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Step 2/Level 2 > Peds > Flashcards

Peds Flashcards

1
Q

Who should NOT receive the rotavirus vaccine?

A
  • h/o intussusception (inc risk of intussusception)

- severe immune compromised (except for HIV– >still recommended)

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2
Q

At what age can a baby transfer a cube and begin to self-feed?

A

6 months

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3
Q

At what age can an infant roll over and laugh?

A

3 months

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4
Q

At what age does object permanence develop?

A

9 months

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5
Q

At what age can a child drink from a cup?

A

1 year

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6
Q

At what age can a child use a fork and spoon and walk backward and run?

A

15 months

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7
Q

At what age can a child climb stairs and brush their teeth with help?

A

18 months

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8
Q

At what age does stranger anxiety develop?

A

6-12 months

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9
Q

At what age does separation anxiety develop?

A

12-15 months

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10
Q

At what age can a child copy a circle, jump forward, and dress themselves?

A

3 yo

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11
Q

At what age can a child hop on one foot and button their clothing?

A

4 yo

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12
Q

At what age can a child tie their shoes and cope a square and triangle?

A

5 yo

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13
Q

At what age can a child skip and begin developing logical thinking?

A

6 years old.

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14
Q

How many calories are present in an ounce of breast milk or formula?

A

20kcal/ounce

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15
Q

What are the caloric requirements for an infant

A

100-120kcal/kg/day

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16
Q

Baby with swelling of the scalp which crosses the suture lines?

A

Caput seccedaneum

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17
Q

Baby with swelling of the scalp which does NOT cross the suture lines?

A

cephalohematoma

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18
Q

2-3mm yellow pustules with a red base arising in the first 24-72 hours of life, with pustular contents that reveal eosinophils?

A

Erythema toxic neonatorum

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19
Q

White papules caused by the retention of keratin and sebaceous material in pilosebaceous follicles?

A

milia

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20
Q

Bluish discoloration over the buttock and base of the spine, usually fades in 1-2 years?

A

Mongolian spots (document well so that it isn’t confused with abuse)

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21
Q

Yellow papule around the more and cheeks that begins about 3-4 months and can persist until about 3yo?

A

Infantile acne

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22
Q

What is the treatment for thrush?

A

nystatin oral suspension

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23
Q

Which tanner stage? Testicular and scrotal growth with skin coarsening

A

Stage 2

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24
Q

Which tanner stage? Penile enlargement and further testicular growth

A

Stage 3

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25
Q

Which tanner stage? Further growth of the glans and darkening of the scrotal skin

A

Stage 4

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26
Q

What is the karyotype of Klinefelters?

A

47XXY

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27
Q

Most common cause of primary amenorrhea?

A

Turners 45XO

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28
Q

Increased nuchal translucency on fetal US?

A

Down syndrome

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29
Q

Hypertonia, micrognathia, rocker-bottom feet, cardiac defects (PDA, VSD) and GI defects (omphalocele or Meckel)?

A

Trisomy 18 (Edwards)

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30
Q

Cleft lip and palate, rounded nose, polydactyly, cardiac and CNS defects, and severe intellectual disability?

A

Patau (trisomy 13) syndrome

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31
Q

Elfin facial features and cardiac defects?

A

Williams syndrome

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32
Q

High-pitched, cat-like cry?

A

Cri du chat

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33
Q

Obesity and overeating?

A

Prader-Willi syndrome

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34
Q

Girl with happy mood, inappropriate laughter, ataxic gait?

A

Angelman syndrome

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35
Q

Male with large ears, intellectual disability, macroorchidism?

A

Fragile X

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36
Q

If a female child is 80th percentile for height and 25th percentile for head circumference, what chromosomal abnormality should you suspect?

A

47XXX

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37
Q

Which vessel carries oxygenated blood from the placenta to the fetus?

A

umbilical vein

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38
Q

What are the 3 areas of shunting in fetal blood flow?

A
  • ductus venosus (liver)
  • Patent foramen ovale
  • Ductus arteriosus (between pulmonary A and aorta)
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39
Q

Continuous machine-like murmur with wide pulse pressure and bounding pulses in an infant?

