2016 Exam Flashcards
Cyclical vomiting syndrome criteria:
“think 5-1=4; 5 attack min. 4 vomit/hour x 1 hour minimum”
Min. 5 attacks Recurrent vomit last 1hour-10d Vomit 4X/hour x 1 hour minimum Normal between episodes Not attributed to another dx
Total body radiation. Risk of radiation effects later?
Secondary malignancy
Adrenal insuff
Hypothyroidism
All of sudden with getting NG feeds getting dumping (diarrhea, sweat, cramp). LIKley reason? and two mechanism?
Hyperosmolar feed
> Pumped too fast
Formula too hyperosmolar formula
Dyslexia DSM5 Criteria
Difficulties with learning and using academic skill x 6mo
Skill less than expected age and cause issue w/ school
LD start at school age
Not better accounted for by IQ disability , visual, auditory or other factors
Chronic Granulomatous Disease. Confirmed via?
NOBI= Neutrophil Oxidative Burst Index
Remember: supportive adenitis, hepatic abscess, recurrent pneumoniae, osteomyelitis at multiple spots etc.
Two indications for hydrocele Sx
Communicating hernia > 18 month age (risk of indirect hernia)
Non communicating: Large and uncomfortable
ASD. 3 findings on cardiac auscultation
Fixed split S2
Systolic murmur at mid sternal area
Rumbling low pitch diastolic murmur
Other cardiac: prominent impulse, heave, lift
CPR compression ratio per minute?
100
CPR ventilation ratio per minute?
8-10
Risk of WPW
Ventricular tachycardia, syncope, sudden death.
4 ways to reduce systematic bias
Large sample size
Set clear inclusion and exclusion to reduce bias
Reduce sampling bias
Use systematic process that is transparent and reliable
Randomize participant to 2 group
Double blinded
Use validated objective criteria for measuring outcome
Mastoiditis complications:
facial nerve palsy, subdural abscess, meningitis, sinus venous thrombosis
3 life threatening complications of GBS
- respiratory depression
- arrhythmia
- dysautonomia (hemodynamic instability)
Other: DVT, PE
OSA two consequences
Cor pulmonale
HTN
3 Perinatal complications of post-dates
Still birth
Macrosomia (and shoulder dystocia)
Meconium Aspiration
What criteria must be met for return to play post concussion?
- *Full return to school must precede sports
* * Only return after symptom free x 7-10d
Advice regarding return to school if concussion:
Return in few days after okay with cognitive task at home.
Accommodation may be necessary
Gradual increase
ODD. Suggested management
Parental training (triple P)
Youth anger management
Stimulant, Atypical anti psychotic
Diagnostic criteria for Bulimia nervosa
Min 1X week x 3 month
Binge eating (excessive amount with lack of control)
Compensatory behaviour (i.e. purge, laxative, restrict)
Self-evaluation influenced by negative perception of body shape and image, weight
Not due to AN or other dx
HPV vaccine present:
Cervical cancer
Genital warts
Anal cancer
Throat Cancer
Asthma versus scoliosis: RV/TLC and FVC
RV= volume in lungs. TLC= total lung capacity FVC= forced vital capacity (total air that can be forceful exhaled)
Asthma: RV/TLC up or normal (more RV); FVC down
Scoliosis: RV/TLC increased (more RV); FVC down++
How do you avoid BPD in NRP resuscitation?
Avoid barotrauma or volume trauma
What is heat rash medical term?
Miliaria= rash over fold (intertrigonal or where two skin rub/touch) and covered areas.
What can you do to prevent future kidney stones?
UP fluid
DOWN salt
normal calcium diet
PO Vitamin K dosing?
Oral dose 2mg at birth
Repeat in 1 and 2 months.
If premature adrenarche- what are you at greater risk later on?
PCOS
Most common craniosynostosis? What next?
Sagittal= Scaphoencephaly
NeuroSx contsult
= discuss option, Sx, risk of ICP and ensure normal growth
3 tests to measure Measles
Measles PCR
Serology (IgM, IgG)
Viral Cx from saliva, urine
When does hand dominance develop?
