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Pediatrics > General Pediatrics > Flashcards

General Pediatrics Flashcards

1
Q

Birthweight doubles by?

A

4 months

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2
Q

Birthweight triples by?

A

1 year

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3
Q

Birth length increased by 50% by?

A

1 year

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4
Q

Birth length doubles by?

A

4 years

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5
Q

Birth length triples by?

A

13 years

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6
Q

Growth rate of head circumference between 0 to 6 months

A

1 cm per month

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7
Q

Growth rate of head circumference between 6 to 12 months

A

0.5 cm per month

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8
Q

Define Macrocephaly

A

Head circumference greater than 98th percentile for age

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9
Q

Define Microcephaly

A

Head circumference less than 2nd percentile for age

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10
Q

Craniosynostosis versus Positional Plagiocephaly

A

Craniosynostosis is deformation of the skull due to premature fusion of one or more sutures; Positional Plagiocephaly has normal sutures and parallelogram head shape

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11
Q

Craniosynostosis should be corrected before what age?

A

5 months

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12
Q

Rate of CSF production in normal child

A

20 mL per hour

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13
Q

Volume of CSF in infant

A

50 mL

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14
Q

Volume of CSF in adult

A

150 mL

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15
Q

Rate of weight growth up to 2 months of age

A

30 grams per day

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16
Q

Rate of weight growth between 3 to 4 months

A

20 grams per day

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17
Q

Number of words at 18 months

A

10 to 15 words

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18
Q

Number of words at 24 months

A

50 to 100 words

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19
Q

Visual acuity at 20/30 at what age?

A

3 years

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20
Q

Visual acuity at 20/20 at what age?

A

4 years

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21
Q

Handedness establishes by what age?

A

3 years

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22
Q

Criteria for legally blind

A

Corrected vision 20/200 or worse

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23
Q

Name all the live vaccines (8)

A 
Intranasal Influenza
MMR
Varicella
Oral Polio
Rotavirus
BCG
Oral Typhoid
Yellow Fever
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24
Q

Vaccine containing clinical significant of egg material

A

Yellow Fever

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25
Q

Postexposure chemoprophylaxis against meningococcal

A

Rifampin or Ciprofloxacin or Ceftraixone

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26
Q

When should HBV and HBIG be given to neonates born to HBsAg pos or unknown mother?

A

Within 12 hours of delivery

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27
Q

Postexposure chemoprophylaxis against pertussis

A

Azithromycin

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28
Q

Postexposure immunoprophylaxis against measles

A

MMR vaccine within 72 hours

Measles Ig within 6 days

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29
Q

Age when able to hop on one foot

A

4 years

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30
Q

Age when able to draw a cross

A 
4 years 
(4 points)
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31
Q

Age when able to balance on one foot

A

3 years

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32
Q

Age when able to copy a circle

A

3 years

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33
Q

Age when able to walk down stairs holding rail

A

2 years

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34
Q

Age when able to walk up stairs alternate feet

A

2.5 years / 30 months

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35
Q

Age when able to write their name

A

5 years / 60 months

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36
Q

Age when able to walk down stairs alternate feet

A

5 years / 60 months

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37
Q

Age when able to draw a triangle

A

5 years / 60 months

has 60 degree angle in it

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38
Q

Age when able to skip

A

5 years / 60 months

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39
Q

Age when able to draw a person with 6 body parts

A

5 years / 60 months

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40
Q

Age when able to draw a person with head and one body part

A

3 years / 36 months

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41
Q

Age when able to catch a ball

A

4 years / 48 months

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42
Q

Age when able to throw a ball

A

2 years / 24 months

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43
Q

Age when able to dress and undress

A

5 years / 60 months

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44
Q

Indication for Soy Formula

A

Galactosemia

Hereditary Lactase Deficiency

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45
Q

Indication for Extensive Hydrolyzed Formula

A

Milk Protein-Induced Enteropathy (non-IgE mediated)

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46
Q

Macronutritents causing peripheral nutrition associated liver disease

A

Lipids

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47
Q

Side effect of sulfasalazine

A

Folate deficiency

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48
Q

Recommended intake for calcium and phosphate in child to adolescents

A

1300mg

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49
Q

Eczematous dermatitis, alopecia & poor growth: Disease?

A

Zinc Deficiency

Acrodermatitis enteropathica

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50
Q

Skin & hair pigment loss, macrocytosis, cardiomyopathy: Disease?

A

Selenium Deficiency

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51
Q

Retinol ==

A

Vitamin A

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52
Q

RIboflavin ==

A

Vitamin B2

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53
Q

Niacin ==

A

Vitamin B3

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54
Q

Pyridoxine ==

A

Vitamin B6

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55
Q

Alpha-Tocopherol ==

A

Vitamin E

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56
Q

Phylloquinone ==

A

Vitamin K

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57
Q

Cause of Marasmus

A

Deficiency in both calories and protein

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58
Q

Cause of Kwashiorkor

A

Long term deficiency in protein only

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59
Q

Poor intake with hypoalbuminemia and peripheral edema

A

Kwashiorkor

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60
Q

Deficiency in infant feed exclusively with Goat’s milk

A

Folate deficiency

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61
Q

Xerophthalmia

A

Dryness of the eyes

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62
Q

Nyctalopia

A

Night blindness

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63
Q

Normal anion gap

A

8 - 12

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64
Q

Causes of increased AFP

A 
RAIN elevates the AFP reservoir
Renal (Nephrosis, renal agenesis, polycystic kidney disease)
Abdominal wall defects
Incorrect dating / multiple pregnancy
Neuro (Ancephaly, spina bifida)
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65
Q

Apt Test

A

Looks for maternal blood in neonate’s gastric aspirate

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66
Q

Presenting symptom in CF

A

Rectal prolapse

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67
Q

Abortive therapy for cyclic vomiting syndrome

A

Sumatriptan

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68
Q

Prophylactic therapy for cyclic vomiting syndrome

A

Amitriptyline

Propranolol

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69
Q

Child with febrile seizure + diarrhea: Cause

A

Shigella (Shake-ella)

