Term
|
Definition
| Diphtheria-tetanus-acellular pertussis (DTaP) is the standard immunizing agent for healthy children.Preparations are administered intramuscularly in dose of 0.5 ml. |
|
|
Term
|
Definition
• Given as MMR at 15 months, second vaccination with MMR varies from 4-6 years to 11-12 years.
• Monovalent measles or MMR may be safely administered simultaneously with DTaP and IPV.
• Adverse affects - febrile, encephalitis occurs at a frequency of 1 per 3 million doses in U.S., convulsions. |
|
|
Term
| Infants born to HBsAg-negative mothers Hep B vaccinations |
|
Definition
| should receive the 1st dose of hepatitis B (Hep B) vaccine by age 2 months. The 2nd dose should be at least one month after the 1st dose. The 3rd dose should be administered at least 4 months after the 1st dose and at least 2 months after the 2nd dose, but not before 6 months of age for infants. |
|
|
Term
|
Definition
• Age 3 months to five years
• Fever of 38.8 Celsius Non central nervous system infection Most are generalized, and occur early in an otitis media, pharyngitis adenitis illnesses Occur in 2-3% of children
• Roseola infantum is rare but classic cause, viral causes in 86% of cases |
|
|
Term
| Juvenile Rheumatoid Arthritis |
|
Definition
• Nomigratory monarticular or polyarticular arthropathy, with a tendency to involve large joints or proximal interphalangeal joints and lasting more than 3 months
• Systemic manifestations with fever, erythematous rashes, nodules, leukocytosis, and occasionally, iridocyclitis, pleuritis, pericarditis, anemia, fatigue, and growth failure |
|
|
Term
| Congenital Dysplasia of the Hip |
|
Definition
• Developmental dysplasia of hip encompasses a spectrum of conditions in which there is an abnormal relationship between the proximal femur and the acetabulum
• Occurs in 1:000 live births
• After first month of life, signs of instability demonstrated by Ortolani's test or Barlow's test become less evident
• Hips and knees are flexed, knees are at unequal heights with dislocated side lower (Allis's sign) Painless limp and a lurch to the affected side, as first described by Trendelenburg
• As child with bilateral dislocation of hips begins to walk, gait is wadding, perineum is widened as a result |
|
|
Term
|
Definition
• If less than 20 degrees, do not require treatment unless show progression
Bracing indicated for curvature of 20-40 degrees in a skeletally immature child Treatment indicated for any curvature that demonstrates progression on serial x-ray examination
• Curvatures greater than 40 degrees are resistant to treatment by bracing |
|
|
Term
|
Definition
• Sudden and unexpected death in infancy
• Incidence in U.S. is 1-2:1000
• Peaks at age 2 months, and most deaths occur in infants a few weeks of age to six months of age
• There is a 3:2 male predominance in most series |
|
|
Term
|
Definition
| • An association has been made between SIDS and prone sleeping position for infants, the Academy of Pediatrics recommends that health infants, when being put down for sleep, be positioned on their side or back |
|
|
Term
| most common type of diabetes in people under age 40 |
|
Definition
| • Insulin-dependent (type I) diabetes mellitus (juvenile-onset) |
|
|
Term
|
Definition
• Growth retardation, diminished physical activity, impaired tissue perfusion, constipation, thick tongue, poor muscle tone, hoarseness, anemia, intellectual retardation if in infancy
• Delayed dental and skeletal maturation, rarely stippling of epiphyses
• Thyroid function studies low; TSH levels elevated in primary hypothyroidism |
|
|
Term
| • Probably the best known disorder of amino acid metabolism is? • Frequency in Caucasians of approximately one in 10,000 live births. Causes mental retardation |
|
Definition
phenylketonuria;on normal phenylalanine intake, affected patients develop hyperphenylalaninemia and produce and excrete phenylpyuvic, phenyllactic, phenylacetic and 2-hydroxyphenylactic acid Clinicians had early success preventing severe mental retardation in phenylketonuric children by restricting phenylalanine from diet starting in early infancy
• Second test necessary only when newborn screening is done before 24 hours of age, and in such cases, the second test should be completed by the third week of life |
|
|
Term
• African, Mediterranean, or Asian ancestry
• Neonatal hyperbilirubinemia Sporadic hemolysis associated with infection or with ingestion of exigent drugs or fava beans
• X-linked inheritance |
|
Definition
Glucose-6-Phosphate Dehydrogenase Deficiency
• Deficiency of G6PD is easily the most common hemolytic anemia caused by a red cell enzyme defect; inherited in an X-linked recessive fashion
• Infections should be treated promptly and antibiotics given when appropriate
• Avoid drugs associated with hemolysis |
|
|
Term
• Recent onset
• Red or yellow, immobile tympanic membrane
• Ear discharge
• Earache |
|
Definition
Otitis Media
• Entire eardrum bulges outward, giving a doughnut-like appearance
• Streptococcus pneumoniae, 32% of cases; Haemophilus influenzae, 28
• In children, use amoxicillin, 50 mg/kg/d orally in three divided doses, continued for 10 days |
|
|
Term
| UNRESPONSIVE OTITIS MEDIA |
|
Definition
• Children with unresponsive otitis media treated with amoxicillin are more likely to have beta-lactamase-producing pathogens in a posttherapy middle ear aspirate than children who respond to initial amoxicillin treatment.
• Children who remain febrile and appear toxic despite 48 hours of antibiotic therapy for acute otitis media should be evaluated for associated occult infection and hospitalized for treatment with intravenous cefotaxime or cefriaxone pending results of cultures.
• If unresponsive otitis media still persists after a second course of antibiotics, myringotomy or tympanocentesis should be performed and the middle ear aspirate cultured to determine the most appropriate antibiotic therapy. |
|
|
Term
|
Definition
• Middle ear effusion present 3-6 weeks after initial course of antibiotic therapy
• Air-fluid levels or bubbles
• Retracted tympanic membrane
• Diminished or absent tympanic membrane mobility
• Middle ear effusions clear spontaneously within 6 weeks in 75-86% of cases |
|
|
Term
| the fourth most common cause of death in children |
|
Definition
Poisonings
• Peak incidence is at age 2 years |
|
|
Term
First Aid for Poisoning
inhaled
swallowed
eye |
|
Definition
carry patient to fresh air
do not induce vomiting in patients who are comatose or convulsing or who have lost the gag reflex
irrigation of the eye with plain water should begin before the patient arrives at the emergency room, continue 15-20 minutes |
|
|
Term
| • A true medical emergency, almost always caused by Haemophilus influenzae type B |
|
Definition
EPIGLOTTITIS
• Once diagnosed, endotracheal intubation should be performed immediately
• Ceftriaxone sodium, 150 mg/kg/d in two divided doses or equivalent cephalosporin; chloramphenicol, 100 mg/kg/d in four divided doses; or ampicillin, 200 mg/kg/d in four divided doses |
|
|
Term
| • Series of acute inflammatory diseases of larynx including viral croup (laryngotracheobronchitis), epiglottitis (supraglottitis), and bacterial tracheitis |
|
Definition
|
|
Term
| • Generally affects younger children in fall and early winter, caused by parainfluenza virus type 1, other organisms are parainfluenza virus types 2 and 3, respiratory syncytial virus, influenze virus, rubeola virus, adenovirus, and Mycoplasma pneumoniae |
|
Definition
Viral Croup
tx: supportive
• Manage as outpatient with mist therapy, oral hydration, and minimal handling
• Patients with stridor at rest require hospitalization |
|
|
Term
• Fever of acute onset
• Respiratory signs (cough, dyspnea, tachypnea, grunting, retractions)
• Abnormal chest examination (rales or decreased breath sounds) or abnormal chest radiograph
• Rales, decreased breath sounds, dullness to percussion, abnormal tactile or vocal fremitus
• Pleural involvement - splinting, pain, friction rub, dullness to percussion
• Meningismus or abdominal pain |
|
Definition
|
|
Term
• Upper respiratory infection prodrome (fever, coryza, cough, hoarseness)
• Wheezing or rales
• Myalgia, malaise, headache |
|
Definition
|
|
Term
• Cough, tachypnea, rales, few wheezes, and no fever
• Appropriate age 2-12 weeks With or without inclusion conjunctivitis With or without peripheral eosinophilia
• Elevated immunoglobulins: IgM>IgG>>IgA |
|
Definition
|
|
Term
• Common cause of acute hospital admissions in young infants especially during winter months, although respiratory syncytial virus is by far the most common pathogen, other viral agents include parainfluenza, influenza, and adenovirus. Mycoplasma, Chlamydia, Ureaplasma, and Pneumocystis are other potential causes of wheezing-associated respiratory illness during early infancy
• Young infant with acute onset of tachypnea, cough, rhinorrhea, and expiratory wheeze
• Chest x-ray with streaky infiltrates and hyperaeration |
|
Definition
|
|
Term
• Addressing growth and development is a major goal in pediatrics, because children's ability to take their place in society is critical.
• History must include information about the family's structure and the environment in which a child is reared; children need a supportive, nurturing, and enabling environment; it is the physician assistant's responsibility to help the family provide appropriate stimulation that simultaneously challenges children to develop and support their success in development. |
|
Definition
|
|
Term
| • An important distinction to be made, particularly in SGA infants, |
|
Definition
| is whether the growth disorder is symmetric (weight, height, and occipitofrontal circumference [OFC]) or asymmetric (sparing of growth in length and OFC); asymmetric growth retardation implies a problem late in the pregnancy; symmetric growth retardation implies an event of early pregnancy: chromosomal abnormality, drug or alcohol use, congenital viral infections. |
|
|
Term
| • Infants who are large for gestational age (LGA) are at risk for |
|
Definition
| are at risk for birth trauma, hypoglycemia, polycythemia, congenital anomalies, cardiomyopathy, hyperbilirubinemia, and hypocalcemia. |
|
|
Term
| • Infants who are small for gestational age (SGA) are at risk for |
|
Definition
| fetal distress during labor and delivery, polycythemia, hypoglycemia, and hypocalcemia. |
|
|
Term
Evaluation of the Newborn Infant
Apgar when?
Apgar in severly dpressed infants? |
|
Definition
| Apgar score and 1 and 5 minutes of age; in case of severely depressed infants, a 10-minute score should also be recorded. |
|
|
Term
Evaluation of the Newborn Infant
HR should be?
RR should be?
