Peds Flashcards
(151 cards)
1
Q
What is precocious puberty?
A
Early secondary sexual development (girls < 8, boys < 9)
Assessment includes checking bone age and hormone levels.
2
Q
What does isolated pubic hair development indicate?
A
Premature Adrenarche
This condition is characterized by early development of pubic hair without other secondary sexual characteristics.
3
Q
What is premature thelarche?
A
Isolated Breast Development
This refers to early breast development in girls.
4
Q
What does high LH indicate after GnRH stimulation?
A
Central Precocious puberty
This can be idiopathic or due to CNS tumors.
5
Q
What does low LH indicate in the context of precocious puberty?
A
Peripheral precocious puberty
Causes include Nonclassical CAH, gonadal/adrenal tumors, or exogenous estrogen exposure.
6
Q
What is a fibroadenoma?
A
Benign, estrogen-sensitive tumor mainly in adolescents and women < 30
It is unilateral, mobile, and located in the upper outer quadrant of the breast.
7
Q
What causes primary dysmenorrhea?
A
Excessive prostaglandin production
Symptoms include pain in the first 2-3 days of menstruation, nausea, vomiting, and diarrhea.
8
Q
What is the most common cause of abnormal uterine bleeding in adolescents after menarche?
A
Immaturity of the Hypothalamic-Pituitary-Ovarian axis
This condition results in painless, irregular, and heavy bleeding.
9
Q
What is the management for undescended testis if not descended by 6 months?
A
Orchiopexy is done < 1 year of age
If not corrected, the risk of testicular torsion and malignancy increases.
10
Q
What is diabetes insipidus?
A
AVP-D (arginine vasopressin) deficiency
It can be central or renal, leading to polyuria and dilute urine.
11
Q
What is the first test for diabetes insipidus?
A
Water Deprivation test
This test helps distinguish between AVP disorders and primary polydipsia.
12
Q
What happens if sodium levels are < 145 during a water deprivation test?
A
Water test indicated
This helps distinguish between central vs renal AVP disorders.
13
Q
What are the signs of gynecomastia in males?
A
Measure LH, Testosterone, Estradiol, hCG
This helps determine the underlying cause.
14
Q
What is phenylketonuria (PKU)?
A
Impaired phenylalanine hydroxylase deficiency
Features include eczema, hypopigmentation, and musty body odor.
15
Q
What characterizes diabetic ketoacidosis (DKA)?
A
Anion gap metabolic acidosis, total body potassium decrease
This condition is common in uncontrolled diabetes.
16
Q
What is scoliosis?
A
Lateral curvature of the spine (Cobb angle > 10)
Red flags include back pain, neurologic symptoms, and rapid progression.
17
Q
What is Scheuermann kyphosis?
A
Excessive curvature of the thoracic spine due to abnormal anterior vertebral wedging
Pain worsens with flexion.
18
Q
What is spondylolysis?
A
Unilateral/bilateral defect in the pars interarticularis, mainly due to overuse injury
Symptoms include pain in lumbar extension.
19
Q
What is calcaneal apophysitis?
A
Overuse injury caused by repetitive microtrauma to the calcaneal apophysis
Symptoms include heel pain and decreased gastrocnemius/soleus flexibility.
20
Q
What is Tarsal tunnel syndrome?
A
Compression of the posterior tibial nerve
Symptoms include pain, numbness, and tingling along the sole of the foot.
21
Q
What is a giant cell tumor?
A
Benign tumor with a soap bubble appearance, mainly in individuals > 20 years
It typically occurs in the long bone epiphysis.
22
Q
What is osteoid osteoma?
A
Benign tumor of long bones in children that often resolves spontaneously
It usually presents with localized pain.
23
Q
What are unicameral bone cysts?
A
Asymptomatic or localized pain in long bones with a well-defined narrow transition zone
They also tend to resolve spontaneously.
24
Q
What is chondroblastoma?
A
Joint pain and swelling involving long bones with locally aggressive behavior
X-ray shows a thin sclerotic margin in the epiphysis.
25
What is osteochondroma?
Most common benign tumor, characterized by a painless hard nodule on long bones
## Footnote
It appears as a bony sprout extending from the metaphysis.
26
What is osteosarcoma?
Most common bone malignancy in children, presenting with localized pain and aggressive periosteal reaction
## Footnote
It features a sunburst pattern and Codman triangle.
27
What is Ewing sarcoma?
Malignant bone tumor with osteolytic lesions and an 'onion skin' appearance
## Footnote
It commonly affects children and adolescents.
