Term
| What are the components of an APGAR score? |
|
Definition
Appearance (skin color):
2- Pink
1- Extremities blue, pink centrally
0- Central cyanosis
Pulse:
2- >100bpm
1- <100bpm
0- No pulse rate
Grimace:
2- grimace plus a cough, sneeze or vigorous cry
1- just a grimace
0- no response
Activity:
2- active motion
1- some muscle tone
0-floppy tone
Respiration:
2-cries well
1- slow and irregular
0- not breathing |
|
|
Term
| In which category of newborns is apnea MC? |
|
Definition
|
|
Term
| What is considered apnea? |
|
Definition
| cessation of breathing >20sec associated with bradycardia, cyanosis, pallor or marked hypotonia |
|
|
Term
| Which form of apnea has pts who have no respiratory effort described as lack of chest wall movement, and no breath sounds on auscultation? |
|
Definition
|
|
Term
| What is the MC form of apnea seen in pre-term infants? |
|
Definition
|
|
Term
| What is the MC cause of obstructive sleep apnea in peds? |
|
Definition
|
|
Term
| Port-wine stains = What condition? |
|
Definition
|
|
Term
| >5 cafe-au-lait spots = What condition? |
|
Definition
|
|
Term
| Ash-leaf spots, shagreen patch, sebaceous adenomas = What condition? |
|
Definition
|
|
Term
| What is the MC disease associated with ARDS? |
|
Definition
|
|
Term
| What is typically the initial PE finding is pts with ARDS? |
|
Definition
|
|
Term
| What does radiologic findings including progressive bilateral interstitial and alveolar infiltrates develop without cardiomegaly indicate? |
|
Definition
|
|
Term
| What is the cornerstone of treatment for ARDS? |
|
Definition
|
|
Term
| What condition results from non-closure of the fetal ductus? |
|
Definition
|
|
Term
| What is patent ductus arteriosis? |
|
Definition
| there is a persistent communication between the descending thoracic aorta and the pulmonary artery |
|
|
Term
| When does the PDA typically close in infants? |
|
Definition
|
|
Term
| On physical exam of a 1 week old premature infant (28 week) who has had reports of FTT and poor feeding is being examined. Findings include normal respiratory rate, normal heart rate, widened pulse pressure, prominent suprasternal & carotid pulsations, there is also a machinery murmur, which is continuous heard loudest along the left upper chest. What condition do you suspect? |
|
Definition
| PDA - Patent Ductus Arteriosus |
|
|
Term
| What is the primary diagnostic study used to evaluate and diagnose patent ductus arteriosus (PDA)? |
|
Definition
|
|
Term
| What is the initial tx for PDA within the first 10 - 14 days of life? |
|
Definition
indomethacin (IV)
ibuprofen (IV) |
|
|
Term
| After one years old, what is the MC method of treating a PDA? |
|
Definition
| Cardiac Catheteritization |
|
|
Term
| What are the components of tetralogy of fallot? |
|
Definition
1 - VSD
2 - Pulmonary Stenosis
3 - Overriding aorta
4 - Right ventricular hypertrophy |
|
|
Term
| MC congenital cyanotic heart defect? |
|
Definition
|
|
Term
| What hormone is a pancreatic hormone with anabolic effect? |
|
Definition
|
|
Term
| A 5y/o female presents to the pediatrician for a well-child visit. On heart exam there a regular rate and rhythm with a normal S1, physiologic split S2. There is a 2/6 musical midsystolic murmur heard best at the left lower sternal border (LLSB), without radiation. There is no systolic click or thrill. Radial and femoral pulses are normal. What is the most likely etiology of this pt's heart murmur? |
|
Definition
| Chordae tendineae vibration |
|
|
Term
| What is the MC innocent murmur of childhood? |
|
Definition
|
|
Term
| Which murmur is described as a vibratory, musical low to medium pitched midsystolic murmur that is heard best at the LLSB, with minimal radiation? |
|
Definition
|
|
Term
| Which childhood murmur is present during infancy, disappearing between 3 and 6 months of age, and is described as high pitched, blowing midsystolic murmur, heard best at the LLSB and radiating to the back and axillae? |
|
Definition
| physiologic peripheral pulmonary stenosis |
|
|
Term
| Which murmur is classically described as producing a high pitched, holosystolic or late systolic murmur, heard best at the apex and radiates to the axilla and back? |
|
Definition
| Mitral Valve Regurgitation |
|
|
Term
| MCC of Mitral Valve Regurgitation? |
|
Definition
|
|
Term
| What murmur is described as a harsh, holosystolic murmur, loudest at the LLSB, radiating toward the xiphoid, with a thrill often present? |
|
Definition
|
|
Term
| What murmur is described as a high pitched early to midsystolic murmur, heard best at the left upper sternal border and radiating toward the left clavicle, with a systolic ejection click or systolic thrill often present? |
|
Definition
| Valvular Pulmonary Stenosis |
|
|
Term
| What is the appropriate initial eval of a pathologic murmur? |
|
Definition
|
|
Term
| A child is brought to the emergency room with colicky pain, history of irritability, and lethargy. Rectal bleeding and "currant jelly" stool are also noted. Plain abdominal film shows evidence of obstruction and barium enema detects coiled-spring appearance to the bowel. What is your Dx? |
|
Definition
|
|
Term
| What is the MC congenital malformation of the GI, present before 2 years of age and is found most frequently in boys and can be associated with causing intussusception? |
|
Definition
|
|
Term
| A one-month old male infant is brought to you with non-bilious vomiting. Physical examination finds dry mucous membranes, slightly decreased skin turgor, jaundice, and a firm, peanut-sized swelling in the epigastrium. The upper GI series finds non-progression of the peristaltic wave and railroad track sign. What condition do you suspect? |
|
Definition
|
|
Term
| What is the first step of treatment in pyloric stenosis? What is the definitive treatment? |
|
Definition
Initial Tx -Fluid replacement and correction of metabolic acidosis
Definitive Tx - Ramstedt procedure |
|
|
Term
| Which x-linked recessive d/o has the clinical features of eczema, microthrombocytes and deficiency of T and B cell immunity? |
|
Definition
|
|
Term
| What chromosome is affected in Prader-Willi syndrome? |
|
Definition
|
|
Term
| Since the child is attending first grade for the second time and still seems to be unable to keep up in school, physically and mentally, the teacher had recommended for him to be checked out. He is 110 cm tall and weighs 50 kg. A body composition test shows significantly increased body fat with very little lean body mass. He has almond-shaped eyes and a narrow forehead. Since the scrotum is hypoplastic and there are no testicles palpable you order a hormone status. TSH 0.6 mU/l, fT3: 2.9 pg/ml, T4 1.1ng/dl, GnRH LH FSH, testosterone. What condition do you suspect? |
|
Definition
|
|
Term
| What condition has characteristics indcluding short in stature, neck webbing, juvenile external genitalia, but usually no mental retardation? |
|
Definition
|
|
Term
| What heart condition is associated with Turner Syndrome? |
|
Definition
|
|
Term
| What is the genotype associated with Turner syndrome? |
|
Definition
|
|
Term
| What genetic condition has characteristics including subnormal intelligence, small penis and testicles, low testosterone, gynecomastia in late puberty, decreased muscle mass and strength; feminine distribution of adipose tissue; diminished libido; decreased physical endurance; and osteoporosis? |
|
Definition
|
|
Term
| What is the genotype associated with Klinefelter syndrome? |
|
Definition
|
|
Term
| What syndrome is characterized by hypertelorism, microcephaly, severe mental deficiency, and a catlike cry? |
|
Definition
|
|
Term
| What syndrome has the classic symptoms including psychomotor retardation, hypotonia, obesity, short stature, brachycephaly, upslanted palpebral fissures, protruding tongue, small ears, epicanthal folds, simian crease in palms, and speckled irises? |
|
Definition
|
|
Term
| What hematologic d/o are Down Syndrome pts at a higher risk for? |
|
Definition
|
|
Term
| What genetic condition is described as usually lethal within the first few weeks of life having characteristics including protruded forehead, downslanted palpebral fissures, microstomy, micronathia, dysplastic ears? |
|
Definition
|
|
Term
| A 4-year-old child develops swelling of eyes in the morning and swelling of legs and feet at the end of the day. Physical examination finds soft and pitting edema. Blood pressure and serum complement levels are normal. Timed 24-hour urine collection finds heavy proteinuria. Red blood cell casts are absent. Renal function is normal. Serum urea and creatinine concentrations are normal. Which of the following is the most appropriate next step in the management? |
|
Definition
|
|
Term
| A 4-year-old child develops swelling of eyes in the morning and swelling of legs and feet at the end of the day. Physical examination finds soft and pitting edema. Blood pressure and serum complement levels are normal. Timed 24-hour urine collection finds heavy proteinuria. Red blood cell casts are absent. Renal function is normal. Serum urea and creatinine concentrations are normal. What is the most likely diagnosis? |
|
Definition
| Nephrotic Syndrome - specifically minimal change disease |
|
|
Term
| A teenager develops pneumonia which is confirmed by chest roentgenography. Tetracycline is prescribed. A day later diffuse macular eruption is observed not only on the skin but also on several mucous membranes. The macules evolve into annular target or iris lesions and persist for several days. What is the most likely cause of the superimposing abnormalities? |
|
Definition
| This is a sign of M. pneumonia |
|
|
Term
| You are working as a resident in the ED when a mother brings in a 5-year-old white male. His right knee is badly swollen, and the boy's mother asks for a wheelchair for her son as soon as she carries him into the foyer. She states that her son has a blood coagulation disorder and that he frequently bleeds into his joints when he sustains even a slight injury while playing. History includes the use of the blood product cryoprecipitate or factor VIII concentrates for treatment for his disorder. Which disorder does this patient suffer? |
|
Definition
|
|
Term
| deficiency of factor VIII is called what? |
|
Definition
|
|
Term
| What is gallstones in children and teens highly suspicious for? |
|
Definition
| congenital spherocytosis or hemoglobinopathy |
|
|
Term
| What are the major criteria of Rheumatic fever? |
|
Definition
Carditis
Chorea
Polyarthritis
Subcutaneous nodules
Erythema marginatum |
|
|
Term
| Which psychological disorder is described as a pt becoming distressed when away from an attachment figure, usually a parent, and pervasive worry that some unknown event threatens the integrity of the family? |
|
Definition
|
|
Term
| Which psychiatric d/o is described as occurring after an individual faces a catastrophic event involving threat of death or serious injury, witnessing such an event, or awareness of such events occurring in the community, causing intrusive recollections of the event, recurrent dreams, a flashback - like re-living of the event that may include sensory hallucinations and symbols that represent the event? |
|
Definition
| Post-traumatic Stress D/O |
|
|
Term
| A 14-year-old girl has a 2 to 3-week history of a foul smelling, blood tinged, yellow/white vaginal discharge. Her periods started at 12.5 years of age and have been regular; her last period was about 3-4 weeks ago. In private, she denies any sexual activity. She has had vaginal discomfort with occasional mild dysuria. She denies any abdominal pain or diarrhea. What condition do you expect? |
|
Definition
|
|
Term
| A febrile child with acute onset of painful swelling of the parotid gland, accompanied by drainage from Stensen's duct, is the clinical picture of what condition? |
|
Definition
|
|
Term
| What condition in childhood is characterized by painful bilateral swelling of the salivary glands, usually the parotid glands and can be complicated by meningoencephalitis, orchitis, oophoritis, thyroiditis, and myocarditis? |
|
Definition
|
|
Term
| On examination, the patient is well-appearing and afebrile. She has a slightly scaly, reddish-brown rash covering approximately 12cm2 in both axillae. The rash is nontender to touch with a well-demarcated border. There is no axillary adenopathy. Wood's light examination reveals coral-red fluorescence of the involved skin. What is your diagnosis? What pathogen causes it? |
|
Definition
Erythrasma
Corynebacterium minutissimum |
|
|
Term
| On examination, the patient is well-appearing and afebrile. She has a slightly scaly, reddish-brown rash covering approximately 12cm2 in both axillae. The rash is nontender to touch with a well-demarcated border. There is no axillary adenopathy. Wood's light examination reveals coral-red fluorescence of the involved skin. What is the treatment of choice? |
|
Definition
| This is erythrasma so erythromycin or another macrolide is the DOC |
|
|
Term
| What is the treatment for severe lead poisoning? |
|
Definition
| administration of succimer (Chemet) |
|
|
Term
| Basophilic stippling of red cells, elevated erythrocyte protoporphyrin concentration, and growth arrest lines in the metaphyseal region are all signs of what condition in childhood? |
|
Definition
|
|
Term
| A 3-year old child is brought to you with symptoms of slow development. Her vocabulary is very limited and does not use appropriate grammatical structures. Her appetite is poor and looks short among others in her age. Her mother is at home, works with stained glass, and does her best in taking care of the children. Diagnostic studies find slower nerve conduction velocities and 52 -g/dl (normal <10). What condition do you suspect? |
|
Definition
|
|
Term
| A 16-year-old female is brought by paramedics to the ED for seizure activity. She has recently emigrated from Central America and has no previous medical problems. She was watching television and began to have a generalized tonic-clonic seizure based on the mother's description. The seizure lasted two minutes; the child was sleepy but then returned to her normal state when the paramedics arrived. There is no family history of seizures. The patient denies head trauma, any recent illnesses, fever, or headache. She denies using any medications or illicit drug use. Her neurological exam is normal. You perform a computed tomography of the brain, which reveals two calcified cyst-like lesions. These findings are most likely caused by what organism? |
|
Definition
| Taenia solium (Pork tapeworm) - cysts in the brain |
|
|
Term
| What blood findings are associated with Hep B immunization? |
|
Definition
| only anti-HBs (surface antibody) |
|
|
Term
| What blood findings are associated with immunity from previous Hep B infection? |
|
Definition
| positive antibodies to both hepatitis B surface antigen and to core antibody (IgM anti-HBc) |
|
|
Term
| What labs will be elevated with acetaminophen toxicity? |
|
Definition
|
|
Term
| What is the med used to reverse acetaminophen toxicity? |
|
Definition
|
|
Term
| At what age should a child be able to follow simple verbal commands, use jargon, running several unintelligible words together, and begin to say his first words? |
|
Definition
|
|
Term
| At what age is a child expected to understand verbal routines such as waving bye-bye or playing peek-a-boo and will point to objects, he also understands "no", he may begin to follow one step commands with gesture? |
|
Definition
|
|
Term
| At what age should a child be able to point to body parts by name and is learning new words slowly and usually will know about 4-6 words? |
|
Definition
|
|
Term
| At what age will respond to his name, babbles and may begin to imitate speech sounds? |
|
Definition
|
|
Term
| At what age will a child be able to understand sentences, learn new words quickly and uses two-word phrases like "go bye-bye" and "go night-night" and will begin using pronouns correctly? |
|
Definition
|
|
Term
| A pre-school aged child with Low grade fever, abdominal pain, and intestinal blockage is showing signs of what infection? |
|
Definition
| Ascariasis (Roundworm infection) |
|
|
Term
| A pt presents with a three day hx of diarrhea and excessive abdominal gas, after swimming in a public pool the day before the symptoms began. What condition do you suspect? |
|
Definition
|
|
Term
| What is the predominant flora of the colon? |
|
Definition
| Bacteroides, bifidobacterium, E. coli |
|
|
Term
| What is the average duration of orchitis associated with mumps? |
|
Definition
|
|
Term
| In the case of mumps orchitis, what is the likelihood of atrophy of the testicles occurring? Additionally, what is the likelihood of the infertility in affected individuals? |
|
Definition
30 - 40% of affected testes will become atrophied
Impairment of fertility occurs in about 13% of pts - absolute infertility is rare |
|
|
Term
| What is the MC pathogen involved in Mumps? |
|
Definition
|
|
Term
| What condition is described as a viral infection that most commonly affects the salivary glands, resulting in tenderness and swelling of the parotid glands, as well as fever, headache, malaise, and muscular pain? |
|
Definition
|
|
Term
| A newborn infant vomited and asphyxiated when given her first feeding. She constantly drooled saliva. Physical examination shows a distended abdomen, tachypnea and bilateral pulmonary rales. What is the most likely congenital anomaly causing this infant's symptoms? |
|
Definition
| Congenital esophageal atresia |
|
|
Term
| What is a likely but preventable adverse effect of cyclophosphamide? How can it be prevented? |
|
Definition
Hemorrhagic cystitis
Prevented using vigorous hydration and mannitol diuretic |
|
|
Term
| Which laboratory test should be performed prior to prescribing methotrexate? |
|
Definition
|
|
Term
