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Third Year Shelf > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

2 day female, feeding were fine. Now bright green emesis. Distended abdomen but can be compressed. No stool in rectal vault. Xray dilated loops of bowel with a ground glass appearance in RLQ and scant air distally in colon. Next step?

A

obstruction

Could be meconium ileus

Test: Upper GI series and contrast enema

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2
Q

Possible tuberculosis in 3 y.o

A

TST (skin test) even if had vaccine

Interferon gamma release assay not done till 5 y.0

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3
Q

Live vaccines

A

MMR, Rota, Varricella, intranasal flu

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4
Q

Inactivated vaccines

A

Hep A, Hep B, Polio, diptheria, streptococcus, pneumococcal, Hib

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5
Q

Vaccines in first year

A

Hep B, Rota, Dtap, Hib, Streptococcal pneumonia, Polio, influenza

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6
Q

Vaccines given at 12 months

A

MMR, varicella, Hep A

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7
Q

Bone pain, sunburst pattern, humerus

Associated with

A

Osteosarcoma

Retinoblastoma

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8
Q

onion skinning w/ lytic appearance, shaft lower extremity

A

Ewing sarcoma

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9
Q

Click in baby’s hip when examining

A

Reexamine at 2 weeks

Ultrasound at 4 weeks if persists

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10
Q

Ciprofloxacin drops

A

Pseudomonas coverage for ear

Otitis externa

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11
Q

Pyloric stenosis

A

IV fluid first

Then pyloromyotomy

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12
Q

Tetanus question

A

If they have had 3 lifetime doses of tetanus then no immunoglobulin needed

If recieved less than 10 years ago then no booster either

If >10 years and clean wound or dirty wound 5 years since booster –> Only need tetanus booster

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13
Q

Eczema, thrombocytopenia, frequent infections in young child

  • due to what
  • tx
A

Wiskott-Aldrich syndrome (WAS)

Impaired cytoskeleton changes in leukocytes, platelets

Tx: Stem cell transplant

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14
Q

Low platelets and hematochezia
Anemia
Schistocytes
Renal failure

A

Hemolytic uremic syndrome

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15
Q

Isolated thrombocytopenia

Large immature platelets

A

Idiopathic thrombocytopenic purpura

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16
Q

X linked agammaglobulinemia

A

Males only

Lacks B cells

Recurrent sinopulmonary infections

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17
Q

Hyper Igm Syndrome

A

Recurrent infections
High IgM
Low IgA IgG

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18
Q

“Spells”
Conscious but unresponsive and unaware of environment

Maintain motor function

Eyes open

Doesnt interact

Repetitive hand movements

Confusion following
No recollection of event

A

Complex partial seizure

Alteration in mentation= complex

No tonic-clonic activity (only automatism)= partial

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19
Q

Complex seizure

A

Alteration in mentation

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20
Q

Complex generalized seizure

A

Tonic clonic
(Full body convulsions)

Alternation in mentation

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21
Q

Prevent drowing

A

Life jacket

Supervision

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22
Q

Cyanotic baby

Persistent hypoxemia that does not improve w/ oxygenation

No murmur

A

Not improving w/ oxygenation –> none of the inspired oxygen is getting to systemic arterial circulation –> transposition of great vessels

Baby only alive due to patent ductus arteriosus

Must keep patent
Tx Prostaglandins prolongs the duct

[Endomethacin (indomethacin) ends the ductus]

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23
Q

Diagnose coarctation of aorta

A

Echo

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24
Q

Water for infant

A

120 or lower to decrease chance of burns

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25
Q

Urethra on ventral side of shaft

A

hypospadias

Delay circumcision so there is foreskin for reconstruction

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26
Q

Kid gets transfusion and has anaphylactic rxn

Recurrent gastrointenstional infections

A

Selective IgA deficiency

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27
Q

ABO mismatch

A

Hemolysis

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28
Q

2 y.o abdominal pain
Fecal occult blood
Cylindrical mass

Relief w/ pulling feet to chest

A

Intussusception

Abdominal US

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29
Q

Technetium 99 scan

A

Meckel’s diverticulum

Presents as asymptomatic GI bleed

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30
Q

Asthma like but no response to therapy

Negative CXR

A

Infxn w/ RSV

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31
Q

Knee to chest position does what

A

Increased systemic vascular resistance

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32
Q

Blue baby when eats, resolves

A

Tetralogy of fallot

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33
Q

2/6 systolic crescendo-decrescendo murmur on left sternal border

A

ventricular septal defect

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34
Q

Transposition of great vessel vs tetralogy of fallot

A

Transposition diagnosed at birth or baby dies

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35
Q

Nodule of tibial tuberosity in teenager

Xray irregularities and haziness over metaphyseal border of tibia

Tx

A

Osgood-Schlatter disease

Decrease activity and NSAIDS follow by PT

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36
Q

Retinal hemorrhages next step

A

CT scan of head for subdural hematoma

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37
Q 
Leg pain
Lytic lesion with clear ring on bone
Worse at night
NSAIDS help some
No fever or WL
A

Osteoid osteoma

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38
Q 
Alcohol consumption
Pain in abdomen 
Resolved by morning
No discharge
No costovertebral angle tenderness

Dx

A

Ureteropelvic junction (UPJ) obstruction

U/S

Narrowing is distended in setting of large diuresis

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39
Q

2/6 holosystolic murmur

Adult
Child

A

Mitral regurg and ventricular septal defect

Ventricular septal defect more common

Children do not have MR

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40
Q

Most common congenital heart disease after age 1

A

Atrial septal defect

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41
Q

Fixed split S2

A

Atrial septal defect

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42
Q

Infant multiple UTI what test

A

Voiding cystourethrogram

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43
Q

Increased conjugated bilirubin and Jaundice

Dx

A

US of RUQ

Blockage somewhere

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44
Q

Sickle cell on peripheral smear

A

Howell-Jolly bodies if no spleen

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45
Q

Bite cells

A

G6PD deficiency

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46
Q

African
Pain crises w/ jaundice
Reduced hemoglobin
Reticulocyte count of 15%

How to prevent death

A

Sickle cell disease

Vaccination w/ conjugate capsular polysaccharide

Strep. pneu
H. flu

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47
Q

5 day old infant with eye infection. Gram negative diplococci

Tx

A

Intramuscular ceftiraxone

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48
Q

Tx chlamydia (unilatearl purulent conjunctivitis)

A

Oral erythrmycin

PO macrolide

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49
Q

Prophylaxis for gonoccal conjunctivitis

A

Topical silver nitrate

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50
Q

Newborn no urine in 24 hrs

Suprapubic mass

Dx

A

Posterior urethral valves

Suprapubic mass= distended bladder

Straight catheterizeation

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51
Q

2 y.o SOB and barking cough. Improved by going outside. Low grade fever. Wheezing

Tx

A

Croup

Parainfluenza

Racemic epinephrine

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52
Q

10 day old infant. Becoming progressively jaundice. Clay stools

Bilirubin 7 with 6 being unconjugated

A

Breast milk jaundice

AFTER baby went home –> Breast feeding or breast milk jaundice

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53
Q

Swollen tonsils with white on them, sore throat

At risk for

A

Streph

Risk for glomerulonephritis

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54
Q

Way to prevent painful legs in sickle cell patient

A

Hydroxyurea

Reduces amount o f sickle hemoglobin in circulation

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55
Q

Contraindications for vaccine

A

Encephalopathy

Relative

  • fever > 105
  • Insoluble cry 3 hrs
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56
Q 
Bleeding in diaper
20 months old 
No pain or distress
Eating and drinking normal 
Sort non distended abdomen

Dx

A

Meckel’s diverticulum

Technetium 99 scan

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57
Q

Seizing child
< 1 y.o
Hyparrhythmia on EEG

Tx

A

West syndrome

TX: ACTH (cosyntropin)

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58
Q

Adams forward bend test

A

Scoliosis

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59
Q

Female 4 y.o who keeps wetting diapers. Feels urge and trained on potty but keeps happening

A

Low implantation of ureter

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60
Q

Toilet training age

A

2-4

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61
Q

Disease of newborn

A

Intraventricular hemorrhage
Bronchopulmonary dysplasia
Retinopathy of prematurity
Necrotizing enterocolitis

