PEDS MINIMUM(done)

Question 1

 1) Imaging modality of choice when evaluating a child for infantile hypertrophic pyloric stenosis:

Answer 1

ultrasonography

Question 2

2) Typical age of intussusception in infants:

Answer 2

3 months - 3 years

Question 3

3) What are the two typical anamnestic features of acute appendicitis?

Answer 3

First epigastric and periumbilical pain, later the pain is localized in the right lower abdominal quadrant.

Question 4

4) Standard imaging modality of polytraumatized patients:

Answer 4

acute CT.

Question 5

5) Most common cause of acute abdomen in children:

Answer 5

appendicitis.

Question 6

6) Which is the most common cause of strangulation ileus?

Answer 6

Incarcerated hernia

=A type of hernia in which the contents of the hernial sac cannot return back through the abdominal wall defect into the peritoneal cavity with the application of gentle external pressure.
Increases the risk of subsequent strangulation and bowel obstruction..

Question 7

7) The most common cause of transfusion-requiring hematochezia, without abdominal pain and without diarrhea:

Answer 7

Meckel’s diverticulum

Question 8

8) You find a high GGT in a patient with ulcerative colitis, what should you think about?

Answer 8

Sclerosing cholangitis.

Question 9

9) What are the typical characteristics of perianal fissures in Crohn’s disease?

Answer 9

Not in the midline, not painful.

deep

Question 10

10) What is the first therapeutic choice in Crohn’s disease?

Answer 10

Exclusive enteral nutrition.

( (no solid foods) diet is designed to induce remission in patients. It is a short-term program and may extend six to 12 weeks.)

Question 11

11) What are the two most frequent chest deformities?

Answer 11

Pectus excavatum and
pectus carinatum.

Question 12

12) What are typical signs of bacterial otitis externa?

Answer 12

Pain and/or tenderness of the tragus.

Question 13

13) What are the 4 most important indications of adenoidectomy?

Answer 13

Recurrent URTI
Recurrent otitis media,
inhibition of nasal breathing,
obstructive sleep apnea.

Question 14

14) The most frequent pathogen of sinusitis and otitis media?

Answer 14

Str. pneumoniae.

Question 15

15) In which cases of middle-ear inflammatory disease should we suggest tympanostomy tubes (Grommet)?

Answer 15

Chronic serous otitis media

Chronic Eustachian tube dysfunction

Question 16

16) What is the most frequent pathogen in urinary tract infections?

Answer 16

E. coli.

Question 17

17) What are the typical abnormalities in urine analysis in glomerulonephritis?

Answer 17

RBCs
RBC cylinders.
Proteinuria

Question 18

18) What is the most frequent cause of hypertension before the adolescent age?

Answer 18

Kidney disease.

Question 19

19) Which is the most frequent glomerulonephritis type?

Answer 19

IgA nephropathy.

Question 20

20) What is the prognosis of West-syndrome or infantile spasm?

Answer 20

Usually poor

Question 21

21) Which bacterium is the most frequent cause of childhood pneumonia?

Answer 21

Str. pneumoniae.

Question 22

22) What are the two main components of the treatment of pseudocroup?

Answer 22

Rectal steroid, inhalation of adrenaline.

Question 23

23) What is the most common cause of new onset cough?

Answer 23

Viral infection.

Question 24

24) What is the Holzknecht sign characteristic for?

Answer 24

Airway foreign body aspiration.

On expiration, the affected lung becomes pneumatic due to occlusion at the level of bronchi. This results in an ipsilateral downward push on the diaphragm by the lung.

On inhalation, the midline shifts to the affected side which is referred to as the Holzknecht sign.

Question 25

25) What is the most common cause of a cough ongoing since birth which always presents during feeding

Answer 25

Tracheoesophageal fistula.

Question 26

26) What percentage of the mortality is caused by accidents in Hungary in children older than 1 year?

Answer 26

36-40%, this is the main cause of death in children older than 1 year.

Question 27

27) What is the prognosis of juvenile absence epilepsy?

Answer 27

Usually favorable.

Question 28

28) What can prevent coronary artery disease (aneurysm) in Kawasaki syndrome?

