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Pediatrics Flashcards

1
Q

What does epiphyseal-metaphyseal “bucket fracture” suggest in infant?

A

shaking of limbs- abuse in infant

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2
Q

Diagnosis of shaken baby syndrome

A

optho exam: retinal hemorrhages

noncontrast CT: subdural hematoma

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3
Q

What drugs predispose to congenital heart disease (4)

A

alcohol
lithium
thalidomide
phenytoin

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4
Q

Maternal illness predisposing to CHD

A

DM, PKU

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5
Q

Infection predisposing to CHD

A

rubella

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6
Q

Noncyanotic heart defects (3Ds)

A

VSD, ASD, PDA

shunt L to R

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7
Q

Cyanotic heart defects (5 Ts)

A 
Truncus arteriosus (One arterial vessel)
Transposition of great vessels (2 arteries switched)
Tricuspid atresia (3)
Tetralogy of Fallot (4)
Total anomolous pulmonary venous return (5 words)
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8
Q

What CHD presents with cyanosis within first few hours of life

A

Transposition

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9
Q

Heart defect associated with Down syndrome

A

ASD, endocardial defects

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10
Q

Heart defect associated with Congenital rubella

A

PDA

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11
Q

Heart defect associated with Turner syndrome

A

Coarctation of the aorta

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12
Q

Heart defect associated with neonatal lupus

A

congenital heart block

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13
Q

Heart defect associated with Williams syndrome

A

supravalvular aortic stenosis

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14
Q

Heart defect associated with DiGeorge

A

Tetralogy

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15
Q

Heart defect associated with maternal lithium use

A

Ebstein’s anomoly

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16
Q

Heart defect associated with neonatal thyrotoxicosis

A

Heart failure

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17
Q

Heart defects associated with maternal diabetes

A

asymmetric septal hypertrophy

transposition

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18
Q

Neonate: Harsh holosystolic murmur at lower left sternal border

A

VSD

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19
Q

Neonate: wide and fixed, split S2; systolic ejection murmur LUSB

A

ASD

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20
Q

Exam associated with PDA

A

Continuous “machine-like murmur”, loud S2, wide pulse pressure, bounding peripheral pulses

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21
Q

Holt-Oram syndrome (3)

A

absent radii, ASD, first degree heart block

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22
Q

Given to close/ open PDA

A

Indomethacin: Closes
PGE1: opens

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23
Q

Where is the most common location of coartation?

A

Just below the L subclavian artery

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24
Q

Associated with “3”s sign on CXR, rib notching

A

Coartcation

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25
Q

What is required to survive transposition

A

septal defect and PDA

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26
Q

CXR shows “egg-shaped silhouette” and increased pulm vascular markings

A

Transposition

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27
Q

Anomolies with tetralogy (PROVe)

A

Pulmonary stenosis (most imp indicator)
RVH
Overriding aorta
VSD

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28
Q

What age stranger anxiety develops

A

6mo

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29
Q

What age pincer grasp develops

A

12mo

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30
Q

Gross motor milestones:

  • 2mo
  • 4-5mo
  • 6mo
  • 12mo
  • 2years
  • 3years
A
  • 2mo: Lift head/chest
  • 4-5mo: Rolls front to back
  • 6mo: Sits unassisted
  • 12mo: Walks alone
  • 2years: Walks up/down steps
  • 3years: Rides tricycle
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31
Q

Language milestones:

  • 12mo
  • 15mo
  • 18mo
  • 2 year
  • 3 year
A
  • 12mo: 1 word, 1-step command
  • 15mo: 5 words
  • 18mo: 8 words
  • 2 year: 2-word phrases, 2-step command
  • 3 year: 3-word phrases
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32
Q

Associated with boot-shaped heart on CXR

A

Tetralogy

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33
Q

PE findings for tetralogy of fallot

A

relieved by squatting

systolic ejection murmur LUSB

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34
Q

Avg age of puberty girls, boys

Abnormal ages

A

Girls: 10.5 years, 8-13
Boys: 11.5 years, 9-14

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35
Q

GI, malignancy, endocrine diseases assoc with Down syndrome

A

Duodenal atresia
Hirschsprung’s
ALL
hypothyroid

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36
Q

What does lymphedema of hands and feet indicate?