Blood pressure |
|
Definition
• Heart rates should range from 120 to 160, respiratory rate is 30 to 60, blood pressure norms are a function of birth weight and gestational age
• An irregularly irregular heart rate, usually due to premature atrial contractions, is a common finding. |
|
|
Term
| jaundice presenting in the first 24 hours of life should be considered |
|
Definition
|
|
Term
| malformed or malpositioned (low-set or posteriorly rotated) ears are often associated with |
|
Definition
| other congenital anomalies. |
|
|
Term
| epithelial pearls, small mandibles may be seen with |
|
Definition
| with Peirre Robin syndrome |
|
|
Term
| , a prominent tongue can be seen in |
|
Definition
| trisomy 21 and Beckwith-Wiedemann syndrome. |
|
|
Term
| expiratory grunting and decreased air entry are seen with |
|
Definition
| hyaline membrane disease. |
|
|
Term
| murmurs are most often benign and are not necessarily present in serious congenital heart disease in the newborn; the two most common presentations of heart disease in the newborn are |
|
Definition
| cyanosis and congestive heart failure with abnormalities of pulses. |
|
|
Term
| most abdominal masses in the newborn are associated with the |
|
Definition
| kidneys (multicystic-dysplastic, hydronephrosis, etc); markedly scaphoid abdomen plus respiratory distress suggests diaphragmatic hernia. |
|
|
Term
| Care Immediately After Delivery: |
|
Definition
| • Gently suction the oropharynx, obtain Apgar scores, support body temperature by drying the skin, then swaddle or place the infant beneath a radiant heat source; if polyhydramnios is present at delivery or if excessive oral secretions are noted, pass a soft catheter into the stomach to rule out esophageal atresia, routine eye prophylaxis to prevent gonorrheal conjunctivitis. |
|
|
Term
| Care of the Normal Newborn Cord Blood: |
|
Definition
| • Cord blood is used for blood typing, Coombs testing, and serology. |
|
|
Term
| Care in Transitional Nursery: |
|
Definition
| • Give vitamin K, 1 mg intramuscularly to prevent hemorrhagic disease of the newborn, calculate birth weight and gestational age to assess risk for certain problems. |
|
|
Term
| Feeding of the Newborn Infant |
|
Definition
• Healthy term infant should be allowed to feed every 2-5 hours on demand, the first feeding usually occurs at 2-6 hours of life; breast feeding can start as early as in the delivery room.
• Generally the volume increases from 0.5-1 ounce per feeding initially up to above 1.5-2 ounces per feeding on day 3; by day 3, the average term newborn takes in about 100mL/kg/d of milk. |
|
|
Term
| Physiology of Birth Asphyxia: |
|
Definition
• Can be the result of several mechanisms (1) acute interruption of umbilical blood flow (2) maternal hypotension or hypoxia (3) premature placental separation (4) chronic placental insufficiency and (5) failure to execute a proper newborn resuscitation.
• Infants in the stage of secondary apnea require positive pressure ventilation. |
|
|
Term
Delivery Room Management:
Steps in Resuscitation- |
|
Definition
• dry infant
• gently apply suction to oropharynx
• assess infant's condition
• infants with heart rates over 100 beats/min require no further intervention; infants with heart rates less than 100 beats/min and apnea or irregular respiratory efforts should be vigorously stimulated, the baby's back should be rubbed with a towel while oxygen is blown over the baby's face
• apply bag and mask ventilation
• most neonates can be effectively resuscitated with a bag and mask however if the infant does not respond favorably in 30-40 seconds, the physician must proceed to intubation |
|
|
Term
|
Definition
Epidemiology- respiratory droplets
Population at risk - children in first two years of life, peak incidence at 6 weeks of age
Seasonal pattern - winter and early spring months
Clinical Picture
Symptoms
• Sudden onset of respiratory difficulty
• 1-2 days of coryza and cough
Signs
• Prolonged respiratory phase and wheezing (24-48 hours.) Deep, hacking cough 2-3 weeks duration Fever is rarely higher than 38.3C
• Tachypnea, cyanosis, flaring alae nasi, shallow intercostal and subcostal retractions and inspiratory rales |
|
|
Term
• 12 hours to 2 days prodome of fever, sore throat, nausea, vomiting, headache, chills and malaise
• Tonsils and pharynx beefy red, may have exudate Tongue and white coating -- peels off as papillae becomes red and swollen "strawberry tongue" Petechiae may be present on soft palate
• Pastia's sign (hyperemic lines on flexor surfaces of wrists, elbows and groin)
Rash
• Bright red, punctuate lesions
• Sandpaper like texture appear 12-48 hours of fever flexor surfaces --- generalized rapidly Face is smooth, red, flushed and circumoral pallor
• Desquamation including feet and hands |
|
Definition
| Scarlet Fever (Scarlatina) |
|
|
Term
"slapped cheek" appearance in otherwise well child; lacelike appearance as rash fades
• Bright red, confluent, maculopapular rash on cheeks
• Circumoral pallor Discrete mac-pap rash on upper and lower extremities
• After rash has subsided it tends to reoccur following variety of skin irritants, bathing |
|
Definition
| Fifth Disease is probably a viral disease of childhood which rarely has any complications or sequelae |
|
|
Term
| 1. The diagnosis of a concussion is established by which of the following findings |
|
Definition
| c. Brief loss of consciousness & amnesia for event |
|
|
Term
| 2. The diagnosis of cerebral palsy is established by which of the following findings on history and physical exam? |
|
Definition
| d. Motor dysfunction secondary to a brain lesion |
|
|
Term
| 3. Duchenne muscular dystrophy is associated with a lack of the protein dystrophin, which normally is found in |
|
Definition
| d. The muscle membrane ** |
|
|
Term
| 4. The diagnosis of epilepsy is made by |
|
Definition
| b. Hx of the event & abnormal EEG finding |
|
|
Term
| 5. Which of the following refers to slow, writhing, continuous movements in the extremities? |
|
Definition
|
|
Term
| 6. Common lesions seen in tuberous sclerosis include all of the following |
|
Definition
a. Hypopigmented spots
b. Café au lait spots
c. Retinal hamartomas |
|
|
Term
| 7. All of the following statements about the Guillain-Barre syndrome are correct |
|
Definition
a. it is considered to be a postinfectious disease
b. the CSF shows an elevated protein level w/o an increased cell count
c. relapses may occur |
|
|
Term
| 8. All of the following statements about spina bifida are true |
|
Definition
a. It is often associated w/ hydrocephalus
c. It may be diagnosed in utero w/ US
d. It can cause urologic problems
e. It requires orthopedic management |
|
|
Term
| 1. The most important piece of historic information that may distinguish a child w/ Hirschsprung's disease from one with functional constipation is: |
|
Definition
| c. a history of infrequent bowel movements dating back to the first week of life ** |
|
|
Term
| 2. 16-yo girl complains of frequent abdominal px of 6 mos duration; pain usually is periumbilical, often exacerbated by eating, & frequently is assoc. w/ nausea. All of the conditions would be included in the differential dx |
|
Definition
a. Lactose intolerance
b. Peptic ulcer disease
c. IBS
d. Chronic pancreatitis |
|
|
Term
| 3. All of the following signs and symptoms are indicative of rotavirus infection in young children |
|
Definition
a. vomiting followed by watery diarrhea
b. No blood in the stool **
c. temperature above 38 degrees C
d. upper respiratory symptoms
e. lactose malabsorption |
|
|
Term
| 4. Gastroesophageal reflux typically give rise to all of the following conditions in a 4-month-old infant |
|
Definition
b. Recurrent pulmonary infiltrates
c. The onset of asthma-like symptoms
d. Failure to thrive |
|
|
Term
| 5. After a viral respiratory infxn, a 1-yo boy suddenly becomes irritable & draws his legs up to his abdomen as if in pain. After several mins, the symptoms partially subside, although the child seems rather lethargic & is not interested in eating. When the child vomits & has another episode of pain, he is brought to the ER by his parents. On arrival at the hospital, the mother notes that her child has passed a bloody stool. On PE, the child is indeed lethargic, & a sausage-like mass is palpable in the RUQ. Conclusions that can be drawn from this hx include: |
|
Definition
| c. a carefully performed barium enema may be both diagnostic and therapeutic ** |
|
|
Term
| 6. An ELISA is useful in the diagnosis of which of the following chronic diarrheal disorders |
|
Definition
|
|
Term
| 1. Severe pulmonary stenosis is characterized by all of the following features |
|
Definition
a. increased right ventricular pressure
b. exertional dyspnea and fatigability
d. right ventricular hypertrophy on ECG |
|
|
Term
| 2. Which of the following features are characteristic of pulmonary atresia with intact ventricular septum? |
|
Definition
a. Ductus-dependent pulmonary blood flow
c. An obligatory right-to-left atrial-level shunt
d. A single S2
e. Decreased pulmonary vascularity
Abnormal right ventricular development |
|
|
Term
| true statements about coarctation of the arota |
|
Definition
a. The obstruction usually is opposite the ductus or ligamentum arteriosum
b. More than 50% of patients have an associated bicuspid aortic valve
c. Left ventricular afterload and proximal aortic pressure are elevated
d. A blood pressure differential is present between upper and lower extremities
There are no grade IV diasystolic murmurs |
|
|
Term
| 4. the following features are characteristic of aortic stenosis? |
|
Definition
a. A thickened aortic valve
b. Ventricular hypertrophy
d. A harsh systolic ejection murmur
symptoms are no frequent |
|
|
Term
| 5. ASD, right bundle branch block, mitral regurgitation are cardiac lesions associated with which of the following? |
|
Definition
|
|
Term
| 6. Tetralogy of Fallot, truncus arteriosus, pulmonary valve atresia with VSD are associated w/ which of the following? |
|
Definition
|
|
Term
| 1. The group A B-hemolytic streptococcus may trigger an attack of acute rheumatic fever when it: |
|
Definition
| b. causes an upper respiratory infection ** |
|
|
Term
| 2. Acute rheumatic fever may cause |
|
Definition
| e. Aortic or mitral valvulitis ** |
|
|
Term
| 3. All of the following findings may occur in JRA |
|
Definition
a. Uveitis
b. High spiking fever
d. Enlargement of the spleen
e. lymphadenopathy |
|
|
Term
| 4. The most common cause of chronic urticaria is: |
|
Definition
|
|
Term
| 5. Clinical features of allergic rhinitis include |
|
Definition
a. Dark shadows under the eyes
b. nasal mucosa **(boggy & blue)
c. Dental malocclusion
d. Thin, watery, nasal secretions
e. Eosinophils in the nasal secretions |
|
|
Term
| 6. An 11-year-old child with atopic eczema is likely to present with |
|
Definition
| b. Lichenified lesions on the flexural surfaces ** |
|
|
Term
| constitutes the most cost effective, safest, & most direct mode of tx for allergic rhinitis? |
|
Definition
| b. Avoidance of the offending allergen ** |
|
|
Term
| 8. Signs and symptoms of seasonal allergic rhinitis might include |
|
Definition
a. Nosebleeds
b. Nasal polyps
c. Loss of smell & taste |
|
|
Term
| communication techniques would be most helpful in taking a history of a child who is in respiratory distress from an asthma attack? |
|
Definition
| c. Close-ended questions ** |
|
|
Term
| 3. An effective interview with an adolescent client requires |
|
Definition
| c. Assess their interactions at home, school, & w/ peers ** |
|
|
Term
| 4. Essential elements of interviewing patients include |
|
Definition
a. Informed consent
b. Assurance of privacy & confidentiality
c. Minimum interruptions |
|
|
Term
| 6. An example of an open-ended question is: |
|
Definition
| b. How are things at home? ** |
|
|
Term
| 7. Clarification as a communication technique may be helpful when information is: |
