MTB - Pediatrics - Newborns 2

Question 1

Newborn with paralyzed hand, drooping eyelid and small pupils - suspect diagnosis? Treatment?

Answer 1

Klumpke palsy (C7, C8 +/- T1)

Claw hand and horners (ptosis, miosis, anhydrosis)

Immobilization

Question 2

Newborn with shoulder dystocia - complication? Assess with? Treat with?

Answer 2

Clavicular fracture

XR

immobilization, splinting and PT

Question 3

Complication from foceps delivery? Treatment?

Answer 3

Facial nerve palsy

#Time
#if no improvement, surgery

Question 4

Causes of polyhydramnios?

Answer 4

#Neurological - Werdnig-Hoffman (cannot swallow)
#GI - Intestinal atresia

Question 5

Causes of oligohydramnios?

Answer 5

#Prune belly - lack of abdomonial muscles (unable to valsalva and urinate)
#Renal agenesis (Potter's syndrome)

Question 6

PE sign of baby with oligohydramnios?

Answer 6

flat facies

Question 7

Mirgagni vs Bochdalek hernias?

Answer 7

Diaphragmatic hernia from retrosternal/parasternal or posterolateral

Question 8

Omphalocele versus gastrochesis?

Answer 8

sac covering vs no sac

Question 9

Screening for omphalocele? Associated with this disease? Treatment?

Answer 9

AFP (AFP indicates neural and GI wall defects)

Edward’s syndrome

surgery

Question 10

Most common cause of AFP elevation?

Answer 10

incorrect dating

Question 11

Surgical treatment for gastrochesis?

Answer 11

Silo formation

Question 12

Infant with no irises - look for? Formation? Clinical Signs?

Answer 12

Wilm’s Tumor; hemihypertrophy of one kidney due to increased vascular demands

#n/v
#Constipations

Question 13

Wilm’s tumor - Best initial test? Most accurate test?

Treatment

Answer 13

Abdominal US; CT

#Chemoradiation
#If bilateral, partial nephrosectomy

Question 14

WAGR?

Answer 14

Wilms’
Aniridia
Genitourinary malformations
Retardation

Question 15

Most common cancer infancy? Clinical Clues? Diagnostic test?

Answer 15

Neuroblastoma (medullary tumor)

Hpysarrthymia (dancing eyes) and opsoclonus (dancing feet)

Urine metanephrines

Question 16

Pt presents with swollen sac in scrotum that transilluminates - suspected diagnosis? Management? Remnant of?

Answer 16

Hydrocele

Resolves in 6 months

tunica vaginalis

Question 17

Cryporchidism is associated with? (which is a contraindiation for this procedure)

Answer 17

Hypospadias (circumcision)

Question 18

Pt with epispadias - must evaluate for?

Answer 18

Bladder exstrophy (bladder protrudes through abdominal wall defect)