Aquifer Practice Qs Flashcards
1
Q
chorioretinitis
A
congenital toxoplasmosis and CMV infections
2
Q
congenital CMV
A
microcephaly jaundice HSM low birth weight petechiae at birth
3
Q
congenital rubella
A
IUGR sensorineural deafness eye abnormalities (retinopathy, cataracts) meningoencephalitis cardiac defects interstitial pneumonitis petechiae HSM jaundice
4
Q
18 months
A
walk backwards (may run) scribble tower of 2 cubes 3-6 words in vocabulary help in house/remove garments
5
Q
Beckwith-Wiedmann syndrome
A
genetic overgrowth syndrome
- WILMS’ timor
- omphalocele
- hemihypertrophy
- hypoglycemia
- LGA
6
Q
neuroblastoma favorable genetics
A
non-amplification of the n-myc gene
7
Q
neuroblastoma prognosis (infants <1 y/o)
A
may spontaneously regress
8
Q
neuroblastoma (infants >18 months of age)
A
prognosis not as good
9
Q
small round blue cells
A
neuroblastoma
Ewing’s sarcoma
medullobasotma
10
Q
enlarged cells with intranuclear inclusion bodies
A
(owl’s eyes)
CMV
11
Q
4-yr milestones
A
hop on 1 foot
copy a cross
pour/cut/mash their own food
brush teeth
12
Q
5-yr milestones
A
mature pencil grasp print some letters/numbers skip, draw person with 6+ body parts copy squares tie knot
13
Q
3-yr milestones
A
throw ball overhand
ride tricycle
build tower of 6-8 cubes
copy circle
14
Q
Lead poisoning
A
homes built before 1978
pt 6-36 mo most at risk for lead poisoning
15
Q
ADHD dx
A
6>/= sx in 2 or more settings for at least 6 mo., and several must be present before 12 y/o
16
Q
neuroblastoma
A
catecholamine xs (Urine or serum VMA/HVA=highly specific)
17
Q
obesity percentile
A
> 95th percentile
18
Q
Rett syndrome
A
X-linked pervasive developmental disorder seen in only females; affected males die in utero/at birth
regression of language/development
ID
ataxia
hand-wringing
19
Q
18 mo. word count
A
at least 6 words
20
Q
acute otitis media bugs
A
strep pneumoniae
H. influenzae
21
Q
acute otitis media 1st linen tx
A
amoxicillin
22
Q
order of puberty in males
A
testicular enlargement
pubic hair
growth of penis and scrotum
first ejaculations
growth spurt
23
Q
Most comm cause of CP I adolescent
A
Precordial catch syndrome
24
Q
TTN is comm assoc w/
A
maternal diabetes
25
hypotonia, absence of flexed posture, weak suck
hypoglycemia of the newborn
(inc in maternal serum glucose stim fetal panic B cells to inc insulin prod --> leads to hypOglycemia when placental glucose supply is discontinued post-delivery)
26
When is hypoglycemia of the newborn required to be corrected
At < 4 hours of life, a glucometer reading of < 25 mg/dL without symptoms or < 40 mg/dL with symptoms would require intervention to correct the hypoglycemic state.
27
PROM
>18 hr prior to delivery --> sepsis risk
28
TTN is more common with which type of delivery?
c/s (the normal mechanical force of labor helping to expel fluid from the lungs is lacking)
29
persistent pulmonary HTN
babies born after 34 weeks
underdevelopment of lungs --> inc pulmonary vascular resistance --> poor prognosis
30
bronchopulmonary dysplasia
is the result of prolonged mechanical ventilation
31
breastfeeding jaundice
usually appears early in first week of life
dec milk supply --> limited enteral intake --> inc enterohepatic circulation (UC bili is reabsorbed into bloodstream and is recirculated - causing a rise in serum levels of UC bili)
32
breast-milk jaudnice
usu in 1-2 week old baby who is breastfeeding well
33
crigler-najjar
first few days of life and persists
UDPGT deficiency/absence
34
T/F: PKU is assoc w/ neonatal jaundice
F
35
caput succedaneum
crosses suture lines
36
cephalohematoma
does not cross suture lines
37
enlarged anterior fontanelle, jaundice, hypotonia, and an umbilical hernia
hypothyroidism
38
tx regimen for congenital hypothyroidism (0-6 mo.)
