Peds Case Files and UWorld Flashcards by Ben Dover

Most common causes of PNA in the first few days of life

GBS and Enterobacteriae

S. pneumonia

Listeria

S. aureus

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Common causes of PNA in the first few months

C. trachomatis

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Most common cause of PNA in a 5y/o

mycoplasma

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Causes of PNA in the intubated patient

P. aeruginosa and Candida

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PNA in cystic fibrosis

pseudomonas

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Child from farm with drooling, tearing, obtunded, and vomiting.

Cause?

Tx?

Organophosphate poinsoning

Atropine and pralidoxime

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Tx for a pt with and anal fissure

Dietary changes and stool softener

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Sx associated with intussiception

coliky pain with episodes of lethargy

Blood in sttol

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A premature infant with first oral intake and bloody stool is at high risk of…

Necrotizing enterocolitis

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Air in bowel wall entering portal circulation on abdominal x-ray

necrotizing enterocolitis

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A patient with acute otitis media fails treatment with abx and returns with a large swelling behind the ear. What is the dx and tx?

Mastoiditis

Myringotomy and drainage

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Young patient (<1) with otitis media. Management?

Admit to hospital

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Patient who becomes cyanotic except when crying

Choanal atresia

Infants are obligate nose breathers through 4mo. of age

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Causes of nonphysiologic jaundice

speticemia

biliary atresia

hepatitis

galactosemia

hypothyroidism

cystic fibrosis

congenital hemolytic anemia

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A child whose parent had a growth delay has this kind of growth delay

constitutional growth delay

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Cuase of growth delay in a child whose growth rate has fallen away from the normal growth curve with normal parents

GH deficiency

Tx: replace GH

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Test to run on a child with delayed growth who has a parent that also had delayed growth

bone age measurement

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Typical WBC count, and CXR in GBS pneumonia

LOW WBC with Left shift

CXR showing infiltrates

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Organisms common implicated in early onset sepsis

GBS

E. coli

H. influenszae

Listeria

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Most common cause of neonatal sepsis from birth to 3mo

GBS

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Timeline for gonoccal v chlamydial conjuctivitis

Gonococcal 2-5d

Chlamydial 5-14d

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A 3mo old child presents with weezing and a new onset heart mumur. Dx?

VSD

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Why does a new heart murmur in a 2-5mo old infant represent a possible non-cyanotic heart lesion like VSD?

between 2-5mo the pulmonary vascular resistance greatly reduces causing increased shunting of blood across the VSD

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What is the immediate management in a patient with transposition of the great vessels?

PGE1

-maintain the PDA bcause TGA is ductus dependant

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When do cyanotic heart diseases usually present?

When the ductus beings to close

classic radiographic finding of TGA

Egg on a string (narrowed mediastinum)

Exercised induced cyanosis and a systolic murmur in a young child. Dx?

Pulmonary stenosis

12 year old patient with no complains and a systolic murmur in the left second intercostal with no radiation, clicks or snaps. Dx?

Innocent murmur Benign pulmonary flow murmur

3 year old with long standing fever, rash, lyphadenopathy, organomegaly, and PIP and DIP joint swlling as well as elevated blood counts and fever. Dx

Juvinile idiopathic arthritis (previously juvenile rhematoid arthritis)

Most common rheumatologic disorder in children?

juvenile idopathic arthritis

What is an important exam for a patient with juvenile idopathic arthritis?

Eye exams anterior uveiitis is common and can lead to vision problems if not treated.

Treatment for juvinie idipathic arthritis

NSAIDs Steroids Methotrexate Immunosuppressive drugs

Infants fed on solely goat's milk are at increased risk for deficiecy of

Vit B12 Folate Brucellosis infection

Anorexia, hyperirritability, altered sleep, decreased play, abdominal pain (constipation, vomiting, colic), ataxia, AMS, and seizures are all signs and symtoms of what in a child?

Lead poisoning

Tx of lead poisoning

Chelation with: EDTA DMSA Succimer

Signs of methyl mercury poisoning

ataxia, tremor, dysarthria, memory loss, altered sensorium (smell, taste, sight)

Baby with microcephaly, low birth weight, and seizures with parents who are showing CNS probs was exposed in utero to....

Mercury

Boy with hematuria (2+ protien and RBC casts) and hx of fever and sore throat two weeks ago. Dx?

APSGN

APSGN C3 and C4 levels

C3 LOW C4 usually normal

If a patient has suspected APSGN and the C3 does not reurn to normal and the hematuria continues over weeks, what Dx must be considered??

SLE lupus nephritis

What drug is used to control HTN in a child with APSGN?

Calcium channel blockers

Recurrent painless gross hematuria, frequently associated with a URI.

IgA Nephropathy

Patient with persistent hematuira and biopsy shows a thinned basement membrany in the kidney. Dad has same problem. Cause?

Beningn familial hematuria autosomal dominant condition

puritic, boggy or vesicular round lesions that erupt on the extremities, buttocks, and shoulders. Can lead to lichenification.

Nummular Dermatitis

Psoriatic lesions on a child with a URI

Guttate psoriasis Psoriasis in a patient with a streptococcal infection. Abx for the strep will result in marked improvement of the psoriasis.

Common causes of meningitis in neonates.

E. coli GBS

Common causes of meningitis in an older vaccinated child? What is added if the child has not been vaccinated?

