Peds

Question 1

bilious emesis in neonate

Answer 1

r/o intestinal obstruction

Question 2

neonates should pass meconium within

Answer 2

24-48 hours

Question 3

microcolon and failure to pass meconium

Answer 3

meconium ileus - pathognomonic for CF (autosomal recessive)

Question 4

neonatal bilious emesis workup

Answer 4

x-ray (r/o surgical emergency) then contrast studies (barium enema) to determine level of obstruction

Question 5

precocious puberty workup

Answer 5

first look at bone age; if advanced bone age, check LH levels to differentiate between peripheral (low LH - d/t inhibition of the hypothalamus by high circulating sex hormones) and central (high) precocious puberty

Question 6

Klinefelter syndrome

Answer 6

47,XXY - causes primary hypogonadism, which is characterized by low testosterone and elevated LH levels; patients have tall stature and puberty is delayed

Question 7

McCune Albright syndrome

Answer 7

• gonodotropin-independent precocious puberty
• irregular cafe-au-lait macules
• fibrous dysplasia of bone

Question 8

Nonclassic congenital adrenal hyperplasia

Answer 8

• 21-hydroxylase deficiency
• 17-hydroxyprogesterone shunted towards adrenal androgen overproduction
• -> precocious puberty - accelerated growth and bone age with low/normal LH levels
• mineralocorticoid and glucocorticoid levels are maintained

Question 9

failure to thrive, LAD, and opportunistic infections (PCP, Candida) in infant

Answer 9

HIV infection

Question 10

aseptic meningitis, parotitis, orchitis

Answer 10

mumps