Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

STEP 2 > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

kid with macrocytic anemia, low retic count and congenital anomalies, suspect what dX?

A

Diamond-Blackfan syndrome aka congenital hypoplastic anemia

see elevated fetal hemoglobin levels

tx: corticosteroids or transfusion therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

adolescent with nasal obstruction, visible nasal mass and frequent nosebleeds

A

juvenile angiofibroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 yo with hypoglycemia, hyperuricemia, hyperlipidemia and lactic acidosis, doll-like face

A

Von Gierke’s

Type 1 glycogen storage disorder caused by deficient glucose-6-phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

patients with precocious puberty and high LH, next step?

A

brain MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what immune deficiency predisposes to Giardia infections

A

IgA deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

kid is peeing protein, best first test?

A

repeat test in 2 weeks, then quantify with 24 hour urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx for erythema toxicum?

A

reassurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

> 25% lymphoblasts is diagnostic for what illness

A

ALL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chorioretinitis, hydrocephalus and intracranial calcs

A

toxo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

mgmt of kid with epiglottitis

A

endotrach intubation in the OR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

mgmt of kid with bilious vomiting and decreased stool output

A

gastrograffin enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

newborn with cyanosis that is aggravated by feeding and resolves with crying

A

choanal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MC complication of sickle cell trait

A

painless hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

mgmt newborn with scaphoid abdomen and respiratory distress

A

congenital diaphragmatic hernia

endotrach intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

mgmt aplastic crisis in sickle cell

A

transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when consider formula supplementation in a neonate

A

if loses >7% of birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

15yo with progressive muscle weakness, atrophy of thenar and hypothenar eminences, testicular atrophy? Dx? inheritance?

A

Myotonic dystrophy

AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when intervene in a kid with cryptorchidism?

A

if testes haven’t dropped within 6 months of birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

newborn with irritability, high pitched cry, diaphoresis, sneezing: what drug did mom abuse?

A

heroin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

kid with white eye reflex, next best step?

A

refer to optho

retinoblastoma until proven otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pt with croup with respiratory failure, next step?

A

Rac Epi before intubate, decreases need for intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

child with acute rheumatic fever with valvular dz

A

all pts wtih rheumatic fever should be treated with PCN. duration depends, but at least til 21 or in some cases 40 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

girl with precocious puberty, pigmentation adn polostotic fibrous dysplasia, dx?

A

McCune Albright

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hep B is associated with what kind of nephropathy?

A

membranous!

see low C3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

mgmt of pubertal gynecomastia

A

no workup or tx usually self resolves within 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

when begin visual acuity testing?

A

3 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

in premature babies, what increases the risk of iron deficiency anemia as infants?

A

introduction of cows milk before age 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

soft tissue swelling in feet and hands of baby with sickle cell

A

dactylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Cri du chat gene is on what chromosome?

A

5p

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

tympanic membrane with peripheral granulation and some skin debris–dx?

A

Choelsteatoma
2/2 chronic middle ear dz
retraction pocket in the tympanic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

kid presents with toxicity with anticholinergic sx

what med? what tx?

A

TCAs

Tx: sodium bicarb if wide QRS >100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

RF for intussuception in older kids

A

Meckel’s diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

kid exposed to chicken pox, nml immunity, no h/o vaccination, next step

A

vaccinate!

only give IVIG if immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

triple bubble sign and gasless colon: dx? Rf?

A

jejunal atresia

RF: mom who used cocaine or other vasoconstrictive drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what congenital cardiac defect is common in Edward’s syndrome?

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

mgmt ITP

A

observation regardless of the platelet count

if severe bleeding, give IVIG or steorids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what illness get a rash after giving ampicillin or amox?

A

Mono

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

tx gonococcal infxn in newborn

A

IM CTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

tx chlamydia infection in newborn

A

oral erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what skin lesion in newborns should be removed

A

nevus sebaceous because of concern for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

high direct bili in a 7 day old newborn dx?

A

biliary atresia

dark urine, pale stool, needs surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

baby with respiratory distress with excess drooling

A

TEF

dx: place feeding tube and do xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

umbilical hernia associated with what?

A

hypothyroidism

big tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

2 week old infant with bilious vomiting, pregnancy complicated by polyhydramnios

A

intestinal atresia or annular pancreas

assoc with downs syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

3 day old newborn hasn’t passed meconium? dx?

