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Pediatric Block > Pediatrics shelf exam and USMLE - Pediatrics shelf exam and USMLE > Flashcards

Pediatrics shelf exam and USMLE - Pediatrics shelf exam and USMLE Flashcards

1
Q

vaccinations given at birth

A

hep b

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2
Q

vaccinations given at 1 month

A

hep b, only if not given at birth

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3
Q

vaccinations given at 2 months

A

Pediarix (HBV, DTaP, IPV)
Prevnar (pneumococc)
Rotavirus
Hib

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4
Q

what is in pediarix

A

HBV
DTaP
IPV

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5
Q

vaccinations given at 4 months

A

Pediarix
Prevnar
Hib
Rotavirus

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6
Q

vaccinations given at 6 months

A

Pediarix
Prevnar
Hib
Rotavirus

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7
Q

vaccinations given at 12 months

A 
DTaP 
Hib
MMR
VZV
Prevnar
Influenza
Hep A
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8
Q

vaccinations given at 24 months

A

none

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9
Q

vaccinations given at 4-6 yrs

A

DTaP
IPV
MMR
Influenza

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10
Q

vaccinations given at 11 yo

A

Tdap

Meningococcus vaccine

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11
Q

what is the schedule for well visits starting from birth

A 
1 mo
2 mo
4 mo
6 mo
9 mo
12 mo
15 mo
18 mo
24 mo
then annually
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12
Q

why shouldn’t babies drink water

A

because their kidneys aren’t mature enough to handle the extra fluid so the babies will become hyponatremic since they can’t excrete the water, and then they can have szs

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13
Q

plagylocephaly

A

mishapen head

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14
Q

sunsetting sign

A

increased icp, eyes are half closed 2ndary to the increased icp on the cranial nerves

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15
Q

craniosynostosis

A

premature closure of the fontanelles

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16
Q

rash pattern in rmsf

A

palms and soles, then spreads to trunk

petechial

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17
Q

rash pattern in rubella

A

rash on face that spreads to the rest of the body

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18
Q

rash pattern in measles

A

rash starts at the head and spreads downwards and disappears in the same manner

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19
Q

rash pattern for erythema infectiosum

A

slapped cheek rash; lacy, reticular

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20
Q

vzv rash pattern

A

begins on trunk, followed by head, face, and extremities

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21
Q

gross motor skills at 1 mo old

A

raises head

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22
Q

gross motor skills at 3 mo

A

holds head up

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23
Q

gross motor skills at 4-5 mo

A

rolls front to back and back/front

sits supported

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24
Q

gross motor skills at 6 mo

A

sits unsupported

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25
Q

gross motor skills at 9 mo

A

crawls
cruises
pulls to stand

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26
Q

gross motor skills at 12 mo

A

walks alone

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27
Q

gross motor skills at 15 mo

A

walks backwards

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28
Q

gross motor skills at 18 mo

A

runs

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29
Q

gross motor skills at 24 mo

A

walks well up and down stairs

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30
Q

gross motor skills at 3 yrs

A

rides tricycle

throws ball overhand

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31
Q

gross motor skills at 4 yo

A

alternates feet going down stairs

skips

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32
Q

fine motor skills at 1 mo

A

follows eyes to midline

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33
Q

fine motor skills at 3 mo

A

hands open at rest

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34
Q

fine motor skills at 4-5 mo

A

grasps with both hands together

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35
Q

fine motor skills at 6 mo

A

transfers hand to hand, reaches with either hand

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36
Q

fine motor skills at 9 mo

A

pincher grasp

finger feeds

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37
Q

fine motor skills at 12 mo

A

throws, releases objects

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38
Q

fine motor skills at 15 mo

A

builds 2 block tower

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39
Q

fine motor skills at 18 mo

A

feeds self with utensils

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40
Q

fine motor skills at 24 mo

A

removes clothing

builds 5 block tower

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41
Q

fine motor skills at 3 yrs

A

draws circle

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42
Q

fine motor skills at 4 yrs

A

catches ball

dresses alone

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43
Q

fine motor skills at 5 yrs

A

ties shoes

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44
Q

Simple febrile sz

A 
btwn 6mo - 6yr
tonic clonic
associated with fever >100.4
sz lasts <15 mins
only 1 sz in 24 hrs
minimal post-ictal state
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45
Q

complex febrile sz

A

6 mo - 6 yrs
focal sz
>15 mins
>1 sz/24 hrs

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46
Q

management of simple febrile sz

A

determine the source of the fever, otherwise, no other w/u is needed

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47
Q

management of complex febrile sz

A

full w/u should be done, but no anti-epileptics, no eeg needed
if pt is <18 mo, LP

