Peds Shelf Flashcards
1
Q
what is the murmur heard in tetrology of fallot?
A
systolic murmur along the left sternal border
2
Q
what 4 anatomic abnormalities are seen in tetrology of fallot?
A
- VSD
- Overriding aorta over the R and L ventrivles
- R ventricular outflow obstruction
- R ventricular hypertrophy
3
Q
what are the 3 most common bugs that cause acute bacterial rhinosinusitis? treatment of choice?
A
- Strep pneumo
- H influ
- Moraxella catarrhalis
tx: amoxicillin-clavulanic acid
4
Q
impetigo is most commonly associated with what disease?
A
post-strep glomerulonephritis
5
Q
what 2 bugs cause impetigo? tx of choice?
A
- GABS
- Staph aureus
tx: topical mupirocin
6
Q
what vaccine has a weight requirement and what is that requirement?
A
Hepatitis B
must be at least 2kg before receiving it
7
Q
what are the characteristics (4) of Edwards syndrome? trisomy 18
A
- Low birth weight
- Closed fists with the index finger overlapping the 3rd digit and the 5th digit overlapping the 5th
- Prominent occiput
- Rocker bottom feet
8
Q
what causes cri-du-chat?
A
5p deletion
9
Q
tx of choice for septic arthritis?
A
surgical drainage
10
Q
pt has rapidly increasing head circumference, imaging? what is it?
A
hydrcephalus
get CT scan of brain
11
Q
continued ear drainage for several weeks despite appropriate antibiotic therapy?
A
cholesteatoma
12
Q
how is a cholesteatoma formed?
A
chronic middle ear disease leads to formation of a retraction pocket in the tympanic membrance which can fill with granulation tissue and skin debris
13
Q
at what age should children follow a moving toy in the side to side AND vertical plane?
A
3 months
14
Q
at what age does an infant maintain a seated position?
A
6-8months
15
Q
At what age can a child copy a square?
A
4-5 years
16
Q
what is the major morbidity of pauciarticular rheumatoid arthritis?
A
blindness: iridocyclitis (tx with steroids)
17
Q
what is Nikolsky sign and what does it indicate?
A
- peeling of the epidermis in response to mild shearing forces
- Ritter disease = staph scalded skin disease
18
Q
what are the major symptoms observed in anaphylactoid purpura? (3)
A
- Generalized acute vasculitis of small blood vessels
- Arthritis of large joints
- GI symptoms: colicky abdominal pain, vomiting, melena
19
Q
what is the most serious complication of anaphylactoid purpura?
A
renal disease
20
Q
Syrup of ipecac should not be given in what isntances?
A
- Ingestion of strong acid or alkali
2. Obtunded, comatose, or impending seizures
21
Q
herald patch -> diffuse rash involving the upper extremities and trunk
A
pityriasis rosea
22
Q
what else should be on the differential for pityriasis rosea?
A
secondary syphilis
23
Q
at what age does neonatal acne peak?
A
2-4 weeks (due to maternal hormone transmission)
24
Q
tx for symptomatic organophosphate poisoning in children?
A
atropine
25
what are the typical symptoms of GBS pneumonia?
1. Rapid onset of respiratory distress, hypothermia, hypotension
2. low WBC count with left shift
26
at what age do children start to pincer grasp?
12 months
27
what CANT you use as treatment for lice in a small infant?
1% lindane
28
what STD goes along with sexual abuse?
gonorrhea
29
in what 3 types of bites do you need antibiotic prophylaxis?
