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Flashcards in Topnotch Deck (288):
1

Washing of the newborn should be delayed after?

After 6 hours

2

Cord clamping should be delayed at?

2 to 3 minutes

3

Non-separation of mother and newborn should for breast feeding should last for?

20 to 60 minutes

4

Newborn eye prophylaxis

0.5 % erythromycin; 1% tetracycline

5

Vitamin K dosage for newborn.

1.5 kg - 1.5 mg; less than 1.5 kg - 1.5 mg

6

NBS

CH; CAH; G6PD; PKU; Galactosemia; MSUD

7

NBS, republic act?

RA 9288

8

NBS should be done after how many hours?

48 hours

9

If NBS was done

2 weeks old

10

21 hydroxylase deficiency

CAH

11

Enzymes deficient in galactosemia.

Galactose 1 phosphate deficiency; Galactokinase deficiency; Galactose 4 epimerase deficiency

12

Most common manifestation without treatment of PKU?

Developmental delay

13

Flat, blue gray with well defined margin that can be seen in sacral area.

Monglian spots

14

Most common benign skin lesion.

Erythema toxicum

15

Lacy pattern on the skin similar to cobblestones.; Vasomotor response to cold stress.

Cutis marmorata

16

Subperiosteal bleed.; Does not cross the suture line.; Resolves in few weeks.

Cephalhematoma

17

Swelling of scalp due to birth trauma.; Involves presenting part.; Crosses the suture lines.; Resolves in few days.

Caput succedaneum

18

Erb duchenne palsy with C4 involvement.

Ipsilateral diaphragmatic paralysis

19

Klumpke palsy with T1 sympathetic fibers involvelement.

Horner syndrome

20

Accumulation of fluid in tunica vaginalis.

Hydrocoele

21

Surgical treatment of undescended testis should be done when?

Not later than 9 to 15 months

22

Funnel shaped chest

Pectus excavatum

23

Pigeon shape chest.

Pectus carinatum

24

Post term, AOG?

>42 weeks

25

LGA, NB is hypoglycemic or hyperglycemic?

Hypoglycemic; Due to hyperinsulinism.

26

Ground glass pattern in CXR.

RDS

27

MCC of persistent pulmonary HPN?

Meconium aspiration syndrome

28

Contributory factor that leads persistent pulmonary HPN of the NB.

NSAID use during 3rd trimester

29

TB less than 5mg/kg/day, peaks at 15, DB less than 10% of TB

Physiologic jaundice

30

TB > 5 mg/dl/day peaks at 15; DB > 10% of TB

Pathologic jaundice

31

In ABO incompatibility, what is the blood type mother and baby?

Mother blood type O, baby type A or B

32

Type of jaundice, decreased milk intake with dehydration, reduced caloric intake.

Breastfeeding jaundice

33

Type of jaundice, presence of glucoronidase in breast milk.

Breast milk jaundice

34

Empiric treatment for neonatal sepsis.

Ampicillin + 3rd gen cephalosphorin or aminoglycosides.

35

Blueberry muffin rash

CMV AND RUBELLA

36

Most common congenital infection.

CMV

37

DOC for CMV

Ganciclovir

38

Cataract, PDA, MR, Deafness, Blueberry muffin

Congenital rubella syndrome

39

Chorioretinits. Microcephaly. Periventricular calcification. Blueberry muffin rash.

CMV

40

Chorioretinitis. Intracranial calcification. Hydrocephalus. Hepatitis. IUGR

Toxoplasmosis

41

Snuffles. Periostitis of long bone. Hutchinson teeth. Saddle nose.

Syphillis

42

Pneumatosis intestinalis

NEC

43

MC life threatening emergency of the GIT in neonates.

NEC

44

Greatest RF for NEC.

Prematurity

45

Triad: Intestinal ischemia. Enteral nutrition. Pathogenic organism.

NEC

46

Average weight of the new born

3kg

47

Average birth length of the newborn.

50cm

48

Average head circumference of the newborn.

