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Step 3 Final > Aaron: Pediatrics > Flashcards

Aaron: Pediatrics Flashcards

1
Q

Bacterial Conjunctivus is differentiated from viral conjunctivitis how?

A

bacterial conjunctivus immediately reaccumulates after being wiped away

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2
Q

Viral conjunctivus is no longer contagious when?

A

the eye discharge stops

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3
Q

Assuming a patient is positive for lyme disease, what is the next test to order?

A

ELISA test, do not order bacterial cultures on the patient

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4
Q

Infantile hypertrophic pyloric stenosis can be cause by what?

A

Macrolide abx exposure

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5
Q

Early daycare exposure can cause what?

A

Atopic dermatitis prevention

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6
Q

A patient has recurrent abscesses, what type of organisms are they vulnerable to?
What disease is this?

A

Catalase +

Chronic Granulomatous Disease

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7
Q

If there is a pediatric emergency, and no parent, what should be done?

A

Do the procedure

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8
Q

If patient has intusception, and the patient has extreme pain after an enema, what is the next step?

A

An Abdominal X-ray

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9
Q

RSV is very dangerous for infants, what is the one symptom that is particularly scary?

A

Apenic episodes

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10
Q

Iron deficiency anemia in patients can cause what?

A

Developmental Delay

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11
Q

A pediatric patient has scoliosis, and the patient’s Cobb angle is less than 10. What is the next best step?

A

Follow up only if the patient is symptomatic

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12
Q

Bilious emesis, abdominal distention, delayed meconium passing and a family history of recurrent sinus infections, what is this disease?

A

Cystic Fibrosis

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13
Q

Meningicoccal Meningitis has what abx given for prophylatic treatment

A

Rifampin

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14
Q

When Syphilis is suspected what other tests should be ordered?

A

Gonorrhea, Chlamydia, and HIV

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15
Q

Elder abuse, what are three things to order?

Patient has rib pain

A

Chest Xray
Tylenol/Toradol
Social Work Consult, get them to the ER

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16
Q

Does Minimal Change Disease have a night relapse risk?

A

Yes

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17
Q

What is a big risk factor for Sudden Infant Death Syndrome?

A

Maternal Smoking

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18
Q

Cranky toddler, pulling on his ear, purulent ear fluid cannot see the tympanic membrane, what could this disease be?

A

Suppurative Otitis media

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19
Q

Chlamydia Conjunctivus can cause what problems?

When is it seen?

A

Bilateral Purulent Drainage

5-15 Days

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20
Q

When Children have leg pain at night, what leg pain attribute is most concerning?

A

Unilateral pain

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21
Q

A patient has bow legs between ages 0-2. What is the next step in management?

A

Observe and Reassure

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22
Q

Hepatotoxicity and thrombocytopenia are side effects of what seizure medication?

A

Valproic Acid

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23
Q

What pediatric disease has an EEG with bilateral polyspike and slow wave discharges? Worse with alcohol and sleep deprivation

A

Juvenile Myoclonic Epilepsy

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24
Q

Are patient’s that have a febrile seizure at risk of having another febrile seizure?

A

Yes, can be caused 2/2 a viral illness. First day, must be observed.

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25
Q

If a patient does not tolerate milk around 3 months. Milk is eliminated from the diet. Then what should happen?

A

The patient should not re-introduce milk into their diet until 1 year old.

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26
Q

Strept throat, what lymph nodes are usually enlarged?

A

Anterior Lymph nodes

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27
Q

What is another name for keratitis?

A

Cornea infection

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28
Q

Hordeolum is a bacterial infection of what?

A

Sebaceous gland

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29
Q

Uveitis is due to an infection of what?

What type of diseases are they usually associated with?

A

Choroid, Vitreous, iris, ciliary body

Autoimmune diseases

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30
Q

Keratitis has what three symptoms?

What is the next best step?

A

Photophobia
Impaired Vision
Foreign Body Sensation

Referral to an ophthalmologist

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31
Q

Egg allergy with influenza, what should be done?

A

Give vaccine but make sure it is inactivated IM influenza vaccine

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32
Q

Non-classical adrenal hyperplasia has a 21 hydroxylase deficiency. What will they not have?

A

No testicular enlargement, early puberty and bone aging.

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33
Q

What are concerning pediatric hematoma features?

A

Greater than 4 cm

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34
Q

What is a big EBV/mono side effect?