| A school-age child starts complaining about some soreness on movement of hips, knees, and ankles. Lately, he also noticed discomfort in the eyes and blurred vision. The onset was gradual and the disorder has been present for several months. Physical examination finds tenderness and severe limitation of range. Tests for antinuclear antigens and rheumatoid factors are negative. A thorough search for a cause has failed to identify infection or malignancy in the background. What is this clinical picture characteristic of? |
|
Definition
|
|
Term
| It is noticed that a newborn is unable to wrinkle the left side of his head and to close the eye on that side. The left corner of the mouth drops and milk dribbles out when the baby sucks. Blood pressure is 80/45mmHg and pulse is 120/min. What is the most likely cause of this abnormality? |
|
Definition
| Forceps delivery causing injury on the left side |
|
|
Term
| It is noticed that a newborn is unable to wrinkle the left side of his head and to close the eye on that side. The left corner of the mouth drops and milk dribbles out when the baby sucks. Blood pressure is 80/45mmHg and pulse is 120/min. What condition is the likely cause? What nerve is most likely damaged? |
|
Definition
| Bell's Palsy, Facial Nerve |
|
|
Term
| Which condition causes a typical EEG pattern, known as hypsarrhythmia, is characterized by high voltage, chaotic slowing, multifocal spikes, and marked asynchrony: As well as symptoms in a pt including flexor, extensor, and mixed flexor/extensor fits? |
|
Definition
|
|
Term
| The approximate risk of the reoccurence of a febrile seizure in child is what percent? |
|
Definition
50% reoccurence rate in children under 1 y/o
35% in children > 1 y/o |
|
|
Term
| What type of seizure is associated with febrlie seizures? |
|
Definition
|
|
Term
| Which sign is described as pain with and limitation of knee extension when the hip is flexed 90° to the trunk? What does it signify? |
|
Definition
|
|
Term
| Which sign is described as spontaneous hip flexion when the examiner flexes the patient's neck? What condition does it signify? |
|
Definition
| Brudzinski: Signifies Meningitis |
|
|
Term
| A school-age girl develops erythematous flat-topped papules over the knuckles and violet discoloration and swelling of the eyelids. Lately she started to complain about weakness and has difficulty in getting up from the floor and climbing stairs. Laboratory studies find elevated aldolase and creatine phosphokinase. What is the most likely diagnosis? |
|
Definition
|
|
Term
| Muscle biopsy showing inflammatory infiltrates and shrunken, atrophied muscle fibers with central vacuolation, is a pathonomic sign for what condition? |
|
Definition
|
|
Term
| Which disease is caused by autoantibodies against neuromuscular acetylcholine receptors and on biopsy has characteristic lymphorrhages around degenerating myofibers and widened synaptic clefts? |
|
Definition
|
|
Term
| Widespread inward migration of sarcolemmal nuclei is suggestive of what condition? |
|
Definition
|
|
Term
| Which condition is described as having a clinical presentation of mild or intermittent pain in the anterior thigh and a limp: with physical exam findings including an antalgic gait, proximal thigh atrophy, and mild shortness of stature? |
|
Definition
| Legg-Calve-Perthes disease |
|
|
Term
| In which condition does the patient usually complains of a limp, with pain in the hip or referred to the knee? What usually precedes these symptoms/condition? |
|
Definition
| Transient synovitis: Usually preceded by URI 1 - 2 weeks previously |
|
|
Term
| Which condition is described as anterior swelling or enlargement of the thigh without pain, with x-ray findings including solitary or multiple lucent, cortical diaphyseal lesions surrounded by sclerosis? |
|
Definition
|
|
Term
| What condition is described as avascular necrosis of the bone underlying the articular cartilage that can be asymptomatic or have sx including edema, pain, and limited mobility? |
|
Definition
| Osteochondritis desiccans |
|
|
Term
| What condition has signs and symptoms including include insidious onset of proximal muscle weakness; stiff, sore and/or indurated muscles; respiratory difficulty, nasal regurgitation, nasal voice, and/or aspiration due to involvement of palatorespiratory muscles; skin lesions, typically violaceous erythema on upper eyelids, a butterfly malar facial rash, and atrophic, scaly, erythema on extensor surfaces of joints? |
|
Definition
|
|
Term
| Which condition has symptoms including a violaceous erythema on upper eyelids, a butterfly malar facial rash, mouth ulcers, alopecia, arthralgia, joint stiffness, serositis, seizures, psychosis, and hemolytic anemia? |
|
Definition
| Systemic lupus erythematosus |
|
|
Term
| What condition is described as having symptoms including a fever that is usually high and occurs in the evenings, and is accompanied by a pale pink rash on the trunk and proximal extremities which may be accompanied by myalgias, but often suffer from severe arthritis? |
|
Definition
|
|
Term
| What condition is described as having symptoms including erythema migrans, an annular rash, common in the axilla, periumbilical area, thigh, and the groin; fever; myalgia; headache; paralysis of the seventh (facial) nerve; and arthritis (usually large joints)? |
|
Definition
|
|
Term
| What group of conditions has four criteria including (1) it is a primary myopathy; (2) it is hereditary; (3) it follows a progressive course; (4) degeneration and death of the muscle fibers occur? |
|
Definition
|
|
Term
| What is the most common cause of sudden cardiac death in young athletes? |
|
Definition
| Hypertrophic Cardiomyopathy |
|
|
Term
| What is the MCC of sudden death in Marfan's syndrome? |
|
Definition
|
|
Term
| What condition is a rare cause of sports related cardiac deaths when cardiac disease is not present and occurs when nonpenetrating trauma to the chest produces ventricular fibrillation during the vulnerable period of cardiac repolarization? |
|
Definition
|
|
Term
| What is the standard test to confirm adrenal insufficiency? |
|
Definition
|
|
Term
| An 8-year-old child is hospitalized with rapidly worsening bacterial pneumonia treated with broad spectrum antibiotics. Symptoms of weakness, lethargy, and postural hypertension develop. Physical examination finds increased heart rate and decreased skin turgor. There is increased pigmentation in areas of friction. Blood cell count shows leukocytosis with eosinophilia. What is the diagnosis? |
|
Definition
|
|
Term
| What is the MCC of central adrenal insufficiency? |
|
Definition
| iatrogenic - long-term corticosteroid administration |
|
|
Term
| A pts labs come back and you note low serum cortisol levels, hyponatremia, high normal serum potassium, and low glucose levels. What condition do you suspect? |
|
Definition
|
|
Term
| What is aldosterone secretion primarily regulated by? |
|
Definition
| Renin-angiotenisin system |
|
|
Term
| Which adrenal zone secretes aldosterone? |
|
Definition
|
|
Term
| What is cortisol secretion regulated by? |
|
Definition
| adrenocorticotropic hormone (ACTH) |
|
|
Term
| MCC of primary adrenal insufficiency? |
|
Definition
| autoimmune destruction of the adrenal cortex |
|
|
Term
| Pt presents with hypoglycemia, and most have hypotension. Orthostatic changes in blood pressure and pulse are cardinal signs of this d/o? |
|
Definition
| acute adrenal insufficiency |
|
|
Term
| Pt presents with chronic fatigue, anorexia, asthenia, nausea, vomiting, loss of appetite, weight loss, recurring abdominal pain, and weakness and a lack of energy. Increased skin pigmentation and salt craving are also an initial presentation of this dz? |
|
Definition
| chronic adrenal insufficiency |
|
|
Term
| In which type of MEN does Islet cell tumor, pituitary adenoma, and adrenocortical adenoma only occur in? |
|
Definition
|
|
Term
| Which bacteria would most likely infect a wound site in a puncture wound of the foot? |
|
Definition
|
|
Term
| What is subdural hemorrhage in children usually a results of? |
|
Definition
| Shaken baby syndrome/Abuse |
|
|
Term
| What hormone level is suppressed by Metyrapone? |
|
Definition
|
|
Term
| A 5-year-old boy is brought to your office due to pallor and easy bruisibility. His mother noted that her son always has bruises on his body and will deny any episode of trauma. He was also noted to be pale which she attributes to having decreased appetite. 3 weeks ago, he had an episode of an acute viral infection, from which he hasn't yet fully recovered. A complete blood count shows evidence of anemia and thrombocytopenia. Peripheral smear shows presence of blast cells. What is the most likely diagnosis? |
|
Definition
| A.L.L - Acute Lymphoblastic Leukemia |
|
|
Term
| A 7-year old boy is brought to you with symptoms of fatigue, pallor, and gradual weight loss. The results of physical examination are unremarkable. Microscopic examination of peripheral blood finds lymphoblasts with deeply basophilic and vacuolated cytoplasm and prominent nucleoli. Refer to the attached laboratory studies. What is the diagnosis? |
|
Definition
| A.L.L. - Acute Lymphoblastic Leukemia |
|
|
Term
| Jaundice caused by elevated stress, decreased appetite. Vital signs WNL. Elevated total and unconjugated bilirubin. These are indicative of what condition? |
|
Definition
|
|
Term
| Jaundice in a child accompanied by acute onset of abdominal pain and ascites are indicative of what condition? |
|
Definition
|
|
Term
| What syndrome is caused by acquired thrombosis occluding the hepatic vein leading to jaundice, acute onset abdominal pain and ascites? |
|
Definition
|
|
Term
| In which age group should tetracycline be avoided? |
|
Definition
|
|
Term
| What organism is responsible for acute laryngotracheobronchitis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| hour-glass sign on x-ray = ? |
|
Definition
| croup - laryngotracheobronchitis |
|
|
Term
| If jaundice is present at birth, what conditions would you expect? |
|
Definition
hemorrhage
sepsis
erythroblastosis fetalis
infections with cytomegalovirus, rubella, or toxoplasmosis |
|
|
Term
| What are the causes of jaundice that appears on the 2nd or 4th day of life? |
|
Definition
physiologic jaundice - jaundice caused by the breakdown of fetal red blood cells, at a time when the liver is unable to conjugate bilirubin very quickly
Early onset breast feeding jaundice
Crigler-Najjar syndrome |
|
|
Term
| What is jaundice appearing during the 4th - 7th usually due to? |
|
Definition
|
|
Term
| Jaundice appearing after the first week of life is usually due to what? |
|
Definition
|
|
Term
| How much time does it take for breast feeding jaundice to improve after discontinuation of breast feeding? |
|
Definition
|
|
Term
| An abrasion on a 4y/o begins to develop redness around the site and purulent drainage from the wound, what pathogen is the most likely cause of the infection? |
|
Definition
|
|
Term
| When is isotretinoin (Accutane) contraindicated? |
|
Definition
|
|
Term
| An 8-month-old infant was brought to your office due to rashes over the scalp and eyebrows. Physical examination showed a dry, scaly, and crusting lesion over the scalp, eyebrows, and nape area. What is the most likely diagnosis? |
|
Definition
|
|
Term
| What skin condition is characterized by erythematous, weepy patches on the cheeks then subsequent extension to the face, neck, wrists, hands, abdomen and extensors surface of the extremities, that are extremely pruritic? |
|
Definition
|
|
Term
| What is atopic dermatitis mediated by? |
|
Definition
|
|
Term
| What is the treatment for atopic dermatitis? |
|
Definition
| wet dressings (Burrow's solution), Topical corticosteroids creams or lotion |
|
|
Term
| What skin condition is characterized by erythematous papules that coalesce to form plagues with irregular borders that appear as silvery or yellow-white scale and when removed induce pinpoint bleeding? |
|
Definition
|
|
Term
| What condition has an associated Auspitz sign? |
|
Definition
|
|
Term
| Removal of a scale from a lesion causes pinpoint bleeding, this sign is known as? |
|
Definition
|
|
Term
| What condition is clinically manifested by intensely erythematous, confluent plaque with scalloped border with the hallmark being numerous papules and vesicopustules, satellite pustules that stud the contiguous skin? |
|
Definition
|
|
Term
| What is the treatment for Candidiasis? |
|
Definition
Nystatin,
Miconazole,
Clotrimazole,
Ketoconazole |
|
|
Term
| What condition is characterized by chronic, pruritic, eczematous, circumscribed solitary plague that is usually hyperpigmented and lichenified, and is most commonly see in the posterior aspect of the neck, dorsum of the feet, wrists and ankles? |
|
Definition
|
|
Term
| What is the treatment for lichen simplex chronicus? |
|
Definition
| Topical Flourinated Corticosteroids |
|
|
Term
| What clinical sign has been proposed as one of the most reliable predictor of Group A streptococcus pharyngitis? |
|
Definition
|
|
Term
| Pt prsents with abrupt onset of fever, throat pain, dysphagia, headache, abdominal pain, absence of cough, hoarseness, rhinitis. There are exudates on 4 + tonsils, and cervical lymphadenopathy, what condition do you suspect? |
|
Definition
|
|
Term
| Rash associated with acute rheumatic fever? |
|
Definition
|
|
Term
| What hormone regulates the synthesis of dihydrotestosterone? |
|
Definition
|
|
Term
| Which tanner stage or sexual maturity stage in a female is described as pubic hair is sparse, lightly pigmented and straight while the breast and papilla are enlarged, areolar diameter is also increased? |
|
Definition
| SMR II or Tanner Stage II |
|
|
Term
| Which tanner stage or sexual maturity stage in a female is described as the pubic hair is darker with increasing amount and it starts to curl, while the breast and areola are enlarged but does not form secondary mound? |
|
Definition
| SMR III or Tanner Stage III |
|
|
Term
| Which tanner stage or sexual maturity stage in a female is described as pubic hair is coarse and curly, abundant in amount but is less than in adult and the areola and papilla form a secondary mound? |
|
Definition
| SMR IV or Tanner Stage IV |
|
|
Term
| Which tanner stage or sexual maturity stage in a female is described as the pubic hair has achieved the adult female triangular shape spreading to the medial surface of the thigh and the nipple projects and becomes a part of the general breast contour? |
|
Definition
|
|
Term
| A 13-year-old female came to your office for a routine physical exam. She appeared to be well nourished and well developed. She has not started menstruation yet. Physical examination of the breast showed enlargement of areolar diameter. Her pubic hair is darker and beginning to curl. Based upon the physical findings, what is her Sexual Maturity rating at present? |
|
Definition
|
|
Term
| What childhood infectious condition has a characteristic rash beginning on the head and spreading downward? |
|
Definition
| Measles (rubeola) - rubies on the forehead |
|
|
Term
| What infectious disease of childhood is characterized by abrupt fever and rush spreading from the trunk peripherally? |
|
Definition
|
|
Term
| What infectious disease of childhood is characterized by three stage rash (erythema of the cheeks, spread from the arms to the trunks and legs, phase of fluctuating severity)? |
|
Definition
| Erythema infectiosum (Fifth's disease) |
|
|
Term
| What pathogen causes scarlet fever? |
|
Definition
|
|
Term
| What is the treatment for Scarlett Fever? |
|
Definition
|
|
Term
| A 16-year-old girl is brought to your office because of a mass palpated over the left breast. There are no associated signs or symptoms noted. Physical examination showed a non tender mass on the upper, outer part of the left breast measuring about 2x3 cm. What is the most likely diagnosis? |
|
Definition
|
|
Term
| What is the MC benign breast solid tumor? |
|
Definition
|
|
Term
| What are the MC pathogens causing breast abscesses? |
|
Definition
| Staphylococcus Aureus and Streptococcus |
|
|
Term
| What breast condition usual presents with a fluctuant palpable mass associated with systemic symptom like fever? |
|
Definition
|
|
Term
| What breast condition is described as asymmetric breast enlargement associated with a firm, mobile, circumscribed mass that can increase in size rapidly and become quite large? |
|
Definition
| Cystosarcoma Phylloides - low grade malignant lesion |
|
|
Term
| What is the treatment for Cystosarcoma Phylloides? |
|
Definition
|
|
Term
| Clozapine is the appropriate medication for which childhood psychiatric disorders? |
|
Definition
| Schizophrenia - it is an atypical antipsychotic |
|
|
Term
| Prometaphase analysis detects deletion of the short arm of chromosome 11 in a child with aniridia and mental retardation. Which test is recommended for frequent monitoring? |
|
Definition
|
|
Term
| What are the MC side effects of inhaled steroids? |
|
Definition
| Oral candidiasis and hoarseness |
|
|
Term
| Urinalysis from a transurethral catheterized specimen is positive for nitrite and leukocyte esterase. The most appropriate treatment for this patient is: |
|
Definition
| Trimethoprim-sulfamethoxazole 10 mg/kg/day PO divided bid for 10 days |
|
|
Term
| Which subtype of the opioid receptor has an enkephalins as a natural ligand? |
|
Definition
|
|
Term
| Which opioid receptor seems to be most concerned with the central pain mechanisms and is the receptor for which the morphine antagonist naloxone has the greatest affinity |
|
Definition
|
|
Term
| How can pyloric stenosis be confirmed? |
|
Definition
| confirmed by barium swallow |
|
|
Term
| In which sex is pyloric stenosis more common? |
|
Definition
|
|
Term
| In what childhood disease does free fatty acids reach dangerous levels in untreated cases? |
|
Definition
| Medium chain acyl-CoA dehydrogenase deficiency |
|
|
Term
| A 2y/o breast feeding child presents with diarrhea, what is the appropriate dietary treatment? |
|
Definition
| Continue breast feeding and add an age-appropriate diet |
|
|
Term
Which of the following is a contraindication to breastfeeding?
