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Flashcards in Peds Deck (189):
1

Nontender abdominal mass associated with elevated VMA and HVA

Neuroblastoma

2

Most common type of tracheoesophageal fistula

Esophageal atresia with distal TEF - 85%
Unable to pass NG tub

3

Not CI to vaccination

Mild illness and/or low grade fever, current abx, prematurity

4

Tests to RO shaken baby syndrome

Opthalmologic exam, CT, MRI

5

Neonate has meconium ileus

CF
Hirschsprung disease is associated with failure to pass meconium for 48 hrs

6

Bilious emesis within hours of first feeding
Double bubble on AXR

Duodenal atresia

7

2 month baby presents with nonbilious project emesis, olive shaped mass
Dx
Managment

Pyloric stenosis
Correct metabolic abnormalities (hypochloremic hypokalemic metabolic alkalosis) then pyloromyotomy

8

Most common primary immunodeficiency

Selective IgA def

9

Infant has high fever and onset of rash as fever breaks- what at risk for

Febrile seizure due to roseola infantum

10

Immunodef: boy has chronic resp infection. Nitroblue tetrazolium test neg

Chronic granulomatous disease

11

Immunodef: child has eczema, thrombocytopenia, high IgA

Wiskot Aldrich

12

Immunodef: 6 month old boy life threatening Pseudomonas infection (or S pneumo or Haemophilus)
No tonsils or other lymph tissue

Bruton's X linked agammaglobulinemia

B cell def

13

Acute phase Tx Kawasaki

High dose ASA for infl and fever
IVIG to prevent coronary a aneurysms

14

Tx mild and severe unconjugated hyperbili

Mild: phototherapy
Severe: exchanges transfusion
DO NOT PHOTOTX IF CONG

15

Sudden onset mental status changes, emesis, liver dysfcn after ASA

Reye's syndrome

16

Child loss of red light reflex. Dx Inc risk of what cancer?

Suspect retinoblastoma
Osteosarcoma inc risk

17

Vaccination at 6 months

HBV
DTaP
Hib
IPV
PCV
Rotavirus

18

Tanner stage 3 in 6 yo female

PRecocious puberty

19

Infection of small airways with epidemics in winter and spring

RSV bronchiolitis

20

Current jelly stools, colicky and pain, bilious vomiting, sausage shaped mass in RUQ, target sign on US
Tx

Intussusception

Air barium enema

21

Congenital heart disease causes secondary HTN
Find on PE?

Coarctation of aorta
Dec femoral pulses on exam

22

1st line Tx otitis media

Amoxicillin x 10 D

23

Most common pathogen causing croup

Parainfluenze type 1

24

Homeless child small for age, peeling skin, swollen belly

Kwashiorkor- protein malnutrition

25

Defect in X linked syndrome with mental retardation, gout, self mutilitaion, choreoathetosis

Lesch Nyhan - pruine salvage problem with HGPRTase def

26

Newborn girl with continuous machine like murmur
Rx

PDA
INdomethocain to close

27

Newborn with posterior neck mass and swelling of hands

Turner

28

Age reflexes disappear

6 months

29

Developmental milestones: 2 months

Social smile
Lift head 45 degrees
Eyes follow to midline
Coos

30

Developmental milestones: 4 months

Laughs, aware of caregiver, localizes sound
Lift head 90 degrees
eyes follow past midline
Rolls front to back, grasps rattle

31

Developmental milestones: 6 months

Differentiate parents from others; STRANGER ANXIETY
Rolls over, holds self up with hands, sits without support
Grasps, attempts to feed self, transfers from hand to hand
Babbles

32

Developmental milestones: 9 months

Interactive games, separation anxiety (9-15 months)
Crawls, pulls to stand
Grasps with thumb (3 finger grasp)
First words
Waves, pat a cake

33

Developmental milestones: 12 months

Separation anxiety (9-15 mo)
Walks with help/alone, throws object
Pincer grasp, makes tower of 2 blocks
5-10 word vocabulary, follows 1 step commands

34

Developmental milestones: 18 months

Parellel play
Walks well, walks backward
Makes tower of four blocks, uses cup or sppob
10-50 word vocabulary with 2 word sentences

