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Pediatrics Flashcards

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1
Q

2 day female, feeding were fine. Now bright green emesis. Distended abdomen but can be compressed. No stool in rectal vault. Xray dilated loops of bowel with a ground glass appearance in RLQ and scant air distally in colon. Next step?

A

obstruction

Could be meconium ileus

Test: Upper GI series and contrast enema

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2
Q

Possible tuberculosis in 3 y.o

A

TST (skin test) even if had vaccine

Interferon gamma release assay not done till 5 y.0

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3
Q

Live vaccines

A

MMR, Rota, Varricella, intranasal flu

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4
Q

Inactivated vaccines

A

Hep A, Hep B, Polio, diptheria, streptococcus, pneumococcal, Hib

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5
Q

Vaccines in first year

A

Hep B, Rota, Dtap, Hib, Streptococcal pneumonia, Polio, influenza

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6
Q

Vaccines given at 12 months

A

MMR, varicella, Hep A

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7
Q

Bone pain, sunburst pattern, humerus

Associated with

A

Osteosarcoma

Retinoblastoma

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8
Q

onion skinning w/ lytic appearance, shaft lower extremity

A

Ewing sarcoma

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9
Q

Click in baby’s hip when examining

A

Reexamine at 2 weeks

Ultrasound at 4 weeks if persists

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10
Q

Ciprofloxacin drops

A

Pseudomonas coverage for ear

Otitis externa

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11
Q

Pyloric stenosis

A

IV fluid first

Then pyloromyotomy

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12
Q

Tetanus question

A

If they have had 3 lifetime doses of tetanus then no immunoglobulin needed

If recieved less than 10 years ago then no booster either

If >10 years and clean wound or dirty wound 5 years since booster –> Only need tetanus booster

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13
Q

Eczema, thrombocytopenia, frequent infections in young child

  • due to what
  • tx
A

Wiskott-Aldrich syndrome (WAS)

Impaired cytoskeleton changes in leukocytes, platelets

Tx: Stem cell transplant

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14
Q

Low platelets and hematochezia
Anemia
Schistocytes
Renal failure

A

Hemolytic uremic syndrome

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15
Q

Isolated thrombocytopenia

Large immature platelets

A

Idiopathic thrombocytopenic purpura

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16
Q

X linked agammaglobulinemia

A

Males only

Lacks B cells

Recurrent sinopulmonary infections

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17
Q

Hyper Igm Syndrome

A

Recurrent infections
High IgM
Low IgA IgG

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18
Q

“Spells”
Conscious but unresponsive and unaware of environment

Maintain motor function

Eyes open

Doesnt interact

Repetitive hand movements

Confusion following
No recollection of event

A

Complex partial seizure

Alteration in mentation= complex

No tonic-clonic activity (only automatism)= partial

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19
Q

Complex seizure

A

Alteration in mentation

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20
Q

Complex generalized seizure

A

Tonic clonic
(Full body convulsions)

Alternation in mentation

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21
Q

Prevent drowing

A

Life jacket

Supervision

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22
Q

Cyanotic baby

Persistent hypoxemia that does not improve w/ oxygenation

No murmur

A

Not improving w/ oxygenation –> none of the inspired oxygen is getting to systemic arterial circulation –> transposition of great vessels

Baby only alive due to patent ductus arteriosus

Must keep patent
Tx Prostaglandins prolongs the duct

[Endomethacin (indomethacin) ends the ductus]

