Minimal Q Pediatrics Flashcards
1
Q
Imaging modality of choice when evaluating a child for infantile hypertrophic pyloric stenosis:
A
US
2
Q
Typical age of intussusception in infants:
A
3 months - 3 years
3
Q
What are the two typical anamnestic features of acute appendicitis?
A
First epigastric and
periumbilical pain, later the pain is localized in the right lower abdominal quadrant.
4
Q
Standard imaging modality of polytraumatized patients:
A
acute CT
5
Q
Most common cause of acute abdomen in children:
A
appendicitis
6
Q
Which is the most common cause of strangulation ileus?
A
Incarcerated hernia.
7
Q
The most common cause of transfusion-requiring hematochezia, without abdominal pain and without
diarrhea:
A
Meckel’s diverticulum
8
Q
You find a high GGT in a patient with ulcerative colitis, what should you think about?
A
Sclerosing cholangitis.
9
Q
What are the typical characteristics of perianal fissures in Crohn’s disease?
A
Not in the midline, deep,
not painful.
10
Q
What is the first therapeutic choice in Crohn’s disease?
A
Exclusive enteral nutrition.
11
Q
What are the two most frequent chest deformities?
A
Pectus excavatum and pectus carinatum.
12
Q
What are typical signs of bacterial otitis externa?
A
Pain and/or tenderness of the tragus.
13
Q
What are the 4 most important indications of adenoidectomy?
A
1) Recurrent infections of the URT
2) recurrent otitis media,
3) inhibition of nasal breathing, 4) obstructive sleep
apnea.
14
Q
The most frequent pathogen of sinusitis and otitis media?
A
Str. pneumoniae.
15
Q
In which cases of middle-ear inflammatory disease should we suggest tympanostomy tubes
(Grommet)?
A
Chronic serous otitis media and/or chronic dysfunction of the Eustachian
tube.
16
Q
What is the most frequent pathogen in urinary tract infections?
A
E. coli.
17
Q
What are the typical abnormalities in urine analysis in glomerulonephritis?
A
Red blood cells and red blood cell cylinders. Proteinuria can also appear.
18
Q
What is the most frequent cause of hypertension before the adolescent age?
A
Kidney disease.
19
Q
Which is the most frequent glomerulonephritis type?
A
IgA nephropathy.
20
Q
What is the prognosis of West-syndrome or infantile spasm?
A
Usually poor.
21
Q
Which bacterium is the most frequent cause of childhood pneumonia?
A
Str. pneumoniae.
22
Q
What are the two main components of the treatment of pseudocroup?
A
Rectal steroid, inhalation of adrenaline.
23
Q
What is the most common cause of new onset cough?
A
Viral infection.
24
Q
What is the Holzknecht sign characteristic for?
A
Airway foreign body aspiration.
25
What is the most common cause of a cough ongoing since birth which always presents during
feeding?
Tracheoesophageal fistula.
26
What percentage of the mortality is caused by accidents in Hungary in children older than 1 year?
36-40%, this is the main cause of death in children older than 1 year.
27
What is the prognosis of juvenile absence epilepsy?
Usually favorable.
28
What can prevent coronary artery disease (aneurysm) in Kawasaki syndrome?
IVIG
29
What is the most serious complication of juvenile idiopathic arthritis?
Macrophage activation
syndrome (MAS).
30
Which muscles are affected in juvenile polymyositis?
Proximal muscles of the limbs.
31
What is the typical feature of stool in biliary atresia?
Clay-colored (acholic) stool.
32
What kind of diseases are included in `atopic march` and in which order?
Atopic dermatitis food
allergy - asthma bronchiale - allergic rhinitis.
33
How is food allergy diagnosed? What is the reliability of IgE testing?
IgE testing is not reliable.
The diagnosis should be based on double blind oral food challenge.
34
In which case serological testing is not informative in celiac disease.
In IgA deficiency.
35
What is the diagnostic basis of endocarditis?
Blood culture and echocardiography.
36
What are the upper airway infections that should be treated with antibiotics?
Streptococcus angina,
acute otitis media and acute bacterial sinusitis.
37
What is the diagnostic basis of erythema migrans?
The fact of tick bite and the clinical
picture: growing erythema which is more than 5 cm in diameter.
38
What is the ideal age for closing the soft palate defect?
Between 9 and 18 months.
39
What is the most likely diagnosis in the following case: patient with polyuria, polydipsia with
positive urine glucose and acetone test?
