Pediatrics

Question 1

hild patient after eat steak has fever and abdomen pain what is the management? Another Q: 3years old presented with watery diarrhea,cramps , dehydration after being exposed to colleague with same presentation at day care

Answer 1

Conservative

Question 2

Child with Hx of eating in a restaurant with abd pain, nausea and vomiting, 10 days later bloody
diarrhea, urinalysis shows 10 RBCs ,

Answer 2

Supportive ttt

Question 3

Child develops petechia in the legs, he has history of URTI. Labs showed: normal CBC except platelet
count was : low. What is the next step in management?

Answer 3

Immunoglobulin ( if sever bleeding like untracranial hemhhrage
C. Steroid ( if mild bleeding ) D. Supportive ( if plattlet more than 30.000 and there is no bleeding )

Question 4

5 years old boy has RUQ pain + normal bowel sounds ,lap show severe drop in hemoglobin and increased reticulocytes count. Blood smear report: target cells and inclusion bodies. diagnosis?

Q-Boy complaining of RUQ pain, he had a history of URTI couple of days ago, cbc shows low hgb and
increased retics, smear shows target cellsand inclusion bodies, dx

Answer 4

Sickle cell disease

Question 5

Child with a long history of watery diarrhea abdominal bloating and pain, what’s the Dx?

Answer 5

chronic giardiasis

Question 6

treatment of dengue fever?

dengue mosquito time of activity?

Answer 6

Supportive and avoid NSAIDs / early morning

Question 7

Treatment of Rota virus?

Answer 7

Reassure

Question 8

Neonate with vaginal mucoid discharge and concerned mother what to do?

Answer 8

Reassure

Question 9

Feverish child T 38, cough, Bilateral infiltrated lung. Nothing else mentioned. Management?

Answer 9

Reassure, viral infection

Question 10

8-month-old with asymmetrical breast enlargement and no other symptoms what is the cause?

Q2- 🌹18 months girl with asymmetrical breast enlargement other examination normal =
Abdominal US ✅ ( Dont choice C.T pelvic or Brain MRI) (if there is GN Rh stimulation test choice it)

Answer 10

Reassure

Question 11

A child with birth weight 3.5kg now weighing 3.1. Breastfeed about 3 times every 15 minutes. Advise to mum? Another Q; mom comes with her neonate who is 1 week of age, she is worried because her neonate lost 1.5 kg from his birth weight

Answer 11

Reassure that all is well ( because babies loose up 10% of birth weigh because its fluid but should re-gain it within 2 weeks of life

Question 12

Two weeks year old child suddenly had erythematous rash on his body (the child was not febrile and he was stable) what to do / another Q : Infant with erythematous macules on erythematous base on the back and trunk

Answer 12

Reassure

Question 13

🌹 Child presented to pre-diagnosis clinic with systolic ejection murmur , no sx ?

Answer 13

( reassure and discharge ✅✅ )

Question 14

Child with 15 months, can only babble and his mother is afraid because he cannot say 2-3 word sentences, hearing test done when he was 5 months old and was normal.

Answer 14

reassure as this is a normal variant another answer Reassurance and come at 24 months

Question 15

Child presents with fever, vomiting and diarrhea on exam of chest there is reduced air entry to right side and murmur was heard , the child CVS and chest exams were previously normal (prior visits) what is the management of murmur?

Answer 15

Reexamine after these symptoms subsides

Question 16

3 years old is going for dental operation had murmur when he stand and disappear when sitting What to do?

Answer 16

Reassure ( innocent murmur )

Question 17

Child 3 years old, fell from bed, immediately cried afterwards, vomited twice, headache, physical exam and neuro exam are normal

Answer 17

Observation

Question 18

Child was brought to hospital with airway swelling and skin lesions all over the body the mother stated that he was in a party at his friends house

Answer 18

Food allergy

Question 19

If there is If language / speaking delay. Firstly do ? Another Q: 2 years old child can’t talk probably and doesn’t understand, he have decreased hearing, what is the required test

Answer 19

Do hearing test

Question 20

what to be screen in neonates / another Q: Newborn examinations?

Answer 20

metabolic diseases, HYPOTHYROIDISM, HEARING. / vision and hearing (vision for red eye reflex)

Question 21

Clear case of congenital prolonged QT syndrome Jervell and Larged-Neilson
Syndrome associated with …..

Answer 21

sensorineural hearing loss

Question 22

Baby abdominal distended what is the first investigation

Answer 22

US

Question 23

child has kernicterus sign what you have expect that you tell his parents ?

Answer 23

Hearing loss

Question 24

3 years old boy came with his mother, she’s concerned he might have abnormal development. He goes to day care, understand only 2 words command (order) and strangers can understand only 75% of his talk. Your action?

Answer 24

Delayed speech disorder

Question 25

Aspiration meconium treatment =…….

Answer 25

Surfactant

Question 26

case of watery diarrhea , what electrolytes abnormalities will you find

Answer 26

HYPONATREMIA, HYPOKALEMIA, METABOLIC ACIDOSIS

Question 27

mother worried about her 6week baby , hes stepping all the formula since birth , what most likely cause

Answer 27

Physiologic reflex, burping the baby and semi setting while feeding

Question 28

year boy with growth pains, management?

Answer 28

Reassure???????

Question 29

Pt with infantile colic scenario, normal feeding, treatment: / another Q; A child with excessive crying and doesnt stop crying. On bottle feeding*. On examination, the child is restless, and abdomen distended. No other significant finding on examination. Treatment?

Answer 29

Reassure mother that it’s normal start on 6 weeks of age and goes away by 6 months of age

Question 30

Typical symptoms of infantile colic, all normal, what is most appropriate management?
Or
6 week baby he spilt out whatever he drink he is now on cow milk his weight in birthday : 2,7 kg and now he is 5.3 kg

Answer 30

Behavioral adaptations/ precautions of reflux and reassure

Question 31

Baby 4 months, distended abdomen, stool yellow and it becomes lighter each day , after birth he passed stool. Dx? Another Q; Infant on breastfeeding after that take bottle feeding and complaining from constipation and distension dx?

Answer 31

Allergy to formula given ( formula intolerance)/ cow milk intolerance

Question 32

Child 12 months age, on breastfeeding for first 9 months then use bottle feeding for another 3 months. Came with symptoms and signs of anemia with splenomegaly
+ hypochromic microcytic anemia with retIculocytes number normal RBC count Peripheral blood smear Target cell What should be restored another Q; Child shifted to cow’s milk, pale with wt loss?

Answer 32

Restore Iron/ iron deficiency/

Question 33

Mother C/O child spitting after each feed cow’s milk, Mx? Another Q; baby with “spitted up” after feeding his weight at birth 3.4 and now 5.5 how should you council the
mother ?

Answer 33

Elevate head during feeding / let the mother spend time purpine and elevate the head of baby after feeding

Question 34

1 month old baby with sob, low grade fever, tachypnea,prolonged expiratory phase and in cxr there is
bilateral infiltration symptoms , what is the most common to be presented in this condition ?

Answer 34

Poor feeding

Question 35

Child with drinking 3 large glasses of milk, he is bicky in food choices, what type of anemia he has? I

Answer 35

Iron deficiency

Question 36

child took tablets, came with black vomiting, most likely material ingested?

Answer 36

Iron

Question 37

Child who is lethargic and losing his concentration, Hgb is 10.5, what to give

Answer 37

IM iron

Question 38

Neonate in first routine visit had low hemoglobin 10.5 and was given oral ferrous sulfate, in this visit also Iow hg 10.3, what next investigation to reach dx

Answer 38

Level of serum iron & serum ferritin

Question 39

Breast mild is rich in ….& ….

Answer 39

Protein and IgA

Question 40

Toddler with pigmentations in his teeth, diagnosis:?

Answer 40

Sleep with milk bottle ( Bottle dental caries )

Question 41

9 days newbon come with jaundice only in the face not extended to the rest of the body.. otherwise he is healthy was delivered by NVD with no complications . and he was breastfeeded immediately. what is the cause of his jaundice

Answer 41

Breast milk jaundice ( Breast milk jaundice appear after the first week and peaks around 2 weeks. )

Question 42

Few or 2 months old baby wakes at night and cries for 1-2 hrs was happening several times he’s fine at what age this usually occurs?

Answer 42

3 months

Question 43

8 yr boy wet his bed at night, the cause is?

Answer 43

detrusor muscle

Question 44

Night bed wetting considered normal till

Answer 44

5 years

Question 45

most important study to do in cases of enuresis in child?

Answer 45

Urine analysis

Question 46

Most worrying sign of Child abdominal pain ?

Answer 46

Late night pain

Question 47

A baby girl complains of dehydration and clitorymegaly ,signs of dehydation. next step ?

Answer 47

Steroids

Question 48

A young boy complains of arthritis , rashes , nodule subcutaneous.He had pharyngitis two weeks back = next step

Answer 48

Echo

Question 49

Boy collapsed during sport On Ex Jerky carotid pulse. what’s Dx? Treatment?

Answer 49

HCOM / treatment: metoprolol

Question 50

child with radiofemoral delay pulse meanse ……

Answer 50

Coartication of Aorta

Question 51

child/baby has no distal pulse what you need to check before reduction?

Answer 51

pulses in other side

Question 52

Baby will be prepared for open heart surgery, mother is very worry about him what is the best way to calm her

Answer 52

explain what will happen before and after the surgery

Question 53

What is Drug decreases the mortality in HF =

Answer 53

ACEI/ARB + beta block

Question 54

Sharp pain relieved by leaning forward, pericardial friction rub, diagnosis and management?

Answer 54

Pericarditis/ Management : NSAID like Ibuprofen

Question 55

PT posterior -inferior MI, few hours developed hypotension, raised JVP, clears lungs on auscultation ?

Answer 55

Right ventricular infarction

Question 56

ECG shows 2:1 heart block, what degree is it

Answer 56

2nd degree heart block ( regular with absent QRS ccomplex )

Question 57

Heart failure due to left ventricular hypertrophy is due to ,,,,,,,,,..dysfunction

Answer 57

Diastolic dysfunction

Question 58

Pediatric patient with sob and productive cough with white sputum for one week that became yellow 3 days ago, on examination there’s bilateral crackles increased in the right middle lobe. On x ray report there’s bilateral pleural effusion with
consolidation in right middle lobe. What is the most appropriate cause

Answer 58

Exacerbation of HF

Question 59

2 months old baby with congestive heart failure and the mother asking about
nutrition requirement

Answer 59

Greater than whats needed for normal healthy baby

Question 60

Congestive heart failure due to systolic left ventricular hypertrophy, treatment

Answer 60

BB + diuretics

Question 61

Baby with congenital heart disease present with symptoms of heart failure (pulmonary edema, crackles, etc ) Heart rate 250-300 what is the Dx?


Answer 61

Atrial fibrillation

Question 62

14M infant had recurrent syncopal attacks worsened the HF and i think FTT on examination she has diffuse crepitations , on ECG she has cardiac arrhythmia narrow complex QRS , and Hr 250-300 Bpm what is the most probable cause

Answer 62

Supra-ventricular arrhythmia

Question 63

Baby after every feeding develop apnea and loss of conscious, what is the cause of admission in hospital

Answer 63

Syncope

Question 64

children with cyanosis and systolic ejection murmur best heard at the left sternal border. Dx?

Answer 64

Teratology of fallout

Question 65

Child noticed having cyanosis with feeding, with Physical exam a Holosystolic murmur was noted:

Answer 65

TOF

Question 66

TOF 5 yo kid with history of surgical correction at 6 months. Now came with new left parasternal decrescendo diastolic murmur with single S1 with left parasternal impulse, no radiation. What is the dx ?
Q Diastolic decresendo murmur in left sternum with previous TOF =…….?
Another Q : Pt with Hx of TOF repair present with murmur in parasternal area it increase with inspiration =…….?

Answer 66

Pulmonary regurgitation ( regurgitation = diastolic murmur ) left = pulmonary, right = tricuspid

Question 67

case of TOF . How does it appear on ECG?

Answer 67

Right axis deviation

Question 68

TOF( Tetralogy of Fallot )mangment

Answer 68

Pain relief and sedation and maybe O2

Question 69

Case of diGeorge syndrome ( certain facial features, cyanosis, recurrent infection , ect ) what is the heart anomaly associated with it

Answer 69

TOF

Question 70

Child with central and peripheral cyanosis, diagnosis

Answer 70

TOF

Question 71

Treatment of Tetralogy of Fallot, Transposition of the great vessels, Tricuspid atresia, Total anomalous pulmonary venous return, and Truncus arteriosus, is …..

Answer 71

Prostaglandin

Question 72

Neonate developed cyanosis (2nd week after delivery) and there is finding on auscultation, there is machinery murmur ,diagnosis? Treatment

Answer 72

PDA, Prostaglandin

Question 73

child with transposition of great vessels. Further evaluation of his mother could reveal?

Answer 73

Elevated fasting blood glucose

Question 74

What is Concerning symptom in croup?

Answer 74

Cyanosis

Question 75

Ptn with croup , given epinephrine, what next

Answer 75

Steroids

Question 76

Egg shaped heart shadow. What’s the congenital heart disease?

Answer 76

Transposition great arteries

Question 77

child crying and cyanotic, management?

Answer 77

sedation and relieve the pain

Question 78

baby cyanosed with parasternal heave no murmur what to give?

Answer 78

Prostaglandin

Question 79

Child is cyanotlc, can’t complete one sentence, management

Answer 79

Intubation

Question 80

Child has CHD , presented with cyanosis , progressing, o2 sat 85, looks ill, cyanosed, crying

Answer 80

Sedation amd analgesia

Question 81

2 months old baby mother complaining of apnea usually happens after feeding with 10 mins of cyanosis, why will u admit this case?

Answer 81

acute life threatening event

Question 82

Baby born at 27 weeks GA developed SOB, tachypnoea. No X-ray. Diagnosis?

Answer 82

apnea of premature

Question 83

Mother brought her 2 years old child to the ER with a history of upper respiratory tract infection for the last 3 days with mild respiratory distress. This evening the child started to have hard barking cough with respiratory distress. Which of the following are the most worrisome signs in this condition.

Answer 83

Cyanosis or nasal flaring

Question 84

Neonate cyanotic, low o2, Dx

Answer 84

Hypoxia

Question 85

What is the least physical activity duration required in pediatrics: …

Answer 85

60 minutes

Question 86

Ptn playing sports and frequently developing sudden attacks of LOC,
examination: mid-systolic murmur in left side, What’s dx?

Answer 86

Hypertrophic cardiomyopathy

Question 87

Preschool checkup for asymptomatic 7 years male, with grade 3 systolic murmur best heard in the
lower left sternal border, intensity increases with standing, the most likely diagnosis

Answer 87

HOCM OR MVP

Question 88

Pediatric with holosystolic murmur in left 3rd intercostal space =

Answer 88

ASD ( not PDA ) ?