10 to 15 mcg/kg/day of crushed levothyroxine in liquid
within 2 weeks of onset to mitigate severe brain damage and cognitive impairment
39
hypotonia, lethargy, constipation, weak cry, respiratory failure, absent DTRs
infant botulism
40
OTC deficiency
elevated urine orotic acid
most com urea cycle disorder
X-linked
41
enlarged liver
mental status changes
hyperammonemia
OTC deficiency
42
hurler syndrome
alpha-L-iduronidase deficiency
AR LSD
sx @ 1 y/o
HSM, coarse facial features, frontal bossing, corneal clouding, developmental delay
43
cystathionine synthase
-homocystinuria
marfanoid body habitus, hypercoag, devel delay
test via inc methionine urine or blood
44
Von Gierke's disease
AR GSD
hypoglycemia, hepatomegaly, metabolic acidosis
45
PKU
vomiring, hypotonia
musty odor
level delay
dec pigmentation of the hair and eyes, eczema
46
Niemann-Pick disease
LSD
presents at 6 mo.
```
hepatomegaly
ataxia
seizures
progressive neuro degeneration
cherry red macula
```
47
Fever without other respiratory symptoms
meningitis and UTI
- can only rule out meningitis by lumbar puncture
- assess for pyelonephritis etiology with US
48
measles
prodrome of 3 Cs + high fever, general malaise, anorexia
2nd-4th day --> maculopapular erythematous rash appears starting on the face/upper neck and spreading downward
49
fever (1d) of 101, fussiness (4d), dec appetite, non-bilious, non-bloody emesis, dec urine output
eval risk for UTI with urinary catheterization
50
sandpaper
scarlet fever
51
hand foot mouth
cocksackie A
52
koplik spots
white spots on buccal mucosa (measles)
53
erythema/edema of the extremities
kawasaki
54
red eyes without discharge
unilateral cervical adenopathy
kawasaki
55
kawasaki dx criteria
fever >/= 5d
1. polymorphous rash
2. conjunctivitis
3. unilateral cervical lymphadenopathy
4. changes in oral mucosa
5. extremity changes (red/swell)
56
still's disease
systemic onset juvenile idiopathic arthritis
57
RMSF
HA
fever
myalgia
centrally progressing petechial rash originating on wrists and ankles
58
suspect group A strep
rapid strep test with back-up if negative
59
kawasaki pt should receive which screening?
echo to look for coronary artery aneurysm
| greatest risk for developing is in subacute phase (>10d)
60
juvenile idiopathic arthritis pt should receive which screening?
ophtho (uveitis)ƒ
iridocyclitis
evanescent rash, macular and salmon-colored
61
paroxysmal stage of pertussis
4-6 weeks
repetitive, forceful coughing
abx will reduce communicability but won't alter clinical course
62
pertussis abx
azithromycin
clarithromycin
erythromycin
63
laryngotracheobronchitis
croup
via parainnfluenza 1
most comm in winter
ages 2-5 y/o
seal bark cough w/ fever
1 wk
64
Acute bronchiolitis
most comm cause of wheezing in infant
febrile pt
CXR: scattered atelectasis and/or diffuse opacities from bronchial obstruction
65
stridor
airway narrowing above the thoracic inlet
seen in resp infections (epiglottis, croup)
laryngomalacia (congenital softening of larynx)
66
epiglotittis
Hib
rarely occurs w/ staph or strep
fever, stridor, drooling, dysphagia, respiratory distress
appear toxic in "sniffing" position (sitting, leaning forward, neck hyperEXTENDED, chin protruding)
thumb sign on film
67
pertussis phases
catarrhal: 1-2 weeks --> URI sx (can be indistinguishable from common cold)
paroxysmal: 4-6 weeks --> whooping cough
confirm dx w/ nasopharyngeal PCR
68
bronchiolitis
RSV
69
all children w/ chronic cough >4weeks
CXR
70
dx of sinusitis
clinic dx (often preceded by URI with nasal congestion as prominent feature, leading to nocturnal cough due to post-nasal drip
*only obtain CT in complicated cases or cases resistant to tx
71
habit cough
loud, short, dry, brassy, spasmodic
unchanged by exercise. or. cold air, classically resolves during sleep
dx of exclusion
72
intermittent asthma
sx <2d/wk or 2 nights/month
