Pediatrics Recall Flashcards

1
Q

Olive shaped mass

A

Pyloric stenosis

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2
Q

“Shoulder Sign” and “Double Tract Sign” on Barium Swallow

A

Pyloric stenosis

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3
Q

Surgical Procedure of Pyloric Stenosis

A

Ramstedt Pyloromyotomy

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4
Q

Birds Beak Sign

A

Volvulus

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5
Q

Inverted U Sign

A

Volvulus

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6
Q

Coffee Bean Sign

A

Volvulus

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7
Q

Failure to recanilize the lumen

A

Duodenal Atresia

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8
Q

Obstruction usually distal to the ampulla of vater

A

Duodenal Atresia

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9
Q

Bilious vomiting without abdominal distention usually noted on the 1st day of life

A

Duodenal Atresia

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10
Q

Double Bubble Sign

A

Duodenal Atresia

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11
Q

Surgical Tx of Duodenal Atresia

A

Duodenoduodenostomy with gastrotomy tube

Pg18 TN

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12
Q

Incomplete rotation of the intestine during fetal development

A

Malrotation

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13
Q

Most common type involve failure of the cecum to move into the RLQ

A

Malrotation

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14
Q

Remnant of the Omphalomesenteric duct

A

Meckel Diverticulum

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15
Q

Intermittent painless rectal bleeding and “Brick colored stool”

A

Meckel Diverticulum

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16
Q

Congenital Aganglionic Megacolon

A

Hirschprung Disease

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17
Q

Most common cause of lower intestinal obstruction in neonates;
M > F

A

Hirschprung Disease

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18
Q

Absence of ganglionic cells in the bowel wall beginning in the “Internal Anal Sphincter”

A

Hirschprung Disease

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19
Q

Absence of Meisnner and Auerbach plexus

A

Hirschprung Disease

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20
Q

Begins at birth with the Delayed Passage of Meconium

A

Hirschprung Disease

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21
Q

Pellet or Ribbon like stool

A

Hirschprung Disease

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22
Q

Currarino Triad

A

Hirschprung Disease

Pg19 TN

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23
Q

Sausage-shaped mass in the RUQ which may inc in size and firmness during a paroxysm of pain

A

Intussusception

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24
Q

Barium enema: “Coiled Spring Sign”

A

Intussusception

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25
Q

UTZ: Doughnut or Target Sign

A

Intussusception

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26
Q

Most common cause of non bilious vomiting

A

Pyloric stenosis

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27
Q

More specific for acute inflammatory pancreatic disease

A

Serum lipase

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28
Q

Abd Xray: Sentinel loop

A

Acute Pancreatitis

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29
Q

Abd Xray: Cutoff Sign: dilated transverse colon

A

Acute Pancreatitis

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30
Q

Abd Xray: Blurring of left psoas margin

A

Acute Pancreatitis

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31
Q

Severe flank pain radiating to the groin

A

Renal Colic from Calculi

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32
Q

Sudden onset offross or microscopic hematuria and unilateral or bilateral flank mass

A

Renal Vein Thrombosis

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33
Q

Gross hematuria, Periorbital edema, Hypertension, Oliguria

A

Acute PostStreptococcal Gromerulonephritis

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34
Q

Most common chronic glomerular disease worldwide

A

IgA Nephropathy

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35
Q

Bilateral flank pain masses during the neonatal period or early infancy

A

Polycystic Kidney Disease

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36
Q

Associated with Potter Facies

A

Polycystic Kidney Disease

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37
Q

Renal UTZ: enlarged and hyperechogenic kidneys with poor corticomedullary distinction

A

Potter Syndrome

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38
Q

Most common cause of acute renal failure in young adults

A

Hemolytic Uremic Syndrome

Pg27 TN

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39
Q

Microangiopathic Hemolytic Anemia

A

Hemolytic Uremic Syndrome

Pg27 TN

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40
Q

Precedes more than 80% of HUS in devolped countries

A

Shiga toxin producing Escherichia coli 0157:H7

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41
Q

Peripheral Smear: Helmet cells

A

Hemolytic Uremic Syndrome

Pg27 TN

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42
Q

Peripheral smear: Burr cells

A

Hemolytic Uremic Syndrome

Pg27 TN

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43
Q

Peripheral smear: Fragmented RBCs

A

Hemolytic Uremic Syndrome

Pg27 TN

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44
Q

Upper limit of normal protein excretion in healthy children

A

150mg/day

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45
Q

T-cells first detected in the thymus

A

7th - 8th week of gestation

Pg29 TN

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46
Q

Vital organ for immune response to blood borne antigens

A

Spleen

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47
Q

Mucosa Associated Lymphoid Tissue (MALT)

