Amboss Q Flashcards
Infectious mononucleosis increases risk of what
Splenic rupture
So avoid contact sports and strenuous actively for 4 weeks
Fe def anemia symptoms and RDW
⬆️ RDW
angular chelitis, koilonychia (spoon shaped con cavity)
<2 yr w/ Resp distress, cough, nasal congestion, wheezes, fever
Bronchilitis, RSV
Kallmann syndrome
X GnRH
X smell/taste
Male or female
Obese, hip pain, passive flexion=ext rot, abduction (Drehmann sign)
What, cause, treatment, age group
Slipped capital femoral epiphysis (femoral displaced from hip joint)
Bc of unstable proximal growth plate instabulity
Surgical pin femoral head
10-16yr
Marfan
Myopia, lens subluxation
Aortic dissection/aneurysm, berry aneurysm
Normal puberty aged
Female-8-13
Male-9-14
21 hydroxylase def
Precocious puberty
(Girls- ambiguous genitalia)
Hypoglcemia, hypotension
Infants with sickle cell prophylaxis
Ab to pneumococcus till 5 yrs old
Weight loss in less than 5 days of life
Less than 7% normal
Gained back by 10-14 days
Congenital rubella
Bilateral cataracts, sensorineural hearing loss, blueberry muffin rash, heart defect (PDA, Pulm A stenosis)
Androgen insensitivity syndrome
Phenotype female, genes male
Form testes remain in inguinal canal/abd
Testosterone turns to estrogen
No ovaries/ uterus
Gonadectomy
Duoudenal vs jejuni atresia
Jujenal— triple bubble x-ray
Duod- double bubblr
Rosella Infantum
HHV6
3-5 day fever
Then truncal rash spreads to face and extremities
Lymphadenopathy
Measles
Cough, coryza, conjunctivitis
Then blanching rash (start at head)
Palate—koplik spots
Generalized lymphadenopathy
Paramyxovirus
Rubella
Maculopapulat rash starts head then to trunk
Post auto ulnar lymphadenopathy
Older-arthritis
Infants asplenic get what
Vaccines anddd penicillin OR amoxicillin till 5yr
Fixed wide split S2
Atrial septal defect
Cavernous sinus thrombosis
HA, vision change, x CN, seizures
Orbital cellulitis
⬇️ vision, proptosis, painful eye movements
Preseptal cellulitis
Ocular pain and swelling/red
VACTERL association
Vertebral anomaly
Anal atresia
Cardiac anamoly
TEF
Renal anomaly
Limb malformation
21 hydroxylase def
Precocious puberty
Acne hypotension
11B hydroxylase def
HTN
precocious puberty
17a hydroxylase def
HTN
male w female genitalia
Female with primary amenorrhea/delay puberty
Palivizumab
For RSV at risk infants
Chlamydia
Conjunctivitis 5-14 days after birth
Pneumonia 4-12 wks after birth
Gonorrhea
Conjunctivitis 2-7dayd after birth
Can lead to septic arthritis and disseminated infection
Shallow genital ulcers + lymphadenopathy
Herpes
Diagnose w PCR
Treat w acyclovir
Minimal change Dz
Nephrotic
Fatty casts
Lots proteinuria
Treat—glucocorticoid, na restriction(edema control)
Bacterial rhinosinutisis
Greater than 10 days symptoms
Probably post viral
S pnuemo, Hib, moraxella
Treat amoxicillin
Amoxicillin to EBV?
Morbilliform rash
Prolong aPTT
internal
8,12,11,9
Prolong PT
Extrinsic
Fibrin form
Vit k def
Warfarin treatment
Vomiting on pH
Low Cl alkalosis
Low na, k
Epididymitis 15-35 yr old (post puberty)
Dysuria, swell/pain, fever, leukocytosis
Chlamydia, gonorrhea (nucleic acids amplification testing urine)
+ prehn- pain relief when lift
Epididymitis prepuberty and >35 yr
E. coli
+prehn- pain relief when lift
Leukocytosis, fever, pain/swell
Congenital adrenal hyperplasia main
Early secondary sexual characteristics
Precocious puberty
Virilization
Bp high or low
Aramatase def
Ambiguous genitalia
No secondary sexual characteristics
Tall stature
Osteoporosis (fractures)
Vomiting on pH and electrolytes
Alkalosis
Low na, k, Cl
Turner’s syndrome on heart
Coarctation of aorta
Corticosteroids for asthma
In acute exacerbation where brnchodiaotors not working
Hypertrophic cardiomyopathy
Systolic ejection murmur @ lower L sternal border
⬇️ squat
⬆️ valsalva
Mesonephric or wolffian duct gender
Male
Paramesonephric/Mullerian gender
Female
Müllerian duct agenesis
No fusion
Uterus, cervix, upper 3rd vagina atresia
Normal secondary sexual characteristics
Primary amenorrhea
Associatevjudney stuff, horseshoe kidney, renal agenesis
Gestational dm infant
Polycythemia (high hematocrit)
Macrosomia (>4000 kg)
Hypoglycemia (<50)
Ewing sarcoma
<20year
Long bone diaphysis
Lytic lesions
Small round blue cells
t, 11, 22
⬆️ESR, leukocytosis
Dark spot on x ray with onion skin around
Acute lymphoblastic leukemia
Age, symptoms, cell markers
2-5 yr
Bone pain
Fever
Hepatosplenomegaly
Lymphadenopathy
+ PAS, cd10, cd19, TdT
Retroogaryngeal abscess w/ labored respirations treat?
