Peds Flashcards Preview

CanQB > Peds > Flashcards

Flashcards in Peds Deck (319):
1

Foreign body ingestion Rx?

1. < 24 HR + no resp Sx
Foley Cath
Bougienage


2. > 24 or resp Sx
Endoscopic removal


3. > 2wks
Need surgical
Risk of erosion!

2

Murmurs in:
1. PDA
2. Tetralogy of Fallot
3. Tricuspid atresia
4. Aortic coarctation
5. Total anomalous

1. PDA = continues machinery murmur at left upper sternal

2. Tetralogy = SEM at left upper/mid-sternal + loud S2

3. Tricuspid atresia = SEM at left lower sternal

4. Coarctation = SEM at left upper sternal radiates to inter-scapular space + wide pulse pressure.

5. Total anomalous = SEM + diastolic rumble + fixed wide split S2

3

Gasoline poisoning Rx?

CVS + Resp support
No antidote
Gasoline poorly absorbed by gut = no need for lavage or charcoal.

If Sx present = CXR 2hr post ingestion + observed in ER for 6 hrs.

Abnormal CXR = admit for blood gas + re-CXR + resp support.

Normal CXR + no Sx = discharge.

4

Organism of erythema infectiosum / 5th Dz?

Parvovirus B19

5

How to determine if wheeze in child is foreign body?

CXR:
Focal infiltration or atelectasis
+
Radio-opacities

6

Dx of Hirschsprung?

Rectal Bx

7

CPR in children Compression-to-Ventilation ratio.

1. Single rescuer:
30:2
Compression = 100 bpm


2. 2 rescuers:
15:2

8

What drug can be used in croup but not bronchiolitis

Oral steroid.

NB: neb epi is beneficial in both.

9

Apnea in infant? Rx

1. If self-correcting, ass w/ feeds = no admission.


2. If sever, life-threatening = admit for observation.

10

Facts about club foot:
- M:F
- Deformity affects walking?
- Rigid type Rx?
- Corrected deformity needs long FU?
- After Rx participate in usual activity?

- 2:1
- Rigid can be Rx w/ cast but may need surgery
- affects walking
- need FU, risk of recurrence
- Go back to normal after Rx

11

Neonate hours after birth develops tachypnea + cyanosis?

Dx?

TTN
Supplement O2
CXR

12

What's herpangina?

Ferbrile disease by Coxasackie virus.

Sx = oropharyngeal vesicles + ulcers

13

Sx of herpangina

Rx?

Sudden fever
Neck pain
Then 2 days later grey plaques => vesicles

Mostly on tonsillar pillars


Rx: symptomatic

14

When is the age for bladder and fecal control?

Bladder: 5
Fecal: 4

15

1ry vs 2ry enuresis

1ry: no dry period
2ry: dry period > 6months

16

Investigation in 2ry enuresis?

UA
R/o: DM, DI, over active bladder, cystitis, psychological, seizures.

17

Child safety seat:
- Stage 1 (Rear facing)
- Stage 2 (Forward)
- Stage 3 (Booster)
- Stage 4 (Seatbelt)

- Stage 1:
At birth
In infant seat.

- Stage 2:
At least 1 Yr + 10 Kg
Forward in infant/child seat

- Stage 3:
At least 18 kg
Child/booster seat

Stage 4:
At 36 Kg and 145 cm
Seatbelt

18

Henoch-Schonlein purpura triad?

Purpuric rash
Abdominal pain/renal failure
Joint pain

19

Type of purpura in HSP?

Non-thrombocytopenic purpura

20

Causes of neonatal jaundice by time?
<24
1 - 3 days
3 - 4 days
> 1 week

1. <24 hr:
ABO/Rh
Sepsis

2. 1-3:
Physiological
Breast feeding
Hemolysis
Sepsis

3. 3-4:
Physiological
Breast feeding
Sepsis

4. > week:
Hypothyroid
Hepatitis
Gilbert's : Crigler-Nijjar
Biliary obstruction
Metabolic error

21

Rx of viral URTI in neonates?

Nasal rubber suction bulbs

NS nasal drops

Cool-mist humidifiers

22

MCC of anemia in children?

Iron deficiency

23

Average birth weight? What happens in first few days then 1-2 wks?

3.5 kg

Baby drops 10% (loss of excess fluid)

In 1-2 weeks baby regain weight

24

What must be supplemented in breast fed infants?

Vit D

Risk of rickets

25

Diarrhea by Aeromonas enteritis?

