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USMLE Step 3 > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Course of action for diaphragmatic hernia during birth of child_____

A

NG + low pressure intubation until lung maturation

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2
Q

_____ is a midline abdominal wall defect associated with Patau (Trisomy 13), Edward (Trisomy 18) syndromes

A

Omphalocele

For large defects, have to encage in a Silo, will have to do step wise manual reductions until surgery is possible

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3
Q

Double Bubble Sign (Pediatrics)
______________
_____________

A

Annular pancreas

Duodenal atresia (bilious vomit)

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4
Q

intestinal atresia is associated with ______

A

Vascular malformations

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5
Q

Meconium ileum is pathpnemonic for ______

A

Cystic fibrosis

Tx: Gastrograffin Enema

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6
Q

Infant with progressive jaundice for 6+ weeks, after accounting for breast milk jaundice etc.

A

Biliary atresia

Dx: Abd US

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7
Q

How to diagnose Hirschprung_____

A

Rectal biopsy : failure in migration of neural ganglia controlling contracting/relaxation of colon, resulting in megacolon

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8
Q

Ocular infections

1) ______ shows up the earliest : Day 2
2) _____ shows up later : Day 7

A

Gonorrhea

Chlymidia (Oral erythromycin)

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9
Q

port wine + seizures + retardation + glaucoma _________ syndrome

A

Sturg Weber (GNAQ mutation, vascular malformation)

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10
Q

_____ skin tags are more concerning, associated with hearing loss, renal injury

A

Peri-auricular

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11
Q

Umbilical hernia is associated with _____

A

Hypothyroidism

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12
Q

CHARGE Association

A

coloboma, heart defect, nasal atresia, GU, Ear

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13
Q

Biliary atresia is associated with ____ syndrome

A

Downs

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14
Q

blueberry muffin + microcephaly + periventricular calcifications ______

A

Rubella

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15
Q

Blueberry muffin + sensorineural hearing loss

A

CMV

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16
Q

Intracranial calcifications + hydrocephalus + chorioretinitis

A

Toxoplasmosis

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17
Q

Teratogen : IUGR, Hypoplastic nails, typical facies _______

A

Phenytoin

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18
Q

__________ is the congenital heart lesion most commonly associated with supraventricular tachycardia.

A

Ebstein anomaly (R atrial enlargement, inferior displacement of tricuspid valve)

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19
Q

______ causes craniofacial abnormalities

A

ACE inhibitors

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20
Q

_____ causes NTD, mental retardation

A

Valproate, Carbamazepine

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21
Q

_____ and _____ are cardiac defects associated with Turners syndrome

A

Bicuspid Aortic Valve

Aortic Co-arctation

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22
Q

________ is associated with single umbilical artery

A

Patau (Trisomy 13)

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23
Q

Horseshoe kidney associated with________

A

Klinefelter (XXY), also hypogonadism

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24
Q

Marfan is a defect in _______

A

Fibrillin (lens displacement , aortic root dissection )

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25
Q

Organ enlargement : macrosomia, macroglossia, hypoglycemia (b cell hyperplasia), reno-megaly + Wilms Tumor __________

A

Beckett Weidmann Syndrome (IGF-2)

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26
Q

_______ kind of pediatric bone tumor results in sunburst pattern on CXR

A

osteogenic sarcoma

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27
Q

Rhinorrhea, sore throat, hoarseness, barking cough, inspiratory stridor________

A

Croup

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28
Q

Age of Croup generally____

A

3 - 5 years

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29
Q

Treatment of croup

A

nebulizer epinephrine, steroids

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30
Q

Muffled voice (hot potato), drooling, dysphagia, high fever, inspiratory stridor, tripod positioning (breathing issue), no barking cough_______. Characterized by _____ sign on XR Neck

A

Epiglottitis

Thumbprint

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31
Q

Two diseases requiring Rifampin prophylaxis to household members

1) N. Meningitides
2) _________

A

Epiglottitis

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32
Q

Biphasic stridor concerning for _____

A

vascular ring in trachea

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33
Q

URI, fever, wheezing cough, dyspnea tachypnea in children age <2_______

A

RSV Bronchiolitis , salvage Prophylaxis for high risk children: Palivizumab

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34
Q

meconium ileus, steatorrhea (pancreatic insufficiency), pneumonia (S.Aureus, H influenzae, Pseudomonas), rectal prolapse, missing vas deferens , are constellations of ___________

