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USMLE STEP 2 CK RETAKE > Pediatrics > Flashcards

Pediatrics Flashcards

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USMLE® Step 1 flashcards
1
Q

Transient Tachypnea of the newborn Presentation, Dx, Tx

A 
Self- limiting 
mostly c-sections 
Pt: Term or near-term 
Grunting 
Dx: CXR=hyperextended/hyperinflation
Tx: positive pressure ventilation
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2
Q

Respiratory Distress Syndrome presentation, Dx. Tx

A 
Premature, Perinatal distress 
Dx: CXR=Hypoextended 
Atelectasis 
Tx: Intubation 
Surfactant
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3
Q

Hypoglycemia in a baby presentation, Dx, Tx

A 
Jittery, Tremors, Seizures, lethargy
Dx: rule out causes of infections 
Tx: Asx-Feed 
Sx- IV D50 
Recurrent set up drip with D5/D10
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4
Q

Bronchopulmonary dysplasia Presentation, Dx, Tx

A 
Pt: Increased O2 demand 
increase FIO2 
Dx: CXR-ground glass opacities 
Tx: Surfactant (post natal)
Steroids (ante natal)
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5
Q

Intraventriculr Hemorrhage

Presentation, Dx, Tx

A 
Premature 
Asx 
Bulging Fontanelles 
Dx: Cranial Doppler 
Tx: VP Shunts or drains
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6
Q

Retinopathy of prematurity

Presentation, Dx, Tx

A

Premature baby on a ventilator (complication of too much oxygen)
Dx: Eye exam
Tx: Photoablation

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7
Q

Necrotizing Enterocolitis

Presentation, Dx, Tx

A

Premature baby with a bloody bowel movement
Dx: X-ray=Pneumotisis intestinalis
Tx: NPO. IV Abx, TPN

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8
Q

Imperforate Anus

Presentation, Dx, Tx

A

Possible Associated syndrome-VACTERL
Pt: No Hole
Tx: Mild=Fix now
Severe=colostomy first then fix later

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9
Q

VACTERL meaning, Associated with?

A 
Vertebral Anomalies US Sacrum 
Anus X-ray 
Cardiac Echo 
TE Fistula Catheter
Esophageal Atresia X-ray 
Renal 
Limb
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10
Q

Meconium Ileus

Presentation, Dx, Tx

A 
Associated with Cystic Fibrosis 
Pt: FTPM and will be premature
Dx: X-ray=transition zone
gas filled plug 
Tx: Water enema
F/u with sweat chloride  test make sure they get ADEK and pancreatic enzymes
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11
Q

Hirschsprung

Presentation, Dx, Tx

A 
Failure of migration, Auerbach/meissner plexus 
Pt: FTPM in 48 hours 
palpable colon
Explosive diarrhea on DRE 
OR 
Chronic diarrhea with overflow incontinence 
Dx: x-ray good-dilated
bad-normal 
best is Bx 
Tx: Resect bad colon
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12
Q

When you have baby emesis what do you consider?

A

bilious or non-bilious

if bilious consider double bubble and uterine course

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13
Q

Malrotation

presentation, Dx, Tx

A 
Bilious emesis 
Pt: Normal pregnancy 
no polyhydramnios, no downs 
Dx: X-ray=double bubble 
Normal gas pattern 
Upper GI series 
Tx: NGT for decompression 
Surgery
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14
Q

Duodenal Atresia

presentation, Dx, Tx

A

Pt: Polyhydramnios, Down syndrome
Dx: X-ray= double bubble
no gas beyond
Tx: Surgery

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15
Q

Annular Pancreas

Presentation, Dx, Tx

A 
Bilious Emesis 
Pt: Polyhydramnios, down syndrome 
Dx: X-ray=double bubble 
No gas 
Tx: Surgery
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16
Q