Question 89

holosystolic

murmur usually caused by ……… septal defect, …….regurgitation or tricuspid ………,

Answer 89

Ventricular, mitral, regurgitation

Question 90

8 year , with late systole ,mid sternum ,crescendo decrescendo, high pitched, diagnosis

Answer 90

systolic regurgitation

Question 91

baby with Ejection systolic murmur with click heard in the left second intercostal and left parasternal
heave distended JVP and ejection systolic murmur increase with inspiration, diagnosis

Answer 91

Congenital pulmonary stenosis ( Click + Ejection systolic murmur +scond intercostal + left = pulmonary stenosis )

Question 92

Pistol shot murmur in pediatrics case, diagnosis

Answer 92

AR

Question 93

VSD picture , symptomatic , management

Answer 93

Refer to surgery

Question 94

child with mother death + he is not concentrating in his class , diagnosis

Answer 94

Dissociation

Question 95

Case of laryngiomalacia 3 months Child with noisy breathing in supine position decreased when the child is sitting, or in prone position, the mother is worried, diagnosis

Answer 95

He will get better spontaneously at the age of 1 year old

Question 96

Q1-Infant with airway obstruction that Increase with supine, decrease with prone=……

Q2- Baby crying when change position decreased. Diagnosis

Q3-Baby developed SOB , whezzing DR start to give broncodilator then no response, think of ………., management?

Answer 96

Laryngiomalacia / Bronchocsopy (laryngioscopy is first choice )

Question 97

What are Physical exam findings (auscultation) in croup ( patient was having nasal congestion , barking cough) ?

Or another Q : croup ++ barking cough , pE shows?

Answer 97

Inspiratory stridor and expiratory wheeze

Question 98

tracheomalacia on children = What is diagnostic image ?

Answer 98

By bronchoscopy

Question 99

barking cough diagnosis

Answer 99

Laryngeotracheobronchitis

Question 100

child with inspiratory stridor, barking cough, most likely diagnosis?

Answer 100

• laryngotracheobronchitis

Question 101

barking cough and respiratory distress, diagnosis?

Answer 101

Croup

Question 102

Treatment for barking cough ( croup )

Answer 102

Inhalation epinephrine and oral steroids

Question 103

classical case barking cough + inspiratory stridor On Auscultation, Diagnosis is …….the causative organism is ……

Answer 103

Croup, Parainfluenza

Question 104

3 years old Patient with hx of mild atopic dermatitis, presented with Barking cough and stridor, what’s the dx:

Answer 104

spasmodic croup

Question 105

Kid with inspiratory stridor, mild respiratory distress, hoarseness of voice, barking cough what is considered concerning symptoms

Answer 105

Blue lips

Question 106

CROUP given epinephrine and after 30 min the symptoms came agine = manag by =

Answer 106

Repeat and give steroid

Question 107

What’s the X-ray finding for ptn with croup?

Answer 107

Steeple sign

Question 108

Fever, Severe sore throat, high-pitched sound when breathing in (stridor), Difficult and painful
swallowing, Drooling, Anxious, restless child . Feeling better when sitting up or leaning forward what is the diagnosis?

Answer 108

Epiglottis

Question 109

Drooling saliva, diagnosis? Sign on X-ray

Answer 109

Epiglottis , thumb sign

Question 110

Child with fever ,sob , drooling what next =

Answer 110

intubantion and mutiblspichil team = Epiglotitis

Question 111

Child preschool age has VSD 2mm, asymptotic, what will you do=

Answer 111

Watchful waiting

Question 112

Whats the newborn myochoniom aspiration syndrome management

Answer 112

MAS occurs, your newborn will need immediate treatment to remove the meconium from the upper airway. After delivery, your doctor will immediately suction the nose, mouth, and throat.
If your baby isn’t breathing or responding well, a tube may be placed in your newborn’s
windpipe (trachea) to suction the fluid containing meconium from the windpipe. The suctioning may then continue until no meconium is seen in the material removed. oxygen therapy to make sure there is enough oxygen in the blood. the use of a radiant warmer to help your baby maintain body temperature.
antibiotics such as ampicillin and gentamicin to prevent or treat an infection. the use of a ventilator (a breathing machine) to help your infant breathe.

Question 113

Pediatric patient has fallen from tall building, presented to ER with SOB and right chest pain, investigations showed multiple fractures multiple sites on his body, CXR showed: Right pneumothorax with mediastinal shift, your management:

Answer 113

Thoracostomy

Question 114

child with erythema marginatum , knee pain , fever = what inv & diagnosis

Answer 114

rheumatic fever , ECG

Question 115

Child presented with ulcers on mouth and gingiva erythematous based and pale in the center. Dx?

Answer 115

Coxaci

Question 116

Rash on the face and inner cheeck there’s whits spots, diagnosis or another Q:

2yrs old child Not vaccinated, had fever for 3-4 days then rash appear, on examination there was white spot in mucosal membrane. What is dx?

Q3- Pediatric patient with coryza, conjunctivitis, and white spots in the mouth, what is the diagnosis

Q4- Fever and cough and maculopapular rash in behind ear and face and trunk

Q-5 7 y/o unvaccinated boy presents with red erythematous irregular patches of rash that is around hls neck and spreads down hls back. What does he have

6 years old child presented with Fever, cough, conjunctivitis and rash. What is the most likely diagnosis

Answer 116

Measles ( Measles should mention the 3Cs (Cough coryza conjunctivitis) mouth koplick spots )

Question 117

Child with sore throat and coryza 2 days ago came with difficulty swallow food what is investigation
Another Q :

Child with acute onset fever, Coryza, sore throat, difficulty swallowing solid food. Ex showed cervical LN 2-3cm , next step

Answer 117

CT

Question 118

Child with fever conjunctivitis, coryza cough, wheezing Tachypenic what is the optimal ttt?

Answer 118

O2 , not steroids

Question 119

Young girl has a recent history of fever, difficulty in swallowing solid food only. enlarged 2cm cervical LN. investigations will you do ?

Answer 119

Lateral neck X RAY

Question 120

child with runny nose and fever which subsides and then rash appear allover
his body starting from the face. Dx?

Answer 120

Rubella, after fever subside it’s roseola, concurrent fever Rubella

Question 121

Baby with white eye reflex (Leukocoria) and murmur. Mother mentioned viral infection during pregnancy

Newborn with absent red eye reflex and new murmur , what does his mother had when she was pregnant

Answer 121

Rubella

Question 122

Absent red reflex caused by wich infection

Answer 122

Rubella

Question 123

Face Rash with conjunctivitis spread later to the trunk, diagnosis or

child with rash started on face and then spread to the trunk?

Answer 123

Rubella

Question 124

pic of skin lesion in child , rash was red and mother tell it start on face the go to trunk , with LN enlarge of groin

Answer 124

Rubella

Question 125

Baby presents as shown in pic ( absent red reflex ) ,what would you do?

Answer 125

Immediate referral to ophthalmology

Question 126

Kawasaki management

Answer 126

IV gamma-globulines

Question 127

Kawasaki sign

Answer 127

bilateral red eyes

Question 128

Kawasaki disease assess for heart complication?

Answer 128

Echo

Question 129

A child presented with 5 days of fever, oral mucosal lesions, cervical lymph node enlargement and limb edema. Lab results essentially normal. treatment?

Answer 129

Aspirin

Question 130

The best treatment of Kawasaki disease?

Answer 130

Aspirin ( for fever ) ,IVIG ( is the ultimate ttt )

Question 131

patient with kawasaki features,what is the best indicator as poor response to IVIG?

Answer 131

High CRP

Question 132

A child is complaining of 5 days of fever , bilateral non-purulent conjunctivitis , rashes in palms and soles ( case of kawasaki, treatment

Answer 132

Aspirin and IVIG

Question 133

Case of Kawasaki ask about what will reduce affect of lvlg

Answer 133

Neutropenia

Question 134

Kawasaki case asking about criteria:

Answer 134

injection conjunctivitis with no exudate

Question 135

Fever 5 days, conjunctivitis, lymphadenopathy, high ESR and CRP. Dx?

Answer 135

Kawasaki

Question 136

child with fever and then rash and peeling on hands and edema with peeling lips

Answer 136

Kawasaki

Question 137

Confirmation of Kawasaki?

Answer 137

Clinical

Question 138

Child with vesicle at lip and gum and proximal tongue and hard palate. Diagnosis

Answer 138

gingivostomatitis

Question 139

Pedia with Egg allergy contraindication

Answer 139

Yellow fever

Question 140

4yrs old fully vaccinated child, came to the ER with on day history of fever and sore throat which started on the same day. What is dx?

Answer 140

Scarlet fever

Question 141

Pt with pharyngitis for 2 days , what’s the possible complication

Answer 141

Scarlet fever

Question 142

• 24-48 h after pharyngitis, rash begins in the groin, axillae, neck, antecubital fossa; Pastia’s lines + may be accentuated in flexural areas
• within 24 h, sandpaper rash becomes generalized with perioral sparing, non-pruritic, non- painful, blanchable, diagnosis and ttt

Answer 142

Scarlet fever, is penicillin, amoxicillin, or erythromycin x 10 d

Question 143

A 12-year-old girl presents with sore throat. Her symptoms began 1 week ago after she attended a sleepover. Her temperature of 101°F (38.3°C). NO cough but has noticed increasing fatigue and difficulty swallowing due to pain. On physical exam, she has anteriorcervical lymphadenopathyandpatchy tonsillar exudates and swelling, diagnosis

Answer 143

Scarlet fever

Question 144

pediatric patient with fever, on examination, there is a white membrane covering the tonsils, the most likely complication to be happened

Q- 14-yrs had fever, pharyngeal exudate, enlaged LN, most common complication

Answer 144

Scarlet fever

Question 145

Case of infant have cough and low grade fever ,rash ,runny nose :

Answer 145

RSV??

Question 146

Child with fever and vomiting and rash on 2nd day rash become over All body

Answer 146

Rocky Mountain fever

Question 147

Prophylaxis for contact with pertussis is ……..

Answer 147

The macrolide antibiotic = erythromycin, clarithromycin, and azithromycin

Question 148

pedia pt not vaccinated, present with sore throat and cervical lymphadenopathy what’s your

Answer 148

Diphtheria

Question 149

How many years the pertussis vaccine last

Answer 149

10 years

Question 150

1-year-old, never vaccinated, presented with “hacking” cough and inspiratory something, What’s the organism

Pediatric patient with neck swelling, inspiratory stridor, difficulty breathing, (I think also with enlarged tonsils), didn’t receive any vaccine, what is the dx?

Answer 150

Pertusis

Question 151

Pertussis with severe vomiting, most complications

Answer 151

Pneumonia

Question 152

4 months old with proven pertussis infection on macrolide. His 3 and 5 years old siblings are vaccinated up to date. What is the proper action to prevent the siblings from getting the infection

Answer 152

Prophylactic macrolids

Question 153

3 month old present with paroxysmal cough with deep inspiration between
the cough, conjunctivitis, diarrhea, he is up to date with his vaccination.. What is the causative organisms

Answer 153

Pertusis❌

Question 154

Pertussis case “whooping cough”Ask about diagnosis and Investigation:

Answer 154

Nasopharyngeal swap

Question 155

diffuse ST elevation (ECG pic) diagnosis, ttt?

Answer 155

Pericarditis, treat with aspirin

Question 156

Child with Sx of varicella. Has immunodeficient brother. Action with the immunodeficient child

Answer 156

Give immunoglobulin

Question 157

Treatment of meningitis

Answer 157

Baby < 1 month = ampicillin + gentamicin
> 1 month = ceftriaxone + vancomycin
Ptn with bacilli catalase = ampicillin

Question 158

Neonatal lumbar puncture (+ ) diplococci Management?

Answer 158

Ampicillin + gentamicin

Question 159

3 days old , csf culture showed gram ( + ) bacilli catalase + beta hemolytic , how to treat?

🌹3 day neonate with B hemolytic and catalse +ve what antibiotic give:

Answer 159

Ampicillin

Question 160

15 months with meningitis, Gram stain G+ double coccus ttt

Answer 160

Ceftriaxone + vancomycin

Question 161

8 years old child came with fever ,neck stiffness ,irritability, normal glucose normal protein ,increases WBC what’s abx

Another Q : 5y/o with fever, lethargy, positive Brudzinski sign. CSF showed lower limit of glucose with high protein. Gram stain revealed gram positive cocci in chains. Your management?

7 y/o with meningeal irritation, headache, and fever. CSF (normal protein and normal glucose and lymphocytosis). What you will give the child?
A.Ceftriaxone and vancomycin and steroids B.ceftriaxone and steroid
C. antiviral ✅✅ Bez( normal glucose )

Answer 161

Meningitis case, ceftriaxone + vancomycin

Question 162

Child with pain that last for 10-15 mints (intermitted pain) crying , postive kering sign ? What is the best treatment ? Kernig’s sign= meningitis

Answer 162

Ceftriaxone + vancomycin

Question 163

Pt 7 yrs old with nausea and vomiting dehydrated comatose acidotic CSF : high protein , normal glucose =

7 year old child, presented to the emergency by his partners with 2 days history of fever and vomiting, child is comatose dehydrated with acidosis. CSF report: Cells 20 (above normal) , Protein 0.45 (above normal) ,Glucose (Normal

Answer 163

Viral meningitis

Question 164

5 y/o with fever, lethargy, positive Brudzinski sign. CSF showed lower limit of glucose with high protein. Gram stain revealed gram positive cocci in chains. Your management?

Answer 164

Ceftriaxone,vancomycin, steroids

Question 165

7 y/o with meningeal signs, headache, and fever. He and his family came from Africa recently. He also has sore throat and lymphadenopathy. CSF (normal protein and normal glucose and lymphocytosis) what’s the organism?

Answer 165

EBV

Question 166

Fever for 6days and tender splenomegaly, which culture is most importantly needed?

Answer 166

Multiple or repeated blood cultures ( maybe case of typhoid). Because fever persistent for more than 6 days with spleenomegaly

Question 167

How do you know if the baby is wetting his/ her diper a lot that the cause is UTI

Answer 167

Presence of fever

Question 168

Girl 7 years old with suprapublc pain No rebound no guarding. Tx?

Answer 168

Discharge with oral antibiotics

Question 169

child with chill ,fever ,irritability , on exam there was neck rigidity and positive Kernig’s,CSF showed clear color, lymph and neutrophils high, protin and glucose normal, diagnosis

Answer 169

Aseptic meningitis

Question 170

Girl confused with fever + sign of meningitis, diagnosis?

Answer 170

encephalitiis , Bez confusion something happen to brain , bactiria in the brain

Question 171

Child with meningitis came with his parents and has papilldema , parents should be afraid of ?

Answer 171

Hearing loss

Question 172

child with Irritability ,headache ,nausea, lethargy and rash all over the body what is dx :

Answer 172

meningococcemia

Question 173

3 mo old boy with pic of bacterial meningitis What’s most common pathogen?

