Deck 3 Flashcards

1
Q

how do you dx esophageal atresia

A

you do an xray to show the nasogastric tube coiled up in the blind ending pouch

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2
Q

what murmurs do you hear at the left sternal border

A

HOCM and aortic/pulmonic regurg

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3
Q

where is ASD heard

A

at the left 2nd intercostal space (pulmonic area)

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4
Q

where is VSD heard

A

in the tricuspid area (slightly to the left of sternum)

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5
Q

what is associated with the VACTERL anomalies

A

Vertebral abnormality, Anal imperforation, Cardiac abnormalities, TracheoEsophageal fistula, Radial, Renal and Limb anomalies

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6
Q

diagnostic tests for growth hormone deficiency

A

after ruling out malnuritional causes, you can get ILP-1 levels (end product of GH axis) and bone age scan

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7
Q

is bone age delayed in constitutional growth delay

A

yes

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8
Q

what is pustular melanosis

A

this is where the newborn has a pustular rash that can erupt and then have a macuole underneath. its benign

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9
Q

pustule vs. vesicle

A

pustule has pus in it and vesicle is just fluid

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10
Q

macule vs. papule

A

macule is flat and papule is raised

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11
Q

what is milia

A

this is a benign rash of childhood in which the epidermal pores get filled with keratin

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12
Q

what is congenital dermal melanocytosis

A

these are areas concentrated with melanocytes and look like a bruise, must be documented so child abuse is not suspected later

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13
Q

what is milaria

A

this is like milia but instead is obstruction of sweat glands, fix by removing insult and cooling infant

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14
Q

signs of congenital dacryostenosis in a neonate

A

increased tearing, eyelash crusting, clear conjunctivae

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15
Q

signs of a peritonsillar abcess

A

severe sore throat, fever, muffled voice, dysphagia, drooling

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16
Q

diagnostic criteria of peritonsillar abcess

A

trismus (lock jaw), unilateral swelling, ulvula deviation, fluctuant bulging of soft palate

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17
Q

do you need any imaging for peritonsilar abcess dx

A

nope!

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18
Q

signs of GAD in children

A

excessive worry + >1 of : restlessness, fatigue, difficulty concentrating, irritability, sleep disturbance

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19
Q

treatment of GAD in children

A

SSRIs (sertraline)

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20
Q

what do tet spells do for children (physiology)

A

they increase systemic vascular resistance which decreases the right to left shunt (decreasing cyanosis)

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21
Q

tetrology of fallot anomalies

A

P: pulmonary stenosis // R: RV hypertrophy // O: overriding aorta // V: VSD

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22
Q

can HIV present as meningitis

A

yes!

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23
Q

can anabolic steroid use cause gynecomasstia

A

yes

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24
Q

can gynecomastia be physiologic in boys?

A

yes! especially as they go through puberty (tanner stages 3/4)

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25
Q

what is WAGR syndrome

A

11p deletion: W: wilms tumor // A: aniridia (no iris) // G:genitourinary abnormalities // R: mental retardation (intellectual disability)

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26
Q

can kids have PTSD

A

yes

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27
Q

signs of prader willi

A

hyperphagia/obesity, intellectual disablity, hypotonia, weak suck, hypogonadism, dysmorphic features

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28
Q

most common bacteria that causes bacterial sinusitis

A

nontypable H flu, strep pneumo, moraxella

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29
Q

treatment of clavicle fracture in a neonate

A

reassurance and gentle handling

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30
Q

location of oral lesions in herpangina

A

gray vesicles –> ulcers along the solft palate, palatine pillars, tonsils and uvula

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31
Q

what causes herpangina

A

coxsackie A

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32
Q

signs of herpetic gingivostomatitis

A

clusters of vesicles in the anterior oral cavity (buccal mucosa, tongue, gingiva, hard palate)

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33
Q

what bug causes herpetic gingivostomatitis

A

herpes simplex

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34
Q

what tests to order in a chlid with obesity

A

lipid panel, HbA1c, liver enzymes (fatty liver), sleep study (polysomnogram)

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35
Q

what is GBS

A

strep agalactiae

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36
Q

signs of GBS in a 5 week old

A

bacterimia, meningitis, bacterimia

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37
Q

gram stain and shape of GBS

A

gram positive cocci in chains/pairs

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38
Q

what shoudl be suspected if a child has encopresis

A

this is fecal incontinence in the sleep, fix their constipation

39
Q

what diagnositc test should be done if a child has gross bleeding per rectum

A

meckel scan!