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48
Q

eeg abnormality associated with infantile spasm

A

hypsarrythmia

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49
Q

definition of recurrent abdominal pain

A

> 3x in 3 mo

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50
Q

1 cause of abdominal pain

A

gastroenteritis

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51
Q

mesenteric lymphadenitits

A

persistent pain following an infx

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52
Q

clinical features of HSP

A 
condition preceded by uri 
non-thrombocytopenic palpable purpura 
hematuria (good prognosis)
proteinuria (poor prognosis) 
spasmodic abdominal pain 
ileus, n/v 
ugi/lgi bleed
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53
Q

tx of hsp

A

steroids

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54
Q

complication of hsp

A

intussusception

kidney probs

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55
Q

clinical features of kawasaki

A 
CRASH and BURN 
Conjunctivitis
Rash (on trunk mostly) 
Aneurysm (coronary) 
Skin peels off, Strawberry tongue
Hands/Feet edema

BURN = FEVER (x 5d)

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56
Q

phases of kawasaki dz

A

acute
subacute (aneurysm formation)
convaslescent

takes 2-3 months to resolve

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57
Q

tx of kawasaki

A

ASA

IVIG

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58
Q

when is colicky pain associated with

A

constipation

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59
Q

what type of stool is seen with bacterial enterocolitis

A

bloody, mucinous stool

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60
Q

when will an appendix perforate in appendicitis

A

w/i 36 hrs

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61
Q

which infx can clinically mimic appendicitis

A

yersinia

campylobacter

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62
Q

what imaging study for appendicitis

A

ct

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63
Q

meds used to tx of perforated appendix

A

amp, gent, flagyl

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64
Q

clinical presentation of intussusception

A

currant jelly stools
lethargy
palpable tubular mass
paucity of gas on xr or evidence of obx

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65
Q

imaging most specific for intussusception

A

barium (or air) enema

is also therapeutic

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66
Q

most common location for intussusception

A

ileocolic

can also develop at meckel’s divertic

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67
Q

major complication of intussusception

A

there is impaired venous return so bowel edema develops –> ischemia, necrosis –> perforation

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68
Q

etiology of intussusception

A

ileum invaginates into colon at ileocecal valve
a previous viral infx –> hypertrophy of the peyer’s patches… this can develop into a lead point
hsp can be association with an ileal-ileal intussusception

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69
Q

tx of intussusception

A

must do fluid resusc first, if needed

hydrostatic reduction with air/barium

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70
Q

recurrence rate of intussusception

A

15%

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71
Q

at what age would a pt present with pyloric stenosis

A

1-3 mo

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72
Q

which medicaation can be associated with pyloric stenosis

A

erythromycin

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73
Q

best imaging for pyloric stenosis

A

u/s

will also see a string sign ugi study

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74
Q

tx of pyloric stenoSIS

A

MUST correct fluids and lytes first!

then pyloromyotomy

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75
Q

describe malrotation

A

small intestines rotate abnormally in utero, so there is an abnormal fixation posteriorly to the mesentary
it can twist on its vascular supply –> volvulus

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76
Q

clinical presentation of malrotation

A

bilious emesis
possibly abdominal distention/shock
+ guiac test = bowel ischemia, poor prognostic sign

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77
Q

tx of malrotation

A

surgery ASAP

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78
Q

tx for scd induced priapism

A

sedation

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79
Q

dz that scd can mimic if htere is abdominal pain

A

appendecitis

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80
Q

when is frontal bossing seen?

A

beta-thal or some other hemolytic process that requires rapid hematopoesis

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81
Q

tx for beta-thal

A

serial transfusion + chelation therapy (desferoxamine) b/c of fe overload

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82
Q

consequence of fe overload

A

hemochromatosis

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83
Q

complications of g6pd deficiency

A

rbcs are destroyed but there is increased amounts of hb liberated in the process –> hb-uria

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84
Q

findings in classic hemophilia

A

bleeding problems + hemarthrosis

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85
Q

battle’s sign

A

basilar skull fx that leads to bleeding/bruise behind the ear

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86
Q

mechanism behind bell’s palsy in neonates

A

forceps deliver… usually resovles

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87
Q

social milestones at 5 yo

A

competetive games

understands rules and abides by them

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88
Q

social milestones at 4 yo

A

imaginative play

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89
Q

social milestones at 3 yo

A

group play

shares

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90
Q

social milestones at 2 yo

A

parallel play

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91
Q

social milestones at 18 mo

A

plays around other children

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92
Q

social milestones at 12 mo

A

comes when called

cooperates with dressing

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93
Q

social milestones at 9 mo

A

pat-a-cake

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94
Q

social milestones at 6 mo

A

recognizes strangers

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95
Q

social milestones at 4-5 mo

A

enjoys observing environment

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96
Q

social milestones at 3 mo

A

reaches for familiar objects/ppl

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97
Q

social milestones at 2 mo

A

recognizes parent

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98
Q

social milestones at 1 mo

A

fixes on face

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99
Q

developmental dysplasia of the hip

A

abnml relationship between head of femur and acetabulum –> instabilility and dislocation of hip joint
develops 2ndary to lack of contact of acetabulum and femur during intrauterine devevlopment

