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Peds Flashcards

1
Q

Late preterm

A

34-37

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2
Q

Term

A

38 or more

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3
Q

Newborn RR

A

40-60

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4
Q

Newborn HR

A

120-160

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5
Q

First step after child delivered

A

Suction mouth and nose

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6
Q

1min APGAR measures

A

Conditions during labor and delivery

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7
Q

5min APGAR measures

A

Response to resuscitative efforts

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8
Q

Is a low APGAR associated with cerebral palsy

A

No

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9
Q

Neonatal conjuctivitis cause at 1 day

A

Chemical irritation

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10
Q

Neonatal conjuctivitis cause at 2-7 days

A

Gonorrhea

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11
Q

Neonatal conjuctivitis cause at >7 day

A

Chlamydia

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12
Q

Neonatal conjuctivitis cause at 3 weeks or more

A

Herpes

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13
Q

Abx drops to prevent opthamia neonatorum (neonatal conjunctivitis)

A

Erythro or Tetra

Silver nitrate

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14
Q

Sx of intercranial bleeding

A

Lethargy

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15
Q

Sx of mucosal bleeding

A

BRBPR

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16
Q

What causes vit K def in newborns

A

Colonic flora not adequate so E.coli not present to make vit K

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17
Q

Why is there bleeding in vit K def

A

Cannot make factors II, VII, IX, X, protein C and S

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18
Q

Prophylactic Rx for vit K def

A

Single IM Vit K

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19
Q

Newborn screening tests

A 
PKU
CAH
Biotinidase
B-thalasemia
Galactosemia
Hypothyroidism
Homocysteinuria
CF
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20
Q

G6PD facts

A

XR
Hemolytic crisis
Reduce oxidative stress and special diet

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21
Q

PKU facts

A

AR
Deficiency in PAH
Mental retardation
Low phenylalanine diet for first 16yrs

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22
Q

Galactosemia facts

A

Precludes normal metabolism of galactose

Cut out all lactose-containing products

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23
Q

CAH facts

A

AR
Errors in steroidogenesis
Replace mineralocorticoid and glucocorticoid
Genetal reconstruction surgery

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24
Q

Congenital hypothyroidism facts

A

1 in 40,000

Cretinism

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25
Q

Why do hearing test in newborns

A

Exclude congenital sensory-neural hearing loss

Assess need for cochlear implant

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26
Q

CF facts

A

Abnormally thick mucous
Elevated sweat chloride
Mutation in CFTR
Abnormal function in at least 1 organ system

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27
Q

Best initial test for CF

A

Sweat chloride

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28
Q

Most accurate test for Cf

A

CFTR gene mutation

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29
Q

Who gets Hep B IG

A

HbsAg+ mother

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30
Q

Pathogenesis of transient polycythemia of newborn

A

Hypoxia in delivery
Increase in EPO
Increase in RBCs

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31
Q

How does transient polycythemia of newborn resolve

A

First breath increases O2
Decrease in EPO
Normalization of Hb

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32
Q

Pathogenesis of transient tachypnea of newborn

A

Compression of rib cage in delivery
Removes fluid from lungs
Therefore C-section babies have excess fluid

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33
Q

Newborn tachypnea lasts >4hrs, think

A

Sepsis

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34
Q

Evaluation of newborn sepsis

A

Blood + Urine Cx

LP w/ CSF analysis and Cx if neuro signs

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35
Q

Cause of newborn subconjunctival hemorrhage

A

Rapid rise in intrathoracic pressure as chest is compressed while passing through birth canal

