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Step 2 CK > peds > Flashcards

peds Flashcards

1
Q

cyanotic infant with L. axis deviation
decreased pulmonary markings on CXR
ASD or VSD

A

tricuspid valve atresia

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2
Q

down syndrome heart

A

complete AV canal defect

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3
Q

maternal lithium use

defect?

A

ebstein’s anomaly (malformed TC valve into the R ventricle)

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4
Q

tetralogy of fallot on CXR

A

boot shaped heart (right v hypertrophy)

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5
Q

normal heart deviation newborn

A

r

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6
Q

total anomalous pulmonary venous return

A

all 4 pulmonary veins dump into r. atrium (R enlargement) or otherwise the systemic circulation (brachiocephalic veins, SVC, portal/renal veins))

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7
Q

digeorge syndrome heart defect

A

truncus arteriosus

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8
Q

Gray visicles in posterior oropharynx. Dz and virus

A

Herpangina

Coxsackie

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9
Q

abx for unilateral cervical adenitis in kids

A

clinda (strep/staph)

must do I & D too

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10
Q

odynophagia

A

pain with eating

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11
Q

2 characteristics of niemann-pick dz but not tay sachs

A

hepatomegaly

arreflexia

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12
Q

enzymes in niemann-pick vs tay sachs

A

NP: sphingomyelinase
TS: B-hexosaminidase

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13
Q

1 year old
thrombocytopenia
recurrent bacterial infections
eczema

A

Wiskott-Aldrich Syndrome (X-linked)

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14
Q

Maculopapular rash
started head spread to body
low fever
arthritis

A

rubella

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15
Q

class of meds to use for tourette’s disorder

A

antipsychotics

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16
Q

child less than 1
macrocytic anemia w/ low retic count
congenital anomalies

A

diamond-blackfan anemia

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17
Q

general tx for OCD

A

high dose SSRI therapy

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18
Q

infection associated (rare) with OCD onset

A

group A strep infection

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19
Q

1st test in torticollis

A

c-spine radiographs

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20
Q

erb-duchenne’s palsy noted. 1st step?

A

reassurance

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21
Q

preterm neonate with:
+gastric volume, vomiting, abdominal distention

w/pneumatosis intestinalis and portal venous air

A

necrotizing enterocolitis

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22
Q

neonate w/ air in stomach, duodenum. but nothing distal

A

(double bubble) = duodenal atresia

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23
Q

neonate w/failure to pass mec w/in 48 hours (2)

A

Hirschsprung dz or CF

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24
Q

infant with virilization

hyponatremia

A

21-hydroxyase deficiency

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25
Q

2 tests for 21-hydroxylase deficiency

A

consyntropin stim test

+17 hydroxyprogesterone levels

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26
Q

Kid with recurrent infections - pneumonias, and suppurative adenitis

A

chronic granulomatous disease

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27
Q

newborn with bilious vomiting and triple bubble sign

A

jejunal atresia

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28
Q

timeline difference of gonococcal vs chlamydial conjunctivitis

A

reverse alphabetical order:

less than 5 days = gonococcal
greater then 5 days = chlamydial

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29
Q

differences in bruton’s agammaglobulinemia VS CVID in

a) gender
b) # B cells
c) age of onset

A

a) Bruton’s is just boys
b) B cells reduced in Bruton’s
c) CVID later onset (15-35)

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30
Q

biggest risk of rotavirus vacc

A

small risk intussusception

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31
Q

timing or weight for sweat test

A

greater than 2 weeks
or
greater than 2 kg

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32
Q

laboratory abnormalities of seminoma vs germ cell tumor (2)

A

seminoma can give +BHCG

germ cell tumors have +BHCG and +AFP

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33
Q

rate over which is tachypnea in a neonate

A

60

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34
Q

AFP level in aneuplodies

A

reduced

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35
Q

AFP w/ neural tube defects, ventral wall defects, or multip

A

increased

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36
Q

infant w/no stool in 24 hours, small colon

A

meconium ileus (CF)

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37
Q

apgar requiring intervention

A

less than 7

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38
Q

missense vs nonsense mutations

A

both point mutations - missense = one different aa. Nonsense makes a stop codon

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39
Q

when to consider adding inhaled steroid to asthmatic tx?

