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NEW PEDIATRIC COMAT ACTUAL EXAM WITH
Q&A NEW MODIFIED TESTED AND APPROVED!!!
Chronic Kidney Disease (CKD) in children -- ANSWER--occurs as a result of an anatomic
abnormality and patient presents with poor growth, fatigue, hypertension, and enuresis.
- Urinalysis reveals proteinuria and/or hematuria
- must measure serum creatinine and complete renal imaging
Systemic Juvenile Idiopathic Arthritis -- ANSWER--Systemic juvenile idiopathic arthritis
presents with fixed arthritis for ≥ 6 weeks, quotidian fever for ≥ 2 weeks, and a rash that
worsens during fever.
- Additional findings can include hepatosplenomegaly, lymphadenopathy, anemia, and
elevated inflammatory markers (eg, erythrocyte sedimentation rate, C-reactive protein,
thrombocytosis).
DiGeorge (22q11.2 deletion) syndrome --> Common Heart Defect -- ANSWER--Tetralogy of
Fallot (TOF)
- Other conotruncal cardiac defects commonly seen in DiGeorge syndrome include
transposition of the great arteries (TGA; which would cause immediate cyanosis),
interrupted aortic arch, truncus arteriosus, atrial or ventricular septal defects, and vascular
rings.
, Page|2
Food protein-induced allergic proctocolitis (FPIAP) -- ANSWER--suspected in a child
younger than 6 months that presents with blood-streaked stools and no evidence of anal
fissure on exam
- Mngmt: breastfed infants --> elimination of dairy from mothers diet
Formual Fed --> switch to hydrolyzed formula
Hemophilic Arthropathy -- ANSWER--consquence of hemosiderin deposition --> triggers
synovial inflammation --> destruction of bone and cartilage (arthritic damage)
- prophylaxis with factor concentrates can prevent this complication.
Maintenance Fluid Requirements Caculations -- ANSWER--Maintenance fluid requirements
can be calculated as follows:
For body weight 0-10 kg give 100 mL/kg/day
For the next 10-20 kg give an additional 50 mL/kg/day
For each kg > 20 give an additional 20 mL/kg/day
, Page|3
Leukocyte Adhesion Defiency (LAD) -- ANSWER--recurrent bacterial infections of the skin
and mucosa, absent pus formation (seroanguinous), and delayed separation of the umbilical
cord.
- Leukocyte adhesion deficiency is an autosomal recessive primary immunodeficiency
disorder caused by defective integrins on the surface of leukocytes. It is characterized by
recurrent bacterial infections of the skin and mucosa (eg, omphalitis,
gingivitis/periodontitis), absent pus formation, and delayed separation of the umbilical cord.
Most common neck mass in the pediatric population -- ANSWER--asymptomatic benign
lymphadenopathy
Child with persisent symptoms of urinary tract infections (>48 hours) or costovertebral angle
tenderness development --> next steps? -- ANSWER--Expand antimicrobial coverage and
complete a renal/bladder ultrasound to evaluate for kidney involvement and to detect any
underlying anatomic abnormalities.
Congenital Umbilical Hernias -- ANSWER--Resolve spontaneously by 5 years of age
- Surgery only required for the management of complications (eg. incarceration)
Constitutional Growth Delay -- ANSWER--Delayed puberty or delayed bone age. Normal
variant. Adult height ends up in normal range
- normal levels of LH, FSH, and testosterone but have short stature and growth drops below
3rd percentile in ages 10-11
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Allergic Rhinitis Treatment -- ANSWER--Intranasal corticosteroids (eg, fluticasone) are the
most effective single treatment for allergic rhinitis.
- you can try oral antihistamines and or intranasal decongestants as combination therapy
Sicke-Cell Anemia Patient with Diarrhea -- ANSWER--Concern for Salmonella
Gastroenteritis
- Prescribe IV ceftriaxone
High-risk pediatric patients with immune suppression, including patients with malignancies,
immunosuppressive therapy, sickle cell anemia, immunodeficiency states and HIV must
receive appropriate antimicrobial therapy in the setting of Salmonella gastroenteritis. Empiric
therapy should begin with IV ceftriaxone in ill patients, although antimicrobial therapy
should be directed by culture results and organism sensitivities when available.
Obstructive Sleep Apnea in Kids -- ANSWER--Presents as daytime sleepiness, learning
problems, enuresis, parasomnias, and loud snoring
- In children, obstructive sleep apnea typically occurs as a result of adenotonsillar
hypertrophy, not obesity. Clinical manifestations are variable and can include a combination
of daytime sleepiness, learning problems, enuresis, parasomnias, and loud snoring. If left
NEW PEDIATRIC COMAT ACTUAL EXAM WITH
Q&A NEW MODIFIED TESTED AND APPROVED!!!
