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Flashcards in Pediatrics Deck (902)
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1
Q

meningite and refractaire hypotension

A

waterhouse fredrichsen syndrome

2
Q

hemiplegia in chidren after having seizures

A

Todd paralysis

3
Q

4 forms of tetanos(2)

A

generalisee
localisee
cephalic
Neonatale

4
Q

dx differentiel of Lytic lesion on bone puls hypercalcemia(4)

A

osteomyelitis
endocrine
neoplastic
idiopathic

5
Q

clue for lytic lesion induced by osteomyelitis

A

brodie abcess

6
Q

endocrine cause of lytic bone lesion(2)

A

hyperparathyroidie

osteoid fibrosa cystica

7
Q

Neoplastic cause of bone lytic lesion(3)

A

erwing sarcoma
Langerhans hystiocystosis
Metastases

8
Q

quid of cephalhematoma

A

hemmoragie sous periostee

9
Q

clue for cephalhematoma

A

it doesn’t cross suture

limited to one cranial bone

10
Q

clue caput succedaneum

A

it crosses suture

11
Q

most common cause of functional asplenism in children

A

sickle cell disease

12
Q

cause of sepsis in asplenia

A

encapsulated bugs

13
Q

most common bug causing sepsis in asplenia

A

s pneumoniae

14
Q

cyanosis in infant first 24 hours of life

A

transposition of great vessels

15
Q

quid of transposition of great vessel

A

aorta in ventricule droit

artere pulmonaire in ventricule gauche

16
Q

what to suspect in child with reccurrent sinopulmonary infection

A

cystic fibrosis

17
Q

gold standard dx test for cystic fibrosis

A

sweat test for Na et CL-

18
Q

consequence of cow milk consumption in infant

A

iron deficiency anemia

19
Q

cyanosis in children less than 4 years

A

Fallot

20
Q

tetralogie de Fallot(4)

A

overriding Aorta
VSD
Subpulmonary stenosis
right ventricular hypertrophy

21
Q

Clue for PDA and VSD

A

no cyanosis

22
Q

Prader willi syndrome(3)

A

binge eating
hypotonia
obesity

23
Q

genetics of prader willi

A

paternal genetics deletion

15q11-q13

24
Q

genetics problem in cat cry syndrome

A

5p deletion

25
Q

genetics problem in angelman

A

15q11-q13

26
Q

genetics in beckwith wiedman

A

11p15

27
Q

clue for bweckwith

A

macroglossie

28
Q

clue megaoblastic anemia

A

hypersegmentation of the nucleus of neutrophils and other blodd cells

29
Q

most common cause of congenital hypothyroidism in the US

A

thyroid dysgenesis

30
Q

quid of thyroid dysgenesis(3)

A

ectopie
aplasie
hypoplasia

31
Q

Disease with Howell jolly bodies

A

sickle cell disease

32
Q

Meaning of howell jolly bodies and why

A

no spleen

spleen normally removes nuclear rmnants of red blood cells

33
Q

bite cells or heinz bodies(2)

A

G6PD deficiency

Thalassemia

34
Q

Helmet cells(3)

A

DIC
HUS
TTP

35
Q

cause of helmet cells

A

traumatic hemolysis

36
Q

other finding in traumatic hemolysis

A

schistocytes

37
Q

casue of basophilic stippling(2)

A

thalassemia

lead poisonning

38
Q

quid diamond blackfan anemia(2)

A

macrocytic anemia

congenital malformation in baby

39
Q

Mc cune albright syndrome(4) 3 P

A

femme
Puberte precoce
pigmentation
polyostotic fibrous dysplasia

40
Q

what will happen in polyostotic fibrous dysplasia

A

fracture a repetition

41
Q

casue of stroke in children(4)

A

internal carotid dissection
AF
homocystinuria
Todd paralysis

42
Q

clue for homocystinuria(4)

A

Marfan’s features
thromboembolic event
downward dislocation of the lens
mental retardation

43
Q

clue for marfans features(3)

A

long emaciated arms and legs
arachnodactily
hyperlaxity of the skin and joints

44
Q

cause of homocystinuria

A

deficiency in cystathione synthetase

45
Q

Dx test for homocystinuria(2)

A

high methionine

high homocysteine

46
Q

Rx of homocystinuria

A

B6

47
Q

failure of B6 in rx of homocystinuria

A

cysteine

48
Q

quid of leucocoria in USMLE

A

white eye reflex

49
Q

cause of leucocoria in kid

A

retinoblastoma until proven the contrary

50
Q

occlusion in first 24 hr in infant(2)

A

hirsprung

meconium ileus

51
Q

cause of meconium ileus

A

cystic fibrosis

52
Q

cause of intestinal occlusion from 24 h to 1 month

A

volvulus of midgut

53
Q

cause of intestinal occlusion > 1 month of age

A

stenose pylorique

54
Q

cause of cyanosis from 24 h to 4 ans

A

tetralogy de Fallot

55
Q

cause of osteogenesis imperfecta

A

deficiency in type 1 collagen synthesis

56
Q

congenital disease with coarctation of aorta

A

turner syndrome

57
Q

complication of congenital adrenal hyperplasia

A

puberte precoce

58
Q

enzyme deficiency in congenital adrenal hyperplasia

A

21 hydroxylase(CYP21A2)

59
Q

baby with cyanosis during feeding and relieved by crying

A

choanal atresia

60
Q

Dx of choanal atresia(2)

A

tube nasal

ct scan

61
Q

Dx test for hereditary spherocytosis

A

osmotic fragility study

62
Q

when to perform coombs test

A

autoimmune hemolytic anemia

63
Q

most common cause of nephrotic syndrome in children

A

minimal change disease

64
Q

next step when dx nephrotic syndrome in adult

A

biopsy renale

65
Q

calculate APGAR score

A
A:appearance
P:pulse
G:grimace
A:activity
R:respiration
66
Q

Monitoring Appearance in APGAR(3)

A

blue=0
blue pink=1
pink=2

67
Q

Monitoring pulse in APGAR(3)

A

absent=0

,100=2

68
Q

Monitoring grimace in APGAR(3)

A

absent=0
grimace,whimper=1
cough/cry=2

69
Q

Monitoring activity in APGAR(3)

A

limp=0
flexion=1
spontaneous active=2

70
Q

Monitoring respiration in APGAR(3)

A

absent =0
slow irregular=1
regular=2

71
Q

Normal APGAR

A

7-9

72
Q

abnormal APGAR

A
73
Q

patient with delayed separation of umbilical cord more than 30 days

A

leucocytes adhesion defect type 1

74
Q

clue for leucocytes adhesion defect type 1

A

CD18 expression deficiency

75
Q

risk in in baby whom mother taking cocaine during pregnancy

A

jejunal atresia

76
Q

xray abdomen in jejunal atresia(2)

A

tripple bubble sign

gasless colon

77
Q

xray showing double bubble sign

A

duodenal atresia

78
Q

abdomen xray in hirsprung

A

dilated loops of bowel

79
Q

how to diffenrenciate microcytic anemia caused by iron deficiency from thalassemia

A

RDW

80
Q

Clue for Iron deficiency anemia using RDW

A

RDW>20 %

81
Q

Normal RDW with microcytic anemia

A

thalassemia

82
Q

cause arthropathy in hemophilic patient(2)

A

deposit of hemosiderrin

fibrosis

83
Q

hemophilic patient cause

A

deficiency in factor 8
et
9

84
Q

children between 4-10 with hip pain(2)

A

Legg calve Perthes disease

avascular necrosis of femoral head

85
Q

Quid of measles

A

rubeola

rougeole en francais

86
Q

quid of koplik spots

A

bluish white lesions on buccal mucous membranes next to first and second molars

87
Q

gender in Mc cune albright syndrome

A

femme

88
Q

pigmentation in Mc cune Albright syndrome

A

cafe au lait spot

89
Q

gender in Lesh Nyhan syndrome

A

Male

90
Q

clue for Lesh Nyhan Syndrome(3)

