Infectious Disease — Prometric Style Questions, Set 2

What this deck covers

Infectious Disease – 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. Grunting on the fourth day
2. Fever that would not settle
3. Coughing until she vomits
4. Croup that stopped responding
5. Better than the film suggests
6. Positive test, well child
7. How long and how many
8. Too young to test
9. Yellow at six weeks
10. Three weeks of getting worse
11. Behind the eyelid
12. A neck he will not turn
13. The ear that sticks out
14. Six weeks and violet
15. The uvula pointing sideways
16. Pain worse than it looks
17. Skin that comes away
18. Sunburn rash with shock
19. Golden crusts round the nose
20. Eczema that turned painful
21. Protecting the baby before birth
22. A test that tells you nothing
23. Hypoxic with a clear chest
24. Why she takes the tablets
25. A needle in the park
26. The culture came back
27. A label from when he was two
28. Asking for a prescription
29. Where the gain actually is
30. Diarrhoea in the second week
31. Six weeks old and febrile
32. Fever by the calendar
33. Three weeks and no answer
34. Well, febrile, nothing found
35. Collapsed at eight hours
36. What to give on day one
37. Pus from both eyes
38. Red around the cord
39. Goats and six weeks of fever
40. A cyst you must not tap
41. Itching that wakes her
42. Months of fever, huge spleen
43. Ten days after the farm
44. Worse once the fever went
45. Before he travels
46. Weeks after the family was ill
47. One negative test is not enough
48. Ten days after the river
49. Bitten by a bat
50. The dangerous half of the procedure

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Oral amoxicillin at home with review in two days, Severe viral croup requiring more adrenaline, Two drugs for three months, Antituberculous treatment with corticosteroids, A further course of oral antibiotics, Oral antibiotics and review in the morning, Intravenous antibiotics after admission, It confirms that the infant is infected, Squeeze the wound firmly to expel any blood, Explain the likely course and give safety-net advice, Discharge with advice to return if he worsens, Blood cultures and inflammatory markers as routine, A blocked tear duct causing discharge, Simple aspiration of the cyst.

Clinical pearls from this deck

• Watch him drink before you decide. A child who has stopped drinking has told you where he is being treated tonight.
• Still febrile on day four means something needs draining. Scan the chest with ultrasound rather than repeating the radiograph.
• A lymphocytosis with a cough is the clue. Very few infections raise the lymphocytes and leave the child well between attacks.
• Croup that stops responding to adrenaline is not croup any more. Call for the airway before you try a second dose.
• No cell wall, no beta-lactam. That single fact chooses the antibiotic and explains why the first one failed.
• Latent does not mean leave it. The two years after exposure are when a well child becomes an ill one.

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 infectious disease case decks · pediatric reference values.