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Step 2 Big Time Study Deck > Deck 1 COPY > Flashcards

Deck 1 COPY Flashcards

1
Q

what are some consequenses of gestational diabetes on the newborn

A

macrosomia (–> shoulder/hip dislocation), hypoglycemia from overactive beta cells during pregnancy, heart defects, polycythemia, organomegaly, hypertrophic cardiomyopathy

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2
Q

what is myositis ossificans

A

this is when there is trauma to a muscle and it filled with new lamellar bone instead of repaird (heterotropic ossification)

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3
Q

myositis ossificans presentation

A

pain on movement, no pain at night, following an injury, swelling/induration

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4
Q

adolescent privacy allowances

A

adolescents have a right to protect certain aspects of their care such as sexual, drug use, and mental health topics so records should be transferred very carefully

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5
Q

how does labial adhesion present

A

itching and normal development

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6
Q

treatment of labial adhesions

A

estrogen cream due to low estrogen in a child

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7
Q

what is spondylosis

A

this is just a general term for degenerative disc changes that cause pain in the spine due to nerve compression

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8
Q

how does spondylosis present in a child

A

typically they will be in sports and forward extension of the spine makes the pain worse

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9
Q

should you do a CT scan in a child

A

NO!!

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10
Q

what should you do if you suspect GBS in a child

A

spirometry then intubate based on function

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11
Q

fetal alcohol presentation

A

thin vermillion border, small palpebral fissures, smooth philtrum

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12
Q

eosinophilic esophagitis presentation in a toddler

A

food aversions especially solid foods! eczema, weight loss

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13
Q

how do you dx EoE in a child

A

endoscopy and biopsy

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14
Q

signs of opiod overdose in a child

A

sleepy, low bp, low HR, prolonged QT, acute change in mental status

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15
Q

history findings of an opiod OD in a child

A

child with grandparents, recent surgery etc.

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16
Q

signs of alcohol ingestion in a child

A

drowsiness, bradycardia, hypotension (no miosis)

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17
Q

signs of clonidine injestion by a child

A

obtundation, miosis, bradycardia, NO QT prolongation

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18
Q

immediate eval of a possible ingestion of a toxic drug

A

spot glucose to make sure the obtundation is not due to hypo/hyperglycemia

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19
Q

what is a pulmonary finding (as in function test) of opioid toxicity

A

decreased tidal volume, residual volume does not change

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20
Q

what is a morbilliform rash

A

this is a macular rash that has big macules that merge into each other to form one big macule, typically from a drug reaction

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21
Q

signs of acute mono infection

A

fatigue, cervical lymphadenopathy, tonsillar exudates, fever, splenomegaly

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22
Q

dx of mono

A

monospot- tests for heterophile Ab

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23
Q

CBC results from a pt. with acute mono

A

abnormal lymphocytes (downy cells which are T cells!) and lymphocytosis

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24
Q

describe what type of virus EBV is

A

EBV is a DNA virus, it is a herpesvirus

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25
Q

treatment of mono

A

rest and rehydration. No trtment. Pts with splenomegaly should avoid contact sports for 3 months

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26
Q

what is a complication of mono

A

tonsillar hypertrophy trt with steroids

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27
Q

differ between EBV (mono) and ALL CBC findings

A

all same symptoms except mono will have only 1 cell line of atypical cells, whereas ALL will have many atypical cells in the smear

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28
Q

how do you verify a mono dx in a young child

A

antibody tests because the monospot is not as reliable in a child

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29
Q

when do babies start to coo or smile back

A

about 6-8 weeks old

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30
Q

neonate HR range

A

100-205

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31
Q

infant HR range

A

100-180

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32
Q

toddler HR range

A

98-140

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33
Q

preschooler HR range

A

80-120

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34
Q

school aged child (6-11) HR range

A

75-118

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35
Q

adolescent-adult HR range

A

60-100

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36
Q

what are the most common bugs that cause otitis media

A

strep pneumo, H flu, moraxella

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37
Q

what typically precedes otitis media

A

a viral URI

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38
Q

treatment of OM

A

amoxicillin unless they have been prescribed it in the past 30 days then they can use a betalactam

