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Pediatrics Clerkship > Last Week Prep > Flashcards

Last Week Prep Flashcards

1
Q

Etiology of pneumatosis intestinalis

A

Often due to poor perfusion to the gut, resulting in hypoxia and subsequent necrosis

As such, it may happen in premature babies OR babies with some risk factor for poor oxygen delivery to the gut

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1
Q

Malrotation anatomy

A
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2
Q

Myelomeningocele is often associated with ___ and ___

A

Myelomeningocele is often associated with Chiari malformation II (inferior displacement of brainstem stuff) and obstructive hydrocephalus

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3
Q

More in depth Jones criteria

A
  • Dx based on:
    1. Clinical or laboratory evidence of previous streptococcal infection
    2. 2 major criteria OR 1 major and 2 minor criteria
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4
Q

JRA aka systemic juvenile idiopathic arthritis can only be diagnosed after. . . .

A

. . . symptoms have been present for at least 6 weeks

This is an easy way to help rule it out in questions

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5
Q

JRA arthritis usually does not. . .

A

. . . mirgate

A quick way to help rule it out in questions

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6
Q

If a kid expresses suicidal intent, then. . .

A

. . . you need to hospitalize them, regardless of parental consent

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7
Q

Umbilical granuloma

A

Presents in newborns after umbilical cord is separated

treat w/ topical silver nitrate

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8
Q

Things that trigger methemoglobinemia and associated O2 sat and PaO2

A
  • Triggers:
    • Dapsone
    • Topical anesthetics (lidocaine, etc)
    • Nitrites
  • O2 sat (by pulse ox: Low
  • Actual PaO2: Normal
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9
Q

___ may be given to prevent or reduce airway obstruction in severe mononucleosis

A

Corticosteroids may be given to prevent or reduce airway obstruction in severe mononucleosis

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10
Q

Primitive reflexes and when they should disappear

A
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11
Q

Retinoblastoma

A
  • Unilateral when sporadic, bilateral when inherited
  • Seriously, suspect this WHENEVER there is a white reflex and no evidence of cataract
  • Strabismus and nystagmus may be present, OR patient may be totally asymptomatic with perfect vision
  • Diagnosis is confirmed with MRI
    • DO NOT biopsy. This can seed the tumor.
  • Treatment depends on stage (surgery, chemo), but we avoid radiation since this can trigger cancer in the other eye in some people.
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12
Q

VZV Ig

A

It exists

Monoclonal antibody against VZV

Give to babies for post-exposure prophylaxis

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13
Q

Kidney biopsy finding in Alport syndrome

A

Longitudinal splitting of the GBM

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14
Q

Niemann-Pick vs Tay-Sachs

A

Key takeaways for differentiation:

  • NP there is hepatosplenomegaly and no reflexes
  • TS there is hyperreflexia and no hepatosplenomegaly
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15
Q

What tests do you need to order for a new diagnosis of Kawasaki disease?

A

EKG and Echo

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16
Q

Bone pain + systemic signs

A

Leukemia!!!

Don’t forget that leukemia causes bone pain too

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17
Q

Dactylitis in sickle cell

A

Pain in acral regions due to sickling within distal arteries of extremities

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18
Q

Second most common surgery in sickle cell patients

A

Tonsillectomy

For Waldeyer’s Ring hyperplasia. Very common in sickle cell patients.

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19
Q

Thumbs in the congenital anemias

A

Diamond Blackfan: Triple phalangeal thumbs

Fanconi: No thumbs

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20
Q

Two most common brain tumors in childhood

A
  1. Astrocytoma. Good prognosis.
  2. Medulloblastoma. Bad prognosis. Often blocks 4th ventricle.
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21
Q

Hypertension + abdominal mass in a child

A

Wilm’s tumor

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22
Q

Intrathecal methotrexate in ALL

A

Always add this to therapy! It prevents recurrence of ALL within the CNS

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23
Q

Reasons a kid might fall off the growth curve

A
  • GH loss
  • Sellar mass
  • Hypothyroidism
  • Turner’s
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24
Q

6-9-15-30 rule of motor development

A

6 months: Roll over

9 months: Sit upright unsupported

15 months: Walk

30 months: Climb stairs

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25
Q

Urinary incontinence is pathologic after age ___.