A

meconium ileus: dx/tx is gastrograffin enema

Hirschsprung’s: DRE –? explosion of poop, bx shows no ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what don’t you do to a newborn with hypospadias

A

circumsize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

lead poisoning tx

A

Mild 5-44: no tx, repeat in 1 month
Mod 45-69: give dimercaptosuccinic acid
>69: Dimercaprol + EDTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

neonatal fever tx

A

amp and gent until 48hr cultures negative, add cefotax if suspect meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Café au lait spots, seizures, large head, AD

A

NF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Mandibular hypoplasia, glossoptosis, cleft soft palate with FAS or Edwards

A

Pierre Robin sequence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Broad, square face, short status, self injurious behavior. Deletion on Chr17

A

Smith Magenis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Seizures, strabismus, sociable with episodic laughter. Deletion on maternal Chr15

A

Angelman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Elfin appearance, friendly, increased empathy and verbal reasoning ability. Deletion on Chr 17

A

Williams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

2 yo with multiple ear infections, diarrheal episodes and pneumonias. No tonsils on exam

A

o X-linked agammaglobulinemia
o Infections start a 6-9 months when maternal antibodies are no longer present
o Labs: absence of B cells on flow cytometry, low levels of all Igs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

17yo F with ↓ levels of IgG, IgM, IgE and IgA but normal numbers of B cells

A 
o	CVID (acquired)
o	Complication: increased lymph tissue→ increased risk for lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

MC B cell defect: recurrent UTIs, diarrhea

A

o Selective IgA deficiency

o Complication: anaphylaxis reaction if given blood containing IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

3 week old male with seizures, truncus arteriosus and micrognathia

A

o DiGeorge syndrome
o Genetic defect: microdeletion on Chr22
o Candida, viruses and PCP pneumonia infections as a kid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Infant with severe infections, no thymus or tonsils, severe lymphopenia

A

SCID

Bacterial, viral and opportunistic bugs
MC is XLR. AR is Adenosine Deaminase deficiency
Tx: peds EMERGENCY, need BMT by age 1 or death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

3yo M child with recurrent swollen, infected lymph nodes in groin and staph aureus skin abscesses

treatment?

A

Chronic Granulomatous disease XLR

PMNs can ingest but not kill catalase + bugs (NADPH oxidase deficiency)

Dx: Nitrotetrazolium blue (yellow means they have the disease) and new test is flow cytometry with DHR-123

Tx: daily bactrim and gamma interferon 3x/wk, BMT is curative but $$$

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

o 18mo M baby with severe eczema, petechiae and recurrent ear infections

A

o Wiskott-Aldrich Syndrome
o Often present with prolonged bleeding after circumcision
o ↓IgM, ↑IgA ↑IgE, slightly low IgG

decreased platelets 2/2 decreased platelet production

infections with encapsulated organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

o Delayed separation of umbilical cord, recurrent bacterial infections, necrotic skin lesions, gingivitis

A

o Lekocyte adhesion defect
o Neutrophilia without polymorphs in the infected tissue or pus
o ↓CD18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

: harsh systolic ejection murmur at L upper sternal border, single S2 – Dx?

A

tetralogy

surgery before 6 months is tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

14yo boy, starts out in 50% for height, in past 2 years is now between 5-10%

A
  • Pathologic Short Stature

* Consider: craniopharyngioma (vision problems), hypothyroidism (TSH), Hypopit (check IGF-1), Turners (check karyotype)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

MMR contraindication

A

neomycin or streptomycin allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

when are live vaccines given

A

12 months
MMR
VZV
HepA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

are febrile seizures a contraindication to tDAP?

A

no!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Newborn cyanotic, O2 doesn’t improve

A

o Transposition of great arteries
• MC: infants of diabetic mom
• No assoc murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

2yo who gets cyanotic and hyperpnea while playing, squats down

A

o Tetraology of Fallot
• VSD and RA hypertrophy, overriding aorta, pulm stenosis
• Murmur: harshe SEM + single S2
• Tx: O2 and knee-chest position, surgical correction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Bipolar woman gives birth to a child with holosystolic murmur worse on inspiration?

Assoc arrhythmia?