1. cat
2. human
3. monkey bites
30
child ingests aunt's pills, prolonged QRS and QT interval
TCA
31
a rash that waxes and wanes over the first days to weeks of life- examination of fluid shows eosinophils
erythema toxicum
32
what does the rash in erythema toxicum look like?
splotchy areas of erythema with a central clear pustule
33
vascular lesions that are more prominent during crying/exercise, face lesions fade over the first weeks of live, occipital and nuchal lesions remain
salmon patches
34
what is pustular melanosis?
newborn disease- more common in AA
| - 1-2mm pustules that rupture and cause a hyperpigmented lesion
35
fine yellow-white 1-2mm lesions scattered on face and gingivae of neonate
milia
36
what is a sebaceous nevi?
small sharply edged lesions that occur on the head and neck of infants
- yellow and orange, slightly elevated
- hairless
- malignant degeneration is possible after adolescence
37
greasy scaly and erythematous rash in newborn that involve the face, neck, axilla and diaper area
seborrheic dermatitis
38
what stage of sleep do nightmares occur?
REM sleep
39
what is somnambulism? when does it happen?
sleepwalking
| occurs in stage 4 non-REM sleep
40
what is somniloquy? when does it occur?
sleeptalking
| can occur at any sleep stage and is seen in all ages
41
age most likely for asphyxiation and choking?
1 year
42
age most likely to drown in a swimming pool?
1-3years
43
leading cause of death in children aged 5-9years?
pedestrian injuries
44
pellagra is a deficiency of what?
niacin
45
niacin is an essential component of what two enzymes?
1. NAD
| 2. NADP
46
pellagra is most common in what areas?
areas that rely on corn as a basic food
47
beriberi is a deficiency of what?
thiamine (vitamin B1)- essencial for synthesis of acetylcholine
48
what are the clinical disturbances seen in thiamine deficiency? (3)
1. Heart failure
2. Peripheral neuritis
3. Psychic disturbances
49
rachitic rosary, craniotabes, scoliosis, pelvic and leg deformities
rickets: disorder of vitamin D
50
what is Waardenburg syndrome?
- Autosomal dominant
- deafness + pigment changes
- white forlock
- heterochromia irides
- uni or bilateral congenital deeafness
- lateral displacement of the inner canthi
51
what is prader-willi syndrome?
- infantile hypotonia and poor feeding
- as get older hyperphagia and obesity
- almond shaped eyes
- hypogonadism
- mild mental retardation
52
what is treacher collins syndrome?
Autosomal dominant
- normal intelligence
- facial abnormalities- malar hypoplasia
- micrognathia, abnormally shaped ears
- hearing loss
53
what is legg-calve-perthes disease?
avascular necrosis of the femoral head
- boy around age 6-7
- painless limp (though can have pain as well)
54
what age group do you most commonly see slipped capital femoral epiphysis?
adolescent- obese male
55
how does osteomyelitis typically present?
focal bone tenderness and fever
56
treatment of lead poisoning?
dimercaprol and calcium EDTA
57
treatment for acetaminophen poisoning
N-acetylcysteine (NAC): removes hepatotoxic metabolites
| - should be given within 16 hours of ingestion, ineffective after 36 hours
58
what is the antidote for morphine/narcotic overdose?
naloxone
59
treatment of salicylate poisoning?
acetazolamide and IV sodium bicarb: enhances the urine excretion of salicylates
60
treatment of organophosphate poisoning?
pralidoxime
61
symptoms of iron toxicity?
phase 1: hematemesis, diarrhea, abdominal pain
| phase 2: cardiovascular collapse after 12 hours
62
treatment of iron toxicity?
deferoxamine
63
methanol toxicity treatment?
ethanol~ saturates the enzyme systems that convert methanol to toxins
64
toxic effect of vitamin A?3
1. hyperostosis
2. Hepatomegaly
3, Increased CSF
65
toxic effect of nicotinic acid? long term toxicity (3)?
erythema of skin and pruritis
| longterm: tachycardia, liver damage, hyperglycemia
66
toxic effect of vitamin C?
kidney stones
diarrhea
cramps
67
toxic effect of vitamin D?
calcification of the heart/kidney/blood vessels/bronchi/stomach
also: weight loss, polyuria, diarrhea
68
toxic effect of pyridoxine?
sensory neuropathy & altered sensation of touch, pain and fever
69
Anomalies in fetus assoc with maternal diabetes? (4)
1. Sacral agenesis (pathognomonic)
2. Cardiac defects: transposition and VSD
3. Renal defects
4. Anencephaly
70
fetal hypoplasia of distal phalanages and nails
phenytoin in utero: fetal hydantoin syndrome
71
Phenytoin causes what in fetuses? Valproate?
