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Paeds · SAQs

SAQs

829 units across 27 domains — Written-answer practice mapped to Paediatrics board objectives.

Back to PaedsJump to first domain
Paediatrics Fellowship SAQs
Plate — paedsMedVellum Press
829Units
27Domains
genetics-dysmorphology-and-metabolismacute-care-resuscitation-and-toxicologyinvestigations-procedures-and-technologygastroenterology-hepatology-and-nutritionpreventive-and-community-paediatricsneurology-neurodisability-and-neuromuscularchild-safety-and-social-paediatricsnephrology-urology-fluids-and-electrolytespaediatric-dermatologyendocrinology-diabetes-and-growthent-hearing-and-oral-healthmental-behavioural-and-psychosomaticrheumatology-musculoskeletal-and-sportspain-palliative-and-end-of-life-carecardiologyrespiratory-sleep-and-airwayadolescent-and-young-adult-medicinegrowth-development-and-behaviourclinical-pharmacology-and-therapeuticsrural-remote-and-contextual-paediatricsclinical-assessment-and-reasoningallergy-and-immunologyhaematology-oncology-and-transfusioninfectious-diseasesfetal-neonatal-and-perinatalprofessional-practice-and-evidenceophthalmology
AtlasPaedsSAQs

Domain

genetics-dysmorphology-and-metabolism

34

22q11.2 deletion syndrome — formative SAQs

Formative SAQs on 22q11.2 deletion syndrome: recognising the multisystem fingerprint that earns a chromosomal microarray, staging every system at diagnosis, deferring live vaccines until T-cell deficiency is excluded, and running an age-based surveillance plan through to adult transition.

Open

Acute metabolic decompensation: recognition and stabilisation

Short-answer question on recognising and resuscitating an infant with acute metabolic decompensation, including interpretation of the metabolic panel and first-hour management.

Open

Amino-acid disorders including phenylketonuria and MSUD — formative SAQs

Formative SAQs on recognising the inherited amino-acid disorders (PKU, MSUD, tyrosinaemia type I, homocystinuria) on their metabolite and clinical signatures, delivering the acute 'switch off catabolism, clear the toxin' protocol for an MSUD crisis, and locking in long-term diet, cofactor and enzyme-substitution therapy with maternal PKU counselling.

Open

Chromosomal microarray, exome and genome sequencing — formative SAQs

Formative SAQs on choosing between chromosomal microarray, whole-exome and whole-genome sequencing: the resolution ladder, diagnostic yields, variant interpretation, secondary findings, consent, and rapid sequencing in the critically ill infant.

Open

Dietary, cofactor and emergency management of metabolic disease

Short-answer question on the four pillars of long-term metabolic therapy, the sick-day regimen, and the cofactor-responsive disorders.

Open

Disorders of metal metabolism: Wilson and Menkes disease — formative SAQs

Formative SAQs on recognising the hepatic and neuropsychiatric faces of Wilson disease and the infantile regression of Menkes disease, interpreting the integrated copper panel and Leipzig score, and delivering the correct-direction treatment and family counselling.

Open

Down syndrome — formative SAQs

Formative SAQs on Down syndrome: recognising the three genetic mechanisms and why a karyotype changes counselling, mapping the comorbidities by system, applying the age-stratified health-supervision schedule, and managing the acute newborn presentations.

Open

Dysmorphology examination and syndrome recognition — formative SAQs

Formative SAQs on a structured dysmorphology examination, anomaly classification, syndrome differential generation and tiered genetic testing.

Open

Ethical issues in genomic diagnosis and cascade testing

Short-answer question on the ethics of predictive testing, secondary findings, and cascade testing in a child with a family history of an adult-onset genetic condition.

Open

Fatty-acid oxidation disorders — formative SAQs

Formative SAQs on recognising the hypoketotic hypoglycaemia signature of a fatty-acid oxidation disorder, delivering the acute intravenous-dextrose protocol, localising the defect with plasma acylcarnitines, and locking in long-term fasting avoidance, an emergency sick-day plan, and disease-specific therapy for long-chain defects.

Open

Fragile X syndrome — formative SAQs

Formative SAQs on recognising fragile X syndrome, confirming the molecular diagnosis with FMR1 PCR plus methylation analysis, classifying the CGG-repeat allele, building comorbidity-driven multidisciplinary support, and running cascade testing of the wider family.

Open

Genetic deafness and blindness syndromes — formative SAQs

Formative SAQs on the infant who fails newborn hearing screening, the tiered genetic workup from GJB2 to whole-exome sequencing, the syndromic causes of deafness including Pendred, Waardenburg, Jervell and Lange-Nielsen and branchio-oto-renal, the recognition of Usher syndrome as the dominant dual-sensory cause, and the role of voretigene neparvovec gene therapy for RPE65 Leber congenital amaurosis.

Open

Genetic history, pedigree construction and inheritance patterns — formative SAQs

Formative SAQs on taking a genetic family history, constructing a standardised pedigree, recognising each inheritance pattern from its shape, applying recurrence-risk arithmetic, and counselling a consanguineous couple non-directively.

Open

Genomic testing, variant interpretation, and counselling — formative SAQs

Formative SAQs on choosing the right genomic test, applying the ACMG/AMP five-tier variant classification framework, managing variants of uncertain significance and secondary findings, and delivering pre- and post-test genetic counselling to families.

Open

Glycogen-storage and carbohydrate metabolism disorders — formative SAQs

Formative SAQs on recognising the hepatic glycogenoses through hepatomegaly with fasting hypoglycaemia and lactic acidosis, separating Pompe disease by its cardiomyopathy and hypotonia, delivering the unifying 'prevent fasting' management with cornstarch and continuous glucose, and holding galactosaemia and hereditary fructose intolerance as the toxic-sugar disorders.

Open

Hypoglycaemia due to inherited metabolic disease — formative SAQs

Formative SAQs on recognising hypoketotic hypoglycaemia as a metabolic emergency, capturing the critical sample before treating, classifying the cause into insulin-driven, glucose-production failure, and fuel-oxidation block, and delivering disease-specific therapy with diazoxide, carnitine and cornstarch.

Open

Inborn errors presenting with neurological regression — formative SAQs

Formative SAQs on the inborn errors of metabolism that present with neurological regression: recognising regression as a red flag, grouping the disorders by affected pathway, deploying a tiered metabolic-and-genomic workup, and identifying the treatable subset before labelling a child degenerative or palliative.

Open

Klinefelter syndrome and sex chromosome aneuploidy — formative SAQs

Formative SAQs on Klinefelter syndrome and sex chromosome aneuploidy: recognising the clinical pattern across the lifespan, confirming the diagnosis with a karyotype, applying the lifespan surveillance framework including testosterone replacement and bone health, counselling a prenatal diagnosis, and managing the neurodevelopmental and psychosocial phenotype.

Open

Lysosomal storage disorders — formative SAQs

Formative SAQs on the lysosomal storage disorders: recognising the cardinal presenting patterns, grouping by stored substrate, confirming with a layered enzyme-and-genotype workup, and matching the disease-modifying therapy to central-nervous-system involvement.

Open

Marfan syndrome and heritable connective-tissue disorders — formative SAQs

Formative SAQs on Marfan syndrome and the heritable connective-tissue disorders: recognising the marfanoid phenotype, confirming with the revised Ghent nosology and FBN1 sequencing, distinguishing Marfan from Loeys-Dietz, vascular and hypermobile Ehlers-Danlos, Beals and homocystinuria by gene and lens direction, and applying the lifelong aortic-root surveillance and treatment plan.

Open

Mitochondrial disease

Short-answer question on the tiered diagnostic approach to a child with suspected mitochondrial disease, including the dual-genome logic, the significance of lactate sensitivity, and the critical pharmacological contraindications.

Open

Mucopolysaccharidoses and oligosaccharidoses — formative SAQs

Formative SAQs on the mucopolysaccharidoses and oligosaccharidoses: recognising the coarse-facies phenotype with dysostosis multiplex, grouping the subtypes by stored substrate and the discriminating cornea-versus-intellect signs, confirming with a layered urine-and-enzyme-and-genotype workup, and matching the disease-modifying therapy to central-nervous-system involvement.

Open

Neurofibromatosis type 1 and type 2 — formative SAQs

Formative SAQs on recognising neurofibromatosis type 1 from six or more cafe-au-lait macules and freckling, applying the NIH diagnostic criteria, confirming molecularly with NF1 sequencing, building surveillance around optic glioma and plexiform neurofibroma, and separating NF2 as a chromosome-22 vestibular schwannoma syndrome.

Open

Noonan syndrome and RASopathies — formative SAQs

Formative SAQs on Noonan syndrome and the RASopathies: recognising the shared RAS/MAPK pathway phenotype, distinguishing Noonan syndrome from the other RASopathies by gene and cardiac profile, confirming with a multigene panel, and applying a genotype-aware surveillance schedule.

Open

Organic acidaemias — formative SAQs

Formative SAQs on recognising the high-anion-gap metabolic acidosis that distinguishes the organic acidaemias from the urea cycle disorders, delivering the 'treat on suspicion' emergency protocol with carnitine and toxin removal, trialling cofactor responsiveness, and locking in long-term medical and transplant-based management.

Open

Peroxisomal disorders — formative SAQs

Formative SAQs on the peroxisomal disorders: splitting the bedside pattern into the biogenesis group (Zellweger spectrum) and the single-enzyme group (X-linked adrenoleukodystrophy), confirming with a plasma very-long-chain fatty acid panel, and matching the disease-modifying therapy to the disorder and the pace.

Open

Prader-Willi and Angelman syndromes — formative SAQs

Formative SAQs on recognising Prader-Willi syndrome in the neonate, recognising Angelman syndrome in the toddler, confirming the molecular diagnosis with methylation analysis, determining the molecular subtype for recurrence-risk counselling, and building syndrome-specific multidisciplinary management.

Open

Prenatal diagnosis and reproductive genetics — formative SAQs

Two formative SAQs on prenatal diagnosis and reproductive genetics: a pathogenic microarray finding after an increased-risk screen, and a consanguineous couple at one-in-four recurrence risk exploring preimplantation genetic testing versus prenatal diagnosis.

Open

Skeletal dysplasias — formative SAQs

Formative SAQs on the skeletal dysplasias: recognising the lethal short-limbed newborn and the disproportionate child, grouping by molecular pathway, confirming with a skeletal survey and molecular testing, and matching the therapy to the diagnosis while running surveillance for the lethal complications.

Open

Syndromic craniosynostosis and craniofacial disorders — formative SAQs

Formative SAQs on syndromic craniosynostosis: recognising the head-face-limb fingerprint that earns the syndromic label, naming the big six by gene, confirming the diagnosis with imaging and targeted genetic testing, securing the airway, the exposed eye and raised intracranial pressure before any cosmetic plan, and coordinating an age-based craniofacial team.

Open

Tuberous sclerosis complex — formative SAQs

Formative SAQs on recognising tuberous sclerosis complex from infantile spasms and hypomelanotic macules, applying the 2012 consensus diagnostic criteria, explaining the hamartin-tuberin-mTOR mechanism, building surveillance around SEGA and epilepsy, and offering everolimus for growing SEGA and refractory seizures.

Open

Turner syndrome — formative SAQs

Formative SAQs on recognising Turner syndrome across the four age-based presentations, confirming the karyotype, classifying the karyotype and its management implications, initiating growth-hormone and timed-oestrogen therapy, and running the cardiovascular and gonadoblastoma surveillance.

Open

Urea cycle disorders and hyperammonaemia — formative SAQs

Formative SAQs on recognising hyperammonaemia as a metabolic emergency, localising the urea cycle defect with plasma amino acids and urinary orotic acid, delivering the acute 'treat on suspicion' protocol, and locking in long-term medical and transplant-based management.

Open

Williams syndrome — formative SAQs

Formative SAQs on recognising Williams syndrome as a 7q11.23 microdeletion, confirming the deletion with chromosomal microarray, staging the elastin arteriopathy and coronary risk, managing infantile hypercalcaemia, and counselling the autosomal dominant inheritance.

Open

Domain

acute-care-resuscitation-and-toxicology

31

ABCDE assessment and stabilisation of the acutely ill child — formative SAQs

Two MedVellum formative short-answer questions on running the systematic ABCDE primary survey of an acutely ill child: treat-as-found stabilisation, age- and weight-appropriate oxygen, fluid, glucose and seizure care, recognising the tiring child, escalating before local support is exceeded, and arranging rural retrieval. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Airway assessment and basic airway management: SAQ

Short-answer questions on a child with a threatened airway, covering bedside airway assessment, positioning and adjunct selection, and two-person bag-valve-mask ventilation with escalation.

Open

Altered conscious state in children — formative SAQs

Two MedVellum formative short-answer questions on the child with an altered conscious state: securing the airway and screening with AVPU and an age-adapted Glasgow Coma Scale, checking and correcting a dangerous low glucose immediately (DEFG), treating an ongoing convulsion at five minutes, recognising raised intracranial pressure, and keeping infection, toxin, metabolic and safeguarding causes open while escalating. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Burns assessment, resuscitation and safeguarding — formative SAQs

Two MedVellum formative short-answer questions on the burned child: cooling and the modified-Parkland fluid plan for a scalded school-age child, and recognition of the threatened airway and inhalation injury in an enclosed-fire child with safeguarding and referral. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Button-battery and magnet ingestion — formative SAQs

Two MedVellum formative short-answer questions on the child with suspected button-battery or magnet ingestion: confirming ingestion and time, the two-hour endoscopic removal target for an oesophageal battery, the honey and sucralfate adjunct regimen with its eligibility and limits, the high-risk status of two or more magnets, and the recognition of delayed life-threatening complications such as aorto-oesophageal fistula. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Cardiogenic and obstructive shock: SAQ

Short-answer questions on paediatric cardiogenic and obstructive shock covering a post-cardiac surgical infant with tamponade, the recognition of Beck triad and pulsus paradoxus, the echo-guided pericardiocentesis pathway, the cautious fluid and inotrope strategy for cardiogenic shock, and the tension pneumothorax decompression in a ventilated child.

Open

Cardiorespiratory arrest and post-arrest care — formative SAQs

Formative SAQs on recognising paediatric cardiorespiratory arrest, achieving return of spontaneous circulation with high-quality CPR, adrenaline and defibrillation, and running the post-arrest bundle of targeted temperature management, normoxia, normocarbia, blood-pressure support, glucose control and seizure detection.

Open

Cardiotoxic and psychotropic medication poisoning — formative SAQs

Two MedVellum formative short-answer questions on the child or adolescent with cardiotoxic and psychotropic medication poisoning: reading the ECG and the toxidrome, giving hypertonic sodium bicarbonate for tricyclic antidepressant cardiotoxicity with a widened QRS, starting high-dose insulin euglycaemic therapy for severe beta-blocker and calcium channel blocker overdose, distinguishing calcium channel blocker hyperglycaemia, managing antipsychotic QT prolongation and neuroleptic malignant syndrome, and reserving lipid emulsion and extracorporeal support for refractory cases. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Care after death, unexpected child death and family support — formative SAQs

Formative SAQs on the immediate care-after-death response, the coronial referral and certification rules, the SUDI multi-agency investigation, breaking bad news with SPIKES, and the AAP 2022 safe-sleep message.

Open

Difficult paediatric airway and emergency front-of-neck access — formative SAQs

Formative SAQs on anticipating and recognising the difficult paediatric airway, the recognise-oxygenate-escalate-rescue sequence, supraglottic-airway rescue, and emergency front-of-neck access for cannot-intubate-cannot-oxygenate.

Open

Envenomation and marine bites — formative SAQs

Two formative SAQs on envenomation and marine bites: the pressure-immobilisation first aid and snake antivenom dosing for an Australian elapid bite, and the marine sting syndrome distinguishing the box jellyfish, Irukandji and bluebottle by first aid and hospital management.

Open

Fluid bolus therapy and vasoactive support — formative SAQs

Two MedVellum formative short-answer questions on fluid bolus therapy and vasoactive support in the shocked child: aliquot-based crystalloid resuscitation with reassessment after each bolus, the first-hour ceiling, escalation to adrenaline or noradrenaline for fluid-refractory shock, the FEAST caution, cold versus warm shock phenotyping, and the dopamine downgrade. The marks and timing support transparent self-assessment.

Open

Heat illness, hypothermia and environmental emergencies — formative SAQs

Two formative SAQs on heat illness, hypothermia and environmental emergencies: the recognition and rapid cooling of exertional heat stroke, and the staging and management of accidental environmental hypothermia including the hypothermic-arrest defibrillation and drug rules.

Open

Humane restraint and behavioural support in emergency care — formative SAQs

Two MedVellum formative short-answer questions on the child with acute behavioural disturbance in the emergency department: ensuring safety and treating medical causes first, leading verbal de-escalation and environmental modification, offering oral medication with consent (supported by the PEAChY-O trial), escalating to parenteral rapid tranquillisation only when oral fails or is unsafe, reserving physical restraint for grave and imminent danger, monitoring every sedated child, and debriefing with the patient, family and team. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Hydrocarbon, caustic and household chemical exposure — formative SAQs

Two MedVellum formative short-answer questions on paediatric household chemical exposure. SAQ 1 covers a hydrocarbon (lamp oil) ingestion: the aspiration risk, the contraindications of induced emesis and gastric lavage, the six-hour observation, and the discharge criteria. SAQ 2 covers a caustic (drain cleaner) ingestion: the contraindication to neutralisation, the timing of endoscopy, the Zargar grading, and the surgical and surveillance plan. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Hypovolaemic and haemorrhagic shock — formative SAQs

Two MedVellum formative short-answer questions on hypovolaemic and haemorrhagic shock in children: recognising compensated shock before hypotension, the bleeding-versus-non-bleeding fluid fork, balanced crystalloid aliquots for dehydration, the massive transfusion protocol, tranexamic acid dosing and timing, the lethal triad and damage control resuscitation, and early escalation to surgery and retrieval. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Initial stabilisation of major paediatric head injury — formative SAQs

Two MedVellum formative short-answer questions on the initial stabilisation of a child with major traumatic brain injury: the neuroprotective primary survey with cervical spine control, airway threshold, ventilation target, fluid strategy and raised intracranial pressure management; and the hyperosmolar therapy evidence, seizure prophylaxis, neurosurgical escalation and rural retrieval. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Iron, salicylate and toxic alcohol poisoning — formative SAQs

Two MedVellum formative short-answer questions on the child who has ingested iron, salicylate or a toxic alcohol: reading the shared high-anion-gap metabolic acidosis and the poison-specific signature, giving the correct weight-based antidote (desferrioxamine for iron, urinary alkalinisation for salicylate, fomepizole for the toxic alcohols), decontaminating by poison, and avoiding the three lethal traps. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Major trauma and paediatric trauma systems — formative SAQs

Two MedVellum formative short-answer questions on managing an injured child within a trauma system: a team-led trauma primary survey that controls catastrophic haemorrhage first, weight-based fluid and early blood for haemorrhagic shock, avoiding the lethal triad, applying paediatric imaging rules, escalating to a paediatric trauma centre before local support is exceeded, and arranging rural retrieval. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Mechanical ventilation principles in children — formative SAQs

Two formative SAQs on paediatric mechanical ventilation: the child with severe paediatric acute respiratory distress syndrome and the lung-protective settings, and the ventilated child being assessed for liberation and post-extubation support.

Open

Oesophageal and gastrointestinal foreign-body ingestion — formative SAQs

Two MedVellum formative short-answer questions on paediatric foreign-body ingestion: emergency recognition and two-hour endoscopy for an oesophageal button battery, radiographic differentiation of battery from coin, the honey demulcent adjunct and its contraindications, and the observation strategy for an asymptomatic gastric coin. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Opioid, sedative and recreational-drug toxicity — formative SAQs

Two MedVellum formative short-answer questions on paediatric opioid, sedative and recreational-drug toxicity: recognising the toxidrome, leading the ABCDE primary survey with oxygen, ventilation, bedside glucose and access, titrating naloxone to effective ventilation rather than full wakefulness, reserving flumazenil for the narrow isolated case because it can precipitate seizures, and managing MDMA toxicity and ethanol hypoglycaemia. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Oxygen, high-flow and non-invasive respiratory support — formative SAQs

Formative SAQs on selecting, dosing and escalating oxygen and non-invasive respiratory support in children.

Open

Paediatric basic and advanced life support — formative SAQs

Two formative SAQs on paediatric basic and advanced life support: the BLS sequence and high-quality CPR, and the ALS loop with defibrillation, adrenaline, reversible causes and post-arrest care.

Open

Paracetamol poisoning — formative SAQs

Two MedVellum formative short-answer questions on paediatric paracetamol poisoning: using the Rumack-Matthew nomogram for a single acute ingestion with a known time, giving activated charcoal early, starting intravenous N-acetylcysteine on or above the 150 mg per litre treatment line, recognising the staggered and unknown-time rules, managing an anaphylactoid reaction to NAC, and escalating when King's College criteria are met. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Poisoned child: structured assessment and decontamination — formative SAQs

Two MedVellum formative short-answer questions on the poisoned child: resuscitation before decontamination, taking the four-question ingestion history and reading the toxidrome, calling the Poisons Information Centre early, and deciding on activated charcoal within the first hour only when the airway is safe and the toxin is adsorbable. SAQ 2 covers the decontamination decision ladder, whole bowel irrigation for iron and sustained-release ingestions, and safeguarding in parallel. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Rapid sequence intubation in children — formative SAQs

Formative SAQs on preparing for and performing rapid sequence intubation in children, including drug selection, tube sizing and the management of complications.

Open

Retrieval, transport and interfacility stabilisation — formative SAQs

Two MedVellum formative short-answer questions on moving a critically ill child between facilities: bringing intensive care to the child before departure, completing the airway, breathing and circulation work at the referring hospital, managing the hostile physics of altitude, vibration and cold, choosing the right mode and escort, and running a structured referral, handover and contingency. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Septic shock resuscitation and vasoactive support — formative SAQs

Two MedVellum formative short-answer questions on resuscitating paediatric septic shock: recognising shock from the whole circulation, the first-hour bundle of reassessed fluid aliquots and antibiotics within the hour, choosing adrenaline for cold shock and noradrenaline for warm shock, recognising fluid accumulation injury, and arranging retrieval before local support is exceeded. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Shock in children: physiology and classification — formative SAQs

Two MedVellum formative short-answer questions on the physiology and classification of shock in children: recognising compensated shock from the whole child and the trend, grading severity, naming the haemodynamic phenotype, explaining why children maintain blood pressure until late, and applying the fluid-as-a-ceiling principle with early escalation. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Submersion injury and hypothermia — formative SAQs

Two formative SAQs on submersion injury and hypothermia: the rescue-breath-first resuscitation and Szpilman severity, and the hypothermic submersion cardiac arrest with staging, rewarming, defibrillation and drug rules.

Open

Domain

investigations-procedures-and-technology

34

Abdominal radiograph and acute imaging decisions — formative SAQs

Formative SAQs on the role of the abdominal radiograph in the acute paediatric abdomen, the ALARA principle and the Pearce 2012 radiation-risk evidence, the ultrasound-first pathway for appendicitis and intussusception, the upper gastrointestinal contrast study for malrotation, and the radiograph for the perforation, the obstruction, and the ingested button battery.

Open

Abscess drainage and minor procedures — formative SAQs

Formative SAQs on abscess drainage and minor paediatric procedures: the bedside decision between a drainable abscess, cellulitis and a necrotising soft tissue infection; the weight-based local anaesthetic dose; the loop drainage technique; the indications for adjuvant antibiotics; and the management of a perianal abscess in a male infant.

Open

Airway suction, oxygen devices and nebuliser technique: SAQ

Short-answer questions on an infant with bronchiolitis failing low-flow oxygen, covering oxygen device classification and escalation, suction technique and complications, and the choice between spacer-MDI and nebuliser for acute wheeze.

Open

Artificial intelligence and clinical decision support in paediatrics — formative SAQs

Formative SAQs on the four classes of paediatric AI, how a machine-learning prediction model is built and where it fails, the validation ladder, the sensitivity-specificity-threshold relationship, alert fatigue and stewardship, automation bias, and the four deployment safeguards.

Open

Audiology and hearing-test interpretation — formative SAQs

Formative SAQs on paediatric audiogram, tympanometry, otoacoustic emissions and ABR interpretation: the degree and type of hearing loss, the Jerger classification, the OAE-to-ABR dissociation of auditory neuropathy, the newborn two-stage screen and the 1-3-6 milestones, and the late-onset risk in congenital cytomegalovirus.

Open

Bag-mask ventilation and basic airway adjuncts: SAQ

Short-answer questions on an apnoeic, bradycardic infant needing immediate airway and ventilation, covering manual ventilation device classification, one- and two-person technique, ventilation rates by context, and airway adjunct selection and contraindications.

Open

Blood gas, electrolyte and acid-base interpretation — formative SAQs

Two MedVellum formative short-answer questions on paediatric blood gas, electrolyte and acid-base interpretation: the five-step systematic method applied to a high-anion-gap metabolic acidosis with Winter's formula and the anion gap, and the management of a mixed acid-base disorder with a venous gas in diabetic ketoacidosis including the corrected sodium and the danger of cerebral oedema. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Bone-marrow aspiration and biopsy principles — formative SAQs

Two MedVellum formative short-answer questions on bone marrow aspiration and biopsy in children: the principle that aspirate and trephine are complementary samples taken at one sitting at the posterior superior iliac spine, with the first pull reserved for morphology and cytogenetics; and the management of a dry tap and bleeding risk in the thrombocytopenic child. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Central venous and arterial access in children — formative SAQs

Formative SAQs on choosing the site, preparing the child, and performing ultrasound-guided central venous and arterial access in children, and on preventing and managing complications.

Open

Chest decompression and intercostal drain insertion — formative SAQs

Formative SAQs on chest decompression and intercostal drain insertion in children: the clinical diagnosis of tension pneumothorax and the immediate needle decompression at the second intercostal space mid-clavicular line or the fourth or fifth intercostal space in the anterior axillary line; the safe triangle and the above-the-rib-below rule; drain sizing by content and age; the never-clamp rule; the ventilated neonate; and the management of complicated parapneumonic effusion and empyema.

Open

Chest radiograph interpretation in children — formative SAQs

Formative SAQs on the technical-quality check, the ABCDEFGH systematic approach, the normal paediatric-specific findings, the radiographic signs, the neonatal film and line positions, and the radiation-aware principle of justification in interpreting the chest radiograph in children.

Open

Defibrillation, cardioversion and transcutaneous pacing — formative SAQs

Two MedVellum formative short-answer questions on paediatric cardiac electrical therapy: delivering an unsynchronised defibrillation shock to a child in ventricular fibrillation at 4 joules per kilogram, and distinguishing synchronised cardioversion of supraventricular tachycardia from transcutaneous pacing of symptomatic bradycardia. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Developmental, cognitive and behavioural assessment tools — formative SAQs

Two MedVellum formative short-answer questions on developmental, cognitive and behavioural assessment tools: the principle that surveillance, screening and diagnostic assessment are three different acts with a scheduled screening programme, and the correct interpretation of a positive screen, the standard-score model and the urgent response to regression. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Echocardiography fundamentals for general paediatricians — formative SAQs

Formative SAQs on the modalities and Z-scores of the paediatric echocardiogram, the systematic report read, the modified Bernoulli equation, and the prostaglandin resuscitation of the duct-dependent neonate.

Open

Electrocardiogram acquisition and interpretation in children — formative SAQs

Formative SAQs on the acquisition, age-specific normal ranges, systematic interpretation, and high-yield abnormal patterns of the paediatric 12-lead ECG, including the QTc, right ventricular dominance of the newborn, and the resuscitation of the paediatric tachyarrhythmia.

Open

Endotracheal intubation and emergency airway equipment — formative SAQs

Two MedVellum formative short-answer questions on paediatric endotracheal intubation: deciding when to secure a definitive airway and sizing the tube, blade and depth by age, and performing rapid sequence intubation with waveform capnography confirmation while preventing hypoxia, oesophageal intubation, right main bronchus intubation and post-extubation stridor. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Gastrostomy, tracheostomy and central-line troubleshooting — formative SAQs

Formative SAQs on recognising the failure modes of the paediatric gastrostomy, tracheostomy and central venous catheter and running the correct bedside algorithm — the tracheostomy emergency sequence, the dislodged gastrostomy and the buried bumper, and central-line occlusion and fracture.

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Genetic and metabolic test selection — formative SAQs

Formative SAQs on the resolution ladder of genetic testing, the diagnostic yields of microarray, exome and rapid whole-genome sequencing, the principles of newborn bloodspot screening by tandem mass spectrometry, the metabolic test panel and its timing, and the consent for the full result space of an exome.

Open

Intraosseous access — formative SAQs

Two MedVellum formative short-answer questions on intraosseous access in children: deciding when to stop attempting intravenous access and place an intraosseous needle in a shocked child, and building the proximal tibial insertion — landmark, weight-based needle, confirmation, drug administration, lidocaine for infusion pain, and the complications to prevent. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Joint aspiration — formative SAQs

Formative SAQs on the indications, relative contraindications, prediction rules, ultrasound-guided technique, synovial fluid interpretation and complications of joint aspiration in infants and children, including the septic-versus-transient-synovitis decision.

Open

Lumbar puncture in infants and children — formative SAQs

Formative SAQs on the indications, contraindications, positioning, technique, CSF interpretation and complications of lumbar puncture in infants and children, including the antibiotics-first rule in suspected bacterial meningitis.

Open

Medical devices, digital health and remote monitoring — formative SAQs

Formative SAQs on the four classes of paediatric medical device, the continuous glucose monitor and pulse oximeter sensor physiologies, the ambulatory glucose profile targets, the equity and accuracy failures of pulse oximetry, and the shared-decision deployment of a remote-monitoring device with a family.

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Nasogastric tube insertion and verification — formative SAQs

Formative SAQs on nasogastric tube insertion and verification in children: the pH verification rule at a threshold of 5.5 or less, the rejection of the deprecated methods, the age-adapted tube size and insertion technique, and the immediate management of a misplaced tube and a Never Event.

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Neuroimaging selection and radiation-aware practice — formative SAQs

Formative SAQs on the choice between CT, MRI, cranial ultrasound and skull radiograph in children, the PECARN head injury prediction rules, the ALARA principle, the attributable cancer risk of paediatric CT, and the counselling of a parent about radiation risk.

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Paediatric ultrasound and point of care ultrasound — formative SAQs

Formative SAQs on the probe selection, lung ultrasound artefact repertoire, the BLUE protocol, the focused assessment with sonography in trauma and its limited sensitivity in children, the intussusception target sign and the pyloric measurement, and ultrasound-guided vascular access in paediatric point-of-care ultrasound.

Open

Paediatric venepuncture and peripheral intravenous access — formative SAQs

Formative SAQs on paediatric venepuncture and peripheral intravenous cannulation, covering site and gauge selection, the comfort bundle, ultrasound-guided access and the management of complications.

Open

Point-of-care glucose, ketone and urinalysis testing — formative SAQs

Two MedVellum formative short-answer questions on the three core paediatric point-of-care tests: the capillary blood glucose meter and its inaccuracy in the neonate from the high haematocrit and the galactose or maltose interference with the glucose dehydrogenase strips with the rule to confirm the critical value with the laboratory plasma glucose, and the blood beta-hydroxybutyrate over the urine acetoacetate in the diabetic ketoacidosis with the ISPAD diagnostic thresholds and the falsely reassuring lagging urine ketones, plus the urine dipstick leukocyte esterase and nitrite performance in the febrile infant with the lower nitrite sensitivity and the screen-versus-culture principle. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Procedural consent, preparation and child-life support — formative SAQs

Formative SAQs on valid consent, assent and capacity for paediatric procedures; the structured pre-procedure preparation conversation by developmental age; the bedside comfort bundle (topical anaesthesia, oral sucrose as absolute volume, breastfeeding, comfort positioning and distraction); the recognition of procedural distress and needle fear; the doctrine of necessity; and the restraint-versus-comfort-position distinction.

Open

Procedural pain: topical anaesthesia, preparation, distraction and non-pharmacological support — formative SAQs

Formative SAQs on the multi-modal comfort bundle for procedural pain in infants and children: agent choice, doses and timings, the methaemoglobinaemia risk of EMLA in the young infant, the sucrose dose, comfort positioning, and when to escalate beyond the bundle to procedural sedation.

