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Emma Peds > Aquifer Practice Qs > Flashcards

Aquifer Practice Qs Flashcards

1
Q

chorioretinitis

A

congenital toxoplasmosis and CMV infections

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2
Q

congenital CMV

A 
microcephaly
jaundice
HSM
low birth weight
petechiae at birth
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3
Q

congenital rubella

A 
IUGR
sensorineural deafness
eye abnormalities (retinopathy, cataracts)
meningoencephalitis
cardiac defects
interstitial pneumonitis
petechiae
HSM
jaundice
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4
Q

18 months

A 
walk backwards (may run)
scribble
tower of 2 cubes
3-6 words in vocabulary
help in house/remove garments
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5
Q

Beckwith-Wiedmann syndrome

A

genetic overgrowth syndrome

  • WILMS’ timor
  • omphalocele
  • hemihypertrophy
  • hypoglycemia
  • LGA
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6
Q

neuroblastoma favorable genetics

A

non-amplification of the n-myc gene

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7
Q

neuroblastoma prognosis (infants <1 y/o)

A

may spontaneously regress

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8
Q

neuroblastoma (infants >18 months of age)

A

prognosis not as good

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9
Q

small round blue cells

A

neuroblastoma
Ewing’s sarcoma
medullobasotma

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10
Q

enlarged cells with intranuclear inclusion bodies

A

(owl’s eyes)

CMV

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11
Q

4-yr milestones

A

hop on 1 foot
copy a cross
pour/cut/mash their own food
brush teeth

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12
Q

5-yr milestones

A 
mature pencil grasp
print some letters/numbers
skip, draw person with 6+ body parts
copy squares
tie knot
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13
Q

3-yr milestones

A

throw ball overhand
ride tricycle
build tower of 6-8 cubes
copy circle

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14
Q

Lead poisoning

A

homes built before 1978

pt 6-36 mo most at risk for lead poisoning

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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

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16
Q

neuroblastoma

A 
catecholamine xs
(Urine or serum VMA/HVA=highly specific)
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17
Q

obesity percentile

A

> 95th percentile

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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

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19
Q

18 mo. word count

A

at least 6 words

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20
Q

acute otitis media bugs

A

strep pneumoniae

H. influenzae

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21
Q

acute otitis media 1st linen tx

A

amoxicillin

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22
Q

order of puberty in males

A

testicular enlargement

pubic hair

growth of penis and scrotum

first ejaculations

growth spurt

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23
Q

Most comm cause of CP I adolescent

A

Precordial catch syndrome

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24
Q

TTN is comm assoc w/

A

maternal diabetes

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25
Q

hypotonia, absence of flexed posture, weak suck

A

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)

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26
Q

When is hypoglycemia of the newborn required to be corrected

A

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.

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27
Q

PROM

A

> 18 hr prior to delivery –> sepsis risk

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28
Q

TTN is more common with which type of delivery?

A

c/s (the normal mechanical force of labor helping to expel fluid from the lungs is lacking)

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29
Q

persistent pulmonary HTN

A

babies born after 34 weeks

underdevelopment of lungs –> inc pulmonary vascular resistance –> poor prognosis

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30
Q

bronchopulmonary dysplasia

A

is the result of prolonged mechanical ventilation

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31
Q

breastfeeding jaundice

A

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)

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32
Q

breast-milk jaudnice

A

usu in 1-2 week old baby who is breastfeeding well

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33
Q

crigler-najjar

A

first few days of life and persists

UDPGT deficiency/absence

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34
Q

T/F: PKU is assoc w/ neonatal jaundice

A

F

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35
Q

caput succedaneum

A

crosses suture lines

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36
Q

cephalohematoma

A

does not cross suture lines

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37
Q

enlarged anterior fontanelle, jaundice, hypotonia, and an umbilical hernia

A

hypothyroidism

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38
Q

tx regimen for congenital hypothyroidism (0-6 mo.)