Phenytoin: fetal hydantoin syndrome
Valproate: neural tube defects
72
what anomalies are seen in neonatal lupus erythematosus?
1. Skin lesions
| 2. Cardiac abnormalities: AV block, transposition, valvular/septal defects
73
most babies with lupus erythematosus will have what kind of antibodies?
anti-rho
74
potential complication of impetigo?
poststreptococcal glomerulonephritis
75
what does the rash in molluscum contagiosum look like?
skin colored dome-shaped, 1-5mm
| central umilication
76
classic presentation of poststreptococcal glomerulonephritis?
1. Change in urine color to bloody
2. Edema
3. HTN
4. Renal insufficiency
77
what vitamin should be given w isoniazid therapy?
pyridoxine: vitamin B6
78
what vitamin should be given to a child with measles in a developing country?
Vitamin A
79
pts with sickle cell disease should be given what supplement?
folate- bc of the ongoing compensatory erythopoiesis
80
what test is done to diagnose: Wiskott-Aldrich syndrome
platelet count
81
what test is done to diagnose:Asplenia
CBC: see howell-jolly bodies
82
what test is done to diagnose: b-cell defects
immunoglobulin: see low A, G, and M levels
83
what test is done to diagnose:t cell deficiencies
intradermal skin test
84
what test is done to diagnose: chronic granulomatous disease
nitroblue tetrazolium
85
what is the etiology behind marfans syndrome?
mutations of the fibrillin-1 gene
86
what are the differences in lens dislocation between Marfans and homocystinuria?
Marfans: dislocated upward
Homocystinuria: dislocated downward
87
what are the symptoms of homocystinuria?
- thromboemblic events
- osteoporosis
- fair complexion
- similar to marfans syndrome
88
what is congenital contractural arachnodacylyl?
- autosomal dominant condition that presents with tall stature
- arachnodactyly
- multiple contractures involving large joints
89
why do pts with turners syndrome have swollen hands and feet?
congenital lymphedema: due to abnormal development of the lymphatic network
90
what two bugs are the most common causes of neonatal sepsis?
1. GBS
| 2. Escherichia coli
91
Accentuated cupids bow of the upper lip
dilantin exposure
92
what are the findings of Alport syndrome in a newborn? (4)
```
hematuria
progressive nephritis
deafness
ocular defects
(Cant see, cant pee, cant hear)
```
93
what drug has been used to induce glucuronyl transferase in newborn infants and can reduce neonatal jaundice?
Phenobarbital
94
what is the treatment of choanal atresia?
surgical correction with placement of nasal tubes
95
when should VZV immunoglobulin be administered to an infant immediately after delivery? (2 instances)
if the mother had the onset of varicella within 5 days prior to delivery
and if mom if diagnosed with chickenpox within 2 days of delivery
96
what is the gold standard for diagnosis of CMV?
urine viral culture for CMV
97
how does symptomatic congenital disease occur?
when a mother has a primary CMV infection in the first trimester of pregnancy
98
what is the apt test?
a test that differentiates fetal from adult (moms) hemoglobin in a bloody specimen
99
what medications are CLEARLY contraindicated in breast feeding? (6)
1. Lithium
2. Cyclosporin
3. Antineoplastic agents
4. Illicits: cocaine and heroin
5. Ergotamines
6. Bromocriptine (suppresses lactation)
100
what do you find on plain radiographs in a neonate with NEC?
pneumatosis intestinalis
101
when should you consult surgery in a pt with NEC?
when theres presence of free air under the diaphragm on XR indicating perforation or if infant clinically worsens with medical management
102
what are the symptoms of NEC? (3)
- usually prematurely born infant
1. feeding intolerance
2. distended abdomen
3. grossly bloody stool
103
breast milk has insufficient ____ and ___ for catch-up growth in premies?
