Brainscape's Knowledge GenomeTM

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


See full index

EORs > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Treatment for tinea capitus

A
  • 1st Line: Oral griseofulvin

- topical therapy of 2.5% selenium sulfide or ketoconazole shampoo twice weekly suppresses viable spores

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

Tinea pedis

- mc org

A

Trichophyton rubrum

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

Tinea pedis

- treatment

A

Topical antifungals

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

Tinea corporis

- mc org

A

Trichophyton rubrum

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

Tinea corporis

- treatment

A
  • Topical azole antifungals (1% clotrimazole, 2% ketoconazole)
  • 1% terbinafine cream applied twice daily for 2–4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tinea versicolor

- org

A

Malassezia furfur

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

Tinea versicolor

- treatment

A

selenium sulfide 2.5% applied to affected skin for 10 minutes.

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

Do hives blanch?

A

Yes

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

Darier’s Sign

A

localized urticaria appearing where the skin is rubbed

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

Darier’s Sign

A

localized urticaria appearing where the skin is rubbed

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

Epinephrine treatment of anaphylaxis

  • Dose adults
  • Dose peds
  • IM dilution
  • IV dilution
A
  • Adults 0.3–0.5 mg
  • Peds 0.01 mg/kg SC/IV
  • IM is 1:1,000 dilution
  • IV is 1:10,000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name for genital warts

A

Condyloma acuminatum

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

Name for genital warts

A

Condyloma acuminatum

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

Acute vs. chronic otitis media

A
  • acute < 3 weeks

- chronic > 3 months

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

Definition of recurrent otitis media

A

3 episodes in 6 months
or
4 episodes in 12 months
with clearing between episodes

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

Chronic OM

A
  • Clear serous fluid in the middle ear without signs or symptoms of ear infection.
  • May have hearing loss, may be asymptomatic, does not require antibiotics.
  • pseudomonas, s. aureus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute otitis media

- treatment

A
  • First line: Amoxicillin x 10-14 days
  • Cefixime in children
  • Augmentin is 2nd line
  • If PCN allergic give Azithromycin, Erythromycin or Bactrim
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MCC epiglottitis

A

H. influenzae type B (Hib)

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

MCC epiglottitis

A

H. influenzae type B (Hib)

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

Epiglottitis

- xray sign

A

thumbprint sign

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

Epiglottitis

- treatment

A
  • Secure airway: anesthesiology and prepare to establish airway, transfer to OR to perform exam, tracheostomy if necessary to maintain airway
  • Admit for observation, humidified O2, IV antibiotics (ceftriaxone + clindamycin), and IV corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Epistaxis: anterior bleed

- MC location

A

Kiesselbach’s Plexus

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

Epistaxis: posterior bleed

- MC location

A
  • Woodruff’s Plexus: sphenopalatine artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Epistaxis: anterior bleed

- treatment

A
  • Direct pressure at least 10-15 minutes, seated leaning forward
  • Short-acting topical decongestants: oxymetazoline/Afrin, phenylephrine, cocaine
  • Anterior nasal packing + antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Epistaxis: posterior bleed

- treatment

A
  • Posterior balloon

- Must be admitted to the hospital and prompt consultation with an otolaryngologist is indicated

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

Recurrent epistaxis

- workup

A

Must rule out hypertension or hypercoagulable disorder

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

Antiviral for influenza

A

zanamivir and oseltamivir

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

Treatment for pinworms

A

mebendazole, albendazole, pyrantel

  • single dose, repeat 2-4 weeks
  • hand washing
  • wash bedsheets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Erythema infectiosum

- causative org

A

parvovirus B19

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

hand foot and mouth

- causative org

A

coxsackie virus

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

Roseola

- causative org

A

HHV 6 or 7

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

Roseola

- clinical presentation

A
  • fever, resolves before rash appears

- pink, macular rash, blanchable

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

Pneumonia MCC
<1
<2
young adults/college

A
  • RSV
  • parainfluenza virus
  • mycoplasma pneumoniae, chlamydia pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What respiratory condition should bulbous myringitis make you think of?

A

mycoplasma pneumoniae pnuemonia

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

outpatient CAP treatment

A
  • macrolide (clarithromycin or azithromycin)

- doxycycline

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

bronchiolitis

- management

A
  • supportive: ensure oxygenation and hydration
  • RSV: consider hospitalization and admin of ribavirin, esp if high risk pt (premie, underlying conditions, severely ill)
  • nebulizer albuterol, IV fluids, antipyretics, chest physiotherapy, humidified O2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

croup

- aka

A

laryngotracheobronchitis

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

croup

- MCC causative orgs

A
  • parainfluenza types 1 and 2
  • RSV
  • adenovirus
  • influenza
  • rhinovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

croup

- clinical findings

A
  • harsh, barking, seal-like cough
  • inspiratory stridor
  • hoarseness
  • aphonia
  • low-grade fever
  • rhinorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

croup

- treatment

A

Mild: hydration, cool humidified air, dexamethasone
Moderate: IM/PO dexamethasone, supportive, +/- nebulized epinephrine
Severe: dexamethasone, nebulized epinephrine, hospitalize (O2 < 92%)

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

how should asthma spirometry respond to albulterol

A

FEV1 or FVC increase > 12%

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

Asthma

  • CXR
  • ABG
A
  • hyperinflation

- hypocarbia: have increased respiratory rate. If normal or high, may be sign of impending respiratory failure

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

Intermittent Asthma

  • daytime sx / SABA use
  • nighttime sx
  • interference with activities
  • FEV1
A
  • ≤ 2 days/week
  • ≤ 2 times a month
  • no interference
  • FEV1 >80% predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Mild persistent asthma

  • daytime sx / SABA use
  • nighttime sx
  • interference with activities
  • FEV1
A
  • > 2 days/week, not daily
  • 3-4 times a month
  • minor
  • FEV1 >80% predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

moderate persistent asthma

  • daytime sx / SABA use
  • nighttime sx
  • interference with activities
  • FEV1
A
  • Daily
  • > once a week, not nightly
  • Some interference
  • FEV1 60-80% predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

severe persistent asthma

  • daytime sx / SABA use
  • nighttime sx
  • interference with activities
  • FEV1
A
  • multiple times daily
  • daily
  • extremely limited
  • FEV1 < 60% predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Asthma therapy steps

A

Step 1: SABA

*steps 2-6 SABA plus…

Step 2: Low dose ICS

Step 3: medium dose ICS OR low dose ICS + LABA/montelukast/theophylline

Step 4: medium dose ICS + LABA/montelukast/theophylline

Step 5: high dose ICS + LABA +/- omelizumab

Step 6: high dose ICS + LABA + oral steroid =/- omelizumab

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

Cystic fibrosis

  • genetics
  • overview
A
  • autosomal recessive

- abnl production of mucus by almost all exocrine glands = obstruction

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

Cystic fibrosis

- clinical

A
  • chronic lung dz, bronchiectasis, pancreatitis, infertility
  • sx: cough, sputum, dec exercise tolerance, sinus pain, purulent nasal dc, steatorrhea, diarrhea, abd pain
  • signs: clubbing of fingers, anteroposterior chest diameter inc, apical crackles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Cystic fibrosis

- dx studies

A
  • ABG: hypoxemia and possible compensated respiratory acidosis
  • PFT: mixed obstructive and restrictive
  • CXR: hyperinflation, peribronchial cuffing, mucous plugging, bronchiectasis, inc insterstitial markings, etc.
  • GS: sweat chloride test (>60 mEq/L) on two diff days, then DNA testing for definitive evidence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Hyaline membrane disease

- aka

A

respiratory distress syndrome, RDS

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

hyaline membrane disease/RDS

- general

A
  • MC cause resp distress in preterm infant

- deficiency of surfactant

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

hyaline membrane disease/RDS

- dx

A
  • CXR: air bronchograms, diffuse bilateral atelectasis causing a ground-glass appearance, doming of the diaphragm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

hyaline membrane disease/RDS

- management

A
  • synchronized intermittent ventilation

- exogenous surfactants

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

Cyanotic heart defect

A

right-to-left shunt (skipping the lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Four cyanotic heart defects

A
  1. Tetralogy of Fallot
  2. Pulmonary atresia
  3. Hypoplastic left heart
  4. Transposition of the great arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Tetralogy of fallot

- define anomoly

A
  • ventricular septal defect
  • aortic origination over defect (aortic override)
  • right ventricular outflow obstruction
  • right ventricular hypertrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Tetralogy of fallot

- murmur

A

crescendo-decrescendo
holosytolic
LSB
radiates to back

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

Tetralogy of fallot

- physical findings

A

cyanosis
clubbing
increased RV impulse at LLSB
Loud S2

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

Tetralogy of fallot

- clinical information

A
  • polycythemia usually present

- tet spells: extreme cyanosis, hyperpnea, agitation (medical emergency)

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

noncyanotic congenital heart anomalies (5)

A
  1. atrial septal defect
  2. ventricular septal defect
  3. atrioventricular septal defect
  4. patient ductus arteriosus
  5. coarctation of the aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Atrial septal defect

- MC subtype

A

osmium secundum

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

Atrial septal defect

- murmur

A
  • systolic ejection murmur at 2nd LICS

- early to middle systolic rumble

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

Atrial septal defect

- physical findings

A
  • failure to thrive
  • fatigue
  • RV heave
  • wide fixed split S2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Ventricular septal defect

- three types

A
  • perimembranous (MC)
  • muscular
  • outlet openings btwn ventricles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Ventricular septal defect

- murmur

A

systolic murmur at LLSB

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

Ventricular septal defect

- physical findings

A

asx to signs of CHF

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

Patent Ductus Arteriosus

- describe

A
  • failed or delayed closure of ductus arteriosus between pulmonary artery and aorta - allows placental gas exchange during fetal state, bypasses the lungs
  • sx treatment generally not indicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Patent Ductus Arteriosus

- treatment

A

IV indomethacin (reduction of prostaglandins)

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

Patent Ductus Arteriosus

- murmur

A

continuous (machine like) murmur

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

Patent Ductus Arteriosus

- physical findings

A
  • wide pulse pressure

- hyper dynamic apical pulse

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

Coarctation of the aorta

- describe

A

narrowed proximal thoracic aorta

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

Coarctation of the aorta

- murmur

A
  • systolic, LUSB/left intrascapular area

- may be continuous

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

Coarctation of the aorta

- physical findings

A
  • infants: CHF
  • older: systolic hypertension or underdeveloped lower extremities
  • difference between UE and LE blood pressure is pathognomonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Treatment for cyanotic defects prior to surgical correction

A
  • if PDA: prostaglandins to maintain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Hypertrophic cardiomyopathy

- presentation

A
  • dyspnea and angina
  • syncope and arrhythmias common
  • asx to sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Hypertrophic cardiomyopathy

- dx

A
  • EKG: nonspecific ST- T-wave changes, exaggerated septal Q wave, LVH
  • Echo: key to dx. LVH, asymmetric septal hypertrophy, small LV, diastolic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Hypertrophic cardiomyopathy

- management

A
  • BB or CCB, disopyramide
  • sx or nonsx ablation of hypertrophic septum
  • dual-chamber pacing, implantable defibrillators, mitral valve replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Rheumatic fever

- describe

A

2-3 weeks following beta-hemolytic strep pharyngitis

  • ages 5-15 MC
  • self-limited to progressive valve deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Rheumatic fever

- valves affected

A
  • MC: mitral valve

- also aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Rheumatic fever

- Jones criteria

A

2 major
or
1 major + 2 minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Rheumatic fever

- Major jones criteria

A
  • carditis
  • erythema marginatum
  • subcutaneous nodules
  • chorea
  • polyarthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Rheumatic fever

- minor jones criteria

A
  • fever
  • polyarthralgias
  • reversible prolonged PR interval
  • rapid ESR
  • CRP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Rheumatic fever

- management

A
  • bed rest
  • IM penicillin (erythromycin if PCN allergic)
  • antipyretics and steroids to reduce joint sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Rheumatic fever

- prevention

A

early tx of strep pharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Kawasaki dz

  • aka
  • etiology
A
  • aka mucocutaneous lymph node syndrome

- etiology unknown, suspect virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Kawasaki dz

- presentation

A
  • fever > 5 D
    AND 1+:
  • conjunctivitis
  • lip crack/fissure, strawberry tongue, inflammation oral mucosa
  • cervical lymphadenopathy
  • polymorphous exanthem
  • red/swelling of hands and feet, subsequent desquamation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Kawasaki dz

- cardiac involvment

A
  • worrisome

- myocarditis, pericarditis, valvular heart disease, coronary arteritis, aneurysms all possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Kawasaki dz

- Testing for all pts

A
  • 2D echo or angiography to r/o heart involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Kawasaki dz

- treatment

A
  • IV immunoglobulin, high dose ASA
  • early treatment -> lower chance cardiac involvement
  • cardiac involvement: long term ASA and annual f/u
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Cause of intussusception

  • child
  • adult
A
  • follows URI
  • neoplasm

(proximal goes into distal portion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Intussusception

- dx

A

barium or air enema

  • diagnostic and therapeutic
  • if not, then surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Vitamin A deficiency

  • function
  • s/sx
A
  • vision, epithelial cell maturity, infection resistance, antioxidant
  • night blindness, dry skin, squamous metaplasia, bitot’s spots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Vitamin C deficiency

  • function
  • s/sx
A
  • collagen synthesis, hormone function, nt synthesis

- scurvy: hyperkeratosis, hemorrhage, hematologic (3 Hs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Vitamin D deficiency

  • function
  • s/sx
A
  • calcium regulation, cell differentiation

- rickets, osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Niacin deficiency

  • function
  • s/sx
A
  • energy, fat metabolism

- Pellagra: diarrhea, dementia, dermatitis (3 Ds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

eosinophilic esophagitis

  • associated with what
  • clinical
A
  • atopic disease

- dysphagia, +- reflux or feeding difficulties in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

eosinophilic esophagitis

  • dx
  • management
A
  • endoscopy: normal +- multiple corrugated rings +- white exudate
  • remove foods that incite allergic response, inhaled topical corticosteroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Crigler-Najjar syndrome

- Type 1

A

no UGT activity = no conversion of indirect to direct bilirubin

  • neonatal jaundice with severe progression in the 2nd week, leads to kernicterus
  • normal LFTs, indirect bilirubin 20-50 mg/dL
  • Tx: phototherapy, plasmapheresis, liver transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Duodenal atresia

  • clinical
  • XR findings
A
  • polyhydramnios in pregnancy, inc risk in Downs
  • intestinal obstruction shortly after birth, abd distention, bilious vomiting
  • double-bubble sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Duodenal atresia

- management

A
  • decompression fo GI tract
  • electrolyte and fluid replacement
  • duodenoduodenostomy: repair or anastomosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

what is the only childhood exanthem that starts on the trunk?

A

roseola

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

when do annual blood pressure readings start (age)

A

3 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

when should intermittent alternating strabismus stop (age)?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

when does the rooting reflex stop?

A

2-3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

by what age should posterior fontanelle close?

A

2 months (usually closed at birth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What drug is used to treat Lyme disease in kid <8 yo

A

amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What level of bilirubin is suspicious for kernicterus?

A

20-25 mg/dL

** encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Hyperbilirubinemia
< 24 hours old
>24 hours old

A

< 24 is more worriesome for non-physiologic causes (ABO, Rh isoimmunization, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What maternal blood types can lead to hyperbilirubinemia in the infant?

A
  • O

- Rh neg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Down syndrome

- dx sx

A
  • hypotonia
  • poor Moro reflex
  • hypermobility of joints
  • flattened facies and occiput
  • excess posterior neck skin
  • anomalous auricles
  • upward-slanting palpebral fissures
  • pelvic dysplasia
  • dysplasia of middle phalanx of 5th finger
  • Simian crease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Down syndrome

- common congenital defect

A

ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

what should always be considered in neonate presenting with fever

A

herpes simplex infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

herpes simplex meningitis neuro signs

A

seizures
lethargy
poor feedings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Test of choice to confirm CNS herpes simplex

A

PCR of cerebrospinal fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Four signs of neonatal herpes simplex infection

A
  1. keratoconjunctivitis
  2. vesicular skin rash
  3. seizure meningitis
  4. sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Duodenal atresia

  • s/sx
  • xray findings
  • management
  • associated with what
A
  • bilious vomiting w/o abd distention within first days of life
  • double bubble sign on XR
  • NG or OG decompression, IVF until surgery
  • Down’s syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What RA finding is rarely found in juvenile idiopathic arthritis

A

rheumatoid factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What are the three types of juvenile idiopathic arthritis?

A
  1. systemic juvenile idiopathic arthritis
  2. Oligoarticular juvenile arthritis
  3. Polyarticular juvenile arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Major clinical manifestation of juvenile idiopathic arthritis

A

persistent joint swelling that may lead to deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What is the age range for febrile seizures

A

6 months to 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Definition of simple febrile seizure

A
  • tonic clonic
  • less <15 min
  • only once w/in a febrile episode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Simple febrile seizure RF

A
  • elevated fever
  • viral infection
    • fam hx
  • recent immunization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Treatment for recurrent febrile seizures

A
  • if >5 min, diazepam gel or suppository (one dose)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Presentation of CF

A
  • chronic sinopulmonary disease: persistent infection with CF pathogens, chronic cough/sputum, chest xr abnl, airway obstruction, nasal polyps, digital clubbing
  • GI and nutritional abnl: meconium ileum, distal GI obstruction, rectal prolapse, pancreatic insufficiency, DM, chronic hepatic dz, FTT, etc.
  • salt loss syndromes
  • male urogenital abnl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

CF

- management

A
  • meds to clear resp secretions (DNase and inhaled hypertonic saline)
  • chest physiotherapy
  • anti-inflammatories
  • nutritional optimization
  • exercise as tolerated
  • *anti-pseudomonal abx when indicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

what two sugars form lactose

A

glucose

galactose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Prolonged QT syndrome

- common presentation

A

syncope

presyncope, torsades de pointes, sudden cardiac death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Prolonged QT syndrome

- QT interval

A

> 440 milliseconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Prolonged QT syndrome

- 1st line treatment

A

beta blockers - blunt paradoxical effects of catecholamine on QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

concerning sign for pathologic murmur

A

widely split and fixed S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

mastoiditis

- s/sx

A
  • anteverted ear

- pain with palp of post auricular area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Mastoiditis

- dx

A

CT - coalescence of air cells, subperiosteal abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Mastoiditis

- management

A
  • sx
  • prolonged abx (initial vanc and ceftriaxone)
  • possible tympanostomy tubes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Effects of fetal coarctation of the aorta in utero

A

blood flow through PDA bypasses the coarctation, resulting in hemodynamic stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

what electrolyte disorder is commonly seen in hyperparathyroidism

A

hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What two meds are known to exacerbate hypercalcemia

A
  • thiazide diuretics

- lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Lead testing

  • screening
  • definitive test
A
  • capillary blood for screening: easier to get but easily contaminated yielding false positives
  • venous blood: confirms dx and guides management based on levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

common lead poisoning sx

A
  • HA
  • joint pain
  • constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Lead poisoning

- management

A
  • education
  • remove lead
  • oral succimer
  • IV EDTA
    • > 45 mcg/dL = chelation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

CF dx

  • test of choice
  • another test
A
  • Sweat chloride test

- Fecal elastase - elevated: indicates malfunction of exocrine pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Perforated TM

- management

A
    • min hearing loss, no vestibular sx
  • ofloxacin drops
  • keep ear dr
  • f/u primary care in 4 weeks: audiometry to assess hearing loss and healing of TM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

what type of ear drops are ototoxic

A

gentamicin - only use if positive TM is not perforated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

f/u for breech baby with unremarkable exam and no family hx of developmental hip dysplasia

A
  • US of hips at 4-6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

developmental hip dysplasia

- RF

A
  • female
  • breech> 34 weeks
  • fam history
  • tight lower extremity swaddling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

developmental hip dysplasia

- testing

A
  • Barlow and Ortolani: subluxation = hip laxity or mild instability
  • Galeazzi: unequal height of legs or asymmetrical skin folds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

developmental hip dysplasia

- tx for <6 mo

A

Pavlik harness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Hereditary spherocytosis

- RBCs

A

biconcave shape

Howell-jolly bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Hereditary spherocytosis

- heredity

A

autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Hereditary spherocytosis

- PE findings

A
  • splenomegaly
  • jaundice
  • scleral icterus
  • microcytic/normocytic anemia
  • reticulocytosis
  • ** increased MCHC
  • Coombs negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

What is cryptorchidism associated with?

A

low birth weight

prematurity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

When do undescended testes usually descend

A
  • by three or four months
  • ## after 6 months, rare to descend further
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Management of undescended testes after four months

A

surgical orchiopex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

Complications associated with cryptorchidism

A

testicular torsion
infertility
malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Croup

- Clinical

A
  • URI sx
  • barking, seal cough
  • stridor
  • sx worse at night
  • hypoxia UNCOMMON
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Croup

- management

A
  • cool, humidified air
  • racemic epinephrine
  • corticosteroids (dexamethasone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Acute otitis media

- abx algorithm

A

1st line: amoxicillin
2nd line: amox-clavulanate (Augmentin)
3rd line: Cefixime, Cefaclor
4th line: Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Acute otitis media + conjunctivitis

- mc org

A

H. influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Acute otitis media + conjunctivitis

- abx

A

Augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

Non-accidental Trauma

- suspicious fracture (6)

A
  1. metaphysical fracture (pathognomonic)
  2. Rib fx
  3. skull fx
  4. scapular fx
  5. sternal fx
  6. transverse long bone fx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Injuries suggestive of non-accidental trauma

A
  • bruises and fractures in various stages of healing
  • retinal hemorrhage
  • cigarette burns
  • glove-and-stocking pattern burns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Comedonal acne

- treatment

A
  • topical retinoid

- azelaic acid/salicylic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Mild papulopustular and mixed acne

- treatment

A
  • topical antimicrobial (benzoyl peroxide/abx) and topical retinoid
    OR
  • benzoyl peroxide and topical abx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

moderate papulopustular and mixed acne

A
  • topical retinoid
  • oral abx
  • topical benzoyl peroxide
    (all)
165
Q

Severe acne

A
  • topical retinoid AND oral abx AND topical benzoyl peroxide

- isotretinoin monotherapy

166
Q

Best acne option for pregnant woman

A

oral erythromycin

167
Q

what test is recommended for children who present with hearing loss

A

ophthalmology exam - often seen together

168
Q

Medication given as pretreatment for chemo (dt non-hodgkin lymphoma)

A

benzodiazepines help with n/v

169
Q

Management for child with mild strabismus but no other vision deficits

A
  • observation

- f/u with ophthalmologist q 6 months

170
Q

Four types of strabismsu

A
  • Esotropia (looks medial)
  • Exotropia (looks lateral)
  • hypertropia (up)
  • hypotropia (down)
171
Q

Tropia vs. phoria

A

Tropia: manifest strabismus, evident with both eyes uncovered
Phoria: latent strabismus, evident when one eye is covered

172
Q

Physiologic anemia

A
  • MC anemia in young infants 6-9 weeks
  • decrease in erythropoiesis dt increased tissue oxygenation
  • hgb drops from 14 g/dL newborn to 11 g/dL
173
Q

At what age are hemoglobinopathies generally discovered?

A

3 and 6 months

- sickle cell and thalassemia

174
Q

What age is iron deficient anemia usually first seen

A

not before 6 months

175
Q

Pertussis

- org

A

bordetella pertussis

176
Q

Pertussis

- stages

A
  1. catarrhal: coryza, cough, low energy, lacrimation (1-2 weeks). Most contagious
  2. paroxysmal: paroxysms of cough, inspiratory stridor, associated with cyanosis, apnea, emesis. up to 2 months
  3. Convalescent phase: sx gradually subside
177
Q

Pertussis

- infants <4 mo

A

higher risk of severe illness, mortality

178
Q

Pertussis

- management

A
  • Azithromycin first line (macrolide)

- Bactrim second line

179
Q

How to remove insect from ear

A
  1. Kill insect: mineral oil, lidocaine, ethanol

2. remove via syringe or alligator forceps

180
Q

Fanconi anemia

  • inheritance
  • presentation
A
  • autosomal recessive
  • pancytopenia and congenital anomalies (hyper or hypo pigmented skin, cafe-au-lait spots, short stature, upper limb abnl, hypogonadism, skeletal abnl, renal malformations, etc.)
181
Q

Fanconi anemia

- management

A
  • supportive care
  • transfusions and abx for infection
  • stem cell transplantation
182
Q

Nutritional vitamin D deficiency

  • phosphate
  • calcium
  • PTH
A
  • hyperphosphatemia
  • hypocalcemia
  • elevated PTH

(due to low calcium levels)

183
Q

Rickets

- MC cause

A

Vit D deficiency

- inadequate mineralization = widened epiphyseal regions, softening bones = bend

184
Q

Rickets

- clincial

A
  • softened cranial bones
  • widened costochondral junctions
  • growth plate widening in wrists and ankles
  • FTT
  • Weakness
  • Seizure
185
Q

Meckel’s Diverticulum

- describe

A
  • persistence of omphalomesenteric duct beyond fetal development
  • contains all layers of small bowel
186
Q

Meckel’s Diverticulum

- rules of two

A
  • M:F 2:1
  • 2% of population
  • within 2 feet of ileocecal valve
  • 2” in length
  • complications usu before age 2
187
Q

Meckel’s Diverticulum

- Complications

A

painless GI bleeding or obstruction

188
Q

Meckel’s Diverticulum

- dx

A

nuclear medicine scan: 99m technetium pertechnetate

189
Q

Fetal lung surfactant

A
  • starts production 20 weeks
  • gradual increase to 33-36 weeks
  • 36+ lrg increase in production
190
Q

Respiratory Distress Syndrome

- RF

A
  • DM mother
  • C-section
  • birth asphyxia
191
Q

Respiratory Distress Syndrome

- decreased risk

A
  • prolonged rupture of membranes

- prenatally admin steroids

192
Q

Respiratory Distress Syndrome

- clinical features

A
  • tachypnea
  • nasal flaring
  • exp grunting
  • retractions
193
Q

Respiratory Distress Syndrome

- management

A
  • mechanical ventilation

- exogenous surfactant

194
Q

Respiratory Distress Syndrome

- prolonged ventilator support at risk for?

A

bronchopulmonary dysplasia

195
Q

Acute cystitis peds

  • MC pathogen
  • Abx
A
  • e. coli
  • cephalosporins, augmentin
  • bactrim if PCN allergic
196
Q

Perioral dermatitis

- management

A
  • 1st line: topical metronidazole and erythromycin
  • oral tetracycline
    • avoid steroids!!
197
Q

Treatment for neonatal conjunctivitis

- gonorrhea

A

IV aqueous PCN G

198
Q

Treatment for neonatal conjunctivitis

- chlamydia

A

PO erythromycin

199
Q

Oral candidiasis

- tx

A
  • nystatin
  • clovtrimazole troches
  • po fluconazole
200
Q

RSV is what family of virus

A

paramyxoviridae

201
Q

Pneumonia

  • MCC org neonates (<28 d)
  • tx
A

S. aureus

- ampicillin + gentamicin or ampicillin + cefotaxime

202
Q

Pneumonia

  • MCC org 2wk - 4 mo
  • tx
A

C. trachomatis

- erythromycin, azithromycin, cefotaxime

203
Q

Pneumonia

  • MCC org >6 weeks lobar
  • tx
A

S. pneumoniae

  • 1st: amox, clindamycin
  • 2nd: ceftriaxone, cefotaxime
204
Q

Pneumonia

  • MCC org atypical 6W to 4Y
  • tx
A
  • B. pertussis

- macrolide or clarithromycin

205
Q

Pneumonia

  • MCC org atypical >4Y
  • tx
A
  • mycoplasma or chlamydia, influenza

- macrolide, doxy

206
Q

Pneumonia prevention

A

vaccination with hib and pneumococcal

207
Q

What sx is most sensitive and specific to pneumonia in kids? Rate by age group

A

tachypnea

  • <2 months >60
  • 2-12 months >50
  • 12 mo - 5 Y >40
  • > 5 Y >20
208
Q

Pertussis

- dx

A

mostly clinical

- Culture and PCR assays

209
Q

Pertussis

- tx

A
  • supportive care: bronchodilators, steroids, antihistamines, anti-tussive agents
  • Macrolide, bactrim 2nd line
210
Q

SSRIs

- list

A 
Paroxetine
Sertraline
Fluoxetine
citalopram
escitalopram
211
Q

SNRI

- list

A

duloxetine

venlofaxine

212
Q

Two SSRI recommended <18 yo

A

Fluoxetine

Paroxetine

213
Q

First line med for ADHD

A
  • stimulant: ritalin
214
Q

Psych treatment for <6 yo

A

behavioral therapy

215
Q

Best medication for bulimia purging

A

fluoxetine (but watch for cardio ADR)

216
Q

what med has ADR of gingival hyperplasia

A

phenytoin

217
Q

US findings in torsion of testicular appendage

A

blue dot sign

218
Q

Marfan findings

A
  • pectus excavatum
  • wrist and thumb signs (stretchy)
  • aortic root dilation and dissection
219
Q

Ehlers Danlos

- findings that differentiate from Marfan

A
  • skin laxity
  • contractures
  • skin nodules
  • Easy bruising
220
Q

Other name for mongolian spot

A

Dermal melanosis

221
Q

Henoch-Schonlein purpura

- overview

A

generalized vasculitis of skin, GI, joints, kidney

222
Q

Henoch-Schonlein purpura

- findings

A
  • palpable purpura: LE and buttocks
  • normal platelet count
  • colicky abd pain
  • intussusception
  • heme + stool
  • microscopic hematuria, proteinuria, elevated BUN/Cr
  • peri-articular disease of knee and ankle
    • Most cases resolve within 6 to 8 weeks, with a recurrence rate of up to 33%.
223
Q

how to confirm dx of appendicitis in pediatrics?

A

ultrasound: noncompressible, dilated appendix, aperistalsis, target appearance, etc.

224
Q

Erythroblastosis fetalis

A

transplacental passage of maternal antibody active against paternal RBC antigens of the infant and is characterized by an increased rate of RBC destruction that leads to anemia and jaundice in newborn infants

225
Q

First line treatment for urticaria

A

Second generation antihistamines: cetirizine, loratadine, fexofenadine

226
Q

necrotizing enterocolitis

A
  • MC neonatal GI emergency
  • abdominal XR to dx
  • RF: premature
  • abd distention, bloody stool, vomiting
  • tx: IVF, abx, sx
227
Q

Shigella

- common complication kids

A

seizures and high fever

228
Q

Still’s murmur

A
  • heard with bell at apex or LLSB
  • systolic, ejection, soft/vibratory
  • grade 1-2/6
  • louder supine
  • decreased sitting, standing, inspiration
229
Q

chlamydia trachomatis infant

- two MCC presentation

A
  • conjunctivitis

- pneumonia

230
Q

chlamydia trachomatis infant

- presentation

A
  • 3-16 weeks of age
  • nontoxic and is afebrile, but is tachypneic with a prominent staccato cough
  • diffuse rales with few wheezes
  • CXR: hyperinflation and diffuse interstitial or patchy infiltrates
  • Labs: eosinophilia
  • Tx: Azithromycin
231
Q

Tx for mod to severe croup

A

steroids

232
Q

Lyme disease

- two abx used in children

A
  • amoxicillin

- doxy

233
Q

Acute epiglottis

- MC orgs

A
  • h. flu (non immunized)

- Group A Strep - more common now due to immunization for h. flu

234
Q

Sickle cell with osteomyelitis

- MCC org

A

Salmonella spp

** overall increased risk of osteomyelitis

235
Q

Burn % of body

A
  • head/neck 9%
  • upper limbs 9% ea
  • trunk 36%
  • lower limbs 18% ea
  • genitalia 1%
236
Q

Burn management

A
  • wash with mild soap and water
  • cool compress
  • water over chemical burn X 20 min
  • Acetaminophen, NSAIDs, opioids
  • Silver sulfadiazine (silvadine) but not on face
237
Q

When is silvadine CI

A

sulfa allergy

pregnant

238
Q

Parkland formula for burn IVF

A

(% burn)(4 mL)(kg)

1/2 first 8 hours, 1/2 next 16 hours

239
Q

Type I allergic reaction

A
  • IgE
  • urticaria and angioedema
  • immediate
240
Q

Type II allergic reaction

A
  • cytotoxic
  • Ab-mediated
  • drug+cytotocix antibody = cell lysis
241
Q

Type III allergic reaction

A
  • Ab-Ag complex
  • vasculitis, serum sickness
  • IgG and IgM
242
Q

Type IV allergic reaction

A
  • delayed, cell mediated
  • morbiliform
  • erythema multiform
243
Q

Drug eruption

- management

A
  • Dc drug
  • antihistamine oral
  • systemic steroids
  • IM epinephrine if warranted
244
Q

Erythema Multiforme

- overview

A
  • Type IV reaction
  • MC 20-40 yo
  • HSV MC cause, also mycoplasma in children
245
Q

Erythema Multiforme

- clincal

A
  • target, dull red, vesicle/bullae in middle with pale rim, red halo
  • often febrile
246
Q

Impetigo

  • MC org
  • 2nd MC org
A
  • staph aureus

- GABHS

247
Q

Mumps

  • org
  • clinical
A
  • paramyxovirus

- low grade fever, myalgia, HA –> parotiditis

248
Q

Mumps

- complications

A
  • orchitis (unilateral)
  • oophoritis
  • encephalitis
  • meningitis
    • MCC pancreatitis in children
249
Q

MMR vaccine

A

12-15 months and 4-6 years

250
Q

measles

- org

A

paramyxovirus

- rubeola

251
Q

Measles

- complications

A
  • diarrhea
  • otitis media
  • pneumonia
  • encephalitis
252
Q

Rubella

- org

A

Togavirus

253
Q

Rubella

- clinical

A

“three day rash”

  • low grade fever, cough, anorexia, lymphedema
  • pink/light-red spotted maculopapular rash on face -> extremities. More rapid spread vs. measles
  • transient photosensitivity and joint pain
254
Q

Rubella

- congenital defects

A
  • sensorineural deafness
  • cataracts
  • TTP (blueberry rash)
  • Mitral regorge
    (part of TORCH)
255
Q

What exanthema is associated with ___ complication in sickle cell / G6PD?

A
  • erythema infectious (Parvovirus B19)

- aplastic crisis risk

256
Q

Lice

- treatment

A
  • permethrin topical
  • head for 10 min
  • pubis and corporis 8-10 hours
  • only >2 yo
257
Q

Lichen Planes

  • RF
  • describe
A
  • Hep C
  • purple, polygonal, planar, pruritic papules
  • fine scale and irregular borders
258
Q

Lichen Planes

- management

A
  • topical steroids
  • antihistamines
  • 2nd line: oral steroids, UVB light, retinoids
259
Q

Scabies

- management

A
  • permethrin topical neck to feet 8-14 hours, repeat in 1 week
260
Q

Conjunctivitis: Viral

  • MCC
  • presentation
  • tx
A
  • adenovirus (pool MC source)
  • red, itchy
  • preauricular lymphadenopathy
  • watery discharge
  • scanty mucoid discharge
  • usu bilateral
  • slit lamp: punctate staining
  • Tx: supportive, antihistamine
261
Q

Conjunctivitis: allergic

  • presentation
  • tx
A
  • cobblestone mucosa
  • itching, red, tearing
  • stringy dc
    +/- chemises
  • topical antihistamines (H1 blockers), olopatadine, pheniramine/naphazoline
262
Q

Conjunctivitis: bacterial

  • MC org
  • presentation
A
  • MC staph aureus, strep pneumo, h. flu
  • purulent dc, lid crusting
  • no visual change or ciliary injection
263
Q

Conjunctivitis: bacterial

- tx

A
  • erythromycin, fluoroquinolone, aminoglycoside topical abx

- contacts: FQ/aminoglycoside to cover pseudomonas

264
Q

MCC org for neonatal conjunctivitis by time

A
  • day 1: chemical from silver nitrate
  • day 2-5: gonococcal
  • day 5-7: chlamydia
  • Day 7-11 HSV
265
Q

orbital cellulitis

  • dx
  • tx
A
  • CT (MRI)

- IV abx (vancomycin, clindamycin, cefotaxime)

266
Q

otitis externa

- tx

A
  • cipro +/- dexamethasone (ok with TM perf)

- neomycin/polytrim +/- steroid (not ok with TM perf)

267
Q

AOM

- MC org

A
  • S. pneumonia (MC)
  • m. cat
  • h. flu
268
Q

AOM with bullae = ?

A

mycoplasma pneumonia

269
Q

Weber

  • sensorineural
  • conductive
A
  • lateralizes to normal ear

- lateralizes to affected ear

270
Q

Rinne

  • sensorineural
  • conductive
A
  • AC > BC

- BC > AC

271
Q

Way to memorize sensorineural

A

sensoriNeural lateralizes to Normal ear and Normal Rinne

272
Q

peritonsillar abscess

- progression

A

tonsillitis > cellulitis > abscess

273
Q

peritonsillar abscess

- mc org

A

GABHS, s. aureus, polymicrobial

274
Q

peritonsillar abscess

- dx

A
  • CT to differentiation from cellulitis
275
Q

peritonsillar abscess

- management

A
  • abx (ampicillin, clindamycin, PCN, metro)

- aspiration / I&D

276
Q

Herpes Simplex

- dx

A
  • PCR most sensitive and specific

- Tzanck smear

277
Q

Pinworms

- tx

A
  • albendazole

- mebendazole

278
Q

Varicella zoster

- org

A

HHV-3

279
Q

Varicella

- presentation

A
  • fever, malaise
  • vesicles on an erythematous base (dew drops on a rose petal) in crops
  • face and trunk -> extremities
280
Q

Pertussis

- dx

A
  • PCR nasopharyngeal swab within first 3 weeks of sx (gold standard)
281
Q

Bronchiolitis

- presentation

A
  • fever
  • URI
  • progresses to respiratory distress (wheezing, tachypnea, nasal flaring, cyanosis, retractions, +/- rales)
282
Q

Bronchiolitis

- CXR findings

A

hyperinflation

peribronchial cuffing

283
Q

Reye syndrome

A
  • ASA + viral illness

- rash, vomiting, liver damage, encephalopathy

284
Q

Acute hepatitis AST and ALT

A

both >500, if viral ALT > AST

285
Q

Hirschsprung dz congenital RF

A

Down Syndrome

286
Q

Hirschsprung

- presentation

A
  • meconium ileus ( no meconium in >48 hrs)
  • bilious vomiting
  • abd distention
  • FTT
  • toxic megacolon
287
Q

Duodenal atresia

  • congenital condition RF
  • associated with what
A
  • Down syndrome

- polyhydramnios

288
Q

Jaundice

- physiologic timing

A
  • rises day 3-5

- falls during first week

289
Q

Jaundice

- indications of pathologic cause

A
  • present within first 24 hours
  • persistent 10-14 days
  • direct >2
  • total >12
290
Q

Jaundice

- what level is worrisome for kernicterus

A

> 20

291
Q

Jaundice

- causes of increased indirect

A
  • premature baby
  • breast feeding jaundice
  • diseases
292
Q

Jaundice

- causes of increased direct

A
  • infection
  • Dubin-Johnson
  • Rotor syndrome
293
Q

hypertrophic cardiomyopathy

- overview

A
  1. hypertrophied septum

2. systolic anterior motion of mitral valve and papillary muscle displacement

294
Q

hypertrophic cardiomyopathy

- murmur

A
  • harsh, systolic crescendo-decrescendo LLSB
  • decreases with increased venous return (preserves outflow)
  • increase with decreased venous return (valsalva, sit to stand)
295
Q

hypertrophic cardiomyopathy

- mgmt

A
  • ICD
  • avoid dehydration and exertion
  • BB (caution with digoxin, nitrates, diuretics)
296
Q

VSD

- location

A
  • MC perimembranous
  • muscular (swiss cheese)
    L to R shunt
297
Q

VSD

- clinical

A
  • small: asx or mild sx
  • moderate: sweating/fatigue, esp during feeding (inc SNS dt reduced CO)
  • large: severe sx
  • restrictive: retained pressure between ventricles (small)
  • non-restrictive: pressure equal between ventricles
298
Q

VSD

- murmur

A
  • loud, harsh holosystolic LLSB
  • signs of CHF
  • ## +/- thrill and diastolic rumble at mitral valve due to increased flow
299
Q

ASD

- mc location

A
  • osmium secundum MC
300
Q

ASD

- clinical

A
  • usu asx until > 30
  • recurrent infections
  • dyspnea
  • FTT
  • fatigue
301
Q

ASD

- murmur

A
  • systolic ejection crescendo-decrescendo at pulmonic

- wide, split, fixed S2

302
Q

PDA

- location

A

descending aorta and pulmonary artery

303
Q

PDA

- murmur

A
  • continuous machinery murmur at pulmonic
  • wide pulse pressure
  • bounding peripheral pulse
304
Q

PDA

  • to keep open
  • to close
A
  • open: prostaglandin (E2)

- close: indomethacin

305
Q

Coarctation of the aorta

- location

A

descending aorta

** associated with bicuspid aortic valve

306
Q

Coarctation of the aorta

- clinical

A
  • 2 HTN
  • bilateral claudication
  • FTT
  • poor feeding
  • incr BP UE
  • delayed or weak femoral pulse
307
Q

Coarctation of the aorta

- murmur

A
  • systolic

- radiates to back/scapula/chest

308
Q

Coarctation of the aorta

  • CXR
  • GS dx
A
  • rib notching dt increased collateral circulation
  • 3 sign
  • GS: angiogram
309
Q

Coarctation of the aorta

- mgmt

A
  • sx
  • balloon angio and stent
  • prostaglandins pre-op
310
Q

Tetralogy of Fallot

- shunt type

A

MC R to L shunt

311
Q

Tetralogy of Fallot

- four components

A
  1. RV outflow obstruction
  2. RVH
  3. VSD (lrg, unrestrictive)
  4. overriding aorta
312
Q

Tetralogy of Fallot

- murmur

A
  • harsh, systolic LUSB

- RV heave

313
Q

Tetralogy of Fallot

- CXR

A

boot shaped heart

314
Q

Turner Syndrome

- clinical

A
  • 1 amenorrhea
  • early ovulation failure
  • delayed 2nd sex characteristics
  • short, webbed neck, edema, low hairline, low-set ears, widely spaced nipples
315
Q

Turner Syndrome

- assoc with what congenital defect

A

coarctation of the aorta

316
Q

Simple partial seizure

A

focal sensory, autonomic, motor sx

- no LOC

317
Q

complex partial seizure

A
  • aura (sensory, autonomic, motor)
  • lip smacking, picking, patting, etc
  • yes LOC
318
Q

Absense seizure

A

MC childhood seizure

- ethosuximide

319
Q

Febrile seizure

- simple

A
  • <15 min, tonic-clonic, once in 24 hours
  • fever >38
  • antipyretics will not prevent
  • no anti convulsive tx
  • may reoccur
320
Q

Febrile seizure

- complex

A

> 38 degrees
15 min or focal or recurs within 24 hours
- phenobarbital, valproic acid

321
Q

Hep B vaccine schedule

A

0, 2, 4 months

322
Q

what vaccines are given at 2, 4, 6 months

A
  • rotavirus
  • DTap
  • PCV
  • Hib
  • Polio
323
Q

when is DTap given

A

2, 4, 6, 15-18 months
4-6 years
12 years

324
Q

what vaccines are given 12-15 months and 4-6 years

A

MMR and varicella

325
Q

Hep A vaccine schedule

A

between 12-23 months

6-18 months apart

326
Q

HPV vaccine schedule

A

11-26 years for F

11-21 years for M

327
Q

Meningococcal vaccine schedule

A

11-12 years

328
Q

MC org meningitis

  • neonate
  • older
A
  • listeria

- strep pneumonia, h flu, N. meningitis

329
Q

LP findings in bacterial meningitis

A

neutrophils
cell # >1000
dec glucose
inc protein

330
Q

bacterial meningitis

- tx

A

IV abx
- ampicillin
+/- cefotaxime
+/- vanc

331
Q

LP findings ascetic meningitis

A
  • lymphocytes
  • cell # <1000
  • nl glucose
  • inc protein
332
Q

Panic disorder

- 3 components

A
  • concern for future panic attack
  • concern about implication of panic attacks
  • change in behavior to avoid panic attacks
    +/- agoraphobia
333
Q

Panic disorder

- mgmt

A
  • SSRI
  • CBT
  • benzo for acute management
334
Q

GAD

- define

A
  • anxiety/worry majority of days about various aspects of life
  • > 6 months
  • not episodic or focal
335
Q

GAD

- mgmg

A
  • SSRI
  • buspirone
  • benzo (ST only)
  • CBT
336
Q

MC offender in sexual abuse

A
  • male who knows the victim
337
Q

MC offender in physical abuse

A

primary female caregiver

** hyphema and retinal hemorrhage shaken baby

338
Q

Neglect

A
  • failure to provide the basic needs

- malnutrition, withdrawal, poor hygiene, FTT

339
Q

Obesity

- BMI

A

> 30 or body weight >= 20% ideal weight

340
Q

Obesity management

A
  • behavioral mod: exercise, diet, therapy
  • SSRI if depression
  • Orlistat (dec fat digestion), Lorcaserin (5HT agonist)
  • bariatric surgery
341
Q

Anorexia nervosa

- types

A
  • Restrictive: reduce kcal intake, diet pills

- purging: vomit, diuretic, laxative, enema

342
Q

Anorexia nervosa

- BMI

A

<17.5

weight <85% ideal weight

343
Q

when to hospitalize anorexia nervosa

A
  • <75% ideal weight

- medical complications

344
Q

Bulimia nervosa

- weight

A
  • normal or overweight
345
Q

management for AN and bulimia

A
  • CBT
  • SSRI (fluoxetine)
  • +/- atypical antipsychotics for AN
346
Q

autism

- describe

A
  • social interaction difficulties (emotional discomfort, detachment)
  • impaired communication
  • restricted, repetitive, stereotyped behavior
347
Q

Autism

- screening

A

M-CHAT

348
Q

Oppositional defiant disorder

- overview

A
  • pattern of negative, hostile, defiant behavior to adults
  • 6 months or more
    1. angry/irritable
    2. argumentative/defiant behavior
    3. vindictiveness
349
Q

Oppositional defiant disorder

  • mgmt
  • may progress to what
A
  • CBT

- conduct disorder

350
Q

Conduct disorder

- overview

A
  • persistent behavior that deviates from age-appropriate norms and violate the rights of others
  • social and academic difficulty
  • 40% become antisocial personality
351
Q

Conduct disorder

- 4 components

A
  1. serious violates of law
  2. aggressive, cruel to animals
  3. deceitful
  4. destruction of property
352
Q

ADHD

- 3 components

A
  1. inattentiveness
  2. hyperactivity
  3. impulse control
353
Q

ADHD

  • required for dx
  • screening test
A
  • must have sx < 12 yo
  • must be in 2+ settings (home, school, etc.)
  • must occur >6 months
  • Vanderbilt to screen
354
Q

ADHD

- mgmt

A
  • behavioral modification
  • sympathomimetic meds (stimulants)
  • non stimulants
355
Q

ADHD

- stimulants

A
  • methylphenidate (Ritalin)
  • amphetamine/dextroamphetamine (Adderall)
  • MoA: blocks NE and dopamine reuptake
  • S/E: anxiety, HTN, tachycardia, weight loss, growth delay, addiction
356
Q

ADHD

- nonstimulant

A
  • atomoxetine
357
Q

1 predictive factor for suicide

A

previous attempt or threat

ask directly if they have a plan

358
Q

Major depressive disorder

- define

A 
- decreased mood and/or anhedonia for 2+ weeks
and >5 of:
- fatigue
- insomnia
- guilt, etc. 
SIGECAPS
359
Q

Major depressive disorder

- mgmt

A
  • CBT
  • SSRI min 3-6 weeks
  • Add on burporpion or mirtazapine
  • 3rd line: TCA, MAO
  • Electroconvulsive therapy
360
Q

Legg-Calve-Perthes

A
  • avascular necrosis of femoral head
  • MC 4-10 male
  • painless limping, worse with activity, end of day
  • lose abduction and internal rotation
  • XR: Crescent sign
  • observation, activity restriction, pelvic ostomy
361
Q

Slipped Capital femoral Epiphysis

A
  • femoral head is posterior and inferior
  • hip, knee pain with limp
  • external rotation of leg
  • Mgmg: ORIF and non weight bearing
362
Q

Osgood Schalter disease

A
  • osteochondritis of patellar tendon at tibial tuberosity
  • dt overuse
  • MC 10-15 yo active male with growth spurt
  • RICE, NSAIDs, quad stretching
363
Q

Scoliosis

A
  • lateral curve >10
  • MC F 8-10 onset
  • 20-40: brace
  • > 40 surgery
364
Q

Osteosarcoma

A
  • 90% on metaphysis of long bone (femur, tibia, humerus)
  • MC mets to lung
  • bone pain, joint swelling
  • XR: hair on end/sunburst
  • mgmt: sx and chemo
365
Q

Ewing Sarcoma

A
  • giant cell tumor
  • MC 5-25
  • femur MC, then pelvis
  • bone pain, mass, joint swelling
  • MC mets to other bone
  • XR: layered periosteal layers “onion skin”
  • mgmt: sx, chemo, radiation
366
Q

Osteochondroma

A
  • mc benign tumor
  • 10-20 male
  • pedunculate, grows away from physics
  • observation, resection if painful or in pelvis
367
Q

congenital hip dysplasia

- RF

A
  • fam hx
  • breech
  • female
  • first born
368
Q

congenital hip dysplasia

- clinical

A
  • unequal thigh folds
  • short leg
  • painless limp
  • ortolani and barlow
  • Galeazzi - unequal knee length
  • Trendelenburg
369
Q

congenital hip dysplasia

  • dx
  • mgmt
A
  • PE at birth and WCC until walking
  • limited hip adduction when knees at 90 flexion
  • Ultrasound
  • observation for spontaneous resolution, Pavlik harness, closed reduction
370
Q

Juvenile RA

- 3 kinds

A
  • Paci-articular
  • systemic/acute febrile
  • polyarticular
371
Q

Juvenile RA

- paci-articular

A
  • 50%
  • <5 joints
  • MC large joints like knee and ankle
  • type I assoc with iridocyclitis / anterior uveitis
  • Type II assoc with ankylosing spondylitis
372
Q

Juvenile RA

- systemic/acute febrile

A
  • 20%
  • daily arthritis
  • diurnal fever
  • large and small joints
  • salmon/pink rash
373
Q

Juvenile RA

- polyarticular

A

30%

  • > = 5 small joints
  • most similar to adult RA
  • risk iridocyclitis
374
Q

Juvenile RA

  • dx
  • mgmg
A
  • ESR, CRP, ANA (RF only 15%)
  • NSAIDs, steroids, methotrexate, leflunomide
  • eye exams
375
Q

Insulin

  • rapid acting
  • short acting
  • intermediate acting
  • long acting
A
  • Humalog and Novolog
  • Regular
  • NPH
  • Levemir and lantus
376
Q

hypercalcemia

- lab findings

A
  • increased ca
  • increased PTH
  • decreased phosphate
377
Q

hypercalcemia

- clinical

A
  • stones, bones, groans, psych overtones

- decreased DTR

378
Q

Hyperthyroid

A
  • MCC graves
  • TSH receptor antibodies increase thyroid hormone synthesis
  • sign: pretibial myxedema
  • dx: thyroid-stimulating ab, red TSH, inc T4
  • RAIU increased uptake
379
Q

hyperthyroid

- mgmt

A
  • radioactive iodine
  • methimazole/PTU
  • BB for sx
  • thyroidectomy
380
Q

Cretinism

- cause

A
  • congenital hypothyroid

- dt maternal hypothyroid or infant hypopituitarism

381
Q

Cretinism

- clinical

A
  • macroglossia
  • hoarse cry
  • coarse facial features
  • umbilical hernia
  • weight gain
  • mental development issues
  • levothyroxine to treat
382
Q

Anemia

- lab

A
  • dec ferritin
  • inc TIBC
  • dec serum iron
  • dec transferrin saturation
383
Q

Anemia

- lead poisoning

A
  • sideroblastic anemia
  • basophilic stippling
  • increased serum lead and iron
  • XR: lead lines at metaphyseal plates
  • screen 9-12 mo and 24 months
384
Q

Thalassemia

- overview

A
  • reduced production of globin chains
  • normal or increased iron
  • suspect if anemia doesn’t respond to iron treatment
385
Q

Thalassemia

- alpha overview

A
  • decreased alpha globin production
  • Asian
    Alleles affected:
    1: asx
    2: mild microcytic anemia
    3: similar to beta-thalassemia
    4: hydrops fettles, still birth
386
Q

Thalassemia

- alpha dx

A

folate, avoid oxidative stress, no Fe supplements

387
Q

Thalassemia

- beta overview

A
  • reduced beta chains, increased alpha chains
  • B-thal. trait (minor): usu asx, mild ot mod anemia
  • B-thal major (Cooleys): asx at birth, sx start about 6 months
388
Q

Thalassemia

- beta major clinical

A
  • frontal bossing and maxillary overgrowth dt extra medullary hematopoeisis
  • hepatosplenomegaly
  • severe hemolytic anemia
389
Q

Beta Thalassemia

- dx

A
  • electrophoresis
    Minor: increased HgbF, decreased HgbA
    Major: major inc HgbF, little to no HgbA
390
Q

Thalassemia

- mgmt

A
  • blood transfusions
  • vitamin C and folate supplementation
  • iron chelation
391
Q

Sickle Cell

- signs

A
  • dactylitis (digital swelling)
  • osteomyelitis (salmonella**)
  • functional asplenia
392
Q

Sickle cell

- dx

A
  • sickled RBC

- Howell-jolly bodies

393
Q

Sickle cell

- mgmg

A
  • pain: O2 and IVF
  • folic acid
  • immunizations: SHiN (s. pneumo, Hib, influenza, N. meningitis)
394
Q

Hemophilia A

A
  • Factor 8
  • MC, almost only males
  • Intrinsic pathway (PTT)- normal platelets but increased PTT
  • hemarthrosis, hemorrhage
  • Factor 8 infusion, DDAVP
395
Q

Hemophilia B

A
  • Factor 9
  • clinically similar to A
  • Factor 9 infusion, DDAVP not used
396
Q

Hodgkin lymphoma

A

Bimodal: peak at 20 and >50

  • Epstein-barr virus association
  • upper body lymph nodes
  • painless lymphadenopathy
  • Reed-Sternberg cells
  • mediastinal lymphadenopathy
397
Q

Non-hodgkin lymphoma

A
  • peripheral lymph nodes

- usually older people

398
Q

Acute lymphocytic leukemia

A
  • malignancy of lymphoid stem cells in bone marrow
  • peak age 3-7
  • RF down syndrome
  • Clinical: pancytopenia (fever MC)
  • CNS sx: HA, vision change, etc.
  • Dx: bone marrow hyper cellular with >20% blasts
  • chemo
399
Q

Brain tumor

A

60% infratentorial

  • pilocytic astrocytoma MC overall: benign
  • medulloblastoma MC malignant
400
Q

Cystitis

- mgmt

A
  • nitrofurantoin
  • bactrim
  • <2 : cefixime
401
Q

Cystitis

- RF

A
  • vesicourethral reflux
  • DM
  • catheter
  • UA: pyuria, leukocyte esterase, nitrites
402
Q

Enuresis

  • def
  • mgmt
A
  • bedwetting > 5 w/o infection

- behavioral (motivation, bladder training, fluid restriction), enuresis alarm, desmopressin, TCA last resort

403
Q

Hypospadias

- mgmt

A
  • do not circumsize
  • bilateral US to eval for ascending pathology
  • pediatric urologist referral
404
Q

Vesicourethral reflux

A
  • mislocated or incompetent uterovesical valves
  • RF: recurrent UTI, weakness of trigone
  • F>M
  • bedwetting, renal insufficiency, HTN, proteinuria
  • Dx: VCUG, renal US
  • magma: spont resolution common, ACE/Arb HTN, abx prophylaxis for UTI
405
Q

Post streptococcal glomerulonephritis

- 3 sx

A
  • hypertension
  • hematuria
  • peri-orbital edema
406
Q

Bacterial tracheitis

- mcc org

A

staph aureus

407
Q

how long can an ingested blunt object be observed before must be removed?

A

24 hours

408
Q

Breast milk jaundice vs. breastfeeding jaundice

A
  • Breastmilk: factor in milk increases enterohepatic recirculation of bilirubin. Onset later half first week of life, peak bilirubin about 2 weeks. Baby feeds, voids, grows, normal development
  • Breastfeeding jaundice: Suboptimal milk intake by baby. Decreased urine output, excessive weight loss, sleepiness, and decreased skin turgor, prolonged duration of meconium,
409
Q

When should infant regain birth weight

A

2 weeks

EORs (9 decks)

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