Pediatrics Review 2026 Exam Guide
- Emma Holliday Ramahi||Brand
New Exam||A+ Booster
General info about how the newborn tolerated labor (1min) and the newborn's response
to resuscitation (5min) - CORRECT ANSWERS-What does the APGAR tell you?
What to do next (does not guide therapy)
How the baby will turn out (does NOT predict neurologic outcome) - CORRECT
ANSWERS-What does the APGAR not tell you?
Erb-Duchenne C5-C6. (Klumpke is C7-C8 + T1) Refer if not better by 3- 6mo for
neuroplasty - CORRECT ANSWERS-PE: When assessing Moro on an LGA newborn,
the right arm remains extended and medially rotated.
Clavicular Fracture.
Will form a callus in 1wk. No tx needed. Can use figure of 8 splint. - CORRECT
ANSWERS-PE: When palpating the clavicles on a LGA newborn, you feel crepitus and
discontinuity on the left.
Caput succedaneum - CORRECT ANSWERS-"Edema. Crosses suture lines."
Cephalohematoma - CORRECT ANSWERS-"Fluctuance. Doesn't cross suture lines."
Mongolian Spots - CORRECT ANSWERS-
Nevus Simplex (Salmon Patch) - CORRECT ANSWERS-
Milia - CORRECT ANSWERS-
Erythema toxicum - CORRECT ANSWERS-Appears in up to half of newborns carried to
term, usually between day 2-5 after birth. Resolves within first two weeks of life, and
frequently individual lesions will appear and disappear within minutes or hours. It is a
benign condition thought to cause no discomfort to the baby
Strawberry Hemangioma - CORRECT ANSWERS-
Neonatal Acne - CORRECT ANSWERS-
Nevus Sebaceous - CORRECT ANSWERS-"an area of alopecia with orange colored
nodular skin"
Remove before adolescence b/c it can undergo malignant degeneration.
,Seborrheic Dermatitis - CORRECT ANSWERS-"thick, yellow/white oily scale on an
inflammatory base".
What to do? Gently clean w/ mild shampoo
Phenylketonuria and Galactosemia. - CORRECT ANSWERS-Two disorders screened
for in every state because they are disastrous if not caught early (and happen to be a
contraindication to breast feeding...)
Deficient G1p-uridyl- transferase. G1p accum to damage kidney, liver, brain.
• Sxs = MR direct hyperbili & jaundice, ↓glc, cataracts, seizures.
• Predisposed to E. coli sepsis.
• No lactose por vida. - CORRECT ANSWERS-Galactosemia.
• Deficient Phe hydrolxalase.
• Sxs = MR, vomiting, athetosis, seizures, developmental delay over 1st few mos
• Signs = fair hair, eyes, skin, musty smell.
• Low Phe diet. - CORRECT ANSWERS-Phenylketonuria.
Physiologic Jaundice. Gone by 5th DOL.
Liver conjugation not yet mature. - CORRECT ANSWERS-3 days old, bili @ 10, direct
is 0.5. Eating & pooping well.
Breast feeding Jaundice. ↓feeding = dehydration = retain meconium & re- absorb
deconjugated bili. - CORRECT ANSWERS-7 days old, bili @ 12, direct is 0.5. dry
mucous membranes, not gaining weight.
Breast milk Jaundice. Breast milk has glucuronidase and de-conj bili. - CORRECT
ANSWERS-14 days old, bili @ 12, direct is 0.5. Baby regained birth weight, otherwise
healthy.
Pathologic Jaundice = on 1st DOL, bili >12, d-bili >2, rate of rise >5/day.
Test: Coombs
Positive: Rh or ABO incompatability
Negative: twin/twin or mom/fetus transfusion, IDM, spherocytosis, G6p-DH deficiency,
etc. - CORRECT ANSWERS-1 day old, bili @ 14, direct is 0.5. Are you worried? Next
best test? If positive? If negative?
