CMS III combined quizlets DOES NOT include EM bc i did not make EM

A neonate is born at 37 weeks and 5 days. What is this considered?

a. preterm

b. early term

c. full term

d. late term

b. early term

What hormone crosses the placenta and is important in maintaining uterine growth?

a. progesterone

b. estriol

c. thyroxine

d. diethylstilbestrol

b. estriol

all these things cross placental barrier

Which of these is not a complication of an infant born to a diabetic mother?

a. sudden fetal death

b. hyperinsulinemia

c. hyperglycemia

d. RDS

c. hyperglycemia

babies have hypoglycemia from hyperinsulinemia (macrosomia)

Immediately following delivery a neonate is acrocyanotic, has a pulse of 90 BPM, a weak cry, slightly grimaces when stimulated, and is actively moving. At 1 minute they are acrocyanotic, 110 bpm, slightly grimaces when stimulated, actively moving with a strong cry. What are the APGAR scores?

a. 6, 8

b. 5, 8

c. 4, 9

d. 6, 9

a. 6, 8

A 39 week infant is delivered by c-section. Within hours of delivery baby is tachypneic, grunting, and has increased work of breathing. CXR shows perihilar streaking. What is the likely diagnosis?

a. hyaline membrane disease

b. transient tachypnea of newborn

c. meconium aspiration

d. persistent pulmonary HTN

b. transient tachypnea of newborn

A neonate is born at 40 + 2 weeks. Within first few minutes of post delivery they show signs of respiratory distress and are cyanotic. They do not latch, there are decreased breath sounds and bowel sounds in the thorax. What is the likely diagnosis?

a. gastroschisis

b. omphalocele

c. necrotizing enterocolitis

d. congenital diaphragmatic hernia

d. congenital diaphragmatic hernia

A 36 week pregnant woman goes into labor before receiving a GBS swab at her OB office. She was GBS positive in her last pregnancy. Due to complications she has an emergency a c/s. What is the proper management of GBS?

a. swab & prophylactically tx with PCN

b. swab mom before c/s, monitor baby post delivery

c. dont swab mom, empiric abx in baby

d. no need for prophylaxis tx

d. no need for prophylaxis tx

emergency c/s or any c/s GBS DOES NOT MATTER

What is a complication of untreated elevated bilirubin?

a. G6PD def

b. kernicterus

c. sepsis

d. hemolytic anemia

b. kernicterus

kernicterus = lethargy, vomiting, irritability, poor feeding, high pitch crying. >18mg. damages basal ganglia (hypertonia early, hypotonia late, deafness, motor deficits)

G6PD, sepsis, hemolytic anemia are things that can cause elevated bilirubin

Which of the following increases risk for SIDS?

a. avoiding co sleeping

b. breastfeeding

c. low birth weight

d. sleeping supine

c. low birth weight

A neonate has visible swelling & ecchymosis of the scalp after birth. The fluid crosses the suture line and is superficial. What is the likely dx?

a. caput seccedaneum

b. cephalohematoma

c. epidural hematoma

d. subgaleal hematoma

a. caput seccedaneum

cephalohematoma does not cross suture line, occurs under periosteum, blood

subgaleal hemorrhage occurs b/w scalp and skull, crosses suture line, blood

Which teeth erupt first in an infant?

a. mandibular incisors

b. molars

c. lateral incisors

d. canines

a. mandibular incisors

An infant has adduction and internal rotation of the shoulder with elbow extension and pronation of their forearm. Their wrist is flexed and they have an intact grasp reflex. What nerve root is affected?

a. c4-c6

b. c5-c7

c. c6-c8

d. c8-t1

b. c5-c7

ERB'S PALSY upper brachial, "waiters tip"

Klumpke's is lower brachial c8-t1, claw hand

What autosomal abnormality is characterized by low birth weight, microcephaly, rocker bottom feet, prominent occiput, clenched hands and tracheal esophageal fistula?

a. trisomy 21

b. trisomy 18

c. trisomy 13

d. trisomy 11

b. trisomy 18

edwards

Which sex chromosome abnormality is characterized by infertility, cryptorchidism, small penis/testes, long extremities, and gynecomastia?

a. Turner's syndrome XO

b. XXX

c. Klinefelters XXY

d. XYY

c. Klinefelters XXY

What condition do you see a horseshoe kidney?

