Peds Flashcards

1
Q

Musical, vibratory, high-pitched, systolic, LLSB or apex, carotid bruit, radiate to axilla, preschool age (2y/o- pre adolescence), decr with sitting/standing/valsalva

A

Still’s murmur

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2
Q

soft, continuous, under clavicle, right >left infraclavicular, preschool age (after 2y/o), best heard sitting, decr supine/jugular compression

A

Venous hum

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3
Q

systolic, eliminated by carotid compression, preschool +

A

Carotid bruit

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4
Q

elevation of nipple only

A

Tanner 1

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5
Q

elevation of breast and nipple, enlarged areola

A

Tanner 2

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6
Q

areola and nipple form secondary mound above breast

A

Tanner 4

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7
Q

projection of nipple only, not areola

A

Tanner 5

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8
Q

male, vellus hair

A

Tanner 1

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9
Q

long downy straight hair at base of penis, testes larger

A

Tanner 2

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10
Q

curlier hair, testes larger, penis length incr

A

Tanner 3

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11
Q

adult curly hair, penis length and width, testes larger

A

Tanner 4

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12
Q

female, hair on medial thigh

A

Tanner 5

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13
Q

female, straight hair on labia

A

Tanner 2

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14
Q

female, curly hair on pubic symphysis

A

Tanner 3

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15
Q

Brushfield’s spots

A

Downs

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16
Q

white plaques do not rub off

A

oral candidiasis

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17
Q

7days old-3mo. >3 hrs/day, >3days/wk, >3wks. Crying normal growth, healthy

A

colic

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18
Q

MCC young gastroenteritis

A

rotavirus

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19
Q

MCC old gastroenteritis

A

norwalk v

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20
Q

study in GERD to r/o others

A

upper GI Xray

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21
Q

projectile non-bilious vomit, FTT, olive mass RLQ, <12wks old

A

pyloric stenosis

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22
Q

Dx pyloric stenosis

A

abdom U/S

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23
Q

Dx & Tx intussusception

A

barium/air enema, admit all

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24
Q

age intussusception

A

3mo-6y/o (MC 5-12 mo)

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25
Q

don’t pass meconium 1st 24 hrs, constipation, NB= Dx test

A

Hirschsprung

abdom Xray

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26
Q

Hirschsprung assoc with

A

Downs

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27
Q

MC fetus intestinal obstruction

A

duodenal atresia/stenosis

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28
Q

vomit within hrs of birth, pass meconium in 1st 24 hrs

A

duodenal atresia/stenosis

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29
Q

duodenal atresia/stenosis Dx

A

abdom Xray, prenatal U/S

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30
Q

Anti-HBs

A

immunity

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31
Q

HBsAg

A

ongoing

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32
Q

Tx neonate with HBsAg pos mom

A

HBIG

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33
Q

jaundice 1st 24 hrs, coombs neg

A

hereditary sphero, G6PD

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34
Q

umbilical hernia RF

A

full term, AA, close by 4y/o

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35
Q

Bitot’s spots

A

vit A def

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36
Q

Dx lactose intol

A

hydrogen breath test

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37
Q

ITP Dx & Tx

A

isolated thrombocytopenia, corticosteroids short-term

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38
Q

TMA pentad (TTP, HUS) +

A

hemolytic anemia, thrombocytopenia, fever, renal insuff, neuro— shistocytes

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39
Q

TTP Sx +

A

hemolytic anemia, thrombocytopenia, fever, neuro (no renal)— decr ADAMST13

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40
Q

HUS Sx +

A

hemolytic anemia, thrombocytopenia, renal insuff (no neuro, no fever)— pos stool cult E.coli O157:H7

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41
Q

TTP Tx

A

plasma exchange

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42
Q

HUS Tx

A

supportive

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43
Q

hemophilia pain reliever

A

celebrex (COX2)

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44
Q

MC inherited bleeding disorder

A

vWD

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45
Q

vWD Tx

A

DDAVP

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46
Q

lead poisoning Tx (2)

A

EDTA, dimercaprol

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47
Q

ADHD criteria

A
  1. impulsivity 2. inattention 3. hyperactivity before 7 y/o
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48
Q

non-stimulant

A

Strattera

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49
Q

OCD Tx

A

SSRI: fluvosamine, sertraline

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50
Q

depression Tx

A

SSRI: fluoxetine, escitalopram

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51
Q

spiculated, sunburst periosteum

A

osteosarcoma

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52
Q

<3mo sepsis causes & Tx

A

GBS, E.coli, Listeria

ampicillin + ceftriaxone

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53
Q

> 3mo septic meningitis causes & Tx

A

S. pneumo, N. gonorrhea, H. flu

ceftriaxone + vanco (not ampicillin)

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54
Q

preseptal/periorbital cellulitis

Sx & Tx

A

low fever, edema/erythema eyelid, pain, normal vision, EOMI

ceftriaxone

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55
Q

orbital cellulitis Sx

A

high fever, edema/erythema eyelid, pain, decr EOM, decr vision, proptosis (protruding), APD (no rxn)

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56
Q

conjunctivitis causes (5)

A

S. pneumo, S. aureus, moraxella, H. flu, adenovirus

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57
Q

bact conjunctivitis Tx

A

erythromycin

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58
Q

gonococcal Tx conjunctivitis

A

ceftriaxone IM

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59
Q

orbital cellulitis cause, Tx

A

S. pneumo, S. aureus, sinusitis infection

amp-sulbactam, ceph

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60
Q

AOM causes

A

S. pneumo!! H. flu, moraxella

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61
Q

Tx AOM

A

amoxicillin, azithromycin (complicated: ceph)

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62
Q

Tx pseudomonas

A

aminoglycosides (mycins), ceftriaxone, pipercillin-tazobactam

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63
Q

epiglottitis Tx

A

IV cephalosporin, steroids

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64
Q

GAS pharyngitis criteria, Tx

A

fever, no cough, exudate tonsillitis, ant cervical LAD

PCN (amox)

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65
Q

MCC perioral dermatitis

A

topical steroids

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66
Q

fixed drug eruption causes (30m-8hrs)

A

abx, PCN, beta lactam, ceph, NSAIDs, sulfa, tetracycline, metronidazole

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67
Q

urticaria causes

A

food, infection, ASA, NSAID, ACEI, PCN, morphine, codeine

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68
Q

burns fluid calc (parkland)

A

LR 3mL x wt(kg) x %BSA

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69
Q

MCC erythema multiforme

A

HSV

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70
Q

impetigo Tx

A

mupirocin (bactroban), bacitractin

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71
Q

lichen planus Tx

A

top steroids high strength (betamethasone, diflorasone)
PUVA, UVB
PO retinoid

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72
Q

pityriasis rosea Tx

A

none

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73
Q

mild acne Tx

A

top abx (clindamycin, erythromycin)
benzoyl peroxide
top tretinoin

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74
Q

mod acne Tx

A

PO abx (doxy)
benzoyl peroxide
top tretinoin

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75
Q

severe acne Tx

A

accutane (isotretinoin)

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76
Q

harsh, holosystolic, 3rd left intercostal, acyanotic

A

VSD

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77
Q

fixed S2 wide split, systolic ejection murmur, 2nd intercostal, RVH

A

ASD

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78
Q

continuous, machinery, Gibson’s, diamond shaped, 2nd left intercostal, wide pulse pressure, LVH

A

PDA

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79
Q

when does PDA close

A

1-5 days

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80
Q

Tx PDA

A

indomethacin (close)

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81
Q

VSD, RVH, pulm outflow obstruction, overriding aorta

A

tetralogy of fallot

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82
Q

presentation tetralogy of fallot at birth

A

acyanotic at birth, cyanosis incr over 6 mo

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83
Q

cyanosis at birth, egg shaped heart

A

transposition of great arteries

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84
Q

transposition of great arteries Tx

A

prostaglandins (keep PDA open) until surg

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85
Q

mitral valve, diastolic murmur, carey-coombs

A

rheum fever

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86
Q

bisferiens carotid pulse

A

HCM

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87
Q

HCM Tx

A

BB

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88
Q

6mo-6y/o, worse in evening, stridor, bark cough

A

croup

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89
Q

cause CAP NB

A

GBS, Ecoli

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90
Q

cause CAP 3wks-4y/o

A

virus!!, S. pneumo, GAS, staph, Hflu

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91
Q

cause CAP >5y/o

A

S. pneumo, mycoplasma

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92
Q

normal urine output

A

> 0.5 mL/kg/hr

>30 mL/hr

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93
Q

howell jolly bodies, hyperseg PMN, lg PLTS, incr homocysteine, incr methylmalonic acid (MMA), periph neuropathy

A

vit B12 def

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94
Q

hyperseg PMN, lg PLTS, incr homocysteine, no neuro Sx

A

folate def

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95
Q

iron def gold std Dx

A

BM prussian blue stain

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96
Q

incr LDH, decr haptoglobin

A

hemolytic anemia, alpha thalassemia

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97
Q

heinz bodies

A

beta thal major

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98
Q

Tx sideroblastic anemia

A

B6 (pyridoxine)

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99
Q

pancytopenia, hypocellular BM, petechia

A

aplastic anemia

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100
Q

Hep B vaccine schedule

A

3 times; 0,2,6 mo

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101
Q

rotavirus vaccine schedule

A

3 times; 2,4,6 mo

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102
Q

DTaP vaccine schedule

A

5 times; 2,4,6,15 mo 4-6 y/o

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103
Q

Hib & PCV vaccine schedule

A

4 times; 2,4,6,12 mo

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104
Q

IPV vaccine schedule

A

4 times; 2,4,6 mo 4-6 y/o

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105
Q

influenza vaccine schedule

A

greater than 6 mo

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106
Q

MMR & varicella vaccine schedule

A

2 times; 12 mo, 4-6 y/o

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107
Q

Hep A vaccine schedule

A

2 times; 12 mo, 6mo apart

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108
Q

hip dysplasia RF

A

FH, breech, female, 1st born

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109
Q

autism screening

A

18 mo

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110
Q

vision hearing screening

A

3 y/o, 4 y/o

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111
Q

anemia lead screening

A

12 mo

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112
Q

oral health

A

6 mo

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113
Q

start complimentary foods

A

6 mo

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114
Q

use cup, table foods, wean bottle

A

9 mo

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115
Q

social smile

A

6 wks

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116
Q

sits

A

6 mo

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117
Q

pulls to stand

A

9 mo

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118
Q

stands

A

12 mo

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119
Q

crawls

A

10 mo

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120
Q

feeds self

A

4 mo

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121
Q

uses spoon

A

12 mo

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122
Q

walk

A

12 mo

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123
Q

stranger anxiety

A

6 mo

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124
Q

roll over

A

4 mo

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125
Q

CN optic blink reflex

A

III oculomotor

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126
Q

rooting reflex, sucking reflex CN

A

V trigeminal

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127
Q

corneal reflex CN

A

V trigeminal

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128
Q

acoustic blink reflex CN

A

VIII vestibulocochlear

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129
Q

suck, swallow CN

A

XII hypoglossal

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130
Q

understandable speech

A

4 y/o

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131
Q

balance on one foot

A

3 y/o

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132
Q

tricycle, hop

A

4 y/o

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133
Q

ride bike

A

6 y/o

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2
3
4
5
Perfectly
134
Q

copies figures

A

5 y/o

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135
Q

parallel, triangular play

A

2, 3 y/o

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136
Q

skip

A

5 y/o

137
Q

reflexes at birth

A

asymm tonic neck, trunk incurvation (-2 mo)
palmar grasp, rooting, moro (-4mo)
landau, support, plantar grasp (-6mo)
anal reflex, babinski

138
Q

parachute reflex

A

8 mo

139
Q

nasal voice + snoring

A

adenoid hypertrophy

140
Q

rocks in mouth

A

tonsillitis

141
Q

appears in 1st 24 hrs, does not cross suture, after difficult birth, resolves wks

A

cephalohematoma

142
Q

bulging ant fontanelle, setting sun sign

A

hydrocephalus

143
Q

abnomal growth and shape of skull

A

craniosynostosis

144
Q

1st yr: liver 1-2 cm below costal margin, palpable spleen tip, S3, diastasis recti, umbilical hernia

A

normal

145
Q

triceps, brachioradialis, abdom reflex

A

start 6 mo

146
Q

ant fontanelle closes

A

4-26 mo

147
Q

post fontanelle closes

A

2 mo

148
Q

wt & ht growth 1st yr

A

wt doubles 6mo, triples 12 mo

ht incr 50% in 1st yr

149
Q

knock knees 18mo - 4y/o

A

normal

150
Q

doll’s eye reflex

A

1st 10 days

151
Q

growth drops 2quartiles, wt <5th%

A

FTT

152
Q

extension, flaccidity, hypotonia, asymm reflex, incr DTR in 1st yr, asymm posture

