Development and Behaviour — Prometric Style Questions, Set 2

What this deck covers

Development and Behaviour — Prometric Style Questions, Set 2 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A newborn who failed the screen
2. One orange, one white
3. An eye that turns inwards
4. Dull drums and loud television
5. A baby who will not look
6. Playing beside, not with
7. Advice from a relative
8. Ready for the nursery
9. Copying shapes on a page
10. Friendly with everybody
11. Screaming early in the night
12. Snoring and struggling at school
13. Rocked to sleep every time
14. Walking with a blank face
15. How much a baby should sleep
16. Behind his classmates in one subject
17. A boy called clumsy for years
18. What the number means
19. Counting from the wrong birthday
20. A normal array, a family history
21. Medically well, not yet safe
22. Insisting that she is fine
23. Getting an honest history
24. A boy who stopped enjoying things
25. Knowing better and doing it anyway
26. Hands that forgot their skill
27. Language that faded away
28. Going backwards at two
29. Words lost after an illness
30. Pleased about a preference
31. What has to be present
32. Choosing among four offers
33. Blaming everything on the label
34. A questionnaire is not a verdict
35. Running out of the hall
36. Asking for tablets at five
37. Falling centiles on treatment
38. Two faints on the football pitch
39. Blinking more since the tablets
40. Difficult at home, fine at school
41. Giving in at the checkout
42. Wet again since the baby
43. Leaving and coming back
44. A mother who feels nothing
45. Sent upstairs for an hour
46. Three hours of video a day
47. Building words at home
48. Pains with no cause found
49. A boy facing exclusion
50. How much running about

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Repeat the same test at one year of age, Immediate insertion of ventilation tubes today, Use only one language until school age, Between six and nine months of age, A sleep-onset association he cannot recreate alone, Global intellectual disability, Correct for prematurity throughout childhood, Outpatient psychological therapy starting next week, All of them have an underlying conduct disorder, A normal variation in the pace of development, Motor coordination and receptive language ability, The questionnaire cannot be used before three years, Stop the drug permanently and offer no alternative, An avoidant pattern of attachment.

Clinical pearls from this deck

• A failed screen is a question, not an answer. What matters is how fast the question gets settled, because language will not wait.
• Check both reflexes together, not one at a time. Asymmetry is what catches this, and the parents will not have seen it.
• The quiet eye is the one in trouble. No complaint of double vision means suppression, and suppression is what destroys the sight.
• Ask about speech, not only about ears. The decision to operate is driven by what the hearing loss is costing the child, not by the eardrum.
• Before you accept that vision is simply late, prove the eye and the pupil are normal. Otherwise you are naming a problem instead of finding it.
• Playing beside other children is the job of a three-year-old. Ask whether he is interested in them, not whether he is playing with them.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Development and Behaviour case decks · pediatric reference values.