|
Definition
|
|
Term
| potential barrier(s) to effective communication? |
|
Definition
a. Cultural differences
b. Frequent interruptions
c. Lack of continuity of care |
|
|
Term
| indicated in a history of a child acutely ill with pharyngitis? |
|
Definition
a. History of present illness
b. Review of systems
d. Chief complaint |
|
|
Term
| 10. A new mother presents at the 2-week visit with her newborn. She appears tired and teary and states that she wishes she never had a baby. What is an appropriate response? |
|
Definition
| You sound like you are feeling overwhelmed.” ** |
|
|
Term
| 11. A suggested order of the physical exam in young children is: |
|
Definition
| a. Heart, lungs, abdomen ** |
|
|
Term
| 12. In a situation where young child is resisting a physical exam, the most appropriate remark to the child would be: |
|
Definition
| I can tell you’re upset. Why do you feel so afraid today?” ** |
|
|
Term
| 13. A physical exam of a fearful 2-year-old should be done: |
|
Definition
| b. On the parent’s lap ** |
|
|
Term
| 14. The physical exam of the prepubescent child is best accomplished: |
|
Definition
| a. With attention to modesty issues ** |
|
|
Term
| 15. Expected percussion findings over a healthy liver are: |
|
Definition
|
|
Term
| 16. Normal percussion findings over a hyperinflated area are: |
|
Definition
|
|
Term
| 17. Bruits can be an abnormal finding on a physical exam and are found during: |
|
Definition
|
|
Term
| 18. Crackles are findings often heard with which of these conditions? |
|
Definition
|
|
Term
| 19. The Romberg test examines which of the following functions? |
|
Definition
|
|
Term
| 20. A normal Rinne test demonstrates which of the following? |
|
Definition
|
|
Term
| 1. A 1-year-old boy is brought to the emergency room with a 10-hour history of fever and listlessness. Physical examination reveals a lethargic child with a temperature of 103 degrees F, a respiratory rate of 35, blood pressure of 60/30, a full fontanelle, and a petechial rash. The most appropriate initial action after obtaining cultures is: |
|
Definition
| b. Administration of IV fluids & antibiotics ** |
|
|
Term
| 2. A 3-year-old girl presents with a nonsuppurative and moderately tender anterior cervical lymph node that measures 2 x 4 cm. What is the most appropriate initial therapy? |
|
Definition
|
|
Term
| 3. A previously healthy 13-year-old boy develops a mild pneumonia characterized by a nonproductive cough. The most appropriate therapy is: |
|
Definition
| c. Erythromycin/azithromycin ** |
|
|
Term
| 4. A 3-month-old infant w/ bronchopulmonary dysplasia is admitted to a hospital w/ fever, wheezing, & respiratory distress. A chest x-ray shows hyperinflation & bilateral, interstitial infiltrates. The CBC is normal, and a rapid test for respiratory syncytial virus is positive. Blood cultures are obtained. The most appropriate therapy is: |
|
Definition
| d. Ribavirin by aerosol ** |
|
|
Term
| 5. A 2-yo child is noted to have an erythematous, bulging R tympanic membrane. The 2 most likely bacterial causes of this illness are: |
|
Definition
| c. H. Influenzae & Strep. Pneumonia ** |
|
|
Term
| 6. A 6-month-old, lethargic infant is brought to the ER w/ a temperature of 105° F. The infant has been ill for 12 hrs & is not responsive. Chest x-ray, urinalysis, & CSF are normal. The CBC shows a white count of 37,000, w/ 50% neutrophils & 40% bands. The pt is treated w/ ceftriaxone for presumed sepsis. Among the following microorganisms, the one most likely to cause sepsis in the infant is: |
|
Definition
| d. Hemophilus influenza type b ** |
|
|
Term
| 7. All of the following statements regarding the diagnosis of sinusitis in children are true |
|
Definition
a. Common symptoms of acute sinusitis in young children include fever, purulent nasal discharge, & persistent daytime cough for longer than 10 days
c. Tranillumination of the sinuses may provide valuable info. For the dx of sinusitis in older children
d. Sinus puncture seldom is needed to confirm the diagnosis of sinusitis
e. Swab cultures of the throat are not reliable for the diagnosis of sinusitis |
|
|
Term
| 7. All of the following statements regarding the diagnosis of sinusitis in children are true |
|
Definition
a. Common symptoms of acute sinusitis in young children include fever, purulent nasal discharge, & persistent daytime cough for longer than 10 days
c. Tranillumination of the sinuses may provide valuable info. For the dx of sinusitis in older children
d. Sinus puncture seldom is needed to confirm the diagnosis of sinusitis
e. Swab cultures of the throat are not reliable for the diagnosis of sinusitis |
|
|
Term
| c. Diagnosis usually is made by identifying nits (dry eggs) ** |
|
Definition
|
|
Term
| 9. Maculopapular rash that begins on the head & spreads downward: |
|
Definition
measles
Cough, coryza, conjunctivitis
Koplik spots |
|
|
Term
| 10. Rash that begins as a marked erythema of the cheeks |
|
Definition
| : erythematous infectiosis (fifths disease) |
|
|
Term
| 10. Rash that begins as a marked erythema of the cheeks |
|
Definition
| : erythematous infectiosis (fifths disease) |
|
|
Term
| 11. Vesicular rash that appears in “crops”: |
|
Definition
|
|
Term
| 12. Maculopapular rash that is assoc. w/ the posterior auricular, cervical, & suboccipital lymphadenopathy: |
|
Definition
|
|
Term
| 13. rash that begins at Ankles and wrists |
|
Definition
| Rocky mountain spotted fever |
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Term
1. Renal ultrasonography can provide useful info. in the diagnosis of all of the following renal disorders EXCEPT:
a. Wilm’s tumor
b. Severity of renal failure in acute tubular necrosis
c. Polycystic kidney disease
d. Ureteropelvic junction obstruction
e. nephrocalcinosis |
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Definition
| b. Severity of renal failure in acute tubular necrosis ** |
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Term
| 2. A 12-year-old girl has a physical examination so she can join the soccer team. A random urinalysis is normal except for 2+ protein on dipstick testing. The most reasonable next study would be |
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Definition
| e. Urinalysis of the 1st morning urine ** |
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Term
| 3. Which of the following statements best characterizes the diagnosis of urinary tract infection in children? |
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Definition
| c. The diagnosis is likely if a clean-catch specimen shows 105 organisms of a single species ** |
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Term
4. Urinalysis may provide useful information about all of the following renal parameters EXCEPT:
a. Renal phosphate handling
b. Renal protein loss
c. Renal concentrating capacity
d. Possible UTI
e. Possible glomerulonephritis |
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Definition
| a. Renal phosphate handling ** |
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Term
5. A 5-year-old, apparently healthy child has had 3 episodes of gross hematuria. Which of the following laboratory procedures are indicated in the evaluation of this child initially?
a. Exam of the urine for red cell morphology & casts
b. Renal & bladder ultrasonography
c. Urinary screening for hypercalciuria
d. Sulfosalicyclic acid precipitation test for proteinuria |
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Definition
| a. Exam of the urine for red cell morphology & casts ** |
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Term
5. A 5-year-old, apparently healthy child has had 3 episodes of gross hematuria. Which of the following laboratory procedures are indicated in the evaluation of this child initially?
a. Exam of the urine for red cell morphology & casts
b. Renal & bladder ultrasonography
c. Urinary screening for hypercalciuria
d. Sulfosalicyclic acid precipitation test for proteinuria |
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Definition
| a. Exam of the urine for red cell morphology & casts ** |
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Term
| 6. Most cases of childhood nephrotic syndrome occur in association with |
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Definition
| e. Minimal change disease ** |
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Term
7. A healthy, 14-year-old black girl experiences the sudden onset of gross hematuria, which persists for 2 days. All of the following are reasonable immediate steps in the evaluation of this patient EXCEPT
a. Cytoscopy to establish the site of bleeding
b. BUN and serum creatinine measurement
c. Urine culture
d. Urinalysis, dipstick & microscopic |
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Definition
| a. Cytoscopy to establish the site of bleeding ** |
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Term
&7. A healthy, 14-year-old black girl experiences the sudden onset of gross hematuria, which persists for 2 days. All of the following are reasonable immediate steps in the evaluation of this patient EXCEPT
a. Cytoscopy to establish the site of bleeding
b. BUN and serum creatinine measurement
c. Urine culture
d. Urinalysis, dipstick microscopic |
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Definition
| a. Cytoscopy to establish the site of bleeding ** |
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Term
8. A 2-yo boy presents w/ a large left-sided andominal mass, which, on intravenous pyelogram, appears to arise w/in the L kidney & to distort & displace the collecting system. On chest x-ray, multiple pulmonary nodules are present. The most likely diagnosis is:
a. Neuroblastoma
b. Wilms’ tumor
c. Non-Hodgkin’s lymphoma
d. Rhabdomyosarcoma
e. Hepatoblastoma |
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Definition
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Term
9. All of the following statements regarding the treatment of childhood urinary tract infections are true EXCEPT:
a. A 10-d course of either amoxicillin or trimethoprim-sulfamethoxazoles adequate for uncomplicated cystitis
b. Antibiotic prophylaxis should be used in children w/ vesicoureteral reflux
c. Short-course therapy is not accepted standard tx for UTIs in children
d. Tx of pyelonephritis requires IV antibiotics to achieve adequate urinary antimicrobial levels
e. Follow-up cultures are indicated at least 72 hrs after completing a course of therapy |
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Definition
| d. Tx of pyelonephritis requires IV antibiotics to achieve adequate urinary antimicrobial levels ** |
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Term
9. All of the following statements regarding the treatment of childhood urinary tract infections are true EXCEPT:
a. A 10-d course of either amoxicillin or trimethoprim-sulfamethoxazoles adequate for uncomplicated cystitis
b. Antibiotic prophylaxis should be used in children w/ vesicoureteral reflux
c. Short-course therapy is not accepted standard tx for UTIs in children
d. Tx of pyelonephritis requires IV antibiotics to achieve adequate urinary antimicrobial levels
e. Follow-up cultures are indicated at least 72 hrs after completing a course of therapy |
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Definition
| d. Tx of pyelonephritis requires IV antibiotics to achieve adequate urinary antimicrobial levels ** |
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Term
10. All of the following statements regarding blood pressure in children are true EXCEPT:
a. BP levels tend to increase w/ age throughout infancy and childhood
b. Family history is an important risk factor in the development of htn in childhood
c. Most cases of childhood htn today have an identifiable cause
d. To avoid BP elevations due to anxiety, the reading should be obtained when the HR is stable & repeated until values are consistent |