Answer 28

IVIG.

Question 29

29) What is the most serious complication of juvenile idiopathic arthritis?

Answer 29

Macrophage activation syndrome (MAS).

Question 30

30) Which muscles are affected in juvenile polymyositis?

Answer 30

Proximal muscles of the limbs.

Question 31

31) What is the typical feature of stool in biliary atresia?

Answer 31

Clay-colored (acholic) stool.

Question 32

32) What kind of diseases are included in `atopic march` and in which order?

Answer 32

Atopic dermatitis food allergy - asthma bronchiale - allergic rhinitis.

Question 33

33) How is food allergy diagnosed? What is the reliability of IgE testing?

Answer 33

IgE testing is not reliable. The diagnosis should be based on double blind oral food challenge.

Question 34

34) In which case serological testing is not informative in celiac disease.

Answer 34

In IgA deficiency.

Question 35

35) What is the diagnostic basis of endocarditis?

Answer 35

Blood culture and echocardiography.

Question 36

36) What are the upper airway infections that should be treated with antibiotics?

Answer 36

Streptococcus angina, acute otitis media and acute bacterial sinusitis.

Question 37

37) What is the diagnostic basis of erythema migrans?

Answer 37

The fact of tick bite and the clinical picture: growing erythema which is more than 5 cm in diameter.

Question 38

38) What is the ideal age for closing the soft palate defect?

Answer 38

Between 9 and 18 months.

Question 39

39) What is the most likely diagnosis in the following case: patient with polyuria, polydipsia with positive urine glucose and acetone test?

Answer 39

Diabetes mellitus.

Question 40

40) A patient with typical diabetes symptoms has a 18.2 mmol/l blood sugar level in the afternoon. What is to be done?

Answer 40

Refer the child to a pediatric diabetic center immediately.

Question 41

41) What kind of hormonal changes are seen in the salt wasting form of congenital adrenal hyperplasia due to deficiency of 21-hydroxylase?

Answer 41

Insufficient glucocorticoid and mineralocorticoid secretion, excessive androgen secretion.

Question 42

42) How does the mother’s iodine deficiency influence the newborn’s thyroid function?

Answer 42

It results in temporary primary hypothyroidism.

Question 43

43) Which is the most common adrenocortical enzyme defect?

Answer 43

The defect of the 21-hydroxylase enzyme.

Question 44

44) What are the most typical histologic findings in ulcerative colitis?

Answer 44

Crypt abscesses.

Question 45

45) Name at least 5 extraintestinal abnormalities in celiac disease:

Answer 45

arthritis, osteoporosis, hepatitis, isolated iron deficiency, Duhring-disease (dermatitis herpetiformis).

Question 46

46) What is the definition of “graft versus leukemia”?

Answer 46

Immunologic attack of the donor cells against the patient's leukaemic cells after allogeneic bone marrow transplantation.

Question 47

47) What is a haploidentical transplant?

Answer 47

Half matched HLA antigen stem cell transplant (from usually a family member).

Question 48

48) What does allogeneic stem cell transplant mean?

Answer 48

The patient (recipient) gets hematopoietic stem cells from another person (donor).

Question 49

49) What glucose levels are diagnostic for diabetes mellitus?

Answer 49

Fasting blood glucose level higher than 7 mmol/l, or more than 11.1 mmol/l at any time or at any point during an oral glucose tolerance test (OGTT).

Question 50

50) Which are the 4 presenting symptoms of diabetes mellitus?

Answer 50

Polyuria, polydipsia, weight loss with good appetite, fatigue-weakness.

Question 51

51) What are the diseases most commonly associated with type 1 diabetes mellitus?

Answer 51

Celiac disease and Hashimoto thyroiditis.

Question 52

52) What is the most modern therapeutic method of type-one diabetes?

Answer 52

Insulin pump with an integrated glucose sensor.

Question 53

53) How much insulin should be given in diabetic ketoacidosis?

Answer 53

0.05-0.1 U/kg/h

Question 54

54) Since the introduction of expanded screening, how many congenital metabolic diseases are screened routinely in Hungary?

