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Flashcards in peds101 Deck (195):
1

antibiotic activity against pseudomonas for Cf patients

ceftazadime(or penicillin deriv) plus aminoglycoside like amikacin or gentamycin

2

digeorge syndrome

catch22- conotruncal cardiac defects; abnormal facies; thymic aplasia, cleft palate; hypocalcemia

3

2 year old vocab

150-300 words

4

micrognathia, microcephaly, overlapping fingers, rocker bottom feet, VSD, absent palmar creases

edwards syndrome, trisomy 18

5

heart defect in trisomy 21

ASD or endocardial cushion defect

6

william's syndrome heart defect

supravalvular aortic stenosis, pulm stenosis, or septal defects

7

what are the CATCH-22 syndromes

digeorge and velocardiofacial

8

what cardiac abnormality is assoc with the catch-22 syndromes

conotruncal abnormalities (truncus, tet of fallot, interupted aortic arch)

9

interupted aortic arch

almost always assoc with VSD

10

congenital heart block assoc with what?

neonatal lupus

11

PDA assoc with what?

congenital rubella

12

coronary artery aneurysms

kawasaki disease

13

treatement of pertussis

macrolides in catarrhal stage; less effective later on

14

macrolide abx

azithromycin, clarithromycin

15

post-tussive emesis

think pertusis

16

hemophilic arthropathy

late complic of hemophilia and caused by hemosidern/iron dep leading to synovitis and fibrosis within the joint

17

patient with alkali ingestion

upper GI endoscopy

18

whenever IV access cannot be obtained, what do you try next?

intraosseus cannulation; osteomyelitis is a rare complication

19

vitD supplementation in breast fed babies

400 IU daily

20

treatment of rickets

1000-2000 IU daily of vit D

21

congenital syphilis

frontal bossing, anterior bowing of the shins (saber shins); saddle nose deformity; notch-gapped teeth (Hutchinson teeth)

22

cupping and fraying of the metaphyses of the lung bones

sign of rickets on xray

23

postpericardiotomy syndrome

pleuropericardial disease that occurs days to months after cardiac surgery; inflamm from surgery leads to pericardial effusion;

24

CHF on chest xray

pulm vascular congestion and interstitial edema

25

treatment for OCD

fluoxetine or other high dose SSRI

26

dermatitis herpetiformis

itchy blistering rash assoc with celiac disease

27

prolonged PR interval on EKG

think rheumatic fever

28

therapy in pericarditis

salicylates

29

paramyxo virus

measles and mumps

30

most common organism responsible for pericarditis

coxsackie virus

31

leukocyte def type 1

deficiency in ability of neutrophils to migrate; absence of pus with infection; delayed umbilical cord separation; poor wound healing; recurrent skin and mucosal bacterial infections; periodontiti, often necrotizine

32

leukocyte def type 1 on lab

leukocytosis with neutrophil predominance; bx shows inflamm infiltrate devoid of neutrophils

33

adenosine deaminase def

AR form of SCID; toxic accum of adenosine leads to def in mature B and T cell formation

34

nitroblue tetrazolium test

neg (abnormal) in chronic granulomatous disease

35

chronic granulomatous disease pathophy

defective intracellular killing due to impaired respiratory burst from activated phagocytes; nitroblue tetrazolium test is neg; dihydrohodamine 123 test is more sens and quantify the severity of illness

36

developmental defects in the pharyngeal arch system

digeoge

37

digeorge immune def

T cell def; also thymic hypoplasia

38

opsonization defects result from what

asplenia because spleen produces opsonizing antibody, which is required for clearance of encapsulated organisms

39

preseptal cellulitis

aka periorbital cellulitis

40

proptosis

eyes popping out

41

murmur in coarctation of the aorta

heard all over the chest due to collaterals developing

42

rib notching

caused by dilation of the collateral chest wall vessels in coarctation of the aorta

43

pericardial calcification

constrictive pericarditis

44

how to diagnose absence seizure

ask patient to hyperventilate; it should mimic the seizure

45

no post-ictal state in absence seizures

right

46

differentiating between typical and atypical absence seizure

atypical is slower (freq 2.5 hz as opposed to 3 hz)

47

iron poisoning tx

deferoxamine

48

TCA and aspirin overdose antidote

sodium bicarb

49

prolonged QT and torsade des pointes- what med to give patien?

