GI, ID, GU

Question 1

How to Dx Malrotation w/volvulus?

Classic sign?

Answer 1

upper GI series

Corkscrew appearance

Question 2

How to Dx Intussusception?

How to treat?

Answer 2

US - target sign

Air or Contrast enema, but must have surgery on backup in case of perforation

Question 3

What can be used to differentiate fetal from swallowed maternal blood In young breast-fed neonates?

Answer 3

Apt test

Question 4

What med can be used for severe pain in HSP if the patient has GI bleeding, severe arthralgia or hematuria?

Answer 4

Prednisone 1 mg/kg/day max 60mg

Question 5

Which objects in the stomach are less likely to pass the pylorus spontaneously?

How to manage if in the esophagus and not stomach?

MC way to remove?

Answer 5

Sharp or Longer than 5cm
Wider than 2cm

Removed urgently w/in 24 hours

Flexible endoscopy

Question 6

Peak incidence of appendicitis?

Uncommon in what age?

Answer 6

9-12

Under 5

Question 7

ABx for acute appy?

Answer 7

Cefoxitin 40 mg/kg max of 2g
Ceftriaxone + Metro 50 mg/kg max 1g + 10 mg/kg max 500mg
Cefotetan 40 mg/kg max 2g
Zosyn 25 mg/kg

Question 8

Acute acalculous cholecystitis has been associated with what infectious entities?

Answer 8

RMSF

Salmonella and Shigella

Question 9

Describe osmotic diarrhea

Answer 9

pH under 6
Stops w/fasting

Ex. Viral AGE

Question 10

Describe secretory diarrhea

Answer 10

pH over 6

Ex. Vibrio cholera, salmonella, shigella, e.coli, c.diff

Question 11

What constitutes a + fecal leukocyte test?

What organisms is it found in?

Answer 11

> 5 leukocytes/HPV

Campylobacter, Yersenia, Invasive E.coli, Vibrio parahemolyticus

Question 12

What are the 3 most useful clinical signs in determining dehydration > 5%?

Answer 12

Prolonged capillary refill
Abnormal skin turgor
Abnormal respiratory pattern

Question 13

How much Dextrose for neonates?

1m - 8 y/o (or max 25kg)?

Answer 13

10% dextrose at 5 mL/kg

25% dextrose at 2 mL/kg

Question 14

How much dextrose for kids > 2 y/o?

Answer 14

50% of 1 mL/kg

Question 15

How much should oral rehydration be in moderate dehydration?

How fast should fluid loss be replaced?

Answer 15

60-80 mL/kg

25% volume should be replaced every hour so that 100% is replaced in 4 hours

Question 16

What are the 2 types of priapism?

Answer 16

Low flow (anoxic/veno-occlusive) 2/2 dec venous outflow —> PAINFUL

High flow (arterial), assoc w/trauma

Question 17

What is a treatment for phimosis?

Answer 17

Topical corticosteroids - 0.1% triamcinolone topical cream 6-8 weeks

Question 18

What is inflammation of the glans penis and foreskin called?

Treat how?

Answer 18

Balanoposthitis

Polysporin (bacitracin + polymyxin)

Question 19

What is Balanitis mean?

Answer 19

Inflammation of the glans penis only (circumcised penis)

Question 20

What is a Bell Clapper deformity?

Answer 20

Tunica vaginalis attaches higher up on the spermatic cord and completely envelops the testes

Question 21

If a patient has testical pain and is found to have b/l varicoceles, what is the treatment?

Answer 21

Surgery

Question 22

Urine Pr/Cr ratio of what correlates to nephrotic syndrome?

What is normal in kids > 2 y/o?
Normal for 6mo - 2 yrs?

Answer 22

> 3.0 mg/dL

< .2 mg/dL
< .5 mg/dL

Question 23

What do hyaline casts suggest in urine?

RBC casts?

WBC casts?

Answer 23

Dehydration or ATN

GN

infection

Question 24

Teenage boy with facial swelling, fever, testicular swelling, what does he probably have?

Must r/o what?

Answer 24

Mumps (orchitis)

Torsion