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70
Q

Diagnostic test for sucrase-isomaltase deficiency

A

Breath hydrogen test (to look for bacterial fermentation of undigested /unabsorbed carbohydrates)

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71
Q

Deficiency associated with dermatitis, dementia and diarrhea

A

Niacin deficiency (Vitamin B3)

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72
Q 
16 year old boy presents with
- Painful swallowing
- Chest discomfort
- Hx of nodular acne on oral doxycyclin
Diagnosis?
A

Pill-induced esophagitis

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73
Q

Electrolyte abnormalities in pyloric stenosis

A

Hypochloremic alkalosis

Hypokalemia

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74
Q

Disorder in children with insufficient intake of protein

A

Kwashiorkor

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75
Q

Newborn with no conjugated bilirubin: Disease

A

Crigler-Najjar Syndrome Type 1

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76
Q

Deficiency associated with

  • Cheilosis / angular stomatitis
  • Sore tongue
A

Riboflavin (Vitamin B2)

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77
Q

Timeframe for upper endoscopy after caustic ingestion

A

12-24 hours

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78
Q

Deficiency in infant given goats milk

A

Folate

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79
Q

GI disease associated with DM1 or selective IgA deficiency

A

Celiac disease

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80
Q

Positive anti-smooth muscle antibodies: Disease

A

Autoimmune hepatitis type 1

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81
Q

Deficiency associated with

  • paraesthesias
  • foot and wrist drop
  • ophthalmoplegia
  • ataxia
  • confusion
A

Thiamine (Vitamin B1) deficiency

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82
Q

Best diagnostic test in a young child with suspected FB aspiration

A

Airway fluoroscopy

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83
Q

Best diagnostic test for vascular rings

A

Barium swallow

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84
Q

Symptoms of hypercarbia

A

Flushing
Agitation
Headaches (elevated CO2 leading to cerebral vasodilation)

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85
Q

Hematological response to chronic hypoxemia

A

Polycytosis (from kidney producing EPO in response to hypoxemia)
Thrombocytopenia

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86
Q

Treatment for Methemoglobinemia

A

IV methylene blue

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87
Q

Normal result for Sweat Test

A

60 mEq or greater

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88
Q

Kartagener Syndrome

A

Type of primary ciliary dyskinesia with situs inversus

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89
Q

Treatment for necrotizing pneumonia

A

Vancomycin

Clindamycin

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90
Q

Best confirmatory test for pneumonia

A

Blood culture

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91
Q

At what age can a child copy a square

A

4 years

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92
Q

Best diagnostic test for microcephaly

A

CT or MRI head

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93
Q

At what age can a child use a cup well?

A

15 - 18 months

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94
Q

Age when able to dress themselves

A

3 years

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95
Q

Diagnosis for fixed and split 2nd heart sound

A

ASD

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96
Q

Diagnosis for blowing holosystolic murmur at left lower sternal border

A

VSD

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97
Q

Disease associated with AV canal defect

A

Down Syndrome

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98
Q

Disease associated with right sided aortic arch

A

22q11 deletion

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99
Q

3 cardiac causes of central cyanosis with no respiratory distress

A

1) Transposition of the great arteries
2) Pulmonary atresia
3) Ebstein malformation

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100
Q

Cause of Ebstein’s anomaly

A

Maternal lithium or benzodiazepine use

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101
Q

Most common congenital heart defect presenting with severe cyanosis in first week of life

A

Transposition of the Great Arteries

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102
Q

Diagnosis with single 2nd heart sound and egg-shaped heart

A

Transposition of the Great Arteries

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103
Q

Single 2nd heart sound

A

Transposition of the Great Arteries

Tetralogy of Fallot

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104
Q

Disease associated with aortic root dissection

A

Marfan Syndomre

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105
Q

Disease associated with supravalvular aortic stenosis

A

Williams Syndrome

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106
Q

Disease associated with supravalvular pulmonic stenosis

A

Noonan Syndrome

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107
Q

Disease associated with coartation of the aorta

A

Turner Syndrome

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108
Q

Most common valvular disease in rheumatic fever

A

Mitral insufficiency

Aortic insufficiency

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109
Q

Best diagnostic test for endocarditis

A

Blood culture

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110
Q

Most common cause of myocarditis

A

Coxsackie group B Virus

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111
Q

Common adverse events after MMR

A

Fever and rash 6-12 days, joint pain 7-21 days after vaccine

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112
Q

Age at which baby roll from front to back

A

4 - 5 months

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113
Q

Age at which baby roll form back to front

A

5 - 6 months

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114
Q

Age at which baby can hold their head up 90 degress and lift their chest

A

4 months

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115
Q

Moro reflex disappears by

A

3 -4 months

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116
Q

Which vaccine is contraindicated for a child whose mother is pregnant?

A

None

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117
Q

Age at which a child can sit with no support

A

7 months

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118
Q

Age at which a child can sit with support

A

6 months

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119
Q

Cut off age for receiving a HiB vaccine

A

5 years

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120
Q

4 subcutaneously administered vaccines

A

MMR
MMRV
Varicella
IPV

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121
Q

Source for Enteropathogenic E Coli

A

Food borne reservoir, such as unfiltered, unpasteurized apple juice

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122
Q

Cause of psuedoappendiitis syndrome

A

Yesina enterocolitica

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123
Q

Source for Yesina enterocolitica

A

Consumption of chitterings Southern US

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124
Q

Organism linked with GBS

A

Campylobacter jejuni

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125
Q

Antibiotic is recommended for which organism causing gastroenteritis

A

Campylobacter jejuni

Treat with erythromycin or azithromycin

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126
Q

Cause of Hemolytic Uremic Syndrome

A

Shiga-Toxin producing E Coli (O157:H7)

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127
Q

Treatment for Biliary Atresia

A

Kasai Procedure (Hepatoportoenterostomy)