Open

Radiation protection and imaging stewardship — formative SAQs

Formative SAQs on the three pillars of radiological protection in children, the linear-no-threshold risk model and the cohort risk estimates, the CT and fluoroscopy dose quantities and the diagnostic reference level, the optimisation levers in paediatric CT, the modern discontinuation of gonadal shielding, and the counselling of a parent about radiation risk.

Open

Safe paediatric procedural sedation — formative SAQs

Formative SAQs on the safe conduct of procedural sedation and analgesia in children: the sedation depth continuum, pre-sedation assessment, fasting and monitoring, the pharmacology of ketamine and nitrous oxide, adverse events and their management, and recovery and discharge.

Open

Simple laceration repair and wound management — formative SAQs

Two MedVellum formative short-answer questions on simple laceration repair and wound management in children: assessing a clean facial laceration and choosing the closure method, analgesia, and aftercare; and managing a contaminated dog bite to the hand with irrigation, the decision against primary closure, antibiotic prophylaxis, tetanus, and safe local anaesthetic dosing. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Suprapubic aspiration and urinary catheterisation: SAQ

Short-answer questions on suprapubic aspiration and urinary catheterisation covering the urine collection methods and their contamination rates, the suprapubic aspiration landmark and the role of the point-of-care ultrasound, the paediatric catheter sizing, and the catheter-associated urinary tract infection prevention bundle.

Open

Umbilical venous and arterial catheterisation — formative SAQs

Two MedVellum formative short-answer questions on umbilical venous and arterial catheterisation in newborns: the two vessel types and courses with the high and low arterial positions, the venous target at the diaphragm, and the Shukla birth-weight depth formula; and the recognition and management of complications including malposition, lower-limb ischaemia, renal artery thrombosis with hypertension, portal vein thrombosis, and line sepsis, with the dwell-time limits of five days for arterial and fourteen days for venous catheters. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Domain

gastroenterology-hepatology-and-nutrition

40

Abdominal wall and umbilical disorders — formative SAQs

Two formative SAQs on abdominal wall and umbilical disorders in children: a newborn with bare bowel to the right of a normal cord testing the distinction of gastroschisis from omphalocele, the embryology, the resuscitation and the surgical pathway; and a six-month-old ex-preterm infant with an irreducible groin mass testing the recognition and emergency management of an incarcerated inguinal hernia alongside the umbilical granuloma treatment question.

Open

Acute abdominal pain in children: SAQ

Short-answer questions on acute abdominal pain in children covering the appendicitis history and migration of pain, the Pediatric Appendicitis Score, ultrasound-first imaging, early analgesia that does not mask the surgical abdomen, the delayed-diagnosis risk of perforation, and the intussusception reduction pathway.

Open

Acute gastroenteritis and infectious diarrhoea — formative SAQs

Two formative SAQs on acute gastroenteritis and infectious diarrhoea in children: a toddler with watery diarrhoea and some dehydration, testing the clinical grading of dehydration and the design of oral rehydration therapy with low-osmolarity solution, early feeding and zinc; and a child with bloody diarrhoea and fever, testing the recognition of dysentery, the cautious antibiotic decision, and the specific threat of haemolytic uraemic syndrome from Shiga-toxin Escherichia coli.

Open

Acute liver failure: SAQ

Short-answer questions on paediatric acute liver failure covering a four-year-old with coagulopathy and altered consciousness, the PALF diagnostic criteria, the role of N-acetylcysteine, and the pathway to liver transplant assessment including why King's College Criteria are not validated in children.

Open

Acute vomiting in infants and children: SAQ

Short-answer questions on acute vomiting in children covering the bilious-vomiting surgical emergency, the age-based differential, the metabolic derangement of pyloric stenosis, clinical dehydration assessment, oral rehydration and the selective role of ondansetron, and the dangerous non-gastrointestinal mimics.

Open

Appendicitis and surgical abdomen — formative SAQs

Two formative SAQs on appendicitis and the surgical abdomen: a nine-year-old with migratory right iliac fossa pain, anorexia and tenderness, testing the Pediatric Appendicitis Score, the ultrasound-first imaging pathway, resuscitation and the choice between laparoscopic appendicectomy and non-operative antibiotics by shared decision; and an irritable three-year-old with a short atypical history plus a bilious vomit, testing the recognition of perforation in the young child and the surgical emergency that a bilious vomit must never let be missed.

Open

Ascites and peritoneal disease: SAQ

Short-answer questions on ascites and peritoneal disease in children covering an eight-year-old with biliary atresia who develops fever and abdominal pain over established ascites, the diagnostic paracentesis and spontaneous bacterial peritonitis threshold, the albumin-based management of SBP, and the stepwise management of cirrhotic ascites including the serum-ascites albumin gradient.

Open

Bilious vomiting and intestinal obstruction — formative SAQs

Two formative SAQs on bilious vomiting and intestinal obstruction: a term neonate with sudden bilious vomiting testing the recognition and emergency management of malrotation with midgut volvulus, and a newborn with abdominal distension and delayed passage of meconium testing the approach to low intestinal obstruction and its differential.

Open

Breastfeeding medicine and lactation support — formative SAQs

Two formative SAQs on breastfeeding medicine and lactation support: a mother with a hot, tender, wedge-shaped breast and fever at three weeks, testing the recognition of the mastitis spectrum, the stepwise management from continued milk removal to antibiotics, and the red flags of abscess; and a fussy, frequently feeding but thriving three-week-old, testing the distinction between perceived and true low supply, the assessment of latch and transfer, and the stepwise management that protects supply.

Open

Chronic and recurrent abdominal pain: SAQ

Short-answer questions on chronic and recurrent abdominal pain covering an eight-year-old with recurrent periumbilical pain, the alarm-feature approach, targeted investigation, and evidence-based management of a functional abdominal pain disorder.

Open

Chronic liver disease, cirrhosis and portal hypertension: SAQ

Short-answer questions on chronic liver disease, cirrhosis and portal hypertension in children covering a five-year-old with biliary atresia presenting with massive haematemesis, the acute variceal bleeding management bundle, the diagnostic criteria and treatment of spontaneous bacterial peritonitis, and the PELD score for transplant listing.

Open

Coeliac disease — formative SAQs

Two formative SAQs on coeliac disease in children: the school-age child with refractory iron-deficiency anaemia and short stature who needs the ESPGHAN 2020 no-biopsy pathway, and the toddler with diarrhoea, a distended abdomen and failure to thrive after weaning onto gluten who needs the gluten-on-board rule and the gluten-free diet.

Open

Constipation and faecal incontinence: SAQ

Short-answer questions on childhood constipation and faecal incontinence covering a five-year-old with overflow soiling, the positive functional diagnosis, red flags, and the disimpaction and maintenance polyethylene glycol regimen with behavioural support.

Open

Dysphagia and oesophageal disorders — formative SAQs

Two formative SAQs on dysphagia and the oesophageal disorders of childhood: a teenager with a food bolus impaction, solid-food dysphagia and atopy, testing the recognition and diagnosis of eosinophilic oesophagitis, the need to biopsy at the impaction endoscopy, and the treatment ladder; and a child with progressive dysphagia to solids and liquids, regurgitation of undigested food and weight loss, testing the differential of achalasia, its confirmation on high-resolution manometry and barium, and the definitive options.

Open

Enteral feeding tubes and home enteral nutrition — formative SAQs

Two formative SAQs on paediatric enteral feeding tubes and home enteral nutrition: the child with severe cerebral palsy and faltering growth referred for a gastrostomy, and the child with a newly passed nasogastric tube whose aspirate pH is 6.5, testing position verification and the management of buried bumper syndrome and a dislodged gastrostomy.

Open

Feeding assessment and paediatric dysphagia — formative SAQs

Two formative SAQs on paediatric dysphagia: the child with cerebral palsy whose cough-free bedside feed cannot be trusted to exclude silent aspiration and who needs a videofluoroscopic swallow study, and the premature infant in the neonatal unit who desaturates with feeds and needs a structured oral feeding pathway with fibreoptic endoscopic evaluation of swallowing.

Open

Food protein-induced enterocolitis and enteropathy — formative SAQs

Two formative SAQs on food protein-induced enterocolitis syndrome: the infant with a recurrent delayed, pallid vomiting collapse after rice cereal who needs recognition of acute FPIES and separation from sepsis, and the formula-fed young infant with chronic intermittent vomiting, diarrhoea and faltering growth who needs recognition of chronic FPIES, the substitute-feed choice and the oral food challenge pathway.

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Formula feeding and complementary feeding — formative SAQs

Two formative SAQs on infant feeding: counselling a parent on safe formula feeding and the timely introduction of complementary foods at around six months, and the work-up of a young infant with iron deficiency anaemia from early whole cow's milk and the principles of correcting it through feeding.

Open

Functional abdominal pain and irritable bowel syndrome: SAQ

Short-answer questions on functional abdominal pain and irritable bowel syndrome covering a twelve-year-old with recurrent pain and altered bowel habit, the Rome IV criteria and IBS subtyping, targeted investigation, and evidence-based biopsychosocial management.

Open

Gastro-oesophageal reflux and reflux disease — short-answer question

Short-answer question on distinguishing physiologic gastro-oesophageal reflux from GORD, the conservative-first stepwise ladder, and the evidence against reflex acid suppression in unsettled infants.

Open

Gastrointestinal bleeding — formative SAQs

Two formative SAQs on gastrointestinal bleeding in children: a toddler with painless bright red rectal bleeding testing the recognition and investigation of a Meckel diverticulum, and an infant with colicky pain, vomiting and bloody stool testing the recognition and emergency management of intussusception.

Open

Hirschsprung disease — formative SAQs

Two formative SAQs on Hirschsprung disease: a term neonate with delayed passage of meconium and abdominal distension testing the diagnostic pathway and preoperative management, and an infant with known Hirschsprung disease presenting with fever and explosive diarrhoea testing the recognition and emergency management of Hirschsprung-associated enterocolitis.

Open

Inflammatory bowel disease: SAQ

Short-answer questions on inflammatory bowel disease in children covering a thirteen-year-old with weight loss, growth faltering, and perianal disease, the ESPGHAN revised Porto criteria, the role of exclusive enteral nutrition, and stepwise management including biologics.

Open

Intussusception — formative SAQs

Two formative SAQs on intussusception in children: a seven-month-old with intermittent colicky screaming, vomiting and a sausage-shaped mass, testing recognition of the rhythmic pattern, the ultrasound target sign, resuscitation before reduction and air enema as first-line therapy; and a four-year-old with intussusception, testing the recognition of a pathological lead point and the move towards surgery alongside the rotavirus vaccine risk-benefit question.

Open

Liver transplantation in children: SAQ

Short-answer questions on paediatric liver transplantation covering a three-year-old with biliary atresia being assessed for transplant and listing by the PELD score, and the management of a post-transplant child with suspected acute cellular rejection including the role of tacrolimus therapeutic drug monitoring and the differentiation from hepatic artery thrombosis.

Open

Malnutrition: nutritional rehabilitation and monitoring — formative SAQs

Two formative SAQs on acute malnutrition and its nutritional rehabilitation in children: a wasted 16-month-old with appetite loss testing the recognition of complicated severe acute malnutrition, the WHO phased rehabilitation from F-75 stabilisation to F-100 catch-up, and the prevention of refeeding syndrome through phosphate, potassium and magnesium monitoring and thiamine; and a malnourished child with dehydration testing the choice of ReSoMal over standard oral rehydration solution and the handling of the sodium-and-fluid-intolerant malnourished heart.

Open

Malrotation and volvulus — formative SAQs

Formative SAQs on malrotation and volvulus: acting on bilious vomiting in a previously well neonate as a midgut volvulus until proven otherwise, choosing the upper gastrointestinal contrast study over a reassuring plain film, the whirlpool sign, and describing the Ladd procedure step by step; and the older child with recurrent bilious vomiting and intermittent volvulus alongside the management of incidental asymptomatic malrotation.

Open

Micronutrient deficiencies — formative SAQs

Two formative SAQs on micronutrient deficiencies in children: the iron-deficient toddler with pallor, pica and faltering growth who needs the twelve-month screen and oral iron, and the exclusively breastfed infant of a vegan mother with apathy and developmental regression who needs urgent parenteral hydroxocobalamin for vitamin B12 deficiency.

Open

Non-alcoholic fatty liver disease in children — formative SAQs

Two formative SAQs on paediatric fatty liver disease, now named metabolic dysfunction-associated steatotic liver disease: the overweight eleven-year-old boy found on screening to have a mildly raised alanine aminotransferase who needs the NASPGHAN sex-specific thresholds and family-based lifestyle therapy, and the obese adolescent with persistent enzyme elevation who needs exclusion of mimics, fibrosis staging, and a discussion of pharmacotherapy and bariatric surgery.

Open

Normal nutritional requirements across childhood: SAQ

Short-answer questions on normal nutritional requirements across childhood covering a seven-month-old breastfed infant starting complementary feeding, the energy and protein requirements by age, and the prevention of iron and vitamin D deficiency across childhood.

Open

Nutritional management of chronic disease — formative SAQs

Two formative SAQs on the nutritional management of chronic disease in children: the cardiac infant with a large ventricular septal defect and failure to thrive who needs fortified feeds and a stepped plan to reach one hundred and fifty kilocalories per kilogram per day, and the child with newly diagnosed Crohn disease and growth failure who is offered six to eight weeks of exclusive enteral nutrition for induction and nutritional repletion.

Open

Oesophagitis, caustic ingestion and oesophageal injury — formative SAQs

Two formative SAQs on paediatric oesophageal injury: the toddler with a suspected oesophageal button battery requiring emergency removal within two hours, and the toddler with a caustic ingestion managed airway-first with graded endoscopy and stricture surveillance.

Open

Paediatric feeding disorder: nutritional and gastrointestinal management — formative SAQs

Two formative SAQs on the nutritional and gastrointestinal management of paediatric feeding disorder: the child with food refusal, faltering growth and poorly controlled reflux whose feeding aversion is layered on a medical driver, and the former premature infant who is tube-dependent at eighteen months and needs a structured multidisciplinary weaning plan.

Open

Pancreatitis and pancreatic disorders — formative SAQs

Two formative SAQs on pancreatitis and pancreatic disorders in children: the eight-year-old on valproate who presents with acute pancreatitis needing the NASPGHAN criteria and early aggressive hydration, and the child with recurrent pancreatitis who needs the genetic workup and the distinction between acute recurrent and chronic disease.

Open

Parenteral nutrition and refeeding syndrome — formative SAQs

Two formative SAQs on parenteral nutrition and refeeding syndrome in children: a malnourished adolescent with anorexia nervosa admitted for refeeding, testing refeeding risk, the insulin-driven biochemistry, thiamine and conservative starting calories and the daily monitoring of phosphate, potassium and magnesium; and a premature infant on long-term parenteral nutrition with a rising conjugated bilirubin, testing the composition streams, the glucose infusion rate, the prevention of intestinal failure-associated liver disease and the lipid strategy.

Open

Peptic disease and Helicobacter pylori — formative SAQs

Formative SAQs on the endoscopy-first, susceptibility-guided approach to peptic disease and H. pylori in children.

Open

Persistent and chronic diarrhoea — formative SAQs

Two formative SAQs on persistent and chronic diarrhoea in children: the thriving toddler with loose stools who needs a positive diagnosis of toddler's diarrhoea and reassurance, and the school-age child with chronic bloody diarrhoea, weight loss and faltering growth who needs a coeliac and inflammatory-bowel-disease workup.

Open

Polyps and inherited gastrointestinal cancer syndromes: SAQ

Short-answer questions on paediatric gastrointestinal polyps covering an eight-year-old with multiple juvenile polyps, the criteria that separate an isolated polyp from juvenile polyposis syndrome, the genes and cancer risks of the inherited syndromes, and the surveillance and genetic-testing plan.

Open

Short-bowel syndrome and intestinal failure — formative SAQs

Two formative SAQs on short-bowel syndrome and intestinal failure in children: a premature neonate after necrotising enterocolitis resection with a high-output jejunostomy testing classification, the sodium principle, IFALD prevention and the rehabilitation ladder; and an older child on home parenteral nutrition testing the role of teduglutide, serial transverse enteroplasty and the indications for transplant.

Open

Viral, autoimmune and metabolic hepatitis — formative SAQs

Two formative SAQs on paediatric hepatitis: the perinatally infected school-age child with chronic hepatitis B in the immune-tolerant phase who needs surveillance not treatment, and the adolescent girl with fatigue, amenorrhoea, a raised immunoglobulin G and a positive antinuclear antibody who needs the simplified autoimmune hepatitis score and the prednisolone-and-azathioprine induction.

Open

Domain

preventive-and-community-paediatrics

37

Aboriginal and Torres Strait Islander child health — formative SAQs

Formative SAQs on cultural safety, structural inequities, ear and lung pathways, and partnered care for Aboriginal and Torres Strait Islander children.

Open

Adolescent preventive health care — formative SAQs

Two formative short-answer questions on confidential adolescent preventive visits, HEADSS/HEEADSSS, screening and safety overrides.

Open

Air pollution, tobacco smoke and vaping — formative SAQs

Formative SAQs on SHS counselling, youth vaping and household air pollution.

Open

Cardiovascular risk screening in childhood — formative SAQs

Formative SAQs on paediatric BP and lipid screening.

Open

Catch-up immunisation and uncertain vaccination history — formative SAQs

Formative SAQs on dose validity, uncertain history and multi-visit catch-up planning.

Open

Childcare attendance, exclusion and infection prevention — formative SAQs

Formative SAQs on exclusion principles, infection prevention and outbreak response in early childhood education and care.

Open

Childhood injury prevention and anticipatory guidance — formative SAQs

Formative SAQs on Haddon framing, age-banded anticipatory guidance, passive strategies and button-battery urgency.

Open

Climate change, heat and child health — formative SAQs

Formative SAQs on heat-stroke recognition, cool-first care, sports acclimatisation and climate-equity counselling.

Open

Community needs assessment and child-health advocacy — formative SAQs

Formative SAQs on needs-assessment cycles, partnership ethics and multi-level child-health advocacy.

Open

Developmental and behavioural screening — formative SAQs

Two formative SAQs on key-age developmental screening, M-CHAT-R/F pathway, behavioural screening and closed-loop referral.

Open

Drowning prevention and water safety — formative SAQs

Formative SAQs on layered drowning prevention, pool fencing, bath safety and emergency response.

Open

Environmental health and children's exposure risks — formative SAQs

Formative SAQs on environmental history, private wells, pesticides and source-control priorities.

Open

Global child health and sustainable paediatric care — formative SAQs

Formative SAQs on global under-five mortality packages and sustainable care.

Open

Housing insecurity, food insecurity and child health — formative SAQs

Formative SAQs on Hunger Vital Sign screening, housing domains and clinic-to-community management.

Open

Immunisation principles and national schedule comparison — formative SAQs

Formative SAQs on immunisation principles.

Open

Indigenous child health and culturally safe care — formative SAQs

Formative SAQs on cultural safety, structural drivers and clinic partnership for Indigenous child health.

Open

Infant health supervision 3–6 months — formative SAQs

Formative SAQs on the 4- and 6-month health-supervision visit, safe sleep, maternal mood and feeding guidance.

Open

Infant health supervision 6–12 months — formative SAQs

Two formative short-answer questions on structuring a 9-month health-supervision visit and managing iron-risk feeding plus developmental concern.

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Infant health supervision birth to 3 months — formative SAQs

Two formative short-answer questions on early post-discharge weight and jaundice management and on structured 2-month health supervision including safe sleep and maternal mental health.

Open

Lead exposure and poisoning prevention — formative SAQs

Formative SAQs on childhood lead screening, source control and chelation limits.

Open

Māori child health, Te Tiriti and culturally safe care — formative SAQs

Formative SAQs on cultural safety, Te Tiriti-informed practice, Hui Process and equity pathways for tamariki Māori.

Open

Newborn bloodspot screening for inherited metabolic disease and follow-up — formative SAQs

Two formative SAQs on critical bloodspot positives in well neonates, incomplete cards, galactosaemia feed safety and MCADD crisis pathways.

Open

Newborn hearing screening — formative SAQs

Two formative SAQs on newborn hearing screening result states, 1-3-6 pathway, NICU modality choice, residual risk after pass and lost-to-follow-up recovery.

Open

Newborn preventive care and screening — formative SAQs

Two formative SAQs on the newborn preventive package, incomplete screens, CCHD fail pathway, hearing refer and vitamin K counselling.

Open

Passenger, bicycle, pedestrian and firearm safety — formative SAQs

Formative SAQs on child passenger restraint staging, helmet and pedestrian counselling, and firearm safe storage.

Open

Population health, epidemiology and prevention in paediatrics — formative SAQs

Formative SAQs on population definition, Rose strategy, Haddon matrix and absolute risk counselling.

Open

Preschool health supervision — formative SAQs

Formative SAQs on preschool preventive visits, school readiness and sensory gates.

Open

Preventive paediatrics and the well-child visit — formative SAQs

Two formative SAQs on well-child visit architecture, developmental surveillance versus screening, and equity redesign.

Open

Rural, regional and remote child-health inequities — formative SAQs

Formative SAQs on rural inequity mechanisms, paediatric readiness, telehealth/retrieval disposition and medical-home loop closure.

Open

Safe sleep and sudden unexpected death prevention — formative SAQs

Formative SAQs on safe-sleep counselling, hazards and unexpected infant death response.

Open

School health and school-based care — formative SAQs

Formative SAQs on school health plans, SBHC integration, anaphylaxis readiness and return-to-learn.

Open

School-age health supervision — formative SAQs

Formative SAQs on school-age health supervision, screening tiers and anticipatory guidance.

Open

Screening test principles in children — formative SAQs

Formative SAQs on programme criteria, predictive values in low prevalence, and false-positive counselling.

Open

Sun protection and skin cancer prevention — formative SAQs

Formative SAQs on layered childhood photoprotection, indoor tanning and vitamin D counselling.

Open

Toddler health supervision: 1 to 3 years — formative SAQs

Formative SAQs on toddler preventive visits, autism screening pathway and anticipatory guidance.

Open

Vaccine contraindications, precautions and adverse events — formative SAQs

Two formative short-answer questions on true versus false contraindications, live-vaccine rules, anaphylaxis response and AEFI planning.

Open

Vaccine hesitancy and risk communication — formative SAQs

Two formative short-answer questions on SAGE determinants and structured clinic risk communication for vaccine delay and refusal.

Open

Domain

neurology-neurodisability-and-neuromuscular

40

Absence, focal and generalised epilepsies — formative SAQs

Formative SAQs on absence, focal and generalised epilepsies: classifying the seizure and the syndrome from the eyewitness account and the EEG, choosing the syndrome-matched first-choice antiseizure medicine, applying the valproate rule in a female adolescent, and recognising the carbamazepine-worsens-absence error.

Open

Acute disseminated encephalomyelitis and demyelinating disease — formative SAQs

Formative SAQs on acute disseminated encephalomyelitis and the acquired demyelinating syndromes of childhood: recognising the first event and the mandatory encephalopathy that defines ADEM, driving the antibody-led pathway that separates ADEM, MOGAD, paediatric multiple sclerosis, and neuromyelitis optica spectrum disorder, treating the acute event with high-dose corticosteroids with escalation to immunoglobulin or plasma exchange when steroid-refractory, and never starting a multiple-sclerosis disease-modifying therapy before the antibody status is known.

Open

Acute neuromuscular respiratory failure: SAQ

Short-answer questions on paediatric acute neuromuscular respiratory failure covering the respiratory pump and the two mechanisms of failure, the bedside forced vital capacity, maximum inspiratory pressure, and maximum expiratory pressure monitoring with the Lawn twenty-thirty-forty thresholds, the airway decision between non-invasive ventilation when bulbar function is intact and intubation for bulbar weakness, the avoidance of suxamethonium and use of rocuronium, the differential across the motor unit, and the disease-specific therapy for Guillain-Barre syndrome, myasthenic crisis, infant botulism, and spinal muscular atrophy.

Open

Antiseizure medicines: selection, adverse effects and monitoring — formative SAQs

Formative SAQs on antiseizure medicine selection, adverse effects and monitoring: classifying the drug by spectrum and enzyme effect, choosing the syndrome-matched first-choice medicine, recognising the adverse-effect signature of each agent, applying the valproate pregnancy prevention programme, and managing the lamotrigine rash scenario.

Open

Ataxia in children: SAQ

Short-answer questions on ataxia in children covering the diagnosis and benign prognosis of post-infectious acute cerebellar ataxia, the red-flag screen and urgent imaging decision for a posterior fossa tumour, and the clinical and genetic diagnosis of Friedreich ataxia with the omaveloxolone evidence.

Open

Autoimmune encephalitis: SAQ

Short-answer questions on paediatric autoimmune encephalitis covering the Graus 2016 diagnostic criteria, the anti-NMDAR presentation across age groups, the first-line and second-line immunotherapy ladder with doses and timing, the ovarian teratoma association, the post-herpes simplex trigger, and the Titulaer outcome data.

Open

Brain death, death by neurological criteria and organ donation: SAQ

Short-answer questions on brain death and death by neurological criteria in a child, covering the irreversible cessation of all function of the entire brain including the brainstem, the prerequisites and the confounders, the bedside examination of the absent brainstem reflexes, the apnoea test with the PaCO2 thresholds, the two clinical evaluations separated by the observation period, and the donation after brain death pathway.

Open

Cerebral vascular malformations: SAQ

Short-answer questions on cerebral vascular malformations in children covering the classification, the haemorrhage presentation of the arteriovenous malformation, the imaging pathway, the Spetzler-Martin grade, the Bicetre neonatal evaluation score for the vein of Galen malformation, and the management of the cavernous malformation.

Open

Concussion and mild traumatic brain injury — formative SAQs

Two formative SAQs on concussion and mild traumatic brain injury: a fourteen-year-old rugby player who is briefly dazed after a tackle and plays on, testing the sideline recognition, the imaging decision with the PECARN and CATCH rules, and the graduated return to learn before return to sport; and an eleven-year-old girl whose symptoms persist six weeks after a fall, testing the definition of persistent post-concussion symptoms, the predictors of a prolonged course, and the active rehabilitation that replaces further rest.

Open

Congenital myopathies and muscular dystrophies: SAQ

Short-answer questions on paediatric congenital myopathies and congenital muscular dystrophies covering the creatine kinase fork, the merosin-deficient LAMA2 form with white matter changes, the dystroglycanopathies with cobblestone lissencephaly, the collagen VI and LMNA forms, the central core RYR1 and nemaline and centronuclear myopathies, the next-generation sequencing panel, the respiratory and nutritional and orthopaedic management, and the malignant hyperthermia and cardiac surveillance.

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Developmental regression and neurodegeneration — formative SAQs

Formative SAQs on developmental regression and neurodegeneration: recognising regression as a red flag, distinguishing true progressive regression from plateau and static loss, reading the bedside pattern and tempo to generate a structured differential, deploying a tiered neuro-investigation strategy, and never accepting a degenerative label until the treatable causes - autoimmune encephalitis, epileptic encephalopathies, GLUT1 deficiency, cerebral adrenoleukodystrophy - have been actively excluded.

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Duchenne and Becker muscular dystrophy: SAQ

Short-answer questions on Duchenne and Becker muscular dystrophy covering the creatine kinase and the genetic confirmation, the glucocorticoid backbone with prednisolone or deflazacort started at the motor plateau, the cardiac and respiratory surveillance, the reading-frame hypothesis, and the precision therapies of exon-skipping and adeno-associated-virus gene therapy, with the FOR-DMD and EMBARK trial evidence.

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Epilepsy syndromes by age — formative SAQs

Formative SAQs on naming the ILAE 2022 epilepsy syndrome from age, seizure semiology and EEG; matching the syndrome to its first-choice antiseizure medicine; and recognising and avoiding the drugs that worsen specific syndromes, including Dravet syndrome and the genetic generalised epilepsies.

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Febrile seizures: SAQ

Short-answer questions on febrile seizures covering the classification and acute termination of a prolonged convulsion, the case against routine prophylaxis, the 2011 AAP lumbar-puncture thresholds, and the counselling of an anxious family on recurrence and prognosis.

Open

First seizure and seizure mimics — formative SAQs

Two formative SAQs on the first seizure and its mimics: an eight-year-old who collapses and jerks briefly while standing in a hot assembly hall, testing the seizure-versus-syncope decision and the work-up that follows; and a fifteen-year-old girl with recurrent episodes that have proved resistant to two antiseizure drugs, testing the recognition and confirmation of psychogenic non-epileptic seizures and the correct pathway to cognitive behavioural therapy.

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Guillain-Barré syndrome and acute flaccid paralysis: SAQ

Short-answer questions on paediatric Guillain-Barré syndrome and acute flaccid paralysis covering the Brighton diagnostic criteria, the albuminocytological dissociation, the ascending areflexic presentation, the first-line intravenous immunoglobulin dose of 2 g per kg over two to five days, the respiratory monitoring with forced vital capacity thresholds, the lack of benefit of corticosteroids, the acute flaccid paralysis differential including acute flaccid myelitis, and the paediatric recovery course.

Open

Headache and migraine in children: SAQ

Short-answer questions on headache and migraine in children covering the ICHD-3 diagnosis of migraine and the red-flag screen, the acute abortive pathway with ibuprofen and a triptan, and the stepped prophylaxis built on lifestyle and cognitive behavioural therapy in light of the CHAMP trial.

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Hydrocephalus and shunt emergencies: SAQ

Short-answer questions on paediatric hydrocephalus and shunt emergencies covering the Rekate functional classification, the age-specific presentation of raised intracranial pressure, the shunt series and the CT or rapid MRI head compared to baseline, the shunt tap, the hyperosmolar bridge to theatre, and the distinction of obstruction from overdrainage and infection.

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Hypoxic-ischaemic brain injury: SAQ

Short-answer questions on paediatric hypoxic-ischaemic brain injury covering the primary versus secondary injury split, the THAPCA out-of-hospital and in-hospital trial results and the Bayesian reanalysis, the targeted temperature management protocol, the neurocritical care bundle, and the multimodal neuroprognostication deferred to at least 72 hours.

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Infantile spasms and developmental epileptic encephalopathy — formative SAQs

Formative SAQs on recognising West syndrome (infantile epileptic spasms syndrome) from clustered epileptic spasms, hypsarrhythmia and developmental regression, applying the ILAE 2022 definition, explaining the immature-cortex and CRH stress-axis mechanism, choosing first-line vigabatrin-versus-hormonal therapy by the tuberous sclerosis decision fork, and counselling that aetiology and speed of spasm cessation drive developmental outcome.

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Moderate and severe traumatic brain injury: SAQ

Short-answer questions on moderate and severe paediatric traumatic brain injury covering the Glasgow Coma Scale severity bands and intubation threshold, the intracranial pressure treatment threshold and cerebral perfusion pressure target, the stepwise management ladder with hyperosmolar doses, the prevention of secondary brain injury, and the evidence from the Hutchison hypothermia and DECRA decompressive craniectomy trials.

Open

Movement disorders, dystonia and chorea: SAQ

Short-answer questions on paediatric movement disorders covering the classification of hyperkinetic movements, the status dystonicus emergency and its escalation ladder, the acute dystonic reaction and its reversal, the empiric levodopa trial in dopa-responsive dystonia, Sydenham chorea as a major Jones criterion with penicillin prophylaxis, Wilson disease screening, and the dystonic cerebral palsy management ladder.

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Myasthenia gravis and neuromuscular junction disorders: SAQ

Short-answer questions on paediatric myasthenia gravis and neuromuscular junction disorders covering the fatigable fluctuating weakness with preserved reflexes and pupils, the acetylcholine receptor and muscle-specific kinase antibody subtypes, the ice pack test and repetitive nerve stimulation, pyridostigmine dosing, the corticosteroid transient worsening with early steroid-sparing, the intravenous immunoglobulin 2 g per kg and plasma exchange for crisis, the forced vital capacity thresholds for intensive care, thymectomy after the MGTX trial, eculizumab for refractory disease, and the subtype-specific treatment of the congenital myasthenic syndromes including the forms worsened by pyridostigmine.

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Neural tube defects and spinal dysraphism: SAQ

Short-answer questions on paediatric neural tube defects and spinal dysraphism covering the periconceptional folic acid prophylaxis, the open and closed classification, the maternal serum alpha-fetoprotein and fetal ultrasound, the neonatal management of myelomeningocele, the Chiari II malformation and hydrocephalus, and the tethered cord and neurogenic bladder management.