A

if 3 or more exacerbations/week

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40
Q

pallid spell

A

minor trauma followed by apnea

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41
Q

association (even with parents) of kids w/cyclic vomiting syndrome

A

migraines

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42
Q

tx for abnormal uterine bleeding, esp. adolescents

A

high dose estrogen therapy

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43
Q

4 classes of hypersensitivities

A 
ACID
Anaphylactic
Cytotoxic (Ab-mediated)
Immune complex
Delayed (cell-mediated)
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44
Q

normal HR range of newborn

A

120-160 BPM

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45
Q

conjunctivitis on newborn at day 1

A

chemical irritation

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46
Q

baby with aniridia. what association?

A

Wilms tumor

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47
Q

timeline for orchipexy in case of crypotchidism with infant

A

after 1 yrs old

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48
Q

hyperbilirubinia velocity that is concerning

A

5 mh/dL per day

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49
Q

cherry vs strawberry angiomas

A

strawberry is on newborns (superficial angiomas), cherry angiomas are the red dots on adults

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50
Q

nevus simplex

A

macular stain

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51
Q

breast milk jaundice vs breastfeeding failure jaundice

A

breastfeeding failure has signs of dehydration (1st week) - brick red crystals in diaper

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52
Q

the 2 genetic conjugated hyperbilirubinemias

A

dubin-johnson (black liver)

rotor (milder)

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53
Q

timeline of physiologic jaundice vs pathologic

A

phys 3 day+

path less than 1 day

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54
Q

phys hyperbilirubinemia with +coombs

A

isoimmunization (Rho or ABO)

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55
Q

phys jaundice with +Hg (2)

A

Twin-twin transfusion

or maternal-baby trx (delayed clamping)

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56
Q

baby with bili >20. tx?

A

exchange transfusion

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57
Q

kid less than 2 w/upper limb, head jerking

A

west syndrome

infantile spasm

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58
Q

tx for west syndrome (infantile spasm)

A

ACTH

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59
Q

kid 3 mos to 6 yrs with colicky abdominal pain relieved by knee-chest position

A

intususseception

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60
Q

test if suspect blood in GI from ingested maternal blood vs vasa previa

A

apt test(alkali-denaturation test)
- if maternal blood ingestion
+ if fetal origin (could be vasa previa, etc)

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61
Q

2 warning signs of anaphylaxis

A

urticaria

hypotension

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62
Q

empiric tx for meningitis in peds (3)

A

ceftriaxone, vanco, ampicillin +/- steroids

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63
Q

rosela fever/rash sequence and path

A

fever 1st

HHV-6

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64
Q

maintenance fluid for kids (3)

A

per day:
0-10 kg: 100 cc/kg
10-20 kg: 50 cc/kg
20+ kg: 20 cc/kg

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65
Q

parkland formula for IVF (day) w/50 % in 1st 8 hours, 50% in next 16 hours

A

%BSA X kg X 4

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66
Q

dx of asthma (post-dilater improvement) cutoff

A

FEV1 greater than 12%

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67
Q

tx of diptheria

A

IVIG

68
Q

hip problem in 5-7 yo M

A

ideopathic osteonecrosis

Legg -Calve-Perthes Dz

69
Q

1st line tx for mild acne

A

topical retinoids

70
Q

association of transposition of great arteries

A

DM mother (not gestational - true DM)

71
Q

kid with croup who doesn’t get better.

dz?

A

bacterial tracheitis

72
Q

test for digeorge

A

mitogen stimulation assay

73
Q

tx of wiskott-aldrich

A

bone marrow trx

74
Q

test to dx developmental dysplasia of hip

A

US

75
Q

type of XR for SCFE

A

frogleg XR

76
Q

tx of retinoblstoma in eye

A

surgery

77
Q

sequelae to retinoblastoma of eye

A

osteosarcoma of bone later in life

78
Q

test for imperforate anus

A

upside down babygram

79
Q

double bubble sign (2 dx possibilities)