A

Pe yer’s patch in the lamina propria of the SI
L ymphoid follicles in the appendix
T onsils in the pharynx
S ubmucosal lymphoid tissue throughout the upper airways & bronchi

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48
Q

A protein that creates pores on cell membranes of target cells resulting in lysis

A

Cytolysin

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49
Q

First line of defense against neonatal herpes virus infection

A

Natural Killer Cells

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50
Q

Functions of Phagocytes

A

Diapedesis
Chemotaxis
Phagocytosis
Killing

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51
Q

Main anaphylatoxins that provokes inflammation

A

C3a and C5a

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52
Q

Role in opsonization

A

C3b and C5b

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53
Q

B Cell Deficiency: deficiency of tyrosine kinase that blocks B cell maturation

A

Bruton’s X-linked Agammaglobulinemia

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54
Q

B Cell Deficiency: deficiency of CD40L on activated T cell

A

X Linked Hyper IgM Syndrome

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55
Q

B Cell deficiency: most common IgA defiency

A

Selective IgA Deficiency

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56
Q

B Cell Deficiency: Delayed onset of maturation of normal IgG

A

Transient Agammaglobulinemia

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57
Q

T Cell Deficiency: Thymic hypoplasia and T cell specific

A

DiGeorge Syndrome

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58
Q

T Cell Deficiency: defective cytoskeletal gylycoprotein

A

Wiskott Aldrich

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59
Q

Most common T Cell Deficiency

A

Severe Combined Immunodeficiency

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60
Q

Adenosine Deaminase Deficiency

A

Severe Combined Immunodeficiency

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61
Q

Defects in Phagocytosis: Deficiency in NADPH oxidase and recurrent infxn with Catalase +

A

Chronic Granulomatosis Disease

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62
Q

Defects in Phagocytosis: absence of CD18

A

Leukocyte Adhesion Defect

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63
Q

Defects in Phagocytosis: Delayed in umbilical cord sloughing

A

Leukocyte Adhesion Defect

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64
Q

Defects in Phagocytosis: Granule structure defect

A

Chediak-Hegashi Syndrome

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65
Q

Defects in Phagocytosis: Recurrent bacterial infxn and partial albinism

A

Chediak-Higashi Syndrome

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66
Q

Defects in Phagocytosis: Deficiency in enzyme needed in HMP

A

Glucose 6 Phosphate Deficiency

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67
Q

Defects in Phagocytosis: Hemolytic Crisis

A

Glucose 6 Phosphate Deficiency

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68
Q

Defects in Phagocytosis: Granule ENZYME deficiency

A

Myeloperoxidase Deficiency

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69
Q

Defects in Phagocytosis: Deficiency in TNF-gamma

A

Job’s Syndrome

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70
Q

Defects in Complement: Deficiency in regulatory of protein

A

Hereditary Angioedema

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71
Q

Screening Test for Macrophage Deficiency

A

Nitroblue Tetrazolium Test

Respiratory Burst Assay

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72
Q

Screening Test for Complement Deficiency

A

CH50

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73
Q

Rachitic Rosary

A

Rickets

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74
Q

Harrison Groove

A

Rickets

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75
Q

Valgus deformity of 1 leg with Varus deformity of the other leg

A

Windswept Deformity

Rickets

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76
Q

Angular Cheilosis

A

Perleche

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77
Q

Magenta Tongue

A

Glossitis

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78
Q

Dermatitis, Diarrhea, Dementia and Death

A

Pellagra

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79
Q

Pellagra

A

Niacin Deficiency

Vit. B3

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80
Q

Microcytic Anemia

A

Vit B6 Deficiency

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81
Q

Megaloblastic Anemia

A

Vitamin B12 deficiency

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82
Q

Scorbutic Rosary

A

Scurvy

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83
Q

Corckscrew Hair

A

Scurvy

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84
Q

Inadequate CALORIC intake + non-edematous

A

Marasmus

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85
Q

Starvation type of diarrhea

A

Marasmus

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86
Q

Insufficient intake of PROTEIN of good biologic value

A

Kwashirkor

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87
Q

Streaky red or grey hair in dark-haired children

A

Hypochromotrichia

Kwashirkor

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88
Q

Extreme Exogenous Obesity

A

Pickwickian Syndrome

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89
Q

Severe cardiorespiratory distress with alveolar hypoventilation

A

Pickwickian Syndrome

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90
Q

Most severe form of neural tube defect (Dysraphism)