Short IP: 1-2 days
Watery diarrhea + fever
In developing countries

26

MCC of travelers diarrhea?

Enterotoxiigenic E. coli

Short IP: 1-2 days.

27

IP of giardia lambilia?

1-2 weeks

28

MCC of CAH?

21-hydroxylase

29

Signs of premature infant?

Scant ear cartilage
Absent breast buds
Thin skin
Hypotonic posture at rest

30

Vaccines at 2 mo

DTaP
Hib
IPV
PCV-13
Rot-1

31

Drugs cause gynecomastia

Antibiotics (isoniazid, ketoconazole, metronidazole)


Cimetidine

Captopril

Digoxin

Hormones

32

Assess severity of dehydration

1. Mild:
HR: N or high
BP: N
Sunken eyes: no
Urine: normal

2. Moderate:
HR: high
BP: N
Eye: sunken
Urine: low

3. Sever:
HR: High
BP: L
Eyes: sunken
Urine: none

33

Accetaminophen toxicity

< 2 HR
Activated charcoal

< 8 HR
N-acetylcysteine (Oral > IV)

34

T/F: Rotavirus is not associated with URTI

T

35

MC nutritional def in kids

Iron def anemia

36

Sx of Atlanto-axaial instability in down

Torticollis
UMN Sx (gait, DTR, clonus..)

37

What's head tilt test?

Tilt patients bed to Dx syncope.

Cardio = HR < 40

Vasodepressor = HR drops <10%

38

T/F: orchitis is more common in kids than torsion

Testicular torsion is more common

39

MCC of otitis media

S. pneumonia

40

New born foot deformity:
Convex lateral border + adduction of forefoot + normal ankle

Metatarsus adductus

41

Facts about metatarsus adductus

LFT > Rt
F > M
80% spontaneous resolution w/in 1 Yr

If not resolved w/ stretches => serial casting

42

MC complication of carniopharyngioma

Central DI

43

Innocent murmur in strept. Infection

SEM
Grade < 3
Not Sx
No thrill or radiation

44

Central DI labs?
Serum Na
Urine Na
Extra cellular fluid
Plasma arginine vasopressin

High serum Na
Low urine Na
Normal ECF
Low plasma arginine

45

Source of carniopharyngioma

Rathke's pouch

46

MCC of septicemia in infants

GBS = strep. Agalactia

47

Risks of GBS septicemia

Pre-mature rupture > 24 hrs before delivery

Chorioamnionitis

48

What's syndesmotic sprain?
Injury?
Dx?
Rx?
Complications?

High ankle sprain
Affects anterior, posterior, transverse tibiofibular ligaments + interosseous membrane.


Contact sports = dorsiflexion +/- inversion of ankle

Dx: squeeze test (compress fibula against tibia at mid-calf) pain if +ve.

External rotation stress test by stabilizing leg and externally rotate foot > pain if +ve

Crossed leg test: place involved ankle opposite to knee and pressure applied to medial side of ankle > pain if +ve


Rx: semirigid support

Complication: ankle instability > hypertrophic ossification

49

Fragile X mutation

CGG repeats on Ch X

50

MCC of inherited mental retardation

FXS

51

Hallmark of constitutional delay

Being <50th most of childhood

Bone age < real age

52

Before Dx constitutional delay what must be checked?

Signs of puberty by age 14.
If no Sx = needs work up

53

Bug in erythema infectiosum (5th)

Parvovirus B19

54

Labs in failure to thrive

Normal

55

MCC of UTI in kids

E. coli 75-90%

56

Risk factors for UTI in kids

Female gender

Vesicouretral reflux

Anatomical abnormalities: (posterior urethral valve, ectopic ureter)

DM

Wiping techniques

57

Approach to baby w/ UTI

1st time: UA + C/S

Recurrent: UA + C/S + US + VCUG

VCUG indications:
F < 2 yrs
F > 5 yrs w/ recurrent UTI
Male w/ UTI
Febrile child w/ UTI

58

MC organism in
1. human bite

2. Cat/dog

3. Goat/sheep

4. Rabbits

5. Prairie dog/rat flea

1. Human: Eikenella (G-ve rod)

2. Cat/dog: pasturella

3. Goat/sheep: brucella melitensis

4. Rabbits: Francisella tularensis

5. Prairie dog/rat flea: yresinia pestis

59

Heinz bodies are seen in what anemia?

G6PD

60

How to Dx accessory nipple?

