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Case Files 4 Flashcards

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1
Q

Why are pts with retropharyngeal abscess usually 4 or younger

A

When retropharyngeal lymph nodes are present, after they atrophy

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2
Q

Most common type of abscess in per population

A

Peritoneal lar

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3
Q

Imaging for pt with suspected neck abscess

A

Lateral cervical x-Ray

Look for widening of retropharyngeal space

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4
Q

Thyroglobulin duct cyst features

A

Midline, move with tongue protrusion, and often noted after URI

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5
Q

Tooth abscess bacteria

A

S mutants, fusobacterium nucleatum

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6
Q

Unique complication for retropharyngeal abscess

A

Mediastinitis from lymphatic spread

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7
Q

What is trismus

A

Inability to open the mouth secondary to pain of inflammation or mass effect involving facial neuromusculature

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8
Q

2 complications of SCFE

A

Osteonecrosis and chondrolysis

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9
Q

DDH risk facors

A

Breech presentation, oligohydramnios, and large for gestational age infants

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10
Q

Work up for suspected septic arthritis

A

CBC, ESR, CRP, and blood culture, as well as joint aspiration and culture

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11
Q

SCFE key physical? first steps in workup

A

Pain during external rotation

Make patient non weight bearing and obtain bilateral hip films (due to high rate of both hip involvement)

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12
Q

What is status migrainosus

A

Migraine lasting more than 72 hours

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13
Q

Pseudotumor cerebri CN palsies

A

III, IV, or VI

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14
Q

First line for abortive therapy for migraines? 2nd line?

A

NSAIDs, then triptans

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15
Q

Most important diagnostic tool for headaches

A

thorough H and P

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16
Q

Good migraine prophylaxis in younger kids

A

Cyproheptadine

Also topiramate, valproic acid, B blockers

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17
Q

Imaging of choice to evaluate 2ndary headaches

A

MRI (unless hemorrhage or fracture suspected)

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18
Q

Most common cause of death from inhalant use

A

Sudden death from dysrhythmias

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19
Q

What is cubitus valgus

A

Physical finding in which the angle between the shaft of the ulna and humerus is increased greater than 15% in females

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20
Q

MCC of turner syndrome

A

Nondisjunction

Majority of 45x sAb in first trimester

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21
Q

Most common heart defect with Down’s

A

Endocardial cushion defects

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22
Q

Baby with webbed neck and edematous feed but not Turners could be

A

Noonan syndrome (seen in both sexes as well)

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23
Q

How many criteria needed to dx lupus

A

4

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24
Q

Drug for children with mild lupus

A

Hydroychloroquine

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25
Lab not to forget in all new lupus workups
UA w/ microscopy
26
Thoracic lupus manifestations
Pleuritis and pericarditis
27
PSGN labs
Low C3 Normal C4 ASO and Anti-DNaseB
28
Do strep Ab help with rheumatic fever or PSGN
Rheumatic fever, not PSGN
29
How to treat PSGN HTN
Calcium channel blockers
30
HSP triad
Purpuric rash, arthritis and abdominal pain
31
IgA nephropathy
Painless hematuria 2 days after URI
32
C3 and C4 in lupus
Both low
33
Crohn's or UC for strictures, fistulas, and abscesses
Crohn (also think skip lesions)
34
Most common site for Crohn's
Terminal ileum
35
Biliary dz associated with UC
Primary sclerosing cholangitis
36
X-ray "lead pipe" appearance seen in
UC
37
Unique Crohn's Ab
anti-Saccharomyces cervisisea ab | *pANCA more common in UC*
38
Most significant complication of UC
Toxic megacolon
39
Celiac disease dx requires what
biopsy of the distal duodenum
40
2 most common causes of rectal bleeding in the infant period
Milk protein allergy and anal fissure
41
What is the psoas sign? obturator? rovsing?
Psoas: passive right hip extension pain Obturator: passive internal rotation of right thigh painful Rovsing: palpation of LLQ causes pain in RLQ
42
Best method to check for rebound tenderness?
Gentle finger percussion to check for peritoneal irritations
43
Why is UA important in suspected appendicitis
To check for glucose and large ketones | Or pyuria w/ nitrites and bacteria
44
EBV structure? What does it infect
dsDNA herpes virus --> infections human oropharyngeal and salivary tissues and B lymphocytes
45
Mono big triad
Fever, posterior cervical adenopathy, and sore throat
46
How old for mono spot to be reliable
5+ years
47
Ab that form only as EBV establishes latency
IgG Ab to EBV nuclear antigen
48
LFTs and platelets in mono
LFTs mildly elevated but jaundice is uncommon | Mild thrombocytopenia but bleeding uncommon
49
When to use steroids in mono
Only when tonsillar hypertrophy threatens airway
50
Electrolyte that is low in rhabdomyolysis
Hypocalcemia
51
Most common cause of AUB in young ones? Key feature of AUB?
Immaturity of HPA, specifically LH surge causing anovulation Key feature is that it's painless
52
Papule vs nodule
Papule's are inflamed bumps under skin | Nodules are papules > 5mm deep
53
two first line acne meds
Topical benzoyl peroxide or topical retinoid (at night)
54
What is adapalene
Retinoid formulation that causes less irritation and photosensitivity and has more activity
55
Odd accutane effects
Blood dycrasias, hyperlipidemia, elevated liver enzymes, conjunctivitis
56
Acne in a farm worker likely
Tina barbae, tx w/ anti fungal
57
What do you recommend in teenager on BC and tetracycline
secondary form of BC (ab may reduce effectiveness)
58
3 big features of ADHD
Inattention, hyperactivity, and impusitivity
59
ADHD caveats
Several features before 12 Symptoms present in 2 or more settings (school, home) Interferes with functioning
60
What do you do for kid who's mom says he "daydreams a lot"
EEG, worry about absence seizures
61
When to start return to play protocol for concussions
After 24 hours asymptomatic (without use of meds)
62
How long do most concussions take to resolve
7-10 days

Pediatrics (14 decks)

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