Cardiology-Table 1 Flashcards
(486 cards)
1
Q
Most common endocrine/metabolic disorder of childhood
A
Type 1 DM
2
Q
(adenoma/destructive lesions) are the more common cause of hypopituitarism
A
Destructive Lesions of the hypothalamus
3
Q
Polyuria, polydipsia, and polyphagia are common S&S of
A
Type 1 DM
4
Q
Acanthosis Nigricans is a S&S of
A
Type 2 DM
5
Q
____have been shown to reverse/delay kidney damage when detected early
A
ACE inhibitors
6
Q
___ is a complication of DKA that results from an osmolar shift of fluid into cells
A
Cerebral edema
7
Q
Diagnostic tests for DKA
A
Blood gasses, CBC, BMP, A1C, UA, Ucx
8
Q
DKA treatments include:
A
Restore fluid volume
Insulin
Replace body salts
Correction of acidosis
9
Q
Emergency management of hypoglycemia includes
A
IV glucose
Bolus D10W
Then Constant Infusion
10
Q
The most common presenting complaint in pediatric endocrinologist
A
Growth disturbances (GH deficiency)
11
Q
Workup for a GH deficiency includes:
A
X ray electrolytes
CBC karyotype
ESR thyroid fxn
Urinalysis, BUN/Cr
12
Q
____ is the most common neonatal metabolic disorder
A
Congenital hypothyroidism
13
Q
____ is the most common cause of goiter and thyroiditis in childhood
A
Hashimoto’s Thyroiditis
14
Q
Hypothyroidism has increased incidence in these 2 chromosomal disorders
A
Trisomy 21
Turner’s syndrome
15
Q
Your patient presents with mental sluggishness, pale skin, non-pitting edema, hoarse voice, and dry skin. You suspect:
A
Hypothyroidism
16
Q
The most common cause of excess thyroid hormone
A
Graves disease
17
Q
Treatment for hyperthyroidism includes
A
B blockers
PTU, methimazole
18
Q
CNS tumors and familial factors are causes of ____ precocious puberty.
A
Central
19
Q
Treatment of central precocious puberty includes
A
Leuprolide (GnRH analog)
20
Q
Most common cause of delayed puberty in boys
A
Kleinfelter syndrome
21
Q
What is the most common cause of female pseudohermaphrodite
A
CAH (Congenital adrenal hyperplasia)
22
Q
___ is the most frequent cause of ambiguous genitalia in the newborn
A
CAH
23
Q
What is the most common cause of CAH?
A
Deficiency of 21-hydroxylase
24
Q
____ help maintain BP by supporting vascular tone and promoting Na and H2O retention
A
Glucocorticoids
25
Most common cause of cushing’s in children
Prolonged administration of exogenous glucocorticoids
26
Poor feeding w/ lethargy in an infant could be a sign of
Cardiac disease or Infection
27
Chest X-rays are good for visualizing these heart characteristics:
Cardiomegaly
Pulmonary circulation
Heart shape
28
The size, shape, flow within, and pressures within the heart can be visualized with ____
ECHO
29
Later stage Heart failure can present with _____ on abdominal exam
Hepatomegaly
30
____ in the fingers is a response to hypoxia
Clubbing
31
Differential pulses could be a sign of ____
Coarctation of the Aorta
32
Bounding pulses could be due to L PDA shunt , or ___
Aortic Insufficiency
33
___ is the heart sound associated with the closing of aortic and pulmonic valves
S2
34
___ is the heart sound associated with closing of mitral and tricuspid valves
S1
35
S1 is best heard at
LLSB or apex
36
___ is heard in diastole & is related to rapid ventricular filling (splash)
S3
37
____ is never normal. Comes just before S1. Pathognomonic with heart failure and decreased ventricular compliance.
S4
38
Aortic or pulmonary stenosis present with this heart sound:
Ejection click
39
Mid-systolic clicks are usually due to
Mitral valve prolapse
40
Loud S2 can be due to
Pulmonary HTN
41
A fixed, split S2 could be due to pulmonary stenosis or ____
ASD
42
Truncus is associated with which heart valves?
Semilunar (only 1)
43
Murmurs are described based on:
Location/radiation
Relationship to cardiac cycle
Intensity
Quality
44
6 most common functional murmurs
```
Newborn
Peripheral pulmonary arterial stenosis (PPS)
Still murmur
Pulmonary Ejection Murmur
Venous Hum
Innominate or carotid Bruit
```
45
Most common murmur of early childhood
Still murmur
46
Most common innocent murmur in older children
Pulmonary ejection murmur
47
Most common CHD presenting in the first week of life
Transposition of Great Arteries
48
Most common CHD presenting beyond infancy
| Most common cyanotic lesion in childhood
Tetralogy of Fallot
49
How do you know if a murmur is benign?
If they have other sx not benign
| Kid OK? benign
50
Which murmur is best heard sitting at the R infraclavicular area?
Venous hum
51
Most causes of syncope in kids is due to this type of cause
Vasovagal or
| Neurocardiogenic
52
Cardiac causes of syncope in kids includes:
Arrhythmia or Congenital Heart Disease
53
____ are a benign rhythm disturbance where there is a compensatory pause before the next beat
PAC
| Premature Atrial Contract.