A

10 to 15 mcg/kg/day of crushed levothyroxine in liquid

within 2 weeks of onset to mitigate severe brain damage and cognitive impairment

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39
Q

hypotonia, lethargy, constipation, weak cry, respiratory failure, absent DTRs

A

infant botulism

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40
Q

OTC deficiency

A

elevated urine orotic acid

most com urea cycle disorder

X-linked

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41
Q

enlarged liver
mental status changes
hyperammonemia

A

OTC deficiency

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42
Q

hurler syndrome

A

alpha-L-iduronidase deficiency

AR LSD

sx @ 1 y/o

HSM, coarse facial features, frontal bossing, corneal clouding, developmental delay

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43
Q

cystathionine synthase

A

-homocystinuria

marfanoid body habitus, hypercoag, devel delay

test via inc methionine urine or blood

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44
Q

Von Gierke’s disease

A

AR GSD

hypoglycemia, hepatomegaly, metabolic acidosis

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45
Q

PKU

A

vomiring, hypotonia
musty odor
level delay
dec pigmentation of the hair and eyes, eczema

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46
Q

Niemann-Pick disease

A

LSD

presents at 6 mo.

hepatomegaly
ataxia
seizures
progressive neuro degeneration
cherry red macula
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47
Q

Fever without other respiratory symptoms

A

meningitis and UTI

  • can only rule out meningitis by lumbar puncture
  • assess for pyelonephritis etiology with US
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48
Q

measles

A

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

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49
Q

fever (1d) of 101, fussiness (4d), dec appetite, non-bilious, non-bloody emesis, dec urine output

A

eval risk for UTI with urinary catheterization

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50
Q

sandpaper

A

scarlet fever

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51
Q

hand foot mouth

A

cocksackie A

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52
Q

koplik spots

A

white spots on buccal mucosa (measles)

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53
Q

erythema/edema of the extremities

A

kawasaki

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54
Q

red eyes without discharge

unilateral cervical adenopathy

A

kawasaki

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55
Q

kawasaki dx criteria

A

fever >/= 5d

  1. polymorphous rash
  2. conjunctivitis
  3. unilateral cervical lymphadenopathy
  4. changes in oral mucosa
  5. extremity changes (red/swell)
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56
Q

still’s disease

A

systemic onset juvenile idiopathic arthritis

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57
Q

RMSF

A

HA
fever
myalgia
centrally progressing petechial rash originating on wrists and ankles

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58
Q

suspect group A strep

A

rapid strep test with back-up if negative

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59
Q

kawasaki pt should receive which screening?

A

echo to look for coronary artery aneurysm

greatest risk for developing is in subacute phase (>10d)

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60
Q

juvenile idiopathic arthritis pt should receive which screening?

A

ophtho (uveitis)ƒ
iridocyclitis
evanescent rash, macular and salmon-colored

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61
Q

paroxysmal stage of pertussis

A

4-6 weeks
repetitive, forceful coughing

abx will reduce communicability but won’t alter clinical course

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62
Q

pertussis abx

A

azithromycin
clarithromycin
erythromycin

63
Q

laryngotracheobronchitis

A

croup
via parainnfluenza 1

most comm in winter
ages 2-5 y/o

seal bark cough w/ fever

1 wk

64
Q

Acute bronchiolitis

A

most comm cause of wheezing in infant

febrile pt
CXR: scattered atelectasis and/or diffuse opacities from bronchial obstruction

65
Q

stridor

A

airway narrowing above the thoracic inlet

seen in resp infections (epiglottis, croup)

laryngomalacia (congenital softening of larynx)

66
Q

epiglotittis

A

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
Q

pertussis phases

A

catarrhal: 1-2 weeks –> URI sx (can be indistinguishable from common cold)
paroxysmal: 4-6 weeks –> whooping cough

confirm dx w/ nasopharyngeal PCR

68
Q

bronchiolitis

A

RSV

69
Q

all children w/ chronic cough >4weeks

A

CXR

70
Q

dx of sinusitis

A

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
Q

habit cough

A

loud, short, dry, brassy, spasmodic

unchanged by exercise. or. cold air, classically resolves during sleep

dx of exclusion

72
Q

intermittent asthma

A

sx <2d/wk or 2 nights/month

tx: SABA rescue inhaler

73
Q

mild persistent asthma

A

3-6 d/wk and 3-4 nights/mo

tx: low ICS and rescue inhaler

74
Q

moderate persistent asthma

A

sx daily and more than 1 night/wk

tx: med ICS and rescue inhaler

75
Q

severe persistent asthma

A

sx throughout day and every night

tx: LABA, high ICS, oral CST

76
Q

difficulty breathing, high fever, drooling

A

epiglottitis

77
Q

failure of amoxicillin for otitis media

A

amoxicillin/clauvulanate

addnl beta-lactamase coverage for H. flu and Moraxella catarrhalis

78
Q

when can you observe acute otitis media

A

6 mo - 2 y/o when pt has non-severe sx (NO high-grade fever)

