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Pediatrics > QBank/Pretest > Flashcards

QBank/Pretest Flashcards

1
Q

A 3-4 month old presents with hypoglycemia, lactic acidosis, hyperuricemia, hyperlipidemia, and a doll-like face with thin extremities and protuberant abdomen- diagnosis?

A

Glucose-6-phosphatase deficiency or Von Gierke’s

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2
Q

A 9 year old with leukemia is under joint custody of divorced parents. The mom consents to chemotherapy while the dad refuses- what is the next step?

A

Perform chemo- only need one parent

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3
Q

A 6 year old who ingested a bunch of pills has several small opacities in the stomach on X-ray. Diagnosis and treatment?

A

Iron tablet ingestion- they show up on X-ray

Treat with iron chelation such as deferoxamine

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4
Q

A child with down syndrome presents with upper motor neuron injuries such as hyperreflexia, positive Babinski sign- what happened?

A

Atlantoaxial instability- due to laxity with posterior transverse ligament leading to increased mobility between C1 and C2
Diagnose with X-rays of cervical spine

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5
Q

A child is diagnosed with Pertussis- what should be done about brothers and sisters?

A

If fully immunized, erythromycin for 14 days

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6
Q

A teenage basketball player complains of knee pain and had tenderness with a swollen tibial tuberosity but negative X-rays- diagnosis?

A

Osgood-Schlatter disease- microfractures in area of patellar tendon

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7
Q

What is the treatment for eczema?

A

Moisturizers and topical steroids

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8
Q

Name the rash: 1 week old with splotchy areas of erythema with central pustules- pustules have eosinophils in them?

A

Erythema toxicum

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9
Q

Name the rash: Adolescent boy has splotchy red rash on his neck that gets more prominent with exercise or stress. Had similar rash on eyelids in neonatal period?

A

Salmon patch- rashes on face regress, sometimes rashes on nuchal area can persist

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10
Q

Name the rash: AA newborn with pustules with hyperpigmentation underneath?

A

Pustular melanosis

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11
Q

Name the rash: newborn with scalp without hair and scaly/yellowish?

A

Sebaceous nevi

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12
Q

Name the rash: infant with small white nonerythematous dots on his nose?

A

Milia- will resolve spontaneously

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13
Q

Name the rash: Newborn with dandruff, flakes of skin on scalp, and flaky eyebrows

A

Seborrheic dermatitis

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14
Q

What age is accidental poisoning most likely?

A

2 years

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15
Q

What age is drowning in a swimming pool most likely?

A

2 years

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16
Q

What age is asphyxiation and choking most likely?

A

1 year

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17
Q

What age are baby-walker injuries most likely?

A

6 months

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18
Q

What age are pedestrian injuries most likely?

A

6 years

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19
Q

A 2 year old has a speech delay, hearing loss, broad nasal bridge, white forelock- diagnosis?

A

Waardenburg syndrome

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20
Q

A 4 year old with normal intelligence, conductive hearing loss, micrognathia, and abnormally shaped ears- diagnosis?

A

Treacher collins syndrome

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21
Q

A pregnant woman with lupus has an increased risk of having a child with what?

A

Heart block

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22
Q

A pregnant woman with insulin dependent diabetes is at risk of having a child with what?

A

Sacral agenesis
Cardiac defects
Renal defects

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23
Q

A baby has cyanosis when feeding and sleeping but returns to normal color when crying- diagnosis?

A

Choanal atresia- diagnose via passing catheter into nose

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24
Q

What kind of sequelae can result in an intubated neonate with respiratory distress on a physiologic level?

A

Sustained rise in pulmonary arterial pressure while systemic pressure drops resulting in persistent L-R shunt

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25
Q

What is an apt test?

A

Tests whether blood is maternal or infant in origin- can be used when meconium is bloody to determine if further work up is necessary

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26
Q

What medications are contraindicated in breastfeeding?

A

Lithium, cyclosporin, ergotamines (for migraines), cocaine, heroin, and bromocriptine (inhibits lactation)

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27
Q

A premature infant is being fed exclusively breast milk- what electrolye abnormalities are likely to occur?

A

Hypocalcemia and hypophosphotemia

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28
Q

What is the most common brain tumor in children?