A) Maternal hepatitis C virus
B) Breast cancer
C) Maternal cytomegalovirus
D) Maternal lithium usage
E) Maternal West Nile fever |
|
Definition
|
|
Term
| Where is Ca chiefly absorbed? |
|
Definition
|
|
Term
| What hormone is a pancreatic hormone that stimulates the hormone-sensitive lipase? |
|
Definition
|
|
Term
| A number of physical findings are assessed in the neonate when estimating conceptional age. Flexion of all four limbs when the infant is lying quietly on its back is seen at approximately _____ weeks? |
|
Definition
|
|
Term
| A number of physical findings are assessed in the neonate when estimating conceptional age. Complete hypotonia of all four limbs when the infant is lying quietly on its back is seen at approximately ______ weeks? |
|
Definition
|
|
Term
| A number of physical findings are assessed in the neonate when estimating conceptional age. A frog like posture when the infant is lying quietly on its back is seen at approximately _____ weeks? |
|
Definition
|
|
Term
| A number of physical findings are assessed in the neonate when estimating conceptional age. Hypertonic limbs are seen at approximately ____ weeks? |
|
Definition
|
|
Term
| Which class of lipoproteins is a source of VLDL? |
|
Definition
|
|
Term
| A 6-month-old Jewish infant was brought to your office due to inactivity. The mother noted that the baby is limp and will cry very loud if he hears a noise and his muscles are weak for his age. She observed that her baby cannot turn-over yet and will not even try to turn on either side. Upon physical examination the infant assumes a frog-like position and reddish discoloration on the eye was also noted. What is the most likely diagnosis? |
|
Definition
| Hexosaminidase A Deficiency/Tay-sachs Dz |
|
|
Term
The typical clinical picture for which disease is described as;
The patient usually develops normally until about 5 months of age, when progressive muscle weakness to severe hypotonia is noted. Hyperreflexia and hyperacusis, cherry-red spot on the macula and blindness are also common. Most infants will assume a frog-like position and hardly interacts with their surroundings. |
|
Definition
| Hexosaminidase A Deficiency/Tay-sachs |
|
|
Term
Which clinical dz has characteristic described as:
Clinical manifestation is by feeding difficulties and failure to thrive. In general, their development is delayed but this is not very apparent since some of them may be able to sit, stand and learn other skills early in life. Later, mental retardation is more pronounced and children become malnourished and hypotonic. Hearing and vision are affected. Protruding abdomen and hepatosplenomegaly, cherry-red spot on the macula are also noted. Bone marrow aspirate will show foam cells. |
|
Definition
| Sphingomyelinase deficiency /Niemann-Pick Disease |
|
|
Term
What dz is described as:
It is characterized by bone pain, fractures, thrombocytopenia and hepatosplenomegaly. Diagnosis is by demonstration of deficiency of the enzyme β-glucosidase. |
|
Definition
| glucocerebrosidase deficiency/ Gaucher's Disease |
|
|
Term
Which dz is described as:
Clinical manifestation is by neuropathy and skin lesions. Pain crises of the extremities are extremely common, which is due to the deposition of sphingolipids in the vascular endothelium supplying the peripheral nerves. Skin eruptions in the naval area, buttocks and angiokeratomas are characteristic. Hypohidrosis and corneal dystrophy are also seen. As they age, cardiac and renal manifestations are noted such as mitral insufficiency, ischemia, conduction defects, proteinuria and kidney failure. |
|
Definition
| α-galactosidase/ Fabry's Disease |
|
|
Term
Which disease is described as:
It is usually seen between 12-18 months of age with irritability, gait difficulties, ataxia, hypotonia and optic atrophy. It rapidly progresses to death within the first decade of life. |
|
Definition
| Metachromatic Leukodystrophy (MLD) - Infantile Form (MC and most severe form) |
|
|
Term
| A child is brought to your clinic for a well child evaluation. You observe that the child uses a pincer grasp, is able to sit independently, is starting to pull himself to a standing position, and is able to feed himself. The child's development is most consistent with that of a child who has reached the age of |
|
Definition
|
|
Term
| You note that the child is able to roll over, sit independently, smiles spontaneously, and is babbling. The child's development is most consistent with that of a child who has reached the age of |
|
Definition
|
|
Term
| Her daughter rolls over both front-to-back and back-to-front. She sits with support, turns toward her mother's voice, smiles spontaneously, and brings objects to her mouth. Her development is most consistent with that of a child who has reached the age of |
|
Definition
|
|
Term
| In the majority of infants, the anterior fontanelle normally closes completely by: |
|
Definition
|
|
Term
| In normal development, hand dominance is usually first observed around the age of |
|
Definition
|
|
Term
| In normal development, a baby born at term should be able to sit unassisted at: |
|
Definition
|
|
Term
| An 8-month-old girl is brought in to the office, by her young mother, with increasing irritability and decreased appetite that started 2 days ago. She has also had some diarrhea and low grade fever. On exam she is afebrile, very fussy, and hard to console, though she appears alert and active. She lies with her hips and knees flexed, crying harder with any movement. A few petechiae are noted on her skin. Leg x-rays are done to assess for possible fracture that shows pencil-thin cortex and a ground glass appearance of the bones. Further history reveals that she has been given evaporated milk since birth to save money and has not yet been started on solids. Which vitamin deficiency would most likely cause this infant's symptoms? |
|
Definition
|
|
Term
| What vitamin deficiency is described as characterized by pinpoint spots on the skin especially on the thighs and legs, called as petechiae, spongy gums, poor healing of bruises, joint pain, bleeding from mucous membranes and thin hair? |
|
Definition
|
|
Term
| Seizures, irritability, peripheral neuritis, dermatitis, and microcytic anemia can be seen with deficiency of vitamin ? |
|
Definition
| vitamin B 6 or pyridoxine |
|
|
Term
| What vitamin deficiency is the leading cause of preventable blindness in children and also increases the risk for severe infections, causing the skin of extensor surfaces becomes dry and scaly with follicular hyperkeratosis; Dryness of the eyes is caused by keratinization of the conjunctiva and lacrimal glands. Bitot spots are small triangular, silvery, foamlike patches that appear on the conjunctiva due to keratinization. Night blindness will occur due to a delay in resynthesis of rhodopsin. Severe inflammation may result in keratomalacia and blindness |
|
Definition
|
|
Term
| What vitamin deficiency results in chelosis, glossitis, keratitis, photophobia, blurring of vision, seborrheic dermatitis, and anemia? |
|
Definition
|
|
Term
| What vitamin deficiency causes muscle weakness, double vision, loss of position sense, hemolytic anemia, reduced reflexes, and constricted visual fields? |
|
Definition
|
|
Term
| A big, healthy child for his 12 years, he has many motor tics. The actions are sudden, rapid, recurrent, and nonrhythmic and occur frequently on a daily basis. The child is upset by his classmates' laughing at him and tries to be a good sport, but he is becoming more withdrawn as the months go on. What is your dx? |
|
Definition
| Chronic Motor or Vocal Tic Disorder |
|
|
Term
| What is a superficial skin infection begins as a small, tender, erythematous papule that progresses to a vesicular stage and may become rapidly "honey-crusted" with a serous discharge? |
|
Definition
|
|
Term
| What pathogens are responsible for impetigo? |
|
Definition
| Streptococcus pyogenes than by Staphylococcus aureus |
|
|
Term
| What condition involving the scalp is very common during childhood and consists of a combination of inflammation with hair breakage and loss. And includes Inflammatory changes that can range from mild scaling and redness to a severe response including tenderness, redness and edema known as a kerion? |
|
Definition
| Dermatophyte infection - Tinea Capitus |
|
|
Term
| What skin condition consists of individual and grouped red, scaly papules and small plaques that progressively enlarge and migrate, forming rings and arcs? |
|
Definition
| Dermatophyte infection - Tinea Corporis |
|
|
Term
| A newborn with multiple cutaneous hemangiomas has high output congestive heart failure. A visceral hemangioma is most likely to be found in which organ? |
|
Definition
|
|
Term
| A newborn has multiple cutaneous hemangiomas, further examination and evaluation determines hepatomegaly and anemia are also present. What serious, potentially life threatening condition must you suspect? |
|
Definition
|
|
Term
| What is the most common cause of stridor in the newborn period? |
|
Definition
|
|
Term
| What condition seen in newborns is described as being caused by a congenital deformity or flabbiness of the epiglottis and supraglottis that leads to collapse of the airway during inspiration? |
|
Definition
|
|
Term
| A 3 day old pt is making noisy, crowing sounds upon inspiration. The sounds worsen when the infant cries. The infant is the product of a normal pregnancy and delivery. No intubation occurred around the time of birth. Symptoms appear worse when the infant is placed on his back. Slight intercostal retractions are noted when the infant is agitated. Direct laryngoscopy reveals collapse of the laryngeal tissues upon inspiration, and no other abnormalities. What is the dx? What is the tx? |
|
Definition
| Laryngomalacia - Usually requires no tx as it tends to spontaneously resolve |
|
|
Term
| A 9-year-old male presents to your office for evaluation of a heart murmur. He is in general good health. On examination you note a mid to early systolic ejection murmur, middle to high pitched heard best at the upper left sternal border. A pulmonic ejection click is also auscultated. The intensity is grade III/VI. No cyanosis is present. Pulses are equal and strong. What murmur do you suspect? |
|
Definition
| valvular pulmonic stenosis. |
|
|
Term
| What maneuver will decrease a venous hum? |
|
Definition
| will decrease with rotation of the head or compression of the jugular venous system |
|
|
Term
| An 8-year-old male presents to your office, complaining of a pruritic rash. The rash began as a few small, red bumps on the arms a few weeks ago, but has now spread across his body, and is much itchier. The itching is worse at night, and he is having problems sleeping because of the pruritus. His mother and brother now have a similar eruption. Examination of his skin reveals diffuse excoriation, with scattered vesicles and erythematous papules. In a few areas, the lesions appear linear. What is the dx? What should you prescribe? |
|
Definition
scabies
Topical scabicide - Permethrin 5% cream (lindane/kwell is not safe in infants) |
|
|
Term
| A newborn presents to your office for his 2-week physical exam. The only finding on exam is white plaques on the buccal mucosa and palate. When you try to remove the plaques, there are small punctate areas of bleeding. Your diagnosis is ? |
|
Definition
|
|
Term
| At birth a child presents with small, white, keratinized lesions found on either side of the mid-palatine raphe. What is the dx? |
|
Definition
|
|
Term
| Infants presents with small cystic lesions located on the buccal and lingual aspects of the maxillary and mandibular ridges in neonates. What is your dx? |
|
Definition
|
|
Term
| Pt presents with a painful ulceration on his oral mucosa. It began as erythematous, indurated papule and now appears eroded forming a necrotic ulcer with an erythematous halo. What is your dx? |
|
Definition
|
|
Term
| When should the triple-screening be done? |
|
Definition
| between 15 - 20 weeks of gestation. |
|
|
Term
| What are the MC used drugs in adolescence? |
|
Definition
|
|
Term
| What is the MC causative agent of a hordeolum? |
|
Definition
|
|
Term
| What gland is infected in a Hordeolum? |
|
Definition
| Meibomian, Zeis and Moll glands |
|
|
Term
| Treatment for a Hordeolum? |
|
Definition
| Warm compress, possible antibiotic ointment |
|
|
Term
| Which is non-tender, chalazion or hordeolum? |
|
Definition
|
|
Term
| Which condition is described as an inflammation of the lid margins which is characterized by redness, scaling or crusting lesion that is initially manifested by itching, irritation and burning sensation, which is generally recurrent, chronic and usually bilateral? |
|
Definition
|
|
Term
| Which condition is described as an inflammation of the meibomian glands characterized by a firm nodule on the upper eyelid which is non-tender? |
|
Definition
|
|
Term
| Which condition is described as the lid margins are directed inwards causing discomfort and corneal damage? |
|
Definition
|
|
Term
| What is the MCC of entropion? |
|
Definition
| Scarring (usually from SJS or trachoma) |
|
|
Term
|
Definition
|
|
Term
| What condition is described as the lid margin is turned outwards or everted associated with overflow of tears, maceration of the lid skin, inflammation of exposed conjunctiva or superficial exposure keratopathy? |
|
Definition
|
|
Term
| What is the tx for ectropion? |
|
Definition
|
|
Term
| An 8-year-old child was brought to your office because of swelling of the left upper eyelid associated with redness and tolerable pain. No fever was noted. Physical examination showed a localized swelling and redness on the upper middle lid of the left eye with slight tenderness on palpation. Vital signs were within normal limits. What is the most likely diagnosis? |
|
Definition
|
|
Term
| What is the MC source of lead exposure? |
|
Definition
|
|
Term
| Paul-Bunnell-Davidson test is used to confirm what illness? |
|
Definition
|
|
Term
| A school-age child has several attacks starting with recurrent contractions at the left corner of the mouth, progressing to adjacent muscles, and ultimately involving the entire left side of his body. The attack lasts a few minutes. The parents are anthropologists and a few months ago the family visited several villages in Central America. EEG detects irregular focal spikes over the right frontal lobe. Examination of CSF reveals decreased glucose, increased protein, and a few eosinophils. CT studies show cystic parenchymal lesions, some of them are calcified. What is the diagnosis? |
|
Definition
| Cysticercosis - caused by the pork tapeworm (Tenia solium) |
|
|
Term
| Cystic lesions, some of them calcified, are pathonomic for ? |
|
Definition
|
|
Term
| Symptomatic Cysticercosis is treated with what? |
|
Definition
| niclosamide or praziquantel |
|
|
Term
| 1st DOC for Complex partial seizures? |
|
Definition
|
|
Term
| Primary drugs for generalized seizures (3) |
|
Definition
| Phenobarbital, primidone, and phenytoin |
|
|
Term
| DOC for absence seizures? |
|
Definition
|
|
Term
| What disorder is characterized by the presence of multiple motor tics and one or more vocal tics, although all are not necessarily present at the same time? |
|
Definition
|
|
Term
| What disorder is characterized by repetitive, driven, and non-functional motor behavior which lasts greater than four weeks? Examples include thumb sucking, nail biting, biting or hitting oneself, hand waving or shaking, head banging, body rocking, picking at nose, or mouthing objects. |
|
Definition
| Stereotypical Movement D/O |
|
|
Term
| Which type of children most often present with stereotypical movement d/o? |
|
Definition
| Children with cognitive impairment |
|
|
Term
| Which disorder is characterized by an individual has obsessions, recurring or persisting thoughts, images, or impulses that interfere with general thinking and cause significant distress or anxiety and/or compulsions, the need to repeat physical behaviors? |
|
Definition
| OCD - Obsessive Compulsive D/O |
|
|
Term
| Which disorder is characterized by either single or multiple vocal and/or motor tics that occur frequently, many times during a day, and last for at least four weeks, but no longer than twelve months? |
|
Definition
|
|
Term
| Which alternative intervention has been found to improve certain skills for children who have ADHD? |
|
Definition
|
|
Term
| A 6 month old child with congenital heart disease develops severe cough, rhinorrhea, and fever in late fall. During hospitalization, worsening cyanosis and radiographic appearance of bronchiolitis are observed. What is the most likely pathogen? What is the drug of choice if laboratory test confirms the most likely pathogen? |
|
Definition
|
|
Term
| A 14-year-old male presents the emergency room with the complaint of the acute onset of nausea and vomiting. He attended a school picnic approximately 4 hours ago. He knows of two other classmates with similar symptoms. On examination he is well developed, well nourished with a temperature of 99.2° F, pulse of 110, and a blood pressure of 108/68. His mucous membranes are slightly tacky. His abdomen is soft and non-tender. What is the most likely etiology of his condition? |
|
Definition
|
|
Term
| A longer incubation period of 16-48 hours, together with abdominal pain and watery diarrhea is typical of what food pathogen contaminant? |
|
Definition
| Norwalk and Vibrio cholerae |
|
|
Term
| What food pathogen causes gastrointestinal symptoms as well as blurred vision, diplopia, dry mouth, and descending paralysis? |
|
Definition
|
|
Term
| Which tetracycline is safest in pts with renal impairment? |
|
Definition
| Doxycycline (as it is mainly secreted through the feces) |
|
|
Term
| Which class of anti-biotics can lead to kernicterus in newborns? |
|
Definition
|
|
Term
| What is the most consistently reported effect on adjustment of children from divorced families? |
|
Definition
|
|
Term
| What pathogen is usually indicated in bacterial tracheitis? |
|
Definition
|
|
Term
| The 5-year-old daughter of African immigrants is brought to your office because she is running a high fever, coughing, and that morning the mother had discovered a rash. The little girl holds her hands in front of her eyes and complains about the light hurting. After questioning the mother, she remembers having seen white dots in her daughter's mouth a few days ago. The girl has not had any vaccination yet. Upon examination you see conjunctivitis, clear secretion coming out of her nose, and a rash with dark-red, irregular macules, up to 1cm in diameter and some confluent. They are most intense behind the ears and it looks if they were spreading centrifugally over trunk and extremities. There are no enlarged lymph nodes, the pharynx is slightly red, and there is no abdominal tenderness or enlargement of liver and spleen. The girls temperature is 40° C (104° F) What is your dx? What is the MC complication? |
|
Definition
|
|
Term
| You are called to the nursery to examine a newborn who is slightly jaundiced on the second day. Your examination is normal and there is nothing significant in the history except that the mother received essentially no prenatal care. She did have a test for syphilis, which was negative; she was immune to rubella; and there is no blood group incompatibility. Upon further questioning of the mother, she admits to having had occasional "recreational" IV drug use during pregnancy. What is this infant at risk for that could cause her sx? |
|
Definition
|
|
Term
| When is the Hep B vaccines given? |
|
Definition
| birth, one, and six months |
|
|
Term
| What hormones promotes conversion of protein to glycogen and antagonizes insulin facilitated transport? |
|
Definition
|
|
Term
| Elastase is responsible for what consequence of childhood acute pancreatitis? |
|
Definition
| vascular necrosis and hemorrhage |
|
|
Term
| The presence of rosette patterns in a highly cellular tumor is characteristic of what childhood condition? |
|
Definition
|
|
Term
| What is the only solid tumor which rarely metastasizes in the lungs? |
|
Definition
|
|
Term
| A 3-year-old girl presents with progressive abdominal enlargement associated with abdominal pain and occasional vomiting. Physical examination shows a palpable mass over the right upper quadrant extending to the right flank. She looks pale and the BP is slightly elevated. Urinalysis shows microscopic hematuria. What is the most likely diagnosis? |
|
Definition
|
|
Term
| MC renal tumor in children 0 - 5y/o |
|
Definition
|
|
Term
| What condition is commonly manifested by an abdominal mass that is described as generally smooth, firm and rarely crosses the midline, and it causes abdominal pain and vomiting and sometimes occurs along with HTN? |
|
Definition
|
|
Term
| What is the most common solid tumor in children outside the CNS? |
|
Definition
|
|
Term
| MCC of precocious puberty in females? |
|
Definition
|
|
Term
| Which form of paralysis affects the small hand and wrist muscles causing limpness and inability to grip? Which nerves are affected? |
|
Definition
| Klumpke's paralysis; cervical nerves 7, 8 and the 1st thoracic |
|
|
Term
| What form of paralysis is described as causing the inability to abduct the arm at the shoulder, rotate externally and supinate the forearm? What nerve does it affect? |
|
Definition
| Erb-Duchenne paralysis; cervical nerves 5, 6 and in 50% 7 |
|
|
Term
| What nerves are damage with phrenic nerve injury? |
|
Definition
| anterior roots of cervical nerves 3, 4 and 5 |
|
|
Term
| What nerve injury is likely to result from lateral hyperextension of the neck especially during breech births or difficult forceps delivery? |
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Definition
|
|
Term
| How can phrenic nerve injury be detected? |
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Definition
|
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Term
| A 5-year-old boy is seen in the family medicine clinic by his physician for limping. According to his mother he had fallen in the playground 2 weeks ago. He has been afebrile and complains only of pain in the right groin area. The pain is worse at the end of the day. Physical examination demonstrates a child who appears comfortable. There is limited abduction of the right hip. The likeliest explanation for these findings is |
|
Definition
| Legg-Calve-Perthes disease |
|
|
Term
| Pain in the right groin area, a two week history of limp, and limited abduction of the right hip in an afebrile 5-year-old boy is consistent with |
|
Definition
| Legg-Calve-Perthes disease (LCPD) |
|
|
Term
| MC complication of Kawasaki's syndrome? |
|
Definition
| Coronary artery aneurysms |
|
|
Term
| What parathyroid testing pattern corresponds with sarcoidosis? |
|
Definition
| Markedly elevated serum calcium, close to normal serum PTH |
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Term
| Pt has decreased serum T4, decreased serum T3, decreased T4 index, normal TSH and increased T3 resin uptake. What is this indicative of? |
|
Definition
| Congenital TBG deficiency |
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|
Term
| A lumbar puncture is performed on a patient with bacterial meningitis. What abnormalities of the cerebrospinal fluid is most predictive of residual neurologic deficits? |
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Definition
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Term
| During the examination of the infant, either for a well baby checkup or if ill, it is important to listen carefully to the infant's breathing and the quality of the cry. What might a shrill high-pitched cry indicate? |
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Definition
|
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Term
| What is suggested by the absence of any cry? |
|
Definition
| Profound mental retardation |
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Term
| An infant presenting with widened sutures, a bulging fontanelle, persistent downward eye deviation (sunset eye sign) and increasing head circumference are all signs of what? |
