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Step 2 Big Time Study Deck > Deck 2 COPY > Flashcards

Deck 2 COPY Flashcards

1
Q

what does molluscum contagiosum look like on a child

A

it is firm round pink or flesh colored papules with a central umbilication, shiny or itchy

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2
Q

treatment of molluscum contagiosum

A

observation and reassurance

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3
Q

what are the two types of transfusion rxns

A

anaphylactic and urticarial

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4
Q

management of a transfusion rxn

A

give antihistamines and stop transfusion

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5
Q

what do you need to do for close contacts of a positive pertussis patient

A

give close contacts a macrolide

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6
Q

what is a normal anion gap

A

6-12

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7
Q

causes of non anion gap metabolic acidosis

A

either renal or GI (diarrhea)

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8
Q

how does a baby present with RTA

A

chronic poor weight gain, declining weight despite regular weight at birth

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9
Q

presentation of atypical pneumonia

A

fever cough dyspnea, bilateral pulmonary infiltrates

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10
Q

what bug causes atypical pneumonia most often

A

mycoplasma pneumoniae

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11
Q

how do you treat mycoplasma pneumoniae

A

azithromycin

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12
Q

what drug do you use to treat tourettes in children

A

risperidone

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13
Q

when do pap smears start

A

age 21

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14
Q

what heart anomaly is seen in trisomy 18

A

VSD

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15
Q

signs of tricuspid valve atresia

A

absent tricuspid valve, tall peaked P waves, Left axis deviation, ASD, VSD

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16
Q

if a murmur in a neonate is holosystolic is it benign or pathologic

A

pathologic

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17
Q

what needs to be administered if a 1-3 day old neonate has sudden onset rapid breathing and cyanosis

A

prostaglandin E to kEEp the PDA open

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18
Q

are turner patients tall or short

A

short! very short

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19
Q

signs of choanal atresia

A

this is when the posterior nasal passage fails to canalize during first trimester causing cyanosis that worsens with feeding and improves with crying

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20
Q

what are the typical causes if a child has a fever without a source

A

occult bacterial infection (UTI, bacteremia, pneumoniae etc)

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21
Q

signs of chronic granulomatous disease

A

recurrent infections with catalase positive infections (staph, serratia, aspergillus)

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22
Q

dx of chronic granulomatous disease

A

DHR flow cytometry

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23
Q

prophylaxis for CGD

A

TMP-SMX, itraconazole, interferon gamma

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24
Q

pathogenesis of minimal change disease

A

cytokine induced glomerular injury

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25
Q

signs of LAD

A

frequent non purulent absesses, delayed umbilical cord separation

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26
Q

lab findings LAD

A

leukocytosis and neutrophilia

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27
Q

triple bubble sign on xray

A

jejenal atresia

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28
Q

signs of congenital syphilis

A

rhinorrhea, skeletal anomalies, desquamating rash on the palms and soles

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29
Q

effects on a neonate of a mother with lupus

A

they will typically have high creatinine levels

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30
Q

signs of functional constipation

A

anal fissure, blood on the outside of stools, pellet stools, infrequent defecation

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31
Q

management of functional constipation

A

adding prune juice or other osmotically active fibers to the diet

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32
Q

when should you switch a baby to a hydrolyzed formula

A

do this when the baby has blood mixed into the stool and has signs of soy/cows milk allergy

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33
Q

signs of tet spells

A

cyanosis upon crying or feeding mostly around the lips, children will squat if able

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34
Q

what are tet spells indicative of

A

tetrology of fallot

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35
Q

signs of gonococcal conjunctivitis in a newborn

A

copius exudate and eyelid swelling

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36
Q

pathogenesis of neonatal thyrotoxicosis

A

this is from maternal anti-TSH antibodies like from graves disease

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37
Q

does PSGN present with abdominal pain

A

No! this is IgA vasculitis

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38
Q

treatment of slipped capital femoral epiphysis

A

physis stabilization with screw fixation

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39
Q

Wiskott aldrich clinical features

A

eczema, microthombocytopenia, recurrent infections

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40
Q

etiology of wiskott aldrich

A

xlinked recessive defect in WAS, impaired cytoskelly

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41
Q

JIA presentation

A

arthritis, fever with cycles that spike high one time a day then return to baseline