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100
Q

dx of developmental dysplasia of hip

A

u/s: see “false acetabulum” in lateral ileum

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101
Q

tx of developmental dysplasia of hip

A

pavick harness (keeps hip abducted and flexed), or body casting on older pts

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102
Q

complications of developmental dysplasia of hip

A

avn

degen arthritis of hip

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103
Q

metatarsus adductus

A

dorsiflexion and plantarflexion are UNRESTRICTED (diff from clubfoot); heels go out and toes go in

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104
Q

tx of metatarsus adductus

A

stretching or a brace

surgery not usualy needed

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105
Q

idiopathic talipes equinovarus (aka)

appearance

A

congenital clubfoot
medial rotation of tibia, fixed plantar flexion, inversion of foot, forefoot adduction
CANNOT DORSIFLEX (unlike metatarsus adductus)

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106
Q

tx of clubfoot

A

bracing

serial casting

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107
Q

legg-calve-perthes dz

A

avn of femoral head
ischemic bone is eventually resolved and re-ossification occurs
–> limp, pain referred to thigh/knee

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108
Q

what movt’s are restricted in legg-calve-perthes dz

A

abduction
flexion
internal rotation

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109
Q

tx of legg-calve-perthes dz

A

bracing
surgery
observation

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110
Q

complications of legg-calve-perthes dz

A

collapse of femoral head

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111
Q

SCFE

A

gradual or acute separation of proximal femoral growth plate
fem head slipps off of femoral neck and rotates inf-post postition

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112
Q

etiology of scfe

A

common during puberty, could be hormonal

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113
Q

presentation of scfe

A

limp, pain in hip and groin, pain referred to knee

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114
Q

dx of scfe

A

plain film frog-leg, lateral position

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115
Q

tx of scfe

A

goal is to prevent further misallignment
pin fixation is done acutely
chronic cases require osteotomy

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116
Q

osgood schlatter dz

A

inflammation, swelling and tenderness over tibial tuberosity 2ndary to tendonitis of distal insertion of infrapatellar tendon

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117
Q

when does osgood schlatter dz occur

A

During growth spurt, in teens

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118
Q

tx of osgood schlatter

A

conservative, supportive management

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119
Q

complication related to achondrodysplasia

A

small foramen magnum seen in homozygotes –> brainstem compression

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120
Q

what is achondrodysplasia

A

d/o of cartilage calcifications and remodeling

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121
Q

why do childre have an increased risk of fx

A

tendons and ligaments are stronger than bones so in kids injuries often lead to fx when they would only cause sprain in adult

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122
Q

types of fx

A 
spiral (twisting forces on tibia during fall) 
epiphyseal fx (use salter classification) 
stress fx (hairline crack from repeated activity) 
torus fx (at metaphysis)
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123
Q

nursemaids elbow

A

subluxation of radial head

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124
Q

define upper airway

A

nose –> carina

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125
Q

sx of upper airway dz

A

inspiratory stridor
tachypnea
respiratory distress

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126
Q

choanal atresia

A

most proximal abnormality of airway
bony or membranous septum btwn 1 or both nasal passages and pharynx, preventing airflow through nose
life threatening if b/l (most young infants are obligate nose breathers)
can’t pass ng tube

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127
Q

complications of long-term intubation

A

subglottal stenosis

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128
Q

laryngeal or tracheomalacia

A

floppiness that closes off airway

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129
Q

how to confirm dx of laryngeal or tracheomalacia

A

bronchoscopy

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130
Q

ddx for wheezing and respiratory distress

A 
asthma
bronchiolitis
foreign body aspiration
gerd
te fistula
vascular sling
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131
Q

pathophysiology of sx in cf

A

cftr is abnormal –> altered cl channel

cl stays in cells and na/water enter the cell to maintain osmotic balance –> viscous secretions

