PED COMAT Flashcards
1
Q
What effects on the fetus is associated with maternal use of heroin/opiates during pregnancy?what should these children be monitored for?
A
increase risk of:fetal growth restrictionplacental abruptionfetal deathpreterm laborintrauterine passage of meconiuminfants should be monitored for NEONATAL ABSTINENCE SYNDROME (uncoordinated sucking reflex = poor feeding, irritability, high pitched cry)
2
Q
what is the cause: 3 day old infantlarge bump on headscleral icterus, abdominal jaundiceswelling over parietal bone - does not cross suture lines
A
Cephalohematoma
3
Q
what is the best tx for osgood-schlatter disease?
A
ibuprofen
4
Q
What is the caloric requirement for most 1. healthy babies2. preterm babies3. VLBW (very low birth weight) infants = <1500gin the first 1 to 2 months of life?
A
- 100 cal/kg/day2. 115 to 130 cal/kg/day3. 150 cal/kg/day
5
Q
when does a child double their birth length?
A
4 years of age
6
Q
what is the Ballard Assessment tool?
A
uses signs of neurologic and physical maturity to estimate gestational age
7
Q
For a 18 month old child what are the milestones for:1. gross motor2. fine motor3. language4. social/adaptive
A
- walks alone, may climb stairs/runs, can help undress2. drinks from cup/spoon, make tower of 2 cubes3. 6 words in vocabulary4. points to show what he wants, shakes head no
8
Q
What is the disease:5 year old with newly discovered cardiac murmur. elfin facies, mild retardationwhat kind of cardiac defect?
A
Williams-Beuren syndrome - also HTN, short statusBicuspid Aortic Valve–aortic regurg–aortic stenosis develops 40s-50s
9
Q
For a 6 month old child what are the milestones for:1. gross motor2. fine motor3. language4. social/adaptive
A
- rolls over, sits unsupported, no head lag when pulled to sit from supine2. reaches for objects, looks for dropped items3. turns to voice, babbles4. feeds self, demonstrates stranger recognition (prelude to stranger anxiety)
10
Q
What is the most likely inborn error of metabolism in a 2 day old infant with severe metabolic acidosis?
A
Glutathione synthetase deficiency–severe metabolic acidosis+ jaundice+ hemolytic anemia
11
Q
what is the infective agent:7 year old w low grade fever, headache, pruritic rash. Rash began on cheeks, spread to trunk and extremities. Physical exam shows maculopapular rash w lacy, reticulated appearance
A
Erythema infectiosum - parvovirus B19
12
Q
cal/mL for 20 cal formula?
A
0.67 cal/mL
13
Q
Neonate IV fluids +/- feeds
A
Increase 20-30 mL/kg/day until 150-160 mL/kg/dayDay 1: 60-80 mL/kg/dayDay 2: 80-100 mL/kg/dayDay 3: …etc…60+(20day)= max limit
14
Q
What is dz and defect?Tall 10 year old, arachnodactyly, ligamentous laxity, pectus excavatum
A
Marfan syndrome - fibrillin
15
Q
what is the etiology:infant born w part of small bowel protruding from abdomen to the right of the umbilicus.
A
Gastroschisis—involution of the second umbilical vein
16
Q
how old is the child:Child says “mama” and “dada” w meaning, follows one-step commands, shows objects to parents to share interest.plays interactive games (peekaboo, waves bye bye). points to desired object
A
12 months
17
Q
What electrolyte abnormalities is most often seen in infants of diabetic mothers?
A
hypoglycemiahypocalcemiahypomagnesemia
18
Q
what is the dx?1 month old with head circumference > 100th percentile. mother had no prenatal care. Macrocephaly w no other dysmorphic features. Transillumination of the head is positive.
A
hydranencephaly
19
Q
cal/mL for 24 cal formula?
A
0.80 cal/mL
20
Q
What will a coin appear like in an AP CXR if in the 1. esophagus2. trachea
A
- Round – The coin will face you2. Linear – You are looking at the coins edge. A Sagital CXR needed to see the front/back of the coin.
