PreTest Pediatrics: "General Pediatrics"

Question 1

What percent of cases of Bell palsy resolve completely?

Answer 1

85%

10% resolve with some residual effects, while 5% do not resolve at all.

Question 2

In addition to occurring after Borrelia burgdorferi infection, Bell palsy can also follow ______________.

Answer 2

viral infection

Question 3

When do kids smile spontaneously?

Answer 3

At one month –before they smile socially or in response to cues

Question 4

When can kids track past midline?

Answer 4

Three months

Question 5

Balancing on one leg is usually done by what age?

Answer 5

Four years (for two seconds) and five years (for longer)

Question 6

The most common systemic manifestation of juvenile idiopathic arthritis is ______________.

Answer 6

anterior uveitis (20%)

Because of this, kids with JIA should get slit-lamp exams routinely.

Question 7

Scalded-skin syndrome presents with what symptoms?

Answer 7

• Desquamating rash
• Fever
• Exquisitely tender skin
• Circumoral crusting

Question 8

The AHA recommends that kids with a history of endocarditis should be given ______________ as prophylaxis.

Answer 8

antibiotics for dental procedures

Question 9

Infected human bites require antibiotics and ______________.

Answer 9

surgical debridement

Question 10

True or false: pityriasis rosea generally does not require treatment.

Answer 10

True

It usually self-resolves in 2 to 12 weeks.

Question 11

Another name for Henoch-Schönlein purpura is ____________.

Answer 11

anaphylactoid purpura

Question 12

Inappropriate passage of feces is called ____________.

Answer 12

encopresis

Question 13

The two types of encopresis are ________________.

Answer 13

retentive and non-retentive

Question 14

How is retentive encopresis treated?

Answer 14

Disimpaction of the stool followed by 3-6 months of stool softeners and behavior modification

Question 15

Describe Blount disease.

Answer 15

Blount disease is characterized by congenital genu varum that worsens with age. Many kids are bow-legged but grow out of it. In Blount disease, a problem with the tibial epiphysis leads to progressive genu varum. Bracing and even surgery may be required.

Question 16

What three tests/situations can be diagnostic of diabetes?

Answer 16

• Fasting glucose greater than 126
• Random glucose greater than 200 with symptoms
• Two-hour glucose challenge greater than 200

Question 17

How can you tell the difference between milia and acne?

Answer 17

Acne will have an erythematous base, while milia will not.

Question 18

Permathrin treats what dermatologic condition?

Answer 18

Scabies

Question 19

Importantly, scabies presents differently in infants: ______________.

Answer 19

while in older kids and adults scabies is thread-like burrows, in infants it presents with large bullae over the whole body

Question 20

Strabismus in a young child should prompt _____________.

Answer 20

referral to an ophthalmologist

Question 21

Why do you need to admit a child with orbital cellulitis?

Answer 21

Orbital cellulitis is most often caused by paranasal infection. Infection of the intracranial sinuses can result. As such, you need to admit for CT scanning (to determine the extent of the infection with possible drainage necessary) as well as IV antibiotics.

Question 22

What kind of rash might be described as an ““erythematous, papulovesicular, weeping eruption”?

Answer 22

Eczema / atopic dermatitis

Question 23

One contraindication to vaccines is encephalopathy within ___________ days of receiving a prior dose of the same vaccine.

Answer 23

7

This can be evidenced by seizures.

Question 24

List the treatment guidelines for lice.

Answer 24

• 1:1 vinegar to rinse to remove nits from hair
• Get rid of used brushes and combs
• Wash clothing and bedding in hot soapy water
• Use permethrin cream in hair
• Lindane cream can be used but not in infants due to transdermal absorption with neurotoxicity

Question 25

Describe the presentation (three stages) of tuberculous meningitis.

Answer 25

• First stage: lethargy, vomiting, anorexia, and fever
• Second stage: seizures, hypertonicity, and focal neurologic deficits
• Third stage: coma, posturing, decompensation, and death

Question 26

True or false: cholesteatoma presents as a hole in the membrane.

Answer 26

False

Cholesteatomas are epithelium-lined sacs that grow out of the tympanic membrane.

Question 27

Describe nonspecific vulvovaginitis in children.