S. pneumo N. gonorrhea Unvaccinated: H. influenszae type B

Most common long term sequlae of meningitis in children?

Hearing loss

Major CBC difference between shigella and salmonella

Shigella: normal WBC count with remarkable left shift Salmonella: Leukocytosis

Yersernia infection can mimic what in children?

Acute appendicitis

How long after O157:H7 does HUS develop?

1 to 2 weeks.

Child with bloody diarrhea and tubular mass in the RUQ. Dx?

Intussiception Air contrast enema is test and possible Tx

Precocious puberty, cafe-au-lait spots, bone defects, and moon facies are all common presentations of...

McCune-Albright disease

Newborn with turner syndrome and lymphadema. Cased by?

Lyphatic dysgensis

common cause of intussiception in a young child following a viral/bacterial illness?

Peyer patch hypertrophy

Patient with recurrent intussiception likely has?

Meckel diverticulum

Patient with failure to thrive and musty odor. Dx? What enzyme is lacking? What builds up?

PKU Phenylalanine hydroxylase Phenylalanine builds up because it is not changed to tyrosine

How does maternal diabetes cause RDS?

High glucose--\> high insulin which antagonizes cortisol--\> cortisol noramlly increases surfactant

NF1 v. NF2?

NF1= short stature, learning diabilities, cafe-au-lait, neurofibromas NF2= bilateral acoustic schannoma

6 year old boy with high grade fever and rash starting of face and spreading to trunk is in the ER. (unvaccinated/foreign/whateverfromanotherplanet) What vitamin has been shown to decrease mortality in this patient?

Measles Vitamin A

Pathophys of breakfeeding failure jaundice

lack of breast feeding leads to an increase unconjugated bilirubin through inadequate stooling=lack of elimination

Hepatitis is a significant risk factor for this kidney disorder

membranous nephropathy

Most common cause of intestinal obstruction ages 6-36 mo.?

Intussiceoption

This ligand is defficient in children with hyper-IgM syndrome

CD40

Patient with lyphadenopathy, pharyngeal exudates, elevated LFT and thrombocytopenia. Dx?

Infectious mononucleosis EBV

EBV is associated with these cancers

burkitt lymphoma Hodgkin lymphoma

Super special name for pinworm

Enterobius vermicularis

Tx of pinworm

mebendazole pyrantel pamoate albendazole

Which intracranial bleed is more common in children \<1yo? Older?

Subdural if \<1 Epidural if \>1

In which kind of brain bleed (sub/epi) are seizures more common?

Subdural

Most common congenital heart defect in edwards syndrome

VSD

What is dentogenisis imperfecta?

Discoloration of the teeth in patient with ostegenisis imperfecta

In a patient with suspected meconium ilius, what is the next best step in Dx after abdominal xray showing sitended loops of bowel with no free air?

Barium enema

Cyanotic infant with left axis deviation and small R waves with prro progression. Dx?

Tricuspid atresia

PAS positivity is specific for what form of leukemia?

Lymphoblastic leukemia

12 year old girl with recurrent middle ear infections and drainage from the ear with peripheral granulation on otoscopy

cholesteatoma

Should premature infants be given vaccines according to chonologic or gestational age?

Chronologic

What is the pathology of a patient that has been starving (anorexia) and resumes feedings?

Resumed feeding causes a spike in **insulin** which leads to cellular uptake of electrolytes (mag, phos, potassium) for energy metabolism. This leads to derangements in these electrolytes and puts the patient at extreme risk for cadiopulmonary failure as well as cardic arrhythmias

Young patient presenting with acidosis and recurrent kidney stones

RTA Most likely type II (excess loss of bicarb

most common cause of sepsis in a sickle cell patient

S. pneumo

Tripple bubble sign with gases colon in a patient of a cocaine mom

Jejunal atresia

inheritance patternt of myotonic muscular dystrophy

autosomal dominant

next step in management in a patient with leukocytosis, fever, high crp and esr, and inflammed joint with a URI 2 weeks previous

arthocentesis (septic joint) therapeutic and diagnositic

What do we give to children \<8yo for lyme

amoxicillin

Patient with fair hair, blue eyes, and mrphanoid body habitus. Dx? Increased risk for?

Homocysteinuria CVA

Who gets a bladder and ureter ultrasound after a UTI

Pt who is less than 24mo

What treatment should be attempted before intubating a patient with croup?

Epinepherine

What is the next best way to follow a patient who has guillian barre syndrome?

Serial PFT and spriometry to evaluate for respiratory failure FVC is the most indicative

Triad of congenital rubella syndrome

Cataracts Sensory-neural hearing loss PDA

15 day old with bilious vomiting and blood stools? Dx? Best first test? Most accurate test?

Malrotation with volvulous First: Xray abd Best: Upper GI series

How to tell larygeomalacia from a vascular ring?

Laryngeomalacia worsens in the supine position and gets better prone Vascular ring improves with extension of the neck

Most common cause of thrombocytopenia in a well child aged 2-10 years?

Immune thrombocytopenic purpura gpIIb/IIIa

suspect abuse...next best step?

Skeletal survey

Roughy 90% of viral meningitis in kiddies is caused by...

Echovirus and coxsackie

Child with tramatic injury to the palate presenting with stroke like symtoms. Dx?

Internal carotid artery dissection

Patient with malaise and throat pain takes amoxicillin and gets a rash. Dx?

EBV Mono

Peds Case Files and UWorld Flashcards

(96 cards)