MISC PREP facts Flashcards
0
Q
Ca + Phos Supplementation dose?
A
1300 IU daily each
1
Q
Cutoff NAS score that requires pharmacology
A
8
2
Q
Reason for anuria in prune belly? Pre/Renal/Post?
A
Post renal (hydroureter) / bladder outlet obstrx
3
Q
major tx for salicylate poisoning (2)
When dialysis?
A
minimize acidosis: alkalinize!
Get it out w/ charcoal: q4h until asx and salicylate conc < 30
Dialysis if >100 level
4
Q
selenium deficiency causes what?
A
cardiomyopathy, skin and hair pigment loss, macrocytosis
5
Q
NA range
A
135-145
6
Q
treatment for an ethylene glycol or methanol toxicity?
A
ethanol or Fomepizole
7
Q
number for low urine sodium
A
<20
8
Q
number for elevated urine osmolality
A
> 600
9
Q
Urine osm number for inability to concentrate urine?
A
<300
10
Q
Typical numbers of urine Na and urine OSM in SIADH?
A
Hi urine Na >40
Hi urine Osm > 600
11
Q
heart issue in Friedrich ataxia?
A
hypertrophic cardiomyopathy
12
Q
trick about tinea capitus dx and what is the tx
A
doesn’t fluoresce in woods lamp
need PO Griseofulvin
13
Q
why no ptu for hyperthyroid
A
liver tox, use methimazole
14
Q
normal post puberty male adol hemoglobin?
A
14-18
15
Q
Cold shock drugs (incr HR, low BP, decr pulses)
A
Epi or Dopamine
16
Q
Warm shock drugs for incr HR, low BP, bounding pulses?
A
NE
17
Q
Drugs for cardiogenic shock?
A
Dobutamine, milrinone
18
Q
puberty U:L length ratio?
A
0.85-0.95
19
Q
infant U:L length ratio?
A
1.7 *short legs
20
Q
Age when arm/leg length ratio is the same = 1
A
10 yrs
21
Q
Treatment of congenital toxo
A
sulfadiazine, pyrimethamine, leucovorin supp
22
Q
Formula for serum osm
Normal value
A
2(Na) + 10 + (Gluc/18 + BUN/3)
Normal is <10 for gap, 290 for osm
23
Q
Equation for FeNa
A
UNa x PCr
_____________ x 100
PNa x UCr
24
Vincristine s/e
SIADH, periph neuropathy
25
Procarbazine s/e
CNS effects
26
mouth abscesses and sulfur granules
| bug and drug?
Actinomyces
| IV PCN G / Amp 4-6 wks
27
Morulae, intraleukocyte inclusions, petechiae after camping
TCP, anemia
?Arkansas
Bug and Drug
Ehrlichiosis, Doxycycline
| Rash less impressive than w/ RMSF
28
bug to think of in toddlers who eat pork shitterlings and has diarrhea
Tx
Yersinia Enterocolitis
| Cefotax, Gent, Bactrim, doxy...
29
bug to think of after pork who has periorbital edema and conjunctival hemorrhage
Trichinella spiralis = tissue nematode
30
drug to use for Malassezia, Tinea Versicolor
Itraconazole
31
Bug to think of in intestinal obstruction, Drug?
```
Ascaris Lumbricoides (roundworm)
Mebendazole, Albendazole, Ivermectin
```
32
Bug not killed by chlorine in swimming pools, causes diarrhea
Drug to tx with?
Cryptosporidium
| Nitazoxanide
33
school of fish / painful ulcer
| Bug and Drug
H. Ducreyii
| CTX, Azithro, or Emycin
34
Dose to treat Trichomonas with?
2g Flagyl for everyone
35
2 bugs that can cause PNA and splenomegaly
Chlamydia psittaci or Coxiella Burnetti (Q fever: Doxy)
36
Urine Na if dehydrated?
<10
37
Hypocalcemia EKG change
Long QT
38
Low magnesium EKG change
Long QT or Long PR
39
The bad nephrotic (if not steroid responsive minimal change)
Focal segmental glomerulosclerosis
40
BAD Nephritic / Nephrotic syndrome and low complement that requires biopsy and NO steroids.
