NZREX Paediatrics and Obstetrics 2

Question 1

In NZ, what is the recommended management of pre-eclampsia?

Accepted Answer

Blood pressure control, monitoring for severe features (headache, visual disturbance, epigastric pain, proteinuria), magnesium sulphate for severe pre-eclampsia, and delivery as definitive treatment

Answer

NZ pre-eclampsia management includes: antihypertensive medication (labetalol or nifedipine), monitoring for severe features (headache, visual changes, epigastric pain, deranged liver/renal function), magnesium sulphate for seizure prophylaxis in severe cases, and planned delivery as the only definitive cure.

Question 2

What is the NZ approach to managing a child with suspected non-accidental injury (NAI)?

Accepted Answer

Document findings carefully, obtain a thorough history, perform a skeletal survey and relevant investigations, report to Oranga Tamariki (child protection), and ensure the child's safety

Answer

NZ management of suspected NAI includes: careful documentation of injuries (photographs, body map), thorough history from all caregivers, appropriate investigations (skeletal survey, bloods, ophthalmology review), mandatory report to Oranga Tamariki (Ministry for Children), and ensuring the child's immediate safety.

Question 3

In NZ paediatric resuscitation, what is the correct compression-to-ventilation ratio for infants?

Accepted Answer

15 compressions to 2 ventilations (with two rescuers) using the two-thumb encircling technique

Answer

ANZCOR guidelines used in NZ recommend a 15:2 compression-to-ventilation ratio for infant CPR with two healthcare rescuers. The preferred technique is the two-thumb encircling hands technique, compressing the lower third of the sternum to one-third of the chest depth.

Question 4

What is the NZ approach to managing postpartum haemorrhage (PPH)?

Accepted Answer

Call for help, ABC assessment, uterine massage, IV oxytocin, establish IV access with fluid resuscitation, and consider additional uterotonics and surgical intervention if not responding

Answer

NZ PPH management follows a structured approach: call for help, ABCDE assessment, bimanual uterine compression/massage, IV oxytocin (10 units), establish large-bore IV access with fluid resuscitation, consider additional uterotonics (ergometrine, misoprostol), IV tranexamic acid, and surgical intervention if medical management fails.

Question 5

A 3-year-old in NZ presents with wheeze and respiratory distress. How do you differentiate bronchiolitis from asthma?

Accepted Answer

Bronchiolitis typically affects infants under 12 months, is preceded by coryzal symptoms, and occurs in first episodes; asthma involves recurrent episodes, often with atopy or family history

Answer

In NZ paediatrics, bronchiolitis typically affects infants under 12 months (peak 2-6 months), is preceded by upper respiratory symptoms, and is usually a first-time wheeze episode caused by RSV. Asthma is characterised by recurrent wheeze episodes, often with personal or family history of atopy (eczema, allergic rhinitis).

NZREX Practice Test

NZREX Practice Test

NZREX Paediatrics and Obstetrics 2