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42
Q

what is another cause of infection in CF patients

A

pseudomonas, bronchopulmonary aspergillosis

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43
Q

comorbidities in turner syndrome

A

aortic dilation/dissection, metabolic syndromes, osteoporosis, vision changes, recurrent otitis media, celiac disease, hypothyroidism

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44
Q

signs of congenital diaphragmatic hernia

A

respiratory distress, absent breath sounds ipsilateral to the defect, concave abdomen, barrel shaped chest

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45
Q

management of congenital diaphragmatic hernia

A

intubation ,gastric decompression, surgery

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46
Q

why do neonates have physiologic jaundice

A

due to decreased hepatic bilirubin clearance, low levels of UDP-glucoronidase, especially in eastern asian newborns

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47
Q

lab findings of hereditary spherocytosis

A

increased MCHC

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48
Q

if a neonate has alveolar densities and pleural effusions what do they have

A

pneumonia

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49
Q

what are some acute causes of hemiplegia in children

A

ischemic stroke, intracranial hemorrhage, seizures, hemiplegic migraine

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50
Q

if a chid has acute onset of psychosis with arthralgia and thrombocytopenia, and hematuria what is the cause

A

lupus

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51
Q

if a child has IgA vasculitis what is a complication they are at risk of

A

intussusception

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52
Q

in failure to thrive what growth parameter is affected first

A

weight then length then head circumference

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53
Q

what are the two types of failure to thrive

A

there is organic (physiologic cause, malabsorption syndromes etc) and inorganic which is typically psychosocial

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54
Q

what is pulsus paradoxus

A

when the systolic blood pressure varies with inspiration

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55
Q

what is pulsus paradoxus a sign of

A

asthma exacerbation, pericardial tampanode, pericarditis

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56
Q

asthma physical exam findings

A

wheezing, hyperexpansion of the thorax, or a prolonged phase of forced exhalation

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57
Q

what drug is given to manage acute asthma exacerbations

A

SABA, SAMA, steroids

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58
Q

when does the late phase reaction occur in asthma

A

2-4 hours later after initial wheezing episode

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59
Q

what are eczema lesions described as

A

erythematous, weeping, crusted lesions

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60
Q

location of infant eczema

A

central trunk/head and extensor surfaces

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61
Q

location of child eczema

A

wrists, ankles, face, flexor surfaces

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62
Q

what is first line therapy for acute eczema flair up

A

topical corticosteroids, can use an oral antihistamine for help with sleep/limiting pruritis at night

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63
Q

what type hypersensitivity is contact dermatitis

A

type 4

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64
Q

treatment options for ADHD

A

stimulant meds (methyphenidate, amphetimines. Second line: atomoxetine (norepi reuptake inhibitor), guanfacine/clonidine (alpha 2 agonists)

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65
Q

before treatment with meds for ADHD what else needs to happen

A

complete psychoeducational assessment

66
Q

galactosemia eye findings

A

cataracts

67
Q

presentation of galactosemia

A

poor feeding, failure to thrive, jaundice, cataracts

68
Q

difference between simple febrile seizure and complex febrile

A

simple is less than 15 minutes and non localizing. complex have multiple seizures within a 30 minute period

69
Q

what demographic gets complex febrile seizures moreso

A

children with abnormal development

70
Q

in a young child (1yo) what test should you do if they have seizure and fever

A

LP to rule out meningitis bc meningeal tests are not reliable

71
Q

postnatal effects of intrauterine growth restriction

A

hypoglycemia, polycythemia, hypothermia, hypocalcemia

72
Q

signs of androgen insensitivity syndrome

A

when a patient is phenotypically female but genetically male, no pubic hair, female external genitalia, etc.

73
Q

treatment of SCID

A

stem cell transplant

74
Q

signs of cold abcesses

A

they are non erythematous and nontender I.e. no sign of inflammation

75
Q

Hyper IgE signs

A

eosinophilia, eczema, recurrent cold abscesses

76
Q

signs of IVH in a newborn

A

seizures, tachycardia, full fontanelle, acute anemia

77
Q

what babies develop IVH

A

premie babies

78
Q

if a baby has macrocephaly but they have normal development and normal head US do they need further workup

A

nope!

