Cataracts are defined as opacity of the lens in one or both eyes. What test do we perform to rule out cataracts in an infant?
a. Red light reflex
b. Cover uncover test
c. Corneal light reflex
d. None of the above - ANS a. Red light reflex
Dustin has just been diagnosed with Amblyo...
Cataracts are defined as opacity of the lens in one or both eyes. What test do we perform to rule
out cataracts in an infant?
a. Red light reflex
b. Cover uncover test
c. Corneal light reflex
d. None of the above - ANS a. Red light reflex
Dustin has just been diagnosed with Amblyopia. His parents are very worried and are asking for
more information. Your patient education is based on your knowledge that this diagnosis results
from:
a. an uneven curvature of the cornea
b. an asymmetrical corneal light reflex
c. a bilateral muscular weakness of extraocular muscles
d. a unilateral deficit secondary to poor/ improper development of visual pathways needed to
attain central vision - ANS d. a unilateral deficit secondary to poor/ improper development
of visual pathways needed to attain central vision
Rizzo, age 18 months has just been diagnosed with a second AOM. He was treated last 2
months ago with Amoxicillin. He has no known allergies. The treatment of choice for Rizzo is:
a. Amoxicillin 50 mg/kg/day divided BID for 7 days
b. Augmentin 80-90 mg/kg/day divided BID for 10 days
c. Cefdinir 14 mg/kg/day given QD for 10 days
d. Amoxicillin 80-90 mg/kg/day divided BID for 10 days - ANS d. Amoxicillin 80-90
mg/kg/day divided BID for 10 days
A 3 year old child with repeated episodes of AOM demonstrates a clear language delay. The
most likely cause of the delay is:
a. autism
b. ceruminosis
c. conductive hearing loss
d. sensorineural hearing loss - ANS c. conductive hearing loss
,Oliver, a 4 year old boy presents with a nasal congestion almost every day of the past 4 winter
months. Parents deny fever but he has a cough off and on. An oral histamine prn has not helped
much. He has no other significant medical problems and has started preschool this year. His
exam reveals green nasal discharge. What is the most likely diagnosis?
a. recurrent URI
b. allergic rhinitis
c. bacterial rhinitis
d. chronic sinusitis - ANS a. recurrent URI
Fourteen-month-old Michele is brought in by her mother with cold symptoms, fussiness, and
fever for the past day. Her history is significant for otitis media 4 times in the last year. Physical
exam reveals that the right tympanic membrane is bulging, erythematous, and has no light
reflex. The remainder of the exam is normal except for nasal discharge that is green. Which of
the following risks factors would contribute to her risk of otitis media?
a. Pacifier use
b. Daycare
c. Passive smoke exposure
d. All of the above - ANS d. All of the above
Perry is a 15 year old male who presents with a history of a sore throat, headache, and a low
grade fever of 100.7 for the past 4 days. He reports fatigue, mild belly pain, and loss of appetite.
He has missed 3 days of school. He has no allergies and no significant health history. He took
ibuprofen at home for his headache which was helpful. On physical exam he has anterior
cervical lymphadenopathy, tonsils are beefy red, slightly swollen with exudates and you note
soft palate petechiae. You differential list would include all of the following EXCEPT?
a. Viral Pharyngitis
b. peritonsillar abscess
c. Infectious Mononucleosis
d. Stretococcal pharyngitis - ANS b. peritonsillar abscess
Perry is a 15 year old male who presents with a history of a sore throat, headache, and a low
grade fever of 100.7 for the past 4 days. He reports fatigue, mild belly pain, and loss of appetite.
He has missed 3 days of school. He has no allergies and no significant health history. He took
ibuprofen at home for his headache which was helpful. On physical exam he has anterior
cervical lymphadenopathy, tonsils are erythematous with exudates and you not soft palate
petechiae. His rapid strep screen is positive for Group A beta hemolytic streptococcal
pharyngitis. What is the first line treatment for Perry?
a. Cephalexin 50 mg/kg/day for 10 days
b. Penicillin VK 500 mg PO BID for 10 days
c. Azithromycin 10 mg/kg PO on day 1 then 5 mg/kg PO on days 2-5.
, d. Clindamycin 15 mg/kg/day for 10 days - ANS b. Penicillin VK 500 mg PO BID for 10
days
Perry is a 15 year old male who presents with a history of a sore throat, headache, and a low
grade fever of 100.7 for the past 4 days. He reports fatigue, mild belly pain, and loss of appetite.
He has missed 3 days of school. He has no allergies and no significant health history. He took
ibuprofen at home for his headache which was helpful. On physical exam he has anterior
cervical lymphadenopathy, tonsils are erythematous with exudates and you not soft palate
petechiae. Early diagnosis and treatment of strep pharyngitis can prevent all of the following
EXCEPT?
a. Poststreptococcal glomerulonephritis
b. Retropharyngeal abscess
c. Kawasaki Disease
d. Rheumatic fever - ANS c. Kawasaki Disease
Thomas a 13 year old male who presents with red eyes. On exam his conjunctiva have
hyperemia with purulent discharge bilaterally. His fever started last night 101.9. He has had cold
symptoms for 5 days with a mild wet sounding cough and no ear pain. His TM's are
erythematous bilaterally with no bony landmark or pus visible. He has a positive light reflex
bilaterally. What would your treatment plan be?
a. Treat with Augmentin 90 mg/kg/day divided in two daily doses for 10 days.
b. Treat with Trimethoprim- polymixin B opthalmic drops (Polytrim) 1-2 drops each eye for 5-7
days.
c. Treat with Amoxicillin 90 mg/kg/day divided in two doses for 10 days.
d. Supportive care - ANS b. Treat with Trimethoprim- polymixin B opthalmic drops
(Polytrim) 1-2 drops each eye for 5-7 days
Janice is an 18-year-old female who has been a patient at your practice since birth. She has an
altered immunization schedule per her parent's request. She is presenting to inquire about
getting caught up on her vaccines and wants to start with the MMR (measles, mumps and
rubella) vaccine. Which of the following would be a contraindication to the vaccine?
a. acute illness (URI symptoms) without a fever
b. late menses, possible pregnancy
c. exercise induced asthma
d. all of the above - ANS b. late menses, possible pregnancy
Children in daycare typically get 6-8 respiratory illnesses per year. Which vaccines lower the risk
for serious respiratory illnesses in infants?
a. Measles
b. Haemophilus influenzae type B
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