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132
Q

gi effects in cf

A 
pancreatic insufficiency 
bowel obx 
rectal prolapse
dm 
cirrhosis
lage bulky smelly stools 
later in life stools --> distal obx
133
Q

pathognomonic finding in cf

A

meconium ileus

134
Q

tx of cf

A

chest pt
exercise
frequent cough
recombinant human dnase given through nebs to break down thick mucous complexes

135
Q

other than respiratory infx, what are some other complications of cf

A 
hemoptysis (>500 cc/d = emergency) tx w embolization
spontaneous ptx (1/2 will recur unless sclerosis is performemd, but if that is done then transplant is very difficult)
136
Q

definition of recurrent abdominal pain

A

> 3x in 3 months

137
Q

mesenteric lymphadenitis leads to

A

persistent pain after infx

138
Q

gi complication from hsp

A

ileal-ileal intussusception

139
Q

sx of hsp

A

non thrombocytopenic palpable purpura in dependent areas

an iga mediated vasculitis involving gi, skin, joints, and kidneys

140
Q

tx of hsp

A

steroids

141
Q

what is hsp usually preceded by

A

uri

142
Q

gi sx of hsp

A

spasmodic pain, ielus, vomiting, ugi/lgi bleed

143
Q

tx of kawasaki dz

A

ivig

asa

144
Q

3 phases of kawasaki

A

acute
subacute (aneurysms form)
convalescent (resolution over 2-3 mo)

145
Q

which bacterial infx can mimic appendicitis

A

campylobacter

yersinia

146
Q

sx of intussusception

A 
BOWEL OBX 
currant jelly stools
lethargy
palpable tubular mass 
paucity of gas on xr or evidence of obx
147
Q

dx of intussusception

A

barium (or air) enema

148
Q

progression of complications of intussusception

A 
impaired venous return
bowel edema 
ischemia
necrosis
perforation
149
Q

pathophys of intussusception

A

most are ileocecal, and occur when the ileum invaginates into colon at ileocecal valve

150
Q

lead points in intussusception

A 
hypertrophy in peyer's patches (often p viral infx) 
meckel's divertic 
intestinal polyp 
lymphoma 
foreign body 
hsp
151
Q

at what age would you expect pyloric stenosis

A

1-3 months

152
Q

what medication if given is associated with pyloric stenosis

A

erythromycin

153
Q

dx of pyloric stenosis

A

u/s, see hypertrophic pyloris

ugi study shows string sign

154
Q

embryology behind omphalocele

A

when midgut loop fails to return to abdominal cavity

see light gray shiny sac protruding from base of umbilical cord

155
Q

embryology behind malrotation of midgut

A

midgut undergoes partial rotation and –> abnormal position fo abdominal viscera, can be assoc with volvulus –> compromised blood flow and gangrene

156
Q

gastroschisis

A

weakness in abdominal wall –> herniation of bowel through the rectus muscle, usually to the right of the umbilicus

157
Q

clinical features of malrotation

A

bilious emesis
possible abdominal distension
xr shows gas in stomach, but no gas in intestines

158
Q

tx of malrotation

A

surgery stat

159
Q

risk factors for deverloping gerd in babies

A 
prematurity
esophageal dz
obx lung dz
overdistension of stomach from overeating
meds (theophylline)
160
Q

dx of gerd

A

pH probe placement in esophagus or ugi endoscopy

barium swallow to confirm nml anatomy

161
Q

tx of ger/gerd

A

small frequent feedings
keep head up for 20mins p eating
thicken feeds with cereal
metoclopramide (increases gastric motility)
h2 blocker or ppi
last resort: nissen fundlopication (fundus of stomach is wrapped around distal esophagus to increase les pressure)

162
Q

tx of diarrhea in children

A

if no serious complications, feed through the diarrhea –> decreased denudement and faster return to nml stooling patterns
don’t give antidiarrheals b/c –> toxic megacolon, unless salmonella, shigella, c diff, or parasites

163
Q

when to do w/u for diarrhea in a child

A

in infant 5d of enterocolitis or salmonella exposure

any infant with + stool dx looking toxic or + blood cx should be eval for pyelo, meningiits, pna, osteo

164
Q

when should a pt with diarrhea be admitted to hospital

A

> 5% dehydration and can’t rehydrate effectively at home

165
Q

obstipation and complications

A

no bm, if after neonatal pd, #1 cause is voluntary witholding
can be caused by pain, on defacation –> fear fo defecation –> further retention

voluntary holding increaess distension of rectum, decreases rectal sensation, requiring increaesed amounts needed to receive urge

166
Q

sx of hirschprung’s

A

h/o diarrhea, fecal spotting alternating with constipation

167
Q

effect on incresaed bll on bm

A

–> constipation

168
Q

how to tx functional constipation

A

incresae fluid, decrease junk food, increase fiber, increase ingestion of undiluted juice