33 to 35 cm

49

Approximate age where adult HC is attained.

6 years old

50

First tooth to erupt.

Mandibular central incisor

51

True or false, theres a 10% decrease in birth weight on the first week of life of a new born?

TRUE

52

Physiologic anorexia occurs when?

2nd year of life

53

Complete myelination occurs when?

2nd year of life

54

VA of 20/20

4 years old

55

All primary teeth errupted at?

3 years old

56

Best time to read poetry.

3 years old

57

Vaccines that cannot be given simultaneously

Yellow fever and cholera

58

Fully immunized child means?

1 dose of BCG at birth, within 12 months. 3 doses of BCG and OPV every 4 weeks. (Starting 2 months) 3 doses of Hepa B after birth. (0,1,6) 1 dose of measles vaccing at 9 months. Plus MMR (6 months after measles vaccine) and Hib (9 moths)

59

Polyarticular disease type of juvinile RA. HLA TYPE?

HLA DR4

60

Pauciarticular disease type of RA, HLA TYPE?

HLA DR8 & DR5

61

Reactive AS would present as?

Reiters syndrome

62

Sacroillitis in xray.

AS

63

More specific for lupus and reflects the degree of disease activity.

Anti-ds DNA

64

MC of the pediatric inflammatory myopathies.

Dermatomyositis

65

Earliest manifestation of scleroderma.

Reynauds phenomenon

66

Less than 5yo: Bilateral bulbar conjunctival injection, non purulent. Dry fissured lips, Strawberry tongue. Edema and erythema of the hands and feet in acute phase and periungual desquamation in the subacute phase. Truncal rash, polymorphus, non vesicular. Cervical LAD.

Kawasaki disease

67

BV most affect by kawasaki.

Medium sized artery (coronary artery)

68

Important PE finding in patient with kawasaki less than 1yo.

Perineal erythema

69

Fibrosis affecting the dermis and arteries of the lung, kidney and GIT.

Scleroderma

70

Vasculitis of all blood vessel esp medium sized arteries.

Kawasaki

71

IgA mediated vasculitis of small vessel.

HSP

72

MCC of nonthrombocytopenic purpura in children.

HSP

73

2 to 8 yo. Male. Palpable, raised purpura, red to brown, lasts for 3 to 10 days. Intermittent abdominal pain.

HSP

74

Hallmark of HSP.

Palpable petichae or purpura that evolve from red to brown that last from 3 to 10 days.

75

Skin biopsy finding of HSP.

Leukocytoclastic angitis

76

Renal biopsy finding of HSP.

IgA mesangial deposition

77

6yo; Female; Heliotrophic rash (periorbital violaceous erythema may cross the nasal bridge); Gottron papules (alligator skin like appearance); (+) ANA with speckled pattern in >60%.

Dermatomyositis

78

Tightness, thickening, non-pitting induration involving proximal to the MCP or MTP joints. Sclerodactyly. Digital pitting scars resulting from digital ischemia. Bibasilar pulmonary fibrosis not attributable to primary lung disease.

Scleroderma

79

Most common esophageal disorder in children of all ages

GERD

80

MC TEF

Type A

81

MC foreign object swallowed by 6 months to 3 years old?

Coins

82

MCC of nonbilious vomiting.

Pyloric stenosis

83

Acid base balance abnormality in patient with pyloric stenosis.

Hypochloremic metabolic acidosis

84

Firm, olive-shaped mass, post-prandial vomiting.

Pyloric stenosis

85

Barium: shoulder sign, double tract sign

Pyloric stenosis

86

Surgical procedure for pyloric stenosis.

Ramstedt pyloromyotomy

87

Bird's beak sign. Inverted U sign. Coffee bean sign.

Volvulus

88

Double bubble sign. Bilious vomiting. Polyhydramnios. Jaundice. Failure to recanalize the lumen during 4th and 5th week AOG.

Doudenal atresia

89

MC type of malrotation.

Failure of the cecum to move into RLQ

90

Remnant of omphalomesenteric duct which connects the yolk sac to the gut in the embryo.

