peds Flashcards
1
Q
cyanotic infant with L. axis deviation
decreased pulmonary markings on CXR
ASD or VSD
A
tricuspid valve atresia
2
Q
down syndrome heart
A
complete AV canal defect
3
Q
maternal lithium use
defect?
A
ebstein’s anomaly (malformed TC valve into the R ventricle)
4
Q
tetralogy of fallot on CXR
A
boot shaped heart (right v hypertrophy)
5
Q
normal heart deviation newborn
A
r
6
Q
total anomalous pulmonary venous return
A
all 4 pulmonary veins dump into r. atrium (R enlargement) or otherwise the systemic circulation (brachiocephalic veins, SVC, portal/renal veins))
7
Q
digeorge syndrome heart defect
A
truncus arteriosus
8
Q
Gray visicles in posterior oropharynx. Dz and virus
A
Herpangina
Coxsackie
9
Q
abx for unilateral cervical adenitis in kids
A
clinda (strep/staph)
must do I & D too
10
Q
odynophagia
A
pain with eating
11
Q
2 characteristics of niemann-pick dz but not tay sachs
A
hepatomegaly
arreflexia
12
Q
enzymes in niemann-pick vs tay sachs
A
NP: sphingomyelinase
TS: B-hexosaminidase
13
Q
1 year old
thrombocytopenia
recurrent bacterial infections
eczema
A
Wiskott-Aldrich Syndrome (X-linked)
14
Q
Maculopapular rash
started head spread to body
low fever
arthritis
A
rubella
15
Q
class of meds to use for tourette’s disorder
A
antipsychotics
16
Q
child less than 1
macrocytic anemia w/ low retic count
congenital anomalies
A
diamond-blackfan anemia
17
Q
general tx for OCD
A
high dose SSRI therapy
18
Q
infection associated (rare) with OCD onset
A
group A strep infection
19
Q
1st test in torticollis
A
c-spine radiographs
20
Q
erb-duchenne’s palsy noted. 1st step?
A
reassurance
21
Q
preterm neonate with:
+gastric volume, vomiting, abdominal distention
w/pneumatosis intestinalis and portal venous air
A
necrotizing enterocolitis
22
Q
neonate w/ air in stomach, duodenum. but nothing distal
A
(double bubble) = duodenal atresia
23
Q
neonate w/failure to pass mec w/in 48 hours (2)
A
Hirschsprung dz or CF
24
Q
infant with virilization
hyponatremia
A
21-hydroxyase deficiency
25
2 tests for 21-hydroxylase deficiency
consyntropin stim test
| +17 hydroxyprogesterone levels
26
Kid with recurrent infections - pneumonias, and suppurative adenitis
chronic granulomatous disease
27
newborn with bilious vomiting and triple bubble sign
jejunal atresia
28
timeline difference of gonococcal vs chlamydial conjunctivitis
reverse alphabetical order:
less than 5 days = gonococcal
greater then 5 days = chlamydial
29
differences in bruton's agammaglobulinemia VS CVID in
a) gender
b) # B cells
c) age of onset
a) Bruton's is just boys
b) B cells reduced in Bruton's
c) CVID later onset (15-35)
30
biggest risk of rotavirus vacc
small risk intussusception
31
timing or weight for sweat test
greater than 2 weeks
or
greater than 2 kg
32
laboratory abnormalities of seminoma vs germ cell tumor (2)
seminoma can give +BHCG
| germ cell tumors have +BHCG and +AFP
33
rate over which is tachypnea in a neonate
60
34
AFP level in aneuplodies
reduced
35
AFP w/ neural tube defects, ventral wall defects, or multip
increased
36
infant w/no stool in 24 hours, small colon
meconium ileus (CF)
37
apgar requiring intervention
less than 7
38
missense vs nonsense mutations
both point mutations - missense = one different aa. Nonsense makes a stop codon
39
when to consider adding inhaled steroid to asthmatic tx?
if 3 or more exacerbations/week
40
pallid spell
minor trauma followed by apnea
41
association (even with parents) of kids w/cyclic vomiting syndrome
migraines
42
tx for abnormal uterine bleeding, esp. adolescents
high dose estrogen therapy
43
4 classes of hypersensitivities
```
ACID
Anaphylactic
Cytotoxic (Ab-mediated)
Immune complex
Delayed (cell-mediated)
```
44
normal HR range of newborn
120-160 BPM
45
conjunctivitis on newborn at day 1
chemical irritation
46
baby with aniridia. what association?