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39
Q

what does the TM look like in OM

A

bulging and erythematous

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40
Q

what is a complication of OM

A

mastoiditis

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41
Q

what do you see in the urine of PSGN

A

RBC casts, proteinuria (+2),

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42
Q

how long after GAS infection does PSGN show up

A

~2 weeks later

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43
Q

presentation of PSGN

A

gross hematuria, periorbital edema, hypertension

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44
Q

treatment of psgn

A

furosemide for the HTN

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45
Q

lab findings of psgn

A

low C3/normal C4 levels due to immune complex formation, ASO titer, etc,

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46
Q

dangerous complication of psgn

A

hypertensive encephalopathy

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47
Q

what are the complement levels like in lupus

A

low C3 AND low C4

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48
Q

in rhabdo, what is in the urine

A

myoglobin, gives false positive for blood on dipstick but does not actually have RBCs

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49
Q

what is the presentation of epiglottitis

A

inspiratory stridor, drooling, dysphagia, hoarseness, refusal to eat

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50
Q

what causes epiglottitis

A

mostly h flu type B but other H flu strains can cause it too

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51
Q

how do you treat H flu

A

ceftriaxone and vanc

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52
Q

dx of scoliosis

A

xray

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53
Q

signs of slipped capital femoral epiphysis

A

patient holds their leg externally rotated (foot angles out), trendelenburg gait, progressive pain, limping

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54
Q

how do you dx slipped capital femoral epiphysis

A

bilateral hip xray

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55
Q

rubella presentation in an unvaxxed adolescent

A

fever, cephalocaudal expansion of maculopapular rash that spares hands, arthralgias, arthritis, lymphadenopathy

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56
Q

signs of intussusception in infant

A

bloody mucusy stools, sudden intermittent abdominal pain, air in abdomen,

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57
Q

what is dysentary

A

this is when you have bloody diarrhea and lymphocytes in the stool

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58
Q

affects of antiepileptic use during pregnancy

A

cleft lip, hypoplasia of the distal phalanges, cardiac abnormalities, neural tube defects (valproate mostly), excessive hair growth

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59
Q

adenovirus signs

A

URI, conjunctivitis, pharyngitis ,

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60
Q

kawasaki disease

A

C: conjunctivitis R: rash A: adenopathy S: strawberry tongue H: hand and foot swelling BURN: high fever

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61
Q

measles presentation

A

4 Cs: cough, coryza, conjunctivitis, koplik spots and fever then maculopapular rash craniocaudal

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62
Q

RMSF presentation

A

fever, headache, rash hands up, myalgia

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63
Q

erythema infectiosum (parvo aka 5th disease)

A

low grade fever followed by facial slapped cheek rash then lacy on body,

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64
Q

roseola presntation

A

high fever for 4 days followed by rash (erythematous macules)

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65
Q

how do you treat kawasaki

A

aspirin and IVIG

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66
Q

signs of inhalent use in an adolescent

A

irritability, nystagmus, normal vitals, perioral rash, hallucinations etc.

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67
Q

signs of cannabis use in an adolescent

A

tachycardia, increased blood pressure, increased respiratory rate, conjunctival injection, dry mouth, and increased appetite

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68
Q

signs of cocaine/amphetamine use

A

increased physical activity, rapid and/or irregular heart rate, increased blood pressure, and decreased appetite

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69
Q

long term AE of inhalents

A

cerebellar atrophy (gait ataxia), restrictive lung disease, dysrhythmias

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70
Q

signs of bath salt use

A

euphoria, dilated pupils, loss of inhibition, involuntary muscle movement, tachycardia, and hypertension

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71
Q

signs of IgA vasculitis (HSP)

A

Purpura, arthralgia, bloody stool, abdominal pain, low grade fever

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72
Q

signs of hemolytic uremic syndrome

A

Irritability, pallor, bloody diarrhea, anemia, thrombocytopenia, decreased urine output, hypertension

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73
Q

what is ITP

A

this is when you have antibodies against platelets, can be primary or secondary to a viral illness

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74
Q

signs of ITP

A

petichiae, purpura, bleeding etc.

