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Anestesi > Minimal Q Pediatrics > Flashcards

Minimal Q Pediatrics Flashcards

1
Q

Imaging modality of choice when evaluating a child for infantile hypertrophic pyloric stenosis:

A

US

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2
Q

Typical age of intussusception in infants:

A

3 months - 3 years

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3
Q

What are the two typical anamnestic features of acute appendicitis?

A

First epigastric and
periumbilical pain, later the pain is localized in the right lower abdominal quadrant.

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4
Q

Standard imaging modality of polytraumatized patients:

A

acute CT

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5
Q

Most common cause of acute abdomen in children:

A

appendicitis

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6
Q

Which is the most common cause of strangulation ileus?

A

Incarcerated hernia.

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7
Q

The most common cause of transfusion-requiring hematochezia, without abdominal pain and without
diarrhea:

A

Meckel’s diverticulum

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8
Q

You find a high GGT in a patient with ulcerative colitis, what should you think about?

A

Sclerosing cholangitis.

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9
Q

What are the typical characteristics of perianal fissures in Crohn’s disease?

A

Not in the midline, deep,
not painful.

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10
Q

What is the first therapeutic choice in Crohn’s disease?

A

Exclusive enteral nutrition.

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11
Q

What are the two most frequent chest deformities?

A

Pectus excavatum and pectus carinatum.

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12
Q

What are typical signs of bacterial otitis externa?

A

Pain and/or tenderness of the tragus.

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13
Q

What are the 4 most important indications of adenoidectomy?

A

1) Recurrent infections of the URT
2) recurrent otitis media,
3) inhibition of nasal breathing, 4) obstructive sleep
apnea.

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14
Q

The most frequent pathogen of sinusitis and otitis media?

A

Str. pneumoniae.

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15
Q

In which cases of middle-ear inflammatory disease should we suggest tympanostomy tubes
(Grommet)?

A

Chronic serous otitis media and/or chronic dysfunction of the Eustachian
tube.

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16
Q

What is the most frequent pathogen in urinary tract infections?

A

E. coli.

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17
Q

What are the typical abnormalities in urine analysis in glomerulonephritis?

A

Red blood cells and red blood cell cylinders. Proteinuria can also appear.

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18
Q

What is the most frequent cause of hypertension before the adolescent age?

A

Kidney disease.

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19
Q

Which is the most frequent glomerulonephritis type?

A

IgA nephropathy.

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20
Q

What is the prognosis of West-syndrome or infantile spasm?

A

Usually poor.

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21
Q

Which bacterium is the most frequent cause of childhood pneumonia?

A

Str. pneumoniae.

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22
Q

What are the two main components of the treatment of pseudocroup?

A

Rectal steroid, inhalation of adrenaline.

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23
Q

What is the most common cause of new onset cough?

A

Viral infection.

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24
Q

What is the Holzknecht sign characteristic for?

A

Airway foreign body aspiration.

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25
Q

What is the most common cause of a cough ongoing since birth which always presents during
feeding?

A

Tracheoesophageal fistula.

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26
Q

What percentage of the mortality is caused by accidents in Hungary in children older than 1 year?

A

36-40%, this is the main cause of death in children older than 1 year.

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27
Q

What is the prognosis of juvenile absence epilepsy?

A

Usually favorable.

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28
Q

What can prevent coronary artery disease (aneurysm) in Kawasaki syndrome?

A

IVIG

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29
Q

What is the most serious complication of juvenile idiopathic arthritis?

A

Macrophage activation
syndrome (MAS).

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30
Q

Which muscles are affected in juvenile polymyositis?

A

Proximal muscles of the limbs.

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31
Q

What is the typical feature of stool in biliary atresia?

A

Clay-colored (acholic) stool.

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32
Q

What kind of diseases are included in atopic march and in which order?

A

Atopic dermatitis food
allergy - asthma bronchiale - allergic rhinitis.

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33
Q

How is food allergy diagnosed? What is the reliability of IgE testing?

A

IgE testing is not reliable.
The diagnosis should be based on double blind oral food challenge.

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34
Q

In which case serological testing is not informative in celiac disease.

A

In IgA deficiency.

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35
Q

What is the diagnostic basis of endocarditis?

A

Blood culture and echocardiography.

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36
Q

What are the upper airway infections that should be treated with antibiotics?

A

Streptococcus angina,
acute otitis media and acute bacterial sinusitis.

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37
Q

What is the diagnostic basis of erythema migrans?

A

The fact of tick bite and the clinical
picture: growing erythema which is more than 5 cm in diameter.

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38
Q

What is the ideal age for closing the soft palate defect?

A

Between 9 and 18 months.

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39
Q

What is the most likely diagnosis in the following case: patient with polyuria, polydipsia with
positive urine glucose and acetone test?

A

Diabetes mellitus.