21
Q
Identify the pathogen:12 day old infant w bilateral eye discharge. conjunctival injection, lid swelling, scant mucopurulent discharge. no rashes
A
chlamydia trachomatis
22
Q
What are the two most prevalent causes of acute otitis media?
A
Streptococcus pneumoniaeHaemophilus influenzae, nontypeable
23
Q
Fluid management for neonate
A
Based on weight until day 7Feeding q 3 hours
24
Q
What is the definition of Small of Gestational age?
A
Less than 10% for Birth WeightAt Term = <2500gAt 37 wk = <2000gAt 34 wk = <1500gAt 31 wk = <1000gAt 24 wk = <500g
25
What are the components of the HEADS adolescent screen?
H-homeE-education/employment/eating disorderA-activities/alcoholD-drugs/depressionS-safety/sex/suicide
26
What are the components of an APGAR score?
Appearance (skin color)Pulse (heart rate)Grimace (reflex irritability)Activity (muscle tone)Respiration
27
What congenital heart defect results in a biscuspid aortic valve and patent ductus arteriosus? neonate has recurrent epistaxis
Coarctation of the aortaa/w--bicuspid aortic valve--persistent ductus arteriosus--ventricular septal defect
28
What is the current guideline for intrapartum antimicrobial prophylaxis against Group B Strep?
If the mother is in labor with ruptured membranes and one of the following is present:G -- Gone -- Unknown StatusB -- Before -- Prev infant infected w/ invasive GBSS -- Soon -- During pregnancy: + bacteriuria, + vag-rec cultureDuring Labor: Premature delivery, ROM >18hrs, +GBS PCR, Maternal Fever
29
cal/mL for D10 formula?
0.34 cal/mL
30
Neonate “feeds only” amount per day
Increase 30 mL/kg/day until 150-160 mL/kg/dayDay 1: 30 mL/kg/dayDay 2: 60 mL/kg/dayDay 3: ...etc...30day=max limit
31
What effect on the fetus can occur from a mother on anticonvulsants?
Cardiac defectsMicrocephaly, dysmorphic craniofacial featureshypoplastic nails, distal phalangesIUGRMental retardationrare: methemoglobinuria
32
what is the cranial nerve affected:1 month old presents w poor feeding, suckling difficulty. she had this problem since birth. pt has a cranial dysfunction
CN IX -- glossopharyngeal
33
What supplement is recommended for exclusively breastfed infants younger than 6 months?
Vitamin D
34
What are 3 risk factors an infant is susceptible to who is small for gestational age?
HypoglycemiaHypothermiaPolycythemia
35
What 3 medications are routinely given to newborns?
1. Intramuscular Vit K2. Hepatitis vaccine (HBIG if mother is + for HbsAg)3. Erythromycin, tetracycline, silver nitrate - for gonococcal conjunctivitis
36
How old is the child:uses more than 50 words, follows two-step commands, engages in parallel play, stacks 5-6 blocks, turn pages in book, throw ball overhand, refer to themselves as "me" or "I"
2 years old-uses two word phrases
37
A 7cm mass is palpated on the right side that does not cross the midline in a 5 month old. The child was born large for gestational age with macrocephaly, macroglossia, hypospadias.what is the etiology?
Wilms Tumor - associated with Beckwith-Wiedemann syndrome = a genetic overgrowth syndromea/w omphalocoele, hemihypertrophy, hypoglycemia, large for gestational age, other dysmorphic features.
38
A 2 year old with 102.6F fever has a seizure. what should you tell the parents?
Simple Febrile Seizure = reassure parents
39
cal/mL for 22 cal formula?
0.73 cal/mL
40
Pounds to grams conversion
1 lb. = 453.59 g
41
What congenital heart condition results in a cleft anterior mitral valve leaflet?
ostium primum atrial septal defect--clefts in anterior leaflet of the mitral valve--a/w anomalies of the AV valves--possible defects on the ventricular septum
42
A child born to a diabetic mother has an absent Moro reflex on the left. left SCM appears to be in spasm. what is the cause?
clavicle fracture = absent moro reflex on affected side + spasm of SCM
43
What type of congenital heart defect:neonate is born and initial physical exam is unremarkable. holosytolic murmur is heard on day 5 of life
Perimembranous VSD--upper ventricular septum close to aortic/mitral valve--left to right shunt occurs several days after birth when pulmonary vascular resistance decreases
44
What does it mean to have a term pregnancy?
born at >37 weeks gestation
45
What are 3 side effects of stimulant medication in a child with ADHD?
