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Peds ⛄️ > Last Minute > Flashcards

Last Minute Flashcards

1
Q

What is the average growth length (growth velocity) per year after 2 years of age (later childhood)?

A

5cm

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2
Q

How much does the head circumference increase per month in the 1st year?

A

1/m

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3
Q

When does the head grow the fastest?

A

First 60 days

.5/wk

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4
Q

Child with enlarged head > 98th percentile, similar to the father, no symptoms and normal cognitive function, head imaging study showed prominent subarachnoid space especially in the frontal region

A

Benign familial macrocephaly

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5
Q

Anterior displacement of the occiput on one side and the frontal region on the ipsilateral side and the ear is more anterior on the side of occipital flattening (parallelogram)

A

Positional plagiocephaly

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6
Q

Anterior displacement of the occiput on one side and frontal bossing on the contralateral side and the ear is displaced more posteriorly (trapezoid)

A

Posterior plagiocephaly (craniosynostosis)

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7
Q

The most common type of craniosynostosis

A

Long narrow head (scaphocephaly), which is an early closure of the sagittal sutures

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8
Q

Infant born to HBsAg positive mom what should be given?

A

Hepatitis B and HepB immunoglobulin in the first 12 h

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9
Q

Encephalopathy within 7 days of administration is an absolute contraindication in which vaccine?

A

Dtap

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10
Q

If you give only MMR vaccine, how long should you wait to do PPD test?

A

4-6 weeks

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11
Q

The child who received MMR vaccine 2 weeks ago Rubella is now having pain in the hip joints. Which component of the vaccine is responsible for this reaction?

A

Rubella

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12
Q

2-month-old child with complement component deficiency. What are the vaccines that should be given at the 2-months well visit?

A

Routine 2 months vaccines plus meningococcal vaccine

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13
Q

Visual acuity for a newborn is

A

20/400

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14
Q

Newborn with a mother who is HIV positive

A

Breastfeeding is contraindicated (except in resource-limited settings)

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15
Q

What is the latest age for first tooth eruption?

A

18 months (after that, dental consult)

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16
Q

Child with a capillary lead level of > 5 μg/ dL. What is the next best step?

A

Obtain venous sample

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17
Q

Gestational age of screening for group B Streptococcus (GBS)

A

35–37 weeks gestation

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18
Q

Birth weight less than 2500 g

A

Low birth weight

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19
Q

Birth weight less than 1500 g

A

Very low birth weight (VLBW)

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20
Q

Birth weight less than 1000 g

A

Extremely low birth weight (ELBW)

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21
Q

Uteroplacental insufficiency is associated with what type of deceleration?

A

Late deceleration

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22
Q

A neonate is born to a mother with chorioamnionitis. The neonate is alert with good tone, no respiratory distress, and vital signs are normal. What is the next best step?

A

Obtain blood culture, complete blood cell count, and start ampicillin and gentamicin

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23
Q

Newborn with one side of the body pink and the other side pale, with a sharp line in-between, no other symptoms

A

Harlequin color change

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24
Q

Children younger than 9 years of age, never been vaccinated for influenza before; how many doses should they receive during the first instance of influenza vaccination?

A

2 doses 1 month apart

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25
Q

neonate is born with severely thickened skin with large, shiny plates of hyperkeratotic scales. Deep, erythematous fissures separate the scales and contraction abnormalities of the eyes (severe ectropion), ears, mouth, and appendages

A

Harlequin ichthyosis (autosomal recessive)

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26
Q

When is surfactant recommended to be used prophylactically after resuscitation in extremely premature neonates to protect the immature lungs?

A

< 27 weeks gestation (some institutions give surfactant as rescue therapy)

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27
Q

An 8-week-old who was born at 27 weeks was intubated for several weeks and now has chronic hypoxemia, tachypnea, wheezing, along with longstanding respiratory insufficiency. Chest radiograph showed: Decreased lung volumes, areas of atelectasis, hyperinflation, and pulmonary edema

A

Bronchopulmonary dysplasia

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28
Q

Full-term infant presents with tachypnea, cyanosis only in the lower body, loud second heart sound. Chest radiograph shows clear lungs and decreased vascular markings

A

Persistent pulmonary hypertension of the newborn

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29
Q

post-term newborn has respiratory distress. The amniotic fluid was stained with meconium, and the point of maximal cardiac impulse is displaced

A

Pneumothorax

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30
Q

A 2-week-old preterm infant born at 26 weeks gestation started having more gastric residuals, abdominal distension, blood in stool, abdominal wall erythema. KUB shows pneumatosis intestinalis and gas in the portal vein