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128
Q

Treatment to prevent NSAID-related complications

A

Misoprostol (prostogladin 2 analogue)

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129
Q

Cause of delayed stooling in newborn with maternal gestational diabetes

A

Neonatal Small Left Colon Syndrome

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130
Q

Disease with Blueberry Muffin Spots in newborn

A

Congenital CMV infection

Congenital Rubella

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131
Q

Newborn with

  • anemia
  • fetal hydrops
  • ascites
  • Cardiomegaly
  • Ventriculomegaly
A

Congenital Parvovirus B19 infection

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132
Q

Newborn with depressed nasal bridge, hypoplastic distal phalanges, stippled epiphyses: Tetralogen

A

Warfarin

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133
Q

Treatment threshold for polycythemia

A

> 65 Hct with symptoms

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134
Q

Most common cause of seizures in first 24 hours of life

A

Hypoxic-Ischemic Injury

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135
Q

Treatment fo galactosemia

A

Soy formula

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136
Q

Bilateral hydroureteral nephrosis
Undescended testes
Wrinkled anterior abdominal wall
Disease?

A

Prune Belly Syndrome

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137
Q

Age at which physiological anemia of infancy occurs

A

8 - 10 weeks

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138
Q

Normal MCV range

A

70 - 90

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139
Q

Microcytic anemia with high RDW: Disease

A

Iron deficiency and lead toxicity

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140
Q

Ringed sideroblast: Disease

A

Lead poisoning

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141
Q

Causes of Vitamin B12 Deficiency

A
  • Intrinsic factor deficiency (pernicious anemia)
  • Bacterial overgrowth
  • After bowel resection
  • Vegetarian diet
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142
Q

Hemolytic anemia with no elevated reticulocyte count: Cause

A

Parvovirus infection

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143
Q

Heinz Bodies: Cause

A

Glucose–phosphate dehydrogenase deficiency

Small, purple granules in RBC as a result of damage to hemoglobin molecule

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144
Q

Young male with anemia, jaundice, dark urine but no hepatosplenomegaly

A

G6PD Deficiency

X linked

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145
Q

Causes of oxidative stress in G6PD

A
  • Sulfa drugs
  • Nitrofurantoin
  • Moth balls
  • Animalarial meds
  • Fava beans
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146
Q

Age at which children with Sickle Cell Anemia has functional asplenia

A

5 years

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147
Q

Next best test for a sickle cell patient with chest pain and infiltrate on xray

A

ABG to confirm hypoxia

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148
Q

Inciting cause of an aplastic crisis

A

Chloramphenicol

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149
Q

Macrocytic anemia with elevated fetal hemoglobin
Absent or hypolastic thumb
Disease?

A

Fanconi’s anemia

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150
Q

Macrocytic anemia with normal WBC and Platelets
Low reticulocyte counts
Dysmorphia
Disease?

A

Diamond Blackfan Anemia

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151
Q

Kostmann Syndrome =

A

Severe congenital neutropenia

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152
Q

Neutropenia + pancytopenia
Exocrine pancreatic dysfunction leading to steatorrhea
Bony abnormalities and short statue
Disease:

A

Shwachman-Diamond Syndrome

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153
Q

Complication of ITP (when presenting with headaches)

A

Intracranial hemorrhage

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154
Q

Kasabach-Merritt Syndrome

A

Thrombocytopenia caused by localized consumptive coagulopathy from an hemangioma

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155
Q

TAR Syndrome

A

Thrombocytopenia Absent Radius

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156
Q

Hemophilia A: Cause

A

Deficiency in Factor 8

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157
Q

Hemophilia B: Cause

A

Deficiency in Factor 9

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158
Q

In hemophilia, what coagulation test is abnormal

A

PTT (vs PT in Vitamin K deficiency)

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159
Q

Treatment for minor bleeding in someone with von Willebrand’s disease

A

DDAVP / Desmopressin (increases factor 8 and plasma vWF)

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160
Q

Lab results in DIC

A

Low fibrinogen
Elevated D-Dimers
Prolonged Thrombin time

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161
Q

Fever
Limping
Pancytopenia
Disease?

A

ALL (Acute lymphocytic leukemia)

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162
Q

Reed Steinberg Cells: Disease

A

Hodgkin’s Lymphoma

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163
Q

Supraclavicular adenopath: Disease

A

Hodgkin’s Lymphoma

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164
Q 
Persistent scalp or diaper seborrheic rash
Ear drainage or mastoiditis
Lytic lesions in skull
Excessive urination
Disease?
A

Langerhans Cell Histiocytosis

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165
Q

Neuroblastoma: Diagnosis

A

Elevated urine VMA and HMA

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166
Q

Hemohypertrophy: Disease association

A

Wilms tumor

Beckwith Wiedemann syndrome

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167
Q

Cyclophosphamide: Side effect

A

Hemorhagic cystitis

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168
Q

Cisplatin: Side effect

A

Nephrotoxicity

hearing loss and peripheral neuropathy

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169
Q

Bleomycin: Side effect

A

Pulmonary fibrosis

(Lung so bad, you “blow-om-icin”

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170
Q

Doxorubicin: Side effect

A

Cardiac toxicity

Doxo-rubies

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171
Q

Vincristine: Side effect

A

Neurotoxicitiy and SIADH

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172
Q

Granulomatosis infantiseptum: Disease

A

Neonatal Listeria Infection

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173
Q

Facial abnormalities (nasal hypoplasia + depressed nasal bridge)
Bone strippling
Fetal exposure to?

A

Warfarin

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174
Q

Facial abnormalities (broad nasal bridge, wide-spaced eyes)
Cardiac abnormalities
Distal digital hypoplasia
Fetal exposure to?

A

Phenytoin

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175
Q

Facial abnormalities
Neural Tube Defects
Fetal exposure to?

