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Practice MCQ Flashcards

1
Q

33 week premature infant is born to a mother with hypertension. Baby is SGA. What other associated findings do you expect?

A

polycythmia

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2
Q

Baby 6 days old presents in shock. Glucose 1.6 and cardiomegaly on CXR. What is the most likely etiology of the shock?

A

congenital heart diseas

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3
Q

Baby with bili of 280 and conjugated 200? What is the most likely cause based on incidence?

A

Neonatal hepatitis 25%

or Extrahepatic Biliary atresia 25%

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4
Q

A newborn term infant had thin meconium at delivery but had good APGAR scores and required only 2 minutes of free flow O2. Now at 12 hours of age he has increasing work of breathing. On CXR there is hyperinflation of the RUL with mediastinal shift. What is the most likely diagnosis:

A

MAS
- hyperinflation
can have pneumothorax and pneumomediastium

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5
Q

Full term baby delivered after traumatic forceps delivery. Now 1 month old with vomiting, lethargy and red plaque on back of hand. What lab test would you check.

A

Calcium!
(hypercalcemia)

Subcutaneous fat necrosis.

Expectant management

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6
Q

Newborn was recently extubated after a course of systemic corticosteroids. What is the likely side effect?

A

hypertropic cardiomyopathy

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7
Q

Fullterm baby delivered to an O+ mom. Looks well but pale. Hb is 70, he is hemodynamically stable. What is the most likely diagnosis?

A

chronic fetal maternal hemorrhage

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8
Q

Breastfed babe born to vegan mom. What supplement should baby have to take?

What should mom have taken in pregnancy?

A

Zinc - fortified starting at 7mo
Vitamin D 400 IU or 800 winter if > 55d latitude

Mom: B12, vitamin D, folic acid, Linolenic acid, calcium

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9
Q

Who should not get soy formula owing to concerns with phytoestrogens

A

congenital hypothyroidism

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10
Q

Neonate with dehydration and mom was IDDM. Baby develops hematuria. What’s the dx:

A

Renal vein thrombosis

associated with IDDM, cyanotic CHD, umbilical lines

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11
Q

Prune belly syndrome

A

congenital disorder with clinical triad: abdominal muscle deficiency, severe Urinary tract abnormalities, bilateral cryptorchidism in males.

bilateral hydroureteronephrosis
VUR
obstruction
malrotation of gut
anorectal maflromations
lung hypoplasia with oligohydramios
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12
Q

3 day old baby sent to NICU. Jittery, tachypneic with nasal flaring, poor feeding, myoclonic jerks. Given the MOST likely diagnosis what is your treatment?

A

Pyridoxine-dependent epilepsy

seizures involve muscle rigidity, convulsions, and loss of consciousness (tonic-clonic seizures). Additional features of pyridoxine-dependent epilepsy include low body temperature (hypothermia), poor muscle tone (dystonia) soon after birth, and irritability before a seizure episode

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13
Q

Term newborn RR 80, sats 89% RA. Remainder vitals stable BP 65/40. CXR shows fluid in the fissure and small R pleural effusion. No cardiomegaly. Next step in management?

A

TTN

CPAP

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14
Q

36 wk baby 2.1 kg (5lbs) at birth, day 7 jittery, irritable, on exam HR 218, T 37.5, RR 70 bp 90/60. Face is flushed, eyes wide open, alert but irritable, normal tone and normal cry, jaundiced, DTR’s 2/4 and symmetric. There is hepatosplenomegaly. What is the likely
diagnosis (1), List 2 tests to confirm your diagnosis

A

Neonatal Grave’s disease
- maternal Thyroid receptor stimulating ab transmitted. meds excreted

  • TSH, T4, TS antibody
Frontal bossing and triangular facies, 
Warm
lid retraction (eyes open)
●Irritability, hyperactivity, 
●Tachycardia with a bounding pulse +/- cardiomegaly, arrhythmia
hepatosplenomegaly
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15
Q

Baby born at home at 38 wks by midwife. Now presents at 7 days with melena. Hb 70, MCV 112, plts normal. What is the most likely diagnosis?

A

hemorrhagic disease of the newborn

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16
Q

2 day old newborn male with jitteriness. At birth he was found to have a cleft palate, but has been bottle feeding well since. harsh systolic murmur.

a. What is the most likely diagnosis?
b. What is the reason for the baby’s jitteriness?

