Questions and Answers
What is the most appropriate next step for a patient presenting with a 2 cm solid thyroid nodule on ultrasound?
In a case of an infant experiencing seizures and decreased feeding with normal CSF analysis, what is the most likely diagnosis?
What is the best management for a 53-year-old male with recurrent abdominal distention and a dilated colon without obstruction on CT?
For a child exposed to chickenpox who has been asymptomatic for two days, what is the recommended action?
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What is the most appropriate management for an unstable patient with lower GI bleeding and fresh blood on examination?
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In a child who had the BCG vaccine and lives with someone who has open TB but is asymptomatic, what should be done?
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What is the most appropriate treatment for a patient who ingested an unknown level of paracetamol 3 hours ago and has a toxic level?
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In a patient with signs and symptoms of croup, how should the diagnosis be confirmed?
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In the case of a known factor deficiency presenting with bleeding, what is the likely differential diagnosis?
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What is the first step in management for a patient with pericholecystic fluid and a thick gallbladder wall post MI?
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What is the initial management step for a 5-year-old child with a misaligned right eye?
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What is the best immediate action for a child presenting with sudden convergent squint and double vision?
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At what age should a 40-year-old relative of a colon cancer patient be screened for colon cancer?
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What is the urgent initial management for a trauma patient with distended neck veins and decreased air entry?
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What is the best next step in managing a 10-year-old child with failed intubation attempts after facial trauma?
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What is the recommended management for a 33-year-old man with a reducible inguinal swelling?
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What is the most likely causative organism for a 7-month-old child with sneezing and rhinorrhea, whose sibling had similar symptoms?
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What is the most appropriate screening tool for a 49-year-old male smoker with a history of smoking looking for pulmonary cancer screening?
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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.