1. decreased appetite2. insomnia3. decreased growth velocity
46
How old is the child:says "mama", ball", "yes", "no", "hi"turn pages in a bookgreet people, show empathylisten to story, drink from a cup
15 months
47
What are the contraindications for a child against receiving a DTaP vaccination?
1. serious allergic reaction/anaphylaxis after a previous dose2. encephalopathy within 7 days after dose
48
3 yo M w/ 3 day hx of fever, fussiness, stiff neck, decreased oral intake. Hx shows Upper resp infection one week ago. throat gram stain gram-positive organisms.Confirm w/ lateral neck radiography... Dx?
Retropharyngeal Abscess--hx of upper respiratory, throat/ear infection--may present w torticollis--S. pyogenes, S. aureus
49
2-day old male w/ numerous small papular, and pustular lesions w/ surrounding erythema on the anterior chest and abdomen. Multiple eosinophils w/o microbial organisms on Bx... Dx?
erythema toxicum neonatorum
50
Age?10-25 words, names one picture on demand. engages in pretend play (feeding doll), laughs in response to others, walk up steps, run, stack 2-3 blocks, use spoon/cup
18 months
51
what are 5 alarming symptoms following vaccination?
FUCSA1. fever > 104F2. unresponsiveness of infant3. crying > 3 hours within 48 hrs4. seizure within 3 days 5. allergic reaction
52
what is the dx:6 year old male w painful oral lesions. had similar episode one year ago. multiple round, clearly defined, small buccal ulcerations w a grayish base that are tender to palpation. lips are normal without lesions. oropharynx is clear w/o erythema, exudate or tonsilar enlargement
aphthous stomatitis (canker sores)
53
What are the 3 circumstances that "Failure To Thrive" describes?
1. Weight falls below the 3rd percentile2. Weight for height/length falls below the 3rd percentile3. Rate of weight gain slows compared to previous growth (growth chart crosses two or more major percentiles)
54
What are the screening guidelines for diabetes?when do you start screening? frequency?
Overweight (>85% weight + height or >120% weight for ideal height) +2 Risk factors:1. fam Hx2. race = NA, AA, Hispanic, Asian3. signs of insulin resistance4. maternal Hx of diabetes/gestational diabetes
55
what are 5 alarming symptoms following vaccination?
1. fever > 104F2. persistent crying > 3 hours within 48 hrs3. seizure within 3 days 4. unresponsiveness of infant5. signs of severe allergic reaction
56
dx:4 year old w fever, respiratory distress. toxic appearing, drooling, sitting upright, holding neck in hyperextension. pt rapidly develops stridor and cyanosis
Epiglottitis--lateral neck x-ray = thumb sign
57
What is the most likely inborn error of metabolism in a 2 year old that develops severe cutaneous photosensitivity?
Hartnup disease - decreased availability (transport) of tryptophan for niacin synthesis
58
What effect on the fetus/pregnancy can Cocaine and other stimulants cause?
Vasoconstriction = placental insufficiency and low birth weight
59
when does an infant1. double2. tripletheir birth weight?
1. 5 months2. 12 months
60
What immunologic abnormalities are found in ataxia-telangiectasia?
undetectable IgA levelselevated IgMnormal IgG
61
what is the pathogen:5 year old w axillary lymphadenopathy. small wound on palmar surface of the third digit adjacent to the distal interphalangeal joint. Cultures are obtained resulting in growth on Warthin-Starry stain.
Bartonella henselae
62
how does depression in adults differ than depression in adolescents?
