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CK_Peds > OME/Book 2 > Flashcards

OME/Book 2 Flashcards

1
Q

2 year old, viral prodrome, barking/seal like cough, stridor in between cough, improves with winter air

dx and rx

A

croup 2/2 PARAINFLUENZA

rx with RACEMIC EPI, steroids, o2 if severe

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2
Q

croup that doesn’t improve with racemic epi consider….

A

bacterial tracheitis 2/2 STAPH AUREUS

dx with tracheal culture and give IV abx

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3
Q

no vaccine history, rapid onset high spiking fever, tripod/drooling/accessory muscles, muffled voice

A

epiglottitis

rx: endotracheal intubation, visualize cherry red epiglottitis….IV abx

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4
Q

super sick, abrupt onset high spiking fever, drooling, tripod, neck stiffness, muffled voice, anterior chain unilateral LAD, tender mass

A

retropharyngeal abscess

dx with CT scan, I+D, iv abx

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5
Q

older kid, muffled voice, sore throat, drooling, uvular deviation

A

peritonsillar abscess

I/D, iv abx

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6
Q

rx sarcoidosis

A

systemic corticosteroids

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7
Q

“egg shell” calcifications on chest xray

A

silicosis

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8
Q

pathophys of Goodpasture

A

IgG antibodies directed against basement membrane of alveoli and glomeruls (type II) hypersensitivity

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9
Q

how can respiratory failure cause coma

A

resp failure = hypercarbia = vasoDILATION of cerebral vessels = increased ICP nad coma

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10
Q

scales antecubital fossa, itchy, vesicles crusts

dx and rx

A 
atopic dermatitis (eczema)
rx: avoid trigger, emulsions, topical steroids (short term)
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11
Q

contact dermatitis hypersensitivity what kind

A

TYPE IV (delayed)

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12
Q

peripheral edema, erythematous skin then darkens, chronic condition predisposing to swelling in legs
dx and rx

A 
stasis dermatitis (a/w stasis ulcers i .e. malleloar)
rx diuretics, compression stockings, leg elevation

(think dude with uncontrolled DM nephropathy you saw in ER)

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13
Q

too much hand washing can cause…?

A

hand dermatitis

rx: stop washing too much, avoid harsh soaps

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14
Q

fever simultaneous with red rash on cheek

A

erythema infectiousum (parvob19)

supportive

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15
Q

complications parvo

A 
aplastic crisis
hydrops fetalis (kid gives pregnant mom parvo, can pass it on to baby in utero)
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16
Q

prodrome (cough, runny nose) conjunctivis, koplick spots/white dots in month) with fever+rash simultaneously…rash starts in face works its way down

A

measles
usually seen in non vaccinated patient
rx supportive

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17
Q

long term effect of measles

A

subacute sclerosing panencephalitis

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18
Q

generalized+tender LAD with fever and rash that starts in face spreads to down to trunk

A

rubella
supportive rx
vaccine!

no associated sequela

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19
Q

very high spiking fever>104, rthen after fever breaks and THEN RASH…rash starts trunk and expands outward

A

roseola (HHV6)

rx supportive, watch out for febrile seizures…abort with benzos if>5min, use acetominophen

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20
Q

diffuse vesicles on erythematous base, in diff stage of healing, eruptions/crusting NO FEVER

A

chicken pox, varicella

rx supportive, dx clinicals

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21
Q

rash that abruptly stops at midline

A

shingles (herpes zoster, vcv)

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22
Q

how to prevent shingles

A

shingles vaccine in patient’s who have had chicken pox over age 60

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23
Q

pubertal male with parotid swelling and orchitis

A

mumps
rx supportive

MMR vaccine!

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24
Q

long term complication mumps

A

infertility (if orchitis)

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25
Q

rash sparing extremities and trunks

A

coxsackie

HFMD

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26
Q

recommended treatment for measles infection

A

VIT A

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27
Q

MOA Wiskot Aldrich

A

XLR in WAS gene (impaired cytoskeleton)

thrombocyto
eczema
recurrent infection

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28
Q

how to prophylax against RSV bronchiolitis (esp in premies, chronic lung diseas prematurity, congenital heart)

A

palivizumab

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29
Q

long term complication RSV

A

apnea

respiratory failure

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30
Q

ped brain tumor with hydrocephalus (ICP symptoms), truncal/gait ataxia

A

medulloblastoma (posterior fossa tumor)

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31
Q

ped tumor with visual field defects, bitemporal hemianopsia, short stature

A

craniopharyngioma

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32
Q

ped tumor/mass with limitaion of upward gaze, bilateral eyelid retraction, light near disssociation

A

parinaud syndrome 2/2 pinealoma

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33
Q

ped tumor presenting with aphasia

A

low grade astrocytoma

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34
Q

paroxysmal cough, post tussive emeiss, subconjunctival hemorrhage, questionable vaccine status

