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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
Postexposure chemoprophylaxis against meningococcal
Rifampin or Ciprofloxacin or Ceftraixone
26
When should HBV and HBIG be given to neonates born to HBsAg pos or unknown mother?
Within 12 hours of delivery
27
Postexposure chemoprophylaxis against pertussis
Azithromycin
28
Postexposure immunoprophylaxis against measles
MMR vaccine within 72 hours | Measles Ig within 6 days
29
Age when able to hop on one foot
4 years
30
Age when able to draw a cross
``` 4 years (4 points) ```
31
Age when able to balance on one foot
3 years
32
Age when able to copy a circle
3 years
33
Age when able to walk down stairs holding rail
2 years
34
Age when able to walk up stairs alternate feet
2.5 years / 30 months
35
Age when able to write their name
5 years / 60 months
36
Age when able to walk down stairs alternate feet
5 years / 60 months
37
Age when able to draw a triangle
5 years / 60 months | has 60 degree angle in it
38
Age when able to skip
5 years / 60 months
39
Age when able to draw a person with 6 body parts
5 years / 60 months
40
Age when able to draw a person with head and one body part
3 years / 36 months
41
Age when able to catch a ball
4 years / 48 months
42
Age when able to throw a ball
2 years / 24 months
43
Age when able to dress and undress
5 years / 60 months
44
Indication for Soy Formula
Galactosemia | Hereditary Lactase Deficiency
45
Indication for Extensive Hydrolyzed Formula
Milk Protein-Induced Enteropathy (non-IgE mediated)
46
Macronutritents causing peripheral nutrition associated liver disease
Lipids
47
Side effect of sulfasalazine
Folate deficiency
48
Recommended intake for calcium and phosphate in child to adolescents
1300mg
49
Eczematous dermatitis, alopecia & poor growth: Disease?
Zinc Deficiency | Acrodermatitis enteropathica
50
Skin & hair pigment loss, macrocytosis, cardiomyopathy: Disease?
Selenium Deficiency
51
Retinol ==
Vitamin A
52
RIboflavin ==
Vitamin B2
53
Niacin ==
Vitamin B3
54
Pyridoxine ==
Vitamin B6
55
Alpha-Tocopherol ==
Vitamin E
56
Phylloquinone ==
Vitamin K
57
Cause of Marasmus
Deficiency in both calories and protein
58
Cause of Kwashiorkor
Long term deficiency in protein only
59
Poor intake with hypoalbuminemia and peripheral edema
Kwashiorkor
60
Deficiency in infant feed exclusively with Goat's milk
Folate deficiency
61
Xerophthalmia
Dryness of the eyes
62
Nyctalopia
Night blindness
63
Normal anion gap
8 - 12
64
Causes of increased AFP
``` RAIN elevates the AFP reservoir Renal (Nephrosis, renal agenesis, polycystic kidney disease) Abdominal wall defects Incorrect dating / multiple pregnancy Neuro (Ancephaly, spina bifida) ```
65
Apt Test
Looks for maternal blood in neonate's gastric aspirate
66
Presenting symptom in CF
Rectal prolapse
67
Abortive therapy for cyclic vomiting syndrome
Sumatriptan
68
Prophylactic therapy for cyclic vomiting syndrome
Amitriptyline | Propranolol
69
Child with febrile seizure + diarrhea: Cause
Shigella (Shake-ella)
70
Diagnostic test for sucrase-isomaltase deficiency
Breath hydrogen test (to look for bacterial fermentation of undigested /unabsorbed carbohydrates)
71
Deficiency associated with dermatitis, dementia and diarrhea
Niacin deficiency (Vitamin B3)
72
``` 16 year old boy presents with - Painful swallowing - Chest discomfort - Hx of nodular acne on oral doxycyclin Diagnosis? ```
Pill-induced esophagitis
73
Electrolyte abnormalities in pyloric stenosis
Hypochloremic alkalosis | Hypokalemia
74
Disorder in children with insufficient intake of protein
Kwashiorkor
75
Newborn with no conjugated bilirubin: Disease
Crigler-Najjar Syndrome Type 1
76
Deficiency associated with - Cheilosis / angular stomatitis - Sore tongue
Riboflavin (Vitamin B2)
77
Timeframe for upper endoscopy after caustic ingestion
12-24 hours
78
Deficiency in infant given goats milk
Folate
79
GI disease associated with DM1 or selective IgA deficiency
Celiac disease
80
Positive anti-smooth muscle antibodies: Disease
Autoimmune hepatitis type 1
81
Deficiency associated with - paraesthesias - foot and wrist drop - ophthalmoplegia - ataxia - confusion
Thiamine (Vitamin B1) deficiency
82
Best diagnostic test in a young child with suspected FB aspiration
Airway fluoroscopy
83
Best diagnostic test for vascular rings
Barium swallow
84
Symptoms of hypercarbia
Flushing Agitation Headaches (elevated CO2 leading to cerebral vasodilation)
85
Hematological response to chronic hypoxemia
Polycytosis (from kidney producing EPO in response to hypoxemia) Thrombocytopenia
86
Treatment for Methemoglobinemia
IV methylene blue
87
Normal result for Sweat Test
60 mEq or greater
88
Kartagener Syndrome
Type of primary ciliary dyskinesia with situs inversus
89
Treatment for necrotizing pneumonia
Vancomycin | Clindamycin
90
Best confirmatory test for pneumonia
Blood culture
91
At what age can a child copy a square
4 years
92
Best diagnostic test for microcephaly
CT or MRI head
93
At what age can a child use a cup well?