a. Turner's syndrome XO

b. Fragile X

c. Patau syndrome

d. Alport syndrome

a. Turner's syndrome XO

Alports disorder of basement membrane of kidney

What condition is characterized by having an intellectual disability, socialization issues, long protruding ears, flattened nasal bridge, prominent jaw, and macro-orchidism?

a. Prader Willi

b. Fragile X

c. Angelman

d. Beckwith Wiedermann

b. Fragile X

Which condition causes osteopenia and therefore bones fracture easily, discoloration of the sclera, spinal curvature, and hearing loss?

a. Hurler syndrome

b. Ehlers Danlos

c. Marfans

d. Osteogenesis imperfecta

d. Osteogenesis imperfecta

If an infant has choanal atresia what congenital condition should be high on your differential?

a. CHARGE syndrome

b. VATER association

c. fetal alcohol syndrome

d. Williams syndrome

a. CHARGE syndrome

What condition is characterized by moderate mental retardation and reduced lifespan, microcephaly, short palpebral fissure, VSD or ASD, thin vermillion border, poor suck and irritability?

a. CHARGE syndrome

b. VATER association

c. fetal alcohol syndrome

d. Williams syndrome

c. fetal alcohol syndrome

Which of the following is not associated with 22q microdeletion?

a. cardiac defect

b. B cell defect

c. cleft palate

d. hypocalcemia

b. B cell defect

CATCH 22

CArdiac defect - truncus arteriosus, interrupted aortic arch, pulWhicm atresia w/ VSD, TOF

T cell defect

Cleft palate

Hypocalcemia

What enzyme deficiency causes a mousy odor, pernicious vomiting, seizures, aggressive behavior, and intellectual disabilities?

a. phenylalanine hydroxylase deficiency

b. galactose 1 phosphate uridyl transferare deficiency

c. adrenal enzyme deficiency

d. 21 hydroxylase deficiency

a. phenylalanine hydroxylase def

PKU

galactose def --> galactosemia --> affects liver, cataracts, splenomeg

adrenal enzyme and 21 hydroxylase def --> congenital adrenal hyperplasia --> salt craving, ambiguous genitalia

Which of the following is not a glycogen storage disorder?

a. Von Gierke Disorder

b. Pompe's Disease

c. Fabry's Disease

d. McArdle Disease

c. Fabry's Disease

lipid

What structure is responsible for shunting blood from the pulmonary artery to the aorta to bypass the fetus's fluid filled non functioning lungs?

a. foramen ovale

b. ductus arteriosus

c. ductus venosus

d. ligamentum arteriosum

b. ductus arteriosus

What is the most common cardiac defect?

a. VSD

b. ASD

c. bicuspid aortic valve

d. PDA

a. VSD

bicuspid aortic valve is most common valvular dz

Which heart defect has normal systemic arterial saturation and is characterized by left to right shunting?

a. ToF

b. hypoplastic left heart syndrome

c. tricuspid atresia

d. ASD

d. ASD

acyanotic: VSD, ASD, AV canal defect, pulmonic stenosis, aortic stenosis, PDA, CoA

cyanotic:

What drug causes Epstein anomaly?

a. alcohol

b. Lithium

c. SSRIs

d. digoxin

b. Lithium

What heart defects can appear in a neonate who's mother drank alcohol during the pregnancy?

a. VSD, tricuspid stenosis

b. ASD, PDA

c. VSD, ASD

d. ASD, CoA

c. VSD, ASD

An infant has poor eating and growth, sweats when they cry, fatigues easily, has a rapid HR, bluish skin tone, and persistent fast breathing. They have a machinery like murmur. What congenital heart defect is the likely dx?

a. ASD

b. PDA

c. VSD

d. ToF

b. PDA

When does PDA normally close in a full term infant?

a. 2-3 days of life

b. 1 week after birth

c. 1-2 months

d. 1 year

a. 2-3 days of life

What feature is not part of the tetralogy of Fallot?

a. RVH

b. overiding aorta

c. ASD

d. pulm stenosis

c. ASD

PROV

pulm stenosis

RVH

overiding aorta

VSD

What cyanotic heart defect is characterized by the RV going to the aorta, and the LV going to the pulmonary artery?

