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Step 2 CK > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Do simple febrile seizures require a workup?

A

No. patients can be discharged home from the emergency department with reassurance

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2
Q

AR deficiency of phenylalanine hydroxylase?

A

PKU - build up of phenylalanine. failure to convert phenylalanine to tyrosine

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3
Q

Clinical features of PKU?

A

intellectual disability, fair complexion, eczema, musty urine and body odor

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4
Q

Diagnosis of PKU?

A 
newborn screening (mass spec)
quantitative amino acid analysis
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5
Q

Aldolase B deficiency?

A

hereditary fructose intolerane
introducing veggies and fruits leads to accumulation of fructose-1-phosphate. affected infants present with vomiting, poor feeds, lethargy

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6
Q

Galactose-1-phosphate uridyl transferase

A

galactosemia: present with jaundice, hepatomegaly, failure to thrive the first few days after birth. After consumption of breast milk or formula

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7
Q

large fontanelles, failure to thrive, hypotonia?

A

hypothyroidism

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8
Q

After suspecting Turner syndrome, what should be your first step in completing a diagnosis or in management?

A

Pelvic ultrasound to evaluate internal female anatomy

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9
Q

First step in evaluation of primary amenorrhea?

A

Pelvic exam or ultrasound

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10
Q

definition of primary amenorrhea?

A

absence of menarche by age 15

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11
Q

When should you do a brain MRI in the evaluation of primary amenorrhea?

A

uterus is present on ultrasound and serum FSH is low or inapp normal. Need to rule in/out pituitary or hypothalamic tumors

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12
Q

why do prolactinomas cause amenorrhea?

A

they inhibit GnRH release

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13
Q

Gold standard for diagnosis of Turners?

A

Karyotype

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14
Q

treatment for OCD?

A

high-dose selective SSRIs and exposure/response prevention based psycotherapy

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15
Q

Fever, pharyngitis, gray vesicles/ulcers on posterior oropharynx?

A

Herpangina from Coxsackie A virus

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16
Q

How does presentation of herpetic gingivostomatitis and herpangina differ?

A

herpetic gingivostomatitis would be found on anterior pharynx whereas coxsackie is posterior. herpetic- erythematous gingiva whereas coxsackie is gray vesicles/ulcers. herpes has grouped vesicles not solitary vesicles.

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17
Q

most common congenital cyanotic heart defect to present in neonatal period

A

transposition of great vessels

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18
Q

how does transposition of great vessels present?

A

First few hours of life with cyanosis and a single, loud, second heart sound.

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19
Q

“egg on a string” heart

A

findings on x-ray for transposition of great vessel

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20
Q

Harsh pulmonic stenosis murmur and a VSD murmur are found in what congenital heart defect?

A

Tet of Fallot.

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21
Q

“Boot shaped” heart due to RVH is seen in?

A

Tet of Fallot

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22
Q

Single S2 heart sound, VSD murmur and minimal blood flow in pulmonary artery?

A

Tricuspid atresia

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23
Q

If transposition of great vessels is suspected, what should you give right away?

A

prostaglandins to keep ductus arteriosus patent to optimize inter-circulatory mixing. also obtain an Echo.

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24
Q

What do ASD, dextrocardia, PDA and VSD have in common?

A

All acyanotic congenital heart diseases

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25
Q

2-3 year old child with impaired visual adaptation to darkness, photophobia, dry skin, xerosis conjunctiva, xerosis cornea, keratomalacia, bitot spots, follicular hyperkeratosis of extensor surfaces

A

vitamin A deficiency

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26
Q

Patients with Tourette syndrome are at significant risk for what other psych comorbidities?

A

ADHD and/or OCD

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27
Q

selective mutism

A

verbal and talkative at home but refuse to speak in specific social settings- commonly at school. (considered an anxiety disorder)

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28
Q

life-threatening descending flaccid paralysis in an infant?

A

botulism. clostridium botulinum spores

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29
Q

treatment for botulism?

A

human derived botulism immune globulin

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30
Q

Other common cause of C. botulinum other than honey ingestion of the spores?

A

Spore inhalation from environmental dust

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31
Q

What is the treatment for ingestion of preformed C. botulinum in food?

A

Equine-derived botulism antitoxin

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32
Q

MOA of botulinum toxin

A

blocks Ach release at presynaptic neurons

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33
Q

Cephalohematoma

A

subperiosteal hemorrhage. presents a few hours after birth as scalp swelling limited to 1 cranial bone. no discoloration of scalp

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34
Q

treatment for cephalohematoma

A

most cases resorb spontaneously within 2 weeks - 3 months

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35
Q

caput succedaneum

A

diffuse, sometimes ecchymotic swelling of scalp. crosses suture lines.

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36
Q

cranial pulsations, increased pressure when crying, evidence of bony defects?

A

cranial meningocele

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37
Q

appearance of “pink stain” or “brick dust” in newborn diapers represents?

A

uric acid crystals

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38
Q

SCM muscle mass, ipsilateral head tilt, contralateral chin deviation?

A

Congenital muscular torticollis

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39
Q

Treatment strategies for congenital muscular torticollis?

A

increased tummy time, passive stretching, physical therapy

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40
Q

cystic hygroma

A

lymphatic system malformations located in posterior triangle of neck. often detected prenatally. high association with aneuploidy

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41
Q

physical exam of cystic hygroma would show

A

fluctuant mass that transilluminates

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42
Q

craniosyntosis

A

premature closure of cranial sutures

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43
Q

anemia of prematurity is caused by?

A

due to diminished epo levels, shortened RBC life span, blood loss (iatrogenic blood sampling)

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44
Q

Meconium ileus is virtually diagnostic for?

A

cystic fibrosis

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45
Q

congenital aganglionic megacolon?

A

Hirschsprung disease

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46
Q

99% of healthy, full-term infants pass stool within the first ____ hours of life

A

48

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47
Q

character of meconium in meconium ileus?

A

thick and inspissated

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48
Q

narrow and underdeveloped microcolon should make you think of?

A

meconium ileus

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49
Q

Hirshsprung disease is associated with?

A

down syndrome

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50
Q

“squirt sign?”

A

forceful expulsion of stool after rectal exam

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51
Q

X-linked agammaglobulinemia (Bruton agammaglobulinemia) results from?

A

impaired maturation of B cells. patients have small or absent lymphoid tissue. experience recurrent sinopulm and GI infections.

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52
Q

Patient with recurrent infections and “small tonsils” should make you think of?

A

x-linked agammaglobulinemia

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53
Q

adenosine deaminase deficiency

A

gene defect resulting in impaired T cell development- severe combined immunodeficiency.

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54
Q

Patients who have recurrent disseminated bacterial infections particularly with encapsulated bacteria may have what deficiency?

A

complement

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55
Q

recurrent skin and pulm infections wth catalase positive organisms and failure to thrive?

A

impaired oxidative burst

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56
Q

hypocalcemia, cardiac defects, failure to thrive, recurrent infections?

A

thymic hypoplasia. DiGeorge syndrome

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57
Q

cystathionine synthase deficiency

A

homocystinuria: errors in methionine metabolism

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58
Q

differential diagnosis of marfinoid body habitus?

A

marfan syndrome, homocystinuria, MEN syndrome

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59
Q

fair hair, fair eyes, developmental delay, cerebral vascular accident are pathognomonic for?

A

homocystinuria

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60
Q

Treatment for homocystinuria?

A

B6, folate, B12 to lower homocysteine levels and antiplatelet and anticoag to prevent stroke

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61
Q

some superficial infantile hemangiomas require treatment with _____ while most regress spontaneously

A

B-blockers

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62
Q

nevus simplex (macular stain, salmon patch, stork bite, angel kiss)

A

blanchable, pink-red patches, occur on eyelid, glabella, midline of nape of neck

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63
Q

post-exposure prophylaxis for rabies

A

rabies immune globulin and rabies vaccine immediately after exposure to high-risk wild animals

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64
Q

hydrophobia and aerophobia (feeling of water or air triggers involuntary muscle spasms) is present in?

A

human rabies

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65
Q

incubation period for rabies and prognosis?

A

1-3 month incubation. almost all patients die within weeks.

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66
Q

coins in the esophagus can be observed up to ___ hr after ingestion

A

24

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67
Q

Duchenne muscular dystrophy presents as

A

age 2-5 with bilateral calf pseudohypertrophy and Gower sign (using hands to push on legs to stand)

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68
Q

transmission of duchenne muscular dystrophy is?

A

X-linked recessive

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69
Q

gold standard for diagnostic testing of duchenne muscular dystrophy is?

A

genetic testing. deletion of dystrophin gene on Xp21

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70
Q

Serum creatinine phosphokinase and aldolase levels are elevated when?

A

screening for muscular dystrophies

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71
Q

congenitally absent or underdeveloped uterus, cervix, upper vagina in a patient with breast development, body hair growth? normal ovaries and external genitalia

A

mullerian agenesis

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72
Q

5-alpha reductase deficiency

A

cant convert testosterone to more potent DHT 46 XY genotype. male internal genitalia. female or undermasculinized external genitalia at birth. at puberty they experience masculinization

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73
Q

46 XY karyotye with defective androgen receptor and male internal genitalia. testicular testosterone is converted to estrogen-breast development

A

androgen insensitivity

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74
Q

cornell criteria

A

tall R wave in avL

Deep S wave in V3. characteristic for LVH

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75
Q

vomiting, encephalopathhy, hepatic dysfunction, abnormal behavior are presenting symptoms for?

A

reye syndrome

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76
Q

blue sclera, hearing loss, recurrent fractures, opalescent teeth

A

osteogenesis imperfecta

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77
Q

Vitamin D deficiency and pathologic fractures?

A

Rickets

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78
Q

blue-gray to yellow-brown discoloration of teeth should make you think of?

A

osteogenesis imperfecta (dentinogensis imperfecta)

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79
Q

4 main causes on differential diagnosis of stridor?

A

croup, foreign body (acute)

laryngomalacia, vascular ring (chronic)

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80
Q

when stridor improves with neck extension, think of ___ as the etiology?

A

vascular rings and slings

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81
Q

collapse of supraglottic structures during inspiration that presents with chronic inspiratory stridor (improves with prone positioning)

A

laryngomalacia

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82
Q

Infants with weight < 10th percentile may have complications such as?

A

hypoxia, polycythemia, hypothermia, hypoglycemia, hypocalcemia

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83
Q

most significant risk factor for ICH in an infant?

A

prematurity

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84
Q

chylothorax exudative or transudative effusion?

A

exudative

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85
Q

pleural effusion with high triglyceride count should make you think of?

A

chylothorax due to disruption of lymphatic flow

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86
Q

metatarsus adductus

A

congenital foot deformity where forefoot turns inward. foot is usually still flexible and this resolves spontaneously also normal neutral position of hindfoot in contrast to club foot.

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87
Q

how is measles spread?

A

infected droplets

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88
Q

prodrome of measles?

A

fever, cough, coryza, non-purulent conjunctivitis, koplik spots

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89
Q

describe the rash of measles

A

erythematous, sometimes puritic macular rash that starts on face and spreads in cephalocaudal direction

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90
Q

diagnosis of measles?

A

PCR

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91
Q

Roseola is caused by?

A

HHV6

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92
Q

When does rash in roseola appear?

A

when the fever resolves

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93
Q

“3 day measles”

A

Rubella (no koplik spots) lower fever

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94
Q

brief period of apnea, cyanosis triggered by emotional change

A

breath holding spell

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95
Q

left axis deviation on ECG and decreased pulm vascular markings should make you think of?

A

tricuspid atresia

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96
Q

3-4 months, hypoglycemia, seizure, lactic acidosis, hyperuricemia, hyperlipidemia, thin extremities, short stature, hepatomegaly, doll-like face with rounded cheeks

A

glucose 6 phos deficiency. von Gierke disease.

inability to break down glycogen into glucose

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97
Q

gold standard treatment for SCFE

A

immediate surgical screw fixation

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98
Q

idiopathic avascular necrosis of the hip that affects boys age 5-7 years old?

A

legg-calve perthes disease

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99
Q

risk factors for milk or soy protein induced colitis

A

FH of allergy, eczema, asthma

100
Q

patient is well appearing 1 month old with consistent vomiting after feeds and painless bloody stools with eczema. think of?

A

milk-soy protein induced colitis

101
Q

Trachoma

A

due to infection with chlamydia trachomatis serotypes A, B, C presenting with follicular conjunctivitis and inflammation

102
Q

delayed umbilical cord separation, recurrent skin and mucosal bacterial infections, severe preidontal disease, leukocytosis with neutrophil predominance suggests? **lack of pus!!

A

leukocyte adhesion deficiency

103
Q

defect in intracellular killing due to impaired respiratory burst from activated phagocytes

A

chronic granulomatous disease

catalase positive organisms (staph aureus, serratia)

104
Q

ingestion of what drug would cause abdominal pain, hematemesis, metabolic acidosis?

A

iron intoxication

105
Q

2 most common causes of acute bacterial sinusitis?

A

Strep pneumo and nontypeable Hflu

106
Q

treatment of choice for sinusitis?

A

amoxicillin-clavulonic acid

107
Q

venous lead level of 5-44 (mild) treat with?

A

no medication. repeat level in < 1 month

108
Q

moderate venous lead level (45-69) treat with?

A

meso-2,3-dimercaptosuccinic acid (DMSA)

109
Q

severe lead poison > 70 treat with?

A

dimercaprol british anti-lewis plus EDTA

110
Q

what is the initial screen for blood lead levels? what do you do if initial screen is > 5 for lead?

A

finger stick

do venous lead

111
Q

most common cause of vaginal bleeding in the neonatal period?

A

maternal withdrawal of hormonal estrogen

112
Q

IUGR, microcephaly, closed fists with overlapping fingers, hypertonia, microagnothia, prominent occiput, rocker bottom feet, severe intellectual disability =

A

trisomy 18

113
Q

gold standard for diagnosis of Hirshsprung

A

rectal suction biopsy

114
Q

neurocutaneous syndrome characterized by congenital unilateral cavernous sinus hemangioma along trigem nerve distribution. radiographic evidence of intracranial calcifications resemble tramline

A

Sturge-Weber syndrome

115
Q

Typical neuro presentation in Sturge-Weber syndrome?

A

seizure, hemianopia, hemiparesis, hemisensory, ipsilateral glaucoma

116
Q

Levonorgestrel and Ulipristal

A

Plan B. oral emergency contraceptive options that prevent pregnancy by delaying ovulation. Its progestin (L) or antiprogestin (U) and can be given 72 (levonorgestrel) or 120 (ulipristal) hours after intercourse

117
Q

treatment for idiopathic avascular necrosis of hip?

A

conservative with observation and bracing but may need surgery if femoral head is not contained in acetabulum

118
Q

treatment for patient with congenital QT syndrome

A

beta blockers and pacemaker placement

119
Q

All patients with central cause of precocious puberty (elevated LH and FSH) should have what test done?

A

head CT or MRI

120
Q

How do you treat central precocious puberty?

A

GnRH analog

121
Q

peripheral precocious puberty is caused by?

A

gonadal or adrenal release of excess sex hormone

122
Q

blueberry muffin spots

A

finding of all congenital infections

123
Q

copious rhinorrhea and a maculopapular rash that desquamates or becomes bullous in a newborn born to mom without prenatal care is concerning for ?

A

congenital syphilis

124
Q

periventricular calcification suggests what congenital disease

A

CMV

125
Q

diffuse intracerebral calcifications and severe chorioretinitis suggests what congenital disease?

A

toxo

126
Q

cataracts and heart defects suggest what congenital disease?

A

rubella

127
Q

microangiopathic hemolytic anemia, thrombocytopenia, acute kidney injury =

A

HUS

128
Q

how can you differentiate DIC from HUS?

A

abnormal coag studies

129
Q

which type of RTA has a basic urine?

A

distal RTA type 1. Defect in hydrogen secretion into the urine.

130
Q

RTA where defect lies in inability to reabsorb bicard?

A

Type II (Proximal)

131
Q

Fanconi syndrome

A

type II RTA (inability to reabsorb bicarb plus glucosuria, aminoaciduria, phosphaturia)

132
Q

RTA with aldosterone resistance?

A

Type IV - results in high serum K (caused by obstructive uropathy, CAH)

133
Q

Treatment for RTA?

A

give serum bicarb

134
Q

most common heart defect with downs syndrome?

A

complete AV septal defect. failure of endocardial cushions to close results in ASD and VSD

135
Q

Dihydrorhodamine 123 or nitroblue tetrazolium testing is used for?

A

chronic granulomatous disease (impaired intracellular killing by phagocytes)

recurrent pulm and skin infections. catalase + organisms

136
Q

cafe-au-lait macules, tumors of skin and central and peripheral nervous systems, axillary, inguinal freckles and lisch nodules (iris hamartomas) and neurofibromas

A

NF1

137
Q

optic glioma is the most common type of intracranial lesion in what disease?

A

NF1

138
Q

bilateral acoustic neuromas (vestibular schwanomas)- cause sensorineural hearing loss and are found in?

A

NF2

139
Q

hypopigmented macules (ash-leaf spots), facial andiofibromas, cardiac rhabdomyomas, renal angioleiomyomas, mental retardation, seizure

A

tuberous sclerosis

140
Q

All patients with central precocious puberty (GnRH dependent) should have?

A

brian MRI with contrast

141
Q

primary treatment option for idiopathic GDPP is?

A

GnRH agonist to maximize adult height potential

142
Q

definition of neonatal polycythemia?

A

hematocrit > 65% in term infants

143
Q

delayed clamping of umbilical cord is a risk for?

A

polycythemia

144
Q

symptomatic infants with polycythemia require?

A

partial transfusion (where blood is removed in exchange for normal saline)

145
Q

asymptomatic neonates with polycythemia require

A

hydration by feeding or parenteral fluids

146
Q

therapy for cyclical vomiting syndrome?

A

anti-emetics and anti-migraine (as family history of migraine is often present)

147
Q

abnormal acidified glycerol lysis test and eosin-5-maleimide binding test suggest?

A

Hereditary spherocytosis

148
Q

AD mutation of ankyrin gene?

A

Hered sphero

149
Q

cough, coryza, conjunctivitis is the typical prodrome for?

A

measles

150
Q

maculopapular rash that spreads in cephalocaudal pattern suggests?

A

Measles

151
Q

Transmission route of measles (rubeola)

A

airborne

152
Q

What precautions should be taken for patients with known or suspected measles?

A

isolation, airborne precautions (negative pressure room), N95 facemask for health care personnel)

153
Q

measles, varicella, TB are all spread?

A

airborne

154
Q

influenza and RSV are spread?

A

droplet

155
Q

Most common presenting symptom for patients with sickle cell trait?

A

painless hematuria or isothenuria (impaired concentrating ability) that can present as nocturia and polyuria

156
Q

most common congenital cause of aplastic anemia?

A

Fanconi anemia

157
Q

diagnosis of fanconi anemia is made by?

A

chromosomal breaks on genetic analysis

158
Q

definitive treatment for aplastic anemia?

A

hematopoietic stem cell transplant

159
Q

patient with aplastic anemia, short stature, microcephaly, abnormal thumbs, hypogonadism, cafe au lait spots, large freckles, low set ears, strabismus, middle ear abnormalities, deafness, chronic infection has?

A

Fanconi anemia

160
Q

Name the 3 categories of muscular dystrophy

A

Duchenne
Becker
Myotonic

161
Q

Duchenne and Becker muscular dystrophy are inherited?

A

X-linked recessive deletion of dystrophin gene on chromosome Xp21

162
Q

mytonic dystrophy is inherited?

A

AD (CTG expansion)

163
Q

2/3 year old with progressive weakness, gower maneuver, calf pseudohypertrophy

A

Duchenne muscular dystrophy

164
Q

5-15 year old with mild weakness who shows up to cardiologist in his 50s with cardiomyopathy

A

Becker muscular dystrophy

165
Q

15 year old with facial weakness, hand grip myotonia (slow relaxation) and dysphagia and testicular atrophy

A

myotonic dystrophy

166
Q

Inspiratory stridor that worsens in supine position and improves with prone position

A

laryngomalacia

167
Q

Increased laxity of supraglottic structures

A

laryngomalacia

168
Q

omega shaped epiglottis?

A

laryngomalacia

169
Q

first test to order for vascular ring? confirmation with?

A

barium swallow

MRI with angiography

170
Q

before surgical correction in DS patients with duodenal atresia yu must?

A

preop cardiac assessment due to high occurance of VSD or ASD

171
Q

sudden vasomotor collapse and skin rash in a patient with meningococcemia?

A

Waterhouse-Friderichsen syndrome

adrenal hemorrhage

172
Q

2 main causes of acute severe anemia in sickle cell disease?

A

Aplastic crisis

Splenic sequestration

173
Q

what is the cause of aplastic crisis in sickle cell disease

A

parvo B19 causes transient arrest of erythropoiesis with decreased retic count

174
Q

Reticulocyte count during splenic sequestration crisis in sickle cell?

A

high

175
Q

Absence seizures can be accompanied by

A

simple automatisms (eyelid fluttering, lip smacking)

176
Q

first line treatment for absence seizures?

A

ethosuximide

177
Q

gait ataxia, loss of reflexes, loss of vibratory sense should make you concerned for?

A

friedreich ataxia

178
Q

GAA repeat AR condiation

A

friedreich ataxia

179
Q

most common causes of meningitis in children 1?

A

strep pneumo and neisseria

180
Q

in infants < 28 days with meningitis who have physiologic hyperbilirubinemia what abx should be used?

A

cefotaxime instead of ceftriaxone. because ceftriaxone displaces bilirubin from albumin and increases risk of kernicterus

181
Q

when is dexamethasone indicated for meningitis?

A

reduce risk of sensorineural hearing loss with H. flu

182
Q

hypertonia, hyperphagia, obesity?

A

Prader-Willi

183
Q

Inheritance of prader willi?

A

loss of paternal copy of 15q11-q13

184
Q

short stature, intellectual disability, smiling laughter, hand flapping, ataxia, seizures

A

Angelmann syndrome (deletion of maternal 15q11-q13)

185
Q

most common sites for osteonecrosis in sickle cell patients?

A

humeral and femoral heads

186
Q

chronic groin, butt, thigh pain that starts hurting only with activity but progresses to rest pain in an adolescent with sickle cell?

A

osteonecrosis/ avascular necrosis of hip

187
Q

most common causes of meningitis is children < 3 months?

A

GBS
E.coli
Listeria
HSV

188
Q

causes of meningitis in children 3mo-10 years?

A

strep pneumo

neisseria

189
Q

> 11 year old child- most common cause of meningitis?

A

neisseria

190
Q

classic injury caused by swinging or pulling child by their arms?

A

subluxation of radial head

191
Q

how do you fix subluxation of radial head?

A

full recovery after closed reduction by hyperpronation of forearm OR

supination of forearm while flexing the elbow

192
Q

common head complication in premature and underweight neonates?

A

interventricular hemorrhage

193
Q

what should you think about if you see ventricles swollen with CSF on CT of neonate?

A

interventricular hemorrhage- impairing absorption of CSF

194
Q

Rash after amoxicillin in a aptient with pharyngitis, fatigue, lymphadenopathy suggests?

A

Mono- EBV

195
Q

Wiskott-Aldrich

A

X-linked disorder characterized by thrombocytopenia, eczema, recurrent infections

196
Q

defect in cytoskeleton regulation leading to microthrombocytopenia?

A

wiskott-aldrich

197
Q

atresia of jejunum or ileum is usually due to?

A

vascular accident in utero

198
Q

triple bubble sign and gasless colon on abd x-ray =

A

gas trapping in stomach duodenum, jejunum

199
Q

most common cause of breast mass in an adolescent?

A

fibroadenoma

200
Q

how to manage adolescent with suspected fibroadenoma?

A

re-examine after next menstrual period for decrease in mass size or tenderness

201
Q

Differentil for a solitary, painful, lytic bone lesion in a child with overlying swelling and hypercalcemia?

A

langerhans cell histiocytosis AND

neoplasm

202
Q

What evaluation is imperitive in people with guillain-barre?

A

Serial spirometry measurements

203
Q

CVID

A

B-cell differentiation is abnormal. Recurrent resp and GI infections

204
Q

Traction apophysitis of tibial tubercle =

A

osgood-schlatter

205
Q

defect in CD40 ligand characterized by high IgM, low IgG and IgA and normal lymphocyte populations

A

hyper IgM syndrome

206
Q

posttussive emesis is characteristic of?

A

pertussis (whooping cough)

207
Q

what will you see on liver biopsy in a patient with reyes syndrome?

A

microvesicular fatty infiltration

208
Q

pediatric aspirin use during flu or varicella infection causes?

A

Reye syndrome

209
Q

pubertal gynecomastia

A

seen in up to 2/3 of adolescent boys in mid-late puberty (can be unilateral, bilateral, painful or not). dont need treatment. it resolves in few months to 2 years

210
Q

Trendelenburg sign

A

drooping of contralateral pelvis when patient stands on 1 foot. waddling gait. caused by weakness/paralysis of gluteus medius and minimus muscles (superior gluteal nerve)

211
Q

First line pharmaceutical for enuresis? If patients dont respond to first line?

A

desmopressin

TCAs

212
Q

two most common posterior fossa tumors in children?

A

cerebellar astrocytoma

medulloblastoma

213
Q

patient with cystic fibrosis presents with mucosal bleeding, easy bruising, prolonged PT- what is going on?

A

Fat soluble vitamin deficiency

Vit K deficiency- leading to deficient factors II, 7, 9, 10, C, S

214
Q

what is the mechanism of hematuria in sickle cell patients?

A

renal papillary necrosis

215
Q

when infants or children are lifted/pulled by the hand or arm what injury can take place?

A

radial head subluxation

216
Q

Erythromycin ophthalmic ointment is highly effective in treating?

A

gonococcal conjunctivitis

217
Q

chemical conjunctivitis presents what timeline?

A

< 24 hours

218
Q

Gonococcal conjunctivitis presents what timeline?

A

2-5 days

219
Q

how do you treat gonococcal conjunctivitis?

A

Single IM dose of 3rd gen cephalosporin

220
Q

timeline presentation of chlamydial conjunctivitis

A

5-14 days

221
Q

how do you treat chlamydial conjunctivitis?

A

PO macrolide

222
Q

complications of gonococcal conjunctivitis?

A

corneal scarring, ulceration, blindness

223
Q

all infants should receive topical prophylaxis within an hour of birth for?

A

gonococcal conjunctivitis

224
Q

what antibiotic is indicated for cat bite?

A

pasteurella multocida

225
Q

sensorineural hearing loss, cardiac defects (PDA), cataracts (leukocoria- white pupillary reflex) =

A

congenital rubella

226
Q

presentation of rubella in kids?

A

fever

cephalocaudal spread of maculopapular rash

227
Q

limb hypoplasia, cataracts, distinctive skin lesions and scarrring = ?

A

congenital varicella

228
Q

chorioretinitis, hydrocephalus, diffuse intracranial calcifications?

A

congenital toxo

229
Q

IgA vasculitis, palpable purpura on lower extremities, abd pain, arthralgias, renal involvement

A

HSP

230
Q

purpura with normal platelet count?

A

HSP (IgA vasculitis)

231
Q

isolated thrombocytopenia and petechia presenting after a viral infection?

A

immune thrombocytopenia

232
Q

Treatment for immune thrombocytopenia?

A

observation. typically self resolves.

IVIG and glucocorticoids if bleeding

233
Q

what is a common way that sickle cell normocytic, hemolytic anemia might change to a macrocytic?

A

folate consumption due to increased reticulocyte count

234
Q

pathophys of refeeding syndrome?

A

carb intake stimulates insulin which causes cellular uptake of phosphorus, potassium, magnesium

235
Q

painless hematochezia in a young toddler is likely due to?

A

Meckel’s diverticulum

236
Q

Diagnosis of Meckel’s diverticulum is best done with?

A

technetium-99m pertechnetate scan

237
Q

craniotabes (softening or thinning of skull bones), rachitic rosary (costochondral bumps), genu varum

A

Vitamin D deficiency rickets

238
Q

Recurrent cystitis in toddlers is often caused by?

A

constipation

239
Q

cyanosis, dark chocolate colored blood and low pulse ox with normal PaO2 on ABG?

A

methemoglobinemia

240
Q

antidote for methemoglobinemia?

A

methylene blue

241
Q

Pralidoxime is antidote for?

A

cholinergics

242
Q

glucagon is antidote for?

A

B-blocker, CCB

243
Q

Fomepizole antidote for?

A

ethylene glycol, methanol ingestion

244
Q

dimercaprol antidote for

A

lead

245
Q

Treatment of choice for impetigo?

A

topical mupirocin

Step 2 CK (26 decks)

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