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COMAT Exams > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

What effects on the fetus is associated with maternal use of heroin/opiates during pregnancy? what should these children be monitored for?

A

increase risk of: fetal growth restriction placental abruption fetal death preterm labor intrauterine passage of meconium infants should be monitored for NEONATAL ABSTINENCE SYNDROME (uncoordinated sucking reflex = poor feeding, irritability, high pitched cry)

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2
Q

what is the cause: 3 day old infant large bump on head scleral icterus, abdominal jaundice swelling over parietal bone - does not cross suture lines

A

Cephalohematoma

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3
Q

what is the best tx for osgood-schlatter disease?

A

ibuprofen

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4
Q

What is the caloric requirement for most 1. healthy babies 2. preterm babies 3. VLBW (very low birth weight) infants = <1500g in the first 1 to 2 months of life?

A
  1. 100 cal/kg/day 2. 115 to 130 cal/kg/day 3. 150 cal/kg/day
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5
Q

when does a child double their birth length?

A

4 years of age

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6
Q

what is the Ballard Assessment tool?

A

uses signs of neurologic and physical maturity to estimate gestational age

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8
Q

For a 18 month old child what are the milestones for: 1. gross motor 2. fine motor 3. language 4. social/adaptive

A
  1. walks alone, may climb stairs/runs, can help undress 2. drinks from cup/spoon, make tower of 2 cubes 3. 6 words in vocabulary 4. points to show what he wants, shakes head no
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9
Q

What is the disease: 5 year old with newly discovered cardiac murmur. elfin facies, mild retardation what kind of cardiac defect?

A

Williams-Beuren syndrome - also HTN, short status Bicuspid Aortic Valve –aortic regurg –aortic stenosis develops 40s-50s

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10
Q

For a 6 month old child what are the milestones for: 1. gross motor 2. fine motor 3. language 4. social/adaptive

A
  1. rolls over, sits unsupported, no head lag when pulled to sit from supine 2. reaches for objects, looks for dropped items 3. turns to voice, babbles 4. feeds self, demonstrates stranger recognition (prelude to stranger anxiety)
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11
Q

What is the most likely inborn error of metabolism in a 2 day old infant with severe metabolic acidosis?

A

Glutathione synthetase deficiency –severe metabolic acidosis + jaundice + hemolytic anemia

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12
Q

what is the infective agent: 7 year old w low grade fever, headache, pruritic rash. Rash began on cheeks, spread to trunk and extremities. Physical exam shows maculopapular rash w lacy, reticulated appearance

A

Erythema infectiosum - parvovirus B19

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13
Q

cal/mL for 20 cal formula?

A

0.67 cal/mL

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14
Q

Neonate IV fluids +/- feeds

A

Increase 20-30 mL/kg/day until 150-160 mL/kg/day Day 1: 60-80 mL/kg/day Day 2: 80-100 mL/kg/day Day 3: …etc… 60+(20day)= max limit

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15
Q

What is dz and defect? Tall 10 year old, arachnodactyly, ligamentous laxity, pectus excavatum

A

Marfan syndrome - fibrillin

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16
Q

what is the etiology: infant born w part of small bowel protruding from abdomen to the right of the umbilicus.

A

Gastroschisis —involution of the second umbilical vein

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17
Q

how old is the child: Child says “mama” and “dada” w meaning, follows one-step commands, shows objects to parents to share interest. plays interactive games (peekaboo, waves bye bye). points to desired object

A

12 months

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18
Q

What electrolyte abnormalities is most often seen in infants of diabetic mothers?

A

hypoglycemia hypocalcemia hypomagnesemia

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19
Q

what is the dx? 1 month old with head circumference > 100th percentile. mother had no prenatal care. Macrocephaly w no other dysmorphic features. Transillumination of the head is positive.

A

hydranencephaly

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20
Q

cal/mL for 24 cal formula?

A

0.80 cal/mL

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23
Q

What will a coin appear like in an AP CXR if in the 1. esophagus 2. trachea

A
  1. Round – The coin will face you 2. Linear – You are looking at the coins edge. A Sagital CXR needed to see the front/back of the coin.
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24
Q

Identify the pathogen: 12 day old infant w bilateral eye discharge. conjunctival injection, lid swelling, scant mucopurulent discharge. no rashes

A

chlamydia trachomatis

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25
Q

What are the two most prevalent causes of acute otitis media?

A

Streptococcus pneumoniae Haemophilus influenzae, nontypeable

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26
Q

Fluid management for neonate

A

Based on weight until day 7 Feeding q 3 hours

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27
Q

What is the definition of Small of Gestational age?

