Uworld12

Question 1

kidney: Podocyte fusion on electron microscopy

Answer 1

minimal change disease

Question 2

kidney:Localized area os mesangial sclerosis and collapse.

Answer 2

focal segmental glomerulosclerosis

Question 3

kidney: glomerular basement membrane thickening

Answer 3

membranous nephropathy

Question 4

kidney: glomerular basement membrane thinning

Answer 4

alport syndrome

Question 5

change in electrolyte in hypertrophic pyloric stenosis

Answer 5

Hypochloremic, hypokalemic

metabolic alkalosis

Question 6

Minimal change disease is the most common cause of nephrotic syndrome in what patient population

Answer 6

preadolescent children (NOT teenagers)

Question 7

Clinical association with membranoproliferazive glomerulonephritis

Answer 7

Hepatitis B and C

Question 8

Treatment for minimal change disease

Answer 8

steroids

Question 9

management of a child with proteinuria

Answer 9

repeat urine dipstick testing on 2 separate occasions

Question 10

Primary defect in renal tubular acidosis 1

Answer 10

poor hydrogen secretion into urine

basic urine

Question 11

primary defect in renal tubular acidosis 2

Answer 11

poor bicarbonate resorption

acidic urine

Question 12

Primary defect in renal tubular acidosis 4

Answer 12

aldosterone resistance

Question 13

postassium levels in renal tubular acidosis

Answer 13

1-2: low-normal

4: high

Question 14

Hyposthenuria

Answer 14

polyuria because inability of kidneys to concentrate urine

sickle cell disease

Question 15

how do you get a clean specimen from a child

Answer 15

diapers: straight catheterization

potty trained: mid-stream clean-catch urine specimen

Question 16

when should a renal and bladder ultrasound be done in a child with UTI

Answer 16

less than 2 years, first febrile UTI
Recurrent UTI
Do no respond to abs

Question 17

when is voiding cystourethrogram done for child UTI

Answer 17

abnormalities on ultrasound
less than 1 month old
children less than 2 with recurrent UTI
UTI from an organism other than E. coli

Question 18

Toddler with a firm, unilateral abdominal mass and hematuria
Diagnosed between age 2-5
asymptomatic abdominal mass

Answer 18

Wilm’s tumor

Question 19

Management of Wim’s tumor

Answer 19

CT first

then chest CT to tule out Mets

Question 20

Clinical finding in neuroblastoma

Answer 20

abdominal mass that crosses the midline

common in first year of life

Question 21

APGAR score

Answer 21

Appearance
Pulse
Grimmace/reaction
Activity/muscle tone
Respiratory effort

Question 22

score of what APGAR requires further evaluation

Answer 22

7

Question 23

Bacterial tracheitis

Answer 23

life-threatening sequela of viral laryngotracheobronchitits

- several days of viral URI, acute elevation of temp and increase in respiratory distress

Question 24

what type of breathing diagnosis croup

Answer 24

inspiratory stridor

-Biphasic stridor and high fever =something else

Question 25

At what age do you start presenting with sickle cell anemia

Answer 25

6 months

Question 26

almost all male patients with cystic fibrosis have?

Answer 26

congenital bilateral absence of vas deferens due to accumulation of inspissated mucus infertility

Question 27

difference between cystic fibrosis and primary ciliary dyskinesia

Answer 27

pancreatic insufficiency - poor growth, deficiency of fat-soluble vitamins only in cystic fibrosis

Question 28

most common cause of bacterial pneumonia in young children with cystic fibrosis ( age less than 20)

Answer 28

age less than 20: Staph. aureus | age greater than 20: Pseudomonas aeruginosa

Question 29

First step in management of newborn with respiratory compromise and suspected congenital diaphragmatic hernia

Answer 29

endotracheal intubation | gastric tube to decompress the stomach and bowel

Question 30

what would be on the differential for congenital diaphragmatic hernia

Answer 30

concave abdomen and barrel-shaped chest

Question 31

Next step in management of foreign body aspirations

Answer 31

immediate bronchoscopy

Question 32

ultrasound or fluoroscopy of chest reveals asymmetric diaphragmatic motion in a seesaw manner in a big baby just delivered

Answer 32

phrenic nerve paralysis `

Question 33

What are lab values for Group B strep. meningitis in normal newborn

Answer 33

low WBC with left shift | thrombocytopenia

Question 34

clubbing and sudden-onset joint arthropathy in a chronic smoker. next step?