tx: SABA rescue inhaler
73
mild persistent asthma
3-6 d/wk and 3-4 nights/mo
tx: low ICS and rescue inhaler
74
moderate persistent asthma
sx daily and more than 1 night/wk
tx: med ICS and rescue inhaler
75
severe persistent asthma
sx throughout day and every night
tx: LABA, high ICS, oral CST
76
difficulty breathing, high fever, drooling
epiglottitis
77
failure of amoxicillin for otitis media
amoxicillin/clauvulanate
addnl beta-lactamase coverage for H. flu and Moraxella catarrhalis
78
when can you observe acute otitis media
6 mo - 2 y/o when pt has non-severe sx (NO high-grade fever)
79
frequent causes of acute otitis media
1. H. influenzae
| 2. M. catarrhalis
80
bilateral yellow and poorly mobile tympanic membranes, developed over 4 months
otitis media with effusion
81
sinusitis in infancy
maxillary or ethmoid
drains to middle meatus
82
sinusitis in 3rd-5th year of life
sphenoid sinuses
83
sinusitis in 6th-10th year of life
frontal sinuses
| *pain over frontal bone and poss facial swelling
84
correcting severe dehydration
LR or normal saline in up to three 20 mL/kg boluses of isotonic solution
reassess for clinical improvement following each admin
when back @ baseline --> attempt oral rehydration
if can't tolerate PO --> continue IV hydration with 5% dextrose, 0.9% normal saline
maintenance fluids: isotonic (0.9% saline, LR)
OR
100mL/kg/day oral rehydration solution losses
85
GERD with esophagitis
blood-streaked emesis if forceful vomiting
86
volvulus
can cause blood in stool
87
intussusception
currant jelly stools = LATE finding (necrosis from bowel ischemia)
sausage mass
88
pyloric stenosis
usu between 3-5 weeks go age, RARELY after 12 wk
olive-sized mass
89
correcting mild-moderate dehydration (min urine output over last day, tachycardia, preserved skin turgor and cap refill)
trial bolus of oral rehydration solution:
50-100ml/kg oral rehydration administered 2-4 hours in small aliquots (sips or with spoon)
90
appendicitis presentation children/infants
migration of pain to RLQ
negative Rovsing's
involuntary guarding
fever without perf
91
rebound tenderness in peds appendicitis pt
neither sensitive nor specific
92
ectopic pregnancy
painless vaginal bleeding 6-8 weeks after their last menstrual period
93
PID pain
post-coital
often during or immediately after menstruation
RUQ pain
fever
94
DKA dx
```
>200 mg/dL
venous pH <7.3
bicarbonate <15 mEq/L
ketoninemia
ketonuria
```
inc adrenergic tone --> tachycardia
95
Cushing triad
HTN
inappropriate slowing of HR
irregular respirations (Cheyne-Stokes respiration)
(*also epigastric discomfort via inc ICP causing vagal stim --> gastric acid secretion)
96
fever
colicky abd pain
diarrhea
gastroenteritis
| *most hospitalizations occur in children <5 y/o
97
Legg-Calves-Perthes disease
avascular necrosis of the capital femoral epiphysis
98
Transient synovitis
usu isolated joint
may follow URI
resolves on its own 3-7d
99
organisms responsible for septic arthritis (neonates < 2 months)
Staph aureus, GBS, E coli
100
organisms responsible for septic arthritis
| older children
Staph aureus, Haemophilus influenzae, Strep pneumo
101
organisms responsible for septic arthritis
| adolescents
Neisseria gonorrhea
102
osteomyelitis bugs
Staph aureus or Strep pyogenes
103
transient synovitis of the hip
recent URI
low-grade fever
dx of exclusion
3-8 y/o
104
criteria more associated w/ septic arthritis than transient synovitis
refusal to bear weight, erythema, swelling, elevated CRP (>20mg/L), elevated WBC count
105
most comm subtype of JIA
pauciarticular juvenile arthritis: pain in 4 or fewer joints for 6 or more weeks
106
reactive arthritis path studies
inflammatory cells in aspirate
negative bacterial cultures
usu post GI or GU infec
adolescents
107
gradual onset of refusing to walk
osteomyelitis
108
poor feeding after a few days-weeks of birth
which murmur?
