Pæds Screening Ques Flashcards
The amount of a single fluid bolus required to treat septic shock:
10 ml/kg.
In which case serological testing is not informative in celiac disease.
In IgA deficiency.
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.
Define paradoxical breathing!
The chest moves inward and the abdomen moves outward during inhalation, and vice versa.
What is the most serious complication of juvenile idiopathic arthritis?
Macrophage activation syndrome (MAS).
What to do in case of neutropenic fever?
Broad spectrum empiric antibiotic therapy after taking blood cultures.
The most common cause of transfusion-requiring hematochezia, without abdominal pain and without diarrhea:
Meckel’s diverticulum
What are the two most frequent chest deformities?
Pectus excavatum and pectus carinatum.
What are the typical characteristics of perianal fissures in Crohn’s disease?
Not in the midline, deep, not painful.
What is the most common cause of new onset cough?
Viral infection.
What is the diagnostic basis of erythema migrans?
Tick bite and the clinical picture:
growing erythema which is more than 5 cm in diameter.
How does the mother’s iodine deficiency influence the newborn’s thyroid function?
It results in temporary primary hypothyroidism.
Which is the most common adrenocortical enzyme defect?
The defect of the 21-hydroxylase enzyme.
Name at least 5 extraintestinal abnormalities in celiac disease:
- Hepatitis
- Osteoporosis
- Arthritis,
- Isolated iron deficiency
- Duhring-disease (dermatitis herpetiformis).
What are the symptoms and laboratory signs of nephritic syndrome?
- Hematuria
- Edema
- Hypertension
- Uraemia
- Oliguria
(kidney failure is correct instead of the latter two)
Which is the contagious disease that causes severe fetal injuries in 80 percent of its cases?
Rubella.
What is the radiological sign of duodenal atresia?
„Double-bubble” sign
What is the most frequent pathogen in urinary tract infections?
E. coli.
What is the most likely diagnosis in the following case: patient with polyuria, polydipsia with positive urine glucose and acetone test?
Diabetes mellitus.
What factors are included in the croup score?
- Sound of inhalation
- Stridor
- Cough
- Signs of dyspnea (nasal flaring, retractions)
- Cyanosis.
What changes can we see in the urine sediment in typical pyelonephritis?
Leukocytes and bacteria
Which disease should be suspected in case of bloody stool and vomiting in neonates?
Volvulus
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
How often should a baby be breastfed?
On-demand.
In which chromosomal abnormality is duodenal atresia common?
Trisomy 21 (Down syndrome)
What are the typical abnormalities in urine analysis in glomerulonephritis?
Red blood cells and red blood cell cylinders.
Proteinuria can also appear.
What radiological examinations can be done to diagnose VUR? (Name three!).
- MCU (Micturating cystourethrogram)
- Sono-cystography
- Dynamic kidney-scintigraphy.
What is the recommended empiric treatment of neonates with suspected sepsis?
Ampicillin + Gentamycin.
Name of the two most common pathogens of newborn meningitis!
Streptococcus agalactiae
E. coli.
What are typical signs of bacterial otitis externa?
Pain and/or tenderness of the tragus.
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.
What is the most frequent cause of hypertension before the adolescent age?
Kidney disease.
What are the physical symptoms of anemia?
- Fatigue
- Paleness
- Tachycardia
- Systolic heart murmurs
What is the most common cause of a cough ongoing since birth which always presents during
feeding?
Tracheoesophageal fistula.
For how long can we see the shadow of the thymus on the thoracic X-ray?
Until 3 years of age.
Standard imaging modality of polytraumatized patients:
Acute CT.
What is a haploidentical transplant?
Half matched HLA antigen stem cell transplant (from usually a family member).
How does the breast milk’s protein content relate to the cow’s milk protein content?
One third.
What is the sixth disease?
Exanthema subitum, roseola infantum.
What is the heart rate and respiratory rate of a healthy newborn?
Respiratory rate: 50-60/min
Heart rate: 120-160/min.
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.
Which is the most frequent glomerulonephritis type?
IgA nephropathy.
Which are the 4 presenting symptoms of diabetes mellitus?
- Polyuria,
- Polydipsia,
- Weight loss with good appetite,
- Fatigue-weakness.
Which is the most common cause of strangulation ileus?
Incarcerated hernia.
What is the choice of imaging modality if acute osteomyelitis is suspected?
MRI
What is the prognosis of West-syndrome or infantile spasm?
Usually poor.
At what age do the fontanelles close at the latest?
Posterior fontanelle: by 3 months
Anterior fontanelle: by 18 months.
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.
In which part of the bone does osteomyelitis start?
In the metaphysis.
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
The most frequent pathogen of sinusitis and otitis media?
Streptococcus pneumoniae
What is the first therapeutic choice in Crohn’s disease?
Exclusive enteral nutrition.
What is chicken pox (varicella) reactivation called?
Herpes zoster.
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).
Which bacterium is the most frequent cause of childhood pneumonia?
Streptococcus pneumoniae
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).
How can we estimate the body weight between the ages of 2-8 years?
(2 x years) + 8.
List the signs of increased work of breathing!
- Use of respiratory accessory muscles
- Intercostal retraction
- Jugular retraction
- Nasal flaring
- Paradoxical breathing
- Grunting.
Which muscles are affected in juvenile polymyositis?