Adult depression often includes early morning waking with difficulty sleeping at night
63
5 year old female with blood in underwear-multiple pathological fractures-tanner stage 2 breast development-multiple hyperpigmented irregularly shaped cutaneous macules
McCune-Albright syndrome--GNAS geneGnRH independent, peripheral precocious puberty from ovarian hyperfunction and cyst formation, episodic estrogen secretion--unpredictable vaginal bleeding--breast development w/o growth of pubic hair--bone lesions - polyostotic fibrous dysplasia
64
6 year old with sore throat, painful swallowing-no cough-febrile-bilateral tonsillar hyperemia, edema-lymph node enlargement in the anterior cervical chain-diffuse, pimply sandpaper-type rash on trunk and extremities
Scarlatina = rash that appears w group A streptococcal infection1. fever2. tonsillar exudates3. cervical adenopathy4. absence of cough
65
What congenital heart condition results in a persistent left superior vena cava
Total anomalous pulmonary venous connection--cyanotic--four pulmonary veins fails to make normal connection in left atrium and drain into systemic venous circulation
66
what is the most appropriate step after suspecting intussusception?
air contrast enema
67
What congenital heart defect causes a redundant tricuspid valve leaflet
Ebsteins anomaly--hypoplastic right ventricle--enlarged right atrium--most patients also have an ASD
68
when should tympanostomy tube placement be considered?
Otitis media w effusion (OEM) for 4 months+hearing loss/documented language/developmental delay
69
What effect on the fetus can tobacco use cause?
Low birth weight
70
what is the cause: lethargic newbornlump on scalp that is slowly growingfirm, fluctuant mass overlying the occiput which crosses over to the left parietal skull
subgaleal hemorrhage
71
What are the four criteria in the diagnosis of diabetes?
1. HbA1c > 6.52. fasting glucose >126mg/dL3. 2 hour fasting glucose > 200 mg/dL4. random plasma glucose > 200 mg/dL
72
Neonate caloric intake goal
100-110 cal/kg/day
73
Pathological Jaundice HPI
Onset: <24 HrsBilirubin Involved: Direct/Conjugated, >2 or >20% TotalRise: >5/day or >0.2/HrResolve: 14 days+
74
Pathological Jaundice HPI
Onset: <24 HrsBilirubin Involved: Direct/Conjugated, >2 or >20% TotalRise: >5/day or >0.2/HrResolve: 14 days +
75
Physiological Jaundice HPI
Onset: <7 daysBilirubin Involved: Indirect/Unconjugated, <10% TotalRise:<5/day or <0.2/HrResolve: w/n 10 days
76
Caffeine Citrate is used for...
Obstructive/Mixed/Central Apnea in Preterm Neonates <35wks
77
Methylxanthine is used in the NICU for...
Apnea control, precursor for caffeine
78
Central Apnea is ...
lack of inspiratory effort
79
Mixed Apnea is ...
Upper airway obstruction w/ inspiration that follows/precedes Central Apnea
80
Sx of Neonatal Abstinence Syndrome
High Pitched CryIrritablePoor FeedingPoor Coordinated Suckle
81
Obstructive Apnea is ...
Inspiratory effort present but ineffective d/t upper airway obstruction
82
A newborn male child has a flat facial profile, upslanted palpebral fissures, epicanthal folds, a small mouth with a protruding tongue, small genitalia, and simian creases on his hands. What of the following chromosomal disorders is most likely in this child?
Tri 21
83
Sign/Sx of congenital hypothyroidism
Cretinism -- severely stunted physical and mental growth
84
Sign/Sx of congenital hypothyroidism
Cretinism
85
Deficiency that causes: Night blindness, xerophthalmia, Bitot spots, follicular hyperkeratosis; immune defects
Vitamin A
86
Deficiency that causes: reduced bone mineralization
Vitamin D
87
Deficiency that causes: Hemolysis in preterm infants; areflexia, ataxia, ophthalmoplegia
Vitamin E
88
Deficiency that causes: Prolonged prothrombin time; hemorrhage
Vitamin K
89
Deficiency common w/ Malabsorption; breastfed infants
Vitamin D
90
Deficiency common with protein-calorie malnutrition; malabsorption
Vitamin A
91
Sx: Pitting Edema, Hypo-albumin, normal weight, muscle atrophy, abdomen is distended, bowel sounds hypoactive. moon facies
Kwashiorkor -- Protein malnutritionAfrican child
92
Sx: Muscle and adipose wasting, hair and skin is dry and thin, bradycardia, hypothermia
Marasmus -- Complete MalnutritionConcentration camp
93
Drugs/Intoxications that cause hypoglycemia
SAD Q-TIP PA ValSalicylatesAlcoholDiabetic MedicationQuinineTMP-SMXInsulinPropanololPentamidineAckee FruitValproic Acid
94
Hypoglycemia without ketonuria suggests...
hyperinsulinism or a defect in fatty acid oxidation.