A

Meningocele

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91
Q

Failure of the neural tube to close spontaneously between the 3rd and 4th wk in utero

A

Meningocele

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92
Q

Due to failure of closure of the ROSTRAL NEUROPORE

A

Anencephaly

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93
Q

Absent cerebral hemisphere and cerebellum with a residue of brainstem

A

Anencephaly

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94
Q

Absent cerebral convolutions and poor formed sylvian fissure

A

Lissencephaly (Agyria)

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95
Q

Faulty neuroblast migration

A

Lissencephaly (Agyria)

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96
Q

Unilateral or bilateral clefts within the cerebral hemispheres

A

Schizencephaly

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97
Q

Presence of cysts or cavities within the brain

A

Porencephaly

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98
Q

Develop during perinatal/postnatal period due to problems of arterial or venous circulation

A

Pseudoporencephalic cysts

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99
Q

Defective cleavage of the prosencephalon and inadequate induction of the forebrain structures

A

Holoprosencephaly

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100
Q

Impaired circulation and absorption of CSF from increase production of CSF

A

Hydrocephalus

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101
Q

Obstruction within the ventricular system

A

Obstructive or Non-communicating type of Hydrocephalus

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102
Q

Abnormality of the Aqueduct or a lesion in the 4th Ventricle

A

Obstructive or Non-communicating type of Hydrocephalus

103
Q

Aqueductal Stenosis

A

Obstructive or Non-communicating type of Hydrocephalus

104
Q

Obliteration of the subarachnoid cisterns

A

Non-Obstructive or Communicating type of Hydrocephalus

105
Q

Malfunction of the arachnoid villi

A

Non-Obstructive or Communicating type of Hydrocephalus

106
Q

Follows a subarachnoid hemorrhage

A

Non-Obstructive or Communicating type of Hydrocephalus

107
Q

Leukemic infiltrates

A

Non-Obstructive or Communicating type of Hydrocephalus

108
Q

Where is CSF produced?

A

Choroid Plexus

109
Q

Setting-Sun Sign

A

Hydrocephalus

110
Q

Long-Tract Sign

A
Brisk DTR's
Babinski sign
Clonus
Spacity
(Hydrocephalus)
111
Q

Percussion of Skull

A

Cracked Pot Sensation

Hydrocephalus

112
Q

Separation of Sutures in the brain

A

Macewen Sign

Hydrocephalus

113
Q

Foreshortened Occipit

A

Chiari Malformation

114
Q

Prominent Occiput

A

Dandy-Walker Malformation

115
Q

Provide temporary relief by reducing the rate of CSF production

A

Acetazolamide and Furosemide

116
Q

Paroxysmal, time-limited changes in motor activity and/or behavior that result from abnormal electric activity in the brain

A

Seizures / Convulsions

117
Q

Present when 2 or more unprovoked seizures occur at an interval greater than 24hrs apart

A

Epilepsy

118
Q

Consciousness RETAINED seizure

A

Simple Seizure

119
Q

Consciousness IMPAIRED seizure

A

Complex Seizures

120
Q

Sudden cessation of motor activity or speech with a blank facial expression or flickering of the eyelids

A

Absence Seizures

121
Q

Seizure that NEVER associated with an aura

A

Absence Seizures

122
Q

Seizure that rarely persist longer than 30 seconds

A

Absence Seizures

123
Q

Seizure that do not lose body tone

A

Absence Seizures

124
Q

Seizure associated with an aura

A

Generalized Tonic-Clonic Seizure

125
Q

Seizure cause loss of sphincter control

A

Generalized Tonic-Clonic Seizure

126
Q

Repetitive seizures consisting of brief, often symmetric muscular contractions with loss of body tone and falling or slumping forward