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Definition
|
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Term
| What orthopedic sign is defined as the palpable sensation of gliding the femoral head in and out of the acetabulum? |
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Definition
|
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Term
| What orthopedic maneuver is described as the thigh is gently abducted, bringing the femoral head from its dislocated posterior position opposite to the acetabulum, reducing the femoral head into the acetabulum? |
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Definition
|
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Term
| What is the treatment for most congenital hip dislocations? |
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Definition
|
|
Term
| What is the preferred method of imaging the hip in the first months of lives? |
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Definition
|
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Term
| What orthopedic maneuver is described as the hip is flexed, the thigh is adducted, and the femur is pushed posteriorly causing the femoral head to dislocate posteriorly from the acetabulum? |
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Definition
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Term
| Which of the following is the correct diagnosis for a clinical picture of an infant with a weak cry and weak sucking reflex and a lack of anti-acetylcholine receptor antibodies? |
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Definition
|
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Term
| What term best describes premature closure of the metopic suture? |
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Definition
|
|
Term
| What is the MCC of short stature in boys? |
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Definition
|
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Term
| Tx for acute suppurative lymphadenitis is? |
|
Definition
| first-generation cephalosporin or penicillin |
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Term
| A 5-year-old male presents with a 4-day history of swelling around his left upper neck. He had been previously complaining of a sore upper left tooth. His past medical history is unremarkable. His immunizations are up to date. There are no animals in the house and there is no history of exposure to wild animals. Upon examination, his temperature is 100.5° F; his neck is significant for a unilateral, firm, tender, discrete, erythematous swelling just below the angle of the left mandible. The swelling does not appear to be fluctuant. Oral examination reveals an obviously infected premolar on the left side of his jaw. The remainder of the examination is within normal limits. What is the most likely diagnosis? |
|
Definition
| acute suppurative lymphadenitis |
|
|
Term
| This child, with wide epicanthal folds, whose corneal light reflex and cover tests are normal, but who still gives the impression of eyes turning inward, is a good example of what condition? |
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Definition
|
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Term
| What eye condition is described as being characterized by limited abduction and/or limited adduction, is typically unilateral, with the left eye being affected more than the right? |
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Definition
|
|
Term
| Define the term premature pubarche |
|
Definition
| Early appearance of pubic hair |
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Term
| The male testis provides two functions. One is production of spermatozoa. What is the other function? |
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Definition
|
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Term
| Intensely pruritic rash with pustules between the fingers are characteristics of what infectious condition? |
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Definition
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Term
| A 9-year-old boy presented to the emergency room with sudden onset of anterior chest pain, vomiting and general malaise. Twelve months before, the patient had a febrile illness associated with conjunctivitis and peeling of the skin on the hands and feet. Physical exam is as follows: Temperature 99°F; pulse 120 beat per minute: respirations 23 per minute; blood pressure 110/60. Skin: normal with no petechiae or splinter hemorrhages. Lungs: Clear. Heart: Normal. Lab: WBC 8,900/mm3, hematocrit 35%. EKG: ST elevation in the right precordial leads with an anterior myocardial infarction. Based on the history and physical exam, what is the most likely diagnosis? |
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Definition
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Term
| What condition is described as a congenital, pathological narrowing of the aorta that usually occurs distal to the takeoff of the left subclavian artery? |
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Definition
|
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Term
| Patients present with hypertension in the upper extremities and relative hypotension in the lower extremities. On exam, there is diminished femoral relative to radial pulse. Auscultation may reveal a palpable thrill over the suprasternal region and characteristic notching of the rib may be present on chest x-ray. What is your dx? |
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Definition
|
|
Term
| Lithium is the appropriate medication for which childhood psychiatric disorders? |
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Definition
|
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Term
Case #200014:
A 4-year-old boy starts to readily develop hematomas. He complains to his mother of knee pain, and she notices that they are swollen and painful. He is frequently getting bruised, and she starts to realize that minor cuts on him seem to bleed readily. His mother is very concerned because she knows that her father had a bleeding disorder. What is the most likely diagnosis? |
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Definition
|
|
Term
| What factor is deficient in Hemophilia A? |
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Definition
|
|
Term
| What factor is deficient in Hemophilia B? |
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Definition
|
|
Term
| In children, the most common malignant tumor of the parotid gland is ___? |
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Definition
|
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Term
| A 6-month-old white male presents to his primary care physician's office for a well child visit and immunizations. The mother reports that he has had no recent illnesses, but is nursing for shorter periods of time and is taking an extra nap in the middle of the day. His past medical history is notable for hyperbilirubinemia in the newborn period requiring phototherapy. Both he and his mother are blood type O positive. Family history is significant for the patient's father having a cholecystectomy and splenectomy at 15 years of age. Physical exam is notable for slight pallor of the skin and conjunctiva and there is a faint yellow cast to the skin. The spleen tip is palpable 1cm below the left costal margin. What is the probable dx? |
|
Definition
| hereditary spherocytosis (HS) |
|
|
Term
| A 5-year-old boy develops severe pharyngitis with a low grade fever. Parents note his pallor and fatigue during the previous weeks. They explain his gradual weight loss with lack of appetite. Physical examination finds lymphadenopathy and an enlarged spleen. Microscopic examination of peripheral blood finds white blood cells with scant cytoplasm and inconspicuous nucleoli. What is the most likely diagnosis? |
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Definition
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Term
A 4-year-old boy presents to your office for further evaluation. He has had a history of frequent nosebleeds since age one year. His father has a similar history but has not sought medical evaluation. There is no history of hospitalization or surgery. The child was treated with iron for a diagnosis of anemia when he was 15 months old.
On physical exam, the child looks well and is very active. The only abnormal finding is dried blood in both nares. There is no rash, no organomegaly and no pallor. The most likely diagnosis is |
|
Definition
|
|
Term
| What is the MCC of acute onset of low platelets in an otherwise well child? |
|
Definition
|
|
Term
| What disease has characteristic signs including organomegaly, petechiae, fever, and severe anemia? |
|
Definition
|
|
Term
| A five year old child has paroxysms of cough that increase in severity and duration. Some coughing episodes are followed by a whooplike, high-pitched inspiratory noise, and vomiting also occurred after paroxysms. Which laboratory test could lead to the earliest confirmation of the likely diagnosis? |
|
Definition
| Immunofluorescent antibody staining |
|
|
Term
| A five year old child has paroxysms of cough that increase in severity and duration. Some coughing episodes are followed by a whooplike, high-pitched inspiratory noise, and vomiting also occurred after paroxysms. What is the most likely diagnosis? |
|
Definition
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|
Term
| An 8-year-old male presents to the emergency room with a one day history of dark colored urine, fever, and lethargy. His physical examination is significant for a blood pressure of 140/95, facial pallor, slight edema of his extremities, and a healing skin lesion around the left nostril. (He had impetigo around his nose approximately two weeks ago that was treated with a topical antibacterial cream.) Urinalysis reveals red blood cell casts, proteinuria, and occasional white blood cells. Complete blood count reveals a mild normochromic anemia. What is the most likely dx? |
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Definition
|
|
Term
| How is a acute glomerulonephritis diagnosis confirmed? |
|
Definition
|
|
Term
| The triad of abdominal pain, lower extremity rash, and joint pain is suggestive of what diagnosis? |
|
Definition
| Henoch-Schönlein purpura (HSP) |
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|
Term
Physical exam of a 5y/o, reveals a thin male in no distress. Weight is 26 kg. Temperature is 99.8o, RR- 26, HR- 112, and BP- 110/62. His head is normocephalic and atraumatic, OP is unremarkable. TMs- normal Neck- supple without adenopathy Chest- clear Heart-rate/rhythm regular without murmur Abdomen- mild, diffuse tenderness throughout, no rebound or guarding present Neurological- intact Extremities- dorsa of both hands with non-pitting edema and tender, bilateral ankles are slightly swollen with some pain upon motion Skin- 1-2 cm erythematous maculopapules on buttocks, thighs, and shins.
What is the expected diagnosis? |
|
Definition
| HSP - Henoch Schonlein Purpura |
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|
Term
| What is the most common complaint with an ectopic ureteric orifice? |
|
Definition
|
|
Term
| What sex chromosome linked disease has the clinical feature of eunuchoid body habitus, low serum testosterone, high estradiol/ testosterone ratio and high urinary gonadotropin levels? |
|
Definition
|
|
Term
| Tx for Prader Willi syndrome? |
|
Definition
|
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Term
| In your pediatric clinic you see an 8-year-old white boy who is attending first grade for the second time and still seems to be unable to keep up in school, physically and mentally. He is 110 cm tall and weighs 50 kg. A body composition test shows significantly increased body fat with very little lean body mass. He has almond-shaped eyes and a narrow forehead and the scrotum is hypoplastic. What is your dx? |
|
Definition
|
|
Term
| The deficiency of which intestinal brush border functions will cause congenital chloride diarrhea? |
|
Definition
|
|
Term
| Which autosomal disorder usually manifests during puberty or later with the classic clinical triad of obesity, hyperglycemia, and hyperinsulinemia? What is the tx? |
|
Definition
| Hypertriglyceridemia - Fibrates (Gimfibrozil) |
|
|
Term
| Which strict diet has a high chance of producing macrocytic megaloblastic anemias? |
|
Definition
|
|
Term
| Seizures, irritability, hypotonia, restlessness, peripheral neuritis, dermatitis, and microcytic anemia can be seen with deficiency of vitamin _______? |
|
Definition
|
|
Term
| What does beriberi result from? |
|
Definition
| deficiency of vitamin B1 or thiamine |
|
|
Term
| What condition has sx including irritability, fatigue, peripheral neuritis, decreased tendon reflexes, loss of vibration sense, congestive heart failure, hoarseness, and ataxia? |
|
Definition
|
|
Term
| What vitamin deficiency results in cheilosis, glossitis, keratitis, photophobia, blurring of vision, seborrheic dermatitis, and anemia? |
|
Definition
|
|
Term
| What vitamin deficiency is characterized by diarrhea, dementia, and a sunburn-like dermatitis? |
|
Definition
| Pellagra - Niacin Deficiency |
|
|
Term
|
Definition
|
|
Term
| What test is used to confirm vit B-12 malabsorption? |
|
Definition
|
|
Term
| What is the shilling's test? |
|
Definition
| Used to determine the absorption of B-12 |
|
|
Term
| Early afternoon, an adolescent boy is brought to the emergency room with abdominal pain, nausea, and vomiting. The pain has been worsening since the onset of symptoms in the morning. Physical examination finds no abdominal tenderness, but psoas sign and tenderness on rectal examination are detected. Temperature and pulse are slightly elevated. Skin turgor is reduced and there is a 10 mm Hg drop in postural blood pressure. Laboratory studies find 18,000 white blood cells per microliter. What could confirm the diagnosis of acute appendicitis without perforation? |
|
Definition
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Term
| A child comes to your office for a routine physical exam. The child is able to walk with one hand held, picks up a pellet with a pincer movement of forefinger and thumb and releases it upon request, says "mama" and "dada," and is able to play a simple ball game. How old is this child? |
|
Definition
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Term
| Patients usually present with hepatosplenomegaly, failure to thrive, and deterioration of psychomotor function. A cherry red spot is seen in the retina. On histology the affected cells are enlarged and filled with numerous small vacuoles that impart foaminess to the cytoplasm. What is the dx? |
|
Definition
|
|
Term
| A 5-month-old male baby is brought to the hospital by his parents. They fear that the baby's developmental milestones are lagging behind and that the baby is mentally retarded. Examination reveals massive splenomegaly, hepatomegaly, enlarged cervical and inguinal lymph node, and atypical psychomotor functions. Ophthalmoscopy reveals a cherry red spot. A liver biopsy is performed. It shows numerous foamy macrophages. The frozen section of the fresh tissue stains positive for fat with oil red O. The most likely diagnosis in this case is |
|
Definition
|
|
Term
| This causes motor and mental deterioration commencing at about 6 months of age, blindness, and also a cherry red spot in the retina. Histologically there is ballooning of neurons with cytoplasmic vacuoles that stain positive for lipids with Oil red O or Sudan black B. What is your Dx? |
|
Definition
|
|
Term
| Clinically there is massive cardiomegaly and muscle hypotonia. Mild hepatomegaly may also be found. The phenotypic expression is variable in age of onset and organ involvement, though all involve a myopathy. Affected children appear normal at birth but soon develop generalized muscle weakness, feeding difficulties, macroglossia, hepatomegaly, and progressively worsening heart failure due to hypertrophic cardiomyopathy. Dx? |
|
Definition
|
|
Term
| It presents with hypotonia and eventual flaccid paralysis resulting in death usually before 2 years of age, though survival may be dependent on the degree of respiratory function. It can also be associated with structural congenital heart defects, but not cardiomyopathy. Dx? |
|
Definition
|
|
Term
| What is the MC defect leading to infantile hypothyroidism? |
|
Definition
| Incomplete development of the thyroid |
|
|
Term
| Infants profoundly affected by this d/o may have coarse facial features with a dull look, large protruding tongue, and puffy-appearing face. Hair may be dry and brittle while skin may be jaundiced. Feeding is poor and constipation is common. Affected infants do not cry a lot, are sluggish, and are inactive with decreased muscle tone. What condition is this describing? |
|
Definition
|
|
Term
| An infantile onset or classic form, which accounts for the vast majority of cases, is characterized by spasticity, irritability, hypertonia, hyperesthesia, psychomotor arrest, and rapidly progressive neurologic degeneration, optic atrophy, and early death. Feeding difficulties, such as vomiting and reflux may cause failure to thrive. Sequelae, including infection and respiratory failure, cause most deaths. What is the condition? |
|
Definition
|
|
Term
| Affected infants present with hypotonia and weakness at birth. There may be joint contractures of variable severity and swallowing difficulties. Some types are also characterized by intellectual retardation, seizures, hydrocephalus, and evidence of structural brain abnormalities or ocular abnormalities. What is the condition? |
|
Definition
| Congenital Muscular Dystrophy |
|
|
Term
| Elevation of what substance is the likely cause of yellow skin in a hypothyroid adolescent? |
|
Definition
| Carotene - In hypothyroid states, carotene from green leafy and yellow vegetables can accumulate. Unlike in jaundice caused by elevated bilirubin, the sclera of the eye is not yellow. |
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Term
| A 10-year old boy develops bone pain. Parents also noticed that his learning disability is worsening. He cannot remember simple tasks and now he needs help for dressing. Physical examination finds hepatosplenomegaly, but there is no sign of motor or sensory impairment. There are no coarse facial or other dysmorphic features. Laboratory studies show anemia, thrombocytopenia. Which disorders is most likely present? |
|
Definition
| Gaucher's Dz - Glucocerebrosidase deficiency |
|
|
Term
| A child comes to your office to receive a well child exam. During your exam you notice that the child's hands are usually held in a fisted position, his head does lift off the table in the prone position for a few seconds, he stares at your face during the exam, and that he exhibits facial responses to various sounds. This child's development is most consistent with that of a child who has reached the age of |
|
Definition
|
|
Term
| A mother brings her son in for a health maintenance examination. You note that the child smiles in response to his mother's vocalizing, he makes cooing noises, and is able to lift his head to 45° when prone. His development is most consistent with that of a child who has reached the age of |
|
Definition
|
|
Term
| A child is brought to the emergency room with colicky pain, history of irritability, and lethargy. Rectal bleeding and "currant jelly" stool are also noted. Plain abdominal film shows evidence of obstruction and barium enema detects coiled-spring appearance to the bowel. Intussusception is diagnosed. Which of the following diseases would you suspect if intussusception is before age 10, there is bleeding, anemia and protein-loosing enteropathy? |
|
Definition
|
|
Term
| What disease commonly presents as intussusception before age 10? |
|
Definition
|
|
Term
| Which pathogen, causing acute infectious diarrhea, can be paired with the pathogenic mechanism of mucosal invasion with intense inflammatory response? |
|
Definition
|
|
Term
|
Definition
| fluid replacement and antibiotics (ampicillin or trimethoprim-sulfamethoxazole). |
|
|
Term
| Which disease is characterized by bloody mucopurulent diarrhea i.e., dysentery, and has neurotoxic effects i.e,, seizures? |
|
Definition
|
|
Term
| Which drug is used to prevent gastric injury by NSAIDs? |
|
Definition
|
|
Term
| As a pediatric resident you see a 6-month-old African American girl whose mother is concerned about her daughter developing a pigeon breast. She also tells you that her child is still exclusively breast-fed and has not been sick since she was born. Pregnancy and delivery had been normal. Since you find a Harrison's groove and costochondral thickening, besides the sternal protrusion, you order a skull X-ray, which shows craniotabes. What is your treatment? |
|
Definition
| Prescribe 3000 IU/day vitamin D3 p.o. for 30 days for the child |
|
|
Term
| As a pediatric resident you see a 6-month-old African American girl whose mother is concerned about her daughter developing a pigeon breast. She also tells you that her child is still exclusively breast-fed and has not been sick since she was born. Pregnancy and delivery had been normal. Since you find a Harrison's groove and costochondral thickening, besides the sternal protrusion, you order a skull X-ray, which shows craniotabes. What is the dx? |
|
Definition
|
|
Term
| What clinical sign is is demonstrated by pressing the bone along the area where the bones of the skull come together, causing the bone to pop in and out, similar to pressing on a Ping-Pong ball? What can this sign be associated with? |
|
Definition
| craniotabes; Assoc with rickets and osteogenesis imperfecta |
|
|
Term
| The deficiency of which intestinal brush border functions will cause milk intolerance? |
|
Definition
|
|
Term
| A newborn in your practice has a positive result on the newborn screening test and confirmation test for hemoglobin FSC. What is this indicative of? |
|
Definition
| The baby has hemoglobin SC disease |
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|
Term
| A 12-month-old female is seen by her pediatrician for a well-baby check-up. The physician notes that the child's height and weight are greater than the 98 percentile, and has been consistently since birth. Her head is also large for her age, as are her hands and feet. She is delayed in both gross and fine motor skills, and has yet to communicate verbally. Hypotonia is present. Karyotype analysis is normal. What is the most probable diagnosis for this child? |
|
Definition
|
|
Term
| Common findings include height and weight greater than the 97 percentile, ear lobe creases or ear pits, a large tongue, omphalocele or umbilical hernia, visceromegaly, embryonal tumor in childhood, asymmetric overgrowth of a region or regions of the body, and renal abnormalities. What condition is described? |
|
Definition
| Beckwith-Wiedemann syndrome |
|
|
Term
| It is characterized by moderate mental retardation. With the phenotypic manifestations of the syndrome including developmental delay, hyperactivity, abnormal craniofacies, and macroorchidism (in post-pubertal males). What is the syndrome? |
|
Definition
|
|
Term
| Phenotypic characteristics include neonatal hypotonia that improves with age, difficulty in feeding as a newborn, excessive weight gain between the ages of 1 and 6 years, distinct facial features, hypogonadism, mild to moderate mental retardation, and atypical behavior concerning food, such as excessive appetite, foraging behavior, or obsession. Behavioral problems are often seen and include temper tantrums and outbursts, rigidity, possessiveness, stealing, and lying. Sleep disturbances are often noted. These individuals also often have a high threshold for pain and do not vomit. Obesity is common due to the compulsive eating and obsession with food and individuals must be strictly monitored. What is the condition described? |
|
Definition
|
|
Term
