Pediatrics Flashcards
(114 cards)
1
Q
Course of action for diaphragmatic hernia during birth of child_____
A
NG + low pressure intubation until lung maturation
2
Q
_____ is a midline abdominal wall defect associated with Patau (Trisomy 13), Edward (Trisomy 18) syndromes
A
Omphalocele
For large defects, have to encage in a Silo, will have to do step wise manual reductions until surgery is possible
3
Q
Double Bubble Sign (Pediatrics)
______________
_____________
A
Annular pancreas
Duodenal atresia (bilious vomit)
4
Q
intestinal atresia is associated with ______
A
Vascular malformations
5
Q
Meconium ileum is pathpnemonic for ______
A
Cystic fibrosis
Tx: Gastrograffin Enema
6
Q
Infant with progressive jaundice for 6+ weeks, after accounting for breast milk jaundice etc.
A
Biliary atresia
Dx: Abd US
7
Q
How to diagnose Hirschprung_____
A
Rectal biopsy : failure in migration of neural ganglia controlling contracting/relaxation of colon, resulting in megacolon
8
Q
Ocular infections
1) ______ shows up the earliest : Day 2
2) _____ shows up later : Day 7
A
Gonorrhea
Chlymidia (Oral erythromycin)
9
Q
port wine + seizures + retardation + glaucoma _________ syndrome
A
Sturg Weber (GNAQ mutation, vascular malformation)
10
Q
_____ skin tags are more concerning, associated with hearing loss, renal injury
A
Peri-auricular
11
Q
Umbilical hernia is associated with _____
A
Hypothyroidism
12
Q
CHARGE Association
A
coloboma, heart defect, nasal atresia, GU, Ear
13
Q
Biliary atresia is associated with ____ syndrome
A
Downs
14
Q
blueberry muffin + microcephaly + periventricular calcifications ______
A
Rubella
15
Q
Blueberry muffin + sensorineural hearing loss
A
CMV
16
Q
Intracranial calcifications + hydrocephalus + chorioretinitis
A
Toxoplasmosis
17
Q
Teratogen : IUGR, Hypoplastic nails, typical facies _______
A
Phenytoin
18
Q
__________ is the congenital heart lesion most commonly associated with supraventricular tachycardia.
A
Ebstein anomaly (R atrial enlargement, inferior displacement of tricuspid valve)
19
Q
______ causes craniofacial abnormalities
A
ACE inhibitors
20
Q
_____ causes NTD, mental retardation
A
Valproate, Carbamazepine
21
Q
_____ and _____ are cardiac defects associated with Turners syndrome
A
Bicuspid Aortic Valve
Aortic Co-arctation
22
Q
________ is associated with single umbilical artery
A
Patau (Trisomy 13)
23
Q
Horseshoe kidney associated with________
A
Klinefelter (XXY), also hypogonadism
24
Q
Marfan is a defect in _______
A
Fibrillin (lens displacement , aortic root dissection )
25
Organ enlargement : macrosomia, macroglossia, hypoglycemia (b cell hyperplasia), reno-megaly + Wilms Tumor __________
Beckett Weidmann Syndrome (IGF-2)
26
_______ kind of pediatric bone tumor results in sunburst pattern on CXR
osteogenic sarcoma
27
Rhinorrhea, sore throat, hoarseness, barking cough, inspiratory stridor________
Croup
28
Age of Croup generally____
3 - 5 years
29
Treatment of croup
nebulizer epinephrine, steroids
30
Muffled voice (hot potato), drooling, dysphagia, high fever, inspiratory stridor, tripod positioning (breathing issue), no barking cough_______. Characterized by _____ sign on XR Neck
Epiglottitis
Thumbprint
31
Two diseases requiring Rifampin prophylaxis to household members
1) N. Meningitides
2) _________
Epiglottitis
32
Biphasic stridor concerning for _____
vascular ring in trachea
33
URI, fever, wheezing cough, dyspnea tachypnea in children age <2_______
RSV Bronchiolitis , salvage Prophylaxis for high risk children: Palivizumab
34
meconium ileus, steatorrhea (pancreatic insufficiency), pneumonia (S.Aureus, H influenzae, Pseudomonas), rectal prolapse, missing vas deferens , are constellations of ___________
Cystic Fibrosis
35
_____ is a treatment for CF only for G551D mutation
Ivacaftor , unfortunately on 5% of cases are this point mutation
36
_____ is the feature that distinguishes Neiman Pick vs Tay Sachs
Neiman Pick = Hepatosplenomegaly
Both: Cherry red macula, neuropathy
37
_____ enzyme is defective in Tay Sachs, resulting in ____ accumulation
_____ enzyme is defective in Neiman Pick, resulting in ____ accumulation
Hexaminidase A, Ganglioside
Sphingomyelinase, Sphingomyelin
38
_____ is a glycogen storage disorder caused by deficiency in _____ leading to cardiomegaly + hypotonia
Pompe, Lysosomal Acid Maltase
39
____ is a glycogen storage disorder , caused by deficiency in _____, results in easy fatiguability, second wind phenomena
McArdle
Muscle Phosphorylase
40
______ is a glycogen storage disorder resulting in neurologic effects (ataxia, dementia), deficiency in _________ enzyme
Metachromatic Leukodystrophy
