Deck 2 COPY Flashcards
1
Q
what does molluscum contagiosum look like on a child
A
it is firm round pink or flesh colored papules with a central umbilication, shiny or itchy
2
Q
treatment of molluscum contagiosum
A
observation and reassurance
3
Q
what are the two types of transfusion rxns
A
anaphylactic and urticarial
4
Q
management of a transfusion rxn
A
give antihistamines and stop transfusion
5
Q
what do you need to do for close contacts of a positive pertussis patient
A
give close contacts a macrolide
6
Q
what is a normal anion gap
A
6-12
7
Q
causes of non anion gap metabolic acidosis
A
either renal or GI (diarrhea)
8
Q
how does a baby present with RTA
A
chronic poor weight gain, declining weight despite regular weight at birth
9
Q
presentation of atypical pneumonia
A
fever cough dyspnea, bilateral pulmonary infiltrates
10
Q
what bug causes atypical pneumonia most often
A
mycoplasma pneumoniae
11
Q
how do you treat mycoplasma pneumoniae
A
azithromycin
12
Q
what drug do you use to treat tourettes in children
A
risperidone
13
Q
when do pap smears start
A
age 21
14
Q
what heart anomaly is seen in trisomy 18
A
VSD
15
Q
signs of tricuspid valve atresia
A
absent tricuspid valve, tall peaked P waves, Left axis deviation, ASD, VSD
16
Q
if a murmur in a neonate is holosystolic is it benign or pathologic
A
pathologic
17
Q
what needs to be administered if a 1-3 day old neonate has sudden onset rapid breathing and cyanosis
A
prostaglandin E to kEEp the PDA open
18
Q
are turner patients tall or short
A
short! very short
19
Q
signs of choanal atresia
A
this is when the posterior nasal passage fails to canalize during first trimester causing cyanosis that worsens with feeding and improves with crying
20
Q
what are the typical causes if a child has a fever without a source
A
occult bacterial infection (UTI, bacteremia, pneumoniae etc)
21
Q
signs of chronic granulomatous disease
A
recurrent infections with catalase positive infections (staph, serratia, aspergillus)
22
Q
dx of chronic granulomatous disease
A
DHR flow cytometry
23
Q
prophylaxis for CGD
A
TMP-SMX, itraconazole, interferon gamma
24
Q
pathogenesis of minimal change disease
A
cytokine induced glomerular injury
25
signs of LAD
frequent non purulent absesses, delayed umbilical cord separation
26
lab findings LAD
leukocytosis and neutrophilia
27
triple bubble sign on xray
jejenal atresia
28
signs of congenital syphilis
rhinorrhea, skeletal anomalies, desquamating rash on the palms and soles
29
effects on a neonate of a mother with lupus
they will typically have high creatinine levels
30
signs of functional constipation
anal fissure, blood on the outside of stools, pellet stools, infrequent defecation
31
management of functional constipation
adding prune juice or other osmotically active fibers to the diet
32
when should you switch a baby to a hydrolyzed formula
do this when the baby has blood mixed into the stool and has signs of soy/cows milk allergy
33
signs of tet spells
cyanosis upon crying or feeding mostly around the lips, children will squat if able
34
what are tet spells indicative of
tetrology of fallot
35
signs of gonococcal conjunctivitis in a newborn
copius exudate and eyelid swelling
36
pathogenesis of neonatal thyrotoxicosis
this is from maternal anti-TSH antibodies like from graves disease
37
does PSGN present with abdominal pain
No! this is IgA vasculitis
38
treatment of slipped capital femoral epiphysis
physis stabilization with screw fixation
39
Wiskott aldrich clinical features
eczema, microthombocytopenia, recurrent infections
40
etiology of wiskott aldrich
xlinked recessive defect in WAS, impaired cytoskelly
41
JIA presentation
arthritis, fever with cycles that spike high one time a day then return to baseline
42
what is another cause of infection in CF patients
