peds101 Flashcards

1
Q

antibiotic activity against pseudomonas for Cf patients

A

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

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2
Q

digeorge syndrome

A

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

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3
Q

2 year old vocab

A

150-300 words

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4
Q

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

A

edwards syndrome, trisomy 18

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5
Q

heart defect in trisomy 21

A

ASD or endocardial cushion defect

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6
Q

william’s syndrome heart defect

A

supravalvular aortic stenosis, pulm stenosis, or septal defects

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7
Q

what are the CATCH-22 syndromes

A

digeorge and velocardiofacial

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8
Q

what cardiac abnormality is assoc with the catch-22 syndromes

A

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

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9
Q

interupted aortic arch

A

almost always assoc with VSD

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10
Q

congenital heart block assoc with what?

A

neonatal lupus

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11
Q

PDA assoc with what?

A

congenital rubella

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12
Q

coronary artery aneurysms

A

kawasaki disease

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13
Q

treatement of pertussis

A

macrolides in catarrhal stage; less effective later on

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14
Q

macrolide abx

A

azithromycin, clarithromycin

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15
Q

post-tussive emesis

A

think pertusis

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16
Q

hemophilic arthropathy

A

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

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17
Q

patient with alkali ingestion

A

upper GI endoscopy

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18
Q

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

A

intraosseus cannulation; osteomyelitis is a rare complication

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19
Q

vitD supplementation in breast fed babies

A

400 IU daily

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20
Q

treatment of rickets

A

1000-2000 IU daily of vit D

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21
Q

congenital syphilis

A

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

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22
Q

cupping and fraying of the metaphyses of the lung bones

A

sign of rickets on xray

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23
Q

postpericardiotomy syndrome

A

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

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24
Q

CHF on chest xray

A

pulm vascular congestion and interstitial edema

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25
Q

treatment for OCD

A

fluoxetine or other high dose SSRI

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26
Q

dermatitis herpetiformis

A

itchy blistering rash assoc with celiac disease

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27
Q

prolonged PR interval on EKG

A

think rheumatic fever

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28
Q

therapy in pericarditis

A

salicylates

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29
Q

paramyxo virus

A

measles and mumps

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30
Q

most common organism responsible for pericarditis

A

coxsackie virus

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31
Q

leukocyte def type 1

A

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

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32
Q

leukocyte def type 1 on lab

A

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

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33
Q

adenosine deaminase def

A

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

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34
Q

nitroblue tetrazolium test

A

neg (abnormal) in chronic granulomatous disease

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35
Q

chronic granulomatous disease pathophy

A

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

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36
Q

developmental defects in the pharyngeal arch system

A

digeoge

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37
Q

digeorge immune def

A

T cell def; also thymic hypoplasia

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38
Q

opsonization defects result from what

A

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

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39
Q

preseptal cellulitis

A

aka periorbital cellulitis

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40
Q

proptosis

A

eyes popping out

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41
Q

murmur in coarctation of the aorta

A

heard all over the chest due to collaterals developing

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42
Q

rib notching

A

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

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43
Q

pericardial calcification

A

constrictive pericarditis

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44
Q

how to diagnose absence seizure

A

ask patient to hyperventilate; it should mimic the seizure

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45
Q

no post-ictal state in absence seizures

A

right

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46
Q

differentiating between typical and atypical absence seizure

A

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

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47
Q

iron poisoning tx

A

deferoxamine

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48
Q

TCA and aspirin overdose antidote

A

sodium bicarb

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49
Q

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

A

mag sulfate

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50
Q

severe lithium toxicity

A

hemodialysis because lithium is very dializable

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51
Q

hyperkalemia- give what to protect the heart

A

calcium gluconate

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52
Q

oral succimer

A

lead poisoning chelating agent

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53
Q

pediatric viral myocarditis caused by what

A

coxsackie or adenovirus

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54
Q

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

A

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

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55
Q

myocarditis on echo

A

global hypokinesis

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56
Q

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

A

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

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57
Q

can you see wheezing in a patient with pulm edema?