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75
Q

lab findings of appendicitis

A

leukocytosis, typically present after first 48 hours of illness

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76
Q

describe the location of pain I nappendicitis

A

starts periumbilically and then moves to mcburneys point (RLQ)

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77
Q

describe the ortolani and barlow maneuver

A

ortolani abducts the hips and barlow adducts the hips

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78
Q

describe the hairloss in alopecia acreta

A

this is patchy hair loss in small circular areas that can be anywhere around teh body (scalp, eyebrows, eyelashes, etc)

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79
Q

describe what the hair shaft looks like in alopecia

A

it is thick at the bottom and thin at teh top called exclamation point hair

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80
Q

what is the treatment for alopecia

A

topical corticosteroids

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81
Q

what is a common finding on the hands of kids with alopecia

A

nail pitting

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82
Q

how do you manage IgA vasculitis

A

symptomatic management with NSAIDs and acetominophen

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83
Q

workup of intussusception

A

if you can see target sign on US, you do not need to do CT just go straight to surgery

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84
Q

what is a typical sign that kids have iron def. anemia

A

PICA

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85
Q

how do you treat IDA?

A

supplemental iron

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86
Q

what labs are seen with Diamond blackfan anemia

A

normal platelet count

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87
Q

physical signs of diamond blackfan anemia

A

triphalangeal thumbs, multiple craniofacial defects

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88
Q

what is the moro reflex

A

moro is when you startle baby by quickly “dropping” them, they should abduct and extend their arms

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89
Q

what does moro reflex test for

A

brachial plexus injury

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90
Q

signs of spondylolithiasis

A

pain with extension of lumbar spine (bending forward), no pain with flexion of lumbar spine, “drop off” observed during palpation

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91
Q

what is spondylolithiasis and who gets it

A

its when the whole vertebral disk is pushed forward anteriorly seen in overuse injuries like divers, gymnasts, etc or elderly individuals

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92
Q

what screening should duchenne MD patients get

A

echo for cardiac abnormalities due to replacement of the muscle

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93
Q

what are signs of an imperforate hymen

A

this is when you have cyclical pain with bowel movements and can have primary amenorrhea. on exam you will see a bulging red mass from the vagina

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94
Q

mean age of menarche

A

13yo

95
Q

what should you evaluate if a child is undergoing precocious puberty?

A

bone age evaluation

96
Q

where is pulmonic regurg heard and what type

A

left sternal border third intercostal space, decresendo diastolic murmur that increases with inspiration

97
Q

lab findings in a newborn of a diabetic mother

A

hypocalcemia, hypomagnesia, hypoglycemia

98
Q

signs of hypocalcemia in a newborn

A

jitteriness

99
Q

what is the first step in management of a newborn with pyloric stenosis

A

first correct their fluids and then surgery

100
Q

how do you treat an acute splenic sequestration

A

packed red cell infusion

101
Q

signs of acute splecic sequestration

A

splenomegaly, abdominal pain, signs of anemia, thrombocytopenia

102
Q

signs of anemia

A

tachy, fatigue, pallor (eyes and nailbeds)

103
Q

when do you lose moro reflex

A

by 6mo

104
Q

signs of sleep apnea in a child

A

enuresis >5yo, large tonsils, daytime irritability,

105
Q

what are signs of empyema

A

pneumonia with pleural effusions, pneumonia that gets worse even after treatment

106
Q

what antibiotics should be given for empyema

A

vanc and ceftriaxone

107
Q

signs of mccune albright

A

cafe au lait spots, precocious puberty

108
Q

what is the management of a biliary cyst

A

surgical resection to prevent malignancy

109
Q

dx of suspected mastoiditis

A

MRI brain

110
Q

treatment of nonbullous impetigo

A

topical mupicorin (rna synthetase inhibitor)

