MedStudy Question Bank Flashcards
When does adrenal crisis occur in congenital adrenal hyperplasia (CAH)?
Adrenal crisis at 1-2 weeks of life (normal newborn period)
What is the presentation of Sotos syndrome?
Intellectual impairment, overgrowth, and developmental delay without endocrinologic issues
What is the first step in evaluation of a patient with tall stature and signs of precocious puberty?
Bone age
What are the cancer screening guidelines in patients with Beckwith-Wiedemann syndrome?
Complete abdominal US and alpha-fetoprotein every 3 months until 4 years of age and then renal US every 3 months from 4-7 years of age
What is the growth pattern in Sotos syndrome?
Accelerated growth for first 5 years of life then return to normal thereafter
Which test can differentiate between constitutional growth delay and genetic short stature?
Bone age
Constitutional growth delay: delayed bone age
Genetic short stature: normal bone age
What is the presentation of Wolfram syndrome?
Central DI, DM, optic atrophy, deafness
What are the characteristic lab findings in primary polydipsia?
Low sodium and low serum osmolality
Which cardiac lesion is commonly associated with Williams syndrome?
Supravalvular aortic stenosis
What is the upper limit of normal of peak pubertal growth in males and females?
Males: by 16 years of age
Females: by 14 years of age
Which risk factor is associated with development of follicular ovarian cysts?
Cigarette smoking
What is the cause of familial male-limited gonadotropin-independent precocious puberty?
Activating mutation in LH receptor
What is the definition of precocious puberty?
Puberty < 9 years of age in boys and < 8 years of age in girls
When is peak height velocity in females?
Between thelarche (10-11 years of age) and menarche (11-12 years of age)
SMR 2-3
Which 4 common AEDs induce CYP450?
Carbamazepine, phenytoin, phenobarbital, topiramate
What is the average time between thelarche and onset of menarche?
2-2.5 years
What is the most common cause of toileting refusal in young children?
Strong will
Will often void in the toilet but not stool
What is the classic XR finding in rickets?
Cupping and fraying of metaphysis
What is the appropriate management of a baby born to a mother who is HBsAg-positive?
HBIG and hep B vaccine at birth followed by hep B vaccine at normal intervals (2 months, 6 months) and lab evaluation (HBsAg and anti-HBsAg) at 9-12 months
What is the Pelger-Huet nuclear anomaly?
Hyposegmented neutrophil in setting of malignancy or genetic anomaly
What is guttate psoriasis?
Erythematous scaly papules associated with concurrent Strep infection
What is the first-line treatment of alopecia areata?
Intralesional corticosteroids
What is the difference in appearance of tinea capitis and alopecia areata?
Both cause localized area of hair loss but tinea capitis has scaling
Which triptan is FDA-approved for young children?
Rizatriptan
What is the difference in presentation of alpha-1-antitrypsin deficiency in children and adults?
Children: liver disease
Adults: liver AND lung disease
What is the most common lab abnormality associated with anabolic steroid misuse?
Increased LFTs
Which lab can distinguish between hypoparathyroidism and pseudohypoparathyroidism?
Hypoparathyroidism: normal PTH
Pseudohypoparathyroidism: high PTH
Both present with low calcium and high phosphorous
What is the presentation of mucopolysaccharidosis type 2 (Hunter syndrome)?
Coarse facial features, hypertelorism, joint stiffness, myocardial hypertrophy, pulmonary HTN
What is the management of epidural hematoma?
`
Urgent NSGY evaluation due to lucid interval followed by herniation
What is the management of children with parvovirus B19 infections who are around pregnant women?
Can return to those settings once slapped-cheek rash appears because that indicates end of contagious period
When do night terrors occur during the sleep cycle?
Non-REM sleep during first 1/3 of the night
What is the presentation of chancroid?
Painful unilateral inguinal LAD associated with painful genital ulcer
What is the cause of chancroid?
H. ducreyi
What is the most common bacteria that causes blistering distal dactylitis?
Group A Strep
At what age can children sit without support?
9 months
What is the presentation of Peutz-Jeghers syndrome?
Intestinal hamartomas (causing colicky abdominal pain secondary to intussusception) and mucocutaneous nodules in the mouth and around the lips
What bone abnormality is seen in lead poisoning?
Linear hyperdensities in the metaphyses of bone (lead lines)
What capillary lead level warrants confirmation with a venous sample?
> 5
What lead level necessitates chelation?
45+
What is the management of urethral prolapse in females?
Topical estrogen cream
What is the treatment of dermatitis herpetiformis?
Dapsone
What is the presentation of pityriasis lichenoides et varioliformis acuta (PLEVA)?
Papules with hemorrhagic crusting followed by hypopigmented or hyperpigmented macules
What is the treatment for pityriasis lichenoides et varioliformis acuta (PLEVA)?
Oral tetracyclines
What is the inheritance pattern of G6PD deficiency?
X-linked recessive
What is the presentation of Mayer-Rokitansky-Kuster-Hauser syndrome?
Underdeveloped upper vagina and uterus
Which nerve roots are affected in Erb and Klumpke palsies?