a. transposition of the great vessels

b. tricuspid atresia

c. truncus arteriosus

d. hypoplastic left heart

a. transposition of the great vessels

HLHS - underdeveloped LV, MV, AV, aorta is mall

TAPVR - pulm veins drain into other vessels or into RA instead of LA

tricuspid atresia - blood enters RA and cant enter RV, so goes to LA via ASD

truncus arteriosus - septum in truncus fails to form and sep aorta from PA

A 16 year old male presents with easy fatiguability, anginal pain when he plays soccer, SOB, and occasional palpitations. There is a murmur that increases while standing, decreases when squatting and valsalva. What should be high on your differential?

a. dilated cardiomyopathy

b. restricted cardiomyopathy

c. hypertrophic cardiomyopathy

d. normal variant

c. hypertrophic cardiomyopathy

Which of the following is seen with Turner's syndrome (theres two)?

a. ASD

b. VSD

c. CoA

d. bicuspid aortic valve

c. CoA

d. bicuspid aortic valve

What heart defect can be seen with Marfan's syndrome?

a. ASD

b. VSD

c. mitral valve prolapse

d. HCM

c. mitral valve prolapse

Which of the following heart defects is not seen in Down syndrome?

a. AV canal defect

b. CoA

c. ASD

d. VSD

b. CoA

Which condition has congenital heart block?

a. Neonatal lupus

b. Williams syndrome

c. 22q Digeorge

d. Cru Du chat

a. Neonatal lupus

A 2 month old infant has a murmur that is loudest in the right infraclavicular area. The murmur disappears when the infant lies supine and compression of the jugular vein. The intensity changes when she rotates her neck. What type of murmur is this?

a. Still's murmur

b. Venous hum

c. Carotid bruit

d. Pulmonary ejection murmur

b. Venous hum

Which of the following reflexes or postural reactions should not be present at 8 months?

a. Moro

b. head righting

c. protective equilibrium

d. parachute

a. Moro

disappears by 4 mos

Baby Jack can roll supine to prone, sit with support, and has some support on hands when hes prone. What age do you suspect he is based on these milestones?

a. 2 mos

b. 4 mos

c. 6 mos

d. 9 mos

c. 6 mos

Little Sally can walk on her tiptoes, climb up stairs with alternating feet, and hop 2 times. What age do you suspect she is based on these milestones?

a. 24 months

b. 3 years

c. 4 years

d. 5 years

b. 3 years

Little Fred can imitate vertical and circular strokes, can put on some clothes, and uses spoon well for apple sauce. What age do you suspect he is based on these milestones?

a. 15 mos

b. 18 mos

c. 24 mos

d. 3 years

c. 24 mos

What age should a baby be able to smile in a mirror?

a. 4-5 mos

b. 5-6 mos

c. 7-8 mos

d. 8-9 mos

b. 5-6 mos

Little Jack says mama and dada nonspecifically, responds to his name and responds to no. What age do you suspect he is based on these milestones?

a. 6 mos

b. 9 mos

c. 12 mos

d. 15 mos

b. 9 mos

By what age should a child be 100% intelligible to a stranger?

a. 2 years

b. 3 years

c. 4 years

d. 5 years

c. 4 years

Which of the following indicates a language delay?

a. speech errors other than "s, ch, sh, z, j, v, th, zh" at 6 years

b. speech not fully intelligible to strangers at age 3

c. doesnt point to wants at 12 mos

d. doesnt respond to name at 6 mos

a. speech errors other than "s, ch, sh, z, j, v, th, zh" at 6 years

b. not an issue until 4 years

c. this isnt an issue until 18 mos

d. not an issue until 9 mos

Which of the following etiologies likely indicates sensorineural hearing loss?

a. otitis media with effusion

b. foreign body

c. external canal atresia

d. bacterial meningitis

d. bacterial meningitis

think of things that are inner ear

What is the most common cause of conductive hearing loss in children?

a. foreign body

b. TM perforation

c. middle ear effusion

d. cerumen impaction

c. middle ear effusion

interference w/ mechanical transmission of sound through external and middle ear

A 6 year old is brought to the clinic by their mother who states something is wrong with their child's ear. The child has pain, itchiness and a visible discharge from the canal. On exam you can somewhat visualize the TM and see no bulging or perforation. What is the likely diagnosis?

a. acute otitis media

b. acute otitis externa

c. malignant otitis externa

d. serous otitis media

b. acute otitis externa

tx w/ ciprodex or cortisporin; systemic abx if evidence of AOM

When should you use augmentin in a child with AOM?

a. only if they're older than 6

b. if they had a course of beta lactam abx in the last 30 days

c. only if you are sure they have AOM

d. you do not give augmentin in AOM

b. if they had a course of beta lactam abx in the last 30 days

AMOXICILLIN first, augmentin if no response or recent tx w/ beta lactam.