Open

Neurodegenerative and leukodystrophy disorders — formative SAQs

Formative SAQs on neurodegenerative and leukodystrophy disorders: reading the contrasted brain MRI to name the mechanism group, recognising the transplant emergency of cerebral X-linked adrenoleukodystrophy, deploying a magnetic-resonance-imaging-led tiered workup, and understanding that the treatable leukodystrophies are treated before symptoms begin through newborn screening and presymptomatic gene therapy or transplant.

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Neurogenetic conditions and precision diagnosis: SAQ

Short-answer questions on paediatric precision diagnosis covering the tiered genomic testing ladder from chromosomal microarray through trio exome and genome sequencing with their diagnostic yields, rapid whole-genome sequencing in the acutely ill infant, the American College of Medical Genetics five-tier variant classification and the management of the variant of uncertain significance, the dominance of de novo change in sporadic severe neurodevelopmental disease, periodic reanalysis, and the treatable neurogenetic conditions unlocked by a molecular diagnosis including glucose transporter one deficiency and the ketogenic diet, creatine transporter deficiency and creatine, dopa-responsive dystonia and levodopa, and biotinidase deficiency and biotin.

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Neurological examination across childhood — formative SAQs

Formative SAQs on performing the age-adapted paediatric neurological examination, reading tone and reflexes through the developmental clock, using the Hammersmith Infant Neurological Examination and General Movements Assessment to detect cerebral palsy early, splitting the floppy infant into central versus peripheral causes, and acting on red-flag findings with urgent imaging and referral.

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Neurorehabilitation and acquired brain injury: SAQ

Short-answer questions on neurorehabilitation after acquired brain injury in children, covering the definition and the International Classification of Functioning framework, the neuroplastic recovery curve, the multidisciplinary goal-directed model, the motor interventions of constraint-induced and bimanual therapy, the spasticity management ladder with the botulinum toxin-A dosing ceiling, the cognitive rehabilitation and the return to school, and the late-emerging executive deficits and the predictors of outcome.

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Non-epileptic events and functional seizures — formative SAQs

Two formative SAQs on non-epileptic events and functional seizures: a fourteen-year-old referred for spells unresponsive to two escalating antiseizure drugs, testing the recognition and video-electroencephalogram confirmation of a functional seizure and the correct pathway of explanation, drug withdrawal and cognitive behavioural therapy; and a sixteen-year-old brought to the emergency department in a prolonged flurry of attacks, testing the safe management of status non-epilepticus and the safeguarding history that the presentation demands.

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Paediatric stroke and cerebral sinovenous thrombosis: SAQ

Short-answer questions on paediatric stroke and cerebral sinovenous thrombosis covering the classification, the arteriopathy cause search, the imaging pathway, the antithrombotic therapy for arterial ischaemic stroke, the anticoagulation for cerebral sinovenous thrombosis, and the Thrombolysis in Pediatric Stroke trial findings.

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Pain, feeding and respiratory care in severe neurodisability: SAQ

Short-answer questions on the three threats that dominate severe neurodisability covering pain assessment in non-verbal children with the revised FLACC and Paediatric Pain Profile and the search for treatable sources, feeding failure with the instrumental swallow study and the role of gastrostomy and reflux management, and the respiratory pathway of weak cough sialorrhoea aspiration and sleep-disordered breathing leading to recurrent chest infection with the prevention bundle of airway clearance antisialogogues and non-invasive ventilation.

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Peripheral neuropathies: SAQ

Short-answer questions on paediatric peripheral neuropathies covering the Charcot-Marie-Tooth classification with CMT1A from PMP22 duplication, the nerve conduction velocity threshold of thirty-eight metres per second, the clinical phenotype of pes cavus and distal wasting, the chronic inflammatory demyelinating polyradiculoneuropathy criterion of more than eight weeks and treatment with intravenous immunoglobulin and corticosteroids, and the vincristine precaution in suspected Charcot-Marie-Tooth disease.

Open

Secondary headache and raised intracranial pressure — formative SAQs

Two formative SAQs on secondary headache and raised intracranial pressure: an eight-year-old with a progressive morning headache and early-morning vomiting, testing the red-flag recognition, the choice and timing of imaging, and the safe triage of a suspected brain tumour; and a fourteen-year-old girl with obesity, daily headache, and papilloedema, testing the Friedman 2013 diagnostic criteria, the work-up to separate idiopathic from secondary intracranial hypertension, and the stepwise management that protects vision.

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Sleep disorders with neurological disease: SAQ

Short-answer questions on sleep disorders with neurological disease covering the four-cluster classification and the bidirectional mechanism, the investigation pathway from polysomnography to the multiple sleep latency test and cerebrospinal fluid orexin, and the stepped management built on sleep hygiene and behavioural therapy with melatonin, iron, airway support, and ventilation.

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Spasticity, dystonia and tone management: SAQ

Short-answer questions on paediatric spasticity, dystonia and tone management covering the Sanger classification of hypertonia into velocity-dependent spasticity and action-induced dystonia, the goal-directed principle that tone is treated only when it limits function comfort or care, the Modified Tardieu Scale and the GMFCS levels, the four core modalities of focal botulinum toxin type A with non-interchangeable products and a twelve-week interval, oral and intrathecal baclofen with the medical-emergency withdrawal syndrome, selective dorsal rhizotomy for the ambulant spastic diplegic child, the dystonia pathway from trihexyphenidyl to GPi deep brain stimulation, and the multidisciplinary prevention of contracture hip subluxation scoliosis and pain.

Open

Spinal cord compression and transverse myelitis — formative SAQs

Formative SAQs on the acute spinal cord syndrome in childhood: recognising that new back pain plus a neurological deficit is a cord emergency until an emergency whole-spine MRI proves otherwise, separating the structural compressive lesion (tumour, epidural abscess) that needs dexamethasone and surgical decompression from the intrinsic inflammatory transverse myelitis that needs high-dose methylprednisolone, the Transverse Myelitis Consortium 2002 criteria including the 4-hour-to-21-day progression window, the longitudinally extensive lesion pointing to neuromyelitis optica spectrum disorder or MOG-antibody-associated disease, and the paediatric malignancies that present with cord compression.

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Spinal muscular atrophy: SAQ

Short-answer questions on paediatric spinal muscular atrophy covering the SMN1 deletion genetics with the SMN2 copy number modifier, the five SMA types, the clinical picture of symmetric proximal hypotonia and areflexia with tongue fasciculations and spared intellect, the genetic diagnosis by homozygous SMN1 deletion, the three disease-modifying therapies nusinersen risdiplam and onasemnogene abeparvovec with their trial evidence, newborn screening and presymptomatic treatment, and the multidisciplinary respiratory nutritional and orthopaedic care.

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Status epilepticus: SAQ

Short-answer questions on paediatric status epilepticus covering the ILAE operational definition, the APLS stepwise pathway from benzodiazepine to levetiracetam or fosphenytoin to anaesthetic infusion, the pharmacodynamic basis for declining benzodiazepine efficacy, the trial evidence from ESETT, ConSEPT, and EcLiPSE, and the reversible causes and the role of continuous EEG.

Open

Tics and Tourette syndrome: SAQ

Short-answer questions on tics and Tourette syndrome covering the DSM-5 diagnosis and the phenomenology that separates a tic from its mimics, the stepped management built on Comprehensive Behavioural Intervention for Tics with alpha-2 agonists and antipsychotics, and the central role of the comorbid attention-deficit or hyperactivity disorder and obsessive-compulsive disorder.

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Transition and advance care planning in neurodisability: SAQ

Short-answer questions on transition and advance care planning in young people with neurodisability, covering the Got Transition Six Core Elements with the age milestones of twelve fourteen eighteen and twenty-one, the distinction between transition and transfer, the transition readiness tools and the named coordinator, the dangerous transition gap with loss to follow-up and deterioration, and paediatric advance care planning across the four domains of goals of care ceiling of treatment resuscitation decisions and preferred place of care, integrated with disease-modifying treatment across the disease trajectory.

Open

Domain

child-safety-and-social-paediatrics

32

Abusive head trauma — formative SAQs

Formative SAQs on recognising abusive head trauma, building the probability of inflicted injury, the imaging and skeletal-survey workup, safeguarding from minute zero, and the medical mimics and triad debate.

Open

Caregiver-fabricated or induced illness — formative SAQs

Formative SAQs on recognising caregiver-fabricated or induced illness, the child-centred definition that replaced Munchausen syndrome by proxy, the RCPCH alerting features, the three mechanisms of harm, and the multi-agency safeguarding response that never confronts the suspected caregiver alone.

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Child maltreatment recognition and response — formative SAQs

Formative SAQs on the recognition-to-response bundle for a sentinel injury and the workup for suspected abusive head trauma, including the TEN-4-FBCP rule, the skeletal-survey standard, the mandatory-reporting trigger, and the trauma-informed examination.

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Child sexual abuse and assault assessment — formative SAQs

Two formative short-answer questions on the tempo of the child sexual abuse assessment, the ano-genital examination and finding interpretation, and the acute assault management bundle with its time-limited elements.

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Children in out-of-home care and foster care — formative SAQs

Two formative short-answer questions on the entry-to-care health assessment, the toxic-stress mechanism, consent authority, conditional confidentiality, attachment and developmental need, and permanency and transition for care-experienced children.

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Expert reports and court evidence in child protection — formative SAQs

Two formative SAQs on expert reports and court evidence in child protection: the witness-of-fact versus expert-witness distinction, the structure of a defensible expert report, the standard of proof, the evidence chain, and the preparation for cross-examination.

Open

Female genital mutilation or cutting — formative SAQs

Two formative short-answer questions on the WHO classification and safeguarding response to FGM, and the acute management of complications and the deinfibulation pathway for Type III infibulation.

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Homelessness and housing instability — formative SAQs

Two formative SAQs on homelessness and housing instability as a paediatric health problem: the housing continuum and the vital-sign screening principle, the five domains of clustered morbidity, the toxic-stress mechanism, the portable health summary, the housing intervention evidence, and the defensible screening-to-stable-housing pathway.

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Inflicted abdominal and thoracic injury — formative SAQs

Formative SAQs on recognising high-specificity inflicted trunk injury, the AST/ALT and lipase occult-injury screen, mandatory skeletal survey, and concurrent trauma-and-safeguarding management.

Open

Inflicted burns and scalds — formative SAQs

Formative SAQs on pattern-based recognition of inflicted burns and scalds, the BuRN-Tool decision rule, co-existing injury assessment, the mandatory safeguarding pathway, and primary prevention with the SafeTea programme.

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Inflicted fractures and other non-accidental musculoskeletal injury — formative SAQs

Two formative SAQs on the high-specificity fracture patterns for abuse, the shearing biomechanics of the classic metaphyseal lesion, the mandatory skeletal-survey protocol with the follow-up survey, and the safeguarding-first, multi-domain assessment in which no fracture is pathognomonic and specificity outranks sensitivity.

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Intimate partner violence and its impact on children — formative SAQs

Formative SAQs on recognising IPV exposure in children, the toxic-stress mechanism and co-occurrence with maltreatment, trauma-informed assessment and screening, the parallel safety-and-response bundle, and regional reporting thresholds.

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Intra-oral injury and occult trauma — formative SAQs

Formative SAQs on recognising inflicted intra-oral injury as a sentinel sign, applying the TEN-4 FACES-B bruising rule, screening for occult trauma (skeletal survey, neuroimaging, ophthalmology, transaminases), and executing the safeguarding pathway with mandatory reporting.

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Kinship care, adoption and permanency health assessments — formative SAQs

Two formative SAQs on the health assessment of children in out-of-home care: the staged assessment schedule, consent and guardianship, developmental-trauma mechanism, the Aboriginal and Torres Strait Islander Child Placement Principle, and the multidomain care plan.

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Mandatory reporting and jurisdictional child-protection frameworks — formative SAQs

Two formative SAQs on mandatory reporting and jurisdictional child-protection frameworks: the reasonable-belief threshold, jurisdictional variation in reporting obligations, barriers and enablers to clinician reporting, and the defensible recognise-to-report pathway.

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Medical neglect and refusal of care — formative SAQs

Two formative SAQs on the omission-versus-rejection definitions, the Diekema harm-principle threshold, the four classic refusal scenarios (vaccines, vitamin K, Jehovah's Witness blood transfusion, cancer chemotherapy), separating access-based neglect from deliberate refusal, the stepped negotiate-to-escalate management, and the mature-minor doctrine.

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Multidisciplinary child-protection case conference — formative SAQs

Two formative SAQs on the multidisciplinary child-protection case conference: the statutory purpose and conference types, the paediatrician's preparation and written report, information-sharing principles, decision-making biases, and the defensible prepare-present-plan algorithm.

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Neglect and supervisory neglect — formative SAQs

Two formative SAQs on the omission-versus-commission definition, the six neglect domains, the supervision-and-injury evidence of Saluja and Morrongiello, separating neglect from poverty, the stepped multi-agency plan pairing support with mandatory reporting, and the closed-loop reduce-recurrence disposition.

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Online sexual exploitation and image-based abuse — formative SAQs

Formative SAQs on recognising online sexual exploitation and image-based abuse, the grooming-to-sextortion mechanism, acute-suicide-risk-first assessment, evidence preservation, the dual reporting pathway, and the regional safeguarding architecture.

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Perplexing presentations and diagnostic uncertainty — formative SAQs

Formative SAQs on the child whose reported symptoms do not fit any recognised disease: the RCPCH three-level escalation, the three-limb parallel differential, the judicious investigation strategy against the over-investigation spiral, the safety-netted multidisciplinary pathway, and the balanced stance that avoids premature closure in either direction.

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Photodocumentation and medicolegal evidence — formative SAQs

Two formative short-answer questions on injury photodocumentation, the three-shot rule, chain-of-custody storage, the fact-versus-opinion distinction, and court-statement preparation in suspected child maltreatment.

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Physical abuse: bruising and sentinel injuries — formative SAQs

Two formative short-answer questions on inflicted bruising, the TEN-4 FACES-L rule, sentinel injuries, the bleeding-disorder differential and the safeguarding pathway.

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Poisoning as maltreatment — formative SAQs

Formative SAQs on recognising poisoning as maltreatment, Rosenberg's triad, the bizarre recurrent toxidrome, the toxicology and separation workup, the stepped safeguarding pathway, and the salt and insulin induction archetypes.

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Poverty, food insecurity and social prescribing — formative SAQs

Two formative short-answer questions on the toxic-stress mechanism of material deprivation, the Hunger Vital Sign and social-needs screening, the five-step social-prescribing pathway, diagnostic overshadowing, and the evidence for income supplements and policy advocacy.

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Prevention of child maltreatment and family support — formative SAQs

Formative SAQs on the stepped prevention and family-support pathway and the evidence base for preventing child maltreatment, including the Nurse-Family Partnership, the Triple P population trial, school-based sexual abuse prevention, the WHO INSPIRE framework, and the toxic-stress rationale.

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Psychological and emotional abuse — formative SAQs

Two formative short-answer questions on psychological and emotional abuse: Glaser's conceptual framework and the APSAC categories, the toxic-stress cascade and ACE dose-response mechanism, recognising the relational and developmental pattern, excluding concurrent maltreatment, and acting through a stepped, trauma-informed, jurisdiction-specific safeguarding pathway.

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Refugee, asylum-seeking and newly arrived children — formative SAQs

Two formative short-answer questions on the on-arrival health assessment, the screening bundle, guardianship and consent, the interpreter rule, the forced-displacement toxic-stress mechanism, mental-health management, and the harm of immigration detention for refugee and newly arrived children.

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Sexually transmitted infections and child sexual abuse — formative SAQs

Two formative short-answer questions on interpreting an STI as graded evidence of sexual contact in a child, the trauma-informed forensic evaluation, the evidence window, and HIV post-exposure prophylaxis and safety planning.

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Strangulation, suffocation and asphyxial injury — formative SAQs

Formative SAQs on recognising and classifying strangulation, suffocation and asphyxial injury; the infant-vulnerability anatomy and the petechial-haemorrhage reality check; resuscitation run in parallel with scene preservation and safeguarding; the safe-sleep and product-hazard prevention message; and the hardest forensic question of accidental overlay versus inflicted suffocation.

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Trafficking, exploitation and forced marriage — formative SAQs

Two formative SAQs on trafficking, exploitation and forced marriage: recognising the hidden presentation of commercial sexual exploitation and the stepwise trauma-informed response, and managing a young person facing a forced marriage as a safeguarding emergency.

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Trauma-informed examination and forensic documentation — formative SAQs

Two formative short-answer questions on the trauma-informed approach to the medical examination of a child who may have been maltreated, the meaning of a normal examination, and the documentation standard that makes a record contemporaneous, objective and court-admissible.

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Youth justice and detained young people — formative SAQs

Two formative SAQs on the health of justice-involved and detained young people: the equivalence-of-care principle, the entry-screening pathway, the clustered health needs (mental illness, neurodisability, substance use, trauma, reproductive health), the post-release mortality spike, and the defensible entry-to-release health sequence.

Open

Domain

nephrology-urology-fluids-and-electrolytes

34

Acid-base disorders in children — formative SAQs

Formative SAQs on paediatric acid-base disorders, covering the six-step systematic approach to a blood gas, the anion gap and its albumin correction, Winters formula for compensation, the delta gap for mixed disorders, diabetic ketoacidosis as the commonest high anion gap acidosis, and the evidence that bicarbonate is rarely indicated.

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Acute kidney injury: SAQ

Short-answer questions on paediatric acute kidney injury covering a six-year-old with septic shock and oliguria, the KDIGO definition and staging, the staged emergency management of hyperkalaemia, the indications for renal replacement therapy, and the long-term risk of chronic kidney disease.

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Acute nephritic syndrome and glomerulonephritis — formative SAQs

Two formative SAQs on acute nephritic syndrome: a six-year-old with cola-coloured urine, periorbital oedema and a low C3 two weeks after a sore throat, testing the post-streptococcal diagnosis, the complement rule and supportive care; and an eight-year-old with IgA vasculitis purpura and nephritic urine whose C3 is normal, testing the differential and the biopsy-and-immunosuppression decision.

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Antenatal hydronephrosis and postnatal evaluation: SAQ

Short-answer questions on antenatal hydronephrosis and postnatal evaluation covering the grading systems, the timing of the first postnatal ultrasound, the investigation pathway, and the risk stratification that separates the transient physiologic dilatation from the pathological obstruction and reflux.

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Calcium, magnesium and phosphate disorders — formative SAQs

Formative SAQs on disorders of calcium, magnesium and phosphate in children and adolescents, covering the emergency management of symptomatic hypocalcaemia with calcium gluconate, hypomagnesaemia as the cause of refractory hypocalcaemia, the biochemistry that separates vitamin D deficiency rickets from X-linked hypophosphataemic rickets, tumour lysis hyperphosphataemia and refeeding hypophosphataemia.

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Chronic kidney disease and progression: SAQ

Short-answer questions on paediatric chronic kidney disease covering a boy with posterior urethral valves and progressive CKD, the KDIGO staging and Schwartz estimation, the nephroprotective bundle with blood-pressure targets and ACE inhibitor therapy, and the management of growth, anaemia and mineral-bone disease.

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Congenital anomalies of the kidney and urinary tract: SAQ

Short-answer questions on congenital anomalies of the kidney and urinary tract covering a male neonate with posterior urethral valves, the classification and embryology of CAKUT, the postnatal investigation pathway, and the long-term risk of chronic kidney disease.

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Dehydration and oral or intravenous rehydration: SAQ

Short-answer questions on paediatric dehydration and rehydration covering a 14-month-old with hypernatraemic dehydration from gastroenteritis, the clinical dehydration scale, the staged intravenous rehydration protocol, the safe correction of dysnatraemia, and the principles of oral rehydration therapy.

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Fluid maintenance and deficit replacement — formative SAQs

Formative SAQs on prescribing intravenous fluid in children, covering the Holliday-Segar maintenance rule, the choice of isotonic maintenance fluid with dextrose and potassium, the percentage method of deficit calculation with half replaced over 8 hours and half over 16, and the slow correction of hypernatraemic dehydration at no faster than 0.5 mmol per litre per hour.

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Haematuria: diagnostic approach — formative SAQs

Two formative SAQs on haematuria in children: a school-age child with cola-coloured urine two weeks after a sore throat testing the recognition, complement pattern and management of post-streptococcal glomerulonephritis, and an unwell child with a positive dipstick but no red cells on microscopy testing the exclusion of myoglobinuria and haemoglobinuria.

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Haemolytic uraemic syndrome: SAQ

Short-answer questions on paediatric haemolytic uraemic syndrome covering a three-year-old with pallor and oliguria after bloody diarrhoea, the distinction between STEC-HUS and atypical HUS, the role of eculizumab, and the approach to a diarrhoea-negative case requiring urgent complement blockade.

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Hypokalaemia and hyperkalaemia — formative SAQs

Formative SAQs on hypokalaemia and hyperkalaemia in children and adolescents, covering the emergency management of hyperkalaemia with ECG changes, the calcium-first rule, salbutamol and insulin-dextrose, safe intravenous potassium replacement, hypomagnesaemia as a refractory cause, and the Bartter versus Gitelman distinction.

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Hyponatraemia and hypernatraemia — formative SAQs

Formative SAQs on hyponatraemia and hypernatraemia in children and adolescents, covering the emergency management of severe symptomatic hyponatraemia with 3 percent hypertonic saline, the correction-rate ceiling to avoid osmotic demyelination syndrome, the volume-status classification, hospital-acquired hyponatraemia and isotonic maintenance fluid, and slow hypernatraemia correction to avoid cerebral oedema.

Open

Hypospadias, cryptorchidism and common male genital disorders: SAQ

Short-answer questions on hypospadias, cryptorchidism and the common male genital disorders covering the classification of hypospadias, the timing and rationale of orchidopexy, the no-circumcision rule, and the disorder-of-sex-development workup for the bilateral non-palpable testis.

Open

IgA nephropathy and IgA vasculitis nephritis: SAQ

Short-answer questions on paediatric IgA nephropathy and IgA vasculitis nephritis, covering a teenager with synpharyngitic macroscopic haematuria and a normal C3, the Oxford MEST-C classification and treatment ladder, and the systemic presentation and management of IgA vasculitis nephritis.

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Inherited tubulopathies: SAQ

Short-answer questions on paediatric inherited tubulopathies covering a neonate with antenatal polyhydramnios and salt-wasting alkalosis (Bartter syndrome) and a contrast of Gitelman and Liddle syndromes using blood pressure, renin, aldosterone, urine calcium and magnesium.

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Kidney replacement therapy and dialysis in children: SAQ

Short-answer questions on paediatric kidney replacement therapy covering a haemodynamically unstable child with acute kidney injury needing continuous renal replacement therapy, the AEIOU indications, modality selection favouring peritoneal dialysis in infants, and the management of peritoneal dialysis-related peritonitis.

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Kidney transplantation in children: SAQ

Short-answer questions on paediatric kidney transplantation covering an eight-year-old assessed for preemptive living-donor transplant, the standard immunosuppression regimen with therapeutic drug monitoring, the workup of a rising creatinine distinguishing rejection from calcineurin inhibitor toxicity and BK nephropathy, and the management of recurrent focal segmental glomerulosclerosis and adolescent non-adherence.

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Lupus nephritis and systemic disease: SAQ

Short-answer questions on paediatric lupus nephritis covering a 13-year-old girl with proliferative Class IV disease presenting with oedema, active urinary sediment, low complement, and positive anti-dsDNA, the ISN/RPS classification, the induction-maintenance paradigm, and the management of a membranous Class V presentation with nephrotic-range proteinuria.

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Nephrolithiasis and nephrocalcinosis — formative SAQs

Formative SAQs on paediatric nephrolithiasis and nephrocalcinosis, covering the lumen-versus-parenchyma distinction, hypercalciuria and the metabolic workup, acute renal colic and the infected obstructed system, medical expulsive therapy with tamsulosin, the surgical ladder, and prevention with fluids, diet, thiazide and potassium citrate.

Open

Neurogenic bladder and dysfunctional voiding: SAQ

Short-answer questions on neurogenic bladder and dysfunctional voiding covering an infant with myelomeningocele and a hostile high-pressure bladder, the urodynamic classification, the management ladder, and the distinction from the functional voiding disorders.

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Nocturnal enuresis — formative SAQs

Two formative SAQs on paediatric nocturnal enuresis: the school-age child with monosymptomatic bedwetting (assessment, classification and first-line therapy with alarm or desmopressin), and the child with new polyuria, polydipsia and weight loss or daytime symptoms (red flags and the divergence of the pathway).

Open

Oedema and nephrotic syndrome — formative SAQs

Two formative SAQs on childhood nephrotic syndrome: a four-year-old with a first presentation of periorbital and ankle oedema and heavy proteinuria, testing the KDIGO 2021 definition, the initial prednisolone 60 mg/m2/day regimen and the four-week response classification; and a six-year-old with frequently-relapsing steroid-sensitive nephrotic syndrome who develops abdominal pain and fever, testing the recognition and management of spontaneous bacterial peritonitis and hypovolaemia.

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Oliguria, anuria and urinary obstruction: SAQ

Short-answer questions on paediatric oliguria, anuria and urinary obstruction covering a male infant with posterior urethral valves and anuria, the urine output thresholds and the post-renal classification, the emergency catheter decompression, and the recognition and fluid management of post-obstructive diuresis.

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Polycystic kidney disease and inherited nephropathies: SAQ

Short-answer questions on paediatric polycystic kidney disease and inherited nephropathies covering a neonate with ARPKD and bilateral enlarged echogenic kidneys with hepatic fibrosis, an adolescent with autosomal dominant polycystic kidney disease and tolvaptan therapy, and a boy with Alport syndrome and the ACE-inhibitor-at-diagnosis strategy.

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Polyuria and polydipsia — formative SAQs

Formative SAQs on the diagnostic approach to a child with polyuria and polydipsia, covering the glucose-first exclusion of osmotic diuresis, the urine osmolality split into water versus solute diuresis, the three-way split of the water diuresis, the water deprivation test and copeptin approach, hypernatraemic dehydration management with slow sodium correction, desmopressin for central disease, and the low-solute and thiazide regimen for nephrogenic disease.

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Post-infectious glomerulonephritis: SAQ

Short-answer questions on paediatric post-infectious glomerulonephritis covering a seven-year-old with smoky urine, periorbital oedema, and hypertension two weeks after a sore throat, the low C3 with normal C4 that recovers within eight weeks, the immune-complex and complement pathophysiology, and the supportive management plus streptococcal eradication.

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Posterior urethral valves: SAQ

Short-answer questions on posterior urethral valves covering a male neonate with the Potter sequence, the immediate catheter decompression and biochemical stabilisation, the diagnostic MCUG and endoscopic valve ablation, the valve-bladder management, and the long-term chronic kidney disease surveillance driven by the nadir creatinine.

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Proteinuria: diagnostic approach — formative SAQs

Two formative SAQs on the diagnostic approach to proteinuria in children: an asymptomatic 14-year-old with proteinuria on a school screen, testing the repeat first-morning discipline, the orthostatic classification and the long-term monitoring stance; and a 6-year-old with heavy proteinuria, oedema and hypoalbuminaemia, testing the recognition of nephrotic-range proteinuria, the quantification thresholds and the urgent nephrology triggers.

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Renal tubular acidosis — formative SAQs

Formative SAQs on renal tubular acidosis in children and adolescents, covering the three-type classification by potassium direction and urine pH, the urine anion gap as a surrogate for ammonium, nephrocalcinosis in distal RTA, the alkali dose difference between distal and proximal RTA, and the safe correction of chronic acidosis.

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Scrotal pain and testicular torsion: SAQ

Short-answer questions on scrotal pain and testicular torsion covering the recognition and the 6-hour salvage window, the TWIST score and the differentiation of torsion from torsion of the appendix testis and acute epididymitis, the immediate surgical and communication plan, the operation with detorsion and bilateral orchidopexy, and the long-term fertility and medicolegal consequences.

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Urinalysis, renal function and paediatric kidney assessment — formative SAQs

Two formative short-answer questions on bedside Schwartz eGFR calculation and staging, urine collection method, dipstick interpretation and the creatinine lag in a sick child.

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Vesicoureteric reflux: SAQ

Short-answer questions on vesicoureteric reflux covering the International Reflux Study grading system, the RIVUR trial evidence on antimicrobial prophylaxis, the management ladder, and the role of bladder and bowel dysfunction in a child with recurrent febrile urinary tract infection.

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Vulvovaginal and common prepubertal gynaecological disorders: SAQ

Short-answer questions on the common prepubertal gynaecological disorders covering the classification and first-line management of vulvovaginitis, the conservative approach to labial adhesions, and the corticosteroid treatment of lichen sclerosus, together with the red flags of foreign body and sexual abuse.

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Domain

paediatric-dermatology

21

Acne vulgaris in adolescents — formative SAQs

Formative SAQs on acne vulgaris in the adolescent: grading the comedonal versus the inflammatory disease, building the stepwise ladder of the topical retinoid and the benzoyl peroxide, the oral doxycycline with the antibiotic stewardship, and the oral isotretinoin with the pregnancy prevention and the lipid and liver monitoring, and escalating the acne fulminans and the hormonal female-pattern acne of the polycystic ovary syndrome.

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Alopecia and hair disorders in children — formative SAQs

Two formative SAQs on alopecia and hair disorders in children: an eight-year-old with a smooth bald patch and exclamation-mark hairs testing the recognition of alopecia areata, its autoimmune associations and stepwise management; and a twelve-year-old with an irregular patch of hairs broken to varying lengths on a normal scalp testing the recognition and first-line behavioural management of trichotillomania, with a question on distinguishing tinea capitis from alopecia areata at the bedside.

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Approach to rash in infants and children — formative SAQs

Formative SAQs on the morphology-first, distribution-aware, red-flag-driven approach to a rash in an infant or child.

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Congenital melanocytic naevi and pigmentary birthmarks — formative SAQs

Formative SAQs on the congenital pigmentary birthmarks: applying the size-based classification and the risk stratification of the congenital melanocytic naevus, recognising the neurocutaneous-melanocytosis risk pattern, and counselling the family on the surveillance and the management.

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Contact dermatitis — formative SAQs

Formative SAQs on contact dermatitis in children: distinguishing irritant from allergic disease, the distribution clues to a contactant, the patch-test procedure and its interpretation, and the three-pillar management of remove, repair and reduce.

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Drug eruptions including DRESS and AGEP — formative SAQs

Formative SAQs on drug eruptions in children: distinguishing a benign morbilliform rash from DRESS and AGEP by timing and systemic features, the RegiSCAR approach, the role of eosinophilia and HHV-6 reactivation, and the four-step management of stop the drug, assess severity, support and prevent recurrence.

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Epidermolysis bullosa and inherited blistering disorders — short-answer questions

Two short-answer questions on the classification, neonatal presentation, diagnostic biopsy and atraumatic multidisciplinary management of inherited epidermolysis bullosa in children, including recessive dystrophic EB and squamous cell carcinoma surveillance.

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Genodermatoses and neurocutaneous skin findings — formative SAQs

Formative SAQs on paediatric genodermatoses and neurocutaneous syndromes: the recognition and stepwise surveillance of a child with neurofibromatosis type 1 — café-au-lait macules, skinfold freckling, the NIH diagnostic criteria, optic pathway glioma and blood pressure surveillance, and the malignant peripheral nerve sheath tumour red flag — and the recognition and management of an infant with tuberous sclerosis complex presenting with infantile spasms and a subependymal giant cell astrocytoma, covering vigabatrin, everolimus and the major-minor diagnostic criteria.

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Impetigo and bacterial skin infection — formative SAQs

Formative SAQs on impetigo and bacterial skin infection: the stepwise management of an infant with widespread bullous impetigo and the recognition of the toxin-mediated extreme, and the diagnosis, treatment and public-health management of impetigo in a remote endemic community — covering topical versus oral therapy, drainage-first abscess management, MRSA, decolonisation, school exclusion and post-streptococcal glomerulonephritis surveillance.

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Molluscum contagiosum and viral warts — short-answer questions

Two short-answer questions on the diagnosis, pathophysiology and expectant-versus-active management of molluscum contagiosum and viral warts in children.