A

Male
dystonia
self mutilation

91
Q

Gout in male children

A

Lesh Nyhan Syndrome

92
Q

physiopatho in Lesh Nyhan Syndrome

A

hypoxanthine guanine phophoribosyl transferase

93
Q

black stool in children

A

Meckel Diverticulum

94
Q

difference between congenital adrenal hyperplasia and hyperandrogenism

A

virilization in women

95
Q

Quid of macrosomia

A

> 4 kg

96
Q

risk in macrosomia

A

clavicular fracture

97
Q

how to recognize fetal alcoholic syndrome(3)

A

small palpebral fissures
absence philtrum
thin upper lip border= thin vermillon border

98
Q

Quid of Edward’s syndrome(5)

A
micrognatia
microcephaly
absent palmar creases
rocker bottom feet
overlapping fingers
99
Q

heart complication of Edward’s syndrome

A

VSD

100
Q

chromosome problem in Edward syndrome

A

trisomy 18

election age

101
Q

Heart problem in trisomy 21

A

ASD

102
Q

Heart problem in william’s syndrome

A

supravalvular aortic stenosis

103
Q

Heart problem in congenital rubella

A

PDA

104
Q

young kid with stomatitis and cheilitis sore throat andscaly pathes on eyebrows cheek and nose and photophobia dx?

A

ariboflavinose

105
Q

cause ariboflvinose in the US(3)

A

Anorexia nervosa
Malabsorption syndrome
Inborn defect in B2 synthesis

106
Q

pain articulation in young kid(3)

A

Legg calve
transient synovitis
hemophilic arthropathy

107
Q

infant with stridor acute respiratory distress toxic appearrance and fever first dx to think

A

epiglotitis

108
Q

first step in epiglotitis

A

intubation

109
Q

what to avoid in epiglotitis

A

never try to watch the epiglotte

110
Q

Bloody diarrhea plus IR plus low platelet

A

HUS

111
Q

cause of HUS in children

A

E coli 0157h7

112
Q

how E coli causes HUS

A

by producing verotoxin

113
Q

young kid with scrotal pain ,purpura and arthralgia

A

Henoch shonlein purpura

114
Q

complication of Henoch shonlein purpura

A

intussiception ileoileale

115
Q

age to have henock shonlein purpura

A
116
Q

seizure in afebrile children with wide qrs complex dry oral mucosa and dilated pupils and hypotension

A

TCA intoxication to rule out

117
Q

Rx of TCA intoxication

A

sodium bicarbonate

118
Q

action of Hydroxyurea

A

Increase HB F

119
Q

importance of hydroxyurea in sickle cell disease

A

prevention of painful crisis

120
Q

clue for cystic fibrosis(2)

A

diarrhea

probleme respiratoire a repetition

121
Q

breastfeeding contraindication(9)

A
herpes mammaire
HIV
TB
varicella
drug
alcohol
fetal galactosemia
chemotherapy
radiation
122
Q

for TB when the mother can be allowed to breastfeed

A

2 weeks after debut of treatment

123
Q

patient with blue eye and susceptibility to fracture

A

osteogenesis imperfecta

124
Q

quid opalescent teeth

A

yellow teeth

125
Q

disease with opalescent teeth

A

osteogenesis imperfecta

126
Q

red eyes in children in the first 24 h(2)

A

iatrogenic

nitrate d’argent

127
Q

red eyes in children in 2-5 days of birth

A

gonoccoque

128
Q

rx of conjunctivitis caused by gonoccoque

A

ceftriaxone

129
Q

red eyes in children 5- 24 jours of birth

A

chlamydia

130
Q

rx for conjuctivitis induced by chlamidya

A

oral erythromycin

131
Q

finding in severe combined immunodeficiency

A

low Lympho B and T

132
Q

cause of post vermis syndrome(2)

A

medulloblastoma

astrocytoma

133
Q

clue for scarlet fever(2)

A

sore throat

sand paper like appearrance

134
Q

clue for 21 hydroxylase in children(newborn)(4)

A

high K+
low TA
Low NA+
high 17 hydroxyprogesterone

135
Q

clue for 11 B hydroxylase

A

high 11 deoxycortocosterone

HTA

136
Q

cause of HTA in 11 B hydroxylase

A

HTA

137
Q

cause of HTA in 17 alpha hydroxylase

A

high corticosterone

138
Q

substance produced by adrenal cortex

A

G,F,R
Aldoesterone=G
fascicule=F
reticule=androgen

139
Q

clue for duchenne muscular dystrophy(2)

A

weakness in children before 5

wheelchair bound before 5

140
Q

clue for Becker muscular dystrophy

A

weakness in children after 5

141
Q

strawberry tongue in USMLE

A

kawasaki

142
Q

clue for Kawasaki(5)

A
Fever
adenopathy
extremities swelling
red eyes
skin erythema
143
Q

syndrome coronarien in kid

A

kawasaki

144
Q

rx of kawasaki(2)

A

aspirin and

immunoglobulin

145
Q

genotype of turner

A

45 XO

146
Q

gendre in turner

A

woman

147
Q

complication of turner(2)

A

osteoprosis

coarctation of aorta

148
Q

physiopatho in Marfan syndrome

A

mutation of the fibrillin -1 gene

149
Q

vascular problem in Marfan

A

aortic root dilation

150
Q

eye problem in marfan

A

upward dislocation of the lens

151
Q

children with unsteady gait ,and myocarditis

A

friedrich ataxia

152
Q

cause of T wave inversion(5)

A
MI
Myocarditis
Pericarditis
digoxin toxicity
Myocardial contusion
153
Q

EKG in friedrich ataxia

A

T wave inversion

154
Q

CAT in club foot

A

treat immediately

155
Q

clue hyper IGM syndrome(2)

A

Low neutophils
high IGM
low IGA and IGG
sinopulmonary infections and PCP pneumonia

156
Q

Bruton’s agammaglobulinemia

A

Low IG M
Low IG G
Low IG A

157
Q

finding in chronic pyelonephritis in children

A

focal parenchymal scarring and blunted calices

158
Q

bugs in otite moyenne(3)

A

strep pneumo # 1
non typable H flu # 2
Moraxella catharalis # 3

159
Q

consequence of vit D deficiency in children

A

rickets

160
Q

epidemiology for rickets

A

black children

161
Q

clue for Neuroblastoma in children(2)

A

high homovanillic acid

vanylilmandelic acid in urine

162
Q

origin of neuroblastoma

A

neural crest cells

163
Q

origin tumor de wills

A

metanephros

164
Q

renal tumor in children(2)

A

neuroblastoma

tumor de wilms

165
Q

murmeur in tetralogy of Fallot

A

squatting increases murmur

166
Q

cardiac problem in Down syndrome(3)

A

endocardial cushion defect #1 or complete atrioventricular canal
VSD
ASD

167
Q

clue for cyclic vomiting in children(2)

A

any cause can be found

history of migraine in the family

168
Q

bug in rheumatic fever

A

strep group A

169
Q

cause of NEC in baby

A

formula use

170
Q

abdomen xray in NEC

A

pneumatosis intestinalis

171
Q

quid of pneumatosis intestinalis

A

intramural air with dilated loops pof bowel

172
Q

rx of prematurity anemia

A

fer

173
Q

Lab for prematurity anemia(5)

A
mormochromic
normocytic 
anemia
low reticulocytes
total normal bilirubin level
174
Q

vasoocclusive manif in hand in sickle cell disease(2)

A

dactilytis

hand foot syndrome

175
Q

early manif of vasooclusive crisis in SCD(2)