mag sulfate

50

severe lithium toxicity

hemodialysis because lithium is very dializable

51

hyperkalemia- give what to protect the heart

calcium gluconate

52

oral succimer

lead poisoning chelating agent

53

pediatric viral myocarditis caused by what

coxsackie or adenovirus

54

why would heart failure due to myocarditis give you a holosystolic murmur

the heart dilates because it is filled with blood it cannot pump and then you get mitral regurg during systole

55

myocarditis on echo

global hypokinesis

56

why is strep pharyngitis (and rheumatic fever) uncommon in kids less than 3

they have fewer epithelial cells in the throat for the strep to infect

57

can you see wheezing in a patient with pulm edema?

yes

58

blue sclerae and hearing loss

osteogenesis imperfecta; defect in type 1 collagen

59

fibrillin-1 defect

marfans

60

the most common predisposing factor for bacterial sinusitis

viral URI

61

treatment for bacterial sinusitis

amox plus clavulonic acid

62

kid with uti less than 24 mos

treat and then do renal and bladder u/s to see if there is anatomic reason exposed to UTI

63

koplik's spots

red spots with bluish specks over the buccal mucosa seen in measles; fade once the rash appears

64

rash in measles

starts on face and spreads to trunk and extremities

65

herpes virus 6 causes what rash

roseola infantum

66

croup aka

laryngotracheobronchitis

67

laryngeal diptheria

can present like croup; in an unvaccin kid

68

hypointense center with ring enhancement on brain CT

brain abscess

69

bullous myringitis

seen in patients with acute otitis media; bullous on the TM; more severe ear pain than normal OM; assoc with mycoplasma pneumoniae

70

cholesteatoma

growth of squamous epithelium in the middle ear

71

what condition is assoc with false pos RPR test results

lupus

72

cystic hygroma

lymphangioma; dilated lymphatic spacies lined by endothelium; commonly occur on the neck

73

clubfoot management

stretching, manipulation of the foot, and serial casting

74

terbinafine

a topical antifungal

75

mongolian spot

congenital dermal melanocytosis; fades spontaneously during the first decade of life

76

babinski reflex

normal (adult) is to have a plantar response; up to 2 year olds, an extensor response is normal

77

acute unilateral lymphadenitis

bacterial infection, usually staph aureus, next most common is group a strep

78

difference between craniopharyngioma and pituitary tumor

craniopharyngioma has calcifications; pit tumor secretes prolactin in addition

79

adolescent with nosebleeds, nasal mass, and nasal obstruction

think juvenile angiofibroma until proven otherwise

80

treatment of juvenile angiofibroma

if asymp, no tx; if symp, surgical removal but recurrance is common

81

what is an endocardial cushion defect?

AV septal defect; assoc with Down syndrome

82

midsystolic click with late systolic murmur

mitral valve prolapse

83

transposition of the great vessels often seen in what patients

infants of diabetic mothers; and males

84

larygoscopy shows collapse of supraglottic structures with inspiration and omega shaped epiglottis

laryngomalacia

85

management of laryngomalacia

reassurance; usually resolve by 18 mos; for some, surgery supraglotoplasty is indicated

86

stridor ddx

croup, laryngomalacia, foreign body,

87

stridor that is worse in the supine pos and exacerbated by crying or wheezing

laryngomalacia

88

when does laryngomalacia present

4-8 months, resolves by 18 mos

89

most common cause of chronic stridor in infants

laryngomalacia

90

vomitting, arching of the back with feeds, and poor weight gain

GER

91

vascular rings, biphasic stridor, and feeding difficulties

anomalous branch of the aortic arch encircles the trache and esophagus; confirm w MRI and angiography

92

toddler with fever, drooling, dysphagia, neck pain, and stridor

retropharygeal abscess

93

prevertebral soft tissue thickening

retropharyngeal abscess

94

pain with eye movements, proptosis, opthalmoplegia, and diplopia

orbital cellulitis; bacterial sinusitis is the most common predisposing factor

95

beckwith-weidemann genetics

11p15 mutation

96

beckwith-weidemann physical exam

fetal macosomia, rapid growth, oomphalocele or umbilical hernia, macroglossia, hemihyperplasia

97

complications of b-w

wilms tumor, hepatoblastoma

98

surveillance in w-d syndrome

serum alpha protein, abdominal/renal ultrasound

99

why do babies with B-W syndrome need to be monitored for hypoglycemia>

they produce excess insulin like growth factor

100

most common complication in patients with sickle cell trait

painless hematuria

101

hep B assoc with what renal disease?

membraneous nephritis

102

most common cause of nephrotic syndrome in kids

minimal change disease

103

classic triad of congenital rubella syndrome

deafness, cataracts, cardiac defects (PDA, ASDs)

104

eczema herpeticum

form of primary HSV that is associated with atopic dermatitis; superimposed on healing eczema lesions after exposure to herpes; umbilicated vesicles on an erythematous base; can be life threatening in infants

105

HSP

leukocytoclastic (destroy WBC) vasculitis; palpable purpura on LE with normal platelet count; can present with scrotal pain/swelling; igA dep; renal disease, abdom pain

106

complications of HSP

GI hemorrhage and intussusception

107

intussusceptions in HSP

more likely to be small bowel or ileo-ileal (as opposed to ileo-colic like in other cases)

108

small bowel intussusception on u/s

target sign; unlike ileocolic intuss, which can be seen on contrast enema

109

serum sickness like reaction occurs when

like 1-2 weeks after you have taking an antibiotic

110

how does maternal diabetes lead to RDS?

fetal hyperinsulinism antagonizes corticoids, which mature the lung; interestingly, intrauterine stress decr the risk of RDS

111

how to treat cervical lymphadenopathy

usually caused by staph and strep; use dicloxacillin

112

difference between simple partial seizures, partial seizures with generalization, and complex partial seizures

no loss of conciousness in simple only; the other two have loss of consciousness; partial generalized has tonic-clonic activity

113

diffuse muscle aches and elevated cpk in a seizure

indicates tonic-clonic

114

Lennox-gaustat syndrome

mental retardation, seizures,

115

cri-du-chat sndrome

cat like cry, hypotonia, short stature, microcephaly with protruding metopic suture, moonlike facies, hypertelorism, epicanthal folds, high arched palate, wide and flat nasal bridge, mental retardation

116

5p deletion

cru-di-chat

117

4 p deletion

wolf-hirschorn

118

wolf-hirschorn syndrome

microcephaly, epicanthal folds, greek helmet facies, ocular hypertelorism,

119

viruses that cause viral meningitis

enteroviruses like cocksackie and echovirus

120

myotonic muscular distrophy (aka steinert diseae)

autosomal dominant; second most common muscular dystophy; all types of muscles (striated, smooth, card) are involved; progressive weakness; delayed muscle relaxation

121

conjucntivitis first 24 hours of life

chemical

122

conjucntivitis days 2-5 of life

gonococcal; treat with IV or IM cef

123

conjunctivitis on day 5-14 of life

chlamydia, treat with oral erythromycin

124

blood stained eye discharge

chlamydial conjunctivitis

125

prophylaxis against gonoccocal conjunctivitis

topical erythromycin or topical silver nitrate (not available in the US)

126

treatment for absence seizures

ethosuximide or valproic acid

127

Reye syndrome

fatty liver with encephalopathy; URI with varicella or influenza PLUS aspirin

128

def of niacin (vit B3)

leads to pellagra (diarrhea, dermatitis, dementia, and death), glossitis, sunburn rash

129

def of thiamine (vit b1)

causes beriberi or wernicke-korsakoff; neuro sx; often seen in alcoholics and patients with recent weight loss surgery

130

supracondylar fracture associated with what other injury

brachial artery injury leading to decr radial pulse so always check radial pulse

131

most common fracture in kids

supracondylar fracture

132

technetium-99m pertechnetate scan

meckle's diverticulum; painless hematochezia; technetium stains the ectopic gastric tissue in meckel'ss

133

hematochezia

bright red stools

134

WPW on ECG

shortened PR interval, delta waves, and widening of QRS

135

continuous antibiotic prophylaxis in rheumatic heart disease- why?

patients with a history of rheumatic fever are at high risk for recurrent GABHS pharyngitis; preferred regimen is IM penicillin every 4 weeks

136

muscle spasms

think tetanus; neonatal tetanus is fatal if left untreated; neonatal tetanus often follows umbilical stump infection

137

Wiskott-Aldrich syndrome

thrombocytopenia with skin lesions characteristic of eczema and a hx of multiple bacterial infections; decreased platelet production is the cause; x-linked

138

why howell jolly bodies in sickle cell diseae

these patients often have infarcted spleens that

139

heinz bodies and bite cells

g6pd def

140

basophillic stippling

thalasemmias or lead poisoning

141

freidrich ataxia

most common type of spinocerebellar ataxia; degeneration of the spinal tract; also causes concentric hypertrophic cardiomyopathy, diabetes, skeletal deformities, cardiomyopathy is most common cause of death; absent ankle jerks

142

allergic contact dermatitis

CELL-mediated hypersens; not igeE mediated

143

developmental dysplasia of the hip

dislocation of the femoral head from the acetabulum; in kids 2 wks- 6 mos, get a hip u/s. in kids more than 6 mos get a hip xray bc by now the femoral head and acet are ossified

144

DDH suspected less than 2 weejs

no imaging, may resolve on its own

145

functional asplenia puts you at risk for infection w what organisms

pneumococcus, h influenza,

146

intestinal obstruction in a neonate management

abdominal xray for pneumoperitoneum for a perforated bowel; next step is contrast enema, which will differentiate between meconium ileus and hirschsprung

147

microcolon on contrast enema

meconium ileus; underused contracted colon as a result of viscous meconium

148

treatment for meconium ileus

hyperosmolar enema to dissolve the meconium

149

when is sweat chloride testing indicated for suspected CF?

greater than 2 weeks old because they do not make sweat before then

150

contrast enema demonstrates transition zone between sigmoid colon and dilated megacolon

hirschsprung

151

Jervell-Lange-Nielson syndrome

long QT and congenital deafness;

152

nursemaid's elbow

radial head slips through part of the annular ligament; child keeps arm pronated and refuses forearm supination

153

3 pathognomonic facial dysmorphisms for fetal alc poisoning

thin vermillion border; smooth filtrim; small palpebral fissues

154

fragile x syndrome face

long narrow face, prominent forehead and chin, large ears, macrocephaly

155

macroorchidism

fragile x syndrome

156

Werdnig-hoffman syndrome

AR disorder involving degeneration of anterior horns and CN motor nuclei

157

trachoma

caused by chlamydia trachomatis. Major cause of blindess, follicular conjunctivitis and pannus (neovascularization) formation in the cornea. Concurrent nasopharynx infxn.

158

treatment for trachoma

topical tetracycline or oral erythromycin

159

mild vit k def

prolonged PT and normal PTT; severe would be prolonged both

160

murmur with hypertrophic myopathy

increases with standing, which decr venous return

161

freidrich taxia

aut recess; excessive trinuc repeats; progressive; necrosis of cardiac muscle and myocarditis,

162

differential for t wave inversion

MI, myocarditis, old pericarditis, myocardial contusion and digoxin toxicity

163

copies a cross and circle

three years

164

copies a rectangle

four years

165

copies a triangle

five years

166

copies a diamond

six years

167

osteogenesis imperfecta type II

fractures, blue sclerae and short, ben extremities; aut dom; typically die in utero for type 2

168

lisch nodules of the iris

associated with neurofibromatosis type 1

169

tuberous sclerosis

ash leaf hypopigmentation, cardiac rhabdomyomas, kidney angioleiomyomas, mental retardatio, seizures

170

sturge weber syndrome

a neurocutaneous syndrome

171

cholesteatoma

growth of squamous epithelium in the middle ear; they are destructive; can lead to infection

172

meniere's diseae

vertigo, tinnitus, hearing loss; more common in adults

173

otosclerosis

abnormal bone growth in the middle ear that causes hearing loss

174

osteoma

benign bony overgrowth that can form in the outer ear and lead to hearing loss

175

nonpitting vs pitting lymphedema

pitting is CHF, liver failure, nephrotic syndrome;

176

measles is more severe than rubella in what way?

higher fever, darker rash

177

erythema multiforme

target lesions; usually follows herpes simplex infection

178

choledochal cyst

cystic dilation of the bile duct

179

acholic stools

clay colored or pale; due to problems in biliary system

180

waterhouse-friderichson syndrome

seen w meningococcemia; adrenal gland failure causes death

181

pseudomonas

gram neg rod

182

gram pos diplococci

strep pneumo

183

gram pos cocci in clusters

staph

184

gram neg cocci

neisseria

185

gram pos rods

listeria and bacillus

186

GNRs

pseudomonase, h. flu, klebsiella, legionella

187

todd's paralysis

post-ictal paralysis

188

treatment for minimal change disease

steroids

189

iron poisoning

anion gap met acidosis

190

TCA antidepressant intox

sodium bicarb

191

HUS preceded by what?

diarrheal illness like EHEC, shigella, salmonella, yersinia, and campylobacter; causes microangiopathic hemolytic anemia

192

diff between DIC and microangioathic hemolytic anemia

PTT and PT are prolonged in DIC

193

hepatosplenomegaly, target cells, microcytosis, hypochromia, and anisopoikilocytosis

thalasemmias

194

macrocytosis and hypersegmented neutrophils

B12 def or folate def

195

microcytic with basophilic stippling

lead poisoning