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AMC September 2024 > PEDIA AMEDEX > Flashcards

PEDIA AMEDEX Flashcards

1
Q

Rubella

A

German measles

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2
Q

Rubeola

A

Measles

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3
Q

Roseola infantum is also known as

A

Exanthem subitum / sixth disease and three day fever

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4
Q

Roseola infantum is caused by

A

HHV 6 / HHV 7 / Enteroviruses such as coxackie virus A and B, echovirus / adenovirus and parainfluenza type 1

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5
Q

Roseola infantum commonly affects

A

infants mostly 6-18 months

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6
Q

Roseola infantum course

A

3-5 days of high fever up to 40C or higher then resolves abruptly then rash

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7
Q

Roseola infantum rash

A

maculopapular rash from the neck and trunk the to the face and extremities, not purpritic

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8
Q

Nagayama spots

A

Roseola infantum

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9
Q

Whooping cough is caused by

A

Bordatella pertussis

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10
Q

Guidelines for admission of patient with pertussis (2)

A
  • infants less than 6 months of age
  • any child with complications (apnea cyanosis pneumonia encephalopathy)
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11
Q

Indication for antibiotics in a patient with pertussis

A
  • patient is diagnosed in catarrhal or early paroxysmal phase (may reduce severity)
  • cough for less than 14 days (may reduce spread; reduces exclusion period)
  • the patient is admitted to the hospital
  • there are complications
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12
Q

Chemoprophylaxis for pertussis is indicated

A
  • child < 6 months
  • < 3 doses of vaccine
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13
Q

blisters of varying stages, macules and papules

A

chicken pox

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14
Q

school exclusion of chicken pox

A

after all the blisters have dried out

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15
Q

PDA

A
  • frequently an isolated phenomenon
  • pansystolic machinery like murmur at the LSB
  • wide pulse pressure
  • definitive management: surgical closure
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16
Q

difficulty in internal rotation and abduction in children aged 4-10

A

Transient synovitis or irritable hip

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17
Q

most sensitive test for TS

A

Log roll test

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18
Q

Treatment

A

bed rest for 7-10 days and the use of crutches to avoid weight bearing of the affected joint
Meds: Paracetamol or NSAIDs

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19
Q

Oppositional defiant disorder

A

Risperidone

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20
Q

Recommendation for premature isolated adrenarche

A

Followup every 3-6 months

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21
Q

GI abnormality most associated with Down syndrome

A

Duodenal atresia or stenosis sometimes associated with annular pancreas

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22
Q

Delayed passage of meconium

A

Hirschsprung disease

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23
Q

Acute bronchiolitis cause

A

RSV

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24
Q

Clinical presentation of acute bronchiolitis

A

cough, coryza + wheezy breathing + tachypnea = hyper-inflated chest with subcostal retractions

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25
Q

LCP features

A

painless limp
trendelenberg gait or abductor lurch
unilateral or successively with contralateral hip joint

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26
Q

LCP is also called

A

AVN of the proximal femoral epiphysis;

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27
Q

Management of LCP

A

Ortho referral
Reduce weight from affected joint
Maintain the femur abducted and internally rotated
Assessment of disease progression via xray

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28
Q

Ultrasound indications for UTI

A

In all children younger than the age of 3 years of age with the first episode of UTI
< 1 year old = ultrasound should be performed first and if normal the next step is VCU
> 1 year of age = ultrasound alone

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29
Q

Deficient in breast milk

A

Vitamin K - can cause intracranial hemorrhage

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30
Q

Infantile hypertrophic pyloric stenosis metabolic picture

A

Increased pH, decreased KCl, increased pCO2 and HCO3
immediate non bilous projectile vomiting in a 3-6 week old baby
demands to be re-fed immediately
olive like mass at lateral edge of the rectus abdominis muscle