A

Infratentorial benign astrocytoma

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29
Q

A baby presents cyanotic after feeding- what is the most likely diagnosis?

A

Tetralogy of Fallot

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30
Q

A 12 year old presents with flaccid paralysis of his legs, absent DTRs and no nuchal rigidity one week after febrile diarrhea- diagnosis?

A

Guillain-Barre syndrome- ascending polyneuropathy of peripheral nerves after viral illness

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31
Q

A baby with no dysmorphic features is irritable, tachypnic, sneezing, vomiting, diarrhea, having tremors and a high pitched cry within the first few days of life- intrauterine exposure to what?

A

Heroin- baby is suffering withdrawal

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32
Q

A 6 year old boy presents with hip and knee pain and now is noticeably limping. Normal vitals and a well appearing child- diagnosis?

A

Legg-Calve-Perthes disease- osteonecrosis of hip in boys ages 4-10

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33
Q

A 16 day old has a palpable clunk on hip exam- what is next step?

A

U/S of the hip to look for developmental dysplasia

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34
Q

A 6 year old presents with abdominal pain and a rash on his lower extremities. U/A shows hematuria- diagnosis and what happens to glomeruli?

A

HSP

glomerulus have mesangial IgA deposits

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35
Q

What is increased residual gastric volume highly suspicious of in a newborn?

A

NEC

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36
Q

An infant presents with noisy breathing especially when lying on his back. On laryngoscopy, the epiglottis rolls from side to side- diagnosis and instructions to parents?

A

Laryngomalacia

Parents should NEVEr feed child lying down and should hold child upright for 30 minute after feeding

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37
Q

A 12 year old with jaundice has a cystic extra hepatic mass on U/S and the gallbladder is separated from the mass- diagnosis?

A

Choledochal cyst

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38
Q

A patient has a tender anterior cervical lymph node and all IUTD. What antibiotic should be used and why?

A

Dicloxacillin to cover for MSSA and strep

NOT amoxicillin as MSSA can be resistant due to beta lactamases

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39
Q

An 8 year old patient with SCD presents with a high grade fever and no bone pain. This is her 5th hospitalization- what is the most likely bacteria?

A

S. pneumo- functional asplenia after all of these pain crises

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40
Q

An 8 year old female presents with cafe-au-lait spots and precocious puberty- most likely diagnosis? What other clinical finding is likely

A

McCune Albright syndrome

Polyostotic fibrous dysplasia- bone deformities

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41
Q

A baby has limited dorsi and plantarflexion of the ankle and a talus in equinus and varus positions, midfoot in varus, and forefoot in adduction- treatment?

A

This is clubfoot and must be treated immediately with stretching and casting

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42
Q

Why would an infant have elevated 17-hydroxyprogesterone and what would be seen clinically?

A

21 hydroxylase deficiency- congenital adrenal hyperplasia

Will see virilization and salt wasting

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43
Q

What is a delta wave, what causes it, and what is the presentation?

A

Delta wave is slurred QRS complex with shortened PR interval
Wolff-Parkinson-White syndrome or accessory AV pathway
Presents with palpitations and SVT on EKG

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44
Q

A 2 day old presents with cyanosis and EKG shows left axis deviation and CXR shows normal size heart- diagnosis?

A

Tricuspid atresia- can see LVH
TOF would have RVH and RA dilation on EKG
Truncus arteriosus would have cardiomegaly

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45
Q

A pediatric patient in the ED needs an IV but IV access cannot be placed- what is next step?

A

Intraosseous access attempt

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46
Q

When and why do breast milk vs breastfeeding jaundice occur?

A

Breast milk- increased unconjugation of bilirubin during 1-3 weeks of life
Breastfeeding- not enough breast milk from Mom, occurs in first 5 days

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47
Q

A 2 year old have painful bloody diarrhea- diagnosis?

A

Intussusception is most likely

Meckel’s is PAINLESS!

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48
Q

An infant has symmetric, pruritic erythematous lesions that spare the diaper area- diagnosis?

A

Atopic dermatitis

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49
Q

A newborn child has rhinorrhea, anemia, and jaundice. Also lesions on his feet- what congenital cause is likely?

A

Syphilis- look for metaphyseal dystrophy or periostitis on XRay

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50
Q

A patient present with subcutaneous emphysema secondary to severe coughing paroxysms- what must be ruled out?