35

Developmental milestones: 2 yrs

Dresses self with help
Runs and climbs stairs
Makes tower of 6 blocks
50-75 word vocabulary with 3 word sentences

36

Developmental milestones: 3 yrs

Magical thinking
Climbs and descends stairs
Makes tower of nine blocks, draw circle
Rides tricycle
3 word sentences

37

Developmental milestones: 4 yrs

Plays with others
Hops 1 foot
Able to draw line image then can draw closed image
250 word vocab with 4 word sentences - knows colors and numbers

38

Developmental milestones: 6 yrs

Distinguish fantasy vs reality
Skips
Draws person
Fluent speech
>5 word sentences

39

What is moro reflex
When disappear
CNS area

Extension head causes extension and flexion of limbs - startle reflex
3 months gone
Medulla and vestibular nuclei

40

What is grasp reflex
When disappear
CNS area

Placing finger in palm causes grasping
3 months
Medulla and vestibular nuclei

41

What is rooting reflex
When disappear
CNS area

Rubbing cheek causes turning of mouth to stimuli
3 months
Medulla and trigeminal

42

What is tonic neck reflex
When disappear
CNS area

HEad turned, arm on faced side extendeds and opposite arm flexes
3 months
Medulla and vestibular nuclei

43

What is Placing reflex
When disappear
CNS area

Rubbing foot dorsum causes foot to step up
2 months
Cortx

44

Vaccines asplenic kid

Hib (do not give to normal kids >5 yrs)
Pneumo

45

Tanner 1-5 male

1: small genitals and no hair
2: testicular and scrotal enlargement with skin coarsening, fine hair
3: penile enlargement and further testicular growth, more hair
4: enlargement and darkening of skin, hair coarser and spreads over larger region
5: adult genitalia with coarse hair

46

Psychosocial issues 10-13 yrs

Concerte thinking and early independent behavior

47

Psychosocial issues 14-16 yrs

emergence of sexuality, increased desire for independence, abstract thought

48

Psychosocial issues 17-21 yrs

increased self awareness, increased confidence in one's own abilities, more open relationship with parents, cognitive maturity`

49

Chr deletion 22q11 - thymic and parathryoid hypoplasia, congential heart disease, tetany (2/2 hypocalcemia)
Recurrent viral and fungal infections b/c insufficient T cells, PCP

DiGeorge

50

Persistent infection of skin, mucous membranes, naisl by Candida from T cel def
Frequently adrenal pathology
Possible dec IgG, poor reaction to cutaneous Candida anergy test

Chornic mucocutaneous candidiasis

51

Abnormal B cell differentiation resulting in low B cells, X linked, boys recurrent bacterial infections >6 mo
No B cells in peripheral smear

X linked agammaglobulinemia

52

Abnromal Ig production by B cells, increased resp and GI infection; Dec IgA, all other Ig normal
Anaphylactic transfusion reaction

IgA def

DO NOT GIVE IVIG

53

Defect T cell CD40 resulting in poor interaction with B cells, Low IgG, excessive IgM
ENCAPSULATED BACTERIA INFECTIONS
Dec IgG and IgG with inc IgM

Hyper IgM disease

54

Autosomal disorder of B cell differentiation resulting in low Ig levels but normal B cell levels and DEC PLASMA CELLS; inc resp and GI infections in 2nd decade lif; inc risk malignant noeoplasms and AI
Low Ig, poor response to vaccines, dec CD4: CD8; both men and women affected

Common variable immunodeficiency

55

Absent T cells and abnormal Ab fcn - severe immunocompromise 2/2 defect in stem cell maturation and dec adenosine deaminase
Recurrent infections of ALL TYPES
Frequently fatal at early age
Dec WBC and Ig

SCID

NEED PCP PROPHY

56

X linked, significant susceptibility to ENCAPSULATED bacteria and opportunistic pathogens, ECZEMA AND THROMBOCYTOPENIA, easy bleeding, recurrent otitis media, dec IgM, inc IgA or IgE, abnormal WASP gene

Wiskott Aldrich

WIPE
Wiskot
Infections
Purpura
Eczema

57

AR - CEREBELLAR DYSF, CUTANEOUS TELANGIECTASIA, inc risk cancer, impaired WBC and IgA development, cerebellar ataxia after 3 yrs of age, recurrent pulm infection
Cause?