Wilms tumor
47
timeline for orchipexy in case of crypotchidism with infant
after 1 yrs old
48
hyperbilirubinia velocity that is concerning
5 mh/dL per day
49
cherry vs strawberry angiomas
strawberry is on newborns (superficial angiomas), cherry angiomas are the red dots on adults
50
nevus simplex
macular stain
51
breast milk jaundice vs breastfeeding failure jaundice
breastfeeding failure has signs of dehydration (1st week) - brick red crystals in diaper
52
the 2 genetic conjugated hyperbilirubinemias
dubin-johnson (black liver)
| rotor (milder)
53
timeline of physiologic jaundice vs pathologic
phys 3 day+
| path less than 1 day
54
phys hyperbilirubinemia with +coombs
isoimmunization (Rho or ABO)
55
phys jaundice with +Hg (2)
Twin-twin transfusion
| or maternal-baby trx (delayed clamping)
56
baby with bili >20. tx?
exchange transfusion
57
kid less than 2 w/upper limb, head jerking
west syndrome
| infantile spasm
58
tx for west syndrome (infantile spasm)
ACTH
59
kid 3 mos to 6 yrs with colicky abdominal pain relieved by knee-chest position
intususseception
60
test if suspect blood in GI from ingested maternal blood vs vasa previa
apt test(alkali-denaturation test)
- if maternal blood ingestion
+ if fetal origin (could be vasa previa, etc)
61
2 warning signs of anaphylaxis
urticaria
| hypotension
62
empiric tx for meningitis in peds (3)
ceftriaxone, vanco, ampicillin +/- steroids
63
rosela fever/rash sequence and path
fever 1st
| HHV-6
64
maintenance fluid for kids (3)
per day:
0-10 kg: 100 cc/kg
10-20 kg: 50 cc/kg
20+ kg: 20 cc/kg
65
parkland formula for IVF (day) w/50 % in 1st 8 hours, 50% in next 16 hours
%BSA X kg X 4
66
dx of asthma (post-dilater improvement) cutoff
FEV1 greater than 12%
67
tx of diptheria
IVIG
68
hip problem in 5-7 yo M
ideopathic osteonecrosis
| Legg -Calve-Perthes Dz
69
1st line tx for mild acne
topical retinoids
70
association of transposition of great arteries
DM mother (not gestational - true DM)
71
kid with croup who doesn't get better.
dz?
bacterial tracheitis
72
test for digeorge
mitogen stimulation assay
73
tx of wiskott-aldrich
bone marrow trx
74
test to dx developmental dysplasia of hip
US
75
type of XR for SCFE
frogleg XR
76
tx of retinoblstoma in eye
surgery
77
sequelae to retinoblastoma of eye
osteosarcoma of bone later in life
78
test for imperforate anus
upside down babygram
79
double bubble sign (2 dx possibilities)
duodenal atresia
| annular pancreas
80
baby w/intestinal atresia (fluid levels)
| association of mom
mom did cocaine
81
babygram showing upper obstruction but normal air below
malrotation
82
girl with normal voiding but constant leak
low implantation of ureters
83
mandatory step w/cryptorchidism, even if pulled down
removal after puberty
84
workup of pediatric hematuria (2)
US
| IVP
85
if sickle cell dz and getting regular transfusions, what to do about Fe
deferoxamine
86
if sickle cell dx, and not get regular trx, what 2 supplements
Fe and folate
87
tx for acute sickle crisis
danger - priapism or AMS, etc (2)
OR with joint pain (3)
exchange transfusion, now (if in danger)
otherwise ivf, O2, pain control
88
tx to sickle pt who is a kid for osteo prophylaxis
abx-penicillin
89
tx, including method for chlamydial conjunctivitis
oral erythromycin
90
bilious vomiting
upper GI series
ligament of treitz on R, corscrew appearance
volvulus (malrotation)
91
infant w/FTT
hepatomegaly
cataracts
disorder, enzyme
classic galactosemia
| galactose-1-p uridyltransferase deficiency
92
galactokinase def vs classic galactosemia
galactokinase def is cataracts only
| no hepatomegaly, FTT-galactokinase is kind
93
normal vs not normal cutoff for weight loss in first 5 days
7%
94
nerves (2 each) affected in
Erb-Duchenne palsy
Klumpke palsy
C5-6
| C8-T1
95
Birth weight should double by:
| Triple by:
5 months
| 12 months
96
Intoeing should resolve by
4 years
97
Tx of Von willebrand dz
Desmopressin
98
1st sign of puberty in boys
Testicular enlargement
99
Adolescent
| Pain on left sternal border exacerbated by deep inspiration
Precordial catch syndrome
100
Cutoff for physiologic jaundice
Needs to be less than 15
101
Time course for breastfeeding jaundice vs breast milk jaundice
Breastfeeding is 1st week
| Breast milk jaundice is 2nd week
102
What day should mec stools transition to yello?
3
103
Swelling of head crossing sutures in a neonate
Caput succedaneum
104
FTT (2)
not gaining weight by 10 days
| failure to regain birthweight by 2 weeks
105
lethargy (2)
absent eye movements
or
not interacting with others.