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Definition
| c. Most cases of childhood htn today have an identifiable cause ** |
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Term
11. Select the laboratory finding which is most likely to be associated with poststreptococcal glomerulonephritis?
a. Hypocomplementemia
b. Chronic hepatitis B antigenemia
c. Microagiopathic anemia & thrombocytopenia
d. Vesicoureteral reflux |
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Definition
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Term
| 1. The primary goal of resuscitation of the newborn is to: |
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Definition
| c. Re-oxygenate the CNS ** |
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Term
| 1. The primary goal of resuscitation of the newborn is to: |
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Definition
| c. Re-oxygenate the CNS ** |
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Term
| 2. The most common complication of a multiple gestation pregnancy is: |
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Definition
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Term
| 3. Hyperbilirubinema is diagnosed in a 2-day-old infant whose serum bilirubin concentrations are 17.5 mg/dl (indirect fraction) & 0.2 mg/dl (direct fraction). All of the following statements concerning the evaluations & management of this infant are true |
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Definition
b. the initial evaluation should include a CBC w/ reticulocyte count, matermal infant blood types, & Coombs' test
c. breast-feeding may have contributed to the elevated bilirubin concentration
d. photootherapy should be administered |
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Term
| 3. Hyperbilirubinema is diagnosed in a 2-day-old infant whose serum bilirubin concentrations are 17.5 mg/dl (indirect fraction) & 0.2 mg/dl (direct fraction). All of the following statements concerning the evaluations & management of this infant are true |
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Definition
b. the initial evaluation should include a CBC w/ reticulocyte count, matermal infant blood types, & Coombs' test
c. breast-feeding may have contributed to the elevated bilirubin concentration
d. photootherapy should be administered |
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Term
4. All of the following are components of the Apgar score EXCEPT
a. Heart rate
b. Muscle tone
c. BP
d. Reflex irritability
e. Skin color |
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Definition
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Term
4. All of the following are components of the Apgar score EXCEPT
a. Heart rate
b. Muscle tone
c. BP
d. Reflex irritability
e. Skin color |
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Definition
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Term
| the following statements about tracheoesophageal fistula are true? |
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Definition
| c. the goal of the initial management is to keep the airway clear of secretions ** |
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Term
| the following statements about tracheoesophageal fistula are true? |
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Definition
| c. the goal of the initial management is to keep the airway clear of secretions ** |
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Term
6. Newborn infants often require lower doses of drugs compared to adults (adjusted for body mass and weight) for all of the following reasons EXCEPT:
a. newborns have lower blood protein and albumin concentrations
b. newborns have a lower glomerular filtration rate
c. glucuronyl transferase activity is reduced in newborns
d. renal tubular secretion os lower in newborns
e. newborns have a lower normal blood pH |
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Definition
| e. newborns have a lower normal blood pH ** |
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Term
6. Newborn infants often require lower doses of drugs compared to adults (adjusted for body mass and weight) for all of the following reasons EXCEPT:
a. newborns have lower blood protein and albumin concentrations
b. newborns have a lower glomerular filtration rate
c. glucuronyl transferase activity is reduced in newborns
d. renal tubular secretion os lower in newborns
e. newborns have a lower normal blood pH |
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Definition
| e. newborns have a lower normal blood pH ** |
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Term
7. Signs and symptoms of neonatal necrozing enterocolitis include all of the following EXCEPT:
a. bile-stained gastric fluid
b. pneumatosis intestinalis
c. guaiac-positive stools
d. apnea
e. jaundice |
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Definition
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Term
7. Signs and symptoms of neonatal necrozing enterocolitis include all of the following EXCEPT:
a. bile-stained gastric fluid
b. pneumatosis intestinalis
c. guaiac-positive stools
d. apnea
e. jaundice |
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Definition
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Term
8. All of the following complications of pregnancy are risk factors for perinatal asphyxia EXCEPT:
a. placental abruption
b. hyperemesis gravidarum
c. prematurity
d. preeclampsia
e. meconium-stained amniotic fluid |
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Definition
| b. hyperemesis gravidarum ** |
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Term
8. All of the following complications of pregnancy are risk factors for perinatal asphyxia EXCEPT:
a. placental abruption
b. hyperemesis gravidarum
c. prematurity
d. preeclampsia
e. meconium-stained amniotic fluid |
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Definition
| b. hyperemesis gravidarum ** |
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Term
1. A 3-year-old girl presents with a history of recurrent pneumonia. On physical examination, wheezing and crackles are heard, and digital clubbing is evident. The most likely diagnosis is:
a. A. pulmonary sequestration
b. Bronchopulmonary dysplasia
c. Cystic fibrosis
d. Asthma
e. laryngomalacia |
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Definition
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Term
2. A 4-month-old boy is brought to the emergency room. His parents report that the child stopped breathing at home, turned blue around his lips, and felt limp. After vigorous shaking of the infant and several mouth-to-mouth breaths, his color returned to normal and he resumed breathing. The infant's condition is best described as:
a. Obstructive disease
b. Apparent life-threatening event
c. Pneumonia
d. CHF |
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Definition
| b. Apparent life-threatening event ** |
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Term
2. A 4-month-old boy is brought to the emergency room. His parents report that the child stopped breathing at home, turned blue around his lips, and felt limp. After vigorous shaking of the infant and several mouth-to-mouth breaths, his color returned to normal and he resumed breathing. The infant's condition is best described as:
a. Obstructive disease
b. Apparent life-threatening event
c. Pneumonia
d. CHF |
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Definition
| b. Apparent life-threatening event ** |
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Term
3. All of the following statements about asthma are correct EXCEPT:
a. Its severity remits or exacerbates w/ or w/o therapy
b. It is a disease of the airway hyperactivity
c. It can be triggered by viral infxns, exercise, or emotions
d. The presence of wheezing is diagnostic
e. Inhaled sympathomimetics are effective therapy |
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Definition
| d. The presence of wheezing is diagnostic ** |
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Term
4. Components of acute asthma attack include all of the following EXCEPT:
a. Bronchospasm
b. Subglottic edema
c. Edema of the airway mucosa
d. Mucus hypersecretion |
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Definition
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Term
5. In the evaluation of a 2-year-old child with x-ray documentation of recurrent pneumonia, all of the following tests would be indicated EXCEPT:
a. Immunoglobulin analysis
b. Complete blood count
c. Sweat test
d. Culture of pulmonary secretions
e. Peak flow home monitoring |
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Definition
| e. Peak flow home monitoring ** |
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Term
6. The best indicator of cystic fibrosis is:
a. a positive family history of cystic fibrosis
b. the presence of digital clubbing
c. a sweat test with a chloride concentration of 70 mEq/L
d. bronchiectasis on a chest x-ray |
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Definition
| c. a sweat test with a chloride concentration of 70 mEq/L ** |
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Term
| 7. The most common chronic lung disease in children is: |
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Definition
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Term
1. A 24-month-old child who has not yet begun to speak is brought to the pediatrician's office. All of the following conditions should be considered in the differential diagnosis EXCEPT:
a. Autism
b. Developmental delay
c. Hearing impairment
d. Severe parental neglect
e. Childhood schizophrenia |
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Definition
| e. Childhood schizophrenia ** |
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Term
1. A 24-month-old child who has not yet begun to speak is brought to the pediatrician's office. All of the following conditions should be considered in the differential diagnosis EXCEPT:
a. Autism
b. Developmental delay
c. Hearing impairment
d. Severe parental neglect
e. Childhood schizophrenia |
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Definition
| e. Childhood schizophrenia ** |
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Term
2. All of the following conditions may cause sensorineural hearing loss EXCEPT:
a. Rubella
b. Meningitis
c. Perinatal asphyxia
d. Otitis media
e. Aminoglycoside administration |
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Definition
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Term
2. All of the following conditions may cause sensorineural hearing loss EXCEPT:
a. Rubella
b. Meningitis
c. Perinatal asphyxia
d. Otitis media
e. Aminoglycoside administration |
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Definition
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Term
3. All of the following statements regarding the use of stimulant medication in attention deficit-hyper-activity disorder (ADHD) are correct EXCEPT:
a. Tourette syndrome is a possible complication of stimulant usage
b. stimulant drugs are the initial treatment for ADHD
c. stimulants usually are administered only on school mornings
d. methylphenidate, dextroamphetamine, and pemoline are the major stimulants in use at this time |
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Definition
| b. stimulant drugs are the initial treatment for ADHD ** |
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Term
4. In the treatment of failure to thrive in a family you are comfortable with when problems are identified in the history or physical examination, the next step should be:
a. more extensive laboratory investigation
b. hospitalization for further evaluation and observation
c. provision of a high-calorie diet on an outpatient basis
d. referral to a dietitian for dietary manipulation
e. referral to a subspecialist |
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Definition
a. more extensive laboratory investigation
b. hospitalization for further evaluation and observation
c. provision of a high-calorie diet on an outpatient basis **
d. referral to a dietitian for dietary manipulation
e. referral to a subspecialist |
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Term
4. In the treatment of failure to thrive in a family you are comfortable with when problems are identified in the history or physical examination, the next step should be:
a. more extensive laboratory investigation
b. hospitalization for further evaluation and observation
c. provision of a high-calorie diet on an outpatient basis
d. referral to a dietitian for dietary manipulation
e. referral to a subspecialist |
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Definition
a. more extensive laboratory investigation
b. hospitalization for further evaluation and observation
c. provision of a high-calorie diet on an outpatient basis **
d. referral to a dietitian for dietary manipulation
e. referral to a subspecialist |
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Term
5. Of the following, select the continence disorder which is associated with a familial tendency:
a. Encopresis
b. Enuresis
c. Both
d. neither |
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Definition
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Term
6. School phobia can result from:
a. A learning disability
b. Overprotective parents
c. A death in the family
d. All of the above
e. None of the above |
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Definition
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Term
7. A mildly obese 6 year old boy presents to you in clinic. His physical examination is normal . He is an average student. His parents are also obese, believe he has a glandular problem. The most likely diagnosis for this boy is:
a. Laurence-Moon syndrome
b. Prader-Willi syndrome
c. Hypothyroidism
d. Exogenous obesity |
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Definition
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Term
7. A mildly obese 6 year old boy presents to you in clinic. His physical examination is normal . He is an average student. His parents are also obese, believe he has a glandular problem. The most likely diagnosis for this boy is:
a. Laurence-Moon syndrome
b. Prader-Willi syndrome
c. Hypothyroidism
d. Exogenous obesity |
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Definition
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Term
9. You are asked to evaluate a mildly obese 6-year-old boy. The boy is tall for his age, has a normal physical examination, and is described as an average student. His parents, who also are obese, believe he has a glandular problem. All of the following would be helpful in the initial evaluation and management of the child EXCEPT:
a. History of the child’s dietary intake
b. Family history
c. Chromosomal analysis
d. BP measurement
e. Serum cholesterol & triglyceride studies |
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Definition
| c. Chromosomal analysis ** |
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Term
9. You are asked to evaluate a mildly obese 6-year-old boy. The boy is tall for his age, has a normal physical examination, and is described as an average student. His parents, who also are obese, believe he has a glandular problem. All of the following would be helpful in the initial evaluation and management of the child EXCEPT:
a. History of the child’s dietary intake
b. Family history
c. Chromosomal analysis
d. BP measurement
e. Serum cholesterol & triglyceride studies |
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Definition
| c. Chromosomal analysis ** |
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Term
1. All of the following statements regarding Down syndrome are true EXCEPT:
a. most individuals are severely or profoundly retarded
b. it is the most common chromosome abnormality
c. hear defects and gastrointestinal abnormalities occur with increased frequency
d. a familial balanced translocation involving chromosome 21 affects a small proportion of individuals |
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Definition
| a. most individuals are severely or profoundly retarded ** |
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Term
1. All of the following statements regarding Down syndrome are true EXCEPT:
a. most individuals are severely or profoundly retarded
b. it is the most common chromosome abnormality
c. hear defects and gastrointestinal abnormalities occur with increased frequency
d. a familial balanced translocation involving chromosome 21 affects a small proportion of individuals |
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Definition
| a. most individuals are severely or profoundly retarded ** |
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Term
2. Amniocentesis is performed on a 36-year-old pregnant woman. The karyotype of the fetus is 46,XY/47,XY,+21, indicating that some of the cells have a normal karyotype and some of the cells are trisomic for chromosome 21. Which of the following statements concerning these findings is true?