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31
Q

vaginal bleeding in the first week after birth

A

maternal estrogen withdrawal

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32
Q

most common cuase of bloody vaginal discharge
may also be purulent

A

Foreign body

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33
Q

nappy rash

A

monilial candida vulvovaginitis

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34
Q

most common suppurative complication of AOM

A

Acute mastoiditis

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35
Q

Common pathogen for acute mastoiditis

A

Streptococcus pneumoniae - 1st
Hib - 2nd

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36
Q

Treatment of acute mastoiditis

A

Flucloxacillin + 3 generation cephalosporin

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37
Q

Acute mastoiditis clinical features

A

postauricular inflammatory signs such as erythema, edema, tenderness and fluctuance
Edema of auricle and or external canal (prior)

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38
Q

Laryngomalaicia (5)

A
  1. noisy breathing - audible wheeze when a baby inhales often worse when the baby is agitated, feeding, crying or sleeping on his back
  2. high pitched sound
  3. difficulty feeding
  4. poor weight gain
  5. choking while feeding
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39
Q

croup / LTB is commonly caused by

A

distinctive seal barking cough and inspiratory stridor
tracheal tug

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40
Q

cause of LTB

A

Para influenza virus type 1

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41
Q

Epiglottitis presentation

A

may lead to sudden obstruction and death
maintains head extended
noisy breathing
sore throat dysphagia high fever drooling inspiratory stridor
4ds: dysphagia, dysphonia, drooling, and distress

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42
Q

Treatment goals for epiglotitis

A

airway protection and antibiotics

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43
Q

Acute bronchiolitis treatment goal

A

oxygen and hydration

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44
Q

hot potato voice

A

epiglotitis

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45
Q

Epiglotitis cause

A

Hib

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46
Q

Retrophayngeal abscess

A

similar to epiglotitis but with bacterial upper respiratory tract infection preceding

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47
Q

until when is the index case of measles excluded from school

A

4 days after rash

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48
Q

exclusion of unvaccinated exposures of measles

A

14 days after the appearance rash on the index case

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49
Q

Croup treatment is based on severity

A

mild
- dexa or
- prednisolone or
- budesonide

severe
- adrenaline + dexamethasone or prednisolone

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50
Q

most common cause of painful rectal bleeding

A

anal fissure

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50
Q

SCFE first symptom

A

hip stiffness that subsides with rest

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50
Q

SCFE (4)

A

limp and irritaility of hip movement
knee pain referred from affected hip
on flexion of the hip it rotates externally - hip is often on external rotation on walking
most movements are restricted especially internal rotation

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51
Q

3 important management principles of SCFE

A
  1. cease weight bearing and refer urgently
  2. if acute slip, gentle reduction via traction is better than manipulation
  3. once reduced pinning is performed
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52
Q

most common intraabdominal tumor of childhood

A

Wilms tumor or nephroblastoma

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53
Q

classic presentation of neproblastoma on physical examination

A

smooth firm non tender palpable abdominal mass that usually does not cross the midline

other manifestations; hematuria, fever, hypertension, abdominal pain

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54
Q

most common solid extracrainail tumor in children

A

neuroblastoma

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55
Q

Neuroblastoma clinical presentation

A

hard, irregular, non tender, extends beyond the midline
loss of apetite
protrusion of both eyes

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56
Q

lobar pneumonia clinical features

A

fever + dob + pale ill and grunting, shallow respiration, normal chest auscultation

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57
Q

bronchiolitis most characteristic findings

A

inspiratory fine crackles

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58
Q

intentional unauthorized or illegal absence from compulsory schooling

A

Truancy

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59
Q

Truancy

A

attempt to draw attention or to make an impression on pears
caused by anger at school or problems at home
children sometimes go on to break laws more seriously when they are older
child tries to hide his or her action from parents
common in low socioeconomic status

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60
Q

Encopresis defenition

A

Voluntary or involuntary passage of formed semiformed or liquid stool into a place other than the toilet for more than 1 time per month for at least 3 months in a child > 4 years

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61
Q

delay to pass meconium
scybalous pebble like hard stool for at least 2 weeks
anal canal devoid of stool on examination with sudden evacuation of stool on digital examination