A

22q11 deletion
hypocalcemia

immunodeficiency
cleft palate
hypocalcemia
cardiac - VSD, right sided arch, TOF
retrognathia, long face with prominent nose
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17
Q

Resp distress syndrome

CXR findings

A

ground glass lungs (bilateral symmetrical)
bell shaped thorax
air bronchograms
hyperinflation

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18
Q

Baby born at 41 wks. Meconium staining. Flat babe requiring resucc. Apgars 2 at 1 min 3 at 5 min and 6 at 7 min. what 5 things may you expect with this baby in the near future. What 2 tests at discharge, if normal would suggests a good neurological outcome for this child

A 
thrombocytopenia
seizures
bradycardia, hypotension
hypocalcemia
resp distress

MRI, EEG

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19
Q

PDA - indomethacin side effects (4)

A 
oliguria, dec GFR
increased serum creatinine
hypoNa, hyperK, hypoglycemia
platelet dysfunction
NEC
GI bleeds/perforation
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20
Q

how to confirm HIV neg in vertical transmission in baby?

A

HIV DNA or RNA PCR is recommended for diagnosis <18 months of age.

reason-ably excluded with 2x negative PCR tests

  • one beyond 1mo old
  • 2nd beyond 2mo old
  • if on AZT, one beyond 4 mo old

CONFIRM with serological assay between 18 and 24 months of age.

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21
Q

5h old kid. Normal wbc/hgb. Plt count 9. Name 3 causes other than sepsis.

A

NAIT (alloimmune)
Autoimmune thrombocytopenia
TAR
congenital platelet disorders

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22
Q

1 week kid with sats 80% not improving with 100% O2. Single S2, III/VI SEM at
LSB. Normal CXR and RVH/RAD on EKG. What is most likely cause.

A

pulmonary stenosis

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23
Q

4 non infectious cause of hearing loss

A

Syndromic

  • AD: Waarenburg, Sticklers, NF2, Treacher Collins
  • AR: Jervell Lange Neislon
  • X linked - Alport

Congenital (mainly AR)

acquired - meningitis, ECMO, ventilation

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24
Q

neonatal toxoplasmosis
CSF findings
how to confirm

A

lymphocytic pleocytosis
elevated protein

PCR on CSF, blood, urine, tissue

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25
Q

Shwachman Diamond syndrome

A 
AR inheritance
exocrine pancreatitic insufficiency
skeletal - metaphyseal dysplasia
short stature
hepatomegaly +/- LE
anemia, neutropenia, or thormbocytopenia
bacterial and funcal infections

Rx: fat malabsoption - similar to CF
G-CSF
allogenic HSCT

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26
Q

Which of the following findings would help to rule out Klinefelter syndrome:

A

testicle size 15ml (should be hypogondadism)

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27
Q

What is the most likely presentation of an inborn error of metabolism?

A

encepalopathy preceeding focal neuro deficit

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28
Q

5 mo with white forelock, 1 iris blue 1 brown. What next investigation would you do?

A 
Waardenburg
hearing!!
AD, PAX-3 mutation
1/15,000 – 1/25,000
Heterochromia
White forelock
SNHL 15 - 25%
Dystropia canthorum
Wide nasal bridge, short palpebral fissures
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29
Q

A 3 month old is suspected of having an inborn error of metabolism, and has neurological and cardiac involvement. Which of the following can be given before a definitive diagnosis is made to prevent further sequelae:

A

b. Carnitine

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30
Q

Russell Silver syndrome (4)

A 
IUGR/SGA
GH def
Short stature
Hypoglycemia
triangular face, normal HC
cafe au lait
normal IQ but difficulties
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31
Q

Smith lemi Opitz

A

AR defect with multiple congenital anomalies. Defect in final enzyme in sterol pathway that convers 7 DHC to cholesterol

Low serum plasma chol levels
microcpehay, second and third toe syndactylyl
IQ low
Cleft palate

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32
Q

Pierre Robin (3)

A

micrognathia, glossoptosis, and cleft palate
pul stenosis
eye, MSK anomalies

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33
Q

a 5 month old baby presents with a history of poor intake and occasional vomiting over the past 24 hours. You find that his glucose is 2.8. The remainder of his bloodwork is unremarkable. He has no ketones present on urinalysis.

List 2 ddx

A

FAOD

hyperinsulinemia`

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34
Q

WAGR

A

Wilms
ANiridia (absent iris)
GU anomalies
Retardation (ID)

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35
Q

Uniparental disomy

A 
refers to the situation in which 2 copies of a chromosome come from the same parent, instead of 1 copy coming from the mother, and 1 copy coming from the father. 
Angelman syndrome (AS)  
-maternal deletion = Paternal UPD
Prader-Willi syndrome (PWS) 
- paternal deletion = Maternal UPD 15q11
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36
Q

Duchenne 4 complications

A

cardiomyopathy - dilated cardiomyopathy, conduction
ortho - # of legs and arms, progressive scholiosis, osteoporosis
resp: nocturnal hypoventilation
nutrition – overweight or underweight

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37
Q

Marfan skeletal deformities (3)

A 
Pectus carinatum
Pectus excavatum
Wrist &amp; thumb sign
Decreased U:L ratio
Decreased elbow extension
pes planus
hindfoot deformity (valgus)
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38
Q

FASD facial feature (5)

A 
short palpebral fissure
increased intercanthal distance
flattened face with short nose
thin upper lip
absent/hypoplastic filtrum
bow shaped mouth
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39
Q

Turner syndrome

5 future complications

A 
short stature
primary amenorrhea
cardiac - coarctation, HTN
lymphedema
GU - renal anomalies
risk autoimmune - TSH q 1 -2 y
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40
Q

5 genetic syndromes predispose luekemia

A 
Fanoni
Shwachman Diamond
SCID
T21
NF1
ataxia telangiectasia
Li Fraumeni
Diamond Blackfan
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41
Q

angelman

A

15q11 - maternal deletion

Ataxia
Speech
severe IQ
seizures
microcephaly
hypotonia, GDD
paroxysms of laughter
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42
Q

Bardet Biedel

A 
AR
obesity
intellectual disability
pigmentary retinopathy
hypogonadotropic hypogonadism
cardiac - AS, VSD, etc
renal anomalies, DI
post axial polydactyly
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43
Q

Ehler Danlos

A

skin elasticity
easy bruising
hyperflexiability
sometimes tricuspid or mitral regurg. sometimes aortic root dilation

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44
Q

Osteogenesis imperfecta
5 findings
3 xray findings

A 
blue sclera
frontal bossing
macrocephaly
dentinogenesis imperfecta
short stature
sclerosis
hearing loss
easy #
Xray;
osteopenia, thin cortices
wormian bones (skull)
saber shin (fibula anterior bow)
coxa vera - femur head smaller angle
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45
Q

Sotos (3)

A 
AD
macrocephaly
LGA
GDD
seizures
developmental delay and behavioural
46
Q

antenatal screen
chorionic villus
amniocentesis

A

9 - 12 weeks CV sampling
1% loss
chromosomes

> 16 weeks Amniocentesis
chromosomes, infection, lung, renal
0.5% loss

47
Q

antenatal screen

serum screens

A

Trisomies: high HCG, low PAPPA, low AFP

NTD high AFP

48
Q

38GA C/S eletive

grunt 10mins of age RR70 min indrawaing. O298% r/a. what do next?

A

observe, no further investigations

TTN - okay to observe as transitioning

49
Q

definition of bronchopulmonary dysplasia?

A

O2 dependence beyond 28 days or 36 weeks post GA

50
Q

how many Kg?
LBW
VLBW
ELBW

A

< 2500
VLBW < 1500

ELBW < 1000g

51
Q

definition of apnea

A

cessation of breathing for 20sec or 10sec with brady (<80)

52
Q

baby 36+6 with bili 350 from community 96hr. Mom O+ve what do you do next?

A

cbc and coombs (if hemolysis and postive, will need exchange)

(> start phototherapy and recheck in 4 -6 hr too long)

53
Q

Twin-twin transfusion. unsuccessful Laser ablation. Twin A Hct 0.75 Twin B 0.35. what is twin B at risk for?

A

Hct high is recipient
so twin B is donor
- low crt, anemia,
HIGH output failure

54
Q

Which of the following pulse profiles matches the diagnosis given:

A

pulsus bigeminus-digoxin toxicity

55
Q

Newborn baby with cyanotic congenital heart disease. Most consistent physical exam finding:

A

normal pulses and quiet precordium

56
Q

Neonatal goiter. What anti-arrhythmic was mom on?

A

amiodarone

can also be on Propythiouracil, methmazole

57
Q

ECG changes with digoxin

A

shortening QTc earliesr
sagging ST
diminished amplitude T wave
slowing HR

then toxicity
PR prolonged
profound sinus brady
SVT
VT/VF
58
Q

Meds - Long QT

A 
amiodarone
procainamide
antibiotics: septra, erythro, clarithro/azithro
TCA, haldol, risperidone
metronidazole
azole: fluconazole, itraconazole
59
Q

electrolytes - prolong QT

A

hypoKalemia
HypoCalcemia
hypo Mg

60
Q

Congenital Prolong QT name and features

A

Jervell-Lange Nielson- AR, deafness, syncope, FmHx

Romano-Ward - AD, syncope, Fmhx

Timothy- webbed fingers& toes

61
Q

term IDM newborn is seen at 48 hours of age with a grade 3/6 SEM at the LSB. On echo there is hypertrophy of the septal muscle but no decrease in function. What is the clinical course:

A

no treatment

62
Q

Which of the following is associated with an increased risk of necrotizing fasciitis?

A

varicella

63
Q

3 yo with a 3/6 SM at the LUSB with an ejection click and a quiet S2:

A

pulmonary stenosis

64
Q

what is ALCAPA?

A

anomalous left coronary arising from polmonary artery

  • usually isolated anomaly
  • myocardial ishcemia tht is progressive, lead to ischemic cardiomyopathy
  • without significant collaterals, function deteriorates in infancy. if okay, later into childhood presentation
  • MR, gallop,
  • ECG gallop, ST segmenet changes, Q waves
65
Q

most likely defect in 22q11

A

TOF

66
Q

etiologies HOCM

A 
familial (AD)
metabolic
GSD - Pomple
MPS - Hunter/Hurler
mitochondrial
Noonan's
Fredrich's ataxia
IDM
67
Q

etiologies of DCM

A 
idiopathic
familial
infectious - myocarditis, RF
(adeno, HIV, coxsacke)
Rheum - SLE, vascular
Duchenne
drug - anthracyclines
coronary - KD, ALPACA
arrhythmias - SVT
68
Q

genetic associations with PS

A

Noonan
Alagille
Congenital Rubella
WIlliams

69
Q

TGA

A 
may have absent murmurs
ECG - mild RVH or normal
Egg shaped heart (narrow mediastinum)
Normal to increased pul vascular flow
Rx prostaglandin
\+/- atrial septostomy
Arterial switch
70
Q

S/E prostaglandin (4)

A 
apnea
hypotension
bradycardia
hypoglycemia
hypocalcemia
jitteriness
fever
71
Q

syncope etiologies

A 
Cardio electrical
- long QT, AV block
- WPW
- short QT <0.3
brugda
catacholamine polymorphic VT
structural
-HCOM, DCM
vavular
PHTN
Marfam - aortic root
acute myocarditis
vasovagal
breatholding
neuropsych
hypoglycemia
seizure
cataplexy
TIA
conversion
72
Q

Name 3 EKG finding of Hyperkalemia.

3 treatment

A

peaked T waves
(shorten QT)
prolonged PR
Widen QRS

rx:
remove K+
bicarb
insulin (with glucose)
kayxylate
ventolin
dialysis
73
Q

T21 repaired CHF

going for elective surgery later. considerations for anesthesia?

A

airway/atlanto spine stability
arrhythmias (heart block)
mitral regurg/insufficiciency

74
Q

CPR - 5 good qualitys

A 
(Decrease chance 10% q1min)
Firm surface
Rate 100 – 120
Depth 4cm infants, 5cm others
Minimize pauses/interruptions
Allow full chest recoil
Lone rescuer 30:2
2 person rescuer 15: 2 (NRP 3:1)

IF AIRWAY secure – 100:8 unsynchronized
Airway
RR 8 – 10
Post ROSC – O2 for sats 94 – 99%

75
Q

WPW ECG findings

A

shorten PR
long QTc
delta waves

76
Q

sudden death risk on history (3)

A
  • Previous sx of exertional chest discomfort, dizziness or prolonged dyspnea with exercise, syncope or palpitations.
  • Fam Hx of prolonged QT, Marfans, sudden death, arrhythmias, cardiomyopathy.
  • Previous recognition of heart murmur or elevated BP.
77
Q

2 heart lesions with single S2

A

Pul atresia
aortic atresia
TGA (P2 not heard)

78
Q

Torsades de pointes

A

Form of polymorphic (VT) that occurs in the setting of acquired or congenital QT interval prolongation

rx Magnesium, lidocaine
if unstable, shock
NO amiodarone ( can lengthen QT)
79
Q

chest pain post surgery

A

Pnuemothorax
MI/angina
pleural effusion

post-pericardiotomy syndrome

  • few weeks to few months
  • fever, CP, irritable, malaise
  • CBC, CRP, ST segment changes, Twaves

NSAIDS/ASA 4 - 6 wks
steroids

80
Q

4mo progressive CHF. aside from septal defects, what other primary cardiac defects?

A

large PDA
ALPACA
(SVT)

81
Q

14 year old boy was found unresponsive in a park the morning after the overnight temperature dropped to -3°C. He has been receiving resuscitation in the ER for 30 minutes. Which of the following would be an indication to stop the resuscitation?

A

PEA

continue until core temp > 34
refractory VF of VT aseen prior to warming
reversible - toxicology potential to prolong

82
Q 
heart lesions with:
22q11
T21
Marfan
WIlliams
Noonan
Turner
Alagille
Ehler-Danlos
Holt-Oram
A 
22q11 - TOF, IAA, TA
T21 - AVSD**> VSD
Marfan Dilated AO> MVP
William Supraval AS/PS 
Noonan - PS, HOCM
Turner - Coarc, AS
Alagille - PS
Ehler - dilAo, MVP
Hlt-Oram - ASD
83
Q

Maternal conditions and heart lesions

A

IDM - HOCM, PDA, VSD
Rubella - PDA, PS
SLE - heart block, cardiomyopathy/myocarditis
FASD - VSD, PDA, ASD

84
Q

VSD - pathophy

Which ventricle?

A

dilated PA, LA, LV

  • LV is the one that recieveds volme
    L–> R during systole so blood goes directly to PA and pul veins to L heart
85
Q

large ASD

A

wide, fixed split s2
grade 2/3 SEM LUSB

dilated RA, RV, PA
later TR, PR mitral valve prolspe
untreated leads to  atrial arrhy
pul HTN
Eisenmenger
86
Q

AVSD sequale

A 
VSD - holosystolic, harsh
diastolic rumble at apex
LVH
cardiomegaly
inc pul marking

LV/RV dilation (everything)
Pul HTN
risk of permanent if not repaired < 6mo
endocarditis

87
Q 
Pulsus paradoxus 
def and ddx (4)
A

on inspiration, SBP drops > 10mmHg

ddx
pericarditis
tamponade
asthma
PE
emphysema
hypovolemia
88
Q

Neurocutaneous syndromes

inheritance

A

Tuberous Sclerosis - AD
NF1, NF 2 - AD
Von Hipple Lindau - AD
Herditary Hemorrhagic Telactectasia - AD

Sturge weber - sporadic
PHACES - sporadic
Ataxia Telangectasia - AR
Inconinentia pigmenti - X linked

89
Q

Child at hospital with tonic movements. Consciousness is preserved. He also has ataxia, vomiting, and inability to close mouth. He has been vomiting for several days and mom has been giving him a suppository but can’t remember its name. What do you do?

A

Rx: diphenylhydramine (benadryl)
Dystonic reactions are reversible extrapyramidal effects that can occur after administration of a neuroleptic drug.

intermittent spasmodic or sustained involuntary contractions of muscles in the face, neck, trunk, pelvis, extremities, and even the larynx.

Although dystonic reactions are rarely life threatening, the adverse effects often cause distress for patients and families

90
Q

What is the most common reason for surgical intervention in a child who is born with a myelomeningocele:

A

hydroecephalus

very common in spina bifida and is related to hindbrain herniation. (more so with mylomeningocele than spinal may develop most rapidly in the 1st postnatal mo; ventricular dilation may precede a change in head circumference or signs of increased intracranial pressure.

91
Q

Which of the following newborns requires surfactant administration according to recent guidelines:

A

29 week infant with no symptoms being transferred between centres

  • NOT infant with RDS intubated >72hrs
    (only recommeded up to 3 doses in72hrs)
92
Q

Young boy with history of four weeks of decreased energy. He has recently started to complain about leg pain. On exam, you find bilateral tenderness over his proximal tibia. There is no erythema and no warmth? What are two diseases that could cause this (2) ?

A

Leukemia, neuroblastoma (if < 5 year old)

ERA (juvenile enthesitis-related arthritis)

93
Q

OI physical findings (4)

A

Blue sclera
Saturn’s rings – perilimbal region is often whiter than remaining sclera -
Dental – dentiogenesis imperfect (hereditary hypoplasia of dentin)
Short stature, bowed legs
Early deafness

94
Q

Boy had recent illness - fx, dx, conjunctivitis, urethritis now with sacroilitis. You diagnose him with Reiter syndrome. List 4 organisms that could cause Reiter syndrome.

A 
Reactive arthritis
Campylobacter, 
shigella, 
yersinia, 
salmonella, 
chlamydia , 
strep
95
Q

Wiskott Aldrich

A 
x linked
thrombocytopenia, eczema, immunodef
- dec IgG, inc IgA
-encapsulated bacterial infections
- thrombocytopenia, bleeding early in life
- risk of malignancy(lymphoma)

Rx: IVIG, BMT

96
Q

In which condition is the IgE level normal:

A

ITP

a) Wiskott-Aldrich syndrome – eosinophilia Nelsons’s
b) immune thrombocytopenic purpura
c) selective IgA deficiency - increased IgE (Nelson’s)
d) Kawasaki disease – increased IgE (Nelsons)
e) ascariasis - parasitic roundworm Ascaris lumbricoides. – increased IgE (Nelsons)

97
Q

Immunotherapy

indications (to what)

A

venom
allergy rhinitis
allergic asthma
atopic dermatitis

risk of immunotherapy

98
Q

IVIG used in all except

ITP
BMT
nephrotic
KD
GBS
A

nephrotic syndrome

99
Q

18 mo M with knee arthritis, aspirate grew N. meningitidis. This is the same organism that grew in his CSF when he had meningitis at 10 months. Which of the following tests is most likely to be abnormal in this child?

A

total hemolytic complement

Complement deficiency
- high risk of meningococcal invasive disease

rx: vaccinations pneumococcal and meninig and prop antibioiotics

100
Q

Neutropenic child with central line site red.

what antibiotics?

A

IV piptazo/vanco
or IV ceftazidime/vanco (3rd gen with pseudo)
cover CONS and pseudomonas

101
Q

Post-transplant complications (non-infectious)

A 
acute GvHD (rejection)
chronic GvHD
HTN
nephrotoxicity
avascular nercrosis of osteoporosis
mental health
nutrition/growth retardation
vaccinations
high risk behaviorus - foods/unpasterurized etc
102
Q

anaphylaxis

  1. immediate treatment
  2. 4 non-acute prevention
A

IM epi 0.01mg/kg 1:1000 to vastus lateralis

autoinject epinephrine
10kg-25kg 0.15mg IM dose
teach parents
have all times
medical alert bracelet
allergist referral
103
Q

What is the most frequent cause of school absence in teenage girls:

A

dysmenorrhea

104
Q

A child presents with watery diarrhea. Stool reducing substances will NOT be positive with which of the following:

A

sucrose

negative reducing substances is unable to r/o a disaccharidase deficiency

105
Q

A previously well 13-month-old presents with generalized puffiness and lethargy.
Urine is negative for protein & blood. Albumin is 13. Initial treatment would include:

A

protein hydrosylate formula

?protein losing enterophathy

106
Q

5 yo with bloody stools. Hyperpigmented lesions on lip and mucosa. Diagnosed with intusseption. What is underlying cause?

A

Peutz-Jehgers

107
Q

3 mo baby with constipation and failure to thrive. What test to do?

a) TSH
b) Anal manometry
c) Sweat chloride

A

sweat chloride

108
Q

Baby with delayed meconium passage, abdo distension and calcifications on AXR

a) Hirschprungs
b) CF
c) duodenal atresia

A

CF

109
Q

An infant is brought for assessment of eczema, failure to thrive, diarrhea, and a rash around
his mouth and anus. What is the likely deficiency:

A

zinc

110
Q

Some vitamins are stored in large amounts and there may be no biochemical or clinical evidence
of deficiency for many months. Which of the following vitamins behaves as such:

A

vitamin B12

111
Q

Neurologically impaired 5 y/o with contractures, non-ambulatory

List 5 objectively assess nutritional status

malnutrition - 5 management options

A

mid-upper arm circumference
-triceps fat-skin fold thickness
subscapular skin fat fold thickness
- weight for length

Rx

  • entera: NG/ Gtube
  • hypercaloric feeds
  • supplemental
  • limit demands: r/o concurrent disease, avoid aspiration, chronic disease mg
112
Q

8 year old F sticking hand down male classmate. what other sexual behaviors to enquire (5)

A
  • sexual behaviors different than those of same age
  • elicit complain from other children
  • oral/genital contact with animals
  • sexualize non sexual things
  • fear, deep guilt associated with sexual behaviors
  • children engaged in sexual behaviors without ongoing mutual play relationship

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