2021 PREP Flashcards by Josh Lipsitz

What diagnosis is supported by high fecal fat but normal pancreatic elastase?

Celiac disease (fat malabsorption but normal pancreatic function)

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What complement levels are expected in PSGN?

Low C3 and normal C4

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Which respiratory virus commonly causes acute hemorrhagic cystitis?

Adenovirus

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Which OTC medication for abdominal pain is commonly associated with melenotic-appearing stools?

Bismuth subsalicylate (Pepto Bismol)

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What is the treatment for bloody otorrhea from superficial trauma (i.e. curette use)?

Supportive care

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What is the evaluation for medullary thyroid carcinoma in patients with MEN 2B?

Thyroid US and serum calcitonin levels

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What are the phenotypes of MEN 1, MEN 2A, and MEN 2B?

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What are the most common symptoms of maternal parvovirus B19 infection?

Lacy rash and arthralgias

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Which congenital cardiac anomalies are associated with Turner syndrome?

Bicuspid aortic valve and coarctation of the aorta

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Which lab abnormality is characteristic of urea cycle disorders?

Hyperammonemia

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Which congenital abnormality is associated with clenched hands with overlapping fingers?

Trisomy 18

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What are the hallmarks of physical exam in trisomy 13?

Cutis aplasia and midline defects

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What is the definition of pubertal delay in boys?

Testicular volume < 4 mL by age 14

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At what age can children be vaccinated against hepatitis A?

≥ 1 year of age

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What is the required timeframe for administering immune globulin after a hepatitis A exposure?

Within 2 weeks

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What is the preferred post-exposure prophylaxis against hepatitis A in children ≥ 1 year of age?

Hepatitis A vaccine

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When is imaging indicated in children with genu valgus?

> 7 years of age with intermalleolar distances greater than 8 cm

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Which bacteria most commonly cause infective endocarditis?

Strep viridans and Staph aureus

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What is the difference in red reflex for cataracts and glaucoma?

Cataracts: usually unilateral
Glaucoma: bilateral clouding

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What is the chance of passing on an X-linked recessive disorder to a male child?

50%

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What is the difference between intention-to-treat and per-protocol analysis?

Intention-to-treat: includes all enrolled participants regardless of study completion (improves power because it increases N)
Per-protocol: includes only participants who completed the study

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How can urinary anion gap help to differentiate between RTA and diarrhea?

Urinary ion gap = [Na + K] compared to Cl

Positive in RTA: [Na + K] > Cl
Negative in diarrhea: [Na + K] < Cl

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How does obesity impact thyroid testing?

Artificially increases TSH

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When should a statin be considered?

LDL ≥ 160 despite dietary and lifestyle changes

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What is the treatment of persistent bacterial bronchitis?

Augmentin for 2-4 weeks

What is the difference in physical exam between acute flaccid myelitis and idiopathic transverse myelitis?

**Acute flaccid paralysis**: can be unilateral and affect 1+ limbs **Idiopathic transverse myelitis**: bilateral

What is the primary treatment of Prader-Willi syndrome in the first year after life?

Growth hormone supplementation

What are the typical physical characteristics of patients with Prader-Willi syndrome?

Almond-shaped eyes, thin upper lip, small hands and feet

What is a potential significant adverse effect of hallucinogens?

Serotonin syndrome

Which nutritional deficiency is associated with goat milk ingestion in infants?

Folate deficiency

Which risk factor is associated with higher weight loss (~10%) in a neonate in the first 24-48 hours after birth?

Birth via CS

What is the difference in results of high-dose dexamethasone suppression test for pituitary vs. adrenal sources of excess cortisol?

**Pituitary source**: suppressed cortisol level **Adrenal source**: no response

What is the appropriate post-exposure prophylaxis for varicella exposure by age and immune status?

**< 12 months of age**: no intervention **> 12 months of age and healthy**: vaccine **Immunocompromised**: immune globulin

What is the pathologic finding of sarcoidosis?

Non-caseating granulomas

What is the treatment of syphilis by stage?

**Primary, secondary, and early latent**: IM penicillin x1 **Late latent and tertiary**: IM penicillin once weekly x3 weeks

Which mutation causes fragile X syndrome?

CGG repeats in FMR1

What is the management of maternal ITP in neonates?

IVIG

What is the expected bladder capacity in children > 2 years of age?

(age + 2) x 30

What is the initial management of an ocular hyphema?

Placement of an eye patch

What are the most common adverse effects of a ketogenic diet?

GI upset, hyperlipidemia, and kidney stones

Which medication should be given to patients with weakness in the setting of organophosphate ingestion?

Pralidoxime ## Footnote Atropine is the first-line treatment but only works at muscarinic receptors, and weakness is related to nicotinic receptors

What is the initial management of tympanic membrane effusions?

Monitor for 3 months prior to further evaluation

Which age group is associated with Kingella septic arthritis and osteomyelitis?

< 5 years of age

What are the consequences of rapid correction of hypernatremia and hyponatremia?