Biliary atresia. Bile ducts cannot drain bile. Causes liver failure. Need surgery. -
CORRECT ANSWERS-7 days old. Dark urine, pale stool. Bili @ 12, dbili is 8. LFTs also
elevated.
Always r/o sepsis!
Galactosemia
Hypothyroid
Choledochal cyst
,CF
Biliary atresia (<2mo) - CORRECT ANSWERS-Other causes of direct
hyperbilirubinemia?
Gilbert - ↓glucoronyl transferase level
Crigler-Najjar (type1) - total deficiency - CORRECT ANSWERS-Random inherited
causes of indirect hyperbili? (2)
Dubin-Johnson Sx - asx, black liver
Rotor Sx - NO black liver - CORRECT ANSWERS-Random inherited causes of direct
hyperbili (2)
Indirect bili can cross BBB, deposit in basal ganglia and brainstem nuclei and cause
*kernicterus*. (esp if bili is >20) - CORRECT ANSWERS-Why do we care about
hyperbilirubinemia?
Phototherapy (Tbil>20)--> ionizes the uncoj bili so it can be excreted.
Double volume exchange transfusion (Tbil>25) if that doesn't work. - CORRECT
ANSWERS-Treatment for hyperbilirubinemia
Diaphragmatic hernia
Concern: Pulmonary hypoplasia
Txt: If dx prenatally, plan delivery at @ place w/ ECMO. Let lungs mature 3-4 days then
do surg - CORRECT ANSWERS-Baby is born w/ respiratory distress, scaphoid
abdomen & this CXR.
• Biggest concern?
• Best treatment?
TE- Fistula
Dx: Place feeding tube, take xray, see it coiled in thorax
Also look for: VACTER associated anomalies- vertebral, anal
atresia, cardiac, radial and renal. - CORRECT ANSWERS-Baby is born w/ respiratory
distress w/ excess drooling.
Best Dx test?
What else do you look for?
Choanal Atresia
Also look for: CHARGE associated anomalies- coloboma, heart defects, retarded
growth, GU anomalies , Ear anomalies and deafness - CORRECT ANSWERS-1 week
old baby becomes cyanotic when feeding but pinks up when crying.
• What else do you look for?
RDS
Prenatal Dx: L/S<2, give antenatal betamethasone
Pathophys: Surfactant def, can't keep alveoli open.
, Txt: O2 therapy with nasal CPAP to keep alveoli open - CORRECT ANSWERS-32 wk
premie has dyspnea, RR of 80 w/ nasal flaring.
- Prenatal Dx?
- Pathophys?
- Txt?
TTN
Pathophys: Lung fluid not squeezed out, retained
Prognosis: Usually minimal O2 needed. Self resolves in hrs to days - CORRECT
ANSWERS-38 wk LGA infant born by C/S to an A2GDM has dyspnea/grunting
- Pathophys?
- Prognosis?
Meconium Aspiration Syndrome
Next: intubate and suction before stimulation
Complications: Pulmonary artery HTN, pneumonitis - CORRECT ANSWERS-41 wk
AGA infant was born
after ROM yielded greenish-
brown fluid.
*Next best step?
*Complications?
Gastroschisis
will see high maternal AFP
Not usually associated w/ other d/o
Complications: May be atretic or necrotic req removal. Short gut syndrome - CORRECT
ANSWERS-Defect lateral (usually R) of midline, no sac
- Assoc w/ other d/o?
- Complications?
Omphalocele
Assoc w/ Edwards & Patau Trisomies, Beckwith Wiedemann Syndrome = big baby w/
big tongue, ↓glc, ear pits - CORRECT ANSWERS-Defect in the midline.
Covered by sac.
- Assoc w/ other disorders?
Umbilical hernia
Assoc w/ congenital hypothyroidism. (also big tongue)
Repair not needed unless persists past age 2 or 3yo - CORRECT ANSWERS-Defect in
the midline. No bowel present.
- Assoc w/ other d/o?
- Txt?