A

Less than 10% for Birth Weight At Term = <2500g At 37 wk = <2000g At 34 wk = <1500g At 31 wk = <1000g At 24 wk = <500g

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28
Q

What are the components of the HEADS adolescent screen?

A

H-home E-education/employment/eating disorder A-activities/alcohol D-drugs/depression S-safety/sex/suicide

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29
Q

What are the components of an APGAR score?

A

Appearance (skin color) Pulse (heart rate) Grimace (reflex irritability) Activity (muscle tone) Respiration

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30
Q

What congenital heart defect results in a biscuspid aortic valve and patent ductus arteriosus? neonate has recurrent epistaxis

A

Coarctation of the aorta a/w –bicuspid aortic valve –persistent ductus arteriosus –ventricular septal defect

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31
Q

What is the current guideline for intrapartum antimicrobial prophylaxis against Group B Strep?

A

If the mother is in labor with ruptured membranes and one of the following is present: G – Gone – Unknown Status B – Before – Prev infant infected w/ invasive GBS S – Soon – During pregnancy: + bacteriuria, + vag-rec culture During Labor: Premature delivery, ROM >18hrs, +GBS PCR, Maternal Fever

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32
Q

cal/mL for D10 formula?

A

0.34 cal/mL

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33
Q

Neonate “feeds only” amount per day

A

Increase 30 mL/kg/day until 150-160 mL/kg/day Day 1: 30 mL/kg/day Day 2: 60 mL/kg/day Day 3: …etc… 30day=max limit

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35
Q

What effect on the fetus can occur from a mother on anticonvulsants?

A

Cardiac defects Microcephaly, dysmorphic craniofacial features hypoplastic nails, distal phalanges IUGR Mental retardation rare: methemoglobinuria

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35
Q

what is the cranial nerve affected: 1 month old presents w poor feeding, suckling difficulty. she had this problem since birth. pt has a cranial dysfunction

A

CN IX – glossopharyngeal

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36
Q

What supplement is recommended for exclusively breastfed infants younger than 6 months?

A

Vitamin D

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38
Q

What are 3 risk factors an infant is susceptible to who is small for gestational age?

A

Hypoglycemia Hypothermia Polycythemia

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39
Q

What 3 medications are routinely given to newborns?

A
  1. Intramuscular Vit K 2. Hepatitis vaccine (HBIG if mother is + for HbsAg) 3. Erythromycin, tetracycline, silver nitrate - for gonococcal conjunctivitis
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40
Q

How old is the child: uses more than 50 words, follows two-step commands, engages in parallel play, stacks 5-6 blocks, turn pages in book, throw ball overhand, refer to themselves as “me” or “I”

A

2 years old -uses two word phrases

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40
Q

A 7cm mass is palpated on the right side that does not cross the midline in a 5 month old. The child was born large for gestational age with macrocephaly, macroglossia, hypospadias. what is the etiology?

A

Wilms Tumor - associated with Beckwith-Wiedemann syndrome = a genetic overgrowth syndrome a/w omphalocoele, hemihypertrophy, hypoglycemia, large for gestational age, other dysmorphic features.

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41
Q

A 2 year old with 102.6F fever has a seizure. what should you tell the parents?

A

Simple Febrile Seizure = reassure parents

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42
Q

cal/mL for 22 cal formula?

A

0.73 cal/mL

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43
Q

Pounds to grams conversion

A

1 lb. = 453.59 g

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44
Q

What congenital heart condition results in a cleft anterior mitral valve leaflet?

A

ostium primum atrial septal defect –clefts in anterior leaflet of the mitral valve –a/w anomalies of the AV valves –possible defects on the ventricular septum

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45
Q

A child born to a diabetic mother has an absent Moro reflex on the left. left SCM appears to be in spasm. what is the cause?

A

clavicle fracture = absent moro reflex on affected side + spasm of SCM

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46
Q

What type of congenital heart defect: neonate is born and initial physical exam is unremarkable. holosytolic murmur is heard on day 5 of life

A

Perimembranous VSD –upper ventricular septum close to aortic/mitral valve –left to right shunt occurs several days after birth when pulmonary vascular resistance decreases

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48
Q

What does it mean to have a term pregnancy?

A

born at >37 weeks gestation

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48
Q

What are 3 side effects of stimulant medication in a child with ADHD?

