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Kaplan step 2 qbank > pediatrics > Flashcards

pediatrics Flashcards

* master clinical principles

1
Q

plain radiographic results …….. exclude foreign body aspiration
(can/cannot)

A

Cannot.

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2
Q

when there is an index of suspicion of foreign body aspiration in children, ……….. should be performed for definitive diagnosis and treatment

A

rigid bronchoscopy

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3
Q

what is the procedure of choice in the management of foreign body aspirations in children

A

rigid bronchoscopy under general anesthesia

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4
Q

what age of children are highest risk for aspiration of foreign objects?

A

ages1-3

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5
Q

why is rigid preferred over flexible bronchoscopy?

A

it provides a greater access to the subglottic airways and allows optimal passage and extraction while maintaining adequate oxygenation of the patient

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6
Q

what are some of the features of supraventricular tachycardia (SVT)

A
  • HR typically between 180 and 360 bpm
  • regular rhythm ( constant R-R interval)
  • narrowed QRS complex
  • usually no P wave can be seen
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7
Q

SVT is particularly associated with what congenital heart defect?

A

Ebstein anomaly

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8
Q

what are the features of Wolff-Parkinson-White syndrome?

A
  • short P-R interval

* delta wave (slow curved upstroke of the R wave)

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9
Q

what is Ebstein anomaly?

A

This is due to the downward displacement of an abnormal tricuspid valve into the right ventricle thus dividing the ventricle into two parts ( atrialization of the right ventricle)

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10
Q

Describe the two parts the ventricle divides into in Ebstein anomaly

A
  • Upper part is a thin-walled portion continuous with the right atrium
  • the lower part is the small right ventricle
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11
Q

what are some of the causes of increased right atrium volume in the case of Ebstein anomaly?

A
  • obstruction of the right ventricular outflow tract
  • small right ventricle
  • tricuspid regurgitation
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12
Q

Ebstein anomaly’s physical findings include:

A

quiet precordium,
holosystolic murmur due to tricuspid regurgitation
*gallop rhythm

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13
Q

what is the most common conduction pathway defect seen in Ebstein anomaly?

A

Wolff-Parkinson-Syndrome

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14
Q

In older children, conversion of SVT may be achieved by ……..

A

submerging the face in iced saline for several minute

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15
Q

In infants, conversion of SVT maybe achieved by …..

A

placing an ice bag over the face

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16
Q

If SVT is recurring, what do we do next?

A

teach older children vagotonic maneuvers

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17
Q

if vagal maneuvers fail acutely in a stable child, what is the next management?

A

rapid IV push of adenosine

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18
Q

if adenosine fails in treatment of SVT, what is the next step in management?

A

synchronized DC cardioversion

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19
Q

if a patient is hemodynamically compromised in a case of SVT, what is the initial management of this patient?

A

synchronized DC cardioversion

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20
Q

Ethylene glycol is found in ,,,,,,,,, and it is sweet (T/F)

A

antifreeze

True

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21
Q

what metabolizes ethylene glycol?

A

alcohol dehydrogenase

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22
Q

an example of a toxic metabolite of ethylene glycol

A

oxalate

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23
Q

presentation of ethylene glycol

A

confusion
stupor
coma
drukenness

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24
Q

treatment of ethylene glycol includes ……

A

fomepizole and ethanol and hemodialysis

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25
Q

what type of crystal is formed in ethylene glycol?

A

calcium oxalate crystals

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26
Q

calcium oxalate crystals leads to ………. and ………

A

renal tubular ischemia and renal failure

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27
Q

infants affected with transposition of great arteries present within minutes with ………

A

severe cyanosis and metabolic acidosis

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28
Q

what are the chest radiograph changes seen in transposition of great arteries?

A
  • narrowed mediastinum
  • narrow heart base
  • absence of the pulmonary artery
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29
Q

what kind of murmur does aortic valve stenosis produce?

A

loud ejection murmur with a prominent systolic click

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30
Q

where is aortic valve stenosis best heard?

A

upper right sternal border

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31
Q

what are the ECG changes seen with tetralogy of fallot?

A
  • right ventricular hypertrophy

* right axis deviation

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32
Q

what does chest radiograph show in tetralogy of fallot?

A

a small heart with a concave main pulmonary artery

33
Q

what are the typical findings of streptococcal pharyngitis?

A
  • mild anterior cervical lymphadenopathy
  • posterior oropharyngeal exudates
  • enlarged erythematous tonsils
  • palatal petecchiae
34
Q

what is the treatment of choice for strep pharyngitis?

A

oral penicillin V (phenoxyethylpenicillin) for 10 days

35
Q

when patient is likely to be lost in follow up or compliance is questionable, what is the appropriate management of strep pharyngitis?

A

single dose benzathine penicillin G IM

36
Q

what can be done to diminish local pain when administering benzathine?

A

shorter acting procaine penicillin (12hr low conc of penicillin)

37
Q

what is the first step in management of a patient who has dehydration (moderate to severe)?

A

correction of the abnormally hemodynamic variables with 20mL/kg of normal saline or ringer’s lactate given rapidly

38
Q

what sodium conc constitute hypernatremic or hypertonic dehydration

A

a serum sodium concentration >150 mEq/L

39
Q

what constitute isonatremic or isotonic dehydration?

A

a serum sodium concentration between 130-150 mEq/L

40
Q

what constitute hyponatremic or hypotonic dehydration?

A

a serum sodium concentration < 130 mEq/L

41
Q

what is the management of a patient with hypernatremic or hypertonic dehydration?

A

administer maintenance therapy with solute and free-water deficit but correct sodium slowly over 48 hours.

42
Q

why must serum sodium be corrected slowly in hypernatremic dehydration?

A

to avoid the danger of fluid shift causing cerebral edema

43
Q

define failure to thrive

A

failure to gain weight or deceleration of weight growth

44
Q

failure to thrive can be either …… or ……….

A

organic or inorganic

45
Q

one of the most common causes of failure to thrive is …………

A

improper preparation of the formula

46
Q

what and how should a 9 month-old be eating

A

4-6 times a day consisting of:

  • chunky lumpy mashed food,
  • finger food
  • start cup drinking
47
Q

fruit juice in a nine month old should never be ……….

A

> 4-6 oz/day

48
Q

what are the clinical manifestations of pyloric stenosis?

A
  • nonbilious projectile vomiting shortly after feeding

* palpable olive-sized mass in the epigastrium

49
Q

when does symptom of pyloric stenosis typically present

A

3rd-4th week

50
Q

what is the acid-base status of a symptomatic pyloric stenosis patient?

A

hypochloremic hypokalemic metabolic alkalosis

51
Q

what is the study of choice for pyloric stenosis?

A

Ultrasound

52
Q

describe what is seen on the study of choice for pyloric stenosis?

A

target sign on cross-sectional view: small amount of white air centrally surrounded by a large black ring- the hypertrophied tissue

53
Q

what is the definitive treatment of pyloric stenosis

A

pyloromyotomy

54
Q

what is the most common cause of neonatal seizure?

A

hypoxic-ishemic encephalopathy (HIE)

55
Q

causes of neonatal seizure includes:

A

HIE, infections, hypoglycemia, hyponatremia

hyperbilirubinemia

56
Q

neurofirbomatosis (NF) type 1 is caused by …….

A

a mutation of a gene (NF-1) on the long arm of chromosome 17

57
Q

………….. should be suspected in children who develop isolated thrombocytopenia and petechiae after a viral infection.

A

Immune thrombocytopenia

58
Q

What is the management of a child with immune thrombocytopenia with low platelet count

A

Observation

59
Q

What is the management of a child with thrombocytopenia who is bleeding

A

Intravenous Immunoglobulin or glucocorticoids

60
Q

What is the empirical treatment for children with meningitis after 1 month of age?

A

Vancomycin with a third generation cephalosporin

61
Q

What is the most common insulin-related cardiac abnormality in infants of diabetic mother

A

Asymmetric septal hypertrophy

62
Q

Diagnosis of DiGeorge syndrome is made with ______________

A

PCR-based genotyping

63
Q

These three syndromes are known as the CATCH -22:

A

DiGeorge syndrome
Conotruncal face syndrome
Velocardiofacial syndrome

64
Q

___________ presents in adolescent boys as a painful limp with limited abduction and external rotation on physical examination

A

Legg-Calvé-Perthes disease

65
Q

____________ usually presents with a painful, swollen mass with limping between 10-12 years of age. Radiographic appearance is a “sunburst pattern”

A

Osteosarcoma

66
Q

_______ is a malignant tumor of bone arising in medullary tissue. Occurs often in cylindrical bones. Radiographs have a primary lyric lesion with periosteal reaction

A

Ewing sarcoma

67
Q

_________ affects the lower extremities and spine most commonly and patients present with pain which is worse at night and relieved with anti-inflammatory drugs.

A

Osteoid osteoma

68
Q

An innocent murmur can never be diastolic. True/False

A

True

69
Q

Neonatal abstinence syndrome reflects dysfunction in four domains which are:

A

Motor and tone
State control and attention
Sensory integration
Autonomic functioning

70
Q

The most common initial event of pubertal development in girls is ___________

A

Thelarche (breast development )

71
Q

The most common initial event of pubertal development in boys is _____________

A

Testicular growth then penile growth

72
Q

what is the treatment for congenital hip dislocating?

A

Pavlik harness with splinting in an abducted fashion for approximately six months.

73
Q

The most common complication of mumps in prepubertal children is ………………..

A

Meningoencephalomyelitis

74
Q

The most common extrarenal manifestations are ____________ and __________

A

Sensorineural hearing loss and anterior lentoconus

75
Q

breast feeding jaundice often shows symptoms of jaundice _________ of life

A

within 3-4 days of life

76
Q

breast milk jaundice often shows symptoms of jaundice _________ of life

A

end of first week - beginning of second week

77
Q

treatment of breast milk jaundice is ________

A

phototherapy

78
Q

treatment of breast feeding jaundice is __________

A

hydration and education on breast feeding

79
Q

_____ is both diagnostic and therapeutic for intussusception in treatment of choice of symptoms less than 48 hrs

A

contrast or air enema

Kaplan step 2 qbank (5 decks)

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