A

Necrotizing enterocolitis

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31
Q

condition specific for the infant of diabetic mother

A

Small left colon syndrome

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32
Q

An abdominal wall defect with uncovered abdominal contents noted right of the umbilicus is

A

Gastroschisis—not associated with genetic abnormalities

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33
Q

An abdominal wall defect covered with a membrane that is often associated with genetic syndromes is

A

Omphalocele

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34
Q

A full-term newborn with missing right index, middle, and ring fingers

A

Amniotic band syndrome

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35
Q

Very small for gestational age (SGA) infant, mother with multiple drug abuse during pregnancy, including alcohol, cigarette smoking, cocaine, marijuana. Which substance is most responsible for SGA?

A

cocaine

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36
Q

Newborn with chorioretinitis, hydrocephalus, and intracranial calcifications

A

Congenital toxoplasmosis

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37
Q

Newborn with microcephaly, and periventricular calcifications

A

Congenital cytomegalovirus infection

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38
Q

Newborn with snuffles, continuous nasal secretions, anemia, thrombocytopenia, hepatomegaly, and periostitis

A

Congenital syphilis

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39
Q

Lithium use during pregnancy is associated with

A

Ebstein anomaly

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40
Q

A virus that can cause fetal hydrops

A

Parvovirus B19

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41
Q

After cleaning the wound of dog or cat bite, what is the most appropriate prophylactic antibiotic?

A

Amoxicillin/clavulanate

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42
Q

Dog or cat bite and allergy to penicillin

A

Clindamycin plus trimethoprim-sulfamethoxazole

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43
Q

After cleaning the wound of dog or cat bite, what is the most appropriate prophylactic antibiotic?

A

Amoxicillin/clavulanate

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44
Q

Dog or cat bite and allergy to penicillin

A

Clindamycin

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45
Q

Significant fall from height according to age

A

in < 2 years of age > 3 ft is a high risk

n > 2 years of age > 5 ft is a high risk

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46
Q

Ingestion of which agent can cause pinpoint pupils, unresponsiveness, and respiratory depression? And treatment?

A

Opiate

Naloxone

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47
Q

Child presents with neck spasms, oculogyric crisis, and tongue thrusting after accidental ingestion of promethazine (anti-nausea medication). What is the drug of choice to treat these symptoms?

A

Diphenhydramine

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48
Q

Healthy child ingests caretaker’s medicine, presents with altered mental status, seizure, drowsiness, lethargy, sinus tachycardia, widened QRS, prolonged QT interval. Likely ingestion?

A

TCA

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49
Q

Adolescent currently on SSRI treatment for depression presents with confusion, sweating, and myoclonus admits to trying ecstasy at a party. Likely cause of symptoms?

A

Serotonin syndrome

50
Q

Child is brought to the ED after ingesting numerous pills of metformin. Possible laboratory finding?

A

Lactic acidosis

51
Q

Child presents with nausea, vomiting, abdominal pain 6 h after accidental ingestion of pills, felt better for a short period, then 24 h later presents with metabolic acidosis, shock, hepatic failure, and 6 weeks later develops pyloric and gastrointestinal scarring. What is the most likely ingested substance?

A

Iron

52
Q

Adolescent presents with slurred speech, tachypnea, cyanosis, pulmonary edema, renal failure, calcium oxalate crystals in the urine, high-anion gap metabolic acidosis. Likely ingestion?

A

Ethylene glycol

53
Q

Child tripped and fell on an outstretched hand presents with tenderness to distal humerus. No obvious fracture on elbow radiograph, although there is a posterior fat pad sign on the lateral view. Most likely diagnosis?

A

Occult supracondylar fracture

54
Q

Toddler presents with right arm pain and decreased during play. No falls or trauma reported. Most likely diagnosis

A

Nursemaid’s elbow (annular ligament arm mobility after being lifted up by the right arm displacement)

55
Q

A healthy infant with 1 day of intermittent bilious emesis. Stable vital signs on arrival. Next best test?

A

Upper GI series to rule out malrotation

56
Q

Toddler presents with sudden onset vomiting and lethargy, bedside point-of-care glucose and venous blood gas are normal with a non-focal neurologic exam, soft abdomen, and no concern for ingestion. Next best test?

A

Ileocolic US to rule out intussusception

57
Q

Child has electrical burns to the mouth after chewing on an electrical cord. Next best step?