A

Pneumothorax- get CXR

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51
Q

A teenage boy presents with hip pain. He is obese. Diagnosis and treatment?

A

Slipped Capital femoral epiphysis- treat with surgery for fear of avascular necrosis
Femoral head will be posteriorly and inferiorly displaced on Xray

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52
Q

What neurologic complication would a child born in eastern europe with cyanosis be at risk for?

A

Children with congenital heart defects are at risk for brain abscesses

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53
Q

Injury to C7-T1 causes what condition and what are the clinical findings?

A

Klumpke’s paralysis- look for Horner’s syndrome and hand paralysis

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54
Q

A child has trauma to his soft palate then presents 10 hours later with symptoms of a stroke- diagnosis?

A

Internal carotid artery dissection- can occur up to 24 hours after trauma

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55
Q

What heart abnormality is seen with Edwards syndrome?

A

VSD

Trisomy 18

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56
Q

A child with a hx of hearing impairment has a syncopal episode without disorientation. What is the treatment?

A

Propanolol

Most likely has a congenital QT prolongation syndrome

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57
Q

A patient has croup and is in respiratory distress- when should you intubate?

A

If racemic epinephrine fails to improve condition

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58
Q

What is the treatment for cat bites?

A

Amox/Clavulanate for five days

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59
Q

What is the most common cause of AOM?

A

S. pneumo

H flu is 2nd

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60
Q

Which comes first in work up for meningitis? LP or antibiotics?

A

Technically LP if it is easy

But do not wait too long for Abx

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61
Q

A child has spike and wave activity on EEG- what is the treatment?

A

Valproate or Ethosuximide

Spike and wave= absence seizures

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62
Q

A boy has mental retardation and self mutilation- diagnosis?

A

Lesch-Nyhan syndrome- deficient in HPRT- hypoxanthine guanine phosphoribosyl transferase

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63
Q

A newborn child has macrosomia, macroglossia, hepatosplenomegaly, omphalocele, hypoglycemia, and hyperinsulinemia- diagnosis?

A

Beckwith-Wiedemann syndrome

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64
Q

A cyanotic newborn has a loud 2nd heart sound but no murmur- diagnosis?

A

Transposition of great vessels

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65
Q

What makes the rash seen with EBV mono more likely?

A

Administration of amoxicillin!

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66
Q

Which organ is responsible for premature appearance of axillary hair? treatment?

A

Adrenal glands- reassure this has no clinical significance

HOWEVER, premature pubic hair is almost always a CNS disturbance

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67
Q

An infant has separation anxiety from her mother, waves bye bye, was babbling but stopped a mother ago, and is crawling. What is the next step?

A

Audiology evaluation- should not have stopped babbling

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68
Q

When should a VSD in a newborn be treated?

A

Signs of pulmonary disease

Very large defect

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69
Q

A newborn born @ 28 weeks has grunting and subcostal retractions at 30 minutes of life. He is cyanotic and has fine reticular granularity of the lower lobes of his lungs. O2 does not improve cyanosis- diagnosis?

A

Hyaline Membrane disease- treat with mechanical ventilation and surfactant

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70
Q

A child presents with isolated proteinuria on urine dipstick- what is the next step?

A

Repeat the dipstick on two subsequent occasions- transient proteinuria is the most common cause of isolated proteinuria

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71
Q

How to differentiate between gonococcal and chlamydial conjunctivitis in newborns?

A

G- within 5 days and copious discharge

C- after 5 days and milder symptoms

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72
Q

What is the diagnostic test for pyloric stenosis?

A

U/S for abdomen

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73
Q

How does riboflavin deficiency present?

A

Sore throat, hyperemic oropharyngeal mucosa, chelitis, glossitis, seborrheic dermatitis, photophobia
In US, these patients typically have malabsorption

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74
Q

How does myocarditis present in a child?

A

Flu-like illness followed by murmur or some acute cardio problem

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75
Q

A 7 year old girl has recurrent prolonged episodes of vomiting that resolve spontaneously with no further sequelae- diagnosis?

A

Cyclical vomiting

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76
Q

What is the treatment for foreign body aspiration?

A

Rigid bronchoscopy

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77
Q

What is traction apophysitis?