Intestinal Atresia

Presentation, Dx, Tx

A 
"Vascular Accident in utero"
Pt: mom taking some sort of vasconstrictor (cocaine) 
\+/- polyhydramnios 
negative for Downs 
Dx: X-ray=Double bubble 
with multiple air fluid levels 
Tx: Surgery
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17
Q

Tracheoesophageal fistula

Presentation, Dx, Tx

A 
Pt: Non-biliary emesis 
Gurgling and bubbling 
Dx: NGT that coils on x-ray 
Tx: TPN
Surgery
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18
Q

Pyloric Stenosis

Presentation, Dx, Tx

A 
causes Gastric outlet obstruction 
Pt: Usually male 2-8 weeks
Normal to projectile vomiting 
Olive shaped mass 
Visible peristaltic waves 
Dx: CMP= decreased Cl, potassium, increased CO2
US= Donut sign 
Tx: IVF to replete electrolytes then 
Surgery
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19
Q

Causes of Conjugated neonatal jaundice

A

Atresia
Sepsis
Metabolic

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20
Q

Causes of Unconjugated Neonatal Jaundice

A

Hemolysis or hemorrhage

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21
Q

Physiologic Jaundice (indirect) Findings

A 
Onset >72 hours 
Resolution <1 wk
Preme (<2 wk) 
Bili unconjugated 
Increase <5/day
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22
Q

Pathologic Jaundice (Direct) Findings

A 
Onset <24 hr 
Resolution >1 wk
preme >2 wk
Bili Conjugated 
Increase >5/day
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23
Q

Diagnostic workup unconjugated neonatal Jaundice

A

Coombs (-)
Hgb
Reticulocyte count

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24
Q

Breast Feeding Jaundice

Presentation, Dx, Tx

A 
Quantity, Not feeding enough 
decrease bowel movements 
increased reabsorption 
presents <7 days 
unconjugated, feed more
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25
Q

Breast Milk Jaundice

Presentation, Dx, Tx

A

Quality of milk
presents after day 7
unconjugated, change to hydrolyzed milk

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26
Q

Biliary Atresis

Presentation. Dx, Tx

A 
Worsening Jaundice 
day 7-14 
Direct Hyperbilirubinemia 
Dx: US=no ducts 
HIDA SCAN 5-7 days give phenobarbital first 
Tx: REsect
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27
Q

Neural tube defects Presentation

A

increased AFP

Tuft of hair on exam

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28
Q

Occulta

A

Tuft of hair with skin covering

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29
Q

Meningocele

A

CSF Outpouching sack

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30
Q

Meningomyelocele

A

CSF and nerves in outpouching

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31
Q

vaccine contraindicated with egg allergy

A

yellow fever

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32
Q

vaccine contraindicated with immunocompromised patients

A

MMRV

Intranasal Flu

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33
Q

if a patient is sick can you vaccinate?

A

yes

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34
Q

Tetanus treatment, <3 lifetime doses, clean wound

A

Tdap

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35
Q

Tetanus treatment <3 lifetime doses, dirty wound

A

Tdap +Ig

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36
Q

Tetanus treatment >3 lifetime doses, Clean wound,

A

> 10 years since last dose= Tdap

< 10 years since last dose= go home

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37
Q

Tetanus treatment >3 lifetime doses, dirty wound

A

> 5 years since last dose=Tdap

<5 years since last dose= go home

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38
Q

Epidural Hematoma

Presenation, Dx, Tx

A 
Strike to the head, most likely sports injury (Ball), Skiiing
Walk, Talk, Die 
- LOC 
lens shaped 
Middle Meningeal artery
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39
Q

Subdural Hematoma

Presentation, Dx, Hx

A 
Pedestrain struck
MVA 
Shaken Baby Syndrome 
\+ LOC then COMA 
Crescent shaped
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40
Q

Erythema Infectiousum Presentation, Tx

A

Parvo B19
Slapped cheek appearance, There is a fever and rash
Tx: Supportive
f/u with aplastic crisis with sickle cell