54
PVC’s have a wide________ and NO compensatory pause
Wide QRS
55
3 PVCs in a row is considered ______
V-tach
56
Re-entrant tachycardia is characteristic of this syndrome caused by supraventricular tachycardia
Wolff-Parkinson-White syndrome
57
Acute treatment for SVT includes IV _____
Adenosine
58
In babies, Ice on the face causes vagal stimulation for treatment of _______
SVT
59
Maternal lupus can lead to ____
Congenital heart block
60
Most common heart block in peds
3rd degree
61
Heart disease in peds is primarily due to _______ abnormalities
Structural
62
____ is the most common CHD presenting in the 1st week of life
Transposition of Great Arteries
63
3 shunts necessary for survival in baby:
Ductous venosus
Foramen ovale
Ductus arteriosus
64
Cyanotic shunts are ___ _____ and the blood bypasses the lungs
R L
65
Most common L R shunt
VSD
66
ASD, VSD, PDA, and blood flow obstructions all cause _____-_____ shunts
L R
67
ASD can cause _____heart enlargement
Right
68
Which heart condition is Pathognomonic with fixed split S2
ASD
69
Most common type of VSD
Peri-membranous
70
Over time, the _____ becomes enlarged in a VSD
Left Ventricle
71
_____ have a harsh holosystolic murmur
VSD
72
______ is an endocardial cushion defect
AVSD
73
AVSD is associated with this genetic condition
Trisomy 21
74
PDA murmurs are holosystolic and ________-like
Machine like
75
_____ is generally not progressive, and may result in decreased blood flow to the lungs depending on size
Pulmonary Stenosis
76
____ is an obstruction of LV output and may occur above or below the valve
Aortic Stenosis
77
___ is usually the first sign of aortic stenosis
Heart murmur
| ejection click, basilar ejection murmur, precordial thrill
78
In older kids, Dizziness and fainting at a low threshold may suggest:
AS (aortic stenosis)
79
CoA (coarctation of the aorta) is commonly associated with this other structural abnormality:
Bicuspid aortic valve
80
CoA presents with a _______ systolic murmur heard best at the ____ axilla
“blowing” Left
81
___ presents with HTN, weak femoral pulses, leg cramps, HA, epistaxis
CoA in older children
82
In a __ ___ shunt, blue blood bypasses the lungs
R L
83
_____ can result in extreme pulmonary overcirculation
Truncus Arteriosis
84
4 components of Tetralogy of Fallot
Pulmonary Stenosis
Displaced aorta
VSD
RV hypertrophy
85
Your 1 week old pt presents with cyanosis, a systolic ejection murmur heard at the LSB, and hypoxemic spells. You suspect:
Tetralogy of Fallot
86
_________ are the hallmark of severe tetralogy, where the child exhibits blue skin during episodes of crying or feeding
Hypoxemic spells
87
A child with Tet of Fallot might do this when they feel a tet spell coming on
Squat
88
Your patient presents with varying degrees of cyanosis, no murmur, tachypnea, and a normal ECG. What do you suspect?
Transposition of the Great Arteries (TGA)
89
___ is an embryologic problem where the LV and aora/arch are misformed
Hypoplastic Left Heart
90
Which type of cardiomyopathy is associated with a prolonged QT interval
Hypertrophic
91
Most common type of cardiomyopathy in kids
Dilated
92
___ is best test for diagnosing pericarditis
ECHO
93
Polyarthritis, Sydenham’s chorea, and erythema marginatum are all systemic findings in _____
Rheumatic Fever
94
This is now the #1 cause of acquired heart disease in kids
Kawasaki disease
95
Treatment for Kawasaki disease includes
IVIG
| High dose aspirin
96
Cardiomyopathies are more common in
Boys
97
Intestines formed outside the abdominal cavity is called
Gastroschesis
98
Gastroschesis is an _____ problem
Organic
99
An LFT consists of
ALT, AST, Alk Phos
100
Which lab tests are better indicators of liver function?
Coags: PT/PTT/ Fibrinogen
101
Most common abdominal imaging study
Xray
102
Microcolon is best visualized with ____
Barium swallow
103
The pylorus, GB, and appendix are best seen with ____
Ultrasound
104
Chronic abdominal pain in kids is usually ______
Functional
105
In young kids, acute abdominal pain is usually due to
Malrotation
Intussusception
Incarcerated hernia
Congenital abnormalities
106
In older kids, acute abdominal pain us usually due to
Appendicitis
107
Most common cause of vomiting in childhood
Viral gastroenteritis
108
Recurrent Abdominal Pain Syndrome of Childhood is also known as…
IBS
109
Your pt presents with projectile vomiting. Your first suspicion is:
Pyloric stenosis
110
Obstruction is more common, and of much greater concern, in ___
Neonates
111
In older kids, most vomiting is due to ____ illness
Viral
112
Your pt presents with bloody emesis. You should suspect:
Mallory Weiss tear
| gastritis, peptic ulcer
113
Management for acute diarrhea in kids is usually:
Management
| Fluids – oral rehydration
114
What is the effect of starvation on diarrhea in most kids?
