Paediatrics Flashcards

According to the Saudi national immunisation schedule, at what age should the first dose of measles-mumps-rubella (MMR) vaccine be administered?

Answer: 12 months

Per the Saudi Ministry of Health national immunisation schedule and SCFHS guidelines, the first dose of MMR vaccine is administered at 12 months of age, with a second dose at 18 months.

A 3-year-old child presents with barking cough, inspiratory stridor, and a 'steeple sign' on anteroposterior neck X-ray. What is the most likely diagnosis?

Answer: Croup (laryngotracheobronchitis)

Croup (acute laryngotracheobronchitis) is characterised by a barking cough, inspiratory stridor, and hoarseness. The 'steeple sign' on AP neck X-ray represents subglottic narrowing, which is the hallmark radiographic finding.

A 6-month-old infant presents with olive-shaped mass in the right upper quadrant, non-bilious projectile vomiting, and visible peristalsis. What is the most likely diagnosis?

Answer: Pyloric stenosis

Infantile hypertrophic pyloric stenosis classically presents between 2-8 weeks of age (can present later) with non-bilious projectile vomiting, a palpable 'olive-shaped' mass in the right upper quadrant, and visible gastric peristalsis.

A 5-year-old child presents with periorbital oedema, proteinuria (4+), and hypoalbuminaemia. Serum cholesterol is elevated. What is the most likely diagnosis?

Answer: Nephrotic syndrome (minimal change disease)

Nephrotic syndrome in children is characterised by heavy proteinuria, hypoalbuminaemia, oedema, and hyperlipidaemia. Minimal change disease is the most common cause in children (80%), and it typically responds well to corticosteroid therapy.

A neonate born at 32 weeks gestation develops respiratory distress within minutes of birth. Chest X-ray shows ground-glass opacification with air bronchograms. What is the most likely diagnosis?

Answer: Respiratory distress syndrome (hyaline membrane disease)

Respiratory distress syndrome (RDS) occurs in premature infants due to surfactant deficiency. The typical chest X-ray shows bilateral ground-glass opacification with air bronchograms. Treatment includes surfactant replacement and supportive ventilation.

A 4-year-old child presents with a purpuric rash on the buttocks and lower extremities, abdominal pain, and joint swelling. Urinalysis shows haematuria and proteinuria. What is the most likely diagnosis?

Answer: Henoch-Schönlein purpura (IgA vasculitis)

Henoch-Schönlein purpura (IgA vasculitis) is characterised by palpable purpura (typically on buttocks and lower limbs), arthralgia, abdominal pain, and renal involvement (haematuria/proteinuria). Platelet count is normal, distinguishing it from ITP.