Answer 34

chest x-ray to rule out malignancy

Question 35

What is Heiner syndrome and what is it associated with

Answer 35

sensitive to cow's milk | Idiopathic pulmonary hemosiderosis

Question 36

Triad for primary ciliary dyskinesia

Answer 36

1. recurrent sinopulonary infection 2. Bronchiectasis 3. Situs inversus

Question 37

What causes subglottic edema

Answer 37

Laryngotracheobronchitis

Question 38

treatment for laryngotracheobronchitis

Answer 38

corticosteroids and nebulizer epinephrine

Question 39

complete white out on X-ray? most common causes

Answer 39

lung empyema S. aureus S. pneumonia S.pyogenes

Question 40

when is a large thyme silhouette a normal finding in a child

Answer 40

age less than 3 years

Question 41

treatment for neonatal respiratory distress syndrome

Answer 41

early continuous positive air pressure vent

Question 42

chest x-ray for transient tachypnea of newborn

Answer 42

bilateral perihilar linear streaking

Question 43

what is the next step for for someone who has suspected subcutaneous emphysema

Answer 43

Chest x-ray to rule out pneumothroax

Question 44

complications of positive pressure ventilation

Answer 44

alveolar damage pneumothorax hypotension

Question 45

management of small pleural effusion in an asymptomatic child

Answer 45

oral abs and close outpatient follow up

Question 46

2 risk factor for neonatal respiratory distress syndrome

Answer 46

prematurity | maternal diabetes mellitus

Question 47

2 complications of RSV

Answer 47

apnea (especially if less than 2 months) | respiratory failure

Question 48

treatment for toxocara canis

Answer 48

albendazole

Question 49

what sinus has pus from superior meatus of nose

Answer 49

sphenoid or posterior ethmoid

Question 50

differentiate respiratory distress syndrome and transient tachypnea of newborn

Answer 50

RDS: low lung volumes (TTN has retained fetal lung fluid) ground-glass opacities air bronchograms on chest x-ray

