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Post on 26-Mar-2015
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Jeopardy Rules
• The team member “buzzing in” will answer
• Discussion is allowed only with final jeopardy
• All responses must be phrased as questions
• Wrong questions will be penalized the value of the question
• The judge’s decisions and ad hoc rules, however pigheaded and uninformed, are final
• Gratuitous abuse of the judge will be penalized
Choose a category. You will be given the answer.
You must give the correct question. Click to begin.
Click here for Final Jeopardy
That’s Sweet!
It’s All In Your Head
My StomachAches
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50 Points
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20 Points 20 Points 20 Points 20 Points
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PicturePotpourri
Vomitings &Diarrhea
This is the first line therapy for management of most children with
AGE
What isORT - Oral rehydration therapy (at 30ml/kg/hr)
These are the 2 most common viral etiologies for gastroenterities in
children
What are Rotavirus and Adenovirus
Bilious emesis in a child is suspicious for this condition
(Hint: Describe where the anatomical lesion is)
What is
Obstruction, distal to ampulla of vater
This bacterial cause of gastroenteritis is commonly known to be associated
with febrile seizures
What is
Shigella
These are the 4 signs that are most helpful in predicting dehydration
What are 1. CR>2s 2. Absent tears 3. Dry mucous membranes 4. General appearance(ill appearance)
This is the leading cause of mortality in children with diabetes
What is DKA
(Cerebral edema is the leading cause of mortality in DKA)
This is the % deficit assumed in patients with DKA
What is
10% (100 mL/kg)
Hypoglycemia in neonates is managed by giving this solution
(Hint: Name the solution and volume)
What is
D10W @ 5 to 10 mL/kg bolus, administered IV or IO (0.5 to 1
g/kg/dose)
Metabolic emergencies in infants often present with nonspecific features that may mimic more common conditions like sepsis.
These are the 3 most common signs & symptoms found in metabolic emergencies
What are
Vomiting, altered mental status, and poor feeding
A type 1 diabetic presents in DKA
Her labs are:
Glucose - 650mg/dl, and Na - 131meq/l
This is her corrected sodium…
What is
140 meq/L
(Correct reported sodium by adding 1.6 meq/L for every
100mg/dl of serum glucose over normal)
This disease usually presents in infancy with delayed passage of meconium or chronic constipation, but can be missed and present later in childhood
What is
Hirschsprung Disease
This neonate presented with bilious vomiting
Describe the X ray, and name the genetic condition most commonly associated with this anomaly
What is
-Double bubble sign (Duodenal atresia)
-Trisomy 21 (Nearly 40%)
This is an abdominal sonogram of a 4 month old infant with vomitings
Describe the finding, and name the diagnosis
What is
Target sign or donut appearance;
This is typical of Intussusception
This adolescent presented with an oval lesion as shown along with a more generalized rash
Name one differential diagnosis and treatment
What is
Secondary Syphilis
Symptomatic treatment
This lesion was noticed on the thigh of a toddler who presented with a seizure
Name the lesion and the condition associated with this lesion
What is
Ash leaf macule (a well demarcated hypopigmented
macule)
Tuberous sclerosis
A 4 year old girl having a GTC seizure, has not responded to 2 doses of Ativan. This is your next step…
(ABC’s, oxygen, d-stick and IV access/labs have been done).
What is
Load with Fosphenytoin (@15-20mg PE/kg IV)
These are the 3 characteristics associated with complex febrile seizures
What are
-Focal seizures-Duration >15 minutes-Two or more seizures in a 24 hour period
A 3 year old with a 3 day h/o vomiting and diarrhea has a GTC seizure.
Temp: 103 FD-stick & shock panel: normal
Describe her diagnosis and management
What isSimple febrile seizure No additional work-up needed
A 10 year old with a 7 month h/o throbbing headaches, associated with nausea and photophobia has a normal neurological exam
This is what you would do next…(Hint: Mom has a h/o headaches)
What is
Treat for migraine headacheNo imaging necessary
The most common cause of headaches in children is _(a)_,
but keep in mind these _(b)_ worrying symptoms which should prompt further work-up (name at least 7)
What is (a)viral illness
(b) Features suggesting secondary pathology:
• headaches on awakening or disrupting sleep
• new onset (< 6months)• changes in behavior,
personality, or school performance
• change in characteristics of headache
• vision disturbances (by hx or exam)
• abnormal neuro exam
• unusual locations (occipital)
• younger age (< 6 yo), • neck stiffness • exacerbated by changes in
posture, coughing, or sneezing
• endocrine changes (precocious puberty, abnormal growth)
A 3 week old male infant presents with vomiting for several daysLabs: Na 131, K 2.5, Cl 82, HCO3 31, Glucose 48, VBG: pH=7.52
Name the most likely diagnosis
What is
Pyloric stenosis
(Hypokalemic hypochloremic metabolic alkalosis)
A 3 year old male with a 2 day h/o intermittent abdominal pain &
vomiting, and the following rash
This is the most likely diagnosis
What is
HSP (Henoch Schonlein Purpura)
A 3 week old male with a 4 hour h/o progressively bilious vomiting, fussiness, and abdominal distension. The stool guaiac is positive
Name the diagnostic study of choice
What is Upper GI series
A 3 y.o.male with intermittent abdominal pain, lethargy…
Name the most likely diagnosis
What is
Intussusception
A 3 wk old male with a 3 day h/o vomiting, poor feeding, decreased wet diapers, and sleeping more than usual
Labs: Na 126, K 7.5, Cl 81, HCO3 11 Glu 40mg/dl, VBG: pH 7.21
Name the most likely diagnoses
What is
Congenital Adrenal Insufficiency
Make your wager
List at least 4 phone extensions to the Pediatric ER
(KCHC only)
What are,
3638, 3860, 3861
3634, 3643, 1435
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