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peds102 Flashcards

1
Q

ITP blood labs

A

isolated thrombocytopenia

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2
Q

what is bleeding in renal failure patients due to?

A

dysfunctional platelets

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3
Q

chronic granulomatous disease puts you at risk for what infections?

A

catalase-producing organisms like staph aureus; neutrophils filled with bacteria are classic finding because they can still chemotax and eat the bacteria but just not do intracellular killing

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4
Q

chronic granulomatous disease- what diseases are you susceptible to?

A

pneumonias and adenitis are common because theses are caused by staph

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5
Q

adenosine deaminase def classic finding on CBC

A

lymphopenia because this leads to lack of maturation of B and T cells

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6
Q

common organisms that you are at risk for with adenosine deaminase activity

A

PCP, candida, paraflu, and herpes virus

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7
Q

when does complement consumption happen (and lead to immunodef)

A

diseases like vasculitis, glomerulonephritis, and certain connective tissue diseases. SLE

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8
Q

C3 def exposes you to risk of what kinds of infections

A

encapsulated bacteria, begins shortly after birth

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9
Q

most common primary immunodef

A

B cell maturation arrest; puts you at high risk for infections with encapsulated bacteria;

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10
Q

types of infections diGeorge syndrome patiens get

A

fungi and viral since T cell dysfunction is the hallmark

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11
Q

tetrad of HSP

A

palpable purpura, arthralgias, abdom pain, renal disease

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12
Q

platelets in HSP

A

normal

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13
Q

meabolic acidosis

A

think ischemia

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14
Q

causes of orbital cellulitis

A

staph and streps

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15
Q

IUGR, diaphoretic, and high pitched cry. Fetus was exposed to what?

A

heroin

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16
Q

fetal hydrantoin syndrome

A

phenytoin

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17
Q

nail and digit hypoplasia, dysmorphic facies and mental retardation

A

fetal hydantoin syndrome

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18
Q

NT defects, cardiac abnormalities, dysmorphic facies like cleft lip, narrow bifrontal diameter, midface hypoplasia, broad and depressed nasal bridge, long philtrum

A

valproic acid

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19
Q

growth deficiency, long smooth philtrum, small palpebral fissures, thin upper lip, in addition to CNS abnormalities like mental retard.

A

fetal alcohol syndrome

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20
Q

jitteriness, excessive sucking, and hyperactive moro reflex

A

cocaine in utero

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21
Q

neonatal abstinence syndrome

A

neonate withdrawal from opiates in the first few days of life; high pitched cry, tremors, seizures, sweating, sneezing, vomitting, diarrhea

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22
Q

Lesch-Nyan syndrome

A

self mutilation in the presence of dystonia; X-linked recessive; def in HPRT enzyme, leads to increased uric acid

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23
Q

clinical features of Lesch-Nyan syndrome

A

all due to build up of uric acid; hypotonia, persistent vomitting, progressive mental retard, choreoathetosis, spasticity, dysarthric speech, dystonia and compulsive self-injury; gouty arthritis, tophus formation, and obstructive nephropathy

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24
Q

treatemnt for Lesch-nyan

A

allopurinol to reduce uric acid levels; patients should also drink lots of fluids

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25
Q

why are SGA infants at risk for polycythemia

A

increased EPO in response to hypoxia

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26
Q

myotonia

A

delayed muscle relaxation

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27
Q

autoimmune myositis with symmetrical proximal muscle weakness, cutaneous findings, arthralgias, and dysphagia

A

juvenile dermatomyositis

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28
Q

mental retard, global developmental delay, hyperactivity, and long narrow face, large ears and macroorchidism

A

fragile x syndrome

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29
Q

contraindic to breast feeding

A

active untreated TB, maternal HIV, herpetic breast lesions, varicells infection less than 5 days before; certain meds; chemo or XRT; street drugs or alcohol

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30
Q

hand-foot syndrome (aka dactylitis)

A

earliest manifestation of vaso-occlusion in sickle cell anemia; acute onset of pain and swelling of hands and feet; fever sometimes

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31
Q

pathophys of hand-foot syndrome in sickle cell disease

A

vascular necrosis of the metacarpals and metatarsals, which may be seen on xray as osteolytic lesions

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32
Q

when giving IV fluid boluses

A

only isotonic solutions such as nromal saline or lactated Ringer’s should be used

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33
Q

hypernatremic hypovolemia bolus?