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62
Q

Air in the stomach and duodenum without any distal air

A

Annular pancreas or duodenal atresia

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63
Q

Multiple air fluid levels

A

Vascular insult

intestinal atresia

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64
Q

Distended proximal colon with normal gas pattern distally

A

Hirschsprung’s disease

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65
Q

Increased soft tissue swelling w/ throat issue

A

Retropharyngeal abscess

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66
Q

Thumb print

A

Epiglottitis

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67
Q

Steeple sign

A

Croup

Bacterial tracheitis

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68
Q

Projectile vomiting of bilious contents is indicative of

multiple air fluid levels

A

Pathlogic emesis in a newborn

Multiple air fluid levels -> Intestinal atresia –> cocaine

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69
Q

Recurrent abscesses

A

Absent macrophages oxidative burst seen in chronic granulomatous disease

Typical pathogens staph, aspergillus, serratia

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70
Q

Percentages of body

A

Head 18% (9% front and back)

Arm- each arm is 9%

Thorax- front and back thorax are 18%

Legs- total is 27%, 13.5 for each leg

Genitals- 1%

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71
Q

Dx esophageal atesia

A

NG tube and x ray to confirm placement

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72
Q

NEwborn, difficulty feeding. Coughs and spits up his feedings both times it is attempted. Gurgling bubbles form mouth. Infant becomes cyanotic but improves w/ suction

A

Esophageal atresia

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73
Q

Pre-eclampsia in mother and infant not passing meconium

A

Check Mg level

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74
Q

Jittery infant with glucose of 20

Diabetic mother

A

IV administeration of D10 bolus

Infant is hypoglycemic

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75
Q

Baby with two blue dots on butt, there at birth

A

Congenital Dermal melanocytosis

Mongolian spot

Latin culture

Spontaneously resolve

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76
Q

7 y.o w/ strep and given pencillin develops hives

what to do

A

Discontinue penicillin

State cephalexin & cetrizine

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77
Q

Lower risk BRUE

A

> 60 days
45 weeks post conception if over 32 weeks
First occurrence

No CPR by trained provdier

No concerning findings on hx/PE

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78
Q

Higher risk BRUE

A 
Premies
Under 2 months
< 60 days
<45 weeks post conceptional 
Multiple episodes
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79
Q

Infant given aspirin check what level

A

ammonia

Hepatic encephalopathy

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80
Q

6 y.o w/ headache and rash. Has been outside on farm. Rash with ring of erythema surrounding a ring of clearing, surrounding a hyperpigmented lesion at the center

A

Lyme disease

Tx: Amoxicillin

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81
Q

16 y.o egg allergy wanting flu shot

A

Inactivated influenza vaccine and observe for 30 min

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82
Q

Legg- Calve Perthes disease

A

Ischemia and osteonecrosis of the femoral head in a child around 6 y.o

Antalgic gait (limp)

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83
Q

Machine like murmur

A

Patent ductus arteriosus

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84
Q

3 y.o
Infxn 6 weeks ago
Flank mass
Hematuria

A

Wilms tumor

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85
Q

4 y.o
Febrile seizure
Hypopigmentation that enhaces under wood’s lamp
Small calcified appearing tumors in brain

Develop later in life?

A

Tuberous sclerosis

Febrile seizure fails to remit
Ash-leaf lesions
Sebacous adenoma

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86
Q

Failure to pass meconium

Distended abdomen w/ palpable stool

Stool in small bowel w/ some in colon. No stool in rectal vault

Proximal colon dilated and distal colon appears normal

A

Hirschsprung disease

Contrast enema

Next step after Rectal suction biopsy to confirm

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87
Q 
Cleft lip
Low set ears
Wide spaced eyes
Hypocalcemia
Reduced PTH
Candida in blood
A

Deletion on chromosome 22

DiGeorge sydnrome

Deficiency of parathyroid gland

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88
Q

9 mn w/ recurrent abscess

A

Leukocyte adhesion deficiency

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89
Q

Nitro blue test positive

A

Indicates oxidative burst produced by leukocytes present

So not Chronic granulomatous disease

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90
Q

Chediak higashi syndrome

A

Neuropenia on lab work

Albinism

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91
Q

Infant w/ downs syndrome most likely heart defect

A

Ventricular septal defect

Holosystolic murmur at the left sternal border

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92
Q

Take to ER for epistatsis

A

After 30 min

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93
Q

Growth delay in kid check

A

Left wrist and hand radiograph

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94
Q

HA, emesis, vision changes, nystagmus and ataxia

A

Intracranial pathology

Check brainstem

MRI

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95
Q

Hearld patch–> generalized rash

What test

A

RPR

pityriasis rosea

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96
Q

Fracture
Blue sclera

Tx

A

Osteogenesis imperfecta

Skin biopsy

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97
Q

Check serum calcium and phosphorus for

A

Rickets

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98
Q

Large newborn with grunts and limp arm

A

Phrenic nerve disruption

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99
Q

3 infections of neisseria meningitidis

A

C6, C7, or C8 deficiency

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100
Q

Chronic skin infections, abscess formation, osteomyelitis, and pneumonia

A

Chronic granulomatous disease

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101
Q

Albino like skin
Ocular albinism
Frequent infections

A

Chediak Higashi syndrome

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102
Q

Fever, aphthous ulcer, stomatitis, and/ or pharyngitis

Repeated episodes

A

Cyclic neutropenia

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103
Q

Mother gets nonspecific flu like symptoms

Brown amniotic fluid and preterm

Baby comes out with pustular rash

A

Listeria monocytogenes

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104
Q

GBS & Ecoli in newborn

A

Normal appearing baby with nonspecific findings of temperature instability, lethargy and poor feeding

GBS –> progresses rapidly to tachypnea, grunting, retractions, trachycardia and poor perfusion

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105
Q

Tx enlarging red mass on baby butt, present at birth

A

Observe

Hemangioma tends to enlarge over first year then slowly decrease in size

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106
Q

late systolic murmur at apex and midsystolic click

Tx

A

Mitral valve prolapse

Tx beta blocker

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107
Q 
Fever 102 (spiking)
Swollen red eyes
Rash
Palms and soles swollen and red
Lymphadenopathy
A

Kawasaki disease

Fever > 5 days
Bilateral non-suppurative conjunctivitis
Dry fissured lips
Injected lips
Strawberry tongue

Risk: Coronary artery aneurysms
Myocardial infarction

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108
Q

Scarlet fever

A

Group A strep

Abrupt onset fever, sore throat, HA, abdominal pain and malaise

Bright red mucous membranes with petechiae on soft palate

Strawberry tognue

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109
Q

CHARGE syndrome

A 
Coloboma
Heart defects (septal defects and aorta/aortic arch defects) 
Choanal atresia
Retardation of growth and development
Genital anomalies
Ear anomalies
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110
Q

Upper limb defect

Cardiac defect

A

Holt-Oram syndrome

Atrial septal defect

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111
Q

Neonatal jaundice w/ days of phototherapy
Anemia (pallor)
Enlarged spleen w/o hepatomegaly

A

Hereditary spherocytosis

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112
Q

Hearing localizes to right. bone conduction greater

A

conductive hearing loss on right

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113
Q

10 y.o fell to floor and acute onset headache

Lethargic
Right central facial weakness

Cannot move right side of body

Eyes deviated to left

A

Occlusion of middle cerebral artery

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114
Q

Post morning stiffness in child/ after nap. +ANA

At risk for

A

Juvenile idiopathic arthritis

Anterior uveitis

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115
Q

Chalazion

A

lump in eye lid

painless
red

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116
Q

Dacryocystitis

A

infxn of lacrimal gland

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117
Q

Hordeolum

A

style

infection on eye lid

hairfollicle

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118
Q

Hyphema

A

pool of blood in eye

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119
Q 
two month old
Seizure
Doll like appearance
Hepatomegaly
Low glucose level
Lactic acidosis
Hyperuricemia
Elevated triglycerides
A

Von Gierke disease

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120
Q

Macroglossia
Hypotonia
Hepatomegaly
Enlarged heart

A

Pompe disease

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121
Q 
Macroglossia
Omphalocele
Large umbilical hernia
Hypoglycemia
Hepatomegaly
Enlarged kidneys
A

