Pediatric Examination and Board Review (253 page)

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Authors: Robert Daum,Jason Canel

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4.
(E)
Delayed eruption of the primary teeth can be caused by all of these conditions. A child with any of these conditions should be evaluated by a dentist by 12 months.

5.
(A)
0.25 mg. The American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD) recommend fluoride supplementation as per the nearby chart (see
Table 144-1
).

TABLE 144-1

 

FLUORIDE CONCENTRATION IN LOCAL WATER SUPPLY
AGE OF CHILD
<0.3 ppm
0.3-0.6 ppm
>0.6 ppm
DAILY DOSAGE OF FLUORIDE
6 months to 3 years
0.25 mg
None
None
3-6 years
0.50 mg
0.25 mg
None
6-16 years +
1.0 mg
0.50 mg
None

 

6.
(E)
All of these can cause fluorosis. Determining a child’s total fluoride intake from all sources is important when deciding if a child will need more fluoride.

7.
(A)
The first molars begin developing at birth. From this point forward, the teeth can be susceptible to development or environmental anomalies.

8.
(B)
The AAP and AAPD recommend a first dental visit within 6 months of the eruption of the first tooth. This is usually around 12 months.

9.
(C)
Infants are colonized by bacteria that originate from the saliva of their primary caregiver, usually the mother (eg, sharing a spoon).

10.
(E)
All of the choices can contribute to early childhood caries. Other factors to be aware of are malformed primary teeth (weak enamel), frequent in between meal snacking and drinking of foods and drinks with fermentable carbohydrates.

11.
(E)
All of these items can cause facial swelling. Depending on the tooth that has become infected, any of the facial spaces can be involved. These infections can be secondary to caries or trauma to a tooth.

S
UGGESTED
R
EADING

 

2010-11 Definitions, oral health policies, and clinical guidelines. American Academy of Pediatric Dentistry Web site.
http://www.aapd.org/media/policies.asp
.

http://www.cdc.gov/FLUORIDATION/safety/infant_formula.htm
.

http://jada.ada.org/cgi/content/full/133/1/93
.

Table of Contents

Contributors

Preface

Acknowledgments

Chapter 1

Cardiology

1 A Neonate with a Heart Murmur
2 A 10-Year-Old Boy with Palpitations
3 A 7-Year-Old with a Heart Murmur
4 A 5-Year-Old with a Heart Murmur and Fever
5 A 10-Year-Old Boy with Elevated Blood Pressure Ascertained at a Routine Physical Examination

Chapter 2

Critical Care

6 A 5-Month-Old with Apnea and Cyanosis
7 A 4-Month-Old with Hypotonia and a Weak Cry
8 A 5-Year-Old Boy with Fever, Drooling, and Stridor
9 A 6-Year-Old Boy Found at the Bottom of the Neighbor’s Pool
10 A 2-Year-Old Boy with Sudden Onset of Coughing
11 A 3-Year-Old Girl with Hypoxia and a History of Hoarseness
12 16-Year-Old Boy with Very High Body Temperature
13 A 4-Year-Old Girl with Snoring
14 A 16-Month-Old Boy with Fever and Cough
15 An 8-Month-Old with Generalized Seizures

Chapter 3

Dermatology

16 A Neonate with a Birthmark on the Face
17 A Neonate Girl with Vesicles
18 An 8-Year-Old Boy with an Itchy Rash
19 A 4-Year-Old Girl with an Itchy Rash
20 An 8-Year-Old Girl with Hair Loss
21 A 6-Month-Old Boy with Birthmarks