Arylsulfatase (accumulation of cerebroside sulfate)
41
Most specific test for PSGN_____
Anti DNA-se B
42
Most common complication from Minimal change disease, therefore requiring immunization for pneumococcus + varicella____
SBP
43
Treatment for minimal change disease____
Steroids for 4-6 weeks
44
Three kinds of rickets
1) Vitamin D deficiency : Calcium elevated, due to high PTH as feedback
2) Vitamin D Dependant (Failure to convert to 1,25 form) : but all labs normal
3______ : Only condition where vitamin D 1,25 is low
X linked hypophos, kidney cannot absorb phosphate for bone mineralization
45
Treatment for congenital hip dysplasia (Ortolani/Bartlow +)_____
Leg-Calve-Perthes caused by _____ of the femoral head
Pavlik Harness
Avascular Necrosis
46
Constellation of fever, conjunctivities, erythematous rash, desquamation of fingers, cervical unilateral lymphadenities, strawberry tongue______
Complications_____
Treatment_______
Kawasaki (medium vessel arteritis)
Coronary artery aneurysm, myocarditis
IVIG, high dose aspirin
*Kawasaki looks like Measles (Rubeola) in symptoms
47
Recurrent pyelonephritis in child, think ______
vesicoureteral reflux : caused by inadequate closure of ureterovesicular junction
Have to start prophylactic bactrim, in setting of multiple prior UTI
48
Recurrent UTI in child
posterior ureteral valves
49
_____ is a leading cause of iron deficiency anemia in infants
Cows milk instead of breast milk
50
Cutoff lead value for initiation EDTA____
Lead lab tests: Peripheral smear (basophillic stippling), microcytic hypochromic anemia like iron deficiency, increased free erythrocyte porpyphrins
45
51
Treatment of acute pediatric seizure_____
Rectal Benzos
52
Typically, febrile seizures do not increase risk of epilepsy (T/F)
True, unless <9 months, status epiliptius
53
Antiepileptics can be stopped after seizure free for ____ years
2
54
AM jerky movement may be a hint to ______ disorder
Juvenile myoclonic epilepsy (Tx: Valproate)
55
Best test for Duchenne dystrophy_____
Treatment______
PCR genetic test, not muscle biopsy (fat replacement of muscle), caused by frameshift mutation
Steroids
56
Empiric therapy for neonatal sepsis
1) Ampicillin + Gentamycin
2) Cefotaxime (meningitis concern)
3) ______, if child <28 days
acyclovir
57
2 infections requiring rifampin for household contacts
1) _____
2) _____
H.influenzae
N meningitidis
58
Catscratch disease caused by ________, treatment______
Bartonella
Azithro/Doxy
59
Most common complication of pediatric meningitis_______
Hearing Loss
60
Palms and Soles Rash
1) Rocky Mountain Spotted: Starts in the hands
2) Cocksakie; Hand Foot Mouth
3) Toxic Shock Syndrome
4) _________
Secondary Syphillis
61
Causes of direct bilirubinemia in children sepsis, TORCH, TPN, hypothyroid, ____, _____
Galactosemia, Tyrosinemia
62
Indirect bilirubinemia
1) Phototherapy if Bili>_____
2) Exchange transfusion if ______
10
Neurological symptoms (concern for kernicterus)
63
Blueberry muffin rash + sensorineural hearing loss____
CMV
64
Blueberry muffin rash + cataract + microcephaly + periventricular calcifications_____
Rubella
65
Hydrocephalus + Chorioretinitis + intracranial calcifications______
Toxoplasmosis
66
Turners associated with : bicuspid aortic valve, aortic co-arctation, _____
Hypothyroidism
67
erythromycin mechanism is blockage of ______ activity, used for chlymidia
bacteria ribosome function
68
Key things for suspected Sturg Weber______
Evaluate eyes
| Anti-epileptics
69
Aniridia in an infant is associated with _______
Wilms tumor (Kidney)
70
Branchial cleft cyst is ____ positioned, does not move with the tongue, do not have to actively manage
Lateral
71
____ is an odd test for respiratory distress of a newborn
Cranial ultrasound (Hemorrhage causing respiratory distress)
72
Surfactant _____ surface tension, produced by type ____ pneumocytes, usually in full swing late in the pregnancy (35 weeks)
Decreased, Type 2
If <34 weeks, give bethamethasone to mother to improve fetal lung maturity, L/S<2.5
73
Complications of premature lungs
1) _____
2) ARDS
3) Retinopathy
4) Cerebral Hemmorhage
bronchopulmonary dysplasia
74
Infant with tachypnea immediately after C section______
transient tachypnea of newborn, just suction or watch
75
TEF fistula results from_____
failure of the division of foregut into esophageal parts
If you suspected VACTERL, you have to find the other shit: ECHO, US Renal, XR Limbs
76
TEF fistula results from_____
failure of the division of foregut into esophageal parts