Prolongs diarrhea
115
Most common viral cause of diarrhea
Rotavirus
116
Rotavirus immunizations are recommended at __, __, and __ mo
2,4,6
117
Your patient has a high fever accompanying their diarrhea. You suspect it is caused by ______
```
Bacteria
Campylobacter
Salmonella
Shigella
E. coli
C diff
```
118
Chronic constipation is defined as 2 or more of the following for 2 months: (6 criteria)
Could be a “which of the following is NOT…” type of questions…
1. 1 episode encoperesis per week
3. impaction of rectum with stool
4. stool that plugs toilet
5. retentive posturing and fecal withholding
6. pain with defecation
119
Most causes of childhood constipation are ____ in nature
Functional
120
Your patient presents with wt loss, growth failure, and is looking ILL with chronic diarrhea. You suspect an_____ cause
Organic
121
How to treat c. diff in peds
Flagyl
Metronidazole
Vanco ($$)
122
Hypothyroid and Hirschsprung disease are both ___ causes of constipation
Organic
123
___ are most common cause of minor bleeding in kiddos
Anal fissures
| other causes: Mallory-weiss, swallowed nasopharyngeal blood
124
Rectal bleeding in infants is usually due to _____, anal fissures, or a milk protein allergy (or NEC in preemies)
Colitis
125
Rectal bleeding in older kids is usually due to Meckel’s diverticulum or ___
IBD
126
____ is an example of an intraluminal obstruction in a kid with CF
Meconium plug
127
Escalating pain is commonly associated with ____
Ischemia
128
Your newborn pt hasn’t passed a stool in the 1st 24 hours of life. You suspect:
Hirschsprung
129
Where to start a workup for a baby with possible obstruction
X-ray
130
____ is the best position for visualization of free air
LL decubitus Xray
131
Inflammation of the _____ presents as a warm, erythematous belly.
Peritoneum
132
____ in neonates presents as dusky blue/gray belly.
Gut perforation
133
Periumbilical blue discoloration in neonates is known ____ sign
Cullen’s sign
134
Blue discolorations on flank, groin, and scrotum is known as____
Gray-Turners sign
135
What is the key for evaluating acidosis?
Bicarb
136
____ is characterized by effortless non-projectile vomiting
Reflux
137
Reflux is usually due to a ____ problem in babies
Neuromuscular
138
T/F a negative barium swallow study can rule out GER
False. Cannot fully R/o
139
Metoclopramide (reglan) can lead to
Tardive Dyskinesia
140
Sx of _____ include copious oral secretions, choking, and aspiration
Esophageal atresia
141
Test for suspected TEF
Cannot pass NG tube
142
TEFs are associated with other ___________ anomalies
VACTERL
143
____ anomalies are the most common association with TEF
Vertebral
144
More (girls/boys) typically have umbilical hernias
Girls
145
More (girls/boys) typically have Inguinal hernias
Boys
146
You have a 4 wk old pt with cc of vomiting after feeding. Active bowel sounds w/ projectile vomiting. Afebrile w/ normal vitals. You suspect:
Pyloric stenosis
147
Test for suspected pyloric stenosis
Ultrasound
148
______ in a neonatal period has been associated with pyloric stenosis
Erythromycin
149
Palpable “olive” in epigastric region is a sign of:
Pyloric Stenosis
150
US of pyloric stenosis shows muscle thickening of ______
>4mm
151
___ is the most common site of atresia and stenosis
Jejunum
152
PUD is more common in _____
boys
153
____ is most definitive test for PUD
UGI
154
H. pylori is (more/less) common in kiddos
LESS
155
_____ obstruction presents sooner with distension and possible emesis
Complete
156
The ____ is the most common site of atresia & stenosis
Jejunum
157
Duodenal atresia is seen on x-ray by the ______ sign
Double bubble
158
Bilious emesis, polyhydramnios, and abdominal distension are sx of ___
Duodenal Atresia
159
Kids with this chromosomal disorder often have duodenal atresia
Down Syndrome
160
Your pt presents looking SICK with a hard, distended belly and bilious vomiting. You suspect:
Malrotation
161
Study of choice for malrotation
Barium study
162
Gastroschisis, omphalocele, and CDH are all _______GI anomalies
Congenital
163
_____ is a herniation through the umbilical cord
Omphalocele
164
Your patient presents with an omphalocele. Your next step should include:
Evaluate for cardiac anomalies
165
80% of patients with congenital diaphragmatic hernias occur on the _____
Left
166
Your patient presents with painless GI bleeding (melena). You suspect
Meckel Diverticulum
167
A patient with meckel diverticulum is at risk for ____ or _____ as well
Intussusception & volvulus
168
Most infants with Hirschsprung’s fail to pass meconium within ____
First 24 hrs of life
169
Lack of gut innervation (ganglion cells) leads to this condition
Hirschsprung
170
Describe stool found in Hirschsprung dz
Foul smelling, ribbon like
171
_____ can result from untreated congenital megacolon
E. coli sepsis
172
Treatment for Hirschsprung disease includes
Diverting colostomy
173
Your 2 yo patient presents with colicky abdominal pain with intermittent fits of crying. Pt draws up legs as if they are bearing down. Pt is afebrile and lethargic. You suspect?
Intussusception
174
Common stool finding of intussusception
Currant jelly stool
175
Treatment for intussusception includes
Contrast enema
176
Pelviectasis may progress to
Hydronephrosis
177
Most common cause of vomiting/diarrhea in kids
Rotavirus
178
Most common cause of acute renal failure in kids
ATN dehydration
179
Most common abdominal mass on newborn exam
Enlarged kidney
180
Your peds patient presents with HTN and edema. What do you suspect?
Renal disease
181
You suspect renal disease in your patient. What other physical findings might increase your suspicion?
