Peds

Question 1

X-ray findings of neonatal respiratory distress syndrome

Answer 1

Atelectasis and diffuse alveolar collapse appear as reticulogranular pattern (ground-glass appearance) with air bronchograms

Question 2

Interstitial infiltrates with prominent interlobar fissures are characteristic of:

Answer 2

Transient tachypnea of the newborn

Question 3

Coarse lung markings with cystic changes can be seen in:

Answer 3

Bronchopulmonary dysplasia (chronic lung disease occurring in patients on oxygen therapy>1 month)

Question 4

What deficiency results in disseminated mycobacterial disease beginning in infancy?

Answer 4

IFN-y receptor deficiency

Question 5

Persistent Pulmonary Hypertension of the Newborn

• Cause
• Diagnostic Work up

Answer 5

Cause: persistent fetal circulation aka right to left shunt across PDA: lower post ductal saturation (right foot) than pre-ductal (right hand)

Question 6

Treatment of otitis externa

Answer 6

topical fluoroquinolone

Question 7

Treatment of Tourette’s

Answer 7

Antidopaminergic (VMAT2): tetrabenazine
Antipsychotics (receptor blockers)
Alpha-2 adrenergic receptor agonists

Question 8

Tx of nonbullous impetigo vs bullous impetigo

Answer 8

Nonbullous: Staph (most common) or term

• limited- topical mupirocin
• extensive- oral cephalexin

Bullous: just staph
- oral cephalexin

Question 9

Newborn less than 1 month with poor feeding, irritability or lethargy, temp instability, leukopenia–> dx/tx

Answer 9

Neonatal sepsis
- empiric ampicillin/gentamicin

Ceftriaxone/vanc are for kids >1 month with suspected sepsis

Question 10

New onset hearing loss, hx of middle ear disease, and chronic ear drainage despite antibiotic tx?

Answer 10

Cholesteatoma

Question 11

What is the mechanism of knee-chest positioning for correcting a tet spell?

Answer 11

Increased systemic vascular resistance to counteract the increased pulmonary vascular resistance 2/2 to exertion

Question 12

Neonatal pulmonary hypertension (hypoxemia/respiratory distress in a newborn)–> causes

Answer 12

1. Congenital malformations that prevent development of pulmonary vascular bed (fixed increase in PVR)
2. alterations of normal fetal circulation in utero (premature closure of PDA, total anomalous pulmonary venous drainage)
3. Insult at birth leading to failure to decrease PVR (meconium aspiration)

Question 13

Trinucleotide repeat repeat in FMR1 gene causing autism like behaviors (hand flapping, self-injury, ASD)

Answer 13

Fragile X syndrome

Question 14

Presentation of malrotation with midgut volvulus in neonate

Answer 14

Bilious vomiting, abdominal distension and upper GI series displaying right-sided ligament of Treitz and corkscrew-shaped duodenum

Question 15

30 month old with 2 day hx sore throat, decreased appetite with small vesicles on uvula, soft palate, and tonsillar pillars–> dx/tx?

Answer 15

Herpangina 2/2 cocksackie A virus (supportive care)

Question 16

Tx kawasaki disease

Answer 16

IVIG

Question 17

Initial fluid resuscitation for moderate-severe dehydration should be with?

Answer 17

20 ml/kg normal saline IV bolus

• D5 should be added to maintenance fluid

Question 18

Empiric tx of epiglottitis

Answer 18

Ceftriaxone (h flu and strep) and vancomycin (MRSA)

Question 19

Horner syndrome and cervical paravertebral mass, harlequin sign (absent facial flushing on one side of face) in 2 year old

Answer 19

Neuroblastoma

Question 20

Cerebellar brain tumors of peds

Answer 20

Medulloblastoma, pilocytic astrocytoma (ataxia/dysmetria)

Question 21

Empiric tx of neonatal sepsis

Answer 21

Ampicillin and gentamicin

Question 22

Tx of diaphragmatic hernia

Answer 22

Endotracheal intubation, gastric decompression, surgical correction

Question 23

Drug-induced immune hemolytic anemia is caused by what drugs?

Answer 23

Penicillin, cephalosporins (ceftriaxone)