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Nail disorders in children — formative SAQs

Formative SAQs on nail disorders in children: the assessment and stepwise management of a child with a suspected fungal nail infection, including the confirm-before-treat principle and weight-based terbinafine, and the assessment and management of an adolescent with a recurrent ingrown toenail, including the role of antibiotics and surgery — covering nail unit anatomy, the site-based diagnostic principle, mycological confirmation, conservative care, paronychia drainage, trachyonychia reassurance, and the red flags for urgent referral.

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Nappy dermatitis — formative SAQs

Formative SAQs on nappy dermatitis: separating the irritant contact subtype on the convex surfaces with spared folds from the candidal subtype with fold involvement and satellite lesions, applying the stepwise management from the general skin care to the barrier to the antifungal, and holding the red flag of the rash that does not respond in seven days.

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Neonatal pustular and vesiculobullous eruptions — formative SAQs

Formative SAQs on neonatal pustular and vesiculobullous eruptions: the recognition, work-up and management of a febrile neonate with clustered scalp vesicles suspected to have neonatal herpes simplex, and the differential, bedside assessment and reassurance-versus-escalate pathway for a well term neonate with a benign pustular eruption — covering erythema toxicum, transient neonatal pustular melanosis, the smear, staphylococcal scalded skin syndrome, incontinentia pigmenti, and epidermolysis bullosa.

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Petechiae, purpura and vasculitic rashes — formative SAQs

Formative SAQs on petechiae, purpura and vasculitic rashes in children: the triage and emergency management of a febrile child with a rapidly progressive petechial rash (the sick-versus-well split, the glass test, first-hour antibiotics and resuscitation, purpura fulminans and the ISTH disseminated intravascular coagulation score), and the assessment and management of a well child with newly diagnosed immune thrombocytopenia including the differentiation from leukaemia and the ASH 2019 risk-based approach.

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Psoriasis in children — formative SAQs

Formative SAQs on psoriasis in children: the stepwise management of a child with moderate to severe plaque psoriasis and the decision to start a biologic, and the diagnosis and management of an adolescent with acute guttate psoriasis after streptococcal pharyngitis — covering severity assessment, potency-matched topical therapy, narrowband UVB phototherapy, methotrexate and the biologics, the obesity and juvenile psoriatic arthritis and psychosocial comorbidities, and the prognosis of guttate disease.

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Scabies, lice and infestations — short-answer questions

Two short-answer questions on the clinical recognition, pathophysiology and household-based management of scabies and head lice in children, including crusted scabies and treatment resistance.

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Seborrhoeic dermatitis and cradle cap — formative SAQs

Formative SAQs on infantile seborrhoeic dermatitis and cradle cap: recognising the greasy yellow scale over the scalp, face, flexures, and nappy area of the well, non-itchy infant of the first three months, separating it from atopic dermatitis on the absent pruritus and the nappy involvement, managing it with the gentle scalp care on the Cochrane evidence of the favourable prognosis regardless of intervention, reserving the ketoconazole shampoo and the hydrocortisone for the refractory case, and escalating the Leiner disease erythroderma and the refractory disease beyond infancy.

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Skin manifestations of systemic disease — formative SAQs

Formative SAQs on cutaneous manifestations of systemic disease in children: the assessment and targeted work-up of a child with cutaneous signs of systemic disease applying the recognise, investigate and refer framework, and the diagnosis and management of dermatitis herpetiformis as the cutaneous face of coeliac disease — covering erythema nodosum and acanthosis nigricans, coeliac serology and duodenal biopsy, the gluten-free diet and dapsone, and the neurocutaneous emergencies.

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Stevens-Johnson syndrome and toxic epidermal necrolysis — formative SAQs

Formative SAQs on Stevens-Johnson syndrome and toxic epidermal necrolysis: the recognition, immediate management and stepwise supportive care of a child with drug-induced SJS-TEN overlap (stop the culprit drug, SCORTEN, burn-unit care, ophthalmology, the no-proven-benefit position on immunomodulation), and the diagnosis and management of Mycoplasma-induced rash and mucositis and how it differs from drug-induced SJS.

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Tinea and fungal skin infection — formative SAQs

Two formative SAQs on tinea and fungal skin infection in children: a five-year-old with a scaly bald scalp patch and broken hair stubs testing the recognition of tinea capitis, the species-guided oral therapy, and household carrier screening; and a four-year-old with a painful boggy purulent scalp mass after contact with a new kitten testing the recognition and management of kerion without incision, alongside a question on tinea incognito from a steroid-containing cream.

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Vascular birthmarks and infantile haemangioma — formative SAQs

Formative SAQs on vascular birthmarks and infantile haemangioma: the classification, PHACE screening and stepwise propranolol management of an infant with a large facial segmental haemangioma, and the recognition and management of an infant with multiple cutaneous haemangiomas complicated by hepatic involvement — covering the tumour-versus-malformation fork, GLUT1 biology, oral propranolol dosing, topical timolol, port-wine stain and Sturge-Weber syndrome, and the Kasabach-Merritt distinction.

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Domain

endocrinology-diabetes-and-growth

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Acquired hypothyroidism and Hashimoto thyroiditis — formative SAQs

Formative SAQs on acquired hypothyroidism and Hashimoto thyroiditis in children and adolescents.

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Adrenal insufficiency and adrenal crisis — formative SAQs

Two formative SAQs on adrenal insufficiency and adrenal crisis in children: the pigmented losing-weight adolescent with primary Addison disease, and the steroid-withdrawn child who collapses with an infection, testing the cortisol-ACTH-renin work-up, the empiric hydrocortisone-first resuscitation, and the lifelong replacement with a stress-dose plan.

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Congenital adrenal hyperplasia — formative SAQs

Two formative SAQs on congenital adrenal hyperplasia: the genitally normal male neonate who salt-wastes at two weeks, and the virilised 46,XX newborn, testing the salt-wasting crisis resuscitation, the 17-OHP work-up and lifelong replacement with stress dosing.

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Congenital hypothyroidism — formative SAQs

Formative SAQs on congenital hypothyroidism: running the newborn-screening-to-treatment pipeline, the levothyroxine dose and timing that protect the developing brain, the primary-versus-central classification, and the permanence reassessment at age three.

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Constitutional delay and familial short stature — formative SAQs

Formative SAQs on distinguishing familial short stature from constitutional delay of growth and puberty, reading the growth-chart trajectory and bone age, excluding the pathological mimics, and counselling the distressed adolescent.

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Cushing syndrome in children — formative SAQs

Two formative SAQs on Cushing syndrome in children: the obese adolescent whose height has fallen off the centiles, and the Cushingoid child with a clear inhaled-steroid history, testing the growth-arrest discriminator, the three-test confirmatory work-up, ACTH localisation, and the perioperative glucocorticoid replacement that prevents adrenal crisis.

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Delayed puberty and hypogonadism in adolescents — formative SAQs

Formative SAQs on confirming delayed puberty against the sex-specific thresholds, splitting the differential with gonadotrophins, separating constitutional delay from permanent congenital hypogonadotropic hypogonadism, recognising Klinefelter and Turner, and delivering pubertal induction with escalating sex steroids over 18-24 months.

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Diabetes insipidus and polyuria-polydipsia — formative SAQs

Formative SAQs on diabetes insipidus and the polyuria-polydipsia syndrome in children, covering the central versus nephrogenic versus primary polydipsia split, the water-deprivation and copeptin tests, congenital nephrogenic disease in the infant, and desmopressin safety.

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Diabetic ketoacidosis — formative SAQs

Formative SAQs on paediatric diabetic ketoacidosis: diagnosing the triad and grading severity, delivering the ISPAD fluid and insulin protocol with the potassium logic, and recognising and treating cerebral oedema at the bedside.

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Disorders of sex development — formative SAQs

Formative SAQs on disorders of sex development: excluding a salt-wasting adrenal crisis before reaching for a label, classifying with the Chicago framework built from the karyotype, confirming with karyotype and 17-hydroxyprogesterone first, deferring non-consent cosmetic surgery, and running a lifelong multidisciplinary plan.

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Endocrine emergencies: integrated approach — formative SAQs

Two formative SAQs on the integrated approach to paediatric endocrine emergencies: the undiagnosed young child with new-onset DKA and the steroid-withdrawn child with secondary adrenal crisis, testing the shared recognition and resuscitation framework, the bedside triage with glucose, gas and electrolytes, the empiric life-saving treatment before confirmatory endocrine tests, and the cross-cutting pitfalls of cerebral oedema, missed cortisol and the insulin bolus.

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Endocrine late effects of cancer treatment — formative SAQs

Formative SAQs on recognising the childhood cancer survivor with growth hormone deficiency after cranial irradiation and the survivor with combined hypothalamic-pituitary deficits, confirming with axis-specific stimulation tests, and delivering hormone replacement in the correct order — hydrocortisone before levothyroxine before sex steroids, with recombinant growth hormone only after magnetic resonance imaging excludes recurrence.

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Growth hormone deficiency and excess — formative SAQs

Formative SAQs on recognising the short child with growth hormone deficiency and the overgrowing child with growth hormone excess, confirming with a stimulation test or an oral glucose load, and delivering recombinant growth hormone for deficiency and surgery with somatostatin analogue or pegvisomant for excess.

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Hypercalcaemia and hyperparathyroidism — formative SAQs

Two formative SAQs on paediatric hypercalcaemia: the adolescent with stones, bone pain and an inappropriately normal PTH, and the child with mild lifelong hypercalcaemia and a low urine calcium, testing the PTH fork, the urine calcium-to-creatinine clearance ratio that prevents the wrong operation, the saline-first resuscitation, and the calcitonin-then-bisphosphonate drug sequence.

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Hyperthyroidism and Graves disease — formative SAQs

Formative SAQs on distinguishing thyrotoxicosis from hyperthyroidism, confirming Graves disease through a suppressed TSH, raised free T4 and a positive TSH-receptor antibody, delivering symptom control with a beta-blocker and hormone control with carbimazole or methimazole, holding propylthiouracil for thyroid storm and first-trimester pregnancy, and recognising transient neonatal thyrotoxicosis in the infant of a mother with Graves disease.

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Hypocalcaemia and hypoparathyroidism — formative SAQs

Formative SAQs on hypocalcaemia and hypoparathyroidism in children and adolescents, covering acute symptomatic management, PTH-led classification, neonatal hypocalcaemia, and the hypoparathyroidism versus pseudohypoparathyroidism distinction.

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Hypoglycaemia in diabetes — formative SAQs

Formative SAQs on recognising and classifying hypoglycaemia in children and adolescents with diabetes, explaining counter-regulatory failure and impaired awareness, delivering the rule of 15 and severe-event rescue, and preventing recurrence with continuous glucose monitoring and hybrid closed-loop therapy.

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Hypopituitarism and pituitary lesions — formative SAQs

Two formative SAQs on paediatric hypopituitarism: the neonate with hypoglycaemia, prolonged jaundice and a micropenis, testing the recognition of congenital hypopituitarism and the glucocorticoid-before-thyroxine rule; and the older child with short stature, a falling height velocity and a visual field defect, testing the work-up of a suprasellar lesion, the order of hormone loss and the dynamic tests that confirm each axis.

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Lipid disorders and familial hypercholesterolaemia — formative SAQs

Two formative SAQs on paediatric familial hypercholesterolaemia: the asymptomatic child flagged by an LDL-C above threshold and a family history, and the adolescent with homozygous FH and xanthomas — testing the diagnostic thresholds, the secondary-cause work-up, the statin-first drug ladder, and cascade screening.

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Monogenic diabetes and neonatal diabetes — formative SAQs

Two formative SAQs on monogenic diabetes: a six-week-old with persistent insulin-requiring hyperglycaemia (neonatal diabetes under six months, the six-month rule, and the potassium-channel switch to glibenclamide), and a twelve-year-old labelled type 1 for five years who is antibody-negative with a preserved C-peptide and an affected parent (HNF1A-MODY and the move from insulin to a sulfonylurea).

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Obesity: assessment, complications and treatment — formative SAQs

Two formative short-answer questions on childhood obesity classification with adult crossover, systematic comorbidity screening and secondary-cause exclusion, and staged weight-neutral management including pharmacotherapy and surgery.

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Osteoporosis and fragility fractures in children — formative SAQs

Formative SAQs on osteoporosis and fragility fractures in children: the ISCD definition that needs low bone mass plus a fragility fracture, the glucocorticoid-exposed child with a vertebral compression fracture, the foundation-first and bisphosphonate treatment pathway with zoledronic acid first-line, and the safeguarding interface with non-accidental injury.

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Phaeochromocytoma and endocrine hypertension — formative SAQs

Two formative SAQs on phaeochromocytoma and endocrine hypertension in children: the hypertensive adolescent with headache, sweating and palpitations, testing the metanephrines-first rule, the alpha-before-beta preoperative sequence and the hereditary genetics; and the hypertensive child with hypokalaemia and suppressed renin and aldosterone, testing the renin–aldosterone fork and the monogenic mineralocorticoid causes.

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Precocious puberty — formative SAQs

Formative SAQs on recognising early sexual development, splitting central (GnRH-dependent) from peripheral (GnRH-independent) causes, interpreting the bone age and basal-then-stimulated gonadotropin panel, choosing the brain-imaging trigger, and matching the treatment to the driver — GnRH analog for central disease, cause-directed therapy for peripheral disease.

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Rickets and metabolic bone disease — formative SAQs

Formative SAQs on rickets and metabolic bone disease: the calcipenic-versus-phosphopenic classification, the emergency management of the hypocalcaemic infant, the treatment of nutritional rickets with cholecalciferol and calcium, and the separate pathway for hereditary disease.

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Short stature and poor linear growth — formative SAQs

Formative SAQs on the diagnostic approach to the short child, the GH-IGF-1 axis and the distinction of variants from pathology.

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SIADH and disorders of water balance — formative SAQs

Formative SAQs on SIADH and disorders of water balance in children, covering the volume-status approach to hyponatraemia, SIADH biochemistry, cerebral salt wasting, hypertonic saline for the seizing child, and the sodium correction rate.

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Tall stature and overgrowth syndromes — formative SAQs

Formative SAQs on tall stature and overgrowth syndromes: separating the familial normal variant from the pathological causes using a structured redistribution assessment, recognising the syndromic overgrowth fingerprint (Sotos, Beckwith-Wiedemann, Weaver), the tumour surveillance that the molecular subgroup dictates, and the treatable endocrine and chromosomal causes.

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Thyroid nodules, goitre and thyroid cancer — formative SAQs

Formative SAQs on paediatric thyroid nodule risk-stratification, FNA/Bethesda triage and multidisciplinary risk-adapted management.

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Type 1 diabetes: diagnosis and initial management — formative SAQs

Two formative SAQs on new-onset type 1 diabetes without ketoacidosis: a six-year-old with a two-week history of thirst, polyuria and weight loss who is alert and not acidotic, testing the diagnostic thresholds, the exclusion of ketoacidosis and the first insulin regimen; and an adolescent in whom the type 1 versus type 2 question turns on autoantibodies and C-peptide, plus the honeymoon phase and the rule that insulin is never stopped.

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Type 1 diabetes: insulin therapy, technology and ambulatory care — formative SAQs

Two formative SAQs on the ongoing care of established type 1 diabetes: a nine-year-old who develops ketoacidosis after insulin is omitted during a viral illness, testing sick-day management and the never-stop-insulin principle; and a seven-year-old on a pump with abdominal pain and ketones, testing the pump-cannula pitfall; plus the HbA1c and time-in-range targets and the transition plan.

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Type 2 diabetes and metabolic syndrome in youth — formative SAQs

Two formative SAQs on type 2 diabetes and metabolic syndrome in youth: a fourteen-year-old girl with acanthosis nigricans, oligomenorrhoea and a raised HbA1c found on screening, and a thirteen-year-old boy with obesity and a strong family history whose metformin monotherapy is failing, testing the diagnostic criteria, the antibody and C-peptide confirmation, the stepwise management ladder, and the comorbidity and complication care.

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Domain

ent-hearing-and-oral-health

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Acute and chronic rhinosinusitis — formative SAQs

Formative SAQs on acute and chronic rhinosinusitis: the recognition and stepwise management of a child with acute bacterial rhinosinusitis using the AAP criteria, the high-dose amoxicillin-clavulanate regimen, saline irrigation and intranasal corticosteroid, and the assessment and management of a child with an orbital complication of sinusitis including the Chandler classification, the contrast CT decision, the intravenous antibiotic regimen and the medical-versus-surgical decision for a subperiosteal abscess.

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Acute otitis media — formative SAQs

Formative SAQs on diagnosing acute otitis media from a bulging tympanic membrane, applying the age-and-laterality antibiotic matrix with weight-based analgesia, recognising acute mastoiditis, and giving a concrete safety-net.

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Ankyloglossia and infant feeding — formative SAQs

Two formative SAQs on ankyloglossia and infant feeding: a two-week-old breastfed infant with poor weight gain, a painful clicking latch and a mother with cracked nipples and engorgement testing the functional assessment, the conservative-first principle, the frenotomy decision and the evidence, with attention to excluding a submucous cleft; and a six-week-old whose mother has read online that the baby is tongue-tied and wants it snipped, testing the counselling that not every tie needs division, the validated assessment, the overdiagnosis pitfall and the safety-net.

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Cleft lip and palate — formative SAQs

Formative SAQs on cleft lip and palate: the Veau classification, the embryology of facial-process and palatal-shelf fusion, the feeding principle that a cleft palate infant cannot generate suction and needs a squeeze bottle, Pierre Robin sequence with airway obstruction, the near-universal otitis media with effusion and the role of grommets, the rule of ten for lip repair, the staged surgical timeline through alveolar bone grafting, and the syndromic associations of Van der Woude, Stickler and 22q11 deletion.

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Congenital ear anomalies and microtia — formative SAQs

Formative SAQs on congenital ear anomalies and microtia: distinguishing a deformational deformity from a true microtia, grading by Marx, explaining why the inner ear is spared and the loss is conductive, the urgency of early bone-conduction hearing in bilateral aural atresia, the newborn molding window, the Jahrsdoerfer CT grading for atresiaplasty, and the syndromic associations of Treacher Collins, hemifacial microsomia and branchio-oto-renal.

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Dental caries and oral-health prevention — formative SAQs

Two formative SAQs on dental caries and oral-health prevention: a three-year-old with brown, cavitated upper front teeth and a bedtime bottle testing the definition and pattern of early childhood caries and the fluoride, diet and dental-home prevention ladder; and a four-year-old with a swollen face, fever and trismus from a necrotic primary molar testing the emergency recognition of spreading odontogenic infection and its airway-first, source-control management.

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Dental trauma and avulsed teeth — formative SAQs

Two formative SAQs on dental trauma and avulsed teeth: an eight-year-old who has just knocked out a permanent upper central incisor on the playground, testing the IADT 2020 scene first-aid protocol, the storage media, the prognostic role of extra-alveolar dry time and the definitive dental management; and a three-year-old who has knocked out a primary incisor in a fall, testing the never-replant-a-primary-tooth rule and the safeguarding consideration of oral injury in a young child.

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Drooling, dysphagia and upper-aerodigestive disorders — formative SAQs

Formative SAQs on separating anterior from posterior drooling, recognising an unsafe swallow and silent aspiration, applying the stepwise drooling ladder with glycopyrrolate and botulinum toxin, and making safe feeding and airway-protection decisions in a child with neurodisability.

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Epistaxis in children — formative SAQs

Two formative SAQs on childhood epistaxis: a seven-year-old with recurrent unilateral nosebleeds, bruising and a maternal history of heavy periods testing the recognition of an underlying bleeding disorder, the investigation sequence and the rationale for caution before cautery; and a four-year-old with an active profuse nosebleed in the emergency department brought in tilted backward, testing correct first-aid technique, the common errors, and the stepwise escalation to cautery and packing.

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Facial swelling and odontogenic infection — formative SAQs

Formative SAQs on recognising a paediatric facial swelling of dental origin, identifying the source tooth, applying the principle of source control, recognising Ludwig angina as an airway emergency, and giving correct empirical antibiotic doses.

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Hearing assessment and childhood hearing loss — formative SAQs

Two formative SAQs on childhood hearing loss: the baby who refers on the newborn hearing screen and the 1-3-6 milestones with congenital CMV as the commonest acquired cause, and the preschool child with persistent bilateral otitis media with effusion and the grommet decision with the Paradise developmental evidence.

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Mastoiditis and otogenic complications — formative SAQs

Formative SAQs on mastoiditis and otogenic complications: the recognition and stepwise management of a febrile child with acute mastoiditis including the contrast temporal-bone CT decision, the intravenous antibiotic regimen and the myringotomy and cortical mastoidectomy decisions, and the management of a subperiosteal abscess and lateral sinus thrombosis — covering the coalescent CT finding, the postauricular signs, the down-and-out pinna, the Gradenigo triad and the causative organisms.

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Nasal foreign body and button-battery injury — formative SAQs

Two formative SAQs on nasal foreign body and button-battery injury: a two-year-old with a missing remote-control button battery and a shiny object seen against the septum, testing the emergency-removal decision, the alkaline-electrolysis mechanism and the complications to surveil; and a four-year-old with a unilateral foul-smelling blood-stained discharge and a smooth round bead on examination, testing the recognition, the first-line removal technique, the instrument choice and the contraindicated manoeuvre.

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Neck masses in children — formative SAQs

Formative SAQs on classifying a paediatric neck mass by location and aetiology, recognising a thyroglossal duct cyst and a non-tuberculous mycobacterial node, choosing ultrasound as the first-line imaging test, and escalating the persistent or supraclavicular node to biopsy and paediatric oncology referral.

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Oral manifestations of systemic disease — formative SAQs

Two formative SAQs on oral manifestations of systemic disease in children: a pale tired six-year-old with swollen bleeding gums and mucosal petechiae testing the recognition of leukaemic gingival infiltration, the urgent full blood count and film, and neutropenic-sepsis safety; and a nine-year-old with chalky symmetrical dental enamel defects, recurrent aphthae, angular cheilitis and faltering growth testing the coeliac diagnosis, the serology with total IgA, and the two-handed management of a gluten-free diet and oral care.

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Oral ulcers and mucosal disease — formative SAQs

Two formative SAQs on oral ulcers and mucosal disease in children: a febrile drooling two-year-old with diffuse painful anterior gingival ulceration testing the diagnosis of primary herpetic gingivostomatitis, the hydration-first assessment and early oral aciclovir within 72 hours; and a ten-year-old with recurrent scarring major aphthae testing the deficiency and coeliac work-up, the differential of systemic aphthosis and the stepwise topical and referral management.

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Otitis externa — formative SAQs

Two formative SAQs on otitis externa: an eight-year-old swimmer with otalgia, otorrhoea and tragal tenderness testing the canal-versus-middle-ear distinction and analgesia-led, topical-first stepwise management with an ear wick; and an immunocompromised child with severe unremitting otalgia and a facial palsy testing the recognition of necrotising otitis externa, the inflammatory-marker and imaging work-up, and prolonged systemic antipseudomonal therapy.

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Otitis media with effusion and grommet decisions — formative SAQs

Formative SAQs on otitis media with effusion and grommet decisions: the stepwise management of a child with persistent bilateral OME and documented hearing difficulty including the grommet criterion and the developmental evidence, and the distinction between OME and acute otitis media with the watchful-waiting plan and the tympanogram interpretation — covering the Eustachian tube pathophysiology, the three-month duration threshold, the at-risk child and the Indigenous context.

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Pharyngitis, tonsillitis, peritonsillar abscess and deep neck infection — formative SAQs

Formative SAQs on applying the McIsaac score to a paediatric sore throat, confirming GAS before treating, recognising a peritonsillar abscess and a deep neck infection, and giving correct antibiotic doses and safety-net advice.

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Salivary gland disorders — formative SAQs

Two formative SAQs on salivary gland disorders in children: an under-immunised five-year-old with bilateral tender parotid swelling and fever testing the diagnosis of mumps, the supportive management, the five-day exclusion and the complications including orchitis, meningitis and pancreatitis; and a four-year-old with recurrent unilateral parotid swelling testing the diagnosis of juvenile recurrent parotitis, the ultrasound findings, the conservative management and the role of sialendoscopy.

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Tinnitus, vertigo and balance disorders in children: SAQ

Short-answer questions on dizziness and vertigo in children covering the diagnosis and reassuring prognosis of benign paroxysmal vertigo of childhood, the peripheral-versus-central assessment of the acute vestibular syndrome through the head impulse, nystagmus, test of skew rule, and the management built on the Epley manoeuvre and early vestibular rehabilitation.

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Domain

mental-behavioural-and-psychosomatic

26

Acute behavioural disturbance and agitation — formative SAQs

Two formative short-answer questions on recognising and managing acute behavioural disturbance and agitation in a child or adolescent: the least-restrictive ladder, verbal de-escalation as first-line treatment, oral and parenteral pharmacotherapy grounded in the PEAChY trials, exclusion of organic causes, and minimising and recovering from restraint.

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Anxiety disorders in children and adolescents — formative SAQs

Formative SAQs on distinguishing disorder from normal developmental fear, multi-informant assessment with SCARED/SCAS/RCADS, stepped care with exposure-based CBT and SSRI evidence (CAMS), and suicidality monitoring.

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Attachment disorders and relational trauma — formative SAQs

Two formative SAQs on the two-disorder DSM-5-TR structure, caregiving-history assessment, the BEIP / ABC / Child-Parent Psychotherapy evidence, no first-line medication, no coercive holding therapy, and safeguarding disposition.

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Avoidant restrictive food intake disorder — formative SAQs

Two formative short-answer questions on avoidant/restrictive food intake disorder: holding the boundary with anorexia nervosa, classifying the driver pattern, protecting nutrition and medical safety, and delivering evidence-based CBT-AR or FBT care with escalation and safety-netting.

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Child and adolescent suicide and self-harm assessment — formative SAQs

Two formative short-answer questions on suicide risk assessment, distinguishing non-suicidal self-injury from suicidal self-harm, risk stratification, safety planning and means restriction.

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Children of parents with mental illness or substance use — formative SAQs

Two formative SAQs on the heightened-but-probabilistic offspring-risk picture, the gene-environment-interplay mechanism, the Weissman STAR*D-child evidence that treating the parent treats the child, the family-focused-prevention evidence base, and the safeguarding conversion when acute risk surfaces.

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Chronic fatigue and post-viral fatigue syndromes — formative SAQs

Two formative short-answer questions on chronic fatigue and post-viral fatigue syndromes in young people: validating biopsychosocial assessment, the three-month paediatric threshold, post-exertional malaise, excluding mimics once, function-first energy management with CBT, school reintegration and the graded-exercise controversy.

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Collaborative care with child and adolescent mental-health services — formative SAQs

Formative SAQs on the four models of paediatric–CAMHS collaboration, the treatment-gap rationale, stepped-care tiers, shared assessment with SDQ screening and consent for information-sharing, and acute-risk and safeguarding overrides of the routine pathway.

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Conduct disorder and antisocial behaviour — formative SAQs

Formative SAQs on the rights-violation definition of conduct disorder, the Moffitt taxonomy, the callous-unemotional specifier, risk and safeguarding, and the NICE CG158 stepped-care ladder led by evidence-based parenting programmes.

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Delirium in children and adolescents — formative SAQs

Formative SAQs on the DSM-5-TR diagnosis of paediatric delirium, motoric subtypes, CAPD screening, the benzodiazepine causal link, the ABCDEF bundle, and antipsychotics as last resort.

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Depressive disorders in children and adolescents — formative SAQs

Formative SAQs on the criteria-based diagnosis of paediatric depression, suicide-risk assessment, stepped care, fluoxetine as first-line SSRI, and the black-box warning used wisely.

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Disruptive mood dysregulation disorder — formative SAQs

Formative SAQs on the criteria-clock diagnosis of DMDD, the bipolar and ODD rule-outs, the behaviour-therapy-first stepped plan, and the adjunctive use of medication for comorbidity.

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Early-onset psychosis and mania — formative SAQs

Formative SAQs on running the psychosis-mania gate: organic exclusion before any psychiatric label, duration of untreated psychosis, TEOSS pharmacotherapy, distinguishing mania from chronic irritability and substance-induced states, and antipsychotic metabolic monitoring.

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Emergency mental-health assessment and disposition — formative SAQs

Two formative short-answer questions on assessing and dispositioning a child or young person presenting to the emergency department in a mental-health crisis: the rapid safety and medical screen, structured suicide-risk assessment with the ASQ and CASSY, risk stratification, matching the level of care to risk, safety planning, means restriction and a confirmed follow-up.

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Family assessment and family interventions — formative SAQs

Two formative SAQs on systematic family assessment (genogram, family-functioning measure, dyad observation), the three named mechanisms, intensity-matched intervention selection across parent training, structured family therapy and multisystem care, and the safety/safeguarding conversion.

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Functional neurological symptoms in children — formative SAQs

Two formative SAQs on positive diagnosis of paediatric FND, the PNES versus epilepsy distinction, iatrogenic perpetuation, the validating diagnosis conversation and stepped multidisciplinary management.

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Grief, bereavement and adjustment disorder in children — formative SAQs

Two formative SAQs on separating normal grief from prolonged grief disorder and adjustment disorder, the DSM-5-TR / ICD-11 structure, grief-versus-MDD-versus-PTSD, suicide and safeguarding assessment, watchful waiting and caregiver-supported care as first-line, the Boelen CBT-for-PGD and Cohen/Mannarino TF-CBT evidence, and no first-line medication.

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Mental state examination in children and adolescents — formative SAQs

Two formative short-answer questions on performing a paediatric and adolescent mental state examination: setting the conditions, the seven domains, developmental adaptation, validated brief screens, and a same-visit response to a positive mood and suicide-risk screen.

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Obsessive-compulsive disorder in children — formative SAQs

Formative SAQs on paediatric OCD recognition, differential and stepped CBT-with-ERP care.

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Pica and rumination disorder — formative SAQs

Formative SAQs on pica and rumination disorder in children and adolescents.

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Post-traumatic stress disorder and trauma responses — formative SAQs

Two formative SAQs on the trauma-response continuum, trauma-informed assessment, stepped care with trauma-focused CBT first-line, watchful waiting, and safeguarding disposition.

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Psychological impact of chronic illness and disability — formative SAQs

Two formative short-answer questions on the psychological impact of chronic illness and disability in children and adolescents: the biopsychosocial, resilience-oriented model, the adjustment-to-disorder continuum, routine screening, stepped family-centred and school-inclusive care, diagnostic overshadowing, and the role of coping as the modifiable mediator.

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Psychopharmacology and psychotropic medicines in children and adolescents — formative SAQs

Two formative short-answer questions on psychopharmacology in children and adolescents: choosing, starting and monitoring an SSRI for adolescent depression (TADS, suicidality warning); and antipsychotic metabolic monitoring with class-choice reasoning for autism irritability, plus recognition and management of serotonin syndrome.

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Selective mutism — formative SAQs

Formative SAQs on selective mutism recognition, the hearing-first differential and behavioural-intervention-first care.

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Somatic symptom and related disorders — formative SAQs

Two formative short-answer questions on somatic symptom and related disorders in children and adolescents: the DSM-5 positive-criteria principle, validation, single red-flag screen, function-first interdisciplinary management, school reintegration, and recognition of fabricated/induced illness as a safeguarding presentation.

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Substance intoxication, withdrawal and use disorders in youth — formative SAQs

Formative SAQs on separating intoxication, withdrawal and the use disorder, CRAFFT screening, SBIRT stepped care, the buprenorphine pathway, and the cannabis-psychosis link.

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Domain

rheumatology-musculoskeletal-and-sports

31

Acute monoarthritis and septic arthritis — formative SAQs

Formative SAQs on acute monoarthritis and septic arthritis: applying the Kocher criteria to the febrile limping child, interpreting the synovial fluid cell count and Gram stain, choosing age-stratified empiric antibiotics covering Staphylococcus aureus and Kingella kingae, and recognising the septic hip as a surgical emergency requiring arthrotomy and washout.

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ANCA-associated and other childhood vasculitides: SAQ

Short-answer questions on ANCA-associated and other childhood vasculitides, covering the Chapel Hill 2012 vessel-size nomenclature, the three ANCA-associated vasculitides of GPA, MPA and EGPA, the EULAR/PRINTO/PRES Ankara 2008 childhood GPA and Takayasu criteria, the pauci-immune mechanism, the remission-induction and maintenance framework, the Kawasaki cross-link, and the Takayasu pathway.