Answer 27

Many young girls get irritated vulva without a clear cause (thought to be from soap or irritating panties in some cases). Recommend that parents stop using bubble bath soaps and switch to only cotton panties.

Note: Foreign bodies will usually present with either bleeding or discharge. Bacterial infections will also present with discharge.

Question 28

How can you differentiate septic arthritis from osteomyelitis of nearby bones?

Answer 28

Septic arthritis will present with the inability to move the joint passively or extreme pain while passively flexing the joint.

Question 29

How does wound care differ for cat and dog bites?

Answer 29

• Cat bites are usually deep punctures and frequently become infected. Prophylactic antibiotics are indicated.
• Only 4% of dog bites become infected, so prophylactic antibiotics are controversial.

Question 30

Naloxone is used to treat what somewhat surprising toxicity?

Answer 30

Clonidine

Question 31

The best screening tool for lead toxicity is ________________.

Answer 31

the blood lead level; toxic levels are often clinically silent –they don’t cause anemia, neurologic symptoms, or protoporphyrin elevation –for a long time

Question 32

Dilution of formula can lead to _________________.

Answer 32

hyponatremia with seizures

Question 33

Describe erythema toxicum.

Answer 33

ET is a benign rash on newborns that goes away in a couple weeks. The lesions are erythematous with occasional pustules. Aspiration will show eosinophils.

Question 34

What are flame nevi?

Answer 34

Flame nevi, also called salmon patches, are benign macular lesions that appear on the eyelids and the occiput. They get redder with crying or heat. Typically the eyelid lesions go away but the occipital lesions can persist.

Question 35

Describe pustular melanocytosis.

Answer 35

More common in black people, PM is a benign rash of the newborn period. It is a hyperpigmented base with a pustule that can be wiped away. It usually goes away by a couple months of life.

Question 36

Sebaceous nevi are ______________.

Answer 36

hairless, scaly, yellow lesions on newborns; they can persist to adolescence

Question 37

Describe the following cold injuries: 
•Frostnip
•Frostbite 
• Chilblain
• Cold panniculitis

Answer 37

• Frostnip: small, white, hard patches in exposed areas
• Frostbite: frozen tissue that becomes destroyed which results in aching and numbness; when rewarmed, the area becomes blotchy and painful
• Chilblain: small, ulcerated lesions on the ears or fingers
• Cold panniculitis: frozen fat

Question 38

Remember that in addition to convulsions and numbness, B6 deficiency also causes ______________.

Answer 38

hypochromic anemia

Question 39

Riboflavin deficiency causes cheilosis, __________, _________, and ___________.

Answer 39

irritated eyes; photophobia; blurred vision

Question 40

What disorder is referred as “happy puppet” syndrome because the odd gait and stereotypical happiness?

Answer 40

Angelman syndrome

Random factoid: it was once thought that all kids with Angelman syndrome were blond-haired and blue-eyed, but now it’s recognized that there are all different complexions.

Question 41

The antidote to acute aspirin poisoning is ______________.

Answer 41

sodium bicarbonate

Question 42

Don’t forget that ____________ can also treat bacterial vaginosis.

Answer 42

tinidazole (a related medication to metronidazole)

Note: tinidazole is contraindicated in pregnancy.

Question 43

Fever, headache, pallor, and splenomegaly in a child after a trip to a third-world-country should make you think of ________________.

Answer 43

malaria

Question 44

Food poisoning with subsequent prolonged diarrhea is a symptom of _____________.

Answer 44

Cyclospora cateyensis

Question 45

An “intensely pruritic, serpiginous lesion on the foot” that occurs after walking on the beach is likely ______________.

Answer 45

Ancylostoma, a hookworm that comes from dog feces

Treat with Ivermectin.

Question 46

In addition to cleaning and corticosteroids, ___________ can also be used to treat seborrheic dermatitis.

Answer 46

selenium sulfide

Question 47

Congenital heart block can arise from maternal _____________ during pregnancy.

Answer 47

lupus

Question 48

The best screening test for suspected Wiskot Aldrich syndrome is _____________.

Answer 48

platelet count

Question 49

Most babies are obligate ______________.

Answer 49

nose breathers

Question 50

When should babies be given VZV-IG?

Answer 50

If the mother got varicella within five days prior to delivery or two days after.