A

o Ebstein anomaly
o Tricuspid insufficiency 2/2 TV displacement into RV
o Associated arrhythmia: WPW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Heart defect associated with DiGeorge syndrome. CXR shows ↑ pulm blood flow and bi-ventricular hypertrophy

A

o Truncus arteriosis
o Eisenmenger develops early
o Do surgery in 1st few weeks of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Tx PDA

A

if not close by 1 week, tx with indomethacin or surgically close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Tx HOCM

A

BBs

CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

does PFO have an associated murmur?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

kid with failure to thrive in early childhood, what dx should you suspect

A

CF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

o Precocious puberty, café au lait spots and multiple bone defects
o

A

McCune Albright

5% of precocious puberty
o assoc with hyperthyroidism, prolactin or GH secreting pituitary adenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

tx Ca oxalate kidney stones

A

HCTZ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

FH of kidney stones, what are they made up of

A

cystieine, can’t resorb certain AA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

MCD tx?

A

prednisone for 4-6 weeks

make sure immunized against pneumococcus and varicella sine infection is the most common complication

79
Q

dx in a nephrotic patient who suddenly develops flank pain?

A

renal vein thrombosis

2/2 peeing out ATII, protein C and S

Do a CT or stat US

80
Q

MCC of sepsis in sickle cell kids

A

strep pneumo

81
Q

tx acute chest syndrome

A

o2, abx and transfusion

82
Q

tx sickle cell pt with stroke

A

transfusion NOT tPA

83
Q

o 4mo pale baby, normal platelets, WBCs but hemoglobin is 4. Increased RBC ADA and low retics, triphalangeal thumbs

A
  • Diamond Balckfan anemia

* Tx: corticosteroids, transfusions, stem cell transplant

84
Q

o 18 mo baby with ↓ plt, ↓WBCs and profound anemia. Has café-au-lait spots, microcephaly and absent thumbs

A
  • Fanconi Anemia
  • Dx: bone marrow shows hypoplasia, cytogenetic studies for chromosome breaks
  • Tx: corticosteroids, androgens, BMT
85
Q

2 yr old baby with hyperactivity, impaired growth, abdominal pain and constipation

A
  • Lead poisoning
  • Dx: venous blood sample, check lead level
  • Tx
  • > 45 with succimer
  • > 70 admit and tx with EDTA and dimercaprol
  • Screening: test blood levels between 12-24 mo if low SES, live in old house (
86
Q

15 yo F with recurrent epistaxis, heavy menses and petechiae. ↓plt only

A

ITP

tx: IVIG for 2 days then pred then splenectomy

NO PLT TRANSFUSION

87
Q

15yo F with recurrent epistaxis, heavy menses, petechiae, normal plts, ↑bleeding time and PTT

A

vWd

DDAVP for bleeding or pre-op
place factor VIII contains vWF if bleeding continues

88
Q

7 yo M recurrent bruising, hematuria, and hemarthroses, ↑PTT that corrected with mixing studies

A
  • Hemophilia

* If mild, tx DDAVP, otherwise replace factors

89
Q

1 week old newborn, born at home comes in with bleeding form the umbilical stump and bleeding diathesis

A
  • Vit K def
  • ↓ II, VII, IX and X
  • same in a CF kid with malabsorption
  • Tx: FFP acutely and vit K shot
90
Q

HUS tx

A

NO PLATELETS
TPN
EARLY PERIOTNEAL DIALYSIS
DO NOT HAVE ANX FOR BLOODY DIARRHEA

91
Q

2 yr old with HTN, asymptomatic abdominal mass that doesn’t ross the midline

A

Wilm’s tumor

best test: abomdinal CT, CXR for lung involvemnt
tx: surgery, cehmo, rads

92
Q

4 yo with jerking mvmts of the eyes and legs, bluish skin nodules and tender abdominal mass that crosses the midline

A

Neuroblastoma

Dx: increased urine homovanillic or vanillymandelic acid

93
Q

tx for otitis externia

A

topical cipro

94
Q

tx Croup

A

rac epi neb

steroids

95
Q

bronchiolitis tx

A

albuterol nebs

no steroids

96
Q

CXR hyperinflation with patchy atelectasis, dx?

A

bronchiolitis

97
Q

tx pertussis

A

erythromycin for 14 days + same for kids in daycare and family members

98
Q

who needs at VCUG

A

all males
females 5 with 2nd UTI
any pyelo

99
Q

5 yo male initially with a cold 1 week ago, now presents with a limp and effusion in the hip, x rays are normal, ESR is 35, T 99.8, WBCs 10k
Dx?