a. The fetus has Down's syndrome
b. The cause of there being two cell lines is prefertilization nondisjunction
c. The chromosome abnormality reflects translocation
d. The recurrence risk for this chromosome abnormality is 15% |
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Definition
| a. The fetus has Down's syndrome ** |
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Term
3. Chromosome analysis is indicated for all of the following conditions EXCEPT:
a. Suspected Down syndrome
b. Recurrent pregnancy loss
c. Primary amenorrhea
d. Nuchal cord
e. Ambiguous genitalia |
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Definition
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Term
3. Chromosome analysis is indicated for all of the following conditions EXCEPT:
a. Suspected Down syndrome
b. Recurrent pregnancy loss
c. Primary amenorrhea
d. Nuchal cord
e. Ambiguous genitalia |
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Definition
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Term
4. Each of the following clinical signs may be indicative of an inborn error of amino acid or organic acid metabolism EXCEPT:
a. metabolic acidosis on an infant
b. an unusual odor of urine or sweat
c. vomiting an lethargy in an infant
d. accelerated growth in a child
e. mental retardation in a child |
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Definition
| d. accelerated growth in a child ** |
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Term
| 5. Evaluation of the newborn boy and his parents suggests a diagnosis of isolated cleft lip and palate. What is the most likely form of inheritance of this defect? |
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Definition
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Term
| 5. Evaluation of the newborn boy and his parents suggests a diagnosis of isolated cleft lip and palate. What is the most likely form of inheritance of this defect? |
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Definition
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Term
6. In which of the following types of disorders would a child display loss of developmental milestones, or regression?
a. Amino aciduria
b. Neuronal storage disorder
c. Chromosomal translocation
d. Teratogenic exposure during fetal development |
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Definition
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Term
| 7. Marfan syndrome is clinically associated with abnormalities in: |
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Definition
| a. connective tissue, causing aortic dilation and loose joints ** |
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Term
8. Maternal ingestion of significant amounts of alcohol throughout pregnancy can result in all of the following EXCEPT:
a. A normal child
b. A child w/ developmental delay who is otherwise normal
c. a child with Down syndrome
d. a child with dysmorphic features, small size, and developmental retardation
e. a child who is microcephalic and small for gestational age |
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Definition
| c. a child with Down syndrome ** |
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Term
9. Of the following, which is the most important evaluation to be performed to 1st determine the cause of the cleft lip & palate?
a. Physical exam
b. Ct scan of the head
c. Serum alcohol level
d. Urine toxic screen
e. Amino acid analysis |
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Definition
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Term
9. Of the following, which is the most important evaluation to be performed to 1st determine the cause of the cleft lip & palate?
a. Physical exam
b. Ct scan of the head
c. Serum alcohol level
d. Urine toxic screen
e. Amino acid analysis |
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Definition
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Term
10. PKU is the most common disorder of amino acid metabolism. Which one of the following regarding PKU is true?
a. PKU is an autosomal dominant disorder
b. Hyperpigmentation is a common sign of PKU
c. Dietary management should begin within 1 month of birth to prevent mental retardation
d. Dietary restriction can be discontinued safely in adolescence
e. heart defects are common in people with PKU |
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Definition
| c. Dietary management should begin within 1 month of birth to prevent mental retardation ** |
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Term
11. Which of the following statements regarding neural tube defects is true?
a. Neural tube defects are produced prior to implantation of the embryo
b. Abnormally low maternal serum AFP levels suggest the presence of a neural tube defect
c. A single autosomal recessive gene is the most common cause of neural tube defects
d. Parents who have had a child w/ a neural tube defect have an increased risk for having another child w/ such a defect
e. Neural tube defects most commonly are part of a syndrome |
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Definition
| d. Parents who have had a child w/ a neural tube defect have an increased risk for having another child w/ such a defect ** |
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Term
11. Which of the following statements regarding neural tube defects is true?
a. Neural tube defects are produced prior to implantation of the embryo
b. Abnormally low maternal serum AFP levels suggest the presence of a neural tube defect
c. A single autosomal recessive gene is the most common cause of neural tube defects
d. Parents who have had a child w/ a neural tube defect have an increased risk for having another child w/ such a defect
e. Neural tube defects most commonly are part of a syndrome |
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Definition
| d. Parents who have had a child w/ a neural tube defect have an increased risk for having another child w/ such a defect ** |
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Term
12. Which of the following statements regarding syndromes is true?
a. All major features of a known syndrome must be present before a diagnosis can be made
b. Internal abnormalities often are associated with dysmorphic features in a syndrome
c. Syndromes almost always can be recognized shortly after birth
d. Syndromes almost always are the result of single gene mutations
e. All syndromes have associated dysmorphic features |
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Definition
| b. Internal abnormalities often are associated with dysmorphic features in a syndrome ** |
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Term
| 1. The best initial treatment for scald burns is to: |
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Definition
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Term
2. All of the following statements about child passenger restraints are true EXCEPT:
a. State laws mandating car seat use have resulted in increased frequency of use
b. Improper installation of car seats has been recognized as an important problem
c. Anticipatory guidance to parents in ineffective in increasing car seat use
d. All states now mandate that car seats or seat belts be used for children under 5 years of age
e. A potential 90% reduction in the fatality rate can be expected through the use of child restraints |
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Definition
| c. Anticipatory guidance to parents in ineffective in increasing car seat use ** |
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Term
2. All of the following statements about child passenger restraints are true EXCEPT:
a. State laws mandating car seat use have resulted in increased frequency of use
b. Improper installation of car seats has been recognized as an important problem
c. Anticipatory guidance to parents in ineffective in increasing car seat use
d. All states now mandate that car seats or seat belts be used for children under 5 years of age
e. A potential 90% reduction in the fatality rate can be expected through the use of child restraints |
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Definition
| c. Anticipatory guidance to parents in ineffective in increasing car seat use ** |
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Term
3. All of the following statements about epidemiology of childhood injuries are true EXCEPT:
a. Injuries are responsible for a greater percentage of hospital admisssions among children than adults
b. Death is the least likely outcome of childhood injuries
c. Respiratory diseases cause more deaths in children than do injuries
d. Most childhood injuries are treated at home |
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Definition
| c. Respiratory diseases cause more deaths in children than do injuries ** |
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Term
| 4. In a comatose child who was poisoned, the most effective way to remove gastric contents is by the use of: |
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Definition
| a. Saline lavage with a wide-bore nasogastric tube ** |
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Term
| 5. Disfiguring mouth burns are most likely to occur as a result of: |
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Definition
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Term
| 6. The most serious acute medical outcome of drowning is: |
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Definition
| c. Hypoxic brain injury ** |
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Term
7. A 2-year-old boy is brought to the emergency department 30 minutes after having ingested 20 of his mother's 325-mg ferrous sulfate tablets. Each tablet contains 65 mg of elemental iron. He has vomited once, but his behavior is otherwise normal. The child's physical examination is unremarkable. He weighs 13 kg. Which of the following statements about this child's status id correct?
a. The dose of iron that this child ingested should cause no clinical sequelae
b. His single episode of vomiting is probably unrelated to the ingestion
c. Although he has vomited once, ipecac should be administered since child is awake and alert
d. Activated charcoal should be given to absorp excess iron in stomach
e. Cathaartics are ineffective in iron poisonings |
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Definition
| c. Although he has vomited once, ipecac should be administered since child is awake and alert ** |
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Term
8. Which statement about sports injuries is correct?
a. Football is the school sport most likely associated with risk of injury
b. Most injuries occur during competition
c. Most injuries require hospital-based care
d. Re-injury is rarely a problem |
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Definition
| a. Football is the school sport most likely associated with risk of injury ** |
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Term
1. Autoimmunity is thought to play a pathogenetic role in which of the following conditions?
a. Hypophosphatemic rickets
b. Familial hypercholesterolemia
c. Congenital hypothyroidism
d. Insulin-dependent (type I) diabetes mellitus (IDDM) ** |
|
Definition
| d. Insulin-dependent (type I) diabetes mellitus (IDDM) ** |
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Term
1. Autoimmunity is thought to play a pathogenetic role in which of the following conditions?
a. Hypophosphatemic rickets
b. Familial hypercholesterolemia
c. Congenital hypothyroidism
d. Insulin-dependent (type I) diabetes mellitus (IDDM) ** |
|
Definition
| d. Insulin-dependent (type I) diabetes mellitus (IDDM) ** |
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Term
2. Factors most likely to contribute to the devpmnt of diabetic ketoacidosis include all of the following EXCEPT
a. Overeating
b. vomiting
c. omission of insulin doses
d. infection
e. lack of patient education |
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Definition
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Term
3. All of the following may be manifestations of an insulin reaction (hypoglycemia) in an insulin-dependent diabetic patient EXCEPT
a. loss of appetite
b. sweating
c. lethargy
d. bizarre behavior
e. slurred speech |
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Definition
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Term
4. All of the following are goals of newborn screening for congenital hypothyroidism EXCEPT
a. to ensure normal linear growth
b. to ensure normal intellectual function
c. to facilitate genetic counseling
d. to prevent sudden infant death syndrome |
|
Definition
| d. to prevent sudden infant death syndrome ** |
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Term
| 1. The first sign of puberty in males is |
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Definition
| d. increased volume of the testes ** |
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Term
| 2. During mid-adolescence, the central issue for anticipatory guidance is |
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Definition
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|
Term
3. Which of the following STDs is most prevalent in the United States?
a. Gonorrhea
b. Genital herpes
c. Chlamydial infection
d. Syphilis
e. Trichomoniasis |
|
Definition
| c. Chlamydial infection** |
|
|
Term
4. Which of the following organisms is one of the most common causes of PID?
a. Mycoplasma hominis
b. Chlamydia trachomatis
c. Staph aureus
d. Escherichia coli
e. Ureaplasma |
|
Definition
| b. Chlamydia trachomatis** |
|
|
Term
| 5. The most common side effect in adolescent women using oral contraceptives is |
|
Definition
| b. break-through bleeding* |
|
|
Term
| 5. The most common side effect in adolescent women using oral contraceptives is |
|
Definition
| b. break-through bleeding* |
|
|
Term
| 6. A 17-year-old female is evaluated for a menstrual period that has lasted twice as long as usual. Which of the following laboratory studies should be included in the initial evaluation of this patient? |
|
Definition
|
|
Term
| 6. A 17-year-old female is evaluated for a menstrual period that has lasted twice as long as usual. Which of the following laboratory studies should be included in the initial evaluation of this patient? |
|
Definition
|
|
Term
7. All of the following statements about suicide are true EXCEPT
a. it is the third leading cause of death for teenagers
b. death by suicide is more frequently seen in males
c. suicide is most commonly committed by overdose
d. a history of a previous attempt is common
e. attempts are more common in females |
|
Definition
| c. suicide is most commonly committed by overdose** |
|
|
Term
6. All of the following statements concerning caput succedaneum in the newborn are true EXCEPT:
a. It is a diffuse edematous swelling of the soft tissues of the scalp
b. It may extend across suture lines
c. Treatment usually includes incision and drainage
d. Associated ecchymoses may necessitate treatment for hyperbilirubinemia |
|
Definition
|
|
Term
8. Acne therapy addresses all of the following factors EXCEPT
a. Diet
b. local hygiene
c. sebum production
d. inflammatory response
e. bacterial activity |
|
Definition
|
|
Term
9. Oral contraceptives prevent pregnancy by all of the following EXCEPT
a. blocking sperm
b. changing the cervical mucus
c. decreasing implantation
d. suppressing ovulation |
|
Definition
|
|
Term
10. All of the following statements regarding substance abuse in adolescents are true EXCEPT
a. substance abuse may retard psychosocial development
b. cocaine is the most commonly abused substance
c. tobacco use is associated with use by parents |
|
Definition
| b. cocaine is the most commonly abused substance ** |
|
|
Term
11. The diagnosis of genital infections is made from a smear of vaginal, cervical, or urethral discharge or by culture from the appropriate site of infection. For each microscopic finding listed below, select the causative organism with which it is most likely associated.