A

Myoclonic Seizures

127
Q

Hypsarrhythmia and begins at 4-5 months old

A

Infantile Spams

128
Q

Management of Generalized Tonic Clonic Seizures

A
P: Phenobarb
P: Phenytoin
Ca: Carbamazepine
La: Lamotrigine
Va: Valproic acid
G: Gabapentine
129
Q

Management of Absence Seizures

A

E: Ethoxsuximide
Va: Valproic acid

130
Q

Managment of Infantile Spasm

A

Vigabatrin

131
Q

Restricted CHO and CHON

A

Ketogenic Diet

132
Q

Most common seizure disorder in childhood

A

Febrile Seizures

133
Q

Febrile Seizures: Peak age of onset

A

14 - 18 months old

134
Q

Seizure occurs only ONCE in 24hrs

A

Simple Febrile Seizures

135
Q

Focal seizures activity

A

Complex Febrile Seizures

136
Q

One seizure lasting 30 minutes or multiple seizures during 30 minutes without regaining consciousness

A

Status Epilepticus

137
Q

Breakthrough Seizures

A

Status Epilepticus

138
Q

Drug for Status Epilepticus

A

Phenytoin

139
Q

Recurrent headache with symptoms free intervals and at least 3 criteria (F R U A N T)

A
Migraine
Family hx
Relief following sleep
Unilateral loc
Aura
Abd pain
Nausea and vomiting
Throbbing in character
140
Q

Type of Migraine: Most prevalent type

A

Migraine without Aura

141
Q

Type of migraine: Throbbing or pounding, and intense nausea and vomiting

A

Migraine without Aura

142
Q

Type of Migraine: Light Headedness, Photophobia, Osmophobia, Phonophobia

A

Migraine without Aura

143
Q

Type of Migraine: Sensory symptoms (blurred of vision, photopsia, fortification spectra)

A

Migraine with Aura

144
Q

Alice in Wonderland Syndrome

A

Migraine with Aura

145
Q

Type of Migraine: Good prognosis in older childrena or adolescent

A

Hemiplegic Aura

146
Q

Type of Migraine: Vertigo, tinnitus, diplopia, scotoma and ataxia

A

Basilar type Migraine

147
Q

Type of Migraine: Altered consciousness with seizures

A

Basilar type Migraine

148
Q

Type of Migraine: Complete resolution after the attack

A

Basilar type Migraine

149
Q

Type of Migraine: after deep sleep, child resumes normal activity

A

Cyclic Vomiting

150
Q

Type of Migraine: Complete Resolution of Symptoms between attacks

A

Cylic Vomiting

151
Q

Type of Migraine: Anorexia, Nausea, Vomiting and Pallor

A

Abdominal Migraine

152
Q

Persistent headache lasting for more than 3 days

A

Status Migrainosus

153
Q

Headache common after the onset of puberty

A

Tension or Stress Headache

154
Q

Waxes and Wanes

A

Tension or Stress Headache

155
Q

Band like tightness or pressure

A

Tension or Stress Headache

156
Q

NOT associated with nausea and vomiting

A

Tension or Stress Headache

157
Q

Neurocutaneous Syndromes

A

Tuberous Sclerosis

Neurofibromatosis

158
Q

Defect in differentiation of the primitive ECTODERM

A

Neurofibromatosis

159
Q

Tuberous Sclerosis Complex Gene 1 encodes:

A

Protein HAMARTIN

160
Q

Tuberous Sclerosis Complex Gene 2 encodes:

A

Protein Tuberin

161
Q

Candle Dripping Appearance

A

Tuberous Sclerosis

162
Q

High Index of suspicion when assessing a child with infantile spasm

A

Tuberous Sclerosis

163
Q

Ash Leaf pigmentation

A

Tuberous Sclerosis

164
Q

Shagreen Patch (lumbosacral region)

A

Tuberous Sclerosis

165
Q

Adolescence presents with subungual or periungual fibromas from the fingers and toes

A

Tuberous Sclerosis

166
Q

Neurofibromatosis 1

A

Von Recklinghausen

167
Q

Affects chromosome 17

A

Von Recklinghausen

168
Q

Lisch Nodules

A

Von Recklinghausen

169
Q

Café Au Lait Macules that spare the face

A

Von Recklinghausen

170
Q

Axillary or Inguinal Freckling

A

Von Recklinghausen

171
Q

Optic Glioma

A

Von Recklinghausen

172
Q

Paroxysmal, time-limited changes in motor activity and/or behavior that result from abnormal electric activity in the brain