A
  1. decreased appetite 2. insomnia 3. decreased growth velocity
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49
Q

How old is the child: says “mama”, ball”, “yes”, “no”, “hi” turn pages in a book greet people, show empathy listen to story, drink from a cup

A

15 months

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50
Q

What are the contraindications for a child against receiving a DTaP vaccination?

A
  1. serious allergic reaction/anaphylaxis after a previous dose 2. encephalopathy within 7 days after dose
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51
Q

3 yo M w/ 3 day hx of fever, fussiness, stiff neck, decreased oral intake. Hx shows Upper resp infection one week ago. throat gram stain gram-positive organisms. Confirm w/ lateral neck radiography… Dx?

A

Retropharyngeal Abscess –hx of upper respiratory, throat/ear infection –may present w torticollis –S. pyogenes, S. aureus

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52
Q

2-day old male w/ numerous small papular, and pustular lesions w/ surrounding erythema on the anterior chest and abdomen. Multiple eosinophils w/o microbial organisms on Bx… Dx?

A

erythema toxicum neonatorum

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53
Q

Age? 10-25 words, names one picture on demand. engages in pretend play (feeding doll), laughs in response to others, walk up steps, run, stack 2-3 blocks, use spoon/cup

A

18 months

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54
Q

what are 5 alarming symptoms following vaccination?

A

FUCSA 1. fever > 104F 2. unresponsiveness of infant 3. crying > 3 hours within 48 hrs 4. seizure within 3 days 5. allergic reaction

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55
Q

what is the dx: 6 year old male w painful oral lesions. had similar episode one year ago. multiple round, clearly defined, small buccal ulcerations w a grayish base that are tender to palpation. lips are normal without lesions. oropharynx is clear w/o erythema, exudate or tonsilar enlargement

A

aphthous stomatitis (canker sores)

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56
Q

What are the 3 circumstances that “Failure To Thrive” describes?

A
  1. Weight falls below the 3rd percentile 2. Weight for height/length falls below the 3rd percentile 3. Rate of weight gain slows compared to previous growth (growth chart crosses two or more major percentiles)
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56
Q

What are the screening guidelines for diabetes? when do you start screening? frequency?

A

Overweight (>85% weight + height or >120% weight for ideal height) +2 Risk factors: 1. fam Hx 2. race = NA, AA, Hispanic, Asian 3. signs of insulin resistance 4. maternal Hx of diabetes/gestational diabetes

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56
Q

what are 5 alarming symptoms following vaccination?

A
  1. fever > 104F 2. persistent crying > 3 hours within 48 hrs 3. seizure within 3 days 4. unresponsiveness of infant 5. signs of severe allergic reaction
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57
Q

dx: 4 year old w fever, respiratory distress. toxic appearing, drooling, sitting upright, holding neck in hyperextension. pt rapidly develops stridor and cyanosis

A

Epiglottitis –lateral neck x-ray = thumb sign

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58
Q

What is the most likely inborn error of metabolism in a 2 year old that develops severe cutaneous photosensitivity?

A

Hartnup disease - decreased availability (transport) of tryptophan for niacin synthesis

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59
Q

What effect on the fetus/pregnancy can Cocaine and other stimulants cause?

A

Vasoconstriction = placental insufficiency and low birth weight

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59
Q

when does an infant 1. double 2. triple their birth weight?

A
  1. 5 months 2. 12 months
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59
Q

What immunologic abnormalities are found in ataxia-telangiectasia?

A

undetectable IgA levels elevated IgM normal IgG

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60
Q

what is the pathogen: 5 year old w axillary lymphadenopathy. small wound on palmar surface of the third digit adjacent to the distal interphalangeal joint. Cultures are obtained resulting in growth on Warthin-Starry stain.

A

Bartonella henselae

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61
Q

how does depression in adults differ than depression in adolescents?

A

Adult depression often includes early morning waking with difficulty sleeping at night

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61
Q

5 year old female with blood in underwear -multiple pathological fractures -tanner stage 2 breast development -multiple hyperpigmented irregularly shaped cutaneous macules

A

McCune-Albright syndrome –GNAS gene GnRH independent, peripheral precocious puberty from ovarian hyperfunction and cyst formation, episodic estrogen secretion –unpredictable vaginal bleeding –breast development w/o growth of pubic hair –bone lesions - polyostotic fibrous dysplasia

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63
Q

6 year old with sore throat, painful swallowing -no cough -febrile -bilateral tonsillar hyperemia, edema -lymph node enlargement in the anterior cervical chain -diffuse, pimply sandpaper-type rash on trunk and extremities

A

Scarlatina = rash that appears w group A streptococcal infection 1. fever 2. tonsillar exudates 3. cervical adenopathy 4. absence of cough

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63
Q

What congenital heart condition results in a persistent left superior vena cava

A

Total anomalous pulmonary venous connection –cyanotic –four pulmonary veins fails to make normal connection in left atrium and drain into systemic venous circulation

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64
Q

what is the most appropriate step after suspecting intussusception?