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23
Q

Diagnose coarctation of aorta

A

Echo

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24
Q

Water for infant

A

120 or lower to decrease chance of burns

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25
Urethra on ventral side of shaft
hypospadias Delay circumcision so there is foreskin for reconstruction
26
Kid gets transfusion and has anaphylactic rxn Recurrent gastrointenstional infections
Selective IgA deficiency
27
ABO mismatch
Hemolysis
28
2 y.o abdominal pain Fecal occult blood Cylindrical mass Relief w/ pulling feet to chest
Intussusception Abdominal US
29
Technetium 99 scan
Meckel's diverticulum Presents as asymptomatic GI bleed
30
Asthma like but no response to therapy Negative CXR
Infxn w/ RSV
31
Knee to chest position does what
Increased systemic vascular resistance
32
Blue baby when eats, resolves
Tetralogy of fallot
33
2/6 systolic crescendo-decrescendo murmur on left sternal border
ventricular septal defect
34
Transposition of great vessel vs tetralogy of fallot
Transposition diagnosed at birth or baby dies
35
Nodule of tibial tuberosity in teenager Xray irregularities and haziness over metaphyseal border of tibia Tx
Osgood-Schlatter disease Decrease activity and NSAIDS follow by PT
36
Retinal hemorrhages next step
CT scan of head for subdural hematoma
37
``` Leg pain Lytic lesion with clear ring on bone Worse at night NSAIDS help some No fever or WL ```
Osteoid osteoma
38
``` Alcohol consumption Pain in abdomen Resolved by morning No discharge No costovertebral angle tenderness ``` Dx
Ureteropelvic junction (UPJ) obstruction U/S Narrowing is distended in setting of large diuresis
39
2/6 holosystolic murmur Adult Child
Mitral regurg and ventricular septal defect Ventricular septal defect more common Children do not have MR
40
Most common congenital heart disease after age 1
Atrial septal defect
41
Fixed split S2
Atrial septal defect
42
Infant multiple UTI what test
Voiding cystourethrogram
43
Increased conjugated bilirubin and Jaundice Dx
US of RUQ Blockage somewhere
44
Sickle cell on peripheral smear
Howell-Jolly bodies if no spleen
45
Bite cells
G6PD deficiency
46
African Pain crises w/ jaundice Reduced hemoglobin Reticulocyte count of 15% How to prevent death
Sickle cell disease Vaccination w/ conjugate capsular polysaccharide Strep. pneu H. flu
47
5 day old infant with eye infection. Gram negative diplococci Tx
Intramuscular ceftiraxone
48
Tx chlamydia (unilatearl purulent conjunctivitis)
Oral erythrmycin PO macrolide
49
Prophylaxis for gonoccal conjunctivitis
Topical silver nitrate
50
Newborn no urine in 24 hrs Suprapubic mass Dx
Posterior urethral valves Suprapubic mass= distended bladder Straight catheterizeation
51
2 y.o SOB and barking cough. Improved by going outside. Low grade fever. Wheezing Tx
Croup Parainfluenza Racemic epinephrine
52
10 day old infant. Becoming progressively jaundice. Clay stools Bilirubin 7 with 6 being unconjugated
Breast milk jaundice AFTER baby went home --> Breast feeding or breast milk jaundice
53
Swollen tonsils with white on them, sore throat At risk for
Streph | Risk for glomerulonephritis
54
Way to prevent painful legs in sickle cell patient
Hydroxyurea Reduces amount o f sickle hemoglobin in circulation
55
Contraindications for vaccine
Encephalopathy Relative - fever > 105 - Insoluble cry 3 hrs
56
``` Bleeding in diaper 20 months old No pain or distress Eating and drinking normal Sort non distended abdomen ``` Dx
Meckel's diverticulum Technetium 99 scan
57
Seizing child < 1 y.o Hyparrhythmia on EEG Tx
West syndrome TX: ACTH (cosyntropin)
58
Adams forward bend test
Scoliosis
59
Female 4 y.o who keeps wetting diapers. Feels urge and trained on potty but keeps happening
Low implantation of ureter
60
Toilet training age
2-4
61
Disease of newborn
Intraventricular hemorrhage Bronchopulmonary dysplasia Retinopathy of prematurity Necrotizing enterocolitis
62
Air in the stomach and duodenum without any distal air
Annular pancreas or duodenal atresia
63
Multiple air fluid levels
Vascular insult | intestinal atresia
64
Distended proximal colon with normal gas pattern distally
Hirschsprung's disease
65
Increased soft tissue swelling w/ throat issue
Retropharyngeal abscess
66
Thumb print
Epiglottitis
67
Steeple sign
Croup | Bacterial tracheitis
68
Projectile vomiting of bilious contents is indicative of multiple air fluid levels
Pathlogic emesis in a newborn Multiple air fluid levels -> Intestinal atresia --> cocaine
69
Recurrent abscesses
Absent macrophages oxidative burst seen in chronic granulomatous disease Typical pathogens staph, aspergillus, serratia
70
Percentages of body
Head 18% (9% front and back) Arm- each arm is 9% Thorax- front and back thorax are 18% Legs- total is 27%, 13.5 for each leg Genitals- 1%
71
Dx esophageal atesia
NG tube and x ray to confirm placement
72
NEwborn, difficulty feeding. Coughs and spits up his feedings both times it is attempted. Gurgling bubbles form mouth. Infant becomes cyanotic but improves w/ suction
Esophageal atresia
73
Pre-eclampsia in mother and infant not passing meconium
Check Mg level
74
Jittery infant with glucose of 20 Diabetic mother
IV administeration of D10 bolus Infant is hypoglycemic
75
Baby with two blue dots on butt, there at birth
Congenital Dermal melanocytosis Mongolian spot Latin culture Spontaneously resolve
76
7 y.o w/ strep and given pencillin develops hives what to do
Discontinue penicillin State cephalexin & cetrizine
77
Lower risk BRUE
> 60 days >45 weeks post conception if over 32 weeks First occurrence No CPR by trained provdier No concerning findings on hx/PE
78
Higher risk BRUE
``` Premies Under 2 months < 60 days <45 weeks post conceptional Multiple episodes ```
79
Infant given aspirin check what level
ammonia Hepatic encephalopathy
80
6 y.o w/ headache and rash. Has been outside on farm. Rash with ring of erythema surrounding a ring of clearing, surrounding a hyperpigmented lesion at the center
Lyme disease Tx: Amoxicillin
81
16 y.o egg allergy wanting flu shot
Inactivated influenza vaccine and observe for 30 min
82
Legg- Calve Perthes disease
Ischemia and osteonecrosis of the femoral head in a child around 6 y.o Antalgic gait (limp)
83
Machine like murmur
Patent ductus arteriosus
84
3 y.o Infxn 6 weeks ago Flank mass Hematuria
Wilms tumor
85
4 y.o Febrile seizure Hypopigmentation that enhaces under wood's lamp Small calcified appearing tumors in brain Develop later in life?
Tuberous sclerosis Febrile seizure fails to remit Ash-leaf lesions Sebacous adenoma
86
Failure to pass meconium Distended abdomen w/ palpable stool Stool in small bowel w/ some in colon. No stool in rectal vault Proximal colon dilated and distal colon appears normal
Hirschsprung disease Contrast enema Next step after Rectal suction biopsy to confirm
87
``` Cleft lip Low set ears Wide spaced eyes Hypocalcemia Reduced PTH Candida in blood ```
Deletion on chromosome 22 DiGeorge sydnrome Deficiency of parathyroid gland
88
9 mn w/ recurrent abscess
Leukocyte adhesion deficiency
89
Nitro blue test positive
Indicates oxidative burst produced by leukocytes present So not Chronic granulomatous disease