Tx AOM: if less than 6 mos tx. if 6mos to 2 years and CERTAIN give abx. if older than 2 years observe

pcn allergy: macrolides (azithro) or cephalosporin (cefdinir)

What would most likely cause an aural polyp in a child?

a. recurrent outer ear infections

b. unhealed TM perf

c. malignancy

d. retained and old tymp tubes

d. retained and old tymp tubes

A 2 day old infant has noisy breathing, cyanosis that worsens with feeds and improves with crying. When you attempt to pass a catheter from the nose to the oropharynx in each nostril it is blocked. What is the likely diagnosis?

a. bilateral choanal atresia

b. unilateral choanal atresia

c. pyriform aperture stenosis

d. nasal polyp

a. bilateral choanal atresia

A 7 year old with recent untreated sinus infection is brought to the ER with severe eyelid edema, fever, and appears toxic. They have pain when they move their eye and decreased vision. What abx do they needed to be started on?

a. vancomycin + ceftriaxone

b. vancomycin + linezolid

c. bactrim + clindamycin

d. bactrim + amoxicillin

a. vancomycin + ceftriaxone

septal/orbital cellulitis -- aggressive IV abx

A child has strep throat and is allergic to pcn. What is the treatment?

a. amoxicillin

b. cefdinir

c. azithromycin

d. bactrim

c. azithromycin

A 4 year old in the ER has fever, drooling, stridor and difficulty breathing. They are sitting upright with their neck extended and head held forward to compensate. Xray shows thumb print sign. Mom says her son has not had any vaccines. What is the likely cause?

a. group A strep

b. HIB

c. S aureus

d. N meningitidis

b. HIB

epiglottitis

airway management (intubate)

tx w/ vanco + ceftriaxone

What causes croup?

a. RSV

b. HIB

c. parainfluenza

d. rotavirus

c. parainfluenza

bark cough, possible stridor and labored breathing, steeple sign

if conserv tx dont work --> racemic epi

A mom brings her 5 year old into the ED worried because her daughter was playing with her barbie dolls and then started having a hard time breathing, coughing, and has a high pitched sound. What is imaging method of choice for diagnosis?

a. CXR

b. chest CT

c. bronchoscopy

d. ultrasound

a. CXR

foreign body aspiration, right mainstem bronchi**, cxr can show asym hyperinflation, diminished breath sounds distal to FB, percussion can be dull or hyperresonant

A 3 month old has an INSPIRATORY stridor that is exacerbated by crying, laying supine, and when they are agitated. It has progressed over the last couple weeks. Mom states she is having a hard time feeding her baby too. No history of croup or trauma. What is the likely diagnosis?

a. laryngeal web

b. subglottilc stenosis

c. tracheomalacia

d. laryngomalacia

d. laryngomalacia

subglottic gets better as larynx grows

webs and atresia present at birth

if stridor is expiratory its tracheal

What is the pathogenesis of bronchopulmonary sequestration?

a. over inflation of lobe due to either primary defect in the lobar airway or parenchyma w/ increased number of alveoli in that tube

b. mass of lung tissue that lacks normal communication with the tracheobronchial tree and receives blood supply from systemic circulation

c. weak cartilage in the walls of the bronchus on expiration

d. right to left shunting of systemic blood into pulmonary veins and left heart

b. mass of lung tissue that lacks normal communication with the tracheobronchial tree and receives blood supply from systemic circulation

a is congenital lobar emphysema

c is bronchomalacia

d is pulmonary arteriovenous fistula

What is the most common location of congenital lobar emphysema?

a. left upper lobe

b. left lower lobe

c. right upper lobe

d. right middle lobe

a. left upper lobe

A neonate still in the hopsital is having respiratory distress, scaphoiding of the abdomen, and enlarged chest. CXR shows loops of bowel in the chest on the left side. What is the treatment?

a. intubation and airway management

b. NG tube w/ suction then surgery

c. resection of the lungs

d. ablation of the tissue

b. NG tube w/ suction then surgery

congen diaphragmatic hernia

What most commonly causes acute bronchiolitis in children?

