One Liners part deuce

Question 1

Aplastic crisis: worsening SOB, weakness, fatigue in kid w/ SCD

Answer 1

Parvovirus B19
- sudden halt in RBC production (so low retics)
- no splenomegaly
(if splenomegaly would be splenic sequestration crisis and high retics)

Question 2

Fibroadenoma:

• mobile or not?
• painful or not?
• unilateral or not?
• single or not?

Answer 2

Single, unilateral, mobile, painful

- increases in pain/size prior to menses

Question 3

Edwards Scissorhands

Answer 3

Overlapping fingers - Trisomy 18
Micrognathia
Prominent occiput
Low-set ears
Heart defects: VSD

Question 4

Recurrent skin + mucosal infections

- periodontitis

Answer 4

Leukocyte adhesion deficiency

- inflammation w/ lack of purulence

Question 5

What does smear show in LAD?

Answer 5

Neutrophilia

Question 6

Classic first presenting sign of LAD?

Answer 6

Delayed umbilical cord separation

Question 7

Which seizure is provokable by hyperventilation?

Answer 7

Absence

Question 8

If looks like absence but NOT provokable by hyperventilation?

Answer 8

Focal seizure

Question 9

How treat absence seizures?

Answer 9

Ethosuximide

Question 10

When use atomoxetine?

Answer 10

Treat ADHD - a non-stimulant

could also use methylphenidate which is a stimulant

Question 11

Pubertal gynecomastia boys

Answer 11

2/3 of adolescent boys - mid/late puberty

• unilateral, bilateral, or painful
• no workup or tx
• resolves w/in months-2yrs

Question 12

Opacities in stomach on abd Xray after kid ingests pills?

Answer 12

Iron pills are radiopaque

- also see hematemesis 30min-6hrs later

Question 13

Tinnitis, fever, hyperpnea (respiratory alkalosis) after ingestion?

Answer 13

Aspirin

Question 14

Acetaminophen overdose timing?

Answer 14

Nausea/vomiting

- many pt’s remain asymptomatic w/in 24 hours of ingestion

Question 15

How chelate iron overdose?

Answer 15

Deferoxamine

- de that fer

Question 16

What is bolus for kid dehydrated?

Answer 16

20mL/kg of NS through IV

Keep dextrose out until maintenance

Question 17

6yo w/ single lytic lesion in right humeral head

- hypercalcemia (mild)

Answer 17

Langerhans cell histiocytosis (aka Langerhans cell granulomatosis)
- solitary, lytic long bone lesions

(in kids can be called eosinophilic granuloma)

Question 18

Kartagener syndrome

Answer 18

Primary ciliary dyskinesia

• displaced point of maximal impulse (dextrocardia)
• recurrent sinopulmonary infections

Question 19

7yo M think he has peripheral precocious puberty, what are electrolytes and why if CAH?

Answer 19

LH levels low at baseline and after GnRH test

Electrolytes normal in non-classical CAH which presents later than classical.

Question 20

Leydig cell tumors do what?

Answer 20

Gonadotropin-independent Peripheral precocious puberty but also unilateral testicular enlargement
- may secrete testosterone

Question 21

15yo w/ no puberty changes (F)

- what order and why?

Answer 21

Don’t need to order Estrogen b/c we know it’s low or else she would have breast changes
Order FSH
- if increased means peripheral cause – then to karyotyping
- if low means central cause – then to MRI for lesion in sella turcica

Question 22

Conjunctival injection both eyes
Age 13 day old - healthy
Scant amount mucopurulent d/c
Tx?

Answer 22

G before C so this is later so it’s
Chlamydial
- give oral erythromycin

Question 23

You can treat Gonococcal (G before C) conjunctivitis with IV or IM ceftriaxone and this other one?

Answer 23

Cefotaxime

- our taxes should pay for infants being treated for gonococcal

Question 24

Recurrent sinopulmonary and gastrointestinal infections. Why?

Answer 24

X-linked agammaglobulinemia

• boy
• defective tyrosine kinase prevents maturation of B-cells
• small/absent lymphoid tissue (tonsils, LN)
• lack of IgA = GI infections
• lack of humoral immunity = encapsulated organisms attack (H-flu, Strep pneumonia)
• after 6 pos b/c waning mother immunity

Question 25

What problem if encapsulated organisms only?

Answer 25

Complement deficiency

• Strep pneumo
• H-flu
• Neisseria meningitidis

Question 26

What get sick w/ if problem w/ oxidative burst?

Answer 26

Chronic granulomatous disease

• problems w/ skin pulmonary infections
• catalase positive organisms
• Staph aureus, Serratia m.

Question 27

How treat scarlet fever?

Answer 27

Penicillin V