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FINALS-PEDIA > 4TH BIMONTHLY RECALLS > Flashcards

4TH BIMONTHLY RECALLS Flashcards

1
Q

The following are TRUE of Type 1 Diabetes Milletus EXCEPT:

a. utilization of glucose by muscle and fat decreases
b. dependent on insulin to prevent metabolic alkalosis
c. Due to autoimmmune destruction of
pancreatic B cells
d. if uncontrolled, would lead to a nonlabored, rapid breathing

A

b. dependent on insulin to prevent metabolic alkalosis

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2
Q

The following statements are TRUE about Type 2 Diabetes Mellitus EXCEPT:

a. Non-insulin dependent diabetes
b. Noted peripheral insulin resistance
c. With absolute insulin deficiency
d. non-autoimmune destruction of B cells

A

c. With absolute insulin deficiency

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3
Q

This is the major cause of morbidity and mortality in children presenting with polyuria, polydypsia and an FBS of
250mg/dL

a. Ketoacidosis
b. Cerebral edema
c. Hyperglycemia
d. Nonketotic Hyperosmolar coma

A

b. Cerebral edema

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4
Q

The diagnosis of diabetes insipidus is
established when:

a. Serum osmolality is > 200; urine
osmolality is < 200
b. Serum osmolality is > 300; urine
osmolality is > 300
c. Serum osmolality is < 200; urine
osmolality is > 200
d. Serum osmolality is > 300; urine
osmolality is < 300

A

b. Serum osmolality is > 300; urine
osmolality is > 300

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5
Q

A water deprivation test is indicated when pathologic polyuria and polydipsia are present and serum osmolality is:

a. > 250 mOsm/kg, < 300 mOsm/kg
b. > 260 mOsm/kg, < 300 mOsm/kg
c. > 270 mOsm/kg, < 300 mOsm/kg
d. > 270 mOsm/kg, > 300 mOsm/kg

A

c. > 270 mOsm/kg, < 300 mOsm/kg

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6
Q

Rapid correction of a person with serum sodium of 115meq/L will cause:

a. Cerebral salt wasting
b. Lateral pontine myelinolysis
c. Central cerebellar myelinolysis
d. Central pontine myelinolysis

A

d. Central pontine myelinolysis

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7
Q

Vasopressin insufficiency is found in what condition?

a. Central Diabetes insipidus
b. Genetic Nephrogenic Diabetes Insipidus
c. Acquired Nephrogenic Diabetes
Insipidus
d. Both Genetic, Acquired Nephrogenic
Diabetes Insipidus

A

d. Both Genetic, Acquired Nephrogenic
Diabetes Insipidus

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8
Q

Chronic SIADH is BEST treated with one of the following :

a. Diuretics
b. Demeclocycline
c. Oral fluid restriction
d. Sodium supplementation

A

c. Oral fluid restriction

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9
Q

The triphasic response mechanism involved after a surgery or trauma is as follows :

a. Transient Diabetes insipidus —
Permanent Diabetes insipidus—
Syndrome of Inappropriate ADH
secretion
b. Syndrome of Inappropriate ADH
secretion — Transient DI — Permanent
DI
c. Transient DI— SIADH — Permanent DI
d. Permanent DI— SIADH — Transient DI

A

c. Transient DI— SIADH — Permanent DI

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10
Q

This is the mainstay for the management of Central Diabetes Insipidus.

a. Pitressin
b. Fluid therapy
c. Desmopressin
d. Caloric load for osmotic load

A

b. Fluid therapy

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11
Q

This is the main goal for the treatment of Nephrogenic Diabetes insipidus.

a. Diuretics
b. Treat underlying problem
c. Provide enough calories
d. High dose Desmopressin

A

b. Treat underlying problem

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12
Q

The following are true in the management of severe Hyponatremia :

a. Fluid restriction
b. Raise serum Na+ @ 0.5mEq/L/Hr using isotonic 3% NaCl
c. Do emergency fluid challenge when
serum sodium is < 130 meq/L
d. Raise serum Na+ no higher than 12
mEq/L/24hrs with hypertonic 3% NaCl