A

Turners

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37
Q

Associated with Large jaw, testes, ears

A

Fragile X syndrome

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38
Q

What does ABG for CF show?

A

hypochloremic alkalosis

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39
Q

Most common cause bowel obstruction first 2 years of life

A

intussusception

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40
Q

Associated with “currant jelly stool”

A

intussusception

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41
Q

Associated with “sausage-shaped” RUQ abdominal mass

A

intussusception

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42
Q

Associated with projectile emesis

A

plyoric stenosis

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43
Q

Drug causing pyloric stenosis

A

Erythromycin

44
Q

Diagnosis and treatment of intussusception

A

air-contrast barium enema

45
Q

Metabolic derangement associated with pyloric stenosis

A

hypochloremic hypokalemic metabolic alkalosis

46
Q

Diagnosis of meckel’s diverticulum

A

Meckel scintography scan (technitium-99m pertechnate)

47
Q

Presents as suddem, intermittent, painless rectal bleeding in child

A

Meckel’s diverticulum

48
Q

Types of tissue in Meckel’s diverticulum (2)

A

Pancreatic, gastric

49
Q

What presents as bilious emesis in first month of life, distension, passage of blood or mucus in stool

A

Malrotation with volvulus

50
Q

AXR shows “bird-beak” appearance in children

A

Malrotation with volvulus

51
Q

AXR shows pneumatosis intestinalis in infant

A

Necrotizing enterocolits

52
Q

When do B-cell deficiencies commonly present?

53
Q

Bruton’s congenital agammaglobulinemia vs transient hypogammaglobulinemia

A

Both show increased susceptibility to infection at 6 mo (encapsulated organisms)
B cells decreased in Bruton’s not THI

54
Q

Dangerous reactions in IgA deficiency

A

Anaphylactic transfusion reaction, IVIG can lead to anti-IgA antiboidies

55
Q

Presentation of DiGeorge

A

Tetany (hypocalcemia) in first days of life

56
Q

Infections in DiGeorge

A

viruses, fungi, PCP

57
Q

Mnemonic for DiGeorge (CATCH 22)

A 
Cardiac abnormalities (transposition)
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia
22q11 deletion
58
Q

When do T cell deficiencies typically present

A

1-3 months

59
Q

Bruton’s vs CVID

A

Similar symptoms, CVID presents later (15-35yrs)

60
Q

Presents with bleeding, eczema, recurrent otitis media

A

Wiskott-Aldrich

61
Q

Caused by a defect in adenosine deaminase

62
Q

Ataxia-telangiectasia defect and presentation

A

Defect: DNA repair
Presentation: Cerebellar ataxia, oculocutaneous telangiactasias, malignancies

63
Q

Malignancies associated with Ataxia-telangiectasia (3)

A

NHL
leukemia
gastric carcinoma

64
Q

Lab findings with Wiskott-Aldrich

A

Decr IgM, thrombocytopenia

65
Q

Organisms causing infection in phagocytic deficiences

A

Catalase +
Fungi
Gram neg enteric organisms

66
Q

Prophylaxis for CGD

A

daily TMP-SMX

67
Q

Nitroblue tetrazolium is diagnostic

68
Q

Presents as omphalitis with delayed separation umbilical cord

A

Leukocyte adhesion deficiency

69
Q

Pneumonic for Wiskott-Aldrich (WIPE)