Ataxia telangiectasia
DNA repair defect

58

Defect in which neutrophils cannot digest engulfed bacteria (not able to make superoxide), recurrent bacterial and fungal infections - usu catalase + = S aureus, E coli, Candida, Klebsiella, Pseudomonas, Aspergillus
Cut, pulmonary, perirectal abscess formation; chronic LNopathy
DX: Nitroblue tetrazolium test

Chronic granulomatous disease

Daily TMP SMX

59

Defect in neutrophil chemotaxis, T cell signaling, overproduction of IgE - chronic dermatitis, recurrent skin abscesses, pulm infections; coarse facial features, retained primary teeth
Inc eosinophils

Hyper IgE/Job

FATED
Coarse Facies
Abscess - S auresus
retained primary Teeth
hyper igE - eosinophilia
Derm- eczema

60

AR dysfcn of neutrophils chemotaxis and MT polymerization - inc Staph aureus, strep, Gram N, fungal infections
Abnormal plts, neutropenia albinism, neuro dysfcn
Large granules in granulocytes on peripheral smear

Chediak Higashi

61

Inability of neutrophils to leave circulation bc abnormal leukocyte integrins (type 1) or E selectin (type 2)
Recurrent bacterial infection of resp and skin
Delayed separation of umbilical cord
Short stature, weird face

Leukocyte adhesion def - type 1 and 2

62

Multiple inherited deficiencies of one or more complement components; cannot form MAC = recurrent Neisseria, meningococcal or GC
Recurrent bacterial infection and predisposition for AI disorders like SLE
Hemolytic complement test abnormal

Complement deficiencies

63

Female with short stature, infertile, abnormal genitls, inc renal and cardiac defects (coarctation of aorta), craniofacial (protruding ears, neck webbing, low occipital hairline), possible horseshoe kidney

Turner 45 XO

64

Male with testicular atrophy, tall thin body, gynecomastia, infertile, mild mental retardation, psychosocial, female hair distribution

Klinefelter 47 XXY

Tx: testosterone

65

Male tall body (>6 ft), ace, mild mental retardation

XYY

66

Female with increased incidence mental retardation, menstrual abnormalities

XXX

67

Mental retardation, craniofacial (protruding tongue, flat nose, small ears), vision and hearing loss, broad hands SIMIAN CREASE, cervical spine instability, increased space between 1st and 2nd toes, inc risk duodenal atresia, AD, ALL, cardiac defects

Trisomy 21 -Down (increase with maternal age)

68

Severe mental retardation, small mouth, limb abnormalities (rocker bottom feet, overlaping fingers on grasp), cardiac and GI, fatal in first year

Trisomy 18 - Edwards

69

Cleft lift and palate, cardiac defects, CNS defects, severe mental retardation, rounded nose, polydactyly, frequently fatal within first year

Trisomy 13- Patau

70

X linked, lots CGG codon repeats, large face with prominent jaw and large ears, mild hand and foot abnormalities, large testicles, mental retardation, hyperactivity, possible seizures
Females only carriers
Gene?

Fragile X

FMR1 gene

71

Entire 5 p chromosome arm
High pitched catlike cry, small head, low birth weight, mental retardation, early mortality 2/2 FTT

Cri di chat

72

4p16 to end of arm
Mental retardation, multiple cranial abnormalities, seizures

Wolf Hirschhorn

73

15q11-15q13 deletion of paternal allele
Overeating, obesity, decreased mm tone, mental retardation, small hands and feet

Prader Willi

74

15q11-15q13 deletion of maternal allele
Puppetlike movement, happy mood, unprovoked laughter, mental retardation, seizure

Angelman

75

22q11, cleft palate, cardiac, mild mental retardation, significant overbite, speech disorder, T cell def, hypoCa, assoc with DiGeorge

Velocardiofacial

76

7q11.23 Elfin facies (short, upturned nose, long philtrum, wide mouth), short, mental retardation, cheerful/friendly, cardiac defects (supravalvular stenosis)