A

d. Raise serum Na+ no higher than 12
mEq/L/24hrs with hypertonic 3% NaCl

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13
Q

One of the following is NOT part of the
management of diabetic ketoacidosis.

a. Sodium HC03 only if pH is < 7.2
b. Initial hydration fluid of hypertonic 3% NaCl
c. Administration of glucose (5% soln in
0.2 N saline)
d. Give K+ added afte

A

b. Initial hydration fluid of hypertonic 3% NaCl

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14
Q

A 12- year old female has a 6-month history of hyperactivity with declining school performance. Although her appetite is increased , she doesn’t gain weight. PE showed mild exophthalmos, slight tremors of the fingers and a neck mass. The following are true for this case EXCEPT:

a. Low TSH
b. Thyroxine is increased
c. Thyroid Receptor Antibody confirms the diagnosis
d. Aside from PTU, may give Carbimazole (more potent) as treatment

A

d. Aside from PTU, may give Carbimazole (more potent) as treatment

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15
Q

A consequence of Radioactive iodine
Ablation in patients with Grave’s disease would be:

a. Hashimoto’s thyroiditis
b. Permanent hypothyroidism
c. Transient diabetes insipidus
d. Transient hypoparathyroidism

A

b. Permanent hypothyroidism

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16
Q

A 2-month old appears to be having
inadequate weight gain. His mother claims that he is constipated. On PE, he has decreased muscle tone, a large fontanel, a large tongue, an umbilical hernia. The most common cause for this case is:

a. Iodine deficiency
b. Thyroid malformation
c. TSH unresponsiveness
d. Defect in thyroid hormone synthesis
e. Maternal Abs: Thyrothropin receptorblocking Ab (TRB Ab)

A

b. Thyroid malformation

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17
Q

A 2-month old appears to be having
inadequate weight gain. His mother claims that he is constipated. On PE, he has decreased muscle tone, a large fontanel, a large tongue, an umbilical hernia. The earliest manifestation of this patient would have been:

a. Hypotonia
b. Cold, mottled skin
c. Prolonged physiologic jaundice
d. Edematous genitalia, extremities

A

c. Prolonged physiologic jaundice

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18
Q

A 1-month old presents with vomiting and severe dehydration. PE shows ambiguous genitalia. Lab tests show hyponatremia. One of the following is the most reliable laboratory parameter to diagnose this patient: An increase in serum _________________?

a. 17-hydroxylase
b. 21A-Hydroxylase
c. 17A- OH progesterone
d. 17A-OH pregnenolone

A

c. 17A- OH progesterone

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19
Q

A 1-month old presents with vomiting and severe dehydration. PE shows ambiguous genitalia. Lab tests show hyponatremia. There is a deficiency in what enzyme/hormone?

a. 11 B-Hydroxylase
b. 17B-Hydroxylase
c. 21A-Hydroxylase
d. 17A-hydroxyprogesterone

A

c. 21A-Hydroxylase

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20
Q

A patient had recently a menigococcal
infection and manifested the following muscular weakness, malaise, anorexia,
nausea, vomiting, wt loss, with salt-craving. On PE, there are highly pigmented- skin creases, mucosa, scars. The definitive test to confirm diagnosis is:

a. Cathecholmaine levels
b. Water deprivation test
c. Single-dose Dexamethasone
Suppression Test
d. Cortisol levels before and after ACTH
administration

A

d. Cortisol levels before and after ACTH
administration

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21
Q

Excessive urine excretion and excessive thirst are common clinical manifestations in the following EXCEPT:

a. Primary polydipsia
b. Cushing syndrome
c. Pheochromocytoma
d. Maturity onset Diabetes of the Young

A

b. Cushing syndrome

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22
Q

The most common cause of patients
presenting with rounded face, prominent cheeks, moon facies, “Buffalo hump”, generalized obesity, abnormal masculinization and Impaired growth with hypertension is:

a. dyshormonogenesis
b. acquired primary adrenal insufficiency
c. autoimmune destruction of pancreatic islets
d. prolonged exogenous administration of glucocorticoid hormones

