Pediatric Ophthalmology Quiz
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Questions and Answers

What is the most appropriate next step for a patient presenting with a 2 cm solid thyroid nodule on ultrasound?

  • Thyroid scan with iodine
  • Fine needle biopsy (correct)
  • Tru cut needle biopsy
  • Repeat US in 6 months

In a case of an infant experiencing seizures and decreased feeding with normal CSF analysis, what is the most likely diagnosis?

  • Hypoxic ischemic encephalopathy (correct)
  • Neonatal tetanus
  • Pyogenic meningitis
  • Neonatal sepsis

What is the best management for a 53-year-old male with recurrent abdominal distention and a dilated colon without obstruction on CT?

  • Decompression colonoscopy with rectal tube (correct)
  • Left side colostomy
  • Emergency colectomy
  • Lower barium enema

For a child exposed to chickenpox who has been asymptomatic for two days, what is the recommended action?

<p>Give vaccine (A)</p> Signup and view all the answers

What is the most appropriate management for an unstable patient with lower GI bleeding and fresh blood on examination?

<p>Angiography (A)</p> Signup and view all the answers

In a child who had the BCG vaccine and lives with someone who has open TB but is asymptomatic, what should be done?

<p>IGRA test, X-ray and give INH (B)</p> Signup and view all the answers

What is the most appropriate treatment for a patient who ingested an unknown level of paracetamol 3 hours ago and has a toxic level?

<p>N-acetylcystine (B)</p> Signup and view all the answers

In a patient with signs and symptoms of croup, how should the diagnosis be confirmed?

<p>Clinical examination (B)</p> Signup and view all the answers

In the case of a known factor deficiency presenting with bleeding, what is the likely differential diagnosis?

<p>Hemorrhagic disease of the newborn (C)</p> Signup and view all the answers

What is the first step in management for a patient with pericholecystic fluid and a thick gallbladder wall post MI?

<p>US guided cholecystostomy tube (B)</p> Signup and view all the answers

What is the initial management step for a 5-year-old child with a misaligned right eye?

<p>HIRSCHBERG corneal reflex test (D)</p> Signup and view all the answers

What is the best immediate action for a child presenting with sudden convergent squint and double vision?

<p>CT scan to rule out space occupying lesion (A)</p> Signup and view all the answers

At what age should a 40-year-old relative of a colon cancer patient be screened for colon cancer?

<p>Screen at 50 and after 5 years (A)</p> Signup and view all the answers

What is the urgent initial management for a trauma patient with distended neck veins and decreased air entry?

<p>Needle decompression (A)</p> Signup and view all the answers

What is the best next step in managing a 10-year-old child with failed intubation attempts after facial trauma?

<p>Cricothyrotomy (B)</p> Signup and view all the answers

What is the recommended management for a 33-year-old man with a reducible inguinal swelling?

<p>Tension-free with mesh (D)</p> Signup and view all the answers

What is the most likely causative organism for a 7-month-old child with sneezing and rhinorrhea, whose sibling had similar symptoms?

<p>RSV (D)</p> Signup and view all the answers

What is the most appropriate screening tool for a 49-year-old male smoker with a history of smoking looking for pulmonary cancer screening?

<p>Low dose CT (C)</p> Signup and view all the answers

Flashcards

Hirschberg test in eye misalignment

Initial assessment for eye misalignment in a 5-year-old.

Convergent squint in children

Sudden onset of convergent squint and double vision in a child, requiring CT for ruling out space-occupying lesions.

Colorectal Cancer Screening Age

40-year-olds with family history should start screening at 50, repeating every 10 years.

MVA neck vein distention

Urgent needle decompression for distended neck veins and decreased air entry after MVA.

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Facial trauma failed intubation

Cricothyrotomy is the best option in a child with facial trauma and failed intubation attempts.

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Reducible inguinal swelling

Tension-free mesh herniorrhaphy for optimal management of reducible inguinal swelling in males.

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RSV in 7-month-old

Sneezing and rhinorrhea in a 7-month-old, especially following similar symptoms in a sibling, suggests RSV.

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Lung cancer screening in smokers

Low-dose CT is the best screening tool for lung cancer in 49-year-old smokers.

