Pulm
ID
Heme/Onc
Cards
GI
100
What is the number one cause of cardiac arrest in pediatric patients?
Respiratory failure!
100
What are the TORCH infections?
Toxoplasmosis
Other (HIV, syphilis, parvovirus B19, varicella, zika virus)
Rubella
CMV
HSV
100
7 yo presents with recurrent bruising, hematuria, hemarthrosis, and prolonged PTT. What is the most likely diagnosis?
Hemophilia A (deficiency of clotting factor 8)
100
14 yo girl with no breast development, short stature, and high FSH. What is the most likely diagnosis and what are the associated cardiac anomalies?
Turner's Syndrome! Coarctation of the aorta and bicuspid aortic valve!
100
4 wk old infant presents to clinic w/ projectile NBNB emesis after feeds and palpable olive shaped mass on abdominal exam. What is the most likely diagnosis and what metabolic derangement would you expect to see?
Pyloric stenosis with hypochloremic hypokalemic metabolic alkalosis!
200
41 wk AGA infant was born after ROM yielded greenish brown fluid with this CXR. What is the most likely diagnosis?
Meconium aspiration syndrome!
200
10 yo presents with thick exudate coming out of b/l ears c/o of ear pain for the past 3 days. Of note, he returned from summer swim camp last week. What is the most likely diagnosis and treatment?
Otitis externa! Tx is topical ciprofloxacin drops!
200
15 yo M presents to his pediatrician with a 3 mo history of fevers and pain just below the femoral head. The pain was initially well controlled with acetaminophen but has progressively gotten worse over the past 4 weeks. Labs are notable for an increased ESR and a mild leukocytosis. Imaging of the femur is consistent with a moth eaten appearance and a “concentric whorling” periosteal bone pattern. Biopsy of the lesion reveals “small blue cells”. What is the diagnosis?
Ewing sarcoma! Note the association with “onion skinning” on imaging!
200
2 yo female presents to the ED with c/o "turning blue around the mouth" and breathing fast while playing. Parents note that patient intermittently squats down while playing. What is the most likely congenital heart lesion and associated murmur?
Tetralogy of Fallot
Murmurs: harsh systolic ejection murmur at the LSB with a single S2
200
7 day old presents with dark urine, pale stool, total bili of 12 and dbili of 8. What is the most concerning diagnosis on your differential?
Biliary atresia!
300
38 week LGA infant born by C/S has dyspnea, grunting, and nasal flaring. CXR notable for perihilar streaking with fluid noted in the interlobar fissures. What is the most likely diagnosis and treatment?
Transient tachypnea of the newborn! Tx with supportive care (O2 as needed if low sats and IVF if cannot feed 2/2 tachypnea)!
300
What are the most common pathogens that cause meningitis in previously healthy pediatric patients?
Strep pneumo, H. flu & N. meningitidis!
300
A 3 yo is brought in with petechiae, abdominal pain, vomiting and lethargy. He had bloody diarrhea 5 days ago after eating hamburgers at a family picnic. Labs reveal thrombocytopenia and elevated creatinine. What is the most likely diagnosis and what is the most common cause?
Hemolytic Uremic Syndrome & E. Coli O157H7
300
2 yo F presents w/ a 2 wk history of daily fevers to 102 and a desquamating rash on the perineum, swollen hands and feet, conjunctivitis and unilateral swollen cervical lymph node. What is the treatment and most serious sequelae?
Aspirin & IVIG! Coronary artery aneurysm!
300
What are the 2 inherited causes of indirect hyperbilirubinemia vs direct hyperbilirubinemia?
Indirect: Gilbert and Crigler-Najjar
Direct: Dubin Johnson and Rotor
400
1 week old noted to have grunting, cyanosis, and difficulty with feeds but pinks up when crying. What is the most likely diagnosis?
Choanal atresia
400
2 yo presents with bilateral swelling above the jaw with 2 days of neck pain, fever, headache, and testicular swelling. He is not UTD on his vaccinations. What is the most likely cause of this presentation?
Mumps! Classic presentation is orchitis/parotitis. Prevent with the MMR vaccine (avoid in pregnant women and kids < 1 yo)
400
What is the most likely cause of anemia in a 2 yo who presents with hyperactivity, impaired growth, abdominal pain and constipation?
Lead poisoning!
400
You go to exam a newborn in the GCN who is clinically well appearing. On exam you note a continuous machine-like murmur in the LUSB. What is the most likely diagnosis and what is the initial treatment?
Patent Ductus Arteriosus (PDA) and NSAIDs (indomethacin/ibuprofen) to close it!
400
What is the difference between gastroschisis and omphalocele and are they associated with any genetic syndromes?
Omphalocele is a midline abdominal defect covered by a sac that is associated with Beckwith Weidemann Syndrome (rare genetic disorder)
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Gastroschisis is a lateral abdominal defect with no sac not typically associated with other disorders.
500
Newborn with respiratory distress, scaphoid abdomen, and this CXR. What is the diagnosis and what is your biggest concern?
Congenital diaphragmatic hernia! C/f pulmonary hypoplasia!
500
A 5 yo is brought to the pediatrician for a routine well child visit. Height, weight, and head circumference have tracked consistently in the 30th percentile. Vitals all WNL. Physical exam is unremarkable although the patient complains of constant itching around his scalp. An examination of the scalp reveals patchy hair loss with no specific distribution. A KOH hair scraping is positive for organisms with long tubular structures. What is the next best step in the management of this patient?
Oral griseofulvin! Tinea capitis requires systemic treatment!
500
14 yo male with PMH of sickle cell disease presents with fever, cough, CP, and SOB. What are you most concerned for?
Acute chest syndrome!
500
15 yo male athlete presents to clinic with complaints of occasional palpations, angina, and dizziness. Last week he fainted during the 1st inning of his baseball game. What diagnosis are you most concerned about and what would you advise the patient to do as far as sports participation goes?
Hypertrophic cardiomyopathy (HOCM)! No sports or heavy exercise :(
500
5 day old ex 33 weeker presents to clinic with c/o vomiting, abdominal distension, and bloody diarrhea. What is the most likely diagnosis and what would you expect to see on XR?
Necrotizing enterocolitis (NEC) and pneumocystis intestinalis!