A

air contrast enema

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65
Q

What congenital heart defect causes a redundant tricuspid valve leaflet

A

Ebsteins anomaly –hypoplastic right ventricle –enlarged right atrium –most patients also have an ASD

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66
Q

when should tympanostomy tube placement be considered?

A

Otitis media w effusion (OEM) for 4 months + hearing loss/documented language/developmental delay

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69
Q

What effect on the fetus can tobacco use cause?

A

Low birth weight

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70
Q

what is the cause: lethargic newborn lump on scalp that is slowly growing firm, fluctuant mass overlying the occiput which crosses over to the left parietal skull

A

subgaleal hemorrhage

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72
Q

What are the four criteria in the diagnosis of diabetes?

A
  1. HbA1c > 6.5 2. fasting glucose >126mg/dL 3. 2 hour fasting glucose > 200 mg/dL 4. random plasma glucose > 200 mg/dL
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73
Q

Neonate caloric intake goal

A

100-110 cal/kg/day

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74
Q

Pathological Jaundice HPI

A

Onset: <24 Hrs Bilirubin Involved: Direct/Conjugated, >2 or >20% Total Rise: >5/day or >0.2/Hr Resolve: 14 days+

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75
Q

Pathological Jaundice HPI

A

Onset: <24 Hrs Bilirubin Involved: Direct/Conjugated, >2 or >20% Total Rise: >5/day or >0.2/Hr Resolve: 14 days +

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76
Q

Physiological Jaundice HPI

A

Onset: <7 days Bilirubin Involved: Indirect/Unconjugated, <10% Total Rise:<5/day or <0.2/Hr Resolve: w/n 10 days

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77
Q

Caffeine Citrate is used for…

A

Obstructive/Mixed/Central Apnea in Preterm Neonates <35wks

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78
Q

Methylxanthine is used in the NICU for…

A

Apnea control, precursor for caffeine

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79
Q

Central Apnea is …

A

lack of inspiratory effort

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80
Q

Mixed Apnea is …

A

Upper airway obstruction w/ inspiration that follows/precedes Central Apnea

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81
Q

Sx of Neonatal Abstinence Syndrome

A

High Pitched Cry Irritable Poor Feeding Poor Coordinated Suckle

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82
Q

Obstructive Apnea is …

A

Inspiratory effort present but ineffective d/t upper airway obstruction

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83
Q

A newborn male child has a flat facial profile, upslanted palpebral fissures, epicanthal folds, a small mouth with a protruding tongue, small genitalia, and simian creases on his hands. What of the following chromosomal disorders is most likely in this child?

A

Tri 21

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84
Q

Sign/Sx of congenital hypothyroidism

A

Cretinism – severely stunted physical and mental growth

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85
Q

Sign/Sx of congenital hypothyroidism

A

Cretinism

86
Q

Deficiency that causes: Night blindness, xerophthalmia, Bitot spots, follicular hyperkeratosis; immune defects

A

Vitamin A

87
Q

Deficiency that causes: reduced bone mineralization

A

Vitamin D

88
Q

Deficiency that causes: Hemolysis in preterm infants; areflexia, ataxia, ophthalmoplegia

A

Vitamin E

89
Q

Deficiency that causes: Prolonged prothrombin time; hemorrhage

A

Vitamin K

90
Q

Deficiency common w/ Malabsorption; breastfed infants

A

Vitamin D

91
Q

Deficiency common with protein-calorie malnutrition; malabsorption

A

Vitamin A

92
Q

Sx: Pitting Edema, Hypo-albumin, normal weight, muscle atrophy, abdomen is distended, bowel sounds hypoactive. moon facies

A

Kwashiorkor – Protein malnutrition African child

93
Q

Sx: Muscle and adipose wasting, hair and skin is dry and thin, bradycardia, hypothermia

A

Marasmus – Complete Malnutrition Concentration camp

94
Q

Drugs/Intoxications that cause hypoglycemia

A

SAD Q-TIP PA Val Salicylates Alcohol Diabetic Medication Quinine TMP-SMX Insulin Propanolol Pentamidine Ackee Fruit Valproic Acid

95
Q

Hypoglycemia without ketonuria suggests…

A

hyperinsulinism or a defect in fatty acid oxidation.

