Screening Questions Flashcards
Imaging modality of choice when evaluating a child for infantile hypertrophic pyloric stenosis
ultrasonography.
Typical age of intussusception in infants
3 months - 3 years
What are the two typical anamnestic features of acute appendicitis?
First epigastrial and paraumbilical pain
Later the pain is localized on the right lower abdominal quadrant.
Imaging study of the polytraumatized patient
acute CT.
Most common cause of acute abdomen in children
Appendicitis
What is the first test in case of bloody stool?
Digital rectal exam
What is two-stage splenic rupture?
- Initial subcapsular haematoma formation may have only mild symptoms.
- later second stage may occur after hours or days, and is usually characterised by the rapid development
of shock, as the spleen and mesentery tend to bleed rapidly and copiously.
Which is the most common cause of strangulation ileus?
Incarcerated hernia
The most common cause of transfusion-requiring hematochaezia, without abdominal pain
and without diarrhea?
Meckel’s diverticulum
You find a high GGT in a patient with ulcerative colitis, what should you think about?
Sclerosing cholangitis (PSC)
What are the features of the perianal fissures in a patient with Crohn’s disease?
- Not in the midline
- Deep
- Not painful.
What is the first therapeutic choice in Crohn’s disease?
Exclusive enteral nutrition
What kind of gas is insufflated during laparoscopy?
CO2
What is the official name of the spring-loaded insufflation needle used to create pneumoperitoneum for laparoscopic surgery?
Veress-needle
In case of thoracic empyema after drainage or thoracoscopy, what kind of method is used in
order to dissolve the thick, highly viscous pleural fluid (pus)?
Fibrinolysis/urokinase/streprokinase
What are the two most frequent chest deformities?
Pectus excavatum and pectus carinatum.
What are typical signs of bacterial otitis externa?
Pain
and/or
Sensitivity of the tragus
What are the 4 most important indication of adenotomy?
- Infection of the upper respiratory tract
- otitis media
- inhibition of nasal breathing,
- obstructive sleeping apnea.
The most frequent pathogen of sinusitis and otitis media?
Streptococcus Pneumoniae
In which case of inflammatory disease of the middle ear can we suggest tympanostomy tubes (Grommet)?
Chronic serous otitis media
and/or
Chronic dysfunction of the Eustachian tube.
What is the most frequent pathogen in urinary tract infections?
E. Coli
What can we find in the urine, in the case of glomerulonephritis?
Red blood cells and red blood cell cylinders. Proteinuria can also appear.
What is the most frequent cause of hypertension before the adolescent age?
Kidney disease
Which is the most frequent glomerulonephritis type?
IgA nephropathy
What kind of anti-hypertensive drug would you recommend in hyperkinetic hypertension?
Beta Blocker
What is the prognosis of West-syndrome or infantile spasm?
Usually poor :(
What is the essential criterion of cerebral palsy?
Non-progressive, residual brain injury.
Which pathogen most commonly causes typical pneumonia?
Streptococcus Pneumoniae
What are the two main components of the home treatment of pseuodocroup?
- Rectal steroids
- inhalation of (fresh) cool air.
(open window or let kid sleep in trolley outside)
What is the most common cause of acute cough?
Viral infection
What is the significance of Holzknecht sign?
Airway foreign body aspiration.
What is the most common cause of coughing, which has been presenting since birth and
occuring always during feeding?
Tracheo-esophageal fistula
How much part (what percentage) of the mortality is caused by accidents in the children older than 1 year, in Hungary?
36-40%
this is the main cause of death in children older than 1 year.
What is the prognosis of juvenile absence epilepsy?
Usually particularly favorable :)
What is the indication of ACTH as an anticonvulsant drug?
West syndrome/infantile spasm/BNS epilepsy.
What can prevent coronary artery disease (aneurysm) in Kawasaki syndrome?
IVIG
What is the most serious complication of neonatal lupus erythematosus?
Congenital heart block - third-degree (complete) atrioventricular heart block.
What is the most serious complication of juvenile idiopathic arthritis?
Macrophage activation syndrome (MAS)
Which muscles are affected in juvenile polymyositis?
Proximal muscles of the limbs
What is typical for the embrionic form of extrahepatic biliary atresia?
Usually other malformations are associated (situs inversus polysplenia, etc)
When can we expect the onset of symptoms of Wilson disease?
After 4-5 years of age
Where does the CFTR protein express in the liver?
In the biliary ducts
What is the typical feature of stool in biliary atresia?
Clay-colored (Acholic) stool
What kind of diseases are included in atopic march and in which order?
- > Food allergy
- -> Atopic dermatitis
- –> Asthma bronchiale
- —> Allergic rhinitis.
What is the frequency of food allergy in childhood according to the parents and in the reality
(after elimination and re-challenge)?
Approx. 7-10%, and 1-2 %, respectively.
How to diagnose food allergy - how reliable is allergen-specific IgE testing?
Allergen specific IgE is not totally reliable. ‘
Elimination diet, and after the sympoms disappear, allergen re-challenge is the suggested method of diagnosis.
How much is the minimal serum IgA concentration, when the tissue-transglutaminase (TTG) antibody or the endomysial anibody (EMA) can be positive in celiac disease?
0,2 g/L
Which 3 criteria are required in order to avoid biopsy in a child with suspected celiac disease?
- Positive clinical signs and symptoms
- Positive tissue-transglutaminase (TTG) antibody AND endomysial antibody (EMA)
- Positive genetic results (HLADQ2 and -DQ8).
What is the diagnostic basis of endocarditis?
Hemoculture and echocardiography.
What are the upper airway infections that should be treated with antibiotics?
- Streptococcus angina
- acute otitis media
- acute bacterial sinusitis.
What is the diagnostic basis of erythema migrans?
