3- 3 year old acc

Question 1

eczema treatments

Answer 1

Protecting skin by lubricating extensively
Using anti-inflammatories in short bursts, and
Treating associated skin infections aggressively.

steroids
antihistamines
topical antiinflammatories- calcienurin inhibitors

Question 2

when should you discotnue the bottle and why

Answer 2

12-15 months

causes dental cavities`

Question 3

intoeing in toddlers vs preschool/school aged

Answer 3

toddlers: caused by tibial torsion. In tibial torsion, when the patella faces straight ahead, the foot turns inward. Tibial torsion resolves naturally with weight bearing - usually by 4 years of age.
school: caused by femoral anteversion. In femoral anteversion both the feet and knees turn inward. Femoral anteversion usually resolves spontaneously by 8-12 years of age.

Question 4

caloric requirements of term infant, preterm infant, and very low birth weight infant

Answer 4

term: 100-120 cal/kg/day
preterm: 115-130

VLBW: 150

Question 5

neonatal acne

Answer 5

Results from hormonal stimulation of the sebaceous glands. Papules and pustules

benign, resolves over time

Question 6

how long do palmar and plantar grasp reflexes last

Answer 6

palm: 2-3 mo

plantar- 8 mo

Question 7

what age is forward facing car seat

Answer 7

2-4 years

Question 8

what age is booster seat

Answer 8

4- 8

Question 9

when should you double and triple your weight

Answer 9

double- 4-5 mo

triple- 12 mo

Question 10

absence of red reflex suggest

Answer 10

Cataracts
Glaucoma
Retinoblastoma
Chorioretinitis

Question 11

when can solid foods be added?

Answer 11

6 mo- every 5 to 7 days.

some infants may be started on rice cereal with a spoon at age 4 months.

Question 12

differential for abdominal mass in asymptomatic 9 year old?

Answer 12

F. Hepatic neoplasm- Asx or jaundice, rare

G. Hydronephrosis- UTI, flank mass

H. Neuroblastoma-age 2- painless or ill from mets

I. Teratoma- painless or pressure, rare

*J. Wilms’ tumor- asx, doesn’t cross midline

Question 13

neuroblastoma on imaging

Answer 13

CT scan may reveal calcifications and a heterogenous mass with cystic areas representing either hemorrhage or necrotic tumor.

Metastases are primarily to regional lymph nodes and to the liver, bone marrow, and skeleton.

Chest radiograph will reveal any lymph node involvement in the chest or additional tumors that may present in the posterior mediastinum.

Question 14

neuroblastoma labs

Answer 14

Histopathology reveals “small round blue cells” or small, uniform cells containing dense, hyperchromatic nuclei and scant cytoplasm, forming small cell rosettes.

Urinary HVA/VMA will be elevated in 90-95% of cases.

CBC: anemia or other cytopenias that are secondary to bone marrow infiltration.

Question 15

wilms tumor imaging

Answer 15

Ultrasound - intrarenal.

CT scan –heterogenous with areas of low density representing necrosis. A pseudocapsule may be observed because of the sharp demarcation between tumor and normal renal parenchyma.

Pulmonary metastases may be identified on chest radiograph.

Question 16

wilms tumor labs

Answer 16

hematuria

Question 17

hepatic tumor imaging

Answer 17

Radiograph of abdomen will demonstrate hepatic enlargement with hepatic tumors.

CT scan will show tumor and origin of tumor.

Chest CT is indicated to look for pulmonary metastases.

Question 18

hepatic tumor labs

Answer 18

Diagnosis is dependent on histologic examination.
Laboratory studies of liver function are usually normal but liver enzymes and bilirubin may be elevated in 20% of cases.
Alpha-fetoprotein levels will be increased in most patients.

Question 19

teratoma imaging

Answer 19

CT best- solid and cystic

x ray only if calcified teeth

Question 20

constipation imaging

Answer 20

plain radiograph

Question 21

is neuroblastoma hereditary?

Answer 21

1% familial- aut dom

Question 22

how old is this child? a child should be able to walk backward, and 50-90% of children can run at this stage. be able to scribble, build a tower of 2 cubes, have 3-6 words in her or his vocabulary, and be able to help in the house and remove garments.

Answer 22

18 mo

Question 23

how old is this child? child should be able to stoop and recover and walk well, put a block in a cup, have a vocabulary of a few words, wave bye-bye, and drink from a cup.

Answer 23

15 mo

Question 24

how old is this child? kids can jump up and throw a ball overhand. They can build a tower of 6-8 cubes, point to 6 body parts, name 1 picture, put on clothing, and wash and dry their hands.

Answer 24

2.5 years

Question 25

how old is this child?children can balance on each foot for 1 second, wiggle their thumbs, name 4 pictures, name 1 color, name a friend, and brush their teeth with help.

Answer 25

age 3

Question 26

when do most babies sleep through the night

Answer 26

4-6 mo

Question 27

initial work up for abdominal mass

Answer 27

CBC- test for anemia

catecholamine excess?

CXR and skeletal survey- mets?

abdominal US > x ray and CT