Calcium and Phosphorus
104
what are the major pulmonary problems found in small-for-date infants?
1. Neonatal asphyxia
| 2. meconium aspiration syndrome -> pneumothorax, pneumomediastinum or pulmonary hemorrhage
105
what is periodic breathing in low birth weight babies?
recurrent breathing pauses of 3-10 seconds
106
what are apneic episodes?
absence of respirations for more than 20s
+ bradycardia
+ cyanosis
107
what is the main cause of hypothyroidism in neonates?
thyroid dysgenesis
108
what can untreated hypothyroidism lead to?
cretinism
109
what does the neonatal metabolic screen test for?
PKU and hypothyroidism
110
what nerves does erb duchenne paralysis affect?
C5 & C6
111
what is klumpke paralysis?
injury to C7, C8 & T1
| - palsy to the hand and can produce Horner's syndrome
112
how do you check for suspected phrenic nerve palsy in a pt with Erb-duchenne or Klumpke's palsy?
- CXR: paralyzed diaphragm can be noted to remain elevated during deep inspiration, cannot see this on expiration
- Fluoroscopy: shows unilateral paralysis of diaphragm
113
tx of erb duchenne or klumpke?
frequently improve spontaneously
114
what are common outcomes of SGA infants born to moms w toxemia?
1. Hypoglycemia
| 2. Polycythemia
115
Manifestations of Polycythemia in a newborn
definition: Hct >65% persistently
- increases blood viscosity causing hyperviscosity syndrome: tremulousness that can progress to seizures
- renal vein thrombosis
- NEC
- tachypnea
116
tx of polycythemia in newborn?
partial exchange transfusion with albumin prior to significant symptoms
117
what is the etiology based on time frame of development of opthalmia neonatorum:
1. 6-12hrs
2. 2-5 days
3. 5-15 days
1. 6-12 hrs: Chemical conjunctivitis (from use of silver nitrate or erythromycin ppx)
2. 2-5 days: Gonococcal conunctivitis
3. 5-14 days: Chlamydial conjunctivitis
118
treatment of chlamydial conjunctivitis?
systemic antibiotics for pt and both parents to prevent risk of chlamydial pneumonia
119
what do you do w a healthy infant born to an HIV positive mom who received HAART therapy for the weeks prior to delivery?
give a course of zidovudine
120
when can you expect a mongolian spot to disappear?
1-2 years of age
121
babies not given vitamin K and are fed breast milk start showing hemorrhagic manifestations when? what are these symptoms? (4)
2nd-7th day of life
1. Melena
2. Hematuria
3. Bleeding from the circumcision
4. Intracranial Hemorrhage/shock (severe)
122
what are the complications of bilateral cleft lip and palate?
recurrent otitis media
hearing loss
speech impairment
123
when is cleft lip repaired versus cleft palate?
Cleft lip: first 2-3 months
| Cleft palate: 6months-5years
124
what does the CXR show in TTN? (3)
1. Prominent pulmonary vascular markings
2. Fluid in fissures
3. Hyperexpansion of lungs (flat diaphragms)
125
Symptoms of untreated congenital syphilis? (5)
1. Infiltrative maculopapular PEELING raash on face, palms, and soles (scrapings contain treponemes)
2. Rhinitis (blood tinged)
3. Hepatosplenomegaly
4. Lymphadenopathy
5. Early jaundice
126
late manifestation of congenital syphilis?