A

Hirschsprung disease

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62
Q

Hirschsprung disease pathophysiology

A

absence of ganglia in the distal colon resuling in functional obstruction

63
Q

meconium ileus due to obstruction of the ileum by viscid meconium may be the earliest sign of

A

cystic fibrosis

64
Q

Hirschsprung disease diagnosis

A

full thickness rectal biospy

65
Q

congenital megacolon

A

Hirschsprung disease

66
Q

ribbon like stools

A

Hirschsprung disease

67
Q

vaccine that has the highest amount of egg protein and contraindicated to patient hypersensitive to eggs

A

Yellow fever vaccine

67
Q

dilated bowel loops with air fluid levels and a granular ground glass material

A

Hirschsprung disease

68
Q

bilous vomiting + schaphoid abdomen

A

midgut volvulus

69
Q

Medications for postherpetic neuralgia

A
  • TCA: amitriptyline and noretriptylline
  • Anticonvulsants: gabapentin
  • opiods: morphine and tramadol
70
Q

Egg containing vaccines

A

mmr
influenza
yellow fever
typhoid

71
Q

medication that decrease both acute and postherpetic pain

A

valacyclovir

72
Q

acquired malabsorption that resolves when the patient is exposed to gluten free diet

A

celiac sprue

73
Q

type of anemia associated with celiac disease

A

microcytic anemia with low serum ferritin levels

74
Q

curant jelly stools

A

intussusception

75
Q

HFMD is casued by

A

coxscakie virus type A

76
Q

Incubation period of varciella

A

11-21 days

77
Q

right hypochondrium sausage shaped-mass and emptiness in the right lower quadrant

A

Dance sign of intussuception

78
Q

currant jelly stools

A

intussusception

79
Q

medications for varicella zoster should be given within __ houRs to prevent viral replication

A

48

80
Q

when should influenza virus be given

A

2nd and 3rd trimester

81
Q

Diagnostic PE finding in patients with NEC

A

pneumatosis intestinalis

82
Q

NEC is typically seen in the

A

NICU in premature infants

83
Q

Molluscum contagiosum (4)

A

2-5mm slightly umbilicated flesh colored dome shaped papules
spread by inoculation
self limited
clear spontaneously in 6-9 months

84
Q

Wassel definition

A

infantile colic
unexplained paroxysmal bouts of fussing and crying that lasted >3 hours per day for > 3 days a week for > 3 weeks duration
no vomitting, normal stools, no weight loss

85
Q

leading cause of congenital hearing loss

A

cmv

86
Q

shallow oral ulcerations confined to the posterior pharynx

A

Herpangina

87
Q

gingivostomatitis that involves the anterior mounth

A

herpes infection

88
Q

petechiae on the soft palate in infectious mononucleosis are referred to as

A

Forchheimer spots

89
Q

treatment of volvulus in the elderly

A

decompression by a sigmoidoscope

90
Q

treatment for hypertropic pyloric stenosis

A

longitudinal pylorotomy

91
Q

measles is caused by

A

paramyxovirus

92
Q

roseola is caused by

A

HV6

93
Q

german measles is also called

A

rubella

94
Q

Erythema infectiosum or 5th disease is caused by

A

Pravovirus B19

95
Q

Orchitis/ (3)

A

pain or orchitis is relieved by gently elevating the testis
when diagnosed in prepubertal males, no need for antibiotics
incidence has diminished since the introduction of mmr

96
Q

mid abdominal pain and diaphoretic but elicits no intensity of pain during abdominal palpation

A

intestinal ischemia

97
Q

pain in the right lower quadrant

A

celcal volvulus
appendicitis

98
Q

common causes of acute onset facial nerve palsy in children

A

AOM
Lyme disease

99
Q

subacute sclerosing panecephalitis is associated with

A

measles

100
Q

throglossal duct cyst most common complication

A

infection

100
Q

medication for herpes simplex keratitis

A

idoxuridine

101
Q

SVT >6 months

A

ice pack

101
Q

SVT in neonates

A

immersion of face in water

102
Q

SVT toodlers

A
103
Q

most common cause of AOM in children >6 weeks

A

S. pneumoniae (1)
H. influenzae

104
Q

most common cause of AOM in neonates

A

RSV

105
Q

cyanotic when laid on back (mild) however O2 increases when the baby is crying. next step?