Diabetes mellitus.
40
A patient with typical diabetes symptoms has a 18.2 mmol/l blood sugar level in the afternoon. What is
to be done?
Refer the child to a pediatric diabetic center immediately.
41
What kind of hormonal changes are seen in the salt wasting form of congenital adrenal
hyperplasia due to deficiency of 21-hydroxylase?
Insufficient glucocorticoid and
mineralocorticoid secretion, excessive androgen secretion.
42
How does the mother’s iodine deficiency influence the newborn’s thyroid function?
It results in
temporary primary hypothyroidism.
43
Which is the most common adrenocortical enzyme defect?
The defect of the 21-hydroxylase
enzyme.
44
What are the most typical histologic findings in ulcerative colitis?
Crypt abscesses.
45
Name at least 5 extraintestinal abnormalities in celiac disease:
hepatitis,
osteoporosis,
arthritis,
isolated iron deficiency, Duhring-disease (dermatitis herpetiformis).
46
What is the definition of “graft versus leukemia”?
Immunologic attack of the donor cells against the patient's leukaemic cells after allogeneic bone marrow transplantation.
47
What is a haploidentical transplant?
Half matched HLA antigen stem cell transplant (from usually a family member).
48
What does allogeneic stem cell transplant mean?
The patient (recipient) gets hematopoietic stem cells from another person (donor).
49
What glucose levels are diagnostic for diabetes mellitus?
Fasting blood glucose level higher than 7 mmol/l, or more than 11.1 mmol/l at any time or at any point during an oral glucose tolerance test (OGTT).
50
Which are the 4 presenting symptoms of diabetes mellitus?
Polyuria, polydipsia, weight loss with good appetite, fatigue-weakness.
51
What are the diseases most commonly associated with type 1 diabetes mellitus?
Celiac disease and Hashimoto thyroiditis.
52
What is the most modern therapeutic method of type-one diabetes?
Insulin pump with an integrated glucose sensor.
53
ow much insulin should be given in diabetic ketoacidosis?
0.05-0.1 U/kg/h
54
Since the introduction of expanded screening, how many congenital metabolic diseases are
screened routinely in Hungary?
27 and SMA screening is also available.
55
The final therapy of biliary atresia is liver transplantation. There is a surgical bridging therapy
before transplantation. What is the name of this operation?
Kasai porto-enterostomy.
56
How often should a baby be breastfed?
On-demand.
57
When is it suggested to introduce cow’s milk for children?
After 12 months of age.
58
How does the breast milk’s protein content relate to the cow’s milk protein content?
One third.
59
What are the most important diseases which can be easily diagnosed and followed up by cranial ultrasound?
Brain hemorrhage and hydrocephalus.
60
For how long can we see the shadow of the thymus on the thoracic X-ray?
Until 3 years of age.
61
What radiological examinations can be done to diagnose VUR? (Name three!).
MCU
(Micturating cystourethrogram), Sono-cystography, Dynamic kidney-scintigraphy.
62
How can you diagnose perforation in a critically ill baby with necrotizing enterocolitis if you cannot
move them in the incubator?
Horizontal X-ray from side position while the baby is lying on the
back.
63
In which part of the bone does osteomyelitis start?
In the metaphysis.
64
How long to wait after surgery before bathing?
7-8 days.
65
What is chicken pox (varicella) reactivation called?
Herpes zoster.
66
What is the sixth disease?
Exanthema subitum, roseola infantum.
67
Which is the contagious disease that causes severe fetal injuries in 80 percent of its cases?
Rubella.
68
Name at least five examples when pulse oximetry is not informative!
Carbon-dioxide
intoxication, methemoglobinemia, severe anemia, cardiac failure, cold extremities.
69
Define paradoxical breathing!
The chest moves inward and the abdomen moves outward during
inhalation, and vice versa.
70
How do we give oxygen to a conscious patient in an emergency situation who is breathing
spontaneously?
Through a face mask with a reservoir, with high flow oxygen (10-15 l/min).
71
How does the concentration of protein and glucose of CSF change in bacterial meningitis?
Protein
concentration is increased, glucose concentration is decreased.
72
Name of the two most common pathogens of newborn meningitis!
Streptococcus agalactiae, E. coli.
73
What affects the sensitivity of blood culture?
The amount of blood drawn within 24 hours after
the fever.