95
Scalp swelling that extends across the midline, and contains serosanguinous, subcutaneous, extraperiosteal. Involves bleeding below the scalp and above the periosteum
Caput Succendaneum
96
Bleeding between the skull and the periosteum, does not cross suture lines.
Cephlahematoma
97
A narrow pulse pressure is seen with...
pericardial tamponade, aortic stenosis, and heart failure
98
A wide pulse pressure may be seen with...
PDA, truncus arteriosus, AV malformations, aortic insufficiency, anemia, vasodilation with fever or sepsis.
99
LLSB or between LLSB and apexVibratory, musical Systolic ejection murmur decreases in upright position
Still/Vibratory/Flow/Innocent Murmur
100
Balloon septostomy is...
the widening of a foramen ovale, patent foramen ovale, or atrial septal defect via cardiac catheterization to allow flow of oxygenated blood in the presence of CHD, to prepare for, or sustain until corrective heart surgery.
101
Down Syndrome heart defects
VSDAVSDCushion defects
102
Cyanotic CHD
Right to Left Shunt1. Truncus Arteriosus2. Transposition of the Great Vessels3. Tricuspid Atresia4. TOF5. TAPVR6. Hypoplastic Left Heart
103
Acyanotic CHD
Left to Right Shunt -- "Holy" ChildASDVSDPDACoA
104
Mid-systolic click indicates...
Mitral valve prolapse
105
Turner Syn heart defects
Bicuspid AortaCoarctation of the Aorta
106
Trisomy 18 Heart Defects
ASDVSDPDABicuspid Aortic/Pulmonary ValveCoA
107
Trisomy 13 Heart Defects
ASDVSDPDABicuspid Aortic/Pulmonary ValveCoA
108
Hyperpigmentation w/ Vitiigo and Hypoglycemia, Hyopnatremia, Hyperkalemia
Addison Disease, get ACTH stimulation test
109
Pt presents w/Floppy BabySmall HeadBulbous noseCleft PalateForked UvelaTOFInterrupted Aortic ArchTruncus ArteriosusLong, tapered fingers... Dx?
Velocardialfascial syndrome
110
Fluid Maintenance Therapy Guideline
4-2-14 ml/kg/hr for the first 10 kg2 ml/kg/hr for the next 10 kg1 ml/kg/hr for remaining kgOver 20 kg: Wt in kg + 40 = Maintenance ml/kg/hr
111
Painful Buccal/Lip/Gum Ulcers along w/ GU Ulcers that scar and Uveitis...Dx?Other findings?
Bechet DzRed papule following skin prick, skin lesions, vasculitis
112
IV Flow Rate Calculation
Vol (Drops per min)/time in min
113
Drop rates for:BloodRegularMicrodrop
Blood = 10/mlRegular = 15/mlMicrodrop = 60/ml
114
Fxn abdominal pain or HA that has no constitutional Sx...Dx?
New life stress
115
Swollen knees/anklesAbdominal painPurpuric rash on feet/legs/buttocksRenal pathology
Henoch-Scholein Purpura
116
Infant presents w/ severe cough, resp failure, apnea. What vaccine was missed by the older sibling.
Tdap
117
First line tx for acute OM
High Dose Amoxicillin
118
FeverAchy jointsHTNEdemaCoughDyspneaHemoptysisDiffuse alveolar hemorrhageRenal Sx
Goodpasture Syn
119
Cardiac finding in Marfan
Mitral prolapse
120
Long Thin FaceHyperflexiblePectus ExcavatumHigh arch palateDental OvercrowdingScoliosisDx?
Fragile-X
121
Follow up management on UTI
Renal ultrasound >> all Males >> all Females <5 yo >> Females >5 yo w/ more that two UTI
122
Small EyesFlattened nasal bridgeThin lipMid-fascial hypoplasiaCardiac septal defectDx?