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41
Q

Roseola

Presentation

A 
HHV6 
Prodrome 
Very high fever >104 
Fever first then rash 
moves from trunk to extremities
42
Q

Measles

Presentation

A

Prodrome-
Conjunctivitis, Coryza, Cough, Koplik Spots
Fever and rash at the same time
moves from Face to trunk

43
Q

Rubella “German measles”

Presentation

A

Prodrome
Generalized
Tender Lymphadenopathy
Fever and rash moves from face to trunk

44
Q

Mumps

Presentation

A

Pubertal males, Parotid swelling, Orchitis

Can lead to infertility

45
Q

Varicella zoster

Presentation

A

Rash without fever
Diffuse rash
Vesicles on an erythematous base in different stages of healing

46
Q

Hand foot mouth disease

Presentation

A

Cocksackie A

Rash Features of varicella on the hand feet and mouth

47
Q

Otitis Media
Presentation
Tx

A

unilateral ear pain
relieved with pulling on the pinna, bulging TM
Tx: Amxociliin, if allergic ceftanir or azithromycin

48
Q

Otitis Externa
Presentation
Tx

A

Swimmers ear Pseudomonnas
Unilateral ear pain, worse by pulling pinna
Tx: Spontaneous resolution

49
Q

Malignant Otitis Externa

Presentation

A

Like Otitis externa with involvement of the bone

Tx: Ciprofloxacin or steroid drops

50
Q

Sinusitis
Presentation
Tx

A

Bilateral purulent discharge
Facial tap=pain
if Temp >38C, Dur >10D
give AMOX-CLAV

51
Q

Pharyngitis

Tx

A

Amoxicillin

52
Q

Croup
Presentation
Dx
Tx

A 
3months - 3 years 
Viral prodrome, Barking/seal like cough 
Dx: Racemic Epinephrine 
(Steeple)
Tx: Mild: Mist 
Moderate: Racemic Epi, Steroids, O2
53
Q

Bacterial Tracheitis
Presentation
Dx, Tx

A

Staph Aureus
5- 7 year old, Croup that does not improve-Patient is toxic
Dx: not better with racemic epi, Tracheal Cx
Tx: IV Abx

54
Q

Retropharyngeal Abscess
Presentation
Dx, Tx

A 
Very sick patient, Abrupt Onset, High Fever, Drooling, hot potato voice 
Anterior chain unilateral LN
Mass=Abscess 
Dx: CT scan 
Tx: Incision and drainage 
IV Antibiotics
55
Q

Peritonsillar Abscess
Presentation
Dx, Tx

A

Hot potato voice, Sore throat, Drooling Dysphagia, Uvular deviation
Tx: Drain and IV Abx

56
Q

Epiglottitis
Presentation
Dx, Tx

A 
Very Sick child, Rapid onset high fever, Tripoding, drooling, Accessory muscle use, Hot potato voice 
Dx: x-ray-thumb sign
Secure airway 
Cherry red epiglottis 
Tx: ET Tube in the OR 
IV Abx
57
Q

Cystic Fibrosis

Presentation

A 
Autosomal Recessive, CFTR gene 
Meconium Ileus 
Recurrent Pulm. Infection 
Failure to thrive 
"Salty" baby
58
Q

Cystic Fibrosis

Dx, Tx

A 
Sweat Chloride test 
>40 infant 
>60 for older 
Tx: Pulmonary toilet 
Replace pancreatic enzymes and give ADEK
59
Q

Grand Mal Seizure features

A

+ LOC, generalized

60
Q

Partial-Complex Seizure features

A

+ LOC, Focal (partial)

