1. Picture It! November Board Review

2. The rash in the sun exposed areas as seen above What kind of deficiency does this kid have? Niacin The name for the entity of dermatitis, dementia & diarrhea? Pellagra

3. Fissuring at the corners of the mouth is associated with this vitamin deficiency Riboflavin Vitamin B2

4. What is the arrow pointing to and what’s the treatment? Ranula Excision

5. What in utero finding would this newborn have? Polyhydramnios from TE fistula

6. What deficiency does this child have? Typical lab finding? Protein malnutrition (Kwashiokor) with low albumin

7. What’s the deformity? What are other anomalies which can be associated with this nutritional deficiency? Genu varus deformity from hypophosphatemic rickets= may have widening of epiphyses, costochodral beading and craniotabes Craniotabes = softening of skull in infants Rickets = Vitamin D deficiency

8. What disease does this girl have? What would you expect the labs to show? * Alagille’s *Elevated d bili *Paucity of bile ducts Biliary hypoplasia, butterfly vertebrae, pulmonic stenosis

9. The first line therapy for the systemic illness associated with the lesion seen below… Steroids of some sort

10. If you don’t know what this is…

11. The name for this lesion Pyoderma gangrenosum--- associated with IBD

12. What lab test should be performed in this patient?

13. What type of cells fill these lesions? Epstein pearls are filled with keratin & squamous epithelium

14. Ewwwww….what’s that??? And what’s the treatment?

15. This disorder is characterized by hypoplasia, hypomaturation of the teeth or hypocalcification Amelogenesis Imperfecta

16. What history questions are important to ask in this patient? Use of antibiotics---specifically tetracycline

17. The name of what is seen below… Aphthous ulcer- not preceded by a vesicle like in HSV

18. This child has poor wound healing and a rash. What’s up? Zinc Deficiency we’ve mentioned this a lot this year so far...why???

19. What are your recommendations for this mom? Keep breastfeeding! It’s mastitis!

20. DON’T FREAK OUT…BUT THIS WAS ON SHANNON’S AND JAY’S BOARDS And last but not least….

21. Hypocalcemia – Lab Interpretation DiseasePTHSerum Phos 25-OH- VitD 1,25-OH- VitD Primary Hypoparathyroidism PTH resistance (pseduohypoPTH) Renal Failure Nutritional Rickets VitD Dependent Rickets VitD Resistant Rickets Normal Or Normal Normal Normal Or Normal

22. Happy Turkey Day!