TN Qs Flashcards by ota ku

3 sign

COA

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6 week old baby presenting with increasing respiratory distress, diaphoresis, lerhargy

COA

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a child presented with exercise intolerance, easy fatigability

disparity in pulsation and BP in the arms and legs
Weak popliteal, posterior tibial, and dorsalis pedis pulses

COA

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a child presented with exercise intolerance, easy fatigability

late systolic murmur

MVP

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a child presented with exercise intolerance, easy fatigability

loud harsh blowing holosystolic murmur

VSD

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a child presented with exercise intolerance, easy fatigability

S2 widely split and fixed in all phases of respiration

ASD

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a child presented with exercise intolerance, easy fatigability

wide pulse pressure
bounding peripheral arterial pulses
continuous murmur

PDA

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a child with known CHD presents with fever, fatigue, weiggt loss, painful skin lesions on the fingers

child is an IV drug user

Pseudomonas

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a child with known CHD presents with fever, fatigue, weiggt loss, painful skin lesions on the fingers

Patient has poor oral hygiene

S. Viridans

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a child with known CHD presents with fever, fatigue, weight loss, painful skin lesions on the fingers

recent repair of VSD

Fungal

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a child with known CHD presents with fever, fatigue, weight loss, painful skin lesions on the fingers

underwent root canal

S. viridans

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A IUGR baby born to a mother with hx of infection during pregnancy

cutaneous scars

Imaging: cortical atrophy

Varicella

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A IUGR baby born to a mother with hx of infection during pregnancy

purpuric hemorrhage lesions all over the body

Rubella (blueberry muffin baby)

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A IUGR baby born to a mother with hx of infection during pregnancy

vesicular lesions on the face and mouth

HSV II

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A IUGR baby born to a mother with hx of infection during pregnancy

chorioretinitis
microcephaly
hepatosplenomegaly
Imaging: intracerebral calcifications

Toxoplasmosis

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A IUGR baby born to a mother with hx of infection during pregnancy

maculopapular rash
imaging: periostitis of the bone (rhagades, snuffles)

Syphillis

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Abdominal cramps, diarrhea, sweating, no fever

ham potato salad cream pastries

Staphylococus

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Abdominal cramps, diarrhea, sweating, no fever

home canned food
muscle weakness
diplopia
blurring of vision

Botulism

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Abdominal cramps, diarrhea, sweating, no fever

reheated fried rice

B cereus

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Abdominal pain, vomiting, +/- distention

bloody currabt jelly stool

sausage shaped RUQ mass / absence of bowel sound in RLQ
coiled sprin sign

intussusception

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Abdominal pain, vomiting, +/- distention

Cant pass NGT
severe pain, emesis

Xray: omega sign, coffee bean sign

colonic volvulus

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Abdominal pain, vomiting, +/- distention

normal hx or recurrent obstructive sx, painless rectal bleeding

scintigraphy scan to detect gastric tissue

meckels diverticulum

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Abdominal pain, vomiting, +/- distention

postprandial vomiting
nonbilous, abdominal distention

olive shaped mass

Barium: shoulder sign, double tract sign

Pyloric stenosis

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absent breath sound. pt is 3 y/o

foreign body

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Alopecia with neurological sx

Biotin (B7)

barking seal

croup

Bitot spot xerosis conjunctiva xerosis cornea

Vit A

``` blalock taussig shunt Gore Tex conduit aortopulmonary window shunt waterson cooley pott shunt ```

TOF

Bloody diarrhea, pus and WBC in stools abdominal cramps, systemic toxicity after antibiotic use

C. difficile

Bloody diarrhea, pus and WBC in stools abdominal cramps, tenesmus, abundant pus and WBC in stool

Shigella

Bloody diarrhea, pus and WBC in stools diarrhea with blood after eating hamburger

EHEC

Bloody diarrhea, pus and WBC in stools high fever, headache, drowsiness, confusion, meningismus, seizures, abdominal distention history of eating egss, poultry unpasteurized milk

Salmonella

Bloody diarrhea, pus and WBC in stools trophozoites with ingested RBC

amoebiasis

boot shaped heart

TOF

``` bowleg or knock knees caput quadratum, periostial osteoid craniotabes ping pong ball sensatiob rachitic rosary, pigeon chest harrison groove ```