61
Q

Partial, simple Seizure features

A
  • LOC, Focal
62
Q

Trigeminal neuralgia Tx

A

Carbamazepine

63
Q

Absence Seizure Tx

A

Ethosuximide

64
Q

Criteria for Simple Febrile Seizure

A

1 in 24 hours
Duration <15 mins
Generalized

65
Q

Necrotizing enterocolitis
Presentation
Dx, Tx

A

Premature baby with a GI bleed
Dx: X-ray-Pneumatosis intertinalis
Tx: NPO, IVF, TPN, IV Abx

66
Q

Meckles Diverticulum
Presentation
Dx, Tx

A

Painless, intermittent hematochezia
Rule of 2s
Dx: Technicium-99
Tx: Resection

67
Q

Meckles, rules of 2s

A 
<2 years old 
<2% of population 
2x more likely in males 
2 ft from ileocecal valve 
2 inches
68
Q

Intussusception

Presentation

A 
Abrupt sudden onset 
colicky abdominal pain 
Knee to chest relief 
*currant jelly diarrhea*
*sausage shaped mass*
3mo-3years
69
Q

Intussusception Dx, Tx

A 
KUB=perforation/obstruction 
U/S=track resolution
Air enema 
Tx: Air enema 
Surgery, if there is signs of peritonitis, perforation, or failure of air enema
70
Q

What are the Left to right shunts

A

ASD, VSD, PDA, non-cyanotic

71
Q

ASD
presentation
Dx, Tx

A

> 1 year old most common congenital defect
Fixed Split S2
Dx: Ech
Tx: Surgery

72
Q

VSD
Presentation
Dx, Tx

A 
Associated with Downs 
Most common <1 year old 
Asx Murmur 
Failure to thrive, CHF 
Dx: Echo 
Tx: Asx=wait 1 year old 
CHF=Surgery
73
Q

PDA
Presentation
Dx, Tx

A 
Continuous machine like murmur 
Multiphasic murmur 
Dx: Echo 
Tx: Indomethacin=closure
Prostaglandin=keep open
74
Q

Transposition of the great arteries
Presentation
Dx, Tx

A 
Moms that have DM
Failure to twist 
Blue baby on day 1 
Tx: Prostaglandin 
Surgery
75
Q

Tetralogy of Fallot
Presentation
Dx, Tx

A 
Associated with down syndrome 
VSD
Overriding aorta 
Pulmonic stenosis 
Right ventricular hypertrophy 
TET spells-Kids will squat 
Dx: CXR-boot shaped heart 
echo 
Tx: Surgery
76
Q

Coarctation of the aorta
Presentation
Dx, Tx

A 
Descending aorta 
HTN in UE 
Hypotension in LE 
Dx: Echo 
Tx: Surgical
77
Q

Developmental Dysplasia of the hip
Presentation
Dx, Tx

A

Newborn
Clicky Hip
Dx: U/s @ 4 weeks
Tx: harness

78
Q

Legg-Calve Perthes Disease
Presentation
Dx, Tx

A

6 Years old
Insidious onset, analgesic Gait
Dx: X-ray
Tx: Cast

79
Q

Sliped Capital Femoral Epiphysis
Presentation
Dx, Tx

A 
Age 13 
Growth Spurt or Obese 
Non-Traumatic Joint pain 
Dx: Frog Leg, x-ray 
Tx: Surgery
80
Q

Septic gait
Presentation
Dx, Tx

A

Any age
Fever, leukocytosis, increased ESR/CRP, cannot bear weight
Dx: Arthrocentesis, >50k WBC
Tx: Drain, Abx

81
Q

Transient synovitis
Presentation
Dx, Tx

A 
Any age 
hip pain after viral illness 
cannot bear weight 
Dx: Clx
Tx: Supportive 
F/u 2 days
82
Q

Osgood Schlatter
Presentation
Dx, Tx

A 
Osteochondrosis 
Teenage atheletes 
Knee pain+Tibial Swelling 
Dx: Clx 
Tx: Sit it out=curative 
or Work through it
83
Q

