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Congenital Umbilical Hernias - (answer)Resolve spontaneously by 5 years of age
- Surgery only required for the management of complications (eg. incarceration)
Constitutional Growth Delay - (answer)Delayed puberty or delayed bone age. Normal variant. Adult
height ends up in normal range
- normal levels of LH, FSH, and testosterone but have short stature and growth drops below 3rd
percentile in ages 10-11
Allergic Rhinitis Treatment - (answer)Intranasal corticosteroids (eg, fluticasone) are the most effective
single treatment for allergic rhinitis.
- you can try oral antihistamines and or intranasal decongestants as combination therapy
Sicke-Cell Anemia Patient with Diarrhea - (answer)Concern for Salmonella Gastroenteritis
- Prescribe IV ceftriaxone
High-risk pediatric patients with immune suppression, including patients with malignancies,
immunosuppressive therapy, sickle cell anemia, immunodeficiency states and HIV must receive
appropriate antimicrobial therapy in the setting of Salmonella gastroenteritis. Empiric therapy should
begin with IV ceftriaxone in ill patients, although antimicrobial therapy should be directed by culture
results and organism sensitivities when available.
Obstructive Sleep Apnea in Kids - (answer)Presents as daytime sleepiness, learning problems, enuresis,
parasomnias, and loud snoring
- In children, obstructive sleep apnea typically occurs as a result of adenotonsillar hypertrophy, not
obesity. Clinical manifestations are variable and can include a combination of daytime sleepiness,
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learning problems, enuresis, parasomnias, and loud snoring. If left untreated, patients can develop
cardiovascular complications, such as systemic hypertension and structural heart changes.
Leukocyte Adhesion Defiency (LAD) - (answer)recurrent bacterial infections of the skin and mucosa,
absent pus formation (seroanguinous), and delayed separation of the umbilical cord.
- Leukocyte adhesion deficiency is an autosomal recessive primary immunodeficiency disorder caused by
defective integrins on the surface of leukocytes. It is characterized by recurrent bacterial infections of
the skin and mucosa (eg, omphalitis, gingivitis/periodontitis), absent pus formation, and delayed
separation of the umbilical cord.
Most common neck mass in the pediatric population - (answer)asymptomatic benign lymphadenopathy
Child with persisent symptoms of urinary tract infections (>48 hours) or costovertebral angle tenderness
development --> next steps? - (answer)Expand antimicrobial coverage and complete a renal/bladder
ultrasound to evaluate for kidney involvement and to detect any underlying anatomic abnormalities.
Chronic Kidney Disease (CKD) in children - (answer)occurs as a result of an anatomic abnormality and
patient presents with poor growth, fatigue, hypertension, and enuresis.
- Urinalysis reveals proteinuria and/or hematuria
- must measure serum creatinine and complete renal imaging
Systemic Juvenile Idiopathic Arthritis - (answer)Systemic juvenile idiopathic arthritis presents with fixed
arthritis for ≥ 6 weeks, quotidian fever for ≥ 2 weeks, and a rash that worsens during fever.
- Additional findings can include hepatosplenomegaly, lymphadenopathy, anemia, and elevated
inflammatory markers (eg, erythrocyte sedimentation rate, C-reactive protein, thrombocytosis).
DiGeorge (22q11.2 deletion) syndrome --> Common Heart Defect - (answer)Tetralogy of Fallot (TOF)