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. crying during urination. bacteriuria pyruria - rec episodes
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone
Diet modification to provide 110kc/kg/d
Imaging study to r/o VUR
Dactylitis; 2nd common is splenic seqestration
2. difference between structural disorder and flexible kyphosis
Angulation in forward bending think about structural problem; will not be corrected on its own; tx milwakee brace
14yrs
Feeding jauding due to lack of feeding; 1st week; tx support; milk jaundice due to milk; afer 7d; lack of glucoronidase; incre unconjugate biill tx; interrupt feeding resume
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
3. non immune pregnant women exposed to rubella in first trimester
SCFE - stable-if patient can bear weight; unstable-if cannot ambulate; complications avascular necrosis; dx xray tx immediate int fixaton
Rapid detection of RSV antigen in nasl
Congenital rubella syndrome
Lateral neck xray in epiglottitis show swollen epiglottis
4. HUS
2wk to 6 months p/w poor feeding - hypotonia - weakness - loss of DTR; soucee raw honey and soil - canned food
1.5%
No intervention; 90% foreign bodies pass without difficulty
<2yrs - abd pain - diarrhoea - ARF
5. microcytic - hypochromic anemia - hepatospelnomegaly
Infection in aqueus and vitreous humors; posttraumatic - postcataract surgery;
Atopic dermatitis; strong allergic/immunologic component; incr IgE
Thalassemia - congenital hemolytic anemia
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
6. How to difference RSV and neonatal chlamydia
Bartonella henselae; complication is suppuration of lymph node
No wheezing - no feever in chlamydia
After 6m; breast mild provides iron until 6m.
Swimmer's ear; due to decrease canal acidity and bacterial overgrowth; pseudmonas
7. What is earliest sign of puberty?
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
If aortic root reaches 45 mm
12 month; inh - rifampin - pyrizinamide for 2m and inh and rifampin for 12m; may be continued to 18-24m based on response
8. How to dx acute angle closure glaucoma
Black
Transmits thought sneezing -coughling - singing - speaking by microscopic aerosol containg the organism; keep patient in resp isoloation until non-infectious (3 sputum acid fast smear negative)
Decresed visio - sudden onset - seeing halos around light - headache - eye pain
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
9. duodenal atresia
ALL - alzheimers autism adhd depression seizure
Bugs; strep pneumonia - mycoplasma; give ceftriaxone and azithro
Epiglotitis; staph - HiB tx: ceftriaxone/cefotaxime
D for d; down syndrome and polyhydramnios
10. hypopigmented spots - family hx bilat deafness
Neurofibromatosis type2
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
Epiglotitis by H influenze; inflammartory edema of the epiglottis that impinges airway--resp arrest; dx clinical; tx relieve obstruction - intubate
Cholesterol--pregnenolore---->17 Oh pregnenolone--->dehydroepiandosterone - pregnenolone--->progesterone--->dexoycorticosterone->corticosterone--->aldosterone -17 oh pregnenolone--->17 0Hprotesteronee--->cortisol - dehydroepiandosterone--->androstene
11. Tx of bact conjunctivitis
No myoclonic activity in JME
Increase of progesteron/17oh progesterone
2wk to 6 months p/w poor feeding - hypotonia - weakness - loss of DTR; soucee raw honey and soil - canned food
Erythromycin ointment - sulfa drops - polymyxin /trimethoprim drops
12. irritable - aggressive - nervous - unable to sleep - dilaed pupil - mouth dry - on methylephenidate
Viral meningitis/encephalitis caused by arbovirus children; HSV in adults
Congenital rubella syndrome
Medical emergency; dimercaprol/edta
Methylephenidate toxicity; cannot be stopped abruptly; taper
13. causes of acute anemia
No myoclonic activity in JME
Splenic sequestraion crisis - aplastic crisis - hyperhemolytic crisis
Atypical lymphocyte
Spores of c boutlium; colonizes in GI tract; release neurotoxin which blocks presynaptic cholinergic transmission; dysfunction of skeletal and smooth muscles
