clin med peds

Question 1

otitis externa tx (3 options)

Answer 1

neomycin/polymyxin B
cipro drops
oxfloxacin drops

Question 2

aphthous stomatitis tx (3 options)

Answer 2

licodaine
simethicone
magic mouthwash

Question 3

hand foot mouth dz:

1) cause
2) most commonly affected area of body?
3) tx?

Answer 3

1) coxsackie
2) hands
3) supportive

Question 4

tonsillitis/pharyngitis:

1) 2 possible causes
2) strep tx? (4 options)

Answer 4

1) mono, GABHS

2) pcn G, pcn VK, amoxicillin, azithro

Question 5

1) s/s: trismus, hot potato breath. dx?
2) imaging?
3) tx?

Answer 5

1) tonsillar abscess
2) CT
3) PO or IV abx, I&D by ENT

Question 6

mastoiditis

1) can occur with inadequately tx’ed what?
2) imaging?
3) initial tx?

Answer 6

1) otitis media
2) CT
3) IV abx w/ surgery

Question 7

epiglottitis:

1) cause
2) 3 common s/s?
3) xray finding?
4) tx?

Answer 7

1) Hib
2) sudden onset fever, drooling, tripod position
3) thumb print sign
4) admit for IV abx

Question 8

1) most common congenital anomaly of larynx
2) what happens to larynx?
3) key s/s?
4) confirmatory dx?

Answer 8

1) laryngomalacia
2) collapse of supraglottic structures during inspiration
3) intermittent wet inspiratory stidor
4) laryngoscopy

Question 9

1) seal like/barking cough. dx?
2) xray findings?
3) tx? (2 options)

Answer 9

1) croup
2) steeple sign
3) cool moist air, single dose IV dexamethasone

Question 10

cystic fibrosis:

1) type of genetic disorder?
2) dx tool?
3) tx? (2 options)

Answer 10

1) autosomal recessive
2) chloride sweat test
3) bronchodilators, lung transplant

Question 11

patent ductus arteriosus (PDA):

1) PE finding?
2) dx tool?
3) tx for mildly symptomatic neonates?

Answer 11

1) holosystolic “machine-like” murmur
2) echo
3) prostaglandin inhibitor

Question 12

ventricular septal defect (VSD):

1) PE finding?
2) dx tool? (3 options)
3) tx?

Answer 12

1) holosystolic murmur in lower left sternal border
2) echo, MRI, cardiac cath
3) most close on their own

Question 13

atrial septal defect (ASD):

1) PE finding?
2) dx tool? (2 options)
3) tx?

Answer 13

1) fixed split S2 and pulmonic ejection murmur
2) TEE, right heart cath
3) closure with patch

Question 14

acute rheumatic fever:

1) sequela of what?
2) dx criteria?
3) tx? (2 options)

Answer 14

1) beta hemolytic strep infx of pharynx
2) major: JONES
3) pcn or erythromycin

Question 15

1) define kawasaki dx.
2) history/PE findings mnemonic?
3) dx criteria?
4) tx? (2 options)

Answer 15

1) acute, self limiting vasculitis
2) CRASH & Burn
3) fever lasting at least 5 days
4) aspirin, IV IG

Question 16

inguinal hernias:

1) dx? (2 options)
2) tx?

Answer 16

1) PE, U/S

2) surgery

Question 17

congenital diaphragmatic hernias:

1) define.
2) usually present with what?
3) dx? (prenatal, postnatal)
4) tx? (2)

Answer 17

1) incomplete diaphragm formation allowing for abd organs to herniate through defect in thoracic cavity
2) severe respiratory distress
3) prenatally= U/S, postnatally= CXR
4) surgery, referral to tertiary care center

Question 18

1) currant jelly stools. dx?
2) imaging?
3) tx? (2 options)

Answer 18

1) intussusception
2) U/S
3) pneumatic enema, surgical intervention

Question 19

1) absence of ganglion cells in mucosal and muscular layers of colon. Dx?
2) tx?

Answer 19

1) hirschsprung dz

2) surgical excision of affected segment

Question 20

1) congenital malformation of duodenum. dx?
2) mostly in infants with what?
3) dx tool? findings?
4) key finding?
5) tx? (3 options)

Answer 20

1) duodenal atresia
2) chromosomal anomaly
3) prenatal U/S, double bubble sign
4) vomiting within hours of birth
5) orogastric suction, IV fluids/nutrition, surgery within days

Question 21

reflux nephropathy:

1) define.
2) when to suspect?
3) dx? (4 options)
4) tx?

Answer 21

1) retrograde flow of uring from bladder into upper urinary tract
2) kids with recurrent UTI
3) voiding cystogram, renal U/S, UA, baseline GFR
4) may resolve on its own (around age 4)

Question 22

hemolytic uremic syndrome (HUS):

1) cause?
2) one of most common causes of what in kids?
3) confirmatory dx?
4) tx?

Answer 22

1) shiga toxin producing e coli
2) AKI
3) stool studies
4) supportive care

Question 23

most common type of spina bifida?

Answer 23

occulta

Question 24

tx for clubfoot?

Answer 24

serial casting weekly for 6-8 wks shortly after birth