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Pediatrics Assessment Exam

May 2008
Group C

Done By: Dalia Sadeq
1st 17 questions were discussed with dr. Majeda Hammoud
Hope u find them useful. GOOD LUCK
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In Non accidental injury, patient needed resuscitation, bag + chest -1
?compression done, but failed to obtain IV access. So what to do next
femoral cut -
intraosseous line -
through endotracheal tube -
nasogatric tube -
subclavian central line -

year-old girl presented with fever of 2 weeks duration, erythematous 5 -2
rash and migratory joint pain. On examination: knee red & swollen. Temp
.38.5 C, HR= 120
?What is the most likely diagnosis
JRA -
acute rheumatic fever -
SLE -
septic arthritis -
Kawasaki -
key word in history MIGRATORY joint pain or transferring from joint to joint
means rheumatic fever

grade 4 reflux not controlled on prophylactic antibiotic -3
.…give 1 week prophylaxis -
…wks prophylaxis 6 -
anti-reflux surgery -

?what is most worrisome -5
month old can not lift his head 6 -
month old can not walk but can cruise 16 -
weeks can not smile 5 -
months can not sit 7 -
newborn who had required brief resuscitation & intubation. He has -6
absent breath sound on one side of the chest
pneumothorax -
atelectasis -
diaphragmatic hernia -
Dr galat answer is pneumothorax l2na it was induced from the resuscitation.
S2lt.ha why not Diaphragmatic hernia qalat it will be more acute problem w
different scenario ymkn more serious
bs l2na elso2al makan wath7 f we all got 1 point 3lah …

a mother of 18 month old girl noticed (something white) in her pupil. .. -7
Dr could not examine properly… but light reflux was absent. What is most
?likely
retinopathy of prematurity -
cataract -
retinoblastoma -

year-old girl presented with painless non tender lump in one breast. 10 -8
?What is the best next step
fine needle aspiration -
total mastectomy -
…excision and nipple -
observation and reassurance -
she is puberty w difference btw breasts is normal
tamoxifin -

yr old. patient has fever sore throat, moderate tonsillar enlargement, 8. -9
spleen 2 cm below costal margin. What should be given
: ampicilin -
this is infectios mononucleosis (EBV) NEVER NEVER give ampicillin
steroid: not given unless VERY severe case like liver failure. This case is not -
severe
acyclovir -
immunoglobulin -
mild analgesia -
month old presented to the ER in the middle of the night because of 6 -10
?inconsolable cry. What is least appropriate
ask about blood in stool -
ask if cry is intermittent -
examine genitalia for testicular torsion -
examine ear -
: give pain killer and reassure -
baby with severe crying we have to rule out intestinal obstruction so don't send
him/her home unless thorough examination was done

patient had sore throat, hematouria, proteinuria, fine crackle at lung -11
bases. BP= 190/110. Na was normal, bicarbonate was low
(K= 6.3 ( normal range for each provided, K is up to 5.5
?<What is 1st priority
treat hypertension -
lower K level -
dialysis -
treat infection -
Potassium if above 7 it will be as important as lowering very high BP
In our case it was 6.3 so near normal not very worrying

what is unlikely to cause : moderate anemia + splenomegaly + -12
enlargement of cervical lymph node
infectious mononucleosis -
(Juvenile chronic arthritis ( systemic -
hereditary spherocytosis : it never causes enlargement of cervical LN -
ALL -
lymphoma -

:all can be found in turner disease except -13
absent uterus -
wide carrying angle -
wide spaced nipple -
infantile genetalia -
?year old boy…. What is best indicator of severity of asthma 7 -14
HR= 130 -
pulses paradoxis < 10 -
coarse crepitation -
audible wheeze -
decrease air entry -

year- old with chronic eczema has severe itching and redness in .. -15
?popliteal area. What is best topical treatment
steroid : because it is severe -
skin emollient : if chronic , and just dryness and mild redness -
antihistamine -
fucidin -

week old baby born SVD was fine. Later develop (intermittent 32 -16
(problem
HR= 80 & sat= 87%
?What is most likely
apnea -
persistent pulmonary HTN -
reflux -

month old girl with 1st episode of UTI 6 -17
admit IV antibiotic & further urinary investigation -
oral antibiotic and further investigation -

baby born healthy on nasogastric feed on day 3 developed jaundice. -18
After few days billirubin was 393, direct billirubin 250. his blood group is
A-. mother is O-. today he is dusky looking, vomited once. Temp 35C .
?what is most likely diagnosis
ABO incompatibility -
neonatal hepatitis -
biliary atresia -
-
newborn baby, term, birth weight is 4.1 kg. Blood sugar is 2.9mmol/L -19
?mother wish to breast feed. What to do
let her breast feed -
give bottle formula -
dextrose 10% -
(repeat investigation immediately ?? ( am not sure about this -

month old breast fed baby, what supplement he need 4 -20
Vit C -
Vit K -
Vit D -
folic acid -
B12 -

.patient with fever vesicle on lip, mouth only . he is well-hydrated -21
?How to Tx
admit and give IV fluid -
oral fluid, antipyretic , discharge -
-
in precousious puberty22 -
increase growth velocity, advanced Bone age, decrease final height -
increase growth velocity, advanced Bone age, increase final height -
decrease growth velocity, decreased bone age, decrease final height -
decrease growth velocity, drec. Bone age, increase final height -

yr old boy since 18- month age he was on 5th centile, parents > 50th 14 -23
?centile. Father recall delayed puberty. What is most likely
familial short stature -
constitutional delay -

a female has epistaxis & menorrhagia, her brother had prolonged -24
bleeding after tonsillectomy. Mother has epistaxis. Father normal.
Assuming there is a hereditary bleeding disorder. What is the pattern of
?inheritance
X-linked -
X-linked dominant -
autosomal dominant -
autosomal recessive -
pansystolic murmur at left lower sternum. Heart mildly 3/6 -25
:hyperactive otherwise normal
innocent murmur -
VSD -