Peds

Question 0

This is a severe life threatening airway obstruction causing fever, dysphagia, respiratory distress. Patient presents with drooling, absence of hoarseness, and sitting forward with neck extended. Dx? Cause? Tx?

Answer 0

Epiglottitis. Strep pyogenes, staph aureus, mycoplasma. Treat by securing airway, IV ceftriaxone, prevention.

Question 1

This is a viral infection causing severe inspiratory strider, barking cough. What bug causes? Sign on X-ray and treatment?

Answer 1

Croup -laryngotracheobronchitis. Steeple sign on neck X-ray, parainfluenza common cause. Treat with humidified air, nebulized epi and corticosteroids.

Question 2

Two clinical findings of epiglottis.

Answer 2

Cherry red epiglottis, thumb sign on lateral X-ray.

Question 3

This bug causes whooping cough.

Answer 3

Bordetella pertussis.

Question 4

Which phase of pertussis is the paroxysmal cough?

Answer 4

Second phase or paroxysmal phase.

Question 5

How do you treat whooping cough/pertussis?

Answer 5

O2, hydration, azithromycin or erythromycin.

Question 6

Who do you avoid giving erythromycin to and why?

Answer 6

children under 1 month because of the risk of infantile hypertrophic pyloric stenosis.

Question 7

MC cause of bronchiolitis?

Answer 7

RSV.

Question 8

Signs of respiratory distress in kids!

Answer 8

Nasal flaring, intercostal retractions, prolonged expirations.

Question 9

If a child has a hx of congenital heart dz or chronic lung dz and gets bronchiolitis what med can you give?

Answer 9

Ribavirin

Question 10

Bronchiolitis age, pathogen, treatment.

Answer 10

<2, RSV, bronchodilator and hydration.

Question 11

Croup age, pathogen, treatment.

Answer 11

1-6 yrs, parainfluenza, dexamethasone, racemic epi

Question 12

MC location for foreign body aspiration?

Answer 12

Major bronchus

Question 13

Choking followed by wheezing think?

Answer 13

Foreign body aspiration

Question 14

Where is the CF gene located?

Answer 14

Long arm of chromosome 7

Question 15

What does the CF gene do?

Answer 15

Directs production of the cystic fibrosis transmembrane conductance regulator protein. (CFTR)

Question 16

A child presents with failure to thrive, large appetite and fatty stools think?

Answer 16

CF

Question 17

Test of choice to dx cystic fibrosis?

Answer 17

Sweat chloride test

Question 18

Acute CF exacerbation treatment?

Answer 18

Ciprofloxacin, steroids. NSAIDs, chest pt, mucomist.

Question 19

Obese teenager presents with knee pain and lack of internal rotation. Dx? X-ray finding? Tx?

Answer 19

SCFE. Ice cream falling off cone. Tx by preventing further slippage, may need fixation

Question 20

This is ideopathic avascular necrosis of the capital femoral epiphysis.

Answer 20

Legg calfe perthes dz.

Question 21

Classic presentation of legg calve perthes dz? Treatment?

Answer 21

Painless limp. Self healing, abduction cast and orthoses.

Question 22

Over use injury of the anterior tibial tubercle presenting with knee pain after injury. Dx? Tx?

Answer 22

Osgood-schlatter dz. intermittent pain? Avoid causative activities and ice to area for 15 min after playing. Severe pain? Complete joint rest for wks. Gradual return to activity.

Question 23

What is the most common genetic cause of osteoporosis?

Answer 23

Osteogenesis imperfecta

Question 24

What causes osteogenesis imperfecta?

Answer 24

Defects in type 1 collagen

Question 25

Classic triad of osteogenesis imperfecta?

Answer 25

Fragile bones, blue sclera, early deafness.

Question 26

Nursemaids elbow is a subluxation of what ligament? Tx?

Answer 26

Annular ligament, supinate forarm then flex elbow.

Question 27

Cryptorchidism is related to what? How to dx? Tx?

Answer 27

Undescended testes. Increased with prematurity. Most testes descend by 3 months. Maternal use of steroids is common. Tx with hormonal therapy or orchidoplexy.

Question 28

This cancer derives from mesenchymal stem cells.

Answer 28

Osteosarcoma.

Question 29

X-ray shows a sunburst pattern and bone changes. Dx? Tx ?

Answer 29

Osteosarcoma, dx with bone bx. Treat with surgery, chemo, RT

Question 30

Malignant tumor from neural crest cells.

Answer 30

Ewing sarcoma.

Question 31

X-ray shows onion skin pattern. Dx? Tx?

Answer 31

Ewing sarcoma. Surgery, RT, chemo.,

Question 32

Child under age 5 presents with a firm painful abdominal mass that crosses the midline. Dx?

Answer 32

Neuroblastoma.

Question 33

Lab findings in neuroblastoma?

Answer 33

Increased urine catecholamines.

Question 34

Treatment for neuroblastoma?

Answer 34

Surgery #1, chemo, RT

Question 35

Under 5 presents to clinic with painless abdominal mass from flank toward midline. Does not cross midline?

Answer 35

Wilms tumor, nephroblastoma.

Question 36

Tx for nephroblastoma?

Answer 36

Nephrctomy with preop chemo, radiation to lungs. Likes to mets in lungs.

Question 37

Child presents with bilious vomiting, peristaltic waves and jaundice. Double bubble sign on X-ray With no distal gas. Dx? Tx?

Answer 37

Duodenal atresia. Tx with decompression, fluids and surgery.

Question 38

Common syndrome associated with duodenal atresia?

Answer 38

Downs

Question 39

At 30 months child height and weight?

Answer 39

30 lbs 30 in

Question 40

At 4 yrs child weight and height?

Answer 40

40 lbs, 40 in

Question 41

Double birth weight at?

Answer 41

6 months

Question 42

Triple birth weight at?

Answer 42

12 months

Question 43

Most common site for intussuception?

Answer 43

Ileal colic

Question 44

Child with sudden onset of recurrent paroxysmal sharp abdominal pain. Vomiting, currant jelly stool and sausage mass in upper abdomen. Dx?

Answer 44

Intussuception. Dx with ultrasound. Barium enema is treatment.

Question 45

This is diffuse hypertrophy of pyloric sphincter muscle.

Answer 45

Pyloric stenosis.