Question 51

treatment for neonatal clavicle fracture

Answer 51

it will heal on its own

Question 52

before what age must ADHD be diagnosed

Answer 52

before 12

Question 53

what happens 12-48 hours after alcohol withdrawal

Answer 53

``` seizures alcoholic haluccinosis (intact orientation) ```

Question 54

Alexia

Answer 54

inability to read

Question 55

Agnosia

Answer 55

inability to recognize objects despite intact senses

Question 56

if a child has a tic... can they still use stimulant ADHD medications

Answer 56

yes

Question 57

conduct disorder vs. oppositional defiant disorder

Answer 57

conduct disorder: aggression and violation of rules | ODD: disobedience toward authority figures

Question 58

first line of treatment of OCD in children

Answer 58

SSRI and CBT

Question 59

Transient distress on initial separation from major attachment figures is age appropriate in children at what age

Answer 59

9-18 months

Question 60

when does stranger anxiety occur

Answer 60

6-12 months

Question 61

repeated object insertion into vagina or anus in a child. normal or not

Answer 61

not normal

Question 62

Sex play involving genital-genital, oral genital, or anal-genital contact, normal or not normal

Answer 62

not mortal

Question 63

masturbatory movements. normal or not normal

Answer 63

normal

Question 64

first line treatment for Tourette disorder

Answer 64

clonidine other: 2nd generation psych

Question 65

side effect of clonidine

Answer 65

sedation

Question 66

what is the triad with tourette

Answer 66

ADHC or OCD

Question 67

triad of arsenic poisoning

Answer 67

abdominal pain hematuria jaundice

Question 68

systemic manifestations of iron poisoning

Answer 68

abdominal pain hematemesis shock metabolic acidosis

Question 69

initial screening for lead poisoning? diagnostic?

Answer 69

capillary (finger stick) blood specimens | confirmed with venous blood draw

Question 70

methemoglobinemia

Answer 70

iron changes in RBC

Question 71

treatment for methemoglobinemia

Answer 71

cyanosis and dark chocolate-colored blood

Question 72

what causes methemoglobinemia

Answer 72

oxidizing agents (dapsone, nitrites/topical anesthetics)

Question 73

what is used to treat seizure overdose from TCA

Answer 73

benzodiazepines

Question 74

which type of ocular conjunctivitis has ocular pruritus

Answer 74

allergic

Question 75

dacryostenosis

Answer 75

obstruction of lacrimal duct

Question 76

what is trachoma

Answer 76

chlamydia trachomatis

Question 77

when does chemical neonatal conjunctivitis occur? Gonorrhea ? Chlamydial?

Answer 77

less than 24 hours of birth g: 2-5 days old CH: 5-14 days old

Question 78

management of dacryostenosis

Answer 78

massaging the nasolacrimal ducts

Question 79

treatment for gonococcal conjunctivitis

Answer 79

one dose of intramuscular ceftriaxone or cefotaxime

Question 80

trachomatis

Answer 80

chlamydia

Question 81

neurofibromatosis type 1 eye problem

Answer 81

optic pathway glioma

Question 82

neurofibromatosis type 2

Answer 82

acoustic neuromas

Question 83

when is strabismus abnormal in a child

Answer 83

after age 4 months

Question 84

when is the visual acuity test started in a child

Answer 84

age 3

Question 85

Stabismus, or ocular misalignment, can cause an asymmetric red reflex with increased intensity in the deviated eye. in retinoblastoma what will be the corneal light reflex

Answer 85

symmetric

Question 86

biggest risk factor for Cryptorchidism

Answer 86

testicular cancer

Question 87

treatment for testicular hydrocele

Answer 87

observation, most resolve by age 1 year

Question 88

What is genetic testing for duchess muscular dystrophy

Answer 88

absent dystrophin gene and undetectable dystrophin protien

Question 89

what confirms the diagnosis of Duchenne muscular dystrophy? What is gold standard therapy for?

Answer 89

muscle biopsy | gold: genetic studies

Question 90

3 categories of clinical symptoms of friedriech ataxia

Answer 90

neurologic skeletal cardiac

Question 91

What is the most common cause of death for friedriech ataxia

Answer 91

cardiomyopathy and respiratory complications

Question 92

Cardiac rhabdomyomas and renal angiomyolipomas and intellectual problems

Answer 92

tuberous sclerosis

Question 93

difference between central and peripheral Bell's Palsy

Answer 93

Central: spares forehead

Question 94

What is procedure is contraindicated with nocturnal headaches and morning vomiting?

Answer 94

signs of elevated intracranial pressure | lumbar puncture is contraindicated

Question 95

Most common type of brain tumor in children

Answer 95

astrocytoma

Question 96

second most common tumor of posterior fossa in children

Answer 96

medulloblastoma

Question 97

"firm, well-demarcated swelling on the right parietal scalp with no discoloration and no apparent tenderness

Answer 97

cephalohematoma:scalp swelling that does not cross suture lines

Question 98

biggest risk factor for cerebral palsy

Answer 98

prematurity

Question 99

if you fall with an object in your mouth. What is the most likely deformity

Answer 99

traumatic carotid injuries or thrombus formation

Question 100

Most common cause of death from child abuse

Answer 100

shaken baby syndrome