a. parainfluenza

b. RSV

c. asthma

d. S. pneumoniae

b. RSV

**18 months, acute viral infection of lower resp tract

acute onset: tachypnea, cough, wheezing, nasal flaring, cyanaosis, shallow breathing

tx w/ saline and suction; trial of albuterol in office; if in distress ADMIT

What is the treatment for bacterial pneumonia caused by S. pneumo?

a. amoxicillin

b. PCN

c. nafcillin

d. vancomycin

a. amoxicillin

S. pyo - PCN

S. aureus - nafcillin, vanco (mrsa)

Mycoplasma - azithromycin, tetra if >8 years

chlamydia - azithromycin

What stage of pertussis is characterized by sneezing, cough and coryza?

a. prodromal

b. catarrhal

c. paroxysmal

d. convalescent

b. catarrhal

tx: macrolides or bactrim (if >2 mo old)

What is the most common cause of bronchiecstasis in children?

a. asthma

b. infection

c. cystic fibrosis

d. foreign body

c. cystic fibrosis

Which of the following clinical features would be highest suspicion for cystic fibrosis?

a. rectal prolapse

b. COPD

c. exocrine pancreatic insuff

d. delayed meconium

d. delayed meconium

A peds patient with asthma is experiencing symptoms 4 times a week and night time symptoms 4 times a month. What type of asthma do they have?

a. intermittent

b. mild persistant

c. moderate persistant

d. severe persistant

b. mild persistant

What t cell deficiency is characterized by cardiac issues, abnormal facies, thymic hypoplasia, cleft palate and hypocalcemia?

a. ataxia telangectasia

b. SCID

c. X linked agammaglobulinemia

d. Di George

d. Di George

SCID is t & b cell, weak nat killer cells, "think bubble boy", tx w/ BMT

ataxia telangectasia is ATM gene affected, neuro problems, oculocutaneous telangiectasia, immune def

x link ag is B cell def, mutation of bruton tyrosine kinase, no mature B cells = no abs

A neonate has recurrent ear infections and cases of enteroviral infections. Diagnositc labs show no antibodies present in the infant's blood. Flow cytometry shows no mature B cells but T cells are present. Titers indicate the baby has failed to make antibodies to any of the things hes been vaccinated for. What is the diagnosis?

a. x linked agammaglobulinemia

b. severe combined immunodef

c. common variable immunodef

d. x linked hyper IgM syndrome

a. x linked agammaglobulinemia

SCID has no T or B cell fx

CVID has b cells they just dont differentiate into plasma cells - they have mature B cells, low abs, and poor ab fx (no response to vax)

hyper IgM - normal/high IgM, LOW IgG/IgA

A 8 year old has recurrent abscess, eczema, scoliosis and hyperexentsiblity of joints. He has a history of several fractures. His teeth are still erupting and is much more delayed than regular children. He has a broad nose and asymmetric jaw. What is the pathogensis behind his condition?

a. deficient beta integrins

b. absence of fucosylated carbohydrate ligands

c. elevated IgE

d. impaired lysosome degranulation

c. elevated IgE

A 4 year old male with a history of recurrent sinusitis and pneumonias is in the peds office for a follow up. He has partial oculocutaneous albinism, intellectual disability for his age, and peripheral neuropathy. Blood smear shows giant granules. What is the diagnosis?

a. Job syndrome

b. Chediak-Higashi

c. leukocytic adhesion deficiency

d. chronic granulomatous disease

b. Chediak-Higashi

What is the average caloric needs for a baby in their first couple years of life?

a. 100 kcal/kg/day

b. 150 kcal/kg/day

c. 200 kcal/kg/day

d. 250 kcal/kg/day

a. 100 kcal/kg/day

What is an important education point to women breastfeeding?

a. there is not enough vitamins in breastmilk so you need to supplement with formula

b. vitamin D supplementation is needed

c. exposure to moms breastmilk can cause allergic rxns in baby

d. there is not a lot of fat in breast milk

b. vitamin D supplementation is needed

Why is it important for formulas to have LIPIL (ARA and DHA fatty acids)?

a. important for bone growth

b. important to prevent rickets

c. supports brain and eye development

d. supports lung development

c. supports brain and eye development

A mom is supplementing breast milk with formula. Her baby is 3 months old. About how many ounces should they be getting per feeding?

