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DIT STEP 2 > PEDIATRICS > Flashcards

PEDIATRICS Flashcards

1
Q

Genetics in Noonan’s syndrome

A

Common AD disorder due to mutation to genes involved in RAS-MAP-K pathway
Can affect both males and females (big difference between Turners)

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2
Q

Thickened helices

A

Noonans syndrome

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3
Q

Severe h/a and dizziness in pt with Noonans syndrome – > screen for

A

Arnold Chiari malformation

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4
Q

Cardiac malformations that contrast Noonans vs Turners

A

Noonans: right sided heart lesions, HOCM
Turners: left sided

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5
Q

Diseases associated with Turners

A

Lymphedema
DM-1
Hashimotos
Autoimmune disorders

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6
Q

Difference between Sotos syndrome and Beckwith-Wiedemann

A

BW features hypoglycemia during newborn period, macroglossia, umbilical hernia and/or omphalocele.

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7
Q

Tumors assoc with Beckwith Wiedemann

A

10% will go on to develop small round blue cell tumors, most commonly Wilm’s.

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8
Q

Croup pathogens

A

RSV, influenza, adenovirus, and parainfluenza virus ** most common.

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9
Q

Moderate/severe croup tx

A

oral or IM corticosteroids, INHALED racemic epinephrine.

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10
Q

Pathogens for Epiglottitis

A

USED to be H. influenza type B.

Now, strep, non-typable H influenza and viral agents.

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11
Q

Subglottic narrowing

A

croup

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12
Q

Supraglottic narrowing

A

epiglottitis

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13
Q

Epispadias is associated with/

A

Bladder extrophy

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14
Q

Where is the testicle usually found in cryptorchidism?

A

Inguinal canal.

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15
Q

Hydrocele is a remnant of what embryological structure

A

Tunica vaginalis.

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16
Q

How do you treat hydocele

A

It will usually resolve within six months.

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17
Q

Abnormality associated with hypospadias

A

Chordee, a ventral curvature of the peniis. The growth differences between the attenuated ventral urethra and its associated tissues, and the normal growing dorsal tissue, is thought to cause this. It is often apparent during an abreaction.

It is also highly a/w cryptorchidism and inguinal hernias.

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18
Q

How many DTaPs do you get

A
  1. Four doses are adequate if the last dose was given on or after the 4th birthday. Should be completed through age 6.
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19
Q

If DTaP was given before age of 4 and the fifth vaccine was not given, what vaccine should you administer?

A

Trap starting at 7 years of age.

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20
Q

Vaccine given to children under 7 y.o. who have a contraindication to pertussis vaccine

A

DT

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21
Q

Tx of pertussis

A

Macrolide like azithromycin.

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22
Q

Tx usually given in a pt allergic to penicillin with strep pharyngitis

A

Azithromycin or other macrolide.

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23
Q

Atypical pneuma usually antibiotic class of choice

A

Azithromycin/macrolide.

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24
Q

Iron studies in a thalassemia patient

A

Normal to high ferritin

Normal to low TIBC

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25
Q

Labs in sickle cell

A

Low Hgb

Elevated reticulocyte count, as it is a hemolytic anemia.

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26
Q

Sideroblastic anemia : iron labs

A

Microcytic, incrased serum ferritin

TIBC saturation is normal or elevated.

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27
Q

An alternative to inhaled glucocorticoids as long-term asthma control agent

A

Montelukast, a leukotriene receptor antagonist

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28
Q

Kienbock’s disease

A

AVN and collapse of the lunate so frequently encountered in individuals who overuse the wrist through repetitive compression loading.

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29
Q

Downey cells

A

MONO!

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30
Q

Metamyelocytes differentiate into?

A

Eosinophils
Basophils
Neutrophils

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31
Q

RMSF rash

A

Blanching erythematous rash with macule and is located on palms of hands and soles of feet. Moves centrally and becomes more petechial in appearance.

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32
Q

Other sx of RMSF

A 
Headache
Confusion
Conjunctival erythma
Pedal edema
Fever
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33
Q

Micro of rickettsia rickettsii

A

Gram negative intracellular obligate coccobacillus.

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34
Q

Rickettsia rickettsii injures blood vessels how?

A

Cause direct vascular injury. Release of prostaglandins –> increased vascular permeability. This causes edema, hypovolemia, hypoalbuminemia, and hypotension. Occasionally, thrombi form due to destruction of endothelial lining by bacteria, resulting in vascular necrosis and thrombosis.

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35
Q

If you get RMSF and can’t take tetracyclines, how do you treat it

A

Chloamphenicol.

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36
Q

How do tetracyclines work

A

Inhibit protein synthesis by binding to the 30S unit of ribosomal bacteria.

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37
Q

MOA of quinine

A

Inhibits parasite growth by changing the internal pH of the organism.

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38
Q

SE of anti malarials

A

Prolongation of QT intervals

Methemoglobinemia.

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39
Q

Tx of choice in non bullous impetigo

A

Mupirocin. Its effective at eradicating staph aureus and GABHS skin infections.

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40
Q

How do we eradicate nasal colonization of MRSA in adult patients and health care workers

A

Mupirocin

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41
Q

Neurologic impairment: TTP or HUS?

A

TTP

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42
Q

Tx for TTP or HUS

A

Plasma exchange.

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43
Q

Low APGAR scores + persistent respiratory distress + CXR with bilateral patchy opacities

A

Meconium aspiration syndrome

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44
Q

Meconium aspiration syndrome is most often seen in what cases

A

Advanced gestational age.

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45
Q

Patients with meconium aspiration syndrome are increased risk of developing what?

A

Persistent pulmonary hypertension. CAuses chronic stress to pulm vasculature, leading to thickening of the vessel walls. This leads to acidosis and hypoxia.

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46
Q

MeCP2 gene mutation

A

Rett syndrome.

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47
Q

HFE mutation

A

Hemochromatosis.

48
Q

ECG in PDA

A

High voltage in elads V1 - V6 (LVH)
RAD and inverted T waves in leads V1-V3 consistent with RVH
Tall, peaked P waves in lead II consistent with right atrial enlargement.

49
Q

Type II arnold chiari presents with herniation of?

A

cerebellar vermis

50
Q

Type I arnold chiari presents with herniation of

A

Cerebellar tonsils.

51
Q

Tx of shigella

A

Azitrhomycin or ciprofloxacin.

52
Q

Fanconi anemia

A

Inheritedd syndrome of BM failure presenting with short stature, hypo pigmented spots on skin, thus abnormalities, microcephaly, and hypogonadism. Mild to moderate thrombocytopenia with mild MACROcytic anemia.

53
Q

Chills, diaphoresis, anorexia, dry cough, a dull frontal headache and myalgia BEFORE the onset of a high fever

A

Typhoid fever. Diarrhea may accompany in children.

54
Q

2 congenital dz assoc with mitral regurg

A

Marfan syndrome

HOCM

55
Q

Marfan syndrome and syphilis are assoc with what heart valve defect?

A

Aortic regurg

56
Q

Heart valve abnormality in Turners

A

Besides coarctation, also aortic stenosis d/t bicuspid aorta.

57
Q

Why would coarctation o the aorta present with cariogenic shock in the first few weeks of life?

A

ductus arterioles closed. Tx if IV PGE1 immediately after the airway and breathing are secured.

58
Q

Tx of diaper rash

A

Topical antifungals such as miconazole.

59
Q

Diff between candidal diaper rash and irritant contact diaper rash

A

In irritant contact, this form doesn’t affect skin folds.

60
Q

Bilious emesis on day 1, x-ray shows “double bubble.” Normal gas pattern beyond. Next step?

A

Do enema, and then upper GI series if negative. Its likely malrotation/volvulus.

61
Q

Mom has polyhydramnios in preg. Baby now has biliary emesis on day 1. NO GAS beyond double bubble on X-ray. Dx?

A

Duodenal atresia (a/w Down syndrome) OR annular pancreas

62
Q

What is the cause of intestinal atresia

A

Vascular compromise in utero –aka mom smoked crack or something.

63
Q

Multiple air fluid levels in a baby along with double bubble

A

Intestinal atresia. Resect these segments.

64
Q

What causes annular pancreas

A

Failure of ventral bud to rotate with the duodenum, causing envelopment.

65
Q

“Donut sign” on ultrasound

A

Pyloric stenosis.

66
Q

CMP in pyloric stenosis

A

Low chloride

Hypokalemic metabolic alkalosis

67
Q

Before doing a myomectomy, how should you treat pyloric stenosis

A

Look at CMP and make sure baby is hydrated.

68
Q

Meckels diverticulum is a remnant of what

A

Vitelline duct

69
Q

“Melena” in a kid ..look for what

A

H/o of epistaxis, iron ingestion, or beets. Kids don’t get melena.

70
Q

Mom has HIV but doesn’t take antiretrovirals. What ppx should you give the newborn?

A

AZT within 12 hours of delivery for 6 weeks.

71
Q

How can we boost a proteae inhibitor

A

Add ritonavir. Its another protease inhibitor that enhances the protease inhibitor it is combined with.

72
Q

“-Vudine”

A

NRTI

73
Q

“-Avir”

A

Protease inhibitor

74
Q

You just had sex with someone who has HIV and you don’t want it. Ppx?

A

2 NRTI + either NNRTI, protease inhibitor, or entry inhibitor.

75
Q

What mutations are involved in resistance to HIV

A

CCR5

CXCR4

76
Q

How do you screen for HIV in pt very early on (aka when they present with flu syndrome)

A

Viral load RNA

77
Q

Pt has PCP pnuemo and G6PD. How do you prophylax?

A

ATOVAQUONE

78
Q

CD4

A

Coccidiomycosis with fluconazole. Especially if they live in endemic regions like Arizona or California

79
Q

Alternative in prophylaxis for MAC if macrocodes cannot be used

A

Rifabutin. However, get CXR first to rule out active TB.

80
Q

Measles rash spread

A

Starts on face and spreads down. Thats how it clears too.

81
Q

Subacute sclerosing panencephalitis is a late complication of what childhood disease

A

Measlers

82
Q

Measles is caused by what virus

A

Paramyxovirus

83
Q

Rash of rubella

A

Starts on face and spreads down

84
Q

Prodrome of rubella

A

Generalized, tender lymphadenopathy. Fever.

85
Q

Roseola is due to what virus

A

HHV-6

86
Q

Roseola: which comes first, fever or rash?

A

Fever first, THEN a rash.

87
Q

Rash of roseola

A

Starts on trunk and spreads outward.

88
Q

Grade III Concussion

A

Loss of consciousness with amnesia. 1 month off.

89
Q

Grade II concussion

A

LOC without amnesia. 1 week off.

90
Q

Grade I concussion

A

No LOC and no amnesia…go back in 20 min

91
Q

Punctate hemorrhages on CT

A

Cerebral contusion

92
Q

4 ft and 40 lbs – carseat?

A

Booster seat.

93
Q

Maintenance fluid in kid 0-10 kg

A

100 cc/kg

94
Q

Maintenance fluid in kid 10-20 kg

A

50 cc/kg

95
Q

Maintenance fluid in kid >20 kg

A

20 cc/kg

96
Q

%BSA in CHILDS head

A

18

97
Q

%BSA in CHILDS thorax (anterior)

A

18

98
Q

%BSA in Child’s arm

A

9

99
Q

% BSA in childs legs together

A

27

100
Q

Clean wound, unknown Td status

A

Give them the Td vaccine

101
Q

Dirty wound, unknown Td status

A

IVIg + vaccine

102
Q

Dirty wound and booster > 5 years gets what tx

A

Vaccine

103
Q

Any wound and booster

A

Observe

104
Q

Egg is fiund in which 3 vaccines

A

MMR
Yellow fever
FLU

105
Q

Live atten vaccine

A

MMR Varicella

FLU** newer vaccine is not live

106
Q

Nml vaccine response

A

Temp

107
Q

What if mom has hep b how do you treat baby

A

Give ivig and hep b vaccine now

108
Q

If moms hep b is unknown how do you treat baby

A

hep b vaccine now

109
Q

First 3 doses of dtap given when

A

1st year of life

110
Q

what is tracheitis

A

crpoup that doesn’t get better. treat with abx

111
Q

what happens if you treat retinoblastoma with radiaton

A

you just provided the second hit and now they’ll get more tumors

112
Q

cause of retinopathy off prematurity

A

high O2 administered

113
Q

4 dz of prematurity

A

IVH
retinopathy off prematurity
NEC
Bronchopulm dysplasia

114
Q

Tx of malrotation

A

EMERGENT SURGERY

115
Q

Tx of gastroschisis/omphalocele

A

Silo

DIT STEP 2 (17 decks)

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