
i. Rotavirus: a. Pertussis (Whooping cough)
c. Haemophilus influenzae B
d.Diptheria
e. Polio
f. Tetanus
h. Pneumococcus
i. Rotavirus
Please visit http://www.immunisationscotland.org.uk/when-to-immunise/immunisation-
schedule.aspx to get full details on the immunisation programme.
2. Which of the following statements about child development are true?
Select one or more:
a. An infant of 3 months tends to hold their hands in the midline and demon-strate "hand
regard"
b. The Moro reflex is an example of a Primitive reflex
c. At 12 months of age normal social development would include feeding with a spoon and
mimicking adults
, Paediatrics - Questions and Problems
d. At 9-months of age an infant will localise sound consistently, babble for self-amusement
and initiate sounds
e. Assessment of vision and fine motor development are closely related
f. Gross motor development at 4-months can be assessed by "pulling to sit": a.
An infant of 3 months tends to hold their hands in the midline and
demonstrate "hand regard" b. The Moro reflex is an example of a Primitive
reflex
d.At 9-months of age an infant will localise sound consistently, babble for self-amusement
and initiate sounds
e. Assessment of vision and fine motor development are closely related
f. Gross motor development at 4-months can be assessed by "pulling to sit"
The normal development to infant and young child can be usefully considered in different
spheres ie gross motor, fine motor and vision, language and hearing, social and play. Whilst
it is important to know the developmental milestones achieved by certain ages it must be
appreciated that there is a wide normal range. The primitive reflexes are important as
persistence suggests neurodevelopmental delay. It can be helpful to think of development
in each of the developmental spheres in a sequential way - eg for gross motor development
- initially lies prone or supine, pushes up on arms in prone, rolls over, can sit, pulls to stand,
'cruises with furniture' etc.
3. Social work and police ask for your opinion after you have examined an eighteen
months old boy with unexplained bruising. He has a non tender reddish blue bruise to
his lower back. They want to know how old it is. What is your response?
Select one:
a. 3-5 days
b. More than 10 days
c. Unable to comment
d. 6-10 days
e. 0-2 days: c. Unable to comment
, Paediatrics - Questions and Problems
Estimating the age of a bruise is notoriously difficult. There are few studies which have
looked into this and systematic review on CORE gives a summary of findings.
http://www.core-info.cardiff.ac.uk/reviews/bruising/ageing/results
4. What is the average age (in years) that a girl enters puberty in the UK?
Select one:
a. 9
b. 12
c. 11
d. 10: c. 11
The average age for a girl to enter puberty in the UK is 11 years. There is a wide range of
what is considered normal for starting puberty - anything between the age of 8-13 years.
There is also a secular trend whereby girls are entering puberty earlier than previous
generations. Girls' puberty follows three distinct phases: adrenarche (greasy skin, spots,
hair); thelarche (breast development); then menarche (periods usually start 2-3 years
after thelarche). On average, boys in the UK enter puberty at 11.5 years.
5. What is the average age (in years) that a boy in the UK experiences their pubertal
growth spurt?
Select one: a.
14
b. 11
c. 12
d. 13
e. 10: a. 14
The average age for a boy to experience his pubertal growth spurt is 14 years. Boys
experience their peak height velocity towards the end of puberty whilst girls tend to grow
faster at the beginning of puberty. Growth stops soon after the pubertal growth spurt. The
fact that boys have a few years of additional growth before this growth spurt is one of the
reasons why, on average, men are taller than women.
, Paediatrics - Questions and Problems
6. Which of the following statements about basic life support in a child of 5 yrs are true?
Tick all that apply.
Select one or more:
a. The correct position for maximising the airway is the 'sniffing' position
b. The correct position for chest compressions is over the lower half of the sternum
c. The ratio of breaths to chest compressions is 2 breaths to 15 chest compres-sions
d. Before giving rescue breaths you should check for signs of life
e. Jaw thrust is the preferred method of opening the airway in a child with a
suspected neck injury: a. The correct position for maximising the airway is the
'sniffing' position b. The correct position for chest compressions is over the lower
half of the sternum
c. The ratio of breaths to chest compressions is 2 breaths to 15 chest compressions
e. Jaw thrust is the preferred method of opening the airway in a child with a
suspected neck injury The correct sequence for basic life support in a child is:
Safe approach, stimulate, shout for help, open airway, look/listen/feel for breathing, give
5 rescue breaths, check for signs of life, give 15 chest compressions, continue CPR at 2
breaths to 15 compressions for 1 minute and then call emergency services.
7. Which of the following statements best describes the reason for measuring the
occipitofrontal (OFC) circumference in infants?
Select one:
a. An increasing head circumference may be the first or only sign of a problem
b. Regular measurement can be used to detect abnormal brain/skull growth
c. It is a good indicator of the general health of an infant
d. An increasing OFC can be an important finding in children who have subdural
haemorrhages from non-accidental injury
e. It is helpful in the assessment of a child's nutritional status: b. Regular measurement can
be used to detect abnormal brain/skull growth
1. The current routine immunisation schedule given at 2 months of age includes
immunisation against:
Select one or more:
a. Pertussis (Whooping cough)
b. Meningitis C
c. Haemophilus influenzae B
d. Diptheria
e. Polio
f. Tetanus
g. Measles
h. Pneumococcus
i. Rotavirus: a. Pertussis (Whooping cough)
c. Haemophilus influenzae B
d.Diptheria
e. Polio
f. Tetanus
h. Pneumococcus
i. Rotavirus
Please visit http://www.immunisationscotland.org.uk/when-to-immunise/immunisation-
schedule.aspx to get full details on the immunisation programme.