Williams

77

Child abuse - which more suspicious GC or Chlam

GC, Chlam can be acquired at birth and persist for 3 years

78

Cyanotic heart defects

5 T
Truncus arteriosus- one atrerial vessel for both ventricles
Transposition of great vessels - Two arteries are switched
Tricuspid atresia
Tetralogy of Fallot
Total anaomlous pulm venous return

79

Noncyanotic heart defects

3d
VSD
ASD
PDA

80

Acyanotic vs cyanotic -which direction A

Acyanoti: Lto R
Cyanotic R to L

81

Associated disorder: ASD and endocardial cushion

Down

82

Associated disorder: PDA

Congenital rubella

83

Associated disorder: Coarctation of aorta

Turner, also may be bicuspid aortic valve

84

Associated disorder: Coronary a aneurysm

Kawasaki

85

Associated disorder: congenital heart block

Neonatal lupus

86

Associated disorder: supravalvular aortic stenosis

Williams

87

Associated disorder: Cotruncal abnormalities

Tetralogy of Fallot, truncus arteriosus, DiGeorge and velocardiofacial

88

Ebsteins

Lithium

89

Associated disorder: heart failure

neonatal thyrotoxicosis

90

Associated disorder: Asymmetric septal hypertrophy and transposition of great vessels

Maternal diabetes

91

Harsh holosystolic murmur at left sternal border

VSD

92

Eisenmenger

L to R shunt leads to pulm HTN and shunt reversal

93

Wide fixed split S2 systolic ejeection murmur left sternal border

ASD

94

Continuous machine like murmur, loud S2, wide PP, bounding peripheral pulses

Tx

PDA

Indomethacin to close

95

ASx HTN, SP of UE>>LE, weak femoral pulses
CXR - 3 sign and rib notching

Coarctation of aorta

96

DiGeorge Syndrome S/S

CATCH 22
Cardiac - transposition
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia
22q11 deletion

97

Language development
12 mo
15 mo
18 mo
2 yrs
3 yrs

12: 1 word
15: 5 words
18: 8 words
2 yrs: 2 word phrase
3 yrs: 3 word phrases

98

Normal sexual development female

Thelarche-->Pubarche-->growth-->menarche

99

Normal sexual devo male

Gonadarche-->pubarche-->adrenarche-->growth

100

AR, normal at birth, few months later mental retardation, fair hair and skin, eczema, blond hair, blue eyes, musty urine odor; inc risk heart disease
What?
Enzyme defect
Tx

PKU
Dec phenylalanine hydroxylase or dec THB cofactor
Tx: dec phenylalainne - artificial sweetener

101

CF - mutation where, AR or AD

CFTR gene on Chr 7
AR

102

FTT, chronic sinopulm disease, recurrent pulm infection, digital clubbing, chronic cough, nasal polyposis, meconium ileus, greasy stools, rectal prolapse, male infertility, def fat soluble vitamins, DMII, salty skin,
Testing?

CF

Sweat chloride test, genetic testing
Hypochloremic alkalosis

103

Def alpha galactoside A - inc ceramide trihexoside
Severe neuropathic limb pain, angiokeratomas, telangiectasias, renal failure, inc thromboembolic events

Fabry's
X linked rec

Fairy galactic

104

Absence galactosylceramide and galactoside - galactosylceramidase def = inc galacocerebreside in brain
Progressive CNS degeneration, death 3 yrs of life

Krabbe's
AR
Krabbe-crab (GC)

105

Def glucocerbrosidase - inc glucocerbroside
Gaucher cells - crinkled paper
Anemia and thrombocytopenia
Infantile form rapid neuro decline
Adult- normal life span

Gaucher
AR

106

Def sphingomyelinase = inc sphingomyelin chol in RES and parenchymal cells
Cherry red spot and hepatosplenomegaly

Niemann Pick
AR
Pick sphinger

107

Absence of hexosaminadse- inc GM2 ganglioside
Normal until 3-6 mo - weakness and slowed development; death age 3
Cherry red spot and no hepatosplenomegaly
European