Remnants on mammary line

61

Salt wasting variant of congenital adrenal hyperplasia

- Enzyme missing
- Sx

- 3B-hydroxysteroid dehydrogenase

- infancy => vomiting, diarrhea, dehydration, arrhythmia, cyanosis, ambiguous genitalia
( hypospadias, bifid scrotum, cryptorchidism)

62

Sleep apnea test

Polysomnography

63

Most helpful labs in assessment of acute asthma in kids?

FEV1
PEF
Pulse oximeter

64

Prolonged bleeding after circumcision in otherwise healthy

Hemophilia A

Factor 8 doesn't cross placenta => early Sx

65

MC Sx in spondylosis

Low back pain radiates to buttocks / posterior thigh.

66

Otitis media Rx contraindicated in kids

Fluoroquinolones
Cipro, levo, fluxa,

67

Prophylaxis to HiB

Rifampin

68

Klinefelter (KLINE)

Turner (TURNER)

Edwards (EDWARDS)

Prader Willi (PRADER)

Fragile X (FRAGILE)

Klinefelter 47 XXY
Killer (aggressive + antisocial)
Large breast
Non disjunction
Elevated (tall)



Tuner 45XO
Tight aorta (coarctation)
Undersized (short)
Renal (horseshoe)
Nipple spacing
Edema
Reproductive failure (ovarian)


Edwards trisomy18
Eighteen
Digit overlapping flexion
Wide head
Absent intellect
Rocker-bottom feet
Diseased heart
Small jaw

Praderwilli
Imprinted 15q
Paternal
Runt (short)
Almond eye
Delay (mental)
Eats lots
Rt HF

Fragile X
FMR1 gene
Repetitive behavior
Anticipation CGC
Gnathism (protruded jaw)
Intellectual impairment
Large ears
Everted ears

69

Incidence of nasolacrimal duct obstruction?
Path?
Dx?
Sx?

5% infants


Obstruction at valve of Hasner (distal end)


Dye disappearance test (all fluorescein drains in 5 min)

Sx: tearing

70

Causes of nasolacrimal obstruction

Congenital

Acquired (sarcoidosis + wegners)

71

Rx of nasolacrimal obstruction

Massage duct area

90% spontaneous resolution

72

What can babies eat at
4-6 mo
12-18 mo
18 mo - 3yr

4-6 mo
Solid food + juices

12-18 mo
Egg, potatoes, iron-fortified cereal margarine

18 mo - 3yr
Meat, bread, fruit

73

Baby
Holosystiloc murmur at lower left sternum

Can't breath
Can't feed

Infections

VSD

74

MCC of hearing loss in infants

Genetic

75

Rx of sinusitis

Amoxicillin
Cefuroxime


Allergic = clarithromycin or azithromycin

76

Role of fundal exam in seizure

To see if it's the 1st seizure

Papilledema, retinal hemorrhage = repetitive seizures

If febrile seizures to confirm it's one time only.

77

Vaccines at 2 mo

DTaP
IPV
HiB
Pneumococcal C-14
Rotavirus

78

Vaccines at 4 mo

DTaP
IPV
HiB
Pneumo-C-13
Rotavirus

Same as 2 mo

79

Vaccines at 6 mo

DTaP-
IPV
HiB
Flu

80

Vaccines at 12 mo

Meningococcal
Pneumococcal C13
MMR

81

Vaccines at 15 mo

Varicella; chicken pox

82

Vaccines at 18 mo

DTaP
IPV
HiB

83

Vaccines 4-6 yr

MMRV
Tdap
IPV

84

Cow milk should be avoided until baby reaches?

Why

12 mo

Low Vit E, iron, FFA
High protein, Na, K

85

What Sx is a must in necrotizing enterocolitis

Bloody diarrhea

86

MCC of HTN in adolescent

Essential 85-95%

87

When to do cryptorchidism for undescended testis?

Why

At 1 Yr

To preserve spermatogenesis.
100% chance of infertility if > 1yr

88

Galactosemia
Path?
Sx?

Galactose-1-phosphate uridyltransferase deficiency


Sx:
Jaundice
Cataract
Failure to thrive
Vomiting, diarrhea

89

What's Developmental dysphasia of hip?