A

Persistent fatigue for months

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35
Q

Non-classical adrenal hyperplasia has a 21-hydroxylase deficiency. What will they not have?

A

No testicular enlargement, early puberty and bone aging.

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36
Q

Pediatric patients that have iron deficiency supplementation should see what changes first?

A

Increase Reticulocyte Count

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37
Q

For Kawaski disease, ibuprofen is the first treatment. What is the next treatment?

A

IV Immunoglobulin

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38
Q

Fever for 5 days, rash (inguinal folds), nonexudative conjunctivitis, mucositis,, in a pediatric patinet?

A

Kawaski Disease

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39
Q

What type of tumor is unilateral, painful, causes hypertension and hematuria?

A

Wilms Tumor

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40
Q

What type of tumor has unilateral abdominal mass, flushing, sweating, and non-painful mass? There is catecholamine release.

A

Neuroblastoma

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41
Q

If a patient has a seizure, low Ca, high phosphate, high PTH, what is going on?

A

Pseudohypoparathyroidism, the patient has end organ resistance to PTH

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42
Q

What rash appears as a single patch, eventually causes an itchy, rash, spares palms and soles???? Viral symptoms

A

Pityriasis Rosea “Hearld patch”

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43
Q

What can cause dental carries and problems with patient’s teeth?

A

Feeding at Night

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44
Q

If an infant is drinking soy milk and he starts to have blood stools, what is the next best step?

A

Switch to formula

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45
Q

What are two things that d/c someone from an organ donation?

A

Under 18 or have uncontrolled psych history

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46
Q

What infectious disease can cause oculoglandular swelling and enlarged lymph nodes?

A

Bartonella Hensala

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47
Q

Are steroids recommended for viral meningitis?

A

No

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48
Q

Rocky Mountain Spotted Fever, what is the treatment of choice?

A

Doxycycline

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49
Q

Puberty development: breasts, no pubic hair, no menstrual cycle at age 15 and no breast/no menarche at age 13 is what?

A

Androgen Insensitivty Syndrome

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50
Q

Higher fever at presentation with bloody diarrhea does or does not hint a Shiga toxin E.coli?

A

High Fever points away Shiga toxin E. coli

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51
Q

A teenager in concussion protocol has dizziness and nausea, what is the next step?

A

Rest 24 hours and start light activity again

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52
Q

Septic Arthritis in a pediatric hip, what is the first treatment step and the respective abx?

A

Vancomycin and aspirate the hip

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53
Q

If you receive ampicillin for GBS and give birth, do you need another round of ampicillin?

A

No you do not

54
Q

Pediatric Tinea Capitis, what is the treatment of choice?

A

Oral Griseofulvin or Oral Terbinafine

55
Q

If I have a low reticulocyte count and arrest of erythropoesis, after an infection, what is this disease?

A

Aplastic Crisis 2/2 parvovirus

56
Q

Delayed testicle enlargement by what age is concerning?

A

14 years old

57
Q

If a patient’s testicle does not descend before what age, should the patient have surgery?

A

6 months, should have an orchiopexy

58
Q

What is the most common side effect of spina bifida?

A

Neurogenic bladder

59
Q

A pediatric patient has family that passed away from a heart attack at age 45, what screening test should be done early on?

A

Lipid panel

60
Q

NF-1 the patient has cafe au late spots and what else?

A

Optic Gliomas

61
Q

NF-2 patients typically have problems where?

A

Ears, deafness

62
Q

Lipid screening happens universally in children between what two age brackets?

A

Age 9-11
Age 17-21

63
Q

If a pediatric patient has being hinted at cystic fibrosis based on the PMHX, what is the abx tx of choice?

A

Cefepime and amikacin

64
Q

Balanitis is what?

A

infection of the glans penis

65
Q

Balanoposthitis is what?

A

infection of the glans penis and foreskin

66
Q

Assuming there is glans penis inflammation and potential fungal infection, what should be evaluated next?

A

Blood Glucose level

67
Q

Cough, Coryza, and Conjunctivitis are what?
What direction does the rash spread?

A

Measles, Vitamin A

Rash spreads from head to feet

68
Q

A patient (healthy) and sibling (post kidney transplant) need a Varicella vaccine, what are the next best steps?