A

Seizures / Convulsions

173
Q

Present when 2 or more unprovoked seizures occur at an interval greater than 24hrs apart

A

Epilepsy

174
Q

Consciousness RETAINED seizure

A

Simple Seizure

175
Q

Consciousness IMPAIRED seizure

A

Complex Seizures

176
Q

Sudden cessation of motor activity or speech with a blank facial expression or flickering of the eyelids

A

Absence Seizures

177
Q

Seizure that NEVER associated with an aura

A

Absence Seizures

178
Q

Seizure that rarely persist longer than 30 seconds

A

Absence Seizures

179
Q

Seizure that do not lose body tone

A

Absence Seizures

180
Q

Seizure associated with an aura

A

Generalized Tonic-Clonic Seizure

181
Q

Seizure cause loss of sphincter control

A

Generalized Tonic-Clonic Seizure

182
Q

Repetitive seizures consisting of brief, often symmetric muscular contractions with loss of body tone and falling or slumping forward

A

Myoclonic Seizures

183
Q

Hypsarrhythmia and begins at 4-5 months old

A

Infantile Spams

184
Q

Management of Generalized Tonic Clonic Seizures

A
P: Phenobarb
P: Phenytoin
Ca: Carbamazepine
La: Lamotrigine
Va: Valproic acid
G: Gabapentine
185
Q

Management of Absence Seizures

A

E: Ethoxsuximide
Va: Valproic acid

186
Q

Managment of Infantile Spasm

A

Vigabatrin

187
Q

Restricted CHO and CHON

A

Ketogenic Diet

188
Q

Most common seizure disorder in childhood

A

Febrile Seizures

189
Q

Febrile Seizures: Peak age of onset

A

14 - 18 months old

190
Q

Seizure occurs only ONCE in 24hrs

A

Simple Febrile Seizures

191
Q

Focal seizures activity

A

Complex Febrile Seizures

192
Q

One seizure lasting 30 minutes or multiple seizures during 30 minutes without regaining consciousness

A

Status Epilepticus

193
Q

Breakthrough Seizures

A

Status Epilepticus

194
Q

Drug for Status Epilepticus

A

Phenytoin

195
Q

Recurrent headache with symptoms free intervals and at least 3 criteria (F R U A N T)

A
Migraine
Family hx
Relief following sleep
Unilateral loc
Aura
Abd pain
Nausea and vomiting
Throbbing in character
196
Q

Type of Migraine: Most prevalent type

A

Migraine without Aura

197
Q

Type of migraine: Throbbing or pounding, and intense nausea and vomiting

A

Migraine without Aura

198
Q

Type of Migraine: Light Headedness, Photophobia, Osmophobia, Phonophobia

A

Migraine without Aura

199
Q

Type of Migraine: Sensory symptoms (blurred of vision, photopsia, fortification spectra)

A

Migraine with Aura

200
Q

Alice in Wonderland Syndrome

A

Migraine with Aura

201
Q

Type of Migraine: Good prognosis in older childrena or adolescent

A

Hemiplegic Aura

202
Q

Type of Migraine: Vertigo, tinnitus, diplopia, scotoma and ataxia

A

Basilar type Migraine

203
Q

Type of Migraine: Altered consciousness with seizures

A

Basilar type Migraine

204
Q

Type of Migraine: Complete resolution after the attack

A

Basilar type Migraine

205
Q

Type of Migraine: after deep sleep, child resumes normal activity

A

Cyclic Vomiting

206
Q

Type of Migraine: Complete Resolution of Symptoms between attacks

A

Cylic Vomiting

207
Q

Type of Migraine: Anorexia, Nausea, Vomiting and Pallor

A

Abdominal Migraine

208
Q

Persistent headache lasting for more than 3 days

A

Status Migrainosus

209
Q

Headache common after the onset of puberty

A

Tension or Stress Headache

210
Q

Waxes and Wanes

A

Tension or Stress Headache

211
Q

Band like tightness or pressure

A

Tension or Stress Headache

212
Q

NOT associated with nausea and vomiting

A

Tension or Stress Headache

213
Q

Neurocutaneous Syndromes

A

Tuberous Sclerosis

Neurofibromatosis

214
Q

Defect in differentiation of the primitive ECTODERM

A

Neurofibromatosis

215
Q

In meningitis, what do you do next if Lumbar Puncture is traumatic?