A

Cystic Fibrosis

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35
Q

_____ is a treatment for CF only for G551D mutation

A

Ivacaftor , unfortunately on 5% of cases are this point mutation

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36
Q

_____ is the feature that distinguishes Neiman Pick vs Tay Sachs

A

Neiman Pick = Hepatosplenomegaly

Both: Cherry red macula, neuropathy

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37
Q

_____ enzyme is defective in Tay Sachs, resulting in ____ accumulation

_____ enzyme is defective in Neiman Pick, resulting in ____ accumulation

A

Hexaminidase A, Ganglioside

Sphingomyelinase, Sphingomyelin

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38
Q

_____ is a glycogen storage disorder caused by deficiency in _____ leading to cardiomegaly + hypotonia

A

Pompe, Lysosomal Acid Maltase

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39
Q

____ is a glycogen storage disorder , caused by deficiency in _____, results in easy fatiguability, second wind phenomena

A

McArdle

Muscle Phosphorylase

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40
Q

______ is a glycogen storage disorder resulting in neurologic effects (ataxia, dementia), deficiency in _________ enzyme

A

Metachromatic Leukodystrophy

Arylsulfatase (accumulation of cerebroside sulfate)

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41
Q

Most specific test for PSGN_____

A

Anti DNA-se B

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42
Q

Most common complication from Minimal change disease, therefore requiring immunization for pneumococcus + varicella____

A

SBP

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43
Q

Treatment for minimal change disease____

A

Steroids for 4-6 weeks

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44
Q

Three kinds of rickets
1) Vitamin D deficiency : Calcium elevated, due to high PTH as feedback
2) Vitamin D Dependant (Failure to convert to 1,25 form) : but all labs normal
3______ : Only condition where vitamin D 1,25 is low

A

X linked hypophos, kidney cannot absorb phosphate for bone mineralization

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45
Q

Treatment for congenital hip dysplasia (Ortolani/Bartlow +)_____

Leg-Calve-Perthes caused by _____ of the femoral head

A

Pavlik Harness

Avascular Necrosis

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46
Q

Constellation of fever, conjunctivities, erythematous rash, desquamation of fingers, cervical unilateral lymphadenities, strawberry tongue______

Complications_____

Treatment_______

A

Kawasaki (medium vessel arteritis)

Coronary artery aneurysm, myocarditis

IVIG, high dose aspirin

*Kawasaki looks like Measles (Rubeola) in symptoms

47
Q

Recurrent pyelonephritis in child, think ______

A

vesicoureteral reflux : caused by inadequate closure of ureterovesicular junction

Have to start prophylactic bactrim, in setting of multiple prior UTI

48
Q

Recurrent UTI in child

A

posterior ureteral valves

49
Q

_____ is a leading cause of iron deficiency anemia in infants

A

Cows milk instead of breast milk

50
Q

Cutoff lead value for initiation EDTA____

Lead lab tests: Peripheral smear (basophillic stippling), microcytic hypochromic anemia like iron deficiency, increased free erythrocyte porpyphrins

A

45

51
Q

Treatment of acute pediatric seizure_____

A

Rectal Benzos

52
Q

Typically, febrile seizures do not increase risk of epilepsy (T/F)

A

True, unless <9 months, status epiliptius

53
Q

Antiepileptics can be stopped after seizure free for ____ years

A

2

54
Q

AM jerky movement may be a hint to ______ disorder

A

Juvenile myoclonic epilepsy (Tx: Valproate)

55
Q

Best test for Duchenne dystrophy_____

Treatment______

A

PCR genetic test, not muscle biopsy (fat replacement of muscle), caused by frameshift mutation

Steroids

56
Q

Empiric therapy for neonatal sepsis

1) Ampicillin + Gentamycin
2) Cefotaxime (meningitis concern)
3) ______, if child <28 days