Membranoproliferative GN
41
Protein/Creatinine ratio indicative of renal disease
>0.2
42
In post strep GN, Complement C3 normalizes when?
w/in 2 mos
43
EKG Axis with
I up
II up
avF up
NORMAL
44
EKG Axis with
I up
II and AVF down
LAD
45
EKG Axis with
I down
II and AVF up
RAD
46
serum iron level that is okay vs very bad
< 50 ok
| >350 bad
47
Define cliteromegaly? Indicates what?
>3mm
| Exposure to strong androgen (tumor, CAH?)
48
Drug for methanol or ethylene glycol tox?
Fomepizole
49
newborn / TPN kid with scaly dermatitis, alopecia, TCP
Lineolic acid def (essential FA)
50
Quick fluid replace: 20kg?
1500 cc/d
51
vitamin def in hemolytic anemia, edema, elevated platelets, weakness
Vit E def
52
Vit def with anemia, angular stomatitis, seborrheic dermatitis
Riboflavin B2
53
Normal weight gain for term and preterm babies
Term 20-30g/day
| Preterm 15-20g/day
54
Newborn / TPN kid with neutropenia, metaphyseal irregularity, irritability, poor feeding?
Copper def
55
The thing mature breast milk doesn't have much of compared to colostrum and formula?
protein
56
prepubertal testes vs mature stage 5 testes?
< 4cc / < 2.5
| 20cc after puberty
57
Drug with both sympathomimetic and cholinergic (flushing, diaphoresis) effects?
Pupils?
PCP, pupils probably actually small!
58
Mechanisms in Scarlet fever vs ARF?
Scarlet fever: Toxin
| ARF: Immune complex
59
Dairy farm bug gram neg coccobacilli and treatment
brucellosis
| LONG tx with Doxy or BActrim AND Rifampin
60
GAS throat infx if PCN Allergic?
Clinda or Emycin
61
Drug for aspergillus?
Ampho B or Vorixonazole
62
Drug needed for CMV retinitis?
Foscarnet
63
s/e of Pyraxinamide
hyperuricemia
64
s/e of Ethambutol
optic neuritis
65
When do babies fixate?
6 wks
66
Level to chelate for lead?
>45
67
LAb predictor of Uveitis in JIA?
ANA
68
Surgery for scoliosis
| Surgery for kyphosis?
scoliosis > 40-45
| Kyphosis > 60
69
baby that squeals and laughs, imitates socially
4 mos
70
baby with peek a boo games?
9 mos
71
3 block tower
15-18 mos
72
overhand throw
2y
73
alternates feet walking up stairs with railing
30 mos
74
8 cube tower
30-36 mos
75
down stairs alternating feet and railing
5y
76
NAS score requiring morphine
8+
77
antidote for anticholinergic OD
physostigmine
78
Antidote for OP or muscarinic SLUDGE poisoning
Atropine, may also need pralidoxime for the nicotinic stuff
79
Stimulant + hallucination effect
LSD
80
amt of kids who have 2nd febrile seizure?
| More than 2?
1/3 have 2
| <10% have more than that
81
Treatment for shigella
BActrim, Azithro if young
| Cipro ok for older kids
82
septic joint w/ no growth on culture
| bug and drug
Kingella, CTX
83
terrible aches, fever, LFTs, TCP
| Dx?
Dengue "breakbone" fever
84
IF you really think EBV or GAS throat, but negative cultures
| Bug and Drug?
Arcanobacterium hemolyticum, Emycin is tx
85
Malaria tx
primaquine
86
Test if you suspect CVID?
Ig levels (normal B and T cells, but low Ig levels)
87
PCP without HIV, think what?
Hyper IgM: X linked, CD 40 ligand absence
88
Tx for CGD
Interferon Gamma
89
recurrent staph, large granules on WBC, partial albinism, peripheral neuropathy
Chediak Higashi
90
What is elevated in ataxia telangiectasia
AFP
91
Retinoblastoma has increased risk of what future cancers?
osteosarcoma, melanoma, sarcoma
92
Chest mass tumors?
Hodgkins, Neuroblastoma
93
HbA1c indicative of DM?