A

normal salie; later on you will deliver (non-bolus) hypotonic saline

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34
Q

signs of hypernatremia

A

lethargy, altered mental status, irritability, and seizures

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35
Q

organisms that cause septic arthritis in birth to 3 month

A

staph, GBS, and gram neg bacilli

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36
Q

antibiotics for septic arthritis birth to 3 mos

A

antistaph (nafcillin or vanc) PLUS gent or cef

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37
Q

organisms that cause septic arthritis in older than 3 mos

A

staph, GABHS and strep pneumo

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38
Q

antibiotics for septic arthritis in greater than 3 mos

A

nafcillin, clinda, cef, or vanc

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39
Q

causes of anemia of prematurity

A

transitions in the erythropoeisis site of the neonate; shorter life span of RBCs in neonates; diminished fetoplacental transfusion

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40
Q

metoclopramide

A

for gastric motility

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41
Q

4 neonatal rashes

A

erythema toxicum neonatorium, neonatal HSV, neonatal varicella, staph scalded skin syndrome

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42
Q

scttered erythematous macules, papules and pustules throughout the body of a neonate but spares palms and soles

A

erythema toxicum neonatorium; no treatment

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43
Q

vesicular clusters on skin, eyes, mucous membrnaes, CNS infection, fulminent dissem multiorgan disease

A

neonatal HSV

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44
Q

fever, rash ranges from vesicular clusters on skin to fulminant dissem disease

A

neonatal varicella

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45
Q

fever, irritability, and diffuse erythema followed by blishtering and exfoliation, pos Nikolsky sign

A

staph scalded skin syndrom

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46
Q

treatment for SSSS

A

oxacillin, nafcillin, or vanc

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47
Q

treatment for neonatal varicella

A

acyclovir

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48
Q

diagnosis of ALL

A

bone marrow biopsy (not lymph node biopsy) showing greater than 25% lymphoblasts

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49
Q

herpangina

A

throat infection caused by enteroviruses, like coxsackie A; ulcerative lesions on palate, tonsils, and pharynx

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50
Q

when herpangina is accompanied by lesions on the palms and soles

A

hand-foot-mouth disease

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51
Q

GB affects which nerves

A

primarily peripheral motor but sensory can also be affected

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52
Q

initial sx of tingling in the foot, followed by ascening weakness; polyneuropathy; flaccid paralysis in final stage

A

G-B

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53
Q

CSF analysis in G-B

A

elevated protein levels and mildly elevated cells

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54
Q

treatment for G-B

A

plasmapheresis or human immunoglobulin

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55
Q

fanconi anemia

A

chromosomal breaks on genetic analysis

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56
Q

treatment of fanconi anemia

A

hematopoeitic stem cell transplant

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57
Q

aplastic anemia, abnormal thumbs, hypogonadism, hypo or hyperpigmented skin, ear findings

A

fanconi anemia

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58
Q

total anomalous pulm venous connection

A

cyanotic disease; blood from lungs goes into the RIGHT atrium and there is ALSO an ASD which means this partially oxygenated blood goes from RA to LA

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59
Q

decreased pulmonary markings on CXR

A

pulmonary undercirculation

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60
Q

holosystolic murmur loudest at LLSB

A

VSD

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61
Q

complete AV canal defect

A

assoc with down syndrome; ASD and VSD

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62
Q

ebstein’s anomaly

A

assoc with maternal lithium use during pregnancy; displacement of tricuspid valve into the RV; results in severe tricuspid regurg and RA enlargement

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63
Q

paucity of vascular markings on CXR

A

tet of fallot and tricuspid valve atresia

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64
Q

boot shaped heart

A

RV hypertrophy, from tet of fallot

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65
Q

truncus is assoc with what syndrome

A

digeorge

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66
Q

treatment of pinworm (enterobius vermicularis)

A

albendazole or mebendazole is first line treatment; pyrantel pamoate is an alternative; NOT metronidazole, thiabendazole, or ivermectin

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67
Q

acute drop in hemoglobin in a sickle cell patient can be caused by what?