Meckels diverticulum

91

Intermittent painless rectal bleeding and brick colored stool. MC congenital GI anomaly

Meckel diverticulum.

92

Delayed passage of meconium. Chronic constipation. Dec blood flow and deterioration of mucosal barrier leading to enterocolitis.

Hirschprung disease

93

Currarino triad: Anorectal malformation. Sacral bone anomalies. Presacral masses.

Hirschprung disease in older patient.

94

Currant jelly stool. Doubles up (legs and knee are flexed with loud crying). Severe paroxysmal colicky pain that recurs at frequent intervals with straining efforts. Sausage shape mass in RUQ. BARIUM: coiled spring sign. UTZ: doughnut or target sign.

Intussusception

95

Standard ORS composition

Glucose : 75, Na: 75, Cl: 65, K: 20, Citrate: 10, Osm: 245mmol/l

96

Sentinel loop. Colon cut off sign. Ileus. Blurring in left psoas margin. Peripancreatic extraluminal gas bubbles.

Acute pancreatitis

97

Prognostic system for acute pancreatitis in adult. Not in children.

Ransons criteria and APACHE score

98

First clinical evidence of HBV infection.

ALT

99

Window phase of HBV infection.

IgM anti HBC

100

Inc risk of transmitting HBV.

HBeAg

101

Most valuable single serologic marker of acute HBV infection.

Anti HBcAg

102

Presence of this will confer lower risk of transmitting HBV.

Anti HBe

103

Microangiopathic hemolytic anemia, thrombocytopenia, uremia.

HUS

104

Helmet cell, Burr cell, Fragmented RBCs

HUS

105

Most common chronic glomerular disease worldwide.

IgA nephropathy

106

Complement decreases in APSGN.

C3

107

What major noxious products of complement activation are produced after c3 activation in APSGN?

Anaphylotoxin and c5a

108

Tea colored urine, hematuria. Periorbital edema. Hypertension. Oliguria.

APSGN

109

Best single Ab titer to document skin infection in patient with APSGN.

DNAse antigen

110

Mangement for APSGN.

Ten day course of penicilline. Furosemide 1mg/kg/dose IV. Sodium restriction. ACE inhibitor or CCB.

111

Bilateral flank mass. Potter facies.

PCKD

112

Most common cause of acute renal failure in young children.

HUS

113

Essential for newborn's functioning of the visual pigment rhodopsin.

Docosahexaenoic acid (DHA)

114

Most commom acyanotic heart disease.

VSD

115

Major energy source in breastmilk.

Fat

116

MC type of VSD.

Perimembranous

117

Initial manifestation of vitamin A deficiency.

Nyctalopia

118

What chamber of heart enlarges in VSD?

Left side and PA

119

General softening of the bones. Rachitic rosary. Harrison groove. Winswept groove.

Rickets

120

Systolic regurgitant murmur at the left lower sternal border, loud and single s2.

VSD

121

Rachitic rosary

Rickets

122

Chamber of the heart that enlarges in PDA.

Left side and PA

123

Kasal's necklace

Niacin

124

Most common cause of cyanotic congenital heart disease in new born.

TGA

125

Scorbutic rosary

Vitamin C

126

Egg shaped cardiac silhouette.

TGA

127

Pellagra

Niacin

128

RV tap along left sternal border. Systolic ejection murmur radiates at the back.

TOF

129

Microcytic anemia

Vitamin B6

130

Failure of development of the spiral septum.

Truncus arteriosus

131

Corckscrew hair

Vitamin C deficiency

132

All pulmonary veins drain to the RA. RV Volume overload.

TAPVR

133

Extreme exogenous obesity in which patient have severe cardiorespiratory distress with alveolar hypoventilation.

Pickwickian syndrome

134

Snowman sign.

TAPVR

135

Aim for the treatment of obesity.

Not weight loss but to slow or halt weight gain - weight maintenance

136

In truncus arteriosus what septal defect is always present?