A

Valporic Acid

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176
Q

Common respiratory complication in Meconium Aspiration Syndrome

A

Pneumothroax

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177
Q

Define very low birth weight

A

Birth weight < 1500 grams

178
Q

Signs of PDA

A

Bounding peripheral pulses
Prominent apical impulse
Systolic thrill at 2nd intercostal space
Continuous machinery-like murmur

179
Q

HELLP Syndrome

A

Hemolytic anemia, Elevated Liver enzymes, Low Platelets

180
Q

Define low birth weight

A

Birth weight < 2500 grams

181
Q

Abnormal level of scalp pH

A

pH < .7.2

182
Q

Normal fetal heartrate

A

120 - 160 bpm

183
Q

Most frequent abnormalities in infants with a single umbilical artery

A

Trisomy 18

184
Q

Newborn with lethargy, hypotonia, tremors and sweating: Cause

A

Hypoglycemia

185
Q

CHARGE Sydnrome

A 
Coloboma of the eye
Heart defects
Atresia of the choanal
Retardation of growth or development
Gential / urinary defects
Ear defects
186
Q

Term newborn at DR with tachypnea, tricuspid regurg murmur and differential cyanosis between upper and lower body

A

Persistent pulmonary hypertension of the newborn

187
Q

Newborn with

  • Wide persisent posterior fontanelle
  • Umbilical hernia
  • Jaundice
A

Hypothyroidism

188
Q

Antibody concentrations to these vaccines can be measured to check response in a < 1 year old

A

Tetanus
Polio
Diphtheria
Hep B

189
Q

Treatment for congenital toxoplasmosis

A

Sulfadiazine

190
Q

Treatment for congenital TB

A

Isoniazid

191
Q

Areas where chloroquine can be used as malaria prophylaxis

A

Central and South America

192
Q

Treatment of resistant head lice

A

Malathion

193
Q

Sources of Shiga Toxin E Coli

A

Undercooked hamburger

Unpasteurized apple juice, goat milk and cow milk

194
Q

Prophalaxis for close contacts to diphtheria

A

1x IM Pen G

Erythromycin PO for 10 days

195
Q

Cause of septic arthritis / osteomyelitis younger than 5 years

A

Kingella Kingae

196
Q

Prophylaxis for close contacts to pertussis

A

Azithromycin (for all ages)
Erythromycin (1 month plus)
Clarithromycin

197
Q

Dog bite Rx Abx

A

Augmentin

Clindamycin + Bactirm

198
Q

Method of transmission for Toxoplasmosis

A

Ingestion of undercooked meat (which has oocytes ingested by the animal)

199
Q

Positive serum galactomannan: Disease

A

Aspergillus infection

200
Q

Side effect of TMP-SMX

A

Neutropenia
Pancytopenia
Hyperkalemia

201
Q

Enterobius vermicularis.

A

Pinworm

202
Q

Test for detecting HIV

A

HIV DNA PCR @ 14-21 days, 1-2 months and 4-6 months

203
Q

Testing for Lyme Disease

A

Step 1) EIA or IFA for Lyme antibodies

Step 2) Western blot for Lyme antibodies

204
Q

Erythema infectiosum

A

Fifth Disease (Parvovirus B19)

205
Q

Treatment for candida

A

Fluconazole and/or Amphotericin B

206
Q

Treatment for Lyme Disease

A

> 8 years Doxycyclin

< 8 years amoxicillin or cefuroxime

207
Q

Fever, non-specific symptoms
Leukopenia, thrombocytopenia, mildly elevated LFTs
Recent camping in Northeast US
Disease?

A

Anaplasmosis

208
Q

Fever, non-specific symptoms
Leukopenia, thrombocytopenia, mildly elevated LFTs
Recent camping in Southeast or South Central US
Disease?

A

Ehrlichiosis

209
Q

Fever, non-specific symptoms
Vasculitic lesion starting peripherally and spread inwards
Disease?

A

Rocky Mountain Spoted Fever

210
Q

Vector for Anaplasmosis

A

Deer tick (lxodes scapularis) (also for Lyme Disease)

211
Q

Treatment for Giardia

A

Tinidazole (>3 year)
Nitazoxanide (> 1 year)
Metronidazole

212
Q

Indication for Iodoquinol

A

Entamoeba histolytica

213
Q

Complication from Shiga Toxin producing E Coli (2)

A

Hemorrhagic colitis

Hemolytic uremic syndrome

214
Q

Which type of E Coli diarrhea causes bloody stools and tenesmus

A

Eteroinvasive E Coli (EIEC)

215
Q

Travellers Diarrhoea: Organism?

A

Enterotoxigenic E Coli (ETEC)

216
Q

Rickettsia rickettsii: Diseaes

A

Rocky Mountain Spotted Fever

217
Q

Rash of Rocky Mountain Spotted Fever

A

Petchiaial rash that beings on wrist and ankles and spread inwards

218
Q

Treatment for chlamydia pneumonia in neonate

A

Erythromycin

219
Q

Targeted treatment for Neisseria meningitidis

A

IV Penicillin G

220
Q

Treatment for Shigella

A

Ceftriaxone

221
Q

Burton agammaglobulinemia vs Common variable immunodeficiency

A

Burton has low B cells. Both has low Ig levels

222
Q

Confirmatory testing for Leukocyte Adhesion Deficiency

A

FLow Cytometry for CD18

223
Q

Diagnostic critieria for common variable immunodeficiency

A

1) Decreased in one immunoglobulin
2) Poor antibody response to protein and polysaccharide vaccines
3) Exclusion of other causes of hypogammaglobinemia

224
Q

Warm-reactive IgG Antibodies: Disease

A

Autoimmune hemolytic anemia

225
Q

Prenatal US shoing bilateral hydronephrosis: Next test

A

VCUG to rule out Posterior Urethral Valves

226
Q

Nephritis disease with low Complement

A

Low compliment in PMS
P - Post-strept
M - Membranoproliferative GN
S - Systemic lupus

227
Q

Berger’s Disease =

A

IgA Nephropathy

228
Q

Micropenis: Disease ssociation

A

Prader-Willi Syndrome

Kallmann Syndrome

229
Q

Most life-threatening issue in neonates with Potter’s Sequence

A

Respiratory failure

230
Q

Definition of Stage 1 hypertension

A

> 95% of BP for height

231
Q

X-link Dominant
Bilateral sensorineural hearing loss
Ocular defects
Complement normal GN

A

Alport Syndrome

232
Q

Newborn with abdominal mass: Renal causes (4)

A

Multicystic dysplastic kidney
Hydronephrosis (from UPJ obstruction)
Renal vein thrombosis
Mesoblastic nephroma

233
Q

Prophylactic antibiotics for UTI in newborn

A

Amoxicillin until 2 months of age

234
Q

Antibiotics against Enterococcus UTI

A

Amoxicillin / Ampicillin

235
Q

Potter Sequence: Cause (2)

A

Autosomal Recessive Polycystic Kidney Disease

Bilateral renal agenesis

236
Q

Pharmalogical treatment for migraine prevention

A

Cyproheptadine
Amitriptyline
Topiramate

237
Q

Causes of pseudotumor cerebri (5)

A 
Megadose vitamins (Isoretinoid)
Steriods
Thyroxine
Lithium
Abx (Tetracyclins)
238
Q

Treatment for pseudotumor cerebri

A

Acetazolamide

239
Q

Cushing’s Triad

A

Hypertension
Bradycardia
Abnormal respirations

240
Q

Cranial bruit in a neonate with hydrocephalus and congestive heart failure: Disease

A

Vein of Galen malformation

241
Q

Key clinical features that distinguish Friedreich Ataxia

A

Elevated plantar arch
Absence of lower extremity deep tendon reflexes
Cardiomyopathy leading to CHF

242
Q

Treatment of Chorea (2)

A

Haloperidol

Fluphenazine

243
Q

Treatment of acute dystonia reactions (2)

A

Diphenhydramine

Metoclopramide

244
Q

Most common malignant brain tumor of childhood

A

Medulloblastoma

245
Q

Werdnig-Hoffmann Disease ==

A

Spinal muscle atrophies type 1 (degeneration of anterior horn cells)

246
Q

Emergency medication for Spinal Trauma

A

Methylprednisone (not dexamethosone)

247
Q

Ramsay Hunt Facial Paralysis: Cause

A

Varicella zoster

248
Q

Tumor associated with Myasthenia gravis

A

Thymoma

249
Q

Myasthenia gravis: Diagnosis

A

Tensilon test using edrophonium as acetylcholinesterase inhibitor

250
Q

Myasthenia gravis: Treatment

A

Pyridostigmine

Thymectomy

251
Q

Duchenne muscular dystrophy: first test

A

CPK

252
Q

Duchenne muscular dystrophy: Inheritance

A

X-linked recessive

DuXchenne

253
Q

Myotonic muscular dystrophy: Distinguishing features (2)

A

Distal muscle wasting

Autosomal dominant

254
Q

Treatment for absence seizures

A

Ethosuximide

255
Q

EEG with biphasic focal centroemporal spikes and slow waves: Disease

A

Benign Rolandic Epilepsy

256
Q

Treatment for Status Epilepticus

A

Lorazepam

IV fosphenytoin

257
Q

Most common risk factor for premature babies developing CP

A

Prenatal infection

258
Q

Amblyopia: Define

A

Loss of visual acuity due to active cortical suppression of the vision of one eye

259
Q

Age by which strabismus should be treated beofre amblyobia occus

A

6 years

260
Q

Congenital cataracts: Causes (3)

A

Rubella
CMV
Galactosemia

261
Q

Treatment for neonatal chlamydial infection

A

PO Erythromycin for 14 days

262
Q

Treatment for neonatal gonorrhea conjunctivitis

A

IV ceftraixone

263
Q

AED for neonatal epilepsy

A

Phenobarbital

Levetriacetam

264
Q

AED for generalized epilepsy

A

Valporic acid

Lamotrigine

265
Q

AED for partial epilepsy

A

Carbamazapine

Oxcarbazepine

266
Q

Adolescent onset
Generalized tonic-clonic seizures
Morning myoclonic jerking
Disease:

A

Juvenile Myoclonic Epilepsy (Janz Syndrome)

267
Q 
Progressive gait ataxia
Oculomotor apraxia
Telangiectasia
Recurrent respiratory infections
Neurological deterioration
Disease?
A

Ataxia-Telangiectasia

268
Q

Opsoclonus-myoclonus- ataxia (OMA) syndrome: Associated disease

A

Paraneoplastic syndrome associated with neuroblastoma

269
Q

Alternative Abx to penicillin for treatment of otitis media

A

Azithromycin or clarithromycin

270
Q

Next test in a patient with nasal polyps

A

Sweat chloride test

271
Q

Which sinuses are developed at birth? (2)

A

Maxillary

Ethmoid

272
Q

When does sphenoid and frontal sinus develop

A

5-6 years of age

273
Q

Complication of Ethmoid sinusitis

A

Orbital cellulitis

274
Q

Mononucleosis: Definitive diagnosis

A

EBV IgG/IGM

275
Q

Pharyngitis with erythematous patches: Disease

A

Conococcal pharyngitis

276
Q

Lateral neck film with widening of the retropharyngel space or paravertebral soft tissues: Disease

A

Retropharyngeal abscesses

277
Q

Latest waiting time for first tooth before referral

A

16 months

278
Q

Bacterial tracheitis: first step after diagnosis

A

Intubation

279
Q

Viral parotitis: Causes (2)

A

Mumps

HIV

280
Q

Spasmus nutans

A

Benign transient disorder with
Pendular nystagmus
Intermittent head tilt
Nodding or head bobbing

281
Q

Congenital cataracts: inhertiance

A

Autosomal dominant

282
Q

Preauricular lymphadenitis + Conjuncivitis: Cause

A

Adenovirus

283
Q

Treatment for rhinitis medicamentosa

A

Stop nasal decongestants and nasal corticosteriods for 1-2 weeks

284
Q

Bluish swelling on nasal septum after facial trauma: Disease

A

Nasal septum hematoma

285
Q

Nasal setum hematoma: Treatment

A

Immediate referral to ENT for excision and drainage

286
Q

Hyperattenunated mucin in Sinus on CT: Disease

A

Allergic fungal sinusitis

287
Q

Empirical treatment for dental abscess

A

Penicillin VK

or Clindamycin

288
Q

Oral Fluroide supplement dosing

A

0 - 3 years: 0.25mg
3 - 6 years: 0.5mg
> 6 years: 1mg

289
Q

Treatment for otitis externa

A

Ciprofloxacin or Ofloxacin

290
Q

Teenage male with worsening epistaxis: Disease

A

Juvenile Nasopharyngeal Angiofibroma

291
Q

How long may an effusion persist after acute otitis media?

