Ped1

Question 1

which vitamin is deficient in milk?

Answer 1

VitD and Vit A

Question 2

X-ray in ricket?

Answer 2

Winding of metaphysis

Question 3

Ricket treatment?

Answer 3

Vit D and Ca

Question 4

Cause of Niemann-pick disease?

Answer 4

sphingomyelinase deficiency

AR

Question 5

CM?

Answer 5

loss of motor milestone 2-6 month
Chery red macula
Hepatosplenomegaly
Hyporeflexia/areflexia

Question 6

How to d/t from tay-sacks disease?

Answer 6

in Tay saks
b-hexosaminidase deficiency
No hepatosplenomegaly
Hyperreflexia

Question 7

Biliary duct cyst?

Answer 7

cystic dilation of bile duct

single and extrahepatic form common

Question 8

CM?

Answer 8

majority of patients <10
RUQ pain
RUQ palpable mass
Obstructive Jaundice with acholic stool
Elevated Panc.Enzyme due to pancreatitis in old children or reflex of pan. enzyme

Question 9

Diagnosis and Managment?

Answer 9

Diagnose with abdominal U/S
Managment
Tumor resection(relieve obstruction and reduce risk of cholangiocarcinoma transformation)

Question 10

How to d/t from biliary atresia?

Answer 10

In biliary atresia, there will be 
Hepatomegaly
Absent visible gallbladder
Present with infancy (2-8) week
No pancreatic enzyme elevation
In U/S absent gall bladder/BD/CBD
Intraoperative cholangiography is GS for diagnosis

Question 11

Managment of BA?

Answer 11

Surgical hepato-portoenterpstomy (Kasai procedure)

Liver transplant

Question 12

Breast milk jaundice?

Answer 12

A peak in the second week
Due to B-glucoronidase in milk-deconjugate intestinal bilirubin
Unconjugated hyperbilirubinemia

Question 13

Neuroblastoma pathogenesis?

Answer 13

Neural crest origin

Involve adrenal medulla and sympathetic chain

Question 14

CM?

Answer 14

Midian age < 2
Abdominal Mass
Fever, weight loss
Opsoclonus(rapid eye movt-Myoclonus(rapid extremity jerking movt) syndrome
Periorbital echemosis
Spinal metastasis

Question 15

Diagnostic evaluation?

Answer 15

Increase catecholamine metabolite
Small, round blue cell tumor
N-myc gene amplification

Question 16

Indications for non-contrast CT in pediatric TBI?

Answer 16

LOC
AMS
Foccal nurogic sighn
sever mechanism of head injury((fall(in-age <2,>0.9m in >2(fall >1.5m//MVC?high impact)
Non frontal scalp hematoma and palpable skul # in <2
Vomiting,S.Headache,basilar Skul # in age 2-18

Question 17

Steeps of neonatal resuscitation?

Answer 17

Dry and stimulate
Clear suction
Provide warmth(skin to skin)

Question 18

when to do first?

Answer 18

Term
Breath/cry
Appropriate tone
If above the APGAR will be 9

Question 19

Ahy tracheal suctioning is not recommended?

Answer 19

Stimulate vagus–apnea/bradychardia

Question 20

Indication for the cardiac monitor?

Answer 20

Bradycardia(<100)
Apnea
Gasping
The patient requires chest compression

Question 21

Friedrick ataxia?

Answer 21

Autosomal resecive
Due to GAA repitision
Fraexine gene defect

Question 22

CM?

Answer 22

Dysarthria
LE weakness
Loss of position and vibration(DCI)
Loss of DTR(PRG injury)
MSK(Kyphoscloliosis, High arched palate)
High risk of Hypertrophic CM(Death by age 40)

Question 23

Imaging?

Answer 23

Cervical spinal cord atrophy

Question 24

Managment?

Answer 24

Supportive
Genetic testing for diagnosis and for family for feaucher risk
Not have disease-modifying drug

Question 25

Acute severe anemia cause In pt. with SCD?

Answer 25

Aplastic crisis | Splenic sequestration crisis

Question 26

Splenic sequestration crisis feature?

Answer 26

``` Anemia Hypotension-shock Thrombocytopnia Rapideley Splenomegaly High reticulocyte Manage with saline, small volume ```

Question 27

Aplastic crisis?

Answer 27

Viral flu symptom Anemia Thrombocytopenia Low reticulocyte

Question 28

Fluid managment in DKA patients?

Answer 28

10ml/kg NS over one hour

Question 29

Risk factor for sudden infant death syndrome?

Answer 29

``` Smoking exposure Age < 20 Inconsistent prenatal care Prone/side position Soft sleep surface/loos bedding Bed-sharing Prematurity Sibling with SIDS ```

Question 30

Definition?

Answer 30

Sudden unexplained with symptom or autopsy death

Question 31

NEC risk?

Answer 31

Prematurity Wight, 1.5 kg Enteral formula feeding

Question 32

CM?

Answer 32

V/S instability Bilious vomiting Bloody stool Abdominal Distension

Question 33

X-ray finding?

Answer 33

Pnumatosis intestinae Portal venous gas Pneumoperitoneum

Question 34

Managment?

Answer 34

Bowel rest/TPF Broad-spectrum IV antibiotic +- surgery

Question 35

Neonate for C/Difficele infection?

Answer 35

Not develop due to absent receptor for Toxine

Question 36

Craniopharyngioma SX?

Answer 36

Cystic/Calcified mas in the suprasellar region Bitemporal HA LOW pituitary hormon

Question 37

Osteogenesis imperfecta pathogenesis?

Answer 37

Autosomal dominant | Collagen 1 gene defect

Question 38

CM?

Answer 38

``` Recurrent # Blue sclera Cond.Hearing loss Short/normal stature Hypermobile joints Dentinogenesis imperfecta In sever(T2)-pulmonary failure/inutro or neonatal # ```

Question 39

Sliped capital femoris ephyphisis risk factor?

Answer 39

Obesity | Adolescence

Question 40

CM?

Answer 40

``` Dull hip pain Refeered knee pain Alerd gait Limited internal rotation Lateral hip rotation during passive hip flexion ```

Question 41

Diangnosis?

Answer 41

Posyterior displacment of femoral head

Question 42

Treatment?

Answer 42

Non-wight bearing | Surgical pining

Question 43

Complication?

Answer 43

Avascular necrosis | Osteoartheritis

Question 44

Bedweting is normal at what age?

Answer 44

Untill child become 5 year

Question 45

When doea incontinence need investigasion in childrens?

Answer 45

When persist more than 4

Question 46

C/I for breast feeding?

Answer 46

``` Active untreated TB HIV Herpti breast lesion Varicella infection < 5 day prior or 3 day post partum Specific maternal indication abuse of street drug or alcohol ```

Question 47

Benifit of breast feeding?

Answer 47

Improved immunity Improved GI infection Prevension of infectious disease(OM,GI,RI and UTI) Dec risk of childhood ca,T1DM and NEC

Question 48

Bedweting managment?

Answer 48

``` Urinalysis to r/o other disease urinate before bed avoid water before alarm avoid sugary and caffeinated beverages institute reward system Enurasis alarm Desmopresine TCA(impiramne),if not respond to desmopresine ```

Question 49

symptome of compartment syndrome?

Answer 49

pain and swelling unresponsive to anangesics | 4P

Question 50

cause of meningitis in age <1 month?

Answer 50

GBS E.Coli and other gram negative L.Monocytinogene HSV

Question 51

>1 month?

Answer 51

S.Pnumonia | N.meningitis