Fetal Alcohol Syn
123
Asx infant w/ possible drain cleaner ingestion. PE unremarkable, next step....
Admit for possible esophageal endoscopy
124
Diffuse rales and wheezingHyper inflated LungsFlat diaphragmPatchy atelectasisHypoxiaCoughReduced appetite
RSV Bronchiolitis
125
Newborn Reflexes
BDRMSTGMoroDanceRootSuckTonic NeckBabinskiGrasp
126
CF pt w/ pancreatic dysfxn presents w/ hemolytic anemia. Why?
Deficient in Vit ADEK d/t decreased lipase. Extensive Vit E deficiency may lead to hemolytic anemia.
127
Children w/ high milk and low meat intake are at of ...
iron deficiency anemia
128
Fever, weight loss, painless nodes... next step?
CXR
129
Easy bruising, hypermobile, hyperelastic skin, slow wound healing... Dx?
EDS
130
Full testicle with twisted mass, non-tender, positive cremaster
Vericocele
131
DKA pt present w/ acidosis, hyponatremia, hypokalemia. IV NS bolus given next step?
IV NS w/ potassiumThe hyponatremia is dilutional
132
Physical Nadir of a newborn
Infant 6-12 weeks has a drop in Hgb to 9-11.Normal occurrence, no intervention needed.
133
Infant has increased renin levels, other vitals/labs normal. Most likely causes (3)
Renal Thrombosis CoACongenital Renal Abnormality (Stenosis, Parenchymal Disease, Wilms Tumor)
134
Aniridia presents w/...
absence of pupil
135
Infant presents w/:DysuriaHematuriau/l painless abdominal massHTNFeverConstipationAniridia
Nephroblastoma: Wilms Tumor
136
A 2-year-old girl is brought to the emergency room after her mother discovers a mass in the girl's abdomen while bathing. The girl occasionally cries when urinating, but is otherwise asymptomatic, without any abdominal pain. On exam, she is found to be hypertensive. There is a palpable, non-tender mass on the right side, which does not cross the midline. A chest radiograph is ordered to assess for lung involvement.
Wilms Tumor
137
Toddler w/:Chest painDyspneaShort PRWide QRSNormal Sinus Rhythm
WPW
138
6 mo w/ nl birth, no PMH presents w/ neuro delay, exaggerated startle response, and no organomegaly...Dx?
Tay-sachs
139
15 mo old w/ nl birth, no PMH presents w/ gargoyle facies, clouded corneas, heart dz, skeletal deformity, hepatomegaly, development delay... Dx?
Hurler syn
140
3 mo w/ nl birth, no PMH presents w/ hepatomegaly, FTT, Resp Tract infxn, irritable.Progresses to hypotonia, develop delay, spastic, rigid, and introversion... Dx?
Neimann-Pick Dz
141
3 yo w/ nl birth, no PMH presents w/ course facies, short for age, hepatosplenomegaly, Skeletal abnormality, vision loss, hearing loss, retardation... Dx?
Hunter Syn
142
Tx for Digoxin toxicity
Digoxin Immune Fab
143
Testicular cancer suspected. Initial work up includes...
U/SAFPBeta-hCG
144
6 mo girl w/ nl birth, no PMH presents w/ rapid decline in motor skills, hypotonia, hand-wringing, introversion, FTT...Dx?
Rett Syn, X-Linked Dominant
145
1 wk old w/ nl birth, no PMH presents w/ a 2 cm raised well circumscribed non-fluid lesion over the lumbar spine. Next step?
U/S to r/o spina bifida
146
9 mo old w/ nl birth, no PMH presents diarrhea, abdominal pain, distention, flatulence, delay tooth eruption, aphthous stomatitis, growth delay, tympanic abdomen... Dx?
Celiac Sprue
147
2 yo prev healthy child presents with black maxillary teeth and nl mandible teeth... Dx?
Bottle Feeding Caries
148
Ig _ crosses the placenta and transfers some imunity
IgG
149
Cyanotic one day old presents w/ grade 1 gallop, hepatomegaly, diminished pulses, RVH...Dx?