Answer 173

Streptococcus pneumoniae

Question 174

pediatric patient has meningitis, with close contact to his brother recently, Asking for what to give to his brother

.Pediatric prophylaxis for maningitis?

3 y/o boy with maculopapular rash on this limbs and buttocks is brought to the ER by his partners saying he is lethargic and irritable. On examination, neck stiffness is noted. LP shows diplococci parents are concerned about his 6 y/o brother. What prophylaxis will give

Answer 174

Oral Rifampicin

Question 175

Most common cause of ear infection or otitis media in children ?

Answer 175

Bacteria

Question 176

Child came from africa. complaining of weakness, he couldn’t move his head and legs especially when hes in prone position

Answer 176

Polio

Question 177

At school age what we tend to prevent?

Answer 177

Hemophilus influenza encephalitis

Question 178

Child with 2 days history of ear pain, exam reveals perforated ear drum with fluid passing through it

Or

Child has fever with perforated tympanic member and pus in the external canal

Answer 178

Acute suppurative otitis media

Question 179

Most common virus cause of acute otitis media in pediatrics

Answer 179

Rhinovirus

Question 180

Pediatric with fever, ear pain ruptured tymp

Answer 180

Acute otitis media

Question 181

Child came limping and non-weight bearing, not allowing anyone to touch his leg, most common organism is:

Q : child has unilateral hip joint pain Flexing Refuse to be touched Mostly causative organism?

Answer 181

staph. Aureus ✅+(septic arthritis

Question 182

child with fever and left knee pain and swelling. Most important single investigation

Answer 182

Joint aspiration

Question 183

Conductive hearing loss could be because of recurrent……

Answer 183

Otitis media

Question 184

honey crust infection is caused by

Answer 184

Staphylococcus aureus

Question 185

Child with pneumonia, indication of hospitalization?

Answer 185

Unable to tolerate or take orally

Question 186

headache, stiff neck, and vomiting, coughing with breathing difficulty , causative oraganism

Answer 186

Streptococcus pneumoniae

Question 187

Pediatrics pneumonia ttt

Answer 187

IV antibiotics

Question 188

13 months old girl present with fever 38 , bilateral lung infiltrate , she looks mildly ill , what is the likely organism

Answer 188

Streptococcus pneumoniae

Question 189

Baby with tachypnea, cough, hemoptysis and bilateral lung infiltrates. What is the treatment

Answer 189

Antibiotics

Question 190

child with flu like symptoms+ fever + has middle lobe crackles+ stony dullness, chest x.ray will show

Answer 190

Pleural effusion

Question 191

Staccato cough is caused by

Answer 191

Chlamydia pneumonia

Question 192

Child with cough, fatigue, 2 time bloody vomiting, low grade fever, with dullness in percussion dx?

Answer 192

Parapneumonic effusion

Question 193

Drugs that are Absolutely contraindicated in penicillin allergy?

Answer 193

Pipracillin/ tazobactam

Question 194

Child with poor feeding since 2 days have oral thrush and dipper dermatitis what you will give

Answer 194

Topical and oral antifungal

Question 195

pt with Rash in cheeks trunk and upper limb:

Answer 195

Herpes simplex

Question 196

…

Cystourethrogram of a pediatric with recurrent UTI = ( pictures) showing distend ureter and kidney

Answer 196

VesicoUrethral reflux is a condition in which urine flows backward from the . bladder to one or both ureters and sometimes to the kidneys

Question 197

case of febrile neutropenia what next?

Answer 197

cluture form sputum,urine,blood and Iv antibiotic

Question 198

Patient presented with typical picture of malaria infection, blood smear showed no
parasite, what’s your next step

Answer 198

Repeat every 8 hours for 2 days

Question 199

Treatment of tonsillitis

Answer 199

amoxacillin / clavi

Question 200

🌹Neonate with sign of sepsis what is empirical antibiotic ?

Answer 200

Ampicillin

Question 201

What’s the treatment of uncomplicated cytits in child ?

Answer 201

Oral amoxicillin

Question 202

Young girl with diarrhea came with left knee swelling, right elbow, left Achilles tendon. Stool analysis shows +ve clostridium toxins. What is the dx?

Answer 202

Reactive arthritis

Question 203

When resuscitating a child with septic shock, which of the following has the least evidence of benefit in treatment? A. ABX B. inotropes C. steroids

Answer 203

Steroids

Question 204

Child with URTI , lethargy , confuse , Tem39, rr35 , hr>100 , diagnosis

Answer 204

Sepsis

Question 205

Commonest cause of shock in children? .

Answer 205

Sepsis

Question 206

Neonate with High fever, developed petechial rash and was hypotensive 70/55, with cold extremities and poor feeding. What is the dx:

Answer 206

Septic shock

Question 207

Case of child with leukemia , after 17 days of chemo coming with fever , neutrophil is normal, tx?

Answer 207

Maybe broad spectrum iv antibiotics

Question 208

Child with fever, vomiting and diarrhea. ABG: Normal pco2 + Normal bicarb Base access -4 “normal range from -2 to 2” Ph 7.3 What type of shock does he has?

Answer 208

Early compensated shock

Question 209

Child with flu symptoms on examination he has membranous exodus in tonsils, causative organism

Answer 209

Streptococcus

Question 210

child present with pain in micturition and lower abdominal , his urine has foul smell, which organis can cause this

Answer 210

E.coli gram (-)

Question 211

10y boy with hx of 2wk of bloody diarrhea and abdominal pain, tenesmus:

Q: Child c/o fever, bloody stool, and tenesmus, abdominal exam showed abdominal distention, Dx

Answer 211

Amebiasis

bloody stool, and tenesmus, fever = Amebiasis

Question 212

Child has bloody diarrhea and oliguria, vomiting, nausea, abdominal pain, fever for 7 days before that
family think this is from restaurant What’s treatment

Answer 212

Antibiotics

Question 213

Child with bloody diarrhea fever 39c dx :

Answer 213

Campylobacter

Question 214

6 years with sore throat + difficulty swallowing + painful cervical lymph nodes. the organism =

Answer 214

streptococcus pyogenes

Question 215

Child with group A strep pharyngitis. What will you do with his brother

Answer 215

Observation

Question 216

Child with chronic diarrhea and labs indicative of macrocytic anemia asks what is important to ask in the past?

Answer 216

giardiasis infection

Question 217

Baby with mass in umbilical and developed veslculopustular rash grape like organism

Answer 217

Group A streptococcus

Question 218

child took hyoscine butylbromide and metoclopramide for gastroenteritis and fulud the he develop jerky movement (not sure about the presentation it was wired to me ) what to give ?

Answer 218

domperidone Thid drug improves symptoms of nausea, vomiting, bloating, and feeling of fullness

Question 219

child is having brief seizure (less than 30 seconds) , EEG (generalized 3-Hz spike-and-wave activity.) treatment

Answer 219

Ethosuximide ( absence seizure )

Question 220

8 year old boy’s his parents complain that he has episodes where he blinks multiple times and becomes okay after that.. he is conscious and responsive during those episodes. The most likely diagnosis is ,,

Answer 220

Blinking disorder

Question 221

🌹Fracture of the left stylomastoid foramen during delivery of a baby:
A. Decreased blood supply to the left ear B. Loss of sensation of the left side of face
C. Loss of anterior 2/3 sensation of tongue

Answer 221

Dont know

Question 222

child unable to feed herself with a spoon , hx of head trauma 10 days ago where is the lesions

Answer 222

Cerebellum

Question 223

1-2months old , full term , diabteic mother , birth weight is 4.8kg and no other complications during delivery , there’s absent moro’s reflex on right side what is the cause:

Answer 223

absent hand motor reflex === Erbs palsy
Earb’s palsy, happened to macrosomia baby Wight more than 4500 …
unilateral moro’s reflex = Erb’s palsy

Question 224

Child has pneumonia+ fever then developed seizures. Treatment:

Answer 224

Diazepam

Question 225

Continuing >35 minutes Seizure epilepticus Given lorazepam iv what’s next

Answer 225

Start with diazepam then lorazepam then IV phenytoin

Question 226

Child k/c of grand mal seizure on Depakine comes with breakthrough seizure
what to give initially after intubation on ER presentation

Answer 226

Diazepam

Question 227

Pt status epilepticus for 5 min, with iv access, what is the first line:

kid with seizure for more than 5 mins, iv line secured = …….

pt with tonic clonic seizure before 5 min resolve ,what Rx. to give ( availability of IV access) .

Answer 227

lorazepam

more than 5 mins, iv line secured = IV lorazepam

Status epilepticus (more than 5m) > Lorazepam
Generalized tonic clonic > Carbamazepine
Partial tonic clonic > Phenytoin
Absent seizure > Ethosuximide

Question 228

Cerebral palsy in kernicterus?

Answer 228

Answer is: Athetoid cerebral palsy or dyskinetic cerebral palsy
Kernicterus is a type of brain damage most often seen in babies. It’s caused by an extreme buildup of bilirubin in the brain.

Question 229

A case of icterus Kernicterus

1-ABO incompatibility 2-RH incompatibility

Answer 229

RH incompatibility 10% will develop kernicterus

Question 230

Fist hand +feet crossed seen in :

Answer 230

Cerebral palsy

Question 231

6w or month old with unilateral absence of red reflex what to do next?
A-Mri brain and optic. B-Funduscopy ( don’t know

best time to do red reflex examinations =…….

Answer 231

At birth and at 6 weeks of age

Question 232

15 months old baby presented to the clinic with developmental delay, on examination patient was having spasticity, crossed leg, lower limb were involved more than the upper limb but both were affected, what’s the type of cerebral palsy he has

Answer 232

Quadriplegia

Question 233

girl with bruises and fecal incontinence after being fully toilet trained:

Answer 233

Sexual abuse

Question 234

Parents came with there child complaining of that there child always blinking on rest and activity on examination there is no pain and tear, whats the diagnosis

Answer 234

Tics disease

Question 235

5-7years old presents with inability to stand or sit unsupported and clumpsy gait and resistance to neck flexion after chicken pox infection weeks ago:dx:

Answer 235

Acute cerebellar ataxia of childhood is a childhood condition characterized by an unsteady gait, most likely secondary to an autoimmune of postinfectious cause, drug induced or paraneoplastic

Question 236

Case of abuse, subdural hematoma and retinal hemorrhage , the childʼs mother is mentally retarded but father is normal , diagnosis

Answer 236

Shaken baby syndrome

Question 237

fetus delivered by Vacuum instrument, has swelling that doesn’t cross the sutures?

Answer 237

Cephalohematoma

Question 238

Child with Head trauma subarachnoid hemorrhage , periorbital edema, bruises and LOC Father said he found her like that , what to do

Answer 238

Call child protection services

Question 239

Can’t close his eye on one side what nerve is affected?

Answer 239

Facial nerve??

Question 240

Duchenne muscular dystrophy sign?



Answer 240

Gowers maneuver ( زي العجوز )

Question 241

child with febrile seizure since 3 days, tonic clonic lasting an hour, he still have fever. what to do?

Answer 241

give phenytoin. B diazepam Ö C-Abx D-Paracetamol
( answer is diazepam but my answer is paracetamol)

N.B: Febrile seizure main treatment is to treat underlying cause, but if patient came to you in ER seizuring then :- If 5 minutes or more –> Diazepam. If < 5 minutes–> Paracetamol.
If non seizuring in ER –> Paracetamol, whatever the duration he seized at home

Question 242

Child afraid of going to school, how can the mother deal with the case =

Answer 242

Talk to him about how his favorite super hero would deal with the situation.

Question 243

Birthmark or lesion or nevous 1x2 cm on the forearm , no symptoms

Answer 243

Follow up

Question 244

What improved to decrease the premature baby mortality rate? hypothermia

Answer 244

I dont know

Question 245

Case of bronchiolitis (severe) with chest recessions what is the management?

Answer 245

Admit for fluid hydration and oxygen

Question 246

pt has tachypnea, runny nose, cough,slightly elevated fever, wheezing , how to reach the definitive diagnosis:

Answer 246

Nasopharyngeal swabs (case of Bronchiolitis caused by RSV

Question 247

18 months with picture of bronchiolitis, developed several episodes of apnea. What’s the appropriate management

Answer 247

Ventilatory management

Question 248

two cases about bronchiolitis: cause and treatment=

Answer 248

RSV. Ttt: supportive rehydration

Question 249

pt has arthralgia after viral infection” watery diarrhoea “ what is the type of arthritis

Answer 249

Reactive arthritis

Question 250

Case with symptos of bronchitis / asking about the diagnisis (Chronic productive cough , SOB, ect )

Answer 250

Bronchitis , RSV ( respiratory syncytial virus ) / supportive ttt

Question 251

Child with Small VSD, asymptotic, Mx:

Answer 251

Observation and watchful waiting

Question 252

Pediatric with intact radial and reduced femoral pulse, with fhx of htn, diagnosis

Answer 252

Coartication of aorta

Question 253

best diagnostic tool for Coartication of aorta?

Answer 253

Echo

Question 254

Child need non invasive M.V ( mechanical ventilation) , Where you will manage him ?

Answer 254

Emergency room

Question 255

Child with mild fever and bilateral conjunctivitis and abdominal pain subsided 2 weeks ago now on x- ray follow up you found bilateral lung infiltration, most common pathogen?

Child present with paroxysmal cough with deep inspiration between the cough, conjunctivitis, diarrhea, he is up to date with his vaccination. What is the causative organism

Answer 255

Adenovirus

Question 256

2 year old boy with pain over anterior tibial tubercle, diagnosis?

Answer 256

Osgood Schlatter Syndrome

Question 257

RTA and you find aortic thoracic injuries and splenic abrasion with hypotension what u do ?

Answer 257

Thoracic surgery ?✅

A. Thoracic surgery B. Abdominal surgery C. Call center for vascular surgery D. laparotomy

Question 258

Young boy Just had a growth spurt came with pain in hls leg , dx ?

Answer 258

Ankle sprint = Osgood schlatter if below the knee

Question 259

positive rebound tenderness in Macc Barney point (case of appendicitis) the pathophysiology =

Answer 259

peripheral vasoconstriction

Question 260

Peds 8 yrs old with RLQ pain and rebound tenderness what’s confirmatory test

Answer 260

US abdomen

Question 261

child having sudden pain at thigh pic of spiral fracture with labs of (PTH Ca) high , diagnosis, ttt
Q: 9y old child , PTH high , ca high , came with bone pain tt ?

Answer 261

primary hyperparathyroid, rehydration + diuretics + bisphosphonate

Question 262

Child with bowed legs Labs: calcium is high. Phosphate is normal. Diagnosis

Answer 262

familial hypophosphatemia ( not nutritional vit D deficiency )
Bowing legs, frontal bossing , management: Vit D3

Question 263

child with rash appeared as vesicles. Some of his other classmates were having the same. He has immunodeficient brother. Family has concern about their immunodeficient child. What is your action

Answer 263

Give IVIG

Question 264

boy came with deep stabbed wound in the anterior right thigh 10 cm in depth. What is your next step

Answer 264

Apply direct pressure on the wound

Question 265

Child abdominal trauma, investigators show splenic lacerations 2cm w peri-spleen
fluid most appropriate management

Answer 265

Non operative ?