| It is not obvious at birth and there are no specialized laboratory tests that can confirm a diagnosis. Rapid growth occurs in the first 5 years of life. At the same time, motor skills and cognitive development are delayed. Hypotonia is present as well. The phenotype includes a large head with a tall narrow skull, eyes that are wide set and downward slanting, flat nose, pointed chin and "receding hairline", advanced bone age, and large hands and feet. What condition is described? |
|
Definition
|
|
Term
| It is characterized by a distinct facial appearance, a low-pitched and hoarse cry, and hypertonia. Also present are psychomotor delay, loose skin and umbilical, and inguinal hernias. Excessive growth is seen in early infancy in all cases, and prenatally in most. Characteristic facial features include micrognathia with a distinctive dimpled chin, hypertelorism, large and low-set ears, and telecanthus. What condition is described? |
|
Definition
|
|
Term
| Which sex chromosome linked diseases has the clinical feature of short stature, streak gonads, and degradation of oocytes by 2 years of age? |
|
Definition
|
|
Term
| A 14 year old boy is brought to you with chest pain. Physical examination finds xanthomas, nodular swellings of the tendons (Achilles, knee, elbow, and dorsum of the hand). What is the most likely diagnosis? |
|
Definition
| Familial hypercholesterinemia |
|
|
Term
| In what childhood disease does phenylalanine reach dangerous levels in untreated cases? |
|
Definition
|
|
Term
| In what childhood disease does ammonia reach dangerous levels in untreated cases? |
|
Definition
| Ornithine transcarbamylase deficiency (OTCD) |
|
|
Term
| A 14-year old girl is brought to you with lack of menarche. Physical examination finds normal breast development but the vagina ends in a blind pouch and there is no palpable uterus. Serum testosterone is in the male range and LH is elevated. What is the most likely karyotype of this child? |
|
Definition
| This girl is most likely a boy with androgen insensitivity syndrome (X,Y) |
|
|
Term
| A 12-year-old, Caucasian boy is admitted to the pediatric intensive care unit by the emergency care physician, since the doctor could not control the asthma attack the patient was suffering from. He is on inhaled albuterol, intravenous aminophylline, and high dose intravenous methylprednisone as well as oxygen by nasal cannula. You proceed with the medication, but increase the albuterol dosage. Which side effect are you worried about? |
|
Definition
| Chest pain - High dosages of beta-agonistic drugs can cause angina and endanger the blood supply to the heart. |
|
|
Term
| Which type of metabolic acidosis, typically presents with failure to thrive, polyuria, and constipation? |
|
Definition
| Renal tubular acidosis (RTA) |
|
|
Term
| Symptoms are typically vomiting, poor feeding, and decreased activity, sometimes progressing to severe lethargy or coma. The presence of alloisoleucine with a sweet syrup smell to the urine is diagnostic. What is the condition? |
|
Definition
| Maple syrup urine disease, an organic acidemia, results from a defect in the processing of certain amino acids. |
|
|
Term
| Which other heart complication is commonly associated with subarterial VSD? |
|
Definition
| Aortic insufficiency (AI) |
|
|
Term
| What is the MC hematological dz of childhood? |
|
Definition
|
|
Term
| What is the MC sign of iron def anemia? |
|
Definition
|
|
Term
| Systolic murmurs, tachycardia, and irritability may be present. Laboratory tests generally show a low hemoglobin, low MCV, low MHC, and high RDW. The peripheral blood smear shows a hypochromic microcytosis. The reticulocyte count may be low, and the platelet count may be elevated. Serum iron will be low. Total iron binding capacity will be high. The signs and lab test are congruent with what dx? |
|
Definition
|
|
Term
| A microcytic anemia with the peripheral smear showing basophilic stippling of the red blood cells. Physical exam is usually normal, though occasionally abdominal pain, poor appetite, vomiting, and constipation may occur. These are signs and sx of what condition? |
|
Definition
|
|
Term
| Which condition is characterized by macrocytosis and hypersegmented neutrophils on the peripheral blood smear, the MCV is elevated, as is the RDW? |
|
Definition
|
|
Term
| Usually occurs in previously healthy children and usually follows a viral illness. MCV is normal for age and normal RBC morphology is noted. Reticulocyte count is low to zero. Signs are pallor and tachycardia. What do these signs and sx point to? |
|
Definition
| Transient erythroblastopenia |
|
|
Term
|
Definition
| Ferrous gluconate 3 mg/kg of elemental iron twice a day for three months |
|
|
Term
|
Definition
|
|
Term
| An 11-year-old boy presents to your office in the summer complaining of extreme itching of both eyes, with increased tearing, of three months duration. There is a family history of atopy. On examination, you find large, flattened, cobblestone-like papillary lesions of the palpebral conjunctivae with a milky conjunctival pseudomembrane. A conjunctival exudate is present. A smear of the exudate reveals many eosinophils. What is the most likely diagnosis? |
|
Definition
|
|
Term
| A 12-year-old white male presented to his local ER a week ago with a 1-month history of progressive confusion, lethargy, and memory loss. A CT scan of the head revealed an isolated, hypodense, cerebral mass. Histologic examination has revealed a high-grade large-cell immunoblastic lymphoma (Non-Hodgkin's lymphoma). A complete oncologic staging evaluation reveals that this is a primary brain tumor with no evidence of metastatic disease. What other malignancy has a higher incidence in children with this patient's underlying disease? |
|
Definition
| Kaposi’s sarcoma - Most children who develop an isolated primary central nervous system lymphoma (PCNSL) of the brain have acquired immunodeficiency syndrome (AIDS); this is a late complication |
|
|
Term
| What is the most important diagnostic test for defining a suspected brain tumor? |
|
Definition
|
|
Term
| Which speech condition is characterized by a lack of awareness of the speech pattern, onset at approximately 2-3 years, spontaneous resolution, and word and phrase repetitions much more common than sound and syllable repetitions? |
|
Definition
|
|
Term
| Which speech condition involves rapid, irregular speech that impedes intelligibility? |
|
Definition
|
|
Term
| Which speech condition is described as a voice disorder with momentary disruption of voice caused by involuntary movements of the muscles of the larynx, and seen usually in adults? |
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Definition
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Term
| What speech condition is described as occurring after an injury to the central nervous system, such as a stroke or closed head trauma? |
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Definition
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Term
| What speech condition is described as a speech disability characterized by abnormal dysfluency with involuntary repetition of sounds, syllables and words, prolongations, blocks, interjections, revisions, word avoidance and/or substitutions, and speech avoidance? |
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Definition
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Term
| A 3-year-old boy is brought in by his parents for an evaluation of his stuttering. They state he has word and phrase repetitions, with only occasional sound repetitions. He does not appear to be aware of his problem, and shows no adverse behavioral reactions when his parents attempt to help him finish his sentences. He has demonstrated normal development prior to this problem. He is on no medications. No family history of stuttering is elicited. Physical exam is entirely within normal limits. The most likely cause of this patient's condition is |
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Definition
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Term
| What is a negative PPD test? What is a pos PPD test? |
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Definition
| Induration of less than 5mm is a negative test. Induration of 10mm or more is a positive reaction. |
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Term
| What is the most common respiratory pathogen of early childhood and the major cause of bronchiolitis and pneumonia in infants younger than one year? |
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Definition
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Term
| Intense perianal pruritus is the classic c/o of what pathogen? |
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Definition
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Term
| DOC for rocky-mountain spotted fever? |
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Definition
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Term
| An 8-year-old male presents to your office with a history of a blister on the ring finger of his left hand. It has been present for three days. His mother has been applying a topical antibiotic ointment with no significant improvement of the blister. Review of systems reveals that the patient had a cold sore approximately one week ago. Past medical history is unremarkable. Examination reveals vesicles with an erythematous base surrounding the nail of the patient's left ring finger. The vesicles appear to have a clear exudate in them. A cold sore is resolving on the patient's upper lip. What is the diagnosis and appropriate treatment? |
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Definition
| Herpetic Whitlow - Analgesics and splinting of the involved digit |
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Term
Question:
A 7-year-old male presents to your office with a one day history of lesions on his hands, feet, and sores in his mouth. He has had no fever or other symptoms. No ill contacts have been noted. He is up to date on his immunizations. His examination is significant for small, gray vesicles in his palms, soles, and the tops of his feet. His oropharyngeal exam reveals whitish-yellow lesions on his tonsillar pillars. He is afebrile. The most likely etiology of these findings is |
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Definition
| Coxsackie - Hand, Foot and Mouth dz |
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Term
Case #200594:
A 14-year-old female is hospitalized because of sore throat and dyspnea. She experienced onset of the sore throat approximately 10 days prior to her admission, and was evaluated in an urgent care center one week prior to her admission, where she was diagnosed with "tonsillitis" and placed on amoxicillin. Her symptoms did not improve and her sore throat has worsened to the point to where she has difficulty drinking and eating. Her dyspnea has worsened over the past 24 hours. On examination, Oropharynx reveals dry, tacky mucous membranes and the tonsils are enlarged and erythematous with a gray exudate covering them. She has enlarged cervical and submandibular lymph nodes. Her abdominal exam demonstrates a liver 4 cm below the right costal margin, and her spleen is 7 cm below the left costal margin. What is the dx and tx? |
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Definition
| Mono - Intravenous rehydration and corticosteroids |
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Term
| A 14-year-old female presents to your office with a complaint of the onset of a rash that began on her face yesterday and it now seems to be spreading down her body. She also has been complaining of sore lymph nodes in the back of her neck for the past 3 days. She has only had a slight fever since yesterday. She is uncertain about her immunization status. Her examination reveals a maculopapular rash that is most prominent on her trunk, abdomen, and back. There is confluence of the rash on some areas and her face appears flushed. She has tender posterior cervical lymph nodes bilaterally. She exhibits some joint tenderness of her distal phalanges. The most likely etiology of these findings is: |
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Definition
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Term
| A 6-year-old male is brought to your clinic with complaints of high fever and a rash all over his face. The boy arrived in this country a week ago from his home in the Asian subcontinent. His mother states that he has a 4 to 5-day history of a cough and cold with a fever and suddenly developed a rash over his face today. She says that he had 3 vaccinations when he was an infant and none after that. On examination, the boy looks malnourished and very ill, with a 104 degree temperature. There was some congestion of the conjunctiva, and some red spots were observed inside his buccal cavity. The rash on his face was maculopapular. What is his dx? |
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Definition
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Term
| A maternal serum alpha-fetoprotein done at 18 weeks was abnormally high; the acetylcholinesterase level was normal. During the sonographic examination the spinal column was surveyed and found to be normal. What is another possible reason for an elevated MSAFP? |
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Definition
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Term
| What hepatic disorders corresponds with a clinical picture involving jaundice, has a good response to phenobarbital, and is autosomal dominant with incomplete penetration? |
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Definition
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Term
| What is the principal cause of asymmetric intrauterine growth restriction (IUGR)? |
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Definition
| Uteroplacental insufficiency |
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Term
| Which of the following is the correct diagnosis for a clinical picture of an infant, born to mother with myasthenia gravis, who hours after birth experiences weakness of bulbar muscles? How is it treated? |
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Definition
Neonatal myasthenia
The treatment is anticholinesterase medication (e.g., pyridostigmine) |
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Term
| A tall, 10-year old boy is brought to you with right leg pain. During the last couple of months he occasionally complained about pain in the right leg but that did not seem to be significant. Lately he is awakened by the pain during the night. Physical examination finds swelling and a palpable mass on the right femur. Plain x-ray finds laminated onionskin type periosteal reaction. What is the dx? |
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Definition
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Term
| Onionskin type periosteal reaction = ? |
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Definition
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Term
| MC involved bone in Ewing's sarcoma? |
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Definition
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Term
| Bone condition described as having signs of high turnover of bone, particularly accumulation of woven bone, and large atypical cells with slightly basophilic cytoplasm and MC occurs in adults > 40y/o? |
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Definition
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Term
| Brodie abscess, Sequestrum and involucrum are all signs of what condition? |
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Definition
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Term
| Which medication may precipitate the onset of Tourette's syndrome in susceptible individuals? |
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Definition
| stimulant methylphenidate or dextroamphetamine for attention deficit hyperactivity syndrome |
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Term
| Parents bring a 3-year-old, hyperactive boy for evaluation and counseling. The boy speaks only in words and his vocabulary consist of only a few words. He never combines words into sentences. He is often angry and attacks others for no apparent reason. The child's head is visibly small and he has a flat nasal bridge, short nose, and long smooth philtrum. There is clinodactyly of fifth fingers on both hands. He has a short stature, below the fifth percentile of normal growth. Blood pressure, thyroid tests, serum electrolyte, and blood count are normal. What is your suspected dx? |
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Definition
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Term
| Which of the following is the correct diagnosis for a clinical picture of progressive muscle weakness two weeks after an infectious disease or vaccination? |
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Definition
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Term
| Tx for febrile seizure is? |
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Definition
| Control of fever with anti-pyretics |
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Term
| What is the correct diagnosis for a clinical picture of progressive weakness starting at age 2-4 and the child never runs or climbs upstairs normally? |
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Definition
| Duchenne muscular dystrophy |
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Term
| A 13-year-old male is brought to your urgent care center with the complaint of right knee pain that began acutely 2 days prior to his visit. He does not recall any trauma. He has not been ill. His past medical history is unremarkable with the exception of parental concerns over his weight, which has been over the 99%tile since age 5. Extremities- left leg within normal limits, right leg reveals significant pain upon any hip motion and he maintains the leg in external rotation and adduction. AP and frog legs views of the hips demonstrate anterior rotation of the femoral neck in relation to the capital epiphysis. The most likely cause of the patient's symptoms is: |
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Definition
| SCFE -Slipped capital femoral epiphysis |
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Term
| For what childhood endocrine and metabolic disorder is the appropriate pharmacologic test (stimulation or suppression) intravenous TRH? |
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Definition
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Term
| A 4-year-old child is seen in a pediatrician's office for inability to stand or walk without support. He had chickenpox a month ago. There has been no vomiting during the past days. On examination he is alert and smiling. A kyphosis is noted and tendon reflexes appear to be weak or absent. There is no resistance to neck flexion. What is the most likely dx? |
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Definition
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Term
| A six-year old child is seen at the urgent care center for suddenly starting clumsy gait and inability to stand or walk without support. He is irritable and there have been several episodes of vomiting during the past days. He had chickenpox three weeks ago. Muscle strength testing does not reveal abnormality but there is resistance to neck flexion. What is the most likely dx? |
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Definition
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Term
| What is the best biomarker of exposure to environmental tobacco exposure? |
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Definition
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Term
| What antenatal ultrasound finding might be a marker for cystic fibrosis? |
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Definition
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Term
| A 9-year-old girl who was found to be 122.5 cm tall (3rd centile) during a routine school health check up was referred by the school nurse to a pediatrician in the hospital.She is not doing well at school. The mother states that the girl has constant constipation and has become very lethargic lately. On examination, the physician finds that the girl is a little pale and has dry scruffy hair. Further laboratory tests reveal a low total T4 and high Thyroid Stimulating Hormone levels. What is the dx? What is the MCC of this illness? |
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Definition
hypothyroidism
MCC is chronic lymphocytic thyroiditis (Hashimoto's thyroiditis) |
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Term
| What is the hallmark of hypothyroidism in children? |
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Definition
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Term
| What bone is MC fractured during delivery? |
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Definition
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Term
| A palpable lump in the center of the clavicle that does not change or heal with any amount of time and is characteristic of what condition? |
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Definition
| congenital pseudoarthrosis of the clavicle |
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Term
| What condition is described as a lymphatic malformation of childhood, presents as a painless soft tissue swelling in the neck? |
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Definition
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Term
| Usually located in the metaphysis of a long bone, it presents with a progressively enlarging painful swelling occurring during the growth spurt What condition is suspected? |
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Definition
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Term
| This neonate has an abnormal heart rhythm, is small, and has abnormal palmar creases. Which drug can cause these symptoms and mental retardation with abnormal facial features? |
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Definition
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Term
| In children with juvenille RA, what screening should be done to find the MC and most concerning complication? |
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Definition
| Slit-lamp examination for chronic iridocyclitis which can lead to blindness |
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Term
| Parents notice a gradual change in the behavior of their two year old daughter. She has become withdrawn, lost interest in playing outdoors, and tends to sit around. Parents also noticed symmetric swelling of the knees and ankles. The girl did not have any infections during the last six months and there is no apparent explanation for these changes. Tests for antinuclear antibody are positive, but for rheumatoid factor are negative. What is the dx? |
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Definition
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Term
| A 5-month-old male is brought to the ED by paramedics after his mother found him having a seizure involving all 4 limbs. His mother tells you that he was born full term without any complications and has been well until two days ago when he developed a fever. He vomited multiple times yesterday and was irritable. He has not had diarrhea or cough. He was given antipyretic medication for his fever. On physical exam, his temperature is 102.7 F, his pulse is 154/min, and BP- 90/50 mmHg and RR- 20/min. He is lethargic, pale, and focal neurological deficits are present. His anterior fontanel is bulging. You suspect that he has bacterial meningitis. After drawing blood samples for investigations, what is the next appropriate step in the management? |
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Definition
| Intravenous empirical antibiotics |
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Term