Budding hyphae—Candida Albicans
Flagellate protozoa—Trichomonas vaginalis
Gram negative diplococci—neisseria gonorrhoeae |
|
Definition
|
|
Term
1. All of the following conditions are characterized by hypochromic, microcytic red cells EXCEPT
a. iron deficiency anemia
b. alpha thalassemia major
c. beta thalassemia minor
d. G6PD deficiency
e. anemia of chronic disease |
|
Definition
|
|
Term
2. Which of the following hemolytic anemias is NOT associated with an intracorpuscular defect?
a. Hereditary spherocytosis
b. Sickle cell anemia
c. Autoimmune hemolytic anemia
d. G6PD deficiency |
|
Definition
| c. Autoimmune hemolytic anemia * |
|
|
Term
3. A 7-year-old patient with known hereditary spherocytosis presents with pallor, low-grade fever, and splenomegaly. Blood counts are as follows: hemoglobin 3 g/dl, reticulocyte count 2%, white blood cell count 8000/mm3, and platelet count 200,000/mm3. The most likely diagnosis is
a. acute splenic sequestration crisis
b. aplastic crisis
c. hemolytic crisis
d. acute leukemia
e. superimposed iron deficiency |
|
Definition
|
|
Term
4. An 8-yo girl presents with fever, numerous bruises over the entire body, & pain in both legs. Physical exam reveals pallor, a soft midsystolic murmur, the spleen at 2 cm below the left costal margin, and ecchymoses and petechiae on the face, trunk, and extremities. Findings on complete blood count include a hemoglobin of 6.3 g/dl, white cell count of 2800/mm3 (10% neutrophils, 1% bands, 2% monocytes, 87% lymphocytes), and platelet count of 29,000/mm3. Which of the following would be the most appropriate initial diagnosis test?
a. Heterophile antibody
b. Bone marrow aspiration
c. Sedimentation rate
d. Skeletal survey
e. Liver and spleen scan |
|
Definition
| b. Bone marrow aspiration * |
|
|
Term
4. An 8-yo girl presents with fever, numerous bruises over the entire body, & pain in both legs. Physical exam reveals pallor, a soft midsystolic murmur, the spleen at 2 cm below the left costal margin, and ecchymoses and petechiae on the face, trunk, and extremities. Findings on complete blood count include a hemoglobin of 6.3 g/dl, white cell count of 2800/mm3 (10% neutrophils, 1% bands, 2% monocytes, 87% lymphocytes), and platelet count of 29,000/mm3. Which of the following would be the most appropriate initial diagnosis test?
a. Heterophile antibody
b. Bone marrow aspiration
c. Sedimentation rate
d. Skeletal survey
e. Liver and spleen scan |
|
Definition
| b. Bone marrow aspiration * |
|
|
Term
5. If the 8-year-old patient were to become febrile to 39.5 degrees C, appropriate responses would include all of the following EXCEPT
a. administer aspirin for the fever
b. obtain a blood culture
c. obtain a chest x-ray
d. obtain a urine culture
e. start intravenous broad-spectrum antibiotics |
|
Definition
| a. administer aspirin for the fever * |
|
|
Term
5. If the 8-year-old patient were to become febrile to 39.5 degrees C, appropriate responses would include all of the following EXCEPT
a. administer aspirin for the fever
b. obtain a blood culture
c. obtain a chest x-ray
d. obtain a urine culture
e. start intravenous broad-spectrum antibiotics |
|
Definition
| a. administer aspirin for the fever * |
|
|
Term
1. An infant has the following physical findings at one minute of age: heart rate 140 beats/minute, cyanotic hands and feet, strong cry and grimace, and good muscle tone. This infant's Apgar score is:
a. 9
b. 8
c. 7
d. 5
e. 4 |
|
Definition
|
|
Term
2. The principal cause of neonatal mortality is:
a. Congenital anomalies
b. Respiratory infection
c. Nonrespiratory infection
d. Respiratory distress syndrome or hyaline membrane disease
e. Asphyxia |
|
Definition
| d. Respiratory distress syndrome or hyaline membrane disease* |
|
|
Term
3. Intrauterine growth retardation (IUGR) has been linked conclusively with all of the following maternal conditions EXCEPT:
a. Chronic alcohol ingestion
b. Phenytoin (Dialantin) use
c. Hypertension
d. Systemic lupus erythematosus
e. Sickle cell anemia |
|
Definition
| d. Systemic lupus erythematosus * |
|
|
Term
4. An infant who receives a score of 60 of a Dubowitz examination (external characteristics plus neurologic characteristics) would have an estimated gestational age of:
a. 32 weeks
b. 36 weeks
c. 40 weeks
d. 44 weeks
e. 48 weeks |
|
Definition
|
|
Term
4. An infant who receives a score of 60 of a Dubowitz examination (external characteristics plus neurologic characteristics) would have an estimated gestational age of:
a. 32 weeks
b. 36 weeks
c. 40 weeks
d. 44 weeks
e. 48 weeks |
|
Definition
|
|
Term
5. The two most common organisms causing neonatal sepsis are:
a. Escherichia coli and group A streptococcus
b. Escherichia coli and group B streptococcus
c. Haemophilus influenzae type B and Streptococcus pneumoniae
d. Haemophilus influenzae type B and Staphylococcus aureus
e. Haemophilus influenzae and Proteus species |
|
Definition
| b. Escherichia coli and group B streptococcus * |
|
|
Term
|
Definition
| c. Treatment usually includes incision and drainage * |
|
|
Term
7. Jaundice is most likely to be physiologic in a term newborn in which one of the following situations?
a. Serum bilirubin level greater than 12 mg/dl
b. Serum bilirubin level rising at less than 5 mg/dl/24 hours
c. Jaundice on the 10th day of life
d. Direct-reacting serum bilirubin greater than 1 mg/dl at any time |
|
Definition
| b. Serum bilirubin level rising at less than 5 mg/dl/24 hours * |
|
|
Term
8. The passage of current jelly stools by a child less than 6 years old who presents with a history of sudden on-set paroxysmal abdominal pain strongly suggests a diagnosis of:
a. Meckel's diverticulum
b. Intussusception
c. Anal fissure
d. Intestinal polyp |
|
Definition
|
|
Term
8. The passage of current jelly stools by a child less than 6 years old who presents with a history of sudden on-set paroxysmal abdominal pain strongly suggests a diagnosis of:
a. Meckel's diverticulum
b. Intussusception
c. Anal fissure
d. Intestinal polyp |
|
Definition
|
|
Term
9. When dealing with an injured child which of the following would cause suspicion of child abuse?
a. Low socioeconomic status of caretakers
b. Contradictory histories from caretakers
c. Both
d. Neither |
|
Definition
b. Contradictory histories from caretakers *
c. Both |
|
|
Term
| 10. Acute epiglottitis is most frequently caused by the organism: |
|
Definition
| c. Haemophilus influenzae, type B * |
|
|
Term
| 10. Acute epiglottitis is most frequently caused by the organism: |
|
Definition
| c. Haemophilus influenzae, type B * |
|
|
Term
| 11. An 8-yo boy with exudative tonsillitis is given oral ampicillin. On the 4th day of therapy, he develops an extensive erythematous maculopapular rash; his sore throat and cervical ademitis persist. The most likely diagnosis is: |
|
Definition
| c. Infectious mononucleosis * |
|
|
Term
| 12. A Denver Development Screening Test is best described as: |
|
Definition
| c. A Screening test to identify children needing further evaluation * |
|
|
Term
13. Each of the following statements about failure to thrive in children is true EXCEPT:
a. Failure to gain weight without evident cause is the most obvious manifestation of failure to thrive
b. Most instances of failure to thrive result from psychosocial circumstances
c. Most children w/ nonorganic failure to thrive never achieve physical development w/in the normal range
d. A controlled environment (hospitalization) is usually sufficient to confirm nonorganic failure to thrive |
|
Definition
| c. Most children w/ nonorganic failure to thrive never achieve physical development w/in the normal range * |
|
|
Term
| 14. An adolescent girl presenting with breast and areolar enlargement but without contour separation and minimally curly public hair corresponds to which Tanner Sex Maturity Rating? |
|
Definition
|
|
Term
| 14. An adolescent girl presenting with breast and areolar enlargement but without contour separation and minimally curly public hair corresponds to which Tanner Sex Maturity Rating? |
|
Definition
|
|
Term
15. Acute depressive reactions in children may be clinically manifested by all of the following EXCEPT:
a. Early morning awakening
b. Decreased physical activity
c. Impaired school performance
d. Separation anxiety |
|
Definition
| a. Early morning awakening * |
|
|
Term
16. The leading cause of death in older adolescents and young adults is which one of the following?
a. Suicide
b. Motor vehicle accidents
c. Drowning
d. Homicide |
|
Definition
| b. Motor vehicle accidents * |
|
|
Term
17. An appropriate parental response to a child's temper tantrum might include all of the following EXCEPT:
a. Provide choices
b. Institute punitive controls
c. Isolate the child
d. Divert the child |
|
Definition
| b. Institute punitive controls * |
|
|
Term
18. Successful treatment of allergic disorders is based on all the following principles of management EXCEPT:
a. Immunotherapy (hyposensitization)
b. Avoidance of allergens
c. Pharmacologic therapy
d. IgE supplementation
e. Prophylaxis (e.g., breast feeding) |
|
Definition
|
|
Term
19. In a child who presents with bilaterally edematous nasal passages which are pale blue in color, a clear mucoid nasal discharge, and a horizontal crease on the dorsum of the nose near the tip, the most likely diagnosis is:
a. Nasal polyposis
b. Allergic rhinitis
c. Foreign body
d. Choana atresia
e. Adenoidal hypertrophy |
|
Definition
|
|
Term
19. In a child who presents with bilaterally edematous nasal passages which are pale blue in color, a clear mucoid nasal discharge, and a horizontal crease on the dorsum of the nose near the tip, the most likely diagnosis is:allergic rhinitis
20. A logical first step toward diagnosing the condition outlined in question might be which of the following?
a. Hansel's stain of nasal secretions
b. Throat culture
c. Sinus x-ray series
d. Sinus transillumination
e. Eustachian tube patency exam |
|
Definition
| a. Hansel's stain of nasal secretions * |
|
|
Term
21. A 3-yo child, a known asthmatic, presents to the emergency room, alert and hydrated, with a respiratory rate of 60 to 70/minute and diffuse, scattered expiratory wheezes upon auscultation. In the absence of other complicating circumstances, the most appropriate initial therapy for this child is:
a. Anhydrous theophylline, 5 mg/kg/dose p.o.
b. Cromolyn sodium inhaler, x2
c. Aqueous Epi, 1:1,000, 0.01 ml/kg s.c.
d. Aqueous epinephrine, 1:1,000, 0.01 ml/kg s.c.
e. Epinephrine (Sus-phine), 1:200, 0.005 ml/kg s.c. |
|
Definition
| c. Aqueous Epi, 1:1,000, 0.01 ml/kg s.c. * |
|
|
Term
22. Polyarthritis, chorea, erythema marginatum, carditis, and subcutaneous nodules are major manifestations of which one of the following?
a. Goodpasture's syndrome
b. Juvenile rheumatoid arthritis (JRA)
c. Rheumatic fever
d. Polyarteritis nodosa
e. Kawasaki disease |
|
Definition
|
|
Term
| 23. A 9-month-old infant presents with brassy cough, mild inspiratory stridor, & restlessness. History includes a 3-day course of upper respiratory infection that becomes significantly worse at night. The child is not drooling & is taking fluids. The most likely diagnosis is: |
|
Definition
| c. Laryngotracheobronchitis * |
|
|
Term
| 24. The etiologic agent that is responsible for 40 to 60% of cases of pneumonia during epidemic periods in school-aged children is: |
|
Definition
| d. Mycoplasma pneumoniae * |
|
|
Term
25. All of the following causes of mental retardation are considered to be static encephalopathies EXCEPT:
a. Lead intoxications
b. Near-drowning episodes
c. Birth trauma
d. Polysaccharidosis |
|
Definition
|
|
Term
| 26. A 10-yo child presents w/ a 3-day history of acute onset fever, vomiting, headache, pharyngitis, & chills. Upon exam, he is noted to have a red, finely papular rash that began in the neck and groin but is now generalized, as well as an exudative tonsillitis. The most likely diagnosis is: |
|
Definition
|
|
Term
| Acute onset of unilateral or bilateral swelling of parotid or salivary gland lasting >2 days without other apparent cause. |
|
Definition
| Mumps Clinical Case Definition |
|
|
Term
Most common cause of vaccine- preventable death in the U.S.
