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47 Cards in this Set

  • Front
  • Back
Newborn infant presents with tachypnea and poor feeding tolerance; physical exam : continuous machine-like murmur
1-wk-old infant is found to have low-set ears, flat occiput, simian crease, small outh, and protruding tongue, PE: holosystolic murmur
Trisomy 21 (Down's syndrome)
1-wk-old infant presents for routine newborn exam; PE: +hip click and dislocation of the hip with posterior pressure
Developmental hip displasia
2 y/o presents with sudden-onset dyspnea and respiratoy distress; PE: decreased breath sounds on the right side
Foreign body aspiration
13 y/o presents with fever, emesis, and diffuse periumbilical pain that has localized to the right lower quadrant , PE: guarding and tenderness in RLq, +psoas and obturator signs
4-month-old Black child presents with pallor, PE: splenomegaly and a II/VI systolic ejection murmur; W/U: Hgb electrophoresis shows Hgb S band
Sickel cell disease
2 y/o who attends daycare presents with 2-day h/o nonbloody, watery diarrhea, and vomiting, PE: increased HR and dry mucous membranes
Viral gastroenteritis (most likely rotavirus)
8 y/o presents with painful purpura after jumping on a trampoline; PE : palpable purpura on the legs and buttocks with mild abd discomfort
Henoch-Schonlein purpura
5 y/o male presents with h/o hemarthrosis and multiple ecchymoses; W/U: prolonged PTT and low factor VIII
Hemophilia A
Newborn w/ h/o T21 and polyhydramnios in utero presents with bilious emesis; PE: abdominal distension; Abd XR shows double bubble sign
Duodenal atresia
8 y/o w/ h/o Type 1 DM presents with abd pain and n/v PE: Kussmall resp and inc HR; art blood gas: met acid; UA ketonuria
7 y/o F presents with breast buds and monthly vaginal bleeding; PE: ht and wt >> 95th%, full pubic and axilary hair, hand XR shows advanced bone age
precocious puberty
8 y/o with h/o sickle cell disease presents with severe abd pain associated with n/v
vasoocclusive pain crisis
1 y/o presents with irritability plus crampy, intermittent abd pain w/ diarrhea; PE; tubular, "sausage-like mass" and guaiac + stool
5 y/o presents with recurrent upper respiratory infections and steatorrhea; PE: nasal polyps and failure to thrive; Sweat chloride test > 60 mEq/L
Cystic fibrosis (CF)
14 y/o M presents with gynecomastia; PE: tall male with a small phallus and small testes
klinefelter's sydrome
4 y/o presents with new-onset wt loss, polyphagia and polyuria, PE: dehydration W/U: glucose = 400mg/dL
Type 1 dm (newly diagnosed)
13 y/o obese male presents w/ a painful limp; Frog-leg XR shows epiphyseal displacement
10 y/o w/ h/o sickle cell disease presents in resp distress; W/U: decreased hematocrit and decreased O2 saturation
Acute chest syndrome
2 y/o presents with painless, rectal bleeding; radionuclide scan reveals ectopic gastric mucosa proximal to the ileocecal valve
Meckel's diverticulum
2 y/o presents with ear pulling; PE: fever, TM is erythematous and bulging w/o a Light reflex
Acute OM
12 y/o presents with leg pain; PE: localized swelling over distal femur; W/U: inc alk phos; XR: lytic bone leison with a "sunburst" appearance
1 m/o infant w/ no sig medical history presents for routine checkup; PE: III/VI harsh holosystolic murmur heard best at the left lower sternal borderr
ventricular septal defect
1 day old F presents with ambiguous genitalia on newborn exam; W/U: hyponatremia, hyperkalemia, hypoglycemia and increased 17-hydroxyprogesterone
congenital adrenal hyperplasia
4 y/o M w/ a 1 wk h/o fever, pallor, headache, and bone tenderness; PE: fever, HSM, and generalized nontender lymphadenopathy; W/U: peripheral blood smear reveals absolute lymphocytosis with abundant lymphoblasts
ALL (acute lymphoblastic leukemia)
4 y/o presents with barky cough and rhinorrhea; PE: fever, inspiratory stridor, XR: "steeple sign"
8 y/o with h/o bowel and bladder dysfunction presents for checkup; PE: tuft of hair over lower back, scoliosis
spina bifida occulta
5 y/o presents w/ 6-day h/o high fevers, PE: conjunctivitis w/ limbal sparing, adenitis, "strawberry tongue," and fissued lips; W/U: increased platelet, decreased hematocrit
kawasaki disease
6 y/o child presents after episodes of "daydreaming" in class which described as "blank-stares"; W/U: EEG reveals three-per-second spike and wave pattern
Absence seizure
3 y/o presents w/ recurrent UTIs; vesicoureterogram reveals abnormally placed ureteral insertion into the bladder
vesicoureteral reflux
4 y/o presents with periorbital edema; PE: also reveals swelling at the ankles; WU: hyperlipidemia and 4+ proteinuria on UA
Minimal change disease
8 y/o sickle cell pt with recent h/o viral prodrome presents w/ fatigue; PE: increased HR, increased RR, W/U: reticulocyte count <1%
Aplastic crisis
15 y/o presents w/ fevers and exudative pharyngitis; PE: genearlized lymphadenopathy; W/U: +heterophile antibody test, PBS reveals atypical lymphocytes
1-day-old infant w/ h/o of prematurity (30 weeks) pesents in resp distress; PE: retractions, nasal flaring, and cyanosis; CXR: diffuse atelectasis
Respiratory distress syndrome
Newborn infant presents with resp distress and episodic bouts of cyanosis; PE: right ventricular heave and loud systolic ejection murmur; CXR: "Boot-shaped heart"
Tetralogy of Fallot
8 y/o who lives with 2 ppd smoker presents w/ persistent nighttime coughing; PE: audible wheezes
15 y/o presents for evaluation of primary amenorrhea; PE: widely spaced nipples, webbed neck; and crescendo/decrescendo systolic murmur at the riht upper sternal border
Turner's (XO) syndrome
Newborn presents with cyanosis and resp distress; PE: right ventricular heave and loud single S2; CXR: cardiomegaly and and an "egg-shaped silhouette"
Transpositoin of the great vessels
1 m/o first-born male presents with projectile, nonbilious voiting; PE: mobile, nontender, olive-shaped mass in the epigastric area
pyloric stenosis
4 y/o w/ h/o "falling off bike" presents with arm pain; PE: tenderness over forearm, bruises in various stages of healing; XR: spiral and metaphyseal fractures
child abuse
12 y/o presents w/ symptomatic, episodic palpiations during exercise; W/U; ECG reveals "delta wave"
Wolff-Parkinson-White syndrome
13 y/o presents with joint pain and fevers; PE reveals a salmon - colored rash and lymphadenopathy; W/U; increased WBC and ESR
3 y/o presents after one generalized seizure lasting for 1 min PE: fever
simple febrile seizure
2 wk old presents with bilious emesis; Upper GI series: an abnormally placed cecum and ligament of Treitz
6 m/o presents in December with cough, rhinorrhea, and fevers; CXR: diffuse atelectasis; nasopharyngeal aspirate reveals RSV antigen +
15 y/o athlete experiences sudden cardiac death during a basketball game; autopsy reveals a muscular intraventricular septum and significant left ventricular hypertrophy
hypertrophic obstructive cardiomyopathy
8 y/o presents w/ fever, photophobia, stiff nceck, and headache; PE: +Kernig's and Brudzinski's signs; LP: nl glucose, mononuclear WBCs, and no organisms on gram stain
viral meningtis