111
Q

neurological sequelae of isotretinoin

A

pseudotumor cerebri (elevated ICP, papilledema, headaches etc)’

112
Q

hypoxic-ischemic injury presenting with HTN and bradycardia

A

highly elevated ICP, this is the cushings triad where the brain is swelling due to cell death, this occludes small blood vessels which causes the cushing reflex which the body responds with increased blood pressure and decreased HR due to baroreceptor overactivity

113
Q

during DKA what are total body potassium stores like

A

they are usually low due to ineffective reabsorption in the the kidney bc of the excess diuresis

114
Q

signs of NEC on X ray

A

air in the bowel and portal veins

115
Q

pathogenesis of anemia of prematurity

A

babies are oxygenated earlier in life so they have decreased EPO production but their RBCs also have a shorter life span so they have anemia with inadequate reticulocyte response. they should have a reticulocytosis

116
Q

benign murmur characteristics

A

grade <2, vibratory, decreases or disappears with standing, etc

117
Q

management of benign murmurs

A

reassurance

118
Q

what is the mutation of marfans

A

fibrillin 1

119
Q

two treatments of pinworm

A

albendazole or pyrantel pamoate

120
Q

signs of RMSF

A

macular/petechial rash on wrists and ankles, general malaise, abdominal pain, fever, headache

121
Q

lab findings RMSF

A

elevated liver enzymes, low sodium, low platelets,

122
Q

treatment of ITP

A

Observation

123
Q

what is strabismus

A

this is when one eye is malaligned, can be deviated inward and have asymmetrical red reflexes

124
Q

how do you ID strabismus

A

dilated fundoscopic exam

125
Q

management of hydrocele

A

reassurance and observation

126
Q

what other organ should be surveiled if a baby has trachesophageal fistula

A

renal ultrasound and echo

127
Q

if a child presents with massive spontaneous intraperitoneal hemorrhage what is the etiology

A

splenic rupture

128
Q

what can precede splenic rupture

A

recent viral illnes

129
Q

if a baby has light stools is there bilirubin being excreted

A

NO!

130
Q

what does UDP-glucoronidase do

A

this conjugates bilirubin so it is making DIRECT bili

131
Q

if the patient has a direct bilirubinemia what is the problem

A

this is an excretion problem

132
Q

what bili would be high if they have crigler najar

A

indirect

133
Q

how do you dx biliary atresia

A

liver biopsy

134
Q

how do you workup primary amenhorrhea

A

you first get an FSH

135
Q

signs of congenital rubella

A

bilateral sensorineuronal hearing loss, PDA, cataracts

136
Q

signs of urinary tract obstruction in a newborn

A

Xray with diminished lung volume, minimal wet diapers, distended abdomen

137
Q

most common cause of urinary tract obstruction in boys

A

posterior urethral valves

138
Q

signs of congenital hypothyroidism

A

apathy, weakness, hypotonia, large tongue, sluggish, abdominal bloating, umbilical hernia

139
Q

main causes of meningitis in newborns

A

GBS, listeria, E coli

140
Q

meningitis pathogens children

A

streptococcus pneumoniae or neisseria meningitidis (rarely H flue type b)

141
Q

neonatal trtment meningitis

A

gent, amp, cef

142
Q

child trtment meningitis

A

vanc and ceftriaxone

143
Q

manifestation of salmonella in gi

A

bloody diarrhea +/- neurologic symptoms

144
Q

treatment of bloody diarrhea

A

typically just rehydration

145
Q

what bug causes HUS

A

EHEC

146
Q

what should make you suspect abuse

A

abrupt onset of mood changes, bedwetting, and/or academic difficulties.