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Angular, rotational and gait variants — formative SAQs

Formative SAQs on the common physiologic variants of the growing lower limb: placing the child on the Salenius and Vankka developmental curve, applying the Staheli rotational profile to the three causes of intoeing, and separating the symmetric painless age-appropriate variant observed and reassured from the progressive asymmetric or short-stature limb referred for Blount disease, rickets, or a skeletal dysplasia.

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Back pain in children and adolescents — formative SAQs

Formative SAQs on back pain in children and adolescents: running the red-flag screen, recognising back pain under five as a red flag demanding investigation for discitis, applying the age-stratified differential from spondylolysis to Scheuermann kyphosis to lumbar disc herniation, choosing the imaging that fits the suspected diagnosis, and managing each subtype from the conservative pars-rest to the empirical intravenous antibiotics for discitis.

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Bone pain and malignancy red flags — formative SAQs

Formative SAQs on paediatric bone pain and malignancy red flags: separating the child whose limb pain is benign from the child harbouring leukaemia, osteosarcoma, or Ewing sarcoma using the red-flag screen, the same-day basic investigations, and the radiographic signatures; and applying the never-biopsy-outside-a-specialist-centre rule and the spinal-cord-compression emergency.

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Clubfoot and congenital limb anomalies: SAQ

Short-answer questions on the clubfoot and congenital limb anomalies, covering the four classical deformities (cavus, adductus, varus, equinus) and the CAVE mnemonic, the Ponseti method of serial casting with the percutaneous Achilles tenotomy and the foot-abduction brace to four to five years, the Pirani and Dimeglio severity scores, the idiopathic-versus-syndromic-versus-positional distinction, the relapse and the anterior tibialis tendon transfer, and the longitudinal, transverse, and digital congenital limb deficiencies.

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Common paediatric fractures and growth-plate injury — formative SAQs

Formative SAQs on common paediatric fractures and growth-plate injury: applying the Salter-Harris classification to a physeal injury and predicting growth-arrest risk, recognising the Gartland III supracondylar humerus fracture as an emergency needing percutaneous pinning with lateral-entry pins, and the FORCE-trial evidence for soft-bandage management of the distal radius torus fracture.

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Concussion and return to learn or play — formative SAQs

Formative SAQs on sport-related concussion in the child and adolescent: recognising the concussion with the age-appropriate tool, running the red-flag screen, giving twenty-four to forty-eight hours of relative rest before early activity, driving the return-to-learn pathway first and then the six-stage return to sport, and identifying the persistent post-concussive symptoms at the four-week mark.

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Developmental dysplasia of the hip — formative SAQs

Formative SAQs on developmental dysplasia of the hip: performing the Ortolani and Barlow tests, applying the Graf ultrasound classification, and choosing the age-stratified management from the Pavlik harness to the open reduction.

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Heat illness, exertional collapse and sudden death prevention — formative SAQs

Formative SAQs on heat illness, exertional collapse and sudden death prevention: running the field-side collapse protocol from the pulse check to the rectal temperature, recognising exertional heat stroke as a core temperature of 40 degrees Celsius or higher with central nervous system dysfunction, managing it with cold-water immersion to below 39 degrees Celsius before transport under the cool first transport second rule, separating exercise-associated collapse from exercise-associated hyponatraemia, and preventing both emergencies through heat acclimatization, wet-bulb globe temperature activity modification, and a rehearsed emergency action plan with a defibrillator.

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IgA vasculitis: SAQ

Short-answer questions on IgA vasculitis (Henoch-Schonlein purpura), covering the EULAR/PRINTO/PRES Ankara 2008 classification criteria of mandatory palpable purpura plus at least one of four additional criteria, the pathogenesis centred on galactose-deficient IgA1 immune complex deposition, the selective corticosteroid indications, the evidence that prednisone does not reliably prevent nephropathy, and the renal monitoring schedule.

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Juvenile dermatomyositis — formative SAQs

Formative SAQs on juvenile dermatomyositis: the clinical diagnosis with heliotrope rash and Gottron papules, the Bohan and Peter and 2017 EULAR and ACR classification criteria, the myositis-specific antibody phenotypes, first-line treatment with corticosteroids and methotrexate, and the prevention and management of calcinosis.

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Juvenile idiopathic arthritis: SAQ

Short-answer questions on juvenile idiopathic arthritis, covering the ILAR classification with the oligoarticular dominance and the persistent-versus-extended split, the chronic anterior uveitis and its three-monthly slit-lamp screening in the high-risk child, the methotrexate at ten to fifteen milligrams per square metre per week, the etanercept and adalimumab biologics, and the Wallace clinically inactive disease criteria and the treat-to-target TREAT trial.

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Musculoskeletal examination and the limping child — formative SAQs

Formative SAQs on the paediatric musculoskeletal examination and the limping child: performing pGALS and pREMS, applying the Kocher and Caird prediction rules to an irritable hip, and recognising the age-stratified differential from toddler's fracture to slipped capital femoral epiphysis.

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Nursemaid's elbow and common upper-limb injury — formative SAQs

Formative SAQs on nursemaid's elbow and the common paediatric upper-limb injuries: recognising the classic traction history and the well child holding the arm flexed and pronated, reducing by hyperpronation on the evidence of the Macias and Aksel randomised trials, omitting the radiograph in the classic case, counselling the family to prevent recurrence, and separating the easily reduced subluxation from the Gartland-graded supracondylar and the torus forearm fracture.

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Osteomyelitis and discitis — formative SAQs

Formative SAQs on paediatric acute haematogenous osteomyelitis and discitis: the metaphyseal pathophysiology, the age-stratified microbiology dominated by Staphylococcus aureus and Kingella kingae, magnetic resonance imaging as the diagnostic gold standard, and the intravenous-to-oral antibiotic switch strategy.

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Pain amplification, juvenile fibromyalgia and complex regional pain syndrome: SAQ

Short-answer questions on amplified musculoskeletal pain, juvenile fibromyalgia and complex regional pain syndrome, covering the central sensitization mechanism, the 2010 American College of Rheumatology criteria, the Budapest clinical criteria, and the multidisciplinary management.

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Performance-enhancing substances in young athletes — formative SAQs

Formative SAQs on performance-enhancing substances in the young athlete: the WADA prohibited list and strict liability, the physical signs and confidential history that reveal anabolic-androgenic steroid use, the cardiovascular growth and psychiatric harms including the suicidal withdrawal, and the counselling-first management with the ATLAS prevention model.

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Periodic fever and autoinflammatory syndromes — formative SAQs

Formative SAQs on recognising the clockwork fever signature, sorting the five periodic fever syndromes, and choosing the pathway-targeted therapy with the amyloidosis prevention.

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Perthes disease — formative SAQs

Formative SAQs on Legg-Calve-Perthes disease: the four radiographic phases of idiopathic avascular necrosis of the femoral head, the Herring lateral pillar classification that drives prognosis, the containment principle, and the age-and-pillar-guided surgical decision.

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Pre-participation sports evaluation — formative SAQs

Formative SAQs on the pre-participation sports evaluation: applying the AHA 14-element cardiovascular history and examination to an athlete with exertional syncope, recognising the red flags that demand restriction and a cardiac work-up, and staging the elevated blood pressure of a young athlete by the AAP clinical practice guideline before the clearance decision.

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Primary immunodeficiency with rheumatic manifestations — formative SAQs

Formative SAQs on recognising the rheumatic-immune overlaps that earn an immune work-up (CVID with symmetric polyarthritis and autoimmune cytopenia, CGD with Crohn-like granulomatous colitis, classical complement deficiency with childhood-onset lupus, and Blau syndrome), confirming each with its matched test, and treating both the immune defect and the rheumatic manifestation in parallel while deferring immunosuppression and live vaccines until the immune screen is back.

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Reactive arthritis and post-infectious inflammatory syndromes: SAQ

Short-answer questions on reactive arthritis and the post-infectious inflammatory syndromes, covering the one-to-four-week latency and the trigger organisms, the distinction of the post-streptococcal reactive arthritis from the acute rheumatic fever, the 2015 Jones criteria with the carditis and the population-risk splits, the naproxen and ibuprofen first-line treatment, the intra-articular triamcinolone hexacetonide, and the stepwise escalation to the sulfasalazine and the anti-tumour-necrosis-factor biologic.

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Relative energy deficiency in sport and athlete nutrition — formative SAQs

Formative SAQs on relative energy deficiency in sport and athlete nutrition: defining energy availability and the disruption threshold, distinguishing the Female Athlete Triad from RED-S, recognising the bone stress injury the absent menstrual cycle and the falling weight, reporting the bone density with the Z-score, and managing the athlete with energy restoration as the first-line treatment through a multidisciplinary team.

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Scleroderma, mixed connective-tissue disease and overlap syndromes: SAQ

Short-answer questions on the paediatric scleroderma, covering the distinction between the localised scleroderma (morphea) and the juvenile systemic sclerosis, the Zulian morphea classification with the linear subtype commonest, the PReS and ACR provisional criteria for the juvenile systemic sclerosis, the anti-U1-RNP overlap of the mixed connective-tissue disease, the methotrexate first-line therapy for the active localised disease, and the pulmonary arterial hypertension and the scleroderma renal crisis that drive the prognosis.

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Scoliosis and spinal deformity — formative SAQs

Formative SAQs on scoliosis and spinal deformity: measuring and staging the curve with the Cobb angle, the Risser sign, and the Sanders scale, running the red-flag screen that separates the idiopathic from the non-idiopathic curve, applying the observe-brace-surgery ladder of under 25, 25 to 40, and 45 to 50 degrees or more, defending bracing with the BrAIST trial, and recognising the early-onset curve that threatens the developing lung.

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Slipped capital femoral epiphysis — formative SAQs

Formative SAQs on slipped capital femoral epiphysis: applying the Loder stability classification to the overweight adolescent with a limp, grading the Southwick angle on the frog-lateral radiograph, recognising the unstable slip as an orthopaedic emergency with a near-fifty per cent avascular necrosis risk, and identifying the atypical age-weight presentation that demands an endocrine work-up.

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Sports injury prevention and overuse injuries — formative SAQs

Formative SAQs on overuse and preventable sports injuries in children and adolescents: separating the overuse (microtrauma) injury from the acute injury, recognising the traction apophysitides and their age bands, applying the injury-risk triad of specialization, training volume and inadequate recovery, and delivering load management with relative rest and a graded return to play while screening for the stress-fracture and relative energy deficiency in sport red flags.

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Systemic juvenile idiopathic arthritis and macrophage activation syndrome: SAQ

Short-answer questions on systemic juvenile idiopathic arthritis and macrophage activation syndrome, covering the ILAR classification, the 2016 EULAR ACR PRINTO MAS criteria, the interleukin-one and interleukin-six blockade, the paradoxical MAS under the tocilizumab, and the refractory MAS escalation.

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Systemic lupus erythematosus: SAQ

Short-answer questions on childhood-onset systemic lupus erythematosus covering a 13-year-old girl with a malar rash, oral ulcers, non-erosive arthritis, cytopenias, positive anti-dsDNA, and low complement; the EULAR/ACR 2019 weighted classification criteria; and the hydroxychloroquine backbone with retinopathy screening and the stepwise escalation to immunosuppression.

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Transient synovitis and the irritable hip — formative SAQs

Formative SAQs on transient synovitis and the irritable hip: applying the Kocher criteria to exclude septic arthritis, interpreting the ultrasound effusion and the inflammatory markers, choosing between watchful waiting and urgent aspiration, recognising the Kingella kingae mimic in the under-four, and applying the safety-net review for the persistent limp.

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Domain

pain-palliative-and-end-of-life-care

13

Acute nociceptive pain management — formative SAQs

Two MedVellum formative short-answer questions on the management of acute nociceptive pain in children: the stepwise, multimodal, opioid-sparing management of a postoperative child up the WHO two-step ladder, including the morphine dose, the patient-controlled analgesia parameters and the sedation-score monitoring with naloxone available; and the early management of a sickle-cell vaso-occlusive pain crisis per the 2020 American Society of Hematology guideline, including opioid analgesia, hydration, incentive spirometry and the individualised pain plan. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Care in the last days of life — formative SAQs

Formative SAQs on care in the last days of life covering definition, classification, bedside pathway, red flags, documentation and family support.

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Chronic primary and secondary pain in children: SAQ

Short-answer questions on chronic primary and secondary pain in children, covering the ICD-11 distinction between primary and secondary pain, the nociplastic mechanism and central sensitisation, the biopsychosocial assessment and red-flag screen, and the interdisciplinary rehabilitation plan built on graded physical reactivation, psychological therapy and judicious, opioid-sparing pharmacology.

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Grief, bereavement and sibling support — formative SAQs

Formative SAQs on grief, bereavement and sibling support covering definition, classification, bedside pathway, red flags, documentation and family support.

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Neuropathic pain in children: SAQ

Short-answer questions on neuropathic pain in children covering the IASP and NeuPSIG definition and grading, the recognition of complex regional pain syndrome and the rehabilitation-first plan, and the cautious off-label use of gabapentin and amitriptyline with their dosing, monitoring, and the limited paediatric evidence base.

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Opioid stewardship and complex analgesia — formative SAQs

Two MedVellum formative short-answer questions on paediatric opioid stewardship and complex analgesia: the weight-based morphine and patient- and nurse-controlled analgesia doses with the sedation-score monitoring, the multimodal opioid-sparing backbone, and the opioid rotation with the equianalgesic principle and the incomplete cross-tolerance reduction; and the recognition and titrated management of opioid-induced respiratory depression including the naloxone dose and the plan for recurrence. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Organ and tissue donation in children — formative SAQs

Formative SAQs on organ and tissue donation in children covering definition, classification, bedside pathway, red flags, documentation and family support.

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Paediatric palliative care principles and referral — formative SAQs

Formative SAQs on the WHO definition and parallel-care model of paediatric palliative care, the four Together for Short Lives (ACT) categories with worked examples, the referral triggers including the Paediatric Palliative Screening Scale (PaPaS), the four domains of suffering, the relationship between the palliative referral and the resuscitation decision, and bereavement follow-through.

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Pain assessment across developmental and cognitive abilities — formative SAQs

Formative SAQs on self-report as the gold standard with the Faces Pain Scale-Revised and the Numerical Rating Scale; FLACC for the two-month to seven-year-old; individualised observational assessment with the revised FLACC and the Non-communicating Children's Pain Checklist for the child with cognitive impairment; COMFORT-behaviour in the PICU; the under-assessment traps of the quiet, freeze, habituated, sedated and paralysed child; and pain as the fifth vital sign with reassessment against the predicted response.

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Palliative care in cancer — formative SAQs

Formative SAQs on palliative care in childhood cancer: the World Health Organization definition and the concurrent parallel model, the early referral at the diagnosis of the high-risk disease, the World Health Organization analgesic ladder and the opioid stewardship for the cancer pain, the goals-of-care and advance care planning conversation, and the bereavement follow-up and the sibling support.

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Palliative care in neurodisability and genetic disease — formative SAQs

Formative SAQs on palliative care in neurodisability and genetic disease covering definition, classification, bedside pathway, red flags, documentation and family support.

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Symptom control in serious paediatric illness — formative SAQs

Formative SAQs on symptom control in serious paediatric illness: the WHO two-step analgesic ladder and weight-based morphine dosing with breakthrough and opioid rotation; the central mechanism of opioid relief of breathlessness and the role of oxygen; matching an antiemetic to the emetic pathway; the stepwise management of terminal agitation and delirium with exclusion of reversible causes; anticholinergic choice for noisy respiratory secretions (death rattle); the subcutaneous route and syringe driver; anticipatory (just-in-case) prescribing; and proportionate palliative sedation for refractory symptoms.

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Withholding and withdrawing life-sustaining treatment — formative SAQs

Formative SAQs on withholding and withdrawing life-sustaining treatment covering definition, classification, bedside pathway, red flags, documentation and family support.

Open

Domain

cardiology

35

Acute rheumatic fever and rheumatic heart disease — formative SAQs

Formative SAQs on acute rheumatic fever and rheumatic heart disease: applying the revised Jones criteria, recognising subclinical carditis on echocardiography, confirming the streptococcal link with serology, committing to secondary prophylaxis with benzathine penicillin, and managing the pregnant young woman with established RHD.

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Adult congenital heart disease transition — formative SAQs

Formative SAQs on the transition of the adolescent with congenital heart disease to adult ACHD care: the structured transition process and readiness assessment, the complexity-based surveillance interval, the danger of loss to follow-up, and the adult-life counselling on contraception, pregnancy risk by the modified WHO classes, and targeted infective endocarditis prophylaxis.

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Aortic and pulmonary stenosis — formative SAQs

Formative SAQs on aortic and pulmonary stenosis: classifying the obstruction by anatomic level, grading severity by echo peak gradient, recognising the duct-dependent critical neonate, and matching the intervention to the lesion from balloon valvuloplasty to the Ross procedure.

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Atrial septal defect and partial anomalous pulmonary venous return — formative SAQs

Formative SAQs on atrial septal defect and partial anomalous pulmonary venous return: recognising the wide fixed split second heart sound, confirming and quantifying the shunt with echocardiography, the device-versus-surgery closure decision, and the contraindication in Eisenmenger physiology.

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Atrioventricular septal defect — short-answer question

Short-answer question on the anatomy, classification, ECG, and timing of surgical repair of atrioventricular septal defect, with the Down syndrome association.

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Bradyarrhythmias, heart block and pacing — formative SAQs

Formative SAQs on paediatric bradyarrhythmias, atrioventricular block and pacing: the ECG classification of AV block and the Mobitz I versus Mobitz II distinction, congenital complete heart block from maternal anti-Ro antibodies, the unstable bradycardic child and transcutaneous pacing, and the permanent pacemaker indications including the seven-to-ten-day post-operative rule.

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Cardiac transplantation and ventricular assist devices — formative SAQs

Two formative SAQs on advanced paediatric heart failure: the infant with a dilated cardiomyopathy who becomes refractory to medical therapy and is bridged with a Berlin Heart EXCOR, and the adolescent on a ventricular assist device who develops a stroke while awaiting transplantation.

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Cardiogenic shock and mechanical circulatory support — formative SAQs

Two formative SAQs on cardiogenic shock and mechanical circulatory support in children: the school-age child who presents three days after a viral illness in compensated then decompensating cardiogenic shock from fulminant myocarditis, testing the bedside distinction from distributive shock, the cautious-fluid principle, the SCAI stages, and the escalation to venoarterial extracorporeal membrane oxygenation as a bridge to recovery; and the adolescent with decompensated dilated cardiomyopathy requiring a durable ventricular assist device, testing the device choice, the four goals of support, the anticoagulation complication burden, and the bridge-to-transplant framing.

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Cardiomyopathies in children — formative SAQs

Two formative SAQs on paediatric cardiomyopathy: the adolescent with exertional syncope and a family history of sudden death (hypertrophic cardiomyopathy and sudden-death risk stratification), and the infant presenting in heart failure with a fast heart rate (dilated cardiomyopathy and the tachycardiomyopathy differential).

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Cardiovascular examination and murmur assessment — formative SAQs

Formative SAQs on performing the systematic paediatric cardiovascular examination, recognising the innocent murmur fingerprint and the departures that mark a murmur as pathological, measuring the four-limb blood pressure and the pre- and post-ductal saturation, and resuscitating the duct-dependent neonate with prostaglandin E1 and the hypercyanotic spell with the knee-to-chest bundle.

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Coarctation and interrupted aortic arch — formative SAQs

Two formative SAQs on coarctation of the aorta and interrupted aortic arch in children: the neonate who collapses on day three of life with weak femoral pulses and metabolic acidosis, testing the prostaglandin-E1-first rule and the ductal-dependent mechanism; and the adolescent girl with coarctation, Turner syndrome and a bicuspid aortic valve, testing the syndromic associations, the four-limb blood-pressure examination and the lifelong follow-up.

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Congenital coronary anomalies and ALCAPA — formative SAQs

Formative SAQs on congenital coronary anomalies: the recognition and pathophysiology of ALCAPA in the two- to three-month-old infant, the echocardiographic definition of coronary origin and course, the surgical re-establishment of dual coronary flow, and the risk stratification and exercise restriction of anomalous aortic origin in the young athlete.

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Cyanotic newborn and critical congenital heart disease screening — formative SAQs

Formative SAQs on the cyanotic newborn and critical congenital heart disease screening: applying the pulse-oximetry thresholds, starting prostaglandin E1 before the echocardiogram, separating cyanotic congenital heart disease from pulmonary and sepsis mimics, and escalating to a cardiac centre.

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Duct-dependent congenital heart disease: SAQ

Short-answer questions on duct-dependent congenital heart disease covering a neonate presenting with cyanosis and shock on day 3 of life, including the two-pathway classification, emergency prostaglandin E1 therapy, side-effect management, the pulse oximetry screening programme, and the transfer pathway to a cardiac surgical centre.

Open

Ebstein anomaly and tricuspid valve disease — formative SAQs

Two formative SAQs on Ebstein anomaly and tricuspid valve disease in children: the severely cyanosed neonate with a wall-to-wall heart, functional pulmonary atresia and metabolic acidosis, testing the prostaglandin-E1-first rule, the GOSE-scored severity grading and the cone-versus-Starnes surgical decision; and the adolescent with previously undiagnosed Ebstein presenting with palpitations, pre-excitation on the ECG and an accessory pathway, testing the arrhythmia link, the lifelong surveillance and the transition to adult congenital heart disease services.

Open

Exercise evaluation and sports participation in heart disease — formative SAQs

Formative SAQs on exercise evaluation and sports participation in heart disease: the red-flag exertional history and the 12-lead ECG, the Mitchell dynamic x static sport classification, the three-tier clearance decision applied across innocent murmurs and repaired lesions through bicuspid valve and repaired tetralogy to hypertrophic cardiomyopathy and channelopathy, and venue safety with a written emergency action plan and an accessible AED.

Open

Heart failure in infants and children — formative SAQs

Two formative SAQs on heart failure in children: the six-week-old infant presenting in overcirculation from a left-to-right shunt, and the adolescent with acute myocarditis progressing toward refractory pump failure and the transplantation pathway.

Open

Hypertension in children — formative SAQs

Two formative SAQs on hypertension in children: a six-year-old with stage 2 hypertension and abnormal urinalysis found at a school health check, testing the secondary-cause work-up and the renal-parenchymal pathway; and a fourteen-year-old with primary hypertension, obesity and an elevated ambulatory blood pressure load, testing the confirmation rule, the target-organ screen and the lifestyle-versus-drug decision.

Open

Hypoplastic left heart syndrome — formative SAQs

Two formative SAQs on hypoplastic left heart syndrome: the neonate who collapses on day three of life with uniformly weak pulses and metabolic acidosis, testing the prostaglandin-E1-first rule and the ductal-dependent mechanism; and the interstage infant between the Norwood and the Glenn, testing the interstage mortality window, the home-monitoring strategy and the response to deterioration.

Open

Infective endocarditis — formative SAQs

Two formative SAQs on infective endocarditis in children: a nine-year-old with repaired tetralogy of Fallot who presents with two weeks of fever, a new murmur and viridans streptococcal bacteraemia, testing the Modified Duke criteria, the culture-before-antibiotic discipline and the targeted-therapy duration; and a neonate with a central line and persistent Staphylococcus aureus bacteraemia, testing the recognition of right-sided endocarditis, line removal and the antibiotic regimen for prosthetic material.

Open

Innocent murmurs and normal paediatric cardiovascular variants — formative SAQs

Formative short-answer questions on recognising innocent murmurs and excluding pathology.

Open

Kawasaki disease and coronary complications — formative SAQs

Formative SAQs on Kawasaki disease and its coronary complications: the clinical diagnostic criteria and the concept of incomplete disease, the ten-day IVIG and aspirin window and its evidence base, IVIG-resistant disease and its escalation, coronary z-score grading and anti-thrombotic management, and the long-term risk of stenosis and myocardial infarction.

Open

Long-QT syndrome and channelopathies — formative SAQs

Formative SAQs on long-QT syndrome and channelopathies: the genotype-specific triggers, the Schwartz diagnostic score and manual QTc measurement, the beta-blocker-first management with LCSD and ICD escalation, and the related entity CPVT with its structurally normal heart and normal resting ECG.

Open

Myocarditis and pericarditis — formative SAQs

Two formative SAQs on acquired inflammatory heart disease in children: the school-age child who presents a week after a viral illness with chest pain, a raised troponin and ventricular dysfunction, testing the diagnostic triad, the fulminant-myocarditis escalation rule and the selective-immunotherapy principle; and the adolescent with recurrent pericarditis and a friction rub, testing the non-steroidal-anti-inflammatory plus colchicine regimen, the corticosteroid-avoidance principle and the emergency-management of tamponade.

Open

Patent ductus arteriosus — formative SAQs

Two formative SAQs on the congenital patent ductus arteriosus: the pathophysiology and clinical assessment of the persistent duct, and the observe-transcatheter-surgical management ladder with the Eisenmenger boundary and the endocarditis-prophylaxis reframe.

Open

Postural orthostatic tachycardia syndrome — formative SAQs

Two formative SAQs on postural orthostatic tachycardia syndrome in young people: a 15-year-old girl with four months of daily orthostatic symptoms meeting POTS criteria, testing the standing-test thresholds, the cardiac-exclusion step and the stepwise non-pharmacological management; and a 14-year-old boy who collapses sprinting with no prodrome and a family history of sudden death, testing the recognition that this is not POTS and the urgent cardiac work-up.

Open

Pulmonary hypertension in children — formative SAQs

Formative SAQs on pulmonary hypertension in children: the haemodynamic definition and WHO classification, the echocardiographic and catheter-based diagnosis, the risk-stratified combination therapy, and the Eisenmenger threshold judgement.

Open

Supraventricular tachycardia — formative SAQs

Formative SAQs on paediatric supraventricular tachycardia: recognition of the pale irritable infant, the acute termination ladder, the ECG interpretation including AVNRT pseudo R-prime and Wolff-Parkinson-White pattern, long-term pharmacological management, catheter ablation, and the risk stratification of WPW syndrome.

Open

Syncope and orthostatic intolerance — formative SAQs

Two formative SAQs on syncope and orthostatic intolerance in children and adolescents: the adolescent who collapses during a school sprint with no prodrome and a family history of sudden death, testing the cardiac red-flag screen and the urgent work-up; and the adolescent girl with months of daily orthostatic symptoms meeting POTS criteria, testing the standing-test thresholds and the stepwise non-pharmacological management.

Open

Tetralogy of Fallot — formative SAQs

Formative SAQs on tetralogy of Fallot: the four features and their embryologic unity, the hypercyanotic tet spell and its emergency management, the echo-to-MRI diagnostic strategy, primary repair versus staged palliation, and the late burden of pulmonary regurgitation and sudden cardiac death.

Open

Total anomalous pulmonary venous connection — formative SAQs

Formative SAQs on total anomalous pulmonary venous connection: the obstructed neonatal presentation as a surgical emergency, the Darling classification, the echocardiographic diagnosis, and the surveillance for recurrent pulmonary venous obstruction.

Open

Transposition of the great arteries — formative SAQs

Formative SAQs on transposition of the great arteries: recognising the parallel-circulation problem in the 'comfortably blue' neonate, the resuscitation trio of prostaglandin E1, balloon atrial septostomy and arterial switch, and the long-term legacy of the atrial-switch era in the adult patient.

Open

Truncus arteriosus and single-ventricle physiology — formative SAQs

Two formative SAQs on truncus arteriosus and single-ventricle physiology. The first tests the neonate who is mildly cyanotic then develops high-output heart failure as pulmonary vascular resistance falls — the truncus bedside picture, the mechanism and the complete neonatal repair. The second tests the staged Fontan pathway, the interstage mortality that home monitoring targets, and the long-term Fontan burden.

Open

Ventricular arrhythmias and sudden cardiac death — formative SAQs

Formative SAQs on ventricular arrhythmias and sudden cardiac death in children: the rhythm classification and four SCD cause families, the acute resuscitation of pulseless VT and VF within the shockable-rhythm loop, the synchronised cardioversion versus amiodarone approach for sustained VT, post-arrest targeted temperature management, the ICD and cascade screening strategy, and the related entity commotio cordis.

Open

Ventricular septal defect — formative SAQs

Two formative SAQs on ventricular septal defect: the infant presenting in heart failure from overcirculation at six weeks, and the adolescent with a large unrepaired VSD and Eisenmenger physiology.

Open

Domain

respiratory-sleep-and-airway

35

Acute severe and life-threatening asthma — formative SAQs

Formative SAQs on grading acute asthma severity, the stepwise escalation from oxygen and continuous salbutamol through ipratropium and steroid to IV magnesium and IV bronchodilators, recognising life-threatening features, and safe disposition and prevention.

Open

Aspiration, swallowing dysfunction and chronic lung injury — formative SAQs

Formative SAQs on recognising chronic aspiration and silent aspiration in the neurologically impaired child, characterising the route, choosing instrumental swallow assessment, and building the multidisciplinary feeding, saliva-control, reflux and lung-protection plan.

Open

Asthma diagnosis and long-term control — formative SAQs

Two formative SAQs on the diagnosis and long-term control of childhood asthma: the school-age child with recurrent cough and wheeze needing objective confirmation and a controller plan, and the adolescent with apparently uncontrolled asthma whose real problem is adherence and technique.

Open

Behavioural insomnia and circadian rhythm disorders — formative SAQs

Two formative SAQs on paediatric sleep-timing problems: the toddler with sleep-onset association behavioural insomnia and frequent night wakings (recognition and behavioural treatment), and the adolescent with delayed sleep-wake phase disorder and school refusal (recognition, assessment and combined light and melatonin therapy).

Open

Bronchiectasis in children — short-answer question

Short-answer question on the definition and chronic suppurative lung disease continuum, the vicious cycle, the aetiological work-up, and the airway-clearance-and-antibiotic management of bronchiectasis in children.

Open

Bronchiolitis and viral lower respiratory tract infection — formative SAQs

Formative SAQs on grading bronchiolitis severity, supportive care with feeding, targeted oxygen and high-flow rescue, the drugs to withhold, apnoea in the young infant, and disposition with safety-net advice.

Open

Central sleep apnoea and hypoventilation syndromes — formative SAQs

Two formative SAQs on central disorders of the control of breathing: a term neonate who breathes when awake but hypoventilates and desaturates in sleep with a normal heart and lungs, testing the recognition of congenital central hypoventilation syndrome, the ventilate-not-oxygenate principle and the PHOX2B confirmation; and a five-year-old with rapid-onset obesity then hypoventilation, testing the ROHHAD diagnosis, the search for a neural crest tumour and the multisystem surveillance.

Open

Chronic cough in children — short-answer question

Short-answer question on the definition, classification by cough quality, specific-cough pointers, and the antibiotic-first management of chronic wet cough in children.

Open

Community-acquired pneumonia — formative SAQs

Formative SAQs on assessing and grading childhood pneumonia severity, choosing first-line oral amoxicillin and the route of therapy, restrained investigation, recognising atypical pneumonia and empyema, and safe disposition with safety-net advice.

Open

Congenital lung and airway malformations — short-answer question

Short-answer question on an antenatally detected congenital lung malformation — the classification, the postnatal work-up, the neonatal safety issues, and the surgery-versus-surveillance decision for the asymptomatic lesion.

Open

Croup — formative SAQs

Formative SAQs on grading croup severity, giving corticosteroid to every child, using nebulised adrenaline and observation, distinguishing croup from its dangerous mimics, and disposition with safety-net advice.

Open

Cystic fibrosis: diagnosis and screening — formative SAQs

Formative SAQs on interpreting a positive newborn screen and the confirmatory sweat test, applying the diagnostic criteria and sweat chloride thresholds, recognising meconium ileus and pseudo-Bartter as CF presentations, and communicating an equivocal CRMS/CFSPID result.

Open

Cystic fibrosis: pulmonary and multidisciplinary management — formative SAQs

Formative SAQs on the four pillars of cystic fibrosis pulmonary care, eradicating a first Pseudomonas isolate, recognising and treating a pulmonary exacerbation, the role of CFTR modulators, and the multidisciplinary management of nutrition and complications.