A

d. prolonged exogenous administration of glucocorticoid hormones

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23
Q

The following are true of Pheochromocytoma EXCEPT:

a. the lesion involve the right kidney
b. Sx-free in between attacks of HPN
c. Most common site is the adrenal cortex
d. Surgical removal is the mainstay of
management

A

c. Most common site is the adrenal cortex

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24
Q

The following are true about Hashimoto’s Thyroiditis EXCEPT:

a. presence of thyrothropin receptor blocking Ab (TRB Ab)
b. patients don’t present with normal
serum T4 and TSH
c. in marked hypothyroidism, there is an elevated TSH, low FT4
d. in subclinical hypothyroidism, there is an elevated TSH and normal FT4

A

a. presence of thyrothropin receptor blocking Ab (TRB Ab)

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25
Q

Diagnostic criteria for Diabetic Milletus
includes the following EXCEPT:

a. FBS >126mg/dL
b. RBS > 100mg/dL
c. HbA1c of >6.5%
d. 2-hour plasma glucose of 200mg/dL

A

b. RBS > 100mg/dL

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26
Q

Epilepsy is defined as:

a. less than 2 unprovoked seizures
occurring in a time frame of >24 hrs
b. More than 2 provoked seizures in >24 hrs
c. More than 2 unprovoked seizures in > 24 hours
d. More than 2 unprovoked seizures in
less than 24 hours

A

c. More than 2 unprovoked seizures in > 24 hours

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27
Q

A 3-month old boy presenting with
prolonged seizures at the emergency room was noted to have an occipital
cephalhematoma on palpation of the head. What is the imaging modality of choice to evaluate for intracranial hemorrhage and to rule out skull fracture?

a. Skull xray
b. Cranial ultrasound
c. Cranial CT scan, plain
d. Cranial MRI

A

c. Cranial CT scan, plain

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28
Q

The imaging modality for vascular
malformations in infants is:

a. Cranial ultrasound
b. Cranial CT scan
c. Cranial MRI
d. MR Angiography

A

d. MR Angiography

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29
Q

In the evaluation of the first seizure,
Magnetic resonance Imaging (MRI) should be seriously considered in all of the following EXCEPT:

a. Children < 1 year old
b. Unexplained acute psychosis
c. Benign partial epilepsy of childhood
d. Electroencephalography showing
secondary generalized epilepsy

A

c. Benign partial epilepsy of childhood

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30
Q

Which diagnostic procedure is done to a 5- month old with simple febrile seizure:

a. EEG
b. Lumbar puncture
c. Cranial ultrasound
d. Serum sodium, potassium, glucose
e. All of the above

A

b. Lumbar puncture

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31
Q

Juvenile myoclonic epilepsy is also known as:

a. Janz syndrome
b. West syndrome
c. Dravet syndrome
d. Lennox-Gastaut syndrome

A

a. Janz syndrome

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32
Q

The triad of Lennox-gastaut syndrome
includes EXCEPT:

a. Developmental delay
b. Myoclonic seizures
c. Polyspike bursts in sleep
d. 1-2 Hz spike and rapid waves

A

d. 1-2 Hz spike and rapid waves

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33
Q

Triad of West sydrome includes EXCEPT:

a. Infantile spams
b. hypsarrhytmia
c. Developmental regression
d. polyspike burst in wakefulness

A

d. polyspike burst in wakefulness

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34
Q

Absence seizures are described as the
following EXCEPT:

a. focal type of seizure
b. generalized type of seizure
c. no postictal period
d. may have simple automatisms

A

a. focal type of seizure

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35
Q

Severe myoclonic epilepsy of infancy is also known as:

a. West syndrome
b. Dravet syndrome
c. Ohtahara syndrome
d. Janz syndrome

A

b. Dravet syndrome

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36
Q

Partial seizures are common in:

a. frontal lobe epilepsy
b. parietal lobe epilepsy
c. occipital lobe epilepsy
d. temporal lobe epilepsy

A

d. temporal lobe epilepsy

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37
Q

It is also called the infantile epileptic
encephalopathy.

a. West syndrome
b. Dravet syndrome
c. Ohtahara syndrome
d. Janz syndrome

A

c. Ohtahara syndrome

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38
Q

How will you initially manage a patient
presenting with febrile seizures at the
emergency room?