M:F

Ass

Subluxation + dislocation of hip

F> M

1st born F
Breech
Oligohydramnois

90

DDH Rx

Close reduction + pavlik harness + US

91

T/F: DDH Dx by hip X-ray

F
Not shown on X-ray need US

92

T/F: normal ESR + CRP role out septic arthritis

T

93

Teratogenicity in DM

1. Sacral agenesis + lumbar vertebral anomalies (esp. caudal region)

2. Macrosomia

3. Congenital heart defects

4. Anencephaly + neural tube, myelomenigocele, hydrocephalus, microcehalus

94

Rectal prolapse in kids

CF

95

Labs in anorexia

Low LH+ FSH

96

What sleep disorders occur at 1-2 HR and 2nd half of night

1-2 hr => parasomnia
Sleep walk and sleep terrors


Late => nightmares

97

Rx of idiopathic thrombocytopenic purpura

Observe

98

Sx of idiopathic thrombocytopenic purpura

Bruise

Hx of infection

PLT < 100 + large PLT on smear

Normal Hg + WBC

Normal coagulation profile

99

Pneumonia in infants < 6mo
At winter

Resp syncytial virus

100

Drug cause acne

Phenytoin
Steroids
Anabolic steroid
DHEAS
OCP

101

Baby with low Hg + no lead

Trial of iron for 1 mo

102

RSV vs C. Trachomatis

- C. Trachomatis:
Conjunctivitis 50%
Hyperinflation + diffuse infiltrates.
Wheeze + rales
Eosinophilia


- RSV:
Rhinorrhea + pharyngitis
Hyperinflation
Wheeze + rales

103

EEG of absence seizure

Generalise symmetric three per second spike

104

Risks for deafness in newborn

FHx
Gentamicin
CMV, toxo or herpes
Low apgar score
Low birth weight
Oxygen deprivation in birth

105

Risks for sudden infant death

Sleep in prone position or on side.
Sleep on soft bedding
Sleep with stuffed toys
Bed sharing

106

T/F: sleeping with pacifiers reduce risk of sudden infant death

T

107

Rx of nursemaid elbow fracture

Subluxed Radial head reduction (hyperprobation > flexion)

Sling is helpful
No wrist splint
No long arm cast

108

Familial vs constitutional vs growth hormone deficiency (short stature)

Constitutional;
Delayed bone age
Delayed puberty
Normal velocity
FHx

Familial:
Normal bone age
Puberty on time

Growth hormone:
Delayed bone age
Growth <3rd percentile
Low growth velocity

109

MCC of epistaxis in kids

Nose picking > mucosal irritation (allergic rhinitis)

110

Sx of osteogenesis imperfecta

Blue sclera
Multiple fracture
Barrel chest
Joint laxity
Microcephaly
Translucent teeth (opalescent)
Hearing loss

111

Defect in osteogenesis imperfecta

De novo mutation in collagen 1

(Sometime FHx)

112

MC sequela of congenital CMV

Hearing loss

113

What's an innocent murmur

At 2-6 yr
Systolic grade 1-2
Pitched murmur at lower left sternum

Changes with sitting and standing

114

Complication of stills murmur

None its innocent

115

Pathology in total anomalous pulmonary venous return

Pulm. veins don't connect to left atrium

Pulm. venous return enters systemic venous circulation via embryonic connection

116

Sx of TAPVR

Pulm HTN + edema
Cyanosis
Parastenal loud S2

117

Bilateral parotid gland enlargement

Bulimia

118

Russell sign in bulimia

Callosities on knuckles

119

Rx pediculosis in kids

Permethrin 1%

120

Bacterial conjunctivitis is infectious until?

Rx started

121

Viral infection has late neuro complication (baby seizure, ataxia, quadriplegic)

Measles

122

Sx of perinatal asphyxia

Hypotonia + low movement
Loss of primitive reflexes
Seizures
Abnormal posture

123

Koplik spots

Measles

124

Infant suddenly flexes arms + forward lean of trunk + extends legs

5 sec

Infantile spasm

125

T/F: infantile spasm asso. with other seizure

True

126

What's rabies

Viral infection in saliva and peripheral nerve

127

Sx of rabies

Pain at site of bite
Encephalitis, confusion, hallucination,

Hydrophobia = can't drink because of laryngeal spasm.

Paralysis.

128

Dx of rabies

Skin biopsy form neck
Animal brain tested

129

Rx of rabies

Death in 3-10 day if not Rx

Prevention:
- pre-exposure: vaccine

- post-exposure:
Clean area w/ soap + water
Vaccine + IG

130

Rabies post-exposure

1. Demotic animal + no Sx
Observe animal 10 days:
No Sx = nothing
Sx = vaccine + IG


2. Domestic + Sx
Vet check animal to Dx
If confirmed => vaccine + IG

3. Wild animal
Capture + kill animal + test brain for rabies.
If + => vaccine + IG

4. Wild animal
Can't capture => give vaccine + IG

131

Infantile colic criteria

Excessive crying >3 Hr day > or = 3x week for 3 weeks

132

T/F: premature infants should use safety seats with restraints that don't have shields, pads, arm rests.