A

Gram stain
Blood Culture
Glucose Level

216
Q

Partial treatment of meningitis

A

Ceftriaxone or Cefotaxime for 7-10 days

217
Q

Drug use for H. Influenza meningitis

A

Dexamethasone IV

218
Q

In meningitis, drug of choice for Penicillin-resistant

A

Vancomycin

219
Q

CSF Analysis: NORMAL glucose, normal to slight increase protein and (+) LYMPHOCYTES

A

Viral Meningitis

220
Q

Most common location of brain abscess

A

Cerebrum (80%)

221
Q

Immune-Mediated Neuromuscular Blockade

A

Myasthenia Gravis

222
Q

Myasthenia Gravis: Earliest and most constant sign

A

Ptosis

Some degree of extra-ocular muscle weakness

223
Q

SSx: Fatigue of muscles, Proximal muscle weakness, more symptomatic late in a day and life threatening (respi muscles involvement)

A

Myasthenia Gravis

224
Q

Though to be the site of production of autoantibodies against Acetylcholine receptors

A

Thymoma

225
Q

Acute unilateral facial nerve palsy that is not associated with other cranial neuropathies

A

Bell’s Palsy

226
Q

Develops abruptly about 2 weeks after a systemic viral infection (?)

A

Bell’s Palsy

EBV, HSV, Mumps virus

227
Q

Acute Demyelinating Polyradiculoneuropathy

A

Guillain-Barre Syndrome

228
Q

Post-infectious polyneuropathy involving mainly MOTOR

A

Guillain-Barre Syndrome

229
Q

Landry Ascending Paralysis

A

Guillain-Barre Syndrome

230
Q

Guillain-Barre Syndrome physical findings are associated with this condition

A

Cranial Nerve Deficits

Miller-Fisher Syndrome

231
Q

Acute Ophthalmoplegia, Ataxia and Areflexia

A

Miller-Fisher Syndrome

232
Q

Guillain-Barre Syndrome: Last function to recover

A

Tendon reflex

233
Q

Guillain-Barre Syndrome: Last to resolve

A

Lower Extremity Weakness

234
Q

CSF Analysis: INCREASE protein, normal glucose, no pleocytosis

A

Guillain-Barre Syndrome

235
Q

Tx for rapidly progressive ascending paralysis

A

IVIG 0.4gms/kg/day for 5 consecutive days

236
Q

Guillain-Barre Syndrome for RELAPSE

A

High dose pulse Methylprednisolone IV

237
Q

Static Encephalopathy

A

Cerebral Palsy

238
Q

Delayed walking or walks in tiptoes

A

Spastic Hemiplagia

Cerebral Palsy

239
Q

Commando Crawl

A

Spastic Diplegia

Cerebral Palsy

240
Q

Homer-Wright Rosettes

A

Medulloblastoma

241
Q

Medulloblastoma oftenly found in

A

Cerebellum

242
Q

Infratentorial Tumors

A

Cerebellar astrocytoma
Brain stem glioma
Ependymoma
Medulloblastoma

243
Q

Most common and with the best prognosis of infratentorial tumors

A

Cerebellar Astrocytoma

244
Q

Supratentorial Tumors

A

Craniopharyngioma
Optic nerve glioma
Choroid plexus papilloma
Astrocytoma

245
Q

Pressure to optic chiasma produces bitemporal visual field defects

A

Cranipharyngioma

246
Q

Gray-brown adherent pseudomembrane

A

Diphtheria

Corynebacterium diphtheriae

247
Q

Bull-neck appearance

A

Diphtheria

Corynebacterium diphtheriae

248
Q

Leather-like adherent membrane

A

Diphtheria

Corynebacterium diphtheriae

249
Q

Whooping Cough

A

Pertussis

Bordatella pertusis

250
Q

Most infectious stage of pertussis

A

Catarrhal stage

251
Q

Explosive outburst in series of 5-10 rapid coughs in one expiration and ending in a high pitch forceful inspiration gasp

A

Whooping Cough

252
Q

CBC result of leukomoid reaction with absolute lymphocytosis

A

Pertussis

Bordatella pertusis

253
Q

Complications of Pertussis:

H S O A P

A

Hemorrhage (subconjunctival / intracranial)
Seizures
Otitis media
Atelectasis, apnea, activation of latent TB
Pneumonia