Question 266

child fall dawn on his hand ( radial&ulna) fracture,1cm open wound

Answer 266

A.Closed reduction with cast above elbow. B.Closed reduction with cast bellow elbow C. Innernal fix with cast till elbow. D. surgical debridement& fixation ( answer is D ) but not sure

Question 267

🌹Child with humural & ulnar & and un able to move extensors muscle of forearme and hand ? median nerve in cubital fossa

Answer 267

Dont know

Question 268

Child with vascular malformation of lower limb , when to interfere :

Answer 268

If there pain

Question 269

Newborn circumcision , chordee and hooded foreskin + hypospadias ,how to manage

Q: Baby for circumcision u found urethra midshaft what procedure will u do
A. gomco clamp B. plastibell C. other name can’t recall D. inform surgeon✅

Answer 269

Inform surgeon

Question 270

An infant with hypospadias and for circumcision, what’s the procedure

Answer 270

The surgeon will use a small piece of foreskin to create a tube that
increases the length of the urethra ✅
Boys who are born with hypospadias should not be circumcised at birth. The extra tissue of the foreskin may be needed to repair the hypospadias during surgery. … During surgery, the surgeon may place a catheter (tube) in the urethra to make it hold its new shape

Question 271

Neonate+ prolonged bleeding after circumcision, aptt high, pt, bleeding time and platelet are narmal, Bleeding Circumcision which factor ? PT high , PTT ==prolonged PT

Bleeding Circumcision which factor is low

Answer 271

Factor 8

Bleeding after ciraumcision factor 8
Bleeding after umbilical stump> factor 13
Bleeding after home delivary - Vit K (factor 10)

Question 272

home delivery baby with umbilical bleeding after day 5, diagnosis ( factor X )

infant had bruises on his thigh after delivery at home what is the cause? vit k def

Answer 272

Factor ( X ) deficiency

Question 273

boy come with gingival hyperatrophy with enlarge and bluish purple friable
gum . What’s vitamin deficiency

Answer 273

Vitamin C

Question 274

Boy bleeds out after tooth extraction Then after develop bruises they mention factors Vlll= +ve , Plat= normal Only slight increase in pt Dx?.

Answer 274

Von Willbrand disease

Question 275

6 months uncircumcised pediatric UTI how to treat:

Q: 6 Months boy Uncircumcised with fever , labs showed UTI =

Answer 275

Ceftriaxone ( 2 answers oral and IV )

Question 276

5 y/o boy uncircumcised presented to ER with fever and abdmonial pain, suspected
to have UTI, urine analysis showed: Nitrate positive and high WBC, What is the most likely
indicates he has UTI?

Q: most likely indicates he has UTI: …………

Answer 276

Nitrate

Question 277

4 months Child with mid-shaft hypospadias, came for circumcision. What u will do

Answer 277

not possible since they will use it for the repair
( Babies who have hypospadias that requires surgery shouldn’t be circumcised, because the foreskin maybe for tissue grafts during the operation )

Question 278

Child circumcised has UTI treated with TMP/SMX and improved, which further should be done?

Answer 278

renal ultrasound B- cystourethrography C- reassuring✅

Question 279

Pediatric patient presented with abdominal pain and jelly like stools, right quadrant mass (case of intussusception) what’s the best diagnostic test?

Answer 279

Abdominal x-ray. B. Abdominal CT. C. Abdominal U/S. D. Barium enema✅
jelly like stools, = the best diagnostic test = Barium enema

Question 280

two cases of Intussusception, one about next step after stabilizing pt.

Another Q : Tt of intussusception in pediatric ?

Q3- Intussusception case stable Best initial = radiological reduction ( not I.v fluid bez he is stable)

Answer 280

Radiological reduction

Q2 answer = hydrostatic enema ( Dont choice reduction by ultrasound or fluroscopic )

Question 281

intussusception case, what would you tell the mother?

Answer 281

Recurrence common after surgery

the probability of recurrence was 100% after the fourth episode of intussusception. After the third
episode, the probability of recurrence and eventual surgery are 68% and 70%,
respectively. Surgical intervention should be considered at the third episode of intussusception.

Question 282

Picture of intussusception : nausea and vomiting Which statement is true regarding diagnosis

Answer 282

A. presence of sausage shape in palpation ✅
B.Present in 2% of population ….
C.Passage of current jelly stool confirm the

Question 283

baby with intermitted pain that is sever to the point where he rise his legs and screams for hours what best nexst step = case of intussusception

Answer 283

Abdominal US

Question 284

Abdominal exam sausage shaped mass =……..?

intussusception case how you confirm it clinically:………?

13-month-old with Abdominal tenderness, vomiting, bloody stool, leukocytosis and US doughnut shape, what do you suspect

Answer 284

Intussusception

Q2 = sausage mass

Question 285

Child cry when left her hip with mass in upper abdomen what’s Dx: …………

Intussusception child first thing to do =………

Case of intussuption child very dehydrated what is the next immediate action

Answer 285

Intussusception

Q2 , Q3= IV FLUIDS AND ANALGESIA

Question 286

13 month old with Abdominal tenderness,vomiting,bloody stool,leukocytosis and US doughnut shape. Diagnosis?

Answer 286

Intussusception

Question 287

A 3 year old girl with bloody diapers. She has no pain or constipation.Diagnosis?

Answer 287

A.Meckel’s Diverticulum ✅✅
B. Intussusception
C. Colon

Question 288

target sign by us=………

Answer 288

Intussusception

Question 289

11 months presented with bloody smelling stool how yo confirm dx A.

Answer 289

US

Question 290

Intussception presentation and question is whats is the initial investigation:

Answer 290

US

Question 291

case of intussuception came with clicky pain + doughnuat sign on ultrasound + bloody stool what is most important step to manage this case

Answer 291

IV fluids

Question 292

Case of baby 6 days passed stool after birth w constipation wts dx

Q2- Abdominal distended, vomiting, picture of obstruction. Dx

Q3-Child with bilious vomiting and pass limited amount stool. 5 days old

Answer 292

Volvulos

Question 293

Neonate with bilios vomiting He pass meconiun (Then he pass yellow stool)=diagnosis?

Q2- A child passed meconium within 24 hrs after birth. Two weeks later, child developed bilious vomiting, abdominal distention and passage of pellet stool. What’s the diagnosis?

Q3- baby 3-7 days presented with bilious vomiting , decrease oral intake , this happened after introducing milk formula He passed meconium after birth and after that yellow stool

Answer 293

Mid gut volvulus

Question 294

Coffee bean sign and want the diagnosis?

Answer 294

Sigmoid vulvulus

Question 295

Thumb print sign in abdomen, daignosis ? Bowel ischemia

Answer 295

Bowel ischemia

Question 296

Abdominal distrnsion, constipation, vomiting. No Xray in choice .Investigation

Answer 296

US or X-ray

Question 297

Case with primary sclerosing cholangitis symptomes, what to do ?

Answer 297

Colonoscopy
( Primary sclerosing cholangitis is a chronic cholestatic liver disease. The majority of
patients with PSC have underlying inflammatory bowel disease . Patients with concurrent PSC and IBD have an increased risk of colorectal cancer )

Question 298

Child tripped on a toy and the right leg was trapped within the toy ,and fell on the leg child complaining of pain ,what type of fracture do you expect:-

Q2- A child was brought by his parents after he refused to walk and insisted on being
carried always, the parents reported this happened after he was playing and
stepped on a toy and his leg was twisted and fell down

Answer 298

spiral fracture of tibial

Question 299

Child with X ray of distal radial and ulnar bone fractures = ttt

Answer 299

Cast below elbow

Question 300

6 y.o child with fracture of thigh and 30% angulation. TTT

Answer 300

Hip spica with traction

Question 301

Child with forarm fracture , mx ?

Answer 301

closed reduction and cast

Question 302

Distal radial fracture in peds patient (xray shown), partially penetrated the skin (picture). management?

Answer 302

internal fixation with casting below elbow

Question 303

Child fall from hight presented to you in ER crying, Bleeding from the ear, tympanic membrane bulging and bleed , imaging confirmed basal skull fracture, The nerve which pass through foramen ovalea injured whatʼs the function which will be affected ?

Answer 303

Mandible nerve, mastication

Question 304

child with supracondylar fracture, distal pulse not palpable, your management:

Answer 304

Exploratory operation

Question 305

Picture of xray of both bone distal forearm fracture, greenstick, your management:

Answer 305

Closed reduction and cast

Question 306

Infant with absent red reflex ( retinoblastoma most likely) What to do:

Retinoblastoma on slit lamp examination , diagnosis

Answer 306

Immediate referral to ophthalmology

Question 307

what is diagnostic for retinoblastoma ?

Answer 307

MRI

Question 308

17 alpha hydroxylase deficiency= autosomal ………..

Q2-child with 17-hydroxylase what type of inheritance?

Answer 308

Autosomal ressesive ,

Question 309

inheritance of an ambiguous genitalia=………..deficiency

Congenital adrenal hyperplasia mode of inheritance?

Answer 309

AR

21 hydroxylase deficiency

Question 310

Pt carry risk of 25% to have genetic dis , What is the type of genetic abnormality ?

Parents carrier 25% chance of having affected child with “Cystic fibrosis”= autosomal …….

Answer 310

Autosomal ressesive

Question 311

Child with cough,wheezing , recurrent infection, poor feeding and poor weight gain and murmur . Diagnosis

Answer 311

Cystic fibrosis

Question 312

case of Neurofibromatosis type 1 (7 cafe au lait spots, axillary freckles), ask mode of inheritance?

What is the type of genetics in pt presented with cafe au lait spots dx neurofibromatosis?

Answer 312

Autosomal dominant

Question 313

Child with multiple cafe au let spot on his body, his mother mentioned that his relatives also have the same spots= diagnosis

Q2- 4 year old boy brought by his mother examination reveals multiple Café au lait spots. The mother says that “it’s a common birthmark in our family” what is your test action

Answer 313

A1= Counsel about NF1

A2= educate her about NF1

Question 314

case about wiskott-aldrich( recurrent infections, eczema, 2 healthy sisters, 1 died before the age of 10 months ask about mode of inheritance?

10 m old infant with pneumococcal infection and repeated infections. His brother died from severe sepsis. on studies he has few B cells but normal T cells diagnosis

Case about a male with immunodeficiency has two normal sister andhx of one brother died due to
pneumonia

Case of 14m boy with a history of 4 lung infections, he has to healthy sisters.

Parent come with their child who have recurrent chest infection and they have another child who died from one attack of chest infection ask about Dx ? -

Answer 314

X-linked

X-linked gammmaglobunemia

(X-linked agammaglobulinemia (XLA) is a rare genetic disorder that affects the body’s ability to fight
infection )

Question 315

Wiskott–Aldrich syndrome has an X-linked ……… pattern characterized by 3 thing : eczema + ………… + immune deficiency or ……..

Q- Child with recurrent URTIs , eczema and thrombocytopenia both brother and uncle have the same condition

Answer 315

an X-linked recessive pattern characterized by 3 thing : eczema + thrombocytopenia + immune deficiency or upper resp infection

Question 316

Child with Tuberous sclerosis his mother also has it with TCH1 mutation what test to order for the child ?

Answer 316

Multiple gene screening

Question 317

What is the recommended screening age for hemoglobin

Answer 317

12 months

Question 318

Baby with green and brown eyes means……disease

Answer 318

Wilson disease

Question 319

Mother is concerned about her 5 month old baby that he’s delayed developmentally how would you relieve her concern

Answer 319

Baby is sitting independently

Question 320

congintal adrenal hyperplasia , now he is dehydrated + low glucose what will give ?

Q-High levels of 17-OH progesterone can indicate a congenital adrenal hyperplasia (CAH) =How to manage

Q-Female child has several episodes of vomiting and enlarged clitoris on examination. studies are given and show sodium 120 with other electrolyte
imbalance treatment = ………

Answer 320

A1= normal saline+ steroids + glucose
Daily hydrocortisone orally
CAH crisis > the definitive ttt is hormonal replacement corticosteroids + mineralocortecoids

Question 321

What is the classic cause of ambiguous genitalia on the Step 2 exam?

Answer 321

Adrenogenital syndrome, also known as congenital adrenal hyperplasia. Ninety percent of cases are caused by 21-hydroxylase deficiency. Girls present as neonates with ambiguous genitalia. Boys present as neonates with salt-losing adrenal crisis or as toddlers with precocious sexual development. Patients
with 21-hydroxylase deficiency have salt-wasting (low sodium), hyperkalemia, hypotension, and elevated 17-hydroxyprogesterone

Question 322

2 months old develop diarrhea (did not mention how many times or any other information) without vomiting or any other symptoms ( did not mention the vital signs or the health status of the baby) The mother concerns about dehydration management?

Answer 322

Oral rehydration solution

Question 323

Child was taking oral rehydration solution, present with mild dehydration, what is the reason of his symptoms

Answer 323

Glucose intolerance

Question 324

Mother came with baby 12 months suffering from recurrent gastritis after introduce normal diet again according to previous pediatrician give him oral rehydration Now baby came with same feature with mild dehydration also =

Answer 324

=Oral rehydration for 24 day then give normal diet ( not for 5 days)

Question 325

pedia pt with polyuria , high glucose , what’s next investigation:=

Answer 325

Hb A1C

Question 326

Pediatric patient with classical symptoms of DKA + elevated blood glucose . What will you do next?

Answer 326

Urine dipstick ( to check ketones )

Question 327

Child lossing 1kg despite he eating and drinking a lot , came dehydrated and irritable What’s the diagnostic test to the reach the diagnosis

Q2- Pediatric presented with hyperglycemia and sx of diabetes In vs RR:60 What is the most important test

Answer 327

Urin dipstick

A2= urine analysis and Hb A1C

Question 328

Diabetic mother, how to know if baby will be normal

Answer 328

Hb A1C

Question 329

Child diagnosed with T1DM screen eyes how often

Answer 329

After 5 years then annually

Question 330

When do screening for uveitis in SLE patients with (-) ANA

Answer 330

6 months

Question 331

6 years old K/c DM type 1 complain of hypoglycemia best TTT ?

Answer 331

Decrease insulin mixture

Question 332

child on glargine + aspart complain of fasting + postprandial hypoglycemia

Answer 332

Reduce both

Question 333

DKA During the management most important thing to be monitored?

Answer 333

Cerebral edema

Question 334

DKA treated but still have hypokalemia why ?

Answer 334

Vomiting

Question 335

child with DKA, PH 7.1 and glucose 20mmol. What is the initial mx step?

