Show:
Cardiovascular
Rashes/Skin Lesions
Respiratory
Hematology
Endocrine
100
What is the most common congenital heart defect?
ASD
100
What Bacteria caused the following?
Staph Aureus, Group A Beta Hemolytic Strep
100
A 4 mo old child with a pertinent PMH of being born at 32 weeks and a 3 week hospital stay without complications presents with a 3 day history of low grade fevers and mother reports child seems to be breathing faster. On exam you note the patient looks ill with increased WOB (nasal flaring, subcostal retractions), tachypnea 60 breaths/min. What is the most likely cause of illness?
RSV Extra 100 points Treatment?
100
An immigrant family presents with their 8 month old child who seems less active then a normal 8 month old. His heart rate is also elevated and on exam a holosystolic flow murmur is audible. His Hgb/Hct is 7.5/22.3 and MCV is 62. What is the diagnosis?
Iron Deficiency Anemia 200 Extra points What is the cause?
100
5 year old M is brought into the ED because he is increasingly confused in the last several hours. Parents report several pounds of weight loss in the last month, fatigue, increased thirst, increased urination. The patient had nocturnal enuresis last night. In the ED, patient has HR = 180 bpm, BP 80/50, T = 36.1, and slow, deep respirations. Physical exam revealed altered mental status, skin tenting, and capillary refill of 5 seconds. What is the specific diagnosis?
Diabetic ketoacidosis
200
A 2 yo male is noted to have spells of weakness in which he turns blue and squats. He is taken to the hospital where an echo is performed that confirms the diagnosis of Tetrology of Fallot. Why does the patient squat during his tet spells?
Increase systemic vascular resistance and thus increase flow through pulmonary artery by decreasing flow across the VSD
200
What is the infectious cause of the following rash?
Parvovirus
200
A previously healthy 2 yo male was playing with his older brother when his mother noticed that he all of a sudden became ill appearing and short of breath. On exam he has increased WOB, is cyanotic, tachycardic and tachypneic. What would you expect to see on Chest XRay?
Collapsed Lower Right Lobe- possibly object of aspiration if metal.
200
What disease do rhesus positive embryos suffer from when mothers are rhesus negative and are sensitized?
Erythroblastosis fetalis Extra 200 points What common complication do neonates suffer from due to ABO incompatibility during the perinatal period?
200
5 yo F presents for well child check up and you notice that she has developed breast and pubic hair. Physical exam revealed height and weight >95th centile, Tanner stage II breast and pubic hair development, and facial acne. Mom denies any use of birth control pills or estrogen creams. What is her dx: a. Precocious puberty b. Premature adrenarche c. Premature thelarche d. Precocious pseudopuberty
Precocious puberty
300
5 yo asian male presents with a fever for the past week and painful red eyes. On physical exam he has erythematous hands and feet, a strawberry tongue, anterior cervical lymphadenopathy and truncal rash. What is the most concerning cardiac sequelae for this patient?
Coronary Aneurysms 50 points Treatment? Normally this treatment is avoided because of what?
300
Diagnose the following rash.
Erythema Toxicum
300
A previously healthy 2 yo female presents to the ED with a 2 day history of mild fever and rhinorrhea. Mother also notes that she has not quite been herself and has a high pitched cough. On exam you note an ill appearing child with increased WOB, barking cough and tachypnea. What is the most likely diagnosis?
Croup Extra 100 points If this patient instead of cough had significant inspiratory stridor, tripoding and drooling what would you be concerned about? Treatment?
300
5 yo female with Hgb SS presents with cough, rhinorrhea, shortness of breath and fever of 38.7 measured orally for the past two days. On exam she is febrile and crackles are palpable. Diagnosis?
Acute Chest Syndrome Extra 100 points What are the 3 causes of ACS?
300
In a patient who was recently diagnosed with congenital adrenal hyperplasia, one would expect the ___sodium, ___chloride, ___potassium, and ____blood sugar levels. (normal, high, low).
Low, low, high, low
400
A 5 day old white male presents to the emergency room with poor feeding. On exam he is tachypneic and is cyanotic. What treatment could help reverse his cyanosis?
Prostaglandin/Misoprostol/Alprostadil
400
What is the diagnosis for the following lesion:
Tuberous Sclerosis Extra 200 points: What imaging exam is an important part of screening for these patients?
400
An previously healthy 8 yo male presents with a 6 day history of sore throat. She reports also having a headache, abdominal pain, cough and vomiting. On exam she has a temperature of 38.9, HEENT shows tonsillar erythema and enlargement. Resp exam shows a mild wheezing. Which of the above signs/symptoms makes a diagnosis of streptococcal pharyngitis unlikely?
Cough CENtor Criteria Extra 100 Points 1. What is the most concerning complication of pharyngitis that leads to increased throat pain, dysphagia and hyperextension of the neck? Diagnostics?
400
A 4 yo female with Hgb SS presents with significant malaise and exhaustion. On physical exam she seems tired but not lethargic, her face has an erythematous rash of bilateral cheeks. In addition to a CBC what is the most important laboratory value?
a. Reticulocyte Count 50 extra points Diagnosis? Treatment?
400
A 14 year old girl presents with primary amenorrhea, short stature, and webbed neck. The most common renal anomaly associated with her disease is_____.
Horseshoe Kidney
500
Name the common cardiac anomalies associated with the following diseases: Turner's syndrome, Down's Syndrome, DiGeorge's Syndrome, Mother with Bipolar Disease?
Coarctation of the Aorta, Endocardial cushion defect, TOF- (CATCH 22), Ebstein's Anomaly
500
What is the appropriate treatment for the following?
No treatment- Epstein Pearl resolves within 2-3 weeks
500
An 4 yo male presents to the ED after a few days of significant fatigue followed by 24 hours worth of vomiting and abdominal pain. His mother reports that he has had a 14 pound weight loss over the past 2 months and has a return of nocturia that had previously relieved. What is the name of the compensatory respiratory mechanism this patient is most likely using?
Kussmaul Breathing
500
A 17 yo male returns from a hiking trip in the northwest where he became one with nature and drank and fished from a local lake. During his trip he began to notice himself feeling dizzy. When he arrives he is short of breath and lethargic. On exam he has tachycardia to 140s and is cyanotic. Diagnosis?
Methemoglobinemia Extra 100 points Shift on the Hgb O2 disassociation curve? Treatment?
500
A 10 year old female presents with severe abdominal pain and gross hematuria. She also complains of muscle weakness, decreased appetite, nausea, vomiting, and constipation. She passes a calculus in her urine. She most likely has
Primary hyperparathyroidism