96
Q

Scalp swelling that extends across the midline, and contains serosanguinous, subcutaneous, extraperiosteal. Involves bleeding below the scalp and above the periosteum

A

Caput Succendaneum

97
Q

Bleeding between the skull and the periosteum, does not cross suture lines.

A

Cephlahematoma

98
Q

A narrow pulse pressure is seen with…

A

pericardial tamponade, aortic stenosis, and heart failure

99
Q

A wide pulse pressure may be seen with…

A

PDA, truncus arteriosus, AV malformations, aortic insufficiency, anemia, vasodilation with fever or sepsis.

100
Q

LLSB or between LLSB and apex Vibratory, musical Systolic ejection murmur decreases in upright position

A

Still/Vibratory/Flow/Innocent Murmur

101
Q

Balloon septostomy is…

A

the widening of a foramen ovale, patent foramen ovale, or atrial septal defect via cardiac catheterization to allow flow of oxygenated blood in the presence of CHD, to prepare for, or sustain until corrective heart surgery.

102
Q

Down Syndrome heart defects

A

VSD AVSD Cushion defects

103
Q

Cyanotic CHD

A

Right to Left Shunt 1. Truncus Arteriosus 2. Transposition of the Great Vessels 3. Tricuspid Atresia 4. TOF 5. TAPVR 6. Hypoplastic Left Heart

104
Q

Acyanotic CHD

A

Left to Right Shunt – “Holy” Child ASD VSD PDA CoA

105
Q

Mid-systolic click indicates…

A

Mitral valve prolapse

106
Q

Turner Syn heart defects

A

Bicuspid Aorta Coarctation of the Aorta

107
Q

Trisomy 18 Heart Defects

A

ASD VSD PDA Bicuspid Aortic/Pulmonary Valve CoA

108
Q

Trisomy 13 Heart Defects

A

ASD VSD PDA Bicuspid Aortic/Pulmonary Valve CoA

109
Q

Hyperpigmentation w/ Vitiigo and Hypoglycemia, Hyopnatremia, Hyperkalemia

A

Addison Disease, get ACTH stimulation test

110
Q

Pt presents w/ Floppy Baby Small Head Bulbous nose Cleft Palate Forked Uvela TOF Interrupted Aortic Arch Truncus Arteriosus Long, tapered fingers … Dx?

A

Velocardialfascial syndrome

111
Q

Fluid Maintenance Therapy Guideline

A

4-2-1 4 ml/kg/hr for the first 10 kg 2 ml/kg/hr for the next 10 kg 1 ml/kg/hr for remaining kg Over 20 kg: Wt in kg + 40 = Maintenance ml/kg/hr

112
Q

Painful Buccal/Lip/Gum Ulcers along w/ GU Ulcers that scar and Uveitis…Dx? Other findings?

A

Bechet Dz Red papule following skin prick, skin lesions, vasculitis

113
Q

IV Flow Rate Calculation

A

Vol (Drops per min)/time in min

114
Q

Drop rates for: Blood Regular Microdrop

A

Blood = 10/ml Regular = 15/ml Microdrop = 60/ml

115
Q

Fxn abdominal pain or HA that has no constitutional Sx…Dx?

A

New life stress

116
Q

Swollen knees/ankles Abdominal pain Purpuric rash on feet/legs/buttocks Renal pathology

A

Henoch-Scholein Purpura

117
Q

Infant presents w/ severe cough, resp failure, apnea. What vaccine was missed by the older sibling.

A

Tdap

118
Q

First line tx for acute OM

A

High Dose Amoxicillin

119
Q

Fever Achy joints HTN Edema Cough Dyspnea Hemoptysis Diffuse alveolar hemorrhage Renal Sx

A

Goodpasture Syn

120
Q

Cardiac finding in Marfan

A

Mitral prolapse

121
Q

Long Thin Face Hyperflexible Pectus Excavatum High arch palate Dental Overcrowding Scoliosis Dx?

A

Fragile-X

122
Q

Follow up management on UTI

A

Renal ultrasound >> all Males >> all Females <5 yo >> Females >5 yo w/ more that two UTI

123
Q

Small Eyes Flattened nasal bridge Thin lip Mid-fascial hypoplasia Cardiac septal defect Dx?

A

Fetal Alcohol Syn

124
Q

Asx infant w/ possible drain cleaner ingestion. PE unremarkable, next step….