74
Name the condition of infants associated with abdominal pain in which bowel movements are
preceded by tension and crying lasting for about 10 minutes?
Infantile dyschezia
75
The pathogen causing neonatal infection that can be identified by maternal vaginal secretion
screening.
Streptococcus agalactiae. (group B Streptococcus, GBS)
76
The amount of a single fluid bolus required to treat septic shock:
10 ml/kg.
77
The most common endocrine disorder causing growth retardation:
Thyroid dysfunction –
hypothyroidism.
78
What does precocious puberty mean in the case of girls?
If the secondary sexual characteristics
appears before the age of 8 years
79
What changes can we see in the urine sediment in typical pyelonephritis?
Leukocytes and
bacteria
80
In which chromosomal abnormality is duodenal atresia common?
Trisomy 21 (Down
syndrome)
81
What is the radiological sign of duodenal atresia?
„Double-bubble” sign
82
What are the B-symptoms in lymphoma?
Fever, night sweats, weight loss.
83
At what platelet count is there major risk of bleeding?
Below 10-20 G/l
84
What to do in case of neutropenic fever?
Broad spectrum empiric antibiotic therapy after taking
blood cultures.
85
What are the serum electrolyte disturbances in case of tumor lysis syndrome?
Elevated potassium,
phosphate and uric acid, decreased calcium.
86
What are the alarming signs of retinoblastoma? What examinations are required?
Strabism,
leukocoria - ophthalmoscopic examination.
87
What is the most common type of malignancy in childhood?
ALL.
88
What are the symptoms of increased intracranial pressure?
Headache, vomiting in the morning, nuchal rigidity, setting-sun sign, focal neurological signs, bradycardia, high blood pressure, irritability, bulging fontanelle.
89
What are the physical symptoms of anemia?
Fatigue, paleness, tachycardia, systolic heart murmurs.
90
How does the total iron binding capacity change in case of anemia and inflammation?
Increased in anemia, decreased in inflammation.
91
What is the treatment of immune thrombocytopenia (first- and second-line treatment.)?
IVIG, corticosteroid
92
List the signs of increased work of breathing!
Use of respiratory accessory muscles, intercostal retraction, jugular retraction, nasal flaring, paradoxical breathing, grunting.
93
At what age do the fontanelles close at the latest?
Posterior fontanelle: by 3 months, anterior fontanelle: by 18 months.
94
What are the symptoms and laboratory signs of nephrotic syndrome?
Proteinuria, hypoalbuminemia, hyperlipidemia, oedema.
95
What are the symptoms and laboratory signs of nephritic syndrome?
Hematuria, oedema hypertension, uraemia, oliguria (kidney failure is correct instead of the latter two).
96
What factors are included in the APGAR score?
Heart rate, respiratory rate, skin color, reflex irritability, muscle tone.
97
Age limits of puberty?
Boys: 9-14 years. Girls: 8-13 years.
98
What are the direct and indirect signs of appendicitis?
Direct sign: tenderness at the McBurney
point. Indirect signs: Blumberg, Rovsing, Obturator, Psoas signs.
99
How can we estimate the body weight between the ages of 2-8 years?
(2 x years) + 8.
100
What does autologous stem cell transplantation mean?
A procedure in which a patient's healthy
stem cells are collected from the blood or bone marrow before high dose chemotherapy,
stored, and then given back to the patient after treatment.
101
What is the heart rate and respiratory rate of a healthy newborn?
Respiratory rate: 50-60/min, Heart
rate: 120-160/min.
102
Which cultured pathogen from throat swabs warrants antibiotic treatment?
Str. pyogenes.
103
In case of maternal GBS positivity, up to what age can this bacteria cause disease in the baby?
Up to
six months of age.
104
What is the recommended empiric treatment of neonates with suspected sepsis?
Ampicillin +
Gentamycin.
105
What factors are included in the croup score?
Sound of inhalation, stridor, cough, signs of
dyspnea (nasal flaring, retractions), cyanosis.
106
In case of pain localized to one point in the bone, when should we order an X-ray if the pain
does not stop?
1 week
107
What is the choice of imaging modality if acute osteomyelitis is suspected?
MRI
108
What is the most common presentation of cow’s milk protein allergy in infants?
Bloody stool
109
Which disease should be suspected in case of bloody stool and vomiting in neonates?
Volvulus
110
Which disease should be suspected in case of neonates with distended abdomen and severe
constipation?
Hirschsprung-disease
111