Ear deformities
182
What is the most reliable indicator of glomerular function?
SrCr
183
___ is the most common identifiable cause of hematuria in kids
UTI
184
___ is defined as the ratio of urine Cr compared to serum Cr
Creatinine clearance
185
Cr should be less than _____ in most kiddos
186
____ and ____ are most common imaging studies for kidneys
US, VCUG
187
Which commonly used imaging technique DOES have inherent radiation exposure?
VCUG
188
If your pt has hematuria AND dysuria, think:
Infection
189
If your pt has hematuria AND associated back pain, think:
pyelonephritis
190
If your pt has hematuria AND proteinuria, think:
Nephropathy
191
____ is the most common form of glomerulonephritis in childhood
APSG
| acute post-streptococcal glomerulonephrnitis
192
___ is the most common CHRONIC form of GN in children and is typically treated using steroids
Membranoproliferative GN
193
The abnormal immune response of membranoproliferative GN includes these 3 findings:
Proteinuria
Hematuria
Hypocomplementemia
194
Treatment of chronic GN includes
Steroids
195
Bergers Disease is a nephropathy caused by ______ deposition
IgA
196
This autoimmune cause of vasculitis presents with a purpuritic rash
Henoch-Schonlein GN
197
An early sign of glomerular injury is ____
Proteinuria
198
Most mild proteinuria in kids is (normal/abnormal)
Normal
199
____ is most common form of primary nephrotic syndrome
Minimal Change Disease
200
Poor bebe presents with orbital edema. Mom states that he recently had some flu-like symptoms. You suspect:
MCNS (minimal change nephrotic syndrome)
201
____ is produced by E. coli and can cause hemolytic-uremic syndrome
Verotoxin (VT)
202
____ usually follows a GI infection (diarrhea) and causes endothelial damage in glomeruli and interstitial vessel thrombosis
Hemolytic-Uremic Syndrome (HUS)
203
Workup for HUS includes
Blood smear, CBC, Retic count, UA, Stool studies
204
These 2 types of meds should be avoided in pts with suspected HUS
Antibiotics
| Antidiarrheals
205
____ is appropriate treatment for rental failure that does not respond to conventional treatments
Peritoneal dialysis
206
Hypovolemia leads to underperfusion which leads to _____
Acute renal failure
207
Dehydration, hemorrhage, and burns are all ____ causes of acute renal failure
Pre-renal causes
208
Post-renal causes of acute renal failure are typically due to ____
Obstruction
209
____ is characterized by marked bilateral renal enlargement, interstitial tubular atrophy, and renal failure in early childhood
ARPKD
210
_____ is usually associated with cysts in other parts of the body, such as the liver, pancreas, ovaries, and cerebellar arteries.
ADPKD
211
Between ARPKD and ADPKD, which is usually worse?
Recessive is always worse
212
Most common cause of bladder outlet obstruction in males
Posterior urethral valves
213
An obstruction at the uretero-pelvic junction
Hydroneprhosis
214
An obstruction at the uretero-vesical junction
Hydroureter & Hydronephrosis
215
Grades _____ of vesicoureteral reflux typically do not cause damage
I-III
216
Suspected reflux can be confirmed with these imaging studies
Renal US or VCUG
217
When would you do a VCUG on a kiddo?
Chronic UTIs to check for reflux
218
Bilateral renal agenesis is also known as
Potter’s syndrome
219
Prune Belly Syndrome is most often caused by
Posterior urethral valves
220
Malposition of the urethral opening in males is called:
Hypospadias
221
How do you tell a hernia from a hydrocele?
LIGHT!
222
HTN + abdominal bruits + diminished leg pulses =
Coarctation of the Aorta
223
HTN + café au lait spots =
NF
224
HTN + flank mass =
Whilm’s tumor
225
HTN + ataxis/ opsoclonus =
Neuroblastoma
226
HTN + tachycardia + flushing + diaphoresis =
Pheochromocytoma (?)
227
HTN + truncal obesity + acne + striae =
Cushing’s
228
Most common secondary etiology of HTN in childhood is ____
Real
229
Renal stones in kids are usually caused by:
Inborn errors of metabolism
230
Vomiting, fever or hypothermia, poor wt gain, strong urine odor are common S&S of UTI in ________
Neonates
231
Vomiting, abdominal or flank pain, fever, frequency, urgency, dysuria, and enuresis are common S&S of UTI in ______
Children
232
Vomiting, diarrhea, fever, poor wt gain, strong urine odor are common S&S of UTI in ____
Infants
233
Fever, abdominal or flank pain, frequency, urgency, and dysuria are common S&S of UTI in_____
Adolescents
234
Gold standard for UTI diagnosis is
Ucx
235
Tx for complicated UTI involve:
Hospitalization
| IV Amp + Gent
236
Tx for uncomplicated UTI involve:
Cephalosporins
Trimethoprim/sulfa
Augmentin
237
Malposition of the urethral opening in males is referred to as:
Hypospadias
238
Severe hypospadias with undescended testes is a form of:
Ambiguous genitalia
239
Adherance of the foreskin is referred to as ____ and is not necessarily abnormal in babies and should resolve by adolescence.
Phimosis
240
___ is an abnormality of the male genitalia where the structure of the penis is curved
Chordee
241
How should you go about locating undescended testes?