Pyloric stenosis
Complications: hypochloremic metabolic alkalosis
- Emma Holliday Ramahi||Brand
New Exam||A+ Booster
General info about how the newborn tolerated labor (1min) and the newborn's response
to resuscitation (5min) - CORRECT ANSWERS-What does the APGAR tell you?
What to do next (does not guide therapy)
How the baby will turn out (does NOT predict neurologic outcome) - CORRECT
ANSWERS-What does the APGAR not tell you?
Erb-Duchenne C5-C6. (Klumpke is C7-C8 + T1) Refer if not better by 3- 6mo for
neuroplasty - CORRECT ANSWERS-PE: When assessing Moro on an LGA newborn,
the right arm remains extended and medially rotated.
Clavicular Fracture.
Will form a callus in 1wk. No tx needed. Can use figure of 8 splint. - CORRECT
ANSWERS-PE: When palpating the clavicles on a LGA newborn, you feel crepitus and
discontinuity on the left.
Caput succedaneum - CORRECT ANSWERS-"Edema. Crosses suture lines."
Cephalohematoma - CORRECT ANSWERS-"Fluctuance. Doesn't cross suture lines."
Mongolian Spots - CORRECT ANSWERS-
Nevus Simplex (Salmon Patch) - CORRECT ANSWERS-
Milia - CORRECT ANSWERS-
Erythema toxicum - CORRECT ANSWERS-Appears in up to half of newborns carried to
term, usually between day 2-5 after birth. Resolves within first two weeks of life, and
frequently individual lesions will appear and disappear within minutes or hours. It is a
benign condition thought to cause no discomfort to the baby
Strawberry Hemangioma - CORRECT ANSWERS-
Neonatal Acne - CORRECT ANSWERS-
Nevus Sebaceous - CORRECT ANSWERS-"an area of alopecia with orange colored
nodular skin"
Remove before adolescence b/c it can undergo malignant degeneration.
,Seborrheic Dermatitis - CORRECT ANSWERS-"thick, yellow/white oily scale on an
inflammatory base".
What to do? Gently clean w/ mild shampoo
Phenylketonuria and Galactosemia. - CORRECT ANSWERS-Two disorders screened
for in every state because they are disastrous if not caught early (and happen to be a
contraindication to breast feeding...)
Deficient G1p-uridyl- transferase. G1p accum to damage kidney, liver, brain.
• Sxs = MR direct hyperbili & jaundice, ↓glc, cataracts, seizures.
• Predisposed to E. coli sepsis.
• No lactose por vida. - CORRECT ANSWERS-Galactosemia.
• Deficient Phe hydrolxalase.
• Sxs = MR, vomiting, athetosis, seizures, developmental delay over 1st few mos
• Signs = fair hair, eyes, skin, musty smell.
• Low Phe diet. - CORRECT ANSWERS-Phenylketonuria.
Physiologic Jaundice. Gone by 5th DOL.
Liver conjugation not yet mature. - CORRECT ANSWERS-3 days old, bili @ 10, direct
is 0.5. Eating & pooping well.
Breast feeding Jaundice. ↓feeding = dehydration = retain meconium & re- absorb
deconjugated bili. - CORRECT ANSWERS-7 days old, bili @ 12, direct is 0.5. dry
mucous membranes, not gaining weight.
Breast milk Jaundice. Breast milk has glucuronidase and de-conj bili. - CORRECT
ANSWERS-14 days old, bili @ 12, direct is 0.5. Baby regained birth weight, otherwise
healthy.
Pathologic Jaundice = on 1st DOL, bili >12, d-bili >2, rate of rise >5/day.
Test: Coombs
Positive: Rh or ABO incompatability
Negative: twin/twin or mom/fetus transfusion, IDM, spherocytosis, G6p-DH deficiency,
etc. - CORRECT ANSWERS-1 day old, bili @ 14, direct is 0.5. Are you worried? Next
best test? If positive? If negative?