Most common cause of bacterial meningitis among infants and young children
Increasing antibiotic resistance |
|
Definition
|
|
Term
Bacteremia without known site of infection most common clinical presentation
Common cause of acute otitis media |
|
Definition
| Pneumococcal Disease in Children |
|
|
Term
| The most common cause of severe gastroenteritis worldwide |
|
Definition
| rotavirus accounts for 29 to 45 percent of nearly 2 million deaths attributed to diarrheal disease. An estimated 600,000 children die from rotavirus each year |
|
|
Term
Normal respiratory rate in infants
abnormal respiratory ratess? |
|
Definition
Normal RR is 30-60
>60 may be 1st sign of CHD
<30 sign of exhaustion |
|
|
Term
| in infants: Cyanotic CHD: name them |
|
Definition
Tetralogy of Fallot
Truncus arteriosus
Total anomalous pulmonary venous return
Ebstein’s anomaly |
|
|
Term
VSD
RV hypertrophy
Caused by VSD + RV outflow obstruction
RV outflow tract obstruction
Pulmonary stenosis (PS)
Subvalvular, valvular, supravalvular stenosis
Overriding aorta |
|
Definition
| Tetralogy of Fallot (TOF) |
|
|
Term
Type 1 – most common
Single artery from left and right ventricles
Circulation to aorta, pulmonary artery and coronary circulation
Single truncal valve
May be stenotic or regurgitant
VSD |
|
Definition
|
|
Term
Tricuspid valve
Downward displacement of leaflets into RV
Tricuspid regurgitation
ASD or PFO
R-to-L atrial shunt
Markedly enlarged RA
Variable RV hypoplasia
May also have PS, PA, VSD |
|
Definition
|
|
Term
Blood vessel lined with smooth muscle
In utero connects pulmonary artery and aorta
Allows blood to bypass the lungs
Functionally closes within hours to several days after birth
Complete anatomic closure by 2 to 4 weeks |
|
Definition
|
|
Term
Two main types
Normally related great arteries 70% (shown)
Transposition of the Great Arteries 30%
Absent tricuspid valve
No direct communication between RA and RV
Blood shunts R-to-L |
|
Definition
|
|
Term
Juxtaductal narrowing of aorta
Some ductal tissue in area of coarctation |
|
Definition
| Coarctation of Aorta (COA) |
|
|
Term
what chromosomal condition?
40 – 50% incidence CHD
Endocardial cushion defect
Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus
Tetralogy of Fallot |
|
Definition
Trisomy 21
(Down syndrome) |
|
|
Term
what chromosomal condition?
90% incidence CHD
Ventricular septal defect
Patent ductus arteriosus
Atrial septal defect
Pulmonary stenosis
Polyvalvular disease |
|
Definition
Trisomy 18
(Edwards syndrome) |
|
|
Term
what chromosomal condition?
90% incidence CHD
Ventricular septal defect
Patent ductus arteriosus
Atrial septal defect
Pulmonary stenosis
Polyvalvular disease |
|
Definition
Trisomy 18
(Edwards syndrome) |
|
|
Term
what chromosomal condition?
35% incidence CHD
Coarctation of the aorta
Bicuspid aortic valve with variable stenosis |
|
Definition
|
|
Term
what chromosomal condition?
35% incidence CHD
Coarctation of the aorta
Bicuspid aortic valve with variable stenosis |
|
Definition
|
|
Term
| Most common congenital heart defect |
|
Definition
Ventricular Septal Defect
L R shunt causing CHF |
|
|
Term
signs of what heart disease in infants?
Poor feeding
Diaphoresis with feeding
Tachypnea; respiratory distress
Tachycardia
Hepatomegaly |
|
Definition
|
|
Term
| Name an Acquired Heart Disease in children? |
|
Definition
Kawasaki Disease
Fever 5 days
and 4 of 5 additional criteria:
Conjunctivitis
Cervical lymphadenopathy
Rash
Changes in lips or oral mucosa
Extremity edema
6 months – 5 years old
Peak incidence in ~2 y/o
No diagnostic test for KD |
|
|
Term
| APGAR includes what signs? |
|
Definition
| heart rate, respiration, activity, grimace, appearance (color) |
|
|
Term
| Most common chronic disease of childhood |
|
Definition
|
|
Term
| The key elements of assessment and monitoring asthma are? |
|
Definition
| severity, control, and responsiveness to treatment. |
|
|
Term
| a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role, in particular, mast cells, eosinophils, T lymphocytes, neutrophils, and epithelial cells. In susceptible individuals, this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and in the early morning. |
|
Definition
|
|
Term
| Risk factors for Developing Asthma |
|
Definition
Males less than 10 years old
African American race, tobacco smoke exposure (including prenatal exposure)
Low socio-economic class
Viral infections? (RSV) |
|
|
Term
| Appropriate asthma management requires the proper use of long term control and quick relief medications. |
|
Definition
Quick-relief medications
Short-acting beta-agonists
Inhaled anticholinergics
Systemic corticosteroids
Long-term control medications
Daily inhaled corticosteroids
Leukotriene modifiers
Long-acting, inhaled 2-agonists (should not be used alone)
Cromolyn sodium and nedocromil |
|
|
Term
Most potent and effective long-term anti-inflammatory medications currently available
Reduce the need for quick-relief medications |
|
Definition
| Inhaled Steroids In Children |
|
|
Term
| Characteristics of Abuser |
|
Definition
Related / caretaker 90% of the time
Often young and immature
Often prior abuse victims themselves
Often psychologically unstable (chemical addiction, schizophrenia)
From any ethnic, religious, socioeconomic group
Caretaker under stress |
|
|
Term
| child risk factors for abuse? |
|
Definition
Age less than three years
Infants separated from their mothers at birth
Infants born with congenital anomalies and children with chronic illness
Children whose parents were abused as children |
|
|
Term
| Typical Sites for Inflicted Bruises |
|
Definition
Buttocks and lower back (padding)
Genitals and inner thighs
Cheek (slap marks)
Earlobe (pinch marks)
Upper lip and frenulum (forced feeding)
Neck (choke marks)
Upper arms |
|
|
Term
| a disorder in which a parent either induces or fabricates illness in a child in order to achieve prolonged or repeated contact with the health care system. |
|
Definition
| Munchausen Syndrome by Proxy |
|
|
Term
| Psychological Measurement Tool for the assessment of ADHD in children ages 3-17 |
|
Definition
|
|
Term
|
Definition
| Medication + Behavioral therapy |
|
|
Term
| Non stimulant options for ADHD? |
|
Definition
Straterra (incrases Norepinephrine)
Intuniv- (alpha blockade) |
|
|
Term
| Non stimulant options for ADHD? |
|
Definition
Straterra (incrases Norepinephrine)
Intuniv- (alpha blockade) |
|
|
Term
| Urinary Tract Infections Treatment of Febrile UTIs |
|
Definition
Urine culture & sensitivity
Parental broad spectrum if >24 hrs & oral if <24 hrs
UTI treatment begin before culture results are available
Delay in diagnosis can result in renal scarring
Imaging |
|
|
Term
| most common form of post infectious glomerulonephritis |
|
Definition
POSTSTREPTOCOCCAL GLOMERULONEPHRITIS
group A beta hemolytic streptococcal infections; recent strep infection can be demonstrated by elevated antistreptolysis O titer or by elevation of one or more antibody titers |
|
|
Term
clinical presentations are largely asymptomatic
gross hematuria (coffee or tea-colored urine)
slight edema
hypertension
Headache
fever not expected
microscopic hematuria may persist for 1-2 years |
|
Definition
| POSTSTREPTOCOCCAL GLOMERULONEPHRITIS |
|
|
Term
Periorbital swelling, oliguria, malaise, abdominal pain
First episode usually under 5 years old
Proteinuria, hypoproteinemia, edema, hyperlipidemia
Urine sediment normal |
|
Definition
|
|
Term
Normal vaginal discharge at menarche
Discharge color clear/whitish
Discharge consistency changes with hormonal cycle |
|
Definition
| VULVOVAGINITIS Physiologic Leukorrhea |
|
|
Term
Undescended testes – common disorder in 3% of term male newborns, 40% of premature male newborns
Unilateral or bilateral
Largely self-limiting 80% of all cases descend by one year old
Malignant neoplasm incidence higher in cases unresolved by puberty |
|
Definition
|
|
Term
| is a condition that is present at birth (congenital) in which the opening of the tube that carries urine and, in males, semen from the body (the urethra) is located below the normal location. |
|
Definition
|
|
Term
| physical exam- orange-red or gray-white skin, often with ‘greasy’ or white dry scaling macules and papules of varying sizes, on scalp you see marked scaling |
|
Definition
Seborrheic Dermatitis/ Cradle Cap
specifically for cradle cap: removal of crusts with warm olive oil compresses, followed by baby shampoo, 2% ketoconazole shampoo and application of 1-2.5% hydrocortisone cream, 2% ketoconazole cream, or 1% pimecrolimus cream |
|
|
Term
| Vascular Birthmarks Flat Hemangioma |
|
Definition
Salmon patch (Nevus Flammeus): light red macule of neck/upper eyelid/glabella
Port wine stain: dark red/purple macules unilateral face/extremity |
|
|
Term
A common, contagious superficial skin infection caused by strep, staph, or both
Can occur anywhere on body, but mostly on exposed areas
Two classic forms:
Bullous (usually S. aureus)
Nonbullous = crusted (>70% of cases, strep was main organism (GABHS), but now staph more common |
|
Definition
|
|
Term
Can occur on any body surface area
Can be easily misdiagnosed as impetigo or zoster
Can get secondary bacterial infection or lymphangitis
Usually caused by HSV-1 in infants and children
Eczema herpeticum is a disseminated HSV infection occurring in pts with atopic dermatitis
In disseminated cases, need IV acyclovir |
|
Definition
|
|
Term
Can occur on any body surface area
Can be easily misdiagnosed as impetigo or zoster
Can get secondary bacterial infection or lymphangitis
Usually caused by HSV-1 in infants and children
Eczema herpeticum is a disseminated HSV infection occurring in pts with atopic dermatitis
In disseminated cases, need IV acyclovir |
|
Definition
|
|
Term
complex interaction of skin barrier, genetic, environmental, pharmacologic, and immunologic factors
Type I (IgE-mediated) hypersensitivity
Diagnosis:
physical exam- dry skin, pruritis (“the itch that rashes”, poorly defined erythematous patches and plaques with or without scale/ chronic = lichenification
Treatment:
patient education to not scratch, antipruritics, hydration, topical anti-inflammatory agents |
|
Definition
|
|
Term
Caused by pox virus
Often affect head, neck & trunk and may be extensive in children with atopic dermatitis
Genital MC increasing in sexually active young adults
May spontaneously regress |
|
Definition
|
|
Term
HPV types 3, 10, 28, 41
Occur primarily on the face, neck, arms, and legs
Can get several hundred lesions!
