2016 Exam Flashcards Preview

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Flashcards in 2016 Exam Deck (54):
1

Cyclical vomiting syndrome criteria:

"think 5-1=4; 5 attack min. 4 vomit/hour x 1 hour minimum"

Min. 5 attacks
Recurrent vomit last 1hour-10d
Vomit 4X/hour x 1 hour minimum
Normal between episodes
Not attributed to another dx

2

Total body radiation. Risk of radiation effects later?

Secondary malignancy
Adrenal insuff
Hypothyroidism

3

All of sudden with getting NG feeds getting dumping (diarrhea, sweat, cramp). LIKley reason? and two mechanism?

Hyperosmolar feed

> Pumped too fast
> Formula too hyperosmolar formula

4

Dyslexia DSM5 Criteria

Difficulties with learning and using academic skill x 6mo
Skill less than expected age and cause issue w/ school
LD start at school age
Not better accounted for by IQ disability , visual, auditory or other factors

5

Chronic Granulomatous Disease. Confirmed via?

NOBI= Neutrophil Oxidative Burst Index

Remember: supportive adenitis, hepatic abscess, recurrent pneumoniae, osteomyelitis at multiple spots etc.

6

Two indications for hydrocele Sx

Communicating hernia > 18 month age (risk of indirect hernia)

Non communicating: Large and uncomfortable

7

ASD. 3 findings on cardiac auscultation

Fixed split S2
Systolic murmur at mid sternal area
Rumbling low pitch diastolic murmur

Other cardiac: prominent impulse, heave, lift

8

CPR compression ratio per minute?

100

9

CPR ventilation ratio per minute?

8-10

10

Risk of WPW

Ventricular tachycardia, syncope, sudden death.

11

4 ways to reduce systematic bias

Large sample size
Set clear inclusion and exclusion to reduce bias
Reduce sampling bias
Use systematic process that is transparent and reliable
Randomize participant to 2 group
Double blinded
Use validated objective criteria for measuring outcome

12

Mastoiditis complications:

facial nerve palsy, subdural abscess, meningitis, sinus venous thrombosis

13

3 life threatening complications of GBS

1. respiratory depression
2. arrhythmia
3. dysautonomia (hemodynamic instability)
Other: DVT, PE

14

OSA two consequences

Cor pulmonale
HTN

15

3 Perinatal complications of post-dates

Still birth
Macrosomia (and shoulder dystocia)
Meconium Aspiration

16

What criteria must be met for return to play post concussion?

**Full return to school must precede sports
** Only return after symptom free x 7-10d

17

Advice regarding return to school if concussion:

Return in few days after okay with cognitive task at home.
Accommodation may be necessary
Gradual increase

18

ODD. Suggested management

Parental training (triple P)
Youth anger management
Stimulant, Atypical anti psychotic

19

Diagnostic criteria for Bulimia nervosa

Min 1X week x 3 month
Binge eating (excessive amount with lack of control)
Compensatory behaviour (i.e. purge, laxative, restrict)
Self-evaluation influenced by negative perception of body shape and image, weight
Not due to AN or other dx

20

HPV vaccine present:

Cervical cancer
Genital warts
Anal cancer
Throat Cancer

21

Asthma versus scoliosis: RV/TLC and FVC

RV= volume in lungs.
TLC= total lung capacity
FVC= forced vital capacity (total air that can be forceful exhaled)

Asthma: RV/TLC up or normal (more RV); FVC down
Scoliosis: RV/TLC increased (more RV); FVC down++

22

How do you avoid BPD in NRP resuscitation?

Avoid barotrauma or volume trauma

23

What is heat rash medical term?

Miliaria= rash over fold (intertrigonal or where two skin rub/touch) and covered areas.

24

What can you do to prevent future kidney stones?

UP fluid
DOWN salt
normal calcium diet

25

PO Vitamin K dosing?

Oral dose 2mg at birth
Repeat in 1 and 2 months.

26

If premature adrenarche- what are you at greater risk later on?

PCOS

27

Most common craniosynostosis? What next?

Sagittal= Scaphoencephaly
NeuroSx contsult
= discuss option, Sx, risk of ICP and ensure normal growth

28

3 tests to measure Measles

Measles PCR
Serology (IgM, IgG)
Viral Cx from saliva, urine

29

When does hand dominance develop?

@ 18 months.

30

Red eye with photophobia. Likely dx?

Corneal abrasion
Glaucoma
FB
Keratitis, Corneal Ulcer, Orbital cellulitis

31

Minimum PEG tx duration for constipation

6 months

32

HIE criteria

min. 36 WK GA
max 6 hour old
mod-severe encephalopathy (Sarnat 2-3)
Two of: APGAR < 5 at 10 min, vent or resus at 10 min, or pH < 7 and BE > 16

33

Qualification for RSV prophylaxis

< 6 month at start AND
... < 30 wk GA
... < 36 and remote community
... term inuit from comm at high risk of RSV

< 1 yr at start AND
... CLD with ongoing med
.... CHD hemodynamically significant

Consider if < 2 AND
.... home O2
... severe pul dx
.. T21
... CF
... immunocompromised

34

Severe EoE start-

oral INH steroid

35

cephalohematoma. What do you do?

No further intervention
Resolve spontaneously in 2-12 weeks

36

Cleft in inferior hymen rim suggest:

Previous trauma to hymen

37

Twin to twin transfusion. Risk to blood recipient versus donor?

Recipient
= heart failure due to extra fluid on body
Resp distress, renal vein thrombosis, clots

Donor= anemia, growth restrict, hypoglycaemia if small

38

GH versus Turner syn in short stature. Difference?

GH= bone age delay (slow), confirm via GH stim test
Turner Syn= F, normal bone age

39

When do you screen for T2DM?

3 RF pre puberty or 2RF post-puberty

- FHX - BMI 95% - ethnicity
- Features of DM (acanthuses) - dyslipidemia

Screen every 2 hour via fasting plasma glucose

40

Teen with CF has drop in PFT. Start?
- ceftaz + cobra
- clox + cobra
- clox + ceftaz
- PO cipro

Ceftaz + Tobra

41

T or F: Mastoiditis is reason for myringotomy?

True

42

Spinal muscular atrophy inherited via

AR

= proximal weakness, hypotonia, reflexia.

43

Glucose at 2 hour 2.1 in BB born to mom with gestational DM. Next step?

Continue to monitor q 3-4 hour
x next 12 hour if LGA and IDM. x 36 if SGA or prem.

If > 2.6 at that time can stop.

Note: < 1.8 at 2 hr or < 2.6 on recheck= IV
Note: if > 2 at 2 hour= monitor only.

44

Eczema, thrombocytopenia, infection, Likely dx?

Wiskott-Aldrich

45

ROP screening

at 4 weeks of age or 31 week corrected- whatever is later

46

Sydenham chorea. Recommend Abx prophylaxis till?

21 y.o.`

47

Bipolar Dx- Manic episode. Med to consider

Lithium

48

Dx test with highest yield of abnormality in F with ASD?
- karyotype
- very long chain f.a.
- fragile x testing
- chromosomal microarray

Chromosomal microarray

49

Best way to monitor thyroid replacement in autoimmune thyroiditis?

TSH

50

How much do you correct low Na?

only up 10-12 in 24 hour.

51

When can you wear a seat belt?

> 36 kg
min. 8 y.o.
ht > 145 cm

52

When do you switch from rear to fwd seat, booster etc.?

Rear until 10 kg + 1 y.o. + walking
Fwd: for kids 10- 22kg and 122cm
Can switch to booster if 18kg and don't fit fwd seat
Booster seat until 36 kg

Seat Belt= > 36 kg
min. 8 y.o.
ht > 145 cm

53

T or F: Optic neuritis at significant risk of developing MS

True

54

10 month old recently immigrated from refugee camp in Turkey. 3 doses oral polio and 4 doses of DAT. Now?
- pneumococcal conjugate + Hib
- pneumococcal, HIB, IPV
- DTap-IPV-Hib, pneumococcal
- No vaccine

Pneumococcal + Hib

3 doses oral count.
Hep B too!

Practical: unless very clear documentation we always assume none and start catch up schedule.