Open

Epiglottitis and bacterial tracheitis: SAQ

Short-answer questions on a toxic preschool child with drooling and a muffled voice, covering recognition of epiglottitis, the do-no-harm approach, controlled airway management, and empiric antibiotics.

Open

Exercise-induced bronchoconstriction — formative SAQs

Two formative SAQs on exercise-induced bronchoconstriction in children: the school-age child with cough and wheeze on sport needing objective confirmation and a management plan, and the adolescent athlete whose exertional breathlessness must be distinguished from inducible laryngeal obstruction.

Open

Foreign-body aspiration — formative SAQs

Two formative SAQs on foreign-body aspiration: the toddler with a witnessed choking episode and a normal chest radiograph, and the child with recurrent same-lobe pneumonia and a fixed wheeze representing a missed retained foreign body.

Open

Interstitial lung disease in children — short-answer question

Short-answer question on the chILD syndrome, the age-based classification, the surfactant-dysfunction and NEHI paradigms, the diagnostic pathway of exclusion, HRCT, genetics and biopsy, and the supportive-plus-disease-specific management of children's interstitial lung disease.

Open

Laryngomalacia, tracheomalacia and vocal-cord dysfunction: SAQ

Short-answer questions on dynamic paediatric airway collapse: an infant with position-dependent inspiratory stridor and feeding difficulty, covering the localisation of noisy breathing, the natural history and red flags of laryngomalacia, awake flexible laryngoscopy, and the indications for supraglottoplasty.

Open

Narcolepsy and hypersomnolence — formative SAQs

Two formative SAQs on narcolepsy and the central disorders of hypersomnolence: a school-aged child with new irresistible daytime sleepiness and emotion-triggered loss of muscle tone, testing the recognition of cataplexy and narcolepsy type 1, the confirmatory sleep studies and orexin measurement, and the layered management; and an adolescent with excessive daytime sleepiness but no cataplexy, testing the differential between narcolepsy type 2, idiopathic hypersomnia and secondary sleepiness and the correct use of the multiple sleep latency test.

Open

Neuromuscular respiratory failure and airway clearance — formative SAQs

Two formative SAQs on neuromuscular respiratory failure: a boy with Duchenne muscular dystrophy with morning headaches, daytime sleepiness and recurrent chest infections, testing the recognition of nocturnal hypoventilation and cough failure and their separate treatments; and an infant with spinal muscular atrophy in a chest infection, testing the rule to clear secretions and ventilate rather than merely oxygenate and the anticipatory plan.

Open

Non-invasive ventilation and home respiratory support — formative SAQs

Two formative SAQs on paediatric non-invasive ventilation: the boy with Duchenne muscular dystrophy and morning headaches (recognising nocturnal hypoventilation, choosing bilevel, monitoring cough), and the infant with bronchiolitis (high-flow nasal cannula, escalation and the signs to intubate).

Open

Obstructive sleep apnoea in children — formative SAQs

Two formative SAQs on paediatric obstructive sleep apnoea: the preschooler with loud snoring, witnessed apnoeas and poor growth (recognition, investigation and adenotonsillectomy), and the obese adolescent with residual symptoms after surgery (residual OSA, CPAP and the high-risk airway).

Open

Oxygen therapy and home oxygen in children — formative SAQs

Two formative SAQs on oxygen therapy in children: an infant with bronchiolitis and a borderline saturation, testing the saturation target, the pulse oximeter's limits and when a rising oxygen requirement means escalation; and an ex-preterm infant with chronic lung disease being considered for home oxygen, testing the readiness criteria, the equipment and safety, and the structured weaning.

Open

Paediatric sleep investigations: polysomnography, sleep-study interpretation and MSLT — formative SAQs

Two formative SAQs on paediatric sleep investigations: a snoring preschooler with a polysomnogram report to interpret, testing event classification, the paediatric apnoea-hypopnoea index thresholds, the role of carbon dioxide and the choice of treatment; and a sleepy adolescent being worked up for narcolepsy, testing the prerequisites and interpretation of the multiple sleep latency test.

Open

Pleural effusion and empyema — formative SAQs

Formative SAQs on recognising a parapneumonic effusion in the pneumonia that will not settle, using ultrasound and Light's criteria, giving antibiotics to every child, choosing between fibrinolytics and VATS, and counselling on the excellent prognosis.

Open

Pneumothorax and air-leak syndromes — formative SAQs

Formative SAQs on recognising tension physiology and managing pneumothorax and air-leak syndromes in children.

Open

Primary ciliary dyskinesia — formative SAQs

Two formative SAQs on primary ciliary dyskinesia: the preschooler with a lifelong wet cough, chronic ear and nasal disease and situs inversus (recognition, diagnostic pathway and cystic fibrosis exclusion), and the school-aged child with confirmed PCD and early bronchiectasis (multidisciplinary management, infection control and azithromycin prophylaxis).

Open

Pulmonary haemorrhage and haemoptysis — short-answer question

Short-answer question on the definition and focal-versus-diffuse classification of paediatric pulmonary haemorrhage, the haemosiderin-laden macrophage, the exclusion-based diagnosis of idiopathic pulmonary haemosiderosis, and resuscitation-and-corticosteroid management.

Open

Recurrent pneumonia in children — short-answer question

Short-answer question on the definition of recurrent pneumonia, the same-site versus different-site classification, the structural and systemic causes, and the staged investigation and management.

Open

Recurrent wheeze in preschool children — formative SAQs

Two formative SAQs on recurrent preschool wheeze: the frequently-wheezy toddler well between colds (phenotype, Asthma Predictive Index, and the evidence for preventive therapy), and the acutely severe wheeze attack with an atypical feature (acute management by severity and the exclusion of a mimic).

Open

Respiratory distress and failure in children — formative SAQs

Formative SAQs on recognising and managing the child in respiratory distress and failure.

Open

Respiratory manifestations of systemic disease — short-answer question

Short-answer question on recognising and managing lung involvement in systemic disease in a child, anchored on sickle cell acute chest syndrome, with the disease-specific reflex across connective tissue disease, immunodeficiency, and malignancy.

Open

Spirometry and paediatric pulmonary-function testing — formative SAQs

Two formative SAQs on spirometry and pulmonary-function testing in children: interpreting an obstructive report with a bronchodilator response in a child with suspected asthma, and disentangling a reduced FVC to decide whether it represents true restriction or an artefact needing lung volumes.

Open

Tracheostomy care and emergencies: SAQ

Short-answer questions on a ventilator-dependent child whose tracheostomy tube blocks and then displaces, covering the emergency algorithm, oxygenation of both the face and the stoma, and the danger of an immature stoma tract.

Open

Upper-airway obstruction and stridor — formative SAQs

Two formative SAQs on upper-airway obstruction: the toddler with a barking cough and stridor at night (croup, severity grading and management), and the toxic drooling child with a rapidly threatened airway (epiglottitis versus bacterial tracheitis and the do-not-distress airway plan).

Open

Domain

adolescent-and-young-adult-medicine

28

Adolescent chronic pain and functional symptoms — formative SAQs

Two formative short-answer questions on adolescent chronic pain and functional symptoms: biopsychosocial assessment, red-flag screening once, function-first interdisciplinary management, school reintegration and avoidance of opioid escalation.

Open

Adolescent consent for research and sensitive services — formative SAQs

Two formative short-answer questions on adolescent consent for research enrolment and for sensitive clinical services, including assent and parental permission, waiver of parental permission, capacity assessment and conditional confidentiality.

Open

Adolescent consultation, HEEADSSS and confidentiality — formative SAQs

Two formative short-answer questions on running an adolescent consultation: time alone and conditional confidentiality, structured HEEADSSS, validated screens, and same-visit action on positive findings.

Open

Adolescent health care for young people in out-of-home care — formative SAQs

Two formative short-answer questions on the entry-to-care health assessment, the toxic-stress mechanism, consent authority, conditional confidentiality, and transition for care-experienced adolescents.

Open

Adolescent health in rural and remote settings — formative SAQs

Two formative short-answer questions on the rural adolescent access gap, its mechanism, a rural-optimised HEEADSSS, and the tiered service model with early retrieval activation.

Open

Adolescent pregnancy and parenting — formative SAQs

Two formative short-answer questions on adolescent pregnancy confirmation, options counselling, antenatal coordination, postpartum contraception and safeguarding.

Open

Adolescent risk assessment and harm minimisation — formative SAQs

Two formative short-answer questions on cross-domain adolescent risk assessment, validated screening, suicide safety, and a domain-specific harm-reduction bundle.

Open

Adolescent sexual health and contraception — formative SAQs

Two formative short-answer questions on confidential adolescent contraceptive counselling, the 5 Ps, LARC-first method choice, dual protection, emergency contraception and a safety override.

Open

Adolescent substance-use screening, brief intervention and harm reduction — formative SAQs

Two formative short-answer questions on universal substance-use screening (S2BI/CRAFFT), motivational-interviewing brief intervention, the fentanyl-era opioid harm-reduction bundle, and a confidentiality decision.

Open

Chronic disease self-management in young people — formative SAQs

Two formative short-answer questions on chronic-disease self-management in young people: assessing adherence and transition readiness objectively, and building a stepwise self-management plan with motivational interviewing.

Open

Consent and confidential care for adolescents — formative SAQs

Two formative short-answer questions on adolescent informed consent, decision-making capacity, conditional confidentiality and lawful override.

Open

Digital media, gaming and cyberbullying — formative SAQs

Two formative short-answer questions on classifying digital-media risk, cyberbullying and suicidality, and assembling a domain-specific harm-reduction bundle with a safeguarding exit.

Open

Dysmenorrhoea and heavy menstrual bleeding — formative SAQs

Two formative SAQs on dysmenorrhoea and heavy menstrual bleeding in the adolescent: the primary-vs-secondary dysmenorrhoea assessment and the NSAID-to-hormonal ladder, and the heavy-from-menarche adolescent and the bleeding-disease screen.

Open

Eating disorders: recognition and medical instability — formative SAQs

Two formative short-answer questions on recognising an eating disorder, applying SCOFF, quantifying medical instability, and identifying the red flags that mandate admission.

Open

Eating disorders: refeeding and multidisciplinary care — formative SAQs

Two formative short-answer questions on refeeding-syndrome risk stratification, micronutrient and electrolyte management, higher-calorie refeeding evidence, family-based treatment and multidisciplinary-care planning.

Open

Gender diversity and gender-affirming paediatric care — formative SAQs

Two formative short-answer questions on the staged, reversible-first gender-affirming pathway, the minority-stress model, conversion-effort prohibition, and bone-health and fertility surveillance in trans and gender-diverse adolescents.

Open

Medication adherence and treatment fatigue — formative SAQs

Two formative short-answer questions on adolescent medication adherence assessment, treatment fatigue, multimodal measurement, and a tailored, non-judgemental adherence-promotion plan.

Open

Menstrual disorders in adolescents — formative SAQs

Two formative short-answer questions on adolescent menstrual disorders: classification of abnormal uterine bleeding, the heavy menstrual bleeding work-up, and stepwise management.

Open

Normal puberty and adolescent development — formative SAQs

Two formative short-answer questions on normal pubertal staging, sequence, timing, normal variants and the referral thresholds for abnormal puberty.

Open

Obesity and body-image concerns in adolescents — formative SAQs

Two formative short-answer questions on adolescent obesity classification with comorbidity screening, body-image and disordered-eating assessment, and staged weight-neutral management.

Open

Polycystic ovary syndrome in adolescents — formative SAQs

Two formative short-answer questions on adolescent PCOS diagnosis with developmental modification, mimic exclusion, lifestyle-first management and metabolic screening.

Open

School refusal, bullying and social exclusion — formative SAQs

Formative SAQs on overlapping school refusal, bullying victimisation and social exclusion: Kearney functional analysis adapted to adolescence, bully-role assessment, suicide risk, graded return and SSRI evidence.

Open

Sexual orientation, identity and inclusive care — formative SAQs

Two formative short-answer questions on affirming history-taking, the minority-stress model, behaviour-based screening, confidentiality, family acceptance and the harms of sexual orientation and gender identity change efforts in adolescent care.

Open

Sexually transmitted infection screening and management — formative SAQs

Two formative short-answer questions on confidential adolescent STI screening, risk- and anatomy-based testing, treatment with pregnancy-aware dosing, partner services and rescreening.

Open

Sleep, fatigue and circadian disorders in adolescents — formative SAQs

Two formative short-answer questions on adolescent sleep physiology, the differential of the tired teenager, and the stepped-care management of insufficient sleep, insomnia and delayed sleep-wake phase disorder.

Open

Tobacco, vaping and nicotine dependence — formative SAQs

Two formative short-answer questions on adolescent nicotine dependence assessment, EVALI recognition, evidence-based cessation pharmacotherapy and follow-up.

Open

Transition readiness and transfer from paediatric to adult health services — formative SAQs

Formative SAQs on structured transition planning, readiness assessment, the transfer package and rescue of the lost young adult.

Open

Youth violence, risky behaviour and injury prevention — formative SAQs

Two formative short-answer questions on the public-health approach to youth violence and injury prevention, private screening, prevention tiering, lethal-means counselling, and immediate-safety exits.

Open

Domain

growth-development-and-behaviour

34

Adolescent transition for neurodevelopmental disability — formative SAQs

Formative SAQs on structured transition planning, readiness and warm handoff for neurodevelopmental disability.

Open

Attention-deficit hyperactivity disorder — formative SAQs

Formative SAQs on multi-setting ADHD diagnosis, mimics and multimodal management.

Open

Augmentative communication, assistive technology and adaptive equipment — formative SAQs

Formative SAQs on AAC prescription, PECS/SGD evidence, seating/access and powered mobility for participation.

Open

Autism spectrum disorder — formative SAQs

Formative SAQs on autism spectrum disorder assessment and management.

Open

Behavioural assessment and functional analysis — formative SAQs

Two formative SAQs on ABC functional assessment, four functions, PBS/FCT and limited medication after formulation.

Open

Behavioural management of defiance and oppositional behaviours — formative SAQs

Two formative SAQs on ODD versus CD formulation, coercive cycles, parent training first-line care and limited medication role.

Open

Cerebral palsy early recognition and classification — formative SAQs

Formative SAQs on CP definition, early detection tools and functional classification.

Open

Cerebral palsy surveillance and multidisciplinary management — formative SAQs

Two formative SAQs on GMFCS-linked hip surveillance, functional classification, tone pathways and medical-home coordination in cerebral palsy.

Open

Children with developmental disability in acute care — formative SAQs

Formative SAQs on diagnostic overshadowing, r-FLACC pain assessment and reasonable adjustments in acute care.

Open

Children with disability in school and community settings — formative SAQs

Formative SAQs on school medical letters, emergency plans and participation supports.

Open

Developmental assessment: history, examination and standardised tools — formative SAQs

Formative SAQs on structured developmental assessment, tools and first actions.

Open

Developmental coordination disorder — formative SAQs

Two formative SAQs on DCD criteria, red-flag exclusions, assessment tools and task-oriented management.

Open

Developmental delay: global diagnostic approach — formative SAQs

Formative SAQs on global developmental delay diagnostic approach.

Open

Developmental regression — formative SAQs

Formative SAQs on urgent recognition and work-up of developmental regression.

Open

Early intervention and developmental care planning — formative SAQs

Formative SAQs on parallel referral, family-centred care plans and urgent developmental gates.

Open

Family-centred developmental care and goal setting — formative SAQs

Formative SAQs on PFCC principles, F-words/ICF-CY framing and GAS/COPM goal co-production.

Open

Feeding problems, food refusal and selective eating — formative SAQs

Two formative short-answer questions on classifying selective eating versus PFD/ARFID and building a stepwise multidisciplinary plan without force-feeding.

Open

General movements and HINE — formative SAQs

Formative SAQs on GMs windows, HINE optimality and combined early CP detection.

Open

Hearing impairment and development — formative SAQs

Formative SAQs on PCHI management, mild loss and post-meningitis pathways.

Open

Intellectual developmental disorder — formative SAQs

Two formative SAQs on IDD diagnostic criteria, GDD framing, aetiological evaluation and longitudinal care.

Open

Motor delay, hypotonia and the floppy infant — formative SAQs

Two formative SAQs on central versus peripheral localisation, can't-miss SMA and botulism pathways, and structured first-line work-up.

Open

Neurodiversity-affirming developmental care — formative SAQs

Formative SAQs on person–environment fit, double empathy, camouflaging/burnout, language preference and closed-loop affirming plans.

Open

Normal cognitive, emotional and behavioural development — formative SAQs

Formative SAQs on age-expected cognition, temperament, self-regulation and action thresholds.

Open

Normal growth from fetal life through adolescence — formative SAQs

Formative SAQs on ICP growth physiology, chart selection and normal-variant versus pathological short stature.

Open

Normal language, communication and social development — formative SAQs

Formative SAQs on normal language and social-communication milestones, red flags and bedside plans.

Open

Normal motor development and developmental variation — formative SAQs

Formative SAQs on WHO motor windows, healthy variation, bedside exam and first-line action bands.

Open

School refusal and school attendance problems — formative SAQs

Formative SAQs on Kearney functional analysis, anxious refusal versus truancy, graded return-to-school, and SSRI evidence for underlying anxiety.

Open

Sensory processing differences — formative SAQs

Formative SAQs on sensory feature classification, assessment, therapy evidence and ethics of care.

Open

Social communication concerns and autism recognition — formative SAQs

Formative SAQs on autism red flags, screening limits and early referral.

Open

Specific learning disorders — formative SAQs

Two formative SAQs on SLD domain classification, medical evaluation, vision-therapy counselling and stepwise school–health management.

Open

Speech and language delay — formative SAQs

Two formative SAQs on speech versus language classification, hearing pathway, late talker versus DLD, and concurrent referral.

Open

Temper tantrums, aggression and emotional dysregulation — formative SAQs

Two formative SAQs on developmental versus impairing tantrums, ABC assessment, parenting first-line care, corporal punishment counselling and specialist escalation.

Open

Toilet training and elimination behaviour — formative SAQs

Formative SAQs on toilet-training readiness, enuresis classification and non-punitive elimination management.

Open

Visual impairment and development — formative SAQs

Formative SAQs on visual impairment and developmental impact.

Open

Domain

clinical-pharmacology-and-therapeutics

22

Adverse drug reactions and pharmacovigilance — formative SAQs

Two formative short-answer questions on ADR classification, causality assessment, and the management and reporting of a suspected severe cutaneous adverse drug reaction in a child.

Open

Analgesics and antipyretics — formative SAQs

Two MedVellum formative short-answer questions on paediatric analgesics and antipyretics: the weight-based calculation of a paracetamol and ibuprofen dose with the adult ceiling, the position on alternating agents, and the safety boundaries of aspirin avoidance and the codeine and tramadol restriction; and the recognition and management of a paracetamol overdose including the time of ingestion, the four-hour level and the N-acetylcysteine decision. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Cardiovascular medicines in children — formative SAQs

Formative SAQs on cardiovascular medicines in children: designing a prostaglandin E1 resuscitative plan for a duct-dependent neonate, and building the stepwise pharmacological management of paediatric heart failure with the carvedilol and single-ventricle enalapril trial evidence in mind.

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Chemotherapy and supportive pharmacology — formative SAQs

Two MedVellum formative short-answer questions on chemotherapy and supportive pharmacology in children: dexrazoxane cardioprotection for the high-cumulative-dose anthracycline child with the vincristine-intravenous-only route rule, and the antiemetic ladder for highly emetogenic regimens with colony-stimulating factor prophylaxis for febrile neutropenia and palifermin for transplant mucositis. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Complementary, alternative and traditional medicines — formative SAQs

Two formative SAQs on complementary, alternative and traditional medicines in children: the five CAM domains and why most use is undisclosed, the four pathways to harm (heavy-metal contamination, herb-drug interactions, misidentification and dosing inconsistency, delay of conventional care), the bedside safety conversation, and the regional regulatory and evidence picture.

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Corticosteroid therapy and adverse effects — formative SAQs

Formative SAQs on corticosteroid therapy in children: designing the dose and weaning plan for a child on long-term prednisolone for nephrotic syndrome, and recognising and managing adrenal crisis in a steroid-dependent child who collapses during a febrile illness with age-banded stress-dose hydrocortisone.

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Developmental pharmacology and age-related pharmacokinetics — formative SAQs

Two formative SAQs on developmental pharmacology: ADME ontogeny in the neonate and the management of a school-age child with subtherapeutic anti-epileptic levels.

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Drug interactions and medication reconciliation — formative SAQs

Two MedVellum formative short-answer questions on anticipating cytochrome P450-mediated drug interactions in children and reconciling every medicine at transitions of care: recognising a tacrolimus-azole interaction, predicting the direction and timing of inhibition versus induction, building a Best Possible Medication History, and performing a safe discharge reconciliation. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Endocrine and diabetes medicines — formative SAQs

Two formative short-answer questions on the DKA insulin and fluid prescribing sequence and on neonatal levothyroxine dosing with recheck planning, plus growth hormone dose and safety surveillance.

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Immunosuppressive and biologic therapies — formative SAQs

Two MedVellum formative short-answer questions on immunosuppressive and biologic therapy in children: low-dose weekly methotrexate as the anchor disease-modifying drug in juvenile idiopathic arthritis with folic acid and full-blood-count and liver-enzyme monitoring, and the pre-biologic screen for tuberculosis, hepatitis B and varicella before a tumour necrosis factor inhibitor is started, with live-vaccine timing and the management of the febrile child on treatment. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Inhaled therapies and device selection — formative SAQs

Formative SAQs on inhaled therapies and device selection in children: matching the device to the child's age and inspiratory flow using the age-based ladder, and defending the spacer-versus-nebuliser choice in acute asthma and the device-and-technique assessment of a 'failing' inhaled corticosteroid before escalating the dose.

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Medication adherence and formulation challenges — formative SAQs

Two formative SAQs on medication adherence and formulation challenges in children: the dimensions of adherence, the formulation gap and palatability science, age-appropriate formulations, excipient safety in neonates, and the stepwise formulation-and-adherence management pathway.

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Off-label and unlicensed medicine use — formative SAQs

Two formative SAQs on off-label and unlicensed medicine use in children: the three prescribing categories, the paediatric evidence gap, the safe-use governance pathway, and the link with adverse drug reactions and pharmacovigilance.

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Opioids and acute pain medicines — formative SAQs

Two MedVellum formative short-answer questions on opioids and acute pain medicines in children: recognising why codeine and tramadol are contraindicated through the CYP2D6 prodrug mechanism, and building a safe weight-based multimodal morphine regimen with paired monitoring, constipation prophylaxis, and a naloxone plan. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Pharmacogenomics and precision therapeutics — formative SAQs

Formative SAQs on pharmacogenomics in children: building a TPMT and NUDT15-guided thiopurine plan for a child with Crohn disease, and applying the HLA-B star 15 colon 02 and CYP2D6 reasoning to a child of Asian ancestry starting carbamazepine and a post-tonsillectomy child sent home with codeine.

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Poisoning antidotes and toxicology pharmacology — formative SAQs

Two MedVellum formative short-answer questions on poisoning antidotes and toxicology pharmacology in children: defending the N-acetylcysteine regimen and timing in paracetamol poisoning, and choosing and dosing the correct antidote across opioid, iron, lead, and snake-envenomation scenarios by mechanism and weight. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Procedural sedation medicines — formative SAQs

Formative SAQs on the medicines used for procedural sedation and analgesia in children: agent selection, ketamine dosing, fasting, monitoring, and adverse event management.

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Renal and hepatic dose adjustment in children — formative SAQs

Two formative short-answer questions on bedside Schwartz eGFR calculation with KDIGO staging and renal dose adjustment, and on Child-Pugh grading with hepatic dose adjustment and a high-risk drug-monitoring plan.

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Safe prescribing, administration and monitoring — formative SAQs

Formative SAQs on safe prescribing, administration and monitoring of medicines in children.

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Therapeutic drug monitoring — formative SAQs

Formative SAQs on therapeutic drug monitoring in children: choosing the vancomycin area-under-the-curve target and sampling time for serious MRSA infection, and applying the nonlinear Michaelis-Menten kinetics and free-fraction reasoning to a child with a toxic phenytoin level and hypoalbuminaemia.

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Vaccines and immunobiology — formative SAQs

Two MedVellum formative short-answer questions on vaccines and immunobiology in children: the live attenuated versus inactivated vaccine distinction with the four-week spacing rule and the contraindications in significant immunocompromise and pregnancy, and a catch-up plan for a child with an incomplete immunisation record built on minimum intervals with the rotavirus age limits and the premature-infant chronological-age rule, plus the recognition of anaphylaxis after a vaccine. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Weight-based dosing, body-surface area and dose calculation — formative SAQs

Two MedVellum formative short-answer questions on paediatric weight-based dosing, body-surface-area calculation and dose-calculation safety: the Mosteller formula worked at the bedside, the maximum adult-dose cap, the leading-zero and no-trailing-zero rules, the choice of weight scalar in obesity, and the therapeutic drug monitoring loop for vancomycin and gentamicin. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Domain

rural-remote-and-contextual-paediatrics

14

Advocacy, policy and health-service design for rural children — formative SAQs

Formative SAQs on advocacy, policy and health-service design for rural children.

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Avoiding racism and institutional bias in child health — formative SAQs

Formative SAQs on avoiding racism and institutional bias in child health.

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Child protection in small and remote communities — formative SAQs

Formative SAQs on child protection in small and remote communities.

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Disaster, outbreak and public-health response for children — formative SAQs

Formative SAQs on disaster, outbreak and public-health response for children.

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Environmental, occupational and agricultural child health — formative SAQs

Formative SAQs on environmental, occupational and agricultural child health.

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Implementing culturally safe Indigenous care in rural and remote services — formative SAQs

Formative SAQs on implementing culturally safe indigenous care in rural and remote services.

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Refugee, immigrant and humanitarian paediatrics — formative SAQs

Formative SAQs on refugee, immigrant and humanitarian paediatrics.

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Remote prescribing and medication access — formative SAQs

Formative SAQs on remote prescribing and medication access.

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Retrieval coordination and transfer risk — formative SAQs

Formative SAQs on retrieval coordination and transfer risk.

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Rural developmental, disability and mental-health care — formative SAQs

Formative SAQs on rural developmental, disability and mental-health care.

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Rural general paediatric practice and scope — formative SAQs

Formative SAQs on rural general paediatric practice and scope.

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Rural newborn and acute paediatric care — formative SAQs

Formative SAQs on rural newborn and acute paediatric care.

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Stabilisation with limited paediatric resources — formative SAQs

Formative SAQs on stabilisation with limited paediatric resources.

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Telepaediatrics and remote specialist support — formative SAQs

Formative SAQs on telepaediatrics and remote specialist support.

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Domain

clinical-assessment-and-reasoning

26

Age-specific normal vital signs and physiological ranges — formative SAQs

Formative SAQs.

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Care of children with medical complexity and technology dependence — formative SAQs

Two formative short-answer questions on CMC definition, technology-dependent deterioration, emergency planning, care coordination and caregiver support. Marks and timing support self-assessment; they are not an official board format.

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Clinical reasoning, problem representation and differential diagnosis — formative SAQs

Two formative short-answer questions on paediatric problem representation, threat-first differentials, cognitive traps and residual-risk handover.

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Continuity of care and the paediatric medical home — formative SAQs

Two formative short-answer questions on continuity domains, medical-home care coordination, loop closure and transition.

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Developmental surveillance and milestone assessment — formative SAQs

Formative SAQs on surveillance, screening and referral.

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Diagnostic test selection and Bayesian reasoning in paediatrics — formative SAQs

Two formative short-answer questions on pre-test probability, likelihood ratios, residual risk after results, and selective paediatric testing.

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Failure to thrive and faltering growth: diagnostic approach — formative SAQs

Formative SAQs on faltering growth diagnostic approach.

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Fatigue and lethargy in children and adolescents — formative SAQs

Formative SAQs on paediatric fatigue and lethargy diagnostic approach.

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Growth measurement, charting and interpretation — formative SAQs

Formative SAQs.

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Handover, referral and consultation in paediatrics — formative SAQs

Two formative short-answer questions on I-PASS handoff, ISBAR referral, residual risk and equity-safe communication.

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Illness severity, deterioration and track-and-trigger systems — formative SAQs

Two formative short-answer questions on paediatric PEWS interpretation, escalation, EPOCH evidence, caregiver concern and rapid-response system design. Marks and timing support self-assessment; they are not an official board format.

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Incidental findings and overdiagnosis in children — formative SAQs

Two formative short-answer questions on paediatric incidental findings, overdiagnosis definitions, cascade control, continuous monitoring and residual-risk communication.

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Interpreting common paediatric laboratory reference ranges — formative SAQs

Formative SAQs on age-aware paediatric laboratory interpretation, threshold types and critical-value safety.

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Lymphadenopathy and organomegaly: diagnostic approach — formative SAQs

Formative SAQs on lymphadenopathy and organomegaly diagnostic approach.

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Medication reconciliation and polypharmacy in children — formative SAQs

Two formative short-answer questions on BPMH, discrepancy classification, CMC polypharmacy and discharge teaching.

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Multimorbidity and diagnostic overshadowing in children — formative SAQs

Two formative short-answer questions on paediatric multimorbidity framing, diagnostic overshadowing, threat-first differentials, polypharmacy safety and residual-risk communication.

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Oedema in children: diagnostic approach — formative SAQs

Formative SAQs on paediatric oedema diagnostic approach.

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Paediatric history and age-adapted consultation — formative SAQs

Two formative short-answer questions on age-adapted paediatric history, confidential adolescent interviewing, interpreters, teach-back and safety-netting.

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Pallor in children: diagnostic approach — formative SAQs

Formative SAQs on paediatric pallor diagnostic approach.

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Poor feeding in infants and children — formative SAQs

Two formative short-answer questions on threat-first assessment of neonatal poor feeding and stepwise multidisciplinary care of chronic pediatric feeding disorder.

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Recognising the seriously ill child and paediatric assessment triangle — formative SAQs

Two MedVellum formative short-answer questions on recognising a seriously ill child, starting age-adapted ABCDE care, reassessing response, using caregiver-reported baseline change, checking medical technology, addressing safeguarding, and arranging rural retrieval. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Safe disposition, escalation, referral and safety-netting — formative SAQs

Two formative short-answer questions on capability-matched disposition, I-PASS handover, caregiver concern, safety-netting content/delivery and retrieval. Marks and timing support self-assessment; they are not an official board format.

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Shared-care planning across primary, secondary and tertiary care — formative SAQs

Two formative short-answer questions on shared-care models, closed-loop co-management, parent intermediaries and multi-level disposition.

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Structured physical examination from newborn to adolescent — formative SAQs

Two formative short-answer questions on age-adapted paediatric physical examination sequencing, newborn screening manoeuvres, measurement technique, safeguarding skin findings and conversion to ABCDE when threats appear.

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Telehealth assessment and remote examination of children — formative SAQs

Two formative short-answer questions on paediatric telehealth suitability, remote examination limits, stewardship, EMS activation and safety-netting.

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Weight loss in children and adolescents — formative SAQs

Formative SAQs on paediatric and adolescent weight-loss assessment.

Open

Domain

allergy-and-immunology

25

Allergic disease in children: integrated approach: SAQ

Short-answer questions on the integrated allergic child covering the shared Th2 mechanism and atopic march, IgE versus non-IgE classification, the anaphylaxis diagnosis and the intramuscular-adrenaline-first rule, early-allergen-introduction prevention, and the shared decision around oral immunotherapy.

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Allergic rhinitis and rhinoconjunctivitis — short-answer questions

Two short-answer questions on the ARIA classification, IgE pathophysiology and stepwise management of allergic rhinitis in a school-aged child.

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Anaphylaxis prevention, action plans and autoinjectors — formative SAQs

Formative SAQs on the community anaphylaxis prevention package: the prevention prescription written after a first anaphylactic reaction in a school-age child (the two ASCIA plans, the weight-appropriate adrenaline autoinjector, education and school liaison), and the risk stratification and transition planning for an adolescent with peanut anaphylaxis and uncontrolled asthma who does not carry the device — the classic fatal-risk triad.

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Anaphylaxis: recognition and emergency management — formative SAQs

Formative SAQs on anaphylaxis: the stepwise emergency management of a four-year-old with peanut anaphylaxis (recognition, IM adrenaline dose and site, adjuncts, observation, discharge package), and the recognition and management of an asthmatic adolescent with food anaphylaxis and no skin signs, including the refractory escalation, tryptase interpretation and the biphasic observation decision.