A

hyperhemolytic crisis, splenic sequestration, or an aplastic crisis

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68
Q

aplastic crisis in sickle cell disease is not the same as aplastic anemia

A

aplastic crisis in SS does not have drops in other blood cells

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69
Q

splenic sequestraton can lead to

A

severe hypotensive shock; accompanied by persistent reticulocytosis; rapidly enlarging spleen; high mortality; splenectomy recommended

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70
Q

vaso-oclusive crisis

A

acute onset of pain; severe anemia and low retics are not seen in vasoocclusive crises

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71
Q

rash, leukopenia, and thrombocytopenia

A

measles

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72
Q

vitamin A reduces the morbidity and mortality rates or patients with measles through immune enhancement

A

measles

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73
Q

calyceal clubbin (blunting of calices) and focal parenchymal scarring

A

chronic pyleonephritis

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74
Q

HBeAg

A

protein marker of viral replication and infectivity

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75
Q

encapsulated bacteria

A

Hib, strep pneumo, neisseria meningitidis, GBS, klebsiella, salmonella (HSKNGS)

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76
Q

nitroblue tetrazolium (NBT) slide test abnormal

A

chronic granulomatous disease

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77
Q

treatment of chronic granulomatous disease

A

prevention of infection with daily bactrim and gamma interferon three times a week

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78
Q

wiskott-aldrich syndrome

A

x linked recess; eczema, thrombocytopenia, and recurrent infections with encapsulated germs; presents at birth;

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79
Q

blood findings in wiskott-aldrich syndrome

A

thrombocytopenia, low IgM, high IgA and IgE, moderateley reduced T cells and platelets

80
Q

chediak-higashi syndrome

A

decreased degranulation, chemotaxis and granilopoeisis; neutropenia and giant lysosomes in neutrophils; treatm with daily bactrim and ascorbic acid

81
Q

mild coagulopathy, peripheral and cranual neuropathy, hepatosplenomegaly, pancytopenia, partial oculocutaneous albinism, freq bacterial infections and progressive lymphoproliferative syndrome

A

chediak-higashi syndrome

82
Q

Hyper-IgM syndrome

A

poor response to vaccines; less than 2% CD19+ B cells in the peripheral circulation

83
Q

parinaud’s syndrome

A

paralysis of vertical gaze that may be assoc with pupillary disturbances and eyelid retracton (collier’s sign); commonly caused by germinomas and pinealomas; endocrine syndrome due to interruption of the hypothal inhib pways

84
Q

treatment of lyme disease in kids less than 8

A

oral amoxicillin; it’s oral doxy in greater than 8 and not preg

85
Q

hypotonia, flat face, upward slanted palpebral fissures, epicanthal folds, Brushfield spots, dysplasia of the pelvis, cardiac malformations, simian crease, hypoplasia of middle phalynx of 5th finger

A

downs syndrome

86
Q

cleft lip, flexed fingers with polydactyly, ocular hypotelorism, bulbous nose, low-set malfromed ears, small abnormal skull, cerebral malform, micropthalmia

A

Patau’s syndrome (trisomy 13)

87
Q

microcephaly, protruding metopic suture, cat-like cry, hypotonia, short stature, moonlike face, hypertelorism, bilateral epicanthic folds, mental retard

A

cri-du-chat syndrome, 5p deletion

88
Q

microcephaly, prominent occiput, micrognathia, closed fists with index finger overlapping the 3rd digir and the 5th digit overlapping the 4th, and rocker bottom feet

A

edwards syndrome

89
Q

when does chlamydia conjnctivitis present? Chlamydia pneumonia?