169
Q

pathophys of hirschsprung’s

A

failure of ganglion cells of myenteric plexus to migrate down colon in utero
therefore distal colon is tonically contracted and there is obx
usually limited to rectosigmoid colon

170
Q

when to suspect hirschsprung’s

A

in any infant who doesn’t pass meconium, then –> bilious vomiting, abdominal distension, and poor feeding

171
Q

tx of hirschsprung’s

A

diverting colostomy with bowel that contains ganglion cells

aganglionic segment is removed by pulling ganglionic segment through rectum

172
Q

sx of meckel’s diverticulum

A

remnant of vitilline duct w/i 2 inches of ileocecal valve
bleeding from divertic
melena, obx (from intussusception), diverticulitis

173
Q

tx of meckel’s diverticulum

A

surgical resection

174
Q

dx of meckel’s divertic

A

technetium-99 scan p h2 antagonist to locate hemorrhagic cells

175
Q

encephalocele

A

projection of cranial content through bony skull defect in occiput –> severe mr, sz, mov’t do

176
Q

myelomeningocele

A

protrusion of neural and meningeal tissue

177
Q

meningocele

A

meninges protrude

178
Q

spina bifida II is associated with

A

chiari II malformation

179
Q

complications of spinal bifida

A

caudal end of cord is tehtered to distal spine and can’t ascend to adult position –> scoliosis, sphincter dysfxn, LE deformities

180
Q

non-communicating hydrocephalus

A

block in exiting ventricles; above blockage, ventricles are big

181
Q

causes of non-communicating hydrocephalus

A

secondary to narrowing at 4th ventricle/aqueduct or malformation at posterior fossa
chiari II malformation
spina bifida occulta

182
Q

communicating hydrocephalus

A

subarachnoid villi are dysfunctional/obliterated

183
Q

sx of motor cp

A

fixed lesion in immature brain -> nonprogressive d/o of mov’t and posture
spasticity is #1 type from injury to motor tracts in brain
pts are hypotonic in early months then later become spastic
CONDITION IS NOT PROGRESSIVE

184
Q

sx of extrapyramidal cp

etiology

A

from basal ganglia damage –> choreoathetoid mov’t, postural ataxia, spasticity

kernicterus, there is usually some sort of brain insult

185
Q

what gcs is required for a head ct to be obtained

A

<12

186
Q

1 cause of ich in kids

A

avm

187
Q

what meds are associated with pseudotumor cerebri

A

tetracyclines

corticosteroids

188
Q

define encephalopathy

A

generalized cerebral dysfxn, ms change, disorientation

189
Q

risk factors for developing retinopathy of prematurity

A

bw <32 weeks
mechanical ventilation
need for supplemental o2

190
Q

causes of leukocoria

A

retinoblastoma (–> death and visceral mets in all cases)
cataracts (most common cause)
retinopathy of prematurity

191
Q

amblyopia

A

visual impairment not corrected by glasses and not due to an ocular lesion
often from strabismus

192
Q

tx of amblyopia

A

occlusion of better seeing eye forces development of affected eye and visual cortex of affected eye

193
Q

at what age will tx not be successful in ambylopia

A

after 8yo

194
Q

tx of retinoblastoma

A

enucleation (removal of the affected eye)
radiation tx
chemo

195
Q

complications of neonatal cataracts

A

if not remoed by 3-4 months, there is irreversible amblyopia

196
Q

course of retinopathy of prematurity

A

most regress spontaneously
if not, cryotherapy can be performed to reduce progression
are still at risk for amblyopia even if treated

197
Q

dacryostenosis

A

congenital nasolacrimal duct obstruction
causes overflow tearing - 6% of neonates
2ndary to failrue of distal membranous end of nasolacrimal duct to open

198
Q

tx of dacryostenosis

A

probing of nasolacrimal dut at 12-15 mo

although most resolve spontaneously by 1 yo (in 96% of infants)

199
Q

ophthalmia neonatorum

A

conjunctivitis occurring in first month of life

p/w eyelid edema, conjunctival hyperemia and ocular d/c

200
Q

when is it normal for there not to be tears

A

in the first few weeks of life

201
Q

age of onset of gonococcal ophthalmia neonatorum

A

2-4 days

202
Q

age of onset of chlamydia ophthalmia neonatorum

A

4-10 days

203
Q

clinical features of gonococcal ophthalmia neonatorum

A

eyelid edema
chemosis
purulent d/c

204
Q

complications of gonococcal ophthalmia neonatorum

A 
sepsis 
meningitis
arthritis
corneal ulceration 
blindness
205
Q

complications of chlamydia ophthalmia neonatorum

A

corneal scarring

PNA

206
Q

tx of chlamydia ophthalmia neonatorum

A

oral and topical erythromycin
tx parents
tx with erythromycin despite the risk of developing pyloric stenosis