Chronic Kidney Disease (CKD) in children -- ANSWER--occurs as a result of an anatomic
abnormality and patient presents with poor growth, fatigue, hypertension, and enuresis.
- Urinalysis reveals proteinuria and/or hematuria
- must measure serum creatinine and complete renal imaging
Systemic Juvenile Idiopathic Arthritis -- ANSWER--Systemic juvenile idiopathic arthritis
presents with fixed arthritis for ≥ 6 weeks, quotidian fever for ≥ 2 weeks, and a rash that
worsens during fever.
- Additional findings can include hepatosplenomegaly, lymphadenopathy, anemia, and
elevated inflammatory markers (eg, erythrocyte sedimentation rate, C-reactive protein,
thrombocytosis).
DiGeorge (22q11.2 deletion) syndrome --> Common Heart Defect -- ANSWER--Tetralogy of
Fallot (TOF)
- Other conotruncal cardiac defects commonly seen in DiGeorge syndrome include
transposition of the great arteries (TGA; which would cause immediate cyanosis),
interrupted aortic arch, truncus arteriosus, atrial or ventricular septal defects, and vascular
rings.
, Page|2
Food protein-induced allergic proctocolitis (FPIAP) -- ANSWER--suspected in a child
younger than 6 months that presents with blood-streaked stools and no evidence of anal
fissure on exam
- Mngmt: breastfed infants --> elimination of dairy from mothers diet
Formual Fed --> switch to hydrolyzed formula
Hemophilic Arthropathy -- ANSWER--consquence of hemosiderin deposition --> triggers
synovial inflammation --> destruction of bone and cartilage (arthritic damage)
- prophylaxis with factor concentrates can prevent this complication.
Maintenance Fluid Requirements Caculations -- ANSWER--Maintenance fluid requirements
can be calculated as follows:
For body weight 0-10 kg give 100 mL/kg/day
For the next 10-20 kg give an additional 50 mL/kg/day
For each kg > 20 give an additional 20 mL/kg/day
, Page|3
Leukocyte Adhesion Defiency (LAD) -- ANSWER--recurrent bacterial infections of the skin
and mucosa, absent pus formation (seroanguinous), and delayed separation of the umbilical
cord.
- Leukocyte adhesion deficiency is an autosomal recessive primary immunodeficiency
disorder caused by defective integrins on the surface of leukocytes. It is characterized by
recurrent bacterial infections of the skin and mucosa (eg, omphalitis,
gingivitis/periodontitis), absent pus formation, and delayed separation of the umbilical cord.
Most common neck mass in the pediatric population -- ANSWER--asymptomatic benign
lymphadenopathy
Child with persisent symptoms of urinary tract infections (>48 hours) or costovertebral angle
tenderness development --> next steps? -- ANSWER--Expand antimicrobial coverage and
complete a renal/bladder ultrasound to evaluate for kidney involvement and to detect any
underlying anatomic abnormalities.
Congenital Umbilical Hernias -- ANSWER--Resolve spontaneously by 5 years of age
- Surgery only required for the management of complications (eg. incarceration)
Constitutional Growth Delay -- ANSWER--Delayed puberty or delayed bone age. Normal
variant. Adult height ends up in normal range
- normal levels of LH, FSH, and testosterone but have short stature and growth drops below
3rd percentile in ages 10-11
, Page|4
Allergic Rhinitis Treatment -- ANSWER--Intranasal corticosteroids (eg, fluticasone) are the
most effective single treatment for allergic rhinitis.
- you can try oral antihistamines and or intranasal decongestants as combination therapy
Sicke-Cell Anemia Patient with Diarrhea -- ANSWER--Concern for Salmonella
Gastroenteritis
- Prescribe IV ceftriaxone
High-risk pediatric patients with immune suppression, including patients with malignancies,
immunosuppressive therapy, sickle cell anemia, immunodeficiency states and HIV must
receive appropriate antimicrobial therapy in the setting of Salmonella gastroenteritis. Empiric
therapy should begin with IV ceftriaxone in ill patients, although antimicrobial therapy
should be directed by culture results and organism sensitivities when available.
Obstructive Sleep Apnea in Kids -- ANSWER--Presents as daytime sleepiness, learning
problems, enuresis, parasomnias, and loud snoring
- In children, obstructive sleep apnea typically occurs as a result of adenotonsillar
hypertrophy, not obesity. Clinical manifestations are variable and can include a combination
of daytime sleepiness, learning problems, enuresis, parasomnias, and loud snoring. If left