No Rx

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36
Q

3 types of skull fractures in newborns

A

Linear - MC
Depressed - Can cause cortical damage
Basilar - Most fatal

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37
Q

What is caput succedameum

A

Swelling of the soft tissues of the scalp that DOES cross suture lines

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38
Q

What is cephalohematoma

A

Swelling of the soft tissues of the scalp that DOES NOT cross suture lines

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39
Q

What is brachial plexus injury in a newborn secondary to

A

Shoulder dystocia

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40
Q

Who is most likely to get brachial plexus injury

A

Macrosomic infants of diabetic mothers

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41
Q

2 types of brachial plexus injuries

A

Duchenne-Erb paralysis: C5-6

Klumpke paralysis: C7-8 +/- T1

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42
Q

MC newborn fracture as a result of shoulder dystocia

A

Clavicular

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43
Q

Best diagnostic test for clavicular Fx

A

XR

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44
Q

Rx clavicular Fx

A

Immobilization, splinting, PT

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45
Q

What causes facial nerve palsy in delivery

A

Trauma from forceps use

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46
Q

Rx facial nerve palsy in neonate

A

Spontaneous recovery

Surgical nerve repair if necessary

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47
Q

Causes of polyhydramnios

A

Neuro
- Werdnig-Hoffman (infant can’t swallow)
GI
- Intestinal atresias

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48
Q

Causes of oligohydramnios

A

Prune belly (no abd muscles so can’t bear down to urinate)
Renal agenesis
High atmospheric pressure causing flat faces

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49
Q

Rx Prune belly causing oligohydramnios

A

Serial foley - high risk of UTI

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50
Q

Association w/ renal agenesis

A

Potter sequence

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51
Q

Bowel sounds in chest and impaired ventilation

A

Diaphragmatic hernia

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52
Q

CXR in diaphragmatic hernia

A

Air fluid levels

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53
Q

Types of diaphragmatic hernias

A

Morgagni - Retrosternal/Parasternal (central)

Bochdalek - Posterolateral (peripheral)

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54
Q

What is an omphalocele

A

Intestines and organs form beyond abd wall w/ a sac covering

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55
Q

Why does omphalocele occur

A

Failure of GI sac to retract at 10-12 weeks

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56
Q

What is umbilical hernia associated with

A

Congenital hypothyroidism

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57
Q

Rx umbilical hernia

A

90% close spontaneously by age 3

Surgical intervention if still present at age 4

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58
Q

What does elevated AFP in utero indicate

A

Neural tube defects

Abd wall defects

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59
Q

MCC elevated AFP

A

Incorrect dating

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60
Q

What is gastroschisis

A

Wall defect lateral to midline
Intestines and organs outside abd wall
No sac

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61
Q

Rx gastroschisis

A

Immediate surgery with gradual introduction of bowel and silo formation

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62
Q

Consequence of overly aggressive surgical management of gastroschisis

A

Third spacing and bowel infarction

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63
Q

PE finding w/ Wilms tumor

A

Large palpable mass felt

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64
Q

Cause of Wilms tumor

A

Hemihypertrophy of one kidney due to increased vascular demands

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65
Q

Highly associated with Wilms tumor

A

Aniridia

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66
Q

MC abdominal mass in children

A

Wilm’s tumor

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67
Q

Best initial test for Wilms

A

ABD U/S

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68
Q

Most accurate test for Wilms

A

Contrast CT

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69
Q

WAGR syndrome

A

Chr 11 deletion

  • Wilms Tumor
  • Aniridia
  • GU malformations
  • Retardation
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70
Q

Rx Wilms

A

Total nephrectomy with chemo and radiation

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71
Q

Most important findings in Neuroblastoma

A

Hypsarrythmia and opsoclonus (Dancing eyes and feet)

Increased urine VMA and metanepherines (diagnostic)

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72
Q

MC cancers in infancy

A

Neuroblastoma

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73
Q

MC extracranial solid malignancy

A

Neuroblastoma

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74
Q

Features of Hydrocele

A

Painless swollen fluid-filled sac containing spermatic cords
Transilluminates
Resolves in 6 months
Differentiate from inguinal hernia

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75
Q

Features of Varicocele

A

Varicose vein of scrotal veins
Swelling of pampiniform plexus
Dull ache and heaviness

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76
Q

Best initial test for varicocele

A

PE showing “bag of worms” sensation

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77
Q

Most accurate test for varicocele

A

U/S scrotum showing dilation of pampiniform plexus vessels >2mm

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78
Q

When to rx varicocele

A

Delayed growth of testes or testicular atrophy

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79
Q

What must you always do when diagnosing varicocele

A

U/S the other testicle

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80
Q

What is cryptorchidism

A

Absence of one teste in scrotum

Found in inguinal canal

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81
Q

Rx cryptorchidism

A

Orchiplexy to bring it down after age 1 to prevent infertility

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82
Q

Risk associated w/ cryptorchidism

A

Increased risk of malignancy regardless of surgical intervention

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83
Q

What is hypospadias associated with

A

Cryptorchidism

Inguinal hernias

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84
Q

Rx hypospadias

A

Surgical

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85
Q

Contraindicated in hypospadias

A

Circumcision

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86
Q

Associations with epispadias

A

Urinary incontinence

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87
Q

Must also be evaluated in epispadias

A

Concomitant bladder extrophy

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88
Q

Rx epispadias

A

Surgery

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89
Q

Developmental reflexes

A 
Sucking
Grasping
Babinski
Moro
Stepping
Superman
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90
Q

Pathognomonic for tetralogy of fallot

A

Exercise intolerance

Squatting while playing outside

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91
Q

Components of tetralogy of fallot

A

Overriding aorta
Pulm stenosis
RVH
VSD

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92
Q

Association with tetralogy of fallot

A

Chr 22 deletions

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93
Q

Presentation of tetralogy of fallot

A

Cyanosis of lips and extremities
Holosystolic murmur (left lower sternal border)
Squatting (tet spells)

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94
Q

How does squatting help kids w/ tetralogy of fallot

A

Increases preload and systemic venous return

Decreases R to L shunt increasing pulm blood flow and O2 sat

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95
Q

CXR findings in tetralogy of fallot

A

Boot shaped heart

Decreased pulm vascular markings

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96
Q

Only definitive therapy for tetralogy of fallot

A

Surgery

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97
Q

VSDs are common in

A

Down
Edward
Patau

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98
Q

MC congenital heart defect in Down

A

Endocardial cushion defect of AV canal

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99
Q

The only 3 holosystolic murmurs

A

MR
TR
VSD

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100
Q

What does transposition require for child to live

A

PDA or ASD or VSD

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101
Q

Presentation of transposition

A

Early, severe cyanosis
Single S2
Egg on a string on CXR

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102
Q

Initial management of transposition

A

PGE1 to keep PDA open

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103
Q

Contraindicated in transposition

A

NSAIDs esp indomethacin b/c it can close PDA

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104
Q

Rx tranposition

A

2 surgeries each having 50% mortality rate

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105
Q

MC cyanotic heart disease during neonatal period

A

Transposition

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106
Q

MC cyanotic heart disease after neonatal period

A

Tetralogy

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107
Q

Pulsus alternans

A

LV systolic dysfunction

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108
Q

Pulsus bigeminus

A

HOCM

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109
Q

Pulsus bisferiens

A

AR

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110
Q

Pulsus tardus et parvus

A

AS

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111
Q

Pulsus paradoxus

A

Cardiac tamponade, tension PTX

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112
Q

Irregularly irregular

A

A-fib

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113
Q

Components of hypoplastic left heart syndrome

A

LV hypoplasia
Mitral valve atresion
Aortic valve lesions

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114
Q

Presentation of hypoplastic left heart syndrome

A

Absent pulses w/ single S2
Increased RV impulse
Gray cyanosis

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115
Q

CXR in hypoplastic left heart syndrome

A

Globular shaped heart

Pulm edema

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116
Q

Most accurate test in hypoplastic left heart syndrome

A

Echo

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117
Q

Rx hypoplastic left heart syndrome

A

3 separate surgeries

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118
Q

Sx truncus arteriosus

A

Dyspnea
Early and frequent resp infections
Single S2
Bounding peripheral pulses

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119
Q

CXR in truncus arteriosus

A

Cardiomegaly with increased vascular markings

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120
Q

Rx truncus arteriosus

A

Early surgery to prevent pulm HTN which can develop in 4 months

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121
Q

Features of total anomalous pulmonary venous return

A

No venous return b/w pulm veins and LA
Oxygenated blood goes to SVC
Can be w/ or w/o obstruction

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122
Q

What constitutes obstruction in TAPVR

A

Angle at which veins enter sinus

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123
Q

Rx Either type of TAPVR

A

Surgery

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124
Q

CXR TAPVR w/ obstruction

A

Pulm edema

Echo definitive

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125
Q

CXR TAPVR w/o obstruction

A

Snowman or figure 8 sign

Echo most accurate (used to actually diagnose)