79
Q

signs of mercery toxicity

A

desquamating rash, neuropsychological changes (insomnia, anxiety, personality changes)

80
Q

in alopecia acreta is there ANY hair growth

A

none at all

81
Q

episodic crying, abdominal tenderness, lethargy

A

intussusception

82
Q

what causes pneumonia mostly in children with CF

A

staph aureus

83
Q

what causes pneumonia in adults with CF

A

pseudomonas

84
Q

treatment of minimal change disease

A

steroids

85
Q

difference between club foot and metatarsus adductus

A

club foot the whole foot is turned in and cant be repositioned. metatarsus adductus only the forefoot is inward and the whole foot can be repositioned. only reassurance needed it will correct itself

86
Q

when is emergency laporatemy indicated

A

signs of intestinal perf

87
Q

if a baby has dilated loops of bowel and tight anal sphincter whats going on

A

hirschsprungs

88
Q

causes of steatorrhea

A

CF, gluten sensitivity, malabsorption syndromes

89
Q

signs of CF in a 1yo

A

growth decline, wet cough, new onset large bulky stools (steatorrhea)

90
Q

management of hypoglycemia in an infant

A

POC glucose check, then send a glucose check via blood to lab, continuous feeds, IV glucose

91
Q

effect of maternal hyperglycemia on the infant (pulmonary)

A

respiratory distress due to antagonist effect on surfactant

92
Q

bronchiectasis appearance on xray

A

linear opacities in a parallel tram-track configuration

93
Q

extrapulmonary signs of CF

A

digital clubbing, recurrent sinusitis, failure to thrive, fat malabsorption, and a history of meconium ileus

94
Q

signs of HIV infection in a child

A

lymphadenopathy, hepatomegaly, oral candidiasis, frequent infection

95
Q

what is always the first step in management of an patient in distress

A

address ABCs!

96
Q

signs of diabetes in a child

A

polydipsia, polyuria, weight loss, tachypnea, abdominal pain, vomiting, fatigue

97
Q

what is the anion gap like in a child in DKA

A

elevated

98
Q

what is the K level like in DKA

A

hyperkalemia

99
Q

Fatty acid levels in DKA

A

increased due to increased lipolysis to use for gluconeogenesis

100
Q

treatment of DKA

A

IV fluids, insulin

101
Q

what is a devastating complication of DKA

A

cerebral edema, 25% do not survive

102
Q

what is the honeymoon phase of diabetes

A

this is when you see a decreased need of insulin ~6mo post diagnosis, it will come back

103
Q

inheritance of DMD

A

xlinked recessive

104
Q

initial screening in suspected DMD

A

creatine kinase level (muscle breakdown)

105
Q

what is a common skeletal complication of muscular dystrophy

A

scoliosis

106
Q

newborn findings of myotonic muscular dystrophy

A

high arched palate, inverted V-shaped upper lip, thin cheeks, and wasting of the temporalis muscles

107
Q

what is the shunt like in PDA initially

A

it is Left to right bc higher pressure

108
Q

consequence of maintained PDA

A

pulmonary hypertension and then eisenmeiger syndrome where the shunt shifts right to left causing cyanosis

109
Q

does a PDA cause contractile dysfunction

A

no! just volume overload

110
Q

how does aortic coarctation effect LV

A

LV pressure overload with intact contractility initlaly but then it declines if not reversed

111
Q

causes of LV contractile dysfuction in infants I

A

cadiomyopathy and MI

112
Q

signs of meningitis in an adolescent

A

diffuse erythema of pharynx, non specific fever, myalgias, skin mottling, vomiting, sore throat, headache, petichiae/purpura

113
Q

when are branchial cleft and thyroglossal duct cysts often detected

A

post URI they can become secondarily infected

114
Q

what are cystic hygromas associated with

A

turners

115
Q

what bugs are seen in patients with affected oxidative burst (chronic granulomatosis disease)

A

bacteria: staph, nocardia, burkholderia, serratia // Fungal: aspergillus

116
Q

what bugs are seen in patients with terminal complement deficiency

A

neisseria

117
Q

what bugs are seen in patients wtih T cell deficiency

A

viral, and fungal infections

118
Q

ocular presentations of neuroblastoma

A

periorbital ecchymoses (raccoon eyes), opsoclonus-myoclonus syndrome (rapid jerking movements of both eyes)

119
Q

what is dactylitis a sign of

A

sickle cell

120
Q

what is preseptal cellulitis

A

this is when the periorbital and eye sockets have cellulitis

121
Q

difference between preseptal cellulitis and orbital cellulitis

A

orbital cellulitis has pain with extraocular movements and shows proptosis and ophthalmoplegia with diplopia and involves the orbital space

