Principles 3 Flashcards

1
Q
A
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2
Q

Do not Rotavirus vaccine to a child with history of __________

A

intussusception

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3
Q

Precautions should be taken when giving MMR Varicella vaccine to a child with personal or family history of _________

A

seizure

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4
Q

____________ is the most common form of glomerulonephritis in the pediatric age group.

A

ACUTE POSTSTREPTOCOCCAL GLOMERULONEPHRITIS (APSGN)

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5
Q

Which is more common

APSGN Following Throat Infection

APSGN Following Skin Infection

A

APSGN Following Skin Infection

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6
Q

Clinical features of VSDs
Breathlessness, feeding difficulties, FTT, profuse sweating, chest infections etc. Congestive cardiac failure early in infancy
________ murmur: best heard at ________________

-________ (in the presence of pulmonary hypertension)

-______________ murmur (due to increased blood flow across mitral valve)

A

Pan-systolic

lower left sternal border (LLSB)

Loud P2

Apical mid-diastolic

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7
Q

Paradoxical embolism: this is the blockage of a _________ by a thrombus formed in a ___________, which has passed through a defect in the heart. This defect is usually a patent foramen ovale (PFO) but may also be a VSD or ASD

A

systemic artery

systemic vein

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8
Q

Clinical features of PDA

Asymptomatic (small PDA)
-Breathlessness, feeding difficulties, FT, profuse sweating, chest infections etc.
-_______________ murmur best heard over the left 1” and 2ndCI spaces Others: wide pulse pressure, apical mid-diastolic murmur, splitting of Sz, loud 2P

A

Continuous machinery

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9
Q

CVS findings in TOF:

_________ murmur at ______ or _______ murmur at _________, a single S2, and ________________ heave with or without systolic thrill

A

pansystolic ; LLSB

ejection systolic; LUSB

left parasternal

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10
Q

Hypercyanotic spells (hypoxic, Tet or blue spells)

These are paroxysms of _________,___________ , agitation, vigorous cry, increasing _________, and ———— intensity of murmur; which folows events causing sudden decrease in oxygen saturation and or systemic vascular resistance e.g. crying,
defecating, playing etc.
Unconsciousness, convulsions, hemiparesis and death may folow severe spells

A

hyperpnea ; restlessness

cyanosis; reduced

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11
Q

• Treatment of Tet spells: _________ position, supplemental oxygen, _________ (for volume expansion), ________ (intranasal midazolam or fentanyl are alternatives), _______ (IV propranolol or esmolol), _________________ (if metabolic acidosis is present)

A

knee-chest

IV fluids

IV morphine

B-blockers

Sodium bicarbonate

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12
Q

egg-on-a-string on X-ray is for?

A

Transposition of great vessels

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13
Q

Constant Features of Down syndrome
List 3

A

Hypotonia
Developmental delay
Mental retardation

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14
Q

Other Features of Down syndrome

Head: ______cephaly, ______cephaly,______ ears, _______ tongue, ______ nasal bridge

Eyes: __________ palpebral fissures, ___________ , epicanthal folds, brushfield spot, ____________

A

brachy; micro; small

protruding; flat

upslanting; cataract

strabismus

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15
Q

Other features of Down syndrome

Cardiovascular: ________________ defects, VSD, ASD, PDA

Musculoskeletal: ________ neck with ________ skin, ________ 5th digit with clinodactyly, wide gap between ________ and ___________ , _____________________ palmar creases

A

endocardial Cushing defects,

short ; redundant skin

short ; 1st and 2nd toes

single transverse

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16
Q

Other features of Down syndrome

Gastrointestinal: _______________ , annular pancreas, __________ , _______________

Others: _________ disorders, __________ dx, ______thyroidism, _________ , ________ , AL, AML etc.

A

duodenal atresia

T-E fistula

imperforate anus

behavioral ; Alzheimer

hypothyroidism ; obesity

DM

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17
Q

Neuroblastoma

Genetics: most cases are _______, only about 1-2% are ________

A

sporadic; familial

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18
Q

Neuroblastoma

Familial cases occur at a younger age, and are associated with mutations in ________ and ________ genes

A

PHOX2B and ALK

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19
Q

Clinical Presentation of neuroblastoma : depends on tumor site and extent of the disease

• Tumor site
Neck: _____________
Paraspinal: _________ and _________ __________

A

Horner syndrome (ptosis, myosis; anhidrosis)

Spinal cord and nerve root compression

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20
Q

Associated anomalies with neuroblastoma : _________ disease, _______________ syndrome, and ____________ type I

A

Hirschsprung disease

central hypoventilation syndrome

neurofibromatosis type I

21
Q

According to ________________ hypothesis, ______ mutations in the RB1 gene are required for retinoblastoma to develop

A

Knudson’s “two-hit”

2

22
Q

Microscopically, retinoblastoma classicaly appears as a small round blue cell tumor, with rosette formation (____________________ rosettes)

A

Flexner-Wintersteiner

23
Q

List the hypotonic crystalloid fluids

A

0.45% NaCI (1/2 NS)
0.2% NaCI (1/4 NS)
0.33% NaCI (1/3 NS)
2.5% dextrose in water

24
Q

List the isotonic crystalloid fluids

A

Normal saline (0.9% NaCl)
Ringer’s lactate solution
5% dextrose in water

25
List the hypertonic crystalloid fluids
5% NaCl 3% NaCl 5% dextrose in 0.9% saline 5% dextrose in 0.45% saline 10% dextrose in water 50% dextrose in water
26
Limitation/Contraindications of normal saline : ______________ failure, severe __________ impairment, _____________ etc
congestive cardiac failure severe renal impairment liver cirrhosis
27
____________ is the most physiological IV fluid; it has electrolyte content similar to that of plasma
Ringer’s lactate
28
The ____________ in Ringer’s lactate is metabolized to _________ in the liver, which helps to correct metabolic acidosis
sodium lactate bicarbonate
29
Limitation/Contraindications of Ringer’s lactate Severe ________ disease Metabolic ____________ e.g. in severe vomiting, gastric outlet obstruction Patient on ________________ (It may promote clot formation, as Ca binds citrate) Others: congestive cardiac failure, severe renal impairment, hypoxia etc.
liver alkalosis blood transfusion
30
The fluid of choice for maintenance and replacement of ongoing loss in pediatrics is???
5% Dextrose in 0.45% NaCl (D5 1⁄2NS)
31
It is recommended that maintenance KCL (_____mEq) be added to each ______ of D5 1⁄2NS in patients with no underlying electrolyte derangement, and NOT in the ___________ age group
20 liter neonatal
32
_______ fluid is used for the Hydration of neonates in the first 48 hr of life
10% dextrose in water
33
_______ is superior to mannitol in treating raised ICP
3% NaCl
34
Normal Head circumference at birth is ???
35cm
35
Rate of increase of Normal Head circumference from birth is ???
2 1 0.5 2 1.5 1
36
About 5-10% of birth weight (BW) is lost within the first _______ of life birth weight (BW) returns around ___________ of life
5-7 days 10-14 days
37
A term baby doubles its BW around ___________ and triples it around _____________
4-5 months 12 months
38
Daily weight gain is ______g in the first 3-4 mo, and ______ gfor the rest of 1st vr
20-30 15-20
39
Birth weight Measuring device: _________________ (at <2 yr) or ___________ (at ≥2 vr)
Bassinet weighing scale Stadiometer
40
Formulae for weight 4months - 12 months 1year to 6 7 years to 12
n+9/2 2n+8 7n-5/2
41
Length is measured in children <____yr using the ___________
2 Infantometer
42
Worthy of note is that length is about 1-2cm greater than height T/F With reason
as joint spaces are reduced by gravity while standing
43
Mid-Upper Arm Circumference (MUAC) It remains fairly constant ni children, between ages ________ , thus, it is particularly relevant in this age group
1-5 yr
44
MUAC It is measured midway the distance between the _________ and ________
acromium and olecranon
45
Head circumference Measurement: an inelastic tape measure is passed (inches up) around the head through the supraorbital ridges and _________ in front and the _________ behind
glabella occiput
46
47
Moderate VA severe dehydration Using the first 11 parameters
Restless, irritable ; drowsy, lethargic , unconscious Depressed; sunken Slightly sunken; deeply sunken Reducer; absent Dry; very dry and parched Eager to drink; unable to drink Rapid; deep and rapid Recoils in <2s ; Recoils in >2s Rapid and thready; feeble or absent Prolonged; much prolonged Oliguria; Anuria
48