1
Q
Who should NOT receive the rotavirus vaccine?
A
- h/o intussusception (inc risk of intussusception)
- severe immune compromised (except for HIV– >still recommended)
2
Q
At what age can a baby transfer a cube and begin to self-feed?
A
6 months
3
Q
At what age can an infant roll over and laugh?
A
3 months
4
Q
At what age does object permanence develop?
A
9 months
5
Q
At what age can a child drink from a cup?
A
1 year
6
Q
At what age can a child use a fork and spoon and walk backward and run?
A
15 months
7
Q
At what age can a child climb stairs and brush their teeth with help?
A
18 months
8
Q
At what age does stranger anxiety develop?
A
6-12 months
9
Q
At what age does separation anxiety develop?
A
12-15 months
10
Q
At what age can a child copy a circle, jump forward, and dress themselves?
A
3 yo
11
Q
At what age can a child hop on one foot and button their clothing?
A
4 yo
12
Q
At what age can a child tie their shoes and cope a square and triangle?
A
5 yo
13
Q
At what age can a child skip and begin developing logical thinking?
A
6 years old.
14
Q
How many calories are present in an ounce of breast milk or formula?
A
20kcal/ounce
15
Q
What are the caloric requirements for an infant
A
100-120kcal/kg/day
16
Q
Baby with swelling of the scalp which crosses the suture lines?
A
Caput seccedaneum
17
Q
Baby with swelling of the scalp which does NOT cross the suture lines?
A
cephalohematoma
18
Q
2-3mm yellow pustules with a red base arising in the first 24-72 hours of life, with pustular contents that reveal eosinophils?
A
Erythema toxic neonatorum
19
Q
White papules caused by the retention of keratin and sebaceous material in pilosebaceous follicles?
A
milia
20
Q
Bluish discoloration over the buttock and base of the spine, usually fades in 1-2 years?
A
Mongolian spots (document well so that it isn’t confused with abuse)
21
Q
Yellow papule around the more and cheeks that begins about 3-4 months and can persist until about 3yo?
A
Infantile acne
22
Q
What is the treatment for thrush?
A
nystatin oral suspension
23
Q
Which tanner stage? Testicular and scrotal growth with skin coarsening
A
Stage 2
24
Q
Which tanner stage? Penile enlargement and further testicular growth
A
Stage 3
25
Which tanner stage? Further growth of the glans and darkening of the scrotal skin
Stage 4
26
What is the karyotype of Klinefelters?
47XXY
27
Most common cause of primary amenorrhea?
Turners 45XO
28
Increased nuchal translucency on fetal US?
Down syndrome
29
Hypertonia, micrognathia, rocker-bottom feet, cardiac defects (PDA, VSD) and GI defects (omphalocele or Meckel)?
Trisomy 18 (Edwards)
30
Cleft lip and palate, rounded nose, polydactyly, cardiac and CNS defects, and severe intellectual disability?
Patau (trisomy 13) syndrome
31
Elfin facial features and cardiac defects?
Williams syndrome
32
High-pitched, cat-like cry?
Cri du chat
33
Obesity and overeating?
Prader-Willi syndrome
34
Girl with happy mood, inappropriate laughter, ataxic gait?
Angelman syndrome
35
Male with large ears, intellectual disability, macroorchidism?
Fragile X
36
If a female child is 80th percentile for height and 25th percentile for head circumference, what chromosomal abnormality should you suspect?
47XXX
37
Which vessel carries oxygenated blood from the placenta to the fetus?
umbilical vein
38
What are the 3 areas of shunting in fetal blood flow?
- ductus venosus (liver)
- Patent foramen ovale
- Ductus arteriosus (between pulmonary A and aorta)
39
Continuous machine-like murmur with wide pulse pressure and bounding pulses in an infant?
PDA
40
Tx of PDA?
Indomethacin (inhibits prostaglandins)
41
Risk for ASD?
Trisomy 21
42
Fixed split S2?
ASD
43
What is Eisenmenger syndrome?
When a long standing left --> right shunt switches to a right --> left shunt 2/2 RV hypertrophy
-Pts become cyanotic
44
Elevated BP in arms and low BP in the legs?
Coarctation of the aorta
45
How should a coarctation of the aorta in a newborn be managed?
