PEADS 1 Clinical mastry series answers

1.b..congenital 3rd degree heart block

2.d hyponatremic encephalopathy not HUS because no
triad
3.a.lipid screening at 9 to 11 and 2nd time at 17 to 21 .uw
4.d. refer uw ,
5.e.case of digeorge syndrome .T cell deficient with VSD
6.F .typical age + typical xray finding collapsed femer
head =LCP
7.hypothermia j wave .bradycardia hypoventilation sign
of moderate hypothermia below 32 to 28c UW
8.d.nonbillious projectile hyponatrimc alkalosis and
progressive worse sign of PS in GERD no vomiting but
only spitting with weight loss peak at 4 month no
metabolic changes
9.b.he has Hep B infection so non immune
10.e. hirshprung dnt cause fatty stool
11.b.Due to concerns regarding possible penicillin-resistant
pneumococcal infection as well as beta-lactamaseproducing H.
influenzae, we recommend that initial empiric therapy
include vancomycin plus either ceftriaxone or cefotaxime
12. c she is pregnant so BHcg first best step sign of
pregnancy positive

13 d.HIV case pneumocystis jirovici lavage and stain

best diagnostic method
14,d cellulitis by staph
15 e mayotonic dystrophy they dnt leave hand once
they shake with any one
16 c prolonged qt hypocalcimia
17 .A ..ductus arteriosis dependent hear lesion appear
with symptom if we dnt give PG E 1 ..most likely
coractation with VSD now DA is closed
18.F typical case of spasm in tuberous sclerosis
19 ANS IS B because they eat unpasteurized food .
for typhoid prevention
Be careful what you eat and drink While traveling, you
should:
Wash your hands with soap and water before eating or
handling food.
Drink only bottled water or water that has been boiled for
at least 1 minute.
Do not get ice in drinks and do not eat popsicles or
flavored ice.
Eat food that has been completely cooked and is still hot.
Eat only fruits that have a peel and that you wash and
peel yourself. Do not eat the peels.
Do not eat vegetables or salads.

Do not buy food or drinks from street vendors.

20 E for rotavirus prevention

Wash your hands with soap and water after you use the
bathroom or change your childs diaper, and before you eat.
Avoid changing your childs diaper near where you prepare
food.
21.c. hashimoto thyroiditis lymphocytic infiltration
22.c .mass is bladder and PUV is most common cause of
distended bladder in new born male
23 E .venous hum typical presentation
24 E.
25.A .edema is most common cause in TYP1 DM loss of
consciousness ..it may be due to disease itsef or
treatment due to fluid overload
26 d.due to pulmonary hypertention there is hypoxic
induced polycythemia
27 c . foreign body lungsd next step rigid bronchoscopy
28 a clear case of aplastic anemia
29 c ingiuinal hernia can be milked up into abdomen
but testes tumor cant be
30 c typical case of impetigo

31 f .DDH pathophysiology is shallow acetabulm high

yield case knw every thing about it
32 .D indication are .
33 A ..ans in key is wrong but we have to follow UW no
indication of VCUG in this case
34 D frcture evident in xry
35.c anorexia nervosa main risk factor
36 c source uw
37 d ,,,lead exposure extremely important to knw and
how to diagnose lead posining irritability with
hypochromic is a sign of lead
38 e ,,its an exam qz ..cause of hyponetrimia in type 1 is
hyperglycemia .it leads to pseudohyponatremia, due to high osmolality
and trans-cellular shift of free water out of cells into vascular space

39 e Wrong prophylaxis he got because Asian maliaria

is FQ resisitant
40 c uw id 2803

41 e ..he is boy so at age 15 to 16 its normal self

resolving
42 a ..first step diet control next weight control next
statin
43 ..its major depression read criteria its fulfilling 5
creiteria of DSM 5

44.d sinusitis
45 B ,lobar pneumonia can cause abdominal pain if lower
lobe involved
46 e typical case of herpes encephalitis
47 e
48 c cystic fibrosis .
49 d
50 d sepsis or infective endocarditis