Vit D

brassy cough

S. aureus

bubbly lungs (cystic lucencies)

BPD

child discovered to have asymptomatic microscopic hematuria during yearly check up at school patoent wears very thick glasses and wears hearing aid child has uncle with same condition

Alport syndrome

child with cough, colds, fever, wheezing, stridor hyperinflation w/ bilateral interstitial infiltrates & peribronchial coughing

RSV

child with cough, colds, fever, wheezing, stridor lobar consolidation

S. pneumonia

child with cough, colds, fever, wheezing, stridor prominent area of cavitation and multiple pneumatocele

Staph

child with cough, colds, fever, wheezing, stridor right sided hilar adenopathy

chills, fever, arthralgia, myalgia, acutely ill looking developing a bew heart murmur

S. aureus

coarctation of aorta associated with

Turner syndrome

coarse streaking granular pattern of both lung fields

meconium aspiration syn

cyanosis manifestibg after the first year of life, usually in an infant or toddler

TOF

cyanosis manifesting within few hours at birtg or within few days of life

TOGA

cysts appearing on the hard palate which is accumulations of epithelial cells

epstein pearls

disappears with sleep

habitual cough

edema, erythema, burning of sun exposed skin on neck and face hands on butterfly dermatitis around the neck diarrhea, dementia

Niacin (B3)

egg shaped cardiac silhoutte with a narrow, superior mediastinum

TOGA | egg on a string sign

figure of 8

TAPVR

finely granularr lungs; ground glass appearance

HND/RDS

Follicular hyperkeratosis perifollicular erythema and hemorrhage bleeding, swollen gums

Vit C

Follicular hyperkeratosis xerosis night blindness

Vit A

fontan procedure

tricuspid atresia

generalized scaly dermatitis alopecia thrombocytopenia failure to thrive

Essential Fatty Acid

hair that covers the skin of preterm infants. seen on term infants around the shoulders

lanugo

hx of atopy in the family. recurrent wheexing especially after mild viral infection or after exercise