hyperdynamic precordium w/ holosystolic murmur (VSD)
109
widely split fixed S2
ASD
110
path of O2 blood to fetal brain in fetal circ
RA > foramen ovale > LA > LV > systemic circulation
*bypasses RV and lungs
111
path of O2 blood to lower body
RV > ductus arteriosus > descending aorta (below where head/neck vessels arise) > systemic circulation
112
holosystolic murmur with parasternal heave
VSD
113
PDA is more common in
premature pt and those w/ neonatal respiratory distress syndrome
114
bloody diarrhea and seizures
shigella
(neurotoxin release)
(WBC in stool on Wright stain)
115
complex partial seizure
all char of simple complex seizures with LOSS OF CONSCIOUSNESS
116
simple partial seizure
localized to small regions of brain (focal defects, one extremity motor defect)
non LOC
117
generalized tonic-clonic
begin acutely with tonic (rigid) stiffening of all extremities and upward deviation of the eyes
then clonic jerks of all extremities
then LOC and poss urinary incontinence
118
migraine prophylaxis in children
TCAs
119
CT use
fast, convenient, intracranial hemorrhage
120
MRI use
more expensive, less convenient, req sedation, but provides best detail of posterior fossa (most comm location of peds brain tumors)
121
infectious cerebellitis
EBV, mums, enterovirus
122
opsoclonus-myoclonus syndrome
occurs most often with neuroblastoma in a young child who presents with atria and jerking or erratic movements + jerking conjugate movements of the eyes
123
HSP tx
supportive
124
ITP tx
IVIG
125
petechiae on wrists and ankles
RMSF
tx: doxycycline
126
calcifications on head CT
CMV
| tuberous sclerosis
127
iron toxicity
GI hemorrhage
| metabolic acidosis
128
acetaminophen toxicity
initially minimal sx, then sx of liver toxicity (RUQ pain, jaundice)
129
toddler's fracture
spiral fracture of the distal tibia in 9 mo - 3 yrs
acute onset of limp, refusal to bear weight
130
bucket handle fractures
metaphyseal fractures
("corner fractures")
occasionally occur in older children
can be seen in violent shaking of younger child
131
Are children with congenital heart disease likely to first present with BRUE?
No, would likely have acute decomp in first few weeks, growth probs, feeding probs, murmur
132
T/F GERD is assoc with BRUE
T (more likely if gross emesis or regurgitation is present)
133
Most common cause of FTT
inadequate caloric intake
134
diaphoresis during feeds
concern of CHF
tachypnea, tachycardia, hepatosplenomegaly
135
erythema nodosum
IBD
136
mesalamine
anti-inflammatory
Crohn's
137
cerebral palsy due to prematurity
spastic diplegia
(legs>arms)
periventricular white matter abnormalities seen on MRI
138
cerebral palsy assoc w/ kernicterus
dyskinetic cerebral palsy
perinatal asphyxia
motor abnormalities
basal ganglia/thalamus/cerebellum on imaging
139
Chrom abnml at risk for childhood malignancy
Down syndrome
leukemia (ALL)
140
lymphedema (edema of hands and feet) in newborn
Turner syndrome
141
narrow or high arched palates in newborn
Turner syndrome
142
cystic hygroma in newborn
Turner syndrome
143
klinefelter
at birth, unremarkable
144
patau
```
shifting facial features toward the midline
microcephaly
polydactyly
cleft lip and palate
umbilical hernias
cutis aplasia
```
145
vaccines for SCD
pneumovax (2 y/o)
Hib and Prevnar (S pneumoniae) (2,4,6 mo)
meningococcal (2 y/o)
146
abx prophylaxis for SCD
penicillin (newborn to 5 or 6 y/o)
147
tinea capitis tx
systemic griseofulvin
148
tinea corporis tx
topical clotrimazole
149
MRSA cellulitis tx
clindamycin
150
pityriasis alba
dec number of active melanocytes and dec number and size of melanosomes
worse after sun exposure
face/neck/trunk/extremities
151
attainment of adult height females
15 y/o
152
attainment of adult height males
17 y/o
153
most comm inherited bleeding disorder
vWD
| AD
154
croup
parainfluenza
| tx: supportive, racemic aerosolized epi