A

Osgood-Schlatter disease

78
Q

A 6 year old has a 10 day history of nasal discharge and swollen and red nasal turbinates- most likely bacteria and treatment?

A

S. pneumo

Amox/Clavalunate

79
Q

A newborn has congenital diaphragmatic hernia- what is the first step in treatment?

A

Orogastric tube to decompress the bowel

80
Q

What characterizes a complex partial seizure?

A

brief episode of impaired consciousness with automatisms (lip smacking, swallowing) and post-ictal confusion with normal EEG

81
Q

What is the treatment for infantile GERD?

A

thickened formula with rice cereal and upright positioning when feeding

82
Q

A male adolescent presents with epistaxis, localized mass, and a bony erosion on the back of the nose has what diagnosis?

A

Angiofibroma

83
Q

What does Reyes syndrome do to the liver?

A

Extensive fatty vacuolization of the liver

84
Q

A 12 year old has back pain and is bed wetting. Pinprick sensation is decreased. Diagnosis?

A

Spondylolisthesis- forward slip of the vertebrae that is palpable on physical exam

85
Q

What is a pharmacologic treatment for persistent enuresis?

A

Desmopressin or imipramine

86
Q

A two week old infant has bloody stools and vomiting with abdominal distension- diagnosis?

A

Midgut volvulus

87
Q

A 2 year old with atopic dermatitis has new vesicles over erythematous skin. Diagnosis and treatment?

A

Eczema herpeticum and treat with acyclovir

88
Q

What is the treatment for Bruton’s?

A

IVIG

89
Q

What is the treatment for pertussis?

A

Erythromycin or another macrolide antibiotic

90
Q

What is the treatment for local impetigo?

A

Topical mupirocin or oral erythromycin

S. aureus is resistant to penicillins!

91
Q

What should be suspected on a 1 week old with crepitus over the clavicle and an asymmetric Moro reflex?

A

Clavicle fracture
Mom might have gestational diabetes
treatment is reassurance

92
Q

An infant has a papular scaly rash on the eyebrows and scalp- diagnosis and treatment?

A

Seborrheic dermatitis- treat with moisturizers, baby shampoo

93
Q

A child shows reluctance to potty train- what is the next best step?

A

Wait a couple of months before trying again

94
Q

A premature baby has a CT scan revealing dilation of the entire ventricular system with enlargement of the subarachnoid space- what happened?

A

Intraventricular hemorrhage causing communicating hydrocephalus

95
Q

A child ingests a battery- what is the first step?

A

X-ray- if battery is in esophagus then immediate endoscopic removal is warranted
If battery is distal, it will most likely pass on its own

96
Q

RSV as an infant increases risk for what?

A

Asthma

97
Q

A newborn has failure to thrive, bilateral cataracts, jaundice, and hypoglycemia- diagnosis?

A

Galactosemia due to galactose-1-phosphate uridyl transferase deficiency
Galactokinase deficiency will only have cataracts!

98
Q

What presents as a seizure with a red flat lesion covering the left face?

A

Sturge-Weber syndrome- will see tramline intracranial calcifications
Tuberous sclerosis can present as seizures as well, but will be > 5 years old and have a adenoma sebaceum

99
Q

A child presents with fever, dysphagia, inability to extend the neck, muffled voice, and an x-ray shows widened prevertebral space- diagnosis?

A

Retropharyngeal abscess

Epiglottitis X ray would show thumb sign!

100
Q

Children with HSP are at risk for what GI problems?

A

GI bleed and intussusception

101
Q

What is the treatment of choice for chlamydial conjunctivitis and why?

A

Oral erythromycin to protect against pneumonia

102
Q

A newborn has a distended palpable bladder and low urine output- diagnosis?

A

Posterior urethral valve is most likely

103
Q

An infant is born at 28 weeks- when should immunizations be given- chronologic or gestational age?

A

Always chronologic

Only exception is Hep B should be given once > than 2 kg in weight

104
Q

Diagnosis and treatment of intussusception?

A

U/S and air enema

105
Q

Who should undergo renal and bladder u/s following a UTI? (4)

A

< 24 months of age with febrile UTI
Recurrent UTIs
UTI with family history
Children not responding to appropriate abx therapy

106
Q

A symptomatic child has a rapidly increasing head circumference and bulging fontanelles- what is the next step?