Tay Sachs

Sax- heXosaminidase

108

Def arylsulfatase A - inc sulfatide
Demyelination - progressive ataxia and dementia

Metachromatic leukodystrophy
AR

109

Def alpha Liduronidase
Corneal clouding, mental retardatin, gargoylism

Hurler's
AR

110

Def iduronate sulfatase
Mild form Hurler without corneal clouding and mild mental retardation

Hunter
X link recessive (Hunters need to see)

111

Cause Meckels

Failure of omphalomesenteric/vitelline duct to obliterate

112

Dx Meckels

Technetium 99 scan

113

Failure to pass meconium in 48 hrs, explolive discharge of stool following rectal exam

Hirschsprung - lack of ganglion cells in distal colon

114

First month of life bilous emesis, distention, bloody or mucous in stool, AXR bird beak

Malrotation with volvulus - form bands that predispose to obstruction and constriction

115

Premature infant, first few days or weeks of lif, feeding intolerance, bloody stools, Sx may rapidly progress, dilated loops of bowel, air in bowel wall (pneumatosis intestinal is)

Necrotizing enterocolitis

116

AD recurrent episodes of angioedema lasting 2- 72 hrs, provoked by stress or trauma

C1 esterase def - hereditary angioedema

117

Kawasaki disease Sx

CRASH and BURN
Conjuctivitis
Rash
Adenopathy- unilat
Strawberry tongue
Hands and feet- red, swollen, flaky = desquamate fingertips, polymorphous rash (truncal)
BURN - fever >40 for >=5 d

118

Scarlet fever vs Kawasaki

Both: strawberry tongue, desquamation hands and feet, erythema of mucous membranes

Kawasaki: bilat nonexudate conjunctivits, dry, red chapped lips

119

AI disorder, morning stiffness, gradual loss motion at lest 6 wks <16 yrs old

Juvenile idiopathic arthritis

120

3 types JIA

-Pacuiarticular: 4 or less joints, ANA+ and RF-, uveitis common - slit lamp exam
-Polyarthritis: 5+ joints, symmetric RF + means severe disease
-Systemic onset/Stills disease: recurrent high fever, salmon colored macular rash, RF and ANA -

121

Common causes otitis media
Tx

S pneumo
nontypable H flu
Moraxella catarrhalis
Influenza A, RSV, parainfluenza

Tx: amoxicillin

122

Cause bronchiolitis
Age
S/S

RSV
<2 yrs
Tachypnea, wheezing, crackles

123

Acute onset fever, dysphagia, drooling, inspiratory retractions, hyperextended neck and chin protruding, tripod position, thumbprint sign
Major problem

Epiglottitis

Laryngospasm- do not exam throat without ENT or anesthesiologist

124

Steeple sign, barking cough,
Cause

Croup
Parainfluenza (RXV, influenza, adenovirus)

125

Cause epiglottitis

Before H flu
Now Strep, viral

126

Subglottic narrowing, cause generally S aureus, can follow viral URI, vaiable respiratory distress ,pseudomembrane

Tracheitis

127

HA, high fever, nuchal rigidity

Meningitis

128

Menigitis with petechial rash

N meningitidis

129

Tx meningitis neonates

Ampicillin + cefotaxime/gentamicin (no ceftriaxone due to risk of kernicterus)
Consider acyclovir

130

Tx meningitis older kids

Ceftriaxone + vanc

131

Common bacterial causes meningitis neonates

GBS
Listeria
E coli

132

Common bacterial causes meningitis children and infants

S pneumo
N meningitidis
H flu

133

age 6mo-6yrs, acute onset high fever, hot potato voice, drooling, unilat, likes to have neck extended
Common bug
Tx

Retropharyngeal abscess
GAS
I and D or aspirate, abx

134

> 10 yrs, hot potato voice, drooling, UVULA DISPLACED TO OPPOSITE SIDE
Common bug
Tx

Peritonsillar abscess
GAS
I and D, tonsillectomy, abx

135

Cause whooping cough

Bordetella pertussis Gram N

136

Gold stand Dx pertussis

Tx

Culture

Erythromycin

137

Prodrome: acute onset of high fever >60/104; no other Sx for 3-4 d
Rash: maculopapular rash that appears as fever breaks begins trunk and spreads to face and extremities, last