Proximal muscles of the limbs.
When is it suggested to introduce cow’s milk for children?
After 12 months of age.
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.
What is the ideal age for closing the soft palate defect?
Between 9 and 18 months.
Age limits of puberty?
Boys: 9-14 years.
Girls: 8-13 years.
Which cultured pathogen from throat swabs warrants antibiotic treatment?
Streptococcus pyogenes
(Group A strep)
What is the most common presentation of cow’s milk protein allergy in infants?
Bloody stool
What is the treatment of immune thrombocytopenia (first- and second-line treatment.)?
IVIG
Corticosteroid
What are the 4 most important indications of adenoidectomy?
- Recurrent infections of the upper respiratory tract
- Recurrent otitis media
- Inhibition of nasal breathing
- Obstructive sleep apnea.
What kind of diseases are included in atopic march and in which order?
- Atopic dermatitis
- Food allergy
- Asthma bronchiale
- Allergic rhinitis.
This order: Atopic dermatitis food allergy - asthma bronchiale - allergic rhinitis
What is the most common type of malignancy in childhood?
ALL.
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.
What are the most important diseases which can be easily diagnosed and followed up by cranial ultrasound?
Brain hemorrhage and hydrocephalus.
What are the B-symptoms in lymphoma?
Fever
Night sweats
Weight loss.
What does precocious puberty mean in the case of girls?
If the secondary sexual characteristics appears before the age of 8 years
What are the serum electrolyte disturbances in case of tumor lysis syndrome?
Elevated potassium, phosphate and uric acid
Decreased calcium.
What is the most modern therapeutic method of type-one diabetes?
Insulin pump with an integrated glucose sensor.
In case of maternal GBS positivity, up to what age can this bacteria cause disease in the baby?
Up to six months of age.
Since the introduction of expanded screening, how many congenital metabolic diseases are screened routinely in Hungary?
27 and SMA screening is also available.
SMA - spinal muscular atrophy
How does the concentration of protein and glucose of CSF change in bacterial meningitis?
Protein concentration is increased
Glucose concentration is decreased.
What are the direct and indirect signs of appendicitis?
Direct sign:
- tenderness at the McBurney point.
Indirect signs:
- Blumberg sign
- Rovsing sign
- Obturator sign
- Psoas sign
How does the total iron binding capacity change in case of anemia and inflammation?
Increased in anemia, decreased in inflammation.
The pathogen causing neonatal infection that can be identified by maternal vaginal secretion
screening.
Streptococcus agalactiae
(group B Streptococcus, GBS)
Which disease should be suspected in case of neonates with distended abdomen and severe
constipation?
Hirschsprung-disease
What is the typical feature of stool in biliary atresia?
Clay-colored (acholic) stool.
How long to wait after surgery before bathing?
7-8 days.
Imaging modality of choice when evaluating a child for infantile hypertrophic pyloric stenosis:
ultrasonography
In which cases of middle-ear inflammatory disease should we suggest tympanostomy tubes
(Grommet)?
Chronic serous otitis media
and/or chronic dysfunction of the Eustachian tube.
What are the alarming signs of retinoblastoma?
What examinations are required?
Alarming Signs:
Strabism
Leukocoria
- ophthalmoscopic examination.
At what platelet count is there major risk of bleeding?
Below 10-20 G/l
What are the diseases most commonly associated with type 1 diabetes mellitus?
Celiac disease
Hashimoto thyroiditis.
What are the most typical histologic findings in ulcerative colitis?
Crypt abscesses.
What does allogeneic stem cell transplant mean?
The patient (recipient) gets hematopoietic stem cells from another person (donor).
You find a high GGT in a patient with ulcerative colitis, what should you think about?
Sclerosing cholangitis.
What are the two main components of the treatment of pseudocroup?
Rectal steroid
Inhalation of adrenaline.
What are the two typical anamnestic features of acute appendicitis?
First, epigastric and periumbilical pain
Later, the pain is localized in the right lower abdominal quadrant.
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.
What are the upper airway infections that should be treated with antibiotics?
- Streptococcus angina
- Acute otitis media
- Acute bacterial sinusitis.
The most common endocrine disorder causing growth retardation:
Thyroid dysfunction – hypothyroidism.
Most common cause of acute abdomen in children:
appendicitis.
Name at least five examples when pulse oximetry is not informative!
- Carbon-dioxide intoxication
- Methemoglobinemia
- Severe anemia
- Cardiac failure
- Cold extremities.
What affects the sensitivity of blood culture?
The amount of blood drawn within 24 hours after
the fever.
What is the Holzknecht sign characteristic for?
Airway foreign body aspiration.
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.
Typical age of intussusception in infants:
3 months - 3 years
What can prevent coronary artery disease (aneurysm) in Kawasaki syndrome?
IVIG.
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.
What factors are included in the APGAR score?
Heart rate
Respiratory rate
Skin color
Reflex irritability
Muscle tone
What is the diagnostic basis of endocarditis?
Blood culture
Echocardiography.
What is the prognosis of juvenile absence epilepsy?
Usually favorable.
What are the symptoms and laboratory signs of nephrotic syndrome?
- Proteinuria
- Hypoalbuminemia
- Hyperlipidemia
- Oedema.
How much insulin should be given in diabetic ketoacidosis?
0.05-0.1 U/kg/h
