Paeds. 2 ~ Extended Matching

Question 1.

Options List

A.) Erythema Infectiosum

B.) Erysipelas

C.) Henoch Schonlein purpura

D.) Kawasaki Disease

E.) Measles

F.) Roseola Infantum

G.) Rubella

H.) Scarlet fever

 I .) Varicella

 

Lead-in Statement

For each of these presentations select the most likely diagnosis.

 

Stems

1. A 5 year old unimmunised girl presents with a 3 day history of fever, coryzal, conjunctivitis and cough. She is febrile and lethargic and has an erythematous maculopapular rash that started on the head and has spread down to her trunk and now to her arms and legs.

 

2. A 5 year old unimmunised girl presents with an erythematous maculopapular rash that started on her shoulders and arms and has spread to her trunk. Two days ago you saw her with an erythematous rash on her face with circumoral sparing.

 

3. A 5 year old unimmunised girl presents with 2 days of fever, headache and sore throat. Her tonsils and pharynx are red and covered with exudate. Her tongue is also covered in exudate with very red and enlarge papillae. She also has a fine red raised rough rash that started on her neck and axillae and has now spread to her trunk.

 

4. A 5 year old unimmunised girl presents with a 3 day history of fever and sore throat. She looks only mildly unwell with enlarged occipital and post-auricular lymph nodes and an erythematous maculopapular rash that was first noted this morning on her face and has now spread to her trunk, arms and legs.

Author: J Haire

Ref: Tintinalli p. 911-17

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Question 2.

Options List

A.) Juvenile idiopathic arthritis

B.) Macrophage activation syndrome

C.) Osteomyelitis

D.) Perthes Disease

E.) Rheumatic fever

F.) Septic arthritis

G.) Serum sickness

H.) Slipped upper femoral epiphysis

 I.) Transient synovitis

 

Lead-in Statement

For each of these presentations select the most likely diagnosis.

 

Stems

1. A 14 year old boy presents with left hip pain. He has had mild hip pain for weeks but it has become much wore in the last few days. On exam he is obese and is holding the left leg in flexion and external rotation. He is unable to weight bear and his range of motion is markedly reduced.

 

2. A 4 year old boy presents with a limp in the left leg that has progressed over the last 3 days. On exam he is weight bearing, is afebrile and has only slightly reduced ROM in the left hip with all other joints and bones non-tender.

 

3. An 8 year old boy presents with a limp in the left leg which started today. He is now not weight-bearing and is holding his left hip in slight flexion and external rotation. ON exam his temperature is 37.5°C and he is very ender in the left hip with markedly reduced range of movement.

Author: J Haire

Ref: Cameron p. 522-28

 

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