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hammer8 Flashcards

1
Q

What is the presentation of Croup and etiology? Treatment?

A

Barking cough, coryza, inspiratory stridor. Presents with signs of hypoxia. Parainfluenza virus 1 and 2. RSV is also a cause. Steeple sign, narrowing of air column. Steroids for mild symptoms and racemic epinephrine for moderate to severe symptoms.

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2
Q

What is the presentation of Epiglottitis and etiology? Treatment?

A

H influenza type B. Fever, hot potato voice, drooling in tripod position, refusal to lie flat.Treat - intubate, Ceftriaxone for 7 to 10 days, Rifampin for all close contacts

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3
Q

What is the presentation of whooping cough and etiology? Treatment?

A

Bordetella pertussis (gram negative aerobic coccobacilli). Catarrhal, Paroxysmal (whooping cough) and Convalescent stage. Dx - butterfly pattern on CXR, burst blood vessels in eyes, post tussive emesis. Tx - Only in catarrhal stage - erythromycin or azithromycin. Isolate child, macrolides for close contact, DTap has decreased incidence

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4
Q

What is the etiology and presentation of Diphteria? Treatment?

A

Corynebacterium diphteriae. Gray highly vascular pseudomembranous plaques on the pharyngeal wall. Do not scrape .ANTITOXIN, not abx.

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5
Q

What is the xray findings of Legg-Calve-Perthe? Age range? Tx?

A

2-8. Joint effusions and widening. Surgery on both hips.

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6
Q

What is the xray findings of SCFE? Age range? Tx?

A

Adolescent. Widening of joint spaces. Internal fixation and pinnig

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7
Q

What is the presentation of Osgood Schlatter? Age range? Tx?

A

13 - 14. Edema, tenderness over tibial tubercule. Separation of tibial tubercule from shaft. Rest. stretching, NSAIDs.

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8
Q

What are the toxicity of Vitamin A?

A

Pseudotumor cerebri, hyperparathyroidism

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9
Q

What vitamin deficiency causes burning feet syndrome?

A

Panthothenic acid, Vitamin B5.

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10
Q

Which coag values are elevated in Vit K deficiency?

A

PT/INR

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11
Q

What is the sx of Vit D toxicity?

A

Hypercalcemia, polyuria, polydipsia

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12
Q

What are the symptoms of congenital varicella?

A

Limp hypoplasia, cutaneous scars, cataracts, chorioretinitis, cortical atrophy

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13
Q

What is a complication of chalmidyal conjuctivitis?

A

Chalmidyal PNA, cough, nasal drainage, scattered crackles, bilateral infiltrates on CXR

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14
Q

What are common endocrine, neuro and cancer risk in Down patients?

A

Hypothyroidism, alzheimer (chromosome on 21), ALL

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15
Q

What are characteristics of Edwards syndrome (Trisomy 18)?

A

Omphaolocele, rocker bottom feet, microcephaly, clenched hand

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16
Q

What are the symptoms of Patau syndrome (Trisomy 13)?

A

Holoprosencephaly, severe MR, microcephaly, cleft lip/palate

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17
Q

What are the symptoms of Prader willi and etiology?

A

Hypotonia, hypogonadism, skin picking, aggression. Deletion on paternal chromosome 15.

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18
Q

What are the symptoms of Angelman syndrome?

A

Seizures, strabismus, sociable with episodic laughter. Deletion on maternal chromosome 15

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19
Q

What are the symptoms of Williams syndrome?

A

Elfin appearance, friendly, increased empathy, deletion on chromosome 17

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20
Q

What are the symptoms of fragile X syndrome?

A

CGG repeats on X chromosome with anticipation. Macrocephaly, macroorchidism, large ears.

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21
Q

What are the symptoms of Waardenburg syndrome?

A

AD. Short palpebral fissures, white forelock, deafness.

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22
Q

What are lab findings of Brutons agammaglogulinemia ?

A

No B cells and low levels of all Igs

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23
Q

What are lab findings and complications of CVID?

A

Low levels of Ig GAME but normal B cells. Increased risk for lymphoma.

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24
Q

What is the most common B cell defect? Symptoms?

A

Selective IgA deficiency. Complications are anaphylaxis if given IgA containing blood.

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25
Q

What are common complications of DiGeorge syndrome? Which chromosome? What type of infections in childhood?

A

CATCH 22
Cardiac abnormality (commonly interrupted aortic arch, truncus arteriosus and tetralogy of Fallot)
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia/Hypoparathyroidism. Seizures, truncus arteriosus, micrognatia. Chromosome 22 micro deletion. Candida, viruses, PCP PNA.

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26
Q

What are the presentation of SCID?

A

Severe infections, no thymus or tonsils, severe lymphopenia. Pediatric emergency, need BM transplant by age 1.

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27
Q

What is the symptoms of CGD? How is it diagnosed?