A

dactilytis

hand foot syndrome

176
Q

quid of gastrochisis

A

no peritoneum covers the intestines

177
Q

quid omphalocele

A

ombilic ring herniation covered by peritoneum

178
Q

most common bugs causing pneumonia in cystic fibrosis(4)

A

Hi flu # 2
pseudomonas # 1
staph aureus # 4
strep pneumo #3

179
Q

gram positive diplococci

A

strep pneumo

180
Q

gram positive cooci in clusters

A

staph

181
Q

gram negativ cocci

A

neisseria

182
Q

gram positive rods

A

Lysteria monocytogenes

183
Q

gram negative rods(4)

A

Pseudomonas
Hi flu
Klebsiella
legionella

184
Q

cause # 1 of bronchiolitis

A

VSR

185
Q

risk future in bronchiolitis

A

asthma

186
Q

risk in use of erythromycin in baby

A

hypertrophis pyloric stenosis

187
Q

clue for Kartagena syndrome(3)

A

situs inversus
reccurrent sinusitis
bronchiectasis

188
Q

risk for patient having received inactivated vaccine in 1960

A

can develop atypical measles

189
Q

gold standard test for Duchenne muscular dystrophy

A

genetic studies

190
Q

number one cause of sepsis in sickle cell disease

A

Pneumococcus

191
Q

important thing to do in premature baby

A

iron till 1 year old

192
Q

consequence of cow milk consumption

A

anemia

193
Q

red blood cells in intrauterine growth restriction

A

polycythemia

194
Q

clue for congenital foot deformity

A

adduction of the foot

195
Q

Rx for congenital foot deformity(2)

A

reassurrance

no cast

196
Q

cardiac problem in congenital rubella(2)

A

PDA

ASD

197
Q

clue for turner (3)

A

feme naine
coarctation of aorta
Miley cyrus concert

198
Q

cardiac problem in Edward

A

VSD

199
Q

bugs causing infection in chronic granulomatosis disease

A

catalase positive organism

200
Q

quid of catalase positive organism(5)

A
SPACE
S:STAPH AUREUS 
P:PSEUDOMANAS
A:SPERGILUS
CANDIDA
ENTEROBACTERIACEA
201
Q

quid of enterobacteriacae

A

klebsiella

…..

202
Q

other name of laryngotracheobronchitis

A

croup

203
Q

indication of epinephrine in respiratory problem(2)

A

croup

asthma

204
Q

rx of in infection caused by pseudomonas in cystic fibrosis(2)

A

ceftazidine + gentamycine
or
ticarcilin + gentamycin

205
Q

rx of CGD

A

gamma interferon

206
Q

quid of henoch shonlein purpura

A

IGA vasculitis

207
Q

how to prevent sudden infant death syndrome

A

supine position while sleeping

208
Q

meaning of non pitting edema

A

lymphatic problem

209
Q

why people with turner has edema in feet

A

lymphedema

210
Q

kidney appearance in turner

A

horse shoe kidney

211
Q

disease with webbed neck

A

turner syndrome

212
Q

meaning of barking cough

A

croup

213
Q

cause of barking cough

A

parainfluenza type 1

214
Q

risk during delivery of macrosomia(3)

A

clavicle fracture
brachial plexus injury
perinatal asphyxia

215
Q

intestinal malformation associated with chromosomal abnormality

A

dudenal atresia

216
Q

risk in premature infant

A

intraventricular hemorrage

217
Q

what disease you can perform gutry test

A

phenylketonuria

218
Q

cause of avascular necrosis in children(3)

A

sickle cell disease
corticosteroid
alcoholism

219
Q

immune thrombocytopenia and viral infection

A

corticosteroid

220
Q

immune throbocytopenia and viral infection platelet 30 000

A

observation

221
Q

dx digeorge syndrome(5)CATCH

A
conotruncal cardiac  defects
abnormal facies
thymic aplasia
cleft palate
hypocalcemia
222
Q

anomaly chromosomal in Digeorge

A

22q11,2

223
Q

facies abnormaly in Digeorge(2)

A

low set ears

micrognatia

224
Q

waiters tip attitude and erb duchenne palsy

A

atteinte C5 C6 C7
extended elbow
pronated forearm
flexed wrist and fingers

225
Q

kid with failure to thrive and metabolic acidosis with normal anion gap,high urine PH 7,9 cause of failure to thrive

A

renal tubular acidosis

226
Q

kid with giardiasis in fection a repetition

A

genetic b cell deficiency

227
Q

physiopatho in nieman pick disease

A

sphingomyelinase deficiency

228
Q

quid of adrenarche

A

axillary hair growth

229
Q

quid of pubarche

A

pubic hair growth

230
Q

clue for bruton’s agamma globulinemia(2)

A

low IGM IGG and IGA

Lymphocytes B absent

231
Q

how’s temperature in neonatal sepsis(2)

A

high 30 C

low

232
Q

jaundice in children cause(4)

A

breastmilk
breast feeding
sepsis
hematologic problem

233
Q

peak in jaundice caused by breastmilk

A

2 weeks

234
Q

complication of galactosemia(2)

A

E coli neonatal sepsis

cataract in newborn

235
Q

enzyme deficiency in galactosemia

A

galactose 1 phosphate uridyl transferase

236
Q

cause of cirrhosis in neonate

A

galactosemia

237
Q

period of infantile colic

A
238
Q

cause of alkali ingestion intox

A

liquid oven cleaner

239
Q

management of alkali ingestion(4)

A

no charbon
no vinegar
no lavage gastrique
endoscopy

240
Q

physiopatho od reye syndrome in aspirin ingestion in infant

A

hyperammonemia

241
Q

advantage of breastfeeding in mother(7))

A
decreased the risk of 
breast cancer
ovarian cancer
more rapid uterine involution and post partum bleeding
fastter return to prepartum weight
improved maternal  infant bonding
imp[roved child spacing
242
Q

advantage of breastfeeding in kid(5)

A
decreased risk of otite moyenne
improve immunity
prevention of respiratory illness
decreased risk of NEC childhood cancer and type 1 diabetes
prevent gastroenteritis
243
Q

additionnal finding in atresia oesophagienne

A

tracheo esophageal fistula

244
Q

clue for foreign body aspiration

A

wheezing in infant

245
Q

best test in foreign body aspiration

A

bronchoscopy

246
Q

enfant controle tete et cou a quel age

A

2 mois

247
Q

controle du bassin(2)

A

4 mois

6 mois

248
Q

pull to stand a quel age

A

9 mois

249
Q

stand and marche a quel age

A

12 mois

250
Q

can say papa mama

A

9 mois

251
Q

language of baby in 12 months(3)

A

mama
papa
plus one word

252
Q

fine motor development in baby a 2 mois

A

ferme les mains

253
Q

fine motor development in baby a 4 mois

A

ouvre mains

254
Q

fine motor development in baby a 6 mois

A

passe objet d’une main a une autre

255
Q

fine motor development in baby a 9 mois

A

pince a 3 doigts

256
Q

fine motor development in baby a 12 mois

A

pince a 2 doigts

257
Q

skin rash and vasomotor collapse during meningoccemia cause of death in children

A

adrenal gland failure

258
Q

meningoccemia and adrenal failure percentage of death

A

100%

259
Q

hemiplegia in infant after seizures that usually improves within 24 hours

A

Todd paralysis

260
Q

seizure description in infant in the USMLE

A

sudden loss of consciousness with following disorientationand slow gain of consciousness

261
Q

importanse of todds paralysis

A

there ‘s a structural abnormality underlying the seizure

262
Q

patient with spasms 14 yo and swollen and erythemastous ombilical cord dx

A

tetanus neonatal

263
Q

major source of protein in milk

A

whey

264
Q

advantage of human mlik

A

more easily absorbs

improves gastric emptying

265
Q

evolution of cephalematoma

A

resorb spontaneously wuthin weeks to 3 months

266
Q

clue for drinking cow milk in USMLE

A

whole milk

267
Q

clue for tetralogy de fallot(2)