Scoliosis
Presentation
Dx, Tx

A 
Spinal deformity 
Teenage girl
Shoulders at different levels 
Dx: Adams test (touch toes) 
X-ray 
Tx: Brace to slow progression
Rods: Reverse
84
Q

Ewing Sarcoma
Presentation
Dx, Tx

A

Midshaft, Onion skin appearance

11,22

85
Q

Osteosarcoma
Presentation
Dx, Tx

A

associated with the retinoblastoma gene
Sunburst pattern
Bone pain- then x-ray- MRI then Bx
Tx: Surgery

86
Q

Retinoblastoma
Presentation
Dx, Tx

A

All White retina
Clx
Surgical
f/u for osteosarcoma

87
Q

Strabismus
Presentation
Dx, Tx

A

Lazy eye
if it is congenital surgery in 6 months
Acquired patch the goodeye and use glasses

88
Q

Amblyopia
Presentation
Dx, Tx

A 
Cortical Blindness 
Strabismus, Cataracts 
Dx: Clx 
Tx: none 
PPX: correct the underlying illness
89
Q

Retinopathy of prematurity
Presentation
Dx, Tx

A 
Premature baby
high levels of O2, growths on the retina 
Dx: Clx 
Tx: Photoablation 
F/u-Bronchopulmonary dysplasia 
intraventricular hemorrhage 
Necrotizing enterocolitis
90
Q

Congenital Cataracts
Presentation
Dx, Tx

A 
Present at birth=due to TORCH infection 
not at birth=Galactosemia 
Pt: Cloudy/Milky white 
Front of the eye 
Dx: Clx 
Tx: Resection
91
Q

Conjunctivitis due to Gonorrhea

A

onset 2-7 days
Bilateral Purulent discharge
Tx: Ceftriaxone

92
Q

Conjunctivitis due to Chlamydia

A

Onset 5-14 days
starts unilateral mucoid discharge then converts to bilateral purulent discharge
Tx: Erythromycin

93
Q

Psoterior Urethral Valves
Presentation
Dx, Tx

A 
No urine out of the bladder
post-obstructive 
Pt: no urinary output and distended bladder 
\+/- oligohydramnios
\+/- Hydro on Prenatal u/s
\+/- increased Creatinine 
Dx: u/s=hydro 
VCUG=r/o reflux 
Insert Catheter 
Tx: Catheter 
Surgery
94
Q

Epispadias

A

Dorsal

95
Q

Hypospadias

A

Ventral

96
Q

Uretopelvic junction obstruction
presentation
Dx, Tx

A 
Normal at normal 
Obstruction with increased flow 
Dx: u/s=hydronephrosis 
VCUG=r/o reflux 
Tx: Surgery
97
Q

Ectopic ureter
Presentation
Dx, Tx

A 
males usually Asx 
females have normal function with a constant leak, have never been dry
Dx: u/s= non hydro 
VCUG=r/o reflux 
Radionucleotide 
Tx: Reimplant
98
Q

Vesicoureteral reflux
presentation
Dx, Tx

A 
Retrograde flow 
Prenatal u/s-Hydro 
Recurrent UTI +/- Pyelonephritis 
Dx: u/s = hydro 
VCUG=shows reflux 
Tx: Abx
Surgery
99
Q

What is the most common cause of ostemyelitis?

A

Staph Aureus

HgbSS-Salmonella

100
Q

Chronic complications of Sickle cell

A

Osteomyelitis

splenic Autoinfarct Avascular necrosis of the hip

101
Q

Sickle cell
presentation
Dx, Tx

A 
Pt: decreased HgB
increased reticulocyte, bilirubin
Chronic pain 
Dx: CBC=sickled cells 
HgB electrophoresis 
Tx: Vasocclusive crisis=IVF, O2, Pain control 
\+/- infxn= Abx 
PPX: Hydroxyurea increases HgbF

USMLE STEP 2 CK RETAKE (15 decks)

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