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Antibody deficiencies — formative SAQs

Formative SAQs on recognising the recurrent-infection pattern that earns an immunoglobulin work-up, interpreting the work-up functionally, classifying the defect, and deciding who needs immunoglobulin replacement.

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Atopic dermatitis and the atopic march — short-answer questions

Two short-answer questions on the diagnostic criteria, barrier-and-Th2 pathophysiology and stepwise management of atopic dermatitis in an infant, with the atopic march.

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Complement deficiencies — formative SAQs

Formative SAQs on recognising the three clinical fingerprints that earn a complement work-up, screening with CH50 and AP50 rather than a lone C3/C4, localising the block to a pathway, and tailoring prevention — meningococcal vaccination and antibiotic prophylaxis for terminal-pathway loss and C1-inhibitor-directed therapy for hereditary angioedema.

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Cow's-milk protein allergy — formative SAQs

Formative SAQs on the phenotyping, clinical diagnosis, and stepwise management of cow's-milk protein allergy in infants.

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Drug allergy and delabelling in children — formative SAQs

Formative SAQs on drug allergy and delabelling in children. SAQ 1 covers the stepwise evaluation and delabelling of a child with a low-risk penicillin-allergy label, including structured history, PEN-FAST risk stratification and the direct oral amoxicillin challenge pathway. SAQ 2 covers the recognition and immediate management of severe drug-allergy reactions (anaphylaxis and the severe delayed syndromes) and explains why these are never re-challenged.

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Egg, wheat, soy, fish and shellfish allergy: SAQ

Short-answer questions on paediatric egg, wheat, soy, fish and shellfish allergy covering the signature allergen proteins, IgE versus non-IgE mechanisms, skin-prick and specific-IgE interpretation, component-resolved diagnostics, the baked-egg ladder, anaphylaxis treatment with intramuscular adrenaline, and the prognosis that separates the childhood-outgrown allergens from the lifelong ones.

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Food allergy diagnosis and oral food challenge — formative SAQs

Formative SAQs on the diagnostic approach to food allergy: structured reaction history, interpretation of SPT and specific IgE thresholds, component-resolved diagnostics, oral food challenge protocol and safety, and the prevention paradigm shift from the LEAP trial.

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Food allergy management and prevention — formative SAQs

Two formative short-answer questions on managing a confirmed food-allergy reaction and on early-allergen-introduction prevention in a high-risk infant.

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Immune dysregulation, lymphoproliferation and autoinflammatory disease — formative SAQs

Formative SAQs on recognising the mechanism, clearing the HLH/MAS threat gate, and choosing pathway-targeted therapy for monogenic immune dysregulation, lymphoproliferation and autoinflammatory disease.

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Immunoglobulin replacement and antimicrobial prophylaxis — formative SAQs

Formative SAQs on confirming the indication for immunoglobulin replacement, choosing the route around the family and the trough goal, dosing to outcome, and layering antimicrobial prophylaxis in antibody-deficient children.

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Insect-sting hypersensitivity — formative SAQs

Formative SAQs on insect-sting (Hymenoptera venom) hypersensitivity: the stepwise management of a nine-year-old with systemic wasp-sting anaphylaxis (recognition, IM adrenaline dose and site, remove the embedded sac, observation, workup at 4-6 weeks and the venom immunotherapy decision), and the recognition and management of sting anaphylaxis in a child with an elevated baseline tryptase and clonal mast-cell disease presenting with collapse and no skin signs, including the tryptase interpretation, lifelong venom immunotherapy and the discharge package.

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Latex allergy — formative SAQs

Two formative short-answer questions on recognising and managing intraoperative latex anaphylaxis in a high-risk child, and on component-resolved diagnostics in latex allergy.

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Oral allergy syndrome and pollen-food syndrome — formative SAQs

Two formative short-answer questions on recognising and risk-stratifying pollen-food allergy syndrome, and on the lipid-transfer-protein systemic-risk phenotype.

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Peanut, tree-nut and seed allergy — formative SAQs

Formative SAQs on IgE-mediated nut and seed allergy: anaphylaxis recognition and adrenaline dosing, the LEAP prevention evidence, component-resolved diagnostics, and cashew and sesame as severe subtypes.

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Phagocyte disorders — formative SAQs

Formative SAQs on phagocyte disorders: the diagnosis and stepwise management of a child presenting with recurrent abscess-forming infection and granulomatous colitis (chronic granulomatous disease — the organism cluster, the DHR assay, prophylaxis, and the transplant decision), and the recognition and emergency management of a neonate with delayed cord separation, omphalitis, and a striking leukocytosis (leukocyte adhesion deficiency type 1 — the CD18 flow cytometry, the paradox of inflammation without pus, and curative HSCT).

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Primary immunodeficiency: warning signs and diagnostic approach — formative SAQs

Formative SAQs on primary immunodeficiency: the tiered diagnostic workup and SCID urgent pathway for an infant with failure to thrive and lymphopenia (warning signs, first- and second-line tests, same-day referral, prophylaxis, transplant window, live-vaccine contraindication), and the recognition and workup of a school-age child with a recurrent sinopulmonary pattern and emerging bronchiectasis including antibody-deficiency management.

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Secondary immunodeficiency — formative SAQs

Formative SAQs on recognising secondary immunodeficiency, sorting the cause into the six mechanism-based categories, linking cause to immune arm to organism to prophylaxis, applying the five-step management ladder, and deciding who needs immunoglobulin replacement.

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Serum sickness and serum-sickness-like reactions — formative SAQs

Two MedVellum formative short-answer questions on serum sickness and serum-sickness-like reactions: (1) a four-year-old with rash, fever and stiff knees eight days after a cefaclor course — the SSLR, the mimic-exclusion, the stepwise management and the individualised avoidance decision; and (2) a teenager with the triad ten days after rituximab for an autoimmune disease — true immune-complex serum sickness, the complement read-out, and why the biologic should not be re-challenged. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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T-cell and combined immunodeficiencies — formative SAQs

Formative SAQs on T-cell and combined immunodeficiencies: the stepwise management of an infant referred after a low TREC newborn screen (confirmation by flow cytometry, protection from iatrogenic harm, urgent transplant referral, family genetic counselling), and the recognition and emergency management of an infant presenting with BCGosis and lymphopenia (the live-vaccine danger, the blood-product rule, prophylaxis, and the transplant timing decision).

Open

Urticaria and angioedema — formative SAQs

Two MedVellum formative short-answer questions on urticaria and angioedema: (1) a school-age child with daily wheals for eight weeks — chronic spontaneous urticaria, the stepwise ladder, alarm-feature screening and the limits of routine allergy testing; and (2) recurrent facial swelling without a rash — the bradykinin pathway, the C4 screen, and why antihistamines fail in hereditary angioedema. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

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Vaccination of immunocompromised children — formative SAQs

Formative SAQs on classifying the immune defect, sorting each vaccine into live-attenuated versus inactivated, timing doses to the intensity of immunosuppression, and verifying serology — so a live vaccine is never given before a combined T-cell defect is excluded.

Open

Domain

haematology-oncology-and-transfusion

34

Anaemia: diagnostic approach — formative SAQs

Formative SAQs on the MCV-based diagnostic approach to paediatric anaemia.

Open

Aplastic anaemia and bone-marrow failure: SAQ

Short-answer questions on aplastic anaemia and inherited bone marrow failure in children, covering the Camitta severity criteria, the immune-mediated pathophysiology, the inherited syndromes of Fanconi and Diamond-Blackfan anaemia, and the treatment fork of haematopoietic stem cell transplant versus immunosuppressive therapy with horse antithymocyte globulin, ciclosporin, and eltrombopag, with the Frickhofen, Scheinberg, and Peffault de Latour RACE trial evidence.

Open

Bleeding child: diagnostic approach: SAQ

Short-answer questions covering a preschool child with immune thrombocytopenia and a separate boy with a possible haemophilia, exploring the platelet-versus-coagulation diagnostic approach and the bleeding history.

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Blood-component therapy in children: SAQ

Short-answer questions on blood-component therapy in children, covering the per-kilogram doses of red cells, platelets, fresh frozen plasma and cryoprecipitate, the restrictive transfusion thresholds of the TRIPICU and PlaNeT-2 MATISSE trials, the special products of leucodepletion, irradiation and cytomegalovirus-negative blood, and the prevention and recognition of the transfusion reactions.

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Bone and soft-tissue sarcomas — formative SAQs

Formative SAQs on bone and soft-tissue sarcomas in children: recognising osteosarcoma from the persistent non-mechanical limb pain and the radiographic pattern, applying the never-unplanned-biopsy rule and the staging panel, and constructing the risk-adapted chemotherapy and surgery plan for an adolescent with an osteosarcoma and a child with a rhabdomyosarcoma.

Open

Brain and spinal tumours: SAQ

Short-answer questions on brain and spinal tumours in children, covering the recognition of raised intracranial pressure, the posterior fossa predominance with medulloblastoma, cerebellar pilocytic astrocytoma, ependymoma and brainstem glioma, the triad of the diffuse intrinsic pontine glioma, the molecular classification of medulloblastoma into WNT, SHH, Group 3 and Group 4, the urgent magnetic resonance imaging of the brain and whole neuraxis, the perioperative stabilisation with dexamethasone and the management of hydrocephalus, and the risk-adapted surgery, craniospinal irradiation and chemotherapy.

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Cancer therapy complications and supportive care: SAQ

Short-answer questions on the complications of anticancer therapy and the supportive care that surrounds it in children, covering chemotherapy-induced nausea and vomiting risk-stratified and treated with a 5-HT3 antagonist plus dexamethasone plus aprepitant, oral mucositis graded on the WHO scale and prevented with cryotherapy, photobiomodulation, and palifermin, anthracycline cardiotoxicity prevented and surveilled with dexrazoxane and echocardiography, febrile neutropenia treated with empiric antibiotics within one hour, and tumour lysis syndrome classified by the Cairo-Bishop criteria, grounded in the Dupuis antiemetic guideline, the MASCC and ISOO mucositis guideline, the dexrazoxane harmonisation and Chow studies, the Cairo-Bishop classification, and the Lehrnbecher fever and neutropenia guideline.

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Childhood cancer warning signs and diagnostic pathways: SAQ

Short-answer questions on the warning signs and diagnostic pathways of childhood cancer, covering the persistent-progressive principle, the five red-flag clusters, the primary-care investigations and the urgent referral pathway, the oncologic emergencies at presentation, the diagnostic interval and the cancer predisposition syndromes.

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Disseminated intravascular coagulation: SAQ

Short-answer questions on disseminated intravascular coagulation in children, covering the trigger-driven acquired syndrome of systemic intravascular coagulation, the ISTH overt-disseminated intravascular coagulation score of five points or more built from the platelet count, the fibrinogen, the D-dimer, and the prothrombin time, the cause-driven management that treats the trigger first and reserves the blood components for the bleeding child, with platelets for the count under fifty times ten to the nine per litre and fresh-frozen plasma at ten to fifteen millilitres per kilogram, and the heparin for the thrombosis-dominated purpura fulminans.

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Febrile neutropenia and infection in oncology: SAQ

Short-answer questions on febrile neutropenia in the child with cancer. The first prompt covers a febrile neutropenic child on induction for acute lymphoblastic leukaemia, asking for the definition, the first-hour empiric management bundle, the indications for adding vancomycin, and the risk stratification that sets disposition. The second prompt covers a high-risk child with persistent fever, asking for the persistent-fever pathway, the empiric versus pre-emptive antifungal strategy, and the management of a central-line infection and the line-removal decision.

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Full blood count and blood-film interpretation in children — formative SAQs

Two formative SAQs on paediatric full blood count and blood-film interpretation: an eighteen-month-old with microcytic anaemia and a heavy milk intake testing the age-specific interpretation, iron dosing, and the distinction of iron deficiency from thalassaemia trait; and a four-year-old with isolated petechiae and thrombocytopenia after a viral illness testing the recognition of immune thrombocytopenia against the leukaemia and artefact pitfalls.

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G6PD deficiency and enzymopathies: SAQ

Short-answer questions on glucose-6-phosphate dehydrogenase deficiency in children covering an acute haemolytic crisis in a boy after fava beans, including the mechanism of oxidative haemolysis, the blood film and the direct antiglobulin-test-negative interpretation, the falsely normal assay pitfall, and the supportive and transfusion management, and a second prompt on neonatal G6PD hyperbilirubinaemia and the kernicterus risk.

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Germ-cell tumours: SAQ

Short-answer questions on germ cell tumours in children, covering the primordial germ cell origin and the midline distribution, the bimodal age distribution, the tumour markers alpha-fetoprotein and beta-human chorionic gonadotropin and the histological subtypes that secrete them, the physiological neonatal alpha-fetoprotein, the Altman classification and the coccygectomy of the sacrococcygeal teratoma, the platinum-based PEB chemotherapy, and the intracranial germinoma versus the nongerminomatous tumour.

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Haematopoietic stem-cell transplantation: SAQ

Short-answer questions on haematopoietic stem-cell transplantation in children, covering the autologous-versus-allogeneic classification, the donor hierarchy and the HLA matching, the myeloablative and reduced-intensity conditioning, the acute and chronic graft-versus-host disease and its prophylaxis with the calcineurin inhibitor and the post-transplantation cyclophosphamide, the sinusoidal obstruction syndrome and the defibrotide, the engraftment milestones and the donor chimerism, and the supportive care of the febrile neutropenia.

Open

Haemolytic anaemia: diagnostic approach: SAQ

Short-answer questions covering a school-age child with autoimmune haemolytic anaemia and a separate boy with glucose-6-phosphate dehydrogenase deficiency crisis, exploring the diagnostic algorithm.

Open

Haemophilia A and B — formative SAQs

Formative SAQs on haemophilia A and B: the factor-level severity classification, the isolated prolonged APTT and the exclusion of von Willebrand disease, the primary prophylaxis evidence and emicizumab, the factor recovery rules and on-demand bleed treatment, the diagnosis and management of inhibitors with the Bethesda assay and immune tolerance induction, and the emergency management of intracranial haemorrhage.

Open

Hereditary spherocytosis and membrane disorders — formative SAQs

Formative SAQs on hereditary spherocytosis and the inherited red cell membrane disorders: the clinical triad and blood film, the eosin-5-maleimide binding test, the severity spectrum and management with folate and transfusion, splenectomy timing and technique, the pre-splenectomy vaccination and post-splenectomy prophylaxis bundle, the parvovirus B19 aplastic crisis, and the critical exclusion of hereditary stomatocytosis before any splenectomy.

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Iron deficiency anaemia — formative SAQs

Formative SAQs on iron deficiency anaemia in children, covering the WHO age-banded thresholds, the ferritin-gated classification of the microcytic anaemias, the hepcidin-ferroportin axis, the dietary and occult-blood-loss causes, oral elemental iron at 3 to 6 mg per kg per day once daily or alternate day for at least three months, the reticulocyte and haemoglobin response, the refractory workup with coeliac serology, restrictive transfusion for cardiovascular compromise, and the neurodevelopmental stakes of infant deficiency.

Open

Leukaemia in children: SAQ

Short-answer questions on leukaemia in children, covering the separation of acute lymphoblastic from acute myeloid leukaemia, the recognition and prevention of tumour lysis syndrome with hyperhydration and rasburicase, the risk stratification by age, white cell count, cytogenetics and minimal residual disease, the management of febrile neutropenia and hyperleukocytosis, and the risk-adapted multi-agent chemotherapy through induction, consolidation and maintenance.

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Long-term follow-up and late effects of childhood cancer: SAQ

Short-answer questions on the long-term follow-up and late effects of childhood cancer, covering the over eighty percent five-year survival and the chronic health condition burden, the organ-system late effects of endocrine failure with growth hormone deficiency and hypothyroidism, anthracycline cardiomyopathy, subsequent malignancy, neurocognitive decline and infertility, the treatment-summary-driven and risk-stratified lifelong surveillance built on the Children's Oncology Group guidelines, and the structured transition of the adolescent survivor to the adult late-effects service.

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Lymphoma in children: SAQ

Short-answer questions on lymphoma in children, covering the separation of Hodgkin from non-Hodgkin lymphoma and the four high-grade paediatric non-Hodgkin subtypes, the urgent diagnostic pathway from excision biopsy with flow cytometry and cytogenetics, the anterior mediastinal mass as an anaesthetic emergency that forbids sedation, the tumour lysis prophylaxis with hyperhydration and rasburicase, and the risk-adapted multi-agent chemotherapy that delivers survival above ninety percent.

Open

Megaloblastic and macrocytic anaemia: SAQ

Short-answer questions on megaloblastic and macrocytic anaemia covering the distinction of macrocytosis from megaloblastic anaemia, the methylmalonic acid and homocysteine metabolite pair that separates B12 from folate deficiency, the infant of the vegan mother with developmental regression, the cardinal rule never to give folate alone, and the British Society for Haematology hydroxocobalamin replacement schedule.

Open

Neuroblastoma: SAQ

Short-answer questions on neuroblastoma in children, covering the neural crest origin and catecholamine secretion, the International Neuroblastoma Risk Group staging system, the MYCN amplification, the iodine-123 metaiodobenzylguanidine scan, the opsoclonus-myoclonus-ataxia syndrome, and the risk-adapted treatment from the observation of low-risk disease to the intensive multimodal therapy of high-risk disease.

Open

Neutropenia and neutrophil disorders: SAQ

Short-answer questions on neutropenia in children. The first prompt covers a febrile severely neutropenic three-year-old on chemotherapy, asking for the first-hour resuscitation and empiric antibiotic management, the severity grading and the mechanism-based classification, and the principles of marrow surveillance in the congenital syndromes. The second prompt covers an incidental chronic isolated neutropenia in a well infant of African ancestry, asking for the differential diagnosis between autoimmune neutropenia of infancy, benign ethnic neutropenia and the inherited disorders, the targeted investigations, and the counselling and safety-net.

Open

Pancytopenia and marrow infiltration: SAQ

Short-answer questions on pancytopenia and marrow infiltration in children, covering the empty-versus-full marrow distinction, the leucoerythroblastic film and myelophthisis, the urgent diagnostic pathway from full blood count and film to bone marrow aspirate and trephine biopsy with flow cytometry and cytogenetics, the stabilisation with irradiated leucodepleted transfusion, tumour lysis prophylaxis with hyperhydration and rasburicase, and empiric antipseudomonal cover for febrile neutropenia, and the cause-specific definitive therapy for acute leukaemia, acquired and inherited marrow failure, Down syndrome transient myeloproliferative disorder, neuroblastoma, Langerhans cell histiocytosis and parvovirus B19 pure red cell aplasia.

Open

Sickle cell acute complications: SAQ

Short-answer questions on the acute complications of sickle cell disease in children, covering the vaso-occlusive pain crisis with its analgesia and fluids, acute chest syndrome with its antibiotics and transfusion, acute splenic sequestration with its cautious transfusion, acute stroke with its exchange transfusion, and priapism with its stuttering-versus-prolonged distinction, grounded in the NHLBI 2014 report, the ASH 2020 guidelines, the STOP trial, and the Vichinsky study.

Open

Sickle cell disease: diagnosis and health maintenance: SAQ

Short-answer questions on the diagnosis and health maintenance of sickle cell disease in children, covering the newborn-screen diagnosis by haemoglobin electrophoresis, the penicillin V prophylaxis schedule, the encapsulated-organ immunisation, the hydroxyurea backbone from nine months, and the annual transcranial Doppler with chronic transfusion for the abnormal result, with the PROPS, Multicenter Study of Hydroxyurea, STOP and TWiTCH trial evidence.

Open

Thalassaemia syndromes: SAQ

Short-answer questions on the thalassaemia syndromes in children, covering the pathophysiology of ineffective erythropoiesis, the haemoglobin electrophoresis diagnosis, the regular transfusion target and the iron chelation programme with deferasirox, the cardiac T2 star surveillance, and the curative options of transplant and betibeglogene gene therapy.

Open

Thrombocytopenia and immune thrombocytopenia: SAQ

Short-answer questions on thrombocytopenia and immune thrombocytopenia in children, covering the diagnosis of isolated thrombocytopenia under 100 times ten to the nine per litre in a well child, the ASH 2019 observation-first principle, the first-line therapy with IVIG at 0.8 to 1 g per kg, a short course of corticosteroids, or anti-D at 50 to 75 micrograms per kg, and the second-line thrombopoietin-receptor agonists such as eltrombopag for the chronic phase, with the ICIS registry, Blanchette anti-D trial, and PETIT eltrombopag trial evidence.

Open

Transfusion reactions and massive transfusion: SAQ

Short-answer questions on transfusion reactions and massive transfusion in children, covering the stop-the-transfusion rule, the bedside distinction of TACO from TRALI, the mechanism and management of the acute haemolytic reaction, and the paediatric massive transfusion protocol with its balanced ratio and the prevention of the citrate, temperature and electrolyte hazards.

Open

Tumour lysis syndrome and oncologic emergencies: SAQ

Short-answer questions on tumour lysis syndrome and the paediatric oncologic emergencies, covering the Cairo-Bishop classification of the laboratory and the clinical syndrome with the thresholds for the urate, the potassium, the phosphate and the calcium, the pathophysiology of the metabolic cascade to the acute kidney injury and the arrhythmia, the prevention with the hyperhydration and the rasburicase with the glucose-six-phosphate-dehydrogenase contraindication, and the structural emergencies of the febrile neutropenia, the hyperleukocytosis, the superior vena cava obstruction and the spinal cord compression.

Open

Venous thromboembolism, pulmonary embolism and thrombophilia in children — formative SAQs

Formative SAQs on paediatric venous thromboembolism, pulmonary embolism and thrombophilia: the provoked and central-venous-catheter-associated epidemiology, the Virchow triad pathophysiology modified by developmental haemostasis, the diagnosis with compression ultrasound and CT pulmonary angiography, the age-stratified low molecular weight heparin dosing and anti-factor Xa monitoring, the rivaroxaban option from the EINSTEIN-Jr trials, the selective approach to hereditary thrombophilia testing, and the management of catheter-related, adolescent and neonatal thrombosis.

Open

Von Willebrand disease — formative SAQs

Formative SAQs on von Willebrand disease: the Sadler 1994 classification into type 1, the type 2 subtypes and type 3, the two functions of von Willebrand factor, the diagnostic panel and the exclusion of mild haemophilia A, the desmopressin response test, VWF concentrate and tranexamic acid, the management of heavy menstrual bleeding in adolescence, and the type-specific cautions including type 2B and type 3.

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Wilms tumour and renal malignancies: SAQ

Short-answer questions on Wilms tumour and the paediatric renal malignancies, covering the recognition of the painless abdominal mass with the haematuria and hypertension, the peak age of three to four years, the syndromic predisposition of WAGR, Beckwith-Wiedemann and Denys-Drash, the first-line ultrasound with the Doppler of the renal vein and the inferior vena cava, the Children's Oncology Group do-not-biopsy strategy of the upfront radical nephrectomy against the SIOP strategy of the preoperative chemotherapy, the risk-adapted vincristine, dactinomycin and doxorubicin chemotherapy and the selective radiotherapy, and the late effects of the cardiotoxicity and the renal irradiation.

Open

Domain

infectious-diseases

39

Animal bites, arthropod bites and zoonoses: SAQ

Short-answer questions on paediatric animal bites and zoonoses covering an infected hand cat bite requiring prophylaxis and the hand-bite rule, and a bat scratch in an Australian child mandating Australian bat lyssavirus post-exposure prophylaxis.

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Antimicrobial pharmacology, selection, dosing and stewardship in children — formative SAQs

Two MedVellum formative short-answer questions covering developmental pharmacokinetics and weight-based dosing, empiric drug selection using WHO AWaRe, vancomycin and aminoglycoside therapeutic drug monitoring, de-escalation, IV-to-oral switch, duration review, and penicillin allergy delabeling. The marks and timing support transparent self-assessment; they are not an official board format or pass standard.

Open

Approach to fever by age and immune status — formative SAQs

Formative SAQs on the age- and immune-status-aware approach to the febrile child.

Open

Bacteraemia and occult bloodstream infection — formative SAQs

Two MedVellum formative short-answer questions on bacteraemia and occult bloodstream infection: (1) the well-appearing vaccinated toddler with fever without focus, and the modern approach to investigation and safety-netting; and (2) the febrile young infant, age-stratified pathway management and interpretation of inflammatory markers. The marks and timing support transparent self-assessment. They are not an official board format or pass standard.

Open

Brain abscess and intracranial suppuration — formative SAQs

Formative SAQs on recognising brain abscess and intracranial suppuration, the imaging and microbiology strategy, empiric and tailored antibiotic therapy, the aspiration-versus-excision neurosurgical decision, subdural empyema as a neurosurgical emergency, and the corticosteroid controversy.

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Cellulitis, abscess and necrotising soft-tissue infection: SAQ

Short-answer questions on a febrile school-age child with a rapidly progressive, painful skin lesion, covering recognition of necrotising fasciitis, the LRINEC score, empiric antibiotic selection, and the surgical decision.

Open

Common viral exanthems — formative SAQs

Formative SAQs on the common viral exanthems of childhood: the assessment and management of a non-immune pregnant woman exposed to a child with erythema infectiosum, and the assessment and management of a child with sickle cell disease who develops parvovirus B19 transient aplastic crisis — covering host-dependent parvovirus B19 disease, the fever-to-rash reasoning chain, serology and PCR, urgent pathways, and the public-health layer.

Open

Congenital syphilis and perinatal sexually transmitted infections — formative SAQs

Formative SAQs on congenital syphilis and the perinatal sexually transmitted infections: the stepwise management of a septic-appearing two-week-old with early congenital syphilis (serological confirmation, ten-day aqueous penicillin, maternal-treatment-adequacy review, public-health follow-up and long-term surveillance), and the assessment and counselling of a pregnant woman with a positive antenatal syphilis screen (staging, benzathine penicillin dosing, the four-week-before-delivery rule, Jarisch-Herxheimer, penicillin desensitisation and prevention).

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COVID-19 and multisystem inflammatory syndrome in children: SAQ

Short-answer questions on multisystem inflammatory syndrome in children covering a school-age child with persistent fever, abdominal pain, and shock appearing three weeks after a COVID-19 illness, including recognition, the echocardiogram and cardiac biomarkers, cautious resuscitation, and immunomodulation.

Open

Dengue and other arboviral infections: SAQ

Short-answer questions on paediatric dengue covering a returned traveller entering the plasma-leak critical phase, including WHO 2009 classification and warning signs, serial haematocrit and platelet interpretation, titrated isotonic crystalloid, the harmful-no-bolus lesson, and family safety-netting.

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Device-associated and healthcare-associated infection — formative SAQs

Two MedVellum formative short-answer questions on device-associated and healthcare-associated infection in children, covering NHSN surveillance definitions, the multimodal prevention bundle, source control by device removal, antimicrobial de-escalation, and an outbreak scenario on a neonatal unit. The marks and timing support transparent self-assessment; they are not an official board format or pass standard.

Open

Enteric fever and invasive bacterial enteritis — formative SAQs

Formative SAQs on the recognition of enteric fever, XDR-aware antibiotic choice, the STEC-HUS danger, and the public-health response to invasive bacterial enteritis.

Open

Epstein-Barr virus and cytomegalovirus infection — formative SAQs

Formative SAQs on EBV and CMV infection: the management of a newborn with suspected congenital CMV — the 21-day diagnostic window, valganciclovir treatment and audiology surveillance — and the diagnosis, complications and counselling of an adolescent with EBV infectious mononucleosis, including the amoxicillin rash, splenic rupture and return to play.

Open

Fever in the returned traveller — formative SAQs

Formative SAQs on the structured assessment, investigation and severity-driven management of the febrile returning traveller, including the same-day malaria film, the single-negative-film pitfall, the AQUAMAT evidence for IV artesunate in severe falciparum malaria, the dengue critical phase, and the empiric antibiotic implications of XDR typhoid.

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Fungal infections in immunocompetent and immunocompromised children — formative SAQs

Formative SAQs on fungal infections in children: the assessment and management of a persistent febrile neutropenic child with suspected invasive fungal disease, and the diagnosis and management of a child with tinea capitis and a kerion — covering host-risk stratification, empirical and definitive antifungal therapy, source control, non-culture diagnostics, and the tinea-incognito and kerion pitfalls.

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Hand-foot-and-mouth disease and enterovirus infection — formative SAQs

Formative SAQs on HFMD and enterovirus infection: the stepwise management of a child with classic HFMD complicated by enterovirus 71 brainstem encephalitis (recognition, escalation, PICU care with fluid restriction and milrinone, prognostic markers and prevention), and the diagnosis, management and prevention of an HFMD outbreak in a childcare centre (sample selection, childcare exclusion, serotype surveillance and household hygiene).

Open

Hepatitis A, B, C and E in children — formative SAQs

Formative SAQs on hepatitis A, B, C and E in children: the assessment and management of a neonate born to an HBsAg-positive mother, and the diagnosis, treatment and counselling of an adolescent found to have chronic hepatitis C — covering transmission route and chronicity, serology and viral-load interpretation, the hepatitis B immunoprophylaxis bundle and maternal suppression, the hepatitis C test-and-treat pathway with direct-acting antivirals, surveillance and the acute liver failure anchor of INR.

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Herpes simplex infection in children — formative SAQs

Formative SAQs on herpes simplex infection in children: the assessment and management of a febrile neonate with possible neonatal HSV, and the management and outcome determinants of a child with herpes simplex encephalitis — covering syndrome recognition, host-risk tiering, PCR diagnosis, high-dose aciclovir, post-treatment suppression, complications and the maternal-neonatal prevention pathway.

Open

HIV exposure and infection in children — formative SAQs

Formative SAQs on paediatric HIV: the stepwise management of an HIV-exposed infant from delivery to confirmation of status (PMTCT cascade, infant prophylaxis, cotrimoxazole, PCR timing and feeding), and the diagnosis and immediate management of a hypoxic infant with suspected Pneumocystis pneumonia born to an HIV-positive mother.

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Infection prevention, isolation and outbreak management — formative SAQs

Formative SAQs on infection prevention and control in the paediatric setting: the management of a norovirus gastroenteritis outbreak on a ward (case definition, early containment, soap-and-water hand hygiene and bleach cleaning), and the recognition and bundle-based prevention of a central-line-associated bloodstream infection in a NICU infant — covering standard and transmission-based precautions, the WHO 5 Moments, device bundles and the stepwise outbreak response.

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Infections in immunocompromised children — formative SAQs

Formative SAQs on the approach to infections in immunocompromised children.

Open

Influenza and antiviral treatment: SAQ

Short-answer questions on a febrile infant in influenza season who presents with poor feeding and apnoea and then develops a biphasic deterioration, covering the atypical infant presentation, empiric oseltamivir, secondary bacterial pneumonia, and prevention through maternal and annual vaccination.

Open

Malaria in children: SAQ

Short-answer questions on paediatric severe malaria covering a febrile returned traveller with impaired consciousness, including severity recognition, blood film and rapid diagnostic test interpretation, intravenous artesunate, and cautious fluid management.

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Measles, rubella and congenital rubella — formative SAQs

Formative SAQs on measles, rubella and congenital rubella syndrome: the stepwise management of an unvaccinated febrile child with a cephalocaudal rash and Koplik spots (vitamin A, supportive care, isolation, notification, post-exposure prophylaxis), and the assessment and counselling of a pregnant woman with a rubella-like rash in the first trimester (serological confirmation, gestational-age CRS risk, fetal-medicine referral and prevention).

Open

Meningitis and encephalitis: SAQ

Short-answer questions on paediatric bacterial meningitis covering a febrile preschool child with headache and neck stiffness, including assessment, CSF interpretation, and empiric management.

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Mumps — formative SAQs

Formative SAQs on mumps: the management of a postpubertal male presenting with parotitis and orchitis (including torsion exclusion and the public-health response), and the diagnosis, supportive management and outbreak control of a vaccinated young adult with mumps in a university outbreak — covering buccal RT-PCR, the five-day isolation and exclusion rule, notification, the absence of any antiviral, and the two-dose MMR schedule with the third-dose outbreak-control strategy.