79
Q

frequent causes of acute otitis media

A
  1. H. influenzae

2. M. catarrhalis

80
Q

bilateral yellow and poorly mobile tympanic membranes, developed over 4 months

A

otitis media with effusion

81
Q

sinusitis in infancy

A

maxillary or ethmoid

drains to middle meatus

82
Q

sinusitis in 3rd-5th year of life

A

sphenoid sinuses

83
Q

sinusitis in 6th-10th year of life

A

frontal sinuses

*pain over frontal bone and poss facial swelling

84
Q

correcting severe dehydration

A

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
Q

GERD with esophagitis

A

blood-streaked emesis if forceful vomiting

86
Q

volvulus

A

can cause blood in stool

87
Q

intussusception

A

currant jelly stools = LATE finding (necrosis from bowel ischemia)

sausage mass

88
Q

pyloric stenosis

A

usu between 3-5 weeks go age, RARELY after 12 wk

olive-sized mass

89
Q

correcting mild-moderate dehydration (min urine output over last day, tachycardia, preserved skin turgor and cap refill)

A

trial bolus of oral rehydration solution:

50-100ml/kg oral rehydration administered 2-4 hours in small aliquots (sips or with spoon)

90
Q

appendicitis presentation children/infants

A

migration of pain to RLQ

negative Rovsing’s

involuntary guarding

fever without perf

91
Q

rebound tenderness in peds appendicitis pt

A

neither sensitive nor specific

92
Q

ectopic pregnancy

A

painless vaginal bleeding 6-8 weeks after their last menstrual period

93
Q

PID pain

A

post-coital

often during or immediately after menstruation

RUQ pain

fever

94
Q

DKA dx

A 
>200 mg/dL
venous pH <7.3
bicarbonate <15 mEq/L
ketoninemia
ketonuria

inc adrenergic tone –> tachycardia

95
Q

Cushing triad

A

HTN
inappropriate slowing of HR
irregular respirations (Cheyne-Stokes respiration)

(*also epigastric discomfort via inc ICP causing vagal stim –> gastric acid secretion)

96
Q

fever
colicky abd pain
diarrhea

A

gastroenteritis

*most hospitalizations occur in children <5 y/o

97
Q

Legg-Calves-Perthes disease

A

avascular necrosis of the capital femoral epiphysis

98
Q

Transient synovitis

A

usu isolated joint
may follow URI
resolves on its own 3-7d

99
Q

organisms responsible for septic arthritis (neonates < 2 months)

A

Staph aureus, GBS, E coli

100
Q

organisms responsible for septic arthritis

older children

A

Staph aureus, Haemophilus influenzae, Strep pneumo

101
Q

organisms responsible for septic arthritis

adolescents

A

Neisseria gonorrhea

102
Q

osteomyelitis bugs

A

Staph aureus or Strep pyogenes

103
Q

transient synovitis of the hip

A

recent URI
low-grade fever
dx of exclusion
3-8 y/o

104
Q

criteria more associated w/ septic arthritis than transient synovitis

A

refusal to bear weight, erythema, swelling, elevated CRP (>20mg/L), elevated WBC count

105
Q

most comm subtype of JIA

A

pauciarticular juvenile arthritis: pain in 4 or fewer joints for 6 or more weeks

106
Q

reactive arthritis path studies

A

inflammatory cells in aspirate

negative bacterial cultures

usu post GI or GU infec

adolescents

107
Q

gradual onset of refusing to walk

A

osteomyelitis

108
Q

poor feeding after a few days-weeks of birth

which murmur?