T
Case neck injury during impact

133

T/F: safety seat is secure if it moves < 5 cm in each direction

F
< 2.5

134

Pyloric stenosis facts:
1. M:F
2. MC age
3. Rarely affects babies older than

M > F

MC at 3-5 wks

Rare after 12 wks

135

MCC of unilateral breast mass in males < 12

Breast development
Assure + repeat in 1 yr

136

Papile Grading system for internevtricular hemorrhage + ventricular dilatation

Grade 1:
Subependymal
Mostly asymptomatic

Grade 2:
Intraventricular w/o ventricular dilatation

Grade 3:
Intraventricular + dilatation

Grade 4:
Intraventricular + parenchyma

137

Strider when baby lies down

Laryngialacia

Immature cartilage = collapse of airway in inspiration

138

Dx laryngiomalacia

Scope

139

Cause of neonatal physiological jaundice

Temporarily impaired hepatic clearance of bilirubin

140

Congenital hypothyroid Sx

Hypotonic
Big tongue
Big forehead
Umbilical hernia
Dry yellow skin
Brittle hair

141

Jones criteria for rheumatic fever

Major:
Joint
Carditis (MV)
Nodules
Erythema marginatum
Sydenham chorea

142

Antiviral contraindicated in babies < 7

Zanamivir

143

Antiviral not for influenza A

Amantadine
Rimantadine

144

Rx of derm herpitiformis

Dapsone
Gluten free diet

145

Scaly papular rash after pharyngitis

Guttate psoriasis

146

Peak age for febrile seizure

6 mo - 5 yrs

147

Rx of impetigo

Dicloxacillin
Cephalexin

148

Skin infection and its fluctuant area? Rx

IV vanco for MRSA
Till culture result

149

Complication of meningitis

Sensorineural deafness 6 wks post Rx

150

Resp distress in neonate CXR

Ground glass atelectasis
Air bronchogram

151

How to divert child attention during abd. exam

Place child hand on top of yours give him sense of control

152

T/F: kids 2-6 Yrs feel responsible for death of loved ones

T

153

Can 2-6 Yr olds attend funerals

Yes but must be accompanied by adults for support

154

Minor jones criteria

Arthralgia
Fever
ESR
CRP
Prolonged PR

155

Heart X-ray in tetralogy of fallot

Boot shaped heart

156

Malformations tetralogy of fallot

Pulm valve stenosis
VSD
Overriding aorta
Rt ventricular hypertrophy

157

Cause of systolic murmur tetralogy of fallot

Pulm. stenosis

158

MCC of scoliosis

Idiopathic

159

Inheritance in hemophilia A + B

XL-recessive

160

XL-recessive transmission to kids

All girls carries
No boy affected

161

MC child abuse in Canada

Child neglect

162

When is scoliosis significant

> 10 degrees

163

Rx of functional abdominal pain

Spontaneous resolution in 2 wks.

Remain active
Address emotional stress
Cope with Sx and prevent 2dry gain of child.

164

Rx of primary enuresis

Motivational + positive reinforcement for 6 mo

165

Nasal polyps in child Dx?

CF

166

Athlete with proteinuria

Exercise induced
Transient + nonpathological

167

Approach to exercise induced proteinuria

UA repeated 48-72 HR from exercise

168

New born in distress
CXR: fluid in fissure

TTN

169

NSAIDs SE?

N/V
Diarrhea / constipation
Low appetite
Rash
Dizziness + headache
Tinnitus
Edema
Kidney failure, liver failure
Ulcer

170

Rx tet spells

Rt-Lt shunt => cyanosis


Rx;
Neosynephrine
Knee-chest
IV morphine (last)

171

Nitroglycerin in tet spells

Worsen Sx

172

T/F: pertussis vaccine could cause infantile spasm

F

173

MCC of poor weight in babies

Inadequate caloric intake

174

Survival rate in patau

90% die in first year

175

1st line Rx impetigo

Topical Abx

176

Head banging in kids
Prevalence?
Age?
Prognosis?

3-15% of 5-11 mo old

Sx resolve spontaneously by age 3

177

T/F: head banging is higher in developmental delay syndrome

T
More in down , autism , leach-nyhan

178

IP of varicella (chickenpox)?