Abdominal US
242
If undescended testes are left intra-abdominally, the patient is at an increased risk of ____ and _____
Infertility
| Cancer
243
Major cause of acute scrotum in boys
Testicular torsion
244
Most common endocrine/metabolic disorder of childhood
Type 1 DM
245
(adenoma/destructive lesions) are the more common cause of hypopituitarism
Destructive Lesions of the hypothalamus
246
Polyuria, polydipsia, and polyphagia are common S&S of
Type 1 DM
247
Acanthosis Nigricans is a S&S of
Type 2 DM
248
____have been shown to reverse/delay kidney damage when detected early
ACE inhibitors
249
___ is a complication of DKA that results from an osmolar shift of fluid into cells
Cerebral edema
250
Diagnostic tests for DKA
Blood gasses, CBC, BMP, A1C, UA, Ucx
251
DKA treatments include:
Restore fluid volume
Insulin
Replace body salts
Correction of acidosis
252
Emergency management of hypoglycemia includes
IV glucose
Bolus D10W
Then Constant Infusion
253
The most common presenting complaint in pediatric endocrinologist
```
Growth disturbances
(GH deficiency)
```
254
Workup for a GH deficiency includes:
X ray electrolytes
CBC karyotype
ESR thyroid fxn
Urinalysis, BUN/Cr
255
____ is the most common neonatal metabolic disorder
Congenital hypothyroidism
256
____ is the most common cause of goiter and thyroiditis in childhood
Hashimoto’s Thyroiditis
257
Hypothyroidism has increased incidence in these 2 chromosomal disorders
Trisomy 21
| Turner’s syndrome
258
Your patient presents with mental sluggishness, pale skin, non-pitting edema, hoarse voice, and dry skin. You suspect:
Hypothyroidism
259
The most common cause of excess thyroid hormone
Graves disease
260
Treatment for hyperthyroidism includes
B blockers
| PTU, methimazole
261
CNS tumors and familial factors are causes of ____ precocious puberty.
Central
262
Treatment of central precocious puberty includes
Leuprolide (GnRH analog)
263
Most common cause of delayed puberty in boys
Kleinfelter syndrome
264
What is the most common cause of female pseudohermaphrodite
CAH (Congenital adrenal hyperplasia)
265
___ is the most frequent cause of ambiguous genitalia in the newborn
CAH
266
What is the most common cause of CAH?
Deficiency of 21-hydroxylase
267
____ help maintain BP by supporting vascular tone and promoting Na and H2O retention
Glucocorticoids
268
Most common cause of cushing’s in children
Prolonged administration of exogenous glucocorticoids
269
Poor feeding w/ lethargy in an infant could be a sign of
Cardiac disease or Infection
270
Chest X-rays are good for visualizing these heart characteristics:
Cardiomegaly
Pulmonary circulation
Heart shape
271
The size, shape, flow within, and pressures within the heart can be visualized with ____
ECHO
272
Later stage Heart failure can present with _____ on abdominal exam
Hepatomegaly
273
____ in the fingers is a response to hypoxia
Clubbing
274
Differential pulses could be a sign of ____
Coarctation of the Aorta
275
Bounding pulses could be due to L PDA shunt , or ___
Aortic Insufficiency
276
___ is the heart sound associated with the closing of aortic and pulmonic valves
S2
277
___ is the heart sound associated with closing of mitral and tricuspid valves
S1
278
S1 is best heard at
LLSB or apex
279
___ is heard in diastole & is related to rapid ventricular filling (splash)
S3
280
____ is never normal. Comes just before S1. Pathognomonic with heart failure and decreased ventricular compliance.
S4
281
Aortic or pulmonary stenosis present with this heart sound:
Ejection click
282
Mid-systolic clicks are usually due to
Mitral valve prolapse
283
Loud S2 can be due to
Pulmonary HTN
284
A fixed, split S2 could be due to pulmonary stenosis or ____
ASD
285
Truncus is associated with which heart valves?
Semilunar (only 1)
286
Murmurs are described based on:
Location/radiation
Relationship to cardiac cycle
Intensity
Quality
287
6 most common functional murmurs
```
Newborn
Peripheral pulmonary arterial stenosis (PPS)
Still murmur
Pulmonary Ejection Murmur
Venous Hum
Innominate or carotid Bruit
```
288
Most common murmur of early childhood
Still murmur
289
Most common innocent murmur in older children
Pulmonary ejection murmur
290
Most common CHD presenting in the first week of life
Transposition of Great Arteries
291
Most common CHD presenting beyond infancy
| Most common cyanotic lesion in childhood
Tetralogy of Fallot
292
How do you know if a murmur is benign?
If they have other sx not benign
| Kid OK? benign
293
Which murmur is best heard sitting at the R infraclavicular area?
Venous hum
294
Most causes of syncope in kids is due to this type of cause
Vasovagal or
| Neurocardiogenic
295
Cardiac causes of syncope in kids includes:
Arrhythmia or Congenital Heart Disease
296
____ are a benign rhythm disturbance where there is a compensatory pause before the next beat
PAC
| Premature Atrial Contract.
