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USMLE Step 3 Master the board > Peds > Flashcards

Peds Flashcards

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USMLE® Step 1 flashcards
1
Q

Meconium illeus assoc with which dz

A

CF- resp inf

Plain x ray shows dilated gas bowel with a ground glass MASS on r side (meconium)

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2
Q

Chlamydia trachomatis is culprit for neonatal conjunctivites and PNA which happens when and how?

A

Conjunctivitis - up to 2 wks
Pna- cxr w hyperinflation, rales, stacato cough (dry and short)
Tx –> oral erythrmycin for 2 wks

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3
Q

Adhd preschool kids

A

First is behavioral therapy. Next is stimulant.

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4
Q

Adhd kid who is on adderral max dose but minimal improvement. What is next option?

A

Switch to norepi reuptake inh like amoxetine or clonidine (a 2 agonist)

Should see effect w these meds within weeks

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5
Q

What should u do if child is Called FTT (Inadequate calorie intake, absorption or increased calorie requirements)

A

Should rec diet modification - need to introduce solid food by 4-6 mo.

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6
Q

Most common causes of acute otitis media and with purulent conjunctival discharge in someone who just finished abx?

Tx?

A

Nontypeable haemophilus influenzae (not hib since we give vaccine), moraxella, strep pneumonia. Most commonly recurrence by these bugs bc initial tx was resistant

Initial tx is amox
recurrent –> augmentin

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7
Q

Choking child- what manuever if 1 yr?

A

Back blow if baby

Abdominal thrusts aka heimlich maneuver

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8
Q

Diagnose hirshsprung disease with

Tx?

A

Rectal SUCTION biopsy. If fail to pass meconium in 2 days.

First get KUB w/ contrast enema

Tx is anastamose normal bowel to anus

10% of pts with down syndrome

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9
Q

3-6 wk old with projectile vomiting, olive mass in ruq and signs dehydration has? What should u do next?

Assoc with which abx?

A

Hypertrophic pyloric stenosis. Need to correct electrolytes before pyloromyotomy bc decr risk if postop apnea

Assoc w/ Erythromycin (given for postexposure pertussis)

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10
Q

16 yo w low lh, fsh, low testosterone, bone age of 12, and fam hx

A

Constitutional pubertal delay relates to bone age

Kallman syndrome anosmia with failed gnrh and thus hypogonadism

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11
Q

Ash leaf spots and new onset seizures is what dz?

A

Tuberous sclerosis
Can also get benign tumors of brain and kidney
thus need –>brain MRI, EEG, Abd. US

Die usually from epilepsy (tumor burden on brain)

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12
Q

Baby is breast only up to age 1 with no supplements has anemia. What kind?

A

Iron defi. anemia bc need supplement with iron fortified food (rich in vitC) or pureed meat after 6 mo.
TX: oral iron supplement

Be aware that cow milk/soy milk before one yr can cause chronic GI bleed!!

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13
Q

How do you diagnose bronchiolitis in babies? Any labs?

Which kids need vaccination?

A

Clinically!

The kids who need ag testing of nasal or pulm secretions are those who received the pavilizumab vaccine bc preterm

Vs croup due to parainfluenza and have barky cough, inspiratory stridor

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14
Q

Obese kid w hip pain, cant bear weight and externally rotated hip. Tx?

A

Scfe- slippe capital femoral epiphysis which should tx with internal fixation w a screw immediately bc risk if AVN

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15
Q

By what age should a boy reach puberty?

If not, what is next test?

A

Delayed puberty if no testicular enlargement or testicle

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16
Q

Lethargic baby w fever, jaundice, and uti should get tx for what and with what?

A

Sepsis! Can cause indirect hyperbili

Tx w/ –> cefoxitime (UTI) and ampicillin for listeria

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17
Q

Kid w painless hematochezia and tectnetium scan showing incr uptake in rlq

A

Meckels diverticulim which may also be painful

Due to failed vitelline duct obliteration means ectopic gastric tissue

18
Q

Baby/toddler w abd pain, palpable sausage shaped mass on r side of abd, hematochezia has? Diagnose with?

What is risk of the tx?

A

Intussuception bc telescoping of bowel causes bowel ischemia

Dx w ultrasound BUT when problem is obvi then go straight to solution w air or water enema!!

Risk of tx is bowel perf!

