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Pediatrics Royal College OSCE > Endo/Allergy/Immuno > Flashcards

Endo/Allergy/Immuno Flashcards

1
Q

Critical sample BW

A
  1. Glucose
  2. Insulin
  3. Cortisol
  4. GH
  5. BHydroxybutrate
  6. FFA
  7. Lactate
  8. NH4
  9. Urine AA
  10. pH
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2
Q

Cushing symptoms

A
    1. Moon facies
    1. Buffalo hump
    1. Truncal obesity
    1. Striae
    1. HTN
    1. Hyperglycemia
    1. Masculinization
    1. growth failure
    1. Ammenorhhea
    1. Osteoporosis
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3
Q

Steriod SE

A
  1. Growth suppresion
  2. Myopathy
  3. AVN
  4. Osteopenia
  5. Immunosuppresion
  6. Peptic ulceration
  7. HTN
  8. Hyperlipidemia
  9. Cataracts
  10. Pseudotumor cerebri
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4
Q

PID warning signs

A
  1. Four or more new ear infections in 1 year
  2. 2 or mroe serious sinus infections within 1 year
  3. 2 or moremonths on antibiotics with little effect
  4. Two or more pneumonias within 1 year
  5. Failure of an infant to gain weight or grow normally
  6. Recurrent deep skin or organ abscesses
  7. Persisten thursh in the mouth or fungal infections on the skin
  8. Need for IV antibiotics to clear infection
  9. Two or more deep seated infections including sepsis
  10. A family history of PID
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5
Q

Anaphylaxis discharge list

A
  1. EpiPen
  2. Anaphylaxis action plan
  3. 3 days of antihis and steroids
  4. Medical ID device
  5. Referral to allergist
  6. Avoidance of trigger
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6
Q

Allergy physical exam

A
  1. Allergic shiners
  2. Dennnie Morgan lines
  3. Allergic salute
  4. Horizontal crease
  5. Allergic facies
  6. Enlarged pale nasal tubinates
  7. Cobblestoning in the psoterior oropharynx
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7
Q

Order of puberty female/male

A

Female puberty:

  1. Breast
  2. Hair
  3. Growth
  4. Menarche

Male puberty:

  1. Testicular vol
  2. Penile length
  3. Hair
  4. Growth
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8
Q

Adrenal crisis

A
  1. n/v
  2. Dehydration and wt loss
  3. Irritability/lethargy
  4. HypoNa
  5. HyperK
  6. HypoGLC
  7. Hypotensive
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9
Q

DDX afebrile septic infant

A
  1. Sepsis
  2. CAH
  3. IEM
  4. NABI/SBS
  5. Toxin/drugs
  6. CHD
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10
Q

RF for cerebral edema in DKA

A
  1. Decreased initial PCO2
  2. Increased Ur
  3. Slow increase in Na with Tx
  4. Tx w/ HCO3
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11
Q

DM t2 RF

A
  1. FamHx
  2. Obesity (increased BF%/BMI)
  3. Race: AfA, Native, Hispanic
  4. Puberty
  5. PCOS
  6. Acanthosis nigricans
  7. Neonatal LGA/LBW
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12
Q

Signs of insulin resistance

A
  1. Acanthosis nigricans
  2. HTN
  3. Neonatal macrosomia/hypoglycaemia
  4. Dyslipidemia
  5. PCOS/oligomennorhea
  6. Ketosis
  7. IGT/IFG
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13
Q

Diabetes screening

A
  1. Retinopathy: Optho q1yr, starting at 15, >5
  2. Nephropathy: albumin:creat (am) ratio q1yr at 12, >5
  3. Neuropathy: PE q1yr
  4. Celiac disease: TTG, IgA PRN
  5. HypoTH: TSH, TPO antibodies at Dx then q2
  6. Macrovascular dz: BP q1yr, lipid profile at 12/17 yr
  7. Addison dz: 8 am serum cortisol + lytes PRN
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14
Q

DKA criteria

A
  1. BG > 11.1 mM/L

2. pH

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15
Q

Complications of hypothyroidism

A
  1. Low IQ (not reversible after 3 ms; rare after 2-3 yrs)
  2. Chronic constipation/ileus
  3. linear growth/adult stature
  4. Prone to SCFE
  5. Slow mental fxn/poor grades
  6. Muscle pseudohypertrophy
  7. Precocious puberty (Br girls, macroO boys, galactor
  8. Delayed puberty
  9. Delerium/dementia/sz/coma
  10. Adrenal insufficiency
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16
Q