A

tet spell

cyanosis during tet

268
Q

cause of tet spells

A

sudden spasm of the right ventricular outflow tract during exertion

269
Q

murmur in Fallot

A

crescendo decrescendo systolic murmur over the left upper sternal border

270
Q

complication of praderr willi syndrome(4)

A

sleep apnea
Type 2 diabetes mellitus
gastric distension and rupture
death by choking

271
Q

howel jolly bodyes

A

nuclear remnant of red blood cell

272
Q

congenital malformation in diamond blacfan diamond(4)

A

short stature
webbed neck
shieleded chest
triphalangeal thumbs

273
Q

lens dislocation in marfan syndrome

A

upward

274
Q

lens dislocation in homocystinuria

A

down ward

275
Q

what to do devant leukocoria

A

refer to ophtalmologist

276
Q

clue for midgut volvulus(3)

A

child less than 1 month with bilious vomiting
abdominal distension
passage of bloodstained stools

277
Q

development of child of 2 years(3)

A

speak in 2 words
follow two steps command
two quarters of speech intelligible

278
Q

development of child of 3 years(3)

A

use three word sentences
threequarters of speech intellible
ride tricycle

279
Q

complicationin severe type 2 osteogenesis imperfecta(4)

A

death in utero
multiple intrauterine fracture
blue sclera
growth retardtion

280
Q

patient with menigitidis requires urgent LP who must give consent for the procedure and why(2)

A

no consent is needed

it’s an emergency procedure

281
Q

emergent act with no need of consent(2)

A

intubation for respiratory failure

LP

282
Q

xray finding in coarctation of the aorta

A

rib notching

283
Q

cause of rib nocthing in coarctzation of aorta in turner

A

dilatation of the collaterals between the hypertensive chest walls vessels

284
Q

characteristics of coarctation of aorta(2)

A

hypertension in upper part of the body

hypoperfusion in the lower part of the body

285
Q

why continuous murmur on chest in coarctation of aorta

A

development of collaterals betweenthe hypertensive and hypoperfused vessels

286
Q

young boy with bitemoral hemianopsia,symptom of intracranial pressure calcified lesion above the sella dx

A

craniopharyngioma

287
Q

MRI with cystic calcified parasellar lesion

A

craniopharyngioma

288
Q

clue for congenital adrenal hyperplasia late onset(non classic)(4)

A

advanced bone age
coarse axillary and pubic hair
severe cystic acne
normal electrolytes

289
Q

clue for peripheral precocious puberty(2)

A

low baseline levels of LH

no modification of LH after stimulation with a gonadotrophin releasing hormone agonist

290
Q

clue for classic CAH(3)

A

neonatal period manifestation
adrenal insufficiency
ambiguous genitalia

291
Q

hemolytic anemia characteristics(5)

A
mild to moderate anemia
reticulocytosis
unconjugated bilirubinemia
low to absent serum haptoglobin
high lactate dehydrogenase
292
Q

first step in children with meningitidis(2)

A

LP

followed by ceftriaxone plus vancomycine

293
Q

when using imaging prior to LP(3)

A

focal neurologic finding
coma
history of neurosurgical surgery

294
Q

local impetigo characteristics

A

vesiculopustular lesions golden yellow and encrusted

295
Q

rx of impetigo

A

topical mupirocin

296
Q

spherocytose hereditaire in new born(3)

A

hemolytic anemia
jaundice
splenomegaly
increased mean corpuscular hb concentration

297
Q

problem in hereditary spherocytosis

A

defect of red blood cell membrane

ankyrin gene abnormality causes spectrin defivciency

298
Q

dx of spherocytosis(2)

A

high osmotic fragility in acidified glycerol lysis test

abnormal eosin5 maleimide binding test

299
Q

rx of hereditary spherocytosis(3)

A

folic acid supplementation
blood transfusions
splenectomy

300
Q

complication of hereditary spherocytosis(2)

A

pigment gallstones

aplastic crisis from parvovirus B19

301
Q

hemiplegia in child after accident with pencil penetration in mouth at school

A

traumatic carotid artery dissection

302
Q

consequence of trauma in the soft palate

A

risk of stroke in children

303
Q

rx of minimal change

A

prednisone

304
Q

during apgar evaluation baby has HR

A

pulse oxymetry monitoring

positive pressure ventilation

305
Q

clue for impaired leucocytes adhesion type 1(5)

A

delayed separation od umbilical cord
reccurrent bacterial infections of skin and mucosal surfaces
necrotic perriodontal infection
no pus in inflamed or infected tissue
leucocytosis with neutrophil predominance

306
Q

maternal I drug user , baby with failure to thrive,lymphadenopathy,thrush dx

A

HIV infection

307
Q

hiv testing in hiv drug use during pregnancy(2)

A

1 trimestre

3e trimestre

308
Q

xray in duodenal atresia

A

double bubble sign

309
Q

cause of microcytic anemia in children

A

consumption of > 24 ounces per day of cow milk(700ml)

310
Q

inheritance of hemophilia

A

Xlinked recessive

311
Q

screening test of hemophilia(2)

A

coagulation studies

platelet count

312
Q

rx of hemophilia

A

administration of factor 8 et 9

313
Q

boy 4 -10 ans with hip and knee pain with insidious onset and antalgic gait.xray

A

legg calve perthes disease

314
Q

adolescent with hip pain obese

A

slipped femoral capital epiphysis

315
Q

when to suspect respiratory distress syndrome in premature infant(3)

A

premature infant with
grunting
flaring
retraction immediately after birth

316
Q

dx in prematured infant with respiratory distress

A

hyaline membrane disease

317
Q

xray in hyaline membrane disease

A

fine reticular granularity

318
Q

treatment of hyaline membrane disease

A

continuous positive air pressure ventilation

319
Q

charactheristics of acquired aplastic anemia

A

everything is low=pancytopenia

320
Q

cause of acquired aplactic anemia(2)

A

drugs

infectiom

321
Q

drug causing acquired aplastic anemia

A

chemo

chloramphenicol

322
Q

toxins causing aplastic anemia(2)

A

benzene

carbon tetrachloride

323
Q

mode de contamination of measles

A

infected droplets from respiratory secretions

324
Q

rash characteristic in measles(2)

A

cephalocaudal and

centrifugal spread

325
Q

confirmatory dx of measles

A

PCR

326
Q

complication of measles(4)

A

otitis media
pneumonia
neurologic
gastroenteritis

327
Q

neurologic complication of measles(2)

A

encephalitis within days

subacute sclerosing panencephalitis within years

328
Q

premature child with seizures hypotension focal neurologic findings bulging and tense fontanel apna and bradychardia cause of symptoms

A

intraventricular hemmorage

329
Q

what do to in any premature infant even if asymptomatic

A

transfontanel ultrasound

330
Q

why gout in lesh nyhan syndrome

A

deficiency in hypoxanthine guanine phosphorybosil transferase

331
Q

role of hypoxanthine guanine phosphorybosil transferase

A

purine metabolism

332
Q

young boy with gout

A

lesh nyhan syndrome

333
Q

clue for intussuception in USMLE

A

palpable cylindrical mass on the right side of the abdomen

334
Q

patient with recurrent intussuception

A

rule out meckel

335
Q

cause of intussuception(3)

A

recent viral illness
rotavirus vaccination
pathological lead point

336
Q

quid of pathological lead point(5)

A
congenital malformation of the intestines like meckel
henoch shonlein purpura
celiac disease
intestinal tumor
polyps
337
Q

clue for meckel(3)

A

suden intermittent abdominal pain
currant jelly stools
sausage shaped abdominal mass

