Questions and Answers
Which of the following measures would decrease the incidence of Sudden Infant Death Syndrome?
Which condition is most likely represented by a child with blood in diapers, pale conjunctiva, and dry oral mucosa?
What is the most likely diagnosis for a patient experiencing fecal incontinence and passage of vaginal flatus postpartum?
After an ASC-US result, what is the most appropriate next investigation following another ASC-US result after treatment?
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What is the most likely diagnosis for a woman with a recent non-tender, mobile cystic mass on the labia that has not improved despite warm soaks?
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What is the most appropriate management for a thoracic aorta injury with free fluid in the abdomen and hypotension?
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In the case of an asymptomatic femoral hernia, what is the most appropriate management?
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What is the next step in managing a patient with a subdural hematoma and GCS of 7/15?
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What is the most likely bone fracture for a pediatric patient presenting with hemotympanum after a fall?
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What is the most appropriate treatment for a child diagnosed with lead poisoning?
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Study Notes
Sudden Infant Death Syndrome (SIDS)
- Use of a pacifier at bedtime can decrease SIDS incidence.
- Sleeping positions that are prone or on soft mattresses are associated with higher risk.
Pediatric Blood in Diapers
- A 3-year-old presenting with blood in diapers, pale conjunctiva, and dry oral mucosa could indicate Meckel's diverticulum as a likely diagnosis.
- The child had previous similar symptoms 3 months ago.
Fecal Incontinence in Postpartum Patients
- A patient complaining of fecal incontinence and vaginal flatus after vaginal delivery is likely suffering from a recto-vaginal fistula.
Atypical Pap Smear Result
- An elderly woman with ASC-US on pap smear and ongoing abnormal results should undergo colposcopy as the next investigation step.
Labial Swelling
- A 25-year-old woman with recent swelling on one side of the labia may have a cystic mass; consider the diagnosis of Bartholin's cyst if it is mobile and non-tender.
Asymptomatic Femoral Hernia in Elderly
- The best management approach for an asymptomatic femoral hernia in a 65-year-old female is laparoscopic repair.
Subdural Hematoma Management
- An elderly patient with subdural hematoma and significant GCS decline should undergo urgent craniotomy.
Pediatric Head Injury
- A pediatric patient with direct head trauma presenting with hemotympanum and a normal neuro exam likely has a basal skull fracture.
Undescended Testes in Infants
- For a child with non-palpable undescended testes, diagnostic laparoscopy is the appropriate next step.
Lead Poisoning Symptoms
- Symptoms of pica, hepatosplenomegaly, and failure to thrive with elevated lead levels suggest lead poisoning; treatment involves chelating agents like D-penicillamine.
Anemia Management
- In a 23-year-old woman with history of ASD and anemia, erythropoietin should be considered if transferrin saturation is low.
Acute Limb Ischemia Management
- In a patient with leg pain and absent dorsalis pedis pulse, the initial management is heparin infusion.
Seizure Management
- In a patient experiencing status epilepticus with multiple seizures, the first-line treatment is benzodiazepines.
Pediatric Eyelid Swelling
- A 19-month-old with lower eyelid swelling and fever is likely suffering from cellulitis given the clinical presentation.
Melanoma Concern in Family History
- A young patient with familial history of melanoma should receive reassurance and follow-up rather than unnecessary intervention.
Deep Vein Thrombosis Prevention
- In a post-op case with a hip fracture, the best initial medication for DVT prevention is enoxaparin.
RUQ Mass Diagnosis
- A patient with RUQ pain, fever, and hypoechoic liver mass likely has an amebic abscess due to the endemic nature of travel history.
Acute Pancreatitis Diagnosis
- A non-thickened gallbladder wall and gallstones indicates likely acute pancreatitis rather than acute cholecystitis or jaundice.
Lower GI Bleeding Causes
- Common causes of lower GI bleeding in the elderly include diverticulosis as the most frequent diagnosis.
Acute Abdominal Pain Diagnosis
- Sudden severe epigastric pain with rigidity suggests perforated peptic ulcer, particularly given the NSAID history.
Treatment for Open Fracture
- In cases of closed tibial fracture, surgical debridement followed by intramedullary nailing is warranted due to significant damage.
Anemia in Pregnancy
- A pregnant woman with low HB and high MCV, along with hypersegmented neutrophils, indicates possible folate deficiency.
Cord Prolapse in Pregnancy
- Persistent fetal bradycardia after membrane rupture raises concerns for cord prolapse requiring immediate evaluation.
Management of Vaginal Bleeding in Early Pregnancy
- For a pregnant woman at 7 weeks with vaginal bleeding and inconclusive ultrasound findings, follow-up ultrasound in 2 days is appropriate.
Fetal Monitoring in Second Trimester
- Pregnant women expressing concerns about fetal movements at 32 weeks should undergo a non-stress test for evaluation.
Cervical Incompetence in Pregnancy
- A patient with cervical incompetence at 20 weeks of gestation should be considered for cervical cerclage to prevent pregnancy loss.
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Description
Test your understanding of pediatric health issues, particularly Sudden Infant Death Syndrome (SIDS) prevention measures and the implications of blood in a child's diapers. This quiz features clinical scenarios to enhance your knowledge in caring for infants and young children.
