PICTURE QUIZ

In each of the following questions there are two images and a brief clinical description concerning a single case. Select the correct diagnosis out of the five choices. Only one answer is correct.

  1. Figure A shows the eye of a 1 day old hypotonic male infant. Figure B shows his karyotype.

Figure A

Figure B

(Atlas of Pediatric physical diagnosis)

What is the diagnosis?

a)Edward syndrome

b)Patau syndrome

c)Down syndrome

d)Aniridia

e)Wilson’s disease

2. A term newborn baby was noted at 6 hours of age to be tachypnoeic and to have the appearance shown in figure A. An arterial blood gas whilst breathing 100% oxygen for 10 minutes is shown in figure B.

Figure AFigure B

(Atlas of Pediatric physical diagnosis)

What is the diagnosis?

a)Transposition of the great arteries

b)Tetralogy of Fallot

c)Surfactant deficiency

d)Coarctation of the aorta

e)Ventricular septal defect

  1. A 7 year old girl presented with a 3 month history of constant severe headaches and a 1 day history of vomiting. Figure A shows her fundal examination and figure B shows her cranial CT with contrast.

Figure A

Figure B

What is the diagnosis?

a)cerebral abscess

b)cerebral metastases

c)meningioma

d)cerebellar medulloblastoma

e)intracerebral haemorrhage

  1. A 3 week old infant boy presented with a four day history of non bile-stained vomiting. Figure A shows the transitory appearance of his abdomen during a feed. The results of his blood tests are shown in figure B.

Figure A
Figure B

(Atlas of Pediatric physical diagnosis)

What is the diagnosis?

a)Duodenal atresia

b)Intussusception

c)Pyloric stenosis

d)Posterior urethral valves

e)Gastroenteritis

5. This 2 year old boy presented with a 2 week history of general malaise and marked weight gain. His blood pressure was 90/65mmHg. His facial appearance is shown in Figure A. Blood and urine results are shown in Figure B.


Figure AFigure B

(Atlas of Pediatric physical diagnosis)

What is the diagnosis?

a)Nephrotic syndrome

b)Congestive heart failure

c)Hereditary angioneurotic oedema

d)Acute nephritis

e)Urinary tract infection

6.A 2 year old breast fed girl was referred by her health visitor on account of delayed walking. Figure A shows her general appearance with marked abnormalities of the limbs. An x-ray of her wrist is shown in figure B.



Figure AFigure B

What is the diagnosis?

A)Rickets

B)Osteoporosis

C)Osteomalacia

D)Osteogenesis imperfecta

E)Achondroplasia

  1. An eight year old boy developed a rash on his lower limbs shown in figure A. He also complained of intermittent abdominal pain and painful ankles. Results of blood and urine tests are shown in Figure B


Figure AFigure B

What is the diagnosis?

a)Idiopathic thrombocytopaenic purpura

b)Acute lymphoblastic leukaemia

c)Henoch-Schonlein purpura

d)Haemolytic uraemic syndrome

e)Meningococcal septicaemia

  1. A 3 month old girl infant presented with frequent flexor spasms which had been diagnosed as infantile colic. Examination revealed the skin lesions shown in figure A. Similar lesions were noted in her healthy mother. Her EEG is shown in figure B.

Figure A

Figure B

What is the diagnosis?

a)Neurofibromatosis type 1

b)Pyridoxine deficiency

c)Idiopathic epilepsy

d)Congenital toxoplasmosis

e)Tuberous sclerosis

9. This 3 year old girl presented with poor weight gain and bulky offensive stools. Her general appearance is shown in figure A. Figure B shows the histological appearance of her jejunal biopsy.



Figure AFigure B

What is the diagnosis?

a)Coeliac disease

b)Cystic fibrosis

c)Giardiasis

d)Cow’s milk protein intolerance

e)Crohn’s disease

10. A 1 year old boy presented with fever, a diffuse erythematous rash and cervical lymphadenopathy of 6 days duration. Figure A shows his fever chart and his response to IVIg. Figure B shows the appearance of his extremeties ten days after IVIg was given.

Figure A

Figure B


What is the diagnosis?

a)Infectious mononucleosis

b)Scalded skin syndrome

c)Kawasaki disease

d)Typhoid fever

e)Hand, foot and mouth disease

Answers

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