asthma | 1st trigger: virus

hx of viral infection among the family members. pt is 2 y/o

bronchiolitis

Hyperostosis | absence of metaphyseal changes

Vit A toxicity

INFECTIVE ENDOCARDITIS (+) CVP (+) Prosthetic valves

Strep viridans

INFECTIVE ENDOCARDITIS after open heart procedure

Fungal

INFECTIVE ENDOCARDITIS GUT or lower bowel manipulation

Group D strep

INFECTIVE ENDOCARDITIS IV drug abuser

``` #1 Staph #2 Pseudomonas ```

INFECTIVE ENDOCARDITIS normal person, no underlying disease

Staph

INFECTIVE ENDOCARDITIS underlting heart disease dental procedure

Strep Viri

inverted e sign

COA

jaundice AFTER 24 H 2-3 DAYS baby normal

Physiologic

jaundice AFTER 24 H 3-4 days mother supplements feeding with sugar water

breast feeding jaundice

jaundice AFTER 24 H > 1 week baby is purely breastfed

breast milk jaundice

jaundice WITHIN 24 H | First born

ABO Incompatibility

jaundice WITHIN 24 H | history of maternal infection during preg

TORCH infection

jaundice WITHIN 24 H | history of prol 2nd stage of labor, no prenatal check up

Sepsis (PROM >18H)

jaundice WITHIN 24 H | second born child

RH incomp; ABO incomp

LM: Diffuse thickening of glomerular capillary walls IF: granular IgG C3 EM: sub epithelial deposits of electron dense material

Membranous GN

LM: focal segmental sclerosis and hyalinosis EM: loss of foot process, epithelial denudation

FSGS

LM: large, hypercellular glomeruli increased mesangial matirx double contour or tram track appearance

membranoproliferative GN

LM: normal EM: diffuse effacement of epithelial foot process, no deposits

Minimal change

most common solid tumor outside CNS

neuroblastoma

malignancy with highest mortality

BRAIN (PNET)

most common solid tumor

brain tumor

most common malignancy

leukemia ALL

most common soft tissue tumor

rhabdomyosarcoma

most severe in the morning

cystic fibrosis

mother is alcoholic | expected heart defect

VSD, PS

mother took aspirin | expected heart defect

PPHPN

mother took Lithiun | expected heart defect

Ebstein Anomaly

mother with DM | expected heart defect

TOGA

mother with RUBELLA | expected heart defect

PDA, Pulm Stenosis

mother with SLE | expected heart defect

complete heart block

mottling of the skin with venous prominence. cobblesrone, lacy appearance

cutis marmorata

Neonate presenting with systemic hypoperfusion & shock with low cardiac output and weak peripheral pulses. severe respiratory distress and grunting. neonate is 4 days old and is cyanotic

TAPVR

Neonate presenting with systemic hypoperfusion & shock with low cardiac output and weak peripheral pulses. severe respiratory distress and grunting. neonate is 4 days old and is not cyanotic

hypoplastic L heart disease

norwood procedure | glenn anastomosis

hypoplastic L heart syndrome

open and closed comedones or inflammatory pustules and papules on the cheeks of the baby usually after a week from.delivery

neonatal acne

patient presenting with CNS infection... Prefrontal headache, high fever, disturbance in smell hx of swimming in warm water

Naegleria fowleri | brain eating amobiasis

patient presenting with CNS infection ascending paralysis history of GIT infection

Campylobacter

patient presenting with CNS infection ascending paralysis history of Respi infection

Hib

patient presenting with CNS infection bells palsy systemic disease, cutaneous lesion, carditis

Borrelia

patient presenting with CNS infection headache, fever confusion, lethargy, nuchal rigidity, vomiting gradual onset of signs and symptoms, not toxic looking

Virus (enterovirus)

patient presenting with CNS infection headache, fever confusion, lethargy, nuchal rigidity, vomiting no mention of proper vaccine <5yo

Hib

patient presenting with CNS infection headache, fever confusion, lethargy, nuchal rigidity, vomiting properly vaccinated child, abrupt onset, toxic looking with rashes all over

meningococcemia

patient presenting with CNS infection headache, fever confusion, lethargy, nuchal rigidity, vomiting RBCs in CSF

HSV

patient presenting with CNS infection headache, fever confusion, lethargy, nuchal rigidity, vomiting renal transplant

Listeria

patient presenting with CNS infection headache, fever confusion, lethargy, nuchal rigidity, vomiting young adult

pneumococcus

patient presenting with CNS infection lethargy and irritability history of viral infection chicken pox aspirin use

Reye Syndrome

patient presenting with CNS infection ocular nerve palsy hsitory of Tb active TB

TB meningitis

patient presenting with CNS infection sepsis, seizure, irritability, bulging of fontanelles, rigidity pt <2mos

Group B strep

patient presenting with hematuria, hypertension, and signs of renal insufficiency 3 weeks ago with SVI Purpuric rasg mist prominent at the buttocks pain in the joints

HSP

patient presenting with hematuria, hypertension, and signs of renal insufficiency history of hemoptysis and severe respi distresss

Good pasture

patient presenting with hematuria, hypertension, and signs of renal insufficiency hx of vomiting and bloody diarrhea and fever hx of eating hamburger

HUS

patient presents s/sx of upper respiratory obstruction air trapping on the right lung with mediastinal shift towards right lung

