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Was that a seizure?
Be my PAL(S)
Fever Schmever
You just ingested what?
GI/FEN Fun
100
Define status epilepticus.
More than 30 minutes of continuous seizure activity or 2 or more sequential seizures without full recovery of consciousness between seizures.
100
You are caring for a 5 year old patient with supraventricular tachycardia. The child is lethargic. The skin is pale and cool with delayed capillary refill. Distal pulses are not palpable. Which of the following would be the best treatment to provide without delay?
Synchronized cardioversion at 0.5 to 1 J/kg
100
It is a leading cause of febrile illness among travelers returning from the Caribbean, South America, and South/Southeast Asia. Classic symptomatic presentation includes severe retroorbital headache, arthralgias, myalgias, rash and minor hemorrhagic symptoms.
Dengue Fever
100
The classic triad of diminished responsiveness, respiratory depression and pinpoint pupils suggests overdose of this drug.
Opiods (morphine, oxycodone, heroin, methadone, codeine)
100
A neonate has bloody diarrhea and a stool sample was positive for C. diff toxin. What do you do?
No treatment is necessary
200
Any of these 3 characteristics would turn a simple febrile seizure to complex.
- Focal - Prolonged (>15 min) - >1 in 24 hours
200
You are caring for a 2 year old unconscious patient who is intubated and receiving mechanical ventilation. The child's heart rate suddenly drops to 40/min and his color becomes mottled. You should respond to these changes by: A) Increasing the ventilator rate, B) Increasing tidal volume, C) Increasing positive end-expiratory pressure (PEEP), D) Using a resuscitation bag provide manual ventilation with 100% oxygen
Using a resuscitation bag provide manual ventilation with 100% oxygen
200
Name two maternal infections in which cessation of breastfeeding is indicated.
Maternal HIV even if on antiretrovirals and untreated, active maternal TB
200
A 15 year old patient intentionally overdoses on her migraine medication amitryptiline, and presents with altered level of conciousness, hypotension and QRS widening on EKG. Name the antidote.
Sodium bicarbonate
200
Name the difference between Nutramigen and Elecare.
Nutramigen is a hydrolyzed formula broken down into simpler proteins whereas Elecare is completely broken down into amino acids.
300
Breathing into a pinwheel fan in the pediatric waiting room, this patient briefly stared off into space for about 7 seconds and did not respond to his mother calling him, then resumed play. Name the disorder and treatment.
- Disorder: absence seizure - Treatment: ethosuxamide or valproic acid
300
You are caring for a patient who developed a tension pneumothorax after several hours of positive-pressure ventilation. Which of the following would be the most appropriate site for needle decompression?
Over the third rib at the midclavicular line
300
Name the top three viruses causing bronchiolitis.
Respiratory Synctial Virus (RSV), Human Metapneumovirus, and Rhinovirus
300
Patient appears intoxicated, has a fruity smelling breath. Labs show non-anion gap acidosis but elevated serum osmolar gap. What did this patient ingest?
Isopropyl alcohol
300
Name the most common cause of failure to thrive.
Inadequate caloric intake
400
Usually these seizures will begin in the first three years of life. EEG shows slow spike and wave activity. Patients often have mental retardation.
Lennox Gastaut Syndrome
400
You are called to treat a 5 year old with a 3 day history of worsening respiratory distress. The child responds only to pain. The heart rate is initially 45/min and regular with poor capillary refill. You provide bag-mask ventilations with high-flow oxygen that produces good chest rise with full and clear bilateral breath sounds. The heart rate rises in response to ventilation, but after you suction the posterior pharynx, bradycardia recurs (40/min). Which of the following interventions would be most appropriate for you to do first? A) Perform transcutaneous pacing, B) Administer epinephrine IV, C) Administer atropine IV, D) Resume bag-mask ventilation
Resume bag-mask ventilation
400
Name 3 out of 5 criteria needed to undergo testing for group A strep pharyngitis.
1) absence of cough, 2) presence of tonsillar exudates or swelling, 3) history of fever, 4) presence of swollen and tender anterior cervical LAD, 5) age younger than 15 years
400
This reversal agent can be used for respiratory depression/ apnea seen in benzodiazepine use/overdose.
Flumazenil
400
Name the most common site for intussusception to occur and 2 common lead points.
- Most common site: ileocecal junction - Lead points: Meckel's Diverticulum, polyps, duplication cyst, lymphoma, reactive lymphoid hyperplasia, bowel wall hematoma (HSP), thick stool (CF), stricture (Crohn's disease)
500
Mother of a 2 year old brings her child in following multiple episodes where patient had loss of conciousness. Mother states these episodes are triggered by physically painful or emotionally upsetting events (such as his older brother taking his toy).
Breath-holding spells
500
You are caring for an 8 year old child who was struck by a car. The child is alert, very anxious, and in respiratory distress. The child is receiving high-flow oxygen by face mask, has a respiratory rate of 60/min, the heart rate is 150/min, systolic blood pressure is 70 mm Hg, and a SpO2 of 86% and falling. Breath sounds and chest rise are absent over the right chest. Which of the following is the most likely cause of this child's distress?
Tension pneumothorax
500
First line antimicrobial therapy in a previously healthy, immunized 3 year old with community acquired pneumonia.
Amoxicillin
500
3 year old patient ingests an unknown amount of his father's diabetes medication. When the family brings the pill bottle, the medication is found to be glipizide. This antidote is used to prevent recurrent hypoglycemia (not glucose).
Octreotide
500
Dermatitis, diarrhea, dementia and death are caused by deficiency of this vitamin.
Niacin