Pedi

Question 1

A newborn being examined in the newborn nursery has no iris in both eyes, liver edge is palpable, has hypospadias, undescended left testis. The boy should be screened for—? Screening is with—? How frequent?

Answer 1

WAGR syndrome (wilms tumor, aniridia, genitourinary abnormalities, mental Retardation
Should be screened for wilms tumor by U/S every three months

Question 2

The ff features r cxs of which glomerulopathies?
A) basement membrane IgG autoantibodies
B) Mesengial n BM immune complex deposits

Answer 2

A) good pasture(RPGN)

B) APSGN

Question 3

In a child being treated for UTI, not improving after 48hr of oral abx, what should be the next step in the mx?

Answer 3

Broaden the abx, and renal n bladder U/S should b obtained to rule out renal abscess or anatomical abnormalities

Question 4

A 3yr old girl on abdominal palpation has mild tenderness in the RUQ, RLQ and a palpable mass on the rt abdomen. U/S reveals a 12cm mass arising from the superior pole of the rt kidney. BP is 156/96
Most likely Dx?
Top ddx Vs Dx?

Answer 4

Wilms tumor- 2-5yr, htn, mass arising from the kidney
DDX- neuroblastoma- age <2yr, mass arises from adrenals, not kidneys, hypertension can occur but is more common with wilms

Question 5

Complication of VUR?
A) fibrosis of renal interstitial space
B) inflammation of renal glomerulus

Answer 5

A

Renal scaring which is focal due to chronic interstitial inflammation and fibrosis

Question 6

Isolated proteinuria( no hematuria, oliguria, edema, htn) in a febrile child (eg. With AGE) what’s the next step in the mx?

Answer 6

First morning urine protein/Cr ratio
If elevated=> further evaluation for persistent proteinuria due to underlying renal dis. If normal=> benign proteinuria, subsequent urinalysis->
-if normal= transient proteinuria (fever, exercise, stress, low volume)
- recurrent proteinuria = orthostatic proteinuria
- a 24 hr urine collection is not routinely done to evaluate proteinuria

Question 7

Which one is more commonly associated with hep B, membranoproliferative or membranous?

Answer 7

Membranous

Question 8

A 4yr old boy is brought for evaluation of UTI sxs. He has hx of previous UTI. Temperature is 39, has suprapubic and right CVA tenderness. He’s given abx n sxs resolve in 24hrs. Ultrasound is normal. The best next step in the mx is?

Answer 8

Voiding cystourethrogram
Which is often obtained in children with UTI in whom VUR should be excluded. Indications:- >=2febrile UTIs, abnormal renal u/s, fever>=39 with bacteria other than E.coli, signs of CKD

Question 9

A 4yr old boy is brought for evaluation of UTI sxs. He has hx of previous UTI. Temperature is 39, has suprapubic and right CVA tenderness. He’s given abx n sxs resolve in 24hrs. Ultrasound is normal. The best next step in the mx is?

Answer 9

Voiding cystourethrogram
Which is often obtained in children with UTI in whom VUR should be excluded. Indications:- >=2febrile UTIs, abnormal renal u/s, fever>=39 with bacteria other than E.coli, signs of CKD