Pediatrics

Question 1

how much milk is allowed per day for picky eaters, so as not to suppress appetite?

Answer 1

no more than 16-24 oz

Question 2

most neonatal umbilical hernias will spontaneously resolve by what age?

Answer 2

5 years old

Question 3

t/f systemic corticosteroids, elimination diets, and topical antibiotics should be avoided in atopic dermatitis

Answer 3

true

Question 4

what type of baths are beneficial for moderate to severe cases of atopic dermatitis?

Answer 4

bleach baths

Question 5

how frequently should you use mid or high potency steroid medication for atopic dermatitis ?

Answer 5

once daily - using twice daily offers minimal improvement

Question 6

t/f topical steroids and calcineurin inhibitors are safer and less expensive options for treatment of atopic dermatitis compared with Opzelura

Answer 6

true

Question 7

t/f tolerance to food antigens improves with frequent exposure in infants

Answer 7

true

Question 8

once remission is achieved for a patient with relapsing atopic dermatitis, what are the two options for maintenance therapy?

Answer 8

once daily midpotency steroid or calcineurin inhibitor two to three times weekly

Question 9

at what age does the USPSTF start recommending comprehensive intensive behavioral intervention for children with BMI > 95th percentile?

Answer 9

6 years

Question 10

what medication can be used to treat atopic dermatitis that is mild in whom the patient prefers to avoid steroids and calcineurin inhibitors?

Answer 10

crisaborole (PDE4 inhibitor)

Question 11

what is the recommended dose of daily ferrous sulfate supplementation for pediatric patients with IDA?

Answer 11

2-6mg/kg/day

Question 12

what is the most common cause of anemia in children less than 5 yo ?

Answer 12

iron deficiency anemia

Question 13

universal screening for anemia should be considered in all children at what age timeline?

Answer 13

9-12 months

Question 14

what is the preferred type of iron to use for supplementation to treat IDA in children?

Answer 14

ferrous sulfate

Question 15

t/f systolic ejection murmur can be a physical sign of anemia

Answer 15

true

Question 16

when should iron supplementation start for infants who are exclusively breastfed?

Answer 16

4 months

Question 17

what 4 studies should be done to further classify normocytic anemia in children?

Answer 17

reticulocyte count, bilirubin, haptoglobin and LDH

Question 18

G6PD deficiency, pyruvate kinase deficiency, hereditary spherocytosis can cause what type of anemia?

Answer 18

normocytic anemia

Question 19

what is the most common inherited blood disorder in the US?

Answer 19

sickle cell anemia

Question 20

if a patient is found to have normocytic anemia with low reticulocyte count, what other test can be performed to further differentiate if this is due to a bone marrow disorder?

Answer 20

peripheral smear

Question 21

inflammation from a virus such as parvovirus B19 may cause what type of anemia? what relative reticulocyte count?

Answer 21

normocytic anemia with low reticulocyte count

Question 22

if a patient is found to have microcytic anemia, what three lab tests should be done for further evaluation?

Answer 22

reticulocyte count, iron panel and lead measurement

Question 23

you diagnose a pediatric patient with IDA. You start oral ferrous sulfate at 2-6mg/kg/day. when should you repeat hemoglobin and reticulocyte count?

Answer 23

2-4 weeks

Question 24

after 2-4 weeks of oral iron supplementation, by what percentage do you expect an increase in Hb levels for a patient being treated for IDA?

Answer 24

50% increase

Question 25

what is the USPSTF position on lead screening for children?

Answer 25

insufficient evidence to measure in asymptomatic children less than 5 yo

Question 26

at what age does the transition from fetal to adult Hb occur?

Answer 26

6 months

Question 27

what ratio can be used to help differentiate thalassemia from iron deficiency in a patient with evidence of microcytic anemia?

Answer 27

Mentzer index (MCV / RBC)

Question 28

what nutritional deficiency may be considered in an infant exclusively fed goat's milk?

Answer 28

folate deficiency

Question 29

what condition may be considered for a patient with suspected B12 deficiency whose anemia is not improving with B12 supplementation?

Answer 29

intrinsic factor deficiency

Question 30

what are the two causes of megaloblastic anemia?

Answer 30

B12 and folate deficiency

Question 31

what type of anemia is characterized by hypersegmented neutrophils?

Answer 31

megaloblastic anemia

Question 32

if intussusception is suspected, what can be both diagnostic and therapeutic?

