Assessment of Neonatal Jaundice

Question no.371

A 7-month old patient presents with a history of 3 days of ferver to 104 F, Which resolved the same day that an exanthem erupted. The exanthem is prominent on the neck and trunk. It is macular, with

USMLE 32

     A 2 year old child was recently adopted from India.She appears to be healthy,and there are no abnormal symptoms.Her weight and height are at 25th percentile for age.Her examination is normal .On screening,you find a positive TB skin test using  PPD with 20mm induration.She has a history of receiving a BCG vaccination at birth.

Your management plan is to do which of the following?

A) Obtain a chest x-ray and treat only of this is abnormal.

B) Repeat the test in 3-6 months.

C) Attribute the +ve PPD to the BCG vaccination & do serial yearly x-rays.

D) Obtain sputum cultures.

E) Obtain a CXR and initiate prophylactic ttt with INH.

USMLE 22

A 4 year old previously healthy girl presents to the E.R. with a 24-hour history of rectal bleeding & dizziness. She has no other GIT symptoms.

On examination she appears pale. Her heart rate is 140 beats/min, she has a 20 mmHg postural drop in systolic blood pressure. her abdomen is not distended and not tender, and fresh blood and clots are in the rectal vault on rectal examination.

What is your clinical diagnosis?

a)  juvenile rectal polyp.

b) Anal fissure.

c) Bleeding Meckel's diverticulum.

d) Hemorrhoids.

e) Intussusception.

What is the appropriate diagnostic study for her condition?

a) Colonoscopy.

b) Laparoscopy.

c) Technetium scan.

d) UGI contrast study with small bowel follow through.

e) Barium enema.

Spot diagnosis 73

What is your clinical diagnosis?

Medical MCQ 41

Hypercyanoptic spell of T.O.F. is best treated with all of the following except:

a- Knee chest position.

b- Morphine.

c- Digoxin.

d- Propranolol.

e- Sodium bicarbonate.

Medical Case 65

a 1 year old infant is complaining of delayed sitting and repeated chest infection,on examination there is prominent costochondral junction, he is exclusively breast fed, He received multiple injections for treatment of his condition.

All of the following are expected complication for his condition except:
1. anorexia .
2. vomiting .
3. oliguria .
4. nephrocalcinosis .

CT 5

A child with occipital soft scalp swelling since birth.

*T1

* FLAIR

What is your radiological diagnosis?

Medical MCQ 39

The carey coomb murmur is due to:

a) Inflammation of the mitral valve.

b) Increased diastolic flow across the mitral valve.

c) Cardiac decompression.

d) Defibrillation.

x ray 35

What is your medical diagnosis?

Spot diagnosis 60

What is your medical diagnosis?

Whooping cough

Spot Diagnosis 54

What is your medical diagnosis?

Medical Case 29

A 5-month-old girl presented with history of constipation and delayed developmental milestones. She had prolonged physiological jaundice. On exam, she is hypoactive, has an open mouth with large tongue. Other systemic examinations are within normal.

What is the next step in management?
A) Checking T4 and TSH
B ) Checking serum bilirubin
C ) Doing CT scan of head
D ) Follow up after 4 weeks

Spot Diagnosis 49

What is your medical diagnosis?

USMLE 10

A 2 week old male infant brought to the office by his 28-year old primiparous mother for the evaluation of jaundice that was noticed two days ago. The infant stool has a lighter color. He is exclusively breastfed. The pregnancy was uncomplicated, and prenatal screening tests for TORCH organisms were all negative. The infant was delivered vaginally with no complications. His temp. is 37.2 C, pulse is 140/min, respirations are 50/min, and capillary refill is <2sec. Examination reveals jaundiced skin and mucous membranes. Abdominal palpation reveals hepatomegaly. The initial investigations show the following:

Hb                          18.0 g/dl

Hct                         52%

Bilirubin total        5mg/dl

Bilirubin Direct     4mg/dl

Blood type             O +ve ( The mother blood type B ــ )

Coomb's test           Negative

What is the most likely diagnosis?

a) Breast milk jaundice

b) Biliary atresia.

c)Physiologic jaundice.

d) Gilbert syndrome.

e) Crigler- Najjar syndrome.

f) Erythroblastosis fetalis.

Medical MCQ 25

The followings are essential for diagnosis of 1ry nephrotic syndrome except:

a) Hypercholesterolemia.

b) Severe edema.

c) Hypoalbuminemia.

d) Renal failure.

e) Heavy proteinuria.

Neonatal resuscitation 1

Pediatric MCQ 3

The combination of fever, joint pain& skin rash in children may be caused by all the following except:

a) Anaphylactoid purpura.

b) Acute rheumatic fever.

c) Aplastic anemia.

d) Acute lymphoblastic leukemia.

e) Juvenile rheumatoid arthritis.

Pediatric Case 8

A 6-month-old boy is brought by his mother because he is floppy when placed in a sitting position. He does not seem to be interested in reaching for toys. At 4 month visit, his head support was weak and had a persistent Moro reflex.

What is the most likely diagnosis?

A ) Duchenne muscular dystrophy
B )Cerebral palsy
C ) Brain tumor
D ) Meningitis