Answer 54

27 and SMA(spinal muscular atrophy) screening is also available.

Question 55

55) The final therapy of biliary atresia is liver transplantation. There is a surgical bridging therapy before transplantation. What is the name of this operation?

Answer 55

Kasai porto-enterostomy.

Question 56

56) How often should a baby be breastfed?

Answer 56

On-demand.

Question 57

57) When is it suggested to introduce cow’s milk for children?

Answer 57

After 12 months of age.

Question 58

58) How does the breast milk’s protein content relate to the cow’s milk protein content?

Answer 58

One third.

Question 59

59) What are the most important diseases which can be easily diagnosed and followed up by cranial ultrasound?

Answer 59

Brain hemorrhage and hydrocephalus.

Question 60

60) For how long can we see the shadow of the thymus on the thoracic X-ray?

Answer 60

Until 3 years of age.

Question 61

61) What radiological examinations can be done to diagnose VUR? (Name three!).

Answer 61

MCU (Micturating cysto-urethro-gram), Sono-cysto-graphy, Dynamic kidney-scintigraphy.

Question 62

62) How can you diagnose perforation in a critically ill baby with necrotizing enterocolitis if you cannot move them in the incubator?

Answer 62

Horizontal X-ray from side position while the baby is lying on the back.

Question 63

63) In which part of the bone does osteomyelitis start?

Answer 63

In the metaphysis.

Question 64

64) How long to wait after surgery before bathing?

Answer 64

7-8 days.

Question 65

65) What is chicken pox (varicella) reactivation called?

Answer 65

Herpes zoster.

Question 66

66) What is the sixth disease?

Answer 66

Exanthema subitum, roseola infantum.

Question 67

67) Which is the contagious disease that causes severe fetal injuries in 80 percent of its cases?

Answer 67

Rubella.

Question 68

68) Name at least five examples when pulse oximetry is not informative!

Answer 68

Carbon-dioxide intoxication, cardiac failure, cold extremities. methemoglobinemia, severe anemia,

Question 69

69) Define paradoxical breathing!

Answer 69

The chest moves inward and the abdomen moves outward during inhalation, and vice versa.

Question 70

70) How do we give oxygen to a conscious patient in an emergency situation who is breathing spontaneously?

Answer 70

Through a face mask with a reservoir, with high flow oxygen (10-15 l/min).

Question 71

71) How does the concentration of protein and glucose of CSF change in bacterial meningitis?

Answer 71

Protein concentration is increased, glucose concentration is decreased.

Question 72

72) Name of the two most common pathogens of newborn meningitis!

Answer 72

Streptococcus agalactiae, E. coli.

Question 73

73) What affects the sensitivity of blood culture?

Answer 73

The amount of blood drawn within 24 hours after the fever.

Question 74

74) Name the condition of infants associated with abdominal pain in which bowel movements are preceded by tension and crying lasting for about 10 minutes?

Answer 74

Infantile dyschezia

Question 75

75) The pathogen causing neonatal infection that can be identified by maternal vaginal secretion screening.

Answer 75

Streptococcus agalactiae. (group B Streptococcus, GBS)

Question 76

76) The amount of a single fluid bolus required to treat septic shock:

Answer 76

10 ml/kg.

Question 77

77) The most common endocrine disorder causing growth retardation

Answer 77

Thyroid dysfunction – hypothyroidism.

Question 78

78) What does precocious puberty mean in the case of girls?

Answer 78

If the secondary sexual characteristics appears before the age of 8 years

Question 79

79) What changes can we see in the urine sediment in typical pyelonephritis?

Answer 79

Leukocytes and bacteria

Question 80

80) In which chromosomal abnormality is duodenal atresia common?

Answer 80

Trisomy 21 (Down syndrome)

Question 81

81) What is the radiological sign of duodenal atresia?

Answer 81

„Double-bubble” sign

Question 82

82) What are the B-symptoms in lymphoma?

Answer 82

Fever, night sweats, weight loss.

Question 83

83) At what platelet count is there major risk of bleeding?

Answer 83

Below 10-20 G/l

Question 84

84) What to do in case of neutropenic fever?