297
PVC’s have a wide________ and NO compensatory pause
Wide QRS
298
3 PVCs in a row is considered ______
V-tach
299
Re-entrant tachycardia is characteristic of this syndrome caused by supraventricular tachycardia
Wolff-Parkinson-White syndrome
300
Acute treatment for SVT includes IV _____
Adenosine
301
In babies, Ice on the face causes vagal stimulation for treatment of _______
SVT
302
Maternal lupus can lead to ____
Congenital heart block
303
Most common heart block in peds
3rd degree
304
Heart disease in peds is primarily due to _______ abnormalities
Structural
305
____ is the most common CHD presenting in the 1st week of life
Transposition of Great Arteries
306
3 shunts necessary for survival in baby:
Ductous venosus
Foramen ovale
Ductus arteriosus
307
Cyanotic shunts are ___ _____ and the blood bypasses the lungs
R L
308
Most common L R shunt
VSD
309
ASD, VSD, PDA, and blood flow obstructions all cause _____-_____ shunts
L R
310
ASD can cause _____heart enlargement
Right
311
Which heart condition is Pathognomonic with fixed split S2
ASD
312
Most common type of VSD
Peri-membranous
313
Over time, the _____ becomes enlarged in a VSD
Left Ventricle
314
_____ have a harsh holosystolic murmur
VSD
315
______ is an endocardial cushion defect
AVSD
316
AVSD is associated with this genetic condition
Trisomy 21
317
PDA murmurs are holosystolic and ________-like
Machine like
318
_____ is generally not progressive, and may result in decreased blood flow to the lungs depending on size
Pulmonary Stenosis
319
____ is an obstruction of LV output and may occur above or below the valve
Aortic Stenosis
320
___ is usually the first sign of aortic stenosis
Heart murmur
| ejection click, basilar ejection murmur, precordial thrill
321
In older kids, Dizziness and fainting at a low threshold may suggest:
AS (aortic stenosis)
322
CoA (coarctation of the aorta) is commonly associated with this other structural abnormality:
Bicuspid aortic valve
323
CoA presents with a _______ systolic murmur heard best at the ____ axilla
“blowing” Left
324
___ presents with HTN, weak femoral pulses, leg cramps, HA, epistaxis
CoA in older children
325
In a __ ___ shunt, blue blood bypasses the lungs
R L
326
_____ can result in extreme pulmonary overcirculation
Truncus Arteriosis
327
4 components of Tetralogy of Fallot
Pulmonary Stenosis
Displaced aorta
VSD
RV hypertrophy
328
Your 1 week old pt presents with cyanosis, a systolic ejection murmur heard at the LSB, and hypoxemic spells. You suspect:
Tetralogy of Fallot
329
_________ are the hallmark of severe tetralogy, where the child exhibits blue skin during episodes of crying or feeding
Hypoxemic spells
330
A child with Tet of Fallot might do this when they feel a tet spell coming on
Squat
331
Your patient presents with varying degrees of cyanosis, no murmur, tachypnea, and a normal ECG. What do you suspect?
Transposition of the Great Arteries (TGA)
332
___ is an embryologic problem where the LV and aora/arch are misformed
Hypoplastic Left Heart
333
Which type of cardiomyopathy is associated with a prolonged QT interval
Hypertrophic
334
Most common type of cardiomyopathy in kids
Dilated
335
___ is best test for diagnosing pericarditis
ECHO
336
Polyarthritis, Sydenham’s chorea, and erythema marginatum are all systemic findings in _____
Rheumatic Fever
337
This is now the #1 cause of acquired heart disease in kids
Kawasaki disease
338
Treatment for Kawasaki disease includes
IVIG
| High dose aspirin
339
Cardiomyopathies are more common in
Boys
340
Intestines formed outside the abdominal cavity is called
Gastroschesis
341
Gastroschesis is an _____ problem
Organic
342
An LFT consists of
ALT, AST, Alk Phos
343
Which lab tests are better indicators of liver function?
Coags: PT/PTT/ Fibrinogen
344
Most common abdominal imaging study
Xray
345
Microcolon is best visualized with ____
Barium swallow
346
The pylorus, GB, and appendix are best seen with ____
Ultrasound
347
Chronic abdominal pain in kids is usually ______
Functional
348
In young kids, acute abdominal pain is usually due to
Malrotation
Intussusception
Incarcerated hernia
Congenital abnormalities
349
In older kids, acute abdominal pain us usually due to
Appendicitis
350
Most common cause of vomiting in childhood
Viral gastroenteritis
351
Recurrent Abdominal Pain Syndrome of Childhood is also known as…
IBS
352
Your pt presents with projectile vomiting. Your first suspicion is:
Pyloric stenosis
353
Obstruction is more common, and of much greater concern, in ___
Neonates
354
In older kids, most vomiting is due to ____ illness
Viral
355
Your pt presents with bloody emesis. You should suspect:
Mallory Weiss tear
| gastritis, peptic ulcer
356
Management for acute diarrhea in kids is usually:
Management
| Fluids – oral rehydration
357
What is the effect of starvation on diarrhea in most kids?