Answer 335

IV fluids

Question 336

child with Sx of dehydration and lethargy He also has fever. Rapid infusion of normal saline has been started; after that, the boy start some abnormal movement and went into deep coma which lead the doctors to intubate and transferred to PICU. Hypotensive, Tachycardic, Na 165, K 3.2, Cl 115. What is the cause behind it

Answer 336

Rapid indusion led to cerebral edema

Question 337

Child with dehydration, depressed anterior fontanel, and decreased skin turgor. What is the percentage of dehydration

Answer 337

10%
if asymptomatic> mild> 1-5%
if more > moderate> 6-10 %
if severe (hypotension)> 15 %

Question 338

in children of diabetic mothers, glucose 12.5% is given in

Q2- Newborn with hypoglycemia what is the route of 20% dexterous?

Answer 338

Central line

A2= Central line ( 20 % taken by central , if 10% peripheral )

Question 339

Child came with hypoglycemia what is the infusion rate ? .

Answer 339

10% dextrose ( 10ml/hour )

Question 340

Notes : Dextrose given peripherally in D5 and D10 but centrally in D12.5 and D15 and D20.

Answer 340

We start ttt of neonatal hypoglycemia by inserting 2ml/kg of D10 peripherally • If no response, persisted hypoglycemia so consider 12.5D through central line
• So initially it is peripheral line, not direct central line

Dextrose given peripherally in ===D5+D10 but centrally in ===D12.5 and D15 and D20

Question 341

newborn with one umbilical artery , what’s the cause: mother with…….

Answer 341

DM

Question 342

7 years old child brought to ER with DKA. What is the best to do after ER treatment?

Answer 342

Supply child and family with a written plan of care

Question 343

mother complains her daughter is less than her age +one parent is short. all lab results normal except insulin growth hormone is low =

Q2- Child 9yrs old came with his mother because she thinks he is short stature. mother is short. When hand bone examiend revealed age of 7 years Investigation All normal including growth hormone. Except insulin like growth hormone was 18 low, What is diagnosis?

Q3- 9 y/o boy, her mother concern about short stature, the investigation result the bone density for age 7 years= constitutional ( not Growth hormone)

Answer 343

Growth hormone deficiency

Question 344

Pt 6 years old with very low weight (25kg), everything is normal in examination and lab, except for low IGF-1, what you will do

Answer 344

Treat with recombinant GH

Question 345

Child with short stature…parents concerned whether he will remain short in the future as well !?
What is the most important thing in history that would determine your answer

Answer 345

Parent’s height

Question 346

Asymmetrical kidneys size on us means

Answer 346

Polycystic kidney disease

Question 347

girl 7 years old has pubic hair, developed breast ,ask about which kind of puberty?

Answer 347

Central Precocious puberty ( is when the signs of puberty start: before age 7 or 8 in girls. before age 9 in boys )

Question 348

5 yrs female with pubic hair , no clitoromegaly obese, hight above 90 centile, diagnosis

Answer 348

Dehydroepiandrosterone Sulfatedehy also known as androstenolone, is a male sex hormone (androgen) that is present in both men and women

When To Get Tested
When a girl or woman has excess facial and body hair (hirsutism), or when shows signs of very early (precocious) puberty such as deeper voice, pubic hair, or muscle development

Question 349

2 y/o developing breast which case

Answer 349

Premature delarche

Question 350

Turnner stage 5 breast and pupic hair = Delay causes…

Q2-: 7Y tanner stage 5 (breast, pubic hair,acne) type of puberty?

Answer 350

Constitutional delay

A2= precious puberty

Question 351

7 year old with pubic hair, no axillary hair, no breast or mensis?

Answer 351

Precocious puberty ( Not adrenarche Bez adrenarche means > axillary and pubic hair and this case no axilla hair

Question 352

male with thick hair and dark scrotum = ………

Boy with pubic hair towards adult distribution and darkening of scrotal skin. Tanner stage?

Answer 352

Tanner stage 4

Question 353

13 years old brought by her mother concerned about her stature, patient is normal, on examination, no signs of breast development and no pubic hair, what is the cause

Answer 353

Constitutional

Question 354

Case of gonadal genesis, she is 17 years no period minimal development of breast with axlllary and pubic hair Outflow obstruction or mullarian agenesis

Answer 354

Pelvic US

Question 355

17 years old boy with unilateral gynecomastia:

Answer 355

Reassure, it will disappear later

Question 356

9 days newborn come with jaundice only in the face not extended to the rest of the body.. otherwise he is healthy was delivered by NVD with no completing.. and he was breastfeed immediately. what is the cause of his jaundice

Answer 356

Breastfeeding jaundice

Question 357

2 years old girl, her mother noticed development of the breast , no other sign of puberty

Answer 357

Premature breast development, Premature thelarche is the term we use for girls who develop small breasts (often an inch or less across), typically before the age of 3 years. Girls with premature thelarche do not have other signs of puberty

Question 358

4 months on breastfeeding, This is her first baby , came with 2 days hx of lethargy constipation, fever, response weak when light directed to his eyes , cause

Or primigravida , baby flat face , no smile :

Answer 358

Infantile boutilism

Question 359

child presented with lower leg long bones angulation. Labs show high CA and low phosphate. X ray shows distal bone hypertrophy

Q2- child has leg abnormal shape and delayed walk, ca high ,alkaline phosphatase high ,normal Pos ?

Answer 359

Rickets

Question 360

Baby delivered at home presented 5 days later with rt thigh bruises other exam unremarkable ( PT high , PTT high , otherwise normal

Answer 360

Hemorrhagic disease of newborn

Question 361

5 day with jaundice, mom said that his brother also was same sx in last delivery, what most important question in history

Answer 361

Mother blood type

Question 362

child was delivered, and he developed jaundice on a 3rd day. He was treated for physiological jaundice but 2 weeks later jaundice became progressive with associated pale stool. Investigations
done and showed: Total bilirubin high, Direct bilirubin high. What’s the diagnosis

Q2- 8 weeks with president jaundice not relive by photophobia , with elevate ALP

Answer 362

Biliary atresia ( Biliary atresia is a condition in infants in which the bile ducts outside and inside the liver are scarred and blocked. Bile can’t flow into the intestine, so bile builds up in the liver and damages it. The damage leads to scarring, loss of liver tissue and function, and cirrhosis )

Question 363

Infant 2 weeks old. On examination he is jaundice, has large fontanel, cold extremities + hypotonia + large toung to his mouth. What’s likely diagnosis

Answer 363

Congenital hypothyroidism

Question 364

2 month old , mother notice bulging tongue , dry mouth, constipation , fhx of autoimmune dis , tSH high 22 , T3 low T4 low what mx

Answer 364

Give life long thyroxine

Question 365

Newborn what is the SINGLE investigation you must to do

Answer 365

Thyroid function test

Question 366

Newborn developed jaundice in first 12 hours , labs shows hb “9” Which test to order

Answer 366

Fragility test

Question 367

Child with jaundice has high total bilirubin, high indirect bilirubin,positive direct and indirect comp test what is diagnosis

Q- 2 yo girl with diarrhea and dehydration , splenomegaly , Hb is low , direct and indirect coomb is +ve ,

Answer 367

Autoimmune hemolytic anemia

Question 368

11 years old with with jaundice Lab test: Increase indirect bilirubin Increased total bilirubin Increase all the lft

Answer 368

Gilbert

Question 369

What indicate hemolysis ?

Answer 369

Increase unconjugated
🌻in extravascular hemolysis plasma levels of unconjugated bilirubin increase because the hepatocytes cannot process the excess bilirubin

Question 370

5 days old baby with jaundice, what is the important question to ask ?

Answer 370

Blood group

Question 371

16/ old with fever and RUQ pain and jaundice, No lab or radiology available: next

Answer 371

Admission to evaluate

Question 372

Pedia 4 days with jaundice and his brother had the same thing, Direct bilirubin and total bilirubin was high what is the diagnosis

Q- Pedia 4 days with jaundice and his brother had the same thing Direct bilirubin and total bilirubin was high = biliary atresia

Answer 372

Choledocal cyst / diffent answers

Question 373

Child 12 h , have jaundice , HCT high , pic of spherocytosis , what is the test u will do ?

Answer 373

Osmotic fragile

Question 374

8 weeks old baby with jaundice, not responding to phototherapy, what is the cause

Answer 374

Biliary atresia

Question 375

Pregnant with Rh-negative blood type her baby have Rh-positive blood type present with jaundice ask about Pathophysiology

Answer 375

autoantibodies against fetal RBCs (Mother’s antibodies attack fetus RBCs)

Question 376

Child with sickle cell andmeia xray

Answer 376

( acute chest syndrome ) The study found that lung consolidation is the most common pulmonary finding, frequently affecting the lower lobe (right more often than left

Question 377

Boy complaining of RUQ pain, he had a history of URTI couple of days ago, cbc shows low hgb and increased retics, smear shows target cells and inclusionbodies, diagnosis

Answer 377

Sickle cell anemia

Question 378

Sickle cell anemia child hb 3 severe pallor and long history given what mostly causes this

Answer 378

Triggered by parovirus 19

Question 379

SIckle cell disease patient came with crises, What’s the appropriate next step to reach diagnosis (to differentiate between aplastic and splenic sequestration

Answer 379

Reticulocytes

Question 380

Patient came with sudden pain in the hands and feet what’s the most likely diagnosis

Answer 380

Sickle cell disease

Question 381

Prevent ACS in SCA

Q-patient with acute chest syndrome and upper/lower limbs vaso occlusive crisis, what’s the effective drug proven to reduce the frequency of painful crisis?

Q- Child with SCD most Important long tami treatment

Answer 381

Hyroxyuria

Question 382

Pic of CXR of rt lobe consolidation With long scenario of SCD pt presented with chest pain and dyspnea and back pain, What is the Dx , how to prevent it

Answer 382

Acute chest syndrome / prevention by hydroxyuria

Question 383

Child with sickle cell anemia presented with shortness of breath and chest pain on is the best initial step in the management

Q- 6yr Sickler with fatigability for 2days. found anemic Spleen 6 Cm below costal margin, management

Answer 383

IV fluids and analgesics

A2 = Splenectomy✅ but hydration and transfusion first

Question 384

patient with a decrease in all cell line WBC, Hgh, and plt (labs) asking about dx?

Answer 384

Aplastic anemia

Question 385

Case of child studies given microcytic anemia he has high Hba2 on electrophoresis what type of anemia?

Answer 385

Beta thalassemia minor

✴ Hg A2 higher in minor b thalassemia ✴HgF in major thalassemia

Question 386

12M fatigue, failure to thrive, stunt growth, large forehead or something?

Answer 386

Beta thalassemia

Question 387

Child lab showed microcytic and hypochoromic anemia with reticulocyte count high (2%) , ferritin normal, and his 2 siblings have the same presentation what is the diagnosis

Answer 387

Alpha thalassemia

Question 388

Child pale and lethargic, with no specific S/s , labs shows only microcytic anemia (low hb,lowMCV) what is the diagnosis

Child lab showed microcytic and hypochromic anemia with reticulocyte count high (2%), ferritin normal, and his 2 siblings have the same presentation what is the diagnosis

Answer 388

Thalassemia trait

Alpha thalassemia train

Question 389

🌹pale child came with MCV : 68 + Lowe plattlet + low ferritin and have 2 siblings with same condition = Diagnosis

Answer 389

Thalassemia minor

Question 390

child ingest iron tablets and come with symptoms, treatment

Answer 390

IV deferoximine

Question 391

child 4 years old loss of weight for long time , most comon cause in this age :

Answer 391

Leukemia (2-8 )

Question 392

Child eating paper, diagnosis

Answer 392

Iron deficiency anemia

Question 393

58 days baby have G6PD they give lab value low HB level : what are the causes of this:

Answer 393

Hemolytic anemia

Question 394

Ptn came for routine F/U Lab show: High RBC low HB Low MVC Normal Reticulocyte

Answer 394

Anemia of chronic disease

Question 395

Female had son with SCA. Remarried and for screening

Answer 395

Husband ( father )

Question 396

What is treated after splenectomy?

A. Alpha thalassemia, B. beta thalassemia, C. sickle cell trait D. ITP

Answer 396

Don’t know ( sickle cell )

Question 397

A child with ALL came to the ER with febrile neutropenia, management?

Answer 397

All spetic workup with IV antibiotics

Question 398

A young boy came with hemarthrosis asking about dx

Answer 398

Hemophilia

Question 399

Direct and indirect coombs test are positive: diagnosis

Answer 399

immune hemolytic anemia

Question 400

Picture

Answer 400

Classic ring-shaped/headphone-shaped trophozoites are seen in case of Malaria = Plasmodium falciparum infection

Question 401

Pt with pallor (anemia) with splenomegaly Lab: high retic. Blood smear: microspherocytes ++ Anisocytosis + Dx?

Answer 401

Hereditary spherocytosis

Question 402

prominence occipital, rocker bottom feet , cardiac = …… syndrome

Answer 402

Edward

Question 403

• Obese child mother complaining of hyperphagia on examination he had dysmorphic features + hypotonia + ascended testes. What is the most likely diagnosis?

Q- Child eats alot and he is obese with undecended testis , facial malformation and cleft plalte?

Answer 403

Prader willi syndrome
classic sign of Prader-Willi syndrome is a constant craving for food, resulting in rapid weight gain, starting around age 2 years. Constant hunger leads to eating often and consuming large portions

Question 404

2cases Turner syndrome (one with primary amenorrhea and other phenotypical features and second one presenting with short stature and the typical phenotype)

Q-17 years old hypertensive not menstruating yet at clinic by her parents ,she is short stature , short neck Most appropriate diagnosis

Q-Parents are worried about the hight of their child on examinations the child look normal with deprsed nose and short neck and large tongue what is the cause of his short stature

Answer 404

Turner syndrome

Question 405

Tall thin child patients (above the 95th percintile) and has flexible joints and pectus excavatum
diagnosis

Answer 405

Marfan syndrome

Question 406

down syndrome: most common cardiac anomaly associated with DS?:

Q- child with Down syndrome came with fixed S2, ejection systolic murmur and enlarged ventricles. What is the most likely diagnosis?

Answer 406

Endocardial Cushion Defect ✅

AVSD

Question 407

Down syndrome is associated with ….thyroidisim

Answer 407

Hypothyroidism

Question 408

Low incidence in down syndrome: Mosaicism

Answer 408

Not sure

Question 409

Investigation of Down syndrome

Answer 409

high Bhcg, high inhipin, low AFP, low estradiol.

Question 410

Mother 27 years I think had Down syndrome baby what Increases hor risk for
having another baby with Down syndrome = A. age B. father chromosome C. mother chromosomes


Answer 410

Age ( not sure )

Question 411


Infant months of age died , they took hx from the parents ( the infant was preterm, problem with lungs , parents are heavy smokers and he was sleep with them ) what is the cause of death

Answer 411

Sudden death infant syndrome ( Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. SIDS is sometimes known as crib death because the infants often die in their cribs. Although the cause is unknown, it appears that SIDS might be associated with defects in the portion of an infant’s brain that controls breathing and arousal from sleep )

Question 412

2months old infant was found dead by his mother. Mom said he was okay without any obvious thing. On
examination, no signs of fractures, bruises, or abuse. What is the important part of history to be asked?

