Pediatric mb mcq

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The child has vomited once and is fussy and lethargic. Laboratory results include a pH of 7. Of the following, the next BEST step in the management of this child is to. Therefore, syrup of ipecac is not indicated.

Administration of sodium bicarbonate to alkalinize the urine as well as correction of acidosis. Within 3 hours of ingestion, these symptoms have resolved. Often, the effect on the heart is delayed; presentation to the emergency department with various other signs and symptoms may precede the cardiac findings.

Ventricular tachyarrhythmias are a common late finding. Electromechanical dissociation EMD can result, leading to the need for urgent cardiopulmonary resuscitation. Two mechanisms are postulated for its therapeutic effect.

Tricyclic antidepressants are protein-bound and become less bound in more acidic conditions. By reversing the acidosis, protein binding increases and bioavailability decreases.

An alternative explanation is that the sodium load helps to reverse the sodium channel-blocking effects of the tricyclic antidepressants. Treatment is otherwise supportive. Respiratory depression can result from the central nervous system sedative properties of these agents, and if present, warrants careful laboratory and clinical observation. However, these findings do not appear late, and this boy has no indication of respiratory compromise.

His pupils are miotic. Of the following, these findings are MOST suggestive of :. A 4-year-old child is brought by ambulance to the emergency department. He is unconscious and has deep, regular, and rapid respirations. A clinical finding that BEST distinguishes this respiratory pattern as central hyperventilation rather than tachypnea is :. Central hyperventilation, characterized by sustained, rapid, and fairly deep hyperpnea, differs from the rapid, shallow respirations of simple tachypnea.

Central hyperventilation typically represents one sign in the stages of coma that result from markedly elevated intracranial pressure and progression toward transtentorial or uncal herniation Figure 25A. The earliest signs are decreased level of consciousness and alterations in the respiratory pattern. Patients who have central hyperventilation may have hypertension and bradycardia Cushing triad.

During the systematic stages of coma, specific signs develop as injury progresses inferiorly along the brainstem. Later, at the midbrain stage, the respiratory pattern changes to sustained central hyperventilation, the pupils become midposition and fixed, and there is a stereotyped decerebrate extensor with all extremities posturing to noxious stimuli. Finally, the extremities become flaccid with absent motor response, breathing becomes ataxic, and death ensues.

Decreased oxygen saturation and diminished mental status are nonspecific findings that can characterize many processes other than central hyperventilation, such as hypoxia secondary to pulmonary disease. A decreased arterial carbon dioxide pressure can be seen in hyperventilation attacks or psychogenic hyperventilation as well as central hyperventilation. Sternal retractions are typical of hypoxia in patients who have lower airway disease and are not a feature of central hyperventilation.

Loss of pupillary response is typical for a midbrain or pontine brainstem process and, combined with loss of consciousness, should alert the clinician to the possibility of impending uncal herniation. Other causes for bilateral loss of pupillary reflex eg, pilocarpine drops, opiates, atropine drops, cocaine, and jimson weed should be considered only after the possibility of increased intracranial pressure has been excluded.

A 3-year-old boy was found with an open bottle of imipramine. At least five 50 mg tablets were missing.To ensure user-safety and faster downloads, we have uploaded this. At Medicos Republic, we believe in quality and speed which are a part of our core philosophy and promise to our readers. We hope that you people benefit from our blog!

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pediatric mb mcq

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You have entered an incorrect email address! Latest article.Infection in Children - Part 3. MCQ Quiz. Need help for Pediatric Board Certification Exams and for post graduate exams? The MCQ tests can be taken online with an immediate assessment of the results.

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Cortisol is secreted from where? Which of these is not secreted from the Anterior Hypohysis? Diabetes Insipidus is a deficiency of what hormone? Which of the following signs strongly support a diagnosis of pituitary adenoma? Increase in colloid Ans: C 9. Her urine output on day two is 10 liters a day. Loop diuretics Ans: C Her TSH is 0.

pediatric mb mcq

ASA Ans: D The serum calcium is 6. Which of the following would be an appropriate medication for someone with hypothyroidism? Which of the following is a measure of blood sugar after 4 or more hours of no food? Which of the following is transcribed correctly?

The patient was diagnosed with type 1 diabetes at 4 years of age. The patient was diagnosed with type I diabetes at 4 years of age. The patient was diagnosed with type I diabetes at 4-years of age.

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You have entered an incorrect email address! Leave this field empty. If you feel that your copyrights have been violated, then please contact us immediately: Contact us: admin fcpspart1dentistry.You are evaluating a year-old girl who complains of malaise, fatigue, and occasional.

You diagnosed hypothyroidism due to chronic lymphocytic thyroiditis. Hashimoto thyroiditis 6 years ago. She has normal serum immunoglobulin A concentrations. She reports that she has been eatinAg poorly and has lost 5 lb since you saw her at the beginning of the summer. Of the following, the MOST important laboratory studies to obtain at this time are. Adrenal insufficiency causes an elevation in serum potassium concentrations, decrease in serum sodium concentrations, and shifts in muscle electrolyte concentrations that result in weakness, myalgias, and gastrointestinal symptoms.

Skin pigmentation is increased by high concentrations of adrenocorticotropic hormone. The presence of both autoimmune hypothyroidism and suspected adrenal insufficiency in this girl suggests the diagnosis of autoimmune polyglandular syndrome type 2.

The genetic defect in this disorder is not yet known, but the girl is at risk for other endocrine autoimmunities, including ovarian failure and diabetes. On examination she looks flushed with warm peripheries, pulse rate bpm. She has a smooth goitre 5 6 cm with an audible bruit. Answers 2. Thyroid function tests 3. The initial investigation is a thyroid profile to include free thyroxine FT4 and thyroid stimulating hormone TSH levels.

pediatric mb mcq

Radio-iodine scans or fine needle biopsies should only be requested in the light of unusual clinical findings such as a nodule. First line treatment is pharmacotherapy with a thionamide drug e. PTU is recommended as a second-line treatment if side effects prevent the use of carbimazole.

There is currently a national trial to establish the relative benefit of these two regimens. In any case close attention to the full blood count during treatment is required, to detect agranulocytosis, and all families are given instructions to attend urgently if unexplained fever and sore throat occurs on treatment.

Beta-blockade in the first 6 weeks reduces the symptoms of thyrotoxicosis but is contraindicated in the presence of asthma. He has previously been well however 10 months earlier he was noticed to have developed pubic hair, which has been increasing steadily.

He has an adult type body odour, and he has developed acne on his face. On examination you note pubic hair and penis Tanner stage 3, testicular volumes of 5 ml bilaterally. Abdominal and neurological examinations are normal.

How would you proceed with this patient? Select ONE answer only please. Which TWO of the radiological tests below would you perform? Select TWO answers only please. Perform a GnRH test and measure testosterone levels 5.

MRI Head, f. Ultrasound scan USS of the adrenal glands 6. Anorexia nervosa Precocious puberty in males: precocious puberty refers to the onset of puberty outside of the lower limit of the normal age range. For boys this is considered as puberty at an age less than 9 years. The first sign of progression into puberty is the enlargement of the testicles, and a volume of 4 ml heralds the onset of puberty. Clinicians should also be aware of virilizing conditions which result in gonadotrophin-independent precocity such as non-salt-losing congenital adrenal hyperplasia, androgen producing tumours where testicles may be smaller than normal, familial testotoxicosis and McCuneeAlbright syndrome with polyostotic fibrous dysplasia of bone and caf e au lait patches.

GDPP in boys is rarely idiopathic and as such all boys should be investigated appropriately by a qualified clinician to rule out an underlying cause. It is important to determine the underlying cause and treat this as appropriate. Depending on the age of presentation it may be important to stop the progression of puberty to reduce psychological distress and to allow longer to grow before epiphyseal fusion.

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