A

neural tube defect

153
Q

infant normal heart sound

A

S3 (gallop, S4 abnormal)

154
Q

growth after 2 y/o

A

2-3kg/yr, 5cm/yr

155
Q

screening tool autism

A

M-CHAT

156
Q

screening tool gest age

A

ballard score

157
Q

screening tool eating disorder

A

SCOFF

158
Q

NB lose how much wt in 1st wk, return to wt when

A

10%, 10 days

159
Q

APGAR

A
Appearance (color)
Pulse rate
Grimace (reflex irritability)
Activity (musc tone)
RR
160
Q

1st sign female puberty

A

telarche (breast)

161
Q

pink/blue extremities, <100 HR, grimace, some musc flexion, slow/irreg RR

A

APGAR 1

162
Q

all pink, > 100 HR, cry, active musc tone/flexion, good resp

A

APGAR 2

163
Q

umbilical cord gone

A

2 wks

164
Q

normal birth wt

A

> 2500 g (2.5 kg)

165
Q

preterm

A

<34 wks

166
Q

late preterm

A

34-36 wks

167
Q

term

A

37-42 wks

168
Q

RR: NB, infant, toddler, preschool/school age

A

60, 50, 40, 30

169
Q

HR: infant, toddler, preschool, school age, adolescent

A

160, 150, 140, 120, 100

170
Q

trends BP, HR

A

incr BP, decr age

171
Q

Dx hip dysplasia

A

ortalani most sensitive, barlow, U/S

172
Q

rash in diaper area, not in skin folds= Tx

A

top barrier, petrolatum, zinc oxide
rest without diaper
NO baking soda, borc acid powder, overcleaning

173
Q

RF irritant dermatitis

A

diarrhea, formula fed, recent abx (incr diarrhea)

174
Q

rash in diaper area, beefy red plaques, satellite lesions, skin folds= Tx

A

nystatin, azoles

175
Q

rash in diaper area, greasy yellow scale, in skin folds, not isolated to diaper area= Tx

A

seborrheic dermatitis

low potency steroids

176
Q

rash in diaper area, fragile pustules, crusted erosions

A

impetigo, S. aureus

177
Q

bright red sharply demarcated perianal rash, blood streaked stools, pruritis, pain, fissures= Tx

A

GAS

abx! PCN, amox, macrolide

178
Q

Tx perioral dermatitis

A

top: metronidazole, pimecrolimus, erythromycin
PO: tetracyclines

179
Q

urticaria Tx

A

H1 antihistamines (hydroxyzine, loratadine, allegra, claritin, zyrtec, cetirizine, diphenhydramine)

180
Q

rash generalized, palms, soles; target lesions= Tx

A

erythema multiforme minor (HSV)

no Tx

181
Q

impetigo cause

A

S. aureus MCC, GAS

182
Q

fawn/salmon colored plaques, neg KOH, spares palms/soles/face

A

pityriasis rosea
Tinea: KOH pos
secondary syphilis: palms and soles, KOH neg

183
Q

meds that worsen acne

A

androgenic steroids, steroids, phenytoin (dilantin), isoniazid, OCP

184
Q

RF for testicular CA

A

cryptorchism

185
Q

RF SIDS

A

cigarette smoke, lying on stomach (NOT side), low birth wt, young mother

186
Q

babble what age

A

6 mo

187
Q

size of avg 4 y/o

A

40 lbs, 40 in

188
Q

Normal birth size, deceleration on growth curve first 2 years of life, normal bone age and puberty, target height is short, <2 y/o!

A

familial short stature

189
Q

Normal birth size, delayed bone age and puberty, target height normal
“Late bloomers”

A

Constitutional Growth Delay

190
Q

Endocrine causes of tall stature

A

pituitary adenoma, GH excess

191
Q

MCC short stature

A

malnutrition

192
Q

Bacterial infections in neonatal period (5)

A
Sepsis
Meningitis
Pneumonia
UTI
Omphalitis
193
Q

pruritic, web spaces, wrists, pustules

A

scabies

194
Q

measles aka

A

rubeola

195
Q

orbital cellulitis Tx

A

IV abx, ampicillin-sulbactam, ceph, clindamycin

196
Q

clear rhinorrhea, sneezing, eye irritation, dry cough, pale/violaceous boggy nasal mucosa= Tx

