II

Question 1

neonate with blotchy erythematous papules and pustules all over body except palms and soles

Answer 1

erythema toxicum neonatorum

benign

Question 2

Legg Calce Perthes disease

Answer 2

idiopathic osteonecrosis (avascular necrosis) of femoral head
boys 4-10 y.o

Question 3

slipped capital femoral epiphysis

Answer 3

obese adolescents
girls ~ 12
boys~ 13.5

Question 4

Most important risk factor for respiratory distress syndrome in neonate

Answer 4

prematurity

Question 5

risk factors for respiratory distress syndrome in neonates

Answer 5

prematurity
male sex
perinatal asphyxia
maternal diabetes
C section without labor

Question 6

how does maternal DM increase risk of RDS

Answer 6

delaying amturation of pulmonary surfactant

hyperglycemia causes hyperinsulinism which antagonize cortisol and block maturation of sphingomyelin

Question 7

CXR of neonate shows diffuse reticulogranular pattern and air bronchograms

Answer 7

RDS

Question 8

first step in neonate fails to pass meconium

Answer 8

abdominal XR to look for pneumoperioneum

Question 9

microcolon

Answer 9

meconium ileus

high suspicion CF

Question 10

what to do if have meconium ielus

Answer 10

hyperosmolar enema

if unsuccessful– surgery

Question 11

mutation in CF

Answer 11

delta F508

Question 12

What is preseptal cellulitis

Answer 12

mild infection of eyelid anterior to orbtal septum

Question 13

signs of orbital cellulitis

Answer 13

pain with EOM, visual impairment and opthalmoplegia

Question 14

dangerous complications of orbital cellulitis

Answer 14

orbital abscess, intracranial infection and cavernous sinus venous thrombosis

Question 15

signs of Cavernous sinus thrombosis

Answer 15

periorbital edema, exopthalmos, chemosis

fundoscopy shows papilledema and dilated tortuous retinal veins

Question 16

Which CN pass through cavernous sinus

Answer 16

III V VI

Question 17

coffee bean sign on abdominal XR

Answer 17

sigmoid volvulus

Question 18

primary dysmenorrhea

Answer 18

lower abdominal cramping with menses

Question 19

Tx primary dysmenorrhea

Answer 19

NSAIDs

Question 20

first step in suspeted meningitis in infant

Answer 20

LP followed by IV antibiotics

Question 21

Tx for meningitis in infant

Answer 21

vanco and cetriazone or cefortaxime

dexame=thasone for Hib meningitis

Question 22

causes of meningitis in ingant

Answer 22

strep pneumo and N meningitidis

Question 23

what stage of sleep cycle to night terrors occur in

Answer 23

non REM stage of sleep

Question 24

Von Gierkes disease

Answer 24

type I glycogen storage disease
glucose 6 phosphatatse deficiency
hypoglycemia, lactic acidosis, hyperuricemia, hyperlipidemia, seizures from hypoglycemia
doll like face with fat cheeks. thin extremities and protubereent abdomen with enlarged liver and kidneys

Question 25

Pompes disease

Answer 25

acid maltase deficiency type II glycogen storage disease first few weeks of life as floppy baby with feeding difficulties and macroglossia and heart failure

Question 26

type III glycogen storage disease

Answer 26

deficiency in glycogen debranching enzyme activity hepatomegaly, hypoglycemia, hyperlipidemia, and growth retardation elevated liver transaminases, fasting ketosis normal blood lactate and urica acid

Question 27

type IV glycogen storgae disease

Answer 27

deficiency of branching enzyme amylopeectinosis first 18 mo of life with HSM and failure to thrive

Question 28

IV fluid bolus of what for hypovolemic hypernatremic infant

Answer 28

normal saline or lactated ringers

Question 29

dropping hypernatremia too quickly can lead to

Answer 29

cerebral edema

Question 30

risk factor for membranous nephropathy

Answer 30

Hep B infection

Question 31

most common pathogens for viral myocarditis

Answer 31

coxsackie B and adeno

Question 32

signs of viral myocarditis in infant

Answer 32

viral prodrome, worsening respiratory distress and holosystolic murmur from mitral regurg because of dilation can have hepatomegaly from passive congestion RHF

Question 33

Dx viral myocarditis

Answer 33

myocardial Bx

Question 34

Tx myocarditis viral

Answer 34

diuretics, inotropes

Question 35

what causes acute rheumatic fever myocarditis

Answer 35

untreated GAS pharyngitis with arthritis

Question 36

why is step pharyngitis uncommon in children

Answer 36

fewer epithelial cell attachment

Question 37

Antibiotic of choice for pertussis

Answer 37

macrolides

Question 38

first step in child with suspected congenital diaphragmatic hernia

Answer 38

endotracheal intubation

Question 39

child with recurrent gross hematuria proteinuria and sensorineural deafnesss

Answer 39

Alports | EM will show thinned and thick capillary loos with splitting of glomerular BM

Question 40

Cholesteatoma

Answer 40

continue ear drainage for weeks despite antibiotic therapy a pocket fills with granulation tissue and skin depris can lead to hearing loss, CN palsis, vertigo, and infections in the brain

Question 41

where are craniopharyngiomas

Answer 41

from rathkes pouch in suprasellar space

Question 42

otosclerosis

Answer 42

bony overgrowth of the stapes footplate that results in conductive hearing loss

Question 43

kid with recurrent sinusitis and known tetrology of fallot | increase risk for seziures because what

Answer 43

brain abscess and byapss of pulmonary phagocytosis because of ventricular defect

Question 44

triad of brain absecess

Answer 44

fever, severe HA and focal neurologic changes

Question 45

sickle cell trait renal complications

Answer 45

papillary necrosis with massive hematuria

Question 46

signs of osteosarcoma

Answer 46

sunburst pattern and codman triangle adolescents and occur in metaphyses of long bones tender soft tissue mass

Question 47

Tx of osteosarcoma

Answer 47

tumor excision and chemo

Question 48

what cause HUS

Answer 48

E choli hemorrhagic 0157:H7

Question 49

presentation HUS

Answer 49

fiarrhea, lethargy irritability pallor, bleeding, petechiae, oliguria and edma

Question 50

lab findings in HUS

Answer 50

hemolytic anemia, thrombocytopenia inc Cr and hematuria, proteinuria, casts increase bilirubin

Question 51

Tx of HUS

Answer 51

fluid and electrolyte management blood transfusions dialysis