A

CT scan- must do this looking for hydrocephalus

107
Q

A child ingests alkali liquid cleaner- next step?

A

Upper GI endoscopy

108
Q

How do tet spells help TOF patients?

A

Knee to chest increases vascular resistance

109
Q

What is the most common cause of anemia in SCD patients?

A

chronic hemolysis

110
Q

How do you differentiate from partial seizure w/ 2ndary generalization and complex partial seizure?

A

Automatisms such as lip smacking or chewing more likely complex
Tongue biting or bladder incontinence makes secondary generalization more likely

111
Q

What is the most common complication of patients with sickle cell trait?

A

painless hematuria

112
Q

What is the most common cause of 2ndary HTN in children and how will it present?

A

Fibromuscular dysplasia

Presents as bruit @ costovertebral angle and angiogram shows string of beads sign

113
Q

What is the guthrie test?

A

tests for PKU

114
Q

What are two drugs used to treat TCA overdose and why?

A

BZDs to treat seizure

NA HCO3 to correct acidosis and narrow QRS elongation

115
Q

What is the most common predisposing factor to acute bacterial sinusitis?`

A

Viral URI

116
Q

What part of the DTaP vaccine can cause seizures?

A

Pertussis component- if this occurs continue to give the DT portions

117
Q

What are SGA infants at risk for?

A

hypoxia, polycythemia, hypoglycemia, hypothermia, and hypocalcemia

118
Q

What helps distinguish orbital cellulitis from preseptal and why is it important?

A

Orbital cellulitis can have ophthalmoplegia, pain with movement, proptosis, and vision impairment
Orbital cellulitis has severe sequelae such as brain abscesses and cavernous sinus venous thrombosis

119
Q

What is the treatment of choice for foreign body INGESTION?

A

Flexible endoscopy

Rigid bronch is for ASPIRATIOn

120
Q

An infant has cyanosis when feeding but relieved when crying- diagnosis?

A

Choanal atresia
Dx via CT scan
Treatment is oral airway and lavage feeding followed with surgery

121
Q

What are some features of benign murmurs?

A

Asymptomatic, normal pulses, normal S2, no other abnormalities, no audible clicks

122
Q

What is the most common cause of orbital cellulitis?

A

Bacterial sinusitis

123
Q

What is the most common cause of acute unilateral lymphadenitis?

A

S. aureus

124
Q

A 2 year old has a PDA, deafness, and cataracts- diagnosis?

A

Congenital rubella

125
Q

A 6 month old has wheezing that does not respond to bronchodilator or corticosteroid therapy but does respond to neck extension- diagnosis?

A

Vascular ring compressing the airway

126
Q

A patient with Turner’s syndrome is at risk of developing what MSK problem later in life?

A

Osteoporosis

127
Q

A patient has pancytopenia, abnormal thumbs, and low set ears- diagnosis?

A

Fanconi anemia- causes chromosomal breaks

128
Q

A patient has Marfanoid features, mental retardation, and thromboembolic events- diagnosis and treatment?

A

Cystathionine synthase deficiency

Treatment is high dose vitamin B6

129
Q

What is the most common cause of death in patients with Frederich Ataxia?

A

Cardiomyopathy

Look for new onset of gait ataxia, skeletal deformities, and degeneration of spinal tracts during teenage years

130
Q

An infant has apathy, weakness, hypotonia, large tongue, sluggish movement, abdominal bloating, and umbilical hernia. Patient was born outside uS

A

Congenital hypothyroidism

131
Q

A newborn has polycythemia- what is he at risk for?

A

Respiratory distress, poor feeding, and neurologic manifestations including seizures
Look out for babies who are SGA

132
Q

What presents with follicular conjunctivitis and neovascularization in the cornea?

A

Chlamydia- trachoma

133
Q

A mother had a positive HbeAg test at her last prenantal visit- what is the treatment for the infant?

A

Hep B IG and Hep B vaccine

134
Q

What is the most common cause of congenital hypothyroidism in the US?

A

Thyroid dysgenesis

135
Q

A 7 year old has new onset hearing loss and ear drainage. Granulation tissue and skin debris on otoscopy exam- diagnosis?

A

Cholesteatoma

136
Q

What is the most common cause of cerebral palsy?