Roseola infantum/ exanthem subitum
HHV6 and 7

137

Prodrome: none
Rash: slapped cheek, pruritic, starts arms and spreads trunk and legs, worse with fever and sun
Complications: arthropathy, congenital infection = hydrops; aplastic crisis

Erythema infectiosum - 5th disease
Caused by Parvovirus B19

137

Prodrome: low grade fever, Cough, Coryza, Conjunctivitis, Kopliks spots (red with gray center)
Rash: maculopapular spreads from head to toe
Complications: otitis media, pneumo, laryngotracheitis, subacute sclerosing panecephalitis

Measles by Paramyxovirus

138

Prodrome: asymptomatic or tender LNopathy
Rash: erythematous, tender, maculopapular from head to toe
Fever is low grade, pt does not appear ill
Complications: encephalitis, thrombocytopenia, congenital infection - PDA, deaf, cataracts, mental retardation

Rubella by rubella virus

138

Prodrome: acute onset of high fever >60/104; no other Sx for 3-4 d
Rash: maculopapular rash that appears as fever breaks begins trunk and spreads to face and extremities, last

Roseola infantum
HHV6 and 7

138

Prodrome: mild fever, anorexia, malaise that precede rash by 24 hrs
Rash: pruritic teardrop vesicular; different stages of healing; face then spreads to reast of body but spares palms and soles
infectious from 24 hrs before eruption until crusts over
Complications: Meningoencephalitis, pneumo, hepatitis, bacterial infection, Reye's syndrome

Varicella - VZV

138

Prodrome: fever, anorexia, oral pain
Rash: oral ulcers, maculopapular vesicular rash on hands feet and sometimes butt
Complications - non

Hand foot and mouth - Coxsackie A

138

Conj vs unconj hyperbilirubinemia in neonatal jaundice

Direct/conj pathologic (cholestatsis, Dubin Johnson, Rotors, TORCH)
Unconj: physiologic or pathologic (hemolysis, breast milkd, inc circulation, bili metabolism disorder, Crigler Najjar, Gilbert)

139

Kernicterus - bili deposits where
Levels must be what to deposit

Pins, basal ganglia, cerebellum
>25-30

140

Phys vs path jaundice of newborn
Time?
Inc bili?
Peak?
Direct % total?
Resolves?

Phys Vs Path
72 hrs after birth vs first 24 hrs life
< 5 mg/dL/d vs >0.5 mg/dL/hr
Peak 15
10% total
Resolves 1 -2 wks vs persists beyond 1-2 wks

141

L: S ratio of what indicates need for surfactant

<2:1

142

Retained amniotic fluid results in prominent perihilar streakin in interlobular fissures, Resolves with O2

Transient tachypnea of the newborn

143

Associated defects tracheoesophageal fistula

VACTERL
Vertebral
Anal
Cardiac
Tracehal
Esophageal
Renal
Limb

144

Herniation of intestine only through abominal wall next to umbilicus with no sac - GI tract exposed

Gastroschisis
Tx: SURGICAL EMERGENCY

145

Herniation of abdominal viscera through abdominal wall into a sac covered by peritoneum and amniotic membrane
Assoc Beckwith Wiedmann and trisomies

Omphalocele

Surgery

146

L: S ratio of what indicates need for surfactant

<2:1

147

Cerebral palsy: spastic paresis of any or all limbs, mental retardation common

Pyramidal / spastic

148

Hemihypetrophy, macroglossia, visceromegaly

Beckwith Wiedemann

149

Ages febrile seizures

6 mo - 5 yrs

150

Bone tumor from neuroectoderm, assoc 11:22 translocation, Caucasion male, local pain and swelling with systemic Sx, found in midshaft of long bones
Dx: leukocytosis, inc ESR, lytic lesion with inion skinning

Ewing sarcoma
Excision w/ chemo and rads

151

Embryonal tumor of neural crest origin,

neuroblastoma

152

Children 2-5 yrs
Assoc: Beckwith Widemann, NF, WAGR
S/S: ASx nontender mass that does not cross midline

