COMQUEST 6

Question 1

most common childhood abdominal malignancy

Answer 1

Wilm’s tumor

Question 2

how does Wilm’s tumor present?

Answer 2

asymptomatic, unilateral abdominal mass incidentally found by a caregiver. child may also present with HTN, aniridia, and hemihypertrophy.

Question 3

name complications that may be seen in SGA babies at birth

Answer 3

hypoglycemia, polycythemia, and perinatal asphyxia (placental insufficiency)

Question 4

picture of a young kid with undiagnosed CF

Answer 4

recurrent PNA, chronic sinusitis, GI malabsorption, failure to thrive, infertility (no vas deferens)

Question 5

signs and sx of ASA sensitivity

Answer 5

nasal polyposis, asthma, and ASA sensitivity

Question 6

kid with immunizations, presenting like epiglottiitis, with full posterior pharynx

Answer 6

retropharyngeal abscess

Question 7

two vessel cord/single umbilical artery is _______ in absence of concerning history or US

Answer 7

benign, reassure parents

Question 8

describe a “Still’s murmur”

Answer 8

benign murmur in healthy child. soft systolic murmur, less than 3/6, louder when supine, disappears when upright. “vibratory” or “musical”.

Question 9

5-10 yr child with a recent URI who has developed a limp

Answer 9

toxic/transient synovitis. normal labs.

Question 10

which type of local anesthetic can cause methemoglobinemia?

Answer 10

topical benzocaine

Question 11

signs of methemoglobinemia

Answer 11

cyanosis unresponsive to oxygen with chocolate brown blood

Question 12

treatment for baby born to mom whose TB skin test was + (active disease), but is not contagious at birth

Answer 12

begin prophylactic isoniazid therapy for baby

Question 13

pt in 1st year of life develops sudden, rapid clusters of tonic contractions of trunk and limb musculature, most often before bed or after waking up

Answer 13

infantil spasms

Question 14

what are infantile spams associated with, and what test is used to identify it?

Answer 14

tuberous sclerosis, Wood’s lamp

Question 15

treatment of choice for baby born with low apgar scores

Answer 15

positive pressure ventilation

Question 16

recurrent, painless, unilateral nodule found in the middle of the upper eyelid

Answer 16

chalazion

Question 17

mom is given narcotic for pain control (meperidine) close to delivery. what sx will baby have?

Answer 17

infant respiratory depression

Question 18

therapy for neonates with narcotic respiratory depression?

Answer 18

maintained on non-invasive oxygenation/ventilation

Question 19

what do you give a neonate whose mother is Hep B surface Ag positive (same with hep B e antigen)?

Answer 19

Hep B vaccine and Hep B Ig

Question 20

single patch/rash that resembles tinea on trunk that 10 days later spreads to spots across trunk and limbs. looks like a christmas tree.

Answer 20

pityriasis rosea

Question 21

pityriasis rosea presents similarly to which STD?

Answer 21

syphillis; in sexually active person get RPR before providing reassurance

Question 22

atopic dermatitis turned to really weepy skin infection with signs of sepsis

Answer 22

atopic dermatitis with secondary bacterial/staph/herpes superinfection tx: parenteral abx

Question 23

first step in dx ankylosing spondylitis?

Answer 23

plain x-ray/radiographs of the spine

Question 24

kid develops high fever, but seems to be fine otherwise (maybe a febrile seizure). 2-3 days into illness, fever goes away, and sudden on set of widespread morbilliform rash occurs.

Answer 24

roseola/roseola infantum

Question 25

children with acquired/congenital/functional asplenia (sickle cell) need which vaccine starting when?

Answer 25

pneumococcal 23 starting at 2 years of age

Question 26

children with acquired/congenital/functional asplenia (sickle cell) are at risk for what organisms?

Answer 26

encapsulated: strep pneumo, H flu, n meningiditis, e coli, staph a

Question 27

what is Rett syndrome?

Answer 27

x-linked dominant; girls by 6 months of age have hypotonia, developmental delays, wringing of hands, worsening hypotonia as they get older

Question 28

developmental delay in a girl with characteristic hand wringing

Answer 28

Rett syndrome

Question 29

what is the most common cause of nephrotic syndrome in kids?

Answer 29

• minimal change disease
  
  • heavy proteinuria (>3+)
  • edema (first periorbital–>then legs)
  • hypo-albuminemia
  • elevated urine protein:creatinine ratio
  • may be preceded by a URI, bee sting, or drug reaction

Question 30

how do you diagnose Minimal Change Disease?

Answer 30

renal biopsy and electron microscopy (loss of foot processes not seen on light microscopy)

Question 31

treatment for minimal change disease

Answer 31

steroids

Question 32

what is Blount disease?

Answer 32

a condition of leg-bowing caused by overgrowth of the medial proximal tibial epiphysis with characteristic “beaking” on examination and readiographic evaluation

• look for:
  
  • african american
  • obese female
  • age 1-3 years

Question 33

adolescent kid who is not sexually active has bleeding between glans and foreskin. what happened?

Answer 33

trauma from masturbation, parental reassurance

Question 34

medical term for sleep walking

Answer 34

sonambulism