Interstitial heratitis:
- photophobia
- corneal haziness
- lacrimation
- eventual scarring
127
fifth finger polydactyly in a white child warrants what?
careful examination of the cardiac system
128
what is Harlequin syndrome?
transient change in the skin color of an otherwise asymptomatic premature newborn
- dependent side of the entire body turns red while the upper side remains pale
129
when should you suspect twin-twin transfusion syndrome?
when the Hct of twins differs by more than 15mg/dL
130
Polyhydramnios is associated with what?
1. Duodenal atresia
2. TEF
3. Trisomy 18
4. Anencephaly
131
Oligohydramnios is associated with what?
Renal agenesis: inhibit formation of fetal urine
132
Treatment of RSV in children?
inhaled epinephrine
133
Treatment of pt with pertussis?
isolated with droplet precautions
134
what is the most common cause of short stature and pubertal delay in adolescents?
Constitutional growth delay
135
what is constitutional growth delay?
- pts have normal birth weight and heigh but between 6mnths-3yrs their growth slows and follows the curve at the 5th-10th percentile
- puberty and growth spurt are delayed but eventually occur
136
which 3 congenital heart defects cause cyanosis and require a patent ductus arteriosus?
1. Pulmonary atresia
2. Tricuspid atresia
3. Tetrology of Fallot
137
when should you get surgery for an umbilical hernia? (5)
1. Persists to 3-4 years
2. Exceeds 2cm in diameter
3. Causes symptoms
4. Becomes strangulated
5. Progressively enlarges after the age of 1-2 years
138
what are the 4 parts of tetrology of fallot?
1. Overriding aorta
2. Right Ventricular Hypertrophy
3. Subpulmonary stenosis (single S2)
4. VSD (pansystolic murmur)
139
stridor in a pt 4-8 months that worsens in supine and improves in the prone position
Laryngomalacia
140
stridor that improves with neck extension
vascular ring
141
what is laryngomalacia?
increased laxity of the supraglottic structures that results in collapse during the inspiratory phase
142
what is the treatment of Kawasakis disease?
Aspirin plus IVIg
| - get baseline ECG and f/u in 6-8 weeks
143
what are two complications of kawasakis disease?
1. Coronary Artery Aneurysm
| 2. Myocardial infarction and ischemia
144
How do you diagnose Kawasakis disease?
- Fever for >5days plus >4 of:
1. Bilateral nonexudative conjunctivitis
2. Mucositis
3. Cervical lymphadenopathy
4. Erythematous polymorphous rash
5. Extremity changes (edema & erythema)
145
Describe the rash in scarlet fever and what is the treatment?
- sandpaper texture that spares the palms and soles
| - amoxicillin and throat culture are necessary
146
Symptoms of rocky mountain spotted fever? treatment?
- Rash on the palms and soles
- HA
- GI symptoms
tx: doxycyline for 5-7 days
147
What are some potential complications of the pertussis component of the DTaP?
1. Immediate anaphylactic reaction
2. Encephalopathy
3. CNS like seizures
148
what is atlantoaxial instability? association?
- associated with Downs syndrome
- pts have excessive laxity in the posterior transverse ligament which causes increased mobility between the atlas and axis
149
at what age should toilet training begin and how do you know when to start?
2-4 years
| - the kid should be able to communicate the need to urinate and can withold potty for a brief period of time
150
MOA of hydroxyurea in sickle cell and side effects?
```
- Increases fetal hemoglobin
Side effects:
1. Leukopenia
2. Anemia
3. Thrombocytopenia
```
151
What is diamond-blackfan anemia? how does it present?
Congenital pure red cell aplasia
- presents in the first 3 months with pallor and poor feeding
- CBC= normocytic or macrocytic anemia with reticulocytopenia
152
What is the most common causes of death in pts with Friedreich ataxia?
Cardiomyopathy & Respiratory complications
153
what two conditions should you think of with delayed meconium passage in neonates?
1. Hirschsprung disease
| 2. Meconium Ileus
154
how does trachoma present? cause?
