Chance
Which subtype of pica is most commonly associated with iron-deficiency anemia?
Pagophagia, the desire to ingest ice.
Is routine EKG and/or echo screening recommended for all high school and college athletes?
NO.
Screening approach to identify high risk athletes includes a targeted history and CV focused physical (exertional syncope, lightheadedness, chest pain, excessive fatigue, shortness of breath, family hx, premature death or disability (<50yrs), fam hx marfan, long QT, hypertrophic cardiomyopathy
What is the most common cause of neural tube defects?
Folate deficiency
A 16-month-old girl presents to the ER with respiratory distress. She's had 2 days of nasal congestion, low-grade temperatures, and decreased appetite. This morning, her parents noted that she was breathing hard and her breathing was noisy. On exam, inspiratory stridor is present at rest and with activity. She is in moderate respiratory distress. Oxygen saturations are 94% on room air. What pathogen is most likely responsible for her respiratory distress?
A) Haemophilus influenzae
B) Parainfluenza virus
C) Respiratory syncytial virus
D) Streptococcus pneumoniae
Parainfluenza virus.
These are typical findings of croup.
Children with asplenia are especially susceptible to what category of bacteria?
Encapsulated. Examples include: Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis.
Most common maternal antibodies to cause neonatal Lupus?
Antibodies to Ro/SSA (Sjögren syndrome type A antigen) and/or La/SSB (Sjögren syndrome type B antigen).
What is the inheritance pattern associated with hypertrophic cardiomyopathy?
Autosomal dominant.
(First-degree family members of patients with hypertrophic cardiomyopathy should be evaluated for the condition as well).
The most common types of spinal muscular atrophy (SMA) have what type of inheritance pattern?
Autosomal recessive.
SMN1 gene mutation, the most common types of spinal muscular atrophy result from mutations on chromosome 5q.
Betamethasone and dexamethasone can be given to pregnant mothers as antenatal corticosteroid therapy to reduce the risk of *this* in their premature infant.
respiratory distress syndrome
16 yo presents to clinic with vesicular lesions. Exam shows pinpoint vesicular lesions on an erythematous base over his right cheek, crossing his mandible, and extending down the neck. A few of the lesions appear ulcerated. He is anxious to be treated and return to practice with his rugby team. When may the clinician approve his return to play?
Once all lesions have crusted.
"herpes rugbiorum" (rugby) and "herpes gladiatorum" (wrestling), caused by HSV-1
What is the most common primary immunodeficiency?
IgA deficiency.
Most pts are asymptomatic with only small proportion presenting with recurrent sinopulmonary infections GI infections. With complete IgA deficiency, pts can have anaphylactic reactions with blood product transfusions due to the presence of circulating anti-IgA antibodies.
What is the most common cause of sudden death in the young U.S. athlete?
hypertrophic cardiomyopathy (HCM)
other important causes: coronary artery anomalies, commotio cordis (blow to the chest resulting in V-fib), aortic rupture 2/2 dilated aortic root (Marfan), others including long QT, WPW
Elevation of this laboratory value is helpful in making the diagnosis of Duchenne muscular dystrophy
Creatinine kinase.
Other muscle enzymes, such as AST, ALT, and aldolase are also elevated in DMD; the elevation of creatinine kinase, however, is most specific for Duchenne muscular dystrophy.
A 5-year-old girl is sent to the ER from clinic for tachypnea and low oxygen saturation level. She's had 2 days of cough and fever. She is started on supplemental oxygen upon arrival due to a saturation of 88% on room air. On exam, RR is 22, she demonstrates moderate subcostal retractions, and crackles are present over the right lower lobe. What organism is most likely causing her respiratory illness?
A) Fusobacterium species
B) Mycoplasma pneumoniae
C) Respiratory syncytial virus
D) Streptococcus pneumoniae
Streptococcus pneumoniae.
Typical findings of community-acquired pneumonia, including cough, fever, tachypnea, and oxygen desaturations. Focal right-sided crackles on exam indicate a lobar infiltrate rather than a more diffuse infiltrate. In this child’s age group, lobar infiltrates are highly suggestive of Streptococcus pneumoniae, which is also known as pneumococcus.
The most common infectious trigger of erythema multiforme in children
herpes simplex virus (HSV)
What form of gastrointestinal obstruction is associated with erythromycin use in young infants?
Pyloric stenosis
Which valve is most commonly affected in rheumatic valvulitis?
The mitral valve.
Mitral regurgitation is a particularly characteristic manifestation of rheumatic carditis.
During which stage of sleep does benign sleep myoclonus of infancy occur?
Non-rapid eye movement sleep.
Typically presents in the first weeks after birth and resolves without intervention by 3 months. The myoclonic jerks are often symmetric and usually involve both arms, both legs, or all extremities. These symptoms may be confused with seizure activity, but, unlike seizure activity, these jerks spontaneously resolve upon awakening.
Within what timeframe do chest radiographs typically return to normal in patients with parapneumonic effusions?
3-6 months
Bilateral facial nerve palsy is pathognomonic for what infectious disease?
Lyme disease
Most common solid extracranial tumor in children
<1 year: muscular
>1 year: perimembranous septum (btwn aortic and tricuspid valve)
When a child presents with symptoms concerning for hemorrhagic stroke, the most sensitive and specific test for diagnosis is what?
Non-contrast CT scan of the brain
A 6-year-old is referred for pulmonary function testing after she was noted to have increased work of breathing and low oxygen saturation at her school physical. She has been seen prior for nonspecific dry cough. Pulmonary function testing suggests restrictive lung disease. CXR is diffusely hazy and hypoinflated. When childhood interstitial lung disease is suspected, which of the following is the best choice for the next diagnostic step?
A) Biopsy of the lung
B) Bronchoalveolar lavage
C) Chest CT
D) Empiric course of corticosteroids
Chest CT.
Chest CT is the preferred next step in diagnosing childhood interstitial lung disease, a group of rare etiologies that affect the alveolar tissue. Biopsy of the lung bronchoalveolar lavage are reserved as secondary tests if the diagnosis requires further elucidation after the less invasive approaches of imaging and genetic testing are complete. Some occur primarily in infancy (eg surfactant deficiencies), some are comorbidities of systemic diseases such as systemic lupus erythematosus and sarcoidosis, and some are due to exposures to environmental substances or medications.
A 5-year-old is being adopted from China. The child undergoes a complete medical examination and ROS. There has been no recent history of fever, cough, or diarrhea. In addition to screening for hepatitis A, hepatitis B, hepatitis C, tuberculosis, human immunodeficiency virus, and syphilis, which additional infectious evaluation should the child receive?
A) Microscopy of blood smear for Plasmodium falciparum
B) Serologic testing for Chagas disease
C) Stool culture for enteric bacterial infections
D) Stool ova and parasite examination for intestinal parasites
Stool ova and parasite examination for intestinal parasites.
Routine screening of internationally adopted children is indicated due to the high prevalence of intestinal parasites even in asymptomatic children. 3 stool samples obtained 48-72 hrs apart increases sensitivity. Highest numbers of parasitic intestinal infections are in children from Russia, Africa, and China. Most common intestinal parasite detected is Giardia intestinalis.