Paediatric Picture Quiz

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Pictures of common Paediatric Problems- See how many you get right

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Paediatric Picture Quiz : 

Paediatric Picture Quiz Dr S Sen Paediatric Registrar North Western Deanery

What’s wrong with this nappy? : 

What’s wrong with this nappy?

Acholic stool : 

Acholic stool Indicates Biliary obstruction Two main causes Extrahepatic biliary atresia Choledochal cyst Will need HIDA scan and possible liver biopsy For EHBA results are best with surgery before 6 weeks of life

What does the CXR show ? : 

What does the CXR show ?

Non Accidental Injury : 

Non Accidental Injury Acute and healing rib fractures in a young infant

Spot the Diagnosis : 

Spot the Diagnosis

Left sided facial palsy : 

Left sided facial palsy Most likely Bell’s palsy Will recover spontaneously Ensure no ear perforation Refer to ENT and Ophthalmology (eye care)

Failure to thrive from nine months of age : 

Failure to thrive from nine months of age

Jejunal biopsy : 

Jejunal biopsy

Coeliac disease : 

Coeliac disease Protruberant abdomen and buttock wasting FTT from weaning (introduction of gluten) Need lifelong gluten free diet

Spot Diagnosis : 

Spot Diagnosis

Hydrocephalus : 

Hydrocephalus Grossly enlarged head Dilated scalp veins Sunsetting sign

Accidental or Nonaccidental? : 

Accidental or Nonaccidental?

Ear bruising : 

Ear bruising Physical abuse

What clinical sign is shown? Name 5 causes. : 

What clinical sign is shown? Name 5 causes.

Clubbing : 

Clubbing Causes Bronchiectasis Congenital cyanotic heart disease Endocarditis Liver disease Inflammatory bowel disease NB lung cancer is NOT the commonest cause in childhood!

Normal or Abnormal ? : 

Normal or Abnormal ?

Neonatal Jaundice : 

Neonatal Jaundice Unconjugated Physiological Rhesus disease ABO incompatibility Other causes haemolysis – spherocytosis etc Breast milk jaundice Hypothyroidism Sepsis Crigler-Najjar syndrome

Neonatal Jaundice : 

Neonatal Jaundice Conjugated EHBA Choledochal cyst Alagille syndrome Neonatal Hepatitis Metabolic disease TPN treatment

What is this danger sign? : 

What is this danger sign?

Papilloedema : 

Papilloedema Sign of raised ICP Needs urgent neuroimaging Causes Space occupying lesion Benign intracranial hypertension Retinal vein obstruction Hypertension

What is the full name of this condition? : 

What is the full name of this condition?

Talipes Equinovarus : 

Talipes Equinovarus If positional needs only physiotherapy Fixed needs orthopaedic input and close examination for neurological lesions

What is the DD in this 5 year old boy? : 

What is the DD in this 5 year old boy?

Haemophilia : 

Haemophilia Haemarthrosis right knee

Spot Diagnosis : 

Spot Diagnosis

Spina bifida : 

Spina bifida Open myelomengicoele Paralysis and sensory loss legs Neuropathic bladder and bowel Hydrocephalus

Spot the abnormal cells : 

Spot the abnormal cells

Sickle cell anaemia : 

Sickle cell anaemia Multiple sickle cells seen

What’s wrong with this X Ray ? : 

What’s wrong with this X Ray ?

Rickets : 

Rickets Cupping and splaying of metaphyses

Spot diagnosis : 

Spot diagnosis

SLE : 

SLE Classical butterfly rash

What is this congenital abnormality? : 

What is this congenital abnormality?

Exomphalos : 

Exomphalos Herniation of gut outside abdomen but within umbilical cord Usually associated other abnormalities

What is this congenital abnormality? : 

What is this congenital abnormality?

Gastroschisis : 

Gastroschisis Gut herniation Usually no other abnormalities

How do you treat this condition? : 

How do you treat this condition?

Atopic eczema : 

Atopic eczema Common in face in infants Treatment is with emollients and steroid creams

What is this skin disease ? : 

What is this skin disease ?

Psoriasis : 

Psoriasis Plaque psoriasis

What are the complications of this condition? : 

What are the complications of this condition?

Cleft lip : 

Cleft lip Child also has underlying cleft palate

How old is this baby ? : 

How old is this baby ?

SGA : 

SGA Thin SGA infant

Accidental or Non Accidental? : 

Accidental or Non Accidental?

Scald : 

Scald Physical abuse – from immersion in hot water

7 month of baby…. : 

7 month of baby….

Fracture femur : 

Fracture femur Fractured femur in young child Must be abuse as child will not be walking yet

What caused this ? : 

What caused this ?

Foetal hydrops : 

Foetal hydrops Severe anaemia Congenital infections Cardiac failure Congenital nephrotic syndrome Idiopathic (50%)

Accidental Or Nonaccidental? : 

Accidental Or Nonaccidental?

Purpuric rash : 

Purpuric rash Meningococcal disease

Causes of this condition? : 

Causes of this condition?

Henoch Schonlein Purpura : 

Henoch Schonlein Purpura HSP Classical purpuric rash on buttocks and legs Mostly resolves spontaneously Can have associated nephritis, gut inflammation and intususception

What bug is responsible for this? : 

What bug is responsible for this?

Impetigo : 

Impetigo Staphylococcal infection of the skin

What is this sign? : 

What is this sign?

And this sign… : 

And this sign…

And this… : 

And this…

Endocarditis : 

Endocarditis Splinter haemorrhage Osler nodes Janeway lesions

DD for this appearance? : 

DD for this appearance?

Tonsillitis : 

Tonsillitis Pustular exudate Likely to be EBV

What is this clinical sign? : 

What is this clinical sign?

Oedema : 

Oedema Albumin - 10 Urinalysis protein +++ What is the diagnosis?

Nephrotic syndrome : 

Nephrotic syndrome Proteinuria Hypoalbuminemia Oedema Hypercholesterolemia

Thank you for staying awake : 

Thank you for staying awake