A

Admit for possible esophageal endoscopy

125
Q

Diffuse rales and wheezing Hyper inflated Lungs Flat diaphragm Patchy atelectasis Hypoxia Cough Reduced appetite

A

RSV Bronchiolitis

126
Q

Newborn Reflexes

A

BDRMSTG Moro Dance Root Suck Tonic Neck Babinski Grasp

127
Q

CF pt w/ pancreatic dysfxn presents w/ hemolytic anemia. Why?

A

Deficient in Vit ADEK d/t decreased lipase. Extensive Vit E deficiency may lead to hemolytic anemia.

128
Q

Children w/ high milk and low meat intake are at of …

A

iron deficiency anemia

129
Q

Fever, weight loss, painless nodes… next step?

A

CXR

130
Q

Easy bruising, hypermobile, hyperelastic skin, slow wound healing… Dx?

A

EDS

131
Q

Full testicle with twisted mass, non-tender, positive cremaster

A

Vericocele

132
Q

DKA pt present w/ acidosis, hyponatremia, hypokalemia. IV NS bolus given next step?

A

IV NS w/ potassium The hyponatremia is dilutional

133
Q

Physical Nadir of a newborn

A

Infant 6-12 weeks has a drop in Hgb to 9-11. Normal occurrence, no intervention needed.

134
Q

Infant has increased renin levels, other vitals/labs normal. Most likely causes (3)

A

Renal Thrombosis CoA Congenital Renal Abnormality (Stenosis, Parenchymal Disease, Wilms Tumor)

135
Q

Aniridia presents w/…

A

absence of pupil

136
Q

Infant presents w/: Dysuria Hematuria u/l painless abdominal mass HTN Fever Constipation Aniridia

A

Nephroblastoma: Wilms Tumor

137
Q

A 2-year-old girl is brought to the emergency room after her mother discovers a mass in the girl’s abdomen while bathing. The girl occasionally cries when urinating, but is otherwise asymptomatic, without any abdominal pain. On exam, she is found to be hypertensive. There is a palpable, non-tender mass on the right side, which does not cross the midline. A chest radiograph is ordered to assess for lung involvement.

A

Wilms Tumor

138
Q

Toddler w/: Chest pain Dyspnea Short PR Wide QRS Normal Sinus Rhythm

A

WPW

139
Q

6 mo w/ nl birth, no PMH presents w/ neuro delay, exaggerated startle response, and no organomegaly…Dx?

A

Tay-sachs

140
Q

15 mo old w/ nl birth, no PMH presents w/ gargoyle facies, clouded corneas, heart dz, skeletal deformity, hepatomegaly, development delay… Dx?

A

Hurler syn

141
Q

3 mo w/ nl birth, no PMH presents w/ hepatomegaly, FTT, Resp Tract infxn, irritable. Progresses to hypotonia, develop delay, spastic, rigid, and introversion… Dx?

A

Neimann-Pick Dz

142
Q

3 yo w/ nl birth, no PMH presents w/ course facies, short for age, hepatosplenomegaly, Skeletal abnormality, vision loss, hearing loss, retardation… Dx?

A

Hunter Syn

143
Q

Tx for Digoxin toxicity

A

Digoxin Immune Fab

144
Q

Testicular cancer suspected. Initial work up includes…

A

U/S AFP Beta-hCG

145
Q

6 mo girl w/ nl birth, no PMH presents w/ rapid decline in motor skills, hypotonia, hand-wringing, introversion, FTT…Dx?

A

Rett Syn, X-Linked Dominant

146
Q

1 wk old w/ nl birth, no PMH presents w/ a 2 cm raised well circumscribed non-fluid lesion over the lumbar spine. Next step?

A

U/S to r/o spina bifida

147
Q

9 mo old w/ nl birth, no PMH presents diarrhea, abdominal pain, distention, flatulence, delay tooth eruption, aphthous stomatitis, growth delay, tympanic abdomen… Dx?

A

Celiac Sprue

148
Q

2 yo prev healthy child presents with black maxillary teeth and nl mandible teeth… Dx?

A

Bottle Feeding Caries

149
Q

Ig _ crosses the placenta and transfers some imunity

A

IgG

150
Q

Cyanotic one day old presents w/ grade 1 gallop, hepatomegaly, diminished pulses, RVH…Dx?

A

TAPVR

151
Q

Asx toddler turns blue and faints following a tantrum…Dx?

A

Breath-holding

152
Q

Two week old presents with a painless mastoid mass and head tilted/flexed to the same side.

