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CK_Peds > OME/Book > Flashcards

OME/Book Flashcards

1
Q

how to dx developmental dysplasia of hip

A

get click on ortolani/barlow,

return in 4 weeks to get U/S if it doesn’t resolve

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2
Q

how to rx ddh

A

harness

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3
Q

6 year old, insidious onset of antalgic gait

dx and rx

A

Leg Calve Perthes (avascular necrosis)

rx with cast

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4
Q

teenage boy, obese,/growth spurt, non traumatic joint pain (dx, rx)

A

slipped capital femoral epiphysis

dx frog leg xray
rx surgery

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5
Q

hip pain in kid after viral illness, inability to bear weight, no fever or leukocytosis

A

transient synovitis

if patient has fever, leukocytosis, ESR/CRP elevation, ARTHROCENTESIS to r/o septic arthritis

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6
Q

teenage athelete, knee pain and tibial swelling/pinpoint tenderness on tibia
dx and rx

A

osgood schlatter’s disease/osteochondrosis
due to traction apophysitis of tibial tuberosity

rx: wait it out, work through it

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7
Q

bad complication of scolosis

A

dyspnea (ribs can’t come together)

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8
Q

dx scoliosis

rx

A

Adams test, xray

brace to slow progression and avoid surgery, or surgery if bad enough, surgical rods

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9
Q

translocation 11,22

A

ewing’s sarcoma

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10
Q

onion skin, MID SHAFT

A

ewing’s

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11
Q

distal femur bone tumor

A

osteosarcoma

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12
Q

location of osteosarcoma and xray finding

A

sunburst pattern

distal femur

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13
Q

rx transient synovitis

A

supportive

NSAIDs, follow up in 2 days

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14
Q

kid with fracture of growth plate

A

TAKE TO OR!

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15
Q

high yield association osteosarcoma

A

retinoblastoma

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16
Q

conservative and major interventions within 1st minute of new born

A

stimulate and get baby breathing

suction (o2 sat60-65% nml), baby may need intubation/ positive pressure ventilation (bagging)

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17
Q

HR goal for new born

A

greater than 100

if less baby may need positive pressure ventilation

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18
Q

long term complication of respiratory distress syndrome?

A

bronchopulmonary dysplasia

decreased surfactant, can’t expand alveoli, leads to scarring

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19
Q

ground glass opacities in neonate with increased o2 requirements

A

BPD

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20
Q

rx BPD

A

SURFACTANT! to child post delivery (NOT VENTILATION….you’ll just be blowing air into closed alveoli and make things worse)
antenatal corticosteroids to mom before birth

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21
Q

pathophys of retinopathy of prematurity

A

neoangiogenesis in retina due to increased 02 requirement

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22
Q

rx ROP

A

laser ablation to prevent early GLAUCOMA

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23
Q

bulging fontanelles, seizure, coma in premature infant

A

IVH
dx with cranial doppler
rx with decreasing ICP via surgery (VP shunt/drain)

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24
Q

bloody BM in premie

diagnostic finding and

A

NEC
dx with xray
rx NPO, IV Abx, TPN, surgery (short gut syndrome)

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25
Q

air in the wall of bowel, pneumatosis coli on xray

A

NEC

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26
Q

complications IVH

A

seizure disorder, hydrocephalus, CVA, intellectual disability/MR, cerebral palsy

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27
Q

most neonates will pass meconium in how many hours

A

48 (anything greater is abnormal)

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28
Q

imperforate anus seen, screen for?

A

VACTERL

vertebrae defects
anal atresia
cardiac defects
tracheo-esophageal fistula
renal abnormalities
limb anomalies

get imaging for all of this (echo, catheter, xray etc)

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29
Q

GI complication CF

A

meconium ileus

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30
Q

rx meconium ileus

A

no water so can’t pass stool

give water enema to dissolve plug
confirm diagnosis with sweat chloride test (if positive give vit ADEK and pancreatic enzymes, pulmonary toilet)

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31
Q

failure of migration of inhibitory neurons in aurback/meisnner plexus with failure to innervate distal colon (muscle can’t relax)

A

hirschsprung’s

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32
Q

palpable colon, explosive diarrhea on digital rectal exam

A

hirshsprung’s

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33
Q

how to dx hirshsprung’s (best test)

A

suction rectal biopsy for missing neurons

can also do contrast enema

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34
Q

effect of thyrotoxicosis on heart

A

hyperdynamic circulation from increased myocardial contractility and HR leads to systolic HTN

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35
Q

how can blood transfusion cause hypocalcemia

A

chelation!

in blood there is citrate, EDTA, or foscarnet which can chelate Ca esp in patients with bad liver function

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36
Q

female with hirsuitism, weight gain, bone loss, has proximal muscle weakness

A

glucocorticoid induced myopathy (Cushing myopathy)

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37
Q

painful red subcutanoues nodules most commonly on anterior lower legs + arthrlagia and malaise

A

erythema nodosum

do chest xray to rule out sarcoid

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38
Q

central face erythema, flushing, telangiectasias, burning within a few minutes of going outside or drinking alcohol,