A

transient synovitis

next best step: bed rest for 1 week + NSAIDs

100
Q

Tx SCFE

A

surgical pinning

101
Q

good and bad prognostic factors for juvenile rheumatoid arthritis

A

good: +ANA
bad: +RF

Tx in order
NSAIDs
MTX
steroids

102
Q

Tx KD

A

IVIG

ASA

103
Q

tx febrile seizure

A

acetaminophen

no increased risk for epilepsy

104
Q

6 month old brought in for multiple symmetric contraction episodes of the neck, trunk, extremities that occur in spells

dx? tx?

A

infantile spasms

common EEG finding: hypsarrhythmia: asynchronous, chaotic, bilateral

Tx: ACTH (pred is 2nd line)

105
Q

newborn with extended wrist, decreased grip, claw hand

A

Klumpke’s palsy
C8 and T1
should resolve on own
also have ipsilateral horners

106
Q

newborn with waiter’s tip hand?

A

Erb-Duchenne palsy
C5-6
grip intact, decreased moro

107
Q

kids with CF who are less than 20 yo should get what ABx?

A

vanc bc staph is MCC of infections in CF pts who are under 20 years old

108
Q

tx for acute bacterial sinusitis

A

augmentin

109
Q

distress, dysphagia and drooling: dx and tx?

A

epiglotitis

tx = endotrach intubation in the OR

110
Q

boy with 2d history of decreased appetite, neck swelling and irritability, keeps his head slightly rotated to the side: best step in mgmt?

A

x ray

likely has acquired torticollis

MC due to URIs, minor trauma, cervical lymphadenitis and retropharyngeal abscess

need C spine films to rule out a fracture or abscess

111
Q

kid less than 2 with wheezing, crackles, tachypnea, retractions and nasal flaring, dx and tx

A

bronchiolitis

supportive tx

watch out for apnea, esp in kids less than 2 months

112
Q

angioedema due to what deficiency

A

C1INH–> elevated levels of edema producing factors C2b and bradykinin

113
Q

dx inspiratory stridor that’s worse when supine, crying or feeding and improves in the prone position?

A

laryngomalacia

dx: flex laryngoscopy, shows omega shaped epiglottis
- most will resolve on their own

114
Q

what intervention for a breech presentation before week 37?

A

nothing, usually self correct before 37th week

115
Q

workup for apnic spells? what associated with

A

CBC

associated with iron deficiency anemia

116
Q

how prevent intraventricular hemorrhage?

A

avoid preterm birth

corticosteroids

117
Q

what does APGAR tell you?

A

how newborn tolerated labor

newborn’s response to resuscitation

118
Q

mental retardation, vomiting, athetosis, seizures and developmental delay over first few months? Dx?

A

PKU

tx: low Phe diet

119
Q

Mental retardation,
direct hyperbili & jaundice
↓glc, cataracts, seizures

Dx?

A

Galactosemia

tx: no lactose for life

120
Q

when worry about neonatal jaundice?

workup?

A

Bili >12
direct bili >2
increases > 5 per day

Coombs: (+) = ABO incompat or Rh

(-) –> twin/twin or mom/fetus transfusion or G6PD, etc.

121
Q

tx for pathologic neonatal jaundice

A

phototherapy, exchange transfusion if that doesn’t work

122
Q

what do we have to rule out with direct hyperbilirubinemia?

A 
sepsis!
galactosemia
hypothyroid
choledochal cyst
CF
123
Q

how dx and treat choanal atresia?

A

dx: can’t pass a catheter, CT scan
tx: oral airway, gavage feeding, surgical repair

124
Q

tx respiratory distress syndrome

A

O2 therapy with nasal CPAP to keep alveoli open

due to Surfactant def, can’t keep alveoli open.

125
Q

38 wkLGA infant born by C/Sto an A2GDM has dyspnea/grunting, CXR is clear: dx? tx?

A

transient tachypnea of the newborn

Lung fluid not squeezed out, retained
Usually minimal O2 needed. Self-resolves in hours to days.

126
Q 
41 wkAGA infant was born
after ROM yielded greenish-
brown fluid.
*Next best step?
*Complications?
A

Meconium aspiration syndrome

Intubate & suction before stimulation

Pulmonary artery HTN, pneumonitis

127
Q

Newborn child with ambiguous genitalia. One month later has vomiting & ↓Na ↑K and acidosis.
–MC Cause?
–Definitive test?
–Tx?