A

Cerebral anoxia

Look for low APGAR scores, hypotonia, hyperactive DTRs, and learning disabilities

137
Q

A 2 week old has elevated direct bilirubin- what is the next step?

A

Must work up- direct hyperbilirubinemia is pathologic
Neonatal cholestasis
Causes include biliary atresia, obstruction, liver cell injury

138
Q

A 2 week old baby is constipated, mildly jaundiced, sluggish, and excessively sleeping- what is the first step?

A

Check results of newborn screen! Congenital hypothyroidism is most likely cause

139
Q

A baby with tachypnea has a suspected phrenic nerve injury- what is the best diagnostic test?

A

Fluoroscopy of chest shows characteristic movements of paralyzed hemidiaphragm on inspiration and expiration
CXR will be normal

140
Q

What is the physiologic difference with hyaline membrane disease with the following? lung compliance, lung volume, shunting?

A

Lung compliance- reduced
Lung volume - reduced
Shunt: R–>L
Work of breathing increased

141
Q

A mother who just gave birth is HBsAg positive- what do you do first: give hep B Ig and Hep B vaccine or determine mother’s HbeAg status?

A

Immunize first

NO NEED for HbeAg status, HbsAg positive means mom has ability to infect baby

142
Q

A mom begins taking penicillin, propanolol, phenytoin, and heparin in the 3rd trimester- what drug is most worrisome for the baby?

A

Propanolol! Can limit baby’s ability to increase HR and CO if asphyxiated
Phenytoin is only harmful during 1st trimester during organogenesis

143
Q

What are some complications of bilateral cleft lip and palate?

A

recurrent otitis media and hearing loss

Speech defects despite good anatomic closure

144
Q

What is one vital sign that should not change during the first few days of life- bilirubin, hematocrit, body weight, stools, temperature?

A

Temperature- change in temp is sign of serious infection

145
Q

What is one therapy that has shown response in RSV?

A

Inhaled epinephrine

146
Q

A premature infant is 7 weeks old and still requires oxygen and daily diuretics- CXR shows patchy fluffy infiltrates with areas of lucency diagnosis?

A

Bronchopulmonary dysplasia

147
Q

An infant has a flat, large vascular malformation on its left face and scalp- diagnosis?

A

Sturge-Weber

Look out for seizures

148
Q

An infant has oval shaped skin macules on trunk and extremities present since birth- diagnosis?

A

Tuberous sclerosis- these are ash leaf spots

149
Q

What type of hematoma is seen with shaken baby syndrome?

A

Subdural

150
Q

What manifestation of rheumatic fever is not alleviated by salicylates or steroids?

A

Chorea- use barbiturates

151
Q

A 2 year old has an S1, 2, 3, and 4, a mid-diastolic murmur at the left sternal border, and a systolic murmur in the pulmonic area- diagnosis?

A

Ebstein’s anomaly

Will see RA hypertrophy as well

152
Q

A child has spiking fevers and spindle shaped swelling of her finger joints, also substernal chest pain- diagnosis?

A

Juvenile rheumatoid arthritis

spindle shaped swelling and pain in weird joints- like sternoclavicular joint

153
Q

A happy child with elfin facies and cognitive impairment will have what type of cardiac abnormality?

A

Supravalvular aortic stenosis

154
Q

What is a typical and lethal complication of s. aureus pneumonia?

A

tension penumothorax

155
Q

A patient with sickle cell has fever, tachypnea, and cough- possible diagnosis? Next step? Is he hypoxic if there is no cyanosis? Treatment?

A

Sepsis, Pneumonia, pulmonary thromboemboli
Next step is admit the patient
Cyanosis is not a good marker of hypoxia in sickle cell patients
Treatment is 100% O2

156
Q

A child presents with fever, difficulty swallowing, and a fluctuant bulge on the posterior wall of the pharynx- diagnosis and treatment?

A

Retropharyngeal abscess

I and D

157
Q

What would blood gases show for a patient with hypertrophied tonsils?

A

respiratory acidosis with metabolic compensation- chronic upper airway obstruction

158
Q

What diagnosis is supported by finding a dilated, stool-filled anal canal with poor tone on the physical examination of a well- grown child presenting with constipation?

A

Functional constipation

159
Q

What is the common serious complication to TPN?

A

Sepsis

160
Q

A 3 year old may have Hirschsprung’s disease- how to diagnose?

