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Pediatrics > Case Files 4 > Flashcards

Case Files 4 Flashcards

1
Q

Why are pts with retropharyngeal abscess usually 4 or younger

A

When retropharyngeal lymph nodes are present, after they atrophy

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2
Q

Most common type of abscess in per population

A

Peritoneal lar

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3
Q

Imaging for pt with suspected neck abscess

A

Lateral cervical x-Ray

Look for widening of retropharyngeal space

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4
Q

Thyroglobulin duct cyst features

A

Midline, move with tongue protrusion, and often noted after URI

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5
Q

Tooth abscess bacteria

A

S mutants, fusobacterium nucleatum

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6
Q

Unique complication for retropharyngeal abscess

A

Mediastinitis from lymphatic spread

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7
Q

What is trismus

A

Inability to open the mouth secondary to pain of inflammation or mass effect involving facial neuromusculature

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8
Q

2 complications of SCFE

A

Osteonecrosis and chondrolysis

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9
Q

DDH risk facors

A

Breech presentation, oligohydramnios, and large for gestational age infants

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10
Q

Work up for suspected septic arthritis

A

CBC, ESR, CRP, and blood culture, as well as joint aspiration and culture

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11
Q

SCFE key physical? first steps in workup

A

Pain during external rotation

Make patient non weight bearing and obtain bilateral hip films (due to high rate of both hip involvement)

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12
Q

What is status migrainosus

A

Migraine lasting more than 72 hours

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13
Q

Pseudotumor cerebri CN palsies

A

III, IV, or VI

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14
Q

First line for abortive therapy for migraines? 2nd line?

A

NSAIDs, then triptans

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15
Q

Most important diagnostic tool for headaches

A

thorough H and P

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16
Q

Good migraine prophylaxis in younger kids

A

Cyproheptadine

Also topiramate, valproic acid, B blockers

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17
Q

Imaging of choice to evaluate 2ndary headaches

A

MRI (unless hemorrhage or fracture suspected)

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18
Q

Most common cause of death from inhalant use

A

Sudden death from dysrhythmias

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19
Q

What is cubitus valgus

A

Physical finding in which the angle between the shaft of the ulna and humerus is increased greater than 15% in females

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20
Q

MCC of turner syndrome

A

Nondisjunction

Majority of 45x sAb in first trimester

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21
Q

Most common heart defect with Down’s

A

Endocardial cushion defects

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22
Q

Baby with webbed neck and edematous feed but not Turners could be

A

Noonan syndrome (seen in both sexes as well)

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23
Q

How many criteria needed to dx lupus

A

4

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24
Q

Drug for children with mild lupus

A

Hydroychloroquine

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25
Q

Lab not to forget in all new lupus workups

A

UA w/ microscopy

26
Q

Thoracic lupus manifestations

A

Pleuritis and pericarditis

27
Q

PSGN labs

A

Low C3
Normal C4
ASO and Anti-DNaseB

28
Q

Do strep Ab help with rheumatic fever or PSGN

A

Rheumatic fever, not PSGN

29
Q

How to treat PSGN HTN

A

Calcium channel blockers

30
Q

HSP triad

A

Purpuric rash, arthritis and abdominal pain

31
Q

IgA nephropathy

A

Painless hematuria 2 days after URI

32
Q

C3 and C4 in lupus

A

Both low

33
Q

Crohn’s or UC for strictures, fistulas, and abscesses

A

Crohn (also think skip lesions)

34
Q

Most common site for Crohn’s

A

Terminal ileum

35
Q

Biliary dz associated with UC

A

Primary sclerosing cholangitis

36
Q

X-ray “lead pipe” appearance seen in

A

UC

37
Q

Unique Crohn’s Ab

A

anti-Saccharomyces cervisisea ab

pANCA more common in UC

38
Q

Most significant complication of UC

A

Toxic megacolon

39
Q

Celiac disease dx requires what

A

biopsy of the distal duodenum

40
Q

2 most common causes of rectal bleeding in the infant period

A

Milk protein allergy and anal fissure

41
Q

What is the psoas sign? obturator? rovsing?

A

Psoas: passive right hip extension pain
Obturator: passive internal rotation of right thigh painful
Rovsing: palpation of LLQ causes pain in RLQ

42
Q

Best method to check for rebound tenderness?

A

Gentle finger percussion to check for peritoneal irritations

43
Q

Why is UA important in suspected appendicitis

A

To check for glucose and large ketones

Or pyuria w/ nitrites and bacteria

44
Q

EBV structure? What does it infect

A

dsDNA herpes virus –> infections human oropharyngeal and salivary tissues and B lymphocytes

45
Q

Mono big triad

A

Fever, posterior cervical adenopathy, and sore throat

46
Q

How old for mono spot to be reliable

A

5+ years

47
Q

Ab that form only as EBV establishes latency

A

IgG Ab to EBV nuclear antigen

48
Q

LFTs and platelets in mono

A

LFTs mildly elevated but jaundice is uncommon

Mild thrombocytopenia but bleeding uncommon

49
Q

When to use steroids in mono

A

Only when tonsillar hypertrophy threatens airway

50
Q

Electrolyte that is low in rhabdomyolysis

A

Hypocalcemia

51
Q

Most common cause of AUB in young ones? Key feature of AUB?

A

Immaturity of HPA, specifically LH surge causing anovulation
Key feature is that it’s painless

52
Q

Papule vs nodule

A

Papule’s are inflamed bumps under skin

Nodules are papules > 5mm deep

53
Q

two first line acne meds

A

Topical benzoyl peroxide or topical retinoid (at night)

54
Q

What is adapalene

A

Retinoid formulation that causes less irritation and photosensitivity and has more activity

55
Q

Odd accutane effects

A

Blood dycrasias, hyperlipidemia, elevated liver enzymes, conjunctivitis

56
Q

Acne in a farm worker likely

A

Tina barbae, tx w/ anti fungal

57
Q

What do you recommend in teenager on BC and tetracycline

A

secondary form of BC (ab may reduce effectiveness)

58
Q

3 big features of ADHD

A

Inattention, hyperactivity, and impusitivity

59
Q

ADHD caveats

A

Several features before 12
Symptoms present in 2 or more settings (school, home)
Interferes with functioning

60
Q

What do you do for kid who’s mom says he “daydreams a lot”

A

EEG, worry about absence seizures

61
Q

When to start return to play protocol for concussions

A

After 24 hours asymptomatic (without use of meds)

62
Q

How long do most concussions take to resolve

A

7-10 days

Pediatrics (14 decks)

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