15 - 18 months
94
Age when able to dress themselves
3 years
95
Diagnosis for fixed and split 2nd heart sound
ASD
96
Diagnosis for blowing holosystolic murmur at left lower sternal border
VSD
97
Disease associated with AV canal defect
Down Syndrome
98
Disease associated with right sided aortic arch
22q11 deletion
99
3 cardiac causes of central cyanosis with no respiratory distress
1) Transposition of the great arteries 2) Pulmonary atresia 3) Ebstein malformation
100
Cause of Ebstein's anomaly
Maternal lithium or benzodiazepine use
101
Most common congenital heart defect presenting with severe cyanosis in first week of life
Transposition of the Great Arteries
102
Diagnosis with single 2nd heart sound and egg-shaped heart
Transposition of the Great Arteries
103
Single 2nd heart sound
Transposition of the Great Arteries | Tetralogy of Fallot
104
Disease associated with aortic root dissection
Marfan Syndomre
105
Disease associated with supravalvular aortic stenosis
Williams Syndrome
106
Disease associated with supravalvular pulmonic stenosis
Noonan Syndrome
107
Disease associated with coartation of the aorta
Turner Syndrome
108
Most common valvular disease in rheumatic fever
Mitral insufficiency | Aortic insufficiency
109
Best diagnostic test for endocarditis
Blood culture
110
Most common cause of myocarditis
Coxsackie group B Virus
111
Common adverse events after MMR
Fever and rash 6-12 days, joint pain 7-21 days after vaccine
112
Age at which baby roll from front to back
4 - 5 months
113
Age at which baby roll form back to front
5 - 6 months
114
Age at which baby can hold their head up 90 degress and lift their chest
4 months
115
Moro reflex disappears by
3 -4 months
116
Which vaccine is contraindicated for a child whose mother is pregnant?
None
117
Age at which a child can sit with no support
7 months
118
Age at which a child can sit with support
6 months
119
Cut off age for receiving a HiB vaccine
5 years
120
4 subcutaneously administered vaccines
MMR MMRV Varicella IPV
121
Source for Enteropathogenic E Coli
Food borne reservoir, such as unfiltered, unpasteurized apple juice
122
Cause of psuedoappendiitis syndrome
Yesina enterocolitica
123
Source for Yesina enterocolitica
Consumption of chitterings Southern US
124
Organism linked with GBS
Campylobacter jejuni
125
Antibiotic is recommended for which organism causing gastroenteritis
Campylobacter jejuni | Treat with erythromycin or azithromycin
126
Cause of Hemolytic Uremic Syndrome
Shiga-Toxin producing E Coli (O157:H7)
127
Treatment for Biliary Atresia
Kasai Procedure (Hepatoportoenterostomy)
128
Treatment to prevent NSAID-related complications
Misoprostol (prostogladin 2 analogue)
129
Cause of delayed stooling in newborn with maternal gestational diabetes
Neonatal Small Left Colon Syndrome
130
Disease with Blueberry Muffin Spots in newborn
Congenital CMV infection | Congenital Rubella
131
Newborn with - anemia - fetal hydrops - ascites - Cardiomegaly - Ventriculomegaly
Congenital Parvovirus B19 infection
132
Newborn with depressed nasal bridge, hypoplastic distal phalanges, stippled epiphyses: Tetralogen
Warfarin
133
Treatment threshold for polycythemia
>65 Hct with symptoms
134
Most common cause of seizures in first 24 hours of life
Hypoxic-Ischemic Injury
135
Treatment fo galactosemia
Soy formula
136
Bilateral hydroureteral nephrosis Undescended testes Wrinkled anterior abdominal wall Disease?