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126
Q

Age of TAPVR w/ obstruction

A

Early in life w/ resp distress and severe cyanosis

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127
Q

Age of TAPVR w/o obstruction

A

1-2yrs w/ RHF and tachypnea

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128
Q

Child, otherwise healthy presents w/ holosystolic murmur and failure to thrive

A

VSD

RVH on EKG

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129
Q

MC congenital heart lesion

A

VSD

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130
Q

Presentation of VSD

A

Dyspnea w/ resp distress
Holosystolic murmur at left lower sternal border
Loud pulmonic S2

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131
Q

Rx VSD

A

Small will close in 1-2yrs
Large need surgery
Diuretics and digoxin for conservative managment

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132
Q

Sequelae of untreated VSD

A

CHF
Endocarditis
Pulm HTN

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133
Q

Kid had stroke from DVT, how

A

ASD

134
Q

Types of ASD

A

Primum - Concomitant mitral valve anomalies
Secundum - MC
Sinus venoses defect

135
Q

Presentation of ASD

A

Fixed wide split S2

136
Q

Most definitive test for ASD

A

Cardiac catheterization

Can do echo

137
Q

Rx ASD

A

Close spontaneously

Surgery or transcatheter closure for symptomatic pts

138
Q

Complications of ASD

A

Dysrhythmias

Paradoxic emboli from DVTs

139
Q

When does PDA close

A

PO2 rises above 50mmHg

Therefore more prevalent in prematurity and high altitude

140
Q

How long after birth is PDA considered normal

A

12hrs

141
Q

Presentation of PDA

A

“Machine-like” murmur
Wide pulse pressure
Bounding pulses

142
Q

MC complications later in life w/ PDA

A

Resp infections

Infective endocarditis

143
Q

Best initial test for PDA

A

Echo

144
Q

Most accurate test for PDA

A

Cardiac cath

145
Q

Rx PDA

A

Indomethacin

146
Q

Mitral lesions radiate to

A

Axilla

147
Q

Tricuspid and pulmonic lesions radiate to

A

Back

148
Q

Aortic lesions radiate to

A

Neck

149
Q

Pear shaped heart on CXR

A

Pericardial effusion

150
Q

Boot shaped heart on CXR

A

Tetralogy of fallot

151
Q

Jug handle heart on CXR

A

Primary pulmary artery hypertension

152
Q

3-like appearance of heart or rib notching on CXR

A

Coarctation

153
Q

Important sx for Long QT

A

Hearing loss
Syncope
NL vitals and PE
FHx sudden cardiac death

154
Q

What is coarctation associated with

A

Turner’s

155
Q

Common features of Turner’s

A 
Short
Webbed neck
Shield chest
Streak gonads
Horseshoe kidneys
Shortened 4th metacarpal
156
Q

Presentation of Coarctation

A

Severe CHF and resp failure in first few months

Reduced pulses in LE, HTN in UE

157
Q

Most accurate test for coarctation

A

Cardiac cath

158
Q

Rx coarctation

A

Resection of narrow segment

Balloon dilation if recurrence

159
Q

When is hyperbilirubinemia pathological

A 
First day of life
Rises > 5mg/dL/day
Above 19.5 in term child
Direct bili rises >2 at any time
Persists after 2nd week of life
160
Q

Dx hyperbilirubinemia

A

Direct and indirect bili levels
Check mother/infant blood type for ABO incompatibility
Peripheral smear and retic count for hemolysis

