DDx

Question 1

Maculopapular rash

Answer 1

Viral: measles, rubella, roseola, parvovirus B19
Bacterial: staph aureus, typhoid
Others: Kawasaki, JIA

Question 2

Vesicular rash

Answer 2

Viral: VZV, HSV, HFMD
Bacterial: impetigo
Others: SJS

Question 3

Purpuric rash

Answer 3

Viral: rubella
Bacterial: meningococcus, IE
Others: HSP, thrombocytopenia, malaria

Question 4

Prolonged fever

Answer 4

Inf: localized (osteomyelitis), difficult to treat (TB)
Inflammation: KD, IBD, JIA, SLE
Mal
Endocrine: thyrotoxicosis

Question 5

Acute cough

Answer 5

Inf: URT (URTI, croup), LRT (bronchiolitis, pneumonia)
Asthma exacerbation
Chem: FB aspiration, GERD

Question 6

Chronic cough

Answer 6

Inf: URT (post viral cough), LRT (TB, bronchiectasis, pertussis)
Allergy: asthma, allergic rhinitis
Chem: GERD
Drug: ACEI
Structural: tracheomalacia, TEF

Question 7

Stridor

Answer 7

Inf: croup, epiglottitis, bacterial tracheitis
FB, angioedema, aspiration
Subglottic spasm

Question 8

Wheeze

Answer 8

Inf: bronchiolitis, bronchitis, pneumonia

Asthma, aspiration

Question 9

Seizure

Answer 9

Febrile seizure
Epileptic seizure: idiopathic, epilepsy syndromes, neurocutaneous syndromes, provoked
Paroxysmal episodes: breath-holding spells

Question 10

Early onset NNJ

Answer 10

Hemat: hemolysis (ABO, Rh, G6PD), polycythemia, concealed hemorrhage
Congenital inf, sepsis

Question 11

Intermediate onset NNJ

Answer 11

Physiological
Breast feeding
Cephalohematoma

Question 12

Prolonged NNJ

Answer 12

Unconjugated: breast milk, congenital hypothyroidism, IO, hemolysis (G6PD, HS), inf (UTI)
Conjugated: biliary obstruction, neonatal hepatitis, inspissated bile

Question 13

Puffy eyes / edema

Answer 13

High hydrostatic pressure: HF, RF, GN, liver cirrhosis
Low oncotic pressure: LF, protein-losing enteropathy, nephrotic
High vascular permeability: sepsis, drug

Question 14

Frothy urine

Answer 14

Physiological
Glomerular: primary (MCD, FSGS), secondary (AI, inf)
Tubular: drug, ATN
Overflow: MM, rhabdomyolysis, amyloidosis

Question 15

Hematuria

Answer 15

Factitious
Glomerular: immune (nephritic), congenital (Alport)
Non-glomerular: urinary tract (inf, tumour, infarct), bleeding tendency

Question 16

HT

Answer 16

Primary (essential)
Renal: GN, Wilm’s tumour, CKD
Endocrine: Cushing, hyperthyroid, hyperaldosterone, pheochromocytoma
Vascular: CoA, RVT, RAS
Respi: OSA

Question 17

Vomiting in neonates

Answer 17

GI: UGI (esophageal atresia, pyloric stenosis, GERD, TEF), LGI (intestinal atresia, malrotation w/ volvulus)
Inf: sepsis
Increased ICP
Metabolic: IEM, CAH

Question 18

Vomiting in children

Answer 18

GI: appendicitis, intussusception
Inf: AOM, UTI, GE
Increased ICP
Metabolic: DKA
Testicular torsion, pregnancy

Question 19

Acute diarrhea

Answer 19

Inf: GI, non-GI (AOM, CNS, UTI)

Non-inf: Hirschsprung-associated enterocolitis, IBD w/ toxic megacolon, endocrine (CAH, hyperthyroid)

Question 20

Chronic diarrhea

Answer 20

Osmotic: malabs, cow’s milk pr intolerance
Secretory: cholera, VIPoma
Dysmotility: IBS, hyperthyroid
Steatorrhea: pancreatic insufficiency, celiac
IBD, mal

Question 21

Bloody diarrhea in neonate

Answer 21

NEC, malrotation w/ volvulus

Trauma

Question 22

Bloody diarrhea in children

Answer 22

Inf: GI, non-GI (AOM, CNS, UTI)
Structural: diverculitis, intussusception, anal fistula, hemorrhoid
Inflammatory: IBD, juvenile polyp
Trauma

Question 23

Acute abdominal pain

Answer 23

GI: inf (GE, appendicitis), obst (intussusception), trauma
Non-GI inf: UTI, cholecystitis, LL pneumonia
GU: stone, torsion, ectopic, PID, endometriosis
Systemic: DKA, HSP

Question 24

Recurrent abdominal pain

Answer 24

GI: func (IBS), anatomical (IBD, PUD)
HBP: gallstone
GU: PID, UTI, dysmenorrhea
Psychosocial

Question 25

LOW

Answer 25

``` Mal AI: SLE, RA Endocrine: DM, hyperthyroid Chronic inf: TB Chronic disease: CHD, CKD Psychi: depression, eating disorder ```

Question 26

FTT

Answer 26

Poor intake: impaired sucking, environmental, anorexia Poor retention: GERD, vomiting Poor absorption: IBD, lactose intolerance Poor utilization: hypothyroid Increased req: chronic disease & inf

Question 27

Obesity

Answer 27

Genetic: Prader-Willi, Beckwith-Wiedemann Environmental Endocrine: hypothyroid, Cushing

Question 28

Single joint pain

Answer 28

``` Inf: septic arthritis, osteomyelitis, reactive arthrtis Mal: leukemia, bone tumour Trauma Hemat: hemophilia Orthopedic: SCFE, Perthe’s Inflammatory: JIA, SLE, HSP, SpA ```

Question 29

Multiple joint pain

Answer 29

``` Inf: rheumatic fever Inflammatory: SLE, JIA, HSP, SpA Hemat Mal Trauma ```

Question 30

Bruising

Answer 30

Thrombocytopenia: ITP, HUS/TTP, DIC, leukemia Coagulopathy: vWD, hemophilia Disrupted vessel integrity: trauma, HSP, meningococcus

Question 31

Speech delay

Answer 31

``` Expressive: cleft lip/palate Receptive: HL Environmental GDD, CP Psychi: autism, selective mutism Genetic: Down, Fragile X ```

Question 32

Syncope

Answer 32

``` Vasovagal Seizure Hyperventilation Arrhythmia: cardiac, others (thyrotoxicosis, drugs, anxiety, anemia, caffeine) Hypogly ```

Question 33

Short stature

Answer 33

Physiological: constitutional delay, genetic short stature Pathological - Proportionate: syndromic (Turner), chronic disease - Disproportionate: rickets, skeletal dysplasia

Question 34

Motor delay

Answer 34

CP Neuro-motor disorders: SMA, DMD, congenital myopathy Acquired e.g. spinal cord injury, tumour

Question 35

HL

Answer 35

Sensorineural - Genetic: single gene, syndromic (Alport, Down) - Env: prenatal (inf, drug), perinatal (birth asphyxia, NNJ, meningitis), postnatal (meningitis, OM, neoplasm) Conductive: earwax, impaired movement of tympanic membrane (AOM, OME, perforation)

Question 36

Low exercise tolerance

Answer 36

CV: CHD, arrhythmia Respi: asthma, bronchiectasis, CF Neuro: SMA, DMD