pseudomonas, bronchopulmonary aspergillosis
43
comorbidities in turner syndrome
aortic dilation/dissection, metabolic syndromes, osteoporosis, vision changes, recurrent otitis media, celiac disease, hypothyroidism
44
signs of congenital diaphragmatic hernia
respiratory distress, absent breath sounds ipsilateral to the defect, concave abdomen, barrel shaped chest
45
management of congenital diaphragmatic hernia
intubation ,gastric decompression, surgery
46
why do neonates have physiologic jaundice
due to decreased hepatic bilirubin clearance, low levels of UDP-glucoronidase, especially in eastern asian newborns
47
lab findings of hereditary spherocytosis
increased MCHC
48
if a neonate has alveolar densities and pleural effusions what do they have
pneumonia
49
what are some acute causes of hemiplegia in children
ischemic stroke, intracranial hemorrhage, seizures, hemiplegic migraine
50
if a chid has acute onset of psychosis with arthralgia and thrombocytopenia, and hematuria what is the cause
lupus
51
if a child has IgA vasculitis what is a complication they are at risk of
intussusception
52
in failure to thrive what growth parameter is affected first
weight then length then head circumference
53
what are the two types of failure to thrive
there is organic (physiologic cause, malabsorption syndromes etc) and inorganic which is typically psychosocial
54
what is pulsus paradoxus
when the systolic blood pressure varies with inspiration
55
what is pulsus paradoxus a sign of
asthma exacerbation, pericardial tampanode, pericarditis
56
asthma physical exam findings
wheezing, hyperexpansion of the thorax, or a prolonged phase of forced exhalation
57
what drug is given to manage acute asthma exacerbations
SABA, SAMA, steroids
58
when does the late phase reaction occur in asthma
2-4 hours later after initial wheezing episode
59
what are eczema lesions described as
erythematous, weeping, crusted lesions
60
location of infant eczema
central trunk/head and extensor surfaces
61
location of child eczema
wrists, ankles, face, flexor surfaces
62
what is first line therapy for acute eczema flair up
topical corticosteroids, can use an oral antihistamine for help with sleep/limiting pruritis at night
63
what type hypersensitivity is contact dermatitis
type 4
64
treatment options for ADHD
stimulant meds (methyphenidate, amphetimines. Second line: atomoxetine (norepi reuptake inhibitor), guanfacine/clonidine (alpha 2 agonists)
65
before treatment with meds for ADHD what else needs to happen
complete psychoeducational assessment
66
galactosemia eye findings
cataracts
67
presentation of galactosemia
poor feeding, failure to thrive, jaundice, cataracts
68
difference between simple febrile seizure and complex febrile
simple is less than 15 minutes and non localizing. complex have multiple seizures within a 30 minute period
69
what demographic gets complex febrile seizures moreso
children with abnormal development
70
in a young child (1yo) what test should you do if they have seizure and fever
LP to rule out meningitis bc meningeal tests are not reliable
71
postnatal effects of intrauterine growth restriction
hypoglycemia, polycythemia, hypothermia, hypocalcemia
72
signs of androgen insensitivity syndrome
when a patient is phenotypically female but genetically male, no pubic hair, female external genitalia, etc.
73
treatment of SCID
stem cell transplant
74
signs of cold abcesses
they are non erythematous and nontender I.e. no sign of inflammation
75
Hyper IgE signs
eosinophilia, eczema, recurrent cold abscesses
76
signs of IVH in a newborn
seizures, tachycardia, full fontanelle, acute anemia
77
what babies develop IVH
premie babies
78
if a baby has macrocephaly but they have normal development and normal head US do they need further workup
nope!