A

Congenital Adrenal Hyperplasia
21 Hydroxylase deficiency. (autosomal recessive)
17-OH progesterone before and after ACTH bolus
Hydrocortisone and fludrocortisone (↑ doses in times of stress)

128
Q

Complications of newborn hypoglycemia due to GDM?

Tx?

A

Neonatal seizure (always check glc!)

Feed frequently if

129
Q

Complications of newborn hypocalcemia?

A

Neonatal seizure (always check Ca!)

130
Q

newborn with
Hydrocephalus, intracranial calcifications and chorioretinitis
dx/tx?

A

Toxoplasmosis. Tx w/ sulfadiazine + leucovorin.

131
Q

Newborn with:
Cataracts, deafness and heart defects (esp PDA, VSD), extramedullary hematopoeisis.

dx? tx?

A

Rubella. No tx.

132
Q

Newborn with Microcephaly, periventricular calcifications, deafness, thrombo-cytopenia and petechiae.

dx? tx?

A

CMV. Tx w/ ganciclovir, but won’t prevent MR

133
Q

newborn with:
Limb hypoplasia, cutaneous scars, cataracts, chorioretinits, cortical atrophy
dx? tx?

A

Congenital Varicella if mom infected 1st or 2nd trimester. If mom is exposed 5 days before –2 days after delivery, baby gets VZIG.

134
Q

DOL 3-5, bilateral purulent conjunctivitis can cause corneal ulceration.

A

Gonococcal conjunctivitis tx w/ topical erythromycin and IV 3rd gen ceph.

135
Q

DOL 7-14, red conjunctiva w/ mucoid discharge & lid swelling

Dx? tx?

A

Chlamydia conjunctivitis tx w/ oral erythromycin. Complication is chlamydial pneumonia cough, nasal drainage, scattered crackles+ bilat infiltrates on CXR

136
Q

Tx Turner’s

A

estrogen replacement for secondary sex characteristics and to avoid osteoporosis

137
Q

14 y/o boy, always been below 5% in height.
Parents are tall & were “late bloomers”.
Dx?

A

Constitutional Growth Delay

Bone age

138
Q

short kid with short parents, bone age = real age, dx?

A

Familial Short Stature

Bone age = Real age.

139
Q

what age does stranger anxiety begin

A

6 months

140
Q

tx enuresis

A

behavioral tx
DDAVP
Imipramine (2nd line because of side effects)

141
Q

immunizations at birth

A

Hep B

142
Q

Loud S1 w/ fixed and split S2. Older child w/ exercise intolerance.

dx?

A

ASD

143
Q

Continuous machine-like murmur w/ bounding pulses and wide pulse pressure.
dx?
tx?

A

PDA
Prematurity, congenital rubella syndrome
If not closed by 1wk, give indomethacin or surgically close

144
Q

MC complication of acute rheumatic fever?

A

Mitral stenosis

145
Q

Asthma: pt has sxs twice a week and PFTs are normal?

A

Albuterol only

146
Q

Asthma: If pt has sxs 4x a week, night cough 2x a month and PFTs are normal?

A

Albuterol + inhaled CS

147
Q

Asthma: If pt has sxs daily, night cough 2x a week and FEV1 is 60-80%?

A

Albuterol + inhaled CS + long-acting beta-ag (salmeterol)

148
Q

Asthma: If pt has sxs daily, night cough 4x a week and FEV1 is

A

Albuterol + inhaled CS + salmeterol + montelukast and oral steroids

149
Q

Diagnostic criteria for diabetes?

A

Fasting glc >125 (twice)2hr OGTT (75g) > 200Any glc > 200 + symptoms

150
Q

MC nephropathy?

A

IGA nephropathy, Berger’s

151
Q

best first test PSGN?

A

ASO titer

152
Q

How tx Ca-oxalate stones

A

HCTZ

153
Q

Treatment for kidney stones
–Stones 2cm
–Stones 5mm-2cm

A

Will pass spontaneously. Just hydrate

Open or endoscopic surgical removal

Extracorporal shock wave lithotropsy

154
Q

Sickle cell kid with Proteinuria and increased creatinine+ recurrent UTIs?

A

Kidney infarcts due to sickled RBCs

155
Q

Tx Thalassemia in kids?

A

Tx w/ transfusion & deferoxamine.
Can see expanded medullary space

target cells on smear

156
Q

9 y/o F with Wilson’s disease developed fulminant liver disease.
–1stfactor depleted?
–2 factors not depleted?