a. Do lumbar tap
b. Give antipyretics
c. Give anticonvulsants
d. Check for the airway, breathing, circulation

A

d. Check for the airway, breathing, circulation

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39
Q

Physical Findings of anemia are the ff.
EXCEPT:

a. Pallor in Hb = 10 g/dl
b. Flow murmur
c. Hepatosplenomegaly
d. None of the above

A

a. Pallor in Hb = 10 g/dl

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40
Q

An initial laboratory tests to be requested on a patient who comes in due to pallor EXCEPT:

a. WBC
b. Bone marrow smear exam
c. Reticulocyte count
d. Red cell indices

A

b. Bone marrow smear exam

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41
Q

Anemia due to decrease RBC production:

a. Hereditary Spherocytosis
b. Thallasemia
c. Megaloblastic Anemia
d. None of the above

A

c. Megaloblastic Anemia

42
Q

One of the ff is/are anemia secondary to increase RBC destruction :

a. low reticulocyte count
b. G6PD Deficiency
c. Physiologic anemia of the newborn
d. All of the above

A

b. G6PD Deficiency

43
Q

True of Von Willebrand disease is/are:

a. Thrombocytopenia occasionally present
b. most common inherited bleeding
c. Treated with Desmopressin
d. All of the above

A

d. All of the above

44
Q

True of Hemophilia B EXCEPT:

a. factor VIII deficiency
b. Hemarthrosis is the hallmark finding
c. X-linked traits
d. None of the above

A

a. factor VIII deficiency

45
Q

True of Idiopathic (Autoimmune)
Thrombocytopenic Purpura is/are:

a. 1-4 wk after exposure to a common
viral infection
b. Common initial manifestation -
generalized petechiae and purpura
c. rarely with hepatosplenomegaly
d. All of the above

A

d. All of the above

46
Q

True of chemotherapy in children EXCEPT:

a. Sequential single-drug therapy is
recommended
b. The most common acute adverse
effects are myelosuppression
c. All of the above

A

a. Sequential single-drug therapy is
recommended

47
Q

True of Childhood leukemias:

a. ALL most common (77% of cases)
b. genetic abnormalities in a
hematopoietic cell give rise to an
unregulated clonal proliferation of cells
c. 31% of all malignancies that occur in
children younger than 15 yr
d. All of the above

A

d. All of the above

48
Q

True Hodgkin lymphoma except:

a. is the most common cancer seen in
adolescents
b. Associated with Epstein-Barr virus (EBV)
c. The Reed-Sternberg (RS) cell, a
pathognomonic feature
d. None of the above

A

d. None of the above

49
Q

One of the following presents with
normocytic, normochromic anemia:

a. Iron deficiency
b. G6PD deficiency
c. Vitamin B12 deficiency
d. Congenital Aplastic anemia

A

b. G6PD deficiency

50
Q

One of the following is an acquired aplastic anemia.

a. Fanconi anemia
b. Pearson syndrome
c. Diamond-Blackman anemia
d. Transient erythroblastopenia of
childhood

A

d. Transient erythroblastopenia of
childhood

51
Q

One of the following characterizes DiamondBlackfan anemia EXCEPT:

a. RBCs are macrocytic
b. Common in 2-6 months old
c. RBCS are microcytic, normochromic
d. Corticosteroids are the main therapy

A

c. RBCS are microcytic, normochromic

52
Q

Transient erythroblastopenia of childhood has the following feature.

a. It has familial predisposition
b. It requires regular blood transfusion
c. Anemia is evident by age 2-5months old
d. It is not associated with congenital
anomalies

A

d. It is not associated with congenital anomalies

53
Q

Megaloblastic anemias include the following EXCEPT:

a. Iron deficiency anemia
b. Folate deficiency anemeia
c. Cobalamin deficiency anemia
d. Vitamin B12 deficiency anemia

A

a. Iron deficiency anemia

54
Q

It is the most common cause of inherited abnormality of the red blood cell membrane.

a. Hereditary spherocytosis
b. Hereditary elliptocytosis
c. Hereditary stomatocytosis
d. Paroxysmal nocturnal hemoglobinuria