Wilms tumor

153

Intermittent abd pain, peripheral neuropathy w/ wrist or foot drop, acute encephalopathy
Microcytic hypochromic anemia with basophilic stippling

Tx
-=70

Pb poisoning

=70: EDTA + BAL

154

Hemihypetrophy, macroglossia, visceromegaly

Beckwith Wiedemann

155

Hx untreated strep infection, sandpaper-like rash on abd and trunk with circumoral pallor and strawberry tongue-->desquamate

SCarlet fever
Give penicillin to prevent rheumatic fever

156

Bone tumor from neuroectoderm, assoc 11:22 translocation, Caucasion male, local pain and swelling with systemic Sx, found in midshaft of long bones
Dx: leukocytosis, inc ESR, lytic lesion with inion skinning

Ewing sarcoma
Excision w/ chemo and rads

157

Strabismus normal until?

3 months

158

Leukocoria indicates

Rb
Congenital cataracts
Retinopathy of prematurity

159

Intermittent abd pain, peripheral neuropathy w/ wrist or foot drop, acute encephalopathy
Microcytic hypochromic anemia with basophilic stippling

Tx
-=70

Pb poisoning

=70: EDTA + BAL

160

Rick bite --> 1 wk later fever or chills, HA, prostration, severe malaise-->4 d later rash on palms and wrist an soles and ankles-->spreads to trunk and face
Tx

RMSF
Doxy or chloramphenical (2nd line)

161

Hx untreated strep infection, sandpaper-like rash on abd and trunk with circumoral pallor and strawberry tongue-->desquamate

SCarlet fever
Give penicillin to prevent rheumatic fever

162

Bilateral renal agenesis causes oligohydramnios (fetus swallows but cannot excrete), limb deformities, abnormal facies, hyoplasia of lungs

Potter syndrome

Pts die

163

AR degeneration of anterior horn cells (LMN)
Hyppotonic at birth, all affectd by age 6 months
Slowly progresive

Werdnig Hoffman disease

164

Sudden onset and hx honey ingestion,
Dx C botulinium tocin in feces

Infant botulism

165

X linked recessive, dystrophin
MM weaknes, elevated CK, pseudohypertrophy of calves, Gowers sign

Muscular dystrophy- Ducchenne

166

Expansile, lytic well demarcated lesion in proximal part of humerus
Benign

Unicameral bone cyst

167

Osteochondritis of tibial tubercle, boys 10-15 yrs, usu bilat,

osgood schlatter
Tx rest and NSAIDS

168

First born girl with breech delivery, + barlow and ortolani

CHD

169

Delayed bone age, knee thigh and groin pain with a limp; 4-10 yrs old

Legg Calve Perthe

170

9-13 yrs, obese, knee, thigh, groin pain with limp

SCFE

171

Grayish pseudomembranes on pharynx, tonsils or uvual w/ myocarditis

Diptheria - Corynebacterium diptheriae
Tx: antitoxin, Pen G / erythromycin

172

Tx pneumo neonates

Ampicillin and gentamicin

173

Tx pneumo neonates after 3-5 d of life

Vanc + gentamicin

174

1-4 mo tx pneumo

Macrolide

175

4 mo- 4yrs Tx pneumo

Amox if bacterial suspected
Viral is most common in this age group

176

>5 Tx pneumo

Macrolide

177

benign vascular tumor present first days of life, increase in size, resolve within first 2-5 yrs in 50%
No Tx

Cavernous hemangiomas

178

Diffuse swellling or edema of scalp that CROSSES midline

Caput succedaneum (2 words - either side of midline)

185

Subperiosteal hemorrhages do not cross midline

Cephalohematomas

186

Abnormal type 1 collagen

osteogenesis imperfecta

187

Glomerulonephritis and hearing loss

Alports

188

Abnormal mm in abdomen causing wrinkled apperance, renal dysplasia, markedley tortuous and dilated ureters, enlarged bladder, cardiac and GI, cryptoorchidism, underdeveloped prostate, resp compromise, bulging abdomen, clubfoot

PRUNE BELLY SYNDROME

189

Chlamydial conjunctivitis also called

Inclusion