Answer 84

Broad spectrum empiric antibiotic therapy after taking blood cultures.

Question 85

85) What are the serum electrolyte disturbances in case of tumor lysis syndrome?

Answer 85

Elevated potassium, phosphate and uric acid, decreased calcium.

Question 86

86) What are the alarming signs of retinoblastoma? What examinations are required?

Answer 86

Strabism, leukocoria - ophthalmoscopic examination.

Question 87

87) What is the most common type of malignancy in childhood?

Answer 87

ALL.

Question 88

88) What are the symptoms of increased intracranial pressure?

Answer 88

Headache, vomiting in the morning, nuchal rigidity, setting-sun sign, focal neurological signs, bradycardia, high blood pressure, irritability, bulging fontanelle.

Question 89

89) What are the physical symptoms of anemia?

Answer 89

Fatigue, paleness, tachycardia, systolic heart murmurs.

Question 90

90) How does the total iron binding capacity change in case of anemia and inflammation?

Answer 90

Increased in anemia, decreased in inflammation.

Question 91

91) What is the treatment of immune thrombocytopenia (first- and second-line treatment.)?

Answer 91

IVIG, corticosteroid

Question 92

92) List the signs of increased work of breathing!

Answer 92

Use of respiratory accessory muscles, intercostal retraction, jugular retraction, nasal flaring, paradoxical breathing, grunting.

Question 93

93) At what age do the fontanelles close at the latest?

Answer 93

Posterior fontanelle: by 3 months, anterior fontanelle: by 18 months.

Question 94

94) What are the symptoms and laboratory signs of nephrotic syndrome?

Answer 94

Proteinuria, hypoalbuminemia, hyperlipidemia, oedema.

Question 95

95) What are the symptoms and laboratory signs of nephritic syndrome?

Answer 95

Hematuria, oedema hypertension, uraemia(too much urea) oliguria (kidney failure is correct instead of the latter two).

Question 96

96) What factors are included in the APGAR score?

Answer 96

Heart rate, respiratory rate, skin color, reflex irritability, muscle tone.

Question 97

97) Age limits of puberty?

Answer 97

Boys: 9-14 years. Girls: 8-13 years.

Question 98

98) What are the direct and indirect signs of appendicitis?

Answer 98

Direct sign: tenderness at the McBurney point. Indirect signs: Blumberg(rebound tenderness, + in peritonitis too) Rovsing (RLQ pain when palpating LLQ) Obturator Psoas signs.

Question 99

99) How can we estimate the body weight between the ages of 2-8 years?

Answer 99

(2 x years) + 8.

Question 100

100) What does autologous stem cell transplantation mean?

Answer 100

A procedure in which a patient's healthy stem cells are collected from the blood or bone marrow before high dose chemotherapy, stored, and then given back to the patient after treatment.

Question 101

101) What is the heart rate and respiratory rate of a healthy newborn?

Answer 101

Respiratory rate: 50-60/min, Heart rate: 120-160/min.

Question 102

102) Which cultured pathogen from throat swabs warrants antibiotic treatment?

Answer 102

Str. pyogenes.

Question 103

103) In case of maternal GBS positivity, up to what age can this bacteria cause disease in the baby?

Answer 103

Up to six months of age.

Question 104

104) What is the recommended empiric treatment of neonates with suspected sepsis?

Answer 104

Ampicillin + Gentamycin.

Question 105

105) What factors are included in the croup score?

Answer 105

cough cyanosis. Sound of inhalation, stridor, signs of dyspnea (nasal flaring, retractions),

Question 106

106) In case of pain localized to one point in the bone, when should we order an X-ray if the pain does not stop?

Answer 106

1 week

Question 107

107) What is the choice of imaging modality if acute osteomyelitis is suspected?

Answer 107

MRI

Question 108

108) What is the most common presentation of cow’s milk protein allergy in infants?

Answer 108

Bloody stool

Question 109

109) Which disease should be suspected in case of bloody stool and vomiting in neonates?

Answer 109

Volvulus

Question 110

110) Which disease should be suspected in case of neonates with distended abdomen and severe constipation?

Answer 110

Hirschsprung-disease