>5.7 predm
| DM > 6.5
94
chronic thrush, hyper PTH, Addison, Gonadal failure, Vitiligo, hepatitis, pernicious anemia, IDDM
Dx?
Type 1 autoimmune polyendocrinopathy
95
Describe Type 2 polyendocrinopathy?
More classic female DM1 w/ incr risk of Addison, hypothyroidism, and HLA D3 and D4
96
color blind, hearing issues, clefts, no puberty, anosmia
Kallman hypogonadotropic hypogonadism
97
Drug to use in hyperthyroid
Methimazole
98
avulsion with separation of proximal patellar tendon from bony insertion overuse
What is this and what do you see on exam?
osgood schlatter: tibial tuberosity swelling
99
tennis elbow vs little league elbow
tennis: lateral epidondylitis
pitching: medial apophysitis
100
level of aortic stenosis gradient that is mild, moderate?
| Restrictions?
mild < 25
| moderate 25-50 - no wt lifting
101
Maintenance fluids per day rule
100,50,20
102
magic number of tylenol ingestion for badness in od?
>150 mg/kg
103
seems like pancreatic exocrine insuff like in CF, but not CF, also infections and skeletal anomalies?
Schwachman Diamond syndrome
105
The bug that comes through contaminated water or slaughter house through skin / mucus membranes and causes liver disease. How do you treat?
Leptospirosis: PCN G
106
immune levels in Ataxia telangiectasia
Low IgE, No IgA
107
CHARGE:
```
Coloboma
Heart
Choanal Atresia
Retarded growth (Charge them)
GU anomalies
Ear anomalies
```
108
VACTERL
```
Vertebral
Anal Atresia
Cardiac (VSD)
TEF
Radial hypoplasia / Renal
Limb
*Single umbi artery
*Normal IQ
```
109
CATCH-22
```
Cardiac (Ao arch)
Absent THymus
T cell defects
Clefts
Hypocalcemia
```
110
Angelman syndrome
| -what id duplicated and what is lost / imprinted
Paternal 15q11 present
| Maternal imprinted / deleted
111
normal baby weight gain per day?
remember 20g/day
| premies 15-20, term 20-30
112
vitamin def with metaphyseal/bone issue, neutropenia, poor feeding, irritability
copper
113
intoxication causing sympathomimetic and cholinergic effects?
(incr HR, BP, but also flushing, diaphoresis, miosis)
PCP
114
ABx for Hflu
CTX
115
weird bug from dairy farm that needs prolonged Abx w/ Doxy and Bactrim + Rifampin
Brucellosis
116
surgery for scoliosis
| surgery for kyphosis
scoliosis >45
| kyphosis > 60
117
Bald,
| itchy rash, neurologic / MS deficits / ataxia
Biotin deficiency
118
Infections and LOTS of neutrophils
| Dx and tx?
CGD, IFN gamma
119
Risk of PCP without HIV
Hyper IgM
120
nephrotic syndrome and calcium?
low (low alb, so low bound Ca)
121
The bad renal syndrome with low C3
membranoproliferative glomerulonephritis
122
Best estimate of serum osms?
2Na + 10
123
Single S2 - two cardiac CHDs, and difference
TOF: incr pulm vasc
TGA: decr pulm vasc
124
Egg shaped heart
| CHD
TGA
125
Prophylaxis for congenital Toxo
Spiramycin for mom
126
Treatment of congenital toxoplasmosis
Pyrimethamine
Sulfadiazine
Folinic Acid
127
petechiae, HSM, jaundice in newborn
CMV
128
normal birthweight
2500-3900g
| above or below is SGA / LGA
129
think of this in baby newborn who looks like a BPD/CLD kid with cystic lungs, but no neonatal hx to suggest it?