A

a. Hereditary spherocytosis

55
Q

The most common manifestation/s of
Glucose-6-Phosphate Dehydrogenase
deficiency(G6PD) is/are:

a. RBCS are microcytic, normochromic
b. It has an autosomal recessive
inheritance
c. Majority of patients are symptomatic
d. Patients present with jaundice and
hemolytic anemia

A

d. Patients present with jaundice and hemolytic anemia

56
Q

This is the most common anomaly in Fanconi anemia.

a. Short stature
b. Renal malformations
c. Skin pigment changes
d. Cardiopulmonary abnormalities

A

c. Skin pigment changes

57
Q

Thalassemia in a fetus with hydrops has most likely this form of hemoglobin.

a. Alpha 2
b. Aplha 4
c. Beta 2
d. Beta 4

A

b. Aplha 4

58
Q

One of the ff/s is a physiologic adaptation to anemia :

a. Tachycardia
b. Decrease Arteria-Venous oxygen
diferrence
c. Shift to the Left of the oxygen
dissociation curve
d. All of the above

A

a. Tachycardia

59
Q

Partial seizures are common in:

a. frontal lobe epilepsy
b. parietal lobe epilepsy
c. occipital lobe epilepsy
d. temporal lobe epilepsy

A

d. temporal lobe epilepsy

60
Q

This is the form of Von Willebrand disease that presents symptoms similar to those seen in mild hemophilias.

a. Type 1 VWD
b. Type 2A VWD
c. Type 2B VWD
d. Type 3 VWD

A

d. Type 3 VWD

61
Q

The most common cause of acute onset of thrombocytopenia in children is:

a. Idiopathic thmbocytopenic purpura
b. Thrombotic thrombocytopenic purpura
c. drug-induced thrombocytopenia
d. Hemolytic uremic syndrome

A

a. Idiopathic thmbocytopenic purpura

62
Q

To diagnose Acute Lymphoblastic Leukemia, this feature alone is adequate.

a. Morphology
b. Signs and symptoms
c. Chromosomal abnormalities
d. Diagnostic procedures

A

a. Morphology

63
Q

A pathognomonic feature of Hodgkin’s
lymphoma is:

a. Multinucleated cells
b. Reed-sternberg cell
c. Ann Arbor cells
d. B or T cells

A

b. Reed-sternberg cell

64
Q

It is the most common extracranial solid tumor in children.

a. Astrocytoma
b. Craniopharyngoma
c. Medulloblastoma
d. Neuroblastoma

A

d. Neuroblastoma

65
Q

A 10-year old girl was brought in for poor school performance. Her teacher was complaining of frequent day dreaming. At the clinic, there was sudden onset of blank stare followed with movements of the eyelids. You consider this patient as:

a. Focal seizure
b. Myoclonic seizure
c. Absence seizure
d. Complex partial seizures

A

c. Absence seizure

66
Q

The main difference between simple febrileand complex febrile seizures is:

a. the gender of the patient
b. the temperature during the seizure
c. the length of time of the seizure
episode
d. the number of seizure episodes in a 24 hour period

A

d. the number of seizure episodes in a 24 hour period

67
Q

This refers to the ability of the child to
understand words spoken to him.

a. Cognitive
b. Social-emotional
c. Receptive language
d. Expressive language

A

c. Receptive language

68
Q

It refers to the child’s ability to think, reason, understand concepts and solve problems.

a. Cognitive
b. Social-emotional
c. Receptive language
d. Expressive language

A

a. Cognitive

69
Q

The following are gross motor red flags
EXCEPT:

a. 5 months old does not roll over
b. 15 months old not walking
c. 2 years old not climbing up and down the stairs
d. 3 years old not hopping

A

d. 3 years old not hopping

70
Q

The following are fine motor red flags
EXCEPT:

a. Unable to hold rattle at 5 months
b. Absent pincer grasp at 10 months
c. Unable to stack 3 blocks at 2 years
d. Unable to draw straight line at 3 years

A

c. Unable to stack 3 blocks at 2 years

71
Q

The following are language red flags
EXCEPT:

a. no babbling at 5 months
b. no 2-word sentence at 2 years
c. does not understand prepositions at 3 years
d. Not using proper syntax at 5 years