| When examining the patient's eyes you find that the left eye is deviated medially. When asked to track your finger with both eyes open, the left eye moves but remains medially deviated. When you cover his right eye, he is able to focus on you by centering his left eye. When you uncover his right eye, then left eye drifts back towards his nose. Vision is normal when you test each eye individually on a Snellen chart. Funduscopic examination is normal. What is the dx and tx? |
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Definition
| Esotropia of left eye which can be treated by atropine drops of the right eye |
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Term
| A 14-year-old girl has had a small, round, slightly tender swelling in her right lower eyelid for 2-3 days that has gradually enlarged, becoming round and painless. There has not been any drainage or itching noted or visual changes. On exam, Her mid right lower eyelid has a 1.5 cm round, nontender, swollen mass that is mildly erythematous without any drainage. The underside of the lid is grayish-red. Based on these findings, what is the most likely diagnosis? |
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Definition
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Term
| The area around the lacrimal sac becomes painful, red and swollen with the eye becoming red and watery and oozes a purulent discharge. Pressure to the lacrimal sac may push pus through the opening near the nose. Fever is common. What condition does this describe? |
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Definition
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Term
| A blockage of flow of tears from the eye to the nose due to narrowing of the nasolacrimal ducts, what condition does this describe? |
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Definition
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Term
| A seven-year old girl has a one centimeter mass in her right cheek. This lesion is painless, firm, sharply demarcated, and the overlying skin has a bluish discoloration. What is the most likely diagnosis? |
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Definition
| Pilomatrixoma - calcifying epithelioma of Malherbe |
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Term
| A 2-year-old female presents for a health care maintenance examination. Her development and growth parameters are normal. Her past medical history is unremarkable. Her parents are concerned about the appearance of her tongue. Over the past 4 months, they have noticed that she has had sores on her tongue that appear to change shape and size slowly over time. On examination, she has multiple, sharply demarcated, irregular, smooth red plaques on the dorsum of her tongue. The margins of the lesions are elevated and gray in color. Which is the most likely dx of this patient's condition? |
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Definition
| Benign migratory glossitis |
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Term
| The most appropriate initial management for otitis media is ? |
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Definition
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Term
| A 12-year-old boy is brought to you with short stature. Bone age, T4, T3 resin uptake and TSH level can be used to confirm or rule out |
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Definition
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Term
| The distinguishing feature that differentiates Anorexia Nervosa from Bulimia Nervosa is: |
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Definition
| Refusal to maintain a minimally normal body weight |
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Term
| A 2-year-old African-American boy is brought to you with painful swelling in the dorsal surfaces of hands, feet, fingers, and toes. His temperature is 38.9° C (102° F). Hemoglobin is 8g/dl and reticulocytes 7%. The peripheral smear shows several elongated and crescent shaped red blood cells. What is the dx? What is the tx? |
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Definition
hand-foot syndrome (serious infection seen in pts with sickle cell anemia)
Penicillin and immunization |
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Term
| Which cause of infective endocarditis is common in children? |
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Definition
| S. aureus and S. epidermidis |
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Term
| A 5-year-old male presents to the emergency room with a one week history of bruising and bleeding gums. He has previously been healthy, with only a viral upper respiratory infection noted a month ago. He lives at home with his parents and a 2-year-old sibling. He is up to date on his immunizations and he is taking no medications. He had an uncle who died from acute lymphoblastic leukemia at the age of twenty-one. On examination, the vital signs are normal. HEENT exam shows palatal petechiae and gingival bleeding. Tympanic membranes are normal. Neck is supple without adenopathy. Extremities are remarkable for large ecchymoses over his anterior tibias. He is active and appears to be in no distress. What is the dx? Which of the following is likely to be abnormal on a complete blood count? |
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Definition
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Term
| What is the most common cause of thrombocytopenia in childhood? |
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Definition
| idiopathic thrombocytopenic purpura (ITP) |
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Term
| The onset is usually of an acute nature, with multiple ecchymoses, petechiae, and epistaxis being common findings. Petechiae are most commonly noticed on the lips and buccal mucosa. Typically there is a preceding viral illness. The onset is usually of an acute nature, with multiple ecchymoses, petechiae, and epistaxis being common findings. Petechiae are most commonly noticed on the lips and buccal mucosa. What condition is described? |
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Definition
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Term
| On Thanksgiving day, a five month old child is brought to the emergency room with wheezing, rapid respirations (>45 breaths/min), and chest retractions. During the last 2 days, the patient had rhinorrhea and a low-grade fever. Breath sounds are normal and there is no cyanosis. Which test can confirm the most likely diagnosis? |
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Definition
| immunofluorescence of nasal secretion - can lead to rapid viral identification of RSV |
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Term
A newborn term female infant born 24 hours ago was found to have hydronephrosis of the right kidney on fetal ultrasound during the 3rd trimester. This was recorded as an 8mm dilation of the right renal pelvis in the anteroposterior diameter. Though the baby was born without incidents and seems to be doing well and has a normal newborn exam. The renal ultrasonogram (USG) comes back normal. What is the most appropriate next step?
A) Voiding cystourethrography (VCUG) prior to discharge
B) VCUG scheduled later as an outpatient
C) Repeat renal USG at 2-3 months
D) Discharge home on prophylactic antibiotics
E) Referral to urology |
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Definition
| A) Voiding cystourethrography (VCUG) prior to discharge |
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Term
| A 10-year-old female presents to your office with a 6-month history of constipation and occasional right-sided abdominal pain. She has no history of fevers, night sweats, urinary frequency, dysuria, emesis, or hematuria. Her appetite and activity have been normal.Abdominal exam reveals a 5cm by 7cm smooth mass in the right upper quadrant. No tenderness is elicited. No hepatosplenomegaly is noted. Some hard stool is palpated in the left lower quadrant. Rectal exam is heme negative. Neurological exam is within normal limits. Computed tomography shows a large cystic mass in the right upper quadrant contiguous with the right renal collecting system. No solid soft tissue component to the mass is noted. The remaining renal parenchyma on the right enhances normally with contrast and is otherwise unremarkable. The left kidney is normal, as are the remaining structures of the abdomen. Which of the following is the most likely cause of the patient's condition? |
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Definition
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Term
| The most appropriate treatment for a pt with croup if stridor is present? |
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Definition
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Term
| A 6-year-old female is referred to your office for further evaluation of "birthmarks". On physical exam, you find multiple café-au-lait spots over her trunk and extremities. What findings would you expect to find to support the diagnosis of neurofibromatosis 1? |
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Definition
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Term
| Adenoma sebaceum, ash-leaf macule, and Shagreen patches are all cutaneous manifestations of what conditions? |
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Definition
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Term
| A port-wine stain is a sign of what neurocutaneous syndrome? |
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Definition
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Term
| Which disease would you suspect if the child is under the age of 2 years and has hypertrophy of Peyer's patches? |
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Definition
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Term
| A 5 year-old-male child was brought to the emergency department due to generalized edema and weakness. Liver is enlarged, there is hyperpigmentation of the covered areas. Weight is normal but height is on the 10th percentile. What is the most likely diagnosis? |
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Definition
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Term
| The inadequate availability of which vitamin listed below can cause hemorrhagic disease of the newborn? |
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Definition
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Term
| What is the most frequent viral cause of diarrhea in older children? |
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Definition
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Term
| A 24-year-old white female, gravida 2, para 2, comes to the emergency department in a distressed state. She has brought her 5-day-old daughter with her and reports that the child started to bleed spontaneously from her vagina. The pregnancy was without any complications; labor was at term and occurred spontaneously without any problems. Examination of the child reveals an afebrile child with blood at the introitus. The child does not appear to be in pain and sleeps through the examination. Which of the following would be the next step in management? |
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Definition
| Reassure the mother and send her home; |
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Term
| A female newborn on physical exam has the following features: hypotonia, flattened facies with upslanting palpebral fissures, simian crease, and protruding tongue. Chromosome analysis would most likely yield which abnormal karyotype? |
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Definition
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Term
| A female neonate presents with gonadal dysgenesis (streak ovaries), webbed neck, low posterior hairline with occasional renal and cardiac defects. Occasionally, these infants present at birth with edema of the dorsum of the foot. Chromosome analysis would most likely yield which abnormal karyotype? |
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Definition
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Term
| A mother brings her child into your office for a well child check. The child is growing well and your exam reveals that she is developing normally. She is able to turn the pages of a book, uses 20 words, points to 4 body parts, walks up steps, and feeds herself with a spoon. Her development is most consistent with that of a child of |
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Definition
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Term
| Greater than 95% of infants have a very good pincer grasp at what age? |
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Definition
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Term
| What is the most common manifestation of inborn errors of metabolism? |
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Definition
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Term
| Amish parents bring their infant to the emergency room in a coma. Parents mention difficulty in feeding and slow development during the last few months. The baby opens his eyes and withdraws only to pain and there is no verbal response to pain. Pupils are responsive and cold water vestibular stimulation is normal. There is tachypnea and hyperpnea. His urine has a burned sugar odor. Laboratory studies indicate metabolic acidosis. Which of the following is the most likely cause of the coma? |
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Definition
| Maple Syrup urine dz - Accumulation of branched chain ketoacids |
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Term
| Bilious vomiting is caused by ? |
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Definition
| intestinal obstruction distal to the ampulla of Vater. |
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Term
| A 4-day-old male infant is seen by the pediatric resident in the newborn nursery for bilious vomiting and abdominal distention. The child had been feeding poorly and has been difficult to console according to the mother. He passed meconium shortly after birth and has passed several seedy, yellow stools per day since then. Physical examination reveals abdominal distention. The likeliest explanation for these findings is |
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Definition
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Term
| A 2-year-old female presents to the emergency room having swallowed a coin approximately 2 hours prior to her arrival. She has some drooling and appears anxious during the examination. Her parents have noted no stridor or dyspnea. Physical examination is unremarkable. A chest radiograph reveals a radiopaque round object at the distal esophagus. What is the most appropriate treatment option? |
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Definition
| Removal of coin via esophagoscopy |
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Term
| A 5-week-old male presents to his pediatrician with a 2-week history of vomiting. The vomitus is white in color and occurs after feedings. Initially, the patient had 2 episodes of emesis daily, but the frequency has increased to 5 times daily and the vomiting has become projectile. The patient is breast fed only, for 20-30 minutes every 3 to 4 hours. The mother has noted that he has developed a yellow color to the skin in the past 3 days. There is no history of fever, diarrhea, cough, respiratory distress, or trauma. The patient has produced fewer wet diapers in the past 2 days and is crying more than usual.The abdomen is soft with positive bowel sounds. There is no organomegaly or guarding. A 2 X 1 1/2 cm mobile mass is intermittently palpated in the midepigastric area. What is the dx? A capillary blood gas is most likely to show a: |
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Definition
Dx - Pyloric Stenosis
- Hypochloremic metabolic alkalosis |
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Term
| Pyloric stenosis creates what type of metabolic derangement? |
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Definition
| hypochloremic metabolic alkalosis |
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Term
| What is the recommended daily value of vitamin D in infants? |
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Definition
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Term
| Exclusively breast fed babies and dark skinned infants are two risk factors for the development of what vitamin deficiency? |
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Definition
| Vitamin D deficiency - Rickets |
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Term
| A 3-month-old male is seen by his pediatrician for a well-baby check-up. His physician notes that he has had excessive growth since his birth. He is hypertonic and shows some motor delay. His cry is hoarse. He has a distinct facial appearance, including micrognathia, hypertelorism and large, low-set ears. Karyotype analysis is normal. What is the most probable diagnosis for this child? |
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Definition
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Term
| The presence of more than _____?_______ obtained by transurethral catheterization has been proposed as criterion for diagnosis for UTI |
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Definition
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Term
| In urine obtained by suprapubic aspiration, ________?_______ is diagnostic of a UTI. |
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Definition
| any growth of gram-negative bacteria |
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Term
| A 6-year-old boy was brought to your office due to edema and brownish discoloration of the urine. Upon physical examination, a grade 1-2 pitting edema over the lower extremities was noted. Vital signs show a BP+ 130/100. Three weeks prior to the onset of the present symptoms, the patient had a fever and sore throat for which he was given medications and improved after several days. A routine urinalysis was requested which revealed RBC-(+++), RBC cast-( ++). What is the most likely diagnosis? |
|
Definition
| Post streptococcal glomerulonephritis |
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Term
| (+) antiGBM antibody and renal pathology showing focal to diffuse proliferation with crescent formation under Light microscopy is characteristic of what condition? |
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Definition
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Term
| MC form of Nephrotic syndrome? |
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Definition
| Nil (lesion) disease or Minimal change |
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Term
| What is the gold standard for warming patients who have cardiac arrest or ongoing cardiovascular instability? |
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Definition
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Term
| Which intravenous anesthetic is used mainly for children and young adults for diagnostic procedures of short duration ? |
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Definition
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Term
| Which type of Anorexia Nervosa, is specifically characterized by Failure to engage in bingeing and/or purging? |
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Definition
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Term
| Typically weight gain occurs throughout the day as edema collects in the lower extremities after prolonged sitting or standing. It occurs almost exclusively in postpubertal women and can occur at any time during the menstrual cycle. Headaches are common and may be related to increased pressure. Many patients will also urinate infrequently during the day and have increased urination during bedtime hours when recumbent. Psychological symptoms are very common and adolescents often become depressed, anxious, and frustrated. In addition fatigue, dizziness, light-headedness, syncope, and unexplained tachycardia may all be present. What condition is described? |
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Definition
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Term
| Which condition is characterized by at least 6 months of profound fatigue and may include impaired memory or concentration, headache, vertigo, and visual disturbances, patients will also have enlarged nodes and frequent sore throat? |
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Definition
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Term
| A non-inflammatory disorder characterized by diffuse pain and at least 5 or more specific tender points found on physical examination. Chronic anxiety, fatigue, poor sleep, chronic headaches, irritable bowel syndrome, subjective soft tissue swelling, numbness, pain modulation by physical activities, weather factors or anxiety, and stress may also be present. What condition is described? |
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Definition
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Term
| What condition is most commonly present as intermittent, brawny, swelling of the extremities with recurrent facial and subglottic swelling as well as recurrent, crampy abdominal pain, and wheezing with edema usually lasting 24-72 hours? |
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Definition
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Term
| It arises most often in puberty and females are affected 4 times as often as males. About 70% of cases are unilateral, with the left lower extremity being involved more often than the right. Histologically the lymphatics are reduced in caliber and number and demonstrate a hypoplastic pattern. What condition is described? |
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Definition
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Term
| A 12-year-old boy is brought to you with short stature. Complete blood count, sedimentation rate, serum electrolytes, and BUN can be used to confirm or rule out: |
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Definition
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Term
| When assessing pubertal development, what information is important to remember in children of Asian descent? |
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Definition
| Pubic hair distribution may not progress beyond stage 3 |
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Term
|
Definition
|
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Term
| Tx for Grp A Strep if pt is PCN allergic? |
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Definition
| Cephalosporin or Macrolide |
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Term
| Tx for Grp A Strep if pt is PCN allergic? |
|
Definition
| Cephalosporin or Macrolide |
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Term
| A 10-year-old male presents to his primary care physician with a 2-day history of sore throat, fever up to 39.0°C orally, and dull midepigastric pain. He has had a single episode of non-bilious emesis. He also reports a moderately severe, non-throbbing frontal headache. There is no history of rhinorrhea, cough, or diarrhea. On physical exam, the patient looks ill but nontoxic. Temperature - 39.3° C, heart rate 105, blood pressure 110/65, respiratory rate - 20. Head, ears, eyes, and nose are normal. Tonsils are enlarged, beefy-red with purulent exudate. Petechiae are present on the soft palate. There is a white "coat" on the tongue. Neck is supple with prominent bilateral anterior cervical adenopathy. Skin is warm with a confluent red "sandpaper-like" rash over the trunk and more prominently in the groin area. What is the dx? |
|
Definition
| Grp A beta Strep - Scarlett Fever |
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Term
| How long should a student with strep be treated before returning to school? |
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Definition
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Term