1st step- endotracheal intubation
Then surgically drain
Cyclic vomiting in less than 5yr treat
Cyproheptadine
Cyclic vomiting syndrome in greater than 5yr
Amitryptyline
Need IV can’t get periph venous access, other option?
Intraoaseous cannulation
Diagnose birch sprung
Rectal biopsy
Friedreich ataxia symptoms and gene
GAA repeat
Dysphagia, insulin R, hypertrophic cardiomyopathy, areflexia
Ataxia and kyphoscolosis obv
Normal BF /24hr
8-12 per 24 hr
If not BF enough?
Jaundice
W/ high unconjug bili
Weight loss
Dehydration
Asplenic at risk of what infections
Hib
Strep pnuemo
N meningitis
Medulloblastoma symptoms
Cerebellum
3-5yr
Icp—-HA, ataxia, vomit
Intussusception symptoms/age/diagnostics
Colicky abd pain, no bile vomit
Red/mucoid stools (currant jelly)
Target sign on US
⬆️3-12 months age
Intussceptio ntreat
Air enema
Monitor for 24 hours
Alpha thalassemia
Microcytic anemia
⬇️/normal RDW
HbH—jaundice, anemia at birth
At risk of Fe def anemia infants
> 6 months—only BF or only cows milk
Or premature birth
Cephalohematoma
Limited by suture lines
Head swelling, assisted vaginal delivery
Capital saccedaneum
Cross suture lines
Swelling may shift with movements
Assisted delivery risk
DKA IV given?
0.9 saline + insulin
21 hydroxylase def treatment
Lifelong glucocorticoid therapy
And hydrocortisone
Wiskott-Aldrich (3 symptoms)
Recurrent infections
Eczema
Thrombocytopenia
Failure to thrive
Osteomyelitis pathogen in sickle cell
Salmonella
Galactosemia symptoms (5)
Jaundice
Diarrhea
Cataracts
Hepatomegaly
Hypoglycemia
Kawasaki
Fever >= 5 days
Conjunctivitis
Strawberry tongue
Lymphadenopathy
Leukocytosis, anemia, thrombocytosis
ESR
Less than 5 yr ^^^
Leuprolide 1st line for what
Precocious puberty (central idiopathic)
⬆️LH and FSH
DKA and K
Decrease total body K even tho serum K normal or elevated
Carbamazepine SE
Aplastic anemia
Pancytopenia and low reticulocytes
Easy bruising
Laryngomalacia
Collapse supraglottic structures during inspiration
Inspiration stridor
Worse supine, feeding, crying
Better prone on stomach
Necrotizing enterocolitis symptoms and findings
Distended abd, ⬇️ bowel sounds, diarrhea, hematochezia
Gas in intestinal wall (pneumatosis intestinalis)
Testicular torsion
No cremasteric reflex (stroke ipsilateral thigh, no elevation of scrotum)
Hypogastric tender, testicular tenderness, scrotal elevation and swelling
IgA vasculitis or HSP (henloch schloen purpura) symptoms (6) and treat
Viral infection before
Colicky abd pain, vomit, blood stool, target sign (intussception), arthritis, hematuria, palpable purpura
Supportive care only
Congenital hypothyroidism
Thyroid dysgenesis
Poor feeding, lethargy, raspy/hoarse cry, jaundice, umbilical hernias, big head, large tongue, hypotonia
Transient synovitis symptoms and treat
Recent URI
Hip pain
No fever or low grade fever
Normal ESR, normal WBC
Joint effusion
Treat NSAIDS and rest
Mccune-Albright syndrome
G protein mutation
Cushing, acromegaly, hyperthyroidism
Fractures, hyperpigmented spots (cafe au lait spots), precocious puberty
⬆️alk phos
Bisphosponates
Hypertrophic pyloric stenosis treatment
Pyleromyotomy
But 1sr fluids and electrolytes to stabilize from vomit
vWD symptoms and treat
Epistaxis
Heavy flow periods
⬆️PTT, ⬆️ bleeding time
Normal plt counts
Treat desmopressin
BUN/Cr in dehydration
> 20
Rocky Mountain spotted fever
⬇️Na, thrombocytopenia
Flu-like
Rash @ ankles and wrists (then spreads to trunk, palms, soles)
Neohroblastoma (wilms)
Nontender abd mass
Doesn’t cross midline
Hematuria
Incidental or sympt (HTN, abd pain)
Neuroblastoma
Abd mass
Cross midline
Constitutional symptoms (fever, weight loss, fail thrive)
Asthma with ⬇️wheezing, RR
Resp arrest may need intubation
IL-12 R def
⬇️IFN-y
No defense against intracellular pathogens (salmonella, TB)
Severe ⬆️ triglycerides treat with
Fenofibrate
Gaucher
Anemia
Thrombocytopenia
Hepatosplenomegaly
Growth delays
Lipid filled macrophages (crumbled)
Glucocerebrodase def
Anticholinergic symptoms (7)
Flushing
Confused /Agitated
mydriasis
Tachycardia
Urinary retention
Dry/warm skin
Constipation/⬇️bowel sounds
Treat Anticholinergic
Physostigmine
X linked agammaglobinemia (bruton)
Recurrent pyogenic infections (n meningitis strep pneumonia, Hib) (otitis media, pneumonias)
Hypoplastic lymphoids
Starts presenting at 3-6 months