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Paediatric sepsis: diagnosis, antimicrobial treatment and source control — formative SAQs

Two MedVellum formative short-answer questions on paediatric sepsis, covering Phoenix-criteria recognition, the first-hour bundle (cultures, empiric antibiotic within one hour, judicious fluids, early vasoactives), source control, reassessment and escalation. The marks and timing support transparent self-assessment; they are not an official board format or pass standard.

Open

Parasitic infections in children: SAQ

Short-answer questions on paediatric parasitic infections covering a child with chronic diarrhoea and failure to thrive from giardiasis, including diagnostic test selection, treatment, and a child on corticosteroids with strongyloidiasis hyperinfection risk.

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Pertussis — formative SAQs

Formative SAQs on pertussis: the management of an infant presenting with apnoea and a household cough contact, and the diagnosis, treatment and public-health management of a school-age child with classic pertussis — covering PCR versus serology, macrolide treatment, isolation and exclusion, notification, chemoprophylaxis and prevention.

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Post-arrival infection screening — formative SAQs

Formative SAQs on the comprehensive post-arrival infection screen for internationally adopted, immigrant and refugee children, including the must-not-miss five (tuberculosis, HIV, hepatitis B, hepatitis C, parasitic disease), the re-verification principle, the IGRA-versus-tuberculin-skin-test choice, the Strongyloides serology that is too often missed, the hepatitis C confirmatory RNA test, and the catch-up immunisation built on serological evidence.

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Prolonged, recurrent and periodic fever — formative SAQs

Formative SAQs on patterning prolonged versus recurrent versus periodic fever, recognising PFAPA from the Marshall and Thomas criteria with a rise-then-fall CRP, distinguishing the hereditary periodic fevers by attack duration and signature features, and delivering evidence-based care while excluding the dangerous mimics.

Open

Staphylococcal scalded skin syndrome: SAQ

Short-answer questions on a febrile infant with rapidly spreading tender erythema and sheet-like desquamation, covering recognition of staphylococcal scalded skin syndrome, the desmoglein 1 mechanism, the distinction from Stevens-Johnson syndrome, and anti-staphylococcal antibiotic selection.

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Travel medicine and pre-travel advice for children — formative SAQs

Formative SAQs on the structured risk assessment and four-lane pre-travel plan for children, including the four-to-six-week timing window, age-appropriate malaria chemoprophylaxis, the visiting-friends-and-relatives family as the highest-risk group, vaccine age thresholds, and the fever-after-travel safety net.

Open

Tuberculosis in children — formative SAQs

Two formative short-answer questions on the exposure-infection-disease spectrum, the age-and-immunity pathophysiology, symptom-and-contact assessment, chest radiograph and Xpert MTB/RIF workup, weight-based treatment of non-severe disease (4-month SHINE regimen), tuberculosis preventive treatment of infection, the emergency recognition of tuberculous meningitis, and the public-health duty of notification, contact tracing and source-case finding.

Open

Undifferentiated fever and fever without a source in infants and children — formative SAQs

Two MedVellum formative short-answer questions on the evaluation and management of the febrile infant and child without a localising source. Covers age-stratified risk assessment, prediction rules, biomarker interpretation, empiric antibiotic selection and safety-netting. These marks and timings support transparent self-assessment and are not an official board format.

Open

Urinary tract infection and pyelonephritis: SAQ

Short-answer questions on paediatric pyelonephritis covering a febrile infant with suspected UTI, including urine sampling by age, urinalysis and culture interpretation, and empiric management with the oral versus intravenous decision.

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Vaccine-preventable disease outbreak response — formative SAQs

Formative SAQs on the systematic response to a vaccine-preventable disease outbreak in children: the stepwise management of a measles outbreak in an under-vaccinated school (isolation, IgM/PCR with genotyping, notification, contact triage, MMR within 72 hours and immunoglobulin within 6 days, exclusion, and catch-up vaccination above the herd-immunity threshold); and the management of an infant with apnoea and a household cough contact, including the public-health response to protect the household's newborn and pregnant contacts.

Open

Varicella and herpes zoster — formative SAQs

Formative SAQs on varicella and herpes zoster: the risk-stratified management of an immunocompromised child with primary varicella, and the assessment and public-health management of a pregnant adolescent with a varicella contact — covering host-risk tiering, antiviral therapy, isolation, exclusion, notification, post-exposure prophylaxis and prevention.

Open

Viral upper respiratory tract infection and the common cold — formative SAQs

Two formative short-answer questions on viral upper respiratory tract infection and the common cold in children: a well child with a cold whose nasal discharge has turned purulent, testing the rationale against antibiotics; and an infant presenting with coryza and fever, testing the red-flag assessment and the under-three-months febrile-infant pathway.

Open

Domain

fetal-neonatal-and-perinatal

59

Antenatally detected kidney and urinary-tract anomalies: newborn management — formative SAQs

Two formative SAQs on the newborn with an antenatally detected kidney or urinary-tract anomaly: a male infant with suspected posterior urethral valves requiring risk-stratification, urgent imaging and prophylaxis, and an infant with isolated antenatal hydronephrosis requiring correct postnatal ultrasound timing and a surveillance plan.

Open

Antenatally diagnosed fetal conditions: paediatric planning — formative SAQs

Two formative SAQs on paediatric planning for antenatally diagnosed fetal conditions: a hypoplastic left heart syndrome with place-of-delivery and prostaglandin planning, and a congenital diaphragmatic hernia with resuscitation and tertiary-centre planning.

Open

Apnoea of prematurity — short-answer question

Short-answer question on the definition, pathophysiology, and caffeine-first management of apnoea of prematurity, with exclusion of secondary causes.

Open

Bilious vomiting and neonatal intestinal obstruction — formative SAQs

Two formative SAQs on bilious vomiting and neonatal intestinal obstruction: the rule that bilious vomit is obstruction until proven otherwise, the immediate resuscitation and decompression pathway, the duodenal atresia double-bubble scenario with Down syndrome, the time-critical midgut volvulus decision, and the condition-specific definitive surgery.

Open

Birth trauma and brachial plexus injury — formative SAQs

Two formative SAQs on birth trauma and brachial plexus injury: the newborn with an upper-trunk injury and the 3-month threshold decision, and the newborn with a total-plexus injury and Horner syndrome who needs early specialist referral.

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Bronchopulmonary dysplasia and chronic neonatal lung disease

Short-answer questions on BPD prevention, classification, and management.

Open

Cephalhaematoma and subgaleal haemorrhage — formative SAQs

Two formative SAQs on the three birth-related scalp swellings: the anatomical-plane classification and the suture-line discriminator, and the deteriorating newborn with a subgaleal haemorrhage requiring resuscitation, coagulation correction and retrieval.

Open

Congenital and perinatally acquired infections: SAQ

Short-answer questions on congenital and perinatally acquired infections covering a neonate with suspected congenital cytomegalovirus infection.

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Congenital anomalies and dysmorphic newborn assessment — formative SAQs

Formative SAQs on recognising the dysmorphic newborn, climbing the diagnostic ladder, and stabilising life-threatening congenital anomalies.

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Congenital heart disease presenting in the newborn — formative SAQs

Two formative SAQs on the newborn with congenital heart disease: the day-three collapsed neonate with coarctation, and the cyanotic newborn with a positive pulse-oximetry screen, testing the bedside split, prostaglandin-first resuscitation and screening interpretation.

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Conjugated jaundice and neonatal cholestasis: SAQ

Short-answer questions on conjugated jaundice and neonatal cholestasis covering a six-week-old infant with pale stools and jaundice, the diagnostic workup, and the management of biliary atresia.

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Extremely preterm infant viability and periviable counselling — formative SAQs

Formative SAQs on shared decision-making at the threshold of viability, prognostic estimation, antenatal interventions, and outcome counselling for periviable infants born at 22 to 25 weeks gestation.

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Family-integrated developmental care in NICU

Short-answer questions on the FiCare model, the developmental care bundle, and the evidence supporting family-integrated neonatal care.

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Fetal assessment, prenatal screening and counselling — formative SAQs

Two formative SAQs on antenatal fetal assessment: a no-call cell-free DNA result with counselling and diagnostic choice, and an abnormal growth scan with Doppler interpretation and delivery planning.

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Fetal growth restriction and small-for-gestational-age infant — formative SAQs

Formative SAQs.

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Follow-up after high-risk birth and NICU discharge — formative SAQs

Formative SAQs on longitudinal follow-up of the high-risk NICU graduate: risk stratification, corrected-age growth and milestone surveillance, early cerebral palsy detection with GMA/HINE/MRI, sensory follow-up, and school-age cognitive and behavioural outcomes.

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Gestational age assessment and preterm classification — formative SAQs

Formative SAQs on assigning gestational age, reconciling antenatal and postnatal estimates, classifying by gestational-age and birthweight bands, and applying size-for-gestational-age and corrected age.

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Haemolytic disease of the fetus and newborn — formative SAQs

Two formative SAQs on haemolytic disease of the fetus and newborn: anti-D prophylaxis and MCA-PSV surveillance, and the postnatal management ladder from phototherapy to exchange transfusion.

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Hearing loss in high-risk neonates — short-answer question

Short-answer question on newborn hearing screening in the high-risk neonate, the OAE versus AABR distinction, the JCIH risk indicators, and the management of confirmed permanent loss.

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Human milk, fortification and preterm nutrition

Short-answer questions on preterm nutrition targets, fortification strategy, and human milk evidence.

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Hypoxic-ischaemic encephalopathy and therapeutic hypothermia — formative SAQs

Two formative SAQs on hypoxic-ischaemic encephalopathy and therapeutic hypothermia: the eligible term infant and the cooling decision, and the late-presenting infant and the boundary of the cooling evidence.

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Intraventricular haemorrhage and periventricular leukomalacia — formative SAQs

Two formative SAQs on intraventricular haemorrhage and periventricular leukomalacia: the preterm infant with a sudden deterioration and a grade III–IV bleed, and the prevention and prognostic-counselling scenario.

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Large-for-gestational-age infant and infants of diabetic mothers — formative SAQs

Formative SAQs.

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Late-preterm infant: risks and corrected-age follow-up — formative SAQs

Formative SAQs on the late-preterm infant (34+0 to 36+6 weeks): disproportionate multi-organ morbidity, the discharge-readiness gate, corrected-age growth and neurodevelopmental follow-up, and bilirubin and glucose management.

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Maternal disease, medication and substance effects on the fetus — formative SAQs

Two formative SAQs: a pregnancy on valproate with counselling and prevention, and an infant of a diabetic mother with neonatal hypoglycaemia and surveillance planning.

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Meconium aspiration syndrome — formative SAQs

Two formative SAQs on meconium aspiration syndrome: the vigour-based delivery-room decision for a non-vigorous infant with PPHN, and the pathophysiology, surfactant rationale and prognosis of MAS.

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Necrotising enterocolitis and spontaneous intestinal perforation — formative SAQs

Two formative SAQs on NEC and SIP: the deteriorating preterm with established NEC needing the medical bundle and the surgical decision, and the well ELBW infant with an incidental pneumoperitoneum testing the NEC-versus-SIP discriminator.

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Neonatal abstinence and withdrawal syndromes — formative SAQs

Two formative SAQs on neonatal abstinence and withdrawal syndromes: the neuroadaptive mechanism and the methadone-exposed infant at 48 hours, the Eat Sleep Console functional assessment and the Finnegan threshold, the non-pharmacologic first-line bundle and breastfeeding, and the morphine-versus-buprenorphine pharmacologic ladder with a structured wean.

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Neonatal acute kidney injury — formative SAQs

Formative SAQs.

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Neonatal air-leak syndromes — formative SAQs

Two formative SAQs on neonatal air-leak syndromes: the unifying mechanism and classification, the deteriorating ventilated preterm requiring emergency decompression, needle aspiration and chest-drain management, and the prevention bundle.

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Neonatal anaemia, polycythaemia and thrombocytopenia: SAQ

Short-answer questions covering a term neonate with severe thrombocytopenia from neonatal alloimmune thrombocytopenia and a preterm infant with the anaemia of prematurity.

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Neonatal bacterial infection and sepsis: SAQ

Short-answer questions on neonatal bacterial sepsis risk assessment and management covering a preterm infant with suspected early-onset sepsis.

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Neonatal cyanosis and collapsed neonate — formative SAQs

Two formative SAQs on the cyanotic or collapsed neonate: the day-3 term infant with a duct-dependent lesion requiring prostaglandin before echo, and the oxygen-refractory blue infant with methaemoglobinaemia.

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Neonatal fluid, electrolyte and nutritional management — formative SAQs

Formative SAQs.

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Neonatal gastro-oesophageal reflux and aspiration — short-answer question

Short-answer question on distinguishing physiologic reflux from GORD, the conservative-first stepwise management, and the evidence against reflex acid suppression and reflux-apnoea causation.

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Neonatal hypoglycaemia — formative SAQs

Formative SAQs.

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Neonatal hypothermia and thermoregulation — formative SAQs

Two formative SAQs on neonatal hypothermia and thermoregulation: the heat-loss pathways and WHO classification, the cold preterm on admission requiring graded rewarming and glucose correction, the delivery-room warm chain and plastic wrap, and kangaroo mother care.

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Neonatal hypotonia and neuromuscular weakness — formative SAQs

Two formative SAQs on the hypotonic neonate: the weak, areflexic, alert infant eligible for SMA disease-modifying therapy, and the floppy neonate of a mildly-affected mother requiring a congenital-myotonic-dystrophy work-up.

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Neonatal jaundice: unconjugated hyperbilirubinaemia: SAQ

Short-answer questions on neonatal unconjugated hyperbilirubinaemia covering a late-preterm breastfed infant with rapidly rising bilirubin, risk assessment, investigation, and management decisions.

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Neonatal pain assessment and procedural comfort - formative SAQs

Two formative SAQs on neonatal pain assessment and procedural comfort: the preterm infant undergoing repeated heel lances, and the ventilated preterm infant and the boundary of routine opioid analgesia.

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Neonatal palliative care and end-of-life decision-making — formative SAQs

Two formative SAQs on neonatal palliative care and end-of-life decision-making: perinatal palliative care for a lethal fetal anomaly, the best-interests balance and window of opportunity, withholding versus withdrawing, futility versus value dispute, and end-of-life symptom management in the newborn.

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Neonatal respiratory distress — diagnostic approach — formative SAQs

Two formative SAQs on the diagnostic approach to neonatal respiratory distress: differentiating RDS, TTN and MAS by CXR and risk profile, and the term infant with refractory cyanosis and a duct-dependent cardiac lesion.

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Neonatal resuscitation and post-resuscitation stabilisation — formative SAQs

Two formative SAQs on neonatal resuscitation and post-resuscitation stabilisation: the first-minute algorithm, escalation to compressions and adrenaline, temperature and glucose control, cord management, and cooling referral.

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Neonatal seizures and encephalopathy — formative SAQs

Two formative SAQs on neonatal seizures and encephalopathy: the encephalopathic term infant eligible for cooling, and the refractory-seizure infant requiring a metabolic and infective work-up.

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Neonatal skin disorders and birthmarks — formative SAQs

Formative SAQs on the assessment and management of neonatal skin disorders and birthmarks.

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Neonatal stroke and intracranial haemorrhage — formative SAQs

Two formative SAQs on neonatal stroke and intracranial haemorrhage: the term infant with focal seizures and perinatal arterial ischaemic stroke, and the extremely preterm infant with grade III IVH and progressive post-haemorrhagic ventricular dilation.

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Neonatal transport and retrieval — formative SAQs

Two formative SAQs on neonatal transport and retrieval: triage and STABLE pretransport stabilisation, temperature and glucose control, the specialist retrieval pathway, and therapeutic hypothermia on transport.

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Newborn examination and screening — formative SAQs

Formative SAQs on the systematic newborn examination, the four universal screens, and escalation of abnormal findings.

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Parenteral nutrition in neonates — formative SAQs

Formative SAQs.

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Patent ductus arteriosus in preterm infants — formative SAQs

Two formative SAQs on patent ductus arteriosus in preterm infants: the pathophysiology of failed ductal closure and the markers of haemodynamic significance, and the expectant-first management ladder with the drug doses, the trial evidence, and the causality-or-bias view of ligation.

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Perinatal infection screening and prevention — formative SAQs

Formative SAQs.

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Persistent pulmonary hypertension of the newborn

Short-answer questions covering PPHN pathophysiology, diagnosis, and stepwise management.

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Poor feeding and feeding intolerance in the neonate — formative SAQs

Formative SAQs.

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Preterm infant — formative SAQs

Formative SAQs on preterm infant delivery-room stabilisation, respiratory and nutritional management, complication prevention and follow-up.

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Respiratory distress syndrome of prematurity — formative SAQs

Two formative SAQs on respiratory distress syndrome of prematurity: the surfactant-deficiency mechanism and management ladder, and oxygen targeting with surfactant dosing.

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Retinopathy of prematurity

Short-answer questions on ROP screening, classification, and the Type 1 treatment decision.

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Routine care of the healthy newborn — formative SAQs

Two formative SAQs on routine newborn care: golden hour elements, vitamin K counselling, discharge readiness, feeding failure and hypernatraemic dehydration.

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Transient tachypnoea of the newborn — short-answer questions

Two short-answer questions on the diagnosis, pathophysiology and stepwise management of transient tachypnoea of the newborn.

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Transition at birth and delayed cord clamping — formative SAQs

Two formative SAQs on neonatal transition and cord management: the deferred-clamp decision for a vigorous term infant, and the preterm cord plan with the milking contraindication.

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Domain

professional-practice-and-evidence

35

Best-interests decisions and treatment limitation — formative SAQs

Two formative SAQs on best-interests decisions and treatment limitation in paediatrics: the best-interests balance, withholding versus withdrawing, futility, time-limited trials, the window of opportunity, and the ethics and court pathway for disputed decisions.

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Biostatistics for paediatric exams — formative SAQs

Formative SAQs on descriptive and inferential statistics applied to paediatric study results, including confidence intervals, p-values, errors, power, test choice, correlation, regression and survival analysis.

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Breaking bad news and serious-illness communication — formative SAQs

Formative SAQs on structured breaking-bad-news conversations, prognostic disclosure and follow-up in paediatrics.

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Clinical epidemiology and measures of effect — formative SAQs

Formative SAQs on the computation and interpretation of measures of effect in paediatric research.

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Clinician wellbeing, fatigue and sustainable practice — formative SAQs

Two formative SAQs on clinician wellbeing and fatigue: the Maslach burnout framework and demands-resources mechanism, the fatigue-to-error cascade, the second-victim phenomenon, and the layered individual, team and organisational response.

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Communicating risk and uncertainty to families — formative SAQs

Formative SAQs on evidence-based risk and uncertainty communication with families in paediatrics.

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Confidentiality with children and adolescents — formative SAQs

Two formative short-answer questions on conditional confidentiality, Gillick/Fraser capacity, the three override thresholds, parental requests for information and electronic-record breaches.

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Conflict, complaints and difficult clinical encounters — formative SAQs

Formative SAQs on de-escalating an angry parent, managing a goals-of-care dispute, and responding to a formal complaint while supporting the clinician as second victim.

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Consent, parental responsibility and mature-minor frameworks — formative SAQs

Two formative SAQs on paediatric consent: parental permission, assent, mature-minor capacity assessment, emergency necessity and refusal of life-saving care.

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Developmentally appropriate communication — formative SAQs

Two formative short-answer questions on developmentally appropriate communication: preschool engagement without leading questions, confidential adolescent interviewing, interpreter use, augmentative communication, behavioural pain reading and teach-back.

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Diagnostic accuracy and screening statistics — formative SAQs

Formative SAQs on diagnostic accuracy and screening statistics applied to child health.

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Ethical allocation of resources in paediatrics — formative SAQs

Two formative SAQs on ethical allocation of resources in paediatrics: the four allocation principles and accountability for reasonableness, scarcity classification and the locus of decision, and the fair process for pandemic surge triage, expensive therapies and drug shortages.

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Evidence-based medicine and critical appraisal — formative SAQs

Formative SAQs on evidence-based medicine and critical appraisal applied to child health.

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Family-centred and child-rights-based care — formative SAQs

Two formative SAQs on family-centred and child-rights-based care: the four IPFCC core concepts and four UNCRC guiding principles, Hart's ladder of participation, and bedside delivery across complex chronic illness and adolescent settings.

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Goals-of-care conversations and advance care planning for children — formative SAQs

Two formative short-answer questions on goals-of-care conversations and advance care planning for children: the Serious Illness Conversation Guide, age-appropriate tools, prognostic disclosure, documentation and disagreement.

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Health literacy and accessible paediatric information — formative SAQs

Two formative short-answer questions on health literacy universal precautions, teach-back, millilitre dosing with oral syringes and pictograms, accessible discharge communication, and language access in paediatric care.

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High-value care, stewardship and avoiding low-value interventions — formative SAQs

Formative SAQs on high-value care, stewardship and the reduction of low-value interventions in child health.

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Implementation science and translating evidence into practice — formative SAQs

Two formative SAQs on translating evidence into paediatric practice: diagnosing the evidence-practice gap with Cabana and CFIR, selecting ERIC strategies, and measuring implementation outcomes with Proctor and RE-AIM.

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Interpreting systematic reviews and clinical guidelines — formative SAQs

Formative SAQs on interpreting systematic reviews, meta-analyses, and clinical practice guidelines applied to child health.

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Leadership and interprofessional team management — formative SAQs

Two formative SAQs on leading and managing an interprofessional team in child health: leadership styles, building a high-performing team, shared mental models, closed-loop communication, psychological safety, crew resource management, TeamSTEPPS and SBAR, structured handover, conflict and burnout, and the Cochrane evidence for interprofessional collaboration and education.

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Medication safety and error prevention in children — formative SAQs

Two formative SAQs on paediatric medication errors: the medication-use process, paediatric vulnerability, tenfold dosing errors, and the layered prevention and response system.

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Medicolegal documentation and expert evidence — formative SAQs

Formative SAQs on structuring a medicolegal report, the witness-of-fact versus expert-witness distinction, the overriding duty to the court, and surviving cross-examination.

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Open disclosure and duty of candour — formative SAQs

Formative SAQs on staged open disclosure, duty of candour, apology and the second victim after a patient safety incident in paediatrics.

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Paediatric consultation with child, young person and family — formative SAQs

Formative SAQs on the triadic paediatric consultation: Calgary-Cambridge structure, the age-adapted encounter, adolescent confidentiality and HEEADSSS, breaking bad news and safety-netting.

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Paediatric study design and bias — formative SAQs

Formative SAQs on choosing study designs and assessing bias in paediatric research.

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Patient safety, human factors and systems thinking — formative SAQs

Formative SAQs on Reason's Swiss cheese model, paediatric medication-safety risk, the structured handover evidence, and the adverse-event response pathway.

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Professional boundaries and social media — formative SAQs

Formative SAQs on professional boundaries, the boundary spectrum, social media conduct, digital professionalism and the safeguard toolkit in paediatric practice.

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Quality improvement methods in child health — formative SAQs

Two formative SAQs on designing a paediatric quality improvement project: the Model for Improvement, aim and measure design, PDSA testing, run-chart interpretation and evidence appraisal.

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Recognition, reporting and analysis of adverse events — formative SAQs

Two formative SAQs on paediatric adverse event recognition, systems analysis, trigger tools and disclosure.

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Refusal of treatment and disagreement over care — formative SAQs

Formative SAQs on navigating a parental refusal of recommended treatment, managing a blood-product refusal, and escalating an entrenched goals-of-care dispute to ethics consultation and the courts.

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Research ethics and assent in paediatric research — formative SAQs

Two formative short-answer questions on paediatric research ethics: risk-benefit categories and permission versus assent; and deferred consent with therapeutic misconception in emergency and oncology research.

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Shared decision-making and assent in children — formative SAQs

Two formative short-answer questions on shared decision-making, assent and dissent, decision aids, capacity and disagreement in paediatric care.

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Teaching, supervision and feedback in paediatrics — formative SAQs

Two formative short-answer questions on feedback models, the educational alliance, entrustment, the struggling learner versus the learner in difficulty, and supervision duties in paediatric training.

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Trauma-informed paediatric care — formative SAQs

Formative SAQs on the SAMHSA trauma-informed care framework, the toxic-stress mechanism, and bedside application in paediatrics.

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Working with interpreters and culturally responsive communication — formative SAQs

Two formative short-answer questions on interpreter use, child-as-interpreter, false fluency, cultural competence frameworks and adolescent-confidential communication in paediatric care.

Open

Domain

ophthalmology

17

Colour vision deficiency and inherited retinal disease: SAQ

Short-answer questions on colour vision deficiency and inherited retinal disease in children, covering the X-linked red-green colour deficiency and the Ishihara testing, the retinitis pigmentosa and the Stargardt disease, the Leber congenital amaurosis and the RPE65 gene, the electroretinography and the molecular genetic testing, the low-vision and the genetic counselling, and the voretigene neparvovec gene therapy.

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Congenital cataract and glaucoma — formative SAQs

Formative SAQs on congenital cataract and glaucoma: the assessment and stepwise management of a 4-week-old infant with a dense unilateral cataract and absent red reflex, including the surgical time-window, the Infant Aphakia Treatment Study evidence on aphakia versus primary IOL, and the lifelong glaucoma surveillance duty; and the assessment and management of a 3-month-old with a tearing, light-averse, enlarging eye (primary congenital glaucoma), including the diagnostic constellation at examination under anaesthesia, the angle-surgery ladder, and the drugs to avoid in the infant eye.

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Congenital nasolacrimal duct obstruction — formative SAQs

Formative SAQs on congenital nasolacrimal duct obstruction: recognising the white quiet watering eye with reflux on lacrimal-sac pressure, excluding congenital glaucoma, applying the conservative-first management with Crigler massage, reasoning through the probing-timing controversy, and escalating the acute dacryocystitis and neonatal dacryocystocele.

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Conjunctivitis and red eye — formative SAQs

Formative SAQs on conjunctivitis and the red eye in children: the triage and cause-matched management of a child with viral conjunctivitis and the recognition of the red-eye red flags, and the assessment and systemic management of a neonate with ophthalmia neonatorum distinguishing chlamydial from gonococcal disease — covering supportive care, the Cochrane-modest-benefit caveat for topical antibiotics, antihistamine-mast-cell-stabiliser treatment, neonatal onset windows, systemic antimicrobial choice, maternal screening and complications.

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Cortical visual impairment — formative SAQs

Formative SAQs on cortical visual impairment in children: the recognition, paradoxical clinical behaviours, diagnostic approach and habilitative management of a preterm infant with periventricular leukomalacia and a child with cerebral palsy, and the urgent response to a child with known CVI who presents with sudden visual deterioration distinguishing stable CVI from acute intracranial pathology — covering the normal-eye exam clue, neuroimaging, structured assessment with the CVI Range, environmental modification, multidisciplinary coordination and the red-flag features that mandate urgent imaging.

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Leukocoria and retinoblastoma: SAQ

Short-answer questions on leukocoria and retinoblastoma in children, covering the white pupillary reflex as the red-flag sign, the RB1 tumour suppressor gene on chromosome thirteen and the Knudson two-hit hypothesis, the International Intraocular Retinoblastoma Classification, the urgent referral and the red reflex test, the differential diagnosis of leukocoria, the ophthalmic artery chemosurgery, the trilateral retinoblastoma and the global disparity in the survival.

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Ocular trauma and chemical injury — formative SAQs

Formative SAQs on paediatric ocular trauma and chemical injury: the immediate and definitive management of a child with an alkali eye injury including the irrigation protocol, the Dua grading and follow-up, and the recognition and stepwise management of a suspected open globe including what must be avoided and the indications for surgery — covering the BETT classification, the Ocular Trauma Score, the alkali-versus-acid pathophysiology, hyphema, retained intraocular foreign body and sympathetic ophthalmia.

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Ophthalmia neonatorum — formative SAQs

Two formative SAQs on ophthalmia neonatorum: a three-day-old with profuse purulent discharge and lid oedema testing the recognition and emergency systemic management of gonococcal ophthalmia, the ceftriaxone-versus-cefotaxime decision and maternal screening; and a ten-day-old with mucopurulent discharge and a staccato cough testing chlamydial ophthalmia with evolving pneumonia, the rationale for systemic erythromycin and the public-health response.

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Ophthalmic manifestations of systemic disease: SAQ

Short-answer questions on the ophthalmic manifestations of systemic disease in children, covering the silent sight-threatening uveitis of juvenile idiopathic arthritis and the ACR screening schedule, the microvascular retinopathy of diabetes and sickle cell disease, the neurocutaneous phakomatoses from the optic pathway glioma to the Sturge-Weber glaucoma, and the metabolic and nutritional eye signs.

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Paediatric eye examination and red-reflex assessment — formative SAQs

Formative SAQs on the paediatric eye examination and red-reflex assessment: the technique and interpretation of the red-reflex (Bruckner) test, the differential and immediate management of a white reflex (leukocoria) led by retinoblastoma and congenital cataract, the age-adapted vision assessment, and the meaning and management of an asymmetric reflex as an amblyopia risk factor.

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Papilloedema and optic nerve disorders: SAQ

Short-answer questions on papilloedema and optic nerve disorders in children, covering the bilateral disc swelling of the raised intracranial pressure, the Friedman criteria with the opening pressure above two hundred and eighty millimetres of cerebrospinal fluid, the Frisén grading, the distinction of the true papilloedema from the pseudopapilloedema of the buried disc drusen, the idiopathic and the secondary intracranial hypertension, the acetazolamide and the weight loss, the optic neuritis with the painful visual loss and the relative afferent pupillary defect, the antibody-mediated disease and the intravenous methylprednisolone.

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Preseptal and orbital cellulitis — formative SAQs

Formative SAQs on preseptal and orbital cellulitis: the recognition and stepwise management of a febrile child with orbital cellulitis including the contrast CT decision, the intravenous antibiotic regimen and the medical-versus-surgical approach to a subperiosteal abscess, and the distinction between preseptal and orbital disease with the oral management of the well child — covering the Chandler classification, the orbital signs, the causative organisms, the lamina papyracea pathophysiology and the cavernous sinus complication.

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Refractive error in children — formative SAQs

Formative SAQs on refractive error in children: the assessment and stepwise management of a school-age child with progressive myopia, including cycloplegic refraction, myopia-control options and the reasoning behind low-dose atropine, and the assessment and management of a young child with significant hyperopia and an accommodative squint, including the role of cycloplegia and amblyopia prevention — covering refractive optics, the myopia severity bands, amblyopia risk-factor thresholds, cycloplegic retinoscopy, outdoor time and the red flags for urgent referral.

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Strabismus and ocular motility disorders — formative SAQs

Formative SAQs on childhood strabismus and ocular motility disorders: detecting a deviation with the cover test, deciding comitant versus incomitant, performing cycloplegic refraction and a dilated fundus examination, applying the amblyopia-first management sequence, and escalating the red-flag presentations to urgent neuroimaging and referral.

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Urgent ophthalmology referral and childhood vision loss: SAQ

Short-answer questions on urgent ophthalmology referral and childhood vision loss, covering the white pupillary reflex and the abnormal red reflex as retinoblastoma until proven otherwise, the tiered same-day and urgent referral pathway, the amblyopia sensitive period, the painful red eye with the orbital cellulitis, the sudden painless loss of vision from the optic neuritis and the cortical visual impairment, the papilloedema of the raised intracranial pressure, the optic nerve hypoplasia of the septo-optic dysplasia, and the safety-net advice.

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Uveitis in children — formative SAQs

Formative SAQs on uveitis in children: the stepwise management of a child with newly diagnosed JIA-associated anterior uveitis from topical prednisolone and cycloplegia through systemic methotrexate to biologic adalimumab; and the 2019 ACR and Arthritis Foundation risk-stratified screening schedule by JIA subtype, ANA status, age at onset and disease duration, with the rationale for slit-lamp surveillance in the silent disease. Covers the SUN anatomical classification, the T-cell mediated pathophysiology of cells and flare, the complications of band keratopathy, cataract, glaucoma, synechiae and amblyopia, and the infectious posterior uveitis differential of toxoplasmosis and toxocariasis.

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Visual development, amblyopia and vision screening in childhood — formative SAQs

Two formative SAQs: a five-year-old with reduced left eye acuity found at school-entry screening testing the recognition of amblyopia as a cortical deficit, the refer threshold and the stepwise management ladder; and a two-month-old with leukocoria and an absent red reflex testing the recognition of the deprivation red flag, the urgent referral pathway and the rationale for early surgery in congenital cataract.

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