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1

What is the difference between anaphylaxis and angioedema?

Anaphylaxis has hypotension

Angioedema looks like anaphylaxis but there is no hypotension/other organ system involvement

2

A patent ductus arteriosus is a connection between what 2 structures?

Aorta and pulmonary artery

3

What abnormality of the biliary tree is expected in pts with sickle cell?

Pigmented gallstones (d/t constant hemolysis and elevated bilirubin)

Cholecystectomy is expected to occur early.

4

Developmental dysplasia of the hip is diagnosed during the well-baby exam when you hear a click sound on hip flexion (Barlow and Ortolani). How is the diagnosis confirmed?

Ultrasound at 4-6 weeks

5

Peripheral eosinophilia, recurrent “cold” abscesses (Staph, H.flu, Strep pneumo), eczema, retained primary teeth, fractures, and post-infectious pneumatoceles

Dx?

Hyper-IgE (Job) Syndrome

6

In newborns, primary apnea occurs due to any perinatal insult. After ongoing primary apnea, there is a brief period of gasping respirations followed by a period of secondary apnea.

Describe management of primary vs. secondary apnea

Primary apnea responds quickly to stimulation

Secondary apnea requires bagging (via mask or tube) — stimulation will NOT work

7

Neonate presents with failure to pass meconium and bilious vomiting. X-ray shows air-fluid level with gas-filled plug. Dx and tx?

Meconium ileus

Perform water-soluble contrast enema to help breakdown obstruction

8

What causes erythema infectiosum

Parvovirus B19

9

Definitive diagnosis of _______ _______ is made with ultrasound showing “donut sign”

Pyloric stenosis

10

Diagnostic algorithm for suspected meningitis if there are signs of increased intracranial pressure (bulging fontanelles)

[Note: FAILS positive = signs of increased intracranial pressure]

Blood culture —> Abx —> CT scan —> LP

11

Management of meconium aspiration syndrome

If meconium is present but infant is vigorous (pulse >100, good resp effort and muscle tone), simple suctioning of nose and mouth is sufficient

If infant has poor tone and resp effort or pulse <100, endotracheal suctioning with passage and withdrawal of ET tube should be performed

12

Continuous machinery like murmur that usually resolves within 7 days in term infants

PDA

13

Patient presents with colicky bladder pain following an alcohol binge, and ultrasound reveals hydronephrosis without hydroureter. Dx?

Ureteropelvic junction obstruction — the ureter at the UPJ has been narrowed, which restricts flow of urinary volume (particularly in high volume states/diuresis)

14

Causes of bilious vomiting in neonate

Duodenal atresia
Annular pancreas
Malrotation/volvulus
Intestinal atresia

15

Immunodeficiency that can present in adults as well as children, both male and female. Less severe but with similar infection types to x-linked agammaglobulinemia. Diagnosis requires deficiency in at least 2 out of 3 of IgA, IgG, and/or IgM. Treat with scheduled IVIG

Common variable immunodeficiency

16

Orthopedic emergency that occurs in adolescents who are either obese or in a growth spurt. They complain of hip or knee pain of sudden onset. Confirm dx with frog-leg position x-ray. Surgery is required

Slipped capital femoral epiphysis

17

First 2 things to do if baby is yellow

Start with transcutaneous sensor

Draw a bilirubin level to determine conjugated vs. unconjugated hyperbilirubinemia

18

Bilious vomiting indicates obstruction distal to the ampulla of Vater. The workup begins with an x-ray and from there, the gas patterns help differentiate disease.

Double bubble sign with a normal gas pattern and a contrast enema showing abnormal cecum position indicate __________

Malrotation

19

What does VACTERL stand for?

Vertebral anomalies
Anus (imperforate)
Cardiac anomalies
Tracheoesophageal fistula
Esophageal atresia
Renal anomalies
Limbs

20

Hep B vaccine guidelines for baby if mom is Hep B negative

Hep B vaccine within 2 months

21

West syndrome (infantile spasm) = symmetric jerking of the head, trunk, or extremities WITHOUT fever, and interictal EEG shows hypsarrhythmia.

The treatment is _______ which can help with spasms, normalizing EEG.

ACTH

22

The old term “ALTE” meant Apparent Life-Threatening Event, and has since been replaced by “BRUE” for Brief Resolved Unexplained Event because ALTE led to too extensive a workup that often found nothing. Define BRUE

<1 year old + <1 minute duration + any of the following:

Change in color
Change in muscle tone
Change in respirations
Change in responsiveness

Separated into low-risk and high-risk — if low-risk you do nothing, if high-risk you pursue relevant tests/imaging

23

T/F: The use of antipyretics to control fever prevents recurrent febrile seizures

False

24

T/F: Erythromycin eyedrops offer prophylaxis against conjunctivitis caused by chlamydia and gonorrhea

False — protects against conjunctivitis caused by gonorrhea only

25

Bilious vomiting indicates obstruction distal to the ampulla of Vater. The workup begins with an x-ray and from there, the gas patterns help differentiate disease.

________________ presents as polyhydramnios in utero and bilious vomiting in the neonate. XR reveals double-bubble sign but there’s no distal air. Repair is surgical. It is associated with ___________

Duodenal atresia; Down syndrome

26

Age at which you would expect the following developmental milestones:

Can hop, draw a cross, speaks in 4-word sentences

4 years

27

Pharyngitis + rash on palms and soles

What virus?

Coxsackie

28

Anatomically stenosed connection between nose and mouth. In severe cases, baby will be blue at rest because they are obligate nose-breathers, and will pink up with crying. May see childhood snore. Surgery is required.

Choanal atresia

29

In term infants, PDA’s are usually no big deal and self-resolve within 7 days. How are they handled in preterm infants?

Closure with indomethacin or surgery (since they can cause hemodynamic instability)

However, prostaglandins are used to maintain PDA if needed for critical heart lesion

30

A pt with sickle cell usually has a hemoglobin between 7 and 9. Transfusions should be avoided unless absolutely necessary. If patients receive transfusions, they’ll become iron overloaded — what do you do if this occurs?

Use iron chelators like deferoxamine (or deferasirox)

Don’t do phlebotomy (like for hemochromatosis), this would just make them anemic