PGE to keep the ductus open then surgical correction
46
Notching of the ribs of chest x-ray?
Coarctation of the aorta
47
What are the defects in tetralogy of Fallot?
- RV outflow obstruction**(most important in severity)
- RV hypertrophy
- VSD
- Overriding aorta
48
Neonate with "boot shaped heart" on chest X-ray?
Tetralogy of Fallot (apex is displaced laterally 2/2 RV hypertrophy)
49
How does squatting help tet kids?
-increases after load --> increases left to right shunt to increase oxygenation
50
What is the treatment for an acute cyanotic spell in a ToF kiddo?
- knees to chest
- oxygen
- morphine
- beta blocker (propranolol)
51
What congenital heart defects are individuals with Trisomy 21 at higher risk of having?
- Endocardial cushion defects
- Tetralogy of Fallot
- Transposition of the Great Vessels
52
What is the most common tracheoesophageal fistula?
- Type C
| - Blind upper esophageal pouch with a lower tracheoesophageal fistula
53
Baby with non-bilious projectile vomiting and palpable olive?
Pyloric stenosis
54
Labs seen in pyloric stenosis?
-hypochloremic, hypokalemic metabolic alkalosis
55
Most common cause of bilious vomiting in a newborn?
Duodenal atresia
56
"blast" sign?
in Hirschsprung disease where you do a rectal exam and the poo explodes!
57
If you see intussusception in an adult, what is the likely cause?
cancer
58
"Currant jelly stool" and a sausage abdominal mass?
intussusception
59
Test for mocked diverticulum?
Scintigraphy to look for ectopic gastric mucosa
60
Tx of Crigler-Najjar type 1?
- phototherapy until liver transplant
| - NO UDP glycuronosyltransferase
61
Tx of Crigler-Najjar Type 2?
-Phenobarbital (increases the conjugation and excretion of bilirubin)
62
Conjugated hyperbilirubinemia in a newborn?
Biliary atresia
63
When should corticosteroids be given to mothers in labor?
Preterm labor before 34 weeks--> stimulate maturation of type II pneumocytes.
64
When is a FQ acceptable to give to a child?
Cystic fibrosis (good with pseudomonas)
65
What is the treatment for respiratory distress syndrome of the newborn?
-IM corticosteroids to moms 0.4 then intubate and give exogenous surfactant
66
Chest x-ray with ground glass appearance and air bronchograms in a newborn?
RDS
67
Newborn chest x-ray with fluid streaking in interlobular fissures and a sunburst pattern (prominent vascular markings from the hilum)?
Transient tachypnea of the newborn (normally in C/S babies)
68
What are the risk factors for meconium aspiration syndrome?
- Post-term
| - fetal distress in labor
69
Kiddo with seal-like cough and inspiratory stridor? Cause?
- Croup
| - parainfluenze type 1 and 2
70
"steeple sign" on chest x-ray?
croup
71
Tx of moderate-severe croup?
- keep pt calm
- dexamethasone IM/PO one time
- Nebulized epinephrine
- humidified O2
72
Thumb sign on lateral neck x-ray?
epiglottitis (HiB or s. aureus)
| -ABX: Vanco or Clinda + Ceftriaxone or Cefotaxime
73
Tx of pertussis?
- Azithromycin (5days) or Bactrim (14 days)
| * PPX azithromycin to all close contacts
74
What medications are effective in RSV bronchiolitis?
- NOTHING
- steroids, antibiotics and anti-vitals are not helpful
- Mostly supportive care
75
What medication is given to premature infants to decrease the risk of hospitalization 2/2 RSV?
Palivizumab
76
How do you confirm the diagnosis of pertussis?
nasopharyngeal swab with PCR assay
77
Congenital infection with a "blueberry muffin" rash?
- Rubella
| - Can also be in CMV
78
Prodrome of fever, conjunctivitis, coryza, and cough followed by a rash from the head down?
Measles (Rubeola)
79
What might be effective in the treatment of measles?
Vitamin A! (still being studied by recommended to patients who get measles)
80
How does the rash differ between measles and Rubella (German measles)?
- Both start on the face/head and then generalize.
| - Rubella will not darken or coalesce
81
Sudden, high fever for 3-4 days followed by a rash when the fever dissipates?
Roseola infantum (HHV-6)
82
Coarse rash ("sandpaper-like") that is erythematous and blanching (sunburn-like)?
Scarlet fever
| caused by streptococcus Pyogenes
83
Possible causes of desquamation of the hands and feet?
- Kawasaki
- Scarlet Fever
- Toxic shock syndrome
- Steven Johnson syndrome
- mercury toxicity (acrodynia)
84
Jaundice and hyperbilirubinemia in the first 24 hours of life?
Hemolytic disease of the newborn
85
Pancytopenia, short stature, hypo pigmented spots, abnormal thumbs?
Fanconi anemia
86
How is fanconi anemia diagnosed?
- Increased chromosomal breakage in lymphocytes
| - Also: pancytopenia, alpha-fetoprotein, hypocellularity in bone marrow
87
Most common adrenal medulla tumor in children?
Neuroblastoma
88
Labs with Neuroblastoma?
VMA and homovanillic (HVA) acid elevations
89
Best test in suspected rhabdomyosarcoma?
MRI
90
Kiddo with low hemoglobin and normal WBC count and platelet count. Bone marrow biopsy shows decreased erythroid precursors?
Diamond-Blackfan anemia
91
Overweight teen boy limping, pain on hip moment, limited internal rotation and abduction of the hip? Tx?
- SCFE (slipped capital femoral epiphysis)
| - Surgery
92
Who should be screened for developmental dysplasia of the hip (even with normal PE findings)?
- any baby born breech
| - females with a FMHX of DDH
93
Avascular necrosis of the capital femoral epiphysis?
Legg-Calve-perthes disease
-Tx: non-weight bearing
94
Young child holding arm pronated and partially flexed or extended at the elbow?
Radial head subluxation (Nursemaid's elbow)
95
Tx of radial head subluxation?
supination/flexion or hyperpronation
96
What is the recommended Vit D supplementation for all babies?
400 IU/day
97
What is the most common location for spondylolisthesis?
L5-S1
98
What are the 3 types of juvenile idiopathic arthritis?
- Pauciarticular (few joints, mostly large)
- Polyarticular (many joints)
- systemic onset JIA (AKA "Still's disease)
99
What is the recommended folic acid supplement for a pregnant woman?
0.4mg (400mcg/day)
100
What is the most common type of Arnold-Chiari Malformation? What is the presenting symptom?
- Type I
- Normally asymptomatic
- can present with headache or cerebellar symptoms later in life (18yo)
101
Cherry red spot on retina?
- Tay-Sachs
- Neimann pick
- Retinal artery occlusion
102
What 2 things does an Rb gene mutation predispose someone to?
retinoblastoma and osteosarcoma
103
What imaging do you want to do in a suspected retinoblastoma?
MRI (other forms of imaging have radiation that increases the risk of another gene mutation)
104
Incomplete closure of the dorsal ventral arches, often at the lumbosacral junction?
Spina bifida occulta
105
Neural tube defect with herniation of the meninges?
Meningocele
106
Neural tube defect with herniation of the meninges and spinal cord?
myelomeningocele
107
Heart defect associated with chromosome 22q11 deletion?
Truncus arteriosus and tetralogy of Fallot
108
Heart defect associated with congenital Rubella?
PDA and pulmonary artery stenosis
109
Heart defect associated with Marfan syndrome?
aortic regurgitation
110
At what age can you begin treating nocturnal enuresis? What medication can be used?
- 7yo
| - DDAVP
111
By what age should an undescended testicle be relocated to the scrotum?
6-12 months
112
Kiddo between 2-4yo and a palpable flank mass?
Wilms tumor
113
What is WAGR syndrome?
- Wilms tumor
- Aniridia
- GU abnormalities
- Retardation
114
What are the recommendations for VCUG in pediatric UTI patients?
- any child with >2 febrile UTIs
| - Any child with first UTI and anomalies on the US, temp >39, pathogen other than E.coli, poor growth, or HTN
115
What are the recommendations for renal and bladder US in a child diagnosed with a UTI?
-child
116
What is required for the diagnosis of ADHD?
-6 symptoms (attention deficit of hyperactivity) before the age of 12 present in multiple environments
117
What are some pharmacological treatment options for Tourette syndrome?
- Clonidine (alpha 2 agonist)
| - Neuroleptics (Fluphenazine or pimozide)