A

Refer to burn surgeon—concern for labial artery bleeding

58
Q

An 8-week-old who was born at 27 weeks was intubated for several weeks and now has chronic hypoxemia, tachypnea, wheezing, along with longstanding respiratory insufficiency. Chest radiograph showed: Decreased lung volumes, areas of atelectasis, hyperinflation, and pulmonary edema

A

Bronchopulmonary dysplasia

59
Q

Meconium-stained amniotic fluid is noted at delivery, and the infant is apneic. What is the next best step?

A

PPV

60
Q

An 8-week-old who was born at 27 weeks was intubated for several weeks and now has chronic hypoxemia, tachypnea, wheezing, along with longstanding respiratory insufficiency. Chest radiograph showed: Decreased lung volumes, areas of atelectasis, hyperinflation, and pulmonary edema

A

Bronchopulmonary dysplasia

61
Q

n is surfactant recommended to be used prophylactically after resuscitation in extremely premature neonates to protect the immature lungs?

A

< 27 weeks gestation

62
Q

Jaundice, hypocalcemia, and hypoglycemia are usually associated with

A

Polycythemia

63
Q

Newborn is very quiet, cries very little, and has prolonged jaundice and umbilical hernia

A

Hypothyroidism

64
Q

An abdominal wall defect covered with a membrane that is often associated with genetic syndromes is

A

Omphalocele

65
Q

An abdominal wall defect with uncovered abdominal contents noted right of the umbilicus is

A

Gastroschisis

66
Q

A full-term newborn with missing right index, middle, and ring fingers

A

Amniotic band syndrome

67
Q

Which anticonvulsant is associated with fetal hydantoin syndrome?

A

Phenytoin

68
Q

Which maternal medication during pregnancy results in a newborn with growth restriction, renal dysgenesis, oligohydramnios, skull ossification defects?

A

ACE inhibitors

69
Q

Lithium use during pregnancy is associated with

A

Ebstein anomaly

70
Q

Newborn with snuffles, continuous nasal secretions, anemia, thrombocytopenia, hepatomegaly, and periostitis

A

Congenital syphilis

71
Q

Which allergy test is preferred in cases of dermatographism, generalized dermatitis, or a clinical history of severe anaphylactic reactions to a given food?

A

Radioallergosorbent test (RAST) (allergenspecific IgE antibody)

72
Q

Child currently on diphenhydramine for allergies is scheduled for skin allergy testing. When should diphenhydramine be stopped?

A

At least 5 days prior to testing

73
Q

Child currently on cetirizine for allergies is scheduled for skin allergy testing. When should cetirizine be stopped?

A

At least 7 days prior to testing

74
Q

Child currently on amitriptyline for migraine headache prophylaxis is scheduled for skin allergy testing. When should amitriptyline be stopped?

A

At least 2 weeks prior to testing

75
Q

Induration reaction to TB testing after 72 h is an example of

A

Type IV

76
Q

Allergy to contrast media is an example of

A

Non-IgE mediated

77
Q

Child received penicillin 10 days ago for the first time, presents with fever, nausea, vomiting, pruritic skin rash (urticaria), angioedema, joint pain, lymphadenopathy, myalgia, and proteinuria

A

Serum sickness

78
Q

What is the most common specific autoimmune association with chronic urticaria?

A

Autoimmune thyroid disease

79
Q

Sudden onset of lip swelling, abdominal pain, swelling of both feet, non-pruritic erythematous skin rash; one family member has the same condition

A

Hereditary angioedema

80
Q

Initial screening test for a patient with suspected hereditary angioedema

A

C4 level most reliable and cost-effective screening test for HAE

81
Q

What is the cause of hereditary angioedema (HAE)?

A

Low levels or decreased function of plasma protein C1 inhibitor (C1-INH). (Autosomal dominant)

82
Q

The test that can differentiate between various types of hereditary angioedema

A

C1-INH functional assay

83
Q

A 6-year-old male with yellow-tan macules located on the upper extremities. Parents notice localized erythema following scratching of the lesions and after taking a hot shower

A

Mastocytosis—Darier sign: urticaria after stroking lesions

84
Q

Common diagnostic lab for mastocytosis

A

Elevated tryptase levels

85
Q

The most common cardiac lesion associated with trisomy 18

A

VSD

86
Q

The most common cardiac lesion associated with Turner syndrome

A

Bicuspid Aortic Valve

87
Q

The most common cardiac lesion associated with Williams syndrome

A

Supravalvar aortic stenosis

88
Q

The most common cardiac lesion associated with Alagille syndrome

A

Branch pulmonary stenosis

89
Q

The most common cardiac lesion associated with Noonan syndrome

A

Pulmonary stenosis 

90
Q

The most common cardiac lesion associated with DiGeorge syndrome

A

TOF

91
Q

The most common cardiac lesion associated with lithium/SV tachycardia

A

Ebstein anomaly

92
Q

Which serologic marker can be positive in rapidly progressive glomerulonephritis?

