pediatrics

Question 1

Pyloric stenosis age of presentation

Answer 1

3-6 wks

Question 2

pyloric stenosis symptoms

Answer 2

“happy spitter”

• projectile non-bilious vomiting
• wants to feed after vomiting
• olive mass lateral side rectus m RUQ

Question 3

Pyloric stenosis risk factors

Answer 3

• male

- first born

Question 4

Pyloric stenosis labs

Answer 4

Consider if ill-appearing

• CMP (Cr, BUN, K, bili)
• CBC

Question 5

pyloric stenosis diagnosis

Answer 5

• abd u/s

- if bilious need UGI study

Question 6

Lead screening in children

Answer 6

• all medicaid eligible or other risks

- 12 and 24 months

Question 7

Lead level abnormal in kids

Answer 7

> 5 has neurocognitive and behavioral development abnormalities
- capillary okay for initial screen, but needs to be confirmed with venous draw

Question 8

Sources of lead

Answer 8

paint, lead contaminated soil, homes built before 1978, water

Question 9

what to do with elevated lead levels

Answer 9

• if symptomatic, is emergency and need admission
• if >45 need chelation
• if lower, do serial draws (timing of draws depends on level) and environmental lead investigation

Question 10

tx depression adolescents

Answer 10

• SSRI benefit
• no benefit from SNRIs!
• prozac and lexapro only FDA approved for kids
• prozac with CBT is best

Question 11

Umbilical hernia repair

Answer 11

Most close by 5 yo
Consider surgery 3-5 yo
More risk if >1.5 cm