2021 PREP Flashcards
What diagnosis is supported by high fecal fat but normal pancreatic elastase?
Celiac disease (fat malabsorption but normal pancreatic function)
What complement levels are expected in PSGN?
Low C3 and normal C4
Which respiratory virus commonly causes acute hemorrhagic cystitis?
Adenovirus
Which OTC medication for abdominal pain is commonly associated with melenotic-appearing stools?
Bismuth subsalicylate (Pepto Bismol)
What is the treatment for bloody otorrhea from superficial trauma (i.e. curette use)?
Supportive care
What is the evaluation for medullary thyroid carcinoma in patients with MEN 2B?
Thyroid US and serum calcitonin levels
What are the phenotypes of MEN 1, MEN 2A, and MEN 2B?
What are the most common symptoms of maternal parvovirus B19 infection?
Lacy rash and arthralgias
Which congenital cardiac anomalies are associated with Turner syndrome?
Bicuspid aortic valve and coarctation of the aorta
Which lab abnormality is characteristic of urea cycle disorders?
Hyperammonemia
Which congenital abnormality is associated with clenched hands with overlapping fingers?
Trisomy 18
What are the hallmarks of physical exam in trisomy 13?
Cutis aplasia and midline defects
What is the definition of pubertal delay in boys?
Testicular volume < 4 mL by age 14
At what age can children be vaccinated against hepatitis A?
≥ 1 year of age
What is the required timeframe for administering immune globulin after a hepatitis A exposure?
Within 2 weeks
What is the preferred post-exposure prophylaxis against hepatitis A in children ≥ 1 year of age?
Hepatitis A vaccine
When is imaging indicated in children with genu valgus?
> 7 years of age with intermalleolar distances greater than 8 cm
Which bacteria most commonly cause infective endocarditis?
Strep viridans and Staph aureus
What is the difference in red reflex for cataracts and glaucoma?
Cataracts: usually unilateral
Glaucoma: bilateral clouding
What is the chance of passing on an X-linked recessive disorder to a male child?
50%
What is the difference between intention-to-treat and per-protocol analysis?
Intention-to-treat: includes all enrolled participants regardless of study completion (improves power because it increases N)
Per-protocol: includes only participants who completed the study
How can urinary anion gap help to differentiate between RTA and diarrhea?
Urinary ion gap = [Na + K] compared to Cl
Positive in RTA: [Na + K] > Cl
Negative in diarrhea: [Na + K] < Cl
How does obesity impact thyroid testing?
Artificially increases TSH
When should a statin be considered?
LDL ≥ 160 despite dietary and lifestyle changes
What is the treatment of persistent bacterial bronchitis?
Augmentin for 2-4 weeks
What is the difference in physical exam between acute flaccid myelitis and idiopathic transverse myelitis?
Acute flaccid paralysis: can be unilateral and affect 1+ limbs
Idiopathic transverse myelitis: bilateral
What is the primary treatment of Prader-Willi syndrome in the first year after life?
Growth hormone supplementation
What are the typical physical characteristics of patients with Prader-Willi syndrome?
Almond-shaped eyes, thin upper lip, small hands and feet
What is a potential significant adverse effect of hallucinogens?
Serotonin syndrome
Which nutritional deficiency is associated with goat milk ingestion in infants?
Folate deficiency
Which risk factor is associated with higher weight loss (~10%) in a neonate in the first 24-48 hours after birth?
Birth via CS
What is the difference in results of high-dose dexamethasone suppression test for pituitary vs. adrenal sources of excess cortisol?
Pituitary source: suppressed cortisol level
Adrenal source: no response
What is the appropriate post-exposure prophylaxis for varicella exposure by age and immune status?
< 12 months of age: no intervention
> 12 months of age and healthy: vaccine
Immunocompromised: immune globulin
What is the pathologic finding of sarcoidosis?
Non-caseating granulomas
What is the treatment of syphilis by stage?
Primary, secondary, and early latent: IM penicillin x1
Late latent and tertiary: IM penicillin once weekly x3 weeks
Which mutation causes fragile X syndrome?
CGG repeats in FMR1
What is the management of maternal ITP in neonates?
IVIG
What is the expected bladder capacity in children > 2 years of age?
(age + 2) x 30
What is the initial management of an ocular hyphema?
Placement of an eye patch
What are the most common adverse effects of a ketogenic diet?
GI upset, hyperlipidemia, and kidney stones
Which medication should be given to patients with weakness in the setting of organophosphate ingestion?
Pralidoxime
Atropine is the first-line treatment but only works at muscarinic receptors, and weakness is related to nicotinic receptors
What is the initial management of tympanic membrane effusions?
Monitor for 3 months prior to further evaluation
Which age group is associated with Kingella septic arthritis and osteomyelitis?
< 5 years of age
What are the consequences of rapid correction of hypernatremia and hyponatremia?