28
What is Legg-Calve-Perthes disease?
Idiopathic osteonecrosis mainly in boys aged 3-12
## Footnote
Symptoms include progressive leg pain and thigh muscle atrophy.
29
What is slipped capital femoral epiphysis (SCFE)?
Overweight adolescent with posteriorly displaced femoral epiphysis
## Footnote
Symptoms include chronic hip, knee, or groin pain.
30
What is Osgood Schlatter disease?
Knee pain in young adolescents during growth spurts due to inflammation of the tibial tubercle
## Footnote
Symptoms worsen with activities, especially jumping.
31
What characterizes systemic juvenile idiopathic arthritis?
Worse in the morning with daily fever for ≥ 2 weeks and fixed arthritis for ≥ 6 weeks
## Footnote
It may include a pink macular rash.
32
What is the evaluation for microcephaly?
Serial HC measures, neurologic symptoms, dysmorphism
## Footnote
If worrisome signs are present, MRI and genetic testing may be indicated.
33
What is the first-line treatment for migraines in children?
Supportive care + simple analgesia (acetaminophen)
## Footnote
Triptans may be used if refractory.
34
What are breath-holding spells?
Two types: cyanotic (most common) and pallid
## Footnote
They usually resolve by age 5.
35
What is a choroid plexus papilloma?
A slowly growing tumor within the ventricles that produces CSF
## Footnote
It is most common in infants and confirmed by MRI.
36
What is a concussion?
Transient neurological disturbance after mild traumatic brain injury
## Footnote
Management includes rest and gradual return to activity.
37
What are the PECARN criteria?
Guidelines for performing head CT w/o contrast in pediatrics
## Footnote
They include specific criteria based on age and symptoms.
38
What are the symptoms of ADHD?
Inattentive symptoms + hyperactive/impulse symptoms present before age 12
## Footnote
Symptoms must be present in ≥ 2 settings.
39
What is craniopharyngioma?
A benign tumor that can compress the optic chiasm and pituitary stalk
## Footnote
It typically presents in ages 5-14 and 50-75.
40
What is medulloblastoma?
Most common malignant pediatric brain tumor, often compressing the 4th ventricle
## Footnote
Symptoms may include truncal and gait ataxia.
41
What is a pinealoma?
Tumor causing increased ICP due to obstructive hydrocephalus
## Footnote
It presents with Parinaud syndrome.
42
What is neuroblastoma?
Tumor of neural crest origin, median age < 2 years
## Footnote
Symptoms include Horner syndrome and elevated urine and serum catecholamines.
43
What is tethered cord syndrome?
Results in LMN signs, incontinence, recurrent UTIs, back pain, and scoliosis
## Footnote
Management includes MRI and surgical untethering.
44
What is Friedreich ataxia?
Autosomal recessive disorder caused by Frataxin gene mutation
## Footnote
Symptoms include neurologic dysfunction, hypertrophic cardiomyopathy, and kyphoscoliosis.
45
What characterizes ischemic stroke in children under 6?
Non-localizing symptoms such as headache and focal seizures
## Footnote
MRI with MR angiography is performed if suspected.
46
What is Niemann-Pick disease type A?
Most severe form, caused by sphingomyelinase deficiency
## Footnote
Symptoms include areflexia and hepatosplenomegaly.
47
What is Tay-Sachs disease?
B-hexosaminidase A deficiency
## Footnote
It presents with hyperreflexia and developmental regression.
48
What is Krabbe disease?
Galactocerebroside deficiency, leading to developmental regression and hypotonia
## Footnote
Symptoms include areflexia.
49
What is Gaucher disease?
Glucocerebrosidase deficiency leading to anemia and hepatosplenomegaly
## Footnote
There is no loss of milestones.
50
What is apnea of prematurity?
Respiratory pauses due to immature central respiratory center
## Footnote
Treatment includes non-invasive ventilation and caffeine.
51
What is respiratory distress syndrome (RDS)?
Characterized by a diffuse reticulogranular pattern on CXR
## Footnote
It results from atelectasis and diffuse alveolar collapse.
52
What is persistent pulmonary hypertension of the newborn (PPHN)?
Elevated fetal pulmonary resistance
## Footnote
Treatment involves oxygenation, ventilation, and inhaled nitric oxide.
53
What is bronchopulmonary dysplasia?
Premature arrest of pulmonary development with reduced septation
## Footnote
It mainly affects infants requiring prolonged oxygen.
54
What is a vascular ring?