A

Recurrent. Swollen and infected lymph nodes in groin and staph aureus skin infections. Nitrozoleum blue (yellow means disease) or flow cytometry.

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28
Q

What is the Ig levels in Wiskott Aldrich?

A

Low IgM, high IgA and IgE, slightly low IgG

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29
Q

When do newborns regain birth weight? Double weight? Triple weight? Increase length by 50%? Double length by?

A

2 weeks. 6 months. 1 year. 1 year. 5 years

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30
Q

How long do most primitive reflexes like Moro, grasp, rooting, placing and tonic neck last for? What about parachute reflex?What is the CNS origin of these reflex?

A

Birth till 4/6 months. Brain stem and vestibular nuclei. Parachute from 6-8 months till for life.

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31
Q

What is the treatment for urinary incontinence?

A

1st line is behavioral - rewards, pee before bed, bell alarm. 2nd is pharmacological - DDAVP or imipramine.

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32
Q

What vaccine is due at birth? At 2,4,6 months? Starting at 6 months? At 12 months? Due before age 2, due before kindergarten, due at age 12?

A

HepB.
Dtap, Rota, HiB, HepB, PCV.
Influenza at six months.
At 12 months, MMR, Hep A, Varicella.
Before age 2 Dtap and 2nd HepA.
Before kindergarten, last IPV, Dtap, MMR and varicella.
At age 12, Tdp booster, meningococcal vaccine and HPV for girls.

33
Q

Which heart defect is associated with DiGeorge syndrome? What are the features?

A

Truncus arteriosus. Eisenmenger syndrome leading to increased pulmonary blood flow and bi ventricular hyper trophy.

34
Q

What is the symptom of ASD?

A

Loud S1 with fixed and split S2. Older child with exercise intolerance.

35
Q

What is the sound of endocardial cushion defects? What is the associated disease of PDA murmur?

A

Fix and split S2 plus SEM with diastolic rumble. Prematurity and congenital rubella syndrome for this murmur with bounding pulses and wide pulse pressure.

36
Q

What are complications of anorexic patients wanting to become pregnant?

A

Miscarriage, IUGR, hyperemesis gravidum, premature birth, cesarean delivery, postpartum depression.

37
Q

What are common findings of anorexic patients?

A

Osteoporosis, elevated cholesterol and carotene levels, prolonged QT interval, euthyroid sick syndrome, HPA axis dysfunction, Hyponatremia 2/2 excess H2O drinking

38
Q

What is the management of patients who are pregnant less than 32 weeks?

A

Betamethasone, Tocolytics, Magnesium sulfate for neuro protection, Penicillin if GBS positive

39
Q

What is the treatment of breastfeeding failure jaundice?

A

Optimizing lactation and increasing breast feeding frequency, supplement with Cow’s milk if necessary

40
Q

What are the symptoms of secondary syphilis?

A

Diffuse rash, epitrochlear LAD, condylomata lata, Oral lesions, Hepatitis

41
Q

What are the symptoms of tertiary syphilis?

A

Tabes Dorsalis, Argyll Robertson pupil, dementia, aortic aneurysms, aortic insufficiency, Gummas

42
Q

What is the symptomatology of arterial occlusion?

A

5Ps - pain (severe onset), pulselessness, paresthesia, paralysis, pallor

43
Q

What is the symptomatology of arterial thrombosis?

A

Slow, progressive narrowing of rhe vascular lumen in the affected limb. Diminished pulses b/l

44
Q

What is the symptomatology of venous thrombosis

A

Pain, edema of the lower extremity and warmth to touch

45
Q

What is the features of central adrenal insufficiency (2/2 glucocorticoid) use?

A

Normal aldosterone with low cortisol and low ACTH. No hyperkalemia, no hyperpigmentation.

46
Q

What is the features of primary adrenal insufficiency?

A

Autoimmune, low cortisol, low aldosterone, elevated ACTH. Hyperpigmentation, hyperkalemia, hyponatremia, hypotension.

47
Q

What meds are used after heparin induced thrombocytopenia?

A

Start a direct thrombin inhibitor (argatroban) or fondaparinux (synthetic pentasaccharide)

48
Q

What is the EKG findings of tricuspid valve artresia?

A

Left axis deviation, decreased pulmonary findings on CXR

49
Q

What is the most common cause of AR in young adults in developing countries? IN developed countries? What is the best way to hear the murmur?

A

Congenital bicuspid aortic valve. Rheumatic heart disease. Have the patient sit up, lean forward and hold breath in full expiration.

50
Q

What is the symptoms of neurogenic claudication? What is seen on PE? How is it diagnosed?

A

Posture dependent pain, lumbar extension worsens the pain, lower extremtity numbnes and tingling. Normal pulses. Do an MRI

51
Q

What is the symptoms of vascular claudication? What is seen on PE? How is it diagnosed?