Beckwith-Wiedeman

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122
Q

Cataracts

Galactosuria

A

Galactokinase deficiency

no mental retardation

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123
Q

Galactosuria and mental retardation

A

classic galactosemia

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124
Q

Hypoglycemia
Ataxia
Coma
Hypothermia

injest what

A

Ethanol

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125
Q

Infants who are small at birth are at risk for

A

Hypoglycemia

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126
Q

Baby is noisy breather
Inspiratory stridor

(no cyanosis)

A

Laryngomalacia

Self limiting

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127
Q

Yellow green nail on infant

A

Meconium in utero

Give Broad spectrum antibiotics

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128
Q

Patient with asthma fails beta agonist and steriods

Test to do

A

Flexable laryngoscope

Inducible laryngeal obstruction (vocal cord dysfunction)

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129
Q

Child w/ sickle cell and has ischemic stroke what to do

A

Admit and begin emergency partial exchange transfusion

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130
Q

Cardiac tumor on ultrasound

also see

A

tuberous sclerosis

Hypopigmented skin lesions

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131
Q

Axillary freckling

A

Neurofibromatosis 1

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132
Q

Brushfield spots on iris

A

Down syndrome

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133
Q

Coloboma

A

CHARGE syndrome and Trisomy 13

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134
Q

Unilateral port-wine lesions

A

Sturge- Weber syndrome

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135
Q

Risk factors of renal vein thrombosis in infant

A

Birth asphyxia (apgar scores less than 7)

Diabetic mother

Polycythemia

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136
Q

Floppy baby

A

Continue oxygenation

Mother given narcotic due to pain –> respiratory depression

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137
Q

Strep decision points

A 
1 point 
[ ]Fever > 100.4 F
[ ] No cough
[ ] Tonsillar exudate
[ ] No mention of cervical lymphadenopathy
[ ] Age 3-14

15-44 +0
45+ -1

Score 0= no testing
Score 1= consider rapid strep test
Score 2 or 3= rapid strep
Score 4= tx empirically

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138
Q

Bilateral hydronephrosis on prenatal ultrasonography

A

Suggests obstuction

(In males posterior urethral valves)

Get renal and bladder ultrasound

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139
Q

Hematemesis in baby with no signs of distress

What exam

A

Send emesis to lab for Apt-Downey test

Blood from another source

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140
Q

Child delivered with prolonged labor, had non-tender demarcated swelling that doesnt cross suture lines over parietal region

A

Cephalohematoma

Observe for extension of lesion or jaundice

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141
Q

Neurologic deterioration with exaggerated resposne to noise and no hepatosplenomegaly

A

Tay-Sachs

Cherry red spot

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142
Q 
Normal birth
2-4 y.o 
Coarse facies
Short
Hepatosplenomegaly
Hearing loss
Retinal degeneration
Mental retardation
A

Hunter syndrome

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143
Q 
1 y.o 
course facies
corneal clouding
Hepatomegaly
Heart disease
Skeletal deformities
Developmental delays
A

Hurler syndrome

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144
Q 
3 months
Hepatosplenomegaly
Cherry red spot
FTT
Resp tract infections

Age 6 hypotonia
Spasticity
Rigidity

A

Niemann-pick

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145
Q

High fever that goes away and rash develops

A

Roseolainfantum

Roseola (HHV 6)

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146
Q 
Day 2 infant
96.9 F
HR 180
Oxygen sat 65%
Cyanosis
Hepatosplenomegaly
A

Shock in infant

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147
Q

Day 2 infant

Enhanced right ventricular impulse, normal first heart sound and loud isngle heart sound

A

Left sided cardiac abnormality

Day 2 closure of ductus in patients with hypoplastic left heart –> cyanosis

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148
Q

Rapid course of altered mental status, fever, shock, and progression of purpura

A

Meningococcemia

Hypotension
Cardiac depression

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149
Q

Fever or bloody diarrea week before

Now elevated BUN and CR
Proteinuria
Hematuria

Anemia
Low platelets

A

Hemolytic uremic syndrome (HUS)

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150
Q

Single slightly raised orange peel like hairless lesion on scalp of new born

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Nevus sebaceus

Removal recommended

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151
Q

New born healthy
Multiple erythematous blotchy macrules on face, back, chest and upper extremities. Have like pustules in center

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Erythema toxicum

Resolves in 14 days

Contains eosinophils

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152
Q

Rash on skin under neck, upper back, lower back and rash appeared in three stages

numberous 2-4 non erythemaous lesions with intact pustules

Ruptured pustules

Rim of thin skin found at endge of denuded pustules

Freckle like lesions of same size noted proximal to previous two lesions

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Pustular melanosis

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153
Q

Ill-defined red macule over the glabella, nuchal area and symmetrically over eye lids

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Nevus simplex (salmon patch)

Fade over first months of life

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154
Q

Pustules isolated to cheeks and forehead

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Neonatal acne

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155
Q

Single lesion on scalp with well-demarcated area of missing skin

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Aplasic cutis congenital

Sporadic
Autosomal dominant
Teratogen exposure (HSV or varicella)
Trisomy 13

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156
Q

Well circumscribed light brown to black macules (may have hair)

A. Aplasic cutis congenital
B. Congenital melanocytic nevi
C. Erythema toxicum
D. Herpes simplex virus infection
E. Mongolian spot
F. Neonatal acne
G. Nevus sebaceus
H. Nevus simplex
I. Port wine stain
J. Pustular melanosis
K. Seborrheic keratosis
A

Congenital melanocytic nevi

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157
Q

Suspected myelomeningocele

What test

A

Ultrasound of lower spine

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158
Q

Seen w/ DiGeorge

A

Cardiac anomalies (tetralogy of fallot, truncus arteriosus, interrupted aortic arch)

Abnormal facies

Thymic hypoplasia

Cleft palate

Hypocalcemia

Chromosome 22

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159
Q

Cleft lip
Mandibular hypoplasia
Downslanted palpebral fissures
Low set notched ears

A

DiGeorge

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160
Q 
Microcephaly
Wide fontanels
Microphthalmia
High arched palate
Malformed ears
heart defect
pulmonary hypoplasia
omphalocele
A

Edwards syndrome (trisomy 18)

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161
Q

Newborn w/ fever, irritability and poor feeding

Voids 15 x per day

Dehydration

Hypernatremia

Urine gravity <1.005

No leukocytes
No Leukocyte esterase

A

Diabetes inspidius

Nephrogenic DI

test

  • water deprivation test
  • MRI brain
  • trial of desmopressin
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162
Q

Microcephaly
Corneal clouding
Jaundice

Petechiae
Murmur (continuous harsh)

A

Congenital rubella

Murmur= patent ductus arteriosus

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163
Q 
Small for gestational age
Hepatosplenomegaly
Anemia
Thrombocytopenia --> petechiae and purpura
Microcephaly
Deafness
cerebral atrophy
A

Congenital cytomegalovirus

Imaging- calcification in a periventricular pattern

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164
Q

Vaginally born
Week old

Sepsis
Penumonia

A

Congenital herpes

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165
Q

Hepatosplenomegaly
Lymphadenopathy
Thrombocytopenia
Mucocutaneous rash

Runny nose
FTT
Chorioretinitis

A

Congenital syphilis

Hutchinson teeth

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166
Q

Microcephaly
Anemia
Thrombocytopenia
Jaundice

Mental retardation
Hearing loss
Blindness
Neurologic sequelae

A

Congenital toxoplasmosis

Intracranial calcifications

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167
Q

Recurrent oral and genital ulcers

  • disease
  • look for
  • test
  • complications (3)
A

Behcet disease

Look for anterior and posterior uveitis

Positive pathergy skin test

Complication= vasculitis (pulmonary artery aneurysms are fatal) and arthritis

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168
Q

Distal small bowel wall thickening on CT

A

Crohns disease

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169
Q

Harsh holosystolic ejection murmur at left lower sternal border

A

Ventricular septal defect

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170
Q

Baby has to stop feeding to catch breath

A

Ventricular septal defect

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171
Q

Harsh systolic murmur at right sternal border at second intercostal space.

Crescendo-decrescendo systolic murmur

A

Aortic stenosis

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172
Q

Tenderness of tibial tuberosity bilateral in healthy adolescent

A

Osgood schlatter disease

Ice
NSAIDs
Stretching

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173
Q 
Cognitive impairment
Small eyes
Mid-face hypoplasia
Thin upper lip
Short nose
Flattened nasal bridge

Also see?