A

2-3 months

292
Q

Major Jones Criteria for Rheumatic Fever

A 
JONES
J = Joints - migratory polyarthritis
O = Obviously cardiac
N = Nodules
E = Erythema marginatum
S = Sydenham Chorea
293
Q

Prophylactic treatment for Rheumatic Fever after first episode

A

IM benzathine penicillin every 21 to 28 days

294
Q

Cutoffs for elevated total cholesterol and LDL levels

A

Total cholesterol > 200

LDL > 130

295
Q

Treatment for Rheumatic Fever

A

Steroids

Penicilin or Erythromycin

296
Q

Cardiac conditions requiring antbiotic prophylaxis

A 
Prosthetic valve
Previous infective endocarditiis
Unrepaired cyanotic CHD
Completely repaired CHD with device within 6 months
Repaired CHD with residual
297
Q

Newborn with severe cyanosis but no respiratory distress
Minimal response to oxygen
Disease?

A

Transposition of the Great Vessels

298
Q

Treatment for SVT

A

Propranolol

299
Q

Tanner staging at onset of menarche

A

Stage 3 or 4

300
Q

Menarche occurs __ years after thelarche

A

2 years

301
Q

Primary amenorrhea: Define

A

Lack of menses by age 15 or 3 years after breast development

302
Q

Secondary amenorrhea: Define

A

3 months of no menses after onset of menarche

303
Q

Treatment for symptomatic labial adhesions

A

Estrogen cream

304
Q

Treatment for candida vaginitis

A

Topical clotrimazole

305
Q

Treatment for condyloma acuminata

A

Podophyllin
Podofilox
Surgical excision

306
Q

Treatment for Pediculosis Pubis

A

Permethrin 1% or 5%
Pyrethrin with piperonyl butoxide
Malathion

307
Q

Which cause of vaginal discharge is not STD

A

Bacterial vaginosis

308
Q

Fishy odor from vaginal discharge

A

Bacterial vaginosis

309
Q

pH > 4.5 from vaginal discharge

A

Bacterial vaginosis

310
Q

Frothy yellow discharge
Strawberry cervix
Disease:

A

Trichomonas vaginalis

311
Q

Treatment for Trichomoniasis

A

Metronidazole

312
Q

Fitz-Hugh-Curtis Syndrom

A

Peri-hepatitis (normal LFTs!) in disseminated gonoccocal or chlamydia infection

313
Q

Pregnancy in younger than 15 year old has increased risk of: (3)

A

Preterm delivery
Low birthweight
Neonatal death

314
Q

Age at which primary amenorrhea should be investigated

A

16 years

315
Q

Cuttoff for anemia in adolescent males and female with Tanner 5

A

Male: 14 Hb

Female 12 Hb

316
Q

Calculation of Mid Parental Height

A

Inches: (Mom’s height + Dad’s height +/- 5) / 2
CM: (Moms height + Dad’s height +/- 12.5) / 2

317
Q

Emergency Contraceptions

A

Levonorgestrel up to 72 hours

Ulipristal up to 5 days

318
Q

Treatment of precocious puberty

A

Leuprolide (GnRH agonist)

319
Q

Treatment for Pelvic Inflammatory Disease

A

IM/IV Ceftriaxone + Doxycycline for 14 days

320
Q

Continued pain in Pelvic Inflammatory Disease after treatment is started: Next step

A

Abdominal ultrasound to look for tubo-ovarian abscess

321
Q

Ovarian cyst: When to treat

A

When > 6cm in size or has significant symptoms

322
Q

Thumb sucking can be tolerated up to age of?

A

4 years

323
Q

Treatment for depression

A

Fluoxetine
Citalopram
Sertraline

324
Q

Best diagnostic test for pneumonia with effusion

A

Ultrasound

325
Q

Best diagnostic test for paralyzed diaphragm

A

Fluoroscopy

326
Q

Risk of undescneded testes

A

Increased risk of cancer, especially seminoma

327
Q

Organism commonly associated with staghorn calculi

A

Proteus

328
Q

What type of anion gap is associated with all renal tubular acidoses

A

Normal anion gap - all are hyperchloremic

329
Q

What vaccines should a child with minimal change nephrotic syndrome receive

A

PCV13 and PPSV23

330
Q

Boy with history of hematuria at the end of urinating with spotting of blood in underwear. Diseaes?

A

Urethrorrhagia (benign self-resolves)

331
Q

Alternative antibiotics for bites

A

Clindamycin + TMX-SMX

332
Q

Spider bites with a necrotic lesion: Cause

A

Brown Reculse Spider

Loxoscles reclusa

333
Q

Black Widow spider bite: Treatment

A

Benzodiazepine for severe muscle spasms
Tetanus prophylaxis
Antivenom as secondary option only

334
Q

Infant with recurrent wheezing worse with crying, feeding or neck flexion: Cause

A

Vascular Ring

335
Q

Expiratory Stridor: Causes (3)

A

Tracheomalacia (from TE fistula repair)
Bronchomalacia
Vascular Ring

336
Q

Biphasic Stridor: Cause

A

Subglottic stenosis

337
Q

Define respiratory failure

A

Hypoxemia PaO2 < 60

Hypercarbia PaCO2 > 50

338
Q

When to refer to burn center?