Prolongs diarrhea
358
Most common viral cause of diarrhea
Rotavirus
359
Rotavirus immunizations are recommended at __, __, and __ mo
2,4,6
360
Your patient has a high fever accompanying their diarrhea. You suspect it is caused by ______
```
Bacteria
Campylobacter
Salmonella
Shigella
E. coli
C diff
```
361
Chronic constipation is defined as 2 or more of the following for 2 months: (6 criteria)
Could be a “which of the following is NOT…” type of questions…
1. 1 episode encoperesis per week
3. impaction of rectum with stool
4. stool that plugs toilet
5. retentive posturing and fecal withholding
6. pain with defecation
362
Most causes of childhood constipation are ____ in nature
Functional
363
Your patient presents with wt loss, growth failure, and is looking ILL with chronic diarrhea. You suspect an_____ cause
Organic
364
How to treat c. diff in peds
Flagyl
Metronidazole
Vanco ($$)
365
Hypothyroid and Hirschsprung disease are both ___ causes of constipation
Organic
366
___ are most common cause of minor bleeding in kiddos
Anal fissures
| other causes: Mallory-weiss, swallowed nasopharyngeal blood
367
Rectal bleeding in infants is usually due to _____, anal fissures, or a milk protein allergy (or NEC in preemies)
Colitis
368
Rectal bleeding in older kids is usually due to Meckel’s diverticulum or ___
IBD
369
____ is an example of an intraluminal obstruction in a kid with CF
Meconium plug
370
Escalating pain is commonly associated with ____
Ischemia
371
Your newborn pt hasn’t passed a stool in the 1st 24 hours of life. You suspect:
Hirschsprung
372
Where to start a workup for a baby with possible obstruction
X-ray
373
____ is the best position for visualization of free air
LL decubitus Xray
374
Inflammation of the _____ presents as a warm, erythematous belly.
Peritoneum
375
____ in neonates presents as dusky blue/gray belly.
Gut perforation
376
Periumbilical blue discoloration in neonates is known ____ sign
Cullen’s sign
377
Blue discolorations on flank, groin, and scrotum is known as____
Gray-Turners sign
378
What is the key for evaluating acidosis?
Bicarb
379
____ is characterized by effortless non-projectile vomiting
Reflux
380
Reflux is usually due to a ____ problem in babies
Neuromuscular
381
T/F a negative barium swallow study can rule out GER
False. Cannot fully R/o
382
Metoclopramide (reglan) can lead to
Tardive Dyskinesia
383
Sx of _____ include copious oral secretions, choking, and aspiration
Esophageal atresia
384
Test for suspected TEF
Cannot pass NG tube
385
TEFs are associated with other ___________ anomalies
VACTERL
386
____ anomalies are the most common association with TEF
Vertebral
387
More (girls/boys) typically have umbilical hernias
Girls
388
More (girls/boys) typically have Inguinal hernias
Boys
389
You have a 4 wk old pt with cc of vomiting after feeding. Active bowel sounds w/ projectile vomiting. Afebrile w/ normal vitals. You suspect:
Pyloric stenosis
390
Test for suspected pyloric stenosis
Ultrasound
391
______ in a neonatal period has been associated with pyloric stenosis
Erythromycin
392
Palpable “olive” in epigastric region is a sign of:
Pyloric Stenosis
393
US of pyloric stenosis shows muscle thickening of ______
>4mm
394
___ is the most common site of atresia and stenosis
Jejunum
395
PUD is more common in _____
boys
396
____ is most definitive test for PUD
UGI
397
H. pylori is (more/less) common in kiddos
LESS
398
_____ obstruction presents sooner with distension and possible emesis
Complete
399
The ____ is the most common site of atresia & stenosis
Jejunum
400
Duodenal atresia is seen on x-ray by the ______ sign
Double bubble
401
Bilious emesis, polyhydramnios, and abdominal distension are sx of ___
Duodenal Atresia
402
Kids with this chromosomal disorder often have duodenal atresia
Down Syndrome
403
Your pt presents looking SICK with a hard, distended belly and bilious vomiting. You suspect:
Malrotation
404
Study of choice for malrotation
Barium study
405
Gastroschisis, omphalocele, and CDH are all _______GI anomalies
Congenital
406
_____ is a herniation through the umbilical cord
Omphalocele
407
Your patient presents with an omphalocele. Your next step should include:
Evaluate for cardiac anomalies
408
80% of patients with congenital diaphragmatic hernias occur on the _____
Left
409
Your patient presents with painless GI bleeding (melena). You suspect
Meckel Diverticulum
410
A patient with meckel diverticulum is at risk for ____ or _____ as well
Intussusception & volvulus
411
Most infants with Hirschsprung’s fail to pass meconium within ____
First 24 hrs of life
412
Lack of gut innervation (ganglion cells) leads to this condition
Hirschsprung
413
Describe stool found in Hirschsprung dz
Foul smelling, ribbon like
414
_____ can result from untreated congenital megacolon
E. coli sepsis
415
Treatment for Hirschsprung disease includes
Diverting colostomy
416
Your 2 yo patient presents with colicky abdominal pain with intermittent fits of crying. Pt draws up legs as if they are bearing down. Pt is afebrile and lethargic. You suspect?
Intussusception
417
Common stool finding of intussusception
Currant jelly stool
418
Treatment for intussusception includes
Contrast enema
419
Pelviectasis may progress to
Hydronephrosis
420
Most common cause of vomiting/diarrhea in kids
Rotavirus
421
Most common cause of acute renal failure in kids
ATN dehydration
422
Most common abdominal mass on newborn exam
Enlarged kidney
423
Your peds patient presents with HTN and edema. What do you suspect?
Renal disease
424
You suspect renal disease in your patient. What other physical findings might increase your suspicion?
Ear deformities
425
What is the most reliable indicator of glomerular function?