VSD

137

Vitamin A dosage for ages 6 to 12 months

100,000IU

138

MC location of coarctation of aorta.

Descending aorta

139

Vitamin A dosage for age one year and older.

200,000IU

140

Congenital anomaly related to coarctation of aorta.

Turner's syndrome

141

NTD is a failure of spontaneous closure of neural tube during?

3rd and 4th week

142

Hypertension in upper extremities. Rib notching in children 7 yo.

Coarctation of aorta

143

Folic acid will prevent the occurance of NTD from preconception until?

12th week AOG

144

Associated with congenital rubella, noonan, and william syndrome.

Pulmonic stenosis

145

Folic acid dosage

0.4mg OD

146

Harsh systolic ejection murmur at the Right upper sternal border. Systolic thrill - Suprasternal notch.

Aortic stenosis

147

Failure to closure of the rostral neuropore.

Anencephaly

148

Systolic ejection murmur at the left upper sternal border with radiation to the back.

Pulmonary stenosis

149

Severe form of NTD

Meningocoele

150

Surgery done in pulmonary stenosis.

Brocks procedure

151

Absent cerebral convolution and a poorly formed sylvian fissure.

Lissencephaly

152

Surgery done in aortic stenosis.

Ross procedure; Valve translocation from pulmonary valve.

153

Uni or bilateral clefts within the cerebral hemispheres.

Schizencephaly

154

Aschoff bodies

RHD

155

Presence of cyst or cavities within the brain.

Porencephaly

156

Most common valvular involvement in adults.

Mitral stenosis

157

Due to defective cleavage of the prosencephalon and inadequate induction of the forebrain structure.

Holoprosencephaly

158

Most common valvular involvement in children with RHD.

Mitral regurgitation

159

CSF is reabsorbed through what process?

Pinocytosis

160

Fish mouth buttonhole deformity. Weak peripheral pulses with narrow pulse pressure. Hemoptysis.

Mitral stenosis

161

CSF is reabsorbed by what cell?

Arachnoid villus cells

162

Systolic regurgitant murmur at the apex with transmission to the left axilla.

Mitral regurgitation

163

Setting sun sign, Long tract sign, Cracked pot sensation or mace wen sign, Chiari malformation (foreshortened occiput), Dandy walker malformation (prominent occiput)

Hydrocephalus

164

Chamber enlarge in MS.

LA and RV

165

Major complication of shunts?

S. epidermidis infection

166

Wide pulse pressure and bounding water hammer pulse. Diastolic murmur heard best at 3rd and 4th LCIS.

Aortic regurgitation.

167

Treatment for infantile spasm.

Vigabatran

168

Most common valvular heart disease.

MVP

169

Most common seizure disorders in childhood?

Febrile seizure

170

Most common complaint, MVP.

Palpitation

171

DOC for status epilepticus.

Phenytoin

172

Murmur at 2nd LICS with widely split S2.

ASD

173

Most prevalent type of migraine

Migraine without aura

174

Murmur at 2nd LICS with radiation to the upper back.

PS

175

Brain lesion consist of tubers located in the covolutions of the cerebral hemispheres at subependymal region that calcified and may produce a candle dripping appearance.

Tuberous sclerosis

176

Murmur at 2nd LICS with radiation to the interscapular area.

COA

177

Hamartomas located within iris

Lisch nodules

178

Murmur at 2nd RICS.

AS

179

Ash leaf skin, Shagreen path, Subungual or periungual fibromas

Tuberous sclerosis

180

Murmur at LLSB.

VSD

181

Murmur at LLSB with radiation to the left anterior axillary line.

MR

182

Sterile endocarditis, SLE

Libman sacks endocarditis

183

MCC of viral meningitis.

Echovirus

184

Osler nodes. Janeway lesion. Splinter hge. Roth spots.

Infective endocarditis

185

Brain abscess if common in age?

4 to 8 yo

186

Use to diagnose hyperpituitarism.

Serum somatomedin c (IGF-1)

187

MC site of brain abscess.