Treatment difficult due to number of lesions:
Cryotherapy, topical retinoids, aldara (immunomodulatory) |
|
Definition
| Flat Warts = Verrucae Plana |
|
|
Term
HPV types 1, 2, 4, 7
• Most common site is hands
• Transmission skin–skin, fomites
• Incubation 1 - >6 months
• Very common in children and adolescents |
|
Definition
| Common Warts = Verrucae Vulgaris |
|
|
Term
proximal complete separation of the nail
Results from full, but temporary, arrest of growth of the nail matrix
Described in a variety of stressful events, eg., Hand-Foot-Mouth Disease |
|
Definition
|
|
Term
Superficial connected polycyclic hypopigmented macules and scales on sun exposed areas
Treatment: Selenium Sulfide 2.5% suspension |
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Definition
| Fungal Infections Tinea Versicolor |
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Term
| beefy red, sharply marginated, with satellite lesions |
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Definition
candida albicans:
Treatment: frequent diaper changes with air drying, avoid rubber/plastic pants
Nystatin Cream for persistent cases |
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Term
| Definition of fever in pediatric patients |
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Definition
| Rectal temperature ≥ 38°C or 100.4°F |
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Term
| Definition of fever in pediatric patients |
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Definition
| Rectal temperature ≥ 38°C or 100.4°F |
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Term
|
Definition
Most will be viral in origin
Inflammatory disease
Appendicitis
Kawasaki’s disease
Rheumatologic disease
Non-serious bacterial infection
Otitis media
Streptococcal pharyngitis |
|
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Term
| Strongly consider UTI in children with fever without source > 39°C (102.2°F) |
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Definition
All girls less than 2 years
Uncircumcised boys less than 1 year
Circumcised boys less than 6 months
Lower threshold for prolonged fever or if accompanied by vomiting |
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Term
Indications for CXR
Fever > 38°C
Tachypnea
0-6 months RR ≥ 59
6-12 months RR ≥ 52
12-24 months RR ≥ 42 |
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Definition
|
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Term
| Fever without source - Workup |
|
Definition
Consider UTI
Consider CXR
LP if patient has meningismus or is worrisome
Consider CBC |
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Term
Occult bacteremia in children 3-36 months with temperatures of 39C or higher is 0.025%.
46% of cases in the U.S. occurred in children younger than 2 years of age. |
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Definition
|
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Term
Extremes of numbers whether high or low predict bacteremia and sepsis.
Many studies consider WBC count > 15,000 and band counts > 1,500 with an increased risk of bacteremia. This cutoff fails to identify 14-21% of bacteremic children.
Low WBC counts are worse than high WBC counts as indicators of sepsis. |
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Definition
|
|
Term
| when is chest xray indicated? |
|
Definition
Chest radiograph should be obtained only when pneumonia is suspected or respiratory distress (e.g. tachypnea, grunting, nasal flaring, retractions, or a low pulse oximetry) is present.
However, in a patient with no apparent source of infection a chest x-ray should be obtained. |
|
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Term
| Urine WBC count is considered positive when? |
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Definition
| Urine WBC count > 5 is considered positive |
|
|
Term
| Urine WBC count is considered positive when? |
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Definition
| Urine WBC count > 5 is considered positive |
|
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Term
| STOOL CULTURE AND WBC COUNT |
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Definition
> 5 WBCs in the stool is considered positive
Most diarrheal infections are viral in origin and do not require treatment with antibiotics.
Stool culture and WBCs should be sent if there is any possibility of infectious diarrhea (e.g.. history of blood in the stool, fever, 10 or more stools in a 24 hour period) |
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Term
| The most important test in the evaluation of pediatric fever in infants less than 3 months. |
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Definition
LUMBAR PUNCTURE
Absence of classic signs and symptoms of meningitis does not exclude meningitis in this age group.
LP should be performed in any infant or child that appears toxic or has meningeal signs (e.g. stiff neck, headache, vomiting). |
|
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Term
| DOES A RESPONSE TO ANTIPYRETIC MEDICATION INDICATE A LOWER LIKELIHOOD OF SERIOUS BACTERIAL INFECTION IN THE PEDIATRIC PATIENT WITH A FEVER? |
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Definition
| A response to antipyretic medication does not change the likelihood of a child having a serious bacterial infection and should not be used for clinical decision making |
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Term
Infectious process
Most common organism: Staph Aureus (predilection for metaphyses of bones)
Spread from medullary to cortical bone
More common in boys |
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Definition
| OSTEOMYELITIS - Clinical Features |
|
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Term
| Developmental dysplasia with abnormal relationship between proximal femur and acetabulum |
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Definition
CONGENITAL DYSPLASIA OF THE HIP
Painless limp, lurch to affected side
Waddling gait, widened perineum
+ Ortolani’s/Barlow’s Test in first month |
|
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Term
Non-migratory Mono or Polyarticular Arthropy
Large or PIP joints
Symptomatic > 3 months
Systemic: fever, rashes, nodules, iridocyclitis, leukocytosis, pleuritis, pericarditis, anemia, fatigue, growth failure |
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Definition
| JUVENILE RHEUMATOID ARTHRITIS |
|
|
Term
| extra fingers is known as? |
|
Definition
|
|
Term
|
Definition
| Supernumery digit of the foot |
|
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Term
|
Definition
| club foot: congenital deformity |
|
|
Term
| s a deformity in the knee joint, so that the knee bends backwards. In this deformity, excessive extension occurs in the tibiofemoral joint |
|
Definition
|
|
Term
|
Definition
|
|
Term
| a physical examination for developmental dysplasia of the hip.[1] |
|
Definition
ortolani's manuver
first flexing the hips and knees of a supine infant to 90 degrees, then with the examiner's index fingers placing anterior pressure on the greater trochanters, gently and smoothly abducting the infant's legs using the
Barlow maneuver
adducting the hip (bringing the thigh towards the midline) while applying light pressure on the knee, directing the force posteriorly.[ |
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|
Term
Almost always occurs during sleep or appearance of sleep
Usually healthy prior to death
May have had a cold or recent physical stress
May have been place down for nap, found not breathing or appearing dead
Parents not hearing signs of struggle |
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Definition
| Typical SIDS Infant Scenario |
|
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Term
| NORMAL DEVELOPMENT: 1 to 2 Months |
|
Definition
Moves with smoother, more controlled body motions
Lying on tummy lifts chin for a few seconds
Cannot support head without assistance
Reflexively grasps items placed in hand
Follows briefly moving objects with eyes |
|
|
Term
| Why screen at 9, 18 and 30 months? |
|
Definition
Time availability
Limited other requirements
Key developmental stages
Early Intervention
Medical interventions |
|
|
Term
|
Definition
Crawls rapidly.
Usually walks with assistance; may walk without assistance
Stands alone
Seats self on floor
Usually follows a definite daily pattern
Opens cabinets, pulls tablecloths
Utters a few words (“mama”, “dada”, “ball”, “dog”)
Continues to prefer people to toys |
|
|
Term
| NORMAL DEVELOPMENT: 18 to 24 MONTHS |
|
Definition
Walks proficiently
Enjoys pushing and pulling toys while walking
Runs awkwardly and falls a lot
Walks backwards a short distance
May begin toilet training
Begins to eat with fork
Speaks from 3 to 50 words
Wants to name everything
Uses a few two-word combinations
Responds to simple requests (“Bring me your book”) |
|
|
Term
| Who is Most at Risk of Lead Exposure? |
|
Definition
Children living in older housing
Pregnant women and developing fetus |
|
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Term
| Neurologic Effects of Lead |
|
Definition
Neurologic effects on children documented at levels below 10 mcg/dL
Low exposure effects: lowered IQ, attention deficits, and impaired hearing
High exposure effects: irritability, convulsions, coma, or death |
|
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Term
| Hematologic Effects of Lead |
|
Definition
Interferes with production of hemoglobin
Can induce two kinds of anemia:
Acute exposure → hemolytic
Chronic exposure → synthetic |
|
|
Term
| Endocrine Effects of Lead |
|
Definition
| Chronic exposure may affect thyroid function |
|
|
Term
| Cardiovascular Effects of Lead |
|
Definition
| Increases risk of hypertension |
|
|
Term
| Sleep Disorders:Parasomnias |
|
Definition
1] Nightmare disorder
2] Sleep terror disorder
3] Sleepwalking disorder |
|
|
Term
| Repeated occurrence of frightening dreams that lead to awakening from sleep. |
|
Definition
|
|
Term
| consisting of abrupt awaking from sleep with a panicky cry, intense fear and difficult in being awakened and comforted. |
|
Definition
Sleep terror disorder
[note difference between this disorder and nightmare disorder as to awaken in nightmare disorder, hard to awaken in sleep terror disorder as examiner or exam questions have focused on the difference.] |
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|
Term
| Repeated episodes of complex motor behavior initiated during sleep, including rising from bed and walking. |
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Definition
|
|
Term
| Arousal disorders (parasomnias) – mostly arising out of |
|
Definition
stages 3 and 4 nonREM sleep
Typically occur during first or second cycle of sleep (1-4 hours after falling asleep) |
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|
Term
|
Definition
|
|
Term
Importance of sleep apnea
Apnea associated with higher seizure rate
Almost 1/3 of patients with intractable epilepsy have evidence of sleep apnea
Treatment of apnea decreases seizure frequency |
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Definition
|
|
Term
Acute, benign viral infection
Sudden onset, high fevers (febrile convulsion may be initial sign)
Anorexia
Irritability
Mild pharyngitis
Signs
Occipital/portauricular adenopathy
Rash
Rose-pink, maculopapular, discrete on chest & trunk
Lasting from hours to 2 days
Appearing post-febrile in 3 to 4 days |
|
Definition
|
|
Term
Human parovirus infection
Incubation
6 to 14 days
No prodrome
Complications
Sequelae rare
“Slapped-cheek” rash
Bright red, confluent, maculopapular, circumoral pallor with discrete mac-pap rash extremities
May reoccur following skin irritants |
|
Definition
| ERYTHEMA INFECTIOUSUM Fifth’s Disease |
|
|
Term
|
Definition
Penicillin is the drug-of-choice
Erythromycin if penicillin allergy
Isolation for 24 hours after initiation of antibiotic |
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