A

hyperdynamic precordium w/ holosystolic murmur (VSD)

109
Q

widely split fixed S2

A

ASD

110
Q

path of O2 blood to fetal brain in fetal circ

A

RA > foramen ovale > LA > LV > systemic circulation

*bypasses RV and lungs

111
Q

path of O2 blood to lower body

A

RV > ductus arteriosus > descending aorta (below where head/neck vessels arise) > systemic circulation

112
Q

holosystolic murmur with parasternal heave

A

VSD

113
Q

PDA is more common in

A

premature pt and those w/ neonatal respiratory distress syndrome

114
Q

bloody diarrhea and seizures

A

shigella
(neurotoxin release)

(WBC in stool on Wright stain)

115
Q

complex partial seizure

A

all char of simple complex seizures with LOSS OF CONSCIOUSNESS

116
Q

simple partial seizure

A

localized to small regions of brain (focal defects, one extremity motor defect)

non LOC

117
Q

generalized tonic-clonic

A

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
Q

migraine prophylaxis in children

A

TCAs

119
Q

CT use

A

fast, convenient, intracranial hemorrhage

120
Q

MRI use

A

more expensive, less convenient, req sedation, but provides best detail of posterior fossa (most comm location of peds brain tumors)

121
Q

infectious cerebellitis

A

EBV, mums, enterovirus

122
Q

opsoclonus-myoclonus syndrome

A

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
Q

HSP tx

A

supportive

124
Q

ITP tx

A

IVIG

125
Q

petechiae on wrists and ankles

A

RMSF

tx: doxycycline

126
Q

calcifications on head CT

A

CMV

tuberous sclerosis

127
Q

iron toxicity

A

GI hemorrhage

metabolic acidosis

128
Q

acetaminophen toxicity

A

initially minimal sx, then sx of liver toxicity (RUQ pain, jaundice)

129
Q

toddler’s fracture

A

spiral fracture of the distal tibia in 9 mo - 3 yrs

acute onset of limp, refusal to bear weight

130
Q

bucket handle fractures

A

metaphyseal fractures
(“corner fractures”)

occasionally occur in older children

can be seen in violent shaking of younger child

131
Q

Are children with congenital heart disease likely to first present with BRUE?

A

No, would likely have acute decomp in first few weeks, growth probs, feeding probs, murmur

132
Q

T/F GERD is assoc with BRUE

A

T (more likely if gross emesis or regurgitation is present)

133
Q

Most common cause of FTT

A

inadequate caloric intake

134
Q

diaphoresis during feeds

A

concern of CHF

tachypnea, tachycardia, hepatosplenomegaly

135
Q

erythema nodosum

A

IBD

136
Q

mesalamine

A

anti-inflammatory

Crohn’s

137
Q

cerebral palsy due to prematurity

A

spastic diplegia
(legs>arms)

periventricular white matter abnormalities seen on MRI

138
Q

cerebral palsy assoc w/ kernicterus

A

dyskinetic cerebral palsy

perinatal asphyxia
motor abnormalities
basal ganglia/thalamus/cerebellum on imaging

139
Q

Chrom abnml at risk for childhood malignancy

A

Down syndrome

leukemia (ALL)

140
Q

lymphedema (edema of hands and feet) in newborn

A

Turner syndrome

141
Q

narrow or high arched palates in newborn

A

Turner syndrome

142
Q

cystic hygroma in newborn

A

Turner syndrome

143
Q

klinefelter

A

at birth, unremarkable

144
Q

patau

A 
shifting facial features toward the midline
microcephaly
polydactyly
cleft lip and palate
umbilical hernias
cutis aplasia
145
Q

vaccines for SCD

A

pneumovax (2 y/o)
Hib and Prevnar (S pneumoniae) (2,4,6 mo)
meningococcal (2 y/o)

146
Q

abx prophylaxis for SCD

A

penicillin (newborn to 5 or 6 y/o)

147
Q

tinea capitis tx

A

systemic griseofulvin

148
Q

tinea corporis tx

A

topical clotrimazole

149
Q

MRSA cellulitis tx

A

clindamycin

150
Q

pityriasis alba

A

dec number of active melanocytes and dec number and size of melanosomes

worse after sun exposure

face/neck/trunk/extremities

151
Q

attainment of adult height females

A

15 y/o

152
Q

attainment of adult height males

A

17 y/o

153
Q

most comm inherited bleeding disorder

A

vWD

AD

154
Q

croup

A

parainfluenza

tx: supportive, racemic aerosolized epi

Emma Peds (2 decks)

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