2. Which of the following statements about child development are true?
Select one or more:
a. An infant of 3 months tends to hold their hands in the midline and demon-strate "hand
regard"
b. The Moro reflex is an example of a Primitive reflex
c. At 12 months of age normal social development would include feeding with a spoon and
mimicking adults
, Paediatrics - Questions and Problems
d. At 9-months of age an infant will localise sound consistently, babble for self-amusement
and initiate sounds
e. Assessment of vision and fine motor development are closely related
f. Gross motor development at 4-months can be assessed by "pulling to sit": a.
An infant of 3 months tends to hold their hands in the midline and
demonstrate "hand regard" b. The Moro reflex is an example of a Primitive
reflex
d.At 9-months of age an infant will localise sound consistently, babble for self-amusement
and initiate sounds
e. Assessment of vision and fine motor development are closely related
f. Gross motor development at 4-months can be assessed by "pulling to sit"
The normal development to infant and young child can be usefully considered in different
spheres ie gross motor, fine motor and vision, language and hearing, social and play. Whilst
it is important to know the developmental milestones achieved by certain ages it must be
appreciated that there is a wide normal range. The primitive reflexes are important as
persistence suggests neurodevelopmental delay. It can be helpful to think of development
in each of the developmental spheres in a sequential way - eg for gross motor development
- initially lies prone or supine, pushes up on arms in prone, rolls over, can sit, pulls to stand,
'cruises with furniture' etc.
3. Social work and police ask for your opinion after you have examined an eighteen
months old boy with unexplained bruising. He has a non tender reddish blue bruise to
his lower back. They want to know how old it is. What is your response?
Select one:
a. 3-5 days
b. More than 10 days
c. Unable to comment
d. 6-10 days
e. 0-2 days: c. Unable to comment
, Paediatrics - Questions and Problems
Estimating the age of a bruise is notoriously difficult. There are few studies which have
looked into this and systematic review on CORE gives a summary of findings.
http://www.core-info.cardiff.ac.uk/reviews/bruising/ageing/results
4. What is the average age (in years) that a girl enters puberty in the UK?
Select one:
a. 9
b. 12
c. 11
d. 10: c. 11
The average age for a girl to enter puberty in the UK is 11 years. There is a wide range of
what is considered normal for starting puberty - anything between the age of 8-13 years.
There is also a secular trend whereby girls are entering puberty earlier than previous
generations. Girls' puberty follows three distinct phases: adrenarche (greasy skin, spots,
hair); thelarche (breast development); then menarche (periods usually start 2-3 years
after thelarche). On average, boys in the UK enter puberty at 11.5 years.
5. What is the average age (in years) that a boy in the UK experiences their pubertal
growth spurt?
Select one: a.
14
b. 11
c. 12
d. 13
e. 10: a. 14
The average age for a boy to experience his pubertal growth spurt is 14 years. Boys
experience their peak height velocity towards the end of puberty whilst girls tend to grow
faster at the beginning of puberty. Growth stops soon after the pubertal growth spurt. The
fact that boys have a few years of additional growth before this growth spurt is one of the
reasons why, on average, men are taller than women.
, Paediatrics - Questions and Problems
6. Which of the following statements about basic life support in a child of 5 yrs are true?
Tick all that apply.
Select one or more:
a. The correct position for maximising the airway is the 'sniffing' position
b. The correct position for chest compressions is over the lower half of the sternum
c. The ratio of breaths to chest compressions is 2 breaths to 15 chest compres-sions
d. Before giving rescue breaths you should check for signs of life
e. Jaw thrust is the preferred method of opening the airway in a child with a
suspected neck injury: a. The correct position for maximising the airway is the
'sniffing' position b. The correct position for chest compressions is over the lower
half of the sternum
c. The ratio of breaths to chest compressions is 2 breaths to 15 chest compressions
e. Jaw thrust is the preferred method of opening the airway in a child with a
suspected neck injury The correct sequence for basic life support in a child is:
Safe approach, stimulate, shout for help, open airway, look/listen/feel for breathing, give
5 rescue breaths, check for signs of life, give 15 chest compressions, continue CPR at 2
breaths to 15 compressions for 1 minute and then call emergency services.
7. Which of the following statements best describes the reason for measuring the
occipitofrontal (OFC) circumference in infants?
Select one:
a. An increasing head circumference may be the first or only sign of a problem
b. Regular measurement can be used to detect abnormal brain/skull growth
c. It is a good indicator of the general health of an infant
d. An increasing OFC can be an important finding in children who have subdural
haemorrhages from non-accidental injury
e. It is helpful in the assessment of a child's nutritional status: b. Regular measurement can
be used to detect abnormal brain/skull growth