A

Fetal alcohol syndrome

Smooth philtrum

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174
Q 
Girl 6 months
Hypotonia
Gross motor developmental delays
Loss of eye contact
Hand wringing
A

Rett syndrome

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175
Q

Newborn who develops cyanosis but which worsens w/ oxygen administration

Tx

A

Congenital cyanotic heart disease

Ductal dependent lesion

Tx: Patency of patent ductus arteriosus
- Prostaglandin E1 infusion

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176
Q

Chest pain and hemoptysis

Severe day cough, SOB, and last several weeks fever and achy joints

Bilateral lower extremity edema

CXR: diffuse alveolar hemorrhage

Test?

A

Good pasture syndrome

Urine analysis

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177
Q

Neonatal jaundice w/ excessive phototherapy

Onset of jaundice to sulfa drug

No hepatosplenomegaly

A

G6PD deficiency

Fave benas
Sulfa meds

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178
Q

Carotenemia

A

Eat alot of carrots and veggies

Jaundice palms and soles and nasolabial folds

Spares sclera

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179
Q 
Poor feeding
Vomiting
FTT
Jaundice
Hepatomegaly
Cataracts
Hypotonia
A

Hereditary galactosemia

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180
Q

Frequent staphylococcal skin infections
Recurrent staph sinusitis/ mastoiditis

COarse facial features
Prominent forehead
Deeply set/ widely placed eyes
Wide fleshy tip nose

Test?

A

Job syndrome

Hyper IgE syndrome

Test: Serum IgE level

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181
Q

Total complement activity

A

Recurrent infection w/ encapsulated bacteria

Meningococci

182
Q

12 month old with continuous low hemoglobin and hematocrit

Elevated RBC distribution

Normal platelet

A

Beta thalassemia

Elevated RBC distruction shows its not iron low)

183
Q

Tall pediatric patient
Joint laxity
Poor vision

At risk for

A

Marfan syndrome

Mitral valve prolapse

Aortic dissection

184
Q

Long thin face

Prominent ears, forehead and jaw

A

Fragile x syndrome

185
Q

Viral meningitis

A

Normal glucose
Protein 80
Negative gram stain

Bacterial
- (+) gram stain
- CSF neutrophil > 1000 cells
CSF protein > 80
Seizure
186
Q

Fever, HA, Rash

Periorbital edema
Conjunctivitis
Edema hands and feet
Rash on wrist, ankles, proximal arms, legs

Oklahoma

Tx

A

Rocky mountain spotted fever

Doxycycline

187
Q

Ceftriaxone tx for

A

Meningococcemia

188
Q

Tx Lyme disease

A

Penicillin G

189
Q

Flu like symptoms
Rash several days after in woods

Tx

A

Lyme disease

Doxycycline

If meningitis suspected= VI cephalosporin

190
Q

Infant w/ UTI

Do waht

A

Renal ultrasound

  • UTI
  • Febrile infants
191
Q 
104 fever for one week
Rash on chest, abdomen and back (no pustules) 
Lips, tongue and oral mucosa bright red
Immunization up to date
Cervical lymphadenopathy

Tx

A

Kawasaki disease
- acute vasculitis

IV immunoglobulin
- prevent coronary artery aneurysms

192
Q

Tx polyarteritis nodosa

A

Plasma exchange

193
Q

4 y.o injested pills
Mildly dilated
twitching legs and arms

Temp 101
BP 115/75
HR 160

Acetaminophen
Amlodipine
Digoxin
Imipramine
Propranolol

Tx

A

Cholinergic inhibition

Mydriasis
Tachycardia
hyperthermia
Sedation
Coma
Twitching
Seizure
Hypotension
Arrhythmia

TCA
- Imipramine

Activated charcoal

If hypotension, arrhythmia or QRS prolongation= sodium bicarbonate

194
Q

Ingested med

Bradycardia
Hypotension
Pulmonary edema
Bronchospasm

A

Beta-adrenergic blockade

Fluids & glucagon= tx hypotension

Bradycardia tx= glucagon, atropine, isoproterenol

Airway protection

Activated charcoal is sustained release

195
Q

Ingested medication

Hypotension
Bradycardia
AV block

A

Calcium channel inhibition

Amlodipine
Diltiazem
Verapamil

Tx

  • Fluids
  • Beta agonist
  • calcium infusions
196
Q

AV block
Bradycardia
Ventricular tachycardia
Severe hyperkalemia

A

Digoxin overdose

Tx: Anti-digitalis ab

197
Q

HA, Nausea, vomiting, dizziness, orthostasis, weakness

Football player

Tx

A

Heart exhaustion

ice packs to axilla and groin

[Heat stroke= CNS disturbances, seizure temp > 104, then submerge in tub]

198
Q

Hearing loss in child w/ strong family hx of deafness

Screening test?

A

Alport syndrome
- hematuria

Urinalysis

199
Q

Enlarging jaw tumor

  • what is it
  • tissue sample shows
  • caused by
  • translocation
A

Burkitt lymphoma

Starry sky appearance

EBV

T(8;14)

200
Q

Pathologic tissue sample shows CD4 T cells

  • name
  • what is it
  • resembles
  • does what
  • tx
  • part of
A

Mycosis fungoides

T cell lymphoma

Resembles eczema

Metastasize to internal organs

Tx Radiation

Mycosis fungoides w/ splenomegaly and peripheral bloodstream involvement= sezary syndrome

201
Q

Pathologic tissue sample shows CD5+ cells w/ T (11;14)

  • what is it
  • affects who
  • PE finding
A

Mantle cell lymphoma

Elderly

Palpable lymphadenopathy

202
Q

Pathologic tissue sample shows cells w/ flower shaped nuclei

  • name
  • caused by
  • prognosis
  • also seen (3)
A

Adult T cell leukemia/ lymphoma

HTLV-1

Aggressive

Hepatomegaly
Bony lesions
Skin lesions

203
Q

Pathologic tissue sample shows germinal centers

  • name
  • part of
  • tx
  • translocation
  • overexpression
A

Follciular lymphoma

NHL

Chemotherapy
[CHOP}
Cyclophosphamide
Doxorubicin
Vincristine
Prednisone
\+ rituximab

T(14;18)
BCL-2 over expression

204
Q

Pathologic tissue sample shows large cells w/ vesicular chromatin

  • name
  • part of
  • also seen
  • prognosis
  • PE
  • Tx
A

Diffuse large B cell lymphoma

NHL

Prominent nucleoli

Aggressive

Rapidly enlarging masses that can be located anywhere

Chemotherapy

205
Q

Pathologic tissue sample shows binucleated giant cells

  • name
  • cells
  • description of cells
A

Hodgkin lymphoma

Reed-sternberg cells

Owl eye

206
Q

Pregnant female w/ fever, sore throat, HA, tender posterior auricular and suboccipital lymphadenopathy

Diffuse rose pink colored maculopapular rash

baby at risk for?

A

Rubella

Sensioneural hearing loss

207
Q

4’8”
low hairline
appropriate adrenarche
Failure of breast development

A

Turner syndrome

Primary amenorrhea

208
Q

Infant with bright red blood in rectum

Born at home

A

Vitamin K deficiency

Vit K given to prevent hemorrhagic disease of newborn

209
Q

Vomiting
Repeat episodes of dehydration
FTT

Triangular facies w/ prominent forehead
Large eyes
Droopy mouth
Protruding ears

A

Bartter syndrome

Consangeuineuous marriage

Maternal polyhydramnios

Polydyspia
Polyuria

210
Q

Child w/ repeated coughing w/ feeding

Pneumonia

A

Tracheoesophageal fistula

211
Q

Down syndrome child that is vomiting after feeding

A

Duodenal atresia

212
Q

Mother antibodies which cross placenta and provide partial protection to herpes

213
Q 
1-6 y.o
Widespread petechiae
Bruises (shin/arms)
Nose bleeding
Gingival bleeding
A

Immune thrombocytopenic purpura

214
Q 
3 months old
Recurrent diarrhea
Otits media
Thrush
Resp infxn
FTT
A

Severe combined immunodeficiency (SCID)

215
Q

Microangiopathic hemolytic anemia (disease of capillaries in which they leak, loss of RBC through destruction)

Thrombocytopenic purpura
Neurologic abnromalities
Fever
Renal disease

Test?