Biliary atresia. Bile ducts cannot drain bile. Causes liver failure. Need surgery. -
CORRECT ANSWERS-7 days old. Dark urine, pale stool. Bili @ 12, dbili is 8. LFTs also
elevated.
Always r/o sepsis!
Galactosemia
Hypothyroid
Choledochal cyst
,CF
Biliary atresia (<2mo) - CORRECT ANSWERS-Other causes of direct
hyperbilirubinemia?
Gilbert - ↓glucoronyl transferase level
Crigler-Najjar (type1) - total deficiency - CORRECT ANSWERS-Random inherited
causes of indirect hyperbili? (2)
Dubin-Johnson Sx - asx, black liver
Rotor Sx - NO black liver - CORRECT ANSWERS-Random inherited causes of direct
hyperbili (2)
Indirect bili can cross BBB, deposit in basal ganglia and brainstem nuclei and cause
*kernicterus*. (esp if bili is >20) - CORRECT ANSWERS-Why do we care about
hyperbilirubinemia?
Phototherapy (Tbil>20)--> ionizes the uncoj bili so it can be excreted.
Double volume exchange transfusion (Tbil>25) if that doesn't work. - CORRECT
ANSWERS-Treatment for hyperbilirubinemia
Diaphragmatic hernia
Concern: Pulmonary hypoplasia
Txt: If dx prenatally, plan delivery at @ place w/ ECMO. Let lungs mature 3-4 days then
do surg - CORRECT ANSWERS-Baby is born w/ respiratory distress, scaphoid
abdomen & this CXR.
• Biggest concern?
• Best treatment?
TE- Fistula
Dx: Place feeding tube, take xray, see it coiled in thorax
Also look for: VACTER associated anomalies- vertebral, anal
atresia, cardiac, radial and renal. - CORRECT ANSWERS-Baby is born w/ respiratory
distress w/ excess drooling.
Best Dx test?
What else do you look for?
Choanal Atresia
Also look for: CHARGE associated anomalies- coloboma, heart defects, retarded
growth, GU anomalies , Ear anomalies and deafness - CORRECT ANSWERS-1 week
old baby becomes cyanotic when feeding but pinks up when crying.
• What else do you look for?
RDS
Prenatal Dx: L/S<2, give antenatal betamethasone
Pathophys: Surfactant def, can't keep alveoli open.
, Txt: O2 therapy with nasal CPAP to keep alveoli open - CORRECT ANSWERS-32 wk
premie has dyspnea, RR of 80 w/ nasal flaring.
- Prenatal Dx?
- Pathophys?
- Txt?
TTN
Pathophys: Lung fluid not squeezed out, retained
Prognosis: Usually minimal O2 needed. Self resolves in hrs to days - CORRECT
ANSWERS-38 wk LGA infant born by C/S to an A2GDM has dyspnea/grunting
- Pathophys?
- Prognosis?
Meconium Aspiration Syndrome
Next: intubate and suction before stimulation
Complications: Pulmonary artery HTN, pneumonitis - CORRECT ANSWERS-41 wk
AGA infant was born
after ROM yielded greenish-
brown fluid.
*Next best step?
*Complications?
Gastroschisis
will see high maternal AFP
Not usually associated w/ other d/o
Complications: May be atretic or necrotic req removal. Short gut syndrome - CORRECT
ANSWERS-Defect lateral (usually R) of midline, no sac
- Assoc w/ other d/o?
- Complications?
Omphalocele
Assoc w/ Edwards & Patau Trisomies, Beckwith Wiedemann Syndrome = big baby w/
big tongue, ↓glc, ear pits - CORRECT ANSWERS-Defect in the midline.
Covered by sac.
- Assoc w/ other disorders?
Umbilical hernia
Assoc w/ congenital hypothyroidism. (also big tongue)
Repair not needed unless persists past age 2 or 3yo - CORRECT ANSWERS-Defect in
the midline. No bowel present.
- Assoc w/ other d/o?
- Txt?
Pyloric stenosis
Complications: hypochloremic metabolic alkalosis