90
Chediak higashi syndrome
Neuropenia on lab work | Albinism
91
Infant w/ downs syndrome most likely heart defect
Ventricular septal defect Holosystolic murmur at the left sternal border
92
Take to ER for epistatsis
After 30 min
93
Growth delay in kid check
Left wrist and hand radiograph
94
HA, emesis, vision changes, nystagmus and ataxia
Intracranial pathology Check brainstem MRI
95
Hearld patch--> generalized rash What test
RPR pityriasis rosea
96
Fracture Blue sclera Tx
Osteogenesis imperfecta Skin biopsy
97
Check serum calcium and phosphorus for
Rickets
98
Large newborn with grunts and limp arm
Phrenic nerve disruption
99
3 infections of neisseria meningitidis
C6, C7, or C8 deficiency
100
Chronic skin infections, abscess formation, osteomyelitis, and pneumonia
Chronic granulomatous disease
101
Albino like skin Ocular albinism Frequent infections
Chediak Higashi syndrome
102
Fever, aphthous ulcer, stomatitis, and/ or pharyngitis Repeated episodes
Cyclic neutropenia
103
Mother gets nonspecific flu like symptoms Brown amniotic fluid and preterm Baby comes out with pustular rash
Listeria monocytogenes
104
GBS & Ecoli in newborn
Normal appearing baby with nonspecific findings of temperature instability, lethargy and poor feeding GBS --> progresses rapidly to tachypnea, grunting, retractions, trachycardia and poor perfusion
105
Tx enlarging red mass on baby butt, present at birth
Observe Hemangioma tends to enlarge over first year then slowly decrease in size
106
late systolic murmur at apex and midsystolic click Tx
Mitral valve prolapse Tx beta blocker
107
``` Fever 102 (spiking) Swollen red eyes Rash Palms and soles swollen and red Lymphadenopathy ```
Kawasaki disease ``` Fever > 5 days Bilateral non-suppurative conjunctivitis Dry fissured lips Injected lips Strawberry tongue ``` Risk: Coronary artery aneurysms Myocardial infarction
108
Scarlet fever
Group A strep Abrupt onset fever, sore throat, HA, abdominal pain and malaise Bright red mucous membranes with petechiae on soft palate Strawberry tognue
109
CHARGE syndrome
``` Coloboma Heart defects (septal defects and aorta/aortic arch defects) Choanal atresia Retardation of growth and development Genital anomalies Ear anomalies ```
110
Upper limb defect | Cardiac defect
Holt-Oram syndrome Atrial septal defect
111
Neonatal jaundice w/ days of phototherapy Anemia (pallor) Enlarged spleen w/o hepatomegaly
Hereditary spherocytosis
112
Hearing localizes to right. bone conduction greater
conductive hearing loss on right
113
10 y.o fell to floor and acute onset headache Lethargic Right central facial weakness Cannot move right side of body Eyes deviated to left
Occlusion of middle cerebral artery
114
Post morning stiffness in child/ after nap. +ANA At risk for
Juvenile idiopathic arthritis Anterior uveitis
115
Chalazion
lump in eye lid painless red
116
Dacryocystitis
infxn of lacrimal gland
117
Hordeolum
style infection on eye lid hairfollicle
118
Hyphema
pool of blood in eye
119
``` two month old Seizure Doll like appearance Hepatomegaly Low glucose level Lactic acidosis Hyperuricemia Elevated triglycerides ```
Von Gierke disease
120
Macroglossia Hypotonia Hepatomegaly Enlarged heart
Pompe disease
121
``` Macroglossia Omphalocele Large umbilical hernia Hypoglycemia Hepatomegaly Enlarged kidneys ```
Beckwith-Wiedeman
122
Cataracts | Galactosuria
Galactokinase deficiency no mental retardation
123
Galactosuria and mental retardation
classic galactosemia
124
Hypoglycemia Ataxia Coma Hypothermia injest what
Ethanol
125
Infants who are small at birth are at risk for
Hypoglycemia
126
Baby is noisy breather Inspiratory stridor (no cyanosis)
Laryngomalacia Self limiting
127
Yellow green nail on infant
Meconium in utero Give Broad spectrum antibiotics
128
Patient with asthma fails beta agonist and steriods Test to do
Flexable laryngoscope Inducible laryngeal obstruction (vocal cord dysfunction)
129
Child w/ sickle cell and has ischemic stroke what to do
Admit and begin emergency partial exchange transfusion
130
Cardiac tumor on ultrasound also see
tuberous sclerosis Hypopigmented skin lesions
131
Axillary freckling
Neurofibromatosis 1
132
Brushfield spots on iris
Down syndrome
133
Coloboma
CHARGE syndrome and Trisomy 13
134
Unilateral port-wine lesions
Sturge- Weber syndrome
135
Risk factors of renal vein thrombosis in infant
Birth asphyxia (apgar scores less than 7) Diabetic mother Polycythemia
136
Floppy baby
Continue oxygenation Mother given narcotic due to pain --> respiratory depression
137
Strep decision points
``` 1 point [ ]Fever > 100.4 F [ ] No cough [ ] Tonsillar exudate [ ] No mention of cervical lymphadenopathy [ ] Age 3-14 ``` 15-44 +0 45+ -1 Score 0= no testing Score 1= consider rapid strep test Score 2 or 3= rapid strep Score 4= tx empirically
138
Bilateral hydronephrosis on prenatal ultrasonography
Suggests obstuction (In males posterior urethral valves) Get renal and bladder ultrasound
139
Hematemesis in baby with no signs of distress What exam
Send emesis to lab for Apt-Downey test Blood from another source
140
Child delivered with prolonged labor, had non-tender demarcated swelling that doesnt cross suture lines over parietal region
Cephalohematoma Observe for extension of lesion or jaundice
141
Neurologic deterioration with exaggerated resposne to noise and no hepatosplenomegaly
Tay-Sachs Cherry red spot
142
``` Normal birth 2-4 y.o Coarse facies Short Hepatosplenomegaly Hearing loss Retinal degeneration Mental retardation ```
Hunter syndrome
143
``` 1 y.o course facies corneal clouding Hepatomegaly Heart disease Skeletal deformities Developmental delays ```
Hurler syndrome
144
``` 3 months Hepatosplenomegaly Cherry red spot FTT Resp tract infections ``` Age 6 hypotonia Spasticity Rigidity
Niemann-pick
145
High fever that goes away and rash develops
Roseolainfantum Roseola (HHV 6)
146
``` Day 2 infant 96.9 F HR 180 Oxygen sat 65% Cyanosis Hepatosplenomegaly ```
Shock in infant
147
Day 2 infant | Enhanced right ventricular impulse, normal first heart sound and loud isngle heart sound
Left sided cardiac abnormality Day 2 closure of ductus in patients with hypoplastic left heart --> cyanosis
148
Rapid course of altered mental status, fever, shock, and progression of purpura
Meningococcemia Hypotension Cardiac depression
149
Fever or bloody diarrea week before Now elevated BUN and CR Proteinuria Hematuria Anemia Low platelets
Hemolytic uremic syndrome (HUS)
150
Single slightly raised orange peel like hairless lesion on scalp of new born ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Nevus sebaceus Removal recommended
151
New born healthy Multiple erythematous blotchy macrules on face, back, chest and upper extremities. Have like pustules in center ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Erythema toxicum Resolves in 14 days Contains eosinophils
152
Rash on skin under neck, upper back, lower back and rash appeared in three stages numberous 2-4 non erythemaous lesions with intact pustules Ruptured pustules Rim of thin skin found at endge of denuded pustules Freckle like lesions of same size noted proximal to previous two lesions ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Pustular melanosis