A

Thrombotic thrombocytopenic purpura (TTP)

Reduced levels of Metalloproteinase

216
Q

5 month old

Hyperdynamic precordium (heart moves too much)

Cyanosis when crying

Normal first heart sound
Second heart sound is single

Harsh ejection murmur loudest over the left sternal border, extending down the entire left sternal border

Murmur softer w/ crying and cyanosis

A

Tetralogy of Fallot

Pulmonary stenosis

Lessening of murmur w/ crying and worsening cyanosis= indicates decreased pulmonary blood flow

217
Q

Hypoplastic heart syndrome

  • time line
  • symptoms (6)
  • not seen
  • imaging shows (2)
A

first 48 hours

Mild tachycardia
Resp distress
Cyanosis
Poor perfusion
hepatoslenomegaly
profound acidosis

No murmur

Small ventricle and ascending aorta

218
Q

Total anomalous pulmonary venous return

  • timeline
  • symptoms (4)
  • imaging (2)
A

24 hours age

Respiratory distress
Tachypnea
Tachycardia
Profound cyanosis

Figure 8
Snowman on CXR

219
Q

tricuspid atresia

A

24 hours old

Profound cyanosis

220
Q

Child w/ sickle cells and painful wrist what to do

A

Electrophoreiss to confirm diagnosis

Tx analgesic until resolution

221
Q

Explosive foul smelling watery diarrhea

Flatus

Colorado

What to do?

A

Giardia

Empiric therapy
- Tinidazole

222
Q

Elevated blood pressure and serum renin levels in child

A

Renal artery stenosis

223
Q

HTN

Low renin

A

Hyperaldosteronism

224
Q

Hypokalemia
Acidosis
Elevated rine pH

A

Renal tubular acidosis type 1

225
Q 
Hypoglycemia
Hypotension
Fatigue
Abdominal pain
Weakness
Lack of energy
A

Adrenal insufficency (addison)

226
Q

Polyuria
Polydipsia
Recurrent dehydration
Poor growth

Proteinuria
Hypokalemia
Hypophosphatemia
Hyperchloremic metabolic acidosis

A

Fanconi syndrome

227
Q

newborn w/ respiratory distress. When crying baby is pink but turns cyanotic when calms down

A

Bilateral choanal atresia

Issue in nasopharynx

228
Q

Fever, HA, red cheeks infant

Will develop what

A

Fifth disease (erytehma infectosum)

Lace-like rash develops over trunk, arms legs

229
Q

Normal CBC
Repeat otitis media, sinusitis, pneumonia

Non palpable lymph nodes
Minimal tonsilar tissue

A

X linked agammaglobulinemia

Bruton agammaglobulinemia

230
Q 
Microcephalic
Anemia
Thrombocytopenia
Jaundice
Deafness

Calcifications scattered in cerebral cortex

A

TORCH infection

Toxoplasmosis

231
Q

Scalp w/ greasy scaly plaques

Tx

A

Seborrheic dermatitis

Cradle cap

Tx: Topical seleniu sulfide

232
Q

Tx lice

A

Topical permethrin

233
Q

Topical mupirocin

A

Tx staphylococcal or streptococcal infections of skin (impetigo)

234
Q

Poor tone
Jaundice
Hoarse cry in baby
Sleep alot

A

Congenital hypothyroidism

235
Q

Tyrosinemia

A 
Fever
Vomiting
Hepatomegaly
Liver disease
- Jaundice
- elevated transaminases
- hypoglycemia

Boiled cabbage

236
Q

Vomiting
Lethary
Sweaty feet odor

A

Isovaleric acidemia

Severe acidosis finding

237
Q

Nandrolone

238
Q

Child on phenytoin

At risk for

A

Folate deficiency

Megaloblastic anemia with hypersegmented polymorphonuclear leukocytes

239
Q

Microcytosis

Basophilic stippling

A

Lead intoxication

240
Q

Physiologic jaundice

A

Peaks around second to fourth day

241
Q

Newborn girl
Swollen hands and feet
Hyperconvex nails
Redundant neck folds

Reduced pulses in lower extremities

Risk for?

A

Turner syndrome

Short stature

Swollen hands and feet, hyperconvex nails
Redundant neck folds suggests lymphedema

Reduced pulses indicates coarctation

242
Q

4 y.o
Stridor, sore throat, fever, cough. Drooling and muffled voice
Uptodate on vacciantions

A

Retropharyngeal abscess

243
Q

Week of bloody diarrhea, fever and emesis

RLQ pain

A

YErsinia enterocolitica

Pseuodappendicitis

244
Q

Progressive muscle weakness that worsens over the day

Blurred vision

Difficulty swallowing

Muscle weakness w/ repeat use

A

Myasthenia gravis

Circulating antibodies blocking neurotransmitter receptors

245
Q

Cat bite on hand

A

Amoxicillin-clavulanate orally

Pasteurella multocida

hand and foot, face, and groin considered high risk

Otherwise clean and observe

246
Q

Human bite tx

A

Amoxicillin-clavulanate

247
Q

Normal age of development

248
Q

Beefy rash w/ satellite lesions in the groin of the child

Previous tx w/ amoxicillin

A

Candida yeast infxn

249
Q

Large amount of painless bleeding from rectum

A

Meckel diverticulum

Technetium 99 scan

250
Q

Unilateral red patch on newborn face

A

Sturge-weber

Further testing including imaging of the brain an ophthalmology consultation is required

Slit lamp evaluation

251
Q

Thin membrane partially covering the introitus

Tx

A

Labial adhesion

Application of estrogen cream to membrane

252
Q

Meningococcal vaccine

A

First given at 11 y.o and booster at 16

253
Q

Recurrent cough and pneumonia that doesnt fully recover

Good movement on left lung

Persistent atelectasis of the right middle lobe

A

Foreign body

254
Q 
Recurrent fevers
Headache
Anemia (pallor)
jaundice
GI complaints

Been to New york, africa and london

255
Q

Itching, tearing redness and discharge of both eyes

A

Viral etiology

Adenovirus

256
Q

White plaques on tongue and cheeks

tx

A

Oral candidiasis

Tx Nystatin oral suspension

257
Q

Newborn w/ eye discharge at 1 week

Pneumonia

tx

A

Chlamydia

erythromycin

258
Q

tx molluscum contagiosum

A

nothing

self limiting

259
Q

Kleihauer betke test

A

determine if an anemic newborns rbc are present in maternal circulatory system

260
Q

Acidosis
Hyperglycemia
Boisterous

261
Q

Preterm infant with bulge in groin, enlarges w/ crying does not transiluminate

A

Inguinal hernia

Pediatric surgery outpatient visit

262
Q

barking cough

tx

A

croup

epinephrine nebulized therapy
Oral dexamethason

263
Q

Infants borns to SLE mothers at risk for

A

third degree heart block

264
Q

deafness
hypopigmented iris (blue iris)
flat nasal bridge
whiteforelock

A

waardenburg syndrome

265
Q

IV fluid for diabetic ketoacidosis

A

Normal saline w/ potassium chloride 40 mEQ/l

266
Q

Single painless ulcer on penis

TEst

A

Syphilis

Rapid plasma reagin

267
Q

Tzanck smear

A

Primary herpes simplex

268
Q

Hx of GERD not responsive ot therapies and increased eosinophils

A

Eosinophilic esophagitis

269
Q

Common in sickle cell patient who gets viral illness

A

Aplastic crisis

Profound anemia

270
Q

Healthy newborn baby with tiny amount of blood in front of diaper at a week of age

A

Estrogen withdrawal

White mucoid discharge found as well

271
Q

Functional murmurs

A

Soft systolic murmur (3/6 intensity) that is louder when supine and disappear when upright

Physiologic splitting of S2 is present

Vibratory or musical in nature

Do nothing
Reassurance

272
Q

afebrile child
Recent URI
Groin and thigh pain
Mild limp

Lack fever
minimal tenderness on exam

Elevated ESR

A

Toxic Transient synovitis

7-10 days after infection

273
Q

linear abrasion on foot
Femoral node
INguinal node

Tx

A

Cat scratch fever

Azithromycin and TMP-SMX

274
Q

5 week projectile vomiting test to diagnose

A

U/S

Pyloric stenosis

275
Q

Normal newborn superficial boggy area that crosses suture lines

A

Caput succedaneum

276
Q

Few days old

Hard irregularly defined pitted subcutaneous plaque that is red/purple in color on butt and trunk

