Taking the Boards

Tips of the Trade

Topics that tend to be highlighted

• Developmental Landmarksa. very specific and detailedb. Study a Denver Devel Screen (or equivalent)

• Endocrinologya. Calcium/ Vitamin D metabolismb. Congenital Adrenal Hyperplasia

• Metabolic Diseasesa. Storage diseasesb. Inborn errors of metabolism

Highlighted Topics (Cont)

• Vitamins and Minerals (Hyper and Hypo)

• General Genetics

• Simple Immunology

TIPS

• Spend more time studying weaknesses than strengths

• Spend more time studying esoteric (metabolism, enzyme defects) than frequently seen subspecialty pediatrics

• Spend last few weeks studying development, esoterica, endocrinology

TIPS

• Read questions carefully – look for words like “most likely”, “except” “best”

• Don’t overintepret the questions

• Use rest of exam as a reference – one question may relate to many others

• Don’t panic! – if a question gives you a real problem, skip it and come back at end.

TIPS

• Study photographs/radiographs closely. They are trying to make a point!

• Don’t ask for Consultants

• Will have only superficial questions on new topics (to make sure all of U.S. has seen it). This was experience w HIV questions. Expect same w CA-MRSA

You are evaluating an infant who regards faces, smiles responsively, laughs and occasionally stares at his hand

for several seconds. He does not try to obtain a toy that is out of reach, bring his hands together, or turn to a sound

of a rattle.

Findings are most consistent w an age of:

A) 1 week

B) 2 months

C) 4 months

D) 6 months

E) 8 months

The average infant is able to pick up a grain of cereal like puffed rice between thumb and forefinger at about the same

time he:

A) Begins to pull to a standing position

B) Can walk without assistance

C) First rolls over

D) First exhibits a social smile

E) First transfer large objects from hand to hand

An infant sits on his mother’s lap. His head control is good. When a toy is offered to him, he reaches out for it

with both hands, grasps it with his R hand, transfers it to his L, and places it in his mouth.

The developmental age appears closest to:

A) 2 months

B) 4 months

C) 7 months

D) 9 months

E) 12 months

Using test as a reference book

1. A 5 mo girl is brought in for evaluation of failure to gain weight and intermittent vomiting during the past 4 weeks. Five wks ago, she was weaned from breast-feeding and a regimen of cow milk and strained fruits and vegetables were started. P.E. reveals an irritable, jaundiced infant with a liver 4 cm below RCM

Patient 1 (continued)

What is most likely diagnosis?

A) Hypothyroid

B) Galactosemia

C) Hereditary Fructose Intolerance

D) Sensitivity to lactoglobulin

E) Glycogen Storage Disease type I

Using test as a reference book

2. A 3 week old girl has fever and vomiting. P.E. includes a bulging fontanelle and hepatomegaly. The patient had jaundice and vomiting during the 1st week of life. She has been breast-fed.

Patient 2 (continued)

What is most likely diagnosis?

A) Fructose aldolase deficiency

B) Fructose 1,6 diphosphate deficiency

C) Glycogen Storage Disease type I

D) Neonatal adrenoleukodystrophy

E) Galactosemia

ANSWERS

• Answer to pt 1 is fructose intolerance since it began when fruits were introduced. Galactose (a part of lactose) is in breast milk and cow milk formula, and problem began late.

• Answer to pt 2 is Galactosemia since illness began w breast feeding right at birth. No fructose in sight! In both cases, GSD type 1 gives hepatomegaly, but well looking, non-icteric kids.