147
Q

what is transient synovitis

A

transient inflammation of the hip joint, commonly following a viral illness

148
Q

management of transient synovitis

A

conservative manatement with NSAIDS

149
Q

what is the squirt sign

A

expulsion of stool or gas following rectal exam

150
Q

what does the squirt sign mean

A

patient has Hirschsprungs

151
Q

signs of congenital toxo

A

hydrocephalus, intracranial calcifications, chorioretinitis, petechiae (blueberry muffin rash), lymphadenopathy

152
Q

signs of congenital CMV

A

small for gestational age, petechiae (blueberry muffin rash), sensorineuronal hearing loss, chorioretinitis, seizures

153
Q

signs of croup

A

inspiratory stridor, barking cough, worse at night, hoarseness

154
Q

signs of croup on xray

A

steeple sign

155
Q

what causes croup

A

parainfluenza

156
Q

haptoglobin levels in RBC hemolysis

A

decreased haptoglobin bc the hemoglobin in the RBC binds to it

157
Q

what is the treatment for infantile hemangioma

A

beta blockers

158
Q

signs of ALL

A

pancytopenia, diffuse nontender lymphadenopathy, splenomegaly, weight loss

159
Q

signs of fanconi anemia

A

short stature, hypo/hyper- pigmented macules, thumb hypoplasia, genitourinary malformations

160
Q

pathophys of fanconi anemia

A

dna repair defect

161
Q

what are the signs of hyperbilirubinemia in a neonate

A

lethargy, change in tone, jaundice

162
Q

when should transfusion therapy be started for hyperbilirubinemia

A

> 25 or if it is unresponsive to light therapy and still rising

163
Q

signs of acute rheumatic fever

A

arthritis, carditis, subcutaneous nodules, erythema marginatum, syndeha chorea, fever, elevated ESR, prolonged PR

164
Q

what is erythema marginatum

A

annular pink rash with sharp, raised edges and central clearing

165
Q

what is the most commo risk factor for orbital cellulitis

A

bacterial sinusitis

166
Q

when does galactosemia present in newborns

A

first few days of birth

167
Q

galactosemia enzyme deficiency

A

galactose-1-phosphate-uridylyltransferase

168
Q

description of seborrheic dermatitis

A

scalp/face/retroauricular greasy scales, interriginous regions with glistening confluent erythema

169
Q

long term complication of vesicoureteral reflux in children

A

fibrosis of the interstitial space

170
Q

describe methemeglobinemia

A

this is when the Fe2+ gets oxidized to Fe3+ and does not bind oxygen.

171
Q

what will the PaO2 on arterial blood gas be in methemeglobinemia

A

it will be normal bc this measures dissolved O2 which does not change

172
Q

what organism causes impetigo

A

staph aureus

173
Q

if a baby has persisent jaundice and they have elevated direct bili what is the haps

A

they have biliary atresia dx by ultrasound RUQ

174
Q

what do you give to infants with NARDS

A

give them surfactant

175
Q

what drug do you give for congenital prolonged QT

A

propanolol

176
Q

most common cause of occult small bowel bleed in a child

A

meckels diverticulum

177
Q

dx process of GI bleed in a child

A

stool test for occult blood –> upper and lower endoscopy with biopsy –> meckels scan

178
Q

if a child has prolonged LOC following a syncope episode what is the likely cause

A

likely a psychogenic pseudosyncope episode which is part of conversion disorder

179
Q

what is constitutional growth delay

A

this is when the child has short stature and delayed bone age but has linear growth curves, they will eventually catch up

180
Q

what causes the pathology in reyes syndrome

A

hyperammonemia

181
Q

in divorced parent families with joint custody, what is needed to get consent

A

only one parents consent for treatment

182
Q

what is first line treatment in suspected NEC

A

blood cultures then antibiotics

183
Q

what is infant dyschezia

A

this is a benign functional stooling disorder in whcih the infants do not have coordinated intraabdominal pressure with relaxation of the pelvic floor, totally normal