Answer 412

A. social history (think about sudden infant death syndrome&raquo_space; smoking)

Question 413

Which of the following decrease RDS incident the most?

Answer 413

parents not smoking near their infant

Question 414

coarctation of the aorta associated with …….syndrome

Answer 414

Turner

Question 415

17 years old medically free brought to Gynecology clinic by her mother with
history of no menstruation. On examination there was low hairline, high BP and short stature. Both mother and father were having short stature at her age.
What is the most likely diagnosis

Answer 415

Turner

Question 416

13 years old boy presented with cushing syndrome symptoms such as central obesity and striaLab test : high cortisone in night and salivary ACTH What next steps

Answer 416

Pituitary MRI

Question 417

child present with central obesity + moon face + striat investigation?

Answer 417

ACTH stimulation test

Question 418

Best lab to dx Turner syndrome=

Answer 418

karyotype if there is = FSH choice it .

Question 419

Case of digeorge syndrome( facial features, recurrent infection and tetany) ask about vaccines not to give before Dx?

Answer 419

All live vaccines

Question 420

8 years old boy don’t understand in school and have many involuntary movements, he is aggressive .. Dx

Answer 420

= There was no ADHA in choices

Note: DD: Tourette syndrome,if with communication impaired or Lesch-Nyhan Syndrome

Question 421

D-tap contraindication

Answer 421

Encephalopathy

Question 422

Malnutrition of african boy with Acitis or edema

Child in poor area with central edema Muscle wasting, diagnosis

Answer 422

Kwashiorkor

Question 423

Pt with ascites and edema, severe muscle wasting, hyperkeratosis, lab show:
slightly decreased glucose, significantly decreased albumin, your Dx:

Q- Pt child with brittle hair and abdominal destination, diagnosis

Answer 423

severe protein deficiency (kwashiorkor)

Question 424

Malnutrition of african boy with Atrophy everywhere =…………

Muscle wasting low protein =…….

Answer 424

Marasmus

Question 425

most common affected organ in pediatric with mumps:

Answer 425

Parotid gland

Question 426

4 year old boy most common cancer

Answer 426

Leukemia

Question 427

child has swelling and redness above knee ( femur)=……..

Orthopedic tumor in pedia there is No limitation of movement?

Answer 427

Osteosarcoma

Question 428

Which lymph node indicate malignancy ( gastric cancer )

Answer 428

Supra-clavicular LN

Question 429

lung Ca, sudden onset of back pain, neurological Ex is normal ,ttt? Steroid then MRI

Answer 429

Don’t know

Question 430

Pt diagnosed with small cell lung cance, presented with dehydration, serum osmo low, urine osmo high., treatment

Answer 430

Normal saline

Question 431

abdominal mass with lung nodule ?

Answer 431

wilms (most common metastis wilms to lung )

Question 432

Child presented to the ER with fever and abdominal pain. After a fall 1 day ago, the mother noticed abdominal distention mainly on the right side. On examination he is pale and hypertensive , your dx ?
…..
🌹 mother while showering her sone noticed abdominal mass =
if central = ………..If flank =……..

Answer 432

Neuroblastoma / if flank wilms tumor

Question 433

🌹Pt boy with abdominal mass noticed by mother while she was bathing him, on examination healthy boy with rt. Flank mass 1st Q what is the investigation:…..
🌹2nd Q what is the dx:………

Answer 433

CT , Wilms tumor

Question 434

Boy came to ER has erosions bone in the hand and in the lab has high Ca, phosphate What treatment will you give

Answer 434

Biophosphonate

Question 435

Child jump with 2 feet, age

Answer 435

2- 3 years

Question 436

4 month old baby which of the following he can do

Can support his head, smile, follows objects with eyes. = 4 months

Baby can move and fix his head when he in prone position , smile, reache object = 4

Answer 436

Head lag

Question 437

Baby crawl and sit and grasp things but unable to do pincer grasp:


Answer 437

7 months

Question 438

child remove cloth by himself and say dada and tell stories =

Answer 438

4 years

Question 439

Child enters the dr’s clinic play w ball throw it to doctor , catch a ball ,draw line, puts books together ?

Q- …
Child enters the dr’s clinic says “Hi”, mother gives her doll. Then he feeds the doll with milk bottle. Mother moves his head then he says “No”. Mother does something and then he imitates her What’s the age?

Answer 439

18 months

Question 440

Child can say 3 words sentence

Baby speech understandable to stranger 75% ,says three word sentences

Answer 440

3 years

Question 441

If baby can say 3 words

Answer 441

> 15 months

Question 442

Sucking reflex disappear, baby cancsit without support

Answer 442

6 months

Question 443

All reflexes disappear at 4-6 months except

Answer 443

Stepping at 2 months

Question 444

Baby can say 5 words, hop on the leg

Answer 444

48 months = 4 years

Question 445

Ride tricycle can not draw square

Answer 445

3 years

Question 446

Smile but not reach objects?.

Answer 446

8 weeks /

Question 447

Child can run , stair , can’t use 3 word together age ?

Answer 447

18 months

Question 448

can speak clearly. can draw squares and cycles

Answer 448

4 years

Question 449

Baby says dada, pincer grasp, walk by furniture, pulls himself to standing
position, sit without support

Answer 449

9 months

Question 450

🌹can sit in his own, stand alone, walk by the furniture, say word of repetitive consonant sounds like “dada” can hold objects between his thumb and index finger

Answer 450

10 moths

Question 451

🍓3 years old with normal milestones to his age except that he doesn’t know how to speak in future tense and can’t say 3-word sentence, what would you tell the mom A. reassure. B. he has a delay in speech only but other milestones are fine
Answer is: refer to ENT for audiogram

Answer 451

Dont know

Question 452

-Question asking about best time to do red reflex examinations

Answer 452

At birth then at 6 week of age

Question 453

Picture of Rooting reflex when disappearing

Answer 453

4 months

Question 454

🌹 Pic of baby and physician hand. He was taping the left side of mouth When the primitive reflexes disappear?

Answer 454

6 months

Question 455

child can run towards you and follow 2 step commands= How old

Answer 455

2 years

Question 456

Child with pincer grip but cant put pallets in a bottle

Answer 456

8 months

Question 457

child whose 3 years old can talk to other children and strangers understand 75% of his speech. What kind of delay

Answer 457

No delay

Question 458

A 4 year old child with a morning limb and knee arthritis and (-) ANA. When should see the ophthalmologist to check for uveitis?

Answer 458

Not sure ( 6 months)

Question 459

what’s the time to say fever of unknown origin in pedia,

Answer 459

After 14 days

Question 460

newborn needs vaccine and his sister died of immunodeficiency disease. What should you do

Answer 460

Evaluation by immunology team

Question 461

🌹Child has a brother who died from severe infection came for vaccines which will u defer till knowing immunity status

Answer 461

Varicella

Question 462

12 y child with mild fever and vehicular rash in chest , trunk upper lower which test has higher dx

Answer 462

Varicella zoster igM

Question 463

🌹Baby present with with tea color urine with sore throat +140/80 Urine analysis done ( tea color, WBC, erythrocyte ) next test

Answer 463

Creatinine

Question 464

🌹 Steroid dependent nephrotic syndrome patient needs vaccine?

Answer 464

wait 6 month after stopping the steroid

Question 465

Female has crohn’s on biological and azathioprine, what about her baby vaccinations?

Answer 465

Delay all 6 months

Question 466

What is the absolute contraindication for DtaP vaccine:

Answer 466

hx of encephalopathy within 7 days following previous dose of DtaP

Question 467

🌹SCD patient took blood transfusion when should you give the vaccines?

Answer 467

Give all vaccines

Question 468

DTP immunization expires in?

Answer 468

10 years

Question 469

Baby missed vaccines 18/24.. 2 days swollen eye pain.. Low eye acuity.. What’s next most appropriate.

Answer 469

Answer is: ORBITAL CELLULITIS ( do CT )

Question 470

🌹10 years old with abdominal pain and lab show high liver enzyme and indirect bilirubin.. diagnosis ?

Answer 470

Viral hepatitis

Question 471

🌹child with “reccurnt infection” with brother died due to septic shock what will give =……….

Answer 471

Don’t give live vaccine

Question 472

….

🌹Baby 3 hours of life. His brother died of immune condition =

Answer 472

Dont give BCG and only give hapatitis vaccn ???? Not surev

Question 473

Vaccination at age of school (6years) = 4

Answer 473

Dtap , MMR, OPV, Varicella

Question 474

what to do for child came for vaccines but he on antibiotics course?

Answer 474

Give vaccines

Question 475

🌹2 year child didn’t complete his vaccination present with fever, unable to swallow , dysphasia , enlarged tonsils

Answer 475

Diphtheria

Question 476

Pregnant negative varicella antibodies

Answer 476

Avoid exposure

Question 477

similar case happened at school weeks ago, the parents were concerned about another immunodeficient child at home what to do with him ?

Answer 477

A. Injection af specific immunoglobulin to the immunodeficient child✅

Question 478

🍓Pregnant lady on chemo what vaccine not to give to child after delivery

Answer 478

Start vaccination after 6 months

Question 479

Vaccines at 4 months

Answer 479

hepb, dtp, Hib, PCV , polio

Question 480

( immunodeficiency ) What vaccine contraindication

Answer 480

Varicella

Question 481

months with diarrhea ONLY, no vomiting or fever = vaccinations?

Answer 481

Give all

Question 482

vaccine to give in 2mo old bby

Answer 482

Dtap, HIB, HBV, OPV, PCV

Question 483

1 year vaccine

Answer 483

MMR, varicella

Question 484

4 months vaccines

Answer 484

DTAP, HIB, HBV, OPV, PCV

Question 485

🌹Immunodeficient baby, What vaccine should you avoid:
….
🌹 Boy with throat thrush, fever and weak Which vaccine will you not give =
…
🍒 What vaccine contraindicated in immunocompromised patients ?

Answer 485

Varicella , Live vaccines

Question 486

2yoars old with fever cough SOB her mother confirms that she had all vaccines without any mIssIng what is the causative organism

Answer 486

Streptococcus pneumoniae

Question 487

baby was born in 35 wk, parents asking about vaccines

🌹 2month infant GA at birth was 27 weeks 1.7 kg and spend 2 weeks in nursery. presented now to the clinic for first time doing good and gaining weight appropriately best action:

Answer 487

Give all vaccines , same dose

Question 488

Case of pediatric patient known to have Seizure, came with syndromic feature hypotonia large head, asking about vaccines

Answer 488

Stop Dtap ( Contraindications to DTaP unstable neurologic disorder such as uncontrolled seizures )

Question 489

🌹most common minor side effects of routine DTP vaccination?

Answer 489

A. injectable site erythema

Question 490

weeks old baby with strong cough and 2 episodes of him losing consciousness. on exam there is intercostal retractions. 02 sat was 90 . What do you do

Answer 490

B2 agonist

Question 491

🍓Pt with tachypnea orthopnea.. (Symptoms and signs) of Rt sided heart failure on lab investigations Liver enzymes are very high abnormal

Answer 491

HF

Question 492

🍓Newborn after CS have respiratory symptoms , CXR shows fluid in the horizontal fissure , what’s the dx

Answer 492

Transient tachypnea of the newborn

Question 493

Baby born 27 weeks after 30 mins started having tachypnea and grunting, most common cause

Answer 493

Respiratory distress syndrome (RDS) is when the neonate has difficulty breathing faced by preterm
infants and is directly related to structurally immature and surfactant deficient lungs

Question 494

Newborn withnasal flaringandsubcostal retraction? Diagnosis

Answer 494

RDS

Question 495

Patient known case of SMA (spinal myotonic atrophy), develops respiratory muscle fatigue and needs intubation , mother refuses as one of her children died of the same condition what will you do

Answer 495

Intubate

Question 496

🌹Baby with x ray show ( TTN ) + symptoms of pneumonia + Lap high Neutrophils Ttt=

Answer 496

Oral amoxicillin for u days

Question 497

🍒 7 year old Child ingested 20 tablet baby aspirin ,what you expect regarding acid base balance

Answer 497

Respiratory alkalosis and metabolic acidosis

Question 498

A 2-hr old baby = What intervention would minimize disability in the first 6 hours?

Answer 498

Respiratory support

Question 499

🌹A newly born presents with meconium aspiration. He was stabilized by intubation and given IV inotropic fluid. After that he developed respiratory distress. His preductal O2 sat was 92% and post ductal O2 sat was 83%. What is the next step in managing the patient

Answer 499

Nitric oxide

Question 500

18 m k/c of cerebral palsy presents with respiratory compromise Then put under MV Given ABG ,Pco2 normal,Po2 low ,PH 7.3 Ask what type of respiratory failure

Answer 500

Hypercapnic ❌

Question 501

young girl presented with palpitation and hypercapnia. Father mentioned issues with schools and exams. What is the diagnosis

Answer 501

Hyperventillation syndrome

Question 502

Child with pneumonia hemolysis + positive agglutination test, what is the organism

15-year-old male presents with a cough, mild fever, and headache. His blood pressure is 110/75, heart rate is 73, temperature is 39.8 OC. chest XRAY shows bilateral infiltrates and a leukocytosis on a complete blood count. What is the most likely infectious agent

Answer 502

Mycoplasma

Question 503

oy came with respiratory infection symptoms, by auscultation: crackle, by precaution: stony dullness direct under the crackles sound, Diagnosis

Answer 503

Pleural effusion

Question 504

neonate presenting after 2 days of delivery with history of seizure and hypertonic extremities, most likely

Answer 504

Don’t ( my answer is hypoxic ischemic encephalopathy or in preterm the most common casue is intracranial hemorrhage )

Question 505

🌹Pre term baby diagnosed with hypoxic ischemic encephalopathy (HIE) what’s the risk factor :

Answer 505

: Low birth weight less than 1500 gm

Question 506

child came with seizure and they give CSF value “ all normal “ Dx?