161
Q

Rx hyperbilirubinemia

A

Blue-green light phototherapy

Exchange transfusion if bili >20-25

162
Q

MC complication of esophageal atresia w/ TEF

A

Recurrent aspiration PN

163
Q

Presentation of TEF

A

Vomitting w/ first feeding
Choking, coughing, cyanosis
Hx of polyhydramnios

164
Q

Dx TEF

A

Gastric air bubble on CXR

Coiling of NGT on CXR

165
Q

Rx TEF

A

Surgery
ABX coverage for anaerobes
Fluid resuscitation before surgery

166
Q

String sign

A

Pyloric stenosis

167
Q

Doughnut sign

A

Intussusception

168
Q

Birt’s beak sign

A

Achalasia

169
Q

Steeple sign

A

Croup

170
Q

What causes pyloric stenosis

A

Hypertrophic pyloric sphincter

171
Q

When does pyloric stenosis manifest

A

1st month of life

172
Q

Auscultation finding w/ pyloric stenosis

A

Succussion splash

173
Q

Hallmark feature of pyloric stenosis

A

Nonbilious projectile vomitting

174
Q

Metabolic imbalances in pyloric stenosis

A

Hypochloremia
Hypokalemia
Metabolic acidosis

175
Q

What is olive sign

A

Mass size of olive palpated in epigastrum in pyloric stenosis

176
Q

Best initial test for pyloric stenosis

A

ABD U/S

177
Q

Most accurate test for pyloric stenosis

A

Upper GI series

178
Q

4 signs in Upper GI series for pyloric stenosis

A

String sign - Thin barium column
Shoulder sign - Antrum filling defect 2/2 muscle prolapse
Mushroom sign - Hypertrophic pylorus against duodenum
Railroad track sign - Excess mucosa: 2 barium columns

179
Q

Rx pyloric stenosis

A

Replace lost volume and electrolytes esp K
NGT to decompress bowel
Myotomy

180
Q

What is choanal atresia associated with

A 
Colobalma
Heart defects
Atresia of the chonae
Retardation of grown and/or development
GU defects
Ear abnormalities
181
Q

Presentation of choanal atresia

A

Child turns blue when feeding, Pink when crying

182
Q

Confirm dx in choanal atresia

A

CT

183
Q

Rx Choanal atresia

A

Surgical perforation of membrane

184
Q

What is choanal atresia

A

Membrane between nostrils and pharyngeal space preventing breathing when feeding

185
Q

What is hirschsprung

A

Lack of innervation of distal bowel by aurbach plexus

186
Q

Associations w/ hirschprung

A

Down

187
Q

Presentation of hirschprung

A

Do not pass meconium for over 48hrs
Extreme constipation and large bowel obstruction
Extremely tight sphincter
Innability to pass flatus

188
Q

Hirschprung XR

A

Distended bowel loops

Retention of barium >24hrs

189
Q

Hirschprung Manometry

A

High pressures in anal sphincter

190
Q

Most accurate dx hirschprung

A

Full thickness Bx w/ lack of ganglionic cells in submucosa

191
Q

What is imperforate anus associated with

A

Down

192
Q

What is imperforate anus a component of

A 
Vertebral anomalies
Anal atresia
Cardio anomalies
TEF
Esophageal atresia
Renal anomalies
Limb anomalies
193
Q

Presentation of imperforate anus

A

No meconium

No anus

194
Q

What is duodenal atresia associated with

A

Down

Annular pancreas

195
Q

Dx duodenal atresia

A

Bilious vomitting within 12hrs of birth

Double bubble sign on CT

196
Q

Rx duodenal atresia

A

Replace fluids and K
NGT to decompress bowel
Surgical duodenostomy

197
Q

Where in the bowel does volvulus usually occur in children

A

Midgut, ileum

198
Q

Presentation of volvulus

A

Vomitting, colickly abd pain

199
Q

Dx volvulus

A

Multiple air fluid levels on XR

Bird beak on upper GI series

200
Q

Best initial therapy for volvulus

A

Endoscopic decompression

201
Q

Most effective therapy for volvulus

A

Surgical decompression

202
Q

What is intussusception associated with

A

Rotavirus vaccine

Henoch-Schonlein purpura

203
Q

Causes of intussusception

A 
Polyp
Hard stool
Lymphoma
Viral
Idiopathic
204
Q

Presentation of intussusception

A

Colichy abd pain
Bilious vomitting
Currant jelly stool
Sausage shaped mass

205
Q

Best initial test for intussusception

A

U/S showing doughnut sign

206
Q

Most accurate test for intussusception

A

Barium enema

Diagnostic and therapeutic

207
Q

When is barium enema contraindicated in intussusception

A

Peritonitis, shock, perforation

208
Q

Rx Intussusception

A

Fluid resuscitation FIRST
NGT decompression of bowel
Barium enema
Surgery if fails