a. 3 oz

b. 5 oz

c. 7 oz

d. 9 oz

b. 5 oz

gen rule 2 plus age in months until 8 oz

Which of the following statements is true regarding feeding infants with solid foods?

a. wait til 12 months to start

b. avoid starting with high allergy foods

c. honey is safe at 6 months

d. introduce 1 new food at a time every 3 days

d. introduce 1 new food at a time every 3 days

introduce 4-6 months

safe to try high allergy foods

honey at 12 months

avoid anything less than whole milk before age 2

A malnourished child is diagnosed with beriberi. What vitamin are they deficient in?

a. vitamin A

b. thiamine (B1)

c. niacin

d. vitamin b12

b. thiamine (B1)

calcium, phos, vit D = rickets/osteomalacia

vit A = night blindness

vit C = scurvy, bleeding

vit E = hemolytic anemia, neuropathy

vit K = petechiae, ecchymoses

thiamine = beriberi, heart failure

niacin = pellagra dermatitis

riboflavin b2 = angular stomatitis, cheilosis

vit b6 = anemia, dermatitis, neuropathy

vit b12 = anemia, neuorphaty, diarrhea for infants

folate = anemia

iron = anemia, koilonychia

biotin = rash, hair loss

essential FA = rash coagulopathy

zinc = rash, growth failure, delayed sex develop

Which of the following is not seen in vitamin B12 deficiency?

a. rash

b. anemia

c. neuropathy

d. diarrhea for infants

a. rash

A newborn is crying more than 3 hours x 3 days a week. This started 3 weeks after they were born. What is the diagnosis?

a. gastritis

b. colic

c. Hirschsprungs

d. intussusception

b. colic

A mother brings her 1 year old daughter into the clinic. She says her baby is uncontrollably crying, pulling her legs towards her abdomen, and vomiting up green stuff. Shes also noticed dark currant jelly stools in the babies diaper. When you palpate the babies abdomen you feel a sausage shaped mass in the upper mid abdomen. What diagnostic method will also treat the condition?

a. ultrasound

b. xray

c. barium enema

d. air insufflation

c. barium enema

intussusception

air insuff isnt diagnostic

if per suspected do not do air insuff or enema

A mother brings her 9 year old son into the peds clinic. She says hes been complaining of pain centered in his upper abdomen. He has not lost weight, vomited or passed blood in his stool. His stomach pain is not relieved by defecation. He denies being bullied at school or having any problems with friends or at school. Grades are good. He hasnt noticed any problems when he eats diary. What is the likely diagnosis?

a. IBS

b. lactose intolerance

c. dyspepsia

d. stress

c. dyspepsia

What is the gold standard for diagnosing GERD?

a. esophageal pH test

b. upper GI series

c. barium swallow

d. endoscopy

a. esophageal pH test

Which of the following would not cause hematochezia?

a. colonic polyps

b. anal fissure

c. infectious colitis

d. gastric ulcers

d. gastric ulcers

this would cause melena --> Upper GI bleed

A child has hamartomatous polyps, freckling on their lips and gums. What polyposis syndrome do they likely have?

a. Juvenile polyposis

b. Peutz jegher's

c. familial adneomatous polyposis

d. Gardener's

b. Peutz jegher's

FAP - colonic adenomas, APC gene mutation

Gardener's - small bowel and colonic adenomas, APC gene mutation, supernummery teeth

Peutz - hamartomatous polyps, lip/gum freckling

juvenile polyposis - hamartomatous polyps in small bowel and colon, PTEN, SMAD4, BNPR1 gene

hereditary nonpolyposis colon cancer - colonic adenomas, associated w/ other tumors (Lynch syndrome)

Which of these is not characteristic of Ulcerative colitis?

a. limited to the colonic mucosal layer and spares upper GI tract

b. bloody diarrhea with tenesmus

c. crypt abscesses

d. cobble stoning appearance

d. cobble stoning appearance

A newborn boy has failed to pass meconium after birth. Their abdomen is distended and there is no stool in the rectal vault. What is the likely diagnosis and how do you diagnose?

a. pyloric stenosis, ultrasound

b. meconium ileus, sweat chloride test

c. Hirschsprung, barium enema

d. intestinal obstruction, xray

c. Hirschsprung, barium enema

Hirschsprungs = failure to pass meconium

Which of the following would likely cause diarrhea in children one month to 2 years of age?

