100-150

Question 1

Pheochromocytoma

Answer 1

Catecholamine-secreting tumor located in the adrenal glands
Sx: paroxysmal headaches, diaphoresis, palpitations, tremors, and vision changes
PE: hypertension, orthostasis
Dx: ↑ 24h urinary catecholamines and metanephrines, or ↑ plasma metanephrine levels, adrenal CT or MRI
Tx:
alpha-blocker (phenoxybenzamine) prior to beta-blockade to prevent unopposed alpha-agonism
surgical resection
Associated with MEN2 (medullary thyroid cancer, pheochromocytoma, +/- primary hyperparathyroidism)

Question 2

Legg-Calvé-Perthes Disease

Answer 2

Patient will be a boy 4–10 years old
Unilateral, intermittent limp
Most commonly caused by osteonecrosis of the proximal femoral head

Question 3

What is the treatment for the akisthetic side effect of metoclopramide?

Answer 3

Diphenhydramine

Question 4

Headaches

Answer 4

Question 5

Headache high risk historical or exam features include

Answer 5

sudden onset or onset with exertion, neurologic changes, fever, immunosuppression, recent antibiotic use, changes from prior headaches, association with trauma, rheumatologic disease, cancer, neck stiffness, and papilledema

Question 6

Bacterial Tracheitis

Answer 6

Patient will be 3–5 years old
High fever, barky cough, stridor
Treat as airway emergency!
Patient will look like croup but appear toxic
he classic presentation is a child with suspected croup who continues to worsen despite treatment. High fever develops. These patients are at increased risk for airway compromise. They should be immediately started on broad-spectrum intravenous antibiotics.