A

VII, so PT increases 1st

VIII and vWF b/c they are made by endothelial cells.

157
Q

TX HSP

A

Symptomatic treatment.

Can use steroids for GI or renal dz.

158
Q

3 year old girl w/ a limp & left leg pain, T = 99.9, HSM, petechiae, & pallor. Cells are shown. Cells are CALLA and TdT +

Dx?
best test?
tx?
poor prog factors?

A

ALL

Bone marrow biopsy >30% lymphoblasts

VDP + CNS tx w/ intrathecal methotrexate
10, >100K WBC

159
Q

14 y/o boy w/ enlarged, painless, rubbery nodes, drenching fevers, and 10% weight loss.
–Best test?
–And then?
–Treatment?

A

Hodgkin Lymphoma

Excisional biopsy.

Staging CT or laparoscopy. (determines tx)

Chemo + Rads. 90% cure if stage I or II

160
Q

7 year old girl with non-productive cough and large anterior mediastinal mass on CXR.
–Best test?
–Treatment?

A

Non-Hodgkin Lymphoma

Biopsy of mass, bone marrow bx for staging

Surgical excision if abdominal tumor. Can use anti-CD20 if B-cell tumor. Rads for some.

161
Q

2y/o w/ a fever to 105, 3 days later gets a pink, mac-pap rash on trunk arms and legs.

A

Roseola HHV6

162
Q

2y/o w/ a low grade fever, lacy reticular rash on cheeks and upper body (spares the palms/soles)
–Who is this bad for?

A

5th Disease/Erythema Infectiosum-Parvovirus B19

Preggos, sickle cell, thalessemia

163
Q

Fine, mac-pap desquamating rash begins on chest and spreads to neck, trunk, & extremities+ strawberry tongue. Sore throat 1-2wks prior.
–Treatment

A

Scarlett Fever, Group A strep

PCN prevents rheumatic fever. (won’t help reduce changes of APSGN)

164
Q

Cough, runny nose, fever macular rash begins behind ears & spreads down. Gray spots on the buccal mucosa.
•Tx?

A

Measles

Vit a + supportive care

165
Q

Sore throat, joint pain fever pinpoint rash on the face and spreads down. Rose spots on the palate.
•Complications?

A

Rubella

congenital rubella syndrome

166
Q

Baby with poor feeding. Vesicles in the mouth on palms and soles + rash on buttocks.

A

Coxsackie virus

Hand-foot and mouth

167
Q

16 year old M with swollen parotid glands, fever & HA.

•Complications?

A

Mumps(paramyxovirus)

Orchitis and sterility

168
Q

6y/o kid from coastal NC, went camping. Had fever, myalgias, abdpain.
–Complications?
–Treatment?

A

Rocky Mountain Spotted fever. Rickettsia rickettsii
Vasculitis and gangrene
Doxy no matter what age

169
Q

Inflamed conjunctiva and multiple blisters. Nikolsky’s+/

–Treatment?

A

Staph Scalded Skin Syndrome
From exfoliative toxin
Tx w/ IV ox or nafcillin

170
Q 
2 y/o w/ fever to 102, tugging on his right ear. Patient’s tympanic membrane is red and bulging.
–Most sensitive dx test?
–RF?
–Treatment?
–Complications?
A

Otitis Media
Limited mobility on insufflation or air-fluid level

↓SES, Native Americans, formula fed, tobacco smoke, around kids

Amox or azithromycin for 10days. If no improvement in 2-3 days, switch to amox-clav

Effusion-place tubes if bilat effusion >4mo or if bilateral hearing loss.

171
Q

A child presents w/ “muffled voice”, stridor and refuses to turn her head to the left.

A

Retropharyngeal abscess

I&D for C&S. GAS + anaerobes. 3rdgen ceph + amp or clinda

172
Q

Indications for tonsilectomy?

A

> 5 episodes of strep/year for 2 years or>3 episodes/year for 3 years

173
Q

1 y/o w/ fever to 100.5 & “barking” cough and loud noises on inspiration.
–Most common bug?
–X-ray buzzword?
–Treatment?

A

Croup
Parainfluenza virus
“steeple sign”
Mist, epinephrine neb, steroids

174
Q 
2 y/o w/ fever to 104 & drooling w/ intercostal retractions and tripod position.
–Most common bug?
–X-ray buzzword?
–Next best step?
–Treatment?
A

Epiglottitis
H. Flu B only in unimmunized Strep pyo, strep pneumo, staph

“thumbprint sign”

Go to OR and intubate

Anti-staph abx + 3rdgeneration cephalosporin

175
Q

Specific findings for chlamydia pneumonia?