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Hemorrhagic disease of newborn

Bleeding and prolonged activated PTT in newborns may indicate hemorrhagic disease.

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Thyroid nodule biopsy

Fine-needle biopsy for evaluation of a 2-cm solid thyroid nodule.

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Croup diagnosis method

Croup diagnosis primarily relies on clinical examination, not imaging.

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Varicella vaccine after exposure

Varicella vaccine is recommended for unvaccinated children exposed, even if asymptomatic.

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Urgent colonoscopy in GI bleeding

Urgent colonoscopy is needed for evaluation and management of lower GI bleeding in unstable elderly patients.

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Colonic distension decompression

Colonoscopy decompression is indicated for abdominal distension and a dilated colon in schizophrenia patients without obstruction

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Hypoxic-ischemic encephalopathy seizure

2-day old infant with seizures and increased muscle tone after normal CSF analysis likely has hypoxic ischemic encephalopathy.

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Tuberculosis testing in vaccinated children

Children vaccinated with BCG and exposed to active TB should undergo IGRA testing, chest X-ray, and consider isoniazid prophylaxis

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Cholecystitis management

Ultrasound-guided cholecystostomy tube is recommended for patients with RUQ pain and pericholecystic fluid.

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Paracetamol overdose treatment

Immediate N-acetylcysteine administration for paracetamol overdose above toxic levels.

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Study Notes

Pediatric Ophthalmology

  • For a 5-year-old with eye misalignment, perform the Hirschberg corneal reflex test as initial assessment.
  • Sudden onset of convergent squint and double vision in a child requires CT scan to rule out space-occupying lesions.

Colorectal Cancer Screening

  • A 40-year-old with a relative diagnosed with colon cancer should start screening at age 50 and repeat every 10 years.

Emergency Management

  • In cases of MVA with distended neck veins and decreased air entry, urgent needle decompression is critical for initial management.
  • For a 10-year-old with facial trauma and failed intubation attempts, cricothyrotomy is the best management step.

Inguinal Hernia Management

  • A 33-year-old male with reducible inguinal swelling should undergo tension-free mesh herniorrhaphy for optimal management.

Pediatric Infectious Diseases

  • A 7-month-old with sneezing and rhinorrhea likely has RSV, especially following similar symptoms in a sibling.

Lung Cancer Screening

  • For a 49-year-old male smoker, low-dose CT is the most appropriate tool for pulmonary cancer screening.

Neonatal Health Issues

  • A newborn with bleeding and prolonged activated PTT may have hemorrhagic disease of the newborn.

Thyroid Nodules

  • In the presence of a 2 cm solid thyroid nodule, fine needle biopsy is the next step for evaluation.

Croup Diagnosis

  • Diagnosing croup relies primarily on clinical examination, without the need for imaging.

Varicella Exposure in Children

  • After exposure to chickenpox, administering the varicella vaccine is recommended for unvaccinated children, even if asymptomatic.

Gastrointestinal Bleeding

  • An unstable elderly patient with lower GI bleeding should receive urgent colonoscopy for evaluation and management.

Colonic Distension Management

  • In a patient with schizophrenia experiencing abdominal distention and a dilated colon without obstruction, decompression via colonoscopy is indicated.

Neonatal Neurological Assessment

  • A 2-day old infant with seizures and increased muscle tone after normal CSF analysis is likely suffering from hypoxic ischemic encephalopathy.

Tuberculosis in Vaccinated Children

  • A 2-year-old who received the BCG vaccine but was exposed to active TB should undergo IGRA testing, a chest X-ray, and consider isoniazid prophylaxis.

Cholecystitis Management

  • For a patient with RUQ pain and pericholecystic fluid, an ultrasound-guided cholecystostomy tube is the recommended management.

Paracetamol Overdose

  • Ingesting paracetamol above toxic levels with no symptoms warrants immediate administration of N-acetylcysteine as antidotal therapy.

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Description

This quiz covers common scenarios and decision-making processes in pediatric ophthalmology. Participants will encounter cases involving eye misalignment in young children and sudden squint with double vision in the emergency setting. Test your knowledge on appropriate referrals and initial assessments.

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