SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
USMLE Step3 Pediatrics
Start Test
Study First
Subjects
:
health-sciences
,
usmle-step-3
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. How to dx endopthalmitis
TB - breastfeeding - asymptomatic hiv
Meconeum ileus; think about CF
Infection in aqueus and vitreous humors; posttraumatic - postcataract surgery;
Erb paralysis leading to diaphragmatic paralysis
2. tzanck
GERD - try thickened formula if no improvement - H2 antagonists - last resort surgery
Herpes
Bacterial: sudden onset - high fever - cxr consolidation. viral; gradual onset - diffuse bilat infhiltrate tx; bact-amoxi;
Dx US tx; correct serum electrolyte - pyloromyotom
3. 3yo - never able to walk
Absence seizure; tx ethosuximide
Penicillin G 4h before delivery
Coarcation - bicuspic aortic valve - mitral prolapse - hypoplastic heart
Order CK to r/o muscular dystrphies; duchene- defect in dystrophin gene; 10-20 times increased serum CK; LDH and aldolase also hight; dx electromyograpy and bx
4. benefits of antibiotic therapy in acute pharyngitis?
Reduction of the severity of symptoms; prevention of rheumatic fever and suppurative complications
<44 - CBC - Electrolyte - and urinanlysis; if >44 oral chelation; >70 hospitalization and parenteral chelation
Decreases height - expensive; reserved for severe cases of delayed puberty
Tx only symptomatic carrier
5. osler rendu weber syndrom
refuse
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
Multiple telangiectesia - vasular lesion in CNS
Endocardial cushion defect (no separation between heart chambers)
6. causes of FTT
110 kcl/kg/day
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone
Feeding prob; milk protein intolerance; errors in metabolism; infection; CF GERD; RTA
If aortic root reaches 45 mm
7. 4m severe papulovesicular rash in genitalia - buttocks - perineum - crural folds
Injury to lower roots of brachial plexus
Decresed visio - sudden onset - seeing halos around light - headache - eye pain
Candidal diapar rash; tx clotrimazol
Imaging study to r/o VUR
8. the risk of lyme after bitten by a tick
Herpes
1.5%
refuse
Hypopigmented macule - glial proliferation - organ haramtomas/cysts
9. Tx of bact conjunctivitis
Dactylitis; 2nd common is splenic seqestration
Aferbrile pneumnia - c. trachomatic - mycoplasma - ureasplams - cmv - rsv; look for onset - if 2-19w - can be chlamydia if asso conjunctivitis dx; cx of nasal secretion - chlamydia pcr
Erythromycin ointment - sulfa drops - polymyxin /trimethoprim drops
Atypical lymphocyte
10. 3yo - febrile - left hip externally rotated
Evaluate other developmental delay (microcephaly - lead poisoing) screen for eye prob and audiometry
Cholesterol--pregnenolore---->17 Oh pregnenolone--->dehydroepiandosterone - pregnenolone--->progesterone--->dexoycorticosterone->corticosterone--->aldosterone -17 oh pregnenolone--->17 0Hprotesteronee--->cortisol - dehydroepiandosterone--->androstene
Transient synovitis or toxic synovitis; bilateral effusion; preceded by URI -
At least 5 of 9 symptoms: DIGFAST depressed mood - insomnia - guilt - f - anhedonia - suicidal ideation -
11. sudden onset of fever - difficulty in breathing
Viral meningitis/encephalitis caused by arbovirus children; HSV in adults
Epiglotitis by H influenze; inflammartory edema of the epiglottis that impinges airway--resp arrest; dx clinical; tx relieve obstruction - intubate
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
24-72 hours
12. Infant with serum billlirubin >25
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Risk of neurological dysfunction
TB - breastfeeding - asymptomatic hiv
Erythromycin (used for pertusis prophylaxis) or macrolides in breastfeeding child
13. tuberous sclerosis
HSP - look for symmetric skin lesions
Hypopigmented macule - glial proliferation - organ haramtomas/cysts
Erythromycin (used for pertusis prophylaxis) or macrolides in breastfeeding child
Age<6 - no past h/o afebrile seizure - temp>38 - no cns infection - no metabolic disturbance
14. duodenal atresia
12 month; inh - rifampin - pyrizinamide for 2m and inh and rifampin for 12m; may be continued to 18-24m based on response
Between pregnenolone and 17oh pregnenolone
Central isosexual precocious puberty; hypothalmaic hamartoma
D for d; down syndrome and polyhydramnios
15. physiological jaundice
