Skin Quest
What's in the joints?
Blood Quad
Guess my age
Magical Potions
100
What WBCs are found in pustules of erythema toxicum neonatorum?
Eosinophils.
Erythema toxicum neonatorum typically occurs in 1st few days of life (rarely present at birth) and tends to resolve within 1st week of life.
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Transient neonatal pustular melanosis (TNPM) : almost always present at birth; lesions may rupture within 2 days leaving behind a hyperpigmented macule. Wright stain preparation from pustules reveals predominance of neutrophils with occasional eosinophils.
100
What type of antibody is seen in mixed connective tissue disease?
anti-U1-RNP antibody
Can diagnose MCTD in patients with anti-U1 RNP antibodies AND at least 3 of the following:
Digital swelling
Raynaud phenomenon
Synovitis
Myositis
Acrosclerosis
100
A child with orbital chloroma, hepatosplenomegaly, anemia and thrombocytopenia most likely has ___
Acute myeloid leukemia
Chloroma (aka myeloid sarcoma) is an extramedullary solid tumor made up of myeloblasts
100
At what age can a majority of children roll from front to back?
6 months
100
What is the dose of IVIG used to treat Kawasaki disease?
2 g/kg infused over 10-12 hours to minimize risk of anaphylaxis, hemolytic anemia, aseptic meningitis, pulmonary edema
200
Small, clustered freckle like cafe au lait spots in the axilla is known as ___ and associated with ____
Crowe sign is a diagnostic criterion for Neurofibromatosis type 1
200
A 10-year-old female presents to clinic with 2 week history of salmonella diarrhea and has the following signs/symptoms:
oral ulcers, conjunctivitis, WBC in urine test and arthritis of left knee
What is her diagnosis?
Reactive arthritis typically presents 1-4 weeks after GI infection with Yersinia, Shigella, Campylobacter or Salmonella. Classic triad is urethritis, conjunctivitis and arthritis known by the mnemonic "cannot see, cannot pee, cannot climb a tree"
200
What histologic features are required for the diagnosis of Langerhans cell histiocytosis?
Intra/extracellular staining with CD207 (Langerin) or extracellular staining with CD1a by immunohistochemistry is required for confirmation.
On microscopy, generally the cells are oval or round with a nuclear groove resembling a coffee bean. On electron microscopy, one can see rod-shaped inclusions in the cytoplasm known as Birbeck granules.
200
At what age do most children lose their Moro reflex?
3-6 months of age. Persistent reflex should raise suspicion for gross motor delay or possible spastic cerebral palsy
200
In NRP, what is the dose of epinephrine given through ETT?
0.1 mg/kg (1 mL/kg) = via ETT
0.02 mg/kg (0.2 mL/kg) = via IV/IO
300
Acrodermatitis enteropathica is due to deficiency of which mineral?
Acrodermatitis enteropathica is a autosomal recessive disease with defect in intestinal zinc absorption. Affected individuals develop diarrhea, alopecia, failure to thrive, ophthalmic disorders (retinal degeneration, corneal scarring, etc)
300
What antibody is associated with recurrent miscarriages in females with SLE?
antiphospholipid antibodies
300
What is the most common benign tumor of the liver in childhood?
Hemangioma. Benign tumor that eventually regress. A skin biopsy can be performed if there is any doubt. Infantile hemangiomas stain positive for GLUT 1. Complications based on hemangioma's size and location. Ulceration is most common complication and occurs in up to 10% of cases and highest risk when in anogenital area, lower lip, axilla, and neck. Can lead to ophthalmic complications such as amblyopia, astigmatism, myopia; airway obstruction; difficulty feeding
300
How old is an infant who can turn his/her head toward sound of your voice and pushes up onto elbows/forearms when on tummy, but cannot make squealing noises?
4 months. A majority of 4-month old infants can make sounds like "ooo" or "aahhh" but cannot yet make squealing noises until 6 months of age
300
What is the sequence of premedication used for intubation in neonates?
1. Atropine (0.02 mg/kg IV)
2. Fentanyl (2 mcg/kg IV)
3. Rocuronium (1mg/kg)
400
What rash is typically seen under the breasts of an adolescent obese female, caused by corynobacterium minutissimum (gram positive, non-spore forming bacillus) and has fluorescent bright red when seen under Wood's lamp?
Erythrasma
Commonly seen in toe webs, followed by groin and axilla
400
A 18-year-old female presents with recurrent buccal aphthous ulcers, recurrent genital ulcers, erythema nodosum, anterior uveitis and papilledema. She most likely has which disease?
Bechet disease presents with classic triad of painful recurrent oral and genital lesions and inflammatory eye disorder. Associated with positive pathergy test.
Formation of pustules or papules approximately 48 hours after pricking skin with a needle
400
What is the philadelphia chromosome translocation?
t(9;22) associated with chronic myeloid leukemia. Results from the juxtaposition of BCR gene on chromosome 22 with ABL gene on chromosome 9 causing a fusion gene that encodes for BCR-ABL protein tyrosine kinase that leads to oncogenesis.
400
At what age does stranger anxiety typically present in majority of children?
By 9 months. Though it can present as early as 6 months in some infants and persist until 1 year of age
400
A child present within 4 hours of accidental ingestion of acetaminophen and is found to be within the toxic level on Rumack-Matthew nomogram. What is the management for this patient?
N-acetylcysteine. Acetylcysteine (also known as N-acetylcysteine) prevents hepatic injury primarily by restoring hepatic glutathione
500
Infant with port-wine stains on lower extremities are at increased risk of which rare syndrome?
klippel trenaunay syndrome - consists of triad of capillary malformation, venous malformations and soft tissue/limb overgrowth.
500
A 3-year-old Greek female presents with an 3 day history of fever that occurs every month with severe abdominal pain and has elevated WBC count and ESR during disease episodes. What is her likely diagnosis?
Familial Mediterranean fever is a autosomal recessive disease among people of Mediterranean, Jewish, and Middle Eastern descent. Fever occurs in predictable cycle and can last anywhere from several hours to 5 days. Usually has abnormal acute phase reactants and WBC count during disease episode that returns to normal during interval periods
500
What is the most common side effect of vincristine?
Neuropathy
Can also cause myelosuppression, abdominal cramping, diarrhea, SIADH, fever, bladder dysfunction (atony)
500
At what age can most children stack at least 2 blocks together, take several steps on their own, try to say 1 or 2 words other than mama or dada, and clap when excited?
15 months
500
How do you calculate maintenance fluid therapy in a child?