Fecal incontinence is pathologic after age ___.

A

Urinary incontinence is pathologic after age 5

Fecal incontinence is pathologic after age 4

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26
Q

MMRV contains ___, which some people are allergic to.

A

Neomycin

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27
Q

Transposition of the Great Arteries features

A
  • Adding O2 will not affect saturation at all
  • No murmur (only cyanotic CHD without one)
  • Diabetic mother
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28
Q

Why do bipolar moms give birth to babies with WPW syndrome?

A

Bipolar mom -> Lithium -> Ebstein anomaly -> WPW syndrome

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29
Q

Associations w/ PDA

A

Congenital rubella

Prematurity

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30
Q

Treatment for Rocky Mountain Spotted Fever

A

ALWAYS Doxy.

Nothing else works. We usually don’t give doxy to kids under 8, but we do for RMSF.

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31
Q

Treatment for Lyme by categories

A

Under age 8: Amoxicillin

8 or older: Doxycycline

If there is any meningitis, ceftriaxone.

32
Q

Unless you have a good reason not to, you should generally do ___ prior to LP

A

Non-contrast CT of head

They might give you some exam signs that ‘tell you’ that there is not increased ICP, but if they don’t then you need to do it.

33
Q

First step in management of epiglottitis

A

Intubate in the OR

(in case there needs to be emergent tracheostomy)

34
Q

Buzz words for chlamydia pneumonia

A

“Stoccato cough”

“Peripheral eosinophilia”

“Associated mucopurulent conjunctavitis”

35
Q

Presentation of acute bronchitis

A

Funky cough, sputum, fever

Only rhonchi on lung exam with no focal signs or rales.

No peripheral leukocytosis.

36
Q

Treatment of contacts in pertussis

A

Also get erythromycin

37
Q

A febrile UTI is __ until proven otherwise

A

A febrile UTI is pyelonephritis until proven otherwise

38
Q

In order to get a clean catch urine sample from very young kiddos, they must be . . .

A

. . . catheterized

39
Q

Indications for VCUG

A
  • UTI in a male
  • UTI in a female younger than 5
  • Any recurrent UTI
40
Q

Nevus simplex

A

Those that occur on face will regress. Those that occur on neck will stay.

41
Q

Nevus sebaceous

A
  • Orange colored
  • Area of alopecia
  • Nodule/raised
  • Need to be removed before adolescence – risk of cancer later in life
42
Q

Features of physiologic jaundice

A

Should not go above ~12-15 at highest

Gone by DOL#5

43
Q

Baby is born with indirect hyperbilirubinemia. Likely etiology?

44
Q

Direct hyperbilirubinemia in a baby. First steps?

A

Rule out infection: Blood cx, urine cx, SCF cx

45
Q

When do you repair a diaphragmatic hernia? What might you need?

A

3-4 days after birth – NOT immediately

ECMO may be necessary.

46
Q

CHARGE syndrome

47
Q

Prenatal things you can test for that are associated with RDS at birth

A

L:S ratio < 2 (as lungs mature, lecithin increases and sphingomyelin decreases)

Low phosphatidylglycerol

48
Q

Big tongue + umbilical hernia

A

Hypothyroidism

49
Q

Barium enema for intussusception

A

Diagnostic and therpaeutic

50
Q

What don’t you do to a baby with hypospadias?

A

Circumsize

51
Q

Congenital varicella

A

Born w/ pox scars

Cortical atrophy

Limb hypoplasia

52
Q

When does baby get VZV Ig?

A

If mom has Sx of varicella 5d before to 2d after delivery

53
Q

Chlamydia conjunctavitis can lead to __ if untreated

A

Chlamydia conjunctavitis can lead to chamlydia pneumonia or blindness if untreated

54
Q

Coarctation of the aorta is associated with. . .

A

. . . Turner’s

55
Q

Pierre-Robins sequence

56
Q

Williams syndrome vs Smith-Magenis syndrome

57
Q

“No tonsils”

A

No B cells

Bruton’s or SCID (if there is also no thymus!)