Answer 32

air / contrast enema

Question 33

what is the most common surgical emergency in children?

Answer 33

appendicitis

Question 34

children with hypertension are how much more likely to experience MACE compared to children without hypertension?

Answer 34

2x as likel;y

Question 35

what is the most common site for acute bacterial arthritis in children?

Answer 35

hip

Question 36

what is the most common pathogen causing acute bacterial arthritis in children?

Answer 36

staph aureus

Question 37

what two lab markers are not helpful in differentiating transient synovitis from bacterial arthritis in children?

Answer 37

procalcitonin and ESR

Question 38

what is the initial imaging that should be done for suspected bacterial arthritis ?

Answer 38

xray

Question 39

delaying antibiotic therapy in the case of bacterial arthritis may increase the risk of what complication?

Answer 39

chondrolysis

Question 40

what two antibiotics can be used orally for treatment of bacterial arthritis if risk of MRSA is low?

Answer 40

cephalexin / clindamycin

Question 41

what is the preferred oral antibiotic for treatment of bacterial arthritis when risk of MRSA is high?

Answer 41

clindamycin

Question 42

what is the summary of evidence of use of corticosteroids in the treatment of bacterial arthritis

Answer 42

not recommended

Question 43

what IV antibiotic is preferred for treatment of possible MRSA bacterial arthritis when there is a high rate of resistance to clindamycin?

Answer 43

ceftaroline

Question 44

aspiration of joint fluid in suspected cases of bacterial arthritis are culture positive in what percentage of cases?

Answer 44

40%

Question 45

evaluating for and identifying what comorbid / related condition is important in the evaluation of suspected bacterial arthritis?

Answer 45

osteomyelitis

Question 46

what is the next step in evaluation if normocytic anemia is found in children

Answer 46

reticulocyte count

Question 47

what is the classic triad of symptoms for intussusception?

Answer 47

colicky abdominal pain, vomiting, and bloody mucoid stools

Question 48

for an ill appearing child, what is indicated immediately in the setting of suspicion for acute bacterial arthritis?

Answer 48

antibiotic therapy (prior to joint fluid aspiration for culture)

Question 49

what are the first line interventions for sleep problems in early childhood?

Answer 49

education and behavioral interventions

Question 50

pacifier use should be decreased or eliminated between what ages to reduce the risk of otitis media?

Answer 50

6-12 months

Question 51

pacifier use and thumb sucking should stop by what age to reduce the risk of dental malocclusion

Answer 51

3 years

Question 52

children 4 -12months should get how much sleep per 24 hours?

Answer 52

12-16 hours

Question 53

t/f behavioral extinction intervention or modified/graduated extinction can help children learn to self sooth and fall asleep faster on their own

Answer 53

true

Question 54

what is the concept of bedtime fading?

Answer 54

temporarily delay bedtime to observe the time of sleep onset, then gradually shift the bedtime to an earlier time to prevent the child from lying awake in bed

Question 55

what is the concept of unmodified extinction in terms of sleep?

Answer 55

putting the baby to bed and letting them cry it out at a consistent designated bedtime

Question 56

t/f there are no FDA approved medications for sleep problems in children

Answer 56

true

Question 57

what is the AAP recommendation on pacifier use?

Answer 57

offer pacifier to infants at the start of sleep to reduce the risk of SIDS

Question 58

what type of reinforcement is encouraged for stopping nonnutritive sucking behavior?

Answer 58

positive reinforcement

Question 59

t/f habit reversal therapy to increase awareness of the child's habit of pacifier use / thumb sucking and encouraging an alternative behavior is an effective strategy

Answer 59

true

Question 60

t/f pressuring a child to eat or punishing a child to eat who is a picky eater should be avoided

Answer 60

true

Question 61

how many times may a child need to try a food before accepting it as part of their diet?

Answer 61

15 x

Question 62

what two things should you focus on for picky eating?

Answer 62

structured, positive mealtime environment and offering a variety of healthy foods

Question 63

what is the most common chronic disease in US children?

Answer 63

dental carries

Question 64

what is a non inferior alternative to fluoride toothpaste?

Answer 64

microcrystalline hydroxyapatite toothpaste

Question 65

at what age should oral fluoride be offered for patients with deficient water supply?

Answer 65

6 months

Question 66

t/f bottle fed children are at higher risk of dental caries compared to breastfed children

Answer 66

true