A

rosasea

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39
Q

microscopy demonstrates linear IgG and C3 deposits along basement membrane, elderly patient with prodroem of urticaria/eczema
dx and rx

A 
bullous pemmphigoid (autoimmoune)
rx with high potency glucocorticoid
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40
Q

non tender firm hyperpigmented nodules <1cm, central dimpling when pinched

A

dermatofibroma

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41
Q

pearly nodule with small telangiectasia in sun exposed area, no dimpling, delderly patients

A

basal cell carcinoma

MCC skin cancer

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42
Q

firm scaly papules or plaques in sun exposed area

A

squamous cell carcinoma

2nd most common skin cancer

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43
Q

inheritance mode g6pd deficiency

A

x linked recessive

44
Q

limited upward gaze, upper eye lid retraction, pupils non-reactive to light but can accomodate

A

parniaud syndrome (n=pineal mass)

45
Q

how to evaluate for possible fibroadenoma

A

follow up after next menses

46
Q

patient with precocious puberty with advanced bone age has high LH, what to do next

A

central precocious puberty

MRI brain then treat with GnRH

47
Q

how to dx CGD

A

dihoydordorhoamine 123 or nitroblue tetrazolium test

48
Q

rx Lyme disease in child<8 or pregnant woman

A

amoxicillin

NOT DOXY

49
Q

rx for gonorrheal/chlamydial conjunctivitis in neonate

A

gonorrhea - appears 1st week; IM dose 3rd gen cephalosporin

chlamydia - appears 2nd week, PO macrolide

50
Q 
double bubble with normal gas pattern on xray
normal pregnancy (no cocaine, no polyhydramnios, no down syndrome)
A

malrotation

51
Q

rx malrotation

A

NG tube, decompress, then surgery if volvulus

52
Q

bilious emesis, hx of polyhydramnios, down syndrome, double bubble on xray + no gas beyond

A 
duodenal atresia (failure of duodenum to recannalize)
rx with surgery
53
Q

bilious emesis, polyhydramnios, bililous emesis, down syndrome, x ray shows double bubble with no gas beyond

A 
annular pancreas (failure of apoptosis of parts of pancreas)
rx with surgery

similar presentation to duodenal atresia

54
Q

bilious emesis, hx of cocaine in mom, possible polyhydramnios, no down’s, double bubble + multiple air fluid levels

A 
intestinal atresia (failure of ventral bud to rotate with duodenum)
rx with surgery but can get short gut syndrome
55
Q

1st day of life, nonbilious emesis, gurgling+bubbling, rx and how to diagnose?

A

tracheoesophageal fistula
dx with NG TUBE that coils
rx with TPN and surgery

56
Q

non bilious emesis (projectile), olive shaped mass, visible peristaltic waves, what to do next?

A

check CMP correct!!!
(hypochloremic/hypokalemic metabolic alkalosis) FIX THESE with IVF and electrolytes
U/S -> elongated pylorus
rx with pyloromyotomy

57
Q

characteristics of ILD

A

decreased lung volumes (low total lung capacity, functional residual capacity, residual volume), preserved FVC1/FVC, INCREASED A-A GRADIENT, reduced diffusion capacity of CO

58
Q

SHOULDER PAIN, horner syndrome, weakness/pain/paresthesia of hand

A

pancoast tumor (superior pulmonary sulcus)

59
Q

cyanosis with feeding, secretions

A

TEF (blind pouch proximally and fistula between brochus and distal esophagus)

60
Q

rectal prolapse, meconium ileus, esophageal varices, recurrent pulmonary infections

A

CF

61
Q

low glucose in pleural effusion indicates….

A

infection (increased WBC)

exudate

62
Q

noenate with direct hyperbilirubienami

A

biliary atresia
sepsis
metabolic

63
Q

two genetic disorders that can cause child with indirect bilirubinemia

A

Gilbert

Crigler Najar

64
Q

two genetic disorders that cause child with direct bili

A

dubin johnson

rotors

65
Q

which bili can cause kernicterus?

A

indirect (non water soluble , fat soluble and can cross BBB) can’t excrete in urine

66
Q

dark colored urine in noenate

A

water soluble so this is direct bili

67
Q

jaundice after 72 hours, resolves in 1-2 weeks, unconj bilirubin, slow rise

A

physiologic

68
Q

jaundice within 1st day, takes longer to resolve, conjugated bili, quick rise

A

pathologic

69
Q

how to work up unconjugated bili

A

coombs (isoimmunization), Hgb (twin twin transfusion, cephalohematoma, delayed clamping), retic count (G6PD, sickle cell, pyruvate kinase deficiency), if all negative

then breast milk vs breast feeding jaundice

70
Q

decreased bowel function, dehydration day 1-7, unconj jaundice

A

breast feeding failure jaundice

71
Q

unconj bili, after day 7 of breast feeding,

dx and rx

A

breast milk jaundice (due to mom’s milk having high quantities of b-glucourinidase)
feed hydrolyzed formula

72
Q

how to treat unconj bili

A
  1. phototherapy more common

2. exchange transfusion for rapidly rising

73
Q

blue child with low O@ sat, supplemental oxygen fails to increase pulse ox

A

methemoglobienima )exposure to oxidasing agent), decreased o2 to peripheral tissues, normal PaO2, saturation gap between pulse ox and ABG)

74
Q

erythematous patches and plaques with yellow oily scales on scalp, face, and umilicus

A 
seborrhic dermatitis ("cradle cap")
(rx with emolients, non med shampoos,)
75
Q

trianglur sail, pediatric chest xray

A

thymus

76
Q

respiratory distress in neonate with suspected CDH

what to do?