A

intranasal corticosteroids (fluticasone, budesonide, beclomethasone)
antihistamines (loratadine, fexofenadine, cetirizine)
ipratropium spray
cromolyn sodium
nasal saline irrigation
montelukast

197
Q

painful erythema ear canal, exudate, tender tragus= Tx

A

dry: isopropyl alcohol/white vinegar
abx gtts: fluoroquinolone, aminoglycoside
steroids (polymyxin B/neomycin/hydrocortisone)

198
Q

fever, ant cervical LAD, no cough, tonsillar exudate= Tx

A

PCN VK, benzathine PCN IM

amox, macrolide

199
Q

erythema, fluffy white patches, pain/mouth/throat discomfort= Tx

A

nystatin, azoles

200
Q

minor jones criteria

A

for rheum fever

PR prolonged, fever, polyarthralgias, incr ESR/CRP, leukocytosis, Hx rheum fever

201
Q

loud S4 gallop, worse with valsalva, better with squatting= Tx

A

HCM- BB

202
Q

vomit within hrs of birth, still pass meconium in 1st 24 hrs, U/S: double bubble

A

duodenal atresia

203
Q

An 18-month-old boy is brought to the emergency department because he has had fever and
cough for the past three days. While in the waiting room, he has a generalized tonic-clonic
seizure that lasts five minutes. He has no history of a seizure disorder. Physical examination
shows a postictal child with a bright red tympanic membrane and green discharge from the nose.
Temperature is 40.6°C (105.0°F). Which of the following is the most appropriate initial
diagnostic study?

A

LP (febrile seizures after meningitis common)

204
Q

criteria for CT

A

instability following multiple traumas, unreliable history or examination
because of possible alcohol abuse or drug ingestion, loss of consciousness for longer than five
minutes, repeated vomiting or vomiting for more than eight hours after injury, posttraumatic
seizures, progressive headache, physical signs of basilar skull fracture, or amnesia

205
Q

A previously healthy 15-month-old boy becomes anxious and begins crying and drooling
copiously. A few minutes earlier he had been calmly playing with his toys. Temperature is
36.7°C (98.1°F), pulse rate is 84/min, and respirations are 18/min. On physical examination, the
posterior pharynx is mildly injected but otherwise clear. The lungs are clear to auscultation and
percussion. Findings on chest x-ray study are normal. Within an hour he is calmer, but he
continues to drool heavily. Which of the following is the most appropriate next step?

A

Esophagogastroduodenoscopy

Dx: FB ingestions

206
Q

neonate/infant with fever and rash- what test?

A

LP

207
Q

flushing, Diarrhea, Dermatitis, Dementia, Death= Dx

A

niacin def, pellagra

urine NMN

208
Q

dry skin, conjunciva dry, bitots spots, night blindness

A

vit A def

209
Q

MCC bronchiolitis

A

RSV

210
Q

viral URI, resp distress, fever, wheezing, incr RR

A

bronchiolitis (RSV)

211
Q

bronchiolitis Tx

A

hydrate, O2, albuterol, epi

212
Q

croup Tx

A

humidified air, nebulized epi, dexamethasone

213
Q

tachypnea, tachycardia, low O2, unilateral wheezing, grunting, unequal breath sounds

A

pneumonia

214
Q

CAP pneumonia Tx

A

macrolide

complicated: levo
inpt: ceftriaxone + azithromycin

215
Q

MC HAP

A

pseudomonas

216
Q

use albuterol > 2days/wk, FEV1>80%

A

mild asthma

step 2: low dose ICS (fluticasone, pulmicort, flovent, beclomethasone) + SABA PRN

217
Q

use albuteral daily, FEV1> 60% but <80%

A

mod asthma

step 3: low dose ICS + SABA PRN + LABA (salmeterol, formoterol)

218
Q

decr turgor, pale, dry mucous membr, incr pulse rate, 3-4 sec cap refill, oliguria, decr tears

A

6-10% dehydration

219
Q

tachycardia, >4 sec cap refill, low BP, anuria, absent tears

A

11-15% dehydration

220
Q

Tx Guillain-Barre (ascending paralysis)