PEADS 2
1.c.hyphema can occure in retinoblastoma source uptd
2.E neuroblastoma

Metastatic spread to the skin manifests as papules or subcutaneous nodules

that can be distributed over the entire body. These lesions are present in approximately one-third of
children with congenital neuroblastoma, and are typically described as firm, bluish-red, and nontender
[24-26]. The lesions have a distinctive response to rubbing, characterized by central blanching with a
surrounding halo of erythema that persists for 30 to 60 minutes [25,26]. The differential diagnosis of skin
nodules is presented below. Rigorous evaluation is important to determine the etiology of the nodules so
that the child can be appropriately treated. Children with skin nodules that are biopsy-proven to be
neuroblastoma should undergo a full tumor evaluation by an oncologist.uptodate

3 B .isoniazid is preffered
4.d.
learn to differentiate it from Kawasaki
5 H Reactive triad

6 A .intussiseption case .surgry is ans only if caused by henoch sholin purpra for ilio ileac intusseption
only exception otherwise alwasys click air enema
7 .C goat milk is famous for Vitamen D deficiency and cow milk for iron deficiency anemia
8 B autoimmune disease cluster always suspect another autoimmune disease
9 c ..first catheterization sampling next treat next always do ultrasound next if normal reassure if abnormal
or other indication for VCUG then do VCUG
10 B NF 1 ADHD is associated with NFI not with tuberous sclerosis Kaplan page 230 .other important
mcq is renovascular hypertention and pheochromocytoma associated with NF1

11.e ..abdominal distention and gaseless abdomen =volvulous

Right abdomen mass plus episodic cramping and leg lifting ==intussiseption
12.e its pathological varus .its not rickests as its not bilateral
Not physiological because it resolved by 2 yr of age
most likely due to bolnut disease at this stage only treatment is surgry ..if at 3 yr then first bracing and
if dnt respond do surgry at 4 yrs
13. A .because no antibody are being formed by plasma cells due to abnormal B cell function
14 a .hirshprung
15 C Kawasaki fulfilling all 5 criteria next step aspirin with IVIG
16 . E .pharngitis ideally in children we do test first and treat later and opposite in adult if center criteria is
fulfilled ,..uw 2193 here no test given so oral antibiotic therapy
17 C .he is having currently no issue and vitally stable so only we have to diagnose down syndrome and
its related heart lesion by Karyotype and ECG
18 A. Addison disease
19 e . non toxic + rhinorea +complete immunization =croup =subglottic edema
Other cause is congental subglottic stenosis confirmed only by larngoscopy ..kaplan
Option c =bronchilolitis

Option d =pnumonea
Option b =epiglottitis but it wl have sudden onset +drooling + toxic plus incomplete immunization
20 e

21.perineal asthma .spirometry gold standard test

hyperinflation on xry plus night cough plus seasonal
worsening are imp clues
22 e .HUS typical case ..he did not gave critinine value
but this is right ans .hemolysis +thrombocytopenia+
bloody diarrhea + increased critinine =HUS
23 e .its normal as precocious puberty foor girl is always
less than 8 and for boys less than 9
24 a .HERIDETRY SPHEROCYTOSIS

25 c

Although grade of varicocele should not be the sole indication for treatment, treatment may be
warranted in adolescents with large varicoceles (grade III) and abnormal semen analysis, since varicocele
repair has been associated with improved semen analysis in adolescents and young me

Only line I got from uptd .it means if we dnt treat

varicocele then it may lead to infertility
26 a .turner syndrome
27 e .do endoscopy with in 24 hour uw
28 a .Indications for intervention Intervention may be required for lesions with potential to interfere
with a vital structure or function. These include, but are not limited to [3]:
Lesions in the airway, liver, or gastrointestinal tract
Lesions in the periorbital region
Very large, rapidly growing cutaneous hemangiomas
We suggest active nonintervention for uncomplicated hemangiomas that are not disfiguring (Grade
2C). Active nonintervention requires regular monitoring of the clinical course and attention to the
psychosocial implications for the child and family. (See 'Active nonintervention' above.)
Intervention is usually required for lesions that may interfere with a vital structure or function and
lesions at increased risk for complications, scarring, or disfigurement. (See 'Indications for
intervention' above.)
Children with periorbital hemangiomas should be evaluated by an ophthalmologist who is
experienced in the treatment of hemangiomas. (See'Periorbital hemangiomas' above.)
We suggest oral propranolol in addition to meticulous wound care and appropriate analgesia for
the treatment of ulcerated hemangiomas that may cause permanent disfigurement, interfere with
daily life activities, or do not respond to wound care measures (Grade 2C). (See 'Ulceration'above.)