Cerebrum

188

Earliest sign of graves disease.

Emotional disturbance with motor hyperactivity.

189

Earliest and most constant sign of myasthenia gravis.

Ptosis and EOM weakness

190

Proximal muscle weakness, symptomatic late in the day.

Myasthenia gravis

191

MC cause of thyroid disease in children and adolescent.

Thyroiditis

192

Thought to be the site of Ach receptor antibodies.

Thymoma

193

MC endocrine metabolic disorder of childhood and adolescent.

DM

194

A short acting cholinestearse inhibitor use for clinical test of patient with guillain barret syndrome. Slight improvement in ptosis and ophthalmoplegia.

Edrophonium chloride IV Or Tensilon test

195

Aplastic anemia with microcephaly, microphthalmia, hearing loss, limb abnormalities.

Fanconis anemia

196

Not associated with other cranial neuropathies or brainstem dusfunction. Occurs after a systemic viral infection.

Bell's palsy

197

Most impt sign of IDA.

Pallor

198

Virus associated with bells palsy.

EBV, HSV, Mumps virus

199

Definitive diagnostis test for alpha thalasemia.

Hb electrophoresis

200

Acute demyelinating polyradiculoneuropathy / symmetric ascending muscle weakness or paralysis.

Guillain barre syndrome

201

Target cell, heinz bodies

Alpha thalassemia

202

Landry ascending paralysis.

Gullain Barre Syndrome

203

Crew cut or hair on end appearance in skull radiograph.

Sickle cell disease * inc erythropoiesis cusing marrow expansion and new bone formation.

204

Last to resolve in guillain barre syndrome.

Tendon reflex and lower extremities

205

Howell jolly bodies.

Sickle cell disease

206

Used to eradicates nasopharyngeal carriage of diphtheria.

Erythromycin 40-50mg/kg/day x14days

207

MCC of thrombocytopenic purpura in childhood.

Idipathic thrombocytopenic purpura

208

MOT of diphtheria

Close contact via Airborne respiratory droplets

209

Fever. Anemia. Thrombocytopenia. Renal dysfunction. Nervous system changes. Inc bun and crea. Deficiency in metalloproteinase (ADAMTS-13).

Thrombotic thrombocytopenic purpura

210

Essential for new borns functioning of the visual pigment.

DHA

211

Omega 3

Linolenic acid. DHA.

212

Omega 6

Linoleic acid. Arachidonic acid.

213

Treatment for von willebrand disease.

Desmopressin and factor 8 concentrate

214

Explosive outburst in series of 5 to 10 rapid coughs in one expiration and ending in a high pitched whoop (forceful inspiratory gasp) often associated with suffusion of face or popping out of eyes and vomiting. Well in between paroxysm. Have petechial hge on the upper body.

Pertussis

215

MC posterior fosaa tumor in children.

Astrocytoma

216

Blood picture with pertussis.

Leukemoid reaction

217

MC supratentorial tumor in children.

Craniopharyngioma

218

DOC pertusis.

Erythromycin 40-50mg/kg/day q6 x14days

219

Abdominal mass that does not cross midline.

Wilms tumor

220

MOT meningococcemia.

Person to person through infected droplets

221

Abdominal mass that crosses the midline.

Neuroblastoma

222

Fever. Morbiliform rash > petechial rash > purpuric rash >echymotic rash

Meningococcemia

223

Sunburst pattern

Osteosarcoma

224

DOC meningococcemia

Pen G 250k-400k IV divided doses for atleast 5to7 days

225

Onion skin, moth eaten appearance.

Ewing sarcoma

226

Prophylaxis for meningococcemia.

Rifampicin

227

Osteosarcoma, what part of long bone?

Metaphysis

228

Rose spots

Salmonella

229

Ewing tumor, what part of long bone?

Diaphysis

230

Mainstay of diagnosis for salmonella.

Blood culture

231

Barking cough

LTB

232

DOC typhoid fever

Chloramphenicol 50-75 mg/kg/day x14-21days

233

Location of LTB.