Erb: C5, C6
Klumpke: C8, T1
What is the appropriate post-exposure prophylaxis after exposure to hep A in unimmunized individuals?
Hep A vaccine (preferred) or immunoglobulin
Which STI is associated with punctate hemorrhages on the vagina and cervix?
Trichomoniasis
What is the treatment for bacterial vaginosis?
Metronidazole for 7 days
What is a highly specific antibody for lupus?
Anti-smith antibody
Which lab tests are typically positive in rheumatoid arthritis?
RF and anti-CCP antibody
What is the management of nevus sebaceous?
Elective excision due to cosmetic concerns and risk of malignant transformation
What is the presentation of Alport syndrome?
Glomerulonephritis and hearing loss
What is the diagnosis of a child who recently underwent cardiac surgery who presents several weeks later with cough, fever, dyspnea, and chest pain?
Post-pericardiotomy syndrome
Which cardiac anomalies are associated with a biphasic pulse?
Aortic stenosis and hypertrophic obstructive cardiomyopathy
What is the management of juvenile plantar dermatosis?
Avoid impermeable shoes, absorbent powders, and topical emollients
“Sweaty sock syndrome”
Which age group is at the highest risk of child abuse?
Birth-1 year
At what ages do Wilms tumors typically present?
3-4
Which genetic mutation is commonly associated with hereditary pancreatitis?
PRSS1
Which genetic mutation is strongly associated with Crohn’s disease?
NOD2
Which genetic mutation is associated with Alagille syndrome?
JAG1
What is the management of children < 12 months of age who are traveling to measles-endemic areas?
1 MMR vaccine in children 6-12 months
Children < 6 months still have protection from transplacental antibodies
What are the most significant risk factors for later development of asthma?
Parent with asthma and/or personal history of concurrent eczema
When should children develop a pincer grasp?
12 months
How does selenium deficiency present?
Hypothyroidism and cardiomyopathy
At what ages is separation anxiety developmentally appropriate?
6 months-3 years
Which cardiac anomaly is associated with a fixed split S2?
ASD
What is the presentation of phenylketonuria?
Light-colored hair and skin, eczema, seizures, developmental delay
What is the cause of homocystinuria?
Deficiency of cystathionine beta-synthase
How does homocystinuria present?
Marfanoid body habitus, downward dislocation of the lens, thromboembolism
What are the tetanus immunoglobulin and vaccine guidelines after a wound?
Tdap preferred over Td in children > 7
What is the first-line treatment for idiopathic intracranial hypertension?
Acetazolamide
Carbonic anhydrase inhibitor
What is the presentation of Denys-Drash syndrome?
Wilms tumor, nephropathy, ambiguous genitalia
Which disease is associated with anti-smooth muscle antibody?
Autoimmune hepatitis
What neutrophil count is expected in cyclic neutropenia?
< 200
Where is the pain in tennis elbow versus golfer’s elbow?
Tennis elbow: lateral epicondyle
Golfer’s elbow: medial epicondyle
Which limb abnormality is associated with trisomy 13?
Polydactyly
What is the main presentation of Klippel-Feil syndrome?
Fusion of cervical vertebrae
What is the first step in management of eosinophilic esophagitis?
Elimination of cow’s milk
What are important adverse effects of IUDs?
Uterine perforation and menstrual irregularities
When is the peak incidence of ALL?
2-5 years
What ages are poor prognostic indicators in ALL?
< 1 or > 10 years
What WBC count at diagnosis is a poor prognostic indicator in ALL?
> 50,000
What is the presentation of tyrosinemia type I?
Hepatic and renal dysfunction
How is tyrosinemia type I diagnosed?
Urine succinylacetone level
Presents with hepatic and renal dysfunction
What is the treatment of tyrosinemia type I?
NTBC
What lab findings are associated with fatty acid oxidation disorders?
Hypoglycemia with absence of urine reducing substances and ketones
How are fatty acid oxidation disorders diagnosed?
Plasma acylcarnitine profile
What is the presentation of nail-patella syndrome?
Nail hypoplasia or dysplasia, orthopedic anomalies, and kidney disease
What are the primary physical exam findings in Fanconi anemia?
Hypoplastic thumbs, hyperpigmented skin and/or cafe-au-lait spots, short stature, abnormal radii
Which type of cancer are patients with Fanconi anemia most at risk of developing?
AML
Which infection is associated with rash that develops after defervescence?
Roseola caused by HHV-6
What are the guidelines for screening children for hyperlipidemia?
All children 9-11 and 17-21
High-risk patients such as those with obesity or strong family history of hyperlipidemia/metabolic syndrome/MI should be screened between 2-8
What is the pathognomonic EEG finding with benign childhood epilepsy?
Centrotemporal spikes
What type of seizure is typical of benign childhood epilepsy?
Focal aware seizure
What is the management of Klinefelter syndrome?
Testosterone replacement
Which condition is associated with cardiac rhabdomyomas early in life?
Tuberous sclerosis
What is the hallmark pulmonary finding in Alagille syndrome?
Peripheral pulmonary stenosis