153
Ill-defined red macule over the glabella, nuchal area and symmetrically over eye lids ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Nevus simplex (salmon patch) Fade over first months of life
154
Pustules isolated to cheeks and forehead ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Neonatal acne
155
Single lesion on scalp with well-demarcated area of missing skin ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Aplasic cutis congenital Sporadic Autosomal dominant Teratogen exposure (HSV or varicella) Trisomy 13
156
Well circumscribed light brown to black macules (may have hair) ``` A. Aplasic cutis congenital B. Congenital melanocytic nevi C. Erythema toxicum D. Herpes simplex virus infection E. Mongolian spot F. Neonatal acne G. Nevus sebaceus H. Nevus simplex I. Port wine stain J. Pustular melanosis K. Seborrheic keratosis ```
Congenital melanocytic nevi
157
Suspected myelomeningocele What test
Ultrasound of lower spine
158
Seen w/ DiGeorge
Cardiac anomalies (tetralogy of fallot, truncus arteriosus, interrupted aortic arch) Abnormal facies Thymic hypoplasia Cleft palate Hypocalcemia Chromosome 22
159
Cleft lip Mandibular hypoplasia Downslanted palpebral fissures Low set notched ears
DiGeorge
160
``` Microcephaly Wide fontanels Microphthalmia High arched palate Malformed ears heart defect pulmonary hypoplasia omphalocele ```
Edwards syndrome (trisomy 18)
161
Newborn w/ fever, irritability and poor feeding Voids 15 x per day Dehydration Hypernatremia Urine gravity <1.005 No leukocytes No Leukocyte esterase
Diabetes inspidius Nephrogenic DI test - water deprivation test - MRI brain - trial of desmopressin
162
Microcephaly Corneal clouding Jaundice Petechiae Murmur (continuous harsh)
Congenital rubella Murmur= patent ductus arteriosus
163
``` Small for gestational age Hepatosplenomegaly Anemia Thrombocytopenia --> petechiae and purpura Microcephaly Deafness cerebral atrophy ```
Congenital cytomegalovirus Imaging- calcification in a periventricular pattern
164
Vaginally born Week old Sepsis Penumonia
Congenital herpes
165
Hepatosplenomegaly Lymphadenopathy Thrombocytopenia Mucocutaneous rash Runny nose FTT Chorioretinitis
Congenital syphilis Hutchinson teeth
166
Microcephaly Anemia Thrombocytopenia Jaundice Mental retardation Hearing loss Blindness Neurologic sequelae
Congenital toxoplasmosis Intracranial calcifications
167
Recurrent oral and genital ulcers - disease - look for - test - complications (3)
Behcet disease Look for anterior and posterior uveitis Positive pathergy skin test Complication= vasculitis (pulmonary artery aneurysms are fatal) and arthritis
168
Distal small bowel wall thickening on CT
Crohns disease
169
Harsh holosystolic ejection murmur at left lower sternal border
Ventricular septal defect
170
Baby has to stop feeding to catch breath
Ventricular septal defect
171
Harsh systolic murmur at right sternal border at second intercostal space. Crescendo-decrescendo systolic murmur
Aortic stenosis
172
Tenderness of tibial tuberosity bilateral in healthy adolescent
Osgood schlatter disease Ice NSAIDs Stretching
173
``` Cognitive impairment Small eyes Mid-face hypoplasia Thin upper lip Short nose Flattened nasal bridge ``` Also see?
Fetal alcohol syndrome Smooth philtrum
174
``` Girl 6 months Hypotonia Gross motor developmental delays Loss of eye contact Hand wringing ```
Rett syndrome
175
Newborn who develops cyanosis but which worsens w/ oxygen administration Tx
Congenital cyanotic heart disease Ductal dependent lesion Tx: Patency of patent ductus arteriosus - Prostaglandin E1 infusion
176
Chest pain and hemoptysis Severe day cough, SOB, and last several weeks fever and achy joints Bilateral lower extremity edema CXR: diffuse alveolar hemorrhage Test?
Good pasture syndrome Urine analysis
177
Neonatal jaundice w/ excessive phototherapy Onset of jaundice to sulfa drug No hepatosplenomegaly
G6PD deficiency Fave benas Sulfa meds
178
Carotenemia
Eat alot of carrots and veggies Jaundice palms and soles and nasolabial folds Spares sclera
179
``` Poor feeding Vomiting FTT Jaundice Hepatomegaly Cataracts Hypotonia ```
Hereditary galactosemia
180
Frequent staphylococcal skin infections Recurrent staph sinusitis/ mastoiditis COarse facial features Prominent forehead Deeply set/ widely placed eyes Wide fleshy tip nose Test?
Job syndrome Hyper IgE syndrome Test: Serum IgE level
181
Total complement activity
Recurrent infection w/ encapsulated bacteria Meningococci
182
12 month old with continuous low hemoglobin and hematocrit Elevated RBC distribution Normal platelet
Beta thalassemia Elevated RBC distruction shows its not iron low)
183
Tall pediatric patient Joint laxity Poor vision At risk for
Marfan syndrome Mitral valve prolapse Aortic dissection
184
Long thin face | Prominent ears, forehead and jaw
Fragile x syndrome
185
Viral meningitis
Normal glucose Protein 80 Negative gram stain ``` Bacterial - (+) gram stain - CSF neutrophil > 1000 cells CSF protein > 80 Seizure ```
186
Fever, HA, Rash Periorbital edema Conjunctivitis Edema hands and feet Rash on wrist, ankles, proximal arms, legs Oklahoma Tx
Rocky mountain spotted fever Doxycycline
187
Ceftriaxone tx for
Meningococcemia
188
Tx Lyme disease
Penicillin G
189
Flu like symptoms Rash several days after in woods Tx
Lyme disease Doxycycline If meningitis suspected= VI cephalosporin
190
Infant w/ UTI Do waht
Renal ultrasound - UTI - Febrile infants
191
``` 104 fever for one week Rash on chest, abdomen and back (no pustules) Lips, tongue and oral mucosa bright red Immunization up to date Cervical lymphadenopathy ``` Tx
Kawasaki disease - acute vasculitis IV immunoglobulin - prevent coronary artery aneurysms
192
Tx polyarteritis nodosa
Plasma exchange
193
4 y.o injested pills Mildly dilated twitching legs and arms Temp 101 BP 115/75 HR 160 ``` Acetaminophen Amlodipine Digoxin Imipramine Propranolol ``` Tx
Cholinergic inhibition ``` Mydriasis Tachycardia hyperthermia Sedation Coma Twitching Seizure Hypotension Arrhythmia ``` TCA - Imipramine Activated charcoal If hypotension, arrhythmia or QRS prolongation= sodium bicarbonate
194
Ingested med Bradycardia Hypotension Pulmonary edema Bronchospasm
Beta-adrenergic blockade Fluids & glucagon= tx hypotension Bradycardia tx= glucagon, atropine, isoproterenol Airway protection Activated charcoal is sustained release
195
Ingested medication Hypotension Bradycardia AV block
Calcium channel inhibition Amlodipine Diltiazem Verapamil Tx - Fluids - Beta agonist - calcium infusions
196
AV block Bradycardia Ventricular tachycardia Severe hyperkalemia
Digoxin overdose Tx: Anti-digitalis ab
197
HA, Nausea, vomiting, dizziness, orthostasis, weakness Football player Tx
Heart exhaustion ice packs to axilla and groin [Heat stroke= CNS disturbances, seizure temp > 104, then submerge in tub]
198
Hearing loss in child w/ strong family hx of deafness Screening test?
Alport syndrome - hematuria Urinalysis
199
Enlarging jaw tumor - what is it - tissue sample shows - caused by - translocation
Burkitt lymphoma Starry sky appearance EBV T(8;14)
200
Pathologic tissue sample shows CD4 T cells - name - what is it - resembles - does what - tx - part of
Mycosis fungoides T cell lymphoma Resembles eczema Metastasize to internal organs Tx Radiation Mycosis fungoides w/ splenomegaly and peripheral bloodstream involvement= sezary syndrome
201
Pathologic tissue sample shows CD5+ cells w/ T (11;14) - what is it - affects who - PE finding
Mantle cell lymphoma Elderly Palpable lymphadenopathy
202
Pathologic tissue sample shows cells w/ flower shaped nuclei - name - caused by - prognosis - also seen (3)
Adult T cell leukemia/ lymphoma HTLV-1 Aggressive Hepatomegaly Bony lesions Skin lesions
203
Pathologic tissue sample shows germinal centers - name - part of - tx - translocation - overexpression
Follciular lymphoma NHL ``` Chemotherapy [CHOP} Cyclophosphamide Doxorubicin Vincristine Prednisone + rituximab ``` T(14;18) BCL-2 over expression
204
Pathologic tissue sample shows large cells w/ vesicular chromatin - name - part of - also seen - prognosis - PE - Tx
Diffuse large B cell lymphoma NHL Prominent nucleoli Aggressive Rapidly enlarging masses that can be located anywhere Chemotherapy
205
Pathologic tissue sample shows binucleated giant cells - name - cells - description of cells
Hodgkin lymphoma Reed-sternberg cells Owl eye
206
Pregnant female w/ fever, sore throat, HA, tender posterior auricular and suboccipital lymphadenopathy Diffuse rose pink colored maculopapular rash baby at risk for?
Rubella Sensioneural hearing loss
207
4'8" low hairline appropriate adrenarche Failure of breast development
Turner syndrome Primary amenorrhea
208
Infant with bright red blood in rectum Born at home
Vitamin K deficiency Vit K given to prevent hemorrhagic disease of newborn
209
Vomiting Repeat episodes of dehydration FTT Triangular facies w/ prominent forehead Large eyes Droopy mouth Protruding ears
Bartter syndrome Consangeuineuous marriage Maternal polyhydramnios Polydyspia Polyuria
210
Child w/ repeated coughing w/ feeding Pneumonia
Tracheoesophageal fistula
211
Down syndrome child that is vomiting after feeding
Duodenal atresia
212
Mother antibodies which cross placenta and provide partial protection to herpes
IgG
213
``` 1-6 y.o Widespread petechiae Bruises (shin/arms) Nose bleeding Gingival bleeding ```
Immune thrombocytopenic purpura
214
``` 3 months old Recurrent diarrhea Otits media Thrush Resp infxn FTT ```
Severe combined immunodeficiency (SCID)
215
Microangiopathic hemolytic anemia (disease of capillaries in which they leak, loss of RBC through destruction) Thrombocytopenic purpura Neurologic abnromalities Fever Renal disease Test?
Thrombotic thrombocytopenic purpura (TTP) Reduced levels of Metalloproteinase
216
5 month old Hyperdynamic precordium (heart moves too much) Cyanosis when crying Normal first heart sound Second heart sound is single Harsh ejection murmur loudest over the left sternal border, extending down the entire left sternal border Murmur softer w/ crying and cyanosis
Tetralogy of Fallot Pulmonary stenosis Lessening of murmur w/ crying and worsening cyanosis= indicates decreased pulmonary blood flow
217
Hypoplastic heart syndrome - time line - symptoms (6) - not seen - imaging shows (2)
first 48 hours ``` Mild tachycardia Resp distress Cyanosis Poor perfusion hepatoslenomegaly profound acidosis ``` No murmur Small ventricle and ascending aorta
218
Total anomalous pulmonary venous return - timeline - symptoms (4) - imaging (2)
24 hours age Respiratory distress Tachypnea Tachycardia Profound cyanosis Figure 8 Snowman on CXR
219
tricuspid atresia
24 hours old Profound cyanosis
220
Child w/ sickle cells and painful wrist what to do
Electrophoreiss to confirm diagnosis Tx analgesic until resolution
221
Explosive foul smelling watery diarrhea Flatus Colorado What to do?
Giardia Empiric therapy - Tinidazole
222
Elevated blood pressure and serum renin levels in child
Renal artery stenosis
223
HTN | Low renin
Hyperaldosteronism
224
Hypokalemia Acidosis Elevated rine pH
Renal tubular acidosis type 1
225
``` Hypoglycemia Hypotension Fatigue Abdominal pain Weakness Lack of energy ```
Adrenal insufficency (addison)
226
Polyuria Polydipsia Recurrent dehydration Poor growth Proteinuria Hypokalemia Hypophosphatemia Hyperchloremic metabolic acidosis
Fanconi syndrome
227
newborn w/ respiratory distress. When crying baby is pink but turns cyanotic when calms down
Bilateral choanal atresia Issue in nasopharynx
228
Fever, HA, red cheeks infant Will develop what
Fifth disease (erytehma infectosum) Lace-like rash develops over trunk, arms legs
229
Normal CBC Repeat otitis media, sinusitis, pneumonia Non palpable lymph nodes Minimal tonsilar tissue
X linked agammaglobulinemia | Bruton agammaglobulinemia
230
``` Microcephalic Anemia Thrombocytopenia Jaundice Deafness ``` Calcifications scattered in cerebral cortex
TORCH infection Toxoplasmosis
231
Scalp w/ greasy scaly plaques Tx
Seborrheic dermatitis Cradle cap Tx: Topical seleniu sulfide
232
Tx lice
Topical permethrin
233
Topical mupirocin
Tx staphylococcal or streptococcal infections of skin (impetigo)
234
Poor tone Jaundice Hoarse cry in baby Sleep alot
Congenital hypothyroidism
235
Tyrosinemia
``` Fever Vomiting Hepatomegaly Liver disease - Jaundice - elevated transaminases - hypoglycemia ``` Boiled cabbage
236
Vomiting Lethary Sweaty feet odor
Isovaleric acidemia Severe acidosis finding
237
Nandrolone
Steroid
238
Child on phenytoin At risk for
Folate deficiency Megaloblastic anemia with hypersegmented polymorphonuclear leukocytes
239
Microcytosis | Basophilic stippling
Lead intoxication
240
Physiologic jaundice
Peaks around second to fourth day
241
Newborn girl Swollen hands and feet Hyperconvex nails Redundant neck folds Reduced pulses in lower extremities Risk for?
Turner syndrome Short stature Swollen hands and feet, hyperconvex nails Redundant neck folds suggests lymphedema Reduced pulses indicates coarctation
242
4 y.o Stridor, sore throat, fever, cough. Drooling and muffled voice Uptodate on vacciantions
Retropharyngeal abscess
243
Week of bloody diarrhea, fever and emesis RLQ pain
YErsinia enterocolitica Pseuodappendicitis
244
Progressive muscle weakness that worsens over the day Blurred vision Difficulty swallowing Muscle weakness w/ repeat use
Myasthenia gravis Circulating antibodies blocking neurotransmitter receptors
245
Cat bite on hand
Amoxicillin-clavulanate orally Pasteurella multocida hand and foot, face, and groin considered high risk Otherwise clean and observe
246
Human bite tx
Amoxicillin-clavulanate
247
Normal age of development
8-12
248
Beefy rash w/ satellite lesions in the groin of the child Previous tx w/ amoxicillin
Candida yeast infxn
249
Large amount of painless bleeding from rectum
Meckel diverticulum Technetium 99 scan
250
Unilateral red patch on newborn face
Sturge-weber Further testing including imaging of the brain an ophthalmology consultation is required Slit lamp evaluation
251
Thin membrane partially covering the introitus Tx
Labial adhesion Application of estrogen cream to membrane
252
Meningococcal vaccine
First given at 11 y.o and booster at 16
253
Recurrent cough and pneumonia that doesnt fully recover Good movement on left lung Persistent atelectasis of the right middle lobe
Foreign body
254
``` Recurrent fevers Headache Anemia (pallor) jaundice GI complaints ``` Been to New york, africa and london
Malaria
255
Itching, tearing redness and discharge of both eyes
Viral etiology Adenovirus
256
White plaques on tongue and cheeks tx
Oral candidiasis Tx Nystatin oral suspension
257
Newborn w/ eye discharge at 1 week Pneumonia tx
Chlamydia erythromycin
258
tx molluscum contagiosum
nothing self limiting
259
Kleihauer betke test
determine if an anemic newborns rbc are present in maternal circulatory system
260
Acidosis Hyperglycemia Boisterous
methanol
261
Preterm infant with bulge in groin, enlarges w/ crying does not transiluminate
Inguinal hernia Pediatric surgery outpatient visit
262
barking cough tx
croup epinephrine nebulized therapy Oral dexamethason
263
Infants borns to SLE mothers at risk for
third degree heart block
264
deafness hypopigmented iris (blue iris) flat nasal bridge whiteforelock
waardenburg syndrome
265
IV fluid for diabetic ketoacidosis
Normal saline w/ potassium chloride 40 mEQ/l
266
Single painless ulcer on penis TEst
Syphilis Rapid plasma reagin
267
Tzanck smear
Primary herpes simplex
268
Hx of GERD not responsive ot therapies and increased eosinophils
Eosinophilic esophagitis
269
Common in sickle cell patient who gets viral illness
Aplastic crisis Profound anemia
270
Healthy newborn baby with tiny amount of blood in front of diaper at a week of age
Estrogen withdrawal White mucoid discharge found as well
271
Functional murmurs
Soft systolic murmur (3/6 intensity) that is louder when supine and disappear when upright Physiologic splitting of S2 is present Vibratory or musical in nature Do nothing Reassurance
272
afebrile child Recent URI Groin and thigh pain Mild limp Lack fever minimal tenderness on exam Elevated ESR
Toxic Transient synovitis 7-10 days after infection
273
linear abrasion on foot Femoral node INguinal node Tx
Cat scratch fever Azithromycin and TMP-SMX
274
5 week projectile vomiting test to diagnose
U/S Pyloric stenosis
275
Normal newborn superficial boggy area that crosses suture lines
Caput succedaneum
276
Few days old | Hard irregularly defined pitted subcutaneous plaque that is red/purple in color on butt and trunk
Subcutaneous fat necrosis
277
Newborn Vacuum extraction Boggy mass over occiput
Subgaleal hematoma
278
Topical benzocaine can cause
methemoglobinemia Acute cyanosis that is unresponsive to oxygen Blood is chocoalte brown Tx Methylene blue
279
URI 10 days ago Swelling around eyes Lower extremity and scrotal edema
Hypoalbuminemia Absence of hematuria & HTN suggests Nephrotic syndrome
280
Tx otitis media in infant
High dose oral amoxicillin
281
URI hx w/ ongoing nasal discharge 10 days after
Sinusitis Give antibiotics
282
Diabetic mother and large baby at risk for
Hypoglycemia | Small left colon syndrome
283
Child to farm Fever, chills, HA, myalgia Painful ulcer Adenopathy Hepatosplenomegaly
Tularemia
284
Healthy Child from central america who has had vaccinations what to check for
Serum lead level
285
Abdominal pain after eating that doesnt improve with PPI
eosinophilic esophagitis Circular rings and esophageal furrows
286
What does croup cause
Edema and narrowing of the proximal trachea
287
Rapid meningitis
Neisseria meningitidis
288
Monoarticular arthritis which migrates Maine
Lyme arthritis Borrelia burgdorferi
289
Timeline of nutrition
Breast feed till 6 months Introduce pureed foods 1 year: cow milk Supplement Vit D and iron
290
Guillain barre affects what
Peripheral nerve fibers (muscle weakness)
291
Illnesses that involve anterior horn cells
Spinal muscular atrophy (paralysis) | ALS
292
Tx lead poisoning
Obtain venous samples (if screening performed by capillary sample) Identify and remove lead sources Chelation therapy if < 45 Dimercaprol if 45-69 EDTA > 70
293
Tx Ethylene glycol or methanol ingestion
FOmepizole
294
TxAcetaminophen poisoning
N-acetylcysteine
295
High fever Rash on body limb sparing Desquamation of hands and feet
Kawasaki disease
296
Cyanosis when feeding | Relieved by crying
Choanal atresia
297
Primary amenorrhea What test to do
Absence of menarche > 13 y.o No breast development Get pelvic u/s
298
Primary amenorrhea Has uterus and small ovaries Elevated FSH Increased LH
Turner syndrome Deletion of an x chromosome Loss of estrogen
299
Test for hereditary spherocytosis
Eosin-5 maleimide binding (EMA) or Acidified glycerol lysis test
300
Erythrocyte CD55 and CD59 protein testing
Paroxysmal nocturanl hemoglobinuria
301
``` 5 day old Fussy Nonbloddy, nonbilious vomiting after feeds Poor tone and jaundice Anterior fontanelle sunken Bilateral cataracts Hepatomegaly ```
Galactosemia GALT deficiency Inability to metabolize breast milk Increased risk of Ecoli sepsis
302
Vit K deficiency does what
Reduced coagulation factor carboxylation
303
Von willebrand
Easy bruising Bleeding Prolong PTT Normal PT
304
UTI in infant tx
E. coli Third generation cephalosporin (cefixime)
305
10 y.o HA, vomiting and visual disturbances Limited upward gaze Upper eyelid retraction (collier sign) Pupillary abnormalities
Pineal gland mass Parinaud syndrome [Limited upward gaze, upper eyelid retraction/ collier sign, pupillary abnormalities]
306
What to do when IV peripheral line cant be accesses
Attempt intraosseous cannulation
307
Diffuse facial swelling after stress or tooth extraction
C1 inhibitor deficiency
308
Primary amenorrhea Normal uterus and ovaries Low FSH and LH
Kallmann syndrome 46, XX
309
Associated w/ Downs syndrome (8)
``` Early onset alzheimers ASD Duodenal atresia Hirschsprung disease Hypothyroidism Type 1 DM Acute leukemia Atlantoaxial instability ```
310
Punctate calcifications around ventricular margin at risk for
CMV Sensorineural hearing loss
311
Werdnig-Hoffman syndrome
Floppy baby syndrome Degeneration of anterior horn cells and cranial nerve motor nuclei
312
``` Muscle weakness Atrophy Myotonia Testicular atrophy Baldness ```
Myotonic congenital myopathy
313
Normal breast development Normal ovaries No uterus
Mullerian agenesis Failure of mullerian duct formation
314
Optic nerve glioma associated with
Neurofibromatosis type 1
315
Pheochromoctyomas associated with
Von Hippel-lindau (VHL)
316
Bilateral vestibular schwannomas associated with
neurofibromatosis type 2
317
Serratia or Aspergillus infxn | x linked
Chronic granulomatous disease Neutrophil fxn testing - dihydrorhodamine 123 test - nitroblue tetrazolium test
318
follicular conjunctiivitis
Trachoma Chlamydia trachomatis
319
Roommate of patient with meningitis that recently had vaccine. What to do
Give dose of ceftriaxoen immediately Or Rifampin
320
Abdominal mass Jerking of arms Periorbital ecchymoses
Neuroblastoma Elevated catecholamine Small round blue cells on histology N-myc
321
Carriers of sickle cell at risk for
hematuria
322
``` Doll like Seizures Hypoglycmeia Lactic acidosis Hyperuricemia Hyperlipidemia ```
G6P deficiency Impaired glycogen to glucose conversion
323
Medication for tourettes
Antidopaminergic agents Tetrabenazine Risperidone haloperidol Alpha 2 adrenergic agonists - guanfacine - clonidine
