MTB Peds

Question 1

normal respiratory rate in a newborn

Answer 1

40-60

Question 2

normal heart rate in a newbown

Answer 2

120-160

Question 3

define the first ‘A’ in Apgar score and its scoring

Answer 3

Appearance; 0=blue all over, 1=normal except extremities, 2=normal all over

Question 4

define ‘P’ in Apgar score and its scoring

Answer 4

Pulse; 0=less than 60 or asystole, 1=greater than 60 but less than 100, 2=greater than 100

Question 5

define ‘G’ in Apgar score and its scoring

Answer 5

Grimace; 0=no response, 1=grimace/feeble cry, 2=sneeze/cough

Question 6

define the second ‘A’ in Apgar score and its scoring

Answer 6

Activity; 0=none, 1=some flexion, 2=active movement

Question 7

define ‘R’ in Apgar score and its scoring

Answer 7

Respiration, 0=absent, 1=weak/irregular, 2=strong

Question 8

baby has conjunctivitis on day 1

Answer 8

chemical irritation from silver nitrate

Question 9

baby has conjunctivitis on days 2-7

Answer 9

neisseria gonorrheae

Question 10

baby has conjunctivitis after more than 7 days post-delivery

Answer 10

chlamydia trachomatis

Question 11

baby has conjunctivitis after 3 weeks or more post-delivery

Answer 11

herpes infection

Question 12

what abx are put in newborns eyes when they are delivered?

Answer 12

erythromycin/tetracycline and silver nitrate

Question 13

tx for G6PD deficiency

Answer 13

reducing oxidative stress and specialized diets

Question 14

inheritance of phenylketonuria (PKU) and enzyme that is deficient

Answer 14

autosomal recessive; phenylalanine hydroxylase (PAH)

Question 15

tx for phenylketonuria (PKU)

Answer 15

diet low in phenylalanine for first 16 yrs of life

Question 16

inheritance of G6PD deficiency

Answer 16

X-linked recessive

Question 17

inheritance of congenital adrenal hyperplasias

Answer 17

autosomal recessive

Question 18

what congenital abnormality leads to cretinism?

Answer 18

congenital hypothyroidism

Question 19

best initial test vs most accurate test for cystic fibrosis

Answer 19

best initial: sweat chloride; most accurate: genetic analysis of CFTR gene

Question 20

what infants should receive hepB immunoglobulin (HBIG)?

Answer 20

infants whose mothers are HBsAg-positive

Question 21

newborn is tachypneic 5 hours post-delivery, what is the next step in mgmt?

Answer 21

order blood and urine cultures (tachypnea is normal only up to 4 hours post-delivery)

Question 22

infant has waiter’s tip appearance, what nerve roots are damaged?

Answer 22

C5-C6

Question 23

infant cannot abduct shoulder or externally rotate and supinate arm, what nerve roots are damaged?

Answer 23

C5-C6

Question 24

infant has claw hand, what nerve roots are damaged?

Answer 24

C7-C8+/-T1

Question 25

infant has paralyzed hand w/ptosis, miosis, and anhidrosis, what nerve roots are damaged?

Answer 25

C7-C8+/-T1

Question 26

what is a hydrocele a remnant of?

Answer 26

tunica vaginalis

Question 27

what are the 3 causes of holosystolic murmurs?

Answer 27

mitral regurg, tricuspid regurg, and ventricular septal defect (VSD)

Question 28

infant has a boot-shaped heart on CXR –> what condition?

Answer 28

tetralogy of fallot

Question 29

4 components of tetralogy of fallot

Answer 29

pulmonary stenosis, right ventricular hypertrophy, overriding aorta, and ventricular septal defect (PROVe)

Question 30

early and severe cyanosis, single S2 heard on cardiac auscultation, and CXR shows “egg on a string”

Answer 30

transposition of great vessels

Question 31

tx for transposition of great vessels

Answer 31

prostaglandin E1 to keep ductus arteriosus open

Question 32

pulsus alternans

Answer 32

L ventricular systolic dysfunction

Question 33

pulsus bigeminus

Answer 33

hypertrophic obstructive cardiomyopathy (HOCM)

Question 34

pulsus bisferiens

Answer 34

aortic regurg

Question 35

pulsus tardus et parvus

Answer 35

aortic stenosis

Question 36

pulsus paradoxus

Answer 36

cardiac tamponade, tension pneumothorax

Question 37

irregularly irregular pulse

Answer 37

atrial fibrillation

Question 38

3 components of hypoplastic left heart syndrome

Answer 38

left ventricular hypoplasia, mitral valve atresia, aortic valve lesions

Question 39

gray cyanosis, absent pulses with single S2, and increased right ventricular impulse

Answer 39

hypoplastic left heart syndrome

Question 40

CXR shows globular-shaped heart

Answer 40

hypoplastic left heart syndrome

Question 41

heart problem that causes severe dyspnea and frequent respiratory infections within first few days of life

Answer 41

truncus arteriosus

Question 42

single S2, systolic ejection murmur, peripheral pulses bounding

Answer 42

truncus arteriosus

Question 43

most severe sequela of truncus arteriosus

Answer 43

pulmonary hypertension (surgery must be completed early to prevent this)

Question 44

CXR shows snowman or figure 8 sign

Answer 44

total anomalous pulmonary venous return without obstruction

Question 45

respiratory distress, severe cyanosis, and pulmonary on CXR early in life

Answer 45

total anomalous pulmonary venous return with obstruction

Question 46

what two cyanotic heart defects are dependent on patent ductus arteriosus?

Answer 46

transposition of the great vessels, hypoplastic left heart syndrome

Question 47

what two cyanotic heart defects include VSD?

Answer 47

tetralogy of fallot, truncus arteriosus

Question 48

what are the sx of ventricular septal defect (VSD)?

Answer 48

dyspnea w/resp distrress, high-pitched holosystolic murmur over lower left sternal border, and loud pulmonic S2

Question 49

congenital heart defect that causes fixed wide splitting of S2

Answer 49

atrial septal defect (ASD)

Question 50

teenager with hearing loss, syncope, normal vitals and exam, and family history of sudden cardiac death

Answer 50

long QT syndrome

Question 51

what syndrome is coarctation of aorta frequently associated with?

Answer 51

Turner syndrome