14. When to do aortic root surgery in marfans to prevent dissection?
If aortic root reaches 45 mm
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
Bact: staph - strep - moraxell - h influenzae; eye redness - mucopurulent disch - thick - viral/allergic: adnovirus - asso with fever - URI - watery disch - severe bacterial infection lead to keratitis
Between pregnenolone and 17oh pregnenolone
15. defcicieny of 21 hydroxylase
No wheezing - no feever in chlamydia
Increase of progesteron/17oh progesterone
Congenital rubella syndrome
Injury to lower roots of brachial plexus
16. dx for turner
Wait until 6 months
Definitive karyotype; echo for cardiac - tsh for hypothyroid; and renal US to eval horshoe kidney; visual and hearing assessment
Diet modification to provide 110kc/kg/d
Injury to lower roots of brachial plexus
17. hx shoulder dystocia - pw tahypnoea - cyanosis - weak cry; dec movement rib cage
<2yrs - abd pain - diarrhoea - ARF
Erb paralysis leading to diaphragmatic paralysis
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone
No myoclonic activity in JME
18. language expectation from 2yo
<2yrs - abd pain - diarrhoea - ARF
RSV - rhino and influenza
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting
50+ vocabulary; 2-3 word phrases; follow 2 step command; if delayed do audiometry
19. acute otitis externa
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
20. How long patient needs to be exposed to tick to get infected
Develops in 21 dasy
<2yrs - abd pain - diarrhoea - ARF
36 hours
Dactylitis; 2nd common is splenic seqestration
21. red oozing rash on cheek - scaly - dry
Atopic dermatitis; strong allergic/immunologic component; incr IgE
24-72 hours
Marfans - ehlers danlos - homocystinuria
Foreign body sensation - photophobia - corneal opacity tx abx
22. down syndrome with holocystolic mumur
9-18yrs; 1300 mg; 19-50;l 1000mg; >50 1200mng
Candidal diapar rash; tx clotrimazol
Endocardial cushion defect (no separation between heart chambers)
After 6m; breast mild provides iron until 6m.
23. 4d old infant with dilated loop of bowel;; constipaion; ground glass mass abdomen
Fluoroqunoloes to kill pseudmonas which is a common pathogen in these patients
Heterosexual precocious puberty in females; inc androgen and cortisol - virilization in females - cushing (incr cortisol)
Meconeum ileus; think about CF
Lateral neck xray in epiglottitis show swollen epiglottis
24. doing worse in school - lack of attention - starring speel
Absence seizure; tx ethosuximide
Swimmer's ear; due to decrease canal acidity and bacterial overgrowth; pseudmonas
Constitutional pubertal delay
Intussuseption; dx Us: tx enema comlication; perforation <1% if patient <6m and symptoms presented 3d; have SBO
25. What is the definition of delayed puberty?
Infection in aqueus and vitreous humors; posttraumatic - postcataract surgery;
Absence of puberty sign by 14yrs; testicle <2.5cm dm;
Less than 5th percentile
Develops in 21 dasy
26. failure to thrive
Viral meningitis/encephalitis caused by arbovirus children; HSV in adults
Less than 5th percentile
Imaging study to r/o VUR
Vaso-occlusive crisis; dx hb electrophoresis
27. pneumonia in CF patient
Wait until 6 months
Tx with antipseudomnal abx; ticar/piper plus tobra or fourth gen cephalosporin ceftazidime - cefepime or carbapenem (imi/ mero)
24-72 hours
Injury to b/l glossopharyngeal. present in botulism
28. side effect of testosteron therapy
Decresed visio - sudden onset - seeing halos around light - headache - eye pain
Faciform RBC cause vascular occlusion
Facial portwine stain
Decreases height - expensive; reserved for severe cases of delayed puberty
29. acute otitis media-pathogen
2wk to 6 months p/w poor feeding - hypotonia - weakness - loss of DTR; soucee raw honey and soil - canned food
URI
36 hours
Strep pneumonie; moraxella; h influenze
30. centor criteria for bact pharyngitis
Female - breech delivery - family history; tx referral to ortho
Iron overload from excessive transfusion and ineffective hematopoisis; many raw material but no products
Age<6 - no past h/o afebrile seizure - temp>38 - no cns infection - no metabolic disturbance
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)
31. pumonary TB
Transmits thought sneezing -coughling - singing - speaking by microscopic aerosol containg the organism; keep patient in resp isoloation until non-infectious (3 sputum acid fast smear negative)
Endocardial cushion defect (no separation between heart chambers)
ALL - alzheimers autism adhd depression seizure
Males - weak stream - bladder distension - bladder wall thickening - vesicoureteral reflex; most common caUse of obstructive uropathy in children dx cystourethrogram
32. How to differentiate croup vs epiglotitis
Use of teratogenic agents like alcohol during pregnancy; reconstruction at 3m; rule of 10; 10ib - 10w and 10g hb
Smoking alters mucosa - cilia - adenoid structure - make children susceptible to infection
Anaphylaxis or encephalopathy within 7d of administration; temporary contraindications moderate to severe illness
Croup; hx coughx2-3d - gradual onset; high fever; barking cough; <3y; epiglotitis; sudden onset; stridor; >3y
33. dx for DDH
US and barlow test: attempt to dislocated unstable hip; sometimes make clunking sound;
Neurofibromatosis type2
Croup tx cool mist; racemic epi - corticosteroid
Between progesteron/170h progestreon adn dexoxycorticosteron/17OH corticosterone