The fact (mark?) of tick bite and the clinical picture: growing erythema, which is more than 5 cm in diameter.
What is the ideal age for closing the soft palate defect?
Between 9 and 18 months
What is the most likely diagnosis in the following case: patient with polyuria, polydypsia with positive urine glucose and acetone test?
Diabetes Mellitus
Patient with typical symptoms has a 18,2 mmol/l blood sugar level in the afternoon. What is to be done?
Direct the child to a pediatric diabetic center immediately
What kind of hormonal changes are seen in the salt wasting form of CAH (congenital adrenal hyperplasia) due to deficiency of 21-hydroxylase?
- Insufficient glucocorticoid and mineralocorticoid secretion
- Excessive androgen secretion
How does the mother iodine deficiency influence the newborn’s thyroid function?
It results in temporary primary hypothyroidism
Which is the most common adrenocortical enzyme defect?
The defect of the 21-hydroxylase enzyme.
You experience low blood sugar level in an infant, who has normal temperature and hepatomegaly, what disease do you think of?
Type I. glycogenosis - von Gierke disease.
What are the most typical histologic findings in ulcerative colitis?
Crypt abcess
Name at least 5 extraintestinal abnormalities in celiac disease:
- hepatitis
- osteoporosis
- arthritis
- isolated iron deficiency
- Duhring-disease (dermatitis herpetiformis)
What is the definition of “graft versus leukaemia”?
Immunologic attack of donor cells against patient’s leukaemic cells.
What is haploidentical trasplant?
Half matched (HLA antigene) stem cell transplant (from usually a family member).
What does allogeneic stem cell transplant mean?
The patient (recipient) gets haemopoetic stem cells from another person (donor).
What glucose levels are diagnostic for diabetes mellitus?
Blood glucose level > 7 mmol/l in any time
or
> 11.1 mmol/l during OGTT
Which are the 4 presenting symptoms of diabetes mellitus?
- Polyuria
- polydypsia
- loss of weight despite good appetite
- fatigue-weakness
What are the most common associated diseases in patients with type 1 diabetes mellitus?
- Celiac disease
- Hashimoto thyreoditis
What is the most modern therapeutic method of type 1 diabetes?
Insulin pump + integrated glucose sensor
How much is the insulin dose in diabetic ketoacidosis?
0,05-0,1 U/kg/h
Since the introduction of expanded screening, how many congenital metabolic diseases are
screened routinely?
26
The final therapy of biliary atresia is liver transplantation. There is a surgical bridge therapy
until transplantation. What is the name of this operation?
Kasai porto-enterostomy
How often should a baby be breastfed?
On-demand
When is it suggested to give cow’s milk for children?
After 12 months of age
How does the breast milk’s protein content relate to the cow’s milk protein content?
One third
human milk has 1,3% protein, cows milk has 3,3% (according to google.)
For how long do the primitive reflexes exist normally?
Until 9 months of age
What are the diseases which can be easily diagnosed and followed up by cranial ultrasound?
Brain hemmorhage and hydrocephalus
For how long can we see the shadow of the thymus on the thoracic X-ray?
Until 3 years of age
How can be the airway foreign body diagnosed? (At least two methods!)
Expiratory and inspiratory chest radiograph
or
fluoroscopy (real-time moving images)
What radiological examinations can be done to diagnose VUR? (Name three!)
- MCU (Mycturating cystourethrogram)
- Sonocystography
- Dynamic kidney-scintgraphy
How can you diagnose perforation in a critically ill baby suffered from necrotising enterocolitis if you can not move him/her in the incubator?
Horizontal X-ray from side position while the baby is lying on the back.
In which part of the bone does osteomyelitis start?
Metaphysis
How can defecation be ensured in the case of high (proximal) anus atresia?
With the creation of a sigmoidostoma.
How long to wait after surgery before bathing?
7-8 days
What is the reactivation of chicken pox (varicella)?
Herpes Zoster
What is the sixth disease?
Exanthema subitum, roseola infantum
Which is that contagious disease that causes severe fetal injuries in 80 percent of the cases?
Rubella
Name at least five examples, where pulsoxymetry is NOT informative!
- CO2 poisoning
- Methemoglobinemia
- Severe anemia
- Cardiac failure
- Cold extremities
Define the matter of paradoxical breathing!/Define paradoxical breathing!
The chest moves inward and the abdomen moves outward during inhalation, and vice versa.
How do we give oxygen to a conscious patient who is breathing spontaneously?
Through a face mask with reservoir, with high flow oxygen (10-15 L/min).
How change the concentrations of protein and glucose in the liquor?
Protein: increase
Glucose: decrease
What are the two most frequent pathogens causing neonatal meningitis?
- Streptococcus Agalactiae (Group B Strep)
- E. Coli
What influences decisively the sensitivity of hamoculture?
The quantity of blood taken in 24 hours following the fever episodes
What is the name of the funcional disorder which is characterised by crying followed by straining for 10 minutes?
Infantile dyschesia
Which bacterium causing neonatal infection could be identified from the vaginal sample?
Group B Strep
How much fluid bolus is necessary for the management of septic shock?
20 ml/kg body weight
What is the most frequently occuring endocrinological disorder causing growth retardation?
Hypothyroidism
How can we define the premature puberty?
Onset of secondary sexual charachteristics starts before 8 years of age.
What can be found in the urinary sediment in typical pyelonephritis?
Leukocytes and bacteria
At which chromosomal abnormality is frequent the occurance of duodenal atresia?
21 trisomy
Down’s syndrome
What is the radiological sign of duodenal atresia?
Double bubble
What is the most important question, which we have to ask at functional gastroenterological complaints in infancy?
How is the infant developing? If somatic development is good, organic causes of the complaints is not probable.