A

duodenal atresia

annular pancreas

80
Q

baby w/intestinal atresia (fluid levels)

association of mom

A

mom did cocaine

81
Q

babygram showing upper obstruction but normal air below

A

malrotation

82
Q

girl with normal voiding but constant leak

A

low implantation of ureters

83
Q

mandatory step w/cryptorchidism, even if pulled down

A

removal after puberty

84
Q

workup of pediatric hematuria (2)

A

US

IVP

85
Q

if sickle cell dz and getting regular transfusions, what to do about Fe

A

deferoxamine

86
Q

if sickle cell dx, and not get regular trx, what 2 supplements

A

Fe and folate

87
Q

tx for acute sickle crisis

danger - priapism or AMS, etc (2)
OR with joint pain (3)

A

exchange transfusion, now (if in danger)

otherwise ivf, O2, pain control

88
Q

tx to sickle pt who is a kid for osteo prophylaxis

A

abx-penicillin

89
Q

tx, including method for chlamydial conjunctivitis

A

oral erythromycin

90
Q

bilious vomiting
upper GI series
ligament of treitz on R, corscrew appearance

A

volvulus (malrotation)

91
Q

infant w/FTT
hepatomegaly
cataracts

disorder, enzyme

A

classic galactosemia

galactose-1-p uridyltransferase deficiency

92
Q

galactokinase def vs classic galactosemia

A

galactokinase def is cataracts only

no hepatomegaly, FTT-galactokinase is kind

93
Q

normal vs not normal cutoff for weight loss in first 5 days

A

7%

94
Q

nerves (2 each) affected in
Erb-Duchenne palsy
Klumpke palsy

A

C5-6

C8-T1

95
Q

Birth weight should double by:

Triple by:

A

5 months

12 months

96
Q

Intoeing should resolve by

A

4 years

97
Q

Tx of Von willebrand dz

A

Desmopressin

98
Q

1st sign of puberty in boys

A

Testicular enlargement

99
Q

Adolescent

Pain on left sternal border exacerbated by deep inspiration

A

Precordial catch syndrome

100
Q

Cutoff for physiologic jaundice

A

Needs to be less than 15

101
Q

Time course for breastfeeding jaundice vs breast milk jaundice

A

Breastfeeding is 1st week

Breast milk jaundice is 2nd week

102
Q

What day should mec stools transition to yello?

A

3

103
Q

Swelling of head crossing sutures in a neonate

A

Caput succedaneum

104
Q

FTT (2)

A

not gaining weight by 10 days

failure to regain birthweight by 2 weeks

105
Q

lethargy (2)

A

absent eye movements
or
not interacting with others.

106
Q

lab to check to screen for inborn error of metabolism

A

NH4

107
Q

2 abnormal labs in ornithine transcarbomylase deficiency (OTC)

A

NH4

urine orotic acid

108
Q

fever without source
vs
fever unknown origin

A

FUO requires 1 wk investigation

109
Q

kernig’s sign

A

resistance to knee extension

110
Q

brudzinksi sign

A

flexion of hip w/ passive neck flexion

111
Q

cutoff for pyuria

A

5

112
Q

F/U after

  1. first UTI
  2. 2nd UTI
A

1 US

2. VCUG

113
Q

Tx of Kawasaki dz (2)

A

Ivig

Aspirin

114
Q

Fever
Rash hands feet
Oral lesions

Pathogen?

A

Coxsackie A

Hand foot mouth dz

115
Q

Besides lateral and PA, best 2 radiographic tests to get on a kids you suspect foreign body aspiration.

A

decubitus

inspiratory/expiratory chest films

116
Q

staccato cough between 4 and 12 weeks of age.

A

chlamydia pneumonia

117
Q

Dennie-Morgan lines

A

lines under the eyes caused by chronic allergies/facial edema

118
Q

transverse nasal crease

A

horizontal line on nose caused by chronic allergies

119
Q

age where kids can start using OTC antihistamines and cold syrups

A

2 years old

120
Q

1st line abx for acute otitis media for kids

A

amoxicillin

121
Q

cutoff temp to give abx for AOM

A

> 39 (102.2)

(always tx if bilateral and

122
Q

otitis media w/effusion (OME) can persist for how long after AOM?

