Pediatric Diagnosis (Final Material)

A 5 year old who presents with fatigue, vascular fragility, fever, and hepatosplemomegaly

Leukemia

What is one of the first questions that should be asked?

Did the child have a fever when he had a seizure?

A boy from a developing county has a very wide neck and trouble breathing because of what looks like a membrane growing across his throat. Every time the membrane is cut it grows back even quicker. These criteria fit the picture of

Diphtheria

A 6 year old child started with an upper respiratory infection about 1 month ago, but then began having paroxysmal coughing attacks. When these attacks occur, he has a very hard time catching his breath. This most likely describes.... A potential diagnosis of?

Pertussis

A patient brings their teenager to you with complaints of night sweats, fevers, fatigue, and weight loss. Upon examination, you notice significant cervical lymph gland swelling that looks like the child may have Mumps. However, with the other factors, it sounds more like:

Hodgkins lymphoma

A 6 year old boy exhibited a temperature of 102.5 degrees, and conjunctivitis. That lasted a few days, and then a coarse red rash appeared all over the child's body If you examined the child thoroughly, what is one sign you will most likely see?

Koplik's spots

A child who was bitten by a tick develops joint paints and neurologic issues. Most likely the tick was infected by which of the following disease?

Lyme disease

A child has had a mosquito bit that initially created a fever but later on progressed to encephalitis. What was the child infected f by the mosquito

MRSA

A 6 year old boy exhibited a temperature of 102.5 degrees, and conjunctivitis. That lasted a few days, and then a coarse red rash appeared all over the child's body The most likely diagnosis is?

Measles

If the child had a febrile seizure, does that mean he/she also has epilepsy?

No, Epilepsy is a cause of seizures, but not all seizures are epilepsy

A 6 month old child comes in with complaints that are consistent with meningitis. What 2 orthopedic tests can you perform to confirm meningitis

None of the above

A 9 year old male basketball player who complains of knee pain and swelling after a week of tryouts.

Osgood schlatter's disease

A 4 year old child has a red rash after strep throat. you notice that the creases of her arm and groin are bright red. These are called ____ and are associated with ____

Pastia's Lines & Scarlet Fever

An 8 year old girl with a severe sore throat and 103 degree liver presents to your office. She is crying because of the pain in her throat. You not a beefy red pharynx and white pus on her tonsils. What is the most likely diagnosis in this case?

Strep throat

A teenage boy works at a horse farm. He presents with what he calls a TMJ problem, and is unable to open his mouth due to the muscle spasm. During your history, he tells you that a few weeks ago he stepped on a nail while out in the pasture. He more likely has what issue?

Tetanus

A 6 year old child started with an upper respiratory infection about 1 month ago, but then began having paroxysmal coughing attacks. When these attacks occur, he has a very hard time catching his breath. This most likely describes.... What other symptoms might be present in this child with a this diagnosis?

A long crowing inspiration that sounds like whooping cough

Regarding the above child with a seizure, it is also important to ask?

All of the above

A 6 year old girl has complaints of difficulty breathing that worsens at night and during the pollen season. She also has a dry cough at night. Auscultation reveals a high pitched inspiratory wheeze. What might be the diagnosis?

Asthma

A 17 year old male complains of several weeks of overpowering malaise after having a high fever, lymph node swelling and bad sore throat. he was barely able to get out bed for a month. The diagnosis sounds like:

Infectious mono

A parent complains that their teenager has recently lost a lot of weight without trying, looks somewhat pale, and is fatigued easily. what is the first thing you must look for?

Cancer

A child was born with meconium aspiration syndrome and required resuscitation. She was kept in the NICU for 6 weeks before being sent home. She is now 6 years old and walks with great difficulty and a scissors gate. She holds her hands in a flexed position and her muscles are rigid. This sounds like:

Cerebral palsy

A two year old is brought to you with complaints of a fever for 2 days, headaches and lack of appetite. A dozen raised blisters are noted on her face and upper body

Chicken pox

Atopic disease, such as allergic rhinitis and hay fever

Commonly seen in fall and spring

Respiratory flu, including fever and muscle aches

Commonly seen in older kids and adults

Gastrointestinal flu, including vomiting and diarrhea

Commonly seen in younger children

A pregnant mom in her 1st trimester presents to the office with concerns about her 3 year old who has fine red reach all over his body. She is worried about her unborn child getting an illness related to her 1st child's disease. Her unbroken child might be in danger of contracting

Congenital Rubella Syndrome

This set of symptoms leads to a possible diagnosis of

Croup

A child presents at your office with a fever, mild constitutional symptoms, and a slapped face appearance on both cheeks. This sounds like it could be?