209
Q

Painless BRBPR in male

A

Meckel’s

210
Q

Most accurate test for Meckel’s

A

Technetium-99m pertechnetate scan

ie. meckel’s scan

211
Q

What is a meckel’s diverticulum

A

Persistant vitelline duct in small intestine

Can contain gastric or pancreatic tissue

212
Q

Presentation of meckel’s

A

Painless rectal bleeding

213
Q

Rx Meckel’s

A

Surgery

214
Q

Second most common cause of infant death worldwide

A

Acute fluid and electrolyte loss 2/2 acute diarrhea

215
Q

Presentation of inflammatory diarrhea

A

Fever
ABD pain
Bloody diarrhea

216
Q

Presentation of noninflammatory diarrhea

A

Vomitting
Crampy abd pain
Watery diarrhea

217
Q

Dx tests in diarrhea

A

Stool for blood and leukocytes
Stool Cx w/ O and P
Sigmoidoscopy in the setting of C. diff

218
Q

Most important next step in acute diarrhea

A

Rehydration
Mild = oral
Severe = IV

219
Q

ABX of choice in NEC

A

Vanco
Genta
Metro

220
Q

Presentation of NEC

A

Severely premature baby, LBW
Vomitting and abdominal distension
Fever

221
Q

Dx tests for NEC

A

ABD XR showing pneumatosis intestinalis

Frank or occult blood

222
Q

Rx NEC

A

Stop feeding (bowel res)
IV fluids
NGT
Surgery if ABX fail

223
Q

Description of shoulder dystocia

A

Arm adducted and internally rotated

224
Q

Most common wrong answer in newborn w/ DM

A

Insulin

225
Q

Effects of macrosomia in IDM

A

Polycythemia, hyperviscosity
Shoulder dystocia
Brachial plexus palsy

226
Q

Dx and Rx of small left colon syndrome in IDM

A

Barium

Smaller, more frequent meals

227
Q

Major cardiac change in IDM

A

Asymmetric septal hypertrophy → decreased CO

228
Q

Dx Asymmetric septal hypertrophy in IDM

A

EKG and Echo

229
Q

Rx Asymmetric septal hypertrophy in IDM

A

BBs

IVF

230
Q

Features of renal vein throbosis in IDM

A

Flak mass and possible bruit

Hematuria and thrombocytopenia

231
Q

Metabolic findings and effects in IDM

A

Hypoglycemia → seizures
Hypocalcemia → tetany, lethargy
Hypomagnesemia → hypocalcemia, decreased PTH
Hyperbilirubinemia → icterus and jaundice

232
Q

Most cases of CAH are due to

A

Deficiency of 21-hydroxylase

233
Q

3 forms of CAH

A

21-hydroxylase
17-hydroxylase
11-beta-hydroxylase

234
Q

MC presentation of CAH

A

Hypotensive child w/ severe electrolyte abnormalities

235
Q

Other features of CAH

A

Ambiguous genitalia in girls
Boys lose sexually defining characteristics w/ age
Decreased Na, K, Cl, glucose
Acidosis

236
Q

Dx tests in CAH

A

Serum electrolytes

Increased 17-OH progesterone

237
Q

Rx CAH

A

Fluid and electrolyte replacement
Lifelong steroids
Psych counselling

238
Q

Cause of Rickets

A

Lack of Vit D, Ca, or PO4

239
Q

When are children at highest risk of rickets

A

6-24mos

240
Q

3 main etiologies of rickets

A

Vit D def
Vit D dependent
X-linked hyperphosphatemic

241
Q

What causes Vit D def rickets

A

Lack of Vit D in diet

242
Q

What causes Vit D dependent rickets

A

Inability to convert 25-OH to 1,25-OH

Child dependent on Vit D supplementation

243
Q

What causes X-linked hyperphosphatemic rickets

A

Innate kidney defect

Inability to retain phosphate

244
Q

Presentation of rickets

A

Ulnar/radial bowing

Waddling gait

245
Q

Risk factors for rickets

A

Sunless environment

Doesn’t drink milk

246
Q

CXR finding in rickets

A 
Rachitic rosary 
(costochondral joints w/ cupping and fraying or epiphyses)
247
Q