A
  1. endotracheal intubation

2. orogastric tube to decompress bowel and improve respiration

77
Q

absoption of breast milk vs formula

A

breast milk protein absorbed better and improves gastric emptying

78
Q

how to prevent SIDS

A
  1. lay infant on back while sleeping (watch for flattened occiput and alternate head)
  2. don’t share bed
  3. smoking cessation
79
Q

benzo overdose vs opoid intoxication

A

benzos only cause mild respiratory depression and normal pupils while opoids can cause severe respiratory depression and constricted pupils

80
Q

dry mouth, eye blurriness, urinary retention, fever, decreased bowel sounds

dx and rx

A

anticholinergic/antihistamine toxicity rx with ache inhibitor
to increase ach…physiostigmine

81
Q

tinnitus, fever, nausea, vomoiting

A

ASA toxicity

82
Q

ingestion, abdominal pain, vomiting, diarrhea, hypotensive shock, metabolic acidosis (anioin gap), hematemasis

A

iron toxicity

rx with whole bowel irrigation, deferoxamine

83
Q

wet with urine, shiny red abdominal protrusion

A

extrophy of bladder

can be mistaken with omphalocele

84
Q

neonate with worsening direct hyperbili @ 2 weeks, no ducts on U/S, then confirm with HIDA after phenobarb (induces biliary tree to secrete bile)

A

biliary atresia

85
Q

traumatic delivery, mother develops waddling, painful ambulation postpartum day 1, dx and rx

A

pubic symmphisis diastasis (widening)

86
Q

for IUFD, when to DnC vs induce labor

A

DNC<24 weeks

induce>24 weeks

87
Q

fetal complications pre-eclampsia (3)

A

IUGR, small for GA, oligohydramnios

all 2/2 uteroplacental insufficiency

88
Q

baby sac in back, CSF but no nerve fibers

A

meningocele

89
Q

babcy sac in back, nerve fibers and CSF in sac

A

meningomyelocele`

90
Q

asthma + nasal polyps/sinusitis

A

ASA sensitive asthma

stop ASA and NSAIDS!

91
Q

how to differentiate anaphylaxis for just regular allergic reaction

A

HYPOTENSION

92
Q

allergic condition associated with angioedema

A

c1 esterase deficiency

rx with FFP

93
Q

polyps with cobblestoning

pale boggy mucosa

A

allergic rhinitis

rx INTRANASAL STEROIDS

94
Q

baby, nausea, vomiting, diarrhea, failure to thrive despite feeding adequate amounts

A

milk protein allergy
try another formula (not SOY)
i.e. breast milk/hydrolyzed

95
Q

targetoid lesion on knees, palms, face, fingers…

A

erythema multiforme (SYPHILIS/LYME DISEASE)

also HSV

rx with topical steroids

96
Q

skin sloughing off, +nikolsky sign, person looking poorl, involvement of basal layer, dusky, <10% total body surface area

A

SJS

STOP ALL MEDS including steroids

97
Q

skin sloughing off, +nikolsky

FULL THICKNESS, >70%

A

toxic epidermal necrolysis (like a burn)

98
Q

what drugs can cause SJS/ toxic epidermal necrolysis

A

sulfa
PCN
anti retrovirals
anti convulsants

99
Q

attack of desmosomes, infant with febrile illness, sloughing of skin @ skin folds

A

staph scalded skin syndrome

rx nafcillin (not PCN)

100
Q

dietary recommendations to prevent calcium stones

A
  1. NML Ca intake
  2. decreased Na
  3. increase fluid intake
101
Q

what order to get if you suspect malignancy, compression fracture, ankylosing spondylitis

A

xray (initially…then do MRI)

102
Q

what to order if you suspect cauda equina, epidural abscess?

A

MRI

if patient can’t tolerate DO BONE SCAN

103
Q

numbness pain between 3rd/4th toes, clicking when palpating space between 3rd and 4th joints

A

morton neuroma

104
Q

burning, numbness, aching of distal plantar surface of toes

A

tarsal tunnel syndrome (compression of tibial nerve at ankle)

105
Q

pulmonary complication rheumatoid arthritis

A

exudative pleural effusion with low glucose

can also be bacterial infxn or TB

106
Q

reproductive age woman, adnexal mass, regular menses, hyperechoic, calcifications

A

dermoid cyst

watch out for ovarian torsion later on!

CK_Peds (3 decks)

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