If you suspected VACTERL, you have to find the other shit: ECHO, US Renal, XR Limbs
77
anything that impinges fetal swallowing = polyhydramnios (TE fistula, duodenal atresia, annular pancreas)
Mechanism of annular pancreas______
Failure of the ventral bud to rotate with the duodenum, so it impinges it
78
Sign of phototherapy success = decrease by____ every q4-6 hours
2 mg/dL
79
You cannot give naloxone to infants due to _____
Seizure risk for opiate withdrawal in this population
80
Prenatal exposure of these cause:
1) _____ hypoplastic nails, typical facies, IUGR
2) _____ bone stippling, facial abnormalities
Phenytoin
| Warfarin
81
Cardiac defects associated with downs: VSD, ASD, _____
PDA (Prostaglandins keep the duct open, blockers such as NSAID will close it)
82
____ renal issue associated with Trisomy 18
polycystic kidneys, ectopic double ureter
83
WAGR Syndrome characterized by : ____
Wilms, aniridia, GU abnormalities, retardation
84
Beckett Weidmann Syndrome (IGF-2 dysregulation) is associated with _____ cancer
Wilms tumor, hepatoblastoma (screen with AFP + ultrasound q6 months)
85
Beckett Weidmann Syndrome (IGF-2 dysregulation) is associated with _____ cancer
Wilms tumor, hepatoblastoma (screen with AFP + ultrasound q6 months)
86
______ sequence associated with alcoholism, characterized by mandibular hypoplasia, cleft palate. Risk of airway obstruction in first 4 weeks of birth
Pierre Robin
87
New marfan diagnosis, you should get a _____ to make sure aortic root is stable
ECHO
88
Both constitutional growth delay and genetic short stature will have parallel normal velocities, BUT ____ has lower bone age
constitutional, also later puberty
89
Scenarios where weight gain is normal but not lenght gain in a child______
1) Skeletal dysplasia (normal bone age)
2) Thyroid deficiency
3) Growth hormone deficiency
4) Cushings
90
____ enuresis pattern is likely representative of real physiologic problem (UTI, DI, Constipation, Abuse)
Diurnal, not just at night
91
Measles has live components, so can only give vaccine after age ___. In contrast Rubella/Mumps have no post exposure prophylaxis
6 months - 12 months
92
Hep A prophylaxis
1) Age< 12 months____
2) Age>12 months_____
Ig Only, need to be atleast 12 months
| Ig + Vaccine
93
Dont forget ____ during suspected child abuse
dilated eye exam
94
Steeple sign narrowing on CXR is concerning for _____
Croup
95
Epiglottitis without drooling or dysphagia_____
Bacterial tracheitis
96
CXR finding for RSV bronchiolitis_____
Hyper-inflated lungs, hospitalize if RR>60
97
Most common type of ASD_____
Secundum, primary requires surgical repair
98
Treatment for pulmonic stenosis______
Balloon valvuloplasty, prostagland (keeps PDA open)
Also give prostaglandin for aortic stenosis
99
Most common cyanotic heart defect______ found after infancy
Most common cyanotic heart defect found during infancy _____
TOF: R ventricle hypertrophy, over-riding aorta, VSD, outflow tract obstruction
D Transposition: PDA dependent
Tricuspid Atresia: Total loss of RV,RA, relies on ASD/VSD, PDA for survival
100
____ characterized by VSD, abnormal connection between aorta and pulm artery
Truncus Arteriousus
101
____ murmur, findings of ebstein anomaly
holosystolic tricuspid regurg murmur, tall P wave, R axis deviation
102
____ parasite may cause chronic malabsorption
Giardia (duodenal aspirate)
103
Test for volvulus/malrotation_____
Ultrasound/ Barium enema
104
Test for volvulus/malrotation_____
Ultrasound/ Barium enema
105
Pediatric Cystitis Treatment
Pyelonephritis: Ampicillin + Gentamycin + Ceftriox
Tetracyclines after age 7 (Rememeber 8 x2 = 16)
Quinlones after age 16
106
Treatment of PSGN____
Penicillin + Supportive , antihypertensives if hypertensive
107
Management after diagnosis of Minimal Change Disease
Normal C3/C4
Steroids
Vaccinations: Varicella/Pneumococcus
108
Treatment of Kawasaki______
High dose aspirin + IVIG, maybe warfarin Plt high
109
Very high voltage , slow irregular waves can be a sign of this epilepsy disorder______. Treated with prednisone, B6, ACTH
West Syndrome, associated with downs syndrome
Highly irregular semiology of seizure
110
Treatment of generalized myclonic seizure____
Topiramate, else Valproate/Carbamazepine
111
For Duchene, the issue is a frameshift deletion of ______ gene
Dystrophin
Dx: Gene Test
Tx: Steroids, Eteplirsen (miRNA exon binder)
112
Absolute child safe cephaosporin______
Cefotaxime
113
Absolute child safe cephaosporin______
Cefotaxime
114
_____ is a Glycogen storage disorder characterized by neuropathy, leads to accumalation in ceremide
Fabry
