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100
These are two vaccines that are given starting at 6 months and followed by a second dose at least 4 weeks later.
What are the flu and COVID19 vaccines?
100
Developmental screening by a professional is recommended per AAP guidelines at these ages
What is 9, 18, and 30 months?
100
This is the treatment for this newborn who was born with copious amounts of mucous, frontal bossing of the skull, and depression in the bridge of the nose. 
What is, penicillin G?
Confirmatory testing is done with dark field microscopy, FTA-Abs, RPR, VDRL
100
This is the treatment for the cause of knee swelling in this young lad. He is 5 years old and was brought in by his mom after two weeks of noticing swelling, warmth, and erythema of his left knee.
On exam, no pain is elicited on ROM assessment or with weight bearing. A couple months ago he returned to sunny San Diego from his sleep away camp in Maine.
What is a 28-day course of amoxicillin?
This is Lyme arthritis, mainstay treatment for Lyme is UNLESS you are pregnant or are <8 years old, in which case you use amoxicillin.
If arthritis is persistent or non-responsibe to antibiotics you will switch to IV antibiotics.
100
This is the management for this athlete presenting with a couple weeks of left knee pain that has progressively worsened in the past couple of weeks. Pain is worsened while destroying anyone that comes in between him and the ball. There is tenderness below the insertion of the patellar tendon on the tibia.
What is NSAIDs and PT?
This is Osgood-Schlatter, diagnosed clinically, though X-ray can be done if there are atypical findings (erythema or pain unrelated to activity). It is caused by a traction of the apophysitis (inflammation of the growth plate) at the tibial tubercle.
200
The disease process below could have been prevented with this vaccine recommended to newborns within 1 week of birth depending on maternal vaccination status AND timing of the year
What is the RSV vaccine?
Chest radiograph of a 14-month-old girl admitted to hospital with RSV‑positive acute lower respiratory infection. There is hyperinflation of the lungs and presence of bronchial wall cuffing (arrows), without evidence of consolidation or effusion.
200
A child with a language delay will be unable to do this at 9 months.
What is, make different sounds like "mama" and "baba"?
200
This treatment will help this who 14 year old girl presented to your ED with nausea and vomiting. She had her first period two days ago. Since then she has been in excruciating abdominal pain, for which she has been taking 2 tabs of Tylenol every 2-3 hours. Last time she took Tylenol was 4 hours ago. Serum acetaminophen levels are 150 mcg/mL.
What is N-acetylcysteine?
This is the treatment for acetaminophen overdose. First step in management is measuring acetaminophen concentration and plotting that on a Rumack-Matthew nomogram, which predicts the probability of hepatotoxicity and need for NAC therapy
200
This medication will help this 13 year old girl who is presenting to your clinic with 2 weeks of a dry cough associated with pharyngitis, fatigue, and low-grade fever. She is up to date on all vaccines. On exam there is oropharyngeal erythema with no exhudates, and scattered crackles and ronchi in both lungs.
What is azithromycin?
This is community acquired pneumonia, which in school aged children (> 5 years) is most commonly caused by Mycoplasma pneumoniae and Chlamydia pneumoniae.
In contrast, lobar pneumonia is most commonly caused by Strep pneumo which is treated with amoxicillin outpatient or IV ampicillin and ceftriaxone if hospitalized
200
This process results in the following peripheral blood smear
What is, microagiopathic hemolytic anemia?
Seen in HUS, TTP, and DIC
300
This 12 month old will receive these vaccines for the first time at their 12 month visit.
BONUS 100 points: what other vaccines will they be receiving if on schedule?
What are the Hep A, Varicella, MMR vaccines?
HiB, PCV
300
A boy with ASD would be this old when unable to perform what the child in the blue sweatshirt is doing.
What is, 2 years old?
300
This murmur would be heard in this baby born small for gestational age, failed their hearing test, and had scattered purple and blue papules and nodules on the skin.
What is continuous machine-like murmur?
This is congenital rubella. Presents with blueberry muffin rash, due to extramedullary hematopoesis, cataracts, and PDA
Treatment is supportive care
300
What are the management steps (be specific) of a vaccinated patient presenting with the following finding?
What is, secure airway and IV vanc cef?
This is epiglottitis, most commonly caused by Hib, though Hib infections are downtrending because of vaccination. Can also be caused by S. pneumo, S. aureus, or Group A strep, so you want to cover with IV vanc and cef
300
The following finding is seen with this syndrome when associated with a decreased platelet count, hemolytic anemia, and increased D-dimer and fibrin
What is Kasabach-Merritt syndrome?
Life threatening. Thrombocytopenia will be profound. Not for the boards, but first-line therapy is mTOR inhibitors and croticosteroids.
400
This is the MAX amount of vaccines that a healthy child will get during their 6th month visit in the US
What is EIGHT?
Hep B, Dtap, Rotavirus, Hib, IPV, PCV, Covid + Flu
Use acronym Dr. HIP for most of the 2, 4, and 6 months vaccines
400
This developmentally appropriate child should be able to do these things by the time they are 30 months.
400
This medication was used by this mom, whose baby was born small for gestational age, and with a flat nose, low set ears, a club foot, and was later admitted to the NICU for respiratory distress.
What is lisinopril?
This description of physical exam findings is called the Potter sequence and is also associated with other causes of oligohydraminos in utero like infantile polycystic kidney disease, obstructive uropathy, or bialteral renal agenesis.
400
This complication occurs when a child is empirically treated for strep pharyngitis when in reality they had EBV?
What is maculopapular rash?
400
A 5 month old presenting with episodes of sudden contractions of their neck and extremities. This EEG finding and treatment are associatied with this condition
What is hypsarrhythmia and ACTH (or vigabratin)?
This is infantile spasms
500
A 2 year old girl comes to your clinic with complaints of sore throat, malaise, cervical lymphadenopathy, and low-grade fever. On HEENT exam you see the following finding. When scraped, the lesion bleeds
The child has which infection and how could it have been prevented? Be specific.
This is diphteria, caused by Corynebacterium diphtheriae which is prevented by the Dtap vaccine which is given in a 3 dose series at 2, 4, and 6 months followed by 2 boosters at 15-18 months and 4-6 years
500
A child with achondroplasia will have difficulty performing this milestone at 18 months. Can list any of the three.
What is walks w/o holding on to anyone or anything, drinks from cup w/o lid, climbs on and off couch with or without help?
Achondroplasia is an autosomal dominant disorder caused by a mutation in the FGF3 gene which leads to the inhibition of endochondral ossification needed for long bone development. Infants will be hypotonic and present with gross motor delay at first. Patients will have characteristic features including: macrocephaly, tibial bowing, short limbs, depressed nasal bridge, and varus deformity.
500
This is the next step in management for this child, whose venous lead level came back as 20 ug/dL during their routine 3 year old well child check.
What is environmental surveillance & notifying public health department?
Lead posioning is screened at 12 & 24 months per CDC guidelines, or once between 24-72months if never done. If done by capillary test, you should confirm with venous sample, if levels are <25 ug/dL then you do not chelate
500
This bug is the most common cause of sepsis in patients who's hematologic condition puts them at high risk of infection from this, and other, reptiles.
What is, Strep pneumo?
Children with SCD are at high risk of infection from encapsulated organisms, like Salmonella, so they should avoid pet reptiles since these tend to carry Salmonella. PCV, Hib, and MCV vaccines are also modified for these patients due to this risk. Most common cause of death in SCD patients is S. pneumo
500
A baby's mother took this medication which resulted in the following ECG associated with a holosysolic murmur. 
What is lithium?
This is Ebstein's anomaly, seen in babies of mothers with bipolar