A

conjunctivitis days 5-14 of life; pneumonia age 4-12 weeks

90
Q

treatmen of BOTH chlamydial conjunctivitis and pneumonia

A

14 day course or oral erythromycin, though there is a risk of hypertrophic pyloric stenosis with oral erythromycin

91
Q

cause of solitary lytic bone lesions

A

langerhans cell histiocytosis

92
Q

langerhans cell histiocytosis

A

clonal proliferation of langerhans cells (abnormal cells deriving from bone marrow and capable of migrating from skin to lymph nodes); isolated bone lesions or multisystem disease

93
Q

histiocytoses

A

abnromal proliferation of histiocytes (activated dendritic cells and macrophages); related to abnormal prolif of WBCs like leukemias and lymphomas

94
Q

most common cause of hypertension in kids

A

fibromuscular dysplasia

95
Q

polyuria and diaper candidiasis

A

red flags for DM type 1

96
Q

sideroblastic anemia

A

body has iron available but cannot incorporate it into hemoglobin. Sideroblasts are atypical erythroblasts that have accum of iron in them

97
Q

dysmorphic anemia

A

two pops or RBCs; commonly seen in transfusion patients

98
Q

treatment of impetigo

A

topical mupyricin; oral erythromycin is an alternative (not topical erythro)

99
Q

mupyricin

A

used for topical skin infections, including MRSA

100
Q

imipramine, amitryptaline, desipramine

A

TCAs; effective for nocturnal anuresis

101
Q

oxybutinin

A

anticholinergic that causes urinary retention; it can be used for use in combo with desmopressin to increae bladder capacity in kids with daytme incontinence

102
Q

meningococcus meningitis can cause a petechial or purpruic rash

A

in 75% of patients

103
Q

when do kids get the meningococcal vaccine

A

11-12 years old and then booster at age 16; at risk kids (asplenic) can get it as young as 2

104
Q

when do kids get the rotavirus vaccine?

A

between 2 and 8 mos; first dose between 6 and 14 weeks; final dose not beyond 8 months

105
Q

what kids get vision exam?

A

all kids 0-5 yo

106
Q

testicular volume in prepubertal boys

A

less than 3 mL

107
Q

increaed risk of male breast cancer

A

klinefelters

108
Q

small firm testes

A

klinefelters

109
Q

p24 antigen testing

A

detects the presence of the p24 protein of HIV

110
Q

most common primary bone tumor in kids

A

osteosarcoma

111
Q

second most common bone tumor in kids

A

ewing’s sarcoma

112
Q

spiculated sunburst pattern of bone on xray

A

osteosarcoma

113
Q

periosteal elvation known as Codman triangle

A

osteosarcoma

114
Q

alk phos and LDH elevated in osteosarcoma

A

from turnover of damaged osteocytes

115
Q

treatment of osteosarcoma

A

tumor excision and chemotherapy

116
Q

osteolytic lesion with a periosteal reaction that produces layers of reactive bone giving onion skin appearance

A

ewing’s sarcoma

117
Q

sclerotic cortical lesion on bone xray with central nidus of lucency

A

osteoid osteoma

118
Q

how does hydroxylurea work to manage sickle cell crises

A

causes the bone marrow to make new blood cells with hemoglobin F

119
Q

oligohydramnios can lead to flat facies and limb deformities

A

interesting

120
Q

excessive consumption f cows milk

A

can lead to iron def anemia

121
Q

beta thal

A

microcytic anemia

122
Q

seborrheic dermatitis

A

cradle cap’ cause unknown

123
Q

atopic dermatitis distribution in kids

A

face, scalp and extensor sufaces (different from distribution seen in adults)

124
Q

first line treatement for pertussis

A

macrolide antibiotic like erythromicin, azithromycin, or clarithromycin

125
Q

pansystolic murmur over left lower sternal border and diastolic murmur at the apex

A

VSD; the diastolic murmur is due to increased flow across the mitral valve

126
Q

wide split and fixed S2, systolic ejection murmur in the left upper sternal border, and sometimes if it is large, diastolic murmur at LLSB