A

Exertionally dependent pain, pain relieved with rest but not with bending forward while walking, lower-extremity cramping. Decreased pulses, cool extremities, decreased hair growth, pallor with leg elevation. Ankle-brachial index

52
Q

What are the findings of Osgood-Schlatter disease?

A

13-14 year old, adolescent mail athletes. Traction apophysitis of the tibial tubercule. Anterior soft tissue swelling, lifting of tubercule from the shaft, irregularity or fragmentation of the tubercule

53
Q

What are teh three Ps of McCune-Albright syndrome? What is the signalling behind it?

A

Precoccious puberty, pigmentation (2/2 cafe au lait spots) and polyostotic fibrous dysplasia (multiple bone defects). Defect in G protein cAMP-kinase function in the affected tissue, resulting in autonomous activity of that tissue.

54
Q

Which tumors produce hypercalcemia 2/2 PTHrP production?

A

Squamous cell cancers, renal and bladder cancer, ovarian and endometrial cancer, breast cancer

55
Q

Which tumors produce hypercalcemia 2/2 1,25(OH) vitamin D production?

A

Lymphomas

56
Q

Which tumors produce hypercalcemia 2/2 bone metastasis?

A

Breast cancer, MM, lymphomas

57
Q

Which cancers are suspected in patients with non-tender, solitary nodes in the head and neck, particularly in patients with significant smoking history?

A

Squamous cell cancer

58
Q

What is the best initial test for head and neck quamous cell cancer?

A

Panendoscopy

59
Q

What vaccinations should unvaccinated patients get if they get blood exposure from active HepB infections?

A

Hep B vaccine and hep B immune globulin

60
Q

What is paradoxical agitation and what meds cause it?

A

Confusion and agitation shortly after taking BENZOS.

61
Q

What eye complications are found in neurofibromatosis patients? How does it present?

A

Optic glioma. slow progressive unilateral visual loss, dyschromatopsia, exopthalmos.

62
Q

What neurological symptoms develop in type 2 diabetics who have hyperosmolar hyperglycemic state without ketoacidosis?

A

Decreased consciousness, Blurred vision 2/2 myopic increase in lens thickness and intraocular hypotension 2/2 hyperosmolarity

63
Q

What is the first test after finding a palpable adnexal mass?

A

Pelvic ultrasound.

64
Q

What is SIRS criteria? What is leading cause of complications after hypovolemic shock in burn patients?

A

Temp > 38.5 or 90, Respiration > 20, WBC > 12000 or 10% bands. Bacterial infection 2/2 bronchopneumonia or burn wound infection.

65
Q

What type of movements characterize tardive dyskinesia and whcih med causes it?

A

Biting, chewing, grimacing, tongue protrusions. Risperidone

66
Q

Which abx are used for pertussis treatment and post exposure ppx?

A

Macrolides, for post exposure ppx - regalrdless of age, immunizaition status or symptoms.

67
Q

What is the most common cause of bronchiolitis in age ? Symptoms, prevention med, complications?

A

RSV. Antecedent nasal congestation/discharge and cough. Wheezing/crackles and respiratory distress, Palivizumab . APNEA and respiratory failure

68
Q

What are common causes of acquired torticollis and what is the management?

A

URI, minor trauma, cervical lymphadenitis and retro pharyngeal abscess. Cervical spine radiographs to ensure no cervical spine fracture/dislocation occurred.

69
Q

What are the typical features of cerebellar degeneration in alcoholics?

A

Progressive gait dysfunction, truncal ataxia, nystagmus, intention tremor and impaired rapid alternating movememnts.

70
Q

What are the complications of atheroembolism (cholesterol embolism)? What is the treatment?

A

cutaneous findings (blue toe syndrome, livedo reticularis, cerebral or intestinal ischemia, AKI and Hollenhorst plaques. Statin therapy

71
Q

What are symptoms of MCL tear?

A

Tenderness at medial knee and valgus laxity

72
Q

What is the managment of patients with acute aortic dissection who are hemodynamically stable?

A

CT angiography

73
Q

What is the follow up of a simple breast cyst after aspiration?

A

Close interval followup

74
Q

What is the presentation of simple/background retinopathy in diabetic retinopathy?

A

Microaneurysms, hemorrhages, exudates, retinal edema

75
Q

What is the presentation of preproliferative retinopathy in diabetic retinopathy?

A

cotton wool spots

76
Q

What is the presentation of proliferative/malignant retinopathy in diabetic retinopathy?

A

Newly formed vessels

77
Q

What is the pathophysiology of graft vs host disease? ow does it present?

A

Donor T cells recognise host major and minor HLA antigens and launch a cell mediated response. Skin, intestine and liver are affected.

78
Q

What are the clinical features of Felty syndrome? Diagnosis? Treatment?

A

RA, Neutropenia (ANC

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