19
Q

Tx for lead poisoning? Mild, mod, severe

A

> 15 inform the health department
45 chelation

Houses built before 1978 have lead
Note that penicillamine is chelating agent for wilson dz

20
Q

down syndrome incr risk of what

A

Leukemia, alzheimer, seizures, depression

21
Q

What is criteria to dx neurofibromatosis 1? What is next eval after dx?

A

First degree relative w/ dz and development of more than 5 cafe au lait spots

Need opthalmic eval to check for 15% risk of optic nerve glioma

Dont need generic test bc 30% false neg

22
Q

Baby w webbed neck, cardiac murmur, hand edema. Barr body. Has what? What is risk of transmission?

A

Xo turner syndrome. Risk is same as general population

23
Q

Baby w hyperk, hypona, hypoglyc, hyPOtension gets genetic testing and positive for?

A

21 hydroxylase (most common congenital adrenal hyperplasia

Due to high mineralocorticoids and glucocoricoids incr androgen and thus ambiguous genitalia in females
High 17-hudroxyprogesterone

Vs 11b hydroxylase and 17a hydroxylase have HTN

Tx –> hydrocortisone (glucocorticoid) and fludrocortisone (mineralocorticoid)

24
Q

13 yr old w persistent sinusitis (3rd ep in 7 mo). No other complaints, parents smokers. Why does she keep getting it?

A

Smoking exposure damages cilia preventing mucus movement through sinuses.

Not kartageners which is sinus inversus, bronchiectasis, sinusitis.

25
Q

What is erbs palsy

A

Diaphragmatic palsy due to phrenic n injury injuring brachial plexus

26
Q

Baby suspected of shaken baby syndrome w retinal hemorrhage should next get what test?

A

CT will find mixed dense pattern of subdural hematoma vs a homogenous hyperdense pattern in accidental head trauma

Eventually do a skeletal survey but not before CT!

27
Q

Baby born to HBantigen positive mother should get hbv ig, hepb series and then when should their hbv be checked??

A

9 mo-15 mo. This is when they have finished the hbv vaccine series

28
Q

Kid who had tick bite 3 mo ago now w monoarticular knee pain, swelling, warmth BUT can bare weight. Next thing to check

Tx?

A

Serum elisa!!! Not arthrocentesis bc higher chance of lyme athritis in kids

Check w elisa and then western blot
Arthrocentesis shows 25k wbc

Tx is amox (kids

29
Q

Tx of croup

A

Croup or laryngotracheitis - see steeple sign which is subglottic narrowing in xray

Tx is humidifed air and Oral STEROIDS

If moderate, ie stridor at REST should get steroids and nebulized epi!!!

It fail initial tx then that is when u hospitalize!!

30
Q

Which steroid to give to preterm baby mama and when?

A

Betamethasone- 24-34 wks

Reduces infant resp distress by stim surfactant

31
Q

6 mo w constipation, poor sucking, lethargy and ate honey will have what on physical exam?

A

Infant botulism- check for gag reflex

No neck muscle rigid

32
Q

Baby born breech w r leg shorter and dislocated and positive batlow test needs what fu?

A

Us (no xray in baby whne cartilage) refer to ortho surg and they place hip in aduction and flexed

33
Q

Baby premature w developmental delay not yet walking at 19 mo, spastic, hyperreflex should get what test done?

A

Mri bc has cerebral palsy diagnosed clinically. Will likely find abn

Not emg

34
Q

Tx of pediatric constipation after lifestyle modification?

A

Mg hydroxide!! Not bisacodyl suppository which is strong

35
Q

Betamethasone or dexamethasone for premie administered how?

A

IM to avoid the troughs and peaks

Decr infant rds and intraventricular hemorrhage

36
Q

Kid w acute otitis comes a month after visit on ear exam w normal TM
And decr mobility. What to do?

A

Effusion - watchful waitig for three months unless pt has symptoms

Dont even need audiometry exam unless after three months

37
Q

Suspect sexual abuse in baby dont discuss w parents. What do u do

A

Report to cps!!

Discussing w parents may endanger kids life

38
Q

Maternal dm causes what change to fetal heart

A

Hypertrophic iv septum from glycogen deposition and also causing chf

Will resolve after birth spontaneously!!

39
Q

When can u break confidentiality w teen

A

Self harm risk ie taking too much adderrall

Abuse, injuries

Things like preg, contraception, std, substance abuse, mental health prob

40
Q

Teen w low bmi and picky eater w constipation. What should u ask

About stool, freq and caliber color
About menses

A

Menses!!

USMLE Step 3 Master the board (33 decks)

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