COMQUEST Wrongs 3

Question 1

signs of hereditary spherocytosis in a baby

Answer 1

jaundice, anemia, splenomegaly

Question 2

what labs should you order to dx hereditary spherocytosis?

Answer 2

CBC (MCHC) and reticulocyte count

Question 3

what differentiates Carotenemia from jaundice?

Answer 3

the sclera are normal colored in carotenemia

Question 4

failure to pass meconium <24 hrs and bilious vomiting after 12 hours?

Answer 4

meconium ileus

Question 5

failure to pass meconium <24 hours and early onset bilious vomiting<12 hours?

Answer 5

duodenal atresia

Question 6

signs and sx of meningitis in younger children?

Answer 6

can be subtle; poor feeding, lethargy, irritability, fever, bulging fontanelle( increased intracranial pressure), high-pitched cry, nuchal rigidity, and seizure; basically: febrile seizures with meningeal signs

Question 7

suspect meningitis. next step?

Answer 7

in child without increased ICP: lumbar puncture–-> CSF and blood cultures–> abx if FAILS negative (no bulging fontanelle/increased ICP)

in a child with increased ICP (bulging fontanelle): blood culture—> abx—. CT scna—> LP if FAILS negative (bulging fontanelle/increased ICP)

Question 8

itching, tearing, redness of sclera and conjunctiva, slight crusting is indicative of what?

Answer 8

viral conjunctivitis

Question 9

most common cause of viral conjunctivitis?

Answer 9

adenovirus

Question 10

treatment of viral conjunctivitis?

Answer 10

supportive care

Question 11

conjunctival hyperemia, edema, mucopurulent exudate, eyes glued together in the morning, ocular pain is indicative of what?

Answer 11

bacterial conjunctivitis; H.flu, pneumococci, staph, strep

Question 12

treatment of bacterial conjunctivitis?

Answer 12

topical abx

Question 13

newborn presents with pallor, tachycardia, tachypnea. What is this?

Answer 13

acute blood loss

Question 14

if cause of acute blood loss in a newborn is not determined, what test should be done?

Answer 14

Kleihauer-Betke test to confirm feto-maternal transfusion

Question 15

Imaging and testing for osteomyelitis?

Answer 15

MRI and blood culture and bone or joint fluid, or even bone biopsy for gram stain and culture

Question 16

How do you diagnose osteogenesis imperfecta?

Answer 16

biochemical studie or DNA sequencing from a skin biopsy

Question 17

signs and sx of aspirin/salicylate toxicity?

Answer 17

difficulty hearing/tinnitus Respiratory alkalosis and metabolic acidosis.

Question 18

Signs of iron toxicity

Answer 18

acute: bloody emesis, cv problems, death Later: coagulopathy, scarring of GI tract with obstruction

Question 19

newborn with bloody emesis with no other signs of distress. Test?

Answer 19

Apt-downey test determines whether blood is baby’s or mom’s

Question 20

new asx kid comes in for well child from guatemala/central america. what test do they need?

Answer 20

lead up to 16 yrs old ; also consider hypothyroidism, PKU

Question 21

newborn with profound cyanosis, respiratory distress, minimal heart murmur with S3 gallop, diminished pulses, and liver enlargement. Enlarged heart with RVH.

Answer 21

total anomalous pulmonary venous return

Question 22

signs and sx of MI in newborn

Answer 22

aberrant origin of coronary artery

Question 23

sx of heart failure with diminished pulses in the lower extremities, and systolic murmur under left clavicle in newborn. no cyanosis.

Answer 23

coarctation of aorta

Question 24

harsh, holosystolic murmur loudest at the lower left sternal border . no cyanosis

Answer 24

VSD

Question 25

newborn presenting with signs and sx of heart failure (fatigue, poor feeding, failure to thrive, sweating). no cyanosis. continuous crescendo/decrescendo machine like murmur over left upper chest with an aortic ejection murmur heard at the right sternal border, second intercostal space.

Answer 25

PDA