A

acyclovir

57
Q

2 infections requiring rifampin for household contacts

1) _____
2) _____

A

H.influenzae

N meningitidis

58
Q

Catscratch disease caused by ________, treatment______

A

Bartonella

Azithro/Doxy

59
Q

Most common complication of pediatric meningitis_______

A

Hearing Loss

60
Q

Palms and Soles Rash

1) Rocky Mountain Spotted: Starts in the hands
2) Cocksakie; Hand Foot Mouth
3) Toxic Shock Syndrome
4) _________

A

Secondary Syphillis

61
Q

Causes of direct bilirubinemia in children sepsis, TORCH, TPN, hypothyroid, ____, _____

A

Galactosemia, Tyrosinemia

62
Q

Indirect bilirubinemia

1) Phototherapy if Bili>_____
2) Exchange transfusion if ______

A

10

Neurological symptoms (concern for kernicterus)

63
Q

Blueberry muffin rash + sensorineural hearing loss____

A

CMV

64
Q

Blueberry muffin rash + cataract + microcephaly + periventricular calcifications_____

A

Rubella

65
Q

Hydrocephalus + Chorioretinitis + intracranial calcifications______

A

Toxoplasmosis

66
Q

Turners associated with : bicuspid aortic valve, aortic co-arctation, _____

A

Hypothyroidism

67
Q

erythromycin mechanism is blockage of ______ activity, used for chlymidia

A

bacteria ribosome function

68
Q

Key things for suspected Sturg Weber______

A

Evaluate eyes

Anti-epileptics

69
Q

Aniridia in an infant is associated with _______

A

Wilms tumor (Kidney)

70
Q

Branchial cleft cyst is ____ positioned, does not move with the tongue, do not have to actively manage

A

Lateral

71
Q

____ is an odd test for respiratory distress of a newborn

A

Cranial ultrasound (Hemorrhage causing respiratory distress)

72
Q

Surfactant _____ surface tension, produced by type ____ pneumocytes, usually in full swing late in the pregnancy (35 weeks)

A

Decreased, Type 2

If <34 weeks, give bethamethasone to mother to improve fetal lung maturity, L/S<2.5

73
Q

Complications of premature lungs

1) _____
2) ARDS
3) Retinopathy
4) Cerebral Hemmorhage

A

bronchopulmonary dysplasia

74
Q

Infant with tachypnea immediately after C section______

A

transient tachypnea of newborn, just suction or watch

75
Q

TEF fistula results from_____

A

failure of the division of foregut into esophageal parts

If you suspected VACTERL, you have to find the other shit: ECHO, US Renal, XR Limbs

76
Q

TEF fistula results from_____

A

failure of the division of foregut into esophageal parts

If you suspected VACTERL, you have to find the other shit: ECHO, US Renal, XR Limbs

77
Q

anything that impinges fetal swallowing = polyhydramnios (TE fistula, duodenal atresia, annular pancreas)

Mechanism of annular pancreas______

A

Failure of the ventral bud to rotate with the duodenum, so it impinges it

78
Q

Sign of phototherapy success = decrease by____ every q4-6 hours

A

2 mg/dL

79
Q

You cannot give naloxone to infants due to _____

A

Seizure risk for opiate withdrawal in this population

80
Q

Prenatal exposure of these cause:

1) _____ hypoplastic nails, typical facies, IUGR
2) _____ bone stippling, facial abnormalities

A

Phenytoin

Warfarin

81
Q

Cardiac defects associated with downs: VSD, ASD, _____

A

PDA (Prostaglandins keep the duct open, blockers such as NSAID will close it)

82
Q

____ renal issue associated with Trisomy 18

A

polycystic kidneys, ectopic double ureter

83
Q

WAGR Syndrome characterized by : ____

A

Wilms, aniridia, GU abnormalities, retardation

84
Q

Beckett Weidmann Syndrome (IGF-2 dysregulation) is associated with _____ cancer

A

Wilms tumor, hepatoblastoma (screen with AFP + ultrasound q6 months)

85
Q

Beckett Weidmann Syndrome (IGF-2 dysregulation) is associated with _____ cancer

A

Wilms tumor, hepatoblastoma (screen with AFP + ultrasound q6 months)