Chapter 4

Development

22 A 2-Month-Old with Colic and Subsequent Development Delay
23 A 4-Year-Old Boy with Motor Disability Preparing to Transition to Public School Kindergarten
24 A 1-Year-Old with Early Handedness
25 A Child with Spina Bifida
26 A 3-Year-Old with Speech Delay
27 A Neonate Girl with Floppy Tone and Upward-slanting Eyes
28 An 8-Year-Old Boy with Autistic Behaviors that are Difficult to Control
29 A 4-Year-Old who was Born Prematurely
30 An 8-Year-Old Boy with Loss of Milestones
31 A 3-Year-Old Boy with Poor Language and Social Skills
32 A 7-Year-Old Boy with ADHD Fails First Grade
33 An 18-Month-Old Boy who has not Spoken
34 A 4-Month-Old Well Child Visit with a Tearful Mother
35 A 6-Year-Old Boy who Failed Kindergarten
36 An 8-Year-Old Girl who is Bossy

Chapter 5

Endocrinology

37 A 10-Year-Old Boy with Short Stature
38 An 81/2-Year-Old with Pubertal Development
39 A 14-Year-Old without any Signs of Puberty
40 A 10-Year-Old with a Goiter
41 A 14-Month-Old with a Seizure
42 A 12-Year-Old Girl with Nausea, Abdominal Pain, and Vomiting
43 A Neonate with Ambiguous Genitalia
44 A 13-Year-Old Girl with Rapid Weight Gain
45 A 16-Year-Old Boy with Fatigue, Anorexia, Intermittent Vomiting, and Weight Loss

Chapter 6

Gastroenterology

46 A 1-Month-Old with Jaundice
47 An 11-Year-Old with Cramping Abdominal Pain
48 A 4-Year-Old Boy with Rectal Bleeding
49 A 6-Week-Old with Vomiting
50 An 8-Year-Old with Jaundice
51 A 6-Year-Old with Fecal Incontinence
52 A 15-Month-Old with Diarrhea

Chapter 7

General Pediatrics

53 A 12-Year-Old with Ear Discharge
54 A 2-Year-Old with Eye Redness
55 A 5-Year-Old Boy with a Painless Limp
56 A 4-Year-Old with Ear Pain
57 A 14-Year-Old Boy with a Sore Throat and Enlarged Spleen
58 A 5-Year-Old with Nosebleeds
59 A 4-Year-Old Girl with “Pink Eye”
60 A 9-Month-Old in a Car Accident
61 An 8-Year-Old with Congestion
62 An 8-Year-Old Girl with Sore Throat
63 A 7-Month-Old with Crossed Eyes
64 A 4-Year-Old with a Neck Mass
65 A 3-Month-Old Boy with Apnea
66 A 2-Year-Old Boy Who Needs a Checkup
67 A 2-Year-Old who Refuses to Walk
68 A 2-Year-Old with Recurrent Wheezing
69 A 5-Year-Old with Hives after 10 Days of Antibiotics
70 A 3-Month-Old with Poor Weight Gain, Recurrent Infection, and Diarrhea

Chapter 8

Adolescent Medicine

71 A 14-Year-Old Girl who Needs a School Physical
72 A 15-Year-Old Boy with Short Stature and Pubertal Delay
73 A 16-Year-Old Girl who has Never had a Menstrual Period
74 A 17-Year-Old Girl with Painful Menses
75 A 14-Year-Old Girl with Painful Urination
76 A 17-Year-Old Girl with Heavy, Irregular Menses
77 A 15-Year-Old Girl with Abdominal Pain, Weight Gain, and Fatigue
78 A 15-Year-Old Girl with Obesity, Acne, No Menses in 3 Months, and Possible Depression

Chapter 9

General Emergency and Urgent Care

79 A 17-Year-Old with Knee Pain
80 A 15-Year-Old and A 17-Year-Old Who Collapse During a Marathon
81 A 5-Year-Old Boy with Abdominal Pain
82 A 3-Year-Old Girl who Drinks a Bottle of Acetaminophen

Chapter 10

Genetics

83 A Neonate with a Heart Defect and Dysmorphic Features
84 A Neonate with Lethargy
85 A Neonate with a Ventricular Septal Defect and a Thin Upper Lip
86 A 6-Month-Old Boy with Short Stature Suggestive of Skeletal Dysplasia

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