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Shelf exams > Pediatric Shelf > Flashcards

Pediatric Shelf Flashcards

1
Q

osteosarcoma

A

location: metaphyses of long bones
risk: most likely in boys 13-16
presentation: pain for a few months that gets progressively worse
xray: sunburst and codman trianlge
labs: ESR, alk phos

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2
Q

lead fingerstick screen is positive in child. what next?

A

test VENOUS blood lead levels, decide to treat based on levels

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3
Q

causes of prepubertal vaginal bleeding (4)

A

1- withdrawal of maternal estrogen
2- trauma
3- rhabdomyosarcom –> will usually visualize tumor
4- foreign body –> TP is most common, will have foul smelling discharge

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4
Q

a child develops isolated petechiae after a cold, what do you do?

A

ITP
just skin: watch, should resolve in 6 months
skin+ bleeding: IVIg and clucocorticoids

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5
Q

how do you manage hydroceles in the newborn

A

watch and wait. most resolve by 12 months. If it doesnt, surgery to prevent inguinal hernia

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6
Q

vague differentiation between sickle cell disease and trait on electrophoresis

A

Trait: HbA +HbS
Disease: NO hba, all HbS and HbF

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7
Q

triad of brain abcess

A

fever
focal neuro change ***** this is differentiating factor between abscess and meningitis
HA (morning or night)

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8
Q

signs of galactosemia in newborn infant

A 
hypoglycemia (jerking movmeents)
bilateral cataracts
jaundice
HSM
FTT
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9
Q

first step in workup of female OLDER than 14 with primary ammenorrhea and no breast development?

A

FSH
lack of breast= lack of estrogen
High FSH= peripheral cause
Low FSH= central cause

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10
Q

CT with or without contrast for concussion w/u?

A

WITHOUT. contrast can confound appearance of accute blood.

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11
Q

association: neonatal abstinence syndrome

A

opiate withdrawal

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12
Q

classic demographic for SCFE?

A

obese male complaining of hip pain

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13
Q

treatment for sickle cell yo reduce pain crises?

A

hydroxyurea

side effect: myelosuppression

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14
Q

in sickle cell disease, how do retics respond in 1) aplastic crisis 2) splenic sequestration

A

1) decreased

2) increased

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15
Q

complete androgen insensitivty aka…

A

testicular feminization syndrome

pt has absent uterus and upper vagina with cryptorchid testes

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16
Q

differentiate a rathkes cleft pouch cyst from craniopharyngioma on CT

A

Craniopharyngioma is associated with Calcifications

sx of both: bitemp hemaniopsia, pituitary stalk compression –> endocrinopathies

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17
Q

most common causes of microcytic anemia in children (2)

A

iron deficiency –> high TIBC, high RDW
thalasemia –> high retic, high iron

**beta thalasemia has increased HgbA2 on electropheresis

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18
Q

down syndrome patient presents with upper motor neuron signs and changes in behavior. dx?

A

atlantoaxial insability

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19
Q

hemophilic arthropathy

A

cause: repeated hemarthrosis in hemophilia A/B
why: hemosiderin and firbin deposition in joint

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20
Q

trachoma

A

leading cause of blindness world wide
chlamydia A,B,C
follicular conjuncitivtis / inflammation

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21
Q

ages that you check lipids for well visits?

A

9-11, 17-21

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22
Q

polycythemia in newborn

A

hct>65%

risk factors: GDM, delayed cord clamping, maternal HTN

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23
Q

androgen insensitivity karyotype

A

46,xy
genetically male but phenotypically female –> do not respond to androgens
normal female external genatalia, but lack uterus

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24
Q

rash of scarlet fever:

A

sand paper rash

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25
Q

effect of granulosa cell tumor in kid

A

precocious puberty –> malignant estrogen secreting

26
Q

abd seq of HSP?

A

ileo-ileal intussusception second to bowel wall edema

27
Q

no wheeze, tachypnea, high CO2 in an asthmatic

A

respiratory failure –> intubate!

28
Q

most common cause of orbital cellulitis?

A

sinusitis
h flu
s aureus
s pneumo

29
Q

bx of aplastic anemia

A

hypocellular marrow with fatty infiltrate

30
Q

most common offenders in viral myocarditis in kids?

A

adeno

coxsackie b

31
Q

you see hepatomegaly in a babe looking like a bronchiolitic/asthmatic. Why?