@ 18 months.
Red eye with photophobia. Likely dx?
Corneal abrasion
Glaucoma
FB
Keratitis, Corneal Ulcer, Orbital cellulitis
Minimum PEG tx duration for constipation
6 months
HIE criteria
min. 36 WK GA
max 6 hour old
mod-severe encephalopathy (Sarnat 2-3)
Two of: APGAR < 5 at 10 min, vent or resus at 10 min, or pH < 7 and BE > 16
Qualification for RSV prophylaxis
< 6 month at start AND
… < 30 wk GA
… < 36 and remote community
… term inuit from comm at high risk of RSV
< 1 yr at start AND
… CLD with ongoing med
…. CHD hemodynamically significant
Consider if < 2 AND .... home O2 ... severe pul dx .. T21 ... CF ... immunocompromised
Severe EoE start-
oral INH steroid
cephalohematoma. What do you do?
No further intervention
Resolve spontaneously in 2-12 weeks
Cleft in inferior hymen rim suggest:
Previous trauma to hymen
Twin to twin transfusion. Risk to blood recipient versus donor?
Recipient
= heart failure due to extra fluid on body
Resp distress, renal vein thrombosis, clots
Donor= anemia, growth restrict, hypoglycaemia if small
GH versus Turner syn in short stature. Difference?
GH= bone age delay (slow), confirm via GH stim test
Turner Syn= F, normal bone age
When do you screen for T2DM?
3 RF pre puberty or 2RF post-puberty
- FHX - BMI 95% - ethnicity
- Features of DM (acanthuses) - dyslipidemia
Screen every 2 hour via fasting plasma glucose
Teen with CF has drop in PFT. Start?
- ceftaz + cobra
- clox + cobra
- clox + ceftaz
- PO cipro
Ceftaz + Tobra
T or F: Mastoiditis is reason for myringotomy?
True
Spinal muscular atrophy inherited via
AR
= proximal weakness, hypotonia, reflexia.
Glucose at 2 hour 2.1 in BB born to mom with gestational DM. Next step?
Continue to monitor q 3-4 hour
x next 12 hour if LGA and IDM. x 36 if SGA or prem.
If > 2.6 at that time can stop.
Note: < 1.8 at 2 hr or < 2.6 on recheck= IV
Note: if > 2 at 2 hour= monitor only.
Eczema, thrombocytopenia, infection, Likely dx?
Wiskott-Aldrich
ROP screening
at 4 weeks of age or 31 week corrected- whatever is later
Sydenham chorea. Recommend Abx prophylaxis till?
21 y.o.`
Bipolar Dx- Manic episode. Med to consider
Lithium
Dx test with highest yield of abnormality in F with ASD?
- karyotype
- very long chain f.a.
- fragile x testing
- chromosomal microarray
Chromosomal microarray
Best way to monitor thyroid replacement in autoimmune thyroiditis?
TSH
How much do you correct low Na?
only up 10-12 in 24 hour.
When can you wear a seat belt?
> 36 kg
min. 8 y.o.
ht > 145 cm
When do you switch from rear to fwd seat, booster etc.?
Rear until 10 kg + 1 y.o. + walking
Fwd: for kids 10- 22kg and 122cm
Can switch to booster if 18kg and don’t fit fwd seat
Booster seat until 36 kg
Seat Belt= > 36 kg
min. 8 y.o.
ht > 145 cm
T or F: Optic neuritis at significant risk of developing MS
True
10 month old recently immigrated from refugee camp in Turkey. 3 doses oral polio and 4 doses of DAT. Now?
- pneumococcal conjugate + Hib
- pneumococcal, HIB, IPV
- DTap-IPV-Hib, pneumococcal
- No vaccine
Pneumococcal + Hib
3 doses oral count.
Hep B too!
Practical: unless very clear documentation we always assume none and start catch up schedule.