Rapid correction of hypernatremia: cerebral edema
Rapid correction of hyponatremia: central pontine myelonelysis
What is the expected testicular volume at puberty?
≥ 4 mL
What are the common signs and symptoms of dextromethorphan overdose?
Euphoria, tachycardia, mydriasis, diaphoresis
In a child with an unbalanced translocation with trisomy 21, which parental karyotype carries the highest risk of passing on trisomy 21 to future children?
Maternal balanced translocation
Which type of insect bite is commonly associated with sympathetic, parasympathetic, and neuromuscular symptoms?
Scorpion bite
What is the main purpose of a cross-sectional study?
Assesses the burden/prevalence of disease in a population at a specific point in time
What are the necessary athletic restrictions for adolescents with significant HTN?
Participation in low-intensity sports only to prevent significant spikes in BP that can cause cerebrovascular events
Which antibody can indicate hepatitis B immunity via past infection?
Positive HBcAb
What is a possible treatment option for refractory colic?
Probiotics
Which long-term consequence is often associated with chemotherapy and administration of cranial radiation?
Metabolic syndrome
Caused by hypothalamic radation
Which deficiency is associated with acrodermatitis enteropathica?
Zinc deficiency
What is the treatment for subluxation of the radial head (nursemaid’s elbow)?
Hyperpronation or supination and flexion
What is the treatment for latent TB?
Isoniazid for 9 months
What is the treatment for active TB?
RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) therapy for 2 months followed by isoniazid and rifampin for 4 months
What is the treatment for active TB?
RIPE (rifampin, isoniazid, pyrazinamide, ethambutol) therapy for 2 months followed by isoniazid and rifampin for 4 months
What is considered a positive PPD test in children ≥ 4 with no risk factors?
≥ 15 mm
What are ketotifen eye drops?
Antihistamine mast cell stabilizer for allergic conjunctivitis
What are the symptoms of VX gas exposure?
Immediate anticholinergic symptoms
What is the definition of micropenis in a term neonate?
Stretched phallic length of < 2-2.5 cm
When should a repeat audiology exam be completed for term neonates who fail the newborn hearing screen?
By 3 months of age
What is seen on hemoglobin electrophoresis in beta-thalassemia major?
0% HbA
What is seen on MRI in adrenoleukodystrophy?
Bilateral posterior demyelination in parieto-occipital lobes
Which systems are affected in Zellweger syndrome?
Brain, liver, and kidneys
How can Rett syndrome be identified on growth charts?
Deceleration of head circumference
Which organism is associated with gastroenteritis following contaminated pork ingestion?
Yersinia enterocolitica
What is the incubation period of salmonella gastroenteritis?
6-48 hours
What is the main risk factor for brucellosis?
Exposure to unpasteurized dairy products
What is the appropriate follow-up after H. pylori treatment?
Urease breath testing or stool antigen testing 4 weeks after completion of treatment
What are the primary symptoms of myotonic dystrophy?
Muscular weakness, cardiac conduction abnormalities, and cataracts
Which mutation is responsible for myotonic dystrophy?
CTG repeats in DMPK gene
What is considered a normal IQ?
85-115
Which type of lesion has an orange-peel appearance and becomes red and swollen after rubbing it?
Mastocytosis
What is found on EKG in anomalous left coronary artery from the pulmonary artery (ALCAPA)?
Deep Q-waves from myocardial ischemia
What leg length discrepancy is considered pathologic and requires an orthopedic surgery evaluation?
> 2 cm
When is zidovudine prophylaxis indicated during labor and delivery?
Maternal viral load > 1000 or unknown
What is the management of babies born to HIV-infected mothers with an undetectable viral load?
Zidovudine for 4 weeks
What is the presentation of Menkes disease?
Loss of milestones, seizures, and hypotonia
What is the mutation that causes osteogenesis imperfecta?
Mutations in COL1A or COL1B
Both are genes for type I collagen
What is the presentation of neuromyelitis optica?
Extensive transverse myelitis and optic neuritis
Which antibody is associated with neuromyelitis optica?
Antibodies against the aquaporin-4 channel
What is the difference in incubation period between norovirus and cryptosporidium gastroenteritis?
Norovirus: 12-48 hours
Cryptosporidium: 3-14 days
What is the ideal time to order a Tylenol level after overdose?
4 hours
When can activated charcoal be administered after a Tylenol overdose?
Within 2 hours of ingestion except in setting of mental status changes
What is the management of pityriasis rosea?
Symptomatic control
What is the treatment of tinea versicolor?
Topical selenium sulfide
What is the treatment of tinea versicolor?
Topical selenium sulfide
What is the confirmatory test for chronic granulomatous disease?
Flow cytometry for dihydrorhodamine 123
What is the appropriate discharge caloric density of feeds for premature babies born at < 1800 grams?
22 kcal/oz
Can use 24 kcal/oz if not growing well in NICU
Which 2 diagnoses are associated with an elevated upper-to-lower body ratio?
Skeletal dysplasia and precocious puberty
