Endocrinology
Development
Neurology
Cardiology
100
What test can help differentiate between constitutional growth delay and familial short stature?
Bone age
- pt with genetic short stature will have a normal bone age, whereas a patient with constitutional growth delay will have a delayed bone age
100
By what age should infants be able to take their first few independent steps?
15 months
100
Why are treatment with antibiotics contraindicated in treatment of infants with botulism?
Bacterial cell lysis -> release of intracellular toxin
- can potentiate the paralytic effect
100
What cardiac anomaly can be caused lithium exposure in utero?
Bonus: describe it
Ebstein anomaly
(apical displacement of the tricuspid valve leaflets -> results in atrialization of a portion of the right ventricle)
200
Newborn is noted to have a protuberant abdomen, macroglossia, umbilical hernia.
What diagnosis should be suspected?
Congenital hypothyroidism
200
What is the language milestone that should be hit by 2 years?
Should be able to put together 2-3 word phrases
200
What is the difference on exam between Bell's palsy and an UMN lesion in the brain?
Bell's palsy -> forehead is affected
Brain lesion -> forehead is spared
200
What is the immediate treatment required for unstable wide complex tachycardia?
Synchronized cardioversion
(if narrow complex and stable, can try vagal maneuvers)
300
What is the formula for calculating midparental height for boys?
(maternal height + paternal height + 13 cm) / 2
(maternal height + paternal height + 5 inches) /2
300
By what age should infants be able to sit without support, transfer objects from one hand to the other, and use fingers to rake food
9 months
300
What disease typically causes progressive distal weakness, sensory loss, depressed or no tendon reflexes, and high-arched feet (pes cavus)?
Charcot-Marie-Tooth
- aka hereditary motor sensory neuropathy
- typically presents in the 1st or 2nd decade and family hx is common
- muscle atrophy leads to "stork legs"
- upper extremities are eventually involved in the later stages
300
Between what ages should children undergo screening for hyperlipidemia?
9-11 and 17-21
400
What is seen in the levels of phosphorus, calcium, alk phos, and PTH in patients with X-linked hypophosphatemic rickets?
Phos -> very low
Calcium -> normal
Alk phos -> high
PTH -> normal or slightly elevated
In XLH, PHEX mutation → ↑ FGF23 → renal phosphate wasting + impaired vitamin D activation → hypophosphatemia → defective bone mineralization → rickets/osteomalacia.
- PTH is often unaffected
400
By what age should babies be able to make a social smile?
2 months
400
A previously healthy 4-day-old infant develops multifocal seizures lasting <2 minutes over a 24 hour period.
Extensive workup is performed and within normal limits.
What is the likely diagnosis?
Benign neonatal seizures
- peaks at 4-6 days of life (aka "fifth day fits")
- often clonic and may be unifocal or multifocal
- diagnosis of exclusion
- usually lasts 24-48 hours and self-resolves
400
What is the most common cyanotic heart defect that manifests immediately after birth?
Transposition of the great arteries
(cyanosis is usually noted on the 1st day of life and progresses rapidly as the PDA closes)
500
What diagnosis should be suspected in a pt who presents with loss of appetite, weight loss, tachycardia, and increased hyperpigmentation along the creases of the palms, mucosal surfaces of the tongue, palate, and gingival borders?
Addison disease (primary adrenal insufficiency)
- low levels of circulating corticosteroids leads to nausea, vomiting, fatigue
- mineralocorticoid deficiency results in hypotension, weakness, salt craving, dehydration with hyponatremia, hyperkalemia, and metabolic acidosis
- hallmark is hyperpigmentation -> increased melanocortin
500
By what age should infants be able to pull to stand, walk with support, pincer grasp?
12 months
500
What are 3 first-line treatment choices for infantile spasms?
ACTH
Prednisolone
Vigabatrin
- vigabatran is the drug of choice for infantile spasms due to tuberous sclerosis
500
How many major and minor criteria are required to diagnose rheumatic fever?
Bonus: what are the major and minor criteria?
2 major criteria
OR
1 major and 2 minor criteria
major -> carditis, erythema marginatum, subcutaneous nodules, polyarthritis, chorea
minor -> arthralgia, elevated acute phase reactants, prolonged PR interval, fever