A

c. does not understand prepositions at 3 years

72
Q

The following are cognitive red flags
EXCEPT:

a. not alert to mother at 2 months
b. not interested in peek-a-boo at 8
months
c. does not know own name at 3 years
d. does not know color at 4 years old

A

d. does not know color at 4 years old

73
Q

Psychosocial red flags include EXCEPT:

a. no social smile at 3 months
b. not laughing at playful situations at 7
months
c. hard to console at 2 years old
d. resists. discipline at 4 years old

A

c. hard to console at 2 years old

74
Q

In Intellectual Disability, these are deficits in intellectual functions EXCEPT:

a. reasoning
b. planning
c. judgement
d. communication

A

d. communication

75
Q

In Intellectual Disability, these are deficits in adaptive functions EXCEPT:

a. problem solving
b. personal independence
c. social responsibility
d. independent living

A

a. problem solving

76
Q

Criteria for language disorder include the following EXCEPT:

a. Reduced vocabulary
b. limited sentence structure
c. symptoms appear later in life
d. Language abilities are below those
expected of age

A

c. symptoms appear later in life

77
Q

Autism spectrum disorder includes
EXCEPT:

a. Rett’s syndrome
b. Asperger’s syndrome
c. Childhood integrative disorder
d. Pervasive developmental disorder

A

c. Childhood integrative disorder

78
Q

Which of the following is NOT an age
appropriate red flag in patients with
Autism?

a. Repetitive clapping at 12. months
b. Does not respond to name at 1 year old
c. Does not pretend play at 1 year 6
months
d. Does not point to objects of interest at 1 year and 2 months

A

a. Repetitive clapping at 12. months

79
Q

The following criteria support Autism
Spectrum Disorder EXCEPT:

a. Difficulty sustaining attention at a given task
b. Difficulty maintaining relationships
c. Difficulty in communication
d. Stereotyped motor movements

A

a. Difficulty sustaining attention at a given task

80
Q

High functioning autism with intact
communication function is also called:

a. Rett’s syndrome
b. Asperger’s syndrome
c. Child Disintegrative Disorder
d. Childhood Pervasive Disorder

A

b. Asperger’s syndrome

81
Q

Repetitive behaviors and compulsivity is NOT found in :

a. Rett’s syndrome
b. Asperger’s syndrome
c. Child Disintegrative Disorder
d. Pervasive Developmental Disorder

A

c. Child Disintegrative Disorder

82
Q

Loss of previously acquired skills or
regression is found in :

a. Rett”s syndrome
b. Asperger’s syndrome
c. Child Disintegrative Disorder
d. pervasive Developmental Disorder

A

c. Child Disintegrative Disorder

83
Q

The following describes Classic Autism
EXCEPT:

a. Regression
b. Speech defect
c. Social impairment
d. Repetitive behaviors

A

a. Regression

84
Q

Best prognostic factors for individual
outcome of patients with Austism include EXCEPT:

a. language impairment
b. presence of a learning disorder
c. presence of intellectual disability
d. absence of intellectual disability

A

b. presence of a learning disorder

85
Q

To diagnose ADHD with combined
presentation, the following symptoms are present for 6 months EXCEPT:

a. On the go attitude
b. talks excessively
c. intrudes others
d. unable to play quietly
e. repetitive patterns of behavior

A

e. repetitive patterns of behavior

86
Q

ADHD severity classification includes the following EXCEPT:

a. Mild
b. Moderate
c. Severe
d. Profound

A

d. Profound

87
Q

Impairments in one of the following is part of the Learning Disorder EXCEPT:

a. Spelling
b. Writing
c. Organizing
d. Abstract reasoning

A

d. Abstract reasoning

88
Q

In a 3 year old, one of the following is a red flag for Learning Disorder:

a. Dislikes reading
b. Difficulty rhyming
c. slow to learn new skills
d. Unable to blend sounds

A

b. Difficulty rhyming

89
Q

In an 8-year old , one of the following is a red flag for Learning disorder:

a. poor handwriting
b. Difficulty telling time
c. problems pronouncing words
d. trouble with learning to tie the shoes