A

Wiskott-Aldrich
Infections
Purpura
Eczema

70
Q

Presents as partial oculocutaneous albinism, peripheral neuropathy, neutropenia

A

Chediak-Higashi

71
Q

Presents as Course facies, abscesses, hyper IgE, retained primary teeth, eczema

72
Q

Job’s vs WAS

A

Both: eczema, infections
Job’s: eosinophilia, abscesses, course facies
WAS: bleeding, encapsulated organisms infection

73
Q

Deficiency presents with recurrent Neisseria infections

A

Terminal complement deficiency (C5-C9)

74
Q

Presentation of C1 esterase deficiency

A

recurrent episodes of angioedema

75
Q

Kawasaki vs Scarlet fever

A

Both: strawberry tongue, rash, desquamation

Scarlet fever: normal lips, no conjunctivitis

76
Q

(pediatrics) presents with recurrent high fever, hepatosplenomegaly, salmon-colored macular rash

A

Still’s disease (RF-, ANA-)

77
Q

Polyarthritis vs pauciarticular arthritis

A

Polyarthritis: >5 joints, symmetric
Pauciarticular: <4, uveitis common

78
Q

3 common causes of otitis media

A

S. pneumo
non-typable h flu
Moraxella catarrhalis

79
Q

(pediatrics) assoc with “steeple sign” on AP film

80
Q

What antibiotic causes biliary sludging and kernicterus in newborns

A

Ceftriaxone

81
Q

Classic presentation of posttussive emesis and apnea in infant <6mo

82
Q

Treatment of pertussis

A

erythromycin

83
Q

Presents as high fever and maculopapular rash after fever breaks

A

Roseola infantum (HHV-6,7)

84
Q

rash pattern for measles, rubella, roseola infantum

A

Measles, rubella: macular papular rash from head to toe

Roseola infantum: spreads from trunk to face and extremeties

85
Q

Associated with posterior auricular lymphadenopathy

86
Q

Parvovirus B19 presentation

A

Slapped cheek, arthropathy, aplastic crisis

87
Q

Of Crigler-Najjar, Dubin-Johnson, Gilbert, Rotor which is unconj, conj?

A

Unconj: Crigler Najjar, Gilbert
Conj: Dubin-Johnson, Rotor

88
Q

Which type of hyperbilirubinemia is always pathologic in newborn?

A

Conjugated

89
Q

CXR in newborn shows ground glass appearance

90
Q

What malformation and malignancy associated with Beckwith-Wiedemenn?

A

Omphalocele

Wilms’ tumor

91
Q

Presents with bilious emesis within hours of first feeding

A

Duodenal atresia

92
Q

ACXR: Double bubble sign

A

duodenal atresia

93
Q

Most common acute leukemia in children

94
Q

Presents with bone pain, fever, anemia, ecchymoses in children

95
Q

Labs for tumor lysis syndrome

A

Hyperkalemia, hyperphosphatemia, hyeruricemia

96
Q

Presents with nontender abdominal mass (may cross midline), horner’s

A

Neuroblastoma

97
Q

Histology shows round, blue tumor cells with characteristic rosette pattern

A

Neuroblastoma

98
Q

WAGR syndrome

A

Wilms tumor
Aniridia
Gentourinary abnormalities
Mental Retardation

99
Q

Presents with “onion skin” periosteal reaction

A

Ewing sarcoma

100
Q

Location, associated symptoms for Ewings sarcoma vs osteosarcoma

A

Midshaft vs metaphyses

Ewing associated with systemic sx

101
Q

Presents with “sunburst” lytic bone lesions

A

osteosarcoma

102
Q

What are 3 possible dx with leukocoria in infants

A

Retinoblastoma
Congenital cataracts
Retinopaty of prematurity

103
Q

Presents as irritability, intermittent abd pain, peripheral neuropathy

A

Lead poisoning

104
Q

CBC shows microcytic, hypchromic anemia and basophilic stippling

A

Lead poisoning

105
Q

Chelation therapies for lead poisoning

A

EDTA, succimer (DMSA), BAL (IM dmercaprol)

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