Causes bi-phasic stridor, improved with neck extension
## Footnote
Imaging includes CXR and CT/MRI angiography.
55
What is meconium aspiration syndrome?
Characterized by patchy infiltrates and lung hyperinflation on CXR
## Footnote
It occurs when meconium is inhaled into the lungs.
56
What causes methemoglobinemia?
Exposure to oxidizing substances (e.g., dapsone, nitrites)
## Footnote
Symptoms include cyanosis and dark chocolate blood.
57
What is laryngomalacia?
Floppy supraglottic tissue causing inspiratory stridor
## Footnote
Symptoms worsen with feeding, crying, or supine position.
58
What is the most common cause of dyspnea in sickle cell patients?
Asthma, pulmonary hypertension, pulmonary fibrosis
## Footnote
These conditions are prevalent due to the underlying sickle cell disease.
59
What are the symptoms of asthma?
Chest tightness, dry cough, midnight cough
## Footnote
X-ray is typically normal; check for other respiratory issues.
60
What is the common presentation of Airway Hemangioma?
Progressive bi-phasic stridor in the first weeks of life with concurrent skin hemangioma in Beard distribution
## Footnote
Airway Hemangioma is a vascular malformation involving the trachea and/or larynx.
61
What are common causes of dyspnea in sickle cell patients?
Asthma, Pulmonary Hypertension, Pulmonary Fibrosis
## Footnote
These conditions are commonly seen in patients with sickle cell disease.
62
What are the symptoms of asthma?
Chest tightness, dry cough, midnight cough
## Footnote
X-ray is usually normal; spirometry should be performed for diagnosis.
63
What does PF stand for and what are its characteristics?
Pulmonary Fibrosis: Increased reticular markings, progressive exertional dyspnea
## Footnote
Symptoms are not intermittent and nocturnal; diagnosis involves CT and transbronchial biopsy.
64
What is choanal atresia and its common presentation?
Congenital obstruction of the posterior nasopharynx; unilateral is most common, causing chronic nasal discharge and cyanosis worsening with feeding
## Footnote
Bilateral choanal atresia may be associated with CHARGE syndrome.
65
What is the management of parapneumonic effusion?
Small effusion without respiratory distress: Oral antibiotics + close monitoring; moderate/large effusion or respiratory distress: US, IV antibiotics, drainage
## Footnote
This management strategy is based on chest X-ray findings.
66
What are the common signs of drowning in asymptomatic patients?
Observation in the hospital for ≥ 8 hours, cardiopulmonary monitoring, assessment for ARDS
## Footnote
A CXR is performed to assess for pulmonary edema at the end of observation.
67
What is the characteristic murmur of pulmonic regurgitation?
Decrescendo diastolic murmur, increases with inspiration
## Footnote
This is a common complication of Tetralogy of Fallot (TOF).
68
What does TOF stand for and what are its components?
Tetralogy of Fallot: RVOT, RV hypertrophy, overriding aorta, VSD
## Footnote
The knee-chest position increases systemic vascular resistance and reduces right-to-left shunting.
69
What is the presentation of congenital toxoplasmosis?
Triad: Chorioretinitis, diffuse intracranial calcifications, Hydrocephalus
## Footnote
Other findings may include seizures and nonspecific symptoms like hepatosplenomegaly.
70
What are the major criteria for diagnosing acute rheumatic fever?
JONES: Joints (migratory polyarthritis), Carditis, Nodules, Erythema marginatum, Sydenham chorea
## Footnote
Diagnosis requires Strep infection plus 2 major or 1 major and 2 minor criteria.
71
What is the treatment for Lyme disease in early localized stage?
21 days of doxycycline
## Footnote
Early localized Lyme disease typically presents with erythema migrans, fatigue, and myalgia.
72
What is the significance of bloody diarrhea in relation to EHEC?
EHEC can lead to HUS; no high fever is present
## Footnote
Antibiotics may increase the risk of HUS in this condition.
73
What are the characteristics of myopia?
Increased axial length of the eye, blurred distance vision, normal near vision
## Footnote
Management includes prescription lenses with diverging lenses.
74
What is the management for neonatal conjunctivitis caused by gonorrhea?
IM/IV ceftriaxone (single dose)
## Footnote
Gonococcal conjunctivitis typically presents 2-5 days after birth.
75
What are the symptoms of Ramsay Hunt syndrome?
Ear pain, facial weakness, vesicular rash in the external auditory canal
## Footnote
This syndrome is associated with Herpes Zoster oticus.
76
What is the screening recommendation for STI in women?
Annual screening for sexually active women < 25 years
## Footnote
This includes screening for gonorrhea and chlamydia.
77
What are the clinical features of preseptal cellulitis?
Eyelid erythema & swelling
## Footnote
This differs from orbital cellulitis, which has additional symptoms.
78
What is the common complication of phenytoin exposure in utero?
Fetal Hydantoin syndrome: Microcephaly, wide anterior fontanelle, cleft lip and palate, distal phalange hypoplasia
## Footnote
This syndrome is also associated with cardiac defects.
79
What is the management of organophosphate poisoning?
Atropine followed by Pralidoxime
## Footnote
Management also includes removing the patient's clothes and irrigating the skin.
80
What is the typical presentation of acute rheumatic fever?
Strep infection plus 2 major or 1 major and 2 minor criteria
## Footnote
Early recognition and treatment are critical to prevent long-term complications.
81
What is the difference between preseptal and orbital cellulitis?
Preseptal cellulitis presents with eyelid erythema and swelling, while orbital cellulitis includes symptoms of preseptal plus pain in extra-ocular movements, proptosis, and ophthalmoplegia with diplopia.
82
What is the first-line treatment for preseptal cellulitis?
Oral antibiotics.
83
What is the first-line treatment for orbital cellulitis?
Intravenous antibiotics.
84
When should sexually active women under 25 be screened for STIs?
Annual screening for gonorrhea and chlamydia.
85
What ages should lipid panels be performed?
Ages 9-11 and 17-21.
86
What is the most effective error prevention method in human factor engineering?
Computerized automation and forcing functions with minimal human effort.
87
What are the symptoms of heat exhaustion?
Hyperthermia <40C with normal mental status, sweating, vomiting, dizziness, hypotension, tachycardia.
88
What is a varicocele?
A coiled 'bag of worms' scrotal mass that does not transilluminate.
89
What is the management for primary varicocele?
Reassurance and observation if asymptomatic.
90
What is an exception to informed consent by a parent/guardian in minors?
Emergency care for life-threatening conditions where treatment delay will cause serious impairment or death.
91
What is the Plan-Do-Study-Act cycle used for?
Quality improvement tools.
92
What does the 'Do' phase of the Plan-Do-Study-Act cycle involve?
Implementing the plan, with collection of data.
93
What is the triple bubble sign associated with?
Jejunal atresia.
94
What is the first-line treatment for eosinophilic esophagitis?
Dietary modification.
95
What is gastroschisis?
Eviscerated bowel without covering membrane, lateral to the umbilical cord.
96
What is the clinical presentation of biliary cysts in children?
Triad: abdominal pain, RUQ mass, jaundice.
97
What is the management for Wilms tumor?
Surgical resection and chemotherapy.
98
What is the hallmark of Prader-Willi syndrome?
Loss of the paternal copy of the long arm of chromosome 15.
99
What are the features of DiGeorge syndrome?
CATCH 22: Cardiac defects, Anomalous face, Thymic aplasia, Cleft palate, Hypoparathyroidism.
100
What is the genetic cause of Turner syndrome?
Monosomy X (45, X).
101
What is the main feature of Duchenne muscular dystrophy (DMD)?
Gower sign.
102
What is the key diagnostic feature of acute hemolytic transfusion reaction?
Mismatch donor and recipient blood (ABO).
103
What is the first step in the evaluation of hemolytic anemia?
Complete blood count (CBC).
104
What is the treatment for hereditary spherocytosis?
Folate, blood transfusion, splenectomy.
105
What are the clinical features of hyper IgE syndrome?
Severe eczema, non-inflammatory cold abscesses, dysmorphic features.
106
What is the hallmark of common variable immunodeficiency?
Normal B cell count with low immunoglobulin levels.
107
What does the 'Eosinophilic esophagitis' diagnosis require?
Endoscopy with esophageal biopsy showing ≥ 15 eosinophils per field.
108
What is the significance of the 'double bubble sign'?
It indicates duodenal atresia.
109
What is the first-line treatment for impetigo?
Topical mupirocin for localized cases; oral antibiotics for widespread cases.
110
What is a common risk factor for jejunal atresia?
Exposure to prenatal cocaine or other vasoconstrictive substances.
111
What is the common lead point in intussusception?
Meckel diverticulum.
112
What are the clinical features of Lesch-Nyhan syndrome?
Hypotonia, intellectual disability, extrapyramidal symptoms, self-mutilation.
113
What is the management for biliary cysts in neonates?