A

viral myocarditis –> right heart failure causing hepatic congestion

32
Q

equinovarus deformity

A

cerebral palsy

  • risk: prematurity
  • hypertonia/hyperreflexia in lower extremeties with both feet pointing downward and inward
33
Q

most common presentation of cerebral palsy in babe

A

spastic parapalegia

34
Q

features of craniopharyngioma (most common brain mass in children)

A
  • endocrinophaties –> pit stalk compression
  • vis field defects –> bitemp hem
  • CALCIFICATION on imaging *** distinction from other masses
  • derived from rathkes pouch
35
Q

comobrbidities of absence siezures?

A

AAA
absence
anxiety
ADHD

36
Q

signs of aplastic crisis in sickle cell anemia

A
  • rapid drop in Hgb
  • low retics <1
  • no splenomegaly
37
Q

seq of PUV in utero?

A
  • on ultrasound –> hydronephrosis from bladder obstruction and oligohydramnios from decreased urination
  • pulmonary hypoplasia
38
Q

potter sequence

A

pulmonary hypoplasia
limb deformities
flat facies

from low amniotic fluid

39
Q

hereditary angioedema

A

C1 inhibitor dysfunction/ deficiency

-non inflammatory edema of face, lips, genitalia, trachea

40
Q

metatarsus adductus vs congenital clubfood

A

MA- medial deviation of forefoot with nl position of hibd foot –> reassurance

CC - medial/ upward deviation of forefoot and hindfoot with rigid poisitioning –> serial casting

41
Q

congenital diaphragmatic hernia, and signs in utero

A
  • abdonminal viscera herniates into chest –> pulm hypoplasia, pulm hypotension
  • 85% of cases on left –> decreased breathsounds
  • can cause concave and barrel shape chest

In-utero: polybydramnios due to compression of esophagus

42
Q

renal complications of sickle cell trait

A

hematuria –> papillary necrosis, shows normal RBC, usu resolves spont

RCC

UTI

43
Q

mccune albright triad (3 Ps)

A

Precocious puberty
Pigmentation: cafe au lait spots
Polyostotic fibrous dysplasia: bone deformities

44
Q

clinical manifestations of vitamin d deficiency rickets

A
  • craniotabes (ping pong skull)
  • genu varum
  • delayed fontanel closure
  • rachitic rosary –> costochondral joint hypertrophy
45
Q

lab value for neonatal polycythemia? name some common causes. how do you treat?

A

Hct > 65%

delayed cord clamping, maternal diabetes, maternal smoking or HTN

treat mainly with hydration

46
Q

vomiting, jaundice, poor weight gain, HM, bilateral cataracts, convulsions

A

classic galactosemia

deficiecny of G-1-P uridyl transferase

47
Q

bugs or orbital cellulitis + treatment

A

mrsa, strep, hemophilus

IV abx!!

48
Q

levonestral

A

plan b!

progeterone

49
Q

kallman

A

XLR do of GnRH and olfactory nerve migration

  • normal genotype
  • normal internal sex organs
  • delayed puberty
  • no GnRH –> low FSH, low LH
50
Q

sickle cell dz on electrophoresis

A

85-95% HbS

5-15% HbF

51
Q

lab values in HSP

A

normal plt and coag studies
hematuria with maybe RBC/ Protein
mildly Cr

treatment is supportive or steroids if req hospitalizations

52
Q

maternal blood types at risk for hemolysis

A

O-, Rh-

53
Q

cephalohematoma

A

subperiosteal hemeroage limited to one surface of bone with no crossing of suture lines
-no discoloration

54
Q

caput

A

crosses midline and suture lines

can be echymotic

55
Q

ALL

A

tdt+
PAS +
>25% lymphoblasts

56
Q

how do you treat lymes? what if the patient is < 8?

A

doxy

can’t use doxy under 8 –> use amox

57
Q

breast feeding failure jaundice. treatment?

A

first week of life
-signs: dehydration, poor feeding

lack of lactation leads to build up of bilirubin

treatment: increase feeding to stimulate milk production

58
Q

breast milk jaundice

A

> 1 week of life

normal feeding, normal exam

59
Q

herpangina

A

gray vesicles on post pharynx

summer/ early fall

60
Q

LAD

A

serum: neutrophilia

recurrent infx, impaired wound healing, absent pus
skin and mucosal infections –> periodontal infections

delayed cord separation

CD18 (integrin)

Shelf exams (40 decks)

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