What should be monitored

A

Patient should get, sister should not

Patient should be monitored for a rash, if he gets a rash, could hurt the sister (immunocompromised)

69
Q

A young girl has scoliosis, what would be concerning symptom regarding this?

A

Back Pain that awakens patients during the middle of the night, concerning for a spinal cord tumor

70
Q

What is a pediatric physiologic response that has 5-10 second breath pauses followed by rapid shallow breaths? Treatment?

A

Periodic breathing, watch and wait, should resolve around 6 months

71
Q

Apnea of prematurity, episodes last how long? When they should resolve by?

A

Greater than 20 seconds, 1st week of life

72
Q

In diaper rash ddx, what should be given for big red beefy plaques? Involves the skin folds

A

Clotrimazole, fungal infection

73
Q

Irritant contact dermatitis spare what areas, what is the treatment?

A

Spares skin Folds, irritant, use a topical barrier, zinc oxide

74
Q

Do cate bite puncture wounds require prophylactic abx, even if domestic animal?

A

Yes, i know

75
Q

How many fever days are needed to start to worry about kawaski disease?

A

5 days of fever

76
Q

How long should a patient take oral penicillin after a S. Pyogenes infection?

A

10 days, cannot prevent glomerulonephritis

77
Q

A young patient was sick a week ago, never sexually active. Arthritis, joint pain, and a slight facial, malar rash is seen. How does one differentiate between Lupus and Viral Arthritis?

A

Viral Arthritis is usually seen a week or so after the patient’s illness. SLE is much more gradual and over time

78
Q

Knock Knee in patients, symmetric angulation inward, the patient should do what, age 3?

A

Do nothing, no walking/corrective shoes are needed, will resolve on its own

79
Q

Acne that does not respond to treatment, regardless of the type, what is usually the next medication step?

A

oral abx (macrolide or doxycycline)

80
Q

If a patient has a 7 minute seizure, and she has a 104F fever, and is not back to her neuo baseline in 10 minutes, why should she have an LP?

A

AMS, not back at baseline, concern for meningitis

81
Q

Mastoidites requires what?

A

Middle Ear Drainage and IV abxs

82
Q

An egg allergy only impacts what vaccination?

A

Yellow Fever

83
Q

What is the SPF number that is suggested for pediatric Sunscreen?

A

30 or higher

84
Q

What age should their be concern if a young female patient has not had her period yet?

A

15 years old

85
Q

Do oral steroids help in RSV?

Is a nasal swab necessary for an RSV diagnosis?

A

No

No

86
Q

If a baby has an RSV disease, what is something that could potentially cause/recurr?

A

Recurrent Wheezing

87
Q

Chronic Cough lasting for more than 4 weeks, what should be done?

A

Spirometry

88
Q

Croup, barking cough, what should the patient be given?

A

IM corticosteroids and nebulized epinephrine

89
Q

Croup has the steeple sign on chest xray, will that be needed to diagnostically treat the patient?

A

No

90
Q

True or False, Eczema will resolve by adulthood

A

True

91
Q

Spine Kyphosis or increased spine curvature between 20-40 degrees, what is the treatment?

A

None, continue to observe

92
Q

What is physiologic jaundice?

Will there be anemia?

A

Jaundice that appears after birth in most infants, due to increased RBC count with a shorter RBC life span, and decreased hepatic bilirubin clearance

No anemia

93
Q

When should pureed foods be introduced into the patient’s diet?

A

6 months

94
Q

Can breast milk incidentally cause iron deficiency anemia?

A

Yes

95
Q

Mentzer index (MCV/RBC) can help differentiate what diseases?

What is the hemoglobin usually under?

A

Mentzer Index > 13, think iron deficiency anemia
Mentzer Index < 13, think about alpha and beta thalassemia

Hemoglobin less than 3

96
Q

When should cow’s milk start to be introduced with babys?

A

One year old

97
Q

Platelet count under 30,000, ITP, what should the patient be given?

A

Immunoglobulins

98
Q

Cephalic swelling at birth that crosses the midline is called what? Treatment?

A

Caput Succedaneum, resolves within a few days

99
Q

Cephalohematoma and subperiosteal bleed is a concerning head finding. What will be seen on physical exam?

A

Swelling that does not cross the midline

100
Q

Lead levels between 0-44, what should be given?

Lead levels between 45-69, what should be given?

Lead levels above 70+, what should be given?