D. A (Fifth Disease) & B (Erythema Infectiousum)

A toddler presents with swollen lymph nodes on 1 side of her neck. Your protocol regarding checking lymph nodes should be:

D. A (See id the Lymph Nodes are Hard & Non-Tender) & C (To check the child's lymph nodes weekly for 3 weeks and if still present refer)

A 3 year old presents with a large palpable mass in her left abdomen, fever, anorexia, abdominal pain, and is generally not a healthy looking kid. Most likely his is?

D. A (Wilm's Tumor) and B (Nephroblastoma)

A 2 year old presents with bilateral black eyes, anorexia, and failure to thrive. She looks quite sickly. one possible diagnosis may be:

D. A (Wilm's Tumor) and C (Neuroblastoma)

A 6 year old boy presents to your office limping from this hip for the last few weeks. He does not have any injury that can be linked to his limp. You suggest frog leg view films. Why?

D. B (Looks at Hip Joints) & C (Rule out Legg-Calve-Perthes Disease)

A 1 month old child presents with a high fever and irritability for several days duration, and yo refer them to the ER. With a child this young, a fever might be classified as ____

Fever of unknown origin

A 10 year old who complains of numbness creeping up on both legs after a stomach infection

Gullian barre syndrome

(T/F) A child with asthma may also have wheezing due to nasal congestion dripping into the lungs

False

Multiple red bites on both feet of a 2 year old child

Fire and bites

A 2 year old child presents to your office with a mosquito bit that he had scratched. This site has become infected and has become honey-colored and now the child has a fever. Most likely the lesion would be diagnosed as:

Impetigo

A child with these symptoms will most likely also exhibit:

Inspiratory strider

Several raised reddish itchy bumps on a childs arm that are called wheals

Mosquito bites

A 6 year old boy presents with complaints of what the mom calls another ear infection. He comments that his jaw also hurts. One side of his face appears swollen, and looking into his mouth reveals a red and inflamed parotid gland duct. The first diagnosis that you think of is:

Mumps

An 11 year old presents to the office a history of URI that turned into something worse. After a week of continued normal activity levels, he had a day when he had lots of chills, and did not go to football practice that day. Then a productive cough began as well as fever and now it hurts to cough. This sounds like?

Pneumonia

A child developed fever, sore throat and vomitting several days ago. Next cam severe headaches and parasthesias, and now has unilateral flaccid paralysis. Your diagnostic workup must include

Poliomyelitis

An 8 year old girl with a severe sore throat and 103 degree liver presents to your office. She is crying because of the pain in her throat. You note a beefy red pharynx and white pus on her tonsils. A week later the above young girl develops a red rash. What problem(s) can be a sequel of the original illness?

Rheumatic fever

A tall teenage female presents to your office with rebounded shoulder and middle back pain. The lateral thoracic x-ray shows anterior wedging, thinner disc spaces, schmorl's nodes, & increased thoracic kyphosis. This sounds consistent with a diagnosis of:

Scheumarnn's disease

A woman brings in their 6 month old child to you who has had a fever of 104 for 2 days and is vomiting. This child is crying uncontrollably and has a raised anterior fontanelle. You palpate the muscles at the base of his skull and they are very stiff. In this case, your recommendation would be to ___ because this might be ____

Send them immediately to the hospital; Meningitis

A woman presents to your office that just had her 1st baby 1 month ago. She explains that one breast yesterday became hard, warm, swollen, and tender and that now she has a fever. What is the most likely diagnosis?

She may have mastitis

A two year old is brought to you with complaints of a fever for 2 days, headaches and lack of appetite. When this child is older and is exposed to long periods of stress, he can develop ___ due to the ____ virus that stays in the body?

Shingles, varicella zoster

A child presents at your office with a fever, mild constitutional symptoms, and a slapped face appearance on both cheeks A few weeks go by and the mom is concerned that the child still gets red in the face when she exercises, is out in the sun, or is stressed. You explain:

This is totally normal for this condition

A 6 year old shows you a bulls eye shaped lesion on his hand after playing in the woods:

Tick bite

(T/F) A child with asthma may have symptoms that vary from dry cough only at night to severe broncho-spasm that restrict breathing?

True