A

P-ANCA

93
Q

Child presents with persistent proteinuria, history of hepatitis B virus infection

A

Membranous glomerulonephritis

94
Q

Adolescent presents with proteinuria, hematuria, hypertension, persistent low C3, hyperlipidemia, renal failure

A

Membranoproliferative glomerulonephritis

95
Q

How is Meckel diverticulum diagnosed?

A

T99

96
Q

What are the 2 most common ectopic tissues found in Meckel diverticulum?

A

Gastric and pancreatic

97
Q

A 2-year-old boy, frank rectal bleeding, anemia, no pain, no other symptoms

A

Meckel diverticulum

98
Q

What is the treatment of H. pylori infection?

A

Amoxicillin or metronidazole + clarithromycin + PPI for 2 weeks

99
Q

Child with recurrent episodes of left lower lobe pneumonia; chest radiographs demonstrated focal consolidation in the same location in all events; between episodes the child is well, active, and playful

A

Pulmonary sequestration

100
Q

An infant has difficulty with feeding, stridor, recurrent wheezing, history of recurrent pneumonia. Barium esophagography showed posterior compressions. What is the most likely diagnosis?

A
101
Q

Child with fever, chest pain, and productive cough; chest radiograph shows cyst-like lesion close to the mediastinum

A

Bronchogenic cyst

102
Q

sore throat with hoarseness; 3 weeks later develops pneumonia

A

Chlamydophila pneumoniae

103
Q

History of asthma, recurrent attacks of fever, fatigue, coughing mucus plugs, hemoptysis, eosinophilia, high IgE

A

Allergic bronchopulmonary aspergillosis

104
Q

Adolescent had influenza A infection, now is having a very high fever, looks toxic; tachypnea, respiratory distress, and tachycardia; chest radiograph is positive for infiltration, cavities, and pleural effusion

A

Staphylococcus aureus pneumonia

105
Q

An infant with cyanosis, the mother is mixing the formula with well water; normal cardiac and pulmonary examination, normal pulse oximetry. Chocolate-colored blood noticed when collecting the blood for testing

A

Methemoglobinemia

106
Q

Child with prosthetic mitral valve going for surgery; is SBE prophylaxis indicated?

A

Yes

107
Q

Child routine physical exam, systolic murmur with Still’s murmur a vibratory character, best heard in the lower sternal border, varies with changes in respiration and position

A

Still’s murmur

108
Q

A 6-year-old with a continuous murmur, lowpitched sound, best heard in the infraclavicular region, disappears when supine and with gentle pressure on the jugular vein

A

Venous hum

109
Q

Cyanosis in lower limbs + decreased lung markings

A

Pulmonary hypertension

110
Q

Cyanosis + Decreased lung marking

A

Tricuspid atresia

111
Q

Cyanosis + Decreased lung marking + murmur

A

Pulmonary stenosis

112
Q

Child with recurrent throat clearing, facial grimacing, and grunting, but otherwise acting normal

A

Tic disorder

113
Q

Multiple café-au-lait spots, Lisch nodules on ophthalmology exam, and presence of multiple neurofibromas

A

NF1

114
Q

Presents with ringing in the ears; imaging shows bilateral vestibular schwannomas

A

NF2

115
Q

MRI showing downward displacement of the cerebellar tonsils through the foramen magnum

A

Arnold–Chiari malformation

116
Q

Cystic expansion of the fourth ventricle in the posterior fossa, associated with hydrocephalus, cerebellar ataxia, and associated with corpus callosum agenesis

A

Dandy–Walker syndrome

117
Q

Triad of infantile spasms, hypsarrhythmia on EEG, developmental regression

A

West syndrome

118
Q

A 6-month-old infant having episodes of tonic flexion of trunk, head, and extremities, occurring in clusters

A

Infantile spasms

119
Q

An 8-year-old boy is having multiple brief daily episodes of behavioral arrest and eye fluttering with an EEG showing 3 Hz/s spike-and-wave discharges

A

Absence seizure

120
Q

This test is very sensitive but not specific for SLE

A

ANA

Peds ⛄️ (12 decks)

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