79
signs of mercery toxicity
desquamating rash, neuropsychological changes (insomnia, anxiety, personality changes)
80
in alopecia acreta is there ANY hair growth
none at all
81
episodic crying, abdominal tenderness, lethargy
intussusception
82
what causes pneumonia mostly in children with CF
staph aureus
83
what causes pneumonia in adults with CF
pseudomonas
84
treatment of minimal change disease
steroids
85
difference between club foot and metatarsus adductus
club foot the whole foot is turned in and cant be repositioned. metatarsus adductus only the forefoot is inward and the whole foot can be repositioned. only reassurance needed it will correct itself
86
when is emergency laporatemy indicated
signs of intestinal perf
87
if a baby has dilated loops of bowel and tight anal sphincter whats going on
hirschsprungs
88
causes of steatorrhea
CF, gluten sensitivity, malabsorption syndromes
89
signs of CF in a 1yo
growth decline, wet cough, new onset large bulky stools (steatorrhea)
90
management of hypoglycemia in an infant
POC glucose check, then send a glucose check via blood to lab, continuous feeds, IV glucose
91
effect of maternal hyperglycemia on the infant (pulmonary)
respiratory distress due to antagonist effect on surfactant
92
bronchiectasis appearance on xray
linear opacities in a parallel tram-track configuration
93
extrapulmonary signs of CF
digital clubbing, recurrent sinusitis, failure to thrive, fat malabsorption, and a history of meconium ileus
94
signs of HIV infection in a child
lymphadenopathy, hepatomegaly, oral candidiasis, frequent infection
95
what is always the first step in management of an patient in distress
address ABCs!
96
signs of diabetes in a child
polydipsia, polyuria, weight loss, tachypnea, abdominal pain, vomiting, fatigue
97
what is the anion gap like in a child in DKA
elevated
98
what is the K level like in DKA
hyperkalemia
99
Fatty acid levels in DKA
increased due to increased lipolysis to use for gluconeogenesis
100
treatment of DKA
IV fluids, insulin
101
what is a devastating complication of DKA
cerebral edema, 25% do not survive
102
what is the honeymoon phase of diabetes
this is when you see a decreased need of insulin ~6mo post diagnosis, it will come back
103
inheritance of DMD
xlinked recessive
104
initial screening in suspected DMD
creatine kinase level (muscle breakdown)
105
what is a common skeletal complication of muscular dystrophy
scoliosis
106
newborn findings of myotonic muscular dystrophy
high arched palate, inverted V-shaped upper lip, thin cheeks, and wasting of the temporalis muscles
107
what is the shunt like in PDA initially
it is Left to right bc higher pressure
108
consequence of maintained PDA
pulmonary hypertension and then eisenmeiger syndrome where the shunt shifts right to left causing cyanosis
109
does a PDA cause contractile dysfunction
no! just volume overload
110
how does aortic coarctation effect LV
LV pressure overload with intact contractility initlaly but then it declines if not reversed
111
causes of LV contractile dysfuction in infants I
cadiomyopathy and MI
112
signs of meningitis in an adolescent
diffuse erythema of pharynx, non specific fever, myalgias, skin mottling, vomiting, sore throat, headache, petichiae/purpura
113
when are branchial cleft and thyroglossal duct cysts often detected
post URI they can become secondarily infected
114
what are cystic hygromas associated with
turners
115
what bugs are seen in patients with affected oxidative burst (chronic granulomatosis disease)
bacteria: staph, nocardia, burkholderia, serratia // Fungal: aspergillus
116
what bugs are seen in patients with terminal complement deficiency
neisseria
117
what bugs are seen in patients wtih T cell deficiency
viral, and fungal infections
118
ocular presentations of neuroblastoma
periorbital ecchymoses (raccoon eyes), opsoclonus-myoclonus syndrome (rapid jerking movements of both eyes)
119
what is dactylitis a sign of
sickle cell
120
what is preseptal cellulitis
this is when the periorbital and eye sockets have cellulitis
121
difference between preseptal cellulitis and orbital cellulitis