10-20 days

179

T/F: chickenpox patient should be in resp isolation till no new lesions appear

T

180

When is varicella not infectious

Lesions are crusted

181

Labs in bone age < real age

TSH

182

Age of anterior fontanelle closure

13 mo

183

FU of early anterior fontanelle closure

Head measurements to R/o: craniosynostosis + abnormal brain development.

184

When to give Abx in sinusitis

1. Sx for 2 weeks
2. Fever 39
3. Facial pain / swelling

185

MCC of pneumonia in kids?
Rx?

M. Pneumonia

Macrolides

186

MCC of otitis externa

P. Aruginosa

187

MC congenital abnormality of small bowel

Meckles

188

What's spermatocele?
Dx?
Contents?
Rx?
Fertility?

Spermatic cyst


Cyst on upper pile of testis next to epididymis
Painless
Benign

Clear fluid
Dead sperms

No Rx

No effect on fertility

189

MCC of leukocoria in well newborn

Cataract

DDx: retinoblastoma

190

Rx of neonatal lupus heart block

Pacemaker

191

Antibodies in neonatal lupus

Anti-SSA/Ro

192

Chubby 10 YO with hip pain
+ / - referred knee pain
Comfort in external rotation

Slipped capital femoral epiphysis

193

Which one improves nutrition:

- Play feeding games w/ healthy meals
- healthy food for all meals including snack

Healthy food all day erry day

194

T/F: stool culture is not part of septic work up

T

195

Prepubertal with labial adhesions!
Cause?
Sx?
Rx?

Idiopathic

Girl fails pulled, can't pee, UTI

Rx: topical estrogen

196

Can bacterial conjunctivitis cause permanent damage

No

197

What ophthalmological risk premature infants are at high risk of?

Retinopathy of prematurity

198

Eye problem in cerebral palsy

Strabismus

199

T/F: 5% permethrin is safe in 2 month baby

T

200

1st sign of puberty in boys

Testicular enlargement

201

At what tanner stage boys reach adult height

4

202

What do you tell a short boy tanner <4?

He'll grow taller

203

Rx of vW disease

DDAVP

Cryoprecipitate

Factor 8

204

Baby with:
Nasal polyps
Rectal prolapse
Malnutrition
Infertile

Dx?

CF

205

How much do babies with CF need to eat?

120-140% of daily recommended calorie intake

206

T/F: inguinal hernia in kids closes spontaneously

F

207

When to Rx inguinal hernia in kids?

ASAP
Risk of Ca and necrosis

208

MCC of unilateral blindness in kids

Amblyopia

209

When does autospleenoectomy occurs in Sickle cell?

5 Yr

210

Shaving vs permethrin 1% I. Pediculosis

Permethrin 1% is better

211

What disease cause disproportionate short stature

Rickets

212

T/F: teratogens cause disproportionate short stature

F
Proportionate

213

MCC of proportionate short stature

Constitutional delay

214

MCC of HTN in < 10 Yrs

Renal disease = UA, US, Culture

215

Most specific sign of peritonsillar abscess

Can't open mouth = trismus

216

Organism of cut. larva migrans

Hookworm from dogs + cats

217

MCC of chronic otitis media in kids

Environmental i.e daycare + smoking + crowds + cleft palate

218

Rx of absence seizure

Ethosuximide

219

Occult bacteremia Sx

Fever only

220

Palivizumab uses

RSV prevention in high-risk kids

Qmonths for 4mo starting nov - feb

221

T/F: Norwalk virus sheds even after acute illness

T

222

Is Norwalk virus resistant to environmental factors?

Yes! Even cont to shed after illness

223

MCC of viral diarrhea in adults

Norwalk

224

Best Rx in obese kids

Family-based + behavior-oriented programs

225

Mom with DM
When to start screening her kids

At 10 Yrs if have other risks the q2yr
i.e obese
FHx
Black
Sx of DM

226

What's little league elbow

Medial epicondyle

227

T/F: preschool speech screening is strongly recommended

F
There's no enough evidence to not do it but not very helpful.

