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Flashcards in Deck 2 Deck (48):
1

Kawasaki disease

multisystem vasculitis of medium vessels

fever, bilateral nonexudative conjunctivitis, mucous membrane chagnes (injected pharynx, cracked lips, strawberry tongue), extremity changes (edema, desquamation, erythema, rash)

2

Osteoid osteoma

affects lower extremities and spine, age 5-24

pain worse at night, relieved by aspirin

can cause leg lenth discrepancy

radiographs usually show a sclerotic leasionand sometimes a loclized lytic defect or nidus within the sclerotic bone

surgical excision

3

what to do when a kid doesn't grow

blood test for IGF-1 and IGF-binding protein

if low, then definitive IV arginine-growth hormone stim test

4

what to do with congenital diaphragmatic hernia

nasogastric suction (bowel decompression)
immediate intubation

5

Jones Criteria for dx of acute rheumatic fever

carditis
migratory polyarthritis
erythema marginatum (serpiginous macular lesions with pale centers)
subcutaneous nodules
chorea

any 2 of those plus micro/ sero evidence of recent group A strep infection (elevated anti DNase B titer, e.g.)

6

what to do with acetominophen overdose

activated charcoal
at least 4 hours after ingestion measure plasma levels to see if N-acetylcysteine should be given (serum concentration over 10 mcg/mL)

7

CHARGE syndrome

colobomas
heart defects
atresial choanae
retardation
genitourinary abnormalities
ear anomalies/ deafness

8

WAGR

Willms tumor
aniridia
genitourinary anormalities
retardation

deletion of chromosome 11

9

hemarthrosis and elevated PTT. What's the nexxt study?

plasma mixing study
with hemophilia PTT will normalize
with antibodies it will not

10

how to confirm di George?

Polymerase chane reaction based genotyping

11

when a premature infant develops obstructive hydrocephalus, think

germinal matrix hemorrhage

12

adrenoleukodystrophy

x-linked, inflammatory, demyelinating disease
mutation--> prevent transport of very long chain fatty acids into peroxisome--> no beta oxidation
accumulation in neurons and adrenal cortex

Boys 5-15- neurologic deficits
half also primary adrenal insufficiency before neuro symptoms

13

most life threatening OD in next 24 hours if already intubated?
benzos
diphenhydramine
ethanol
olanzapine
opiates

diphenhydramine --> tachycardia and seizures
also sodium channel lockage

Red as a beet, dry as a bone, hot as a hare, blind as a bat, (mydriasis), mad as a hatter, full as a flask


the other stuff causes respiratory depression but when already intubated not a problem

14

HUS

classically associated with a prodrome of diarrhea followed by:

thrombocytopenia
microangiopahic hemolytic anemia (weakness, decreased Hb, elevated LDH)
acute renal failure: oliguria and BUN/creatinine under 15:1

15

what to do with ingestion of caustic material

flexible esophagoscopy
most common problem: esophageal stricture

chest x-ray to rule out perforation and mediastinitis

give IV hydration, analgesics, abx

16

pregnancy after congenital adrenal hyperplasia baby

give dexamethasone to mom no later than 6th week of pregnancy, then chorionic villus sampling between 10 and 12 weeks

17

what to do with undescended testicle

locate by surgery at 4 months
attempt orchiopexy no later than 9-15 months

18

what to do for SVT in baby

give adenosine IV

if hemodynamically stable you can try a vagal maneuver like ice bag over face

19

eczema herpeticumm

= Kaposi varicelliform eruption

commonly caused by hHSV-1
typically in kids with parent with recurrent herpes labialis

solitary vesicles and punched out ulcurations

20

most common cause of pneumonia in kids over 5

mycoplasma

treat with azithromycin

21

S3

is very common in kids and young adu

if asymptomatic no further workup

22

preseptal cellulitis

painful eyelid swelling
erythema
break in the periorbital skin (abrasion, insect bite) allowing staph or strep into the preseptal space

23

Di George

Conotruncal Cardiac
Abnormal Faces
Thymic aplasia
Cleft palat
Hypercalcemia

24

Celiac Disease

dermatitis herpetiformis- vesicular on extensor surfaces

iron deficiency anemia

25

NFM I

Cafe au lait
neurofibromas
Lisch nodules

26

anorexia + nasogastric -->

insulin --> detrioration

27

iron poisoning

ab pain
vomiting
diarrhea
hypotensive shock
metabolic acidosis

within 2 days hepatic necrosis
within 2-8 weeks: pyloric stenosis

anion gap metabolic acidosis
Radiopaque pills

Treat: whole bowel irrigation, deferoxamine, supportive care fo rABCs

28

taking ampicillin or amoxicillin in the setting of infectious mononucleosis

causes a diffuse maculopapular rash

29

most common cause of Ebstein anomaly

(atrialization of right ventricle --> SVT)
Wolf Parkinson White

30

most common causes of newborn cataracts

galactosemia and congenital rubella syndrome

31

bacterial meningitis in kids by age

1-2 months Group B strep (agalactiae) and gram neg bacilli, Strep pneumo

3 mos = 3 years: Strep pneumo, N. meningitidis, S agalactiae

3-10 S pneumo and N meningitidis

10-19 years N. meningitidis

32

Transient tachypnea of the newborn

retained lung fluid
more common in c section

CXR shows increased lung expansion with air trapping, insterstitial fluid and fluid in the fissures

33

autopsy finding supporting SIDS

diffuse intrathoracic petechiae

34

most common cause of HTN in kids

renal disease

35

what does hypoplastic left heart syndrome sound like?

precordial hyperactivity
loud second heart sound
weak pulse

36

most likely complication of mumps in kids

meningoencephalomyelitis

orchitis-- in men

37

afebrile baby with staccato cough

chlamydia pneumonia

38

rx for staph scalded skin

parenteral penicillinase-resistant abx (nafcillin or oxacillin)

supportive skin measures

39

opiates in pregnancy-->

high-pitched cry
fist-sucking
increased wakefulness
autonomic symptoms (fever)
termors, myoclonic jerks
irritability
poor feeding, weight loss, vomiting, diarrhea

= neonatal abstinence syndrome

40

treat pertussis

trimeth- sulfameth

41

most common cardiac abnormality in infants of diabetic mothers

asymmetric septal ypertrophy

will resolve in time

42

Henoch Schoenlein purpura

most common vasculitis and cause of non-thrombocytopenic purpura in kids in the US

IgA deposition in small vessels of the skin, joints, intestines, glomeruli (viral illness before)

intestinal vasculitis, usually also renal involvement

microscopic hematuria

43

treatment of tinea capitis

oral griseofulvin

44

Juvie RA what test need to do?

slit lamp for anterior uveitis

45

what to do for 2-month old with large PDA still?

transcatherter closure of lesion in the catheterization lab

46

if suspicion of testicular torsion or traumatic hemorrhage into a hydrocele or testes, eeven if clinically unlikely due to the absence of pain and a positive transilumination test

perform a doppler ultrasound to exclude the acute scrotal conditions

47

RX for pinworm

mebendazole or albendazole

48

when lyme suspected but no bulls eye rash seen or described

ELISA serologic testing followed by western blot