207
Q

tx of gonococcal ophthalmia neonatorum

A

topical erythromycin
IV cefotaxime
tx parents

208
Q

when should steroid containing eye drops not be given in conjunctivitis

A

if hsv-1 is suspected etiology

can make dz worse

209
Q

hordeolum

A

acute infection of sebacous tarsal glands

staph aureus is usually cause

210
Q

tx of hordeolum

A

warm compresses

211
Q

chalazion

A

area of sterile lipogranulomatous reaction within meibomian glands that can enlarge
can be chronic and recurrent

212
Q

is periorbital or orbital cellulitis an emergency

A

orbital cellulitis

213
Q

sx of periorbital cellulitis

A

skin around eye is indurated, warm, and tender
no eye pain
may have si/sx of sinus infx

214
Q

sx of orbital cellulitis

A

severe pain with eye movement
proptosis
vision changes
decreased ocular mobility

215
Q

dx of orbital cellulitis

A

ct scan

216
Q

organisms to cover with orbital cellulitis

A

strep

h. flu
m. cat

217
Q

tx of periorbital cellulitis

A

iv abx

can –> meningitis, tx agressively with vanco, pcn, 1st gen cephalosporin

218
Q

orgs to tx in periorbital cellulitis

A

strep
h flu
m cat

219
Q

features of fragile x syndrome

A 
hyperactive
mr
large body
long face
prominent jaw and ears
thickened nasal bridge 
large testes 
\+/- autism
220
Q

facial features of xyy

A

long asymmetric ears

incresaed length: breadth in hands, feet, and cranium

221
Q

nutritional deficiencies in goat’s milk

A

decreased vit d, iron, folate, b12

222
Q

infectious dz associated with drinking raw cow’s milk

A

brucellosis

223
Q

what supplements should moms receive if they are vegan

A

b12 to prevent buildup of mma

224
Q

effects of excess vit d

A

hypercalcemia
azotemia
poor growth
n/v/d

225
Q

vit e deficiency in premies –>

A

hemolytic anemia

226
Q

b1 defic –>

A

beriberi
(neuritis, edema, chf)
hoarseness
anorexia

227
Q

b2 deficiency –>

A

photophobia
cheilosis
glossitis
corneal vascularity

228
Q

b3 deficiency –>

A

pellagra (dermatitis, dementia, diarrhea)

229
Q

pathophys of primary hypophosphatemia

A

defective po4 resorption

no conversion of 25-vit D –> 1,25-vit D in proximal tubules

230
Q

lab studies in primary hypophosphatemia
ca
po4
alk phos

A

low/nml
low
high

231
Q

clinical findings in primary hypophosphatemia

A

smooth LE bowing (not angular, as is seen in ca defic)
intraglobulin dentin deformities (ca deficiency –> enamel defects)
coarse trabecular bone and fraying

232
Q

somogyi phenomenon

A

nocturnal hypoglycemia manifested as night terrors, early am sweating, then later has hyperglycemia, ketonuria, glucosuria (sugars increase because of glucagon release)

233
Q

what is an absolute contraindication for DTaP

A

if first dose –> encephalophaty or encephalitis

234
Q

clinical presentation of pb poisoning

A

emotional lability
abdominal pain
achy bones
intermittent vomiting and constipation

235
Q

at what BLL should tx be initiated

A

> 45

236
Q

clinical presentation of acute hg poisoning

A 
gi pain
fever
chills
HA
visual changes
cough 
cp
237
Q

clnical presentation of chronic hg poisoning

A

gingivostomatitis
tremor
neuropsych features

238
Q

clinical presentation of acute arsenic poisoning

A 
n/v/d, abdominal pain 
3rd spacing
hemorrhage
hypovolemic shock
vtach 
qt prolongation
239
Q

narcosis

A

deep stupor, unconsciousness

240
Q

clinical presentation of cerebral palsy

A

postural hypotonia
failure ot reach for toys
gross and fine motor delay
cognitive and sensory deficits

241
Q

complications of cp

A

sz

mr

242
Q

differences in etiology for quadriplegia and paraplegia

A

quadriplegia results from umn damage

paraplegia results from lmn or spinal cord damage

243
Q

most likely organisms ot –> pna in cf

A

staph or pseudomonas

244
Q

clinical presentation of meconium ileus

A

vomiting
abdominal distension
distended bowel loops
“soap bubble” on axr

245
Q

pathophys of meconium ileus

A

obx begins in utero –> underdeveloped distal lumen

246
Q

tx of meconium ileus

A

surgical emergency

gastrograffin enema

247
Q

vitamin a deficiency –>

A

pseudotumor cerebri (among other things)
will see bulging fontanelles, ha, n/v
may be seen as first presenting sign in a pt with cf