338
Q

dx of Meckel(3)

A

target sign on ultrasound
technetium 99m pertechnetate scanning
explorative laparoscopy

339
Q

rx of intussuception(2)

A

enema

surgery for removal of lead point

340
Q

management of cyanosis in fallot(2)

A

knee chest positionning

inhaled o2

341
Q

definitive rx of Fallot

A

surgery before age of 6

342
Q

the most common cause of congenital adrenal hyperplasia

A

21 hydroxylase deficiency

343
Q

what will happen in 21 hydroxylase deficiency(2)

A

hyeperandrogenism=hirsutism

Plus virilism

344
Q

clue for congenital adrenal hyperplasia(2)

A

elevated 17 hydroxyprogesterone

certain degree of dsalt wasting

345
Q

most common cause of hyperandrogenism and oligo ovulation

A

PCOS

346
Q

cause of hyperandrogenism en dehors de PCOS(6)

A
ovarian or adrenal tumors
late onset of adrnal hyperplasia
hyperprolactinemia
hyperprolactinemia
acromegaly
cushing disease
347
Q

hyperandrogenism plus high 17 hydroxyprogesterone

A

CAH

348
Q

clue for acromegaly

A

high insulin like growth factor

349
Q

clue for clavicular fracture in baby(2)

A

crepitus

moro reflex asymetric

350
Q

consequence of hyperinsulinism in macrosome(2)

A

viceromegaly

fat accumulation

351
Q

cause of intellectual disability(3)

A

fetal alcohol syndrome
down syndrome
fragile X syndrome

352
Q

clue fragile x syndrome(5)

A
macroorchidism
macrocephaly
large ears
long narrow face
prominent forehead and  chin
353
Q

face of patient with down syndrome

A

flat facial profile
slanted palpebral fissure
small low set ears

354
Q

body of patient with Down(4)

A

excessive skin at nepe of the neck
single transvers palmar crease
clinodactyly
large space between the first 2 toes

355
Q

2 yo kid with noisy breathing worsen when lying on his back or crying or feeding dx?

A

laryngomalacia

356
Q

2 yo kid with noisy breathigh worset when lying on his back or crying way to confirm the dx

A

flexible laryngoscopy

357
Q

flexible laryngoscopy of laryngomalacia(2)

A

collapse of supraglottic structures with inspiration

omega shape epiglottis

358
Q

evolution of laryngomalacia

A

spontaneous resolution by age of 18 months

359
Q

inspiratory stridor in laryngomalacia

A

noisy breathing

360
Q

peak for laryngomalacia

A

4-8 mois

361
Q

clue for hypothyroidism in infant(6)

A
baby normal at birth 
later apathy
hypotonia
sluggish movement
abdominal bloating 
umbilical hernia
362
Q

screening test in baby in the US(3)

A

hypothyroidism
Phenylketonuria
galactosemia

363
Q

murmur in VSD

A

holosystolic murmur at the left sternal border

364
Q

most common cause of congenital abnormality

A

VSD

365
Q

best tes if you suspect VSD

A

echocardiography

366
Q

evolution of vSD

A

75% des cas close spontaneously by age 2

367
Q

blood stained odorless vaginal discherger in kid

A

reassurrance

368
Q

cause of vaginal discherge in infant

A

effect of maternal estrogen

369
Q

how many doses a kid from 6 weeks to 6 years should receive

A

5 doses

370
Q

patient in the past has febrile seizure when receiving DTP acellular can we give this patient hs 4 th dose and why (2)

A

yes

febrile seizure is not a contrindication for acellular pertussis

371
Q

contrindication for further administration of pertussis(3)

A

immediate anphylaxia
unstable neurologic disorder
encephalopathy
wthin a week administration of pertussis containing vaccines

372
Q

child from 3-10 year old develops hip pain following rhinorrhea and intermittent cough xrayu is normal no history of fever is noted dx

A

transient synovitis

373
Q

rx of transient synovitis(3)

A

Ibu
rest
follow up in 1 week

374
Q

indicator to look at in dx septic arthritis

A
fever > 38.5
inability to bear weight
wBC> 12000
ERS > 40
CRP>2.0 mg/dl
375
Q

normal CRP

A

20 mg/l

376
Q

why you should ask bilateral hip xray even if you suspect transient synovitis

A

to rule out leg calve perthes disease

377
Q

patient presenting in consultation a 24 mois d’age with .cover test reveals moderate deviation of the left eye dx

A

strabismus

378
Q

complication of strabismus

A

amblyopia

379
Q

what to do in dx of strabismus

A

occlusion of the normal eye

380
Q

cause of amblyopia(3)

A

strabismus
errors of refraction
opacity of the media along the visual axis

381
Q

can you see a patient with epiglotittis like out patient

A

no because it’s a medical emergency

382
Q

patient dx with epiglotitis with respiratory distress next step

A

endotracheal intubation with a set up for tracheostomy

383
Q

why you can ‘t encounter epiglotitis caused by HIB

A

because of vaccination

384
Q

after bloody diarrhea patient develops anemia
low platelet
and renal insufficiency dx?

A

SHU

385
Q

cause of SHU

A

E coli producing verotoxin

386
Q

patient between 2-12 ans with bilateral lower extremities pain occurring at night bilateral with normal physical exam with normal activity leveldx?

A

growing pain

387
Q

cause of growing pain

A

unknown

388
Q

rx of growing pain(4)

A

observation
parental reassurance
massage
over the counter pain medications

389
Q

quid of purpura in USMLE

A

non blanching rash

390
Q

pathogenesis of Henoch shonlein purpura(2)

A

IG A deposit in affected organs

immune mediated leukocytoclastic vasculitis

391
Q

role in sodium bicarb in the rx of TCA intoxication(2)

A

correct the acidosis

narrow the qrs complex prolongation

392
Q

patient presenting with microcephaly,hypotonia

short stature and cat like cry

A

cri du chat syndrome

393
Q

weight loss in baby

A

up to 7% in the first 5 days

394
Q

baby comes by the day five with weight loss of

A

continue exclusive breast feeding

395
Q

baby comes by the day five with weight loss of > 7% next step(4)

A

assess for oromotor dysfunction
assess for lactation failure
daily weights
consider formula supplementation

396
Q

in vignette diaper with brick dust appearance or pink stains in baby with dehydration why

A

it’s caused by uric acid crystals

397
Q

when should a babay regain weight after losing weight during the 5 first days

A

entre 10 a 14 jours

398
Q

cause of growth failure in cystic fibrosis

A

pancreatic insufficiency

399
Q

cause of pancreatic insufficiency in cystic fibrosis(2)

A

inspissation

obstructionof pancreatic ducts

400
Q

tests for cystic fibrosis(3)

A

Sweat chloride test
genotyping
fecal elastase

401
Q

kid with growth failure and reccurrent respiratory infection

A

cystic fibrosis

402
Q

contrindication of breast feeding maternal conditions(8)

A

active unrx TB
maternal hiv infection
herpetic breast lesions
varicella infection

403
Q

when a mother on anti TB can begin to breast feed baby

A

2 weeks after beginning anti TB drugs

404
Q

infants condition with contrindication of breastfeeding

A

galactosemia

405
Q

clue for osteogenesis imperfecta(5)

A
autosomal dominant
osteopenia
blue sclerae
hearing loss
dentinogenesis imperfecta
406
Q

quid of dentinogenesis imperfecta

A

opalescent blue gray to yellow brown discoloration caused by discolored dentin shining through the transluscent and weak enamel

407
Q

what about intelligence in patient with osteogenesis imperfecta

A

normal intelligence

408
Q

rx of neonatal conjunctivitis induced by gonoccoque

A

parenteral ceftriaxone
or
cefotaxime

409
Q

rx of neonatal conjunctivitis induced by chlamydia trachomatis

A

oral erythromycin

410
Q

characteristic of chlamydial neonatal conjunctivitis(2)

A

blood stained eye discharge

mucoid discharge

411
Q

patient with reccurent sinopulmonary infections oral candidiasis persistent diarrhea absent lymp nodes Low B and T cells and natural killer absent thymic shadow dx

A

severe combined immunodeficiency

412
Q

most 2 common tumor of posterior fossa(infratentorial tumor) in children(2)

A

astrocytoma

medulloblastoma

413
Q

if a kid has a medulloblastoma what area of the brain will be most likely affected

A

cerebellar vermis

414
Q

post vermis syndrome(4)

A

unbalanced gait
trunk dystaxia
horizontal nystagmus
papilledema

415
Q

vaginal discharge and enlargement of mammary glands in newborn infants next step?

