Adolescent
Hematology
Infectious Disease
GI
Neonatology
100
At what ages should precocious puberty be considered in boys vs girls?
Girls -> 8 years of age
Boys -> 9 years of age
100
What is often the first pain crisis in patients with SCD <2 years of age?
Dactylitis
(as the pt ages, vasoocclusive crises usually affect the long bones, vertebrae, sternum, ribs, lower back, and abdomen)
100
At what point can a HBsAg+ mother start breastfeeding their newborn?
Immediately after birth
100
What electrolyte derangements are expected in infants with pyloric stenosis?
Hyochloremic hypokalemic metabolic alkalosis
- metabolic alkalosis and hypochloremia result from recurrent loss of gastric contents containing H+ and Cl
- volume depletion causes renal Na retention and K excretion -> results in hypokalemia
- contraction alkalosis contributes to renal Na losses
100
4 day old is found to have several macules with central pustules on an erythematous base on the cheeks, arms, and torso.
What is the likely diagnosis?
Erythema toxicum neonatorum
200
What recreational drug can cause galactorrhea in both boys and girls?
Marijuana
200
At what age should a full term infant start supplementation with iron?
Bonus: what about a preterm infant?
4 months
(bonus: 1 month)
200
What diagnosis should be suspected in a patient with 3-5 day prodrome of fever, malaise, headache followed by a macular and petechial rash that starts on the ankles, palms, soles and spreads centrally?
(bonus: what electrolyte abnormality is commonly seen?)
Rocky mountain spotted fever
(bonus: hyponatremia <130)
200
Patient presents with psychosis and evidence of liver injury. Exam of the eye is shown.
Wilson disease
200
During delivery, brachial plexus injury of C8-T1 can result in what deformity?
(Bonus: what about C5-C6?)
Klumpke palsy
300
Which 2 vaginal infections are associated with an elevated pH >4.5?
Bacterial vaginosis
Trichomonas
300
What is the inheritance pattern of G6PD deficiency?
X-linked recessive
300
Newborn is noted to have microcephaly, bilateral cataracts, multiple areas of scarring along a dermatome, and a shortened hypoplastic leg.
What is the most likely cause?
Congenital varicella syndrome
300
What should be suspected in an otherwise asymptomatic infant with painless gross bloody stools?
(bonus: how is it diagnosed?)
Meckel diverticulum
(bonus: technetium 99 scan - ectopic gastric tissue)
300
What syndrome is characterized by a spectrum of structural defects of the sacral region, lumbar region, spinal dysraphism, cord tethering, and bowel/bladder dysfunction in the newborn?
(bonus: what is the major maternal risk factor)
Caudal regression syndrome
(bonus: maternal diabetes)
400
What 3 electrolytes need to be monitored for refeeding syndrome? Are they increased or decreased?
Bonus: what is the mechanism?
Hypophosphatemia
Hypomagnesemia
Hypokalemia
400
What bugs should be covered with empiric abx for acute chest syndrome in patients with SCD?
(bonus: what abx?)
Pneumococcus
Mycoplasma
Chlamydia
(ceftriaxone, azithromycin)
400
8 year old presents with a dirty wound after stepping on a nail. His most recent tetanus vaccine was in 2019. He is otherwise up to date on vaccinations.
What should he receive, if anything?
Tdap booster
(TIG indicated if unvaccinated or unknown status)
400
The presence of the following skin abnormality should raise concern for what underlying disease?
(bonus: what is this called?)
IBD
(bonus: pyoderma gangranosum)
400
What are the 4 neurotoxicity risk factors to consider in a baby with hyperbilirubinemia?
Gestational age <38 weeks
Albumin <3
Hemolytic disease
Sepsis
500
PCOS is often a clinical diagnosis but what 2 lab tests can help support it?
LH:FSH >2
Elevated testosterone
500
Infant solely drinks goat's milk. The peripheral smear is shown below. What deficiency should be suspected?
Folate deficiency
500
For measles PEP, what is recommended for a child <6 months of age who was exposed 3 days ago or less?
IGIM (or IVIG)
(if exposure >6 days ago then no PEP needed)
500
After cystic fibrosis, what is the 2nd most common cause of exocrine pancreatic insufficiency in children?
Shwachman-Diamond syndrome (SDS)
(growth faltering, recurrent infections, neutropenia and thromobocytopenia, and abnormal development of the growth plates)
500
What is the triad of renal vein thrombosis in the newborn period?
Gross hematuria
Unilateral or bilateral flank mass
Thrombocytopenia