Miscellaneous #1 - aa

Question 1

Which swelling/edema crosses suture lines and which one doesn’t?
~cephalohematoma
~caput succedaneum

Answer 1

~cephalohematoma: does NOT cross suture lines

~caput succedaneum: crosses suture lines

Question 2

At what age?
~lift head
~roll over
~sit without support
~crawl
~walk
~run

Answer 2

lift head: 2 months
roll over: 4 months
sit without support: 6 months
crawl: 9 months
walk: 12 months
run: 18 months

Question 3

What is the timing of closure of fontanels?

Answer 3

posterior: closed by 2 months
anterior: closed by 2 years

Question 4

By what age does an infant re-achieve their birth weight?
Double birth weight?
Triple birth weight?

Answer 4

re-achieve birth weight: 2 weeks
double birth weight: 5 months
triple birth weight: 12 months

Question 5

What age does stranger anxiety develop?

Answer 5

6-10 months

Question 6

What is the normal range for infant
~HR
~RR

Answer 6

~HR: 100-160

~RR: 40-60

Question 7

If a newborn failed to receive the Beutler test before discharge, what might they have and not know it?

Answer 7

galactosemia

Question 8

Treatments for anxiety disorders?

Answer 8

1. Cognitive and behavioral therapy
2. SSRIs
3. Benzodiazepines

Question 9

What’s the problem with giving antidepressants to depressed children?

Answer 9

Black box warning for antidepressants for children - increased risk of suicidal ideation and suicide

Question 10

< 85% of normal body weight or BMI < 17.5

Answer 10

anorexia nervosa

PKM

Question 11

What has the highest mortality rate of all psychiatric disorders? What is the suicide rate compared to average population?

Answer 11

anorexia nervosa; 50x average rate

PKM

Question 12

What are the 3 core deficits of autism?

Answer 12

1. impairment in communication
2. impairment in reciprocal social interactions
3. stereotypical, restrictive, and repetitive patterns of behavior, interests, and activities

Question 13

You witness a 7 month old baby have a seizure that lasted 2 minutes. There was acute loss of consciousness, with tonic posturing, and the infant’s temperature was 103F.
What kind of seizure is this?
What might you suspect as the cause?
Will you order an MRI?

Answer 13

~Febrile seizure (90+% are generalized seizures)
~acute respiratory illness; roseola infantum is a rare but classic cause
~immunizations may also be a cause
~a single simple febrile/generalized seizure with normal exam usually doesn’t require imaging

Question 14

The diagnosis of ____ requires the presence of a characteristic pattern of facial abnormalities:
~short palpebral fissures
~thin upper lip
~indistinct or smooth philtrum

Answer 14

Fetal alcohol syndrome (FAS). FAS refers to the full syndrome associated with prenatal alcohol exposure. Also has growth deficiency and evidence of CNS damage and neurodevelopmental abnormalities. This diagnosis can be made with or without confirmed maternal prenatal use of alcohol.

Question 15

~Webbed neck, triangular facies, short stature, wide-set nipples, amenorrhea, and absence of secondary sex characteristics.
~Associated with coarctation of the aorta and genitourinary malformations.
~IQ is usually normal but learning disabilities are common.

Answer 15

Turner Syndrome (Monosomy X)

Question 16

~Upslanting palpebral fissures, epicanthal folds, midface hypoplasia, small pinnae
~Generalized hypotonia, cognitive disabilities (mild to moderate)
~Congenital heart diseases (AV defects) and GI anomalies
~Trisomy 21

Answer 16

Down syndrome

Question 17

~Diagnosis rarely made before puberty due to normal pre-pubertal phenotype.
~After puberty: microorchidism, lack of libido, minimal facial hair, tall/eunuchoid build
~Azoospermia, sterility, gynecomastia, normal to borderline IQ
~XXY

Answer 17

Klinefelter syndrome

Question 18

Benign tumors consisting of Schwann cells, nerve fibers, and fibroblasts

Answer 18

neurofibromas

Question 19

The most common cause of cognitive disabilities in males.

Answer 19

Fragile X Syndrome

1:1000 males

Question 20

~intellectual disabilities
~oblong facies with large ears
~large testicles after puberty
~hyperextensible joints, mitral valve prolapse
~hyperactive
~infantile autism or autistic-like behavior

Answer 20

Male with fragile X syndrome

Question 21

Clinical expression of fragile X differs in male and female offspring depending on which parent is transmitting the gene.
T/F

Answer 21

True

Question 22

What are the most severe and mildest forms of spina bifida?

Answer 22

most severe: meningomyelocele

mildest (may be asymptomatic): spina bifida occulta

Question 23

• Boys with ____ show proximal muscle weakness and pseudohypertrophy of calf muscles by age 5-6
• Become non-ambulatory by age 13 with markedly elevated serum creatine kinase levels
• Affected individuals frequently die in their 20s of respiratory and cardiovascular failure

Answer 23

Duchenne muscular dystrophy

Question 24

Thriving infant 3-12 months with recurrent paroxysms of abdominal pain, screaming and drawing up the knees, followed by vomiting and diarrhea (90%), and bloody mucus-y BMs in next 12 hours (50%), lethargic child, may be febrile, tender distended abdomen, sausage shaped mass in mid-upper abdomen.

Answer 24

intussusception

Question 25

bile-stained vomiting

Answer 25

volvulus