a. volvulus

b. rotavirus

c. inflammatory bowel disease

d. allergy to breast milk

b. rotavirus

neonate: allergic causes, anatomical causes

one mo - 2 yr: post infectious enteritis, parasitic - giardia, rotavirus

2-18 yrs: postinfectious, celiac sprue, sorbitol in juice, IBS, IBD, laxative abuse

do NOT use antidiarrheals in children

What is the pathophysiology of Duane syndrome?

a. failure of normal development of the abducens nerve

b. palsy of CN VI after having an viral illness

c. a weakened medial rectus muscle

d. CN III paralysis

a. failure of normal development of the abducens nerve

LR is innervated by the oculomotor nerve (CN 3) - cannot abduct the eye

What is a bluish, fluctuant welling in the floor of the mouth that is a retention cyst associated with trauma to a salivary duct?

a. aphthous ulcer

b. melanotic neuroectodermal tumor

c. Bohns nodule

d. ranula

d. ranula

Which of these live vaccines is not typically given in the united states?

a. MMR

b. BCG

c. rotavirus

d. varicella

b. BCG

Which of the following statements regarding live vaccines is true?

a. live vaccines need many doses to be effective

b. if two vaccines in a series are given less than 28 days apart the 2nd dose does not count

c. increase the interval between doses renders the vaccine series ineffective

d. decreasing the interval between doses of multi dose vaccines increases antibody response

b. if two vaccines in a series are given less than 28 days apart the 2nd dose does not count

Which of these is an invalid contraindication from receiving a live vaccine?

a. a 28 pregnant woman

b. a 4 year old with immunosuppression from cancer

c. a 6 month old with encephalopathy

d. a 10 year old who is getting an influenza vaccine with a mother allergic to the vaccine

d. a 10 year old who is getting an influenza vaccine with a mother allergic to the vaccine

Which dose would be valid in a person <7 years old if they are given Tdap instead of Dtap?

a. 1st

b. 2nd

c. 3rd

d. 4th

d. 4th

doses 1-3 NEED TO BE DTAP. doses 4-5 can be valid if given tdap

When should the first dose of Tdap be given in children?

a. 8 years

b. 10 years

c. 12 years

d. 14 years

c. 12 years

11/12 years and every 10 years thereafter

Which of the following is the correct MMR dosing?

a. 12-15 mos; 4-6 years

b. 10-12 mos; 4-6 years

c. 12-15 mos; 24-36 months

d. 10-12 mos; 24-36 months

a. 12-15 mos; 4-6 years

MMR given prior to 12 months is invalid

Which of the following is not true regarding MMR and PPD?

a. apply PPD first then give MMR when skin test is read

b. if MMR given first, wait 4-6 weeks for PPD

c. apply PDD at same time as MMR

d. if MMR given first, wait 2-4 weeks for PPD

d. if MMR given first, wait 2-4 weeks for PPD

When is the booster dose for Hib given?

a. 4-6 months

b. 6-8 months

c. 8-12 months

d. 12-15 months

d. 12-15 months

Who is contraindicated from getting the Hib vaccine?

a. infants less than 6 weeks

b. child with acute illness

c. immunocompromised children

d. a 6 year old with functional asplenia

a. infants less than 6 weeks

can give to immunocomp children because not live

fx asplenia pt gets additional dose after 5 years old

Which of the following vaccines has the same schedule of 2, 4, 6, 12-15 month schedule like the Hib vaccine ( ActHIB not PedvaxHib)?

a. PCV23

b. PCV13

c. Dtap

d. Hepatitis B

b. PCV13

Which of the following statements regarding Hepatitis B vaccination is incorrect?

a. dose 1 and 2 are a minimum of 4 weeks apart

b. last dose of infant series is not to be given prior to 6 months of age

c. booster doses are recommended

d. typically first dose is given at birth

c. booster doses are recommended

1: birth

2: 1-2 months

3: 6-18 mos

What is the correct polio series?

a. 2, 4, 6 mos

b. 2, 4, 10-12 mos, 2-4 years

c. 2, 4, 6, 12-15 mos

d. 2, 4, 6-18 mos, 4-6 yrs

d. 2, 4, 6-18 mos, 4-6 yrs