🌹Mother had obstructed and difficult labor, she gave birth to a child who wasn’t crying and cynosed. His ABG:pH6.9,HC037,028.What’s the diagnosis

Answer 506

Hypoxic ischemic encephalopathy

Question 507

6y old child k/c of asthma came with asthma exacerbation , lab showed RR = 7/minutes , Hypercapnia best initial

Answer 507

Intubate

Question 508

🍓pt on ventolin not improved, what to add

Answer 508

ICS

Question 509

🍓Infant diagnosis with VSD present with symptoms and sign of heart failure ( hepatomegaly, SOB, Cardiomegaly ) what’s the next step in management

Answer 509

Give diuretics

Question 510

🌹Patient with recurrent dyspnea attack due to inhaling dust or perfumes, on examination has inspiratory
wheeze. Asks about initial management

Answer 510

Ventolin nebulizer

Question 511

Asthmatic patient on inhaled corticosteroid and short acting beta 2 agonist which he use 3 times daily. What is next step in the management

Answer 511

Long acting B agonist

Question 512

🌹A child who had flu-like symptoms, then has a typical picture of asthma exacerbation What is the first line of management

Answer 512

B agonist

Question 513

🌹Pregnant lady, just delivered and she’s known to have bronchial asthma. Which of the following uterotonic medications you would avoid giving

Answer 513

Carpostol F2 alpha

Question 514

🌹child has asthma symptoms but when do spirometry was normal what is the best :

Answer 514

Methacholine

challenge test

Question 515

🌹child had mild dyspnea, when exposed to dust diagnostic test of asthma

Answer 515

Spirometry ( not sure )

Question 516

🌹 12 yo girl complaining of nausea and vomiting if the flight was more than 1 hour what is the best antiemetic for her

Answer 516

The Dx is Motion Sickness > Tx with Anticholinergic agent like Scopolamine
Or with Antihistamines agent like Dimenhydrinate

Question 517

5 year boy with bronchial asthma on 2 medication, has syrr mother concern about him not gaining weight. Was : Less than 5th percentile weight and At 25th percentile height choices were

Answer 517

investigate more for possible asthma mimickers

Question 518

S & S of cystic fibrosis and asked about which sign u suspect to find

Answer 518

Nasal polyps

Question 519

ind ? Nasal polyp

Child presenting for check up clinic when to be concerned about growth

Answer 519

Body persisting at 10 percentile

Question 520

🌹Criteria to help diagnose HTN in a 12 YO girl?

Answer 520

> 95% for age / sex

Question 521

Growth chart (similar to the pic) showing normal at birth, increasing but below the 3rd centile, diagnosis

Answer 521

Failure to thrive

Question 522

🌹Pediatric pt with ptosis and dlplopia and knee hyperreflexia with no fasciculation symptoms worse through the day and improve next morning , what is the pathophysiology :


Answer 522

anti-bodies against Acetyle cohen receptors


Question 523

Child with +ve cover test -) stabismus

This is an Important risk for, as it can cause

Answer 523

Amblyopia (Note:+ve cover test Diagnosis ? Strabismus)

Question 524

🌹Baby with AV block… Which of the following Maternal conditions is associated with the bad
presentation

Answer 524

SLE

Question 525

Child with URTI then complaining of bleeding from nose, gum and bruising the treatment is ?

Answer 525

Prednisolone ( for mild bleeding + less than 30, 0000 + like this case all symptom is “mild bleed

Question 526

4 y old girl with history of limping and movement restriction for 2 months, ANA negative, she is otherwise normal What is the screening for Uveitis ?

Answer 526

Every 6 months ( Uveitis Screening in Patients with Juvenile Idiopathic Arthritis
Uveitis is a serious complication of juvenile idiopathic arthritis (JIA). Approximately 6% of all cases of uveitis occur in children, and up to 80% of all cases of anterior uveitis in childhood are associated with JIA)

Question 527

3 years old boy his mom complained that she noticed blood spotting in the dipper,
there was another episode 3 months ago, no abdominal pain or other manifestation, on examination patient looks pale and mucosal dryness, what’s the most likely diagnosis:

Answer 527

Juvenile polyposis syndrome is a disorder characterized by multiple noncancerous (benign) growths
, typically develop polyps before age 20; These growths occur in the gastrointestinal tract, typically in the large intestine (colon). The number of polyps varies from only a few to hundreds, even among affected members of the same family. . . Polyps may cause gastrointestinal bleeding, a shortage of red blood cells. Anemia

Question 528

🍒 juvenile idiopathic arthritis case : both knees arthritis , nothing else, type?Oligoarthritis
…
🌹Pediatric Knee+elbow pain increase in morning ? Juvenile rheumatoid idiopathic🌹

12 y boy with right knee and wrist swelling and subcutaneous nodule = Juvenile rheumatoid arthritis …
🌹Pediatric patient with rt elbow pain and lt knee pain, worse in the morning and
improve with day A. juvenile idiopathic arthritis

Answer 528

Not sure

Question 529

🌹 Baby with painless per rectal bleeding in the diaper Hx of same complaint 3 month?Dx?
A. Mechels diverticulum
🌹if there is familly history = Juvenile polyp
…
🌹pedia 3y pt have painless bleeding per rectum ?
A. Juvenile polyp ✅ B. Meckel’s diverticulum (age)=typically appear before the age of two years.

Answer 529

Read

Question 530

🌹 Pediatric patient presented with sudden apnea, has a history of upper respiratory infections, on examination the patient takes coughs several hacking cough then takes a breath with inspiratory wheeze, between coughing she looks fatigued and exhausted. No fever. Best investigation

Answer 530

Sweet chloride test ( used to diagnose cystic fibrosis)

Question 531

Pediatric Patient Dx with cystic fibrosis, sibling no hx What appropriate management?

Answer 531

Test siblings for sweet chloride test

Question 532

🍇Child presented to ER with parents c/o hematuria and urine Incontinence with previous hx 2 weeks ago with constipation and fever . Lab show Wbc; 8000 with low Hb, UA show : + protein and +++Rbcs, What’s most likely diagnosis

Q- A child presented with joint pain and hematuria. Mother reported history of URTI 4 weeks ago. On exam there was petechial rash involving buttocks and thigh, otherwise normal. Platelets normal. What is the appropriate Diagnosia? Treatment

Answer 532

Henoch scholine purpura ( petechea , joint pain , Abd pain or previus infection / Treatment = mainly Suppurative. But with syptom active = Steroid .

Question 533

🌹Young pt have hx of bloody diarrhea, after 1 week he developed petechiae rash, he have hematuria and low platelet - Pt & ptt normal

Answer 533

HUS

Question 534

🌹Young pt have hx of bloody diarrhea, after 1 week he developed petechiae rash, he have hematuria and low platelet - Pt & ptt normal=

Answer 534

(HUS) is a condition that affects the blood and blood vessels. It results in the destruction of blood platelets (cells involved in clotting), a low red blood cell count (anemia) and kidney failure due

Question 535

thrombocytopenia and uremia in studies and has fever and headache

Answer 535

Hemolytic-uremic syndrome (HUS) often occurs after a gastrointestinal infection with E coli bacteria (Escherichia coli O157:H7) = 3 thing happen ( low plattler + low RBC ( anemia ) + high creatinin (kidny failure

Question 536

Child with feverv,hematuria

Answer 536

Child with fever hematuria headache ask dx = TTP
….
🌹A child complains of Headache and petechiea , labs show decreased plt , normal creatinin.There is attaches pic shows schizocytes. What is the probable diagnosis : TTP
…..
Rx pf TTP? plasma exchange
…
What is the dx: TTP
…..
🌹Treatment of thrombotic thrombocytopenic purpura = mainly by Plasmapheresis with or without steroids


Question 537

🍇.7 years old child day 7 post appendectomy come with fever and bad general .condition but her in mechanical ventilation . After that do ct contrast . The child bleed from lvlne trachea and wound site ,
✅
…..
🍇Child came from a visit to Africa. neck stiffness . can not elevate head or limbs : EBV ✅

…
🍓11 years old child had severe diarrhea 3 weeks ago, now the child presented with
bilateral lower limbs weakness and numbness, dx?
A. Poliomyelitis B. Guillain Barre syndrome✅✅✅ C. Muscular dystrophy D. Cerebral palsy
….
🌹Child post-GI infection a few weeks back develops ascending symmetrical muscle weakness associated with loss of reflexes. (It’s Guillain-Barré) how will you treat this child? A. Steroids B. Immunoglobulins
…
Child Herpes gingivostomatitis sx (lips, gums, tongue, palate vesicles) and he can’t feed orally. What will you give him?
A. Antiviral (i’m not sure if they write acyclovir or antiviral)
What is the Diagnosis

Answer 537

DiC

Question 538

🌹 Child previous URTI came with petechiae and abrasion Every thing is normal except platelets 15000 , treatment

Answer 538

Platelets transfusion ( TIP) not sure

Question 539

GBS case with involvement of all lower limb and respiratory symptoms : IVIG

Answer 539

IVIG

Question 540

Child presented with erythematous pharynx, with cervical lymph nodes and rapid strplysin test negative and low grade fever with positive EBV . It next step

Answer 540

Antipyretic and fluid

Question 541

Child came from a visit to Africa. neck stiffness . can not elevate head or limbs :

Answer 541

EBV

Question 542

11 years old child had severe diarrhea 3 weeks ago, now the child presented with
bilateral lower limbs weakness and numbness, dx?

Answer 542

GBS

Question 543

🌹 A 12 month old child developed painful vesicles around his lips, tongue, gu and hard palate. He is unable to tolerate orally. What is the most appropriate management

Answer 543

IV acyclovir and fluids

Question 544

🌹 child with gum bleeding, erythema papules in mouth. Swab showed ( multinucleated giant cell ) on tzanck smear

White vesicles around mouth and gum with cervical lymphadenopathy, diagnosis? HSV
…
🌹5 years old presented with rash (picture provided) the rash started as one scratch and then became generalized over the body. Inguinal and axillary lymph nodes are swollen. What will you give

Answer 544

Herpes simplex / acyclovir

Question 545

A young child presented with tonsillar ulcer and painful lesion in the back of her mouth and soft palate , what the dx ?

Answer 545

Herpes angina

Question 546

Child with fever 39 ,sore throats on examination there is white exudate over the tonsils most appropriate step to reach the diagnos

Answer 546

Throat culture

Question 547

Neonate , palpable mobile mass non tender , what is it ?

-Child came with testicular swilling wasn’t painful positive transillumination normal sensations in preanal area

Answer 547

Hydrocele

Question 548

testicular asymmetry and was tender on palpation = ………… A testicle that’s positioned higher than normal or at an unusual angle.

Answer 548

Testicular torsion

Question 549

5 years old child found to have one testes in the scrotum and the other in the ingunal area what to do?

Answer 549

Orchidopixy

Question 550

Baby with painless scrotal swelling bilaterally , neg transillumination test, Dx?

Answer 550

Idiopathic scrotal edema

Question 551

15 years old with scrotal pain and absent cremasteric reflex diagnosis?

Answer 551

Testicular torsion ( varicocele is with positive cremasteric reflex )

Question 552

12 years old male with testicular pain (horizontally lying, mildly elevated, no swelling or erythema of scrotum

🌹child complain of “unilatral scrotal swelling “ dose not transillium whats nexst step ?

Answer 552

Surgical exploration

US then surgery

Question 553

10 month girl , her parents noticed lump in the girl while she crying, disappeared in sleeping
(umbilical hernia) she is otherwise healthy. Management?

18 month baby complain of umbilical hernia become huge with cry =

Answer 553

Reassure, watch and wait

Question 554

…..

🌹Child with swelling, red, tender hernia. Dx?

Answer 554

Incarceration (red inflammed tender is incarcerated.

Question 555

neonate with hiatus hernia .. ?! NGT🌹
The first step in management is nasogastric tube placement and securing the airway (intubation). The baby will usually be immediately placed on a ventilator.
…
🌹baby with diaphragmatic hernia what will you do after stabilization? NGT
….
🌹Baby with diaphragmatic hernia (pic provided) what is your management ?
A. Chest tube. B. Immediate Nasogastric tube C. Immediate hernia repair

Answer 555

Right

Question 556

Child with bilateral inguinal hernia what is the treatment :

Answer 556

Herniyotomy

Question 557

Baby 6 weeks, direct bilirubin high. Dx?

Answer 557

Choldedocal cyst

Question 558

child w/ gastroenteritis and they asked diagnostic test =

Answer 558

Stool antigen

Question 559

🌹Scenario about baby fall down on his RIGHT abdomen from 1 day then develop abdominal pain and fever

Answer 559

Liver contusion

Question 560

Pt baby with abdominal distention and difficulty passing stool , on PR examination empty rectum, but after finger pulled out there is diarrhea, DX:

3 Days neonate passed meconlum and since then he is passing seedy yellow
stool and on breastfeeding he has intestinal obstruction what is the diagnosis?

Answer 560

Hirschsprung disease

🌹Sx of hirschsprung disease with plc asking for a dx = Delayed passed meconium = Diagnostic by = Biopsy Teated by resection and anastomoses, leveling colectomy

Question 561

Patient came with gastroentrietis When start normal diet after the ORT

Answer 561

After 24 hours

Question 562

🌹 Child with his parents start to develop fever lethargy, parents mention 2 days before changing his eye color to yellow to he became ictrus, which type of viral hepatitis he had:

Answer 562

Hepatitis A

Question 563

…

🌹Child with attacks of severe midline abdominal pain with facial pallor. Poor appetite .. hx 2 = sisters with migraine

Answer 563

Abdominal migraine

Question 564

🌹10 years old boy with fever and lethargy and mild abdominal pain + recurrent diarrhea sometimes bloody + loss of weight and on Examination child looks pale

Answer 564

UC

Question 565

child presented with 3 days of vomiting and stooling. Other information were given. What will be the electrolyte derangement

Pyloric stenosis what is electrolytes abnormalities:-

Answer 565

Hypochloremic metabolic alkalosis

Question 566

🌹 gastric cancer what is of high diagnostic value?

Answer 566

Fasting gastrin level

Question 567

🌹12 year with maldigestion. He has greasy foul smelling diarrhea and trouble gaining weight+ feels lethargic most of the time. BMI: 16, Hg low the diagnostic test=

Answer 567

Antiendomysial antibodies ( celiac )

Question 568

🌹 celiac diseas , indicates activity of the disease=

Answer 568

Anti Tissue transglutaminase Ab

Question 569

🌹 13 Years old girl has type 1 dm , her weight 40 kg ( below 50th percentile ) and his hight 150 cm ( below 95th percentile ) , she has no signs of secondary sexual characteristics of puberty, you want to perform annual screening in clinic for

Answer 569

Celiac disease screening

Question 570

Signs of obstruction in a child best initial modality of diagnosis

Answer 570

US

Question 571

Pediatric patient with PUD, what’s your management?

Answer 571

PPI + Amoxacillin + lmidazole

Question 572

4 years old presented with preforated divertcular. laprtomy cleaning done. after days the patient
presented with fever, abdomen was soft, wound was .clean in DRE found anterior bulging and apropreate
management:

Answer 572

A- us drainage (mostly abscess and need drainage not only antibiotics

Question 573

Pediatric had gastroenteritis and she took metoclopramide that leads to involuntary movement facial grimace and tongue protruding what to give:

Answer 573

Diphenhydramine ( Acute dystonic reaction, common side effect of metacroplomide. treated by IV anticholinergic such as benztropine or diphenhydramine)

Question 574

🍓 4week old neonate full term Co projectile vomitting- Ex there is mass olive shape Investigation the:

Answer 574

SONOGRAPHY ✅ Projectile non-bilious vomiting ,olive like abd mass: dx? A-pyloric stenosis

Question 575

Child with projectile non biliary vomiting + mass in epigastric most accurate investigation?