TAPVR
150
Asx toddler turns blue and faints following a tantrum...Dx?
Breath-holding
151
Two week old presents with a painless mastoid mass and head tilted/flexed to the same side.
Congenital Torticollis
152
16 yo w/ Fever, HA, Sore Throat, Abdominal Pain...Dx?
Strep Pharyngitis
153
Tongue coated in white w/ prominent red papilla
Strawberry Tongue
154
Low back pain that decreases throughout the day, fatigue, pain in achilles/plantar fascia...next step?
X-ray of the spine
155
Causes for fractures in infants other than abuse...
Rickets (Secondary Hyperparathyroid)Osteo imperfecta
156
Neonate presents w/:Irregular port wine stain on face that follows CNVHamartoma of eye/skin/CNSSeizures Mental retardationAmblyopia...Dx?
Sturge-Weber Syn
157
Infant presents w/:Posterior Fossa AbnormalityHemangiomaArterial AbnormalityCardiac DefectEye Abnormality... Dx?
PHACE Syn
158
Child presents w/6+ cafe au lait spots >5mmADHDAxillary FrecklesFamHx of seizures...Dx?
NF1
159
Reasons not to breastfeed...
Varicella 5 days prior/2 days after birthIllicit drug useActive, untreated TBChemoHIVActive HSVInfant w/ galactosemiaRadiation
160
Tx for labial fusion...
Estrogen Cream
161
Newborn presents w/Large hands and feetHypoplastic concave nailsDiminished pulse in legsRedundant neck folds... Dx?
Turner Syndrome
162
Fever, rash, splenomegaly, sore throat that follows an ampicillin tx...
Mononucleosis
163
Newborn presents w/MicrocephalyRetardationThrombocytopeniaBlindnessHearing lossJaundiceAnemiaScattered calcification throughout cortex... Dx?
Toxoplasmosis
164
Prev healthy 3 yo presents w/ hoarseness, PE unremarkable...Dx?
Vertical HPV in resp tree
165
Flu like Sx with tender adenopathy along w/ vesicles on GU and cervix... Dx?
HSV
166
Short child w/ recurrent skin infections, abscess formation, osteomyelitis and PNA w/ a likely immunodeficiency... Dx?
Chronic Granulomatous Dz
167
Pseudo albinismOcular albinismFrequent infections...Dx?
Chediak-Higashi Syndrome
168
Every 21 days (-ish) pt presents w/:Oral ulcersFeverStomatitisPharyngitis... Dx?
Cyclic Neutropenia
169
Neonate presents w/ Poor ToneProlonged JaundiceEnlarged fontanelleExcessive sleepHoarse cryFTTCoarse faciesConstipation... Dx?
Hypothyroid
170
Infant presents w/ VomitingMusty smellEczemaSeizuresSelf-mutilation... Dx?
PKU
171
Infant presents w/ JaundiceIrritableHepatomegalySmells of boiled cabbage... Dx?
Tyrosinemia
172
Infant presents w/ Projectile vomitLethargicSmells of sweaty feet... Dx?
Isovaleric Acidemia
173
Greasy, scaly plaque that causes hair loss...
Seborrheic Dermatitis
174
Uniformly broken hairs, black dots on scalp, circle lesion...
Tinea Captitis
175
Permethrin is used to tx ...
Lice and scabies
176
Pneumococcal pneumonia classically presents as...
Sudden onset of high feverRespiratory distressLobar consolidationElevated white blood count with left shift
177
GBS presents as ...
Sudden onset of respiratory symptoms HypothermiaRespiratory failureDiffuse bilateral granular infiltratesNeutropenia with marked left shift
178
Causes of PNA in neonate...
GBSE. ColiListeria
179
Patient between 5 to 20 years of age with a several day or week history of cough and low gradefever who has evidence of pneumonia likely has ...
MycoplasmaTx w/ macrolide
180
Age?Uses dada or mama specific to each parentUses simple gestures (waving bye) and copy gesturesRespond to simple requests and pull up to stand.
12 months
181
Age?Puts on clothingWashes and dries handsCombines two different wordsName a picture, and can throw a ball overhand
24 months
182
Age?Dress with supervisionCopy a crossDraw a man of three partsKnows first and last nameUse plurals.