A

3 months

123
Q

2nd line tx for AOM or first episode w/high fever

A

augmentin

124
Q

GCS (2)

A

EVM 456

125
Q

cutoff for dx DM using A1C

A

6.5%

126
Q

what to calculate if a hyponatremic dehydration

A

free salt deficit

127
Q

what to calculate if a hypernatremic dehydration

A

free water deficit

128
Q

risk to watch out for in managing DKA

A

cerebral edema

129
Q

OTC topical anesthetic cream that can be applied 30 min prior to needle stick

A

ELA-max

130
Q

pediatric dose ibu profen

A

10 mg/kg

131
Q

joint pain that sets in a few weeks after infectious diarrhea

A

reactive arthritis

132
Q

murmur that is musical or vibratory, and is heard best at the left lower sternal border in the supine position.

A

Still’s murmur

133
Q

Why are VSDs not heard in the nursery?

A

Newborns have elevated pulmonary vascular resistance

134
Q

path of fetal blood (4)

A

RA > RV > ductus arteriosus > systemic circulation

135
Q

main finding in CSF of viral meningitis

A

pleocytosis (most commonly lymphocytosis)

protein, glucose are normal

136
Q

type of seizure: simple vs complex

A

simple: generalized
complex: focal

137
Q

a “slapped cheek” appearance and a reticular, lacy rash on the extremities

A

fifth dz (erythema infectiosum)

138
Q

high fever w/bulging fontanelle, the diffuse blanching rash

A

Roseola

139
Q

Roseola pathogen

A

HHV-6

140
Q

most common pediatric brain tumor

A

Medulloblastoma

141
Q

cutoff size for concerning lymph nodes in kids

A

2 cm

142
Q

7 chars. pain

A

P=Position (be exact)

Q=Quality (dull, sharp, burning)

R=Radiation (be exact)

S=Severity (scale from 1 to 10, if the patient can do this)

T=Timing (when it happens)

A=Alleviating factors

A=Aggravating factors

A=Associated symptoms

143
Q

HEEADSSS

A 
home
eating
education
activities
drugs
suicide
safety
sex
144
Q

4 categories that cause AMS

A

(1) Hypoxemia (2) Shock (septic, hypovolemic, cardiac) (3) Hypoglycemia (4) Poisoning

145
Q

prophylaxis for meningicocemia in adults vs children

A

adults cipro

children rifampin

146
Q

IV tx for hypoglycemia

A

D25 bolus

147
Q

effects of anticholinergics on pupils

A

dilate them

148
Q

FTT (3)

A

below 3rd percentile in weight, weigh for length
OR
weight loss crossing 2 or more major percentiles on growth curve

149
Q

kcal/ day needed to grow in normal baby

A

100-110 Cal/kg/24 hours

150
Q

nadir of Hg in infant at 2 months

A

11 g/dL

151
Q

Screening tool for autism. 16, 30 mos.

A

M-chat

152
Q

Most common reason for cp

A

Prematurity

153
Q

2 most common surgeries sickle cell pts

A

cholecystectomy

tonsillectomy

154
Q

prophylactic med for sickle cell, and age to admin to

A

penicillin

age 5-6

155
Q

2 vaccinations sickle cell pts should have at 2 (in addition to standards)

A

23-valent PNM

meningococcal

156
Q

anasarca

A

generalized edema

157
Q

most common nephrotic dz in peds

A

minimal change dz

90% of cases

158
Q

pathophys of edema in nephrotic syndrome

A

lowering of plasma colloid osmotic pressure.

159
Q

tx (2) of nephrotic syndrome

A

steroids

salt restriction

160
Q

lesions that are flat vs raised, less than 1 cm

A 
flat = macule
raised = papule
161
Q

lesions that are flat vs raised more than 1 cm

A 
flat = patch
raised = plaque
162
Q

pustular lesions in axilla, groin, perianal regions

A

hidradenitis suppurativa

163
Q

tx rosaciea

A

topical metronidazole

164
Q

lifespan of lice w/o host

A

26 hours

165
Q

tx for tinea versicolor

A

selenium sulfide

166
Q

tx tinea capitis

A

griseofulvin

Step 2 CK (12 decks)

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