Pediatrics

Question 1

Nontender abdominal mass a/w elevated VMA and HVA

Answer 1

Neuroblastoma

Question 2

Most common type of tracheoesophageal fistula (TEF). Dx?

Answer 2

Esophageal atresia w/ distal TEF (85%). Unable to pass NG tube.

Question 3

Not contraindications to vaccination.

Answer 3

Mild illness and/or low-grade fever, current abx therapy, and prematurity

Question 4

Tests to r/o shaken baby syndrome

Answer 4

Ophthalmologic exam, CT, and MRI

Question 5

A neonate had meconium ileus

Answer 5

Cystic fibrosis (Hirchsprung’s dz is a/w failure to pass meconium for 48 hours).

Question 6

Bilious emesis w/I hours after the first feeding

Answer 6

Duodenal atresia

Question 7

2 mo baby present w/ nonbilious projectile emesis. Dx? What are the appropriate steps in management?

Answer 7

Pyloric stenosis. Correct metabolic abn; then correct pyloric stenosis with pyloromyotomy

Question 8

The most common 1` immunodeficiency

Answer 8

Selective IgA deficiency

Question 9

An infant has a high fever and onset of rash as fever breaks. What is he at risk for?

Answer 9

Febrile seizure (due to roseola infantum)

Question 10

What is the immunodeficiency: A boy has chronic respiratory infections. Nitroblue tetrazolium test is (-)

Answer 10

Chronic granulomatous dz

Question 11

What is the immunodeficiency: child has eczema, thrombocytopenia and high levels of IgA

Answer 11

Wiskott-Aldrich syndrome

Question 12

What is the immunodeficiency: 4 mo boy has life-threatening Pseudomonas infxn

Answer 12

Bruton’s X-linked agammaglobulinemia

Question 13

Acute-phase tx for Kawasaki dz

Answer 13

High-dose ASA for inflammation and fever; IVIG to prevent coronary artery aneurysms

Question 14

Tx for mild and severe unconjugated hyperbilirubinemia

Answer 14

Phototherapy (mild) or exchange transfusion (severe). (Do not use phototherapy for conjugated hyperbilirubinemia)

Question 15

Sudden onset of mental status changes, emesis, and liver dysfunction after ASA intake

Answer 15

Reye’s syndrome

Question 16

A child has loss of red light reflex (white pupil). Dx? The child has an increased risk of what cancer?

Answer 16

Suspect retinoblastoma. Osteosarcoma

Question 17

Vaccinations at a 6-mo well-child visit

Answer 17

HBV, DTaP, Hib, IPV, PCV, rotavirus

Question 18

Tanner stage 3 in a 6 y/o girl

Answer 18

Precocious puberty

Question 19

Infxn of small airways w/ epidemics in winter and spring

Answer 19

RSV bronchiolitis

Question 20

Cause of neonatal RDS

Answer 20

Surfactant deficiency

Question 21

A condition a/w red “currant-jelly” stools, colicky abd pain, bilious vomiting, and a sausage-shaped mass in the RUQ.

Answer 21

Intussusception

Question 22

A congenital heart dz that causes 2` Htn. What would you find on physical exam?

Answer 22

Coarctation of the aorta; decreased femoral pulses

Question 23

First-line tx for otitis media

Answer 23

Amoxicillin x 10 days

Question 24

Most common pathogen causing croup

Answer 24

Parainfluenza virus type 1

Question 25

Homeless child is small for his age and has peeling skin and a swollen belly

Answer 25

Kwashiorkor (protein malnutrition)

Question 26

Defect in an X-linked syndrome w/ mental retardation, gout, self-mutilation, and choreoathetosis.

Answer 26

Lesch-Nyhan syndrome (purine salvage problem w/ HGPRTase deficiency)

Question 27

Newborn girl has a continuous “machinery murmur”. What drug would you give?

Answer 27

Patent ductus arteriosus (PDA). Indomethacin is given to close the PDA

Question 28

Newborn w/ a posterior neck mass and swelling of the hands

Answer 28

Turner’s syndrome