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Peds Flashcards

1
Q

most common bugs in Retropharyngeal abscess

A

Strep pyogenes
Staph aureus
oral aneaerobes

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2
Q

retropharyngeal abscess is an infection of what space

A

space between pharynx and vertebral fascia

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3
Q

widening of prevertebral space on neck XR

A

suggests retropharyngeal abscess

confirmed by CT with contrast

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4
Q

thumb sign on lateral neck XR

A

epiglottitis

swollen epiglottis

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5
Q

what pts get Pvalizumab for RSV ppx?

A

children <2 years and have

  • preterm <29 wks
  • chronic lung disease of prematurity
  • HD signific congenital heart disease
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6
Q

complications of bronchiolitis

A

apnea, respiratory failure

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7
Q

most middle ear infections are caused by what bugs

A

strep pneumo
moraxella
H flu

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8
Q

treatment for history of acute rheumatic fever now with MR but otherwise healthy?

A

IM penicillin every 3-4wks for secondary prevention of ARF

pts with h/o ARF at high risk for recurrence and progression of rheumatic heart disease with subsequent group A strep infection

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9
Q

total iron binding capacity is a measure of

A

transferrin

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10
Q

stranger anxiety timing

A

starts 6 months
peaks 8-9 months
resolves 2 years

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11
Q

separation anxiety resolves when

A

18-24 months

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12
Q

Kawasaki diagnosis

A

fever >= 5 days and at least four of:

  1. conjunctivitis
  2. mucositis (erythematous fissured lips, strawberry tongue)
  3. rash
  4. extremity changes
  5. cervical LAD >1.5cm
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13
Q

lab findings supportive of kawasaki

A 
high CRP
hypoalbuminemia
sterile pyrua
anemia
thrombocytosis
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14
Q

describe the three types of renal tubular acidosis

A

1 (distal)