- caused by chlamydia trachomatis serotype A-C
- follicular conjunctivitis
- pannus (neovascularization)
- concurrent infection occurs in the nasopharynx
155
how do you diagnose trachoma?
giemsa stain examination of conjunctival scrapings
156
tx of trachoma?
topical tetracycline or oral azithromycin
157
tx of choice for absence seizures? (2)
ethosuximide
| valproic acid
158
most common congenital cause of aplastic anemia?
Fanconi anemia
- autosomal recessive/X-linked disorder
- caused by chromosomal breaks
159
treatment of aplastic anemia?
hematopoietic stem cell transplantation
160
what is the appearance of a pt w fanconi anemia? (5)
1. Short stature
2. Microcephaly
3. Abnormal thumbs
4. Hypogonadism
5. Hypo/Hyperpigmented areas, cafe au lait spots, large freckles
161
what industrial chemical can cause aplastic anemia?
benzene
162
symptoms of henoch-schonlein purpura? pathogen?
- IgA mediaed vasculitis
- palpable purpura symmetric over legs, buttocks and arms
- arthralgias/arthritis
- colicky abdominal pain
163
biopsy of a pt with HSP?
deposition of IgA in the mesangium
164
linear deposition of IgG on the basement membrane of kidney
Goodpasture syndrome
165
edema + hematuria
| - EM shows flattening of the podocytes
minimal change disease
166
what is the best diagnostic test for meckels diverticulum?
technetium-99m pertechnetate scan (meckels scan)
167
What are the symptoms of Rubella in neonates exposed in utero? (8)
1. Hepatosplenomegaly
2. Deafness
3 Microcephaly
4. Growth retardation
5. Chorioretinitis
6. Thrombocytopenia
7. Blueberry muffin appearance (purpura)
8. Sensorineural hearing loss
168
purpura w a blueberry muffin appearance
Rubella as a TORCH
169
what is the most common predisposing factor to orbital cellulitis?
bacterial sinusitis
170
what are the 4 key symptoms of orbital cellulitis?
1. Pain with eye mvmts
2. Proptosis
3. Ophthalmoplegia
4. Diplopia
171
if the heart rate of a newborn drops below ___, chest compressions should be performed
60
172
what are the most common causes of torticollis in a child? (4)
1. URI
2. Minor trauma
3. Cervical lymphadenitis
4. Retrophayngeal abscess
173
why are patients with turners syndrome (XO) at a higher risk of osteoporosis & bone fractures?
low estrogen levels from gonadal dysgenesis
174
if you cant get IV access via a peripheral site, what is the best site to obtain IV access?
intraosseous
175
what are the two infections most commonly seen in hyper-IgM syndrome?
1. Recurrent sinopulmonary
| 2. Pneumocystis jiroveci pneumonia
176
what are the 4 findings of X linked agammaglobulinemia (XLA)?
1. Recurrent bacterial infections <5yrs
2. Low serum IgG, IgM and IgA
3. Absent isohemagglutinins or poor response to vaccines
4. Less than 2% CD19+ B cells
177
How is Common variable immunodeficiency different from XLA?
1. Low IgG, IgM and IgA but not as severe as XLA
| 2. do not become symptomatic until 15-35 years of age
178
what is the most common cause of hip pain in children, esp in boys aged 3-10?
transient synovitis: usually follows a viral infection or mild trauma
179
what is the testicular volume in prepubertal boys?
<3 mL
180
what is the diagnostic study of choice when a patient presents with accidental alkali ingestion?
upper GI endoscopy
181
what are the symptoms of neonatal tetanus?
1. Poor suckling and fatigue followed by rigidity, spasms and opisthotonus
182
what causes mortality in neonatal tetanus in the first week versus second week?