Wilson Mikity syndrome
130
hypoglycemia in baby tx
3mL/kg of D10 (100mg/ml)
131
CXR in RDS
air bronchograms, ground glass appearance, decreased lung volume
132
Mec aspiration CXR
large lung volumes- hyperinflation, patchy atelectasis, hazy opacifications
133
CXR showing no air bronchograms, perihilar haziness, good lung volumes, fluid in fissures
TTN
134
The endocrine thing with calcified basal ganglia
Pseudohypoparathyroidism with high PTH but low Ca, moon face, and calcified BG due to maternal imprinting *hereditary osteodystrophy*
135
radioactive uptake in Graves vs Hashimoto vs subacute thyroiditis
high in Graves, low in Hashimoto and subacute thyroiditis
136
parotid swelling, dry mouth, no tears
| Dx
Mikulicz disease
137
Abx for Shigella
Bactrim
138
Abx for Campylobacter?
Erythromycin, Azithromycin
139
Acid vs Base ingestion and type of necrosis and area of most damage
ACid: CoAgulation - stomACh (Acid / stomach)
ALkali: Liquefaction: esophagus
140
water park bug not killed by chlorine
| tx
cryptococcus
| Tx nitazoxanide
141
diarrhea, liver and brain abscesses.
Entamoeba Histolytica
142
5 drugs for pseudomonas coverage
Ceftaz, Cefepime, Gent, Tobra, Zosyn
143
Bugs and tx for spontaneous peritonitis
Strep pneumo
| 3rd gen ceph + gent
144
possible treatment for urea cycle disorder vs organic acid disorder
urea: Arginine
| Organic Acid: Biotin
145
acroparesthesia in what disease, transmission, enzyme
Fabry - x linked dom
| alpha galactosidase A
146
metabolic d/o that looks like CP, ID, with icythosis
Sjogren Larsson syndrome
147
sweaty feet metabolic disorder, tx
isovaleric Acidemis (protein restrict)
148
metabolic disorder causing leukodystrophy
Krabbe
149
drug needed in MSUD
thiamine
150
+ reducing substances in urine, hepatomegaly, hypoglycemia
galactossemia
151
cbc s/e in macrolides
neutropenia
152
nmyc and age prognosis in Neuroblastoma
<1 good
| nmyc bad
153
ALL age that is good
>2y
154
cancer risk after neuroblastoma, and where doesn't it met to?
osteosarcoma,
| NB doesn't go to lung
155
Hb with two alpha and two delta is what in what disease
HBA2 in beta thal
156
Fanconi anemia vs Schwachman Diamond
- age
- platelet issue
*both incr risk of what?
AML in both
Fanconi is in toddlers, has renal issues, and LOW PLTS
DS is in babies, normal plts, but exocrine pancreas probs
157
TEC vs Diamond Blackfan anemia
- age
- in TEC? retic / MCV
TEC in 1-4 year old, no retic (stopped production), nl MCV
| DB in infant w/ no precursors in marrow
158
tumor lysis syndrome and calcium?
low calcium (all other things are high)
159
Reed Sternberg Cells in what Ca?
Hodgkins
160
Wiskott Aldrich IG levels?
Hi IgA, low IgM
161
think of this in bleeding from umbi stump
Factor 13 def (Unlucky Umbi)
162
Think of this in incidental long aPTT and clotting
Factor 12 def
163
hemolytic anemia with high MCHC but normal osmol fragility test and increased exercise tolerance?
pyruvate kinase def
164
Factor not made in liver (when looking at liver failure vs DIC)
Factor VIII
165
s/e of chemo with clots and pancreatitis
Aspariginase
166
ETT size rule
[Age / 4] + 4
167
ETT depth rule
[Age/2] + 12
168
normal baby sized tube uncuffed, and normal depth
term: 3.5 uncuffed (3 cuffed)
| Depth x 3 = 10ish
169
antidote for methanol or ethylene glycol tox
Fomepizole
170
OP sludge antidotes
pralidoxime (nicotinic) / Atropine (musc)
171
Anticholinergic antidote (MAD HOT)
physostigmine
172
transient vs congenital MG in neonate
transient doesn't involve eyes
262
The wormy that comes from pork and causes fever, myalgia, periorbital edema, red eyes/conjunctival injection/hemorrhage
Trichinosis
263
birth weight rule at 3 time points
BW 3500g
doubles 5 mos
triples 1 yr
quadruples 2y
264
length rule at 3 age marks
50cm
incr 50% at 1 yr
doubles 4 yrs
triples 13 yrs