A

Subcutaneous fat necrosis

277
Q

Newborn
Vacuum extraction
Boggy mass over occiput

A

Subgaleal hematoma

278
Q

Topical benzocaine can cause

A

methemoglobinemia

Acute cyanosis that is unresponsive to oxygen

Blood is chocoalte brown

Tx Methylene blue

279
Q

URI 10 days ago
Swelling around eyes
Lower extremity and scrotal edema

A

Hypoalbuminemia

Absence of hematuria & HTN suggests

Nephrotic syndrome

280
Q

Tx otitis media in infant

A

High dose oral amoxicillin

281
Q

URI hx w/ ongoing nasal discharge 10 days after

A

Sinusitis

Give antibiotics

282
Q

Diabetic mother and large baby at risk for

A

Hypoglycemia

Small left colon syndrome

283
Q

Child to farm
Fever, chills, HA, myalgia

Painful ulcer
Adenopathy
Hepatosplenomegaly

284
Q

Healthy Child from central america who has had vaccinations

what to check for

A

Serum lead level

285
Q

Abdominal pain after eating that doesnt improve with PPI

A

eosinophilic esophagitis

Circular rings and esophageal furrows

286
Q

What does croup cause

A

Edema and narrowing of the proximal trachea

287
Q

Rapid meningitis

A

Neisseria meningitidis

288
Q

Monoarticular arthritis which migrates

Maine

A

Lyme arthritis

Borrelia burgdorferi

289
Q

Timeline of nutrition

A

Breast feed till 6 months

Introduce pureed foods

1 year: cow milk

Supplement Vit D and iron

290
Q

Guillain barre affects what

A

Peripheral nerve fibers (muscle weakness)

291
Q

Illnesses that involve anterior horn cells

A

Spinal muscular atrophy (paralysis)

ALS

292
Q

Tx lead poisoning

A

Obtain venous samples (if screening performed by capillary sample)

Identify and remove lead sources

Chelation therapy if < 45

Dimercaprol if 45-69

EDTA > 70

293
Q

Tx Ethylene glycol or methanol ingestion

A

FOmepizole

294
Q

TxAcetaminophen poisoning

A

N-acetylcysteine

295
Q

High fever
Rash on body
limb sparing
Desquamation of hands and feet

A

Kawasaki disease

296
Q

Cyanosis when feeding

Relieved by crying

A

Choanal atresia

297
Q

Primary amenorrhea

What test to do

A

Absence of menarche > 13 y.o

No breast development

Get pelvic u/s

298
Q

Primary amenorrhea
Has uterus and small ovaries
Elevated FSH
Increased LH

A

Turner syndrome Deletion of an x chromosome

Loss of estrogen

299
Q

Test for hereditary spherocytosis

A

Eosin-5 maleimide binding (EMA)

or

Acidified glycerol lysis test

300
Q

Erythrocyte CD55 and CD59 protein testing

A

Paroxysmal nocturanl hemoglobinuria

301
Q 
5 day old
Fussy
Nonbloddy, nonbilious vomiting after feeds
Poor tone and jaundice
Anterior fontanelle sunken
Bilateral cataracts
Hepatomegaly
A

Galactosemia

GALT deficiency

Inability to metabolize breast milk

Increased risk of Ecoli sepsis

302
Q

Vit K deficiency does what

A

Reduced coagulation factor carboxylation

303
Q

Von willebrand

A

Easy bruising
Bleeding

Prolong PTT
Normal PT

304
Q

UTI in infant tx

A

E. coli

Third generation cephalosporin (cefixime)

305
Q

10 y.o HA, vomiting and visual disturbances

Limited upward gaze
Upper eyelid retraction (collier sign)
Pupillary abnormalities

A

Pineal gland mass

Parinaud syndrome
[Limited upward gaze, upper eyelid retraction/ collier sign, pupillary abnormalities]

306
Q

What to do when IV peripheral line cant be accesses

A

Attempt intraosseous cannulation

307
Q

Diffuse facial swelling after stress or tooth extraction

A

C1 inhibitor deficiency

308
Q

Primary amenorrhea
Normal uterus and ovaries
Low FSH and LH

A

Kallmann syndrome

46, XX

309
Q

Associated w/ Downs syndrome (8)

A 
Early onset alzheimers
ASD
Duodenal atresia
Hirschsprung disease
Hypothyroidism
Type 1 DM
Acute leukemia
Atlantoaxial instability
310
Q

Punctate calcifications around ventricular margin

at risk for

A

CMV

Sensorineural hearing loss

311
Q

Werdnig-Hoffman syndrome

A

Floppy baby syndrome

Degeneration of anterior horn cells and cranial nerve motor nuclei

312
Q 
Muscle weakness
Atrophy
Myotonia
Testicular atrophy
Baldness
A

Myotonic congenital myopathy

313
Q

Normal breast development
Normal ovaries
No uterus

A

Mullerian agenesis

Failure of mullerian duct formation

314
Q

Optic nerve glioma associated with

A

Neurofibromatosis type 1

315
Q

Pheochromoctyomas associated with

A

Von Hippel-lindau (VHL)

316
Q

Bilateral vestibular schwannomas associated with

A

neurofibromatosis type 2

317
Q

Serratia or Aspergillus infxn

x linked

A

Chronic granulomatous disease

Neutrophil fxn testing

  • dihydrorhodamine 123 test
  • nitroblue tetrazolium test
318
Q

follicular conjunctiivitis

A

Trachoma

Chlamydia trachomatis

319
Q

Roommate of patient with meningitis that recently had vaccine.

What to do

A

Give dose of ceftriaxoen immediately

Or Rifampin

320
Q

Abdominal mass
Jerking of arms
Periorbital ecchymoses

A

Neuroblastoma

Elevated catecholamine

Small round blue cells on histology

N-myc

321
Q

Carriers of sickle cell at risk for

322
Q 
Doll like
Seizures
Hypoglycmeia
Lactic acidosis
Hyperuricemia
Hyperlipidemia
A

G6P deficiency

Impaired glycogen to glucose conversion

323
Q

Medication for tourettes

A

Antidopaminergic agents

Tetrabenazine
Risperidone
haloperidol

Alpha 2 adrenergic agonists

  • guanfacine
  • clonidine
324
Q

Nasal congestiona nd rhinorrhea previously

Now fever and respiratory distress

Murmur

Lymphadenopathy

Hepatomegaly

A

Viral myocarditis

Coxsackievirus B
Adenovirus

CXR shows
- cardiomegaly

325
Q

Acute rheumatic fever

A

Fever

Arthritis after untreated group A strep

326
Q

Intermittent collapse of arytenoid cartilages during crying

A

With inspiration

Laryngomalacia

Inspiratory stridor

327
Q

Rhonchi

A

Low pitched
Rattling sounds

Caused by secretions in the bronchi

Pneumonia

328
Q

Rabies time line

A

1-3 months after exposure

329
Q

Nevus flammerus

A

Port wine stain

Do not regress

Unilaterally located on face

330
Q

Nevus simplex

331
Q

Organophosphate poisoning

A

Atropine tx

Then Pralidoxime

332
Q

2-8 weeks jaundice
light colored stools
Direct hyperbilirubinemia

Tx

A

Biliary atresia

U/S RUQ

333
Q

Sick from cook out
Started w/ abdominal pain, vomiting and diarrhea

Now blood in stool
Tired
Not drinking

Scleral icterus
Edema

  • Condition
  • Caused by
  • MOA
  • Lab findings (7)
  • Tx (3)
A

Hemolytic uremic syndrome

Shiga toxin (Ecoli)

Vascular damage and microthrombi formation

Hemolytic anemia
(Schistocytes, Increased bilirubin)
Thrombocytopenia
Acute kidney injury (Increased BUN, Cr)

Tx:
Fluids
Blood transfusion
Dialysis

334
Q

Routine newborn care

A

Newborn screen (metabolic/ genetic disorders)

Hyperbilirubinemia

Hearing screen

Pre/Post ductal pulse oximetry (congenital heart disease)