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40
Q

A patient with typical diabetes symptoms has a 18.2 mmol/l blood sugar level in the afternoon. What is
to be done?

A

Refer the child to a pediatric diabetic center immediately.

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41
Q

What kind of hormonal changes are seen in the salt wasting form of congenital adrenal
hyperplasia due to deficiency of 21-hydroxylase?

A

Insufficient glucocorticoid and
mineralocorticoid secretion, excessive androgen secretion.

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42
Q

How does the mother’s iodine deficiency influence the newborn’s thyroid function?

A

It results in
temporary primary hypothyroidism.

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43
Q

Which is the most common adrenocortical enzyme defect?

A

The defect of the 21-hydroxylase
enzyme.

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44
Q

What are the most typical histologic findings in ulcerative colitis?

A

Crypt abscesses.

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45
Q

Name at least 5 extraintestinal abnormalities in celiac disease:

A

hepatitis,
osteoporosis,
arthritis,
isolated iron deficiency, Duhring-disease (dermatitis herpetiformis).

46
Q

What is the definition of “graft versus leukemia”?

A

Immunologic attack of the donor cells against the patient’s leukaemic cells after allogeneic bone marrow transplantation.

47
Q

What is a haploidentical transplant?

A

Half matched HLA antigen stem cell transplant (from usually a family member).

48
Q

What does allogeneic stem cell transplant mean?

A

The patient (recipient) gets hematopoietic stem cells from another person (donor).

49
Q

What glucose levels are diagnostic for diabetes mellitus?

A

Fasting blood glucose level higher than 7 mmol/l, or more than 11.1 mmol/l at any time or at any point during an oral glucose tolerance test (OGTT).

50
Q

Which are the 4 presenting symptoms of diabetes mellitus?

A

Polyuria, polydipsia, weight loss with good appetite, fatigue-weakness.

51
Q

What are the diseases most commonly associated with type 1 diabetes mellitus?

A

Celiac disease and Hashimoto thyroiditis.

52
Q

What is the most modern therapeutic method of type-one diabetes?

A

Insulin pump with an integrated glucose sensor.

53
Q

ow much insulin should be given in diabetic ketoacidosis?

A

0.05-0.1 U/kg/h

54
Q

Since the introduction of expanded screening, how many congenital metabolic diseases are
screened routinely in Hungary?

A

27 and SMA screening is also available.

55
Q

The final therapy of biliary atresia is liver transplantation. There is a surgical bridging therapy
before transplantation. What is the name of this operation?

A

Kasai porto-enterostomy.

56
Q

How often should a baby be breastfed?

A

On-demand.

57
Q

When is it suggested to introduce cow’s milk for children?

A

After 12 months of age.

58
Q

How does the breast milk’s protein content relate to the cow’s milk protein content?

A

One third.

59
Q

What are the most important diseases which can be easily diagnosed and followed up by cranial ultrasound?

A

Brain hemorrhage and hydrocephalus.

60
Q

For how long can we see the shadow of the thymus on the thoracic X-ray?

A

Until 3 years of age.

61
Q

What radiological examinations can be done to diagnose VUR? (Name three!).

A

MCU
(Micturating cystourethrogram), Sono-cystography, Dynamic kidney-scintigraphy.

62
Q

How can you diagnose perforation in a critically ill baby with necrotizing enterocolitis if you cannot
move them in the incubator?

A

Horizontal X-ray from side position while the baby is lying on the
back.

63
Q

In which part of the bone does osteomyelitis start?

A

In the metaphysis.

64
Q

How long to wait after surgery before bathing?

A

7-8 days.

65
Q

What is chicken pox (varicella) reactivation called?

A

Herpes zoster.

66
Q

What is the sixth disease?

A

Exanthema subitum, roseola infantum.

67
Q

Which is the contagious disease that causes severe fetal injuries in 80 percent of its cases?

A

Rubella.

68
Q

Name at least five examples when pulse oximetry is not informative!

A

Carbon-dioxide
intoxication, methemoglobinemia, severe anemia, cardiac failure, cold extremities.

69
Q

Define paradoxical breathing!

A

The chest moves inward and the abdomen moves outward during
inhalation, and vice versa.

70
Q

How do we give oxygen to a conscious patient in an emergency situation who is breathing
spontaneously?

A

Through a face mask with a reservoir, with high flow oxygen (10-15 l/min).

71
Q

How does the concentration of protein and glucose of CSF change in bacterial meningitis?

A

Protein
concentration is increased, glucose concentration is decreased.

72
Q

Name of the two most common pathogens of newborn meningitis!

A

Streptococcus agalactiae, E. coli.

73
Q

What affects the sensitivity of blood culture?

A

The amount of blood drawn within 24 hours after
the fever.

74
Q

Name the condition of infants associated with abdominal pain in which bowel movements are
preceded by tension and crying lasting for about 10 minutes?