| As you examine a 4 day old infant born through vaginal delivery, you notice that she has a very poor grip reflex of the right hand. Evaluation of her face also reveals slight ptosis and miosis of the right eye. What condition explains the findings regarding this infant? |
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Definition
| Klumpke's paralysis with involvement of the sympathetic fibers of T1 |
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Term
| Which method of assessment would provide clues about the duration of exposure and the degree of lead accumulation? |
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Definition
| Heme precursor, protoporphyrin level |
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Term
| A sexually active adolescent develops fever, pain with movement of fingers, and weak grasp. Physical examination finds point tenderness in the hand and petechial rash on the dorsum of the hands. Culture of the joint fluid is sterile. What is the dx? |
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Definition
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Term
| Which test should be performed to confirm the dx of gonorrheal arthritis? |
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Definition
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Term
| A 4-year-old boy is brought in by his mother for assessment of possible Attention Deficit Hyperactivity Disorder (ADHD). He has continued to show some immature behavior; unwillingness to eat or dress independently, an inability to consistently toilet train as well as poor attention skills. He achieved his major developmental milestones more or less on time, though fine motor and language development were attained late. What is an essential part of this child's evaluation with cognitive impairment as part of your dx? |
|
Definition
| High resolution chromosome analysis |
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Term
| A 4-year-old boy is brought in by his mother for assessment of possible Attention Deficit Hyperactivity Disorder (ADHD). He has continued to show some immature behavior; unwillingness to eat or dress independently, an inability to consistently toilet train as well as poor attention skills. He achieved his major developmental milestones more or less on time, though fine motor and language development were attained late. What is an essential part of this child's evaluation with cognitive impairment as part of your dx? |
|
Definition
| High resolution chromosome analysis |
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Term
| What condition includes disordered thought, delusions, and visual or auditory hallucinations, such as imaginary persons or voices with onset that is insidious, and may include paranoid delusions, aggressive behavior, changing moods, social withdrawal, or pathologic silliness? |
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Definition
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Term
| Does Rett disorder affect females or males? |
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Definition
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Term
| Onset is typically in the second year of life, beginning with regression in motor and language development, and progressing to autistic behaviors, microcephaly, and a characteristic hand-wringing behavior. This describes what condition? |
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Definition
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Term
| Cause of bacterial tracheitis? |
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Definition
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Term
| A 2-year-old female presents to your office with a complaint of severe anal itching over the past 3 weeks. The itching has kept her up at night. No others in the household have similar symptoms, but a few children in the day care have manifested similar itching recently. Her physical exam is completely unremarkable except for minimal perianal erythema. What is the most appropriate treatment option? |
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Definition
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Term
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Definition
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Term
|
Definition
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Term
|
Definition
|
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Term
| Tx for cystitis if allergic to Bactrim? |
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Definition
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Term
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Definition
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Term
| Drug of first choice for Lyme disease of a 10-year-old child. |
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Definition
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Term
| Which hepatic disorders corresponds with a clinical picture involving conjugated hyperbilirubinemia, gastrointestinal symptoms, and dark pigment in hepatocytes? |
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Definition
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Term
| A mother brings her 2-year-old son to your office because she has concerns about his sleep. She notes that he is easy to put to sleep and has a regular bedtime at 7:30 P.M. For the past three weeks, on most nights, about 90 minutes after being put to sleep, he begins to thrash violently in the bed and, at times, lets out blood-curdling screams. He has his eyes open and seems to be talking, but he does not respond to either parent when spoken to. He sweats a lot. The episodes last about 15 minutes and then he goes back to sleep. He seems fine in the morning. What is the dx? |
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Definition
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Term
| Occurring about 60 - 100 minutes after going to sleep, there may be thrashing and moaning that lasts between five and fifteen minutes. The child may appear to be awake with eyes open and confused or upset. The episodes are difficult to interrupt, and children do not respond to parental consoling. They may occur multiple times, but tend to decrease in intensity if they extend into the second half of the night. They occur more commonly when the child's schedule has been altered, the child is overly tired, or the child is upset or ill. |
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Definition
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Term
| More common early in the morning, most common between 3 and 6 years and more common in children with mental retardation, depression, and certain CNS disorders. They are characterized as frightening dreams and often reflect daytime stress and the child is easily arousable and comforted. What condition does this describe? |
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Definition
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Term
| What is the MC reason infants wake within the first thirty minutes of going to sleep? |
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Definition
| Sleep association disorders |
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Term
| This is a situation where an infant has an association with going to sleep, such as nursing or having a parent lie down in the bed. If the child wakes and does not have the association present, then the child does not have the skills to go back to sleep alone. What is the disorder? |
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Definition
| Sleep association disorders |
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Term
| A male newborn is brought to the neonatal intensive care unit with an anterior abdominal mass. The mass extends off the right side of the abdomen and measures 3.5 centimeters. This uncovered mass appears to contain small bowel. No other physical abnormalities are seen and a genetic profile is pending. What is the most likely differential diagnosis for this child? |
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Definition
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Term
| A 13-year old child has recurrent pulmonary infections. All childhood immunizations have been received as scheduled. Results of laboratory studies, including blood counts, plasma immunoglobulins, and sweat test, are within normal limits. Intradermal injection of 1:5 dilution of tetanus toxoid does not lead to an erythematous, indurated lesion during the next 3 days. What is the most likely dx? |
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Definition
| Impaired T cell function which needs further investigation |
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Term
| Abdominal tumors arising from the adrenal glands or retroperitoneal sympathetic ganglia account for 75% of all neuroblastomas and present as solid, often fixed, painful or painless, irregularly shaped masses crossing the midline. Constitutional symptoms may be caused by catecholamine production and include fever, weight loss, flushing, sweating, and irritability. What is the most likely dx? |
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Definition
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Term
| A 4-year-old boy presents to the emergency department late one night with remittent abdominal as well as right hip pains, fever, sweating, decreased appetite, and constipation with pencil-thin stools worsening over a 2 week period. Abdominal exam reveals alarge, distinct, palpable, firm, slightly tender 10 x 12cm mass crossing the midline centered in the lower right quadrant. What is the most likely dx? |
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Definition
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Term
| Radiation therapy is most commonly associated with the development of which secondary malignancy? |
|
Definition
| Bone and soft tissue sarcoma |
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Term
| Which childhood diseases corresponds with thymic hypoplasia? |
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Definition
|
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Term
| MCC of watery diarrhea in the US? |
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Definition
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Term
| A four-year old child develops generalized urticaria. Past history and results of physical examination are unremarkable. What is the most appropriate next step in the management? |
|
Definition
| Antihistamines and follow-up to determine if the urticaria is chronic or recurrent |
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Term
| A 3-year-old female presents to your office with a 4-day history of burning with urination. Her mother states that she has had no fever, no diarrhea, and is on no medications. She uses a bubble bath twice a week. Her mother has also noted a clear mucoid discharge from the vagina. She does not attend day care. She is potty trained and performs her own wiping. Physical exam reveals an erythematous and slightly swollen vaginal introitus. A clear, thin, mucoid discharge is noted. The hymen is intact. Anus appears normal. Unusual odors are not detected. Urinalysis is within normal limits. The most likely cause of her condition is: |
|
Definition
| Nonspecific vulvovaginitis |
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Term
| Approximately eight hours after a forceps delivery the newborn is observed to be lacking unilateral facial movement. What is the most probable cause? |
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Definition
| Neurapraxia of the facial nerve (VII) |
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Term
A 1-month-old former premature male infant with BPD remains intubated and monitored in the NICU. He has been doing relatively well and is being gradually weaned from the respirator. Suddenly, his O2 saturations and heart rate plummet and he becomes very dusky. On quick exam, there are decreased breath sounds on the right with an asymmetric chest rise.
What is the most likely explanation for his sudden respiratory and clinical change? |
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Definition
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Term
| A 10-year old boy is brought to the emergency room with symptoms of blurred vision, difficulty of swallowing, and weakness. The symptoms evolved rapidly, and his speech became slurred. Pupils are dilated. There is ptosis and loss of accommodation. The muscle action potential is low, and there is an incremental response on rapid repetitive stimulation. Which of the following is the most likely causal organism? |
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Definition
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Term
| 3 weeks after a virus infection, a 7-year-old child develops muscle weakness. It first started with the legs and subsequently progressed to other muscles. On examination, the child is alert but strength testing confirms muscle weakness and areflexic motor paralysis. Analysis of cerebrospinal fluid shows acellular rise of total protein. What is the most important test in follow-up of this disorder? |
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Definition
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Term
| Edrophonium chloride test is used to dx what condition? |
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Definition
|
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Term
| MC diaphragmatic herniation in newborns? |
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Definition
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Term
| An 11-year-old presents to your office with a 3-week history of right heel pain. He has been active playing baseball over the past 2 months. No history of trauma is elicited. His past medical history is unremarkable. His only medication is occasional ibuprofen. On physical examination, he has tenderness to lateral compression of his right heel. His height and weight are in the 90th percentile. The remainder of the examination is within normal limits. What is your dx? What is an expected radiographic finding associated with that diagnosis? |
|
Definition
Sever dz - osteochondrosis
Fragmented and dense calcaneal apophysis |
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Term
| On physical exam, the child appears smaller than the stated age of 6 months. The head circumference is in the 90th percentile for age. The temperature is 35° C (95° F). The child is sluggish. The anterior and posterior fontanels are widely open, but flat and soft. The eyes appear far apart and the nose is broad with a depressed bridge. The eyes appear swollen and the palpebral fissures are narrow. The tongue is thick and protrudes from the mouth. The hands are broad and the fingers are short. There is no simian crease or clinodactyly. The skin is dry and scaly. The hair is coarse, brittle, and scant. The abdomen is large and distended. The baby appears lethargic and developmentally delayed. This child most likely suffers from |
|
Definition
| Congenital Hypothyroidism |
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Term
| Which condition is described as deficient T cell immunity and viral infections, cardiovascular defects like interrupted aorta or truncus arteriosus, thymus hypoplasia, fish-shaped mouth, low-set ears lymphocytopenia? |
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Definition
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Term
| You are the attending physician at a progressive hospital-based urgent care center. A 5-year-old female is brought in with a generalized seizure associated with a fever of 105° F. Her spinal tap is negative. After the seizure, she is unable to move her left arm for 1 hour. This paralysis is known as |
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Definition
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Term
| A 17 year-old girl complains of sore throat and weakness, with a fever of 100oF. There is cervical lymphadenopathy in physical exam, and the test of Monospot is positive. After eight days, the patient develops acute abdominal pain. During the abdominal examination, she suddenly becomes pale, sweaty, and cold. The illness described above is caused by: |
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Definition
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Term
| A 17 year-old girl complains of sore throat and weakness, with a fever of 100oF. There is cervical lymphadenopathy in physical exam, and the test of Monospot is positive. After eight days, the patient develops acute abdominal pain. During the abdominal examination, she suddenly becomes pale, sweaty, and cold. What is the appropriate treatment? |
|
Definition
| An urgent laparotomy is indicated because patient is in shock with internal hemorrhage, due to rupture of the spleen |
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Term
| Two weeks after an upper respiratory infection, an adolescent starts complaining about diarrhea, sweating, and increased heart rate. Physical examination finds tremor and a swollen, tender, and painful thyroid gland. Pulse rate is 110/min and blood pressure is 130/60mmHg. Refer to the attached laboratory studies. What is the diagnosis? What is the appropriate treatment? |
|
Definition
Dx - hyperthyroidism caused by subacute thyroiditis
Tx - Symptomatic (NSAID, beta blocking drug) |
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Term
| An 18-month-old female is brought by her mother to the ED for evaluation. The child appeared to have a fainting spell earlier in the day. The child has no previous medical problems. The mother states that the child was playing and became startled by a loud noise. She began crying and then became pale. She then went limp, fell to the ground, and then stiffened. After a few seconds, she "woke up" and cried. The child is now acting normally according to the mother. Based on this history, the most likely diagnosis is |
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Definition
|
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Term
| What should be used to reverse hypoglycemia in infants? |
|
Definition
| 0.5-1 g/kg of glucose as D10W |
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Term
| What is the most important first step in detecting IUGR early? |
|
Definition
| Accurate dating of pregnancy |
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Term
| What is considered Low Birth Weight (LBW)? |
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Definition
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Term
| A 6-year-old boy with a history of strabismus goes to his ophthalmologist for follow up and corrective intervention. His exam expectedly reveals his condition is as follows: on the cover test when his left eye is covered, his right eye moves toward his nose while observing a target. Based on your vision exam, which of the following eye deviations does this boy have? |
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Definition
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Term
| How can you tell the difference between tinea of the skin and dermatophyte infection of the hair? |
|
Definition
| On Wood's lamp dermatophyte infection will have a pale green fluorescence |
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Term
| A 4-year-old male presents to his family doctor with a 1-month history of a red area on his cheek that has gradually enlarged. The rash is slightly pruritic but nontender. The patient was given a new kitten for his birthday 2 months ago. Past medical history and family history are unremarkable. On examination, the patient is well appearing and afebrile. He has a 3-cm annular erythematous lesion on his right cheek. It is slightly scaly with central clearing and a papulovesicular border. The rash is nontender to touch. There is no cervical adenopathy. What is the dx? What is the tx? |
|
Definition
| Tinea corporis - Clotrimazole cream |
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Term
| A 6-year-old child is seen at your center for a school physical exam-on examination you note a neck mass. The child has been asymptomatic according to the mother. On physical exam, you find a 3-cm fluctuant cystic midline neck mass just below the level of the hyoid bone. The mass rises with protrusion of the tongue and with swallowing. The most likely diagnosis is |
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Definition
|
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Term
| What is the MC congenital neck mass? |
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Definition
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Term
| t typically follows a respiratory infection. Children are not able to bear weight on the extremity or may limp or complain of knee pain. The CBC is normal, as is the erythrocyte sedimentation rate. Radiographs are normal or may show a small effusion. What condition is described? |
|
Definition
| Toxic Synovitis of the hip |
|
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Term
| What is the tx for toxic synovitis of the hip? |
|
Definition
| The condition typically resolves in 1-3 weeks and responds to nonsteroidal inflammatory agents. |
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Term
| What condition has typical features of including fever, toxicity, and limited range of motion, externally rotated and partially flexed posturing of the involved leg, elevated white blood cell count and erythrocyte sedimentation rate, and a positive bone scan. |
|
Definition
| Septic arthritis of the hip |
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Term
| These children typically present with a limp or mild anterior thigh pain. Antalgic gait, muscle spasm, limitation of range of motion, and proximal thigh atrophy are often seen. What condition is described? |
|
Definition
| Legg-Calve-Perthes Dz - Avascular necrosis of the femoral head |
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Term
| Typically presents in obese or rapidly growing adolescent males, usually between the ages of 12 and 15. It may occur from an upward blow through the femoral shaft, but is generally not associated with any significant trauma. Radiographic findings include widening of the epiphyseal plate in the pre-slip condition and frank slippage of the femoral neck in relation the capital epiphysis. What condition is suspected? |
|
Definition
| SCFE - Slipped Capital Femoral Epiphysis |
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Term
| A 3-year-old female presents to the emergency room with a 4 day history of limp and left leg pain. She points to the anterior thigh as the source of her pain. Upon review of symptoms, it is noted that she had a viral upper respiratory infection approximately 1 week ago. She has been afebrile. She has otherwise been well. Exam is notable for normal range of motion of all lower extremity joints. She is afebrile. CBC and ESR are normal. Radiographs of her hips and legs are normal. What is the likely cause of her symptoms? |
|
Definition
| Toxic synovitis of the hip |
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Term
| What is the most reliable method of establishing the diagnosis of sinusitis in children? |
|
Definition
| Sinus aspiration for bacterial culture - although it is rarely used |
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Term
| What is the most common cause of secondary amenorrhea in adolescents? |
|
Definition
| Stress-related conditions (2nd MC is pregnancy) |
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Term
| She is 12-hours-old, feeding well, and maintaining her temperature adequately. Physical examination is notable for small superficial pustules on the chin, lower back, and extremities, some which have ruptured and are surrounded by a collarette of fine scale. Some of these ruptured vesicles have a central hyperpigmented macule in the center. A smear is taken of the vesicular contents. What is the most likely diagnosis? |
|
Definition
| Transient neonatal pustular melanosis |
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Term