A

rigid NGT

106
Q

cyanotic when laid on back (mild) however O2 increases when the baby is crying. diagosis and diagnostics?

A

choanal atresia
rigid NGT

107
Q

CHARGE syndrome

A

coloboma, heart difect, atresia choanae, retarded growth and development, ear abnormality
females&raquo_space;
abnormality in upper airway

108
Q

coanal atresia

A

once confirmed
o2, oropharngeal airway
intubation if life threatening
ct scan

109
Q

treatment for primary nocturnal enuresis

A

desmopressin (minirin) spray

110
Q

family name

A

4 years old

111
Q

bleeding post tonsiellectomy management
(late bleeding) cause

A

infection of tonsillar fossa

112
Q

management of post tonsillectomy hemorrhage

A

resuscitation - 2 large bore cannula
reservation of crossmated rbc
iv antibiotics 1.2 g benzyl penicillin + metronidazole
analgesia without nsaids
hydrogen peroxide gargle (1:6)

113
Q

diphtheria, tetanus, and acellular pertussis (DTaP) vaccine schedule

A

Administered at 2, 4, and 6 months of age.

114
Q

enuresis is cutoff

A

5 years old

115
Q

Management of Pertussis Exposure for symptomatic individuals

A

If symptoms of pertussis develop, treatment with azithromycin (first-line antibiotic) should be started within the first 21 days of symptom onset to reduce the severity and transmission of the disease.
Infected individuals should be isolated for at least 5 days after starting antibiotics to prevent spreading pertussis to others.

116
Q

very common cause of wheezing in children younger than 12 months

A

bronchiolitis

117
Q

common cause of wheezing in children younger than 5 years

A

asthma

118
Q

wheezing associated with feeding

A

reflux

119
Q

wheezing when supine

A

laryngomalacia

120
Q

unilateral wheezing

A

foreign body aspiration

121
Q

benign murmur

A

murmur increases when the child is supine

122
Q

asymptomatic hematuria in the background of febrile illness other than uti next step

A

assess after uti

123
Q

hematuria in the background of uti next step

A

urine culture

124
Q

asymptomatic hematuria confirmation

A

2 positive urine exams out of 3 in 2-3 weeks before any further assessment

125
Q

Marfan (3)

A

aneurysms dilatation, aortic regurgitation, aortic root dissection

126
Q

AR murmur

A
127
Q

mid systolic ejection murmur at the 2nd rics

A

HOCM

128
Q

Austin flint

A

> low pitched rumbling mid diastolic mumur over the apex
heard in severe AR

129
Q

pan systolic murmur at LSE with no radiation

A

VSD

130
Q

machinery murmur at 2nd lics

A

PDA

131
Q

murmur in marfan

A

ASD

132
Q

Daytime bladder control and coordination usually occurs by

A

4 years of age

133
Q

Night-time bladder control typically takes longer and is not expected until a child is

A

5–7 years old.

134
Q

Typically treatment is not started before age _____, as there is a high rate of spontaneous resolution

A

6 years

135
Q

Rotavirus vaccine

A

first dose cant be given after 12 weeks of age since high incidence of intussuception

136
Q

intermittent fevers well between fevers

A

roseola

136
Q

rash of roseola

A

maculopapular or erythematous
beginning on the trunk and may spread to involve the neck and extremities
non pruritic
blanches on pressure

136
Q

Varicella is given at

A

18 months with MMR as single dose or at 14 years old and up, 2 doses, at 4 week intervals

136
Q

Bronchiolitis obliterans is caused by

A

adenovirus

136
Q

adenovirus manifestations

A

folicular conjunctivitis, gastroenteritis, intussuception, hemorrhagic cystitis, myocarditis

initial symptoms: cough, chest pain, hemoptysis
symptoms abate then worsens

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AMC September 2024 (8 decks)

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