The CDC recommends empirical treatment of:

1) lower abdominal pain

2) uterine/adnexal tenderness

3) Cervical motion tenderness

Which antibiotic course should you use for treatment?

During your adolescent medicine rotation, you see this on exam. After prepping a slide with KOH you are overwhelmed by the fishy odor. Under microscopy you see _______ and decide to treat with ________ .

In this disease the sacroiliac joint is mainly affected, the predominance of male:female is 3:1, and the eye is also affected (iritis, uveitis).

Name the disease and the antigen that is associated with it (90% of the time).

Children with this disease have apthous stomatitis, genital ulcerations, and uveitis. They can also complain of abdominal pain (GI ulcers) and joint pain (arthritis).

A hysterical babysitter brings in a 5 year old boy after noticing “bruising” all over his legs and buttocks. She recalls that last week he had a runny nose and cough and had complained of crampy abdominal pain.

Labs in ER reveal proteinuria, hematuria, and a normal platelet count. What is the likely diagnosis?

A 12-year-old girl presents for evaluation of areas of skin thickening, tightness, and discoloration that developed 2 months ago. PE reveals shiny, hypopigmented patches with brown borders that are located in a linear distribution on the right upper extremity. The affected skin is immobile, firm, and has a “bound-down” feeling.

A diagnosis of this is suggested when 4 or more of the following are present over time:

•Malar rash

•Discoid lesions

•Photosensitivity

•Oral/nasal ulcerations

•Arthritis

•Persistent cellular casts in the urine

Which serum test is most sensitive for this disease?

A diagnosis of this is suggested when 4 or more of the following are present over time:

•Malar rash

•Discoid lesions

•Photosensitivity

•Oral/nasal ulcerations

•Arthritis

•Persistent cellular casts in the urine

Which serum test is most specific for this disease?

Little Yatyng is brought to the clinic. She is eating a snack and says to you “I want cheese,” when prompted she points to 6 parts of her body. Dad says she can make a tower of 8 cubes and go up stairs but cannot draw a circle. This is her age: ____ months.

Baby Seth sits with no support, has the parachute reflex, uses his thumb to grasp cubes, and has separation anxiety. His age?

This infection is characterized by an elevated temperature for 4 to 5 days, pharyngitis, conjunctivitis, preauricular and cervical lymphadenopathy, and rhinitis.

At 11pm in the ED, you sign up for a yellow chart with CC: fever, refusal to eat in a 3 year old boy. You walk into the room and see your patient drooling with his neck hyperextended; lateral neck films are ordered. What might you find on XRay?

After visiting her cousins in Minnesota over winter break, a 15-month old girl develops tender red nodules on her cheeks. The deep-seated plaques and nodules are known as this. What is the likely diagnosis?

What sign or symptom might help differentiate Strep pharyngitis from EBV mononucleosis?

While at Jackson you are examining a newborn. She starts to cry and you notice inspiratory stridor. The infant likely has this _________.

During your first call in the NICU, you admit a 4-hour old neonate with lowset ears, hypoplastic nails, a prominent occiput, and rockerbottom feet. What is this trisomy? What renal anomaly is associated with it?

As you’re drawing a blood culture from a newborn at JMH, the meconium beeper goes off…your presence is requested at an emergency C-section (oligohydramnios on ultrasound, breech presentation); as you’re bagging the newborn you observe clubfeet, “glove-like” excess skin on the hands, and flattened facies.

During a routine wellchild (15 month) visit you note that one side of the child’s body appears larger than the other; reviewing his history he was SGA and has remained low weight-for-height on the growth curves. He had hypospadias repair at 6 months of age. On physical exam, you observe a triangular face (hypoplastic midface/chin) , lowset ears, and a curved in 5th finger. What is the likely diagnosis?

Characteristic facies of this syndrome include:

Confluent eyebrows (synophrys)

Long curly eyelashes

Low anterior and posterior hairline

Underdeveloped orbital arches

Long philtrum

Anteverted nares

Down-turned angles of the mouth

Low-set ears

High arched palate

Late eruption of widely spaced teeth

A 17 year old male comes to see you because he is concerned about his sexual development. On Physical examination you note that he is Tanner Stage 1 and has a testicular size of 3 mL bilaterally. His exam is otherwise unremarkable, except for a decreased sense of smell.

What you will see on MRI of the brain?

A 17 year old male with a history of bipolar disorder is hospitalized after cutting himself to relieve stress so he could sleep after partying for 3 days. During routine laboratory screening upon admission, he is noted to have a serum sodium of 129 mEq/L. Which of the following medications is most often associated with this finding?

Following the discovery of an abdominal mass during a scheduled health maintenance visit, a 3 year old boy is found to have Wilms tumor on abdominal ultrasound.

Which of the following clinical findings are most often identified in patients with a Wilms tumor?

A 3 year old boy presents with sudden onset of unilateral proptosis and periorbital ecchymosis. Following additional evaluation, it is determined that his eye findings represent metastatic disease.

Which of the following neoplasms is most likely to metastasize to the eye?

A 3 year old boy presents to the ED with acute respiratory distress. Which of the following, if present, would suggest epiglottitis rather than laryngotracheobronchitis?

During a routine sport examination, a 16 yo F is found to have 16 degrees of lumbar scoliosis. She has intermittent lower backaches but has been playing soccer for the past 6 years without difficulty.

Which of the following is the most appropriate recommendation at this time?

A 2-month old girl presents for recheck of a large hemangioma overlying her left cheek, extending over, above, and below her left ear, and partially obstruction her left external ear canal. It is noted to have increased in size since her last visit only 3 weeks ago.

She is increased risk for which of the following?

During a physical exam in an undernourished 14 year old who was removed from his home due to medical neglect and physical abuse, a "spooning" deformity is noted in the fingernails and toenails.

In which of the following is a dietary deficiency associated with this clinical finding?

A 15 year old gymnast presents with acute lower back pain that is worse with extreme extension.

Which of the following is the most likely diagnosis?

A 13 year old girl presents with complaints of bilateral knee pain. She states the symptoms are worse when she is going up or down stairs. On examination, there is no effusion, but there is pain with pressure on the over the distal femur. This is enhanced if the quadriceps are flexed. Which of the following is the most likely diagnosis?