A

IVIG, plasmapheresis

221
Q

GERD Tx

A
H2 blocker (zantac, pepcid, tagamet)
PPI (omeprazole)
222
Q

ADR of PPI

A

C diff, osteoporosis (Fx), decr Fe, decr B12

223
Q

on abdom U/S see string sign

A

pyloric stenosis

224
Q

FB ingestion Tx

A

esophagogastroscopy

225
Q

thrombosis, elev PLT= Tx

A

essential thrombocytosis

Tx: hydroxyurea

226
Q

teardrop poik, leukoerythroblastic blood, giant PLT

A

primary myelofibrosis

227
Q

erythromelagia (numb/burning extremities), high Hct >54% male, >51% female

A

PV

pruritis after warm shower

228
Q

pancytopenia, blasts= Dx test

A

ALL

Dx: TdT staining

229
Q

pancytopenia, blasts= Tx

A

ALL

Tx: chemo (vincristine, prednisone, daunorubicin, cyclophosphamide)

230
Q

auer rod= Dx test

A

AML

Dx: sudan black stain, myeloperoxidase pos

231
Q

painless cervical LAD, teens/young adults, reed sternberg cells= Dx

A

HL

232
Q

HL assoc with what illness?

A

EBV

233
Q

reed sternberg cells

A

HL

234
Q

RA, splenomegaly, neutropenia

A

Felty syndr

235
Q

MC brain tumor kids

A

medulloblastoma

236
Q

HA, seizure, personality changes, focal weakness, esotropia

A

medulloblastoma

CN 6 palsy= esotropia

237
Q

medulloblastoma location

A

cerebellum

238
Q

4th ventricle brain tumor

A

ependyoma

239
Q

IFG-I <84

A

GH def

240
Q

hyperthyroidism Tx

A

BB (propranolol)
methimazole
ablation
iodated contrast agents

241
Q

nephrocalcinosis, osteomalacia, abdom pain, constipation, lethargy, depression, memory loss

A

hypercalcemia, hyperparathyroidism

242
Q

short QT

A

hypercalcemia, hyperparathyroidism

243
Q

Tx hypercalcemia

A

bisphosphonates (alendronate)- stop osteoclast activity

calcitonin

244
Q

DM, incr blood sugar in AM, natural, incr counter-regulatory hormones, normal/high sugar 2-3 AM

A

dawn phenomenon

245
Q

prebreakfast, rebound hyperglycemia, man-made, poor DM mgmt, low sugar 2-3AM = Tx

A

Somogyi effect

Tx: incr evening insulin, incr snack PM

246
Q

ADR metformin

A

LA, GI (diarrhea), wt loss

don’t use in CKD!

247
Q

kid holding wrist, cry, no swelling, no bruising, pulling theme= Tx

A

Supination/flexion or hyperpronation

248
Q

4-9 y/o, afebrile, insidious hip/knee pain, limp, normal WBC, loss of motion= study of choice, findings

A

MRI

Xray: incr density, flattening, deformed

249
Q

legg-calve-perthes Tx

A

protected wt bearing

250
Q

Tx scoliosis <15 degrees

A

watch, f/u

251
Q

Tx scoliosis 15-20 degrees

A

serial AP Xrays

252
Q

Tx scoliosis >20 degrees

A

brace

253
Q

trendelenburg pos

A

hip dysplasia

254
Q

distal femur, prox tibia, metaphysis, incr ALP 2-3fold, sunburst sign

A

osteosarcoma

255
Q

onion skin appearance, diaphysis, metastasizes early

A

ewing sarcoma

256
Q

MC benign neoplasia bone

A

osteochondroma

257
Q

chronic synovitis, extra-articular (fever, rash, wt loss), uveitis, spiking fever

A

juvenile rheum/idiopathic arthritis

pauciarticular: <4 lg joints, MC, pos ANA
systemic: spiking fever, polyarthralgia, MP rash

258
Q

painless scrotal swelling, worsen through day, present in NB= Dx test

A

Hydrocele

Scrotal U/S

259
Q

foreskin retracted

A

paraphimosis

260
Q

inability to retract foreskin

A

phimosis

261
Q

MCC testicular pain boys >12 y/o

A

testicular torsion

262
Q

cremaster reflex absent, during sleep/trauma/excercise, unilateral scrotal pain, edema, erythema, neg Phren sign= Dx test

A

testicular torsion

U/S

263
Q

Asymptomatic abdominal swelling in 4 yo

A

Wilms tumor

Wilms tumor

264
Q

Wilms tumor Dx

A

U/S, CT

265
Q

medical Tx for nocturnal enuresis

A

desmopressin (DDAVP)

266
Q

palpable purpura on buttocks and legs in kids, abdom pain, hematuria= Dx

A

HSP (Henoch-Schonlein purpura)

Tx none

267
Q

hypoalbuminemia, hyperlipidemia, proteinuria, edema, young kids= Tx

A

minimal change dz

Tx prednisone

268
Q

wks after GABH strep infection, azotemia, incr ASO= Tx

A

postinfectious GN

Tx none

269
Q

1st line agent in Tx UTI in kids

A

3rd gen ceph ( cefpodoxime, cefixime, cefdinir, ceftibuten, cefotaxime, ceftriaxone)

270
Q

pruritic, dewdrops on rose petals, rash everywhere

A

varicella zoster

271
Q

high fever, cough, resp Sx, febrile seizures, fever resolves then rash, rash starts on neck and spreads to body

A

roseola, HHV 6

272
Q

cough, coryza (runny nose), conjunctivitis, koplik spots, rash 5 days after prodrome, rash starts on face and spreads to body

A

measles

273
Q

pruritic rash starts on face, spreads to body, blueberry muffin baby, suboccipital LAD

A

rubella

274
Q

pregnancy high risk for this infection, esp in 1st 4 mo

A

rubella

275
Q

rubella aka

A

german measles

276
Q

slapped cheek, lacy rash, flu-like illness, arthritis

A

5th dz, erythema infectiosum, parvovirus B19

277
Q

5th dz high risk for 2 things

A
hydrops fatalis (during preg)
aplastic crisis (dangerous in sickle cell)
278
Q

spasms of rapid coughing fits, whooping cough, no fever, sneezing, coryza, malaise= Tx

A

pertussis

erythromycin!!

279
Q

elec abnorm in anorexia/bulimia

A

hypoCl, hypoK, incr BUN, metab alkalosis

280
Q

Sx after stressful event, unconscious feelings and Sx result in secondary gain

A

conversion disorder

281
Q

short, normal GH, epicanthal folds, low pos hairline, short 4th metacarpals, broad chest, wide spaced nipples, no secondary sex characteristics, hypogonadism

A

turner syndrome

282
Q

hypotonia, poor moro, hypermobility of joints, simian palmar crease, macrosomia, mental retardation, brushfield spots= common complication/sequelae

A

Downs

congenital heart dz- AV septal defect MC

283
Q

pathophys seizure

A

glutamate- excitatory, Ca influx
GABA- inhibitory
NMDA channels open- Ca influx

284
Q

elec causes seizure

A

hypoNa, hypoCa, hyperthyroidism

285
Q

age of absence seizures

A

5-18 y/o

286
Q

no aura, eye blinking, incontinent, head movement, postictal picking/etc= Tx

A

absence seizure

Tx depakote, zarontin

287
Q

MCC infant resp distress (3)

A

aspiration, congenital pneumonia, transient tachypnea

288
Q

infant with hypospadia. what test do you order?

A

bilateral renal U/S (to r/o ascending pathology)

289
Q

ear pain, drainage, hearing loss

A

FB in ear

290
Q

funcional/innocent murmurs

A

still’s, venous hum, carotid bruits (older), pulm ejection murmur (older kids)

291
Q

upper left sternal border, systolic ejection murmur, 3y/o- adolescence, louder supine, decr valsalva

A

pulm ejection murmur (functional murmur)

292
Q

posterior pharyngeal vesicles

A

herpangina (coxsackie A)

293
Q

drug causing prolonged QT

A

TCA

294
Q

drug poisoning: mucosal irritation, vomit, bloody diarrhea, resp distress, cyanosis, tachycardia, CNS depression, fever

A

hydrocarbons (benzene, gas, petroleum)

Tx no emetics. O2

295
Q

drug poisoning: mucosal/skin burns, hematemesis, resp distress, convulsion

A

caustics (cleaners)
Tx water/milk. no emetics
tests EGD for esophageal injury

296
Q

drug poisoning: irritated mucous memr, resp distress, stomach/esophagus perforation

A

bases (clorox, drano)

297
Q

vomit, hyperapnea (hyperventilation), renal failure, coma, seizure, lethargy

A

ASA

Tx emesis! charcoal, lavage

298
Q

intestinal bleeding, impaired coagulation, acidosis, shock, red urine

A

iron (vitamins, prenatal vitamins)

Tx emesis! lavage, whole bowel irrigation

299
Q

0-24hrs: N/V
24-72 hrs: asymptomatic, incr LFT
72-124hrs: jaundice, encephalopathy, pancreatitis, renal failure

A

acetaminophen

Tx acetylcysteine

300
Q

appropriate wt gain

A

1 oz/day 1st 6 mo

0.5 oz/day next 6 mo

301
Q

appropriate caloric intake

A

120 kcal/kg/day 1st 6 mo

100 kcal/kg/day after

302
Q

premature infant immunization schedule

A

same as term

303
Q

contraindication to immunization

A

anaphylactic rxn

304
Q

immunocompromised can’t get what vaccines?

A

no MMR, varicella

305
Q

gelatin allergy- no vaccine?

A

varicella

306
Q

baker’s yeast allergy- no vaccine?

A

Hep B

307
Q

egg allergy- no vaccine?

A

influenza

308
Q

not reasons to postpone vaccines

A

mild fever <39, mild sick, PMH/FH seizures, using abx, recent pos TB skin test

309
Q

postpone MMR if what illness?

A

TTP

310
Q

drowning MC

A

1-3 y/o

<1y/o in bathtub

311
Q

rear facing car seat until

A

2 y/o, 35 lbs

312
Q

lap and shoulder belt what age?

A

8-12 y/o

313
Q

rear car seats until

A

13 y/o

314
Q

RF vit K def

A

NB, breast fed NB who didn’t receive vit K at birth prophylactically
prolonged PT

315
Q

RF iron def

A

breast fed infants, untreated mom anemia, prematurity, blood loss

316
Q

skeletal bone age lag behind chronological age, puberty delayed, family normal ht, development normal

A

constitutional growth delay

317
Q

before 2 y/o, deceleration in ht, normal development, bone age equal to chronologic age

A

familial short stature

318
Q

decr growth velocity, subnormal growth

A

GH def

319
Q

galactosemia inborn error of metabolism causes what def?

A

carb

320
Q

tall, thin, scoliosis common, mild evelopmental delay, hypogonadism, ataxia, espressive lang disorder

A

klinefelter’s XXY

male and females

321
Q

pale blue irides, long narrowed facies, large protruding ears, large protruding jaw, flat feet, hyperextensible fingers, prepubertal large gonads, mod mental retardation, mitral valve prolapse

A

fragile X syndr

males

322
Q

SGA, hypogonadism, small hands/feet, almond eyes, mental retardation, short
eventually obesity, pickwickian, DM

A

prader-willi

323
Q

developmental delay/retardation, tongue thrusting, paroxysmal laughter

A

angelman’s syndr

324
Q

collagen! joint laxity, hyperelastic skin, bruising

A

ehlers-danlos

325
Q

ehlers-danlos inheritance

A

autosomal dominant

326
Q

marfan inheritance

A

autosomal dominant

327
Q

tall, lanky, joint laxity, long digits, myopia, arched palate

A

Marfan syndr

328
Q

marfan complications

A

mitral valve prolapse, spontaneous pneumothorax, aneurysm, aorta root dilation

329
Q

born and stay small, microcephaly, long smooth philtrum, thin upper lip, small distal phalanges

A

FAS

330
Q

FAS complications

A

developmental delay, hyperactivity, mod retardation, internal organs

331
Q

Turner syndr complications

A

visual/spatial perceptive disabilities, primary amenorrhea, ovarian dysgenesis, no secondary sex characteristics, horseshoe kidney, aorta stenosis, coarctation aorta

332
Q

phenylketonuria s/s, Tx

A

mental retardation, seizures, behavior problems
hyperactive, autism
Tx: low protein diet; no meat, dairy, beans, nuts, eggs

333
Q

galactosemia s/s

A

neonatal N/V, jaundice, hepatic dysfunction, mental retardation
Tx: lactose/galactose free diet

334
Q

spina bifida- aperta

A

neural tube defect involves overlying skin

335
Q

spina bifida- occulta

A

hairy tufts, dimples, dermal sinus in lumbosacral region

336
Q

s/s spina bifida

A

hypotonia, hydrocephalus, incontinence

337
Q

tripoding

A

6 mo

338
Q

pincer grasp

A

9 mo