Ricketts physical exam

A
  1. Genrally: FTT, listless, weak (proximal), dist abd, #s
  2. Craniotabes
  3. Frontal bossing
  4. Delayed fontanelle closure
  5. Delayed dentition/caries
  6. Craniosynostosis
  7. Rachitic rosary
  8. Harrison groove
  9. Recurrent LRTI/atelectasis
  10. Scoliosis/kyphosis/lordosis
  11. Enlargement of wrists and ankles (growth plate)
  12. Valgus/varus deformities/ windswept def
  13. Ant bowing of tibia and femur
  14. Coax vara
  15. Leg pain
  16. Hypocacemic sxs: tetany, szs, stridor
17
Q

Metabolic syndrome

A
  1. Obesity (central)
  2. HTN
  3. Dyslipidemia
  4. IGT and/or glucose intolerance
  5. Prothormbotic state
  6. Pro-inflammatory state ( CRP)
18
Q

Treatment of precious puberty

A
  1. M sex
  2. > CA
  3. Psychosocial disturbances
19
Q

Hyperthyroidism causes

A
  1. Medical (propythiouracil, methimazole)
    a. Rash
    b. Arthralgias
    c. Alopecia
    d. n/v
    e. Agranulocytosis (rare) and transient granulocytopenia
  2. Radiation Tx (I131)
    a. HypoTH (60%)
    b. Genetic damage
    c. Risk of CA (leukemia, thyroid)
  3. Surgical (thryoidectomy)
    a. HypoTH
    b. HypoPTH
    c. Recurrent laryngeal nerve damage
    d. Usual surgical risks
20
Q

Causes of common hypothyroidism

A

Chron lymphocytic thyroiditis (anti-thyroglobulin

21
Q

PCOS RF and definition

A 
Definition: 2/3 of:
1.	oligo or anovulation (irr menses)/amenorrhea
2.	Clinical or biochemical hyperandrogenism
a.	Acne, facial hair, cliteromegaly
b.	Total and free testosterone 
3.	Polycystic ovaries on u/s 
RF to developing PCOS
1.	premature adrenarche
2.	SGA/IUGR
3.	FHx type 2 DM
4.	RF for insulin resistance
22
Q

Growth hormone side effects

A 
1. Pseudotumor cerebri
worsened scoliosis
2.	SCFE
3.	Hypothyroidism
4.	Adrenal insufficiency
5.	Leukiema
6.	Gyencomastia
23
Q

Hypo CA DDX

A
  1. HypoPTH
    a. API (Addison’s, chronic mucocutaenous candidiasis, +/- hypothyroid)
    b. Congenital (DiGeorge)
  2. Severe vitamin D deficiency
  3. PseudohypoPTH (increased PTH)
  4. CRF
  5. Liver disease
  6. Prematurity
  7. VDR mutation (Vit D dependent rickets type II)
  8. 1α-hydroxylase mutation (Vit D dep rickets type I)
  9. HypoMg
  10. Chronic AED Tx
24
Q

Chronic urticaria

A
  1. Physical: cold, dermatographism, anticholinergic
  2. Chronic AI urticaria: a/w other AI d/o
  3. Idiopathic urticaria (most common)
  4. C1 esterase deficiency (laryngeal angioedema)
  5. d/t ACEi (laryngeal angioedema)
25
Q

CVID

A
  1. Onset in 2nd to 3rd decade
  2. Increased risk of malignancy (lymphoma)
  3. Increased risk of AI d/o (AIHA, ITP)
  4. a/w IgA deficiency
  5. Recurrent sinopulmonary infxns
  6. Recurrent GI infxns
  7. N B cell #s/abN fxn
26
Q

DDx of hypogammaglobulinemia

A
  1. CVID
  2. XLA
  3. HyperIgM
  4. Thymoma
  5. Drugs: AEDs
  6. PLE
  7. Nephrotic syndrome
  8. NHL/HL

Pediatrics Royal College OSCE (11 decks)

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