A

Consider for BSA 5-10%

Definitely for BSA > 10%

339
Q

When to refer if genu varum persists?

A

After 2 years

340
Q

Blount’s Disease

A

Pathologic varus deformity that results from disruption of normal cartilage growth at the medial aspect of the proximal tibial physis

341
Q

Classic triad for fetal alcohol syndrome

A

Abnormal facies
Growth deficiency
CNS problems

342
Q

Patient Health Questionnaire -9: Purpose

A

Depression in adults and adolescents

343
Q

Caloric requirement for infants with heart failure

A

130 - 140 kcal/kg/day

344
Q

Potential nutritional deficiency in a child on a vegan diet

A

Iron

Vitamin B12

345
Q 
Hyponatremia
Decreased urine output
Elevated urine sodium > 25 &amp; elevated urine osm
Normal renal function
Disease?
A

SIADH

346
Q

Optimal blood pressure cuff size

A

> 75% of upper arm length and 40% of the upper-mid arm circumference

347
Q

Neonate with brain abscesses: Cause

A

Citrobacter koseri

348
Q

Dietary recommendations for children with cholestatic liver disease

A

Increased caloric content
70% of fat calories as Medium Chain Triglycerides
Water soluble forms of vitamin A, D, E, K
Calcium supplementation
Zinc supplementation

349
Q

First sign of pubertal development in males:

A

Testicular enlargement > 2.5cm

350
Q

Definition of delayed puberty

A

Boys: by age 14
Girls: by age 13

351
Q

Treatment for delayed puberty:

A

Boys: IM testosterone
Girls: PO estrogen

352
Q

Premature adrenarche: diagnsis

A

Elevated DHEA

Low testosterone

353
Q

Premature adrenarche: Definition

A

Adrogenic sexual characteristics (hair, acne, body odor) without estrogenic sexual characteristics or growth spurt

354
Q

Premature Thelarche: Definitiion

A

Breast development < 8 year without other characteristics

355
Q

Precocious Puberty: Definition

A

Secondary sexual characteristics with acceleration in linear growth or advance bone age

356
Q

Androgen Insensitivity Syndrome: Definition

A

Genetic males with end organ insensitivity to androgens (XY genetically but looks like female but no uterus or ovaries)

357
Q

Congenital Adrenal Hyperplasia: Cause

A

21-Hydroxylase deficiency leading to elevated testosterone but low aldosterone and cortisol

358
Q

Deficiecy in 21-hydroxylase leads to elevation in?

A

17-hydroxyprogesterone

359
Q

Treatment for adrenal crisis

A

Bolus D5N/S over 1 hr

IV hydrocortisone

360
Q

Addison Disease ==

A

Primary Adrenal Deficiency

361
Q

Addison Disease: Treatment

A

Fludrocortisone for mineralocorticoid replacement

Hydrocortisone for glucocorticoid replacement

362
Q

Secondary Adrenal Deficiency: Diagnosis

A

ACTH stimulation test resulting in release or cortisol

363
Q

Syndrome cause of cushing syndrome in fants

A

McCune Albright Syndrome

364
Q

Growth curve & bone age in Nutritional deficiency

A

Fall in weight curve
Fall in height curve
Normal Bone age

365
Q

Growth curve & bone age in Constitutional delay

A

Normal weight
Low height and decrease in growth rate
Bone age below chronological age
Family history of growth delay

366
Q

Growth curve & bone age in Familial Short Stature

A

Follows low weight percentile
Follows low height percentile
Parents are short
Bone age = chronological age

367
Q

What should levothyroxine not mixed in?

A

Soy formulas

368
Q

Hashimoto thyroiditis: Diagnosis

A

Elevated TSH

Anti-thyroglobulin and anti-thyroid peroxidase

369
Q

Graves Disease: Cause

A

igG antibody known as thyroid-stimulating immunoglobulin

370
Q

Graves Disease: Diagnosis

A

Radioactive iodine update

371
Q

Graves Disease: Treatment

A

Methimazole

372
Q

Thyroid nodule: Diagnosis

A

Fine Needle Aspiration

373
Q

Diabetes mellitus: Diagnosis

A

HbA1c > 6.5% or 2x random glucose > 200 or fasting glucose > 126

374
Q

When should lipids levels be monitored in DM1?

A

From age 12

375
Q

Dose of oral hydrocortisone to replace endogenous glucocorticoid production

A

8 - 12mg/m2 per day

376
Q

Treatment for hypophosphatemic rickets

A

Oral neutral phosphate salts +

Calcitrol (1,25 vit D)

377
Q

Most common autoimmune disorder associated with DM1 is?

A

Chronic lymphocytic thyroiditis

378
Q

Growth curve characteristics with arrest of linear grwoth but normal or increasing weight gain: Disease

A 
Growth hormone deficiency
Hypothyroidism 
Genetic disorders (turner)
379
Q

Growth curve characteristics with fall off in weight then fall off in height

A

Malnutrition

Chronic disease

380
Q

Growth curve characteristics with reset of linear growth to bottom of chart but continuing on that percentile

A

Familial short stature

Constitutional delay of growth

381
Q

Triglyceride levels

A

< 9 years: < 75 and unacceptable > 100

10 - 19 years: < 90 and unacceptable > 130

382
Q

HDL Levels

A

Normal > 45. Unacceptable < 35

383
Q

Malignant complication of Fanconi Anemia

A

Leukemia (AML, mylodysplastic syndrome)

Squamous cell carcinoma

384
Q

Side effect of ACEi

A

Cough and rhinitis

385
Q

Samter’s triad

A

Rhinosinusitiis
Nasal polyps
Asthma
- in a child using NSAID or aspirin

386
Q

Hemolytic anemia
Renal failure (elevated BUN) w/ hematuria
Thrombocytopenia
Disease:

A

Hemolytic uremic syndrome

387
Q

JIA with ANA positive. Higher risk of what complication:

A

Uveitis or Iridocyclitis

388
Q

Risk factors associated with increased risk of recurrent febrile seizure: (4)

A

Younger age at first febrile seizure
Family history of febrile seizure
Lower degree of fever at first seizure
Shorter interval between fever onset and seizure

389
Q

Most common cause of necrotizing fasciitis

A

Group A Streptococcus (Strept pyrogens)

390
Q

Inheritance of von Willibrand Disease Type 1

A

Autosomal dominant

391
Q

Young child with hypotonia and finger trembling

A

Spinal Muscular Atrophy

392
Q

Diagnostic test for Noonan’s

A

PTPN11 testing

393
Q

Associated disorder with congeital scoliosis

A

Renal disease

Cardiac disease

394
Q

Age at which toe walking is abnormal

A

2-3 years

395
Q

Cause of sleepiness for patient on valporate

A

Hyperammonemic encephalopathy

396
Q

Papular Urticaria: Cause

A

Delayed hypersensitvity to an insect bite

397
Q

Pityriassi rosea with involvemnet of palms and soles: important DDx

A

Syphilis

398
Q

Sprengel anomaly ==

A

Upward displacement of scapular

399
Q

Treatment of Gropu A Strep throat

A

Penicillin V for 10 days
Amoxicillin once a day for 10 days
Clindamycin for 10 days
IM Penicillin once

400
Q

Maternal quadruple serum screen with elevated alpha-fetoprotein & decreased HCG: Disease

A

Anencephaly

401
Q

Maternal quadruple serum screen with decreased alpha-fetoprotein but increased HCG: Disease

A

T21

402
Q

Treatment for Juvenile Myoclonic Epilepsy

A

Valporate

403
Q

Darier Sign

A

Development of localized urticaria, erythema, or bullae after rubbing, scratching, or stroking the skin or skin lesions that are heavily infiltrated with mast cells (in cutaneous mastocytosis)

404
Q

Levels of intellectual disability

A 
Based on IQ mean 100 SD 15
Mild: 2 to 3SD below (55 - 70)
Moderate  3 to 4 SD (40 - 55)
Severe 4 to 5 SD (25 - 40)
Profound < 5 SD < 25
405
Q

What vaccines are only given to children less than 59 months

A

Hib and PCV13

406
Q

At what age is only Tdap instead of DTap given

A

> = 7 years

407
Q 
Newborn with
- Sensorineural deafness
- Cardiac lesions
- Cataracts
Infection?
A

Rubella

408
Q

Prophylactic erythromycin ointment for ophthalmia neonatorum is for what organism?

A

N. Gonorrhea

Not effective against chlamydia

409
Q

Synovial fluid WBC in septic arthritis

A

50k - 100k

410
Q

Assent should be obtained from a child age?

A

7 years or older

411
Q

When to refer to endocrinologist for constitutional growth delay for hormone therapy?

A

14 years old

412
Q

Treatment for Trichomoniasis

A

Metronidazole single dose

413
Q

Most common side effect of prolong acyclovir treatment

A

Myelosuppression

414
Q 
Colon polyposis with
- Mucocutaneous
- Hyperpigmentation
- Freckling
Syndrome:
A

Peutz-Jeghers Syndrome

415
Q

Intestinal hamartomatous polyps
Macrocephaly
Benign skin tumors

A

Cowden Syndrome

416
Q

Intestinal polyps
Osteomas
Extra teeth

A

Gardner Syndrone

417
Q

When to refer to surgeon for unilateral undescended testes

A

6 months of age

418
Q

Lab findings in PCOS

A

Elevated androgens: testosterone, free testosterone, dehydroepiandrosterone, or androstenedione
Increased LH to FSH ratio

419
Q

What organism from line blood culture should mean prompt removeal of PICC line? (3)

A

Gram neg bacteria
Yeast
Staph aureus

420
Q

Newborn with linear arrangement of vesicles and papules: Disease?

A

Incontinentia pigmenti

421
Q

Caloric Needs of a healthy full term infant

A

100 - 110 kCal/kg/day

422
Q

Caloric Needs of a preterm infant

A

90 - 120 kCal/kg/day

423
Q

Caloric Needs of a preterm infant wtih chronic disease

A

120 - 140 kCal/kg/day

424
Q

Most sensitive screening test for celiac disease

A

Tissue transglutaminase IgA

425
Q

Rate of linear growth after 3 years

A

4 to 7 cm per year

426
Q

Rate of weight gain after 3 years

A

2.5kg per year

427
Q

Arthrogryposis ==

A

Congenital joint contracture

428
Q

Treatment for organophosphates poisonings

A

Atropine-Pralidoxime

429
Q

Pellagra ==

A

Vitamin B3 deficiency

430
Q

Caloric needs for normal children

A

100 kcal/kg (1st 10kg)
50 kcal/kg (2nd 10kg)
then 20 kcal/kg

431
Q

Physiological hydrocortisone dose

A

6 - 10 mg/m^2 per day

432
Q

Stress hydrocortisone dose

A

For procedure 50mg/m^2

Septic 100 mg/m^2

433
Q

Size of ovarian cyst requiring surgical intervention

A

5cm

434
Q

Diagnosis of pheochromocytoma

A

Fractionated metanephrines in plasma or urine

435
Q

Persistent hyperinsulinemic hypoglycemia: Treatment

A

Diazoxide

436
Q

Estimation of systolic BP

A

Systolic BP = 70 + (2 x age)

437
Q

Unpasteurized daily products from Mexico: Infectious risk

A

Brucella

438
Q

Names of antiphospholipid antibodies (2)

A

Anti-β2-glycoprotein

Anticardiolipin antibodies

439
Q

Child following a vegan diet need what supplementation?

A

Iron and Vitamin B12

440
Q

Referral for strabismus

A

Constant: at any age
Intermittent: 4 months

Pediatrics (3 decks)

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