A

ASD

127
Q

elevated 17-oh progesterone

A

CAH

128
Q

loud P2

A

pulmonary hypertension

129
Q

parotitis

A

think mumps

130
Q

orchitis

A

think mumps

131
Q

sore throat, hyperemic and edematous mucous membranes, chilitis, stomatitis, glossitis, normocytic normochrmic anemia, seborrheic dermatitis, and photophobia

A

riboflavin (vit B2) def

132
Q

cheilitis

A

inflamm of the lips

133
Q

stomatitis

A

inflamm of the mouth

134
Q

impaired collagen synthesis and damaged connective tissue; ecchymosies, petechiae, bleeding gums, hyperkeratosis, Sjogren’s, arthralgias, and impaired wound healing

A

ascorbic acid def (vit C)

135
Q

pellagra

A

niacin def (vit b3)

136
Q

symmetric reddish rash in exposed areas of skin, red tongue, nonspec symptoms

A

pellagra

137
Q

infantile and adult beriberi

A

thiamine (b1) def

138
Q

fulminant cardiac syndrome with cardiomegaly, tachycardia, cyanosis, dyspnea, and vomiting

A

thiamine def (infantile beriberi)

139
Q

photophobia, drya scaly skin, dry conjunctiva, dry cornea, and a wrinkled cloudy cornea; bitot spots and follicular hyperkeratosis of the shoulders, butt and extensor surfaces are less common findings

A

vit A def

140
Q

anorexia, pruritis, lack of weight gain, incr irritability, limitation of motion, tender swelling of bones, alopecia, seborrheic cutaneous lesions, incr ICP, hepatomegaly

A

hypervitaminosis A (ingestion of excessive vit A)

141
Q

crigler-najjar

A

inherited def of UDP-glucuronyl transferase that results in unconj hyperbilirubinemia; patients die in the first year

142
Q

gilbert’s syndrome

A

inherited def in UDP glucouronyl transferase and leads to unconj hyperbilirubinemia

143
Q

ankylosing spondylitis

A

inflamm of the spine that can lead to fusion

144
Q

spondylolisthesis

A

forward displacement of a vertebra, commonly in lumbar spine; results in back pain and neuro disfunction

145
Q

kids must be at least 2 kg to get vaccines

A

remember in premies

146
Q

sinopulm infections and intermittent episodes of diarrhea since childhood

A

igA deficiency, since IgA is involved in mucosal barrier protection

147
Q

why are patients with iga def at risk for anaphylactic transfusion reactions?

A

they form antibodies to iga that they get from the transfused blood

148
Q

hypoparathyroidism, thymic aplasia, hypocalcemia, cleft palat, and congenital heart disease

A

digeorge syndrome

149
Q

predisposes to fungal infections

A

digeorge because T cell def

150
Q

sinopulm infections and pseudomonas

A

x linked agammaglobulinemia (bruton’s)

151
Q

x linked combined B and T cell disorder

A

wiskott-aldrich

152
Q

recurrent otitis media, eczema, and thrombocytopenia

A

wiskott aldrich

153
Q

recurrent resp infections, sinus disease, pancreatic insuff, and infertility

A

CF

154
Q

elevated IgM and depressed IgG and IgA

A

hyper-IgM syndrome

155
Q

susceptible to Giardia and recurrent sinopulm infection, lymphoid hyperplasia common

A

hyper-igM

156
Q

first line drugs for primary generalized tonic clonic seizures or partial seizures with ot without secondary generalization

A

phenytoin and carbamazepine

157
Q

first line agent for mixed seizures

A

lamotrigine

158
Q

drugs for absence seizures

A

ethosuximide and valproic acid

159
Q

side effects of phenytoin

A

gingival hypertrophy, lymphadenopathy, hirsutism, and rash

160
Q

side effect of phenytoin and carbamazepine in the first several weeks of therapy

A

stevens johnson syndrome and toxic epidermal necrolysis

161
Q

aut dom mutation of COL1A1

A

osteogenesis imperfecta

162
Q

osteopenia, with blue sclerae, recurrent fractures, easy bruisability, hypotonia, and hearing loss