Answer 575

US,pyloromyotomy

Question 576

🌹 Child came constipation and bilious vomiting for 1 week pain and mild tenderness in left side and abdominal distension and ancient bowl sounds ,the reason for surgical referral ?

Answer 576

Bilious vomiting

Question 577

🌹Baby 2 yer Came with apnea -vomiting - dehydration- lethargic-FTT- not gaining wt what is the problem

Answer 577

Hyperthrophic pyloric muscle

Question 578

scenario of pyloric stenosis , best diagnostic?

Answer 578

US

Question 579

🌹Child with Metronidazole and Omeprazole for eradication of H.Pylori drug you want to add =

Answer 579

Clarithromycin

Question 580

liability of diagnosed necrotizing enterocolitis :…….
most important risk factor for Necrotizing enterocolitis: - ……..
…
Baby preterm 32 weeks , wight 1200g .. symptoms of bloody diarrhea, he has necrotizing enterocolitis .. what related to that ?
….
🌹NEC case asking about factor If its absent risk for NEC ?? Full term .
…
🌹🌷continuous bilious vomiting , Abd destention, Passes meconium after birth, now yellowish thin diarrhea===diagnosis

Necrotizing enterocolitis (NEC) is a medical condition where a portion of the bowel dies. It typically occurs in newborns that are either premature or otherwise unwell

Answer 580

Pre term / low birth wt <1.5 /

Question 581

Note : ingestion of corosive substance

Answer 581

Diagnostic endoscopy may be required. Treatment is supportive. Gastric emptying and activated charcoal are contraindicated. Perforation is treated surgically.

nasogastric tube is contraindicated because it can damage already compromised mucosal surfaces.)

Dilution with milk or water is only useful in the first few minutes after ingesting a liquid caustic, but delayed dilution may be useful after ingesting a solid caustic. Dilution should be avoided if patients have nausea, drooling, stridor, or abdominal distention.

Esophageal or gastric perforation is treated with antibiotics and surgery (see Acute Perforation). IV corticosteroids and prophylactic antibiotics are not recommended. Strictures are treated with bougienage or, if they are severe or unresponsive, with esophageal bypass by colonic interposition.

Question 582

Child ingested iron Serum iron 90 Came with nausea and vomiting I think 9 hours ago, Mx?

Answer 582

IV defroxamine

Question 583

high potassium unresolving to treatment)

Answer 583

Ca gluconate

Question 584

25 yo male his sister has adult polycystic kidney asking about screening for him

Answer 584

US

Question 585

Dark urine, Proteinuria 2+, HTN. ttt?

Answer 585

Furosemide

Question 586

4y with fever 39.9 , dark urine , irritability, o/e tender abdomen with no organomegaly, investigation( WBC 16.000 , urinalysis show proteinuria +2 and erythrocyte 18 normal is 0-3 or 2 .. what you will give the child

Answer 586

Ceftriaxone

Question 587

🌹Young with fever and dark urine has history of constipation , urinalysis: high leukocyte, high erythrocytes, high protein =

Answer 587

Pyelonephritis

Question 588

C hild with edema in eyelid and ankle with pale and dark urine . What you need in hx ?

Answer 588

Impetigo infection last month

Question 589

🍓child developed generalized edema with fever and dark urine, all labs normal except low calcium and low albumin, what is dx?

Answer 589

Minimal change disease

Question 590

10 years boy c/o puffy eyes for 1 week with a history of recent infection, no edema no urine changes
and labs completely normal what to give him?

Answer 590

Treatment of patients with minimal change GN? . Steroid

Question 591

How to know steroid resistant nephrotic syndrome:

Answer 591

After 4 weeks

Question 592

Child e Nephrotic syndrome What medication to avoid in management:

Answer 592

NSAIDS (aspirin)

Question 593

🌹Child with nephrotic (diagnoses given), after ttt given when can you confirm the baby completely resolve?

Answer 593

A. After normal dipstick 3 Consecutive time

Question 594

child with facial and lower limb edma with protinurea on thiasid and other medication , what’s the best thing to do

Answer 594

Switch thiazide to furosemide

Question 595

Child with tonsillitis.. I think the question was about complication.

Answer 595

Glomerulonephritis

Question 596

A 16 year old presents with cola colored urine and has fever that followed a rash. Urinalysis was provided + creatinine was high, Most likely diagnosis

Answer 596

Acute glomerulonephritis

Question 597

Child had UTI one day next develop hematuria’ diagnosis

Answer 597

Poststreptococcal glomerulonephritis

Question 598

Baby with ankle and knee arthritis, he had UTI prior 2 wk what to give

Answer 598

Methotrexate

Question 599

🌹Pediatric complain of arthralgia, SOB, rash in lower extremity , fever past hx of dental procedure before 2 month and sore throat before 2 week . on lap proteinuria and hematuria , On examination murmur .. what diagnosis

Answer 599

Post streptococcal infection

Question 600

….

🌹Child has abdominal mass, aniridia and undescended testicle

Answer 600

Wagner disease

Question 601

URTI after 3 day develop hematuria

Answer 601

IgA nephropathy

Question 602

Child with glomerulonephritis then develop hemoptysis ?

Answer 602

goodpasture syndrome

Question 603

Child presents with hematuria. history of constipation for 1 week and presents with hematuria and urinary incontinence. Upon examination he had tender abdomen, Labs: Low Hb, RBC in urine, Protein in urine, WBC in urine == UTI (not PSGN)

Answer 603

Not sure

Question 604

_neonate _ less than one year common area eczema==== * ……….
….
one year area and Adults common area eczema=== -……….-

Answer 604

<1= scalp , >1=flexor

Question 605

3m young pt with ear drum perforation.. what infection cause?

Answer 605

Rihnovirus

Question 606

The screening for haematological diseases in children who are low risk , age in months

Answer 606

12. Months

Question 607

after slnusitis surgery affect sensation in lower eye and upper lip nerve ? Infra-orbital

Answer 607

True

Question 608

Child after brain trauma developed polyuria . Investigations shows elevated serum osmolality and decreased urine osmolality

Answer 608

Central DI

Question 609

Child came to emergency dehydrated, history of increased thirst and wets diapers a lot after recent seizure attack, Urine osmolality low. Blood osmolality high. Whats management

7 years old boy , mother concern because he still wet his bed despite he is fully toilet trained.. he is a shamed by that and ask for help (the boy ), what is the best management :

Answer 609

Desmopressin ( DI ) / bed alarm and positive reinforcement

Question 610

child with recurrent convulsions at the time of vaccination what vaccine to defer?

Answer 610

DPT

Question 611

14. Mother of 12 years old fears that he is not getting tall enough for his age. Current height is at 145 cm (10th percentile) and bone age is 10. His mother is 155 and his father is 178 What is the ideal target height? “Choices show various ranges of numbers”

Answer 611

Answer is: If boy 165 – 181 Ideal target

N.B: Height: Male: (Father + Mother + 13) /2 = 173 Female: (Father + Mother - 13) /2=160

Question 612

Prominent occiput, overlapping fingers, hearing problems?

Answer 612

Edwards syndrome

Question 613

children with cyanosis and systolic ejection murmur best heard at the left sternal border. Dx

Answer 613

TOF

Question 614

28. Adolescent boy with fatigue and there is a finding of heart block murmur There was ECG with 2nd heart degree block What he will progress in future?

Answer 614

Answer is: B, if Mobitz 1 > no need pacemaker, if Mobitz 2 > B.

Question 615

After birth, A newborn develops cyanosis. Echocardiography shows transposition of the great vessels. What is the next step in management

Answer 615

Give prostaglandin E1

Question 616

Preschool checkup for asymptomatic 7 years male, with grade 3 systolic murmur best heard in the lower left sternal border, intensity increases with standing, the most likely diagnosis?

Answer 616

HOCM

Question 617

Case about Kawasaki how you will assess coronary artery disease?

Answer 617

Echo

Question 618

Pediatric patient with murmur found in a routine visit with grade 3 in intensity, increases in supine and it is vibratory inequality?

Answer 618

Still murmur ( innocent murmur)

Question 619

URTI with lymph node enlargement for child who missed vaccine?

Answer 619

Diphtheria

Question 620

43. A 6-month-old infant is presented with an upper respiratory tract infection. The child is having cough and feeding difficulties and is breathing rapidly. He has suffered no previous episodes of such symptoms. Physical examination shows flaring of alae nasi and use of accessory muscles of respiration. Percussion note is hyper-resonant. X-ray chest reveals hyperinflation of the lungs with increased lucency, increased broncho-vascular markings and mild infiltrates. WBC count is normal. What is the most likely diagnosis?

Answer 620

Bronchiolitis

Question 621

Child has SOB, recurrent infections, FTT (Failure to Thrive), vomiting what does he has

Answer 621

Relaxation of lowe esophageal sphincter

Question 622

8. An otherwise asymptomatic 7-year-old male has a blood pressure above the 95th percentile for gender, age, and height on serial measurements. Which one of the following studies would be most appropriate at this time?

Answer 622

Renal US

Question 623

Infant with Bilateral non tender scrotal edema and redness extending to groin. What’s the diagnosis

Answer 623

Idiopathic testicular edema

Question 624

Child with Absent iris. abdominal mass, hematuria?

about mass in the flank in a child?

Answer 624

Wilms tumor

Question 625

Young pt have hx of bloody diarrhea, after 1 week he developed petechiae rash, he has hematuria and low platelet - Pt & ptt normal?

Answer 625

HUS

Question 626

9 years old Girl with only pubic hair the mother is concerned with no breast enlargement all negative except pubic hair

Answer 626

Premature Pubarchae

Question 627

16 years female with high Bp. High testosterone level, normal breast development

Answer 627

Congenital adrenal hyperplasia

Question 628

mother come to clinic worried about her 13y old girle , that she’s short , with no family history or any disease , also with no breast or pupic hair . They gave the hight below 10 percental And wt also below 95 percentile (What is the cause of her short stutre?

Answer 628

Chromosomal

Question 629

A child brought by his mother concerned about his height.. he’s 9 yo and have type 1 DM. the mother seems to be short also. his labs are all normal GH is normal at 4 pm. except insulin growth factor 1 is low. skeletal survey showed his bones to be of a 6 yo..what type of short stature

Answer 629

GH deficiency

Question 630

9 months girl with asymmetrical breast enlargements , next investigation

Answer 630

Pelvic US

Question 631

Patient developed mucous bleeding after dental extraction, and then develops cutaneous petechiae. Labs show 87% activity of factor 8, normal platelet count, normal APTT, very slightly high PT (0.1 above the normal only), bleeding time was not available. What does he have

Answer 631

Von Wilbrand disease

Question 632

Sickle cell anemia child Hb 3 severe pallor and long history given what mostly causes this

Answer 632

Parovirus B19

Question 633

Child with sickle cell anemia presented with shortness of breath and chest pain on is the best initial step in?

Answer 633

lv fluid and analgesic (Acute chest syndrome

Question 634

5-year-old child recently diagnosed with rheumatic heart disease, his mother stated that he is allergic to penicillin. What prophylaxis should be given instead?

Answer 634

Oral Azithromycin

Question 635

child with rash start at the head then spread to the body (crops and vesicles) and fever, what to give to his immunosuppressant brother

Answer 635

Specific Ig

Question 636

child with eczema and ecchymosis and recurrent infection what is your diagnosis?

Pediatric patient with eczema, bruising(thrombocytopenia) and repeated infections (immune deficiency), his uncle and other male relative has same problem, diagnosis

Answer 636

Wiskot aldrich syndrome

Question 637

child with vesicular lesions on the chest upper limb and face. What antibody will you find

Answer 637

Varicella zoster virus ( VSV )

Question 638

child with a long history of chronic diarrhea (watery initially, then loose greasy stools), abdominal cramps, bloating, fatigue and weight loss. Stool examination shows antigen to a trophozoite. Which is the most common diagnosis?

Answer 638

Chronic giardiasis

Question 639

Chlamydia in pregnant woman, what is the most commonly infected part of the neonates

Answer 639

Eyes

Question 640

Ptn with : Wilms tumor, aniridia, genitourinary anomalies, and retardation. Diagnosis

Answer 640

WAGR syndrome

Question 641

12 yrs old male with midline cervical or just below hyoid bone mass that move with swallowing What is diagnosis

Answer 641

Thyroglossal cyst

Question 642

Young child drowsy, dry mouth, unstable, with lab results showing Ketone bodies. 1st management

Answer 642

Iv fluid

Question 643

infant presented with cough, sneezing, circuoral cyanosis, secretions in the mouth, On chest exam there is crackles

Answer 643

Bronchiolitits

Question 644

Child with fever and vomiting and rash on 2nd day rash become over All body?

Answer 644

Rocky Mountain fever

Question 645

18 months girl with asymmetrical breast enlargement other examination normal?
A. Abdominal US

Answer 645

Not sure

Question 646

Aspiration meconium treatment?

neonate presents with meconium aspiration; how will you treat it?

Answer 646

Surfactant / nitric oxide ( ifthere is sign of pulmonary HTN )

Question 647

The baby came with father he walks & holds ball then he holds cubes and put them above one another, and he draws line

Answer 647

24 months

Question 648

child with meningitis signs and symptoms what is the isolation period?

Answer 648

24 h

Question 649

Egg on string sign on x-ray, what is the Dx

Answer 649

TGA

Question 650

What comes with Teratology of Fallot?

Answer 650

Pulmonary stenosis

Question 651

TOF 5 years kid with history of surgical correction at 6 months. Now came with new left parasternal decrescendo diastolic murmur with single S1 with left parasternal impulse, no radiation. What is the diagnosis?

Answer 651

Pulmonary regurgitation

Question 652

child was lethargic + sunken eye + depressed fontanel lab shows: high Na + low glucose What to give?

Answer 652

NS20ml/kgbolos

Question 653

child with GERD on PPI with a diagnosis of eosinophilic esophagitis what might be a sign in the history?

Answer 653

Excessive food chewing

Question 654

Asymptomatic child Urinalysis: +ve RBC What to do next?

Answer 654

Repeat urinalysis

Question 655

DKA and lab show hypo K, what is the cause

Answer 655

A. vomiting
B. K infusion
Answer is: if at diagnosis > A, if at later and after administration of insulin > insulin.

Question 656

patient breast development; coarse pubic hair; no mensuration; and high testosterone, what do?

Answer 656

Mullerian Agenesis

Question 657

Patient with symptoms of PCOS lab give high FSL/LH/testosterone, what you will order next?

Answer 657

glucose and lipid

Question 658

child with white vesicle in mouth and gum, fever and enlarged cervical LN what is diagnosis?

child with eczema and develop secondary infection they mention it was (cluster of grapes) what is the infection?

Child with vesicle at lip and gum and proximal tongue and hard palate. A. Gingivostomatitis

Child with oral and diaper dermatitis what is treatment? A. Oral + topical for 5 days

Answer 658

Herpes simplex/ gengivostomatitis