Cyst resection, consider Roux-en-Y for biliary drainage.
114
What is the typical presentation of acute hemolytic transfusion reaction?
Fever, flank pain, hypotension, dark urine.
115
What is a key complication of chronic granulomatous disease?
Recurrent infections with catalase-positive organisms.
116
What does the presence of more than 3 RBCs in urine indicate?
Hematuria.
117
What is the treatment for hypernatremia if hypovolemic and symptomatic?
Isotonic solution (saline 0.9%) until euvolemic.
118
What is the characteristic appearance of a neonatal hemangioma?
Bright red raised plaque during the proliferation phase.
119
What is the genetic mutation associated with Rett syndrome?
MECP2 gene mutation.
120
What is the primary cause of atopic dermatitis?
Mutation in the filaggrin gene.
121
What is the treatment for chronic granulomatous disease?
Prophylaxis with TMP-SMX, itraconazole, and INF-gamma.
122
What is the main complication of Turner syndrome?
Primary ovarian insufficiency leading to amenorrhea.
123
What is the typical finding in patients with WAGR syndrome?
Wilms tumors, aniridia, genitourinary abnormalities.
124
What is the characteristic feature of Becker muscular dystrophy?
A milder form of Duchenne muscular dystrophy.
125
What is the most common lead point for intussusception?
Meckel diverticulum.
126
What is the typical presentation of hyper IgE syndrome?
Severe eczema, cold abscesses, elevated IgE levels.
127
What is the diagnostic method for UTI in children?
Urine culture
## Footnote
Empiric antibiotics (3rd generation cephalosporins) generally improve within 48 hours.
128
What conditions are associated with UTI and fever?
Pyelonephritis / Renal abscess
## Footnote
Broaden antibiotics and perform renal + bladder ultrasound.
129
What is the treatment for hypovolemic symptomatic hypernatremia?
Isotonic solution (saline 0.9%) until euvolemic.
130
What should be given for hypovolemic asymptomatic or euvolemic hypernatremia?
Hypertonic solution (e.g., 5% dextrose).
131
What is the formula for calculating anion gap (AG)?
AG = Na - (Cl + HCO3)
132
What does a high anion gap metabolic acidosis indicate?
MUDPILES
## Footnote
Methanol, Uremia, DKA, Propylene glycol / Paraldehyde, Iron / Isoniazid, Lactic acidosis, Ethylene glycol (antifreeze), Salicylate (aspirin).
133
What is the most common cause of Membranous Nephropathy in adults?
Idiopathic / primary disease.
134
What conditions can lead to secondary Membranous Nephropathy in children?
Malignancy, HBV, HCV, Syphilis, SLE, thyroiditis, NSAIDs, penicillamine.
135
What is the typical presentation of Membranous Nephropathy?
Subacute nephrotic syndrome. BP + GFR are usually normal.
136
What condition is caused by posterior urethral valves?
Distended bladder with thickened wall.
137
What is the most common cause of urinary tract obstruction in newborn boys?
Congenital urethral membrane.
138
What are the consequences of in utero oligohydramnios?
Lung hypoplasia (potter sequence).
139
What is the first test in the workup for posterior urethral valves?
Renal and bladder ultrasound.
140
What is the management for recurrent cystitis in children?
Address functional constipation.
141
What is the definition of recurrent UTI in children?
>= 6 months OR >= 1 year.
142
What treatment is recommended for UTI in post-menopausal women?
Topical vaginal estrogen.
143
What symptoms are associated with nephrolithiasis?
Hematuria, no fever, irregular contractions, flank pain.
144
What is the management for nephrolithiasis?
Renal and pelvic ultrasound.
145
What characterizes septic pelvic thrombophlebitis?
Unresponsive to antibiotics, diagnosis of exclusion.
146
What is the treatment for septic pelvic thrombophlebitis?
Anti-coagulation, Broad Spectrum Antibiotics.
147
What are the symptoms of ovarian torsion?
Sudden onset pelvic pain, nausea & vomiting, adnexal mass with absent Doppler flow.
148
What is the treatment for ovarian torsion?
Laparoscopy with detorsion, ovarian cystectomy, oophorectomy if necrosis/malignancy.
149
What is aromatase deficiency?
No conversion of androgens to estrogens.
150
What are the effects of aromatase deficiency in XX individuals?
Ambiguous genitalia with normal internal genitalia and virilization of the female fetus.
151
What laboratory findings are associated with aromatase deficiency?
No menses, Acne, high FSH, LH, low to indetectable Estradiol and Estrone.
