Cleveland Clinic

Question 1

PHACE

Answer 1

Posterior fossa malformations, Hemangiomas, Arterial anomalies of head and neck, Cardiac anomalies, Eye anomalies

Question 2

Klippel-Trenaunay syndrome

Answer 2

When vascular malformation asymetrically affects the growth of underlying bone and soft tissue

Question 3

Sturge-Weber syndrome

Answer 3

Port wine stain on face in ophthalmic branch of trigeminal nerve, ipsilateral leptomeningeal angiomatosis, cortical calcifications, glaucoma. Risk seizures and mental delay

Question 4

What type of vaccine is HiB?

Answer 4

A capsular polysaccharide / protein conjugate vaccine

Question 5

What’s least likely cause of death in 2-18 yo? Suicide, homicide, MVA, cancer?

Answer 5

Cancer

Question 6

Night terror sleep phase?

Answer 6

Non REM. Don’t remember. Unlike nightmare, remember, REM, REMember.

Question 7

Thumb sucking not normal after what age?

Answer 7

5 and older, permanent teeth set in

Question 8

5 yo boy with enuresis. Best initial intervention?

Answer 8

Urinalysis, to rule out uti or DM before reassurance / behavior modification

Question 9

Tinea capitis (patchy scaliness with hair loss, or broken black dot hairs) treatment?

Answer 9

Oral antifungal (griseofulvin) 6-8 weeks, often with selenium sulfide shampoo. Add steroid if kerion (boggy inflammatory mass surrounded by pustules)

Question 10

Antibiotic for dog bite?

Answer 10

Augmentin (covers Pasteurella and anaerobes). Dog bite less likely infected than cat.

Question 11

Rickets causes which in 6 mo child? Poor growth, costochondral rosary, bowlegs, soft skull / craniotabes, wide epiphyses

Answer 11

Not bowleg yet because have to be weight bearing

Question 12

Reyes syndrome, which lab predicts coma?

Answer 12

Ammonia. Aspirin during flu and varicella especially, acute encephalopathy and fatty liver degeneration

Question 13

Acrodermatitis enteropathica?

Answer 13

Autosomal recessive malabsorb zinc, dermatitis

Question 14

Terminal ileum resection, which vitamin deficiencies?

Answer 14

ADEK and B12

Question 15

Intussueception radiologically reduced, recurrence risk?

Answer 15

10%

Question 16

Measles treatment?

Answer 16

Vitamin A

Question 17

Fitz-Hugh-Curtis

Answer 17

Gonococcal perihepatitis

Question 18

What clinical feature only in Crohn’s and not UC?

Answer 18

Perianal disease

Question 19

Long term complication chronic UC?

Answer 19

Adenocarcinoma of the colon

Question 20

Patient with UC now fever, jaundice, pruritis, epigastric pain?

Answer 20

Primary sclerosing cholangitis

Question 21

Mild IBD therapy includes all except: cyclosporine, mesalamine, sulfasalazine, olsalazine, 5-ASA suppositories?

Answer 21

Cyclosporine (refractory UC). If small bowel CD, need pH dependent or time release mesalamine

Question 22

Azathioprine side effects include all except pancreatitis, bone marrow suppression, liver toxicity, cardiomyopathy?

Answer 22

Cardiomyopathy

Question 23

Down syndrome, diarrhea, difficulty gaining weight?

Answer 23

Celiac

Question 24

14 yo difficulty swallowing, now food impaction?

Answer 24

Eosinophilic esophagitis

Question 25

What hematologic abnormality with goats milk?

Answer 25

Folate deficiency anemia

Question 26

Vegan diet or resection ileum?

Answer 26

Vitamin B12 deficiency

Question 27

IDM term baby DOL1, bilious emesis and nontender distension?

Answer 27

Hypoplastic left con syndrome

Question 28

14yo 8 months intermittent fevers, RLQ pain and fullness, weight loss, blood in stool. Which study? Abdominal CT, barium enema, UGI with SBFT, abdominal US, stool culture?

Answer 28

UGI with SBFT (Crohn’s. Good first test before scope, looking at terminal ileum)

Question 29

Painless bloody stool: maroon/brick red vs bright red

Answer 29

Meckel diverticulum vs juvenile polyp

Question 30

Coin in stomach?

Answer 30

Dc home and mom searches poop. If not in 4 weeks, then x-ray and scope

Question 31

Developmental regression, hepatomegaly and coarse facial features?

Answer 31

Mucopolysaccharidosis (MPS), like Hurler (AR) or Hunter (hair, XLR) syndrome

Question 32

1 month old, ill, jaundice, petechiae, bruises, normal ammonia, glucose 79, acidosis

Answer 32

Galactosemia (GALT test, give iv glucose)

Question 33

14 kg kid is 10% dehydrated. What is the fluid deficit?

Answer 33

1,400 ml. .1*14=1.4 kg down = 1.4 L down. Fluid requirements for next 24h would be that plus maintenance rate (421 rule) *24, plus estimate ongoing losses (usually given to you).