34. lens dislocation
No intervention; 90% foreign bodies pass without difficulty
Epiglotitis; staph - HiB tx: ceftriaxone/cefotaxime
Rapid detection of RSV antigen in nasl
Marfans - ehlers danlos - homocystinuria
35. How to difference viral and bact pneumonia
24h to 7d of birth
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
Bacterial: sudden onset - high fever - cxr consolidation. viral; gradual onset - diffuse bilat infhiltrate tx; bact-amoxi;
110 kcl/kg/day
36. When to do surgery for undescended testes
Rash distribution same; measles-3C - cough - conjunctivitis - coryza; koplik spot; rubell; LG fever. lymphadenopahty - tx; self limiting
To make hip flexed and abducted position in DDH
Caput crosses suture line; caput has color (echymotic); caput clears early (within weeks versus several months in cephalo)
Wait until 6 months
37. most common complication of otitis media
1.5%
Another episode of otitis media; children more than 2 episodes have inc risk; other compli acute mastoiditis
Spores of c boutlium; colonizes in GI tract; release neurotoxin which blocks presynaptic cholinergic transmission; dysfunction of skeletal and smooth muscles
24h to 7d of birth
38. lead >70
Anosmia and hypogonadotropic hypogonadism; genetic defect; defective migration of GnRH secreting and olfactory neurons to their final destination
Hospital admission - NG feeding - purgative botulinum antitoxin - no abx (they cause lysis of spores--release more toxin) -
Thalassemia - congenital hemolytic anemia
Medical emergency; dimercaprol/edta
39. tuberous sclerosis
Hypopigmented macule - glial proliferation - organ haramtomas/cysts
Croup; hx coughx2-3d - gradual onset; high fever; barking cough; <3y; epiglotitis; sudden onset; stridor; >3y
Transient synovitis or toxic synovitis; bilateral effusion; preceded by URI -
36 hours
40. Parents can _____ vaccine
Iron overload from excessive transfusion and ineffective hematopoisis; many raw material but no products
Absence seizure; tx ethosuximide
Injury to b/l glossopharyngeal. present in botulism
refuse
41. Nocturnal enuresis
Meconeum ileus; think about CF
Coarcation - bicuspic aortic valve - mitral prolapse - hypoplastic heart
If <7 reassure parents; use alarms - desmopressin and tricyclics less effective than alarms
50+ vocabulary; 2-3 word phrases; follow 2 step command; if delayed do audiometry
42. can women with abnormal smear or genital get vaccine
110 kcl/kg/day
Prednisone/methyleprednison; IVIG - chronic ITP-spelenctomy
Yes; but it will be less effective
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)
43. Febrile seizure
Smoking alters mucosa - cilia - adenoid structure - make children susceptible to infection
Nocturnal increase of LH; then daytime increase of gonadotrophin/testosteron; physical exam enlargement of testes
Age<6 - no past h/o afebrile seizure - temp>38 - no cns infection - no metabolic disturbance
Swimmer's ear; due to decrease canal acidity and bacterial overgrowth; pseudmonas
44. indications of audiometry in childrens
Fifth disease; febrile syndrome
Central isosexual precocious puberty; hypothalmaic hamartoma
Diet modification to provide 110kc/kg/d
Hx hearing loss - meningitis - recurrent or persisten OM >3m - IU infection - ototoxic meds
45. How to evaluate well appearing child just born in GBS pos mother?
Anaphylaxis or encephalopathy within 7d of administration; temporary contraindications moderate to severe illness
At first imaging test to dx bone age; if normal do testing to r/o chromosomal or endocrine abnormality
Refeeding syndrome; edema and heart failure; severe hypophosphatemia tx iv phosophate
Observe for 48h; look for bacerimia - sepsis - meningitis - ventrculitis
46. complete airway obstruction with FB
Decresed visio - sudden onset - seeing halos around light - headache - eye pain
Pneurmocystis; TMP-SMZ IV doc. if intolerant pentamidine or atovaquone
>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
Tonsilar exudate - tender cervical nodes - fever - no cough/nasal dischr (suggest viral inf)
47. mcCune albright`
Cafe au lait spot - fibrous dysplasia of bone; excessive production of estrogen from ovarian cysts
Middle ear effusion persists 3 m after OM; if no symptoms - just watch - if symptoms add another abx. if no improvement tympanocenesis/myringotomy
Feeding jauding due to lack of feeding; 1st week; tx support; milk jaundice due to milk; afer 7d; lack of glucoronidase; incre unconjugate biill tx; interrupt feeding resume
Absence seizure/epilepsy: normal EEG - no myoclonic activity; prognosis good if no generalized seiure
48. Parvovirus
Fifth disease; febrile syndrome
Diet modification to provide 110kc/kg/d
refuse
If <7 reassure parents; use alarms - desmopressin and tricyclics less effective than alarms
49. poor feeding - rhinorrhoea - no fever - hyperinflation - eosinophilia - 2m
Tx with antipseudomnal abx; ticar/piper plus tobra or fourth gen cephalosporin ceftazidime - cefepime or carbapenem (imi/ mero)
Age<6 - no past h/o afebrile seizure - temp>38 - no cns infection - no metabolic disturbance
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
Parvovirus B19 infection---failure of erythropoisis---no reticulocytes
50. Neonatal conjugated hyperbilirubinemia
Biliary atresia; tx surgery
Prolactinoma
Wait until 6 months
No intervention; 90% foreign bodies pass without difficulty