A

observation

416
Q

bugs causing scarlet fever

A

Group A streptococcus producing exotoxins

417
Q

kid with sore throat ,fever sand paper rash stawberry tongue and circumoral pallor dx

A

scarlet fever

418
Q

rx of choice of scarlet fever

A

penicillin V

419
Q

first born boy 3 a 5 semaines de naissance with projectile nonbilious vomiting after feed
physical exam reveals palpable olive shaped mass in the RUQ

A

pyloric stenosis

420
Q

metabolic problem in pyloric stenosis(3)

A

hypochloremic
hypokalemia
metyabolic acidosis

421
Q

dx of pyloric stenosis (2)

A

abdominal US

elongated and thickened pylorus

422
Q

rx of choice of pyloric stenosis

A

pylotomyotomy

423
Q

what to do before surgical rx of pyloric stenosis and why(2)

A

correct metabolic problem

sinon risque of post op apnea

424
Q

characteristics in 21 hydroxylase deficiency(5)

A
anbiguous genitalia in  girl
salt  wasting
hypotension 
low NA+
high K+
425
Q

hormone abnormality in 21 hydroxylase deficiency(3)

A

low cortisol and aldosterone
high testo
high hydroxyprogesterone

426
Q

characteristics in 11 B hydroxylase deficiency(3)

A

ambiguous genitalia in girls
fluid and salt retention
hypertension

427
Q

hormone abnormality in 11 B hydroxylase deficiency(4)

A

low cortisol and aldosterone
high testo
high 11-deoxycorticosterone
high deoxycortisol

428
Q

characteristics in 17 @ hydroxylase deficiency(3)

A

all patients are female
fluid and salt retention
hTA

429
Q

hormone abnormality in 17 2 hydroxylase deficiency(3)

A

low cortisol and testo
high mineralocorticoids
high corticosterone

430
Q

first step in the management of choanal atresia(2)

A

placing oral airway

lavage feeding

431
Q

definitive rx of choanal atresia(2)

A

repairing obstruction with surgery
or
with endoscopy

432
Q

child less than 5 years with proximal muscles weakness gower sign and bilateral calf pseudohypertrophy dx

A

duchenne muscular dystrophy

433
Q

quid of gower sign

A

patient uses hands to walk up the legs in order to stand up

434
Q

cause of DMD

A

dystrophin gene deletion on XP 21

435
Q

cause of death in DMD(2)

A

respiratory failure
or
heart failure

436
Q

clue for kawasaki disease(6)

A

fever > ou egal a 5 jours plus > ou egal a 4 findings
bilateral non exsudative conjunctivitis
mucositis
cervical lymph node with at least one > 1,5 in diameter
erythematous polymorphous rash
extremity changes( edema or erythema)

437
Q

mucositis in kawasaki disease(3)

A

strawberry tongur
injected or fissured lips
injected pharynx

438
Q

complication of kawasaki(2)

A

coronary artery aneurism

myocardial infarction and ischemia

439
Q

rx of kawasaki(2)

A

aspirin
plus
IV immunoglobulin

440
Q

role of aspirin and immunoglobulin in kawasaki

A

to reduce incidence of complications such as coronary artery aneurisms

441
Q

clue for turner(4)

A

short height
high arched palate
widely spaced nipples
45 X0 karyotype

442
Q

why osteoporosis in turner(2)

A

low estrogen levels

only one X chromosome involved in bone metabolism

443
Q

patient with an autosomal dominant disorder presenting with tall stature,long and emaciated extremities,arachnodactyly hypermobility of joints upward lens dislocation aortic root dilation dx

A

Marfan syndrome

444
Q

patient at risk for transposition of great vessels(2)

A

diabetic mother

males

445
Q

physical examination in transposition of great vessels(2)

A

loud second heart sound

cyanosis

446
Q

patietn with history of diabetes mellitus type 1 presents with conjonctival pallor and micrcytic anemia but no blood in feces examination.skin with vesicule erythemateuses symmetrically distributed over the extensor surfaces of elbows and knees .dx

A

celiac disease

447
Q

extraintestinal manifestation on celiac disease in the vignette(3)

A

diabete type 1
dermatitis herpetiforme
iron deficiency anemia

448
Q

skin problem in celiac disease(2)

A

dermatite herpetiforme

vitiligo

449
Q

endocrine problem in celiac disease(2)

A
diabete type 1
autoimmune thyroiditis (hypo ou hyper)
450
Q

psychiatric problem in celiac disease(2)

A

depression

psychosis

451
Q

musculoskeletal problem in celiac disease(2)

A

osteopenia/osteoporosis

osteomalacia

452
Q

dx of celiac disease

A

upper GI andoscopy with biopsy of small intestine

453
Q

marker of celiac

A

IG A antitissue transglutaminase

454
Q

9 yo girl with unsteady gait and weakness in the lower limbs .On examination widebased gait and constant shifting of position to maintain her balance.you have decreased vibratory and position sense in lower extremities

A

friedrich ataxia

455
Q

MRI in friedrich ataxia(2)

A

marked atrophy of cervical spinal cord

minimal cerebellar atrophy

456
Q

what you should advise to mother with kid suffering from friedrich ataxia

A

prenatal counselling if the mother desires any future pregnancy

457
Q

quid of friedrich ataxia(2)

A

autosomal recessive

abnormality in tocopherol transfer protein

458
Q

infectious protection by sickle cell trait

A

severe complication of malaria

459
Q

differenciate hyper IGM syndrome from xlinked agammaglobulinemia(3)

A

in hyper IgM syndrome
opportunistic infection+++
neutropenia
high IGM levels

460
Q

risk factor for chronic pyelonephritis

A

vesicoureteral reflux

461
Q

clinical feature of media otitis(2)

A

middle ear effusion\

bulging tympannic membrane

462
Q

complication of otitis media(3)

A

conductive hearing loss
mastoiditis
meningitis

463
Q

rx of otitis media(2)

A

amox
or
amox clavulanate

464
Q

risk factor for media otitis in children(4)

A

age 6-36 months
formula intake
exposure to cigarette smoke
upper respiratory infection

465
Q

Ct for mastoiditis(2)

A

no air in mastoid air cells

they are opacified

466
Q

patient 11 months with pliable skull bones,bony prominences of costochondral junctions genu varum cause of these findings(2)

A

nutritionnal deficiency

vit D

467
Q

costochondral joint hypertrophy in rickets quid?