324
Nasal congestiona nd rhinorrhea previously Now fever and respiratory distress Murmur Lymphadenopathy Hepatomegaly
Viral myocarditis Coxsackievirus B Adenovirus CXR shows - cardiomegaly
325
Acute rheumatic fever
Fever | Arthritis after untreated group A strep
326
Intermittent collapse of arytenoid cartilages during crying
With inspiration Laryngomalacia Inspiratory stridor
327
Rhonchi
Low pitched Rattling sounds Caused by secretions in the bronchi Pneumonia
328
Rabies time line
1-3 months after exposure
329
Nevus flammerus
Port wine stain Do not regress Unilaterally located on face
330
Nevus simplex
Birthmark
331
Organophosphate poisoning
Atropine tx Then Pralidoxime
332
2-8 weeks jaundice light colored stools Direct hyperbilirubinemia Tx
Biliary atresia U/S RUQ
333
Sick from cook out Started w/ abdominal pain, vomiting and diarrhea Now blood in stool Tired Not drinking Scleral icterus Edema - Condition - Caused by - MOA - Lab findings (7) - Tx (3)
Hemolytic uremic syndrome Shiga toxin (Ecoli) Vascular damage and microthrombi formation Hemolytic anemia (Schistocytes, Increased bilirubin) Thrombocytopenia Acute kidney injury (Increased BUN, Cr) Tx: Fluids Blood transfusion Dialysis
334
Routine newborn care
Newborn screen (metabolic/ genetic disorders) Hyperbilirubinemia Hearing screen Pre/Post ductal pulse oximetry (congenital heart disease) Hypoglycemia
335
Miliaria
heat rash
336
Pseudofolliculitis
ingrown hair
337
Elevated red blood cell distribution width
Iron deficiency anemia
338
Increased bilirubin INcreased AST, ALT Ecoli infxn Jaundice Hepatomegaly
Galactosemia
339
INadequate NADPH production for oxidative injury
G6PD deficiency Jaundice Hemolytic anemia Transaminases normal
340
Mutation of the proteins linking the red blood cell membrane to its cytoskeleton
Spherocytosis
341
A single AA substitution within the beta globin chain
Sickle cell
342
Severe cough w/ apnea | Posttussive emesis
Pertussis Tx Azithromycin
343
Sensorineural hearing loss caused by
Damage to inner ear Congenital cytomegalovirus (CMV)
344
Concave abdomen Barrel shaped chest Respiratory distress Breath sounds only one lung
Congenital diaphragmatic hernia Incomplete fusion of pleuroperitoneal folds
345
Tx minimal change disease
Steriods
346
Edema | Proteinuria
Minimal change disease
347
Asymmetric bowing of femurs | Delayed closure of fontanels or enlarged
Nutritonal rickets Def Vit D
348
Low hemoglobin Low MCV High reticulocytes RBC elevated
Thalassemia minor
349
Abnormal gait Loss of position Loss of vibratory sense
Friedriech ataxia
350
Anemia Jaundice Splenomegaly
Hereditary spherocytosis
351
``` 3 day old Red reflex absent Harsh continous murmur over left upper sternal border Hepatosplenomegaly Failed hearing test ```
Rubella (german measles)
352
Complications associated with myopia
Nearsightedness Retinal detachment Macular degeneration
353
Chronic arthritis Daily fever Rash
Systemic juvenile idiopathic arthritis
354
Gray vesicles that progress to fibrin coated ulcers
Herpangina Coxsackie A virus Fever Pharyngitis Gray vesicles/ ulcers Tx supportive
355
ALL causes
Decreased in platelet production
356
Contraindication to Rotavirus vaccination
Hx of intussecption
357
Hearing loss Hematuria - Name - Mutation - Inherited - Biopsy
Alport syndrome Mutation of type IV collagen X linked Longitudinal splitting of GBM
358
Effacement of podocyte foot processes - name - symptoms (4)
Minimal change disease Proteinuria No hematuria Renal insufficiency HTN
359
Linear deposition of IgG along the glomerular basement membrane
Good pasture Renal & Pulmonary
360
Mesangial and glomerular capillary deposition of Cd and IgG - Name - Symptoms (4)
Poststreptococcal glomerulonephritis Edema Hematuria HTN C3 level decreased
361
Mesangial deposition of IgA - Name - Symptoms (2)
IgA nephropathy Gross hematuria URI
362
Benign heart murmur
``` Normal child No family hx Early or mid systolic Grade 1 or II Decreases w/ standing & valsalva Low pitched Musical ```
363
Congenital adrenal hyperplasia
21 hydroxylase deficiency Ambiguous genitalia in girls Salt wasting syndrome - Hypotension - dehydration - vomiting High 17-hydroxyprogesterone low na, glucose high potassium
364
Placental aromatase deficency
Prevents conversion of androgens into estrogens Virilization of female fetus and mother
365
Radial head subluxation tx
Nursemaid elbow Hyperpronation of forearm Supination of forearm & flexion of elbow
366
ADHD alternative medication
Atomoxetine
367
5% hemoglobin A2 | 95% hemoglobin F
Beta thalassemia Absent beta globin expression Tx Transfusion & Chelation therpay
368
Polycythemia
Hematocrit >65%
369
Urinating frequently Low urine specific gravity Mother w/ sickle cell
Hyposthenuria Sickle cell trait
370
<32 weeks need what exam
Head ultrasound
371
Painful pustules on arm | Honey crusted
Impetigo Staph aureus Tx: Mupirocin
372
Tx pertussis
Macrolides
373
Tan colored lesions in the iris
Neurofibromatosis type 1
374
Lead poisoning house
Before 1978
375
Muscle weakness | Calf pseudohypertrophy
Duchenne muscular dystrophy Tx Glucocorticoids
376
Chronic rhinosinusitis Nasal polyposis Malabsorption (diarrhea weight loss)
Cystic fibrosis
377
Hole in eye structure Nasal catheter cant pass through
Coloboma Atresia choanae CHARGE SYNDROME
378
Tx pin worm
Pyrantel pamoate | Albendazole
379
Septic arthritis
Vancomycin | Ceftriaxone
380
Purplish nonblanching rash on buttocks and posterior thigh Abdominal pain Difficulty walking Trace protein
Henoch-Schonlein purpura IgA mediated vasculitis Palpable purpura Arthritis/arthralgia Abdominal pain/ intussusception Renal disease Supportive tx
381
How to prevent spread of measles (rubeola)
Airborne precautions
382
``` Tall stature Long thin limbs Joint hyperlaxity Ectopic lens Fair hair and eyes Developmental delay Cerebrovascular accident ```
Homocystinuria Thrombosis is common Error in methionine metabolism Cystathionine synthase def
383
Arthritis Hematuria Rash on legs and back
Henoch Schoenlein purpura
384
Thickening of the glomerular basement membrane
Membranous nephropathy Edema Proteinuria
385
Glomerular basement membrane thinning
Alport syndrome Abnromalites in type IV collagen Sensorineural hearing loss Ocular abnormalities
386
Linear deposition of IgG on the BM
Good pasture Ab against BM Pulmonary hemorrhage Glomerulonephritis
387
Localized areas of mesangial sclerosis and collapse
Focal segmental glomerulosclerosis Edema Proteinuria
388
Mesangial deposition of IgA
Henoch Schonlein purpura
389
Podocyte fusion
Minimal change disease Nephrotic syndrome (Edema Proteinuria) Fusion/flattening of podocytes
390
Hypothermia Lethargy Low white blood cell count
Neonatal sepsis Group B strep
391
4 y.o HTN Right sided scrotal mass Doesnt reduce supine
IVC compression by fixed mass (wilms tumor) Abdominal U/S Varicocele
392
Left sided varicocele
no concern Compression of left renal vein between SMA and aorta Incompetent venous valves
393
Empiric tx for epiglottitis
Ceftraixone | Vancomycin
394
Azithromycin
Lower resp tract infections by atypical bacteria Mycoplasma pneumoniae Chlamydia pneumonia Whooping cough (bordetella pertussis)