Rx rickets

A

Ergocalciferol
Calcitrol
Annual VIt D monitoring

248
Q

Who gets vit D supplementation

A

All infants exclusively breastfed starting at 2mos

249
Q

Child with febrile seizure, what is next step

A

Evaluate for underlying sepsis

250
Q

What is a full sepsis evaluation in children

A 
CBC + diff
UCx
U/A
CXR
LP
251
Q

MCC neonatal sepsis

A

PN

Meningitis

252
Q

MC organisms in neonatal sepsis

A

GBS #1
E. coli
S. aureus
L. monocytogenes

253
Q

Dx tests in neonatal sepsis

A

Blood and urine Cx

CXR

254
Q

Rx neonatal sepsis

A

Amicillin and gentamicin

255
Q

What are TORCH infections

A 
Toxo
Other infections (syphilis)
Rubella
CMB
HSV
256
Q

Presentation of neonatal toxo

A

Chorioretinitis

Multiple ring enhancing lesions on CT

257
Q

Best initial test for neonatal toxo

A

Elevated IgM

258
Q

Most accurate test for neonatal toxo

A

PCR

259
Q

Rx neonatal toxo

A

Pyrimethamine and sulfadiazine

260
Q

Presentation of neonatal syphilis

A

Rash on palms and soles, snuffles, frontal bossing

Hutchinson 8th nerve palsy and saddle nose

261
Q

Best initial test for neonatal syphilis

A

VDRL or RPR

262
Q

Most accurate test for neonatal syphilis

A

FTA ABS or dark field

263
Q

Rx neonatal syphilis

A

PCN

264
Q

Presentation of neonatal rubella

A

PDA, VSD, ASD
Cataracts, deafness, hepatosplenomegaly
Thrombocytopenia
Blueberry muffin rash and hyperbilirubinemia

265
Q

Diagnosis of neonatal rubella

A

Maternal IgM

266
Q

Rx neonatal rubella

A

Supportive

267
Q

Presentation neonatal CMV

A

Periventricular calcifications
Microencephaly, chorioretinitis
Hearing loss, petechiae

268
Q

Best initial test for neonatal CMV

A

Urine or saliva viral titres

269
Q

Most accurate test for neonatal CMV

A

Urine or saliva for PCR for viral DNA

270
Q

Rx neonatal CMV

A

Ganciclovir if end organ damage

271
Q

Presentation of neonatal herpes

A

Week 1: Shock and DIC
Week 2: Vesicular skin lesions
Week 3: Encephalitis

272
Q

Best initial test for neonatal herpes

A

Tzank

273
Q

Most accurate test for neonatal herpes

A

PCR

274
Q

Rx neonatal herpes

A

Acyclovir and supportive care

275
Q

Rx for all childhood viral illness

A

Supportive

276
Q

Best initial test for varicella

A

Tzank

277
Q

Most accurate test for varicella

A

Viral Cx

278
Q

Presentation of rubeola (measles)

A

Cough, Coryza, Conjunctivitis

Koplik spots

279
Q

Most accurate test in measles

A

IgM

280
Q

Presentation of 5th disease

A

Fever, URI

Progresses to slapped cheek rash

281
Q

Presentation of roseola

A

Fever and URI

Progresses to diffuse rash

282
Q

Presentation of Mumps

A

Fever precedes parotid gland swelling and possible orchitis

283
Q

Cause of scarlet fever

A

Strep pyogenes

284
Q

Presentation of scarlet fever

A

Fever, Pharyngitis, Diffuse sandpaper rash, Strawberry tongue, Cervical lymphadenopathy

285
Q

Correlation w/ clinical dx of scarlet fever

A

Elevated antistreptolysin O titre, ESR, CRP

286
Q

Rx scarlet fever

A

PCN
Azithromycin
Cephalosporins

287
Q

MCC croup

A

Parainfluenzae 1 and 2

RSV is #2

288
Q

Most important step in child w/ severe croup

A

Racemic epi

289
Q

Presentation of croup

A

Barking cough
Coryza
Inspiratory stridor

290
Q

XR signs of croup (rarely done)

