Hamilton review 2021

Question 1

A 9-month-old girl was seen for a well baby check up. She was born at 32-week gestation but has been well since discharge. She drinks five 250mL bottles of 3.25% milk per day. You screen for iron deficiency and find that her hemoglobin is 60 with MCV of 50. She is treated with oral elemental iron 6mg/kg/day for one month. On repeat testing her Hgb is 62, MCV is 50, and her reticulocytes are 1%. What do you do next?

A) Bone marrow aspiration
B) Verify compliance with oral iron C) Hemoglobin electrophoresis
D) Jejunal biopsy

Answer 1

B) Verify compliance with oral iron

Question 2

All of the following are clinical features of iron deficiency EXCEPT:
A) Pica
B) Koilonychia
C) Cheilosis
D) Scleralicterus
E) Psychomotor retardation

Answer 2

A) PICA

Question 3

Which treatment modality has been proven to reduce the risk of second episode of stroke in sickle cell patient?
A. Hydroxyurea
B. Simple transfusion C. Folic acid
D. Penicillin

Answer 3

A. hydroxurea

Question 4

A 5year old boy presents acute onset jaundice since yesterday.
On CBC you find hemoglobin 82, MCV 80, normal WBC and platelets. You suspect acute hemolytic anemia. Which lab findings would confirm this?
A. High conjugated bilirubin, high retics, high LDH
B. High unconjugated bilirubin, high retics, high LDH
C. High conjugated bilirubin, low retics, high LDH
D. High unconjugated bilirubin, high retics, low LDH

Answer 4

B. High unconjugated bilirubin, high retics, high LDH

Question 5

A full term newborn is born with petechiae and bruising. The baby is otherwise well appearing.
On bloodwork, his platelets are 12, WBCs are 18 and his Hgb is 140. He is given a platelet transfusion and a repeat platelet count is 16.
The mother’s CBC shows platelets of 80. What is the best treatment you can give today?
A. Transfusion of random donor platelets
B. Transfusion of PLA-1 negative platelets
C. Infusion of IVIG
D. Transfusion of washed maternal platelets

Answer 5

A

Question 6

You are seeing a 2-year-old child. He has only 3 words, makes no eye contact and spends all his time playing with his toy trucks. His hearing is normal.
A. What is the likely diagnosis?
B. Name 2 underlying neurological disorders that are associated with this diagnosis?

Answer 6

A. What is the likely diagnosis? ASD
B. Name 2 underlying neurological disorders
that are associated with this diagnosis? Genetic Syndromes:
Tuberous Sclerosis Complex, Rett Syndrome, NF, Angelman, T21

Question 7

An infant can sit with a round back using his hands for support, can roll from prone to supine, stands with support, has a palmar grasp, laughs, and babbles. What is his most likely age?

a) 3 months
b) 6 months
c) 8 months
d) 12 months

Answer 7

b) 6 months

Question 8

SLEEP
22-month-old child. Mother rocks him to bed. Was breast fed since birth until 8 months. Wakes up frequently at night and needs to be in parents’ bed to fall asleep.
What is the diagnosis?
a) Sleep/Wake Transition Disorder
b) Sleep Association Disorder
c) Night Terrors
d) Nocturnal Awakenings of Typical Development

Answer 8

b) Sleep Association Disorder