86
Q

______ sequence associated with alcoholism, characterized by mandibular hypoplasia, cleft palate. Risk of airway obstruction in first 4 weeks of birth

A

Pierre Robin

87
Q

New marfan diagnosis, you should get a _____ to make sure aortic root is stable

A

ECHO

88
Q

Both constitutional growth delay and genetic short stature will have parallel normal velocities, BUT ____ has lower bone age

A

constitutional, also later puberty

89
Q

Scenarios where weight gain is normal but not lenght gain in a child______

A

1) Skeletal dysplasia (normal bone age)
2) Thyroid deficiency
3) Growth hormone deficiency
4) Cushings

90
Q

____ enuresis pattern is likely representative of real physiologic problem (UTI, DI, Constipation, Abuse)

A

Diurnal, not just at night

91
Q

Measles has live components, so can only give vaccine after age ___. In contrast Rubella/Mumps have no post exposure prophylaxis

A

6 months - 12 months

92
Q

Hep A prophylaxis

1) Age< 12 months____
2) Age>12 months_____

A

Ig Only, need to be atleast 12 months

Ig + Vaccine

93
Q

Dont forget ____ during suspected child abuse

A

dilated eye exam

94
Q

Steeple sign narrowing on CXR is concerning for _____

A

Croup

95
Q

Epiglottitis without drooling or dysphagia_____

A

Bacterial tracheitis

96
Q

CXR finding for RSV bronchiolitis_____

A

Hyper-inflated lungs, hospitalize if RR>60

97
Q

Most common type of ASD_____

A

Secundum, primary requires surgical repair

98
Q

Treatment for pulmonic stenosis______

A

Balloon valvuloplasty, prostagland (keeps PDA open)

Also give prostaglandin for aortic stenosis

99
Q

Most common cyanotic heart defect______ found after infancy

Most common cyanotic heart defect found during infancy _____

A

TOF: R ventricle hypertrophy, over-riding aorta, VSD, outflow tract obstruction

D Transposition: PDA dependent

Tricuspid Atresia: Total loss of RV,RA, relies on ASD/VSD, PDA for survival

100
Q

____ characterized by VSD, abnormal connection between aorta and pulm artery

A

Truncus Arteriousus

101
Q

____ murmur, findings of ebstein anomaly

A

holosystolic tricuspid regurg murmur, tall P wave, R axis deviation

102
Q

____ parasite may cause chronic malabsorption

A

Giardia (duodenal aspirate)

103
Q

Test for volvulus/malrotation_____

A

Ultrasound/ Barium enema

104
Q

Test for volvulus/malrotation_____

A

Ultrasound/ Barium enema

105
Q

Pediatric Cystitis Treatment

A

Pyelonephritis: Ampicillin + Gentamycin + Ceftriox

Tetracyclines after age 7 (Rememeber 8 x2 = 16)

Quinlones after age 16

106
Q

Treatment of PSGN____

A

Penicillin + Supportive , antihypertensives if hypertensive

107
Q

Management after diagnosis of Minimal Change Disease

A

Normal C3/C4

Steroids

Vaccinations: Varicella/Pneumococcus

108
Q

Treatment of Kawasaki______

A

High dose aspirin + IVIG, maybe warfarin Plt high

109
Q

Very high voltage , slow irregular waves can be a sign of this epilepsy disorder______. Treated with prednisone, B6, ACTH

A

West Syndrome, associated with downs syndrome

Highly irregular semiology of seizure

110
Q

Treatment of generalized myclonic seizure____

A

Topiramate, else Valproate/Carbamazepine

111
Q

For Duchene, the issue is a frameshift deletion of ______ gene

A

Dystrophin

Dx: Gene Test

Tx: Steroids, Eteplirsen (miRNA exon binder)

112
Q

Absolute child safe cephaosporin______

A

Cefotaxime

113
Q

Absolute child safe cephaosporin______

A

Cefotaxime

114
Q

_____ is a Glycogen storage disorder characterized by neuropathy, leads to accumalation in ceremide

A

Fabry

USMLE Step 3 (19 decks)

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