58
Q

Cornelia de Lange Syndrome

A

Slow growth before and after birth leading to short stature; intellectual disability that is usually moderate to severe.

Also with severe forearm and hand abnormalities. Often missing multiple fingers or with V-shaped hand.

59
Q

Truncus arteriosus is tightly linked to __.

A

Truncus arteriosus is tightly linked to DiGeorge syndrome.

60
Q

Weight after birth

A
  • Birth: BW
  • 7d: BW - 10%
  • 2 wks: BW
  • 6 mo: 2x BW
  • 1 yr: 3x BW
61
Q

Dominant protein and fat in breast milk

A

Protein: Whey

Fat: Long-chain

62
Q

Bone age in obesity

A

Bone age > chronological age

Due to the effects of extrogen produced by adipocyte aromatase

Thus, final height is reduced in childhood obesity

63
Q

Bone age in precocious puberty

A

Bone age > chronological age

Due to sex hormones (estrogen or testosterone) produced by gonads

Thus, final height less than predicted height

64
Q

Bone age in hyperthyroidism

A

Bone age > chronologic age

Think of the hyperthyroid as causing bone to move along faster than usual. This ultimately results in shorter stature.

65
Q

PTLD and rejection

A

“If you have PTLD, you can’t reject. If you are rejecting, you can’t have PTLD.”

66
Q

Neonatal renal cysts

A

Nephronophthisis

Problems w/ renal epithelial cell polarization. Results in scarring of renal tubules.

Presents in adolescents with pyuria, scarring, ESRD if not caught early in life.

67
Q

Antibodies in T1DM

68
Q

Things to do prior to discharge after BRUE

A
  1. CPR training of parents
  2. PMD followup scheduled
69
Q

Canavan disease

A
  • Spongiform leukoencephalopathy
  • Due to abnormal metabolism and buildup of N-acetylaspartic acid (NAA), which accumulates in brain
    • Is detectable in urine for diagnosis
    • Missing enzyme is aspartoacylase
  • Autosomal recessive
  • Occurs in Ashkenazi Jewish populations
70
Q

Low risk vs high risk BRUE management

A

Low risk: ED obs, 1-6 hrs, 2 feedings

High risk: Admit for CR monitoring 6-24 hrs, 2 feedings, sleep, and wake states

71
Q

FPIES

A
  • Food protein induce enterocolitis syndrome
  • Non-IgE-mediated hypersensitivity
  • Presents as chronic watery diarrhea w/ acute intermittent vomiting (immediately after consumption of trigger)
  • Begins early in infancy – within one to four weeks following introduction of cow’s milk (CM) or soy protein. Usually first 6 months of life.
  • ~30% have atopy too
  • Treat w/ elimination diet
72
Q

Children < age 5 get __ for pneumonia

A

Children < age 5 get amoxicillin for pneumonia

73
Q

Lyme meningitis CSF looks a lot like. . .

A

. . . viral meningitis CSF

Often with even less WBC

74
Q

Causes of meningitis in infants < 1 month of age

A
  • GBS
  • E. coli
  • Other gram negative bacilli
  • HSV
  • Listeria
  • Strep pneumoniae
  • Treat w/ ampicillin + cefotaxime
75
Q

Causes of meningitis in infants between 1-2 months of age

A
  • E. coli
  • Strep pneumoniae
  • Enterovirus
  • HIB
  • GBS
  • Treat w/ vancomycin + ceftriaxone
    • ​or vancomycin + meropenem
76
Q

Causes of meningitis in children 2 months - 6 years of age

A
  • Strep pneumoniae
  • N. meningitides
  • Enterovirus
  • Borrelia (Lyme)
  • HIB
  • Treat w/ vancomycin + ceftriaxone
    • ​or vancomycin + meropenem
77
Q

Causes of meningitis in children 6 years-adolescence

A
  • S. pneumoniae
  • N. meingitides
  • Enterovirus
  • Lyme
  • Treat w/ vancomycin + ceftriaxone
    • ​or vancomycin + meropenem
78
Q

Master meningitis table

Pediatrics Clerkship (23 decks)

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