AFI's 100 years 100 movie quotes
"I see dead people."
The 6th Sense
At what age does the preferred method of imaging for DDH change from ultrasound to plain radiograph?
6 months
A 9 y/o girl with hx of atopic dermatitis now presents with areas of hypopigmentation with a fine scale mostly on cheeks and extensor extremities. What is the most likely diagnosis?
Pityriasis alba
In a child, what is severe calorie malnutrition without edema called?
Marasmus
A 2 wk/o infant with history of intrauterine CMV presents with lethargy, vomiting, marked increase in head circumference, dilated scalp veins. What is the likely diagnosis?
Hydrocephalus
"There's no crying in baseball!"
A League of Their Own
A 12 y/o boy is a pitcher for a junior league baseball team. For 2 weeks, he c/o right elbow pain, especially after pitching. PE reveals painful palpation of right medial epicondyle, worsened with resisted wrist flexion and valgus testing of the right elbow. XRs are negative.
What is the injury AND what is the recommended treatment?
Medial Elbow Apophysitis--NSAIDs, PT, 4-6 weeks of rest
10 y/o presents with well defined, erythematous skin lesions with distinctive, mica-like (silvery) scales that are symmetrical on the nknees, elbows, sacral area, and scalp. She has ice pick-like pitting of her nails, thickened nails, and onycholysis. What is the most likely diagnosis?
Psoriasis
A 1 year old presents with irritability, anorexia, follicular hyperkeratosis, "corkscrew-coiled" hairs, gingival bleeding, normochromic, normocytic anemia. What is the most likely diagnosis?
Vitamin C Deficiency (Scurvy)
A 16 y/o M presents with unilateral retroorbital pain that feels "like an ice pick," ipsilateral lacrimation, eye redness, and nasal congestion, headache that has occurred at the same time of the day for the last 3 days. What is the best acute treatment for this boy?
Oxygen
"Keep your friends close, but your enemies closer."
Godfather Part 2
What Cobb angle (thoracic curve) suggests a need for surgical intervention?
50 degrees
What skin condition consists of red, tender, warm nodules that appear on the shins and is associated with infection, drugs, and IBD?
Erythema nodosum
Cystic Fibrosis
As a single risk factor, what is the most common cause of strokes in children?
Sickle Cell Disease
"I love the smell of napalm in the morning."
Apocalypse Now
Which of the following clinical presentation scenarios would you accept as normal?
A: genu valgum in a 3 y/o
B: persistence of genu valgum in a 9 y/o
C: Genu valgum in a 15 mo/o
D: asymmetric genu varum
E: asymmetric genu varum in a 3 y/o
A: genu valgum in a 3 y/o
During the past 2 months, an 18 y/o M ahas experienced recurrent episodes of redness overlying his nose and cheeks. He reports that the affected areas often burn and sting; physical exercise and sudden temperature changes worsen his symptoms. On physical examination, prominent erythema, multiple inflammatory papules, and telangiectasisa are present on the nose, chin, and medial cheeks. The underlying skin is rough and slightly scaling. Which of the following is most likely to be effective as a component of treatment in this patient?
A: topical mid-potency corticosteroid cream
B: topical metronidazole
C: oral augmentin
D: topical clindamycin
E: Topical low-potency corticosteroid/ketoconaole cream
B: topical metronidazole
A 4 y/o boy is noted to have deeply pigmented, bluish-brown to black spots on the lips, buccal mucosa, and around the mouth. His mother reports that the spots appeared soon after birth. Which of the following is most often associated with this clinical finding?
A: recurrent episodes of colicky abdominal pain
B: recurrent episodes of arthralgia and malaise
C: recurrent episodes of hypoglycemia
D: recurrent episodes of muscle weakness and easy fatigue
E: recurrent episodes of scleral icterus
A: recurrent episodes of colicky abdominal pain
The parents of a 9 y/o boy bring their son to the ED because "something is wrong with his face." There is no history of trauma or associated systemic symptoms. On physical exam, he is unable to wrinkle his forehead on the left and has also lost the ability to close his left eye and raise the left corner of his mouth. Decreased nasolabial fold prominence on the left is also noted. Which of the following is the cause of the patient's findings?
A: lower motor neuron dysfunction of left CN7
B: lower motor neuron dysfunction of left CN5
C: upper motor neuron dysfunction of right CN5
D:lower motor neuro dysfunction of left CN5 and 7
E: upper motor neuron dysfunction of right CN7
A: lower motor neuron dysfunction of left CN7
"I'll have what she's having."
When Harry Met Sally
A 19 y/o college athlete c/o fatigue is noted to have elevated BP and peripheral edema. Lab findings include fasting glucose of 220 and A1c of 8.2%. Which of the following performance enhancing drugs is most likely to have caused this patient's clinical signs and symptoms
A: recombinant human growth hormone
B: erythropoietin
C: Androstenedione
D: testosterone
E: human chorionic gonadotropin
A: recombinant human growth hormone
Which of the following is the most appropriate step in confirming the suspected cause of this patient's clinical findings?
A: Tzanck smear
B: Aspiration and culture of fluid within an intact bullous lesion
C: skin biopsy
D: wright or Giemsa Stain of fluid within an intact bullous lesion
E: Surface culture from the skin underlying an area of desquamation
C: skin biopsy
Which of the following is the approximate potential energy available from dietary fat?
A: 3 kcal/kg
B: 9 kcal/kg
C: 5 kcal/kg
D: 4 kcal/kg
E: 2 kcal/kg
B: 9 kcal/kg
A 4 y/o M with trisomy 21 presents to the ED following his third seizure in the past 4 months. He appears postictal, and his neuro exam is concerning for lack of withdrawal of the left UE upon painful stimulation. After 48 hours he is back to baseline except he cannot move his LUE. No history of trauma, and plain films of the extremity are normal. Cranial CT shows a hypodensity in the right cerebral hemisphere. Additional imaging in this patient is most likely to reveal which of the following disease processes?
A: atlantoaxial subluxation
B: right epidural hematoma
C: intracranial aneurysm
D: Moyamoya disease
E: intracranial abscess
D: Moyamoya disease