A

Infantile dyschezia

75
Q

The pathogen causing neonatal infection that can be identified by maternal vaginal secretion
screening.

A

Streptococcus agalactiae. (group B Streptococcus, GBS)

76
Q

The amount of a single fluid bolus required to treat septic shock:

A

10 ml/kg.

77
Q

The most common endocrine disorder causing growth retardation:

A

Thyroid dysfunction –
hypothyroidism.

78
Q

What does precocious puberty mean in the case of girls?

A

If the secondary sexual characteristics
appears before the age of 8 years

79
Q

What changes can we see in the urine sediment in typical pyelonephritis?

A

Leukocytes and
bacteria

80
Q

In which chromosomal abnormality is duodenal atresia common?

A

Trisomy 21 (Down
syndrome)

81
Q

What is the radiological sign of duodenal atresia?

A

„Double-bubble” sign

82
Q

What are the B-symptoms in lymphoma?

A

Fever, night sweats, weight loss.

83
Q

At what platelet count is there major risk of bleeding?

A

Below 10-20 G/l

84
Q

What to do in case of neutropenic fever?

A

Broad spectrum empiric antibiotic therapy after taking
blood cultures.

85
Q

What are the serum electrolyte disturbances in case of tumor lysis syndrome?

A

Elevated potassium,
phosphate and uric acid, decreased calcium.

86
Q

What are the alarming signs of retinoblastoma? What examinations are required?

A

Strabism,
leukocoria - ophthalmoscopic examination.

87
Q

What is the most common type of malignancy in childhood?

A

ALL.

88
Q

What are the symptoms of increased intracranial pressure?

A

Headache, vomiting in the morning, nuchal rigidity, setting-sun sign, focal neurological signs, bradycardia, high blood pressure, irritability, bulging fontanelle.

89
Q

What are the physical symptoms of anemia?

A

Fatigue, paleness, tachycardia, systolic heart murmurs.

90
Q

How does the total iron binding capacity change in case of anemia and inflammation?

A

Increased in anemia, decreased in inflammation.

91
Q

What is the treatment of immune thrombocytopenia (first- and second-line treatment.)?

A

IVIG, corticosteroid

92
Q

List the signs of increased work of breathing!

A

Use of respiratory accessory muscles, intercostal retraction, jugular retraction, nasal flaring, paradoxical breathing, grunting.

93
Q

At what age do the fontanelles close at the latest?

A

Posterior fontanelle: by 3 months, anterior fontanelle: by 18 months.

94
Q

What are the symptoms and laboratory signs of nephrotic syndrome?

A

Proteinuria, hypoalbuminemia, hyperlipidemia, oedema.

95
Q

What are the symptoms and laboratory signs of nephritic syndrome?

A

Hematuria, oedema hypertension, uraemia, oliguria (kidney failure is correct instead of the latter two).

96
Q

What factors are included in the APGAR score?

A

Heart rate, respiratory rate, skin color, reflex irritability, muscle tone.

97
Q

Age limits of puberty?

A

Boys: 9-14 years. Girls: 8-13 years.

98
Q

What are the direct and indirect signs of appendicitis?

A

Direct sign: tenderness at the McBurney
point. Indirect signs: Blumberg, Rovsing, Obturator, Psoas signs.

99
Q

How can we estimate the body weight between the ages of 2-8 years?

A

(2 x years) + 8.

100
Q

What does autologous stem cell transplantation mean?

A

A procedure in which a patient’s healthy
stem cells are collected from the blood or bone marrow before high dose chemotherapy,
stored, and then given back to the patient after treatment.

101
Q

What is the heart rate and respiratory rate of a healthy newborn?

A

Respiratory rate: 50-60/min, Heart
rate: 120-160/min.

102
Q

Which cultured pathogen from throat swabs warrants antibiotic treatment?

A

Str. pyogenes.

103
Q

In case of maternal GBS positivity, up to what age can this bacteria cause disease in the baby?

A

Up to
six months of age.

104
Q

What is the recommended empiric treatment of neonates with suspected sepsis?

A

Ampicillin +
Gentamycin.

105
Q

What factors are included in the croup score?

A

Sound of inhalation, stridor, cough, signs of
dyspnea (nasal flaring, retractions), cyanosis.

106
Q

In case of pain localized to one point in the bone, when should we order an X-ray if the pain
does not stop?

A

1 week

107
Q

What is the choice of imaging modality if acute osteomyelitis is suspected?

A

MRI

108
Q

What is the most common presentation of cow’s milk protein allergy in infants?

A

Bloody stool

109
Q

Which disease should be suspected in case of bloody stool and vomiting in neonates?

A

Volvulus

110
Q

Which disease should be suspected in case of neonates with distended abdomen and severe
constipation?

A

Hirschsprung-disease

111
Q
A

Anestesi (4 decks)

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