We suggest oral propranolol as the first-line agent for the treatment of complicated hemangiomas

29 .VSD
A diastolic rumble due to increased flow across the mitral valve may be heard at the apex in infants with
moderate to large VSDs with a ratio of pulmonary to systemic blood flow (Qp:Qs) >2:1 source uptd ..it
confused me a lot now solved take my much time so

VSD can come with diastolic murmur of mitral stenosis ,aortic and pulmonary regurgitation u must know
the location of murmur to get the idea ..here at apex so its VSD severity leading to rumble at mitral area
30 g .its syphilis typical;l case sharp border no pain no exudate sub-Saharan
31 .I .versicolr= hypopigmentation of subacute onset plus itching plus scales by fungus
Complete abscense of melanocytes in 20 to 30 yr is called vitilligo ..no pruritis here and it has predilection
for acral areas
Discoid lesions ;are characterized by discrete, erythematous, slightly infiltrated plaques covered by a wellformed adherent scale that extends into dilated hair follicles (follicular plugging). Lesions of DLE are most
often present on the face, neck, and scalp, but also occur on the ears and, infrequently, on the upper
torso

32 E .more than 95 % child get recoverd chronic renal failure is rare in children

33 A ,V IMP MCQ whenever ANA positive always think for juvenile rheumatoid arthritis here is a table u
must know forget about Kaplan about this topic then

34 a ,,,ARDS leading to corpulmonale .its due to brochopulmonary dysplasia I searched a lot and most
suitable ans is A .all feature of corpulmonale are here but I did not get the how corpulmonale lead to
sysytemic hypertention it can cause pulmonary hypertention as far I know well our group discussion
concluded on A
35 B ,mixed hyperbilurubinimia and pale stool = excretion defect most probably due to bile duct problem
or excretion problem at any point
36 .c nephroblastoma .learn to differentiate from neuroblastoma
37 c ,,,prerenal azotemia due to hypoperfusion as ration of BUN/CRITININ is >20 /1
38 a.its constituaional delay
normal velocity +bone age less than chronoclogical age =CD
so here u only have to knw bone age to confirm diagnosis so next step wl be left hand wrist xry
39 E .measle case after MMR very rare but can occure in immunecompromised people .

MMR contraindication are given in table

40 c .use hydrolysed milk here in milk colitis its non IGE mediated reactiomn uw id 2464
41 a .
Bulging of the tympanic membrane and other signs of acute inflammation Signs of acute
inflammation are necessary to differentiate AOM from otitis media with effusion (OME). The best and most
reproducible sign of acute inflammation is distinct fullness or bulging of the tympanic membrane ].
Experienced otoscopists rarely make the diagnosis of AOM in the absence of bulging of the tympanic
membrane
Marked redness of the tympanic membrane is another sign of acute inflammation [22]. However, marked
redness of the tympanic membrane without bulging is unusual in AOM [15]. A distinctly red tympanic
membrane in the absence of bulging or impaired mobility has a positive predictive value of only 15
percent for AOM
Acute onset + bulging +redness+ decreased mobility =AOM
42 c
Age
Term

Without risk factor

Bilurbin above 25

With risk factor

Above 20

Treatment
transfusion

preterm

Above 21

16 to 19

transfusion

This patient is Term + bilirubin above 20 with risk factor like Herdert hemochromatosis so next step wl be
transfusion approach its all from uptd
43 a ..its confirm ans ..this is first best approach next approach wl be decrease exercise duration to avoid
hypoglycemia
44 b typical case of ARDS
45 a cmv typical case
46 d ,,asplnic patient need prophylaxis of penicillin
47 a..in emergency no consent is required from a child
48 . ans is c ,,,its ABO incompatibility type of HDN
HDN has two major types RH and ABO Rh never occurred in positive blood group..liver normaly
palbable in infants so its normal thing not galatosemia in which direct bilirubin is elevated
49 b ..he is having rigidity so muscle relxant wl be next best step
50 D .SLE pancytopenia plus autoimmune hemolytic antibodies positive +seizur

Thats all .sources are uw Kaplan ,uptd .

Remember me in prayers .i did all this so that ur time

can be saved its very hectic and time consuming
job well its over for peads