106
lab to check to screen for inborn error of metabolism
NH4
107
2 abnormal labs in ornithine transcarbomylase deficiency (OTC)
NH4
| urine orotic acid
108
fever without source
vs
fever unknown origin
FUO requires 1 wk investigation
109
kernig's sign
resistance to knee extension
110
brudzinksi sign
flexion of hip w/ passive neck flexion
111
cutoff for pyuria
5
112
F/U after
1. first UTI
2. 2nd UTI
1 US
| 2. VCUG
113
Tx of Kawasaki dz (2)
Ivig
| Aspirin
114
Fever
Rash hands feet
Oral lesions
Pathogen?
Coxsackie A
Hand foot mouth dz
115
Besides lateral and PA, best 2 radiographic tests to get on a kids you suspect foreign body aspiration.
decubitus
| inspiratory/expiratory chest films
116
staccato cough between 4 and 12 weeks of age.
chlamydia pneumonia
117
Dennie-Morgan lines
lines under the eyes caused by chronic allergies/facial edema
118
transverse nasal crease
horizontal line on nose caused by chronic allergies
119
age where kids can start using OTC antihistamines and cold syrups
2 years old
120
1st line abx for acute otitis media for kids
amoxicillin
121
cutoff temp to give abx for AOM
>39 (102.2)
| (always tx if bilateral and
122
otitis media w/effusion (OME) can persist for how long after AOM?
3 months
123
2nd line tx for AOM or first episode w/high fever
augmentin
124
GCS (2)
EVM 456
125
cutoff for dx DM using A1C
6.5%
126
what to calculate if a hyponatremic dehydration
free salt deficit
127
what to calculate if a hypernatremic dehydration
free water deficit
128
risk to watch out for in managing DKA
cerebral edema
129
OTC topical anesthetic cream that can be applied 30 min prior to needle stick
ELA-max
130
pediatric dose ibu profen
10 mg/kg
131
joint pain that sets in a few weeks after infectious diarrhea
reactive arthritis
132
murmur that is musical or vibratory, and is heard best at the left lower sternal border in the supine position.
Still's murmur
133
Why are VSDs not heard in the nursery?
Newborns have elevated pulmonary vascular resistance
134
path of fetal blood (4)
RA > RV > ductus arteriosus > systemic circulation
135
main finding in CSF of viral meningitis
pleocytosis (most commonly lymphocytosis)
protein, glucose are normal
136
type of seizure: simple vs complex
simple: generalized
complex: focal
137
a "slapped cheek" appearance and a reticular, lacy rash on the extremities
fifth dz (erythema infectiosum)
138
high fever w/bulging fontanelle, the diffuse blanching rash
Roseola
139
Roseola pathogen
HHV-6
140
most common pediatric brain tumor
Medulloblastoma
141
cutoff size for concerning lymph nodes in kids
2 cm
142
7 chars. pain
P=Position (be exact)
Q=Quality (dull, sharp, burning)
R=Radiation (be exact)
S=Severity (scale from 1 to 10, if the patient can do this)
T=Timing (when it happens)
A=Alleviating factors
A=Aggravating factors
A=Associated symptoms
143
HEEADSSS
```
home
eating
education
activities
drugs
suicide
safety
sex
```
144
4 categories that cause AMS
(1) Hypoxemia (2) Shock (septic, hypovolemic, cardiac) (3) Hypoglycemia (4) Poisoning
145
prophylaxis for meningicocemia in adults vs children
adults cipro
| children rifampin
146
IV tx for hypoglycemia
D25 bolus
147
effects of anticholinergics on pupils
dilate them
148
FTT (3)
below 3rd percentile in weight, weigh for length
OR
weight loss crossing 2 or more major percentiles on growth curve
149
kcal/ day needed to grow in normal baby
100-110 Cal/kg/24 hours
150
nadir of Hg in infant at 2 months
11 g/dL
151
Screening tool for autism. 16, 30 mos.
M-chat
152
Most common reason for cp
Prematurity
153
2 most common surgeries sickle cell pts
cholecystectomy
| tonsillectomy
154
prophylactic med for sickle cell, and age to admin to
penicillin
| age 5-6
155
2 vaccinations sickle cell pts should have at 2 (in addition to standards)
23-valent PNM
| meningococcal
156
anasarca
generalized edema
157
most common nephrotic dz in peds
minimal change dz
| 90% of cases
158
pathophys of edema in nephrotic syndrome
lowering of plasma colloid osmotic pressure.
159
tx (2) of nephrotic syndrome
steroids
| salt restriction
160
lesions that are flat vs raised, less than 1 cm
```
flat = macule
raised = papule
```
161
lesions that are flat vs raised more than 1 cm
```
flat = patch
raised = plaque
```
162
pustular lesions in axilla, groin, perianal regions
hidradenitis suppurativa
163
tx rosaciea
topical metronidazole
164
lifespan of lice w/o host
26 hours
165
tx for tinea versicolor
selenium sulfide
166
tx tinea capitis
griseofulvin