SrCr
426
___ is the most common identifiable cause of hematuria in kids
UTI
427
___ is defined as the ratio of urine Cr compared to serum Cr
Creatinine clearance
428
Cr should be less than _____ in most kiddos
429
____ and ____ are most common imaging studies for kidneys
US, VCUG
430
Which commonly used imaging technique DOES have inherent radiation exposure?
VCUG
431
If your pt has hematuria AND dysuria, think:
Infection
432
If your pt has hematuria AND associated back pain, think:
pyelonephritis
433
If your pt has hematuria AND proteinuria, think:
Nephropathy
434
____ is the most common form of glomerulonephritis in childhood
APSG
| acute post-streptococcal glomerulonephrnitis
435
___ is the most common CHRONIC form of GN in children and is typically treated using steroids
Membranoproliferative GN
436
The abnormal immune response of membranoproliferative GN includes these 3 findings:
Proteinuria
Hematuria
Hypocomplementemia
437
Treatment of chronic GN includes
Steroids
438
Bergers Disease is a nephropathy caused by ______ deposition
IgA
439
This autoimmune cause of vasculitis presents with a purpuritic rash
Henoch-Schonlein GN
440
An early sign of glomerular injury is ____
Proteinuria
441
Most mild proteinuria in kids is (normal/abnormal)
Normal
442
____ is most common form of primary nephrotic syndrome
Minimal Change Disease
443
Poor bebe presents with orbital edema. Mom states that he recently had some flu-like symptoms. You suspect:
MCNS (minimal change nephrotic syndrome)
444
____ is produced by E. coli and can cause hemolytic-uremic syndrome
Verotoxin (VT)
445
____ usually follows a GI infection (diarrhea) and causes endothelial damage in glomeruli and interstitial vessel thrombosis
Hemolytic-Uremic Syndrome (HUS)
446
Workup for HUS includes
Blood smear, CBC, Retic count, UA, Stool studies
447
These 2 types of meds should be avoided in pts with suspected HUS
Antibiotics
| Antidiarrheals
448
____ is appropriate treatment for rental failure that does not respond to conventional treatments
Peritoneal dialysis
449
Hypovolemia leads to underperfusion which leads to _____
Acute renal failure
450
Dehydration, hemorrhage, and burns are all ____ causes of acute renal failure
Pre-renal causes
451
Post-renal causes of acute renal failure are typically due to ____
Obstruction
452
____ is characterized by marked bilateral renal enlargement, interstitial tubular atrophy, and renal failure in early childhood
ARPKD
453
_____ is usually associated with cysts in other parts of the body, such as the liver, pancreas, ovaries, and cerebellar arteries.
ADPKD
454
Between ARPKD and ADPKD, which is usually worse?
Recessive is always worse
455
Most common cause of bladder outlet obstruction in males
Posterior urethral valves
456
An obstruction at the uretero-pelvic junction
Hydroneprhosis
457
An obstruction at the uretero-vesical junction
Hydroureter & Hydronephrosis
458
Grades _____ of vesicoureteral reflux typically do not cause damage
I-III
459
Suspected reflux can be confirmed with these imaging studies
Renal US or VCUG
460
When would you do a VCUG on a kiddo?
Chronic UTIs to check for reflux
461
Bilateral renal agenesis is also known as
Potter’s syndrome
462
Prune Belly Syndrome is most often caused by
Posterior urethral valves
463
Malposition of the urethral opening in males is called:
Hypospadias
464
How do you tell a hernia from a hydrocele?
LIGHT!
465
HTN + abdominal bruits + diminished leg pulses =
Coarctation of the Aorta
466
HTN + café au lait spots =
NF
467
HTN + flank mass =
Whilm’s tumor
468
HTN + ataxis/ opsoclonus =
Neuroblastoma
469
HTN + tachycardia + flushing + diaphoresis =
Pheochromocytoma (?)
470
HTN + truncal obesity + acne + striae =
Cushing’s
471
Most common secondary etiology of HTN in childhood is ____
Real
472
Renal stones in kids are usually caused by:
Inborn errors of metabolism
473
Vomiting, fever or hypothermia, poor wt gain, strong urine odor are common S&S of UTI in ________
Neonates
474
Vomiting, abdominal or flank pain, fever, frequency, urgency, dysuria, and enuresis are common S&S of UTI in ______
Children
475
Vomiting, diarrhea, fever, poor wt gain, strong urine odor are common S&S of UTI in ____
Infants
476
Fever, abdominal or flank pain, frequency, urgency, and dysuria are common S&S of UTI in_____
Adolescents
477
Gold standard for UTI diagnosis is
Ucx
478
Tx for complicated UTI involve:
Hospitalization
| IV Amp + Gent
479
Tx for uncomplicated UTI involve:
Cephalosporins
Trimethoprim/sulfa
Augmentin
480
Malposition of the urethral opening in males is referred to as:
Hypospadias
481
Severe hypospadias with undescended testes is a form of:
Ambiguous genitalia
482
Adherance of the foreskin is referred to as ____ and is not necessarily abnormal in babies and should resolve by adolescence.
Phimosis
483
___ is an abnormality of the male genitalia where the structure of the penis is curved
Chordee
484
How should you go about locating undescended testes?
Abdominal US
485
If undescended testes are left intra-abdominally, the patient is at an increased risk of ____ and _____
Infertility
| Cancer
486
Major cause of acute scrotum in boys
Testicular torsion