A

b. Difficulty telling time

90
Q

Accommodations in Learning Disorders include but not limited to, EXCEPT:

a. Providing test via audio
b. Giving instructions verbally
c. Reducing the number of items per page
d. Providing tests in darker prints

A

d. Providing tests in darker prints

91
Q

American Academy Of Pediatrics (AAP)
recommends the following guidelines in developmental screening:

a. all children screened for autism at 18 months, 24 months
b. all children screen to assess their
general development at 9, 18, 24
months
c. Only A
d. Only B
e. Both A and B

A

e. Both A and B

92
Q

A 13-year old female with mental retardation was brought in for consult due to headache. The mother reported that when it happens, the patient would hit her forehead several times as if indicating pain on the frontal area and she would not stop shouting and crying. This has happened 3x already in the past 2 months. In all three occasions, the patient would gradually become clumsy and drowsy and distorted (“Alice in Wonderland”)followed within an hour, by head slapping and the incessant crying often lasting for several hours. There was no family history of migraine, tumors, epilepsy. There were no lateralizing signs noted on the physical examination.

Given the limited reliability of both
informant and patient, what is the most likely consideration in this case?

a. Migraine without aura
b. Migraine with typical aura
c. Migraine with atypical aura
d. Tension-type of headache

A

c. Migraine with atypical aura

93
Q

A 13-year old female with mental retardation was brought in for consult due to headache. The mother reported that when it happens, the patient would hit her forehead several times as if indicating pain on the frontal area and she would not stop shouting and crying. This has happened 3x already in the past 2 months. In all three occasions, the patient would gradually become clumsy and drowsy and distorted (“Alice in Wonderland”)followed within an hour, by head slapping and the incessant crying often lasting for several hours. There was no family history of migraine, tumors, epilepsy. There were no lateralizing signs noted on the physical examination.

Headcahe management plan include the following:

a. Acute treatment + behavioral therapy
b. Acute & preventive strategy +
biobehavioral therapy
c. Acute & preventive strategy + biobehavioral therapy + neuroimaging
d. Acute & preventive strategy +
biobehavioral therapy + neuroimaging + EEG

A

c. Acute & preventive strategy + biobehavioral therapy + neuroimaging

94
Q

True regarding treatment of migraine
headaches EXCEPT:

a. The most effective abortive treatment is to use NSAIDs first, limited to 2-3 attacks per month, then adding triptan if unresponsive to NSAIDs
b. The most commonly used preventive therapy for migraine is amitryptiline
c. IV prochlorperazine is very effective in aborting attack in the emergency room with improvement in 1 hour
d. IV prochloroperazine plus ketorolac has a better response rate of 93%

A

a. The most effective abortive treatment is to use NSAIDs first, limited to 2-3 attacks per month, then adding triptan if unresponsive to NSAIDs

95
Q

What is a major risk factor for febrile seizure recurrence present in this case?

a. Female gender
b. Family history of epilepsy
c. Strong family history of febrile seizures
d. Fever starting 5 hours prior to seizure and ER admission

A

d. Fever starting 5 hours prior to seizure and ER admission

96
Q

What is the cumulative risk for subsequent epilepsy in this case?

a. 1%
b. 6%
c. 19%
d. 33%

A

c. 19%

97
Q

Which of the following indications for a
lumbar tap best applies to this case?

a. lumbar tap should be done in all infants younger than 12 months old
b. lumbar tap should be done immediately to allow initiation of antibiotic treatment for confirmed bacterial meningitis
c. lumbar tap should be done immediately due to nuchal rigidity, decreasing sensorium
d. lumbar tap should be done if
immunization status is unknown

A

d. lumbar tap should be done if immunization status is unknown ????

98
Q

According to the PPS, a 16-month old
presenting with simple febrile seizure,
lumbar tap is routinely done.

True
False

A

True

99
Q

EEG is routinely done to patients with
complex febrile seizures regardless of age.

True
False

A

True

100
Q

Anticonvulsants are given as
maintenance medications after an episode of febrile seizure.

True
False

A

False

FINALS-PEDIA (16 decks)

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