A

rachitic rosary

468
Q

genu varum in rickets

A

femoral and tibial bowing

469
Q

risk factor for Vit D deficiency(4)

A

increasd skin pigmentation(black)
exclsive breastfeeding
inadequate sun exposure
maternal vit D deficiency

470
Q

pliable skull bones with step offs in rickets or ping pond ball skull

A

craniotabes

471
Q

xray in rickets

A

metaphysal cupping and fraying of long bones

472
Q

rx of rickets

A

Vit D 1000-2000 UI daily

473
Q

most common form of cerebral palsy seen in premature infants

A

spastic diplegia

474
Q

quid of spastic displegia(4)

A

hypertonia
hyperreflexia
involving lower extremities
clasp knife

475
Q

quid of clasp knife in cerebral palsy

A

resistance to passive muscle movement increases with more rapid movement of the affected extremity

476
Q

leading cause of cerebral palsy

A

prematurity

477
Q

other causes of cerebral palsy(7)

A
intrauterine growth restriction
intrauterine infection
antepartum hemorrage
placental pathology
multiple gestation
maternal alcohol consumption
maternal tobacco use
478
Q

rx of cerebral palsy in spasticity(2)

A

baclofen and

botulinum toxin

479
Q

comorbidities associated with cerebral palsy(4)

A

intellectual disability
epilepsy
strabismus
scoliosis

480
Q

localisation of neuroblastoma(2)

A

adrenal gland

any location along the paravertebral sympathetic chains

481
Q

quid of neural crest cells

A

precursor cells of the sympathetic chains and adrenal medulla

482
Q

CT or Xray in neuroblastoma(2)

A

calcifications

hemorrage

483
Q

quid of metanephros

A

embryologic precursor of renal parenchyma

484
Q

quid of metabolites of cathecholamines found in neuroblastoma(2)

A

HVA

VMA

485
Q

key physical exam for down syndrome(5)

A
upslanting palpebral fissures
epicanthal folds
brushfield spots
single transverse crease
sandal gap toes
486
Q

GI problem associated with Down(2)

A

duodenal atresia

hirshprung disease

487
Q

neurocognitive problem associated with Down syndrome(2)

A

intellectual disability

early onset alzheimer

488
Q

hematologic problem associated with Down syndrome

A

acute leukemia

489
Q

endocrine problem associated with Down syndrome(2)

A

hypothyroidism

type 1 diabetes mellitus

490
Q

musculoskeletal problem associated with Down syndrome(2)

A

atlantoaxial instability

491
Q

porcentage of down with heart problem

A

50%

492
Q

what age down syndrome patient will have heart failure

A

around 6 weeks

493
Q

auscultation finding in heart failure in patient with down

A

S2 due to pulmonary hypertension

494
Q

patient with circular rash after trip in connecticut dx

A

lyme disease

495
Q

prevention of lyme in lyme endemic area(2)

A

wear permethrin treated pants

long sleeved shirts

496
Q

7 yo girl comes for vomiting,this is the 3 episode the last two were self limiting .Physical exam is ok dx

A

cyclical vomiting

497
Q

parental antecedent for children with cyclical vomiting

A

migraine in parents

498
Q

patient with severe dehydration IV line can be found next step

A

intraosseous access

499
Q

how long can you use an intraosseous access

A

24 a 48 heures

500
Q

patient with difficulty writting and jerky movements,days later he has sore throat but now has low grade fever.pericardial friction,a subcutaneous nodules over the hands dx?

A

rheumatic fever

501
Q

cause of rheumatic fever

A

Group A streptococus

502
Q

5 major criterai in jones criteria(5)

A
polyartritis
carditis
chorea
subcutaneous nodules
erythema marginatum
503
Q

3 minor criteria for jones

A

fever
athralgia
previous rheumatic fever

504
Q

dx of rheumatic fever(3)

A

one major pour 2 minor
or
two major
plus detection af antistreptolysin antibodies or cultures or varrious antigens detection

505
Q

rx of rheumatic fever

A

PNC G

506
Q

2 day old baby is seen with irritabilioty,high pithed cry,poor sleeping tremors,seizures sweating sneezing tachypnea poor feeding vomiting and diarrhea dx

A

neonatal abstinence syndrome

507
Q

drug involved in neonatal abstinence syndrome(2)

A

heroin

methadone

508
Q

time of apparition of neonatal abstinence syndrome(2)

A

48 h after birth for heroin withdrawal

48 a 72 h for methadone withdrawal

509
Q

clue for NEC(5)

A
newborn with 
abdominal distension 
bloody diarhea
 and leucocytosis 
after introduction of formula feeding
510
Q

clue for craniopharyngyoma(3)

A

young boy with increased intracranial pressure
bitemporal hemianopsia
calcified lesion above the sella

511
Q

clue for cranyopharyngioma

A

cystic clcified parasellar lesion on MRI

512
Q

cause of anemia in premature infant(4)

A

transition in the erythropoiesis sites of the neonate
shorter red blood cells in neonates
diminished fetoplacental transfusion
blood loss

513
Q

black child 9 month old with augmentation de volume des pieds et mains et douleur dx

A

dactylitis caused by sickle cell anemia

514
Q

pathophysiology of dactilytis

A

vaso occlusive phenomena

515
Q

what the earliest manif of vasoocclusive disease in sickle

A

dactylitis

516
Q

neonate seen in with matted mass of edematous bowel loops protruding from the abdomen .There is no covering ovr the bowel loops dx

A

gastrochisis

517
Q

gastrochisis next step after the DX

A

sterile saline dressing and wrapping of exposed bowel

518
Q

characteristics of gastrochisis(4)

A

bowel protrude through a defect on the right side of the ombilical cord
bowel is not covered by protective membrane
bowel looks angry and matted
no other abnormalities associated

519
Q

characteristics of omphalocele(3)

A

intera abdominal contents through the umbilical ring
bowel is covered with amnioperitoneal membrane
associated with other abnormalities(heart ,kidney)

520
Q

patient with omphalocele what other organ to look at(2)

A

heart

kidney

521
Q

why you should wrap and dress bowel in gastrochisis(2)

A

to minimize heat loss

and fluid loss

522
Q

most common cause of pneumonia in cystic fibrosis

A

Pseudomonas aeruginosa

523
Q

mode de transmission de cystic fibrosis CF

A

autosomal recessive

524
Q

why bronchiectasia in CF

A

recuurrent pneumonia

525
Q

quid of clubbing

A

bulbing enlargement of the tips of digits

526
Q

cause of clubbing in CF

A

chronic hypoxia

527
Q

appearance of thorax in CF

A

barrel chest

528
Q

3 phases in developping bordetella pertussis(3)

A

catarrhal phase
paroxysmal phase
convalescent phase

529
Q

whooping chronic cough in kid with delayed immunization with posttussive emesis

A

bordetela pertussis infection

530
Q

clue for catarrhal phase in pertussis(2)

A

mild cough

rhinitis

531
Q

clue for paroxysmal phase in pertussis(4)

A

coughing paroxysm lasting 20 a 30 mn
inspiratoty whoop
staccato cough
posttussive emesis

532
Q

clue for convalescent phase in pertussis(2)

A

cough

posttussive emesis resolve

533
Q

duration of paroxysmal phase

A

4-6 weeks

534
Q

dx pf pertussis(2)

A

PCR

pertussis culture

535
Q

hemogramme in pertussis

A

lymphocyte predominant leukocytosis

536
Q

complication of pertussis(6)

A
pneumonia
weight loss
subconjonctival hemorrage
pneumothorax
respiratory failure 
death
537
Q

rx of pertussis

A

macrolides

538
Q

macrolides used in pertussis(3)

A

azythromycin
erythromycin
clarythromycin

539
Q

what age you can have death in infant with pertussis

A

less than 6 months

540
Q

the only way to prevent chlamydial conjunctivitis in neonates

A

maternal prenatal testing

541
Q

clue for duchenne muscular dystrophy(3)

A

bilateral calf pseudohypertrophy
gower sign
mx weakness

542
Q

transmission of Duchenne

A

x linked recessive transmission

543
Q

screening of Duchenne muscular dystrophy(2)

A

elevated serum creatine phosphokinase

elevated aldolase levels

544
Q

dx support of duchenne(2)

A

fibrosis

fatty infiltration in biopsy

545
Q

gold standard to confirm the dx of DMD

A

genetic studies

546
Q

risk factor for iron deficiency anemia in kid(3)

A

cow’s milk before 12 months
prematurity
maternal iron deficiency

547
Q

why you should introduce vit D to all chldren exclusively breastfed during first month of life

A

human milk does not contain enough VIT D to meet daily requirement of the infant

548
Q

dose of VIT D to give in infant exclusively breast fed

A

400 UI

549
Q

quid of small for gestationnal age infant for age

A

weight under 10 th percentile for gestationnal age at birth

550
Q

complication of small gestationnal age child(5)

A
hypoxia
polycythemia
hypoglycemia
hypothermia
hypocalcemia
551
Q

classification of intrauterine growth restriction(2)

A

symmetrical

assymetrical

552
Q

clue for symmetrical intrauterine growth restriction

A

head weight and head are equally affected

553
Q

clue for asymmetrical intrauterine growth restriction

A

weight is affected more than height and head circumference

554
Q

quid of metatarsal adductus(2)

A

deformity of foot

adduction of the anterior aspect of the foot with convex lateral border and concave medial border

555
Q

rx of metatarsal adductus

A

reassurrance

556
Q

rx of internal torsion of tibia in infant

A

reassurrance

557
Q

baby 4 months old with blue macules on buttocks and and lower back (2)

A

mongolian spot

also called congenital dermal melanocytosis

558
Q

epidemiology of mongolian spots(4)

A

african
asian
hispanic
native american

559
Q

evolution of mongolian spots

A

fades spontaneously in the first decade of life

560
Q

is mongolian spot dangerous

A

no its benign

561
Q

triad for congental rubella(german measles)(3)

A

sensorineural deafness
cardiac defects
cataracts

562
Q

complication of first trimaester rubella(2)

A

spontaneous abortion

congenital rubella syndrome

563
Q

clue cataract in USMLE

A

leukokoria

564
Q

cardiovascular anomaly in turner

A

bicuspid aortic valve

565
Q

face and neck of turner patient(3)

A

narrow high arched palate
low set ears
low hairline
webbed neck

566
Q

chest of turner(3)

A

broad chest with widely spaced nipples
coarctation of aorta
bicuspid aortic valve

567
Q

abdomen of turner

A

horse shoe kidney

568
Q

limbs of turner(2)

A

cubitus valgus

short stature

569
Q

pelvis of turner(3)

A

streak ovaries
amenorrhea
infertility

570
Q

why echo coeur should be done in patient with turner(3)

A

to dx
bicuspid aortic valve
coarctation of aorta
aortic root dilation

571
Q

dx of chronic granulomatus disease(3)

A

nitro blue tetrazolium slide test
flow cytometry
cytochrome c reduction

572
Q

Rx of CGD(2)

A

daily TMS

gamma inrterferon 3 f jour

573
Q

patient with recurrent or unusual lymphadenitis hepatic abcess or osteomyelitis at multiple sites or infection with catalase positive organisms

A

CGD

574
Q

patient seen in emergency with barking cough and difficulty respiratoire DX

A

croup

575
Q

first thing to do in croup

A

racemic epinephrine before any invasive procedure

576
Q

pneumonia plus influenza in young children with CF, bugs in cause

A

staphyloccocus aureus

577
Q

medication to use in patient with cystic fibrosis in a context of influenza

A

vancomycin

578
Q

most common cause of pneumonia in cystic fibrosis in young children

A

staph aureus

579
Q

most common cause of pneumonia in cystic fibrosis in adult

A

pseudomonas aeruginosa

580
Q

Henoch shonlein purpura clue(4)HSP

A

lower extremity purpura
athralgias and arthritis
coliky abdominal pain
reenal involvement

581
Q

why coliky abdominal pain in HSP

A

local vasculitis

582
Q

dx of HSP

A

clinical

583
Q

dx of HSP in atypical presentation

A

renal biopsy

584
Q

renal biopsy in HSP

A

deposition of IGA in the mesangium by immunofluorescence

585
Q

peak of incidence sudden infant death syndrome

A

1 month and 1 year in the US

586
Q

cause of edema in turner syndrome

A

lymphedema

587
Q

cause of lymphedema in turner

A

dysgenesis of the lymphatic network

588
Q

kid with with ascending symmetric flaccid paralysis in both legs absent deep tendon treflexes and decreased superficial touch and vibratory senses.dx

A

guillain barre

589
Q

structures affected in guillain barre

A

peripheral motor nerves

590
Q

albumino cytologic dissociation dx

A

guillain barre syndrome

591
Q

rx of Guillain barre(2)

A

plasmapheresis
or
human immunoglobulin

592
Q

cause of GBS

A

most of the time follows viral infection

593
Q

macrosome with clavicle fracture next step

A

reassurrance and gentle handling

594
Q

period of time for healing clavicle fracture

A

7-10 jours

595
Q

prema with neurologic symptoms

A

intraventricular hemorrage

596
Q

risk for intracerebral hemorrage in prema(2)

A
597
Q

screening test for intracerebral hemorrage in prematurity

A

serial head ultrasounds

598
Q

clue for intracerebral hemorrage(4)

A

rapidly increasing head circumference
bulging fontanel
hypotonia
lethargy

599
Q

cranial ultrasound of intraventricular hemorrage in prema(2)

A

bilateral IVH

dilated ventricles

600
Q

why communicating hydrocephalus in intracerebral hemorrage

A

accumulation of blood in subarachnoid space impaitr the ability of the arachnoid villi to absorb cerebrospinal fluid

601
Q

main problem in phenylketonuria(2)

A

deficiency in phenylalanine hydroxylase

accumulation of phenylalanine in the blod and body tissues

602
Q

screening test for phenylketonuria

A

gutrie test

603
Q

clue for phenylketonuria(4)

A

faitr hair and skin
blue eyes
eczematous changes
urine with mousy odor

604
Q

what to avoid in phenylketonuria

A

protein

605
Q

12 yo with back pain with or without incontinence ,physical exam reveals step off of lumbosacral area dx

A

spondylisthesis

606
Q

physiopatho of spondylisthesis

A

developmental disorder with forward slip of vertebra usually L5 over S1

607
Q

6 yo with down syndrome presents urinary incontinence,hyptonic and hyperreflexia wit positive babinski

A

atlanto axial instability

608
Q

cause of atlanto axial instability in down syndrome

A

excessive laxity in the post transverse ligament causing increased mobility between atlas C1 ant the axis C2

609
Q

upper motor neuron findings in patient presenting with down syndrome

A

atlantoaxial instability

610
Q

children with inattention impulsivity and hyperactivity in 2 or more settings dx

A

deficit hyperactivity syndrome disorder

611
Q

patiuetn with sickle cell disease presents with pain in his right hip that started several days ago dx

A

avascular necrosis

612
Q

cause of avascular necrosis(6)

A
sickle cell disease
SC hemoglobin disease
corticosteroid therapy
SLE
alcoholism'
Gaucher disease
613
Q

physiopatho of aeptic necrosis in sickle cell disease(3)

A

occlusion of end arteries supplying the femoral head
bone necrosis
colapse of the periarticular bone and cartilage

614
Q

children with isolated thrombocytopenia and petechiae after viral infection dx

A

immune thrombocytopenia

615
Q

children with isolated thrombocytopenia and petechiae after viral infection next step

A

observation regardless the level of platelet

616
Q

children with isolated thrombocytopenia and petechiae after viral infection ,experiencing bleeding next step(2)

A

IV glucorticoids
or
IV immunoglobulin

617
Q

physiopatho of immune purpura(2)

A

antibody binds to platele

destruction of complex antibody-platelet-in spleen

618
Q

period of time to recover from immune purpura

A

6 months

619
Q

hemogram in measles(2)

A

leukopenia(T cell cytopenia)

thrombocytopenia

620
Q

what seem to decrease the morbidity and mortality in measles