Title Peds 6-2022.pdf ✅

SPOT LIGHT ON PEDIATRICS 2022 MCQS BOOK DR FADI QUTISHAT Pediatrics 6/2022 MCQs 1 st Edition • For internship doctors, residents and students in medical schools. • For preparation to internship exams, entrance exam for residency in JUH, Royal medical services and Ministry of health of Jordan. • More than 30 frequently tested facts • Past papers exam QUTISHAT FADI, MD 2022/2023
SPOT LIGHT ON PEDIATRICS 2022 MCQS BOOK DR FADI QUTISHAT Pediatrics 6/2022 1) About febrile seizure, all of the following statements are correct except A. It occurs in children age 6 months to 5 years B. It is usually occurring in the setting of viral CNS infection C. Viral infection and family history are recognized risk factors D. Simple type is the most common type of febrile seizure E. Episodes that last more than 15 minutes indicate complex type Explanation SUMMARY AND RECOMMENDATIONS ●Description – Febrile seizures occur in children with fever, usually in the setting of systemic viral or bacterial infection. Affected patients are typically between the ages of six months and five years of age and do not have epilepsy, central nervous system (CNS) infection or inflammation, or other triggers for seizures. (See 'Definitions' above.) ●Epidemiology and risk factors – Febrile seizures occur in 2 to 4 percent of children younger than five years of age, with a peak incidence between 12 and 18 months. Febrile seizures are an age- dependent phenomenon, likely related to a vulnerability of the developing nervous system to the effects of fever in combination with an underlying genetic susceptibility. Aside from age, the most commonly identified risk factors include high fever, viral infection, recent immunization, and a family history of febrile seizures. (See 'Epidemiology' above and 'Risk factors' above.) ●Presentation – The majority of children have their febrile seizures on the first day of illness and, in some cases, it is the first manifestation that the child is ill. (See 'Presentation' above.) ●Characteristics •Simple febrile seizures – These are the most common type and are characterized by seizures that last less than 15 minutes, have no focal features, and occur once in a 24-hour period. These are mainly generalized tonic-clonic seizures but may also be atonic or tonic in character. (See 'Simple febrile seizures' above.) •Complex febrile seizures – These are characterized by episodes that last more than 15 minutes, have focal features or postictal paresis, or occur more than once in 24 hours. (See 'Complex febrile seizures' above.) ●Differential diagnosis – The differential diagnosis of febrile seizure includes nonepileptic events or movements, CNS infection (eg, meningitis or encephalitis), and rare forms of genetic epilepsy in
SPOT LIGHT ON PEDIATRICS 2022 MCQS BOOK DR FADI QUTISHAT which seizures are particularly common with fever. While meningitis and encephalitis are the main concerns in a child presenting with fever and seizures, a thorough history and examination will almost always detect the child with meningitis. (See 'Differential diagnosis' above.) ●Evaluation – Febrile seizures are a clinical diagnosis. In children with a typical history and a reassuring and nonfocal exam, diagnostic testing is unnecessary in most cases. (See 'Diagnostic evaluation' above.) •Role of lumbar puncture (LP) – An LP is unnecessary in most well- appearing children who have returned to a normal baseline after a febrile seizure. Postictal drowsiness typically resolved within 5 to 10 minutes, depending upon the duration and type of seizure. LP should be performed when there are meningeal signs or symptoms or other clinical features that suggest possible meningitis or intracranial infection. Additional circumstances that warrant consideration of LP include (see 'Lumbar puncture' above): -Infants between 6 and 12 months of age, if the immunization status for Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae is deficient or undetermined -Current treatment with antibiotics since antibiotics can mask the signs and symptoms of meningitis -Febrile status epilepticus (FSE) -Seizures that occur after the second day of a febrile illness •Other tests – Laboratory testing, neuroimaging, and electroencephalography (EEG) are required only in specific circumstances. (See 'Other laboratories' above and 'Neuroimaging' above and 'Electroencephalography' above.) Reference https://www.uptodate.com/contents/clinical-features-and-evaluation- offebrileseizures?csi=687e43a535cc4ca099bf9d190512e385&source =contentShare 2) A one-and-a-half-year-old child is referred to pediatrics for failure to thrive. On examination he is a clean, well-dressed child. He is pale and looks thin with wasted buttocks. His examination is otherwise unremarkable. His growth chart shows good growth along the 50th centile until 6 months followed by weight down to the 9th, height down to 25th. What is the most likely cause of this child’s growth failure? A. Coeliac disease B. Neglect C. Constitutional delay D. Normal child E. Beta thalassemia