Prune Belly Syndrome
137
Age at which physiological anemia of infancy occurs
8 - 10 weeks
138
Normal MCV range
70 - 90
139
Microcytic anemia with high RDW: Disease
Iron deficiency and lead toxicity
140
Ringed sideroblast: Disease
Lead poisoning
141
Causes of Vitamin B12 Deficiency
- Intrinsic factor deficiency (pernicious anemia) - Bacterial overgrowth - After bowel resection - Vegetarian diet
142
Hemolytic anemia with no elevated reticulocyte count: Cause
Parvovirus infection
143
Heinz Bodies: Cause
Glucose--phosphate dehydrogenase deficiency | Small, purple granules in RBC as a result of damage to hemoglobin molecule
144
Young male with anemia, jaundice, dark urine but no hepatosplenomegaly
G6PD Deficiency | X linked
145
Causes of oxidative stress in G6PD
- Sulfa drugs - Nitrofurantoin - Moth balls - Animalarial meds - Fava beans
146
Age at which children with Sickle Cell Anemia has functional asplenia
5 years
147
Next best test for a sickle cell patient with chest pain and infiltrate on xray
ABG to confirm hypoxia
148
Inciting cause of an aplastic crisis
Chloramphenicol
149
Macrocytic anemia with elevated fetal hemoglobin Absent or hypolastic thumb Disease?
Fanconi's anemia
150
Macrocytic anemia with normal WBC and Platelets Low reticulocyte counts Dysmorphia Disease?
Diamond Blackfan Anemia
151
Kostmann Syndrome =
Severe congenital neutropenia
152
Neutropenia + pancytopenia Exocrine pancreatic dysfunction leading to steatorrhea Bony abnormalities and short statue Disease:
Shwachman-Diamond Syndrome
153
Complication of ITP (when presenting with headaches)
Intracranial hemorrhage
154
Kasabach-Merritt Syndrome
Thrombocytopenia caused by localized consumptive coagulopathy from an hemangioma
155
TAR Syndrome
Thrombocytopenia Absent Radius
156
Hemophilia A: Cause
Deficiency in Factor 8
157
Hemophilia B: Cause
Deficiency in Factor 9
158
In hemophilia, what coagulation test is abnormal
PTT (vs PT in Vitamin K deficiency)
159
Treatment for minor bleeding in someone with von Willebrand's disease
DDAVP / Desmopressin (increases factor 8 and plasma vWF)
160
Lab results in DIC
Low fibrinogen Elevated D-Dimers Prolonged Thrombin time
161
Fever Limping Pancytopenia Disease?
ALL (Acute lymphocytic leukemia)
162
Reed Steinberg Cells: Disease
Hodgkin's Lymphoma
163
Supraclavicular adenopath: Disease
Hodgkin's Lymphoma
164
``` Persistent scalp or diaper seborrheic rash Ear drainage or mastoiditis Lytic lesions in skull Excessive urination Disease? ```
Langerhans Cell Histiocytosis
165
Neuroblastoma: Diagnosis
Elevated urine VMA and HMA
166
Hemohypertrophy: Disease association
Wilms tumor | Beckwith Wiedemann syndrome
167
Cyclophosphamide: Side effect
Hemorhagic cystitis
168
Cisplatin: Side effect
Nephrotoxicity | hearing loss and peripheral neuropathy
169
Bleomycin: Side effect
Pulmonary fibrosis | (Lung so bad, you "blow-om-icin"
170
Doxorubicin: Side effect
Cardiac toxicity | Doxo-rubies
171
Vincristine: Side effect
Neurotoxicitiy and SIADH
172
Granulomatosis infantiseptum: Disease
Neonatal Listeria Infection
173
Facial abnormalities (nasal hypoplasia + depressed nasal bridge) Bone strippling Fetal exposure to?
Warfarin
174
Facial abnormalities (broad nasal bridge, wide-spaced eyes) Cardiac abnormalities Distal digital hypoplasia Fetal exposure to?
Phenytoin
175
Facial abnormalities Neural Tube Defects Fetal exposure to?
Valporic Acid
176
Common respiratory complication in Meconium Aspiration Syndrome
Pneumothroax
177
Define very low birth weight
Birth weight < 1500 grams
178
Signs of PDA
Bounding peripheral pulses Prominent apical impulse Systolic thrill at 2nd intercostal space Continuous machinery-like murmur
179
HELLP Syndrome
Hemolytic anemia, Elevated Liver enzymes, Low Platelets
180
Define low birth weight
Birth weight < 2500 grams
181
Abnormal level of scalp pH
pH < .7.2
182
Normal fetal heartrate
120 - 160 bpm
183
Most frequent abnormalities in infants with a single umbilical artery
Trisomy 18
184
Newborn with lethargy, hypotonia, tremors and sweating: Cause
Hypoglycemia
185
CHARGE Sydnrome
``` Coloboma of the eye Heart defects Atresia of the choanal Retardation of growth or development Gential / urinary defects Ear defects ```
186
Term newborn at DR with tachypnea, tricuspid regurg murmur and differential cyanosis between upper and lower body
Persistent pulmonary hypertension of the newborn
187
Newborn with - Wide persisent posterior fontanelle - Umbilical hernia - Jaundice
Hypothyroidism
188
Antibody concentrations to these vaccines can be measured to check response in a < 1 year old
Tetanus Polio Diphtheria Hep B
189
Treatment for congenital toxoplasmosis
Sulfadiazine
190
Treatment for congenital TB
Isoniazid
191
Areas where chloroquine can be used as malaria prophylaxis
Central and South America
192
Treatment of resistant head lice
Malathion
193
Sources of Shiga Toxin E Coli
Undercooked hamburger | Unpasteurized apple juice, goat milk and cow milk
194
Prophalaxis for close contacts to diphtheria
1x IM Pen G | Erythromycin PO for 10 days
195
Cause of septic arthritis / osteomyelitis younger than 5 years
Kingella Kingae
196
Prophylaxis for close contacts to pertussis
Azithromycin (for all ages) Erythromycin (1 month plus) Clarithromycin
197
Dog bite Rx Abx
Augmentin | Clindamycin + Bactirm
198
Method of transmission for Toxoplasmosis
Ingestion of undercooked meat (which has oocytes ingested by the animal)
199
Positive serum galactomannan: Disease
Aspergillus infection
200
Side effect of TMP-SMX
Neutropenia Pancytopenia Hyperkalemia
201
Enterobius vermicularis.