228

Flank painless mass in < 5 Yr DDx

Willms tumor

229

What kind of Ca is willms tumor

Embryonal

230

MCC of wheeze in infants

GERD

231

T/F: infantile GERD resolves at 1 year

T

232

Most effective Rx for asthma

Inhaled steroids

233

In asthma leukotriebne vs LABA

LABA are more effective

234

In allergic rhinitis:
Intranasal steroids vs leukotriene inhibitors

Intranasal steroids more effective

235

What vaccine associated with egg allergy

Yellow fever > flu or MMR

236

Fetal Alcohol syndrome Sx

Smooth philtrum
Thin upper lip
Flat nose
Clinodactyly (bent finger)
Wide palmar crease end b/w 2-3 fingers
Railroad ears
Small eyes

237

Anemia of lead poisoning

Abdominal pain
Neuro Sx (wrist drop)
Micocytic anemia

238

Normal stages of puberty in F

Thelarche (breast)
Pubarche (hair)
Height peak
Menarche

239

T/F: ovulatory cycles start 2 yrs after menarche

T

240

What's Dance Sign in intussusception

Rt hypochondrium sausage-shaped mass + empty RLQ

241

Risks for sudden infant death

1. Prone sleep
2. Overheating (clothes, blankets)
3. Cold weather
4. Soft bedding
5. Stuffed toys
6. Smoke

242

Best estimate of volume loss in dehydration

Weight change since disease.

243

Lab indicates sever iron deficiency

High free erythrocyte protoporphyrin

244

Roseola Sx

3 days of high fever then rash that fades in 2 days

245

Rash in roseola

Maculopapular
Starts on trunk
Not itchy
Blanching

246

HIV screen in babies of HIV+ mom

HIV DNA PCR at 48 HR, 2mo, 6mo

247

Erb's palsy effect on normal baby reflexes

Grasp reflex: not affected


Moro, biceps, radial reflexes: absent

248

Is Philadelphia chromosome a good or bad prognostic sign in ALL

Good

249

Rx of bullous impetigo

Oral cephalexin

250

What's DEET N,N-diethyl-3-methylbenzamide

Insect repellant

251

Safety of DEET in kids

Not safe in kids < 6mo

252

How to use DEET

Spray least concentrated 10%

Avoid hands + face

3x/d max

253

BB antidote?
MOA?

Glucagon

Increase intercellular cAMP independent of blocked beta receptors.

254

Mastoiditis on CT scan

Clouding to destruction of septa b/w mastoid cells and soft tissue swelling

+/- temporal bone destruction

255

MCC of neonatal death in babies with DM mom?

Congenital anomalies esp. cardiac + CNS

256

Vaginal exam in prepubertal girls
> 2 yr
< 2 yr
Adolescent

> 2 yr
Knee-chest on exam table
Without instrument


< 2 yr
Lying supine in mom lap


Adolescent
Knee spread apart
Exam table

257

Rx of croup

Dexamethasone single dose

Racemic epi

258

MCC of ambylopia

Strabismus

259

What's amblyopia

Lazy eye

260

T/F: in acute asthma ipratropium + inhaled SABA reduce hospitalization rate

T

261

MCC of occult bacteremia in kids

Strep. Pneumonia

262

Boy with itchy anus at night

Enterobiasis
Pinworm helminth

263

Name of enterobiasis pinworm?
Where does it live in bowel?
How does it cause itchiness?

Enterobious vermicualris


In ileocecal region


Itchiness from egg deposit in anus at nighttime
Egg survives 3 wk before hatching

264

How's pinworm Dx + Rx

Tape at anus at early morning = see worms under microscope


Rx: albendazole or mebendazole

265

What can mom do to cause her baby necrotizing enterocolitis?

Cocaine

266

Snowman in a storm on CXR

TAPVR

267

MCC of osteomyelitis in kids

Rx?

Staph aureus
Rx IV Vanco

268

Sx of retinitis pigmentosa

Night blindness

269

Role of ABG in dehydration

None

270

Cause of encephalopathy in Reye's syndrome (ASA)

High ammonia

271

Rx of genu varus

Observation
Spontaneous correction in 2 yrs

272

How a bay holds arm in nursemaid fracture

Adducted + pronated + flexed elbow

273

MCC of buckle/torus fracture

Fall on outstretched hand

274

What's buckle, greenstick fractures

Buckle: compression

Greenstick: incomplete

275

Whats osgood-schlatter disease?
Age?
X-ray?
Uni or bilateral?
Rx?

It's apophysitis of tibial tubercle
In athletic kids esp. jumping


Almost exclusive to kids


No need for X-ray
If done = irregular tubercle + hazy metaphyseal border


Rx: self-limited
Rest, ice, NSAIDs
Can resume activity in 2-3 wk

276

Pathophysiology of omphalocele?

