BURNS' PEDIATRIC PRIMARY CARE BY DAWN
LEE FINAL STUDY PAPER 2026 COMPLETE
QUESTIONS AND ANSWERS
◉ What happens if too much protein is consumed? Answer: Leads to
an *underconsumption* of adequate carbohydrates and fats, causing
the excess protein to be stored as fat.
◉ For Preparticipation physical examination (PPE), what should the
provider do if the parent disagrees with the providers advise to
refrain from participation? Answer: obtain a Signed Informed
consent from the pt's guardian.
◉ Which cardiac conditions may warrant an athlete to seek a
cardiologist before performing in Physical activity/sports? Answer:
Pathologic murmur, EKG dysrhythmias, hypertrophic
cardiomyopathy, Coronary artery abnormalities, carditis, marfans,
ehlers-danlos, mitral valve prolapse.
◉ How should diabetics monitor their glucose with physical
activity? Answer: before, q30min during, and 15 min after exercise &
Before bedtime
,◉ What should the Physical exam include? Answer: The
musculoskeletal Examination
General Head to toe (generalized focus on Cardiac and Neuro)
◉ What is the 90-second musculoskeletal exam? Answer: +Standing
Posture & shoulder - acromioclavicular alignment
+ Cervical ROM
+ Shoulder Shrug/strength
+ Elbow ROM/strength
+ supination/pronation ROM & Hand clench test
+ Stand & bend at knee to chest
+ Squat test
+ Lumbar ROM/Scoliosis
+ Tip/Toe Calf Symmetry
◉ What cardiovascular examinations should be done for sports
physical? (4) Answer: Auscultate for heart murmur
(sitting/lying/standing)
Femoral Pulses
Marfan's Sx's
Bilateral blood pressure
,◉ How is Exercise induced Asthma typically manifested? Answer:
occurs during or minutes after vigorous activity, Reaches peak 5-
10min after activity
◉ How is Exercise Induced Asthma managed? Answer: perform
warm-up drills and cool downs
+ short acting beta-2 agonists 15 to 30 min before sports activity
(*Duration lasts up to 6 hours*)
◉ Why would a squat to stand Cardiac auscultation show a murmur?
Answer: Increases venous return to the heart, thus increasing left
ventricular size and stroke volume.
◉ What would be indicated if patient has Softer murmur with
squatting and *Louder with Standing and Valsalva Maneuver*?
Answer: Hypertrophic cardiomyopathy or mitral valve prolapse
must be ruled out
◉ What occurs with people WITHOUT diabetes when they exercise?
Answer: exercise leads to decreased plasma insulin levels and
increased glucagon that triggers hepatic glucose production.
◉ What happens with Type 1 diabetics when they exercise?
Pathophys? Answer: diabetic individuals who have too little insulin
, in their system exercise can trigger release of high levels of glucose
and Keytone bodies, leading to hyperglycemia and eventually DKA
◉ What is the most concerning clinical issue with infectious
mononucleosis? Answer: Splenomegaly
◉ How long should nothing stay out for sports if they are diagnosed
with infectious mononucleosis? Answer: Three weeks
◉ About 15% of children with down syndrome can have what?
Answer: Atlantoaxial or anlanto-occipital instability
*anomaly of the Cervical vertebrae at the space between C-1 and C-2
◉ How are asymptomatic cases of Atlantoaxial Instability screen?
Answer: by obtaining lateral radiographic views of the C-spine
◉ What does the female athlete triad consist of? Answer: 1.
Disordered eating patterns
2. Menstrual dysfunction (amenorrhea or oligomenorrhea)
3. Osteopenia or osteoporosis
◉ Why is co-sleeping discouraged? Answer: Risk of SIDS
LEE FINAL STUDY PAPER 2026 COMPLETE
QUESTIONS AND ANSWERS
◉ What happens if too much protein is consumed? Answer: Leads to
an *underconsumption* of adequate carbohydrates and fats, causing
the excess protein to be stored as fat.
◉ For Preparticipation physical examination (PPE), what should the
provider do if the parent disagrees with the providers advise to
refrain from participation? Answer: obtain a Signed Informed
consent from the pt's guardian.
◉ Which cardiac conditions may warrant an athlete to seek a
cardiologist before performing in Physical activity/sports? Answer:
Pathologic murmur, EKG dysrhythmias, hypertrophic
cardiomyopathy, Coronary artery abnormalities, carditis, marfans,
ehlers-danlos, mitral valve prolapse.
◉ How should diabetics monitor their glucose with physical
activity? Answer: before, q30min during, and 15 min after exercise &
Before bedtime
,◉ What should the Physical exam include? Answer: The
musculoskeletal Examination
General Head to toe (generalized focus on Cardiac and Neuro)
◉ What is the 90-second musculoskeletal exam? Answer: +Standing
Posture & shoulder - acromioclavicular alignment
+ Cervical ROM
+ Shoulder Shrug/strength
+ Elbow ROM/strength
+ supination/pronation ROM & Hand clench test
+ Stand & bend at knee to chest
+ Squat test
+ Lumbar ROM/Scoliosis
+ Tip/Toe Calf Symmetry
◉ What cardiovascular examinations should be done for sports
physical? (4) Answer: Auscultate for heart murmur
(sitting/lying/standing)
Femoral Pulses
Marfan's Sx's
Bilateral blood pressure
,◉ How is Exercise induced Asthma typically manifested? Answer:
occurs during or minutes after vigorous activity, Reaches peak 5-
10min after activity
◉ How is Exercise Induced Asthma managed? Answer: perform
warm-up drills and cool downs
+ short acting beta-2 agonists 15 to 30 min before sports activity
(*Duration lasts up to 6 hours*)
◉ Why would a squat to stand Cardiac auscultation show a murmur?
Answer: Increases venous return to the heart, thus increasing left
ventricular size and stroke volume.
◉ What would be indicated if patient has Softer murmur with
squatting and *Louder with Standing and Valsalva Maneuver*?
Answer: Hypertrophic cardiomyopathy or mitral valve prolapse
must be ruled out
◉ What occurs with people WITHOUT diabetes when they exercise?
Answer: exercise leads to decreased plasma insulin levels and
increased glucagon that triggers hepatic glucose production.
◉ What happens with Type 1 diabetics when they exercise?
Pathophys? Answer: diabetic individuals who have too little insulin
, in their system exercise can trigger release of high levels of glucose
and Keytone bodies, leading to hyperglycemia and eventually DKA
◉ What is the most concerning clinical issue with infectious
mononucleosis? Answer: Splenomegaly
◉ How long should nothing stay out for sports if they are diagnosed
with infectious mononucleosis? Answer: Three weeks
◉ About 15% of children with down syndrome can have what?
Answer: Atlantoaxial or anlanto-occipital instability
*anomaly of the Cervical vertebrae at the space between C-1 and C-2
◉ How are asymptomatic cases of Atlantoaxial Instability screen?
Answer: by obtaining lateral radiographic views of the C-spine
◉ What does the female athlete triad consist of? Answer: 1.
Disordered eating patterns
2. Menstrual dysfunction (amenorrhea or oligomenorrhea)
3. Osteopenia or osteoporosis
◉ Why is co-sleeping discouraged? Answer: Risk of SIDS
