PEDIATRICS TEST BANK ALL
ANSWERS CORRECT
Which phase of Kawasaki disease is associated with coronary aneurysms?
A. Acute febrile phase
B. Subacute phase
C. Convalescent phase
D. Phase of complications
E. All of the above Ans- 1 B.
Kawasaki disease presents with characteristically high, unremitting fever and 4 out of the 5
principal features:
Bilateral nonexudative bulbar conjunctival injection with limbal sparing;
Erythema of the oral and pharyngeal mucosa with strawberry tongue and dry, cracked lips;
Edema and erythema of the hands and feet;
Rash of various forms (scarlatiniform, maculopapular, erythema multiforme);
Nonsuppurative cervical lymphadenopathy (usually unilateral, with node size >1.5cm).
,Acute febrile phase - fever and the acute signs of illness and usually lasts 1-2wks
Subacute febrile phase - desquamation, thrombocytosis, coronary aneurysms and highest risk of
sudden death usually lasts 2 wks
Convalescent phase - All clinical signs have disappeared until ESR normalizes typically 6-8wks
after onset on illness
Source: Nelson's Textbook of Pediatrics 19th edition p864
A four year old presents with low-grade fever, intermittent crampy abdominal pain with emesis
and swollen knees of 3 days duration. A purpuric rash distributed below the knees of both lower
extremities is noted on physical examination. This patient most likely has:
A. Meningococcemia
B. Idiopathic thrombocytopenic purpura
C. Henoch-Scholein purpura
D. SLE E. Juvenile Rheumatoid arthritis Ans- 2 C.
,HSP is a common vasculitis among children and presents with the classic findings of abdominal
pain with or without rectal bleeding, vasculitis rash, arthritis and nephritis. The platelet count is
normal. Gastrointestinal involvement may progress to intussusception.
Source: Nelson's Textbook of Pediatrics 19th edition p868
A 3 year old female presents with 1 week history of daily (quotidian) fever associated with
arthritis of both ankles and her right knee. Her mother notes that she has decreased activity and
also notes rashes that come and go in different parts of her body but not on the face. On physical
examination, salmon colored patches were noted on the trunk and extremities. Palpation revealed
splenomegaly. What is the diagnosis?
A. Henoch Schoenlein Purpura
B. Systemic Lupus Erythematosus
C. Juvenile Rheumatoid arthritis
D. Juvenile Dermatomyositis
E. Dengue fever Ans- 3 C.
Don't forget to study rheumatic diseases of childhood even if it's not your favorite topic.
, Familiarize yourself with the relatively common ones like JRA, SLE and dermatomyositis, HSP
and scleroderma. Pay attention to the characteristics of the rash and other features. (Don't fall for
the trap of rash + arthritis = SLE.. It's not always SLE!)
JRA - Salmon colored patch, evanescent, spares the face
SLE - Malar rash, photosensitive
Dermatomyositis - heliotrope (periorbital) rash, gottron papules (rash on the knuckles)
HSP - purpura in dependent portions
For JRA, know the differences between subtypes (oligoarticular vs polyarticular vs systemic
onset)
This case in particular is a case of systemic onset Juvenile Rheumatoid arthritis (also called
Still's Disease)
Source: Nelson's Textbook of Pediatrics 19th edition p830
A 4 yr old boy presents with his third episode of painful cervical lymphadenitis. Each was
treated with incision and drainage and grew S. aureus. He also experiences recurrent skin
infections. A year ago, he was hospitalized for osteomyelitis. The most important laboratory test
is:
ANSWERS CORRECT
Which phase of Kawasaki disease is associated with coronary aneurysms?
A. Acute febrile phase
B. Subacute phase
C. Convalescent phase
D. Phase of complications
E. All of the above Ans- 1 B.
Kawasaki disease presents with characteristically high, unremitting fever and 4 out of the 5
principal features:
Bilateral nonexudative bulbar conjunctival injection with limbal sparing;
Erythema of the oral and pharyngeal mucosa with strawberry tongue and dry, cracked lips;
Edema and erythema of the hands and feet;
Rash of various forms (scarlatiniform, maculopapular, erythema multiforme);
Nonsuppurative cervical lymphadenopathy (usually unilateral, with node size >1.5cm).
,Acute febrile phase - fever and the acute signs of illness and usually lasts 1-2wks
Subacute febrile phase - desquamation, thrombocytosis, coronary aneurysms and highest risk of
sudden death usually lasts 2 wks
Convalescent phase - All clinical signs have disappeared until ESR normalizes typically 6-8wks
after onset on illness
Source: Nelson's Textbook of Pediatrics 19th edition p864
A four year old presents with low-grade fever, intermittent crampy abdominal pain with emesis
and swollen knees of 3 days duration. A purpuric rash distributed below the knees of both lower
extremities is noted on physical examination. This patient most likely has:
A. Meningococcemia
B. Idiopathic thrombocytopenic purpura
C. Henoch-Scholein purpura
D. SLE E. Juvenile Rheumatoid arthritis Ans- 2 C.
,HSP is a common vasculitis among children and presents with the classic findings of abdominal
pain with or without rectal bleeding, vasculitis rash, arthritis and nephritis. The platelet count is
normal. Gastrointestinal involvement may progress to intussusception.
Source: Nelson's Textbook of Pediatrics 19th edition p868
A 3 year old female presents with 1 week history of daily (quotidian) fever associated with
arthritis of both ankles and her right knee. Her mother notes that she has decreased activity and
also notes rashes that come and go in different parts of her body but not on the face. On physical
examination, salmon colored patches were noted on the trunk and extremities. Palpation revealed
splenomegaly. What is the diagnosis?
A. Henoch Schoenlein Purpura
B. Systemic Lupus Erythematosus
C. Juvenile Rheumatoid arthritis
D. Juvenile Dermatomyositis
E. Dengue fever Ans- 3 C.
Don't forget to study rheumatic diseases of childhood even if it's not your favorite topic.
, Familiarize yourself with the relatively common ones like JRA, SLE and dermatomyositis, HSP
and scleroderma. Pay attention to the characteristics of the rash and other features. (Don't fall for
the trap of rash + arthritis = SLE.. It's not always SLE!)
JRA - Salmon colored patch, evanescent, spares the face
SLE - Malar rash, photosensitive
Dermatomyositis - heliotrope (periorbital) rash, gottron papules (rash on the knuckles)
HSP - purpura in dependent portions
For JRA, know the differences between subtypes (oligoarticular vs polyarticular vs systemic
onset)
This case in particular is a case of systemic onset Juvenile Rheumatoid arthritis (also called
Still's Disease)
Source: Nelson's Textbook of Pediatrics 19th edition p830
A 4 yr old boy presents with his third episode of painful cervical lymphadenitis. Each was
treated with incision and drainage and grew S. aureus. He also experiences recurrent skin
infections. A year ago, he was hospitalized for osteomyelitis. The most important laboratory test
is:
