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Nr 602 Final Exam Questions and Answers
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Nr 602 Final Exam Questions and Answers
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Nr 602 Final Exam Questions andAnswers
management of testicular torsion Correct Ans-· Surgical emergency (within 6-12 hours to
prevent retorsion, preserve fertility, and prevent abscess, and atrophy).
· Occasional manual reduction can be performed
· Contralateral orchiopexy may also be done
education, prevention, prognosis of testicular torsion Correct Ans-Can result in necrosis if
torsion persists for more than 24 hours.
Wilm's Tumor Correct Ans-Most common malignancy of the GU tract. Ages 2-5 years old.
Higher in African Americans, lower in Asian
-Firm, smooth mass in the abdomen or flank that DOES NOT cross the midline
that it is associated with congenital abnormalities including renal, cryptorchidism, hypospadias,
duplication of the collecting system, ambiguous genitalia, hemihypertrophy, aniridia, cardiac
abnormalities, and Berkwith- Wiedemann, Denys-Drash, and Perlman syndromes
Wilm's tumor stage 1 Correct Ans-limited to kidney and can be completely excised
Wilm's tumor stage 2 Correct Ans-extends beyond the kidney but can still be completely
excised
Wilm's tumor stage 3 Correct Ans-post-surgical residual non-hematogenous extension
confined to the abdomen
Wilm's tumor stage 4 Correct Ans-hematogenous metastasis, frequently to the lung
Wilm's tumor stage 5 Correct Ans-bilateral kidney involvement
,wilm's tumor S&S Correct Ans-increased abdominal size or palpable mass
diagnostic studies for wilms tumor Correct Ans-Chest and abdominal can be performed to
differentiate neuroblastoma, abdominal ultrasonography to differentiate a solid from cystic
mass or hydronephrosis, UA shows hematuria in 25-33%, CT to stage disease
differential for wilm's tumor Correct Ans-Neuroblastoma but this will cross the midline.
management of wilms tumor Correct Ans-based on stage and patient condition. Surgery,
chemo and radiotherapy are options
complications of wilms tumor Correct Ans-lungs and liver are most common sites of
metastasis, HTN b/c of renal ischemia
wilms tumor prognosis Correct Ans-80-90% for infants with stage 4, re-occurrence- less than
50% response to chemo
turner syndrome Correct Ans-Short stature, short neck with webbing, low posterior hairline,
posteriorly rotated ears, ptosis, short 4th/5th metacarpals, short legs, hyperconvex nails,
bicuspid aortic valve, COA, hip dysplasia, scoliosis, horseshoe kidney, chronic OM with
conductive hearing loss, delayed puberty/infertility
turner syndrome - PCP concerns Correct Ans-Monitor growth- short stature is expected, GH
tx is typically begun early (4-5 yrs)
- Nonverbal (math) learning disabilities are common
- Annual hearing exam, recurrent otitis media, progressive mid frequency sensorineural hearing
loss
- Ongoing vision assessment- strabismus
- Early onset osteo-penia/ -porosis, vitamin D supp, appropriate estrogen therapy, exercise
,- Monitor BP (HTN)
- Annual thyroid screen (Hyper/ hypo)
- Ongoing assessment for celiac disease (tissue transglutaminase immunoglobulin A)
- Careful early monitoring for kyphosis, scoliosis, lordosis
- Increased risk for hyperlipidemia, cardiac defects (aortic root dilation, bicuspid aortic valve,
coarctation of aorta (35%), renal anomalies, pulmonic stenosis
- Supplemental estrogen therapy for sexual development and preservation of bone mineral
density
- Tendency to form keloids
Down Syndrome- Trisomy 21 Correct Ans-Short stature, brachycephaly, midface hypoplasia
with flat nasal bridge, brushfield spots, epicanthal folds with up-slanting palpebral fissures,
small mouth with protruding tongue, Myopia/cataracts, small ears/narrow canals, extra skin at
nape of neck, lax joints, short broad hands/feet/digits, single palmar crease, clinodactyly,
exaggerated space/plantar groove between great and second toes, congenital heart disease, at
risk for leukemia, hypothyroidism, and Alzheimer disease
- Intellectual/cognitive disability/ developmental delays, hearing loss, hypotonia (infant)
down syndrome PCP concerns/issues Correct Ans-- Careful review of newborn screen or
hypothyroid
- Careful review of newborn critical congenital heart disease
- Ongoing ophthalmologic exam for cataracts
- Increased risk for duodenal atresia
- High risk for atlantoaxial instability
- Monitor for neurological conditions (infantile spasms, seizures, moyamoya malformation)
- Systemic screening for celiac disease
- Increased risk for leukemia
Strabismus Correct Ans-crossed eyes; a defect in In ocular alignment, or the position of the
eyes in relation to each other; It is commonly called lazy eye. And strabismus, the visual axes are
not parallel because the muscles of the eyes are not coordinated; When one eye is directed
straight ahead, the other deviates
, Retinoblastoma Correct Ans-tumor arising from a developing retinal cell; intraocular tumor
that develops in the retina. Although it is rare, this malignant retinal tumor is the most common
tumor in childhood (some 4% of cancers in children younger than 15 years of age)
Retinoblastoma clinical findings Correct Ans-strabismus is the most common finding
there is a decreased visual acuity uni- or bilateral white pupil (leukocoria), described often as an
intermittent "glow, glint, gleam, or glare" by parents, is usually seen in low light settings or
noted in photographs taken with a flash i.e. (cat's eye reflex); other symptoms include an
abnormal red reflex, nystagmus, glaucoma, orbital Cellulitis and photophobia, hyphema,
hypopyon (plus an anterior Chamber of eye); Signs of global rupture or also possible
leukocoria Correct Ans-condition of white pupil
Bulbar or palpebral conjunctival infection Correct Ans-a common presentation, which can be
unilateral or bilateral
conjunctival infection differential diagnosis Correct Ans-allergy, conjunctivitis, infection,
foreign body, chemical exposure, or systemic inflammatory disease, irritation of the conjunctiva
or cornea, and congenital glaucoma.
conjunctival infection drainage Correct Ans-watery discharge; purulent/mucoid discharge
watery discharge Correct Ans-can occur with allergies, nasolacrimal obstruction, foreign
bodies, viral infection, and iritis.
Purulent or mucoid discharge Correct Ans-noted with chronic dacrocystitis or nasolacrimal
obstruction.
Dacrocystitis Correct Ans-inflammation of the tear sac
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