  • poor hydrogen secretion
  • high urine pH

2 (proximal)
-poor bicarb resorption

4
-aldosterone resistance

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15
Q

hexagonal crystals on UA

A

cystinuria

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16
Q

maneuvers to fix radial head subluxation

A

apply pressure to radial head and

forearm hyperpronation
or supination plus flexion

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17
Q

kid with radial subluxation keeps hand in __ position

A

pronated

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18
Q

Crigler Najjar

A

absent uridine diphosphate glucuronosyl transferase

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19
Q

Gilbert

A

mild deficiency uridine diphosphate glucuronosyl transferase

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20
Q

rash on trunk –> groin, axilla –> peeling hands and feet

with headache, fever, sore throat

A

scarlet fever - strep pyogenes

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21
Q

bilirubin threshold for phototherapy

A

20

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22
Q

tx minimal change disease

A

corticosteroids

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23
Q

WAGR

A

wilms tumor
aniridia
GU abnormalities
retardation

screening u/s for wilms q3mo

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24
Q

signs/sxs HUS

A

thrombocytopenia
microangtiopathy hemolytic anemia
AKI

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25
Atomoxetine moa
selective NE reuptake inhibitor
26
most common heart defect in Down's syndrome
complete atrioventricular septal defect failure of endocardial cushions to merge --> both ASD and VSD
27
Tetralogy of Fallot
- pulmonic stenosis - overriding aorta - VSD - RV hypertrophy
28
clinical findings of complete atrioventricular septal defect
- heart failure (blood mixing between chambers and severe AV valve regurg leading to vol overload) - fixed split S2 (delayed pulm valve closure from flow across ASD) - systolic ejection murmur due to increase pulmonic flow from the atrial septal defect
29
what happens to most innocent murmurs upon valsalva or standing?
decreased intensity with maneuvers that decr blood flow to the heart
30
lymphocyte predominant leukocytosis
bordatella pertussis
31
firstline therapy for immediate effects on night time enuresis
desmospressin; decreases urine production enuresis alarm is best but takes 3-4 months
32
what should you counsel pts on desmopressin?
minimize water intake to prevent hyponatremia
33
how to differentiate peripheral from central precocious puberty?
central has high LH
34
path and symptoms of intussception
ileum telescopes into cecum -> pain, obstruction edema -> compression of blood vessels -> bowel ischemia -> rectal bleeding (currant jelly stools)
35
well appearing infant with painless, bloody stools
suspect food-protein induced allergic proctocolitis manage by eliminating maternal consumption of diary and soy or switch to hydrolyzed formula
36
risk factors for baby intraventricular hemorrhage
prematurity (highest risk <32 wks; germinal matrix involutes at 32wks) very low birth weight
37
imaginary friends are most common at what ages?
3-6 years
38
overlapping fingers | retrognathia
edwards syndrome
39
kid with recurrent staph abscesses
CGD impaired NADPH oxidase complex can't form hydrogen peroxide
40
risk factors for acute OM
young age (6-18mo) smoke exposure daycare no breastfeeding
41
common bugs bacterial rhinosinusitis
H flu | Strep pneumo
42
treatment bact rhinosinusitis
amox + clavulanate
43
diagnostic criteria bact rhinosinusitis
1 of any: - persistent sxs >=10 days without improvementt - severe onset (fever >102.5 and drainage) for 3 or more days - worsening sympttoms after initial improvemen
44
osteoid osteoma
- worse at night, unrelated to activity - classic: responds to NSAIDs - single small round lucency
45
Ewing sarcoma
- onion skinning - worse with activity - doesn't improve with NSAIDs
46
osteosarcoma
- chronic localized pain - soft tissue mass - XR bony destruction with sunburst pattern of periosteal reaction
47
high fever, cramping, diarrhea that becomes bloody
shigella
48
key lab finding of hereditary spherocytosis
elevated MCHC
49
microcytic anemia, elevated retics
thalassemia
50
list the 4 types of hypersensitivity reactions, underlying immunology, and example causes
Type I (immediate): IgE, anaphylaxis, urticaria Type II (cytotoxic): IgG, IgM autoantibody; autoimmune hemolytic anemia, Goodpasture Type III (immune complex): antibody-antigen complex deposition; serum sickness, post strep glomerulonephritis, lupus nephritis Type IV: T cell and macrophage; contact dermatitis, tb skin test
51
fever, weight loss, Horner's syndrome; MRI with cervical paravertebral mass
Neuroblastoma most common extracranial solid tumor of childhood! tumor of neural crest cells, which give rise to adrenal medulla and sympathetic ganglia
52
swimming pool, large macules - name of condition and causative organism?
tinea versicolor - Malessezia
53
cause of hand and foot swelling in turner syndrome
lymphatic dysgenesis (occurs in half of Turner pts)
54
ppx options for close contacts of meningitis
ceftriaxone, ciprofloxacin, rifampin
55
pathophys hereditary angioedema
C1 inhibitor deficiency -> elevated bradykinin -> edema autosomal dominant
56
joint effusion after minor trauma, suspect _
hemophilia | get coags = prolonged PTT, normal PT and platelets
57
Hemolytic Uremic Syndrome triad
- hemolytic anemia - acute kidney injury - thrombocytopenia
58
stable pt can be observed with repeat imaging in 12-24hr if a sharp FB is distal to the __
proximal duodenum (at this point, usu will be excreted uneventfully)
59