Tx only symptomatic carrier
24h to 7d of birth
Marfans - ehlers danlos - homocystinuria
Decreased UGT enzyme
16. cat scratch disease
Pipercillin (zosyn) - ticarcillin
Bartonella henselae; complication is suppuration of lymph node
Current moderate of severe fever; anaphylaxis to gelatin/neomycin; immunodeficiency(hiv - chemo); thrombocytopenia; recent administration of immunoglobulin (can diminish efficacy); preganancy
Brown
17. Tx of FTT
D for d; down syndrome and polyhydramnios
Lateral neck xray in epiglottitis show swollen epiglottis
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
Diet modification to provide 110kc/kg/d
18. aplasic crisis
Decreased UGT enzyme
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram
14yrs
19. indications of VUR
<5 febrile UTI. males after first UTI - females <3yrs after first UTI - UTI unreponsive to abx - recurrent UTI
Thrombocytopeni - micorangiopathic hemolytic anemia - neurolotgical signs - RF - fever ; p/w PPPP pallor - petechia - pever - pailure tx plasmpheresis
Pho for forward bending; forward defect; common finding has no adverse physical effect
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
20. infantile hypertrophic pyloric stenosis
Dx US tx; correct serum electrolyte - pyloromyotom
Neonatal chlamydia; time after birth important. develops 3-10 week after delivery
Croup
Bladder dysfunction; UTI and renal dysfunctoin
21. low grade fever - cough - diffuse bilat ground glass opacities
Current moderate of severe fever; anaphylaxis to gelatin/neomycin; immunodeficiency(hiv - chemo); thrombocytopenia; recent administration of immunoglobulin (can diminish efficacy); preganancy
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone
Thrombocytopeni - micorangiopathic hemolytic anemia - neurolotgical signs - RF - fever ; p/w PPPP pallor - petechia - pever - pailure tx plasmpheresis
Bartonella henselae; complication is suppuration of lymph node
22. most common complication of otitis media
Bartonella henselae; complication is suppuration of lymph node
Prednisone/methyleprednison; IVIG - chronic ITP-spelenctomy
Croup; hx coughx2-3d - gradual onset; high fever; barking cough; <3y; epiglotitis; sudden onset; stridor; >3y
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
23. How to investigate delayed puberty
SCFE - stable-if patient can bear weight; unstable-if cannot ambulate; complications avascular necrosis; dx xray tx immediate int fixaton
At first imaging test to dx bone age; if normal do testing to r/o chromosomal or endocrine abnormality
Risk of neurological dysfunction
HSP - look for symmetric skin lesions
24. How to dx RSV
refuse
>1yr ; heimlich maneuver-series of 5 abdominal thrust with child sitting/standing; <1yr blows on the back with heel of hand alternating with chest thrust
After 6m; breast mild provides iron until 6m.
Rapid detection of RSV antigen in nasl
25. 4d old infant with dilated loop of bowel;; constipaion; ground glass mass abdomen
Penicillin G 4h before delivery
Thrombocytopeni - micorangiopathic hemolytic anemia - neurolotgical signs - RF - fever ; p/w PPPP pallor - petechia - pever - pailure tx plasmpheresis
At first imaging test to dx bone age; if normal do testing to r/o chromosomal or endocrine abnormality
Meconeum ileus; think about CF
26. how smoking contributes otitis media in children
Erythromycin (used for pertusis prophylaxis) or macrolides in breastfeeding child
<44 - CBC - Electrolyte - and urinanlysis; if >44 oral chelation; >70 hospitalization and parenteral chelation
Smoking alters mucosa - cilia - adenoid structure - make children susceptible to infection
Black
27. lens dislocation
Increase of pregnenolone
24-72 hours
Marfans - ehlers danlos - homocystinuria
<44 - CBC - Electrolyte - and urinanlysis; if >44 oral chelation; >70 hospitalization and parenteral chelation
28. starring spells 10-20sec
Anaphylaxis or encephalopathy within 7d of administration; temporary contraindications moderate to severe illness
Dactylitis; 2nd common is splenic seqestration
1.5%
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
29. When to bevioral and enviromental measure in led intoxication?
Observe for 48h; look for bacerimia - sepsis - meningitis - ventrculitis
Prolactinoma
<44 - CBC - Electrolyte - and urinanlysis; if >44 oral chelation; >70 hospitalization and parenteral chelation
