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Peds Correction

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5 YOB comes with with 3 w of painful limp. No history of serious illness or trauma, no other sx. Unable to
bear full wt on right and wince on right foot. Flex and internal rotation of hip decr. XR shows dense Legg-Clave- Perthes
conjtracted femoral capital epiphysis. Dx?
6 MOB comes in with 1 week of unprovoked startle movements. each is sudden wuick flexion of head, arms
leg. He cries during these episodes,. He has areas of hypopigemntation, mental retarsation, and periventricular tuberous sclerosis
nodules. Dx?
12 MO AA G with SCD with high fever, iritabily, tachypna. Diet consist of iron fortified formula and fruits cefotaxime ( brroad spectrum
and veggies. misses occasional penicillin doses. T 102.2, HR q80. rr 48. Exam shows pallor 2/6 murmur LSB. cephalosporins with SCD and
WBC 23, nl platelts. best abtx? infectious pictures)
5 YOB comes to ED 30 mins after onset of acute shpoulder pain while wrestling, exam shows left arm w/ dont see humeral head, ugly bones,
tenderness of humeral area. XR of left shoulder & upper extremity shattered and ugly. Underlying cause? pathologic fracture of humerus
16 YOB comes for routine exam. No PMH. BOth maternal and paternal has fhx of premature coronary artery
disease, HTN, hyperlipidemia BMI of pt is 35. Has mildly elevated lipid studies. Best next step in weight loss (reduced calories diet )
managment?
12 YOG has HA and mental status change. She got the dx of T1DM, was admitted to the hospital for treamtent
of ketoacidosis. She got 3 NS bolues and serum glucose 874 --> 400. She responds to painful stim Cerebral edema
Fundoscopic exam no venous pulse. Cause of AMS?
2 days after de;ivery, a newborn has urinary dribbling and decr urine outpu. Born at term to healthy mom. on
exam there is a 6cm rund, midline, suprapubic pelvis mass. not circumsized. labs show mild changes to posterior urethral valves
electrolyes.Cause of oliguria?
A 4 YOG comes in w/ fever, abd crams, diarrhea for 2 days. She sttends daycare & went to a picnic where
fully cook the chicken
there was chicken. Center has pet hamster. Stool cx grows salmonella. what public health measure to prevent?
18 YOB comes with 3 days of diarrhea. He attends daycare and several other children at the center have it.
strict hand washing precautions
Ends up having rotavirus. what could be done to prevent?
What is the mechanism of congenital hip displasia? shallow poorly developed acetabulum
12 YOB has recently begun to snore loudly. He has a hx of chronic URI and steatorrhea. Most likely cause of
Nasal polyps
snoring?
a 30 MOG has abd pain, 2 loose stools,T 101. Malaise and fever persist during the day and she has 2 more
loose bloody stools. That night she has a generalized tonic clonic seziure. Exam shows alet and oriented, fever shigellosis ( simple febrile seizure)
to 103.5 , no nuchal rigidity, dx?
Down syndrome patient has polycythemia. Hb 16. 8. Exam shows mild to moderatecyanosis and digital
pulmonary artey hypertension
clubbin. There is a large VSD, What is the cause of the polycythemia?
A 4 YOG has been on bactrim prophylaxis for 3 w with recurrent UTIs.Previously treated with amoxicillin
Bactrim
and cefotaxime. Labs show WBC 2.4 ( low)with low neutrophils. Cause of neutropenia?
17 YOG comes for precollege PE. Not sexually active. Menses at 28d intervals. Smokes 0.5 packs daily for 3
years50 YOM mom was dx w breast cancer 1 year ago Her father and grandfather died in 30s of heart disease. serum lipid studies
Most appropriate screening test?
12 hour newborn female has difficulty breathing and 2 mins genralized tonic clonic seziure. Born at 36 w by
c/s for breech. Mom has GDM poorly controlled and didnt take insulin. Exam shows decreased tone and bilirubin ( common in GDM)
lethargy. ECG: long QT. Next conc to follow?
16 YOB comes in with 3 days of pain and presure over left cheek. x of strep pneumonia at 6 and 10, and 2
imparied humoral immunity ( thinking
episodes of sinusitis in past 2 years. t 100.5. PE: bilat tender maxillary sinuses and boggy tubinates. Sputum
IgA i think)
grows H flu. Cause of this infection?
Previously healthy 3 YOG 3 w of fever, pallor, decr appetite. Takign tylenol. Over past weeek also bruses on
aplastic anemia
legs. T 101.3. Exam shows ecchymoses and oral ulcers. Labs show low WBc, plt, WBc. Dx?
16 MOB comes with 1d fever and foul smelling urine. Urinalyisis shows UA. abtx given and sx resolve. Next
voiding cystourethrogram.
step?
a 3 YO with progressive failure to thrive. Parents sat she has frequentlarge greasy stools and flatus over past
3m. She was born at termand did not pass meconium until 3d old. Below 5th percentile for ht and wt. Exam exocrine pancreatic insufficincy
shows decr soft tisse. cause of FTT
1 w/o w 1d of difficulty breathing and discoloration. Born at term. Rectal temp 97.5, p 160, RR 52 BP 60/36 in
UE and none in lower. skin and MM appear dusky. 3/6 holosystolic murmur. Liver palpable. CXR with closure of ductus? coaractation
cardiomaegaly. Explain the condition.
previosuly healthy 2 motnh old boy brought to physician w 3 days of vomiting. Mother sats taking cow mild
product butvomtis after every feeding. Vomitng incre with amount and force. Vom is NBNB formula. 25th GERD
percentile for lenthg and 10th for ht. Dx?
16 YOB has painless lump in right breat. he is tanner 4. It's under the nipple, no retraction, no axillary
physiologic pubertal development
lymphadenopathy. Dx?
Previously heathy 16 YOB has 6 hr of fever and right foot pain. 1 week of itching rash bw 2nd and 3rd toes of S. aureus, this is itching progressinvg
both feet. Active athlete. T 101, right foot shows erythema and induration. Most likely organism? to cellulitis
A previosuly healthy 11 YOB has 14 d of fever, HA, yellow green nasal discharge. Nocturnal cough and sister
has a cold. T 102.2, P 100, RR 18, Posterior wall is eryhtmatous and covered with gray mucus. lungs clear. sinusitis
Dx?

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