A

0-44: No medications

45-69: DMSA, succimer

70+: Dimercaprol and EDTA

101
Q

In order for lead poisoning to be treated with activated charcoal, when should be given?

A

Appear in an hour

102
Q

IgA nephropathy shows up with painless hematuria after a viral URI, what other disease symptoms are concerning with the patient after the hematuria has resolved?

A

HTN, elevated creatinine, and persistent proteinuria

103
Q

What is the magic number that if bilirubin is above it, the patient needs a blood transfusion/exchange?

A

Bilirubin 20-25 mg/dL

104
Q

Corticosteroid suppression over what length needs a taper?

A

3 weeks, otherwise, no taper

105
Q

What disease pathology occurs when a patient progresses from stable (able to bear weight) to unstable cannot bear weight? The patient is young, obese, no trauma, no fever

A

Slipped Capital femoral epiphysis

106
Q

If an infant is an IV drug user, what should they have done regarding hepatitis B treatment?

A

Hepatitis Vaccine and immunoglobulin within 12 hours of birth, should be given promptly

107
Q

New Type 1 DM, elevated A1c and Vaginal candidiasis, what is other test that should be ordered?

A

Thyroid function

108
Q

Scoliosis with a Cobb angle greater than 40 degrees needs what? Less than 40 degrees means what?

A

Ortho consult

Less than 40 degrees leave alone

109
Q

Hyperglycemic baby can have what heart problem?

A

Thickened IV septum, resolves without surgery

110
Q

Legg-Calve-Perthes disease is seen in what pediatric age group?

A

5-7 years old

111
Q

What empiric abx Sickle Cell Coverage should be given? Concerned for osteomyelitis?

A

Clindamycin and Ceftriaxone

112
Q

What type of cellulitis is worse with eye movement? Tx?

A

Orbital Cellulitis, IV abx plus or minus surgical debridement

113
Q

What type of cellulitis is not worse with eye movements?

A

Septal Cellulitis

114
Q

What type of cellulitis is worse with eye movement? Tx?

A

periobital Cellulitis, IV abx plus or minus surgical debridement

115
Q

Stressful situations can have a potential complications with elevated glucose and ketones with a sickness and illness is what?

A

Stress hyperglycemia

116
Q

TSC Patients have elevated chance of what? What test should be ordered?

A

Epilepsy and EEGs evaluate the problems

117
Q

Walking on the lateral part of the foot as an infant is what?
What is the treatment?

A

Clubfeet
Tx: Applying molding casts to the feet can improve the condition

118
Q

In babies, is ceftriaxone recommended in babies?
why or why not?

A

No ceftriaxone in the first month of life
Can displace bilirubin from albumin, can make kenicterius worse

119
Q

A baby has sepsis the first month of life, what are the best meds?

A

Ampicillin and Gentamicin

120
Q

S. Pharyngitis typically has what kind of lymphadenopathy?

A

Anterior Cervical Lymphadenopathy

121
Q

Sickle Cell patient has macrocytic anemia, what is the first thing to evaluate?

A

B9 deficiency

122
Q

Speech regression, loss of purposeful hand movements, gait disturbances, and seizures in a pediatric patient. What is this?

A

Rett Syndrome (MECP2 gene)

123
Q

Wilms tumor
Anirida
Genitoiurinary Syndrome
Mental Retardation

Where is the malignancy based?

A

Renal Mass

124
Q

If a patient presents with drinking a lot of water and is not in DKA, what is the first test?

A

Water Deprivation test, concern for polydypsia

125
Q

If patient has a penicillin allergy and needs pre-surgery abx, what is an alternative?

A

Vancomycin

126
Q

Recurrent headache, minutes to hours, 30 year old male, little past medical history, what is the most likely diagnosis?

A

Rupture AVM

127
Q

Focal Nodular Hyperplasia is characterized by what?

A

hyperdense lesion that has central, stellate scar

128
Q

A young child has stridor when laying supine, but resolves when prone. What is this?

A

laryngomalacia, should do flexible fiberoptic larygnscopy

129
Q

After having the flu, a patient takes an aspirin, this causes hepatomegaly with jaundice, cerebral edema, low glucose, and elevated liver enzymes, what is this?

A

Reye Syndrome

130
Q

Patient has a cold, runny nose one week, and the symptoms have resolved, the patient has a murmur and bilateral wheezing, what is this?

A

Viral Myocarditis

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