248
Q

what effect does phenobarb have on jaundice

A

it improves it by increaseing gluocoronyl transferase

249
Q

cancer that is associated with (germline) retinoblastoma

A

osteosarcoma is most common
melanoma
squamous cell ca

250
Q

conditions associated with aniridia

A

congenital glaucoma
surge-weber
marfan
neurofibromatosis

251
Q

presentation of malrotation

A

obx
typically normal for first few days of life than malrotation worsens –> abdominal fullness, especially in ruq –> bilious vomiting –> ischemia and necrosis

252
Q

1 malrotation

A

volvulus

253
Q

pathophys of volvulus

A

cecum fails to move to rlq and never adheres to abdominal wall
mesentary and sma are tethered to narrow stalk and twist about itself
band of adhesive tissue can extend from cecum to ruq -> duodenal obx

254
Q

presentation of children with 2ndary htn

A

ha
epistaxis
visual sx
easy fatiguability

255
Q

describe how biliary atresia can occur post-natally

A

from scarrin gan dinflammation of intrahepatic or extrahepatic biliary ducts
etiology is unclear

256
Q

describe findings of prenatal biliary atresia

A

gb is absent

257
Q

sx of congenital toxo

A

chorioretinitis
hydrocephalus
intracranial calcifications

258
Q

complement levels in post-strep gn

A

decreased c3

259
Q

what are “currant jelly stools”

A

bloody stools

indicative of intussusception

260
Q

tx of intussusception

A

barium/air enema

261
Q

germinal matrix

A 
embryonic tissue present near caudate nucleus, often gets damaged by hypoxia/ischemia 
#1 place for intraparenchymal bleed
262
Q

progression of intraparenchymal bleed in a newborn

A

blood can flow into ventricles w/i 3 days of life

263
Q

what bvs are damaged in shaken baby syndroem

A

bridging veins

264
Q

what bvs are involved in sah

A

circle of willis

265
Q

signs of svt

A

hr 220-270

no p waves

266
Q

pathophys of strawberry hemangioma

A

vascular tissue fails to communicate with adjoining tissue

enlarges –> raised tumor

267
Q

most common causes for pna in a child > 6 yo

A

mycoplasm

strep pneumo

268
Q

cardiac complications in marfan syndrome

A

aortic root dilatation, aortic dissection

mvp

269
Q

most common orgs in peritonsillar abscess

A

anaerobes

GAS

270
Q

physical findings of patau syndrome

A

forebrain fails to develop (holoprosenceph)
midface developmental abnormalities
abnml genitalia
severe mr

271
Q

which chromosomes are associated with

  1. edwards
  2. patau
A 
Edwards = Election age (18) 
Patau = Puberty age (13)
272
Q

porencephaly

A

cyst/cavity in brain that communicates with ventricles

273
Q

causes of euvolemic hyponatremia

A

siadh
glucocorticoid deficiency
hypothyroid
water intoxication

274
Q

vacterl

A 
vertebral
anal 
cardiac
trach 
esophageal
renal 
limb
275
Q

gastrografin

A

way to dx meconium ileus
is demonstates unused microcolon and pellets of meconium higher up
can draws water into lumen and meconium gets unplugged (dx and tx)

276
Q

features of neonatal listerosis

A

respiratoyr distress at 5 days

meningitis

277
Q

clinical presentation of congenital hypothyroid

A 
constipation 
jaundice
ftt
enlarged fontanelle
umbilical hernia
278
Q

presentation of neuroblastoma

A 
asx abdominal mass
horner's 
dancing eyes
dancing feet
blueberry muffin lesions 
htn
279
Q

patau’s or edwards syndrome:

microcephaly

A

patau

280
Q

patau’s or edwards syndrome

prominent occiput

A

edwards

281
Q

patau’s or edwards syndrome

narrow forehead

A

edwards

282
Q

patau’s or edwards syndrome

microphthalmia

A

patau

283
Q

patau’s or edwards syndrome

cutis aplasia

A

patau

284
Q

patau’s or edwards syndrome

micrognathia

A

edwards

285
Q

patau’s or edwards syndrome

low-set malformed ears

A

edwards

286
Q

patau’s or edwards syndrome

cleft lip

A

patau

287
Q

patau’s or edwards syndrome

congenital heart dz

A

both

288
Q

patau’s or edwards syndrome

omphalocele

A

patau

289
Q

patau’s or edwards syndrome

clenched hands with overlapping fingers

A

both

290
Q

patau’s or edwards syndrome

rocker bottom feet

A

edwards

291
Q

patau’s or edwards syndrome

polydactyly

A

patau

292
Q

patau’s or edwards syndrome

polycystic kidney dz

A

patau

293
Q

patau’s or edwards syndrome

horseshoe kidney

A

edwards

294
Q

patau’s or edwards syndrome

crytorchidism

A

patau

295
Q

patau’s or edwards syndrome

agenesis of corpus callosum

A

patau

296
Q

genetic changes in prader willi

A

paternal deletion, 2 defective maternal chromosomes

297
Q

physical appearance of pts with prader willi

A

obese
almond shaped eyes
downturned mouth
small hands and feet

298
Q

genetic changes in angelman’s

A

maternal deletion, 2 deffective paternal chromosomes

299
Q

physical appearance of angelman’s

A

large mouth
short stature
tiptoe walk
szs

300
Q

galactosemia

A

galactose 1-p builds up and accumulates in liver and brain

301
Q

complications of galactosemia

A

increased risk of e coli sepsis
LD
premature ovarian failure

302
Q

tx of galactosemia

A

eliminate galactose containing foods from diet

303
Q

complications of pku during pregnancy

A

if diet not followed, baby can develop microcephaly, mr, and congenital heart dz

304
Q

physical features of homocystinemia

A

marfan like appearance

dislocaed lens

305
Q

what effect does sepsis have on bilirubin

A

disrupts the bbb so it can cause diffusion of bili into the brain

306
Q

what effect does temp have on bili

A

cold temperature can –> bili dissociation from albumin

307
Q

protocol for neonates whose mom developed varicella infection just after delivery

A

if mom develops sx w/i 2 days of delivery or during end of pregnancy, treat baby wiht ivig and acyclovir. if greater amt of time is lapsed, no tx needed

308
Q

consequences of neonatal asphyxia

A 
cerebral edema
irritability 
sz
cardiomegaly
renal and heart failure 
DIC
RDS
309
Q

what is the apt test

A

used to differentiae fetal from maternal blood

310
Q

which drugs are contraindicated for breastfeeding

A 
lithium 
cyclosporin 
antineoplastic drugs
ergots
bromocriptine
tetracyclines
311
Q

classic finding on xr for nec

A

pneumanitis intestinalis

312
Q

consequences of cold temparature in a premie

A

increased metabolic rate in order to raise body temp, but their ventilation rate increased as well
but, b/c of respiratory problems in premies they can’t oxygenate enough so lactic acide accumulates –> metabolic acidosis

313
Q

which is worse:

ABO incompat or Rh incompat

A

Rh incompat

314
Q

lab findings in abo incompat

A

increased retic count

weakly + coomb’s

315
Q

lab findings in rh incompat

A

strongly + coombs

316
Q

pathophys of transient apnea of the newborn

A

immature respiratory centers, esp in premies

317
Q

how to id the underlying cause of congenital hypothyroid

A

iodine uptake scan

318
Q

late development of clavicle fx during delivery… when does this occur?

A

callous formation in anterior shoulder

1 week

319
Q

physical findings of subgaleal hemorrhage

A

feels like cephalohematoma that crosses midline

can lose 1/3 of

320
Q

onset of gonococcal conjunctivitis in a newborn

A

DOL 2-5

321
Q

onset of chlamydia conjunctivitis

A

DOL 5-14

322
Q

what effects does surfactant deficiency have on lung compliance and lung volume
cardiac effecT

A

decreases both

R–>L shunt

323
Q

what should be given to newborns whose moms are infected with Hep B

A

Hep B Ig and HBV

324
Q

effect of propanolol in utero

A

iugr
decreased ability of asphyxiated nb to incresae hr and co
associated with hypoglycemia and apnea

325
Q

when is surgery for cleft lip done

A

3 mo

326
Q

when does transient tachypnea of nb resolve

A

DOL #3

327
Q

significance of 5th finger polydactyly

A

in black infants, no consequence

in white infants, can be associated with cardiac abnormalities, must do an echo

328
Q

twin twin transfusion

A

donor twin –> oligohydramnios, anemia, ypovolemia
recipient twin –> polyhydramnios, larger size (20% difference in body weight), hyperviscocity, respiratory distress, hyperbili, hypocalcemia, renal vein thrombosis

329
Q

when does serum bili peak

A

DOL 3-5

Pediatric Block (3 decks)

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