Medical emergency; dimercaprol/edta
30. What is earliest sign of puberty?
Injury to lower roots of brachial plexus
Aferbrile pneumnia - c. trachomatic - mycoplasma - ureasplams - cmv - rsv; look for onset - if 2-19w - can be chlamydia if asso conjunctivitis dx; cx of nasal secretion - chlamydia pcr
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
31. What are the risk factors of developmental dysplais of hip
Wait until 6 months
Female - breech delivery - family history; tx referral to ortho
Meconeum ileus; think about CF
Swimmer's ear; due to decrease canal acidity and bacterial overgrowth; pseudmonas
32. How to difference RSV and neonatal chlamydia
At first imaging test to dx bone age; if normal do testing to r/o chromosomal or endocrine abnormality
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro
No wheezing - no feever in chlamydia
Less than 5th percentile
33. sturge weber syndrome
Pho for forward bending; forward defect; common finding has no adverse physical effect
Herpes
Central-increased androgen - inc GnRH; peripheral-increased androgenq(acne - growth acceleration) dec GnRH (due to feedback)
Facial portwine stain
34. coin in child's stomach
No intervention; 90% foreign bodies pass without difficulty
ALL - alzheimers autism adhd depression seizure
Caput crosses suture line; caput has color (echymotic); caput clears early (within weeks versus several months in cephalo)
Tx with antipseudomnal abx; ticar/piper plus tobra or fourth gen cephalosporin ceftazidime - cefepime or carbapenem (imi/ mero)
35. sickle cell with symmetrical swelling of hands and feet
After 24h of abx therapy
Hypopigmented macule - glial proliferation - organ haramtomas/cysts
Vaso-occlusive crisis; dx hb electrophoresis
24h to 7d of birth
36. What is the definition of delayed puberty?
Viral meningitis/encephalitis caused by arbovirus children; HSV in adults
Absence of puberty sign by 14yrs; testicle <2.5cm dm;
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
37. irritable - aggressive - nervous - unable to sleep - dilaed pupil - mouth dry - on methylephenidate
Methylephenidate toxicity; cannot be stopped abruptly; taper
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
URI
INH 9m if INH resistant rifampin 6m in children and 4m in adults
38. HUS
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes
<2yrs - abd pain - diarrhoea - ARF
Cafe au lait spot - fibrous dysplasia of bone; excessive production of estrogen from ovarian cysts
Transient synovitis or toxic synovitis; bilateral effusion; preceded by URI -
39. infant botulism
Candidal diapar rash; tx clotrimazol
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes
refuse
2wk to 6 months p/w poor feeding - hypotonia - weakness - loss of DTR; soucee raw honey and soil - canned food
40. How long patient needs to be exposed to tick to get infected
36 hours
Wait until 6 months
Heterosexual precocious puberty in females; inc androgen and cortisol - virilization in females - cushing (incr cortisol)
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro
41. echymoses with low platelet <30k
Prednisone/methyleprednison; IVIG - chronic ITP-spelenctomy
R/o serious disorder; Hirschprug's disease; CF - hypothyroidism; then tx MgOH
US and barlow test: attempt to dislocated unstable hip; sometimes make clunking sound;
Atypical lymphocyte
42. association with infantile pyloric stenosis
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram
Cafe au lait spot - fibrous dysplasia of bone; excessive production of estrogen from ovarian cysts
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
Erythromycin (used for pertusis prophylaxis) or macrolides in breastfeeding child
43. lead >70
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
Age<6 - no past h/o afebrile seizure - temp>38 - no cns infection - no metabolic disturbance
Multiple telangiectesia - vasular lesion in CNS
Medical emergency; dimercaprol/edta
44. How to prevent GBS in neonate
Strep pneumonie; moraxella; h influenze
Bladder dysfunction; UTI and renal dysfunctoin
Penicillin G 4h before delivery
Transient synovitis or toxic synovitis; bilateral effusion; preceded by URI -
45. What is the calorie requirement of newborn?
Foreign body sensation - photophobia - corneal opacity tx abx
No reticulocyte vs high reticulocyte
Definitive karyotype; echo for cardiac - tsh for hypothyroid; and renal US to eval horshoe kidney; visual and hearing assessment
110 kcl/kg/day
46. How to evaluate well appearing child just born in GBS pos mother?
Observe for 48h; look for bacerimia - sepsis - meningitis - ventrculitis
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)
Brown
Meconeum ileus; think about CF
47. language expectation from 2yo
R/o serious disorder; Hirschprug's disease; CF - hypothyroidism; then tx MgOH
50+ vocabulary; 2-3 word phrases; follow 2 step command; if delayed do audiometry
SCFE - stable-if patient can bear weight; unstable-if cannot ambulate; complications avascular necrosis; dx xray tx immediate int fixaton
Black
48. When to give hpv vaccien
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro
Erythromycin ointment - sulfa drops - polymyxin /trimethoprim drops
Methylephenidate toxicity; cannot be stopped abruptly; taper
11-12yrs as late as 26yrs; hpv2 and hpv4 against strains 16 and 18 which casuse 70% of cervical ca; not live vaccines; give 0 1 6
49. acute otitis media-pathogen
URI
Marfans - ehlers danlos - homocystinuria
Strep pneumonie; moraxella; h influenze
GERD - try thickened formula if no improvement - H2 antagonists - last resort surgery
50. down syndrome has inreased risk of developing
Decresed visio - sudden onset - seeing halos around light - headache - eye pain
ALL - alzheimers autism adhd depression seizure
Do HIV testing at first
Hypopigmented macule - glial proliferation - organ haramtomas/cysts