First week: apnea
| Second week: septicemia from infection orinally from umbilical stump
183
Clinical features of iron poisoning:
1. Within 30min - 4 days
2. Within 2 days
3. Within 2-8 weeks
1. abdominal pain, hematemesis, melena, hypotensive shock, metabolic acidosis
2. Hepatic necrosis
3. Pyloric stenosis
184
diagnostic findings of iron poisoning?
1. Anion gap metabolic acidosis
2. Radiopaque pills
3. Measure serum iron levels
185
Treatment of iron poisoning?
1. Whole bowel irrigation
2. Deferoxamine
3. Supportive care for circulation, airway, breathing
186
Symptoms of acute acetaminophen poisoning?
Asymptomatic for first 24 hours
| then nausea and vomiting
187
symptoms of acute aspirin poisoning?
1. Tinnitus
2. Fever
3. Hyperpnea (resp alkalosis, metabolic acidosis_
* not radiopaque and cannot see on xx ray
188
symptoms of lead poisoning in children?
1. Abdominal pain
2. Vomiting
3. anemia
4. Behavioral problems
- radiopaque on xray
189
seizures, mental retardation, port wine stain or nevus flammeus along territory of trigeminal nerve
sturge weber synrome
190
Diagnostic study of choice for pyloric stenosis?
Ultrasound of the abdomen
191
what two things can cause HYPERvolemic hypernatremia?
1. Exogenous sodium intake
| 2. Mineralocorticoid excess (eg hyperaldosteronism)
192
what is the most common cause of croup?
parainfluenza virus
193
what are the 3 characteristic findings on lateral neck x ray for epiglottitis?
1. Swollen epiglottis (thumb sign)
2. Thickened aryepiglottic flods
3. Obliteration of the vallecula
194
What are 3 complications of prolonged Cystic fibrosis?
1. Gallstones
2. Cirrhosis with portal hypertension
3. Pancreatic fibrosis
195
what is the protein excretion cutoff for diagnosis nephrotic syndrome?
Greater than 3g/day
196
what nephrotic syndrome is associated with Hepatitis B infection?
membranous glomerulonephritis
197
Describe the rash of scarlet fever?
- starts initially on neck, axilla, and groin within 12-48 hours and subsequently generalizes within 24 hours of rash onset
- finely papular texture "sandpaper like"
198
how often and how much should a baby be breastfeeding and stools/diapers?
- 15-20minutes on each breast eight times/day (q3H)
- 4-6 wet diapers mixed with
- 8-12 stools/day
199
Difference between duchenne and beckers muscular dystrophy?
age of presentation- Duchennes presents before the age of 5 and beckers presents around the age of 12
200
what is and when do you see peptostreptococcus?
anaerobic bacteria that causes unilateral lymphadenitis
| - usually in older children with a hx of periodontal disease
201
what is the theorized pathophys of jejunal or ileal atresia?
vascular accident in utero
risk factors include poor fetal gut perfusion from maternal use of vasoconstrictive medications or drugs like cocaine and tobacco
- not associated with chromosomal abnormalities
202
when does cocaine withdrawal in a newborn usually present?
day 2-3 of like
203
what is the cause of duodenal atresia?
failure of the duodenum to recanalize
204
what are the 3 most common bacteria of acute otitis media? 2 viruses?
1. Strep pneumo (40%)
2. H flu (25-30%)
3. Moraxella catarrhalis (10-15%)
viruses:
1. RSV
2. Rhinovirus
205
what does light microscopy show in minimal change disease?
normal renal architecture
206
what does electron microscopy show in minimal change disease?
diffuse effacement of foot processes of podocytes
207
treatment of minimal change disease?
4-6 weeks of steroids
208
erb duchenne palsy involves what nerves?
C5, C6 and sometimes C7
209
marfans features + thromboembolic events
classic homocystinuria
210
difference in lens dislocation between marfans and homocystinuria?
