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Clin Med > Peds > Flashcards

Peds Flashcards

1
Q

What can occur in peds patients who are malnourished and receiving increased nutrition?

A

Refeeding syndrome (severe shifts in electrolytes & fluid)
Potentially fatal

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2
Q

What is the goal weight for obesity in children?

A

< 85% BMI for the pts age

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3
Q

What is the difference between anorexia nervosa and bulimia nervosa?

A

Anorexia: restricted eating due to fear of weight gain and/or body image disturbance
Bulimia: recurrent episodes of binge eating with a sense of lack of control/guilt which may include recurrent episodes of purging

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4
Q

What BMI is common to see in pts with anorexia nervosa?

A

< 18%

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5
Q

What are the 2 subtypes of ADHD?

A

Inattentive
Hyperactive

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6
Q

For a diagnosis of ADHD, where should symptoms be present?

A

In multiple settings

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7
Q

What is the treatment for ADHD?

A

Stimulants (amphetamines, methylphenidates)
SNRI (atomoxetine), NDRI (wellbutrin), TCA (amitriptyline)
Alpha-agonists (clonidine, guanfacine)

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8
Q

What are contraindications to children playing sports?

A

Active myocarditis or pericarditis
Acute enlargement of spleen or liver
Recent concussion & symptoms of postconcussion syndrome
Hypertrophic cardiomyopathy
Long QT syndrome
Athletes w/bleeding disorders should not do contact/collision sports

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9
Q

Which autosomal trisomies are not compatible with long-term survival?

A

Trisomy 13 (patau syndrome) (3rd most common)
Trisomy 18 (Edward syndrome) (2nd most common)

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10
Q

What are the signs/symptoms of trisomy 13?

A

Microcephaly
Anophthalmia/microphthalmia
Abnormally shaped/low-set ears
Rocker bottom feet
Weak muscle tone at birth

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11
Q

What are the signs/symptoms of trisomy 18?

A

Pinched face appearance
Clenched fists w/overlapping fingers
Club/rocker bottom feet

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12
Q

What is the most common autosomal trisomy?

A

Trisomy 21 (down syndrome)

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13
Q

What are the signs/symptoms of trisomy 21?

A

Flat facies
Brushfield spots in iris
Prominent epicanthic folds
Flat occiput
Simian crease

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14
Q

What is the average life expectancy of a person born with trisomy 21?

A

60 yo

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15
Q

What disorder is characterized by males being born with 2 or more X chromosomes?

A

Klinefelter syndrome

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16
Q

What are the signs/symptoms of Klinefelter syndrome?

A

Increased height
Long extremities
Gynecomastia
Delayed/incomplete puberty
Speech/language delays

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17
Q

What treatment is required for life starting in adolescence in pts with Klinefelter’s?

A

Testosterone

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18
Q

What disorder is characterized by females born with 3 X chromosomes?

A

Triple X syndrome

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19
Q

What are the signs/symptoms of triple X syndrome?

A

Increased height
Weak muscle tone
Kidney abnormalities
Increased of menstrual irregularity/infertility

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20
Q

What disorder is characterized by males born with 2 Y chromosomes and 1 X chromosome?

A

XYY syndrome

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21
Q

What are the signs/symptoms of XYY syndrome?

A

Increased height
Dental abnormalities
Scoliosis
Hand tremors

22
Q

What used to be thought about people with XYY syndrome but has been disproven?

A

That they are aggressive/violent

23
Q

What is the most diagnosed inherited cause of intellectual disability in males that is caused by a genetic abnormality of an X chromosome?

A

Fragile X syndrome

24
Q

What are the signs/symptoms of fragile X syndrome?

A

Physical/intellectual/behavioral problems
Large protruding ears
Prominent chin/forehead
Large testes
Hyperflexible joints

25
Q

What is the most common sex chromosomal abnormality in females who are born with 1 of 2 X chromosomes partially or completely missing?