A

Barium enema and rectal manometry

161
Q

How to diagnose lactose intolerance?

A

Hydrogen breath test after lactose ingestion

162
Q

What % of bilirubin should be direct to consider obstructive cause?

A

20%

163
Q

In what order do teeth erupt?

A

Mandibular central incisors–> maxillary central incisors–> lateral incisors–> molars–> cuspids

164
Q

When is activated charcoal indicated?

A

Drugs with enterohepatic circulation- phenobarbital, TCAs, theophylline

165
Q

A 1 year old presents with FTT, dehydration not associated with diarrhea or vomiting, frequent voiding of diluted urine, and excessive thirst- diagnosis?

A

Nephrogenic diabetes insipidus

166
Q

A 4 year old falls back off his bike and hits his head- he has no LOC and is alert and oriented on exam, but has blood behind his left tympanic membrane- diagnosis?

A

Basilar skull fracture

167
Q

How could homocystinuria cause acute hemiplegia in a 6 month old?

A

Causes thromboembolic events

168
Q

What could cause bitemporal hemianopsia, papilledema, and poor growth?

A

Craniopharyngioma

169
Q

What can occur 10 days after resolution of parotitis in Mumps?

A

CNS involvement

169
Q

What can occur 10 days after resolution of parotitis in Mumps?

A

CNS involvement

170
Q

What should parents of sickle cell patients be educated about early on?

A

Abdominal exam and temperature taking

171
Q

What is a poor prognostic factor for ALL?

A

Mediastinal mass!
also < 12 months of age
WBC > 100,000

172
Q

A 1 year old has iron deficiency anemia- how to treat in short and long term?

A

Oral ferrous sulfate in short term to restore iron stores

Iron-fortified cereals and limiting cow’s milk

174
Q

Which chemotherapy drug can cause mucositis which presents as erythema of mouth and esophagus and trouble swallowing?

A

MTX

175
Q

A patient has an Erlenmeyer flask femur on X-ray and has abnormal cells on bone marrow biopsy- diagnosis?

A

Gaucher’s disease- deficiency in glucocerebrosides

176
Q

A pregnant mother has hyperthyroid that is uncontrolled- what is the baby at risk for?

A

Thyrotoxicosis- tachycardia, irritability, possibly heart failure

177
Q

A 10 year old boy comes in with Cushing symptoms- what is most likely diagnosis and what test should be ordered?

A

Bilateral adrenal hyperplasia

Measure morning cortisol levels

178
Q

What is the treatment for labial adhesions in a newborn girl?

A

Topical estrogen

179
Q

An otherwise healthy boy who is the shortest in his class has a normal upper-lower segment ratio for his age- what is the most likely cause of his short stature?

A

Growth hormone deficiency

180
Q

A 2 week old girl has bilateral inguinal hernias- most likely diagnosis?

A

Testicular feminization

181
Q

What lab values are seen in rickets: Serum calcium, Serum P, Urine calcium, Alk Phos?

A

Serum calcium is normal
Serum P is low
Urine Ca is low
Alk Phos is high

182
Q

What are the calcium and phosphate levels in Hyperparathyroidism?

A

Low P, high Ca

183
Q

What are the Ca and P levels in vitamin D resistant rickets?

A

Low P, normal Ca

184
Q

What are the Ca and P levels in psuedohypoparathyroidism?

A

Low Ca, high P

185
Q

Na and K levels in Addison’s disease?

A

Na low, K high

186
Q

Na and K levels in hyperaldosteronism?

A

Na high, K low

187
Q

What is the first sign of puberty in males, females?

A

Males: testes enlarge
Girls: breast buds develop

188
Q

An adolescent attempts suicide by ingesting some pills, but has a negative toxicology screen- next step?

A

Admit the patient for full history and physical- suicide attempts are serious

189
Q

A patient comes in with the typical manifestation of DKA- what is the most urgent aspect that needs intervening?

A

Dehydration first and foremost

190
Q

What are some facial dysmorphisms seen with fetal alcohol syndrome?

A

Small palpebral fissures, smooth philtrum, thin vermilion border

191
Q

What are 2 risk factors for hyaline membrane disease?

A

Maternal diabetes

Prematurity

Pediatrics (1 decks)

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