A

pertussis
need five dose Dtap 4-6 then Tdap in adolescence

RX WITH MACROLIDES (azithro, erythromycin)

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35
Q

sequence of DM nephropathy

A
  1. glomerular hyperfiltration (1st)
  2. basement membrane thickening
  3. mesangial expansion
  4. nodular sclerosis (last)
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36
Q

how to manage ARDS

A
  1. low tidal volume (prevents alveolar distension)
  2. high PEEP (15-20) - prevent alveolar collapse
  3. FI02 oxygenation <0.6 with goal to oxygenate for SPo288-95)
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37
Q

prolactin level in prolactinoma

A

usually >200 (nml = 15)

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38
Q

adolescent develops ataxia/dysarthria, scoliosis/feet deformities, and cardiac myopatyh (concetnric hypertrophic cardiomyopatyh)

A

freiderich ataxia

MCC death is cardiomyopathy

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39
Q

small papules with central umbilication, diffuse, can effect face and eyelid

A

molloscum contagiosum (poxvirus)

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40
Q

tic doloreaux (trigeminal neuralgia) rx

A

carbemazepine

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41
Q

acute thyrotoxicosis, low radioiodine uptake, elevated T4, low TSH, mild enlargement of thyroid, non tender

A

silent/painless thyroiditis

42
Q

DM patient with watery diarrhea, skin lesions (crusting enlarging erythematous plaques), weight loss

A

glucagonoma

43
Q

rx active seizure

A

benzos

44
Q

rx simple febrile seizure

A

acetominophen

NOT ASA

45
Q

bilateral symmetrical limb jerking NOT GENERALIZED, no fever, young infant <1 yo
dx , dx test, rx

A

infantile spasm (west syndrome)

dx with intraictal EEG/hypsarythmia

rx with ACTH, watch out for MR

46
Q

infant presents with infantile spasm, what to screen for?

A

tuberous sclerosis
angiofibromas, ash leaf spots (woods lamps

get CT/MRI
rx supportive, poor prognosis

47
Q

seizure, LOC, no loss of tone, generalized

A

absence seiuzure
dx EEG
rx ethosux

48
Q

rx upper aiway cough syndrome (post nasal drip)

A

first generation antihistamine (

49
Q

transudative pleural fluid has what kind of pH

A

7.45

50
Q

foreign body aspiration extrathoracic vs intrathoracic

A

extra - inspiratory stridor (call ENT)
intra - exp wheezes

bronchoscopy - if in resp
endoscpy - if GI
laryngoscopy - if ENT

51
Q

first step when patient comes back with asthma refractory to meds

A

PATIENT EDUCATION

52
Q

inheritance CF

A

AR

CFTR gene

53
Q

recurrent hexagonal kidney stones during childhood

dx and what test

A

cystinuria

test with urinary cyanide nitroprusside

54
Q

teenage boy dull aching pain in leg, occurs mostly at night, improved with NSAIDs, not related to physical activity xrray shows hypodense lesion on proximal femur

A

osteoid osteoma (small round lucency)

serial exam q4-5 months

55
Q

if patient has abnormal first trimester combined test (increased b hcg, PAPP-A, nuchal translucency)…what to do at 15 weeks?

A

NOT QUAD SCREEN (this isn’t diagnostic)

offer amniocentesis for definitive diagnosis for abnormal initial 1st trimester test

chorionic villus is before 12 weeks

56
Q

most common murmur infective endo

A

new REGURGITANT murmur

MITRAL REGURG

57
Q

premie with GI bleed, pneumatosis intestinalis on xray…what to do next

A

NEC!

NPO
IVF
TPN
IV Abx

58
Q

painless hematochezia, 2 year old, intermittent

dx test

A

meckel’s

tech 99 toddler
CT in teenager

59
Q

Apts test?

A

tests if baby swallowed moms blood (melena in newborn)

60
Q

rx anal fissure in neonate

A

nothing

usually self resolving

61
Q

how to prevent CIN

A

fluids + acetycystine (mucomist)

62
Q

young man with hemptysis, dyspnea, renal failure

A

good pasture

rx with cyclophos + steroids

63
Q

heart manifestation of extreme renal failure

A

uremic pericarditis

64
Q

rx acute closure glaucoma

A

acetazolamide
BBs
pilocarpine

65
Q

cohort vs case control study

A

cohort - start with risk factor, see who develops disease, RELATIVE RISK RATIO

case control - start with disease, then work backwards to identify risk factor, ODDS ratio

66
Q

experimental study where control group switches to getting intervention and intervention group stops getting intervention

A

cross over study

GOOD WAY TO REDUCE BIAS

67
Q

way to reduce bias

A

randomization, control group, blinding (esp double blinding)

68
Q

bias that arises when study subjects act differently when they know they’re being observed

A

hawthorne effect

69
Q

bias that arises when subjects (esp those in sick group) remember more about exposures

what kind and how to reduce this kind of bias

A

recall bias

use single blinding

70
Q

when researchers divide subjects into groups that are different at baseline (give rx to sickest patients, and placebo to not sickest patients)

A

selection bias

counter this with randomization ( don’t let researcher know who goes into whch group) or matching (subjects have similar demographics)

71
Q

researcher knows who’s in each gorup so it changes how you evaluate the study subjects

A

observer bias

counter this with blinding

72
Q

how to counter confounding….