Persistence of normal physiological herniation b/c abdomen too small for mid gut formation / liver

Herniation occurs at 6 wks
Return should occur at 10 wks

277

Pathophysiology of gastrochosis

Failure of lateral abdominal fold to fuse

278

Cause of umbilical hernia

Herniation through linea alba

279

T/F: APGAR Score correlates with risk of necrotizing enterocolitis

T

280

T/F: HTN causes necrotizing enterocolitis

F

281

MC complication of sinusitis

Orbital cellulitis

282

MC cause of pneumonia in preschool kids?

Viruses

283

T/F: pulmonary hemosiderosis associated with milk allergy?

T

284

CXR in pulmonary hemosiderosis

Fluffy infiltrates

285

Lung Bx in pulm hemosiderosis

Hemorrhage with hemosiderin laden macrophages

286

Rx of Lyme in kids

Amoxicillin

287

Chubby boy with painful hip

Slipped capital femoral epiphysis

288

Slipped capital femoral

Dx?
Rx?

Dx: X-rays frog-leg
Wide epiphyseal line
Displacement of femoral head


Rx: urgent surgery = screw fixation

289

What's in the urine of a baby with galactosemia

Lots of reduced substance

No ketone bodies

290

Neonate + reduced substance + low glucose

Galactosemia

291

MCC of diarrhea in kids?

Rotavirus
60% clod weather
50% tropicals

292

Dx unilateral renal agenesis

Doppler US

293

When can baby mobilized arm after Rx of nursemaid fracture

20 min

294

What's flexible flat foot

Rx?

Arched when not bearing weight

Flat when bares weight


Rx: none corrects in 1 year of walking

295

What's tarsal coalition?
Dx?
Rx?

Fusion of tarsal bones
50% bilateral


Dx:
Asymptomatic
Tenderness on subtalar joint / ankle
Rigid flat foot
Peroneal tightness


Rx:
Conservative

296

Associations in nephroblastoma / willms

Willms tumor
Aniridia
GU abnormalities
Mental retardation

297

Sx of willms

Abdominal mass
Doesn't cross midline
Asymptomatic

298

Becker + Duchenne inherence

XL-R

299

14 + no period + no 2 sexual approach

FSH + LH => high > karyotype

FSH + LH => low > wait till 16 (constitutional delay)

300

14 + no periods + has 2 sexual

US

301

MCC of recurrent acute otitis media

Penicillin resistant strep. Pneumonia

302

Foreign body removal from ear?

Water irrigation
Fast acting glue
If not work or baby not cooperative send to ENT to do it under GA

303

T/F: congenital umbilical hernia resolve spontaneously

T

Surgery if not at 2-3 years

304

Rx of PKU?

Phenylalanine free diet

Sapropterin tetrahydrobioterin (BH4) helps in 50%

305

If mom gives birth to baby with PKU,
Chances of having another baby with PKU?

25%
It's AR

306

Risks for CMV in preggo

Poor mom
Hx of STDs
Hx of cervical dysplasia

307

Baby with Hg < 4?

Transfuse PRBC

308

Complications of juvenile idiopathic arthritis

Micrognathia (2/2 early closure of mandibular epiphysis)


Iridocyclitis => scarring + glaucoma

309

Storage of breast milk

Stored to 4 HR at room temperature.


Stored 48 HR in refrigerator


Stored for 3 mo frozen
If frozen must be thawed slowly to preserve nutrients

310

Tropical disease could present months after travel?

Malaria

311

Neonate + fever + resp Sx + CXR peribronchiolar edema

RSV
Rx: supportively

312

MCC of bleeding in Meckel's

Ulceration of small bowel 2/2 acid of ectopic gastric mucosa

313

Helpful imaging modality in septic arthritis?

US

314

Storage of breast milk

Stored to 4 HR at room temperature.


Stored 48 HR in refrigerator


Stored for 3 mo frozen
If frozen must be thawed slowly to preserve nutrients

315

T/F: lactose intolerance should avoid all dairy products

F
Only lactose containing
Can add probiotic

316

1st line Rx of head lice / pediculosis

Permethrin 1%
Malathion 0.5%
Pyrethrins 0.33% pipernyl butoxide 4%

317

Chances of having a 2 baby with cleft lip

Both genders 3%
M sibling 4%
F sibling 2.5%

318

Rx of internal tibial intoeing

Cause?

No Rx (not even stretches)
No prone sleep


Cause = prone sleep + sitting in feet

319

Fire ant bite

Clean with soap + water only