pwdi 12

Question 1

Sturge-Weber-Syndrome pathophysiology?

Answer 1

GNAQ gene mutation

Question 2

CM?

Answer 2

Port-wine stain TN(V1 & V2) distribution
Leptomeningeal capillary-venous malformation
Seizures +/- Hemiparesis
Intellectual Disability
Visual field defect
Glaucoma

Question 3

Diagnosis?

Answer 3

MRI of the brain with contrast

Question 4

management?

Answer 4

Leser therapy
Antiepileptic drug
Intraocular pressure reduction

Question 5

Indication for immediate removal in case of esophageal foreign bodies?

Answer 5

Being high risk(2 magnets, battery, and sharp object)
Esophageal obstruction symptom
Respiratory conpromise

Question 6

If a sharp object is observed in the distal to the first part of the duodenum?

Answer 6

Asymptomatic: repeat Cxr after 24-48 hr

If symptomatic: immediate removal

Question 7

CM?

Answer 7

HTN in upper extremity
Low perfusion to the lower extremity (Dec. post ductal o2 sat., dec. femoral pulse and lower extremity claudication)
Heart failure
Palpable intercostal vessel
Systolic ejection murmur at left intercostal area

Question 8

Low perfusion to the lower extremity?

Answer 8

1-Dec. post ductal o2 sat.,
2-Dec. femoral pulse
3-Lower extremity claudication

Question 9

Heart failure symptoms?

Answer 9

Start to develop when DA began to close on day 3
Irritability
Poor feeding
Diaphoresis
Cardiogenic shock
Tachypnea

Question 10

Treatment?

Answer 10

Surgical repair

Question 11

When do we need cast after closed reduction in radial head subluxation?

Answer 11

If a patient is not able to have full for arme activity

NB: Hyperpronation with head compression is more successful than Flexion and supination.

Question 12

When do we need an X-Ray?

Answer 12

Focal arm pain in age >5
High force injury, focal swelling, and deformity in age <5
But in 3-5 age X-ray difficult b/c poor ossification

Question 13

cause of Premature adrenarche?

Answer 13

early activation of adrenal androgens

Question 14

CM?

Answer 14

precocious puberty

normal bone growth

Question 15

Complication?

Answer 15

T2DM
Metabolic syndrome
PCOS

Question 16

most specific finding in AOM?

Answer 16

Bulging TM
Decrease TM movement
Middle ear effusion
Air fluid level

Question 17

Pathophysiology of sunburn?

Answer 17

DNA damage

Question 18

A complication of orbital cellulitis?

Answer 18

Visual loss(optic nerve)
CNS extention(infection and CST)

Question 19

Willms tumour(Nephroblastoma) CM?

Answer 19

The MC childhood malignancy
Peak age 2-5
Usually asymptomatic
Unilateral mass
\+/- Abd.Pain, haematuria, and HYTN
Mass arise from metanephros

Question 20

Associated genetic disease?

Answer 20

WAGR
Beckwith-Widman-Syndrome
Danys-Drash-Syndrome

Question 21

What about neuroblastoma?

Answer 21

MC age <5
HTN less common
Arise from the neural crest (maybe adrenal)

Question 22

Pheochromocytoma?

Answer 22

Arise from adrenal

Question 23

PKD?

Answer 23

Bilateral

Cyst on US

Question 24

Serum sickness-like reaction etiology?

Answer 24

Immune complex
Antibiotics(Beta-lactam and CTM)
Acute hepatitis B

Question 25

CM?

Answer 25

``` 1-2 weeks after exposure Fever Rash Polyarteralgia LDP ```

Question 26

Treatment?

Answer 26

Remove offending agent Supportive care Plasmapheresis/Corticosteroid

Question 27

How to d/t from a rash of IM after Amoxaclin TX?

Answer 27

IN IM with Amoxapine Rash not involve extremity No artheralgia

Question 28

LCPD and TS d/c?

Answer 28

TS: Symptome resolve within 4 weeks, able to bear weight LCPD: More chronic and not bear weight LCPD may have normal X-rays in early lesions like TS

Question 29

Childhood depression-associated symptom?

Answer 29

Headache | Abdominal pain

Question 30

CM of acute iron poisoning?

Answer 30

``` Abdominal pain Haematemesis Diarrhea Shock Hepatic necrosis ```

Question 31

Diagnostic finding?

Answer 31

Anionic GAP metabolic acidosis Elevated serum Iron Radiopeque pills on Bdominal X-ray

Question 32

Treatment?

Answer 32

Deferoxamine | Whole bowel irrigation

Question 33

Shock and Iron poisoning?

Answer 33

Myocardial injury: Cardiogenic shock Hepatic necrosis Distributive shock due to systemic vasodilation

Question 34

Abnormal aortic arch ring?

Answer 34

The abnormal second aortic arch formation that encircles the esophagus and trachea

Question 35

CM?

Answer 35

Food impaction Recurrent aspiration pneumonia Biphasic stridor due to tracheal obstruction Indentation around esophagus at T4

Question 36

How d/t Asprin toxicity from IRON?

Answer 36

In Asprin toxicity Tablet will not be visible There will be tinitus

Question 37

Spinal muscular atrophy(WHD) and botulism?

Answer 37

In WHD Paralysis more on; lower extremity Not affect pupil

Question 38

IVH hemorrhage cause?

Answer 38

lesion on germinal matrix

Question 39

CM?

Answer 39

``` Prematurity and LBW Seizure Apnea Bulging fontanel Acute Anemia Increase HC Bradycardia Lethargy and hypotonia ```

Question 40

Diagnosis?

Answer 40

Cranial ultrasound

Question 41

IVH hemorrhage cause?

Answer 41

lesion on germinal matrix

Question 42

CM?

Answer 42

``` Prematurity and LBW Seizure Apnea Bulging fontanel Acute Anemia Increase HC Bradycardia Lethargy and hypotonia ```

Question 43

Diagnosis?

Answer 43

Cranial ultrasound