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Other paediatric singletons

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Teaching point — how the wording changes the answer

Assorted one-off paediatric stems grouped for completeness.

Q5 Child, systolic murmur at left upper sternal border, no radiation. Diagnosis?
Key clue Soft systolic, no radiation
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Innocent murmur (vs pulmonary stenosis if ESM radiating to back)
Q79 Clinical features of Duchenne muscular dystrophy. Investigation?
Key clue DMD features
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Creatine kinase (screen) then genetic analysis
Q162 Child cough + fever, clear chest, red inflamed tonsils. Treatment?
Key clue Tonsillitis / GAS
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Phenoxymethylpenicillin (penicillin V)
Q202 Child started cereal at 5 months, within 2 h vomiting, low BP, tachycardia, increased CRT. Investigation?
Key clue Acute food reaction (FPIES)
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None invasive — clinical diagnosis, supportive
Q360 Galactosaemia case
Key clue Galactosaemia
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Lactose-free / soy-based formula
NA 10-month dehydration + irritable, CRT 3 s, low Na/K/Cl, high urea, glucose normal
Key clue Hypochloraemic dehydration
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0.9% saline bolus then reassess