A

Steeple sign

Narrowing of air column in trachea

291
Q

How to differentiate croup from epiglottitis

A

Croup presents w/ hypoxia

292
Q

Rx croup

A

Mild - steroids

Moderate/severe - racemic epi

293
Q

Signs of epiglottitis, next best step

A

Intubate immediately

294
Q

Cause of epiglottitis

A

H. influenzae type B

295
Q

Presentation of epiglottitis

A 
Unvaccinated
Hot potato voice
Fever
Drooling in tripod position
Refuse to lie flat
Hot cherry red epiglottis
296
Q

Classic XR sign in epiglottitis

A

Thumbprint sign

297
Q

Rx epiglottitis

A

Intubate in OR
Ceftriaxone for 7-10 days
Rifampin for all close contacts

298
Q

Cause of whooping cough

A

Bordetella pertussis

299
Q

Catarrhal stage in whooping cough

A

Severe congestion and rhinorrhea

14 days

300
Q

Paroxysmal stage in whooping cough

A

Severe coughing episodes with extra gasp for air followed by vomitting
14-30 days

301
Q

Convalescent stage in whooping cough

A

Decreased frequency of coughing

14 days

302
Q

Clinical Dx of whooping cough

A

Whooping inspiration
Vomitting
Burst blood vessels in eye

303
Q

CXR in whooping cough

A

Butterfly pattern

304
Q

Most accurate test for whooping cough

A

PCR of nasal secretions

Pertussis toxin ELISA

305
Q

Rx whooping cough

A

Erythromycin or azithromycin for catarrhal
Isolate child and macrolides for close contacts
DTaP vaccine

306
Q

Bronchitis features

A

Bacterial/viral inflammation of airways
Productive cough for 7-10 days w/ fever
Clinical Dx
Supportive care

307
Q

Pharyngitis features

A

Group A hemolytic strep pharynx inflammation
Cervical adenopathy, petechiae, fever > 104, acute rheumatic fever, glomerulonephritis
Rapid DNAse test
PCN 10 days or macrolide if allergy

308
Q

Diphtheria features

A

Membranous pharynx inflammation by corynebacterium diphtheriae
Gray vascular pseudomembranous plaques
Cx superficial membrane
Antitoxin as Rx

309
Q

Scrape diphtheria pseudomembranes

A

No

310
Q

Dx congenital hip dysplasia

A

Ortolani and Barlow maneuver

Click or clunk in the hip

311
Q

Rx congenital hip dysplasia

A

Pavlik harness

312
Q

Presentation of legg-calve-perthes

A

Painful limp

313
Q

Dx legg-calve-perthes

A

Joint effusions and widening on XR

314
Q

Rx legg-calve-perthes

A

Rest and NSAIDs

Surgery on both hips

315
Q

Findings in Vit A deficiency

A

Poor night vision

Hypoparathyroidism

316
Q

When does SCFE present

A

Adolescence, esp obese

317
Q

Presentation of SCFE

A

Painful limp

Externally rotated leg

318
Q

Dx SCFE

A

Widened joint space on XR

319
Q

Rx SCFE

A

Internal fixation and pinning

320
Q

Findings in Vit A tox

A

Pseudotumor cerebri

Hyperparathyroidism

321
Q

Which vitamins have no toxicity

A

All B vitamins

Vit C

322
Q

Findings in Vit B1 def

A

Beriberi

Wernicke

323
Q

Findings in Vit B2 def

A

Angular chelosis
Stomatitis
Glossitis

324
Q

Findings in Vit B3 def

A

Pellagra

  • Diarrhea
  • Dermatitis
  • Dementia
  • Death
325
Q

Findings in Vit B5 def

A

Burning feet syndrome

326
Q

Findings in Vit B6 def

A

Peripheral neuropathy

Give w/ INH

327
Q

Findings in Vit B9 def

A

Megaloblastic anemia

Hypersegmented neutrophils

328
Q

Findings in Vit B12 def

A

Megaloblastic anemia
Hypersegmented neutrophils
Peripheral neuropathy

329
Q

Findings in Vit C def

A

Scurvy

330
Q

Findings in Vit D def

A

Rickets

331
Q

Findings in Vit K def

A

Increased PT/INR
Signs and sx of mild to severe bleeding
Analogous to warfarin therapy

332
Q

Findings in Vit D tox

A

Hypercalemia
Polyuria
Polydipsia

Step 2 CK (21 decks)

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