A

Staccato cough, eosinophilia

176
Q 
9mo infant w/ runny nose, wheezy cough, T = 101.5, and RR = 60. Retractions are visible and pulse ox is 91%.
–Most common bug?
–CXR findings?
–Treatment?
–Who needs vaccine?
A 
Bronchiolitis
RSV. 
Confirm w/ swab
Hyperinflation w/ patchy atelectasis
Hospitalize if respiratory distress. Albuterol nebs. NO steroids

Palivizumab for premies, CHD, lung dz, immune dz

177
Q

Tx pertussis

A

erythromycin for 14 days

178
Q

UTI follow up in kids?

A

Test of cure to confirm sterility

179
Q 
2y/o F w/ a 2 wk history of daily fevers to 102 and a desquamating rash on the perineum. She has swollen hands and feet, conjunctivitis and unilateral swollen cervical lymph node.
–Other lab findings?
–Best 1st test?
–Treatment?
–Most serious sequelae?
A

Kawasaki

↑plts (wk2-3), ↑ urine WBC, ↑LFTs, ↑CSF protein
2D echo and EKG.

Repeat the Echo after 2-3wks of tx

Acute = IVIG + high dose aspirin.
Then aspirin + warfarin

Coronary artery aneurysm or MI

180
Q

More diffuse bone pain in a patient w/ petechiae, pallor and increased infections

A

Don’t forget bone pain can be presenting sx for leukemia

181
Q

Anytime you see a meningocele or myelomeningocele…

A

Do a head CT looking for hydro-cephalus. (Arnold Chiari II)

182
Q

Anytime you see an infant with a head circumference >95th%…

A

Consider hydrocephalus. Also bulging fontanelle, ↑DTRs, HA, vomiting.

183
Q

Noncommunicating hydrocephalus

A

Stenosis of CA, tumor/malformation near 4th ventr

184
Q

Communicating hydrocephalus

A

SAH, pneumoncoccal/TB meningitis, leukemia

185
Q

Infant with increasing head size, prominent occiput, cerebellar ataxia and delayed motor development.
–Dx?
–What will you see on CT or MRI?

A

Dandy-Walker malformation

Cystic expansion of 4th ventricle. Can see Agenesis of cerebellar vermis.

186
Q

8y/o w/ difficulty w/ balance while walking, no DTRs, bilateral Babinski and “explosive, dysarthricspeech”.
–Most common cause of death?

A

Friedrich Ataxia
AR, trinuc repeat

HOCM –> CHF.

187
Q

2y/o w/ gait disturbance, loss of intellectual fxn, nystagmusand optic atrophy. Cresylviolet metachromatic staining.
–Pathophys?

A

Metachromatic leukodystrophy

AR Deficiency of arylsulfatase A accum cerebroside sulfate

188
Q

12y/o w/ decreased school performance, behavior changes, ataxia, spasticity, hyperpigmentation, ↑K, ↓Na, acidosis.
–Prognosis?

A

Adrenoleukodystrophy XLR

Death w/in 10 years

189
Q

9mo who had previously been reaching milestones starts to lag. Seizures, hypotonia, cherry red macula
Pathophys?

A

Tay-Sachs
XLR
Def of hexosaminidase A accum GM2

190
Q

3mo infant lays in the “frog-leg” position,

A

SMA 1-Werdnig Hoffman Disease

Most die before age 2

191
Q

6y/o is brought in 2/2 “clumsiness” and frequent falls. The lower leg has decreased muscle bulk and appears “stork-like”. There are multiple small injuries on the hands and feet. You notice pes cavus and claw hand.
–Dx?
–Tests?
–Treatment?

A

Marie-Charcot-Tooth Disease
Decreased motor/sensory nerve vel, sural nerve bx. *CPK is normal Stablize ankles w/ surgical fusion. Usually normal lifespan and most remain ambulatory.

192
Q

tx meningitis 0-4 weeks?

A

Amp + cefotax

193
Q

tx meningitis 1 year to 50 years?

A

Vanc + CTX

194
Q

pt presents with recent URI and neovascularization of cornea: dx?

A

trachoma
2/2 Chlamydia

dx: giemsa
tx: topical azithro or tetracycline

STEP 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions