CysticFibrosis
Asthma
potpourri
Organ is um
Nose Knows
100
C.F is caused by defects in which gene?
What is gene for cystic fibrosis transmembrane conductance regulator (CFTR), which encodes for a protein that functions as a chloride channel and is regulated by cyclic adenosine monophosphate (cAMP). Cystic fibrosis is caused by many different mutations of the CF gene; to date, more than 600 unique mutations have been described. However, one mutation, the delta F508 mutation, accounts for 70% of CF genes in the United States
100
Classify the following patient (i.e moderate persistent, mild intermittent, etc) 10 year old with cough > 1 month's duration. Cough is daily with nighttime cough greater than once a week at night.
What is Moderate persistent
100
At what age are the maxillary and ethmoid sinuses present.
What is since the newborn period. Sphenoids by 5 years of age then Frontal by 7 y/o
100
Virus associated with exudative pharyngitis, conjunctivitis, and acute hemorrhagic cystitis.
What is adenovirus
100
The primary cause of epistaxis in children
What is Local trauma (ie, nose picking)
200
A value of more than ??(what number)?? mmol/L of chloride in a sweat test is consistent with a diagnosis of cystic fibrosis
What is value of more than 60 mmol/L of chloride in the sweat is consistent with a diagnosis of cystic fibrosis
200
What is PEF or FEV1 for mild persistent
What is greater than or equal to 80%
200
Difference between rigid and flexible bronchoscopy (1/2 credit) Which do you use to remove Bronchial foreign body (1/2 credit)
Flexible bronchoscope is longer and thinner than a rigid bronchoscope. It contains a fiberoptic system that transmits an image from the tip of the instrument to an eyepiece or video camera at the opposite end. Most flexible bronchoscopes also include a channel for suctioning or instrumentation, but these are significantly smaller than those in a rigid bronchoscope. Flexible bronchoscopy causes less discomfort for the patient than rigid bronchoscopy and the procedure can be performed easily and safely under moderate sedation. It is the technique of choice nowadays for most bronchoscopic procedures. A rigid bronchoscope is a straight, metal tube with an inner diameter of up to one centimetre. It is inserted through the mouth, the patient lying in a supine position and the neck hyperextended. The procedure causes significant discomfort and is performed under general anesthesia. Rigid bronchoscopy is less often used today, but it remains the procedure of choice for removing foreign materials (HERE IS THE ANSWER!!!), as the greater diameter of the rigid bronchoscope allows instruments to be more easily inserted through it. Rigid bronchoscopy also becomes useful when bleeding interferes with viewing the examining area, and allows for more interventions, such as cautery to stop the bleeding. A flexible bronchoscope is inserted with the patient in a sitting or supine position. Once the bronchoscope is inserted into the upper airway, the vocal cords are inspected. The instrument is advanced to the trachea and further down into the bronchial system and each area is inspected as the bronchoscope passes. If an abnormality is discovered, it may be sampled, using a brush, a needle, or forceps. Specimen of lung tissue (transbronchial biopsy) may be sampled using a real-time x-ray (fluoroscopy). Flexible bronchoscopy can also be performed on intubated patients, such as patients in intensive care. In this case, the instrument is inserted through an adapter connected to the tracheal tube. Rigid bronchoscopy is performed under general anesthesia. Rigid bronchoscopes are too large to allow parallel placement of other devices in the trachea; therefore the anesthesia apparatus is connected to the bronchoscope and the patient is ventilated through the bronchoscope.
200
This dimorphic soil fungus native to the San Joaquin Valley of California, southern portions of Arizona, northern portions of Mexico, and scattered areas in Central America and South America is responsible for causing shortness of breath, cough, chest pain, fever, and fatigue. CXR with right sided hilar adenopathy (Also pulmonary nodules).
What is Coccidioidomycosis
200
Term AGA newborn with apgars of 6(1 minute) and 8 (at 5 minuetes) presents with noisy breathing immediately after birth and is dusky. skin is noted to improve in color following crying. What is first step to do
What is try and pass 5F catheter per naris (I.E thinking choanal atresia)
300
How often does meconium ileus present in newborns with CF?
What is approx 10%
300
What is prefered daily treatment for mild intermittent asthma
What is No daily med needed.
300
TRUE or FALSE You must take into account the BCG status when determing if a PPD is positive or negative
What is FALSE!!! Ignore if they had or have not had BCG in past. Use the same measurments for each group when determining if positive or negative PPD.
300
This virus is most commonly known for it's association with Herpangina (Not gingovostomatitis-Herpes Simplex Virus)
What is Coxsackievirus
300
Most common cause of nasal polyps in kids.
What is Cystic Fibrosis
400
True or false C.F men are frequently sterile?
What is True. Males are frequently sterile because of the absence of the vas deferens. Undescended testicles or hydrocele may be present.
400
Preferred treatment for Mild Persistent Asthma
What is Low dose inhaled corticosteroids
400
9 y/o obese male presents with 2 month history of night time symptoms including snoring, restlessness, enuresis, sleep walking, restlessness, profuse diaphoresis, loud gasping respirations, paradoxical chest movements, and retractions. During the day patient with symptoms including noisy breathing, mouth breathing, chronic rhinorrhea, morning headache, behavior disturbances, poor school performance, and excessive daytime sleepiness. Physical findings on routine office examination included adenoid facies and tonsillar hypertrophy.Name the diagnostic test of choice!
What is Polysomnography
400
4 year old with Hx of no immunizations presents with fever, malaise and sore throat. On exam of pharynx it appears patient with pharyngeal erythema and edema, thick, gray, leathery membrane variably covers the tonsils, soft palate, oropharynx, nasopharynx, and uvula. Name that organism (Bacteria)
What is Corynebacterium diphtheria
400
Most common nasopharyngeal cancer in kids
What is rhabdomyosarcoma
500
Is C.F autosomal Dominant, autosomal recessive, X-linked recessive, or Y dominant
What is autosomal recessive
500
What is prefered treatment for Severe Persistent asthma
What is High dose inhaled corticosteroids AND Long acting inhaled beta 2 agonists
500
This is a 4 week old male who has been brought to your office with a one week history of "noisy breathing." His parents note that his noisy breathing is worse when they lay him down or with crying. It is most noticeable when he takes a breath in. There has been no history of fever, coughing, runny nose, change in his cry, apnea, or feeding difficulties. He has been gaining weight appropriately. Prenatal course was uneventful and he was delivered at 38 weeks gestation by spontaneous vaginal delivery without complications. Family History is unremarkable. Suspect?
What is Laryngomalacia
500
TRUE STORY: A 3-year-old Colorado boy fell ill (fever and swollen axillary lymph nodes. His symptoms persisted despite treatment with amoxicillin clavulanate) after a bite from a pet hamster (or could it have been a rabbit?). The Colorado boy's family had bought six hamsters from a Denver pet store in January or February 2004. All the hamsters died of a diarrheal disease within a week after they were bought, but one of them bit the boy on a finger before it died. Seven weeks after the onset of the boy's symptoms, an axillary biopsy and subsequent laboratory tests led to the detection of organism.
What is Tularemia (Treat with streptomycin)
500
which virus has been linked with nasopharyngeal cancer?
What is Epstein Barr virus (EBV).
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