184
Q

describe signs of infant dyschezia

A

episodes of straining for 10 minutes with normal stool consistency and frequency

185
Q

what is congenital melanocytic nevus

A

this is a benign proliferation of melanocyte cells, solitary hyperpigmented patch with dark course hair

186
Q

signs of congenital hypothyroidism

A

aysmptomatic at birth, lethargy, poor feeding, protuding tongue, constipation, prolonged jaundice, dry skin

187
Q

course of infantile Hypertrophic cardiomyopathy of diabetic mothers

A

spontaneous regression by 1yr

188
Q

what is the lesion called when an infant spontaneously gets a vascular bright red plaque that proliferates suddenly

A

this is a strawberry or superficial hemangioma

189
Q

management of baby with GERD

A

reassurance and positioning therapy

190
Q

signs of viral myocarditis

A

viraI prodrome, respiratory distress, murmur, hepatomegaly (from RHF)

191
Q

cardinal features of neonates with down syndrome

A

low birth weight, upslanting palprebral fissures, epicanthic folds, single palmar crease

192
Q

what is erythema toxicum neonatorum

A

this is a benign neonatal rash with pustules and erythematous bases on the trunk and proximal extremities

193
Q

management of benighn neonatal rashes

A

observation

194
Q

2 month gross motor

A

lifts head/chest when prone

195
Q

2 month fine motor

A

eyes track past midline

196
Q

2 month social/communication

A

alerts to sound, social smile

197
Q

2 month cognitive

A

recognizes parent

198
Q

4 month gross motor

A

rolls front to back

199
Q

4 month fine motor

A

grasps rattle

200
Q

4 month social

A

laughs, soothed by parents voice

201
Q

4 month cognitive

A

orients head to direction of voice

202
Q

6 month gross motor

A

can sit with little or no support

203
Q

6 month fine motor

A

reaches with one hand, transfers objects

204
Q

6 month communication/social

A

babbles, stranger anxiety

205
Q

6 month cognitive

A

feeds self

206
Q

9mo gross motor

A

pulls to stand

207
Q

9mo fine motor

A

bangs together two objects, immature pincer grasp

208
Q

9mo communication/social

A

waves bye bye, says mama/dada, separation anxiety

209
Q

9mo cognitive

A

plays gesture games

210
Q

12mo gross motor

A

stands/walks alone

211
Q

12mo fine motor

A

finger pincer grasp

212
Q

12 mo communcation/social

A

one word other than mama/dada

213
Q

12 mo cognitive

A

uses spoon/cup, points to desired object

214
Q

18 mo gross motor

A

runs well

215
Q

18mo fine motor

A

builds tower 3 blocks

216
Q

18mo communication/social

A

points to 1-3 body parts

217
Q

18mo cognitive

A

“helps” in house

218
Q

2yr gross motor

A

throws ball overhand, kicks ball

219
Q

2yr fine motor

A

copies a line with crayon

220
Q

2yr communication/social

A

2 word sentences, >50 words

221
Q

2yr cognitive

A

removes article of clothing

222
Q

3yr gross motor

A

pedels tricycle

223
Q

3yr fine motor

A

copies circle

224
Q

3yr communcation/social

A

speaks in three word sentences, 75% langueage is intelligible

225
Q

3yr cognitive

A

brushes teeth with help

226
Q

4 yr gross motor

A

hops on two feet

227
Q

4yr fine motor

A

copies square

228
Q

4yr communication/social

A

100% of language intelligible, plays in a group

229
Q

4 yr cognitive

A

knows 4 colors

230
Q

5 yr gross motor

A

skips

231
Q

5 yr fine motor

A

copies triangle

232
Q

5 yr communication/socila

A

defines simple words, uses 5word sentences

233
Q

5 yr social

A

dresses self

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