40
Q

acute unilateral cervical lymphadenitis bug

A

staph aureus or strep pyogenes

41
Q

murmur characteristics of a physiologic curvature of the jugular or subclavian veins

A

continuous, heard on right infraclavicular space, decreases in intensity turning head to ipsilateral side

42
Q

peutz jeghers syndrome findings

A

brown macules on lips and buccal mucosa, colonic hamartomas in GI tract

43
Q

signs of occult blood loss

A

fatigue, anemia

44
Q

signs of bronchopulmonary dysplasia in neonate

A

continued requirement of supplemental oxygen >28 days

45
Q

pathogenesis of bronchopulmonary dysplasia

A

reduced septation of the alveoli due to arrest of pulmonary development from being on a vent

46
Q

what is laryngomalacia

A

this is intermittent collapse of the arytenoid cartiliage on inspiration

47
Q

signs of laryngomalacia in infants

A

noisy breathing, GERD

48
Q

when do you hear the stridor in laryngomalacia (inspiratory or expiratory)

A

inspiratory stridor

49
Q

can the infant have HSV even if mom had no signs

A

definitely, often times transmission is from asymptomatic mothers

50
Q

signs of congenital HSV infection

A

chorioretinitis, skin vesicles or scars, microcephaly

51
Q

three presentations of HSV in a neonate

A

1) skin, eye, mouth 2) meningoencephalitis 3) disseminated disease

52
Q

big differences between crohns and UC

A

crohns: skip lesions (granulomas), transmural, mostly small intestine, perianal disease // UC: mainly epithelial lesions, continuous, starts in rectum

53
Q

presentation of IBD in a child

A

dramatic weight loss, bloody stool, diarrhea, early satiety, etc

54
Q

UC enema exam finding

A

lead pipe - loss of haustra

55
Q

complications of crohns

A

strictures; fibrosis; fistulas

56
Q

treatment of crohns

A

azothioprine, 6-mercaptopurine, methotrexate

57
Q

treatment of UC

A

sulfasalazine, olsalazine, or balsalazide

58
Q

what is required for dx of celiac disease

A

biopsy of the duodenum

59
Q

what is a BRUE

A

this is when the infant has a brief resolved unexplained event that means the infant has normal vitals and appearance, is growing normally and is not otherwise ill

60
Q

how do infants present with volvulus

A

Abdominal distention, bilious vomiting, and blood per rectum; usually presents in infancy

61
Q

pathophysiology of volvulus

A

incomplete intestinal rotation during fetal development

62
Q

imaging findings in volvulus

A

birds beak or corkscrew sign

63
Q

difference between heat exhaustion and heat stroke

A

heat exhaustion maintains their mental status, heat stroke loses mental abilities and is >104F

64
Q

treatment of OCD in a child

A

SSRI

65
Q

signs of neonatal abstinence

A

irritablity, hypertonia, tremor, sneezing, yawning, diaphoresis, diarrhea, etc

66
Q

two causes of late passing of meconium

A

hirschsprungs or meconium ileus

67
Q

pathophys of meconium ileus

A

inspissated stool due to cystic fibrosis

68
Q

xray description of meconium ileus

A

dilated loops of bowel proximal to the lesion

69
Q

what is Legg-Calvé-Perthes disease

A

this is just idiopathic avascular necrosis of the femoral head

70
Q

what does avascular necrosis of the femoral head look like on xray

A

fragmentation of the femoral head

71
Q

complications of mono

A

splenic rupture, acute airway closure due to tonsillitis, autoimmune hemolytic anemia

72
Q

how do you evaluate gross hematuria of a child

A

kidney and bladder US

73
Q

what is the main cause of a metaphyseal corner fracture

A

child abuse

74
Q

what type of hypersensitivity is poison ivy

A

type 4

75
Q

signs of osteoid osteoma

A

pain worse at night, progressive worseness, relieved by NSAIDS

76
Q

signs of turners in a newborn

A

lymphedema (horseshoe kidney), loose skin around neck, dysplastic nails

77
Q

description of webbed neck

A

short with loose skin

78
Q

pathophys of hypoplastic left heart

A

non-functional LV due to mitral atresia, aortic valve etc.

79
Q

what do hypoplastic left heart babies need to survive

A

maintence of the PDA and ASD

80
Q

signs of hypoplastic left heart

A

postnatal cyanosis once PDA closes, no correction of cyanosis with O2, no murmur

81
Q

what is TAPVR

A

this is when all the pulmonary veins (oxygen blood) return to the SVC/RA/IVC etc instead of the LA

82
Q

when does TAPVR present

A

cyanosis at birth

83
Q

what is APVR

A

this is when > or equal to 1 pulmonary vein returns to the SVC/RA/IVC etc instead of LA

84
Q

when does APVR present

A

adolescence

85
Q

signs of APVR in an adolescent (xray)

A

enlarged R sided heart markings due to chronic volume overload and pulmonary overcirculation

86
Q

clinical signs of APVR in an adolescent

A

signs of pulmonary hypertension= exertional dyspnea, fatigue

87
Q

what do you see on cardiac cath O2 levels of a APVR adolescent

A

increased spO2 in the RA and RV compared to the IVC

88
Q

what is post transplant lymphoproliferative disorder

A

this is when a child with an organ transplant develops lymphadenopathy, fever and a leukopenia

89
Q

what is the pathophys of post transplant lymphoproliferative disorder

A

this is when you are taking immunosuppressents and this causes T cells to have limited surveilance viral oncogenic pathogens which leads to abnormal B cell hyperproliferation due to EBV

90
Q

what imaging do you do for a suspected volvulus

A

you do an upper GI series

91
Q

urine findings in kawasakis

A

sterile pyuria (WBCs)

92
Q

clinical signs of evlevated lead levels in children

A

developmental regression (especially speech), constipation, anemia, fatigue, irritability, emotional lability

93
Q

treatment of lead poisonin

A

chelation with succimer, EDTA