A

OI

163
Q

dentinogenesis imperfecta

A

blue gray to yellow brown discoloration caused by dentin shining through the weak enamel in OI

164
Q

aortic root dilation

A

marfan syndrome

165
Q

retinal hemorrhages and subdural hematomas

A

child abuse

166
Q

most common affected sites in NEC

A

terminal ileum and colon

167
Q

feeding intolerance, incr abdominal girth, bloody stools, and vomitting

A

classic features of NEC

168
Q

pneumatosis intestinalis on abdominal xray

A

NEC

169
Q

bloody stools, uncommon in the neonate

A

intussception

170
Q

“target sign” on xray or US of abdomen

A

intussusception

171
Q

vomitting and abdominal pain n neonates less than 1 month

A

malrotation with midgut volvulus

172
Q

gasless abdomen on xray

A

malrotation, due to obstruction in the duodenum

173
Q

toga virus

A

rubella

174
Q

rubella transmission in the first 4 weeks of pregnancy

A

risk of CRS is 50%, but drops to % if transmission in the third trimester

175
Q

IUGR, deafness, PDA or ASD, micropthalmia, cataract, retinopathy, hepatosplenomegaly, thrombocytopenia and CNS involvement

A

congenital rubella syndrome

176
Q

purple skin lesions

A

blueberry muffin baby rubella

177
Q

port wine stain on the trigeminal nerve distribution, mental retard, seizures and glaucoma

A

sturge-weber

178
Q

hydrocephalus, cerebral calcification, chorioretinitis, microcephaly, and micropthalmis

A

CMV and toxo

179
Q

lymphedema, high-arched palate, congenitally bicuspid aortic valves, coarctatin of the aorta

A

turners syndrome

180
Q

anaphylaxis

A

ige- mediated type 1hypersensitivity reaction

181
Q

post-exposure prophylaxis for varicella for patients greater than 1 yr who are immunocomp

A

varicella vaccine

182
Q

post-exposure prophylaxis for immunocomp hosts

A

varicella zoster immunoglobulin within 10 days of exposure; can reduce disease severity

183
Q

how can H-S lead to intussuscepton

A

causes a hematoma that acts as a lead point

184
Q

periodic abdominal pain assoc with drawing the legs up toward the abdomen, emesis may follow these episodes

A

intusussception

185
Q

currant jelly stools

A

intussception that is not treated and causes ischemia; currant jelly is grossly bloody

186
Q

tubular sausage shaped mass in the RUQ

A

intussusception

187
Q

what imaging to detect intussusception

A

ultrasound

188
Q

most common organism in osteomyelitis

A

staph aureus; also GBS and e coli in infants and strep pyogenes in children

189
Q

osteomyelitis assoc with prosthetic devices. What organism?

A

staph epidermis

190
Q

osteomyelitis when patient has a history of UTI. What organisms

A

klebsiella and pseudomonas

191
Q

air xray for bronchiolitis

A

air trapping or atelectasis may be seen

192
Q

ribavirin

A

administer to kids at high risk for RSV

193
Q

contraindic to rotavirus vaccine

A

history of intussusception, history of uncorrected congenital malform of the GI tract like meckel’s; severe combined immunodef

194
Q

at what age is the rotavirus vaccine series given

A

age 2-6 months; there is a risk of intussusception with this vaccine

195
Q

anemia, heat intolerance, steatorrhea, wheezing, hemoptysis, clubbing, rectal prolapse, hx of neonatal jaundice

A

CF

196
Q

complications of prolonged CF

A

gallstones, cirrhosis with portal htn, and pancreatic fibrosis

197
Q

pos Coomb’s test

A

autoimmunue hemolytic anemia (warm antibodies directed against RBCs). Typical patient is 2 to 12 yo and the anemia is usually acute and transiet lasting 3-6 mos; freq preceded by infection

Peds (99 decks)

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