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Flashcards in BRS - Peds Deck (90)
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31

What lab abnormality will be found in patients with Grave's disease? What are young girls with this condition at risk of?

- High T3/T4
-High thyroid stimulating immunoglobulins (cause of thyrotoxic state)
-Delayed menarche

32

What growth deficiencies present with bone age less than expected for chronological age?

GH deficiency, constitutional growth delay, hypothyroidism and hypercortisolism

33

What growth deficiencies would present with bone age same as chronologic age?

-Genetic short stature, skeletal dysplasias, intrauterine growth retardation and Turner syndrome

34

What is the presentation of McCune-Albright Syndrome and what type of mal-development may occur with this?

- bony changes (polyostotic fibrous dysplasia), skin findings (coast of Maine cafe au lait spots) and endocrinopathies (Peripheral precocious puberty or hypertyroidism)

35

What features should make one suspicious of congenital hypopituitarism?

Any newborn with midline defect (e.g. cleft palate), hypoglycemia and microphallus

36

What should be considered in newborns with hypoglycemia for >4 days?

Hyperinsulinemia (nesidioblastosis - beta cell hyperplasia) and Beckwith-Wiedmann syndrome

37

What are the signs of Beckwith-Wiedmann syndrome?

LGA w/ visceromegaly, hemihypertrophy, macroglossia, umbilical hernias, distinctive ear creases

38

What is the management for fever (>38C) in an infant younger than 28 days?

Very serious - complete w/u for SBI (blood, urine, csf) empiric IV abx and hospitalization

39

What may result if a child with mono is given amoxcillin?

Diffuse pruritic rash

40

What is the initial management for presumed bacterial meningitis?

Third generation cephalosporin + Vancomycin (until sensitivities are available)

41

What may be the presentation of a child with Giardia lamblia infection?

Bulky, foul-smelling stools, weight loss, and day care attendance

42

What is the most common complication of measles and cause of mortality?

Bacterial PNA

43

When is a tubuerculin skin test positive in the pediatric population? What test(s) should be done?

Patient younger than 4 or if living in area endemic for TB

Get CXR and if + get gastric aspirates

44

What may be the cause of a 3 yo boy presenting with acute onset high fevers, bloody diarrhea and generalized tonic clonic seizures and why?

Shigella sonnei, caused by release of neurotoxin

45

What may be the presentation of staphylococcal scalded skin syndrome?

Infant/child with fever, erythematous tender skin rash, widespread bullae with a positive Nikolsky sign

46

What may be the presentation of staphylococcal scalded skin syndrome?

Infant boy with fever, erythematous tender skin rash, widespread bullae with a positive Nikolsky sign

47

What is another name for erythroblastosis fatalis and what is the cause?

Alloimmune hemolytic disease - mismatch between fetal/maternal blood types (Coombs+ and hyperBR)

48

How can malformation and midgut volvulus be diagnosed?

Upper GI series ":
1. If ligament of treitz on R side of abd think malrotation
2. If corkscrew pattern think volvulus

49

How can you beat distinguish impetigo from HSV infection?

Impetigo will spread across the face while HSV is usually informed to orolabial region

50

What are the clinical features of prader Willi syndrome? What is it caused by?

-hypotonia and poor suck as infant
-hyperphagia, obesity and short stature
-hypogonadism and dysmorphic face
-intellectual disability
Deletion of paternal 15q11

51

What does brief LoC, HA and vomiting following a fall most suggest? What should be done?

Mild TBI or concussion

Get non con CT or monitor for 4-6 hrs in ED

52

What is indication for brain MRI in girls with late onset of absent puberty?

Hx of HA or visual disturbance

If normal uterus and FSH levels are low

53

What is the cause of edema in babies with Turner syndrome?

Congenital lymphedema from abnormal development of lymphatic structures

54

What should be done for an immunocompetent child that has been exposed to chickenpox and is currently asymptomatic? Immunocompromised?

- administer VZV vaccine
- administer VZIG

55

How can HUS be distinguished from henoch-schonlein purpura?

HUS - has low platelets and Hx of bloody diarrhea
HSP - has joint pain, purpura on buttocks

56

What puts kids with congenital heart diseases at increased risk for systemic infections like brain abscess?

Presence of VSD, which may bypass pulmonary circulation where bacteria would normally be phagocytosed and removed

57

which congenital heart disease presents with a snow man appearance on CXR?

TAPVR

58

what is a likely cause of pericarditis post cardiac surgery? what findings are present?

postpericardiotomy

friction rub and pulsus paradoxus

59

what is the most likely exam finding for a small VSD? what is the prognosis?

loud murmur, will resolve on its own

60

when is the onset of CHF in newborns with critical severe AS?

very fast, within first 24hrs