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1

Cause of hemophilia A

Factor VIII

Hemophilia B is Factor IX

2

What is considered precocious puberty?

Girls 8 or younger
Boys 9 or younger

3

What causes precocious puberty in obese children?

Isolated premature adrenarche

Oily hair/skin, pubic/axillary hair, acne. Generally will not have menarche/thelarche.

Mediated by DHEA-S

4

Where does the abdomen begin with regard to penetrating injury?

Anything below the nipple is considered to involve abdomen and thorax until proven otherwise.

5

Indications for ex-lap after penetrating injury

Injury to abdomen or chest below nipples with:
-HD instability
-Peritoneal signs
-Evisceration

6

Symptoms of Wilson's Dz

Liver disease (children/adolescents)
Neuropsych disturbances (tremor, rigidity, depression, catatonia)

7

Diagnosis of Wilson's dz

Ceruloplasmin

8

What is seen on liver biopsy in A1AT deficiency?

Emphysema & early liver failure

PAS-positive and diastase-resistant granules

9

What drugs cause intersitial nephritis?

Cephalosporins
Penicillins
Sulfa drugs
NSAIDs
Phenytoin
Allopurinol

10

Symptoms of drug-induced interstitial nephritis

Arthralgias
Rash
Acute renal failure
Eosinophilic casts in urine

11

How long for exclusive breastfeeding?

First 6mo of life

12

Maternal benefits of breastfeeding

Reduced risk of ovarian and breast cancer

13

Infant benefits of breastfeeding

Prevention of AOM, NEC, respiratory infx, UTI
Decreased risk of T1DM & childhood cancer

14

Contraindications to breastfeeding

Galactosemia
Untreated maternal TB
Maternal HIV infection
Peripartum maternal varicella infx
Chemoradiation
Alcohol or drug abuse

15

Appearance of herpes lesions

Painful
Multiple, small, shallow, grouped ulcers
Tender LAD

16

Appearance of H. ducreyi infection

Single or multiple, painful
DEEP ulcers with ragged border
Base may have exudate
Matted LN's can rupture

17

Which STI ulcers are painful vs. painless

Painful: Herpes, Chancroid (H. ducreyi)
Painless: Syphilis, Chlamydia, Klebsiella granulomatis

18

Presentation of acute syphilis infection

Single, well-circumscribed painless ulcer
Clean base
Nontender LAD

19

Presentation of Chlamydial ulcers L1-L3 serovars

Small shallow painless ulcers
Painful buboes

20

Immune complex-mediated nephritic syndromes

Postinfectious GN
IgA nephropathy

21

Diagnosis of post-infectious GN

Oliguria, edema, HTN, coca cola colored urine, recent pharyngitis
Low serum C3
ASO titer

22

Treatment of IgA nephropathy

Glucocorticoids
ACEi's if proteinuria present

23

What are the types of nephritic syndrome?

Immune complex:
--Postinfectious GN
--IgA nephropathy

Pauci-immune:
--Wegener's granulomatosis

Anti-GBM:
--Goodpasture's syndrome
--Alport's syndrome

24

Treatment of Wegener's GN

High dose corticosteroids & cytotoxic agents

25

Treatment of Goodpasture's syndrome

Plasma exchange
Pulsed steroids

26

What is seen in Alport syndrome?

Hematuria
Sensorineural deafness
Eye disorders

Presents in boys 5-20y

27

Symptoms of nephritic syndrome

Proteinuria
Hematuria
Azotemia
RBC casts
Oliguria
Hypertension

28

Symptoms of nephrotic syndrome

Proteinuria (>3.5g per day)
Albumin low
Lipids high
Edema

29

What are the causes of nephrotic syndrome?

Minimal change disease
FSGS
Membranous nephropathy
Diabetic nephropathy
Lupus nephritis
Renal amyloidosis
Membranoproliferative nephropathy

30

Treatment of minimal change disease

Steroids

Most children have a full recovery