orbital cellulitis has pain with extraocular movements and shows proptosis and ophthalmoplegia with diplopia and involves the orbital space
122
treatment of preseptal cellulitis vs. orbital cellulitis
preseptal: oral antibiotics // orbital: IV antibiotics +/- surgery
123
what type of saline do you give initially to rehydrate children
20mL/kg normal saline IV bolus
124
risk factors for acute otitis media
age (6-18mo), lack of breastfeeding, day care attendance, smoke exposure
125
signs of tinea capitis in a child
scaly erythematous patch, black dots on the affected area, tender lymphadenopathy
126
treatment of tinea capitis
oral griseofulvin or terbinafine
127
signs of drug induced hemolytic anemai
onset severa hours post exposure, jaundice, dark urine, abdominal/back pain
128
mechanism of drug induced hemolytic anemia
the durg bidns directly to erythrocytes and creates a hapten (place to bind) for IgG which causes the RBCs to be sequestered by splenic macrophages
129
pathogenesis of UTIs in kids with chronic constipation
urinary stasis, the constipation causes occlusion fo the urethra leading to retention and increased risk of UTI
130
MEN1
pituitary, parathyroid, and pancreas
131
MEN2a
parathyroid, pheo, med thyroid
132
MEN2b
pheo, med thy, Marfanoid habitus, mucosal neuromas
133
which MEN has marfanoid habitus
MEN2b
134
screening in an adolescent well child visit
contraceptive/safe sex, depression, substance use
135
valsalva maneuver/standing effect on preload and afterload
decreases preload and afterload
136
handgrip effect on preload/afterload
increases afterload
137
when does HOCM get louder
decreased afterload (valsalva, standing)
138
Aortic stenosis with increased preload/afterlaod
gets louder with increased preload, quieter with increased afterload
139
squatting effect on preload and afterload
increases preload and increases afterload
140
how do you get HOCM to increase in intensity (physiology)
you want decreased blood in the left ventricle so therefore you decreaes preload
141
definition of amblyopia
this is when you have decreased visual acuity due to visual disturbances early in childhood
142
causes of amblyopia
cataracts, strabismus, uncorrected refractive error
143
management of amblyopia
corrective lenses, surgery to remove cataracts, encourage use of the amblyopic eye
144
signs of 21-alpha hydroxylase deficiency in a genetic female
virulization, high potassium, low BP
145
signs of virulization in a genetic female
enlarged clitoris, (underdeveloped phallus with hypospadias), fused labioscrotal folds
146
signs of virulization in a genetic male
phenotypically normal or hypervirilized (enlarged phallus)
147
lab studies in a 21-a-hydroxylase deficiency
high K, low Na, 17-hydroxyprogesterone elevated
148
signs of 11B hydroxylase deficiency in XX babies
virulization, high BP, low K
149
signs of 17-a-hydroxylase deficiency in XX babies
secondary sex characterisitcs underdeveloped, high BP, low K, no cortisol
150
signs of 17-a-hydroxylase deficiency in XY babies
undescended testes, atypical genetalia (bc no DHT which is necessary for external genitalia)
151
what does it mean if there are gamma tetramers seen on hemoglobin electrophoresis
this means that there is hemoglobin H which is what happens when there are 3 alpha genes lost and so the Beta globin accumulate as the homotetramers
152
MCV in alpha thallesimia
low
153
erythrocyte level in hemoglobin H disease
typically elevated to make up for hemolyzed RBCs
154
which antibiotics do you use for UTI in children
cephalosporin
155
what is common variable immunodeficiency
this is when you have abnormal differentiation of b cells into plasma cells and decreased immunoglobulin production
156
management of common variable immunodeficiency
IV Immune globulin infusion
157
manifestations of common variable immunodeficincy
recurrent respiratory infections, recurrent GI infections, chronic diseases
158
normal urine output in a neonate
> or equal to 1 void per day of life so a 48hour old baby should have 2 wet diapers/day
159
management of oliguria in a neonate
renal and bladder ultrasound
160
diarrhea in a 1yr following resolved diarrheal illness
secondary lactose intolerance due to damaged epithelium