A

Turner syndrome

26
Q

What are the signs/symptoms of Turner syndrome?

A

Short stature
Webbed neck
Low posterior hairline
Shield chest
Amenorrhea
Absence of puberty

27
Q

What IQ score is indicative of an intellectual disability?

A

< or = 70

28
Q

What medications are commonly used in pts with intellectual disabilities?

A

Aggression/impulse control: anticonvulsants or lithium
Anxiety/self-injurious behaviors: clomipramine, SSRIs, buspirone, naltrexone

29
Q

What are the signs/symptoms of Prader-Wili syndrome?

A

Obesity
Decreased muscle tone
Decreased mental capacity
Sex glands produce little or no hormones

30
Q

What disorder is characterized by excess copper being deposited into the body tissues?

A

Wilson’s disease

31
Q

What are the signs/symptoms of fetal alcohol syndrome?

A

Low IQ
ADHD
Faces w/broad set eyes
Narrow eye slits
Flat cheeks
Thin upper lip
Growth retardation

32
Q

What are the signs/symptoms of Autism spectrum disorder?

A

Sensory sensitivity
Limited eye contact
Repeat/echo words
Difficulty w/schedule changes
Fixate on objects or sounds
Difficulty interacting
Repetitive behaviors

33
Q

What is avoidant/restrictive food intake disorder (ARFID)?

A

Eating/feeding disturbance based on sensory characteristics w/failure to meet appropriate nutritional needs

34
Q

What is the FDA medication and off label medication used to treat ARFID?

A

No FDA approved treatment
Periactin (cyproheptadine) off label

35
Q

What medication can be used when conservative management fails for enuresis?

A

Desmopressin

36
Q

What disorder is characterized by severe, recurrent temper outbursts, irritability/anger most of the day nearly every day?

A

Disruptive mood dysregulation disorder (DMDD)

37
Q

At what age do you provide pharm treatment for depression in pediatrics?

A

Fluoxetine (prozac) at age 8
Sertraline (Zoloft) or Escitalopram (Lexapro) at age 12

38
Q

What are the signs/symptoms of oppositional defiant disorder (ODD)?

A

Loses temper
Easily annoyed
Angry/resentful
Argues with adults
Actively defies rules
Deliberately annoys others
Blames others
Spiteful

39
Q

What is a precursor to antisocial personality disorder?

A

Conduct disorder

40
Q

What are the signs/symptoms of tetralogy of fallot?

A

Hypercyanotic episodes (“tet spells”)
SOB
Restlessness
Gasping
Syncope

41
Q

What are the 4 ways tetralogy of fallot can occur?

A

Overriding aorta
R ventricle hypertrophy
Ventricular septal defect
R ventricle outflow tract obstruction

42
Q

What will you see on a CXR in a pt with tetralogy of fallot?

A

Boot sign

43
Q

What disorder has an egg on a string appearance on CXR?

A

Transposition of great vessels

44
Q

What disorder is due to a single artery arising from the heart that supplies both the aorta and the pulmonary artery?

A

Truncus arteriosus

45
Q

What disorder is due to the failure of the tricuspid valve to develop which leaves no connection between the right atrium and right ventricle?

A

Tricuspid atresia

46
Q

What is the mainstay treatment for cyanotic heart lesions?

A

Oxygen and prostaglandins

47
Q

Which cyanotic heart condition is most common overall, and which most commonly requires hospitalization in the first 2 weeks of life?

A

Overall: tetralogy of fallot
Hospitalization: transposition of great vessels

48
Q

What is the most common acyanotic congenital heart lesion?

A

Ventricular septal defect

49
Q

What are the different types of innocent heart mumurs?

A

Still’s (vibratory) (most common)
Venous hum
Pulmonary ejection murmur
Carotid bruit
Peripheral pulmonary stenosis (most common in 1st year of life but resolves)

50
Q

Are innocent murmurs systolic or diastolic?

A

Systolic
They are NEVER diastolic

Clin Med (15 decks)

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