A

Congenital Torticollis

153
Q

16 yo w/ Fever, HA, Sore Throat, Abdominal Pain…Dx?

A

Strep Pharyngitis

154
Q

Tongue coated in white w/ prominent red papilla

A

Strawberry Tongue

155
Q

Low back pain that decreases throughout the day, fatigue, pain in achilles/plantar fascia…next step?

A

X-ray of the spine

156
Q

Causes for fractures in infants other than abuse…

A

Rickets (Secondary Hyperparathyroid) Osteo imperfecta

157
Q

Neonate presents w/: Irregular port wine stain on face that follows CNV Hamartoma of eye/skin/CNS Seizures Mental retardation Amblyopia …Dx?

A

Sturge-Weber Syn

158
Q

Infant presents w/: Posterior Fossa Abnormality Hemangioma Arterial Abnormality Cardiac Defect Eye Abnormality … Dx?

A

PHACE Syn

159
Q

Child presents w/ 6+ cafe au lait spots >5mm ADHD Axillary Freckles FamHx of seizures …Dx?

A

NF1

160
Q

Reasons not to breastfeed…

A

Varicella 5 days prior/2 days after birth Illicit drug use Active, untreated TB Chemo HIV Active HSV Infant w/ galactosemia Radiation

161
Q

Tx for labial fusion…

A

Estrogen Cream

162
Q

Newborn presents w/ Large hands and feet Hypoplastic concave nails Diminished pulse in legs Redundant neck folds … Dx?

A

Turner Syndrome

163
Q

Fever, rash, splenomegaly, sore throat that follows an ampicillin tx…

A

Mononucleosis

164
Q

Newborn presents w/ Microcephaly Retardation Thrombocytopenia Blindness Hearing loss Jaundice Anemia Scattered calcification throughout cortex … Dx?

A

Toxoplasmosis

165
Q

Prev healthy 3 yo presents w/ hoarseness, PE unremarkable…Dx?

A

Vertical HPV in resp tree

166
Q

Flu like Sx with tender adenopathy along w/ vesicles on GU and cervix… Dx?

A

HSV

167
Q

Short child w/ recurrent skin infections, abscess formation, osteomyelitis and PNA w/ a likely immunodeficiency… Dx?

A

Chronic Granulomatous Dz

168
Q

Pseudo albinism Ocular albinism Frequent infections …Dx?

A

Chediak-Higashi Syndrome

169
Q

Every 21 days (-ish) pt presents w/: Oral ulcers Fever Stomatitis Pharyngitis … Dx?

A

Cyclic Neutropenia

170
Q

Neonate presents w/ Poor Tone Prolonged Jaundice Enlarged fontanelle Excessive sleep Hoarse cry FTT Coarse facies Constipation … Dx?

A

Hypothyroid

171
Q

Infant presents w/ Vomiting Musty smell Eczema Seizures Self-mutilation … Dx?

A

PKU

172
Q

Infant presents w/ Jaundice Irritable Hepatomegaly Smells of boiled cabbage … Dx?

A

Tyrosinemia

173
Q

Infant presents w/ Projectile vomit Lethargic Smells of sweaty feet… Dx?

A

Isovaleric Acidemia

174
Q

Greasy, scaly plaque that causes hair loss…

A

Seborrheic Dermatitis

175
Q

Uniformly broken hairs, black dots on scalp, circle lesion…

A

Tinea Captitis

176
Q

Permethrin is used to tx …

A

Lice and scabies

177
Q

Pneumococcal pneumonia classically presents as…

A

Sudden onset of high fever Respiratory distress Lobar consolidation Elevated white blood count with left shift

178
Q

GBS presents as …

A

Sudden onset of respiratory symptoms Hypothermia Respiratory failure Diffuse bilateral granular infiltrates Neutropenia with marked left shift

179
Q

Causes of PNA in neonate…

A

GBS E. Coli Listeria

180
Q

Patient between 5 to 20 years of age with a several day or week history of cough and low grade fever who has evidence of pneumonia likely has …

A

Mycoplasma Tx w/ macrolide

181
Q

Age? Uses dada or mama specific to each parent Uses simple gestures (waving bye) and copy gestures Respond to simple requests and pull up to stand.

A

12 months

182
Q

Age? Puts on clothing Washes and dries hands Combines two different words Name a picture, and can throw a ball overhand

A

24 months

183
Q

Age? Dress with supervision Copy a cross Draw a man of three parts Knows first and last name Use plurals.