Subglottic space

234

2 weeks High grade fever, abdominal pain, hepatosplenomegaly, anorexia, diarrhea, rash

Typhoid fever

235

Thumbprint or leaf sign.

Acute epiglotitis

236

MOT measles

Droplet spray

237

Steeple sign.

LTB

238

Branny desquamation

Measles

239

Location of acute epiglottitis.

Supraglottic

240

Vitamins given on complicated measles.

Vitamin A

241

Muffled voice, drooling.

Acute epiglotitis

242

3 day fever

German measles/rubella

243

Most common cause of brochilitis.

RSV

244

Forscheimer spot

German measles/rubella

245

Staccato cough.

Chlamydia

246

Blueberry muffin skin lesion

Congenital rubella syndrome

247

Most common significant pediatric cardiac arrhythmia.

SVT

248

DOC for SVT.

Adenosine

249

Familial nonhemolytic unconjugated hyperbilirubinemia.

Criggler najjar syndrome, Gilberts syndrome

250

Most frequent complication of mumps.

Meningoencephalitis

251

Inherited conjugated hyperbilirubinemia

Dubin johnson syndrome, Rotor syndrome

252

Roseola suppresses what cellular lineage within bone marrow?

All

253

Maternal treatment for toxoplasmosis.

Spiramycin

254

Nagayama spots - uvulopalatoglossal junction

Roseola

255

Paraventricular calcification.

CMV

256

Interruption of limb development at 6 to 12 weeks AOG. eye and brain involvement in 16-20 weeks AOG.

Congenital VZV.

257

When is the best time to give acyclovir in VZV.

Within 24 hours the onset of rash

258

Hydrocephalus with generalized calcifications.

Toxoplasmosis

259

Use to measure the bone age-reference standards.

Radiograph of left hand and wrist

260

Herpangina causative agent.

Cox A

261

Skeletal maturity is linked to? Sexual maturity or chronological age?

Sexual maturity

262

5th disease

Erythema infectiosum

263

Dominant protein in human milk.

Whey

264

Slapped cheek appearance

Erythema infectiosum

265

Dominant milk in cows milk.

Casein

266

Primary cell line affected by erythema infectiosum.

Erythroid cell line

267

Eczema. Thrombocytopenia. Recurrent infection. Decreased IgM. T and B cell deficiency

Wiskott-aldrich syndrome

268

Lacy, reticulated appearance rash, sparing the palm and soles without desquamation.

Eryhthema infectiosum

269

Prolonged detachment of the umbilical cord.

Chronic granulomatous disease

270

6th disease

Roseola

271

Associated with IM. Symmetric rash on the cheek. Erythematous papules.

Gianotti crosti syndrome

272

Most common congenital infection.

CMV

273

Moist, honey colored crust

Impetigo

274

Tender, warm, erythematous plaques with ill defined borders.

Cellulitis

275

Mild rubbing of the skin results in epidermal separation leaving a shiny, moist, red surface.

Nikolsky sign

276

Malassezia furfur invades what layer of epidermis?

Stratum corneum

277

Causative agent of scabies.

Sarcoptes scabei

278

Brown crusted nodules on the trunk; s-shaped burrows.

Scabies

279

White or yellow 1-6mm discrete papules with a central umbilication

Molluscum contagoisum

280

Thick silvery scales, nail involvement and isomorphic phenomenon.

Psoriasis

281

Oval or round, fixed, red skin lesionwith dusky central zone. Target lesion. Iris lesion. No systemic signs and symptoms. Due to HSV specific host response.

Erythema multiforme

282

Fetal CO depends on?

HR

283

Functional closure of DA.

10-15 hours

284

Anatomical closure of DA.

2-3 weeks

285

Strongest stimulus for constriction of the ductal smooth muscle.

Inc in oxygen saturation

286

Most common ASD.

Ostium secundum

287

Chamber enlarge in ASD.

Right side and PA

288

Systolic ejection murmur at LEFT 2nd ICS.

ASD