```
marfans = dislocated upward
homocystinuria = dislocated downward
```
211
bullous type impetigo is caused by what?
staphylococcus
212
genetic defect and inheritance of Osteogenesis imperfecta?
autosomal dominant mutation of COL1A1
213
complications of prader willi syndrome?
1. Sleep apnea
2. DM type 2
3. Gastric distension/rupture
4. Death by choking
214
How do you confirm diagnosis of ALL?
bone marrow biopsy shows presence of >25% lymphoblasts
215
What is the classic triad of Hemolytic Uremic syndrome? (HUS)
1. Uremia
2. Thrombocytopenia
3. Hemolytic Anemia
216
maternal lupus is associated with what?
first degree AV block
217
what does apgar stand for?
```
Activity
Pulse (0 points for 0 pulse, 1 point for less than 100)
Grimace
Appearance
Respiration
```
218
Large anterior fontanelle is seen in what instances?
1. Hypothyroidism
2. Osteogenesis imperfect
3. Some chromosomal abnormalities
219
When does the anterior fontanelle close?
9-12months
220
large tongue in newborn assoc w what 3 disease?
1. Downs
2. Hypothyroidism
3. Beckwith Wiedemann syndrome
221
omphalocele versus gastroschisis- main difference?
omphalocele is covered by an amnioperitoneal membrane!
222
immediate care of newborn with omphalocele or gastroschisis?
sterile wrapping of the bowel to preserve heat and minimize insensible fluid loss
223
omphalocele versus gastroschisis- which one is assoc with other congenital abnormalities?
omphalocele
224
what is the most common cause of infantile febrile seizures?
HHV-6 aka Roseola aka Exanthema subitum aka sixth disease
225
what is the most common extracranial solid tumor of childhood?
neuroblastoma NBL (median age of diagnosis = 2)
226
in TOF what is the most important factor in determining the severity of symptoms?
the degree of pulmonary stenosis
227
which vaccine is most likely to cause delayed fever?
MMR
228
what is the most common long-term sequelae of meningitis?
hearing loss
229
what is the causative organism of congenital rubella infection?
toga virus
230
what are the 3 symptoms seen in McCune-Albright syndrome?
1. Precocious puberty
2. Cafe au lait spots
3. multiple bone defects
+ endocrine disorders
231
What are craniopharyngiomas derived from?
epithelial remnants of Rathkes pouch
232
cyclical vomiting syndrome is high in pts who have what family history?
parentts have migraines!
233
how does one differentiate between transient synovitis and legg-calve-perthes disease?
transient synovitis usually follows a viral infection and symptoms resolve within 1-4 weeks, LCP have symptoms for >1 month
234
what is the classic triad of a brain abscess?
1. Fever
2. Nocturnal or morning HA severe
3. Focal neurologic changes
235
inheritance of duchennes MD?
x-linked recessive
236
when does beta thalassemia usually present? ie what age?
presents at 6-12 months of age
237
at what age does sickle cell disease usually present? why?
after 6 months, bc the presence of HgF protects the infants from sickling during the first 4-6 months of life
238
what is the treatment for immune thrombocytopenia and when should you intervene?
Corticosteroids: used in all age groups for thrombocytopenia less than 30,000 and/or for severe symptoms
239
what is a side effect of oral erythromycin in newborns?
hypertrophic pyloric stenosis
240
what are 3 earlier complications of measles? what are 2 late complications?
```
Earlier:
1. Pneumonia
2. Vitamin A deficiency
3. Bronchiectasis
Late:
1. Immunosuppression
2. Subacute sclerosing panencephalitis
```
241
What virus causes measles?
paramyxovirus
242
WHat virus causes roseola infantum?
HHV-6
243
What virus causes rubella?
togavirus
244
what virus causes erythema infectiosum?
parvovirus
245
what virus causes croup?
parainfluenza virus type 1 (most commonly)
246
almost 90% of viral meningitis are caused by what two viruses?
non-polio enteroviruses like
1. Echovirus
2. Coxsackie
