A 3-month-old infant presents with inspiratory stridor that worsens when supine and improves when prone. Laryngoscopy shows supraglottic collapse during inspiration. What is the most likely diagnosis?
Anonymous Quiz
12%
Foreign body aspiration
18%
Tracheomalacia
18%
Subglottic stenosis
4%
Vocal cord paralysis
47%
Laryngomalacia
A 2-year-old has ptosis, miosis, and facial anhidrosis. Labs: ↑ urine VMA. Imaging: cervical sympathetic chain mass. Most likely diagnosis?
Anonymous Quiz
15%
Ganglioneuroblastoma
25%
Congenital Horner
5%
Lymphangioma
46%
Neuroblastoma
9%
Pancoast tumor
A 3-week-old infant presents with persistent, non-bilious projectile vomiting after feeds. On exam, you palpate a firm “olive-sized” mass in the right upper quadrant. Labs show hypochloremic, hypokalemic metabolic alkalosis. Next best step in management?
Anonymous Quiz
5%
Immediate endoscopic pyloric dilation
86%
Correct fluid & electrolyte imbalance, then perform pyloromyotomy
7%
Start proton pump inhibitor and observe
1%
Upper GI series, then discharge with oral feeds
2%
Initiate nasogastric suction only
A 6-week-old infant presents with progressive jaundice, hepatomegaly, and pale stools. Labs show direct hyperbilirubinemia. What is the most likely diagnosis?
Anonymous Quiz
11%
Neonatal hepatitis
6%
Galactosemia
73%
Biliary atresia
7%
Alpha-1 antitrypsin deficiency
3%
Choledochal cyst
👍4
A full-term newborn is 30 hours old and has not yet passed urine or meconium. Which is most accurate regarding normal timing?
Anonymous Quiz
2%
Timing is irrelevant in healthy newborns
5%
Both urine and meconium must occur within 12 hours
13%
Meconium within 72 hours, urine within 48 hours
18%
Urine within 48 hours, meconium within 24 hours
63%
Urine within 24 hours, meconium within 48 hours
A 4-day-old newborn has not passed meconium, feeds poorly, and appears hypotonic. Exam shows a large anterior fontanelle and constipation. Most likely cause?
Anonymous Quiz
16%
Hirschsprung disease
13%
Meconium ileus (cystic fibrosis)
65%
Congenital hypothyroidism
3%
Small left colon syndrome
3%
Normal variant
❤3
A 3-week-old infant presents with sudden bilious vomiting, abdominal distension, and lethargy. Vital signs show tachycardia and hypotension. What is the most likely diagnosis?
Anonymous Quiz
39%
Midgut Volvulus
12%
Hirschsprung disease
20%
Pyloric stenosis
10%
Meconium ileus
19%
Necrotizing enterocolitis
A 2-year-old swallows a metallic pin. X-ray shows it lodged in the proximal duodenum. The child is asymptomatic. What is the next best step?
Anonymous Quiz
33%
Observe and repeat X-ray in 24 hours
8%
Give laxatives and monitor stools
40%
Immediate endoscopic removal
4%
Attempt removal with magnet or external manipulation
15%
Wait for spontaneous passage
6-month-old infant with hard, infrequent stools, otherwise healthy.
Initial management?
Initial management?
Anonymous Quiz
31%
Fruit juice/puree
7%
Mineral oil
26%
Lactulose solution
25%
Rectal stimulation
11%
Anorectal testing
A 3-year-old child presents with recurrent febrile urinary tract infections. Ultrasound shows normal kidneys. Which of the following diagnostic tests is indicated to evaluate for vesicoureteral reflux?
Anonymous Quiz
3%
MRI of the kidneys
86%
Contrast voiding cystourethrogram (VCUG)
6%
Cystoscopy
3%
Plain abdominal X-ray
2%
Nuclear medicine renal scan
A 2-year-old child presents with dehydration: dry mucous membranes, tachycardia, and lethargy. Labs reveal hypernatremia. What is the most appropriate initial management?
Anonymous Quiz
50%
Emergency fluid resuscitation with isotonic saline
36%
Rapid correction with hypotonic solution (0.45% NaCl)
10%
Oral rehydration solution
2%
Hypertonic saline infusion
2%
Diuretic therapy
❤1
A newborn presents with respiratory distress, flattened facies, and limb deformities. Prenatal history reveals severely decreased amniotic fluid in the third trimester. What is the primary underlying abnormality?
Anonymous Quiz
26%
Pulmonary hypoplasia
32%
Oligohydramnios
3%
Flattened facies
2%
Limb deformities
37%
Renal agenesis
A 7-year-old child presents with dark urine and mild edema. Laboratory studies show low serum C3 with normal C4. Which of the following is the most likely diagnosis?
Anonymous Quiz
63%
Poststreptococcal glomerulonephritis
9%
Alport syndrome
9%
Lupus nephritis
14%
IgA nephropathy
5%
Membranous nephropathy
❤3
Forwarded from Black Lion | School of Medicine 💉💊
A 60-year-old man presents with progressive abdominal distension. Paracentesis reveals: Ascitic albumin: 1.0 g/dL, Serum albumin: 3.5 g/dL, Total protein (ascites): 3.8 g/dL, WBC: 180/mm³ (lymphocyte predominant). Most likely cause of this ascites is?
Anonymous Quiz
44%
Cirrhosis
21%
Peritoneal carcinomatosis
13%
Nephrotic syndrome
16%
Heart failure
6%
Pancreatic ascites
❤2
Forwarded from Black Lion | School of Medicine 💉💊
A 72-year-old man with a history of recurrent diverticulitis presents with pneumaturia and recurrent UTIs. He denies abdominal pain. Which of the following statements is most accurate regarding colovesical fistula?
Anonymous Quiz
19%
Fecaluria is present in almost all patients.
29%
CT scan is more sensitive than cystoscopy for diagnosis.
11%
Antibiotic therapy is usually curative.
38%
Colorectal cancer is the most common cause in Western countries.
2%
Surgery is contraindicated in elderly patients.
❤1
Forwarded from Black Lion | School of Medicine 💉💊
A 65-year-old man has a right groin bulge lateral to the inferior epigastric vessels, reducible and worse with coughing. Which of the following is the most accurate?
Anonymous Quiz
32%
This is most likely a direct inguinal hernia passing through Hesselbach’s triangle.
10%
Indirect inguinal hernias are more common in older men than in young men.
7%
Femoral hernias are more common than inguinal hernias in men.
49%
Indirect inguinal hernias enter the deep inguinal ring lateral to inferior epigastric vessels.
2%
Direct inguinal hernias are usually congenital due to a patent processus vaginalis.
Forwarded from Black Lion | School of Medicine 💉💊
A 45-year-old man presents with painless bright red rectal bleeding on defecation. On anoscopy, you see a hemorrhoid that prolapses with straining and spontaneously reduces. Which of the following statements is most accurate?
Anonymous Quiz
10%
This is a Grade I internal hemorrhoid
69%
This is a Grade II internal hemorrhoid
15%
This is a Grade III internal hemorrhoid
3%
This is a Grade IV internal hemorrhoid
2%
Hemorrhoidectomy is immediately indicated