48 months
183
Nenonate presents w/FeverDecreased FeedingSunken FontenelleNormal - High Urine outputHypernatremiaDilute Urine... Dx?
DI
184
Electrolyte disturbances in hyperthermia
```
Elevated
* Creatine Kinase
* Hyperphosphatemia
* Hyperuricemia
* Cardiac Troponin I
* Hyperkalemia
Depressed
* Hypoalbuminemia
* Hypocalcemia
```
185
Infant has high white count and recurrent infections w/o pus. Sig PMHx include delayed cord seperation at birth...Dx? Transmission?
LADAutosomal Recessive
186
4 wk M presents w/ vomiting, dehydration, hyponatremia, hyperkalemia.Dx?
CAH, most likely 21-hydroxylase-deficency
187
Excessive circulating thyroid stimulating IgDx?
Graves Dz
188
Mom has fever, sore throat, headache, tender posterior auricular and suboccipital lymphadenopathy, and a diffuse rose-pink colored maculopapular rash...neonate most likelt to present w/...
Rubella Congenital Defects:1. Hearing Loss2. Cataracts/Glaucoma3. PDA/Aortic Stenosis4. Blueberry Rash
189
A child who develops intermittent excess gas and diarrhea suggests ...
an infectious agent or food intolerance
190
Teenager w/ fever, joint pain, weight loss, pallor, and joint edema. Evaluate for ...
ANA, SLE
191
Topical benzocaine has recently been identified as a cause of ...
methemoglobinemia
192
Tx for OE
Topical steroids and oral Abx
193
Howell Jolly bodies indicate ...
Asplenia/Hyposplenia
194
Tx w/ phenytoin can cause ... anemia, ... will be seen on blood smear
Folate Deficent Hypersegmented PMN
195
Micro Anemia + Basophilic Stippling...Dx?
Lead Intoxication
196
The only reasons not to give a vaccines...
* Anaphylactic allergy
* Live vaccines in severely immunocompromised
* Encephalopathy within seven day
* MMR or varicella in the pregnant patient
197
Emperic Tx for PID
CeftriaxoneDoxycyclineMetronidazole
198
First meningococcal vaccine given at ___ yo.2nd at ___ yo>
1116
199
Premature infant being started on enteral feeds presents w/ temperature instability, abdominal distension, increased feeding residuals, apnea, and bradycardia.Imaging shows dilated loops, abnormal gas pattern, and bowel wall edema...Dx?
Necrotizing Enterocolitis
200
3 to 4 mo w/ “doll’s face” presents with seizures, hypoglycemia, hepatomegaly, lactic acidosis, massive hyperlipidemia, and hyperuricemia.
Von Gierke disease
201
2 mo presents w/ hypotonia, macroglossia, hepatomegaly, and profound cardiomegalyDeath w/n first year d/t cardiorespiratory failure
Pompe disease
202
Newborn presents w/ bulging, thin membrane over the introitus... Dx?... Next step?
Imperforate hymenU/S
203
Yellow fever is a mosquitoborne virus infection endemic in parts of northern South America and in central Africa. The classic description is of Child w/ recent travel presents w/ sudden onset of fever, headache, myalgia, lumbosacral pain, nausea, and vomiting, flushing of the face, conjunctivitis, and red tongue. Sx improve for a few days, but then a recurrence of the fever, gastrointestinal symptoms, jaundice, renal failure, seizures, and coma ensue.... Dx?... Tx?
Yellow FeverSupportive
204
A soft, short, medium pitched systolic ejection click at the apex of the heart that does not change with Valsalva maneuver suggests a ...
bicuspid aortic valve
205
Pt w/ sickle cell and history of fever, cough, and increased work of breathing suggests ...
pneumonia or chest syndrome
206
Appy is suspected, next step?
U/S
207
Sickle cell pt has osteomylitis, most common bug?
Salmonella
208
An afebrile child with a recent upper respiratory infection who has groin and thigh pain, and mild limp is suspicious for having ...
toxic (transient) synovitis
209
HTN is more prevelant in babies that spend time in ...
rhe NICU