A

yes

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58
Q

blue sclerae and hearing loss

A

osteogenesis imperfecta; defect in type 1 collagen

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59
Q

fibrillin-1 defect

A

marfans

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60
Q

the most common predisposing factor for bacterial sinusitis

A

viral URI

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61
Q

treatment for bacterial sinusitis

A

amox plus clavulonic acid

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62
Q

kid with uti less than 24 mos

A

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

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63
Q

koplik’s spots

A

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

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64
Q

rash in measles

A

starts on face and spreads to trunk and extremities

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65
Q

herpes virus 6 causes what rash

A

roseola infantum

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66
Q

croup aka

A

laryngotracheobronchitis

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67
Q

laryngeal diptheria

A

can present like croup; in an unvaccin kid

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68
Q

hypointense center with ring enhancement on brain CT

A

brain abscess

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69
Q

bullous myringitis

A

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

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70
Q

cholesteatoma

A

growth of squamous epithelium in the middle ear

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71
Q

what condition is assoc with false pos RPR test results

A

lupus

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72
Q

cystic hygroma

A

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

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73
Q

clubfoot management

A

stretching, manipulation of the foot, and serial casting

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74
Q

terbinafine

A

a topical antifungal

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75
Q

mongolian spot

A

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

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76
Q

babinski reflex

A

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

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77
Q

acute unilateral lymphadenitis

A

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

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78
Q

difference between craniopharyngioma and pituitary tumor

A

craniopharyngioma has calcifications; pit tumor secretes prolactin in addition

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79
Q

adolescent with nosebleeds, nasal mass, and nasal obstruction

A

think juvenile angiofibroma until proven otherwise

80
Q

treatment of juvenile angiofibroma

A

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

81
Q

what is an endocardial cushion defect?

A

AV septal defect; assoc with Down syndrome

82
Q

midsystolic click with late systolic murmur

A

mitral valve prolapse

83
Q

transposition of the great vessels often seen in what patients

A

infants of diabetic mothers; and males

84
Q

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

A

laryngomalacia

85
Q

management of laryngomalacia

A

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

86
Q

stridor ddx

A

croup, laryngomalacia, foreign body,

87
Q

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

A

laryngomalacia

88
Q

when does laryngomalacia present

A

4-8 months, resolves by 18 mos

89
Q

most common cause of chronic stridor in infants

A

laryngomalacia

90
Q

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

A

GER

91
Q

vascular rings, biphasic stridor, and feeding difficulties

A

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

92
Q

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

A

retropharygeal abscess

93
Q

prevertebral soft tissue thickening

A

retropharyngeal abscess

94
Q

pain with eye movements, proptosis, opthalmoplegia, and diplopia

A

orbital cellulitis; bacterial sinusitis is the most common predisposing factor

95
Q

beckwith-weidemann genetics

A

11p15 mutation

96
Q

beckwith-weidemann physical exam

A

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

97
Q

complications of b-w

A

wilms tumor, hepatoblastoma

98
Q

surveillance in w-d syndrome

A

serum alpha protein, abdominal/renal ultrasound

99
Q

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

A

they produce excess insulin like growth factor

100
Q

most common complication in patients with sickle cell trait

A

painless hematuria

101
Q

hep B assoc with what renal disease?

A

membraneous nephritis

102
Q

most common cause of nephrotic syndrome in kids

A

minimal change disease

103
Q

classic triad of congenital rubella syndrome

A

deafness, cataracts, cardiac defects (PDA, ASDs)

104
Q

eczema herpeticum

A

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
Q

HSP

A

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
Q

complications of HSP

A

GI hemorrhage and intussusception

107
Q

intussusceptions in HSP

A

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

108
Q

small bowel intussusception on u/s

A

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

109
Q

serum sickness like reaction occurs when

A

like 1-2 weeks after you have taking an antibiotic

110
Q

how does maternal diabetes lead to RDS?

A

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

111
Q

how to treat cervical lymphadenopathy

A

usually caused by staph and strep; use dicloxacillin

112
Q

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

A

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

113
Q

diffuse muscle aches and elevated cpk in a seizure

A

indicates tonic-clonic

114
Q

Lennox-gaustat syndrome

A

mental retardation, seizures,

115
Q

cri-du-chat sndrome

A

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
Q

5p deletion

A

cru-di-chat

117
Q

4 p deletion

A

wolf-hirschorn

118
Q

wolf-hirschorn syndrome

A

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

119
Q

viruses that cause viral meningitis

A

enteroviruses like cocksackie and echovirus

120
Q

myotonic muscular distrophy (aka steinert diseae)

A

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

121
Q

conjucntivitis first 24 hours of life

A

chemical

122
Q

conjucntivitis days 2-5 of life

A

gonococcal; treat with IV or IM cef

123
Q

conjunctivitis on day 5-14 of life

A

chlamydia, treat with oral erythromycin

124
Q

blood stained eye discharge

A

chlamydial conjunctivitis

125
Q

prophylaxis against gonoccocal conjunctivitis

A

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

126
Q

treatment for absence seizures

A

ethosuximide or valproic acid

127
Q

Reye syndrome

A

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

128
Q

def of niacin (vit B3)

A

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

129
Q

def of thiamine (vit b1)

A

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

130
Q

supracondylar fracture associated with what other injury

A

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

131
Q

most common fracture in kids

A

supracondylar fracture

132
Q

technetium-99m pertechnetate scan

A

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

133
Q

hematochezia

A

bright red stools

134
Q

WPW on ECG

A

shortened PR interval, delta waves, and widening of QRS

135
Q

continuous antibiotic prophylaxis in rheumatic heart disease- why?

A

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

136
Q

muscle spasms

A

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

137
Q

Wiskott-Aldrich syndrome

A

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

138
Q

why howell jolly bodies in sickle cell diseae

A

these patients often have infarcted spleens that

139
Q

heinz bodies and bite cells

A

g6pd def

140
Q

basophillic stippling

A

thalasemmias or lead poisoning

141
Q

freidrich ataxia

A

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
Q

allergic contact dermatitis

A

CELL-mediated hypersens; not igeE mediated

143
Q

developmental dysplasia of the hip

A

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
Q

DDH suspected less than 2 weejs

A

no imaging, may resolve on its own

145
Q

functional asplenia puts you at risk for infection w what organisms

A

pneumococcus, h influenza,

146
Q

intestinal obstruction in a neonate management

A

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

147
Q

microcolon on contrast enema

A

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

148
Q

treatment for meconium ileus

A

hyperosmolar enema to dissolve the meconium

149
Q

when is sweat chloride testing indicated for suspected CF?

A

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

150
Q

contrast enema demonstrates transition zone between sigmoid colon and dilated megacolon

A

hirschsprung

151
Q

Jervell-Lange-Nielson syndrome

A

long QT and congenital deafness;

152
Q

nursemaid’s elbow

A

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

153
Q

3 pathognomonic facial dysmorphisms for fetal alc poisoning

A

thin vermillion border; smooth filtrim; small palpebral fissues

154
Q

fragile x syndrome face

A

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

155
Q

macroorchidism

A

fragile x syndrome

156
Q

Werdnig-hoffman syndrome

A

AR disorder involving degeneration of anterior horns and CN motor nuclei

157
Q

trachoma

A

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

158
Q

treatment for trachoma

A

topical tetracycline or oral erythromycin

159
Q

mild vit k def

A

prolonged PT and normal PTT; severe would be prolonged both

160
Q

murmur with hypertrophic myopathy

A

increases with standing, which decr venous return

161
Q

freidrich taxia

A

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

162
Q

differential for t wave inversion

A

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

163
Q

copies a cross and circle

A

three years

164
Q

copies a rectangle

A

four years

165
Q

copies a triangle

A

five years

166
Q

copies a diamond

A

six years

167
Q

osteogenesis imperfecta type II

A

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

168
Q

lisch nodules of the iris

A

associated with neurofibromatosis type 1

169
Q

tuberous sclerosis

A

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

170
Q

sturge weber syndrome

A

a neurocutaneous syndrome

171
Q

cholesteatoma

A

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

172
Q

meniere’s diseae

A

vertigo, tinnitus, hearing loss; more common in adults

173
Q

otosclerosis

A

abnormal bone growth in the middle ear that causes hearing loss

174
Q

osteoma

A

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

175
Q

nonpitting vs pitting lymphedema

A

pitting is CHF, liver failure, nephrotic syndrome;

176
Q

measles is more severe than rubella in what way?

A

higher fever, darker rash

177
Q

erythema multiforme

A

target lesions; usually follows herpes simplex infection

178
Q

choledochal cyst

A

cystic dilation of the bile duct

179
Q

acholic stools

A

clay colored or pale; due to problems in biliary system

180
Q

waterhouse-friderichson syndrome

A

seen w meningococcemia; adrenal gland failure causes death

181
Q

pseudomonas

A

gram neg rod

182
Q

gram pos diplococci

A

strep pneumo

183
Q

gram pos cocci in clusters

A

staph

184
Q

gram neg cocci

A

neisseria

185
Q

gram pos rods

A

listeria and bacillus

186
Q

GNRs

A

pseudomonase, h. flu, klebsiella, legionella

187
Q

todd’s paralysis

A

post-ictal paralysis

188
Q

treatment for minimal change disease

A

steroids

189
Q

iron poisoning

A

anion gap met acidosis

190
Q

TCA antidepressant intox

A

sodium bicarb

191
Q

HUS preceded by what?

A

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

192
Q

diff between DIC and microangioathic hemolytic anemia

A

PTT and PT are prolonged in DIC

193
Q

hepatosplenomegaly, target cells, microcytosis, hypochromia, and anisopoikilocytosis

A

thalasemmias

194
Q

macrocytosis and hypersegmented neutrophils

A

B12 def or folate def

195
Q

microcytic with basophilic stippling

A

lead poisoning