395
Piperacillin-Tazobactam
psuedomonas infxn pulmonary infxn w/ cystic fibrosis
396
Dermatophyte infxn Tx
Tinea capitis African americans Scaly erythematous patch of hair loss ORal griseofluvin or terbinafine
397
Elevated indirect bilirubin Jaundice Elevated TSH Low Thyroxine Large tongue Hoarse cry
Thyroid dysgenesis Congenital hypothyroidism
398
Watery diarrhea Now dark red mucus diarrhea Seizure
Shigella sonnei High fever Cramping Supportive care
399
Nephrotic syndrome
Edema Hypoalbuminemia Urine protein elevated No hematuria Minimal change for peds Adults - FSGS - Membranous nephropathy - Membranoproliferative glomer
400
Nephritic syndrome
``` HTN Oliguria Hematuria Proteinuria Casts ``` Post strep glomerulonephritis HUS
401
Nephrotic syndrome | Hep B infxn
Membranous nephropathy
402
Colic
>3 hrs a day >3 days a week >3 months No reason
403
``` 3 day old Vomiting Seizures Hypotonia Jaundice Hepatomegaly ``` Elevated direct bilirubin Elevated ammonia Decreased glucose + urine reducing substance
Galactosemia Galactose-1-phosphate uridylyltransferase (GALT) deficiency Hypoglycemia --> seizures
404
Staphylococcal scaleded skin
Superficial flaccid bullae Extensive exfoliation of skin Infancy doesnt occur beyond 5
405
Rash red underarms and private areas Fever Sore throat Peeling of hands
Scarlet fever tx pencillin (amoxicillin)
406
Webbed neck Carpal and pedal edema Nail dysplasia Horseshoe kidney
Turner syndrome Congenital lymphedema due to lymphatic network dysgenesis
407
Chest pain in sickle cell patient
Aplastic crisis [not acute chest syndrome]
408
Knee pain worse at night Fevers Tender immobile mass on left knee Moth eaten
Ewing sarcoma
409
Risk factors for Respiratory distress syndrome
Male sex Perinatal asphyxia Maternal diabetes Cesarean section w/ labor
410
Hearing loss PDA Red reflex absent
Rubella
411
Tx unilateral cervical lymphadenitis
Staph aureua Strep pyogenes Clindamycin Amoxicillin-clavulanate
412
Bilious emesis Abdominal distension Leukocytosis Metabolic acidosis
Necrotizing enterocolitis Xray with air in the bowel wall and portal veins
413
Tx Neonatal conjunctivitis
Oral azithromycin Chlamydia
414
Neonatal exposure to ``` High pitched cry Sleeping Difficulty feeding Sneezing Vomiting ```
Heroin
415
Neonatal exposure to cocaine
Excessive sucking Jitteriness Hyperactive Moro reflex
416
Premature adrenarche
Early activation of adrenal androgens Acne Pubic and axillary hair
417
``` Seizure Low grade fever Perioral cyanosis Lethargic Anterior fontanel full Hemorrhage in left temporal lobe No calcifications ```
Herpes simplex virus
418
Refeeding syndrome increase in what
Insulin
419
Tx Neisseria meningitidis
ceftriaxone
420
Trigger for intussception (8)
Hypertrophied peyer patches Viral illness Rotavirus vaccination Congenital malformation of the intestine Henoch Schonlein purpura Celiac disease Intestinal tumor Polyps
421
Sudden onset uncontrollable continuous writhing of arms and hands Grimacing of face Month ago sick w/ sore throat and fever Pericardial friction rub Elevated ESR Prolonged PR interval and diffuse ST elevations What organism
Acute rheumatic fever Streptococcus pyogenes Risk: Mitral regurg/ stenosis Friction rub= carditis Chorea (jerks)
422
Parvovirus B19
slap cheek
423
Streptococcus mutans
Dental caries | Endocarditis
424
Trypanosoma cruzi
Chagas disease Cardiomyopathy (due to myopericarditis) Achalasia
425
Hypotonia at birth Delay muscle development Spasticity and dystonia Biting fingers and hands Now hypotonic Hyperreflexia
Lesch-Nyhan syndrome Deficiency of hypoxanthine guanine phosphorbosyltransferase Hypoxanthine and uric acid accumulation
426
vomiting labs
Hypochloremic hypokalemic metabolic alkalosis
427
WBC > 1000 Glucose < 40 Protein >250
Bacterial meningitis
428
WBC 5-1000 Glucose < 10 Protein > 250
Tuberculous meningitis
429
WBC 10-500 Glucose 40-70 Protein < 150
Viral meningitis Group B Coxsackie virus
430
Cyanosis | Knee chest position does what
Increased systemic vascular resistance
431
Respiratory distress Decreased lung aeration (pulmonary hypoplasia) Flattened facies Limb deformities Abdominal distension Suprapubic mass
Potter syndrome Abdominal distension + suprapubic mass= bladder distension from urinary tract obstruction Due to posterior urethral valves
432
Increased reticulocytes elevated mean corpuscular hemoglobin concentration Negative coombs
Hereditary spheroctyosis
433
Increased reticulocytes Low mean corpuscular hemoglobin concentration Negative coombs
G6PD deficiency
434
Breast development Elevated LH Advanced bone age
MRI of brain Central precocious puberty Premature activation of hypothalamic-pituitary-gonadal axis
435
Pulmonary abscess Recurrent cutaneous abscesses Aspergillus infxn
Chronic granulomatous disease Catalase positive pathogens (staph aureus, serratia, burkholderia, aspergillus) Mutation of phagocytic oxidative burst Dihydrohodamine 123 test Nitroblue tetrazolium test
436
Prematurity Delayed motor milestones 10 mn cant stand Hyperreflexia
Cerebral palsy
437
WAGR syndrome
11p deletion Deletion on chr 11p13 Wilms tumor Aniridia (lack iris) Genitourinary abnromalities (hypospadias) Mental retardation
438
FMRI | Mental delays
Fragile X syndrome ``` Prominent forehead Large ears Long narrow face Prominent chin Macro-orchidism ``` CGG repeat
439
Seen w/ cystic fibrosis
Pancreatic insufficiency Greasy stools (steatorrhea) Vit K deficiency
440
Lytic bone lesion Rash Polyuria
Langerhans cell histiocytosis
441
Fever Hive Joint pain 1 wk after pencillin for strep pharyngitis
Serum sickness like rxn
442
Tumor of pituitary stalk
Craniopharyngioma
443
Anemia Hypopigmented macules Hypoplastic and thenar eminences are flattened
Fanconi anemia DNA repair defect
444
Infant botulism
Constipation Poor feeding Hypotonia Oculobulbar palsies (absent gag reflex) (ptosis) Symmetric, descending paralysis ``` Autonomic dysfunction (decreased salivation, fluctuating HR/BP) ```
445
Unilateral cervical lymphadenitis 1) Most common 2) Dental caries/ periodontal disease 3) Hx of contact w/ infected animal 4) Nontender, violaceous 5) Bilateral
1) Staph aureus Strep pyogenes 2) Anaerobic bacteria (prevotella) 3) Francisella tularensis 4) Mycobacterium avium 5) Adenovirus
446
Absence vs focal seizure
Focal seizure - Motor, sensory or autonomic - underlying structural abnormality - impairment of awareness - Assoc w/ chewing - Postictal confusion/ lethargy - One hemisphere EEG/ MRI ``` Absence - both hemispheres - staring spells 10-20 seconds - provoked by hyperventilation - no postictal period ```
447
Seizures Intellectual disability Slow spike and wave
Lennox Gastaut syndrome
448
Large primary lesions | Other lesion follow tension lines
Pityriasis rosea
449
6 y.o Insidious hip pain and limp Restricted hip abduction, internal rotation Normal Lab and Xray previously
Legg-Calve Perthes disease Early stage: normal Later: Femoral head flattening, fragmentation, sclerosis MRI: avascular necrotic femoral head
450
Howell jolly bodies
persistance RBC precursor nuclei single round blue inclusion

Third Year Shelf (7 decks)

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