I think I'd Have a Heart Attack
What is the most common heart defect in Trisomy 21?
Complete Atrioventricular Canal Defect
Bonus Points: What is the most common congenital Heart Lesion?
By how much does an RBC transfusion of 10 mL/kg raise the hemoglobin?
2.5 - 3 g/dL
A year old girl is experiencing recurrent episodes of 5-15 second lapses in awareness with amnesia during the episodes. She also has flickering of her eyelids during these episodes. Episodes are abrupt onset and ending and sometimes occur in the middle of conversation.
What is the most likely diagnosis?
Absence Seizures
A 3 year old girl presents with rectal prolapse & nasal polyps. What is the most likely diagnosis
Cystic Fibrosis
A breastfed 2 month old only passes stool once every 5-10 days. What workup should you initiate?
None, Provide Reassurance
A 7 year old boy presents for a camp physical. The following found:
- systolic ejection murmur with a vibratory character
- murmur is best heard in the lower precordium and not in the back
- murmur decreases with standing up
What is the most likely murmur?
Still's Murmur
What is the most common cause of IV catheter-related bacteremia?
Staph epidermidis
A 5 year old suffers a fall and develops bilateral orbital ecchymosis wiith appearance of otorrhea. What is the most likely cause of her injury?
Basilar Skull Fracture
2 week old infant presents with inspiratory stridor. It is worse when the child is upset. What is the most likely diagnosis?
Laryngomalacia
What is the most common anatomical esophageal abnormality?
Esophageal Atresia with Distal Tracheoesophageal Fistula
A 4 month old infant presents with tachycardia and respiratory distress. An ECG is done and shows a narrow complex rhythm with a rate of 240 bpm. What maneuver can be done to slow the ventricular rate and potentially return the child to normal sinus rhythm?
Diving Reflex: Place an ice bag on the infant's face for 10-20 seconds
What is one of the first symptoms in children with sickle cell disease?
Dactylitis
A child presents pulseless and is found to have ventricular tachycardia on ECG. CPR is initiated. What is the next best step in management?
Defibrillation (2 J/kg)
A 3 year girl presents with abrupt onset of fever, sore throat, and stridor. She is given treatment for croup but does not respond. You notice she is also drooling. She deteriorates rapidly and is intubated in the emergency department. She has not yet received her primary series for vaccines.
What is the most likely diagnosis?
Epiglottitis
What is the usual treatment for gastroesophageal reflux in a 5 month old with normal growth parameters?
Reassurance!
A 15 year old presents with
- Chest pain that improves with leaning forward
- Fever
- ST segment elevation in most leads
What is the most likely diagnosis?
Acute Pericarditis
A child with cyanotic heart disease presents with new-onset headache and seizure. MRI shows a brain abscess.
What are the likely organisms?
Staphylococcus aureus
- Grade 4/6 crescendo-decrescendo systolic murmur at the R upper sternal border
- The murmur gets louder with valsalva or standing up
Hypertrophic Cardiomyopathy
Bonus Points: explain why the murmur gets louder with valsalva.
A 17 year old boy has the following:
- Sinusitis
- Bronchiectasis
- Situs Inversus
What is the most likely diagnosis?
Primary Ciliary Dyskinesia (Kartagener Syndrome)
16 year old presents with painful swallowing & chest discomfort. He has a history of nodular acne and takes a multivitamin & oral doxycycline. What is the most likely diagnosis?
Pill-Induced Esophagitis
A newborn presents with cyanosis of the fingers & hands, but not of the toes or feet. What cardiac condition does this indicate?
Transposition of the Great Arteries
a 9 month old presents with:
- Pallor & Irritability
- Growth retardation
- Jaundice & hepatosplenomegaly
- Hgb electrophoresis shows hgb F only
What is the most likely diagnosis?
beta-thalassemia Major (Cooley Anemia)
A high school basketball player passes out and dies while playing a game. Hypertrophic cardiomyopathy is ruled out as a cause. What is the next most likely cause of sudden death in an exercising adolescent?
Anomalous Left Coronary Artery (From the Opposite Cusp or Pulmonary Artery)
An 18 year old young man presents with
- Hx of hemoptysis, Iron deficiency anemia
- New onset renal insufficiency
- Biopsy shows linear deposition of IgG & C3 aon alveolar and glomerular basement membranes
- ANCA is negative
Antiglomerular Basement Membrane Antibody Disease (Goodpasture Syndrome)
Painless rectal bleeding in children less than 2 years of age is most commonly caused by what condition?
Meckel Diverticulum