Hypoglycemia

335
Q

Miliaria

336
Q

Pseudofolliculitis

A

ingrown hair

337
Q

Elevated red blood cell distribution width

A

Iron deficiency anemia

338
Q

Increased bilirubin
INcreased AST, ALT
Ecoli infxn

Jaundice
Hepatomegaly

A

Galactosemia

339
Q

INadequate NADPH production for oxidative injury

A

G6PD deficiency

Jaundice
Hemolytic anemia

Transaminases normal

340
Q

Mutation of the proteins linking the red blood cell membrane to its cytoskeleton

A

Spherocytosis

341
Q

A single AA substitution within the beta globin chain

A

Sickle cell

342
Q

Severe cough w/ apnea

Posttussive emesis

A

Pertussis

Tx Azithromycin

343
Q

Sensorineural hearing loss caused by

A

Damage to inner ear

Congenital cytomegalovirus (CMV)

344
Q

Concave abdomen
Barrel shaped chest
Respiratory distress
Breath sounds only one lung

A

Congenital diaphragmatic hernia

Incomplete fusion of pleuroperitoneal folds

345
Q

Tx minimal change disease

346
Q

Edema

Proteinuria

A

Minimal change disease

347
Q

Asymmetric bowing of femurs

Delayed closure of fontanels or enlarged

A

Nutritonal rickets

Def Vit D

348
Q

Low hemoglobin
Low MCV
High reticulocytes
RBC elevated

A

Thalassemia minor

349
Q

Abnormal gait
Loss of position
Loss of vibratory sense

A

Friedriech ataxia

350
Q

Anemia
Jaundice
Splenomegaly

A

Hereditary spherocytosis

351
Q 
3 day old
Red reflex absent
Harsh continous murmur over left upper  sternal border
Hepatosplenomegaly
Failed hearing test
A

Rubella (german measles)

352
Q

Complications associated with myopia

A

Nearsightedness

Retinal detachment
Macular degeneration

353
Q

Chronic arthritis
Daily fever
Rash

A

Systemic juvenile idiopathic arthritis

354
Q

Gray vesicles that progress to fibrin coated ulcers

A

Herpangina

Coxsackie A virus

Fever
Pharyngitis
Gray vesicles/ ulcers

Tx supportive

355
Q

ALL causes

A

Decreased in platelet production

356
Q

Contraindication to Rotavirus vaccination

A

Hx of intussecption

357
Q

Hearing loss
Hematuria

  • Name
  • Mutation
  • Inherited
  • Biopsy
A

Alport syndrome

Mutation of type IV collagen

X linked

Longitudinal splitting of GBM

358
Q

Effacement of podocyte foot processes

  • name
  • symptoms (4)
A

Minimal change disease

Proteinuria
No hematuria
Renal insufficiency
HTN

359
Q

Linear deposition of IgG along the glomerular basement membrane

A

Good pasture

Renal & Pulmonary

360
Q

Mesangial and glomerular capillary deposition of Cd and IgG

  • Name
  • Symptoms (4)
A

Poststreptococcal glomerulonephritis

Edema
Hematuria
HTN
C3 level decreased

361
Q

Mesangial deposition of IgA

  • Name
  • Symptoms (2)
A

IgA nephropathy

Gross hematuria
URI

362
Q

Benign heart murmur

A 
Normal child
No family hx
Early or mid systolic
Grade 1 or II
Decreases w/ standing &amp; valsalva
Low pitched
Musical
363
Q

Congenital adrenal hyperplasia

A

21 hydroxylase deficiency

Ambiguous genitalia in girls

Salt wasting syndrome

  • Hypotension
  • dehydration
  • vomiting

High 17-hydroxyprogesterone
low na, glucose
high potassium

364
Q

Placental aromatase deficency

A

Prevents conversion of androgens into estrogens

Virilization of female fetus and mother

365
Q

Radial head subluxation tx

A

Nursemaid elbow

Hyperpronation of forearm
Supination of forearm & flexion of elbow

366
Q

ADHD alternative medication

A

Atomoxetine

367
Q

5% hemoglobin A2

95% hemoglobin F

A

Beta thalassemia

Absent beta globin expression

Tx Transfusion &
Chelation therpay

368
Q

Polycythemia

A

Hematocrit >65%

369
Q

Urinating frequently
Low urine specific gravity
Mother w/ sickle cell

A

Hyposthenuria

Sickle cell trait

370
Q

<32 weeks need what exam

A

Head ultrasound

371
Q

Painful pustules on arm

Honey crusted

A

Impetigo

Staph aureus

Tx: Mupirocin

372
Q

Tx pertussis

A

Macrolides

373
Q

Tan colored lesions in the iris

A

Neurofibromatosis type 1

374
Q

Lead poisoning house

A

Before 1978

375
Q

Muscle weakness

Calf pseudohypertrophy

A

Duchenne muscular dystrophy

Tx Glucocorticoids

376
Q

Chronic rhinosinusitis
Nasal polyposis
Malabsorption (diarrhea weight loss)

A

Cystic fibrosis

377
Q

Hole in eye structure

Nasal catheter cant pass through

A

Coloboma

Atresia choanae

CHARGE SYNDROME

378
Q

Tx pin worm

A

Pyrantel pamoate

Albendazole

379
Q

Septic arthritis

A

Vancomycin

Ceftriaxone

380
Q

Purplish nonblanching rash on buttocks and posterior thigh

Abdominal pain

Difficulty walking

Trace protein

A

Henoch-Schonlein purpura

IgA mediated vasculitis

Palpable purpura
Arthritis/arthralgia
Abdominal pain/ intussusception
Renal disease

Supportive tx

381
Q

How to prevent spread of measles (rubeola)

A

Airborne precautions

382
Q 
Tall stature
Long thin limbs
Joint hyperlaxity 
Ectopic lens
Fair hair and eyes
Developmental delay
Cerebrovascular accident
A

Homocystinuria

Thrombosis is common

Error in methionine metabolism

Cystathionine synthase def

383
Q

Arthritis
Hematuria
Rash on legs and back

A

Henoch Schoenlein purpura

384
Q

Thickening of the glomerular basement membrane

A

Membranous nephropathy

Edema
Proteinuria

385
Q

Glomerular basement membrane thinning

A

Alport syndrome

Abnromalites in type IV collagen

Sensorineural hearing loss
Ocular abnormalities

386
Q

Linear deposition of IgG on the BM

A

Good pasture

Ab against BM

Pulmonary hemorrhage
Glomerulonephritis

387
Q

Localized areas of mesangial sclerosis and collapse

A

Focal segmental glomerulosclerosis

Edema
Proteinuria

388
Q

Mesangial deposition of IgA

A

Henoch Schonlein purpura

389
Q

Podocyte fusion

A

Minimal change disease

Nephrotic syndrome
(Edema Proteinuria)

Fusion/flattening of podocytes

390
Q

Hypothermia
Lethargy
Low white blood cell count

A

Neonatal sepsis

Group B strep

391
Q

4 y.o
HTN
Right sided scrotal mass
Doesnt reduce supine

A

IVC compression by fixed mass (wilms tumor)

Abdominal U/S

Varicocele

392
Q

Left sided varicocele

A

no concern

Compression of left renal vein between SMA and aorta

Incompetent venous valves

393
Q

Empiric tx for epiglottitis

A

Ceftraixone

Vancomycin

394
Q

Azithromycin

A

Lower resp tract infections by atypical bacteria

Mycoplasma pneumoniae
Chlamydia pneumonia

Whooping cough (bordetella pertussis)

395
Q

Piperacillin-Tazobactam

A

psuedomonas infxn

pulmonary infxn w/ cystic fibrosis

396
Q

Dermatophyte infxn

Tx

A

Tinea capitis

African americans

Scaly erythematous patch of hair loss

ORal griseofluvin or terbinafine

397
Q

Elevated indirect bilirubin
Jaundice
Elevated TSH
Low Thyroxine

Large tongue
Hoarse cry

A

Thyroid dysgenesis

Congenital hypothyroidism

398
Q

Watery diarrhea
Now dark red mucus diarrhea
Seizure

A

Shigella sonnei

High fever
Cramping

Supportive care

399
Q

Nephrotic syndrome

A

Edema
Hypoalbuminemia
Urine protein elevated

No hematuria

Minimal change for peds

Adults

  • FSGS
  • Membranous nephropathy
  • Membranoproliferative glomer
400
Q

Nephritic syndrome

A 
HTN
Oliguria
Hematuria
Proteinuria
Casts

Post strep glomerulonephritis
HUS

401
Q

Nephrotic syndrome

Hep B infxn

A

Membranous nephropathy

402
Q

Colic

A

> 3 hrs a day >3 days a week
3 months

No reason

403
Q 
3 day old
Vomiting
Seizures
Hypotonia
Jaundice
Hepatomegaly

Elevated direct bilirubin
Elevated ammonia
Decreased glucose
+ urine reducing substance

