Pediatrics Clerkship > Last Week Prep > Flashcards

Last Week Prep Flashcards

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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
6-9-15-30 rule of motor development
6 months: Roll over 9 months: Sit upright unsupported 15 months: Walk 30 months: Climb stairs
25
Urinary incontinence is pathologic after age \_\_\_. Fecal incontinence is pathologic after age \_\_\_.
Urinary incontinence is pathologic after age **5** Fecal incontinence is pathologic after age **4**
26
MMRV contains \_\_\_, which some people are allergic to.
Neomycin
27
Transposition of the Great Arteries features
* Adding O2 will not affect saturation at all * No murmur (only cyanotic CHD without one) * Diabetic mother
28
Why do bipolar moms give birth to babies with WPW syndrome?
Bipolar mom -\> Lithium -\> Ebstein anomaly -\> WPW syndrome
29
Associations w/ PDA
Congenital rubella Prematurity
30
Treatment for Rocky Mountain Spotted Fever
ALWAYS Doxy. Nothing else works. We usually don't give doxy to kids under 8, but we do for RMSF.
31
Treatment for Lyme by categories
Under age 8: Amoxicillin 8 or older: Doxycycline If there is any meningitis, ceftriaxone.
32
Unless you have a good reason not to, you should generally do ___ prior to LP
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
First step in management of epiglottitis
**Intubate in the OR** (in case there needs to be emergent tracheostomy)
34
Buzz words for chlamydia pneumonia
"Stoccato cough" "Peripheral eosinophilia" "Associated mucopurulent conjunctavitis"
35
Presentation of acute bronchitis
Funky cough, sputum, fever Only rhonchi on lung exam with no focal signs or rales. No peripheral leukocytosis.
36
Treatment of contacts in pertussis
Also get erythromycin
37
A febrile UTI is __ until proven otherwise
A febrile UTI is **pyelonephritis** until proven otherwise
38
In order to get a clean catch urine sample from very young kiddos, they must be . . .
. . . **catheterized**
39
Indications for VCUG
* UTI in a male * UTI in a female younger than 5 * Any recurrent UTI
40
Nevus simplex
Those that occur on face will regress. Those that occur on neck will stay.
41
Nevus sebaceous
* Orange colored * Area of alopecia * Nodule/raised * **Need to be removed before adolescence -- risk of cancer later in life**
42
Features of physiologic jaundice
Should not go above ~12-15 at highest Gone by DOL#5
43
Baby is born with indirect hyperbilirubinemia. Likely etiology?
Hemolysis
44
Direct hyperbilirubinemia in a baby. First steps?
Rule out infection: Blood cx, urine cx, SCF cx
45
When do you repair a diaphragmatic hernia? What might you need?
3-4 days after birth -- NOT immediately ECMO may be necessary.
46
CHARGE syndrome
47
Prenatal things you can test for that are associated with RDS at birth
L:S ratio \< 2 (as lungs mature, lecithin increases and sphingomyelin decreases) Low phosphatidylglycerol
48
Big tongue + umbilical hernia
Hypothyroidism
49
Barium enema for intussusception
Diagnostic and therpaeutic
50
What don't you do to a baby with hypospadias?
Circumsize
51
Congenital varicella
Born w/ pox scars Cortical atrophy Limb hypoplasia
52
When does baby get VZV Ig?
If mom has Sx of varicella 5d before to 2d after delivery
53
Chlamydia conjunctavitis can lead to __ if untreated
Chlamydia conjunctavitis can lead to **chamlydia pneumonia or blindness** if untreated
54
Coarctation of the aorta is associated with. . .
. . . Turner's
55
Pierre-Robins sequence
56
Williams syndrome vs Smith-Magenis syndrome
57
"No tonsils"
No B cells Bruton's or SCID (if there is also no thymus!)
58
Cornelia de Lange Syndrome
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
Truncus arteriosus is tightly linked to \_\_.
Truncus arteriosus is tightly linked to **DiGeorge syndrome.**
60
Weight after birth
* Birth: BW * 7d: BW - 10% * 2 wks: BW * 6 mo: 2x BW * 1 yr: 3x BW
61
Dominant protein and fat in breast milk
Protein: Whey Fat: Long-chain
62
Bone age in obesity
Bone age \> chronological age Due to the effects of extrogen produced by adipocyte aromatase Thus, final height is reduced in childhood obesity
63
Bone age in precocious puberty
Bone age \> chronological age Due to sex hormones (estrogen or testosterone) produced by gonads Thus, final height less than predicted height
64
Bone age in hyperthyroidism
Bone age \> chronologic age Think of the hyperthyroid as causing bone to move along faster than usual. This ultimately results in shorter stature.
65
PTLD and rejection
"If you have PTLD, you can't reject. If you are rejecting, you can't have PTLD."
66
Neonatal renal cysts
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
Antibodies in T1DM
68
Things to do prior to discharge after BRUE
1. CPR training of parents 2. PMD followup scheduled
69
Canavan disease
* 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
Low risk vs high risk BRUE management
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
FPIES
* 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
Children \< age 5 get __ for pneumonia
Children \< age 5 get **amoxicillin** for pneumonia
73
Lyme meningitis CSF looks a lot like. . .
. . . **viral meningitis CSF** Often with even less WBC
74
Causes of meningitis in infants \< 1 month of age
* GBS * E. coli * Other gram negative bacilli * HSV * Listeria * Strep pneumoniae * **Treat w/ ampicillin + cefotaxime**
75
Causes of meningitis in infants between 1-2 months of age
* E. coli * Strep pneumoniae * Enterovirus * HIB * GBS * **Treat w/ vancomycin + ceftriaxone** * **​**or vancomycin + meropenem
76
Causes of meningitis in children 2 months - 6 years of age
* Strep pneumoniae * N. meningitides * Enterovirus * Borrelia (Lyme) * HIB * **Treat w/ vancomycin + ceftriaxone** * ​or vancomycin + meropenem
77
Causes of meningitis in children 6 years-adolescence
* S. pneumoniae * N. meingitides * Enterovirus * Lyme * **Treat w/ vancomycin + ceftriaxone** * ​or vancomycin + meropenem
78
Master meningitis table

Pediatrics Clerkship (23 decks)

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