**Rapid correction of hypernatremia**: cerebral edema **Rapid correction of hyponatremia**: central pontine myelonelysis

What is the expected testicular volume at puberty?

≥ 4 mL

What are the common signs and symptoms of dextromethorphan overdose?

Euphoria, tachycardia, mydriasis, diaphoresis

In a child with an unbalanced translocation with trisomy 21, which parental karyotype carries the highest risk of passing on trisomy 21 to future children?

Maternal balanced translocation

Which type of insect bite is commonly associated with sympathetic, parasympathetic, and neuromuscular symptoms?

Scorpion bite

What is the main purpose of a cross-sectional study?

Assesses the burden/prevalence of disease in a population at a specific point in time

What are the necessary athletic restrictions for adolescents with significant HTN?

**Participation in low-intensity sports only** to prevent significant spikes in BP that can cause cerebrovascular events

Which antibody can indicate hepatitis B immunity via past infection?

Positive HBcAb

What is a possible treatment option for refractory colic?

Probiotics

Which long-term consequence is often associated with chemotherapy and administration of cranial radiation?

Metabolic syndrome ## Footnote Caused by hypothalamic radation

Which deficiency is associated with acrodermatitis enteropathica?

Zinc deficiency

What is the treatment for subluxation of the radial head (nursemaid's elbow)?

Hyperpronation or supination and flexion

What is the treatment for latent TB?

Isoniazid for 9 months

What is the treatment for active TB?

RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) therapy for 2 months followed by isoniazid and rifampin for 4 months

What is the treatment for active TB?

RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) therapy for 2 months followed by isoniazid and rifampin for 4 months

What is considered a positive PPD test in children ≥ 4 with no risk factors?

≥ 15 mm

What are ketotifen eye drops?

Antihistamine mast cell stabilizer for allergic conjunctivitis

What are the symptoms of VX gas exposure?

Immediate anticholinergic symptoms

What is the definition of micropenis in a term neonate?

Stretched phallic length of < 2-2.5 cm

When should a repeat audiology exam be completed for term neonates who fail the newborn hearing screen?

By 3 months of age

What is seen on hemoglobin electrophoresis in beta-thalassemia major?

0% HbA

What is seen on MRI in adrenoleukodystrophy?

Bilateral posterior demyelination in parieto-occipital lobes

Which systems are affected in Zellweger syndrome?

Brain, liver, and kidneys

How can Rett syndrome be identified on growth charts?

Deceleration of head circumference

Which organism is associated with gastroenteritis following contaminated pork ingestion?

Yersinia enterocolitica

What is the incubation period of salmonella gastroenteritis?

6-48 hours

What is the main risk factor for brucellosis?

Exposure to unpasteurized dairy products

What is the appropriate follow-up after H. pylori treatment?

Urease breath testing or stool antigen testing 4 weeks after completion of treatment

What are the primary symptoms of myotonic dystrophy?

Muscular weakness, cardiac conduction abnormalities, and cataracts

Which mutation is responsible for myotonic dystrophy?

CTG repeats in DMPK gene

What is considered a normal IQ?

85-115

Which type of lesion has an orange-peel appearance and becomes red and swollen after rubbing it?

Mastocytosis

What is found on EKG in anomalous left coronary artery from the pulmonary artery (ALCAPA)?

Deep Q-waves from myocardial ischemia

What leg length discrepancy is considered pathologic and requires an orthopedic surgery evaluation?

> 2 cm

When is zidovudine prophylaxis indicated during labor and delivery?

Maternal viral load > 1000 or unknown

What is the management of babies born to HIV-infected mothers with an undetectable viral load?

Zidovudine for 4 weeks

What is the presentation of Menkes disease?

Loss of milestones, seizures, and hypotonia

What is the mutation that causes osteogenesis imperfecta?

Mutations in COL1A or COL1B ## Footnote Both are genes for type I collagen

What is the presentation of neuromyelitis optica?

Extensive transverse myelitis and optic neuritis

Which antibody is associated with neuromyelitis optica?

Antibodies against the aquaporin-4 channel

What is the difference in incubation period between norovirus and cryptosporidium gastroenteritis?

**Norovirus**: 12-48 hours **Cryptosporidium**: 3-14 days

What is the ideal time to order a Tylenol level after overdose?

4 hours

When can activated charcoal be administered after a Tylenol overdose?

Within 2 hours of ingestion except in setting of mental status changes

What is the management of pityriasis rosea?

Symptomatic control

What is the treatment of tinea versicolor?

Topical selenium sulfide

What is the treatment of tinea versicolor?

Topical selenium sulfide

What is the confirmatory test for chronic granulomatous disease?

Flow cytometry for dihydrorhodamine 123

What is the appropriate discharge caloric density of feeds for premature babies born at < 1800 grams?

22 kcal/oz ## Footnote Can use 24 kcal/oz if not growing well in NICU

Which 2 diagnoses are associated with an elevated upper-to-lower body ratio?

Skeletal dysplasia and precocious puberty