A

Galactosemia

Galactose-1-phosphate uridylyltransferase (GALT) deficiency

Hypoglycemia
–> seizures

404
Q

Staphylococcal scaleded skin

A

Superficial flaccid bullae

Extensive exfoliation of skin

Infancy doesnt occur beyond 5

405
Q

Rash red underarms and private areas
Fever
Sore throat
Peeling of hands

A

Scarlet fever

tx pencillin (amoxicillin)

406
Q

Webbed neck
Carpal and pedal edema
Nail dysplasia
Horseshoe kidney

A

Turner syndrome

Congenital lymphedema due to lymphatic network dysgenesis

407
Q

Chest pain in sickle cell patient

A

Aplastic crisis

[not acute chest syndrome]

408
Q

Knee pain
worse at night
Fevers
Tender immobile mass on left knee

Moth eaten

A

Ewing sarcoma

409
Q

Risk factors for Respiratory distress syndrome

A

Male sex
Perinatal asphyxia
Maternal diabetes
Cesarean section w/ labor

410
Q

Hearing loss
PDA
Red reflex absent

411
Q

Tx unilateral cervical lymphadenitis

A

Staph aureua
Strep pyogenes

Clindamycin
Amoxicillin-clavulanate

412
Q

Bilious emesis
Abdominal distension
Leukocytosis
Metabolic acidosis

A

Necrotizing enterocolitis

Xray with air in the bowel wall and portal veins

413
Q

Tx Neonatal conjunctivitis

A

Oral azithromycin

Chlamydia

414
Q

Neonatal exposure to

High pitched cry
Sleeping
Difficulty feeding
Sneezing
Vomiting
415
Q

Neonatal exposure to cocaine

A

Excessive sucking
Jitteriness
Hyperactive Moro reflex

416
Q

Premature adrenarche

A

Early activation of adrenal androgens

Acne
Pubic and axillary hair

417
Q 
Seizure
Low grade fever
Perioral cyanosis
Lethargic
Anterior fontanel full
Hemorrhage in left temporal lobe
No calcifications
A

Herpes simplex virus

418
Q

Refeeding syndrome increase in what

419
Q

Tx Neisseria meningitidis

A

ceftriaxone

420
Q

Trigger for intussception (8)

A

Hypertrophied peyer patches

Viral illness
Rotavirus vaccination

Congenital malformation of the intestine

Henoch Schonlein purpura

Celiac disease

Intestinal tumor

Polyps

421
Q

Sudden onset uncontrollable continuous writhing of arms and hands

Grimacing of face

Month ago sick w/ sore throat and fever

Pericardial friction rub

Elevated ESR

Prolonged PR interval and diffuse ST elevations

What organism

A

Acute rheumatic fever

Streptococcus pyogenes

Risk: Mitral regurg/ stenosis

Friction rub= carditis

Chorea (jerks)

422
Q

Parvovirus B19

A

slap cheek

423
Q

Streptococcus mutans

A

Dental caries

Endocarditis

424
Q

Trypanosoma cruzi

A

Chagas disease

Cardiomyopathy
(due to myopericarditis)

Achalasia

425
Q

Hypotonia at birth

Delay muscle development

Spasticity and dystonia

Biting fingers and hands

Now hypotonic
Hyperreflexia

A

Lesch-Nyhan syndrome

Deficiency of hypoxanthine guanine phosphorbosyltransferase

Hypoxanthine and uric acid accumulation

426
Q

vomiting labs

A

Hypochloremic
hypokalemic
metabolic alkalosis

427
Q

WBC > 1000
Glucose < 40
Protein >250

A

Bacterial meningitis

428
Q

WBC 5-1000
Glucose < 10
Protein > 250

A

Tuberculous meningitis

429
Q

WBC 10-500
Glucose 40-70
Protein < 150

A

Viral meningitis

Group B Coxsackie virus

430
Q

Cyanosis

Knee chest position does what

A

Increased systemic vascular resistance

431
Q

Respiratory distress
Decreased lung aeration (pulmonary hypoplasia)

Flattened facies

Limb deformities

Abdominal distension
Suprapubic mass

A

Potter syndrome

Abdominal distension + suprapubic mass= bladder distension from urinary tract obstruction

Due to posterior urethral valves

432
Q

Increased reticulocytes
elevated mean corpuscular hemoglobin concentration
Negative coombs

A

Hereditary spheroctyosis

433
Q

Increased reticulocytes
Low mean corpuscular hemoglobin concentration
Negative coombs

A

G6PD deficiency

434
Q

Breast development
Elevated LH
Advanced bone age

A

MRI of brain

Central precocious puberty

Premature activation of hypothalamic-pituitary-gonadal axis

435
Q

Pulmonary abscess
Recurrent cutaneous abscesses
Aspergillus infxn

A

Chronic granulomatous disease

Catalase positive pathogens (staph aureus, serratia, burkholderia, aspergillus)

Mutation of phagocytic oxidative burst

Dihydrohodamine 123 test

Nitroblue tetrazolium test

436
Q

Prematurity
Delayed motor milestones
10 mn cant stand
Hyperreflexia

A

Cerebral palsy

437
Q

WAGR syndrome

A

11p deletion

Deletion on chr 11p13

Wilms tumor
Aniridia (lack iris)
Genitourinary abnromalities (hypospadias)
Mental retardation

438
Q

FMRI

Mental delays

A

Fragile X syndrome

Prominent forehead
Large ears
Long narrow face
Prominent chin
Macro-orchidism

CGG repeat

439
Q

Seen w/ cystic fibrosis

A

Pancreatic insufficiency

Greasy stools (steatorrhea)

Vit K deficiency

440
Q

Lytic bone lesion
Rash
Polyuria

A

Langerhans cell histiocytosis

441
Q

Fever
Hive
Joint pain

1 wk after pencillin for strep pharyngitis

A

Serum sickness like rxn

442
Q

Tumor of pituitary stalk

A

Craniopharyngioma

443
Q

Anemia
Hypopigmented macules
Hypoplastic and thenar eminences are flattened

A

Fanconi anemia

DNA repair defect

444
Q

Infant botulism

A

Constipation
Poor feeding
Hypotonia

Oculobulbar palsies
(absent gag reflex)
(ptosis)

Symmetric, descending paralysis

Autonomic dysfunction
(decreased salivation, fluctuating HR/BP)
445
Q

Unilateral cervical lymphadenitis

1) Most common
2) Dental caries/ periodontal disease
3) Hx of contact w/ infected animal
4) Nontender, violaceous
5) Bilateral

A

1) Staph aureus
Strep pyogenes

2) Anaerobic bacteria (prevotella)
3) Francisella tularensis
4) Mycobacterium avium
5) Adenovirus

446
Q

Absence vs focal seizure

A

Focal seizure

  • Motor, sensory or autonomic
  • underlying structural abnormality
  • impairment of awareness
  • Assoc w/ chewing
  • Postictal confusion/ lethargy
  • One hemisphere

EEG/ MRI

Absence
- both hemispheres
- staring spells
10-20 seconds
- provoked by hyperventilation
- no postictal period
447
Q

Seizures
Intellectual disability
Slow spike and wave

A

Lennox Gastaut syndrome

448
Q

Large primary lesions

Other lesion follow tension lines

A

Pityriasis rosea

449
Q

6 y.o
Insidious hip pain and limp
Restricted hip abduction, internal rotation

Normal Lab and Xray previously

A

Legg-Calve Perthes disease

Early stage: normal

Later: Femoral head flattening, fragmentation, sclerosis

MRI: avascular necrotic femoral head

450
Q

Howell jolly bodies

A

persistance RBC precursor nuclei

single round blue inclusion

Third Year Shelf (7 decks)

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