| Neonatal skin condition described as typically 1-2 mm white-to yellow papules or pustules on an erythematous base will be observed. What condition is described? |
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Definition
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Term
| A child has a port-wine stain of the face within the distribution of the trigeminal nerve. Which of the following is the most likely diagnosis? |
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Definition
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Term
| Characterized by profound thrombocytopenia in conjunction with a single, large hemangioma or diffuse hemangiomatosis. Other clinical manifestations include petechiae, ecchymoses, or intimal bleeding. Thrombocytopenia is secondary to platelet trapping. What condition is described? |
|
Definition
| Kasabach-Merritt Syndrome |
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Term
| Characterized by a cutaneous port-wine stain overlying a combined vascular malformation; limb hypertrophy frequently results. What condition is described? |
|
Definition
| Klippel-Trenaunay-Weber Syndrome |
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Term
| The following symptoms, 1) anorexia with regular menses, 2) loss of weight but a weight within normal limits, 3) bulimic behavior at a rate where binging and purging is less than two times a week, and 4) bulimic behavior for a period of less than three months; would warrant a diagnosis of which of the following? |
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Definition
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Term
| Physical examination is normal except for the following findings: The left testicle is approximately 1½ times the size of the right testicle. The skin is diffusely erythematous. Due to tenderness when touched, it is difficult to palpate the scrotum. Cremasteric reflex is absent. There are small, soft, pea-sized lymph nodes in both inguinal areas. Penis is circumcised and appears normal. Because you are unsure of the diagnosis, you order scrotal ultrasonography with Doppler ultrasound that demonstrates decreased blood flow to the testis. The most likely diagnosis is |
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Definition
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Term
| Tenderness is usually localized to the upper portion of the testis and, typically, a blue dot is seen on the scrotal skin resulting from the venous congestion in the appendix testis. Cremasteric reflex is usually present. What condition is described? |
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Definition
| Torsion of the appendix of the testis |
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|
Term
| 90% of patients have a unilateral presentation. The scrotal skin is red and tender, but the testis appears to be normal. The redness tends to extend off the scrotum onto the perineum or onto the penis. Doppler ultrasound, if done, demonstrates good blood flow to the testis with peritesticular edema and fluid in the scrotal wall. |
|
Definition
| Acute idiopathic scrotal edema |
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Term
| A 2½-year-old white male presents to the clinic with a 1-month history of decreased energy and increased somnolence. His mother admits that he is a picky eater and that he "loves to eat mattresses." Review of systems reveals that he drinks milk only with cereal and has occasional constipation. His vital signs are within normal limits. What deficiency do you suspect in this pt? |
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Definition
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Term
| A 17-year-old female presents to the clinic due to chronic fatigue. Review of systems reveals heavy monthly menses since menarche began at age 13. Labs are as follows: pregnancy test negative; cervical cultures negative; thyroid studies within normal limits; white blood count 9 K, hemoglobin 10, platelet count 250 K. Peripheral blood smear is consistent with microcytic, hypochromic anemia. Prothrombin time, partial thromboplastin time (PT, PTT), and fibrinogen are normal. Bleeding time is prolonged. The most likely diagnosis is: |
|
Definition
| Von Willebrand disease - Iron deficiency anemia |
|
|
Term
| MC cause of pneumonia in infants aged 2 weeks to 3 months? |
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Definition
|
|
Term
| staccato cough, afebrile infant, and eosinophilia in a 2 mo old are classic symptoms of what type of pneumonia? |
|
Definition
|
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Term
| What is the treatment of choice for chlamydia trachomatis pneumonia in children? ... in adults? |
|
Definition
In children Erythromycin
In adults Tetracycline |
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Term
| A three-month old infant develops rapid breathing and staccato cough, but otherwise appears well and is afebrile. Physical examination detects fine rales over the lungs. The tympanic membrane is red and thickened. A chest x-ray shows bilateral patchy infiltrates. Laboratory studies indicate eosinophilia and elevated serum immunoglobulin concentrations. Which of the following is the most likely causal organism? What is the tx? |
|
Definition
| Chlamydia trachomatis and tx is erythromycin |
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Term
| A five-month old infant is presented with tachypnea and cough. Conjunctival blood vessels are hyperemic and the temperature is 100.1° F. Chest auscultation reveals occasional wheezes and diffuse rales. Chest x-ray shows hyperinflation and diffuse interstitial infiltrates. Laboratory studies indicate eosinophilia. Which of the following antibiotics is the most likely choice for this patient? |
|
Definition
| Erythromycin (Tx of choice for chlamydial trachomatis) |
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Term
| A newborn was brought to the emergency department after being delivered accidentally in a taxicab. Upon physical examination, he is limp, small, weighing 2000gms. Distinct facial facies were also noted, such as mild ptosis, epicanthal folds, short nose and a smooth upper lip. There is a harsh murmur heard best at the midsternal border. Upon questioning the relative, the mother has a history of drinking alcohol while she was pregnant. Based upon the findings, what would be the likely diagnosis? |
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Definition
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Term
| On physical exam, you note that the child has upward-slanting eyes, a small upturned nose with a saddle bridge, inner epicanthal folds, small ears, simian creases, and clinodactyly of both fifth fingers. The child appears to have floppy tone as well. These findings are typical for what trisomy? |
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Definition
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Term
| Children with this trisomy have multiple congenital anomalies, such as cleft lip, hemangiomas of the face, forehead, or neck, broad flat nose, low-set malformed ears, small abnormal skull, cerebral malformations, cardiac malformations, and visceral and genital anomalies. what is the trisomy? |
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Definition
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Term
| The clinical manifestations are severe mental retardation, rocker bottom feet, micrognathia, and cardiac and renal malformations. What trisomy is described? |
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Definition
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Term
|
Definition
|
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Term
| What medication can cause a deficiency of Vitamin B6 (pyridoxine) after a period of prolonged application? |
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Definition
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Term
| What deficiency manifests as generalized seizures in infants and polyneuritis and sideroblastic anemia in older children and adults? |
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Definition
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Term
| What agent can cause a deficiency of Vitamin B1 after a period of prolonged application? |
|
Definition
| Ethanol - Causes thiamine deficiency |
|
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Term
| What GI pathogen causes acute infectious diarrhea and can be paired with the pathogenic mechanism of enterotoxic, enteropathogenic, enteroinvasive and enterohemorrhagic effects? |
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Definition
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Term
| An 8-month old infant develops spasticity and episodic sudden contractions of muscles. During such attacks, eyes converge and do not focus on an object simultaneously. The tone of the masseter muscles is increased. Contraction of the back muscles produces an arched back. Examination finds hepatosplenomegaly and pancytopenia. Which of the following tests should be performed to confirm the most likely diagnosis? |
|
Definition
| Bone marrow biopsy and enzyme analysis - to dx Gaucher's dz |
|
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Term
| The classic triad of strabismus, trismus (lockjaw), and opisthotonus in association with spastic and seizure disorder is highly suggestive of what condition? |
|
Definition
| neuronopathic infantile form of Gaucher's disease |
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Term
| Lifting the head from the prone position with ability to turn the head from side to side occurs at what age? |
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Definition
|
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Term
| No head lag when pulled from the supine to the sitting position occurs at what age? |
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Definition
|
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Term
| Rolling over from the prone to the supine position, sitting with support occurs at what age? |
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Definition
|
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Term
| Sitting without support, rolling over from the supine to prone position, transferring objects from hand to hand occurs at what age? |
|
Definition
|
|
Term
| Stands holding onto support occurs at what age? |
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Definition
|
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Term
| Walks with support at what age? |
|
Definition
|
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Term
| When you start an evaluation for possible failure to thrive, what is the most important tool in your evaluation and the basis for an approach to the differential diagnosis? |
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Definition
|
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Term
| A child washing his hands alone indicates what age? |
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Definition
|
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Term
| Throwing a ball overhand = what age? |
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Definition
|
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Term
| Child tells a story at what age? |
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Definition
|
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Term
|
Definition
|
|
Term
| Parallel play with other children at what age? |
|
Definition
|
|
Term
| Interactive play with other children at what age? |
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Definition
|
|
Term
| Potty trained by what age? |
|
Definition
|
|
Term
| DOC for acute otitis media? |
|
Definition
|
|
Term
| What GI pathogen can cause post-infectious polyneuropathy (Gullain-Barre Syndrome)? |
|
Definition
|
|
Term
| For which seizures would diazepam, lorazepam, followed by phenytoin be prescribed as the appropriate drug treatment for prevention? |
|
Definition
|
|
Term
| What is the MCC of status epilepticus? |
|
Definition
| stopping of anti-seizure med |
|
|
Term
| DOC for status epilepticus? |
|
Definition
| Benzos - diazepam or lorazepam |
|
|
Term
| For seizures would carbamazepine, phenytoin, and primidone be prescribed as the appropriate drug treatment for prevention? |
|
Definition
|
|
Term
| Which seizure has a clinical presentation of impaired consciousness with motor, sensory, or autonomic symptoms which are focal? |
|
Definition
|
|
Term
| Which childhood psychiatric disorders corresponds with the clinical picture of profound helplessness, failure at home, poor school performance, and frustration? |
|
Definition
|
|
Term
| Which childhood psychiatric disorders corresponds with the clinical picture of emotional blunting, formal thinking disorder, hallucinations, delusions and broadcasting? |
|
Definition
|
|
Term
| During what stage of sleep do Night terrors occur? |
|
Definition
| Stage 4 - delta wave sleep |
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Term
| During what stage of sleep does sleeptalking or sleepwalking occur? |
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Definition
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Term
| During what stage of sleep do night mares occur? |
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Definition
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Term
| Which seizure has a clinical presentation of episodes of unresponsiveness (10 to 20 seconds) with typical onset between 4-6 years of age? |
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Definition
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Term
| Which seizure has a clinical presentation of short cry, loss of consciousness and generalized rigidity, rhythmic contractions and flaccidity? |
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Definition
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Term
| The most common organism causing bacterial meningitis in newborns is |
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Definition
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Term
| The most common bacterial meningitides in infants and children? |
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Definition
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Term
| The most common bacterial meningitides in young adults? |
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Definition
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Term
| Which seizure type has a clinical presentation of motor, sensory, or autonomic symptoms which are focal without impaired consciousness? |
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Definition
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Term
| A 10-year-old child complains of anorexia, malaise, mild fever, and sore throat for 2 days, then painful sore red spots some with blisters on the tongue, gum, inside of the cheek, palms, and feet. What is the most probable diagnosis? |
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Definition
| Hand-foot-and-mouth disease |
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Term
| Which childhood psychiatric disorders corresponds with the clinical picture of cyclic expansiveness, aggressiveness and impulsivity? |
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Definition
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Term
| What other abnormalities may be found in a child with fetal alcohol syndrome other than facial dysmorphia, growth deficits? |
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Definition
| Central nervous system abnormalities |
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Term
| A 3-month-old female infant presents with a maculopapular rash on her trunk. You diagnose exanthema subitum, caused by human herpesvirus 6. What else characteristically accompanies this rash? |
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Definition
| there is a rapid onset of high fever |
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Term
| The glans penis starts to develop in which Tanner stage of male sexual maturity? |
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Definition
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Term
| The most common ("classic") form of congenital adrenal hyperplasia is deficiency of _____? |
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Definition
| cytochrome P-450 21 hydroxylase |
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Term
| If clubfoot were suspected, which sonographic criteria would determine its presence? |
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Definition
| The bottom of the foot is on the same plane as the long axis of the lower leg |
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Term
| Deficiency of lysosomal a - 1-4- and 1-6 glucosidase (acid maltase) is characteristic of which disease? |
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Definition
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Term
| What is the most frequently occurring non-glial tumor in childhood? |
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Definition
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Term
| What are the MC presenting sx of a craniopharyngioma? |
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Definition
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Term
| Small for Gestational Age (SGA) weight refers to birth weights less than what percentile on the intrauterine growth curve? |
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Definition
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Term
| Large for Gestational Age (LGA) weight refers to birth weights greater than what percentile on the intrauterine growth curve? |
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Definition
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Term
A full term baby is sent home, along with the mother, two days after normal vaginal delivery. Five months later, the mother brings the baby to the clinic. The baby has increased sweating and fatigue (excursion during breastfeeding) during feeding. In addition, as a result of poor feeding, the mother feels that the baby is not gaining sufficient weight. On examination, a pansystolic murmur is heard at the lower left sternal border. Which of the following would you suspect?
A Hypertrophic subaortic stenosis
B Hypoplastic left heart syndrome
C Coarctation of the aorta
D Ventricular septal defect
E Bicuspid aortic valve |
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Definition
| D - Ventricular Septal Defect |
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Term
| What condition is characterized by downward displacement of the septal and posterior leaflets of the tricuspid valve into the cavity of the right ventricle (RV), leading to atrialization of the right ventricle with abnormal attachment of the anterior leaflet to the RV free wall. |
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Definition
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Term
| A cardiac systolic murmur was detected at the left lower sternal border of a 7-year-old male child during a routine visit to the pediatric clinic. The child is asymptomatic and there were no other significant findings on physical examination. Echocardiography revealed apical displacement of the septal and posterior tricuspid valve leaflets, and ECG revealed right axis deviation and right bundle-branch block. What condition is described? |
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Definition
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Term
| A 6-year-old boy is brought to his pediatrician for follow-up of asthma. He has been categorized as mild persistent asthma. Which is the preferred treatment for this patient for maintenance of long-term control? |
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Definition
| Low-dosage inhaled corticosteroid |
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Term
| Which type of seizure has a clinical presentation of thirty minutes of continuous seizure activity and the convulsive form is a medical emergency? |
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Definition
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Term
| What chromosome abnormality causes a Wilm's tumor? |
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Definition
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Term
| Which disease has a clinical picture of insufficient production of glutathione and formation of Heinz bodies? |
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Definition
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Term
| Which disease has a clinical picture of ganglioside accumulation with hyperacusis, later seizures, and death in early childhood? |
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Definition
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Term
| Which disease has a clinical picture of sphingomyelin accumulation in the reticuloendothelial system and vacuolated histiocytes? |
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Definition
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Term
| Which disease has a clinical picture of gluceramide accumulation and large foam cells in the bone marrow? |
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Definition
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Term
| If a family has a child with Down syndrome, what are the chances of a sibling having it as well? |
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Definition
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Term
| Which inherited diseases has a clinical picture of hepatomegaly, choreoathetoid movement and Kayser-Fleischner ring? |
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Definition
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Term
| Which inherited diseases has a clinical picture of viscid secretions, pancreatic insufficiency and chronic pulmonary disease? |
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Definition
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Term
| Which disease has a clinical picture of autistic features, mental retardation, large jaw and ears? |
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Definition
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Term
| For which seizure would Carbamazepine be prescribed as the appropriate drug treatment for prevention? |
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Definition
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Term
| Machinery-like murmur = ? |
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Definition
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Term
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Definition
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Term
| Diagnostic test for intussuception? |
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Definition
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Term
| What is the characteristic diagnostic finding in pertussis? |
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Definition
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Term
| What chromosome is affected in CF? |
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Definition
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Term
| If hemolytic disease of the newborn is suspected what test is used to confirm it? |
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Definition
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Term
| Which test can be used to diagnose varicella and herpes zoster? |
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Definition
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Term
| Which test can be used to diagnose varicella and herpes zoster? |
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Definition
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Term
| How is Hirschsprung dz diagnosed? |
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Definition
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