A

PDA

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40
Q

Tx of PDA?

A

Indomethacin (inhibits prostaglandins)

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41
Q

Risk for ASD?

A

Trisomy 21

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42
Q

Fixed split S2?

A

ASD

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43
Q

What is Eisenmenger syndrome?

A

When a long standing left –> right shunt switches to a right –> left shunt 2/2 RV hypertrophy
-Pts become cyanotic

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44
Q

Elevated BP in arms and low BP in the legs?

A

Coarctation of the aorta

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45
Q

How should a coarctation of the aorta in a newborn be managed?

A

PGE to keep the ductus open then surgical correction

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46
Q

Notching of the ribs of chest x-ray?

A

Coarctation of the aorta

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47
Q

What are the defects in tetralogy of Fallot?

A
  • RV outflow obstruction**(most important in severity)
  • RV hypertrophy
  • VSD
  • Overriding aorta
48
Q

Neonate with “boot shaped heart” on chest X-ray?

A

Tetralogy of Fallot (apex is displaced laterally 2/2 RV hypertrophy)

49
Q

How does squatting help tet kids?

A

-increases after load –> increases left to right shunt to increase oxygenation

50
Q

What is the treatment for an acute cyanotic spell in a ToF kiddo?

A
  • knees to chest
  • oxygen
  • morphine
  • beta blocker (propranolol)
51
Q

What congenital heart defects are individuals with Trisomy 21 at higher risk of having?

A
  • Endocardial cushion defects
  • Tetralogy of Fallot
  • Transposition of the Great Vessels
52
Q

What is the most common tracheoesophageal fistula?

A
  • Type C

- Blind upper esophageal pouch with a lower tracheoesophageal fistula

53
Q

Baby with non-bilious projectile vomiting and palpable olive?

A

Pyloric stenosis

54
Q

Labs seen in pyloric stenosis?

A

-hypochloremic, hypokalemic metabolic alkalosis

55
Q

Most common cause of bilious vomiting in a newborn?

A

Duodenal atresia

56
Q

“blast” sign?

A

in Hirschsprung disease where you do a rectal exam and the poo explodes!

57
Q

If you see intussusception in an adult, what is the likely cause?

A

cancer

58
Q

“Currant jelly stool” and a sausage abdominal mass?

A

intussusception

59
Q

Test for mocked diverticulum?

A

Scintigraphy to look for ectopic gastric mucosa

60
Q

Tx of Crigler-Najjar type 1?

A
  • phototherapy until liver transplant

- NO UDP glycuronosyltransferase

61
Q

Tx of Crigler-Najjar Type 2?

A

-Phenobarbital (increases the conjugation and excretion of bilirubin)

62
Q

Conjugated hyperbilirubinemia in a newborn?

A

Biliary atresia

63
Q

When should corticosteroids be given to mothers in labor?

A

Preterm labor before 34 weeks–> stimulate maturation of type II pneumocytes.

64
Q

When is a FQ acceptable to give to a child?

A

Cystic fibrosis (good with pseudomonas)

65
Q

What is the treatment for respiratory distress syndrome of the newborn?

A

-IM corticosteroids to moms 0.4 then intubate and give exogenous surfactant

66
Q

Chest x-ray with ground glass appearance and air bronchograms in a newborn?

A

RDS

67
Q

Newborn chest x-ray with fluid streaking in interlobular fissures and a sunburst pattern (prominent vascular markings from the hilum)?

A

Transient tachypnea of the newborn (normally in C/S babies)

68
Q

What are the risk factors for meconium aspiration syndrome?

A
  • Post-term

- fetal distress in labor

69
Q

Kiddo with seal-like cough and inspiratory stridor? Cause?

A
  • Croup

- parainfluenze type 1 and 2

70
Q

“steeple sign” on chest x-ray?

A

croup

71
Q

Tx of moderate-severe croup?

A
  • keep pt calm
  • dexamethasone IM/PO one time
  • Nebulized epinephrine
  • humidified O2
72
Q

Thumb sign on lateral neck x-ray?