bedwetting is normal until age _
5
60
what screening tests should be done at time of Duchenne muscular dystrophy diagnosis?
Echo and EKG | absent dystrophin in cardiac muscle can lead to dilated CM and conduction abnormalities
61
when should you consider tympanocentesis with culture
>=3 AOM in 6 months | persistent >3 mo middle ear effusion with hearing loss
62
why can refeeding syndrome be fatal?
feeding stimulates insulin release insulin promotes cellular uptake of electrolytes (eg phosphorus, Mg) resulting in electrolyte deficiency which can cause cardiac arrythmia
63
definition primary amenorrhea
14yo with no secondary sexual char 15yo with secondary sexual char
64
when do electrolyte abnormalities manifest in infants w/ CAH?
1-2 weeks earlier than that, normal levels bc of maternal adrenal hormones
65
bruising, petechiae, bleeding, hepatosplenomegaly, nontender lymphadenopathy bone pain nonspecific sxs- fever, fatigue, weight loss
ALL nonspecific systemic symptoms
66
post concussive syndrome definition, cause, time to resolution
>4 weeks concussion sxs (HA, sleep disturbance) due to not following gradual return to play protocol most pts improve within 3 months
67
symptomatic management of conscussion
- headache (eg amitriptyline) - CBT (for insom, anxiety) reassurance if mild sxs
68
liver biopsy Reye syndrome would show
microvesicular fatty infiltration
69
triple bubble
jejunal atresia not a/w chromosomal abnormalities due to vascular insult eg maternal cocaine use
70
long limbs, scoliosis, joint hypermobility lens dislocation aortic root dilation condition? biochemical cause?
Marfan's | mutation in fibrillin 1 gene
71
cause of methemoglobinemia
Hemoglobin gets oxidized to Methemoglobin (which can't transport O2) by an oxidizing agent (eg lidocaine prilocaine) low SpO2 that doesn't improve with oxygen (will stay same bc the way methemoglobin is measured on pulse ox) falsely normal PaO2 (bc only measures unbound arterial oxygen) saturation gap - more than 5% diff between pulse ox and ABG
72
treatment of methemoglobinemia, how does it work
IV methylene blue, helps reduce the methemoglobin high dose vitamin C is reducing, can be used when don't have methylene blue or contraindicated (eg G6PD deficiency)
73
anemic child with history of ileum resection from nec enterocolitis most likely deficient in __. why?
B12 | IF-B12 complex absorbed when it binds receptors in distal ileum
74
juvenile pernicious anemia cause
can't secrete intrinsic factor
75
maternal B12 from placenta lasts __
1-2 years
76
pts w/ Beckwith-Weidemann should get what tests routinely and why?
from birth to age 4: abdominal u/s - wilm's tumor AFP- hepatoadenoma from age 4-8: renal ultrasound
77
what are howell jolly bodies
RBC nuclear remnants
78
what is in basophilic stippling
precipitated ribosomal ribonucleic acid
79
most effective med for Tourette (after failure of habit reversal therapy)
antidopaminergic (Tetrabenazine, antipsychotics w antidopa)
80
palpable purpura abdominal pain arthritis nephropathy, hematuria
Henoch Schonlein Purpura
81
path of Henoch Schonlein Purpura
IgA immune complex deposition
82
type of stridor in laryngeomalacia vs tracheomalacia and why
laryngeomalacia - inspiratory stridor (decr pressure beyond larynx leads to airway narrowing) tracheomalacia- expiratory stridor (increased intrathoracic P during expiration)
83
most common pneumonia isolate in children and infants with CF
staph aureus!
84
paroxysmal phase of pertussis can last ___
4-6 weeks
85
vit K important in hepatic activation of what factors?
2, 7, 9, 10, proteins C and S
86
children age __ should get renal and bladder u/s after first febrile UTI
<2
87
myelomeningocele is a/w with what abnormality
chiari II malformation loss of CSF thru the neural tube defect --> collapse of cranial structures --> small posterior fossa --> medulla and cerebullum get displaced downward
88
pathogenesis post strep glomerulonephritis
deposition of antibody-antigen complexes in mesangium and BM
89
tanner stage when breast forms secondary mound
IV
90
treatment von willebrand and mechanism
desmopression (IV or intranasal) - causes release of vWF from endothelial cells
91
first sign of puberty in a boy
testicular enlargement
92
DKA lab findings
- low Na (dilutional and renal losses) | - high Cr (hypovolemia)
93
how do you calculate anion gap
Na - (HCO3 + Cl)
94
what is considered elevated AG
>12
95
Diagnostic criteria for DKA
3 criteria: - random BG >200 - venous pH <7.3 or bicarb <15 - mod/large ketonuria or ketonemia
96
Diagnostic criteria for DM
-A1C >=6.5% -fasting gluc >=126 -2 hour gluc >= 200 (all above need repeat testing) OR classic sxs hyperglycemia and random gluc >=200
97
oily nonbloody foul smelling diarrhea
giardiasis
98
mechanism giardiasis
disrupts tight junctions between small intestine enterocytes --> malabsorption lasting up to a month
99
diagnostic test for PKU for a baby that didn't get screened
quantitative amino acid analysis (elevated Phenylalanine levels)
100
most Duchenne's patients die from what
cardiac/respiratory failure
101
painless rectal bleeding
Meckel diverticulum
102
diagnosis of Meckel
technetium 99 scan
103
brain tumor: ataxia, truncal instability
medulloblastoma
104
preteen irritable doesn't want to hang out with friends leave me alone grades going down
Major depressive disorder
105
microcephaly cleft lip distal phalange hypoplasia wide anterior fontanelle
fetal hydantoin syndrome, from exposure to antiepileptics in utero
106
in dehydrated child, what is the ratio of acute weight loss to fluid loss?
1kg = 1L
107
disruptive mood dysregulation disorder
PERSISTENTLY irritable, not episodic | easily set off, out of proportion responses

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