Pinworm
202
Test for detecting HIV
HIV DNA PCR @ 14-21 days, 1-2 months and 4-6 months
203
Testing for Lyme Disease
Step 1) EIA or IFA for Lyme antibodies | Step 2) Western blot for Lyme antibodies
204
Erythema infectiosum
Fifth Disease (Parvovirus B19)
205
Treatment for candida
Fluconazole and/or Amphotericin B
206
Treatment for Lyme Disease
> 8 years Doxycyclin | < 8 years amoxicillin or cefuroxime
207
Fever, non-specific symptoms Leukopenia, thrombocytopenia, mildly elevated LFTs Recent camping in Northeast US Disease?
Anaplasmosis
208
Fever, non-specific symptoms Leukopenia, thrombocytopenia, mildly elevated LFTs Recent camping in Southeast or South Central US Disease?
Ehrlichiosis
209
Fever, non-specific symptoms Vasculitic lesion starting peripherally and spread inwards Disease?
Rocky Mountain Spoted Fever
210
Vector for Anaplasmosis
Deer tick (lxodes scapularis) (also for Lyme Disease)
211
Treatment for Giardia
Tinidazole (>3 year) Nitazoxanide (> 1 year) Metronidazole
212
Indication for Iodoquinol
Entamoeba histolytica
213
Complication from Shiga Toxin producing E Coli (2)
Hemorrhagic colitis | Hemolytic uremic syndrome
214
Which type of E Coli diarrhea causes bloody stools and tenesmus
Eteroinvasive E Coli (EIEC)
215
Travellers Diarrhoea: Organism?
Enterotoxigenic E Coli (ETEC)
216
Rickettsia rickettsii: Diseaes
Rocky Mountain Spotted Fever
217
Rash of Rocky Mountain Spotted Fever
Petchiaial rash that beings on wrist and ankles and spread inwards
218
Treatment for chlamydia pneumonia in neonate
Erythromycin
219
Targeted treatment for Neisseria meningitidis
IV Penicillin G
220
Treatment for Shigella
Ceftriaxone
221
Burton agammaglobulinemia vs Common variable immunodeficiency
Burton has low B cells. Both has low Ig levels
222
Confirmatory testing for Leukocyte Adhesion Deficiency
FLow Cytometry for CD18
223
Diagnostic critieria for common variable immunodeficiency
1) Decreased in one immunoglobulin 2) Poor antibody response to protein and polysaccharide vaccines 3) Exclusion of other causes of hypogammaglobinemia
224
Warm-reactive IgG Antibodies: Disease
Autoimmune hemolytic anemia
225
Prenatal US shoing bilateral hydronephrosis: Next test
VCUG to rule out Posterior Urethral Valves
226
Nephritis disease with low Complement
Low compliment in PMS P - Post-strept M - Membranoproliferative GN S - Systemic lupus
227
Berger's Disease =
IgA Nephropathy
228
Micropenis: Disease ssociation
Prader-Willi Syndrome | Kallmann Syndrome
229
Most life-threatening issue in neonates with Potter's Sequence
Respiratory failure
230
Definition of Stage 1 hypertension
> 95% of BP for height
231
X-link Dominant Bilateral sensorineural hearing loss Ocular defects Complement normal GN
Alport Syndrome
232
Newborn with abdominal mass: Renal causes (4)
Multicystic dysplastic kidney Hydronephrosis (from UPJ obstruction) Renal vein thrombosis Mesoblastic nephroma
233
Prophylactic antibiotics for UTI in newborn
Amoxicillin until 2 months of age
234
Antibiotics against Enterococcus UTI
Amoxicillin / Ampicillin
235
Potter Sequence: Cause (2)
Autosomal Recessive Polycystic Kidney Disease | Bilateral renal agenesis
236
Pharmalogical treatment for migraine prevention
Cyproheptadine Amitriptyline Topiramate
237
Causes of pseudotumor cerebri (5)
``` Megadose vitamins (Isoretinoid) Steriods Thyroxine Lithium Abx (Tetracyclins) ```
238
Treatment for pseudotumor cerebri
Acetazolamide
239
Cushing's Triad
Hypertension Bradycardia Abnormal respirations
240
Cranial bruit in a neonate with hydrocephalus and congestive heart failure: Disease
Vein of Galen malformation
241
Key clinical features that distinguish Friedreich Ataxia
Elevated plantar arch Absence of lower extremity deep tendon reflexes Cardiomyopathy leading to CHF
242
Treatment of Chorea (2)
Haloperidol | Fluphenazine
243
Treatment of acute dystonia reactions (2)
Diphenhydramine | Metoclopramide
244
Most common malignant brain tumor of childhood
Medulloblastoma
245
Werdnig-Hoffmann Disease ==
Spinal muscle atrophies type 1 (degeneration of anterior horn cells)
246
Emergency medication for Spinal Trauma
Methylprednisone (not dexamethosone)
247
Ramsay Hunt Facial Paralysis: Cause
Varicella zoster
248
Tumor associated with Myasthenia gravis
Thymoma
249
Myasthenia gravis: Diagnosis
Tensilon test using edrophonium as acetylcholinesterase inhibitor
250
Myasthenia gravis: Treatment
Pyridostigmine | Thymectomy
251
Duchenne muscular dystrophy: first test
CPK
252
Duchenne muscular dystrophy: Inheritance
X-linked recessive | DuXchenne
253
Myotonic muscular dystrophy: Distinguishing features (2)
Distal muscle wasting | Autosomal dominant
254
Treatment for absence seizures
Ethosuximide
255
EEG with biphasic focal centroemporal spikes and slow waves: Disease
Benign Rolandic Epilepsy
256
Treatment for Status Epilepticus
Lorazepam | IV fosphenytoin
257
Most common risk factor for premature babies developing CP
Prenatal infection
258
Amblyopia: Define
Loss of visual acuity due to active cortical suppression of the vision of one eye
259
Age by which strabismus should be treated beofre amblyobia occus
6 years
260
Congenital cataracts: Causes (3)
Rubella CMV Galactosemia
261
Treatment for neonatal chlamydial infection
PO Erythromycin for 14 days
262
Treatment for neonatal gonorrhea conjunctivitis
IV ceftraixone
263
AED for neonatal epilepsy
Phenobarbital | Levetriacetam
264
AED for generalized epilepsy
Valporic acid | Lamotrigine
265
AED for partial epilepsy
Carbamazapine | Oxcarbazepine
266
Adolescent onset Generalized tonic-clonic seizures Morning myoclonic jerking Disease:
Juvenile Myoclonic Epilepsy (Janz Syndrome)
267
``` Progressive gait ataxia Oculomotor apraxia Telangiectasia Recurrent respiratory infections Neurological deterioration Disease? ```
Ataxia-Telangiectasia
268
Opsoclonus-myoclonus- ataxia (OMA) syndrome: Associated disease
Paraneoplastic syndrome associated with neuroblastoma
269
Alternative Abx to penicillin for treatment of otitis media
Azithromycin or clarithromycin
270
Next test in a patient with nasal polyps
Sweat chloride test
271
Which sinuses are developed at birth? (2)
Maxillary | Ethmoid
272
When does sphenoid and frontal sinus develop
5-6 years of age
273
Complication of Ethmoid sinusitis
Orbital cellulitis
274
Mononucleosis: Definitive diagnosis
EBV IgG/IGM
275
Pharyngitis with erythematous patches: Disease
Conococcal pharyngitis
276
Lateral neck film with widening of the retropharyngel space or paravertebral soft tissues: Disease
Retropharyngeal abscesses
277
Latest waiting time for first tooth before referral
16 months
278
Bacterial tracheitis: first step after diagnosis
Intubation
279
Viral parotitis: Causes (2)
Mumps | HIV
280
Spasmus nutans
Benign transient disorder with Pendular nystagmus Intermittent head tilt Nodding or head bobbing
281
Congenital cataracts: inhertiance
Autosomal dominant
282
Preauricular lymphadenitis + Conjuncivitis: Cause
Adenovirus
283
Treatment for rhinitis medicamentosa
Stop nasal decongestants and nasal corticosteriods for 1-2 weeks
284
Bluish swelling on nasal septum after facial trauma: Disease
Nasal septum hematoma
285
Nasal setum hematoma: Treatment
Immediate referral to ENT for excision and drainage
286
Hyperattenunated mucin in Sinus on CT: Disease
Allergic fungal sinusitis
287
Empirical treatment for dental abscess
Penicillin VK | or Clindamycin
288
Oral Fluroide supplement dosing
0 - 3 years: 0.25mg 3 - 6 years: 0.5mg > 6 years: 1mg
289
Treatment for otitis externa
Ciprofloxacin or Ofloxacin
290
Teenage male with worsening epistaxis: Disease
Juvenile Nasopharyngeal Angiofibroma
291
How long may an effusion persist after acute otitis media?
2-3 months
292
Major Jones Criteria for Rheumatic Fever
``` JONES J = Joints - migratory polyarthritis O = Obviously cardiac N = Nodules E = Erythema marginatum S = Sydenham Chorea ```
293
Prophylactic treatment for Rheumatic Fever after first episode
IM benzathine penicillin every 21 to 28 days
294
Cutoffs for elevated total cholesterol and LDL levels
Total cholesterol > 200 | LDL > 130
295
Treatment for Rheumatic Fever
Steroids | Penicilin or Erythromycin
296
Cardiac conditions requiring antbiotic prophylaxis
``` Prosthetic valve Previous infective endocarditiis Unrepaired cyanotic CHD Completely repaired CHD with device within 6 months Repaired CHD with residual ```
297
Newborn with severe cyanosis but no respiratory distress Minimal response to oxygen Disease?
Transposition of the Great Vessels
298
Treatment for SVT
Propranolol
299
Tanner staging at onset of menarche
Stage 3 or 4
300
Menarche occurs __ years after thelarche
2 years
301
Primary amenorrhea: Define
Lack of menses by age 15 or 3 years after breast development
302
Secondary amenorrhea: Define
3 months of no menses after onset of menarche
303
Treatment for symptomatic labial adhesions
Estrogen cream
304
Treatment for candida vaginitis
Topical clotrimazole
305
Treatment for condyloma acuminata
Podophyllin Podofilox Surgical excision
306
Treatment for Pediculosis Pubis
Permethrin 1% or 5% Pyrethrin with piperonyl butoxide Malathion
307
Which cause of vaginal discharge is not STD
Bacterial vaginosis
308
Fishy odor from vaginal discharge
Bacterial vaginosis
309
pH > 4.5 from vaginal discharge
Bacterial vaginosis
310
Frothy yellow discharge Strawberry cervix Disease:
Trichomonas vaginalis
311
Treatment for Trichomoniasis
Metronidazole
312
Fitz-Hugh-Curtis Syndrom
Peri-hepatitis (normal LFTs!) in disseminated gonoccocal or chlamydia infection
313
Pregnancy in younger than 15 year old has increased risk of: (3)
Preterm delivery Low birthweight Neonatal death
314
Age at which primary amenorrhea should be investigated
16 years
315
Cuttoff for anemia in adolescent males and female with Tanner 5
Male: 14 Hb | Female 12 Hb
316
Calculation of Mid Parental Height
Inches: (Mom's height + Dad's height +/- 5) / 2 CM: (Moms height + Dad's height +/- 12.5) / 2
317
Emergency Contraceptions
Levonorgestrel up to 72 hours | Ulipristal up to 5 days
318
Treatment of precocious puberty
Leuprolide (GnRH agonist)
319
Treatment for Pelvic Inflammatory Disease
IM/IV Ceftriaxone + Doxycycline for 14 days
320
Continued pain in Pelvic Inflammatory Disease after treatment is started: Next step
Abdominal ultrasound to look for tubo-ovarian abscess
321
Ovarian cyst: When to treat
When > 6cm in size or has significant symptoms
322
Thumb sucking can be tolerated up to age of?
4 years
323
Treatment for depression
Fluoxetine Citalopram Sertraline
324
Best diagnostic test for pneumonia with effusion
Ultrasound
325
Best diagnostic test for paralyzed diaphragm
Fluoroscopy
326
Risk of undescneded testes
Increased risk of cancer, especially seminoma
327
Organism commonly associated with staghorn calculi
Proteus
328
What type of anion gap is associated with all renal tubular acidoses
Normal anion gap - all are hyperchloremic
329
What vaccines should a child with minimal change nephrotic syndrome receive
PCV13 and PPSV23
330
Boy with history of hematuria at the end of urinating with spotting of blood in underwear. Diseaes?
Urethrorrhagia (benign self-resolves)
331
Alternative antibiotics for bites
Clindamycin + TMX-SMX
332
Spider bites with a necrotic lesion: Cause
Brown Reculse Spider | Loxoscles reclusa
333
Black Widow spider bite: Treatment
Benzodiazepine for severe muscle spasms Tetanus prophylaxis Antivenom as secondary option only
334
Infant with recurrent wheezing worse with crying, feeding or neck flexion: Cause
Vascular Ring
335
Expiratory Stridor: Causes (3)
Tracheomalacia (from TE fistula repair) Bronchomalacia Vascular Ring
336
Biphasic Stridor: Cause
Subglottic stenosis
337
Define respiratory failure
Hypoxemia PaO2 < 60 | Hypercarbia PaCO2 > 50
338
When to refer to burn center?
Consider for BSA 5-10% | Definitely for BSA > 10%
339
When to refer if genu varum persists?
After 2 years
340
Blount's Disease
Pathologic varus deformity that results from disruption of normal cartilage growth at the medial aspect of the proximal tibial physis
341
Classic triad for fetal alcohol syndrome
Abnormal facies Growth deficiency CNS problems
342
Patient Health Questionnaire -9: Purpose
Depression in adults and adolescents
343
Caloric requirement for infants with heart failure
130 - 140 kcal/kg/day
344
Potential nutritional deficiency in a child on a vegan diet
Iron | Vitamin B12
345
``` Hyponatremia Decreased urine output Elevated urine sodium > 25 & elevated urine osm Normal renal function Disease? ```
SIADH
346
Optimal blood pressure cuff size
> 75% of upper arm length and 40% of the upper-mid arm circumference
347
Neonate with brain abscesses: Cause
Citrobacter koseri
348
Dietary recommendations for children with cholestatic liver disease
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
First sign of pubertal development in males:
Testicular enlargement > 2.5cm
350
Definition of delayed puberty
Boys: by age 14 Girls: by age 13
351
Treatment for delayed puberty:
Boys: IM testosterone Girls: PO estrogen
352
Premature adrenarche: diagnsis
Elevated DHEA | Low testosterone
353
Premature adrenarche: Definition
Adrogenic sexual characteristics (hair, acne, body odor) without estrogenic sexual characteristics or growth spurt
354
Premature Thelarche: Definitiion
Breast development < 8 year without other characteristics
355
Precocious Puberty: Definition
Secondary sexual characteristics with acceleration in linear growth or advance bone age
356
Androgen Insensitivity Syndrome: Definition
Genetic males with end organ insensitivity to androgens (XY genetically but looks like female but no uterus or ovaries)
357
Congenital Adrenal Hyperplasia: Cause
21-Hydroxylase deficiency leading to elevated testosterone but low aldosterone and cortisol
358
Deficiecy in 21-hydroxylase leads to elevation in?
17-hydroxyprogesterone
359
Treatment for adrenal crisis
Bolus D5N/S over 1 hr | IV hydrocortisone
360
Addison Disease ==
Primary Adrenal Deficiency
361
Addison Disease: Treatment
Fludrocortisone for mineralocorticoid replacement | Hydrocortisone for glucocorticoid replacement
362
Secondary Adrenal Deficiency: Diagnosis
ACTH stimulation test resulting in release or cortisol
363
Syndrome cause of cushing syndrome in fants
McCune Albright Syndrome
364
Growth curve & bone age in Nutritional deficiency
Fall in weight curve Fall in height curve Normal Bone age
365
Growth curve & bone age in Constitutional delay
Normal weight Low height and decrease in growth rate Bone age below chronological age Family history of growth delay
366
Growth curve & bone age in Familial Short Stature
Follows low weight percentile Follows low height percentile Parents are short Bone age = chronological age
367
What should levothyroxine not mixed in?
Soy formulas
368
Hashimoto thyroiditis: Diagnosis
Elevated TSH | Anti-thyroglobulin and anti-thyroid peroxidase
369
Graves Disease: Cause
igG antibody known as thyroid-stimulating immunoglobulin
370
Graves Disease: Diagnosis
Radioactive iodine update
371
Graves Disease: Treatment
Methimazole
372
Thyroid nodule: Diagnosis
Fine Needle Aspiration
373
Diabetes mellitus: Diagnosis
HbA1c > 6.5% or 2x random glucose > 200 or fasting glucose > 126
374
When should lipids levels be monitored in DM1?
From age 12
375
Dose of oral hydrocortisone to replace endogenous glucocorticoid production
8 - 12mg/m2 per day
376
Treatment for hypophosphatemic rickets
Oral neutral phosphate salts + | Calcitrol (1,25 vit D)
377
Most common autoimmune disorder associated with DM1 is?
Chronic lymphocytic thyroiditis
378
Growth curve characteristics with arrest of linear grwoth but normal or increasing weight gain: Disease
``` Growth hormone deficiency Hypothyroidism Genetic disorders (turner) ```
379
Growth curve characteristics with fall off in weight then fall off in height
Malnutrition | Chronic disease
380
Growth curve characteristics with reset of linear growth to bottom of chart but continuing on that percentile
Familial short stature | Constitutional delay of growth
381
Triglyceride levels
< 9 years: < 75 and unacceptable > 100 | 10 - 19 years: < 90 and unacceptable > 130
382
HDL Levels
Normal > 45. Unacceptable < 35
383
Malignant complication of Fanconi Anemia
Leukemia (AML, mylodysplastic syndrome) | Squamous cell carcinoma
384
Side effect of ACEi
Cough and rhinitis
385
Samter's triad
Rhinosinusitiis Nasal polyps Asthma - in a child using NSAID or aspirin
386
Hemolytic anemia Renal failure (elevated BUN) w/ hematuria Thrombocytopenia Disease:
Hemolytic uremic syndrome
387
JIA with ANA positive. Higher risk of what complication:
Uveitis or Iridocyclitis
388
Risk factors associated with increased risk of recurrent febrile seizure: (4)
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
Most common cause of necrotizing fasciitis
Group A Streptococcus (Strept pyrogens)
390
Inheritance of von Willibrand Disease Type 1
Autosomal dominant
391
Young child with hypotonia and finger trembling
Spinal Muscular Atrophy
392
Diagnostic test for Noonan's
PTPN11 testing
393
Associated disorder with congeital scoliosis
Renal disease | Cardiac disease
394
Age at which toe walking is abnormal
2-3 years
395
Cause of sleepiness for patient on valporate
Hyperammonemic encephalopathy
396
Papular Urticaria: Cause
Delayed hypersensitvity to an insect bite
397
Pityriassi rosea with involvemnet of palms and soles: important DDx
Syphilis
398
Sprengel anomaly ==
Upward displacement of scapular
399
Treatment of Gropu A Strep throat
Penicillin V for 10 days Amoxicillin once a day for 10 days Clindamycin for 10 days IM Penicillin once
400
Maternal quadruple serum screen with elevated alpha-fetoprotein & decreased HCG: Disease
Anencephaly
401
Maternal quadruple serum screen with decreased alpha-fetoprotein but increased HCG: Disease
T21
402
Treatment for Juvenile Myoclonic Epilepsy
Valporate
403
Darier Sign
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
Levels of intellectual disability
``` 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
What vaccines are only given to children less than 59 months
Hib and PCV13
406
At what age is only Tdap instead of DTap given
>= 7 years
407
``` Newborn with - Sensorineural deafness - Cardiac lesions - Cataracts Infection? ```
Rubella
408
Prophylactic erythromycin ointment for ophthalmia neonatorum is for what organism?
N. Gonorrhea | Not effective against chlamydia
409
Synovial fluid WBC in septic arthritis
50k - 100k
410
Assent should be obtained from a child age?
7 years or older
411
When to refer to endocrinologist for constitutional growth delay for hormone therapy?
14 years old
412
Treatment for Trichomoniasis
Metronidazole single dose
413
Most common side effect of prolong acyclovir treatment
Myelosuppression
414
``` Colon polyposis with - Mucocutaneous - Hyperpigmentation - Freckling Syndrome: ```
Peutz-Jeghers Syndrome
415
Intestinal hamartomatous polyps Macrocephaly Benign skin tumors
Cowden Syndrome
416
Intestinal polyps Osteomas Extra teeth
Gardner Syndrone
417
When to refer to surgeon for unilateral undescended testes
6 months of age
418
Lab findings in PCOS
Elevated androgens: testosterone, free testosterone, dehydroepiandrosterone, or androstenedione Increased LH to FSH ratio
419
What organism from line blood culture should mean prompt removeal of PICC line? (3)
Gram neg bacteria Yeast Staph aureus
420
Newborn with linear arrangement of vesicles and papules: Disease?
Incontinentia pigmenti
421
Caloric Needs of a healthy full term infant
100 - 110 kCal/kg/day
422
Caloric Needs of a preterm infant
90 - 120 kCal/kg/day
423
Caloric Needs of a preterm infant wtih chronic disease
120 - 140 kCal/kg/day
424
Most sensitive screening test for celiac disease
Tissue transglutaminase IgA
425
Rate of linear growth after 3 years
4 to 7 cm per year
426
Rate of weight gain after 3 years
2.5kg per year
427
Arthrogryposis ==
Congenital joint contracture
428
Treatment for organophosphates poisonings
Atropine-Pralidoxime
429
Pellagra ==
Vitamin B3 deficiency
430
Caloric needs for normal children
100 kcal/kg (1st 10kg) 50 kcal/kg (2nd 10kg) then 20 kcal/kg
431
Physiological hydrocortisone dose
6 - 10 mg/m^2 per day
432
Stress hydrocortisone dose
For procedure 50mg/m^2 | Septic 100 mg/m^2
433
Size of ovarian cyst requiring surgical intervention
5cm
434
Diagnosis of pheochromocytoma
Fractionated metanephrines in plasma or urine
435
Persistent hyperinsulinemic hypoglycemia: Treatment
Diazoxide
436
Estimation of systolic BP
Systolic BP = 70 + (2 x age)
437
Unpasteurized daily products from Mexico: Infectious risk
Brucella
438
Names of antiphospholipid antibodies (2)
Anti-β2-glycoprotein | Anticardiolipin antibodies
439
Child following a vegan diet need what supplementation?
Iron and Vitamin B12
440
Referral for strabismus
Constant: at any age Intermittent: 4 months

Pediatrics (3 decks)

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