BootCamp GEN Peds 2 Flashcards
what is the most initial ix for duscenne?
CK
what kills kids with muscular dystrophy?
Resp failure
A 5-year-old girl presents to the emergency department with acute onset of muscle weakness. The mother carried the girl to the examination room and states that the muscle weakness started in her daughter’s legs yesterday. The weakness became worse today and progressed to the trunk and both arms. She was also complaining difficulty of breathing earlier today. She has been otherwise healthy but had a common cold about 10 days ago. On examination, her respirations are 26/min and shallow. She has profound muscle weakness in her lower extremities, and moderate weakness in her upper extremities. Her deep tendon reflexes are absent. A lumbar puncture is performed, which shows increased protein concentration but no pleocytosis. Which of the following is the most likely diagnosis?
Guillian Barre
A 4-year-old girl is brought to the physician because of intermittent muscle cramping over the past 3 months. The episodes last from a few seconds to a few minutes and are relieved with gentle massages and comfort measures. She has had mild developmental motor delay since birth physical, occupational, and speech therapy since infancy has improved her skills. Her father has similar muscle cramping, especially after exercising or heavy lifting. She is awake and alert. Examination shows mild muscle weakness distally. Deep tendon reflexes are normal. Babinski sign is absent.
She has difficulty relaxing her grip after squeezing the physician’s fingers. She answers questions appropriately but has impaired enunciation. Which of the following is the most likely diagnosis?
Cerebral palsy Congenital muscular dystrophy Duchene muscular dystrophy Myasthenia gravis Myotonic dystrophy
Myotonic Dystrophy
- distal muscle weakness
- autosominal dominant
- female so not duschenne (duschenne is a male)
A 6-month-old previously health child is brought to the doctor’s office because of sudden onset of lethargy, constipation, generalized weakness and poor feeding. He has been meeting all development milestones and his immunization schedule is up to date. On further questioning, his parents mention that his diet was recently advanced to a homemade formula of evaporated milk and honey. On physical examination, he has stable vital signs, clear lungs, normal skin turgor and full fontanelles. Which of the following is the most likely explanation for the patient’s presentation?
Botulism Hirschsprungs disease Hypernatremia Hyponatremia Hypothyroidism
Botulism
Which of the following statements is / are true about infant mortality in Canada:
- Injury is the commonest cause of death
- The peak occurs between the 4th and 8th month of life
- Neonatal mortality rate refers to deaths occurring in the first week of life
- Infant mortality rates have declined by more than 50% in the last 50 years
- None of the above
infant mortality rates have declined by more than 50% in last 50 years
- SIDS 2 - 4 mo peak
- most common cause of death up to 1y = sids
- Neonatal death is first 1 month(28d)
Most common cause of death in neonate os?
chromosomal abN
is a child <1 more likely to have epidural or subdural hematoma?
subdural
T/F subdural hematoma is more common at the extremes of age
True
You are about to see an 18 month old boy for a well child check-up. The nurse expresses concern to you that the baby looks a bit thin. The most accurate method of assessing failure to thrive in this child would be to:
Check the graph of his weight since birth
Check whether his weight is below the 5th percentile for his age
Screen for developmental delay
Compare his weight to that of his older brother at age 18 months
Weigh him weekly to check for weight loss
check weight since birth
A 9 year old boy is seen in the outpatient clinic for lethargy, poor academic performance, constipation, and slow growth of 12 months duration. Which one of the following diagnosis is the most likely?
Diencephalic syndrome Hypothyroidism Diabetes mellitus Panhypopituitarism School phobia
Hypothyroid
A 2-year-old boy is brought to the emergency department 30 minutes after the onset of severe respiratory distress characterized by rapid breathing and retractions. He has a 5-day history of fever and cough that has not responded to acetaminophen therapy. He lives with a foster family, and no medical history is available about his biological parents prior to 5 months of age except for maternal drug use. Since 5 months of age, he has had failure to thrive, frequent thrush, and recurrent diarrhea. He is at the 5th percentile for height and below the 3rd percentile for weight. His temperature is 38.5°C (101.3°F), pulse is 125/mm, respirations are 65/mm, and blood pressure is 100/52mm Hg. Pulse oximetry on room air shows an oxygen saturation of 82%. Examination shows tachypnea, grunting, and nasal flaring. Diffuse crackles are heard; air entry is symmetrical. Abdominal examination shows hepatosplenomegaly. A chest x-ray shows diffuse interstitial infiltrates. Which of the following is the most appropriate next step in diagnosis of this patient’s pulmonary problem?
Sputum culture Blood culture Serologic VDRL test Silver stain of bronchoalveolar fluid CT scan of the chest Notify CAS Consult dietitian
D. Silver stain of bronchoalveolar fluid
to diagnose PJP because kid is immunocompromised.
A 12-year-old boy is brought for a routine health maintenance examination prior to entering middle school He expresses concern because he is the shortest boy in his class. His father is 185 cm (6 ft 1 in) tall, and his mother is 168 cm (5 ft 6 in) tall. His father was the shortest boy in his class until his senior year in high school. The patient is below the 5th percentile for height and at the 25th percentile for weight His growth velocity is within normal limits. Sexual development is Tanner stage 1. The remainder of the examination shows no abnormalities. Which of the following is most likely to confirm the diagnosis?
- Determination of bone age
- Measurement of serum cortisol concentration
- Measurement of serum growth hormone concentration
- Thyroid function studies
- MRI of the brain
determination of bone age (constitutional vs familial)
familial BA =CA
A 15-year old girl brought to the physician by her mother, who is concerned that her daughter has not started her menses. She had breast budding one year ago. Her past medical history is unremarkable. Physical examination demonstrates a well-developed young lady at the 5th percentile in her height and weight.
Breast exam shows enlargement of breasts and buds without separation of contours. Pubic hear is noted to be sparse, long, and straight and covering the pubis. What is the best interpretation for her not yet having menstrual periods:
Arrest of puberty Constitutional delay Familial short stature Secondary amenorrhea Turner’s syndrome
constitutional delay
A 12-month old child is brought to the physician for a well-child exam, and the Denver II is used to assess his development. He does not sit alone but sits with support, has monosyllabic babbling, reaches for objects, and picks up a raisin using a raking motion. His mother is concerned that he is not developing as her other two children did. Which of the following best characterizes his development:
Normal Language delay Fine motor delay Gross motor delay Global delay
global developmental delay