A

48 months

184
Q

Nenonate presents w/

Fever

Decreased Feeding

Sunken Fontenelle

Normal - High Urine output

Hypernatremia

Dilute Urine

… Dx?

A

DI

185
Q

Electrolyte disturbances in hyperthermia

A

Elevated

  • Creatine Kinase
  • Hyperphosphatemia
  • Hyperuricemia
  • Cardiac Troponin I
  • Hyperkalemia

Depressed

  • Hypoalbuminemia
  • Hypocalcemia
186
Q

Infant has high white count and recurrent infections w/o pus. Sig PMHx include delayed cord seperation at birth…Dx? Transmission?

A

LAD

Autosomal Recessive

187
Q

4 wk M presents w/ vomiting, dehydration, hyponatremia, hyperkalemia.

Dx?

A

CAH, most likely 21-hydroxylase-deficency

188
Q

Excessive circulating thyroid stimulating Ig

Dx?

A

Graves Dz

189
Q

Mom has fever, sore throat, headache, tender posterior auricular and suboccipital lymphadenopathy, and a diffuse rose-pink colored maculopapular rash…

neonate most likelt to present w/…

A

Rubella Congenital Defects:

  1. Hearing Loss
  2. Cataracts/Glaucoma
  3. PDA/Aortic Stenosis
  4. Blueberry Rash
190
Q

A child who develops intermittent excess gas and diarrhea suggests …

A

an infectious agent or food intolerance

191
Q

Teenager w/ fever, joint pain, weight loss, pallor, and joint edema. Evaluate for …

A

ANA, SLE

192
Q

Topical benzocaine has recently been identified as a cause of …

A

methemoglobinemia

193
Q

Tx for OE

A

Topical steroids and oral Abx

194
Q

Howell Jolly bodies indicate …

A

Asplenia/Hyposplenia

195
Q

Tx w/ phenytoin can cause … anemia, … will be seen on blood smear

A

Folate Deficent

Hypersegmented PMN

196
Q

Micro Anemia + Basophilic Stippling

…Dx?

A

Lead Intoxication

197
Q

The only reasons not to give a vaccines…

A
  • Anaphylactic allergy
  • Live vaccines in severely immunocompromised
  • Encephalopathy within seven day
  • MMR or varicella in the pregnant patient
198
Q

Emperic Tx for PID

A

Ceftriaxone

Doxycycline

Metronidazole

199
Q

First meningococcal vaccine given at ___ yo.

2nd at ___ yo>

A

11

16

200
Q

Premature infant being started on enteral feeds presents w/ temperature instability, abdominal distension, increased feeding residuals, apnea, and bradycardia.Imaging shows dilated loops, abnormal gas pattern, and bowel wall edema

…Dx?

A

Necrotizing Enterocolitis

201
Q

3­ to 4­ mo w/ “doll’s face” presents with seizures, hypoglycemia, hepatomegaly, lactic acidosis, massive hyperlipidemia, and hyperuricemia.

A

Von Gierke disease

202
Q

2 mo presents w/ hypotonia, macroglossia, hepatomegaly, and profound cardiomegaly

Death w/n first year d/t cardiorespiratory failure

A

Pompe disease

203
Q

Newborn presents w/ bulging, thin membrane over the introitus… Dx?

… Next step?

A

Imperforate hymen

U/S

204
Q

Yellow fever is a mosquito­borne virus infection endemic in parts of northern South America and in central Africa. The classic description is of Child w/ recent travel presents w/ sudden onset of fever, headache, myalgia, lumbosacral pain, nausea, and vomiting, flushing of the face, conjunctivitis, and red tongue. Sx improve for a few days, but then a recurrence of the fever, gastrointestinal symptoms, jaundice, renal failure, seizures, and coma ensue.

… Dx?

… Tx?

A

Yellow Fever

Supportive

205
Q

A soft, short, medium­ pitched systolic ejection click at the apex of the heart that does not change with Valsalva maneuver suggests a …

A

bicuspid aortic valve

206
Q

Pt w/ sickle cell and history of fever, cough, and increased work of breathing suggests …

A

pneumonia or chest syndrome

207
Q

Appy is suspected, next step?

A

U/S

208
Q

Sickle cell pt has osteomylitis, most common bug?

A

Salmonella

209
Q

An afebrile child with a recent upper respiratory infection who has groin and thigh pain, and mild limp is suspicious for having …

A

toxic (transient) synovitis

210
Q

HTN is more prevelant in babies that spend time in …

A

rhe NICU

COMAT Exams (6 decks)

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