122
Q

treatment of preseptal cellulitis vs. orbital cellulitis

A

preseptal: oral antibiotics // orbital: IV antibiotics +/- surgery

123
Q

what type of saline do you give initially to rehydrate children

A

20mL/kg normal saline IV bolus

124
Q

risk factors for acute otitis media

A

age (6-18mo), lack of breastfeeding, day care attendance, smoke exposure

125
Q

signs of tinea capitis in a child

A

scaly erythematous patch, black dots on the affected area, tender lymphadenopathy

126
Q

treatment of tinea capitis

A

oral griseofulvin or terbinafine

127
Q

signs of drug induced hemolytic anemai

A

onset severa hours post exposure, jaundice, dark urine, abdominal/back pain

128
Q

mechanism of drug induced hemolytic anemia

A

the durg bidns directly to erythrocytes and creates a hapten (place to bind) for IgG which causes the RBCs to be sequestered by splenic macrophages

129
Q

pathogenesis of UTIs in kids with chronic constipation

A

urinary stasis, the constipation causes occlusion fo the urethra leading to retention and increased risk of UTI

130
Q

MEN1

A

pituitary, parathyroid, and pancreas

131
Q

MEN2a

A

parathyroid, pheo, med thyroid

132
Q

MEN2b

A

pheo, med thy, Marfanoid habitus, mucosal neuromas

133
Q

which MEN has marfanoid habitus

A

MEN2b

134
Q

screening in an adolescent well child visit

A

contraceptive/safe sex, depression, substance use

135
Q

valsalva maneuver/standing effect on preload and afterload

A

decreases preload and afterload

136
Q

handgrip effect on preload/afterload

A

increases afterload

137
Q

when does HOCM get louder

A

decreased afterload (valsalva, standing)

138
Q

Aortic stenosis with increased preload/afterlaod

A

gets louder with increased preload, quieter with increased afterload

139
Q

squatting effect on preload and afterload

A

increases preload and increases afterload

140
Q

how do you get HOCM to increase in intensity (physiology)

A

you want decreased blood in the left ventricle so therefore you decreaes preload

141
Q

definition of amblyopia

A

this is when you have decreased visual acuity due to visual disturbances early in childhood

142
Q

causes of amblyopia

A

cataracts, strabismus, uncorrected refractive error

143
Q

management of amblyopia

A

corrective lenses, surgery to remove cataracts, encourage use of the amblyopic eye

144
Q

signs of 21-alpha hydroxylase deficiency in a genetic female

A

virulization, high potassium, low BP

145
Q

signs of virulization in a genetic female

A

enlarged clitoris, (underdeveloped phallus with hypospadias), fused labioscrotal folds

146
Q

signs of virulization in a genetic male

A

phenotypically normal or hypervirilized (enlarged phallus)

147
Q

lab studies in a 21-a-hydroxylase deficiency

A

high K, low Na, 17-hydroxyprogesterone elevated

148
Q

signs of 11B hydroxylase deficiency in XX babies

A

virulization, high BP, low K

149
Q

signs of 17-a-hydroxylase deficiency in XX babies

A

secondary sex characterisitcs underdeveloped, high BP, low K, no cortisol

150
Q

signs of 17-a-hydroxylase deficiency in XY babies

A

undescended testes, atypical genetalia (bc no DHT which is necessary for external genitalia)

151
Q

what does it mean if there are gamma tetramers seen on hemoglobin electrophoresis

A

this means that there is hemoglobin H which is what happens when there are 3 alpha genes lost and so the Beta globin accumulate as the homotetramers

152
Q

MCV in alpha thallesimia

A

low

153
Q

erythrocyte level in hemoglobin H disease

A

typically elevated to make up for hemolyzed RBCs

154
Q

which antibiotics do you use for UTI in children

A

cephalosporin

155
Q

what is common variable immunodeficiency

A

this is when you have abnormal differentiation of b cells into plasma cells and decreased immunoglobulin production

156
Q

management of common variable immunodeficiency

A

IV Immune globulin infusion

157
Q

manifestations of common variable immunodeficincy

A

recurrent respiratory infections, recurrent GI infections, chronic diseases

158
Q

normal urine output in a neonate

A

> or equal to 1 void per day of life so a 48hour old baby should have 2 wet diapers/day

159
Q

management of oliguria in a neonate

A

renal and bladder ultrasound

160
Q

diarrhea in a 1yr following resolved diarrheal illness

A

secondary lactose intolerance due to damaged epithelium

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