AC-PNCB: Questions With Complete Solutions (100%)
Jaundice (medical emergency) Right Ans - w/in 24hrs of birth,
yellowing of palms and soles
Otoscope: how to straighten canal Right Ans - ≥ 3 y/o: Up & back
< 3 y/o: Down & out
Phenylketonuria (PKU): definition, SSx, c/b Right Ans - Autosomal
recessive disorder (two carrier parents affected one child):
inability to break down amino acid phenylalanine
SSx: Musty urine odor
c/b: untreated, can lead to albinism (b/c phenylalanine can't convert to
melanin), neurologic changes (nonadherence to diet of low-protein)
Congenital Adrenal Hyperplasia: definition; SSx (x4) Right Ans - enzyme
deficiency for synthesis of cortisol
SSx:
- ambiguous genitalia
- lethargy, poor feeding/FTT
- metabolic acidosis = hyperK, hypoNa, hypoglycemia
- hypotension, hypothermia
Anterior and Posterior Fontanels closures Right Ans - P: 1-3mos; A: 18-
24mos
Erickson's 8 Stages of Psychosocial Development Right Ans - 1) INFANT:
trust vs mistrust
2) TODDLER: autonomy vs shame and doubt
3) PRESCHOOL: initiative vs.guilt
4) GRADE SCHOOL: industry vs. inferiority
5) TEENAGER: identity vs role confusion.
6) YOUNG ADULT: intimacy vs isolation
7) MIDDLE AGE: generativity vs. stagnation
8) OLDER ADULT: integrity vs. despair
,MMR vaccine contraindication Right Ans - severely compromised
% of understandable language: 1-4yrs Right Ans - 1 yo: 1-word sentences,
25%
2 yo: 2-word sentences, 50%
3 yo: 3-word sentences, 75%
4 yo: 5-6+ word sentences, 100%
Laryngotracheobronchitis (Croup): common age/gender, causative virusus,
SSx (x2), Dx, Tx Right Ans - 6mos- 3yrs, males>females
Parainfluenza 1&2, RSV
SSx: seal/barky cough, stridor
Dx: steeple sign
Tx: steroids (dexamethasone 0.6 mg/kg IV/IM)
pneumonia: common organisms, school-age, SSx (x2), Dx, Tx Right Ans -
community acquired: strep pneumoniae
school-age: atypical viral mycoplasma pneumoniae (low fever)
SSx: rales/crackles, focal diminished breath sounds
Dx: focal infiltrates on XR
Tx: high-dose Amoxicillin or Ceftriaxone; Azithromycin (atypical mycoplasma
p.)
Pertussis (whooping cough): pathophys, SSx (x2), Dx, Tx Right Ans -
bacteria attaches to cilia in resp tract
→ produces toxins
→ causes inflammation and loss of surfactant
SSx:
- paroxysmal (violent/painful/uncontrollable) cough
, - post-tussive emesis
Dx: pertussis PCR + Cx
Tx:
- Azithryomycin (infants)
- Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS (infantile
hypertrophic pyloric stenosis)
Tracheitis & Epiglottitis similarities: organism, lateral neck XR, SSx (x3), Tx
(x2) Right Ans - HFlu
Dx: present with thumb print sign on lateral neck XR
SSx: tripod, drooling, stridor
Tx: broad spectrum Abx, steroids
Tracheitis: cardinal SSx (x1) Right Ans - HIGH FEVER usually >103
(Tracheitis → Toxic appearing)
Epiglottitis: distinctive definition, SSx (x2), Tx (x4) Right Ans - Airway
emergency! Acute, sudden, severe
SSx: muffled/hot-potato voice, beefy-red/swollen epiglottis
Tx:
- avoid stimulus
- humidified oxygen until decision re: intubation (consult
anesthesia/otolaryngology(ENT) for intubation)
- Abx (3rd gen. cephalosporin for 7-10 days)
- IV fluids!
pulmonary edema: SSx (x4), Dx Right Ans - SSx: left-sided HF, tachycardia,
S3, cough with frothy sputum (often pink)
Dx: Kerley B lines