April 30th Flashcards
What is erythema infectiosum?
Parvovirus B19 viral infection, causes slapped cheek rash
How does staph scalded skin present?
Caused by staph aureus; presents with flaccid bullae followed bhy extensive exfoliation of the skin; most common in infancy and rare beyond age 5
How does roseola present?
High fever, then rash
What is seen on imaging in a neuroblastoma?
Calcifications and hemorrhages
What are the most common metastatic sites of a neuroblastoma?
Long bones, skull, bone marrow, liver, lymph nodes, and skin
2 year old female with elevated homovanillic acid and vanillylmandelic acid in urine
Neuroblastoma
Wilms’ tumor arises from what embryonic structure?
Metanephros
What does the embryonic structure mesonephros give rise to?
Seminal vesicles, epididymis, ejaculatory ducts and ductus deferens
What does the embryonic structure paramesonephron give rise to?
Fallopian tubes, uterus and part of the vagina
What is congenital dermal melanocytosis?
“Mongolian spots” Blue grey patches on lower back/buttocks; more common in Asains and African Americans
What is a nevus flammeus?
Port wine stain; do no regress, respect midline
What is a nevus simplex?
Blanching pink patches that fade with time, usually located on eyelids, glabella and nape of neck
How is preeclampsia diagnosed?
New onset HTN (SBP >140 and/or diastolic >90) at >/= 20 weeks gestation, plus proteinuria (and/or end-organ damage); proteinuria being urine protein/Cr ratio >/= 0.3 or a 24 hr urine with >300 mg of total protein
What are the severe features of preeclampsia? (There are 6)
SBP > 160 OR DBP >110; thrombocytopenia, increase Cr, increased transaminases, pulmonary edema, visual or cerebral symptoms
How is PTSD treated?
SSRIs/SNRIs, trauma-focused CBT, and prazosin for nightmares
How is preterm labor managed if GA is < 32 weeks?
Betamethasone, tocolytics (eg indomethicin, nifedipine), MgSO4 for fetal neuroprotection, and penicillin if BGS positive/unknown
How is preterm labor managed from 32-33 6/7?
Betamethasone, tocolytics (nifedipine or indomethicin), penicillin if GBS positive/unknown
How is preterm labor at >34 weeks managed?
Betamethasone and penicillin if GBS positive or unknown
What is seen on MRI in Friedreich ataxia?
Marked atrophy of the cervical spinal cord and minimal cerebellar atrophy
What are the neurologic exam findings of Friedreich ataxia?
Limb and gait ataxia, loss of DTRs, loss of vibratory and position sense
What cardiovascular manifestations are seen in Friedreich ataxia?
Necrosis, degeneration of fibers, myocarditis, fibrosis, cardiomyopathy, arrhythmia, CHF
Loss of fetal station (fetus retracts) in a patient with previous uterine surgery
Pathognomonic for uterine rupture
How does a positive urine urobilinogen assay help with the diagnosis of elevated bilirubin?
Positive urine urobilinogen assay (more urobilinogen and no bilirubin in the urine) is seen in hemolysis; positive urine bilirubin assay reflects buildup of conjugated bilirubin
What cardiac abnormalities are seen in DiGeorge Syndrome?
Truncus arteriosus (strongest), others: tetralogy of fallot, interrupted aortic arch, and septal defects
What test is used to determine the dose of anti-D immune globulin after delivery?
Kleihauer-Betke test; if large enough dose not given, patients can become alloimmunized
What is seen on US in an endometrioma?
Adnexal mass with ground glass appearance
Physical examination reveals what in endometriosis?
Adherent, immobile uterus
What is Beckwith-Wiedemann syndrome?
Syndrome that presents with hemihyperplasia, macroglossia, omphalocele, hyperinsulinism
What is a superficial infantile hemangioma?
Aka strawberry hemangioma; benign capillary tumor; vascular birthmark appears during first few weeks of life, undergoes rapid growth, then spontaneous regression
How is a superficial hemangioma managed?
Observation, topical beta blocker if ulcerated or in cosmetically sensitive area, or eyelid/trachea
What are the contraindications to breastfeeding?
Active untreated TB, maternal HIV infection, herpetic breast lesions, active varicella infection, chemo or radiation therapy, active substance abuse; baby with galactosemia
How is dactylitis treated?
Hydration and pain control
Which antipsychotics have highest risk for metabolic syndrome?
Olanzapine and clozapine (second gen)
What should be periodically monitored in Lithium use?
TSH
What is the treatment for bacterial vaginosis?
Metronidazole; safe to use in pregnancy
What is seen on US of the ovaries in Turner Syndrome?
Streak ovaries
What is the inheritance pattern of osteogenesis imperfecta?
Autosomal dominant; type I collagen mutation
What type of anemia is seen in riboflavin deficiency?
Normocytic
What is the treatment for nonbullous impetigo?
Topical antibiotics (eg mupirocin)
How is Parkinson disease dementia differentiated from Lewy Body dementia?
PDD is diagnosed when parkinsonism predates cognitive impairment by > 1 year
Neonate with central cyanosis, LAD and small/absent R waves on ECG
Think tricuspid valve atresia
4 yo M with fever, odynophagia, drooling, neck stiffness, muffled voice with inability to extend neck and widened prevertebral space seen on XR is suggestive of what?
Retropharyngeal abscess
Abdominal pain, jaundice and palpable mass in RUQ of child < 10 years old
Think biliary cyst
What is the treatment of neonatal thyrotoxicosis?
Methimazole plus beta blocker (for symptomatic patients)
