Pediatrics_RR

Question 1

Non-tender abdominal mass associated with elevated VMA and HVA

Answer 1

Neuroblastoma

Question 2

The most common type of tracheoesophageal fistula (TEF). How is the diagnosis made?

Answer 2

Esophageal atresia with distal TEF (85%).

Unable to pass NG tube

Question 3

Not contraindications to vaccination

Answer 3

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

Question 4

Tests to rule out shaken baby syndrome

Answer 4

Ophthalmologic exam, CT, and MRI

Question 5

A neonate has meconium ileus

Answer 5

Cystic fibrosis
(Hirschsprung's Disease is associated with failure to pass meconium for 48 hours)

Question 6

Bilious emesis within hours after the first feeding.

Answer 6

Duodenal atresia

Question 7

A 2-month-old baby presents with non-bilious projectile emesis. Diagnosis? What are the appropriate steps in management?

Answer 7

Pyloric stenosis.

Correct metabolic abnormalities; then correct pyloric stenosis with pyloromyotomy

Question 8

The most common primary 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 seizures (due to roseola infantum)

Question 10

What is the immunodeficiency?
A) A boy has chronic respiratory infections. Nitroblue tetrazolium test is negative.
B) A child has excema, thrombocytopenia, and high levels of IgA.
C) A 4-month-old boy has life-threatening Pseudomonas infection.

Answer 10

A) Chronic granulomatous disease
B) Wiskott-Aldrich syndrome
C) Bruton’s X-linked agammaglobulinemia

Question 11

Acute-phase treatment for Kawasaki disease

Answer 11

High-dose aspirin for inflammation and fever;

IVIG to prevent coronary artery aneurysms

Question 12

Treatment for mild and severe unconjugated hyperbilirubinemia

Answer 12

Phototherapy (mild) or exchange transfusion (severe).

Do not use phototherapy for conjugated hyperbilirubinemia.

Question 13

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

Answer 13

Reye’s syndrome

Question 14

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

Answer 14

Suspect retinoblastoma.

Osteosarcoma.

Question 15

Vaccinations at a 6-month well-child visit.

Answer 15

HBV,
DTaP,
Hib,
IPV,
PCV,
Rotavirus

Question 16

Tanner stage 3 in a 6-year-old girl

Answer 16

Precocious puberty

Question 17

Infection of small airways with epidemics in winter and spring.

Answer 17

RSV bronchiolitis

Question 18

Cause of neonatal respiratory distress syndrome (NRDS)

Answer 18

Surfactant deficiency

Question 19

A condition associated with red “currant-jelly” stools, colicky abdominal pain, bilious vomiting, and a sausage-shaped mass in the RUQ

Answer 19

Intussusception

Question 20

A congenital heart disease that causes secondary hypertension. What would you find on physical examination?

Answer 20

Coarctation of the aorta;

Decreased femoral pulses

Question 21

First-line treatment for otitis media

Answer 21

Amoxicillin x 10 days

Question 22

The most common pathogen causing croup

Answer 22

Parainfluenza virus type 1

Question 23

A homeless child is small for his age, and has peeling skin and a swollen body.

Answer 23

Kwashiorkor (protein malnutrition)

Question 24

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

Answer 24

Lesch-Nyhan syndrome

Purine salvage problem with HGPRTase deficiency

Question 25

A newborn girl has a continuous “machinery murmur.” Diagnosis? What drug would you give?

Answer 25

Patent ductus arteriosus (PDA).

Indomethacin is given to close the PDA

Question 26

A newborn with a posterior neck mass and swelling of the hands

Answer 26

Turner’s syndrome