A

randomize, better study design, matching

73
Q

OCPs increase risk of DVT (so make study linking DVT) but you also find that smoking WITH DVT can increase risk

A

effect modification

third factor related to outcome=dvt, not necessarily OCP use, but enhances relationship

74
Q

benefits and risks of hydroxyurea

A

reduce pain crises
reduce stroke risk

BUT
risk myelosuppression

75
Q

tick bite, flu like illness, neurologic symptos NO RASH, LEUKOPENIA, THROMBOCYTOPENIA

ELEVATED LIVER ENYMES

A

erlichosis (e ewingii, chaffenesis)
south eastern US

rx with DOXY
(same as lyme)

76
Q

heart complication ankylosing spond

A

aortic regurg

77
Q

POD#1 fever what to do

A

“WIND”
get chest xray to r/o pneumonia

but its probably ATELECTASIS

78
Q

POD#2 fever what to do

A

“WIND”
chest xray
it’s probably pneumonia
treat with rx abx

79
Q

POD#3 fever what to do

A

“WATER”
U/A START ABX

always take FOLEY out!

80
Q

POD#7 fever

A

WOUND
U/S for wound abscess

but probably cellulitis

81
Q

POD#10-14 fever

A

get U/S
probably an ABCESS

GO BACK TO OR FOR I&D

82
Q

structure of tetanus vaccine

A

TOXOID!!!!

83
Q

admin IVIG

what kind of immunity?

A

passive (gives preformed antibodies)

active (antigen toxoid to prime PATIENT’S OWN IMMUNE SYSTEM)

84
Q

vaccine c/i egg allergy

A

yellow fever (YELLOW EGG)

85
Q

kid gets vaccine (fever>104, anaphylaxis)

A

don’t give that vaccine in the future

86
Q

what to do if baby born with HepB positive om

A

give vaccine and HbIG NOW!

87
Q

DtAP and TDAP

A

DTAP - 3 doses 1st year, 2 doses 1-4 years

Tdap - booster every 10 year

88
Q

if patient gets behind on HepB vaccine

A

just give whenever

3 HepB, 2 HepA

89
Q

nail wound, less than 3 TdAP doses….what to do

A

clean - tdap
dirty - tdap + TIG

dirty = rust, dirt, feces, metal, soil, saliva

IF LESS THAN 3 LIFETIME DOSES OR UNKNOWN, TIMING DOESN’T MATTER

90
Q

if nail wound, patient has more than 3 doses Tdap..what to do….

A

check timing
clean wounds = within 10 years, send home, if greater then 10 years give Tdap

diryt wounds = tdap within last 5 years, send home, t dap greater than 5 years give tdap

91
Q

patient comes with fever, dysphagia, dypnea with pseudomembranes what to do

A

IF QUESTIONABLE VACCINE STATUS this is diptheria

intubate, give anti toxin
iv abx

92
Q

what vaccine contraindicated in intussuseption

A

rotavirus

93
Q

hx of angioedema in family, low C4

A

C1 esterase inhibitor deficiency

94
Q

AIHA is what kind of hypersensitivity

A

type II (preformed IgG and IgM)

95
Q

MOA type 4 hypersensitivity

A

delayed hypersens due to sensitized T cells releasing T inflammatory mediators

ex: contact derm, granulomatous/sarcoid, chronic transplant rejection

96
Q

patient presents with mon like syndrome (sore throat, pharyngitis, fever , malaise)

what else to consider

A

HIV

initial seroconversion can present like this

97
Q

how to confirm diagnosis of HIV rapid test

A

ELISA
western BLot

initial rapid testing can be negative, re check in 6 months

98
Q

giant granules in neutrophils, recurrent infetions, ocularcutaneous albinism

A

chediak higashi

bad microtubule polymerizaiton

99
Q

deficient Nitrobule terazolium in granulocytes

A

CGD

100
Q

recurrent, chronic candida infection in mouth, head, skin, no other immunodeficiencies

dx and a/w”?

A

chronic mucutaenous candidiases

a/w hypothyroidism

101
Q

complications of SGA infant

A

hypoxia -> polycythemia
hypoglycemia
hypocalcemia
hypothermia

everything LOW

CK_Peds (3 decks)

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