foreign body; atelectasis | tx: rigid bronchoscopy

patient presents s/sx of upper respiratory obstruction patchy infiltrates and ragged tracheal column

tracheitis (s.aureus) | tx penicillin

patient presents s/sx of upper respiratory obstruction steeple sign

Croup | tx: racemic mixture

patient presents s/sx of upper respiratory obstruction thumb sign

epiglotitis | tx: antibiotics

patient presents with sore, scratchy throat, nasal obstructiob and rhinorrhea headache, facial pain periorbital edema, rhinorrhea for >2 weeks

sinusitis

patient presents with sore, scratchy throat, nasal obstructiob and rhinorrhea hx of prolonged use of topical or oral decongestant

rhinitis medicamentosa

patient presents with sore, scratchy throat, nasal obstructiob and rhinorrhea paroxysms of cough leaving the baby breathless & conjunctival hemorrhage

whooping cough

patient presents with sore, scratchy throat, nasal obstructiob and rhinorrhea persistent rhinorrhea with onset in the 1st 3 mos of life

congenital syphyllis

patient presents with sore, scratchy throat, nasal obstructiob and rhinorrhea prominent itchibg and sneezing nasal eosinophilia

allergic rhinitis

patient presents with sore, scratchy throat, nasal obstructiob and rhinorrhea unilateral foul smelling discharge, bloody nasal secretion

foreign body

pearly white papules seen mostly on the chin and around the cheeks

milia

Pellagra Casal necklace pellagrous glove and boots glove and boot lesions

Niacin (B3)

perihilar streaking

neonatal.pneumonia

Perleche

pink macular lesions on the nape glabella upper, eyelids, or nasolabial region

nevus simplex

prominent pulmonary vasculat marking; fluid line in fissure

TTN

pt with fever, cough, and tachypnea hx of eye discharge during the 1st 5-14 days of neonatal period

Chlamydia

pt with fever, cough, and tachypnea poorly nourished unvaccinated with onset of rasges all over the body

measles

pt with fever, cough, and tachypnea pt has CF pt has CGD pt is a burn pt pt is neutropenic

Pseudomonas

pt with fever, cough, and tachypnea pt has his own aviarium in his home

psittacosis

pt with fever, cough, and tachypnea pt is a teen/young adult, lives in dorm initial cough is nonproductive

mycoplasma

Rashkind atrial septostomy Jantene arterial switch Senning and Mustard

TOGA

rib notching on xray

COA

slate blue well demarcated areas of pigmentation over buttocks and back

mongolian spots

small white occcasionally vesiculopustular papules in an erythematous base develops after 1-3days. contains eosinophil

erythema toxicum

snowman appearance

TAPVR

staccato cough

chlamydia

sudden onset of gross hematuria history of strep throat ornpyoderma severely depressed C3 level

PSGN

sudden onset of gross hematuria patient is febrile with URT infection or GIT infection normal C3

IgA nephropathy

thick white creamy material usually absent in post term.infants

vernix caseosa

tight sounding with wheezing

asthma

Vesiculobullou eczematous, dry scaly or psoriasiform lesions, symmetric perioral acral and perianal areas chronic diarrhea, stomatitis, glossitis, irritability,

Zinc

vesiculopustular eruption over a dark macular base around the chin, neck, back, and soles. contains neutrophils

pustular melanosis

Watery diarrhea, vomiting after history of travel

ETEC

Watery diarrhea, vomiting day care center infants and toddlers

Rota virus | ETEC

Watery diarrhea, vomiting | greasy stool after camping

giargia lamblia

Watery diarrhea, vomiting | profuse diarrhea after eating raw ousters or undercooked shellfish

Vibrio parahemolyticus

Watery diarrhea, vomiting profuse diarrhea and vomiting flecks if mucous on voluminous diarrhea

Cholera

what is the earliest joint hemorrhages in children?

ankles

what is the hallmark of hemophilia?

Prolonged bleeding

what is the most common and most serious congenital coagulation factor deficiencies?

Hemophilia A

what is the most common hereditary bleeding disorder?

von willebrand

what is the most common hereditary hypercoagualable disorder?

Factor V leiden

wheezes are heard loudest over tge trachea. persistent wheezing never seems to go away

chondromalacia

white line on end of shafts | scorbutic rosary

Vit C

whooping/ post tussive vomiting

bordetella

with vigorous exercise

asthma

Mosy common cause of hemolytic disease of the newborm

ABO incompatibility

patient presents s/sx of upper respiratory obstruction subglottic narrowing

croup | tx: racemic epinephrine

Most common hematologic disease of infancy and childhood

IDA

Crew cut appearance on xray of skull | Moth eaten appearance

Sickle Cell Anemia

Most common seizure disorder durong childjood

Simple Febrile Seizure

Most commkn pediatric inflammatory myopathies

Juvenile Dermatomyositis

First line tx for dermatomyositis

Methylprednisolone

Pathophysiologic mechanism involved in HSP

Deposition of IgA and immune complexes (Type III) Affected vessel: small arteries

Most common cause of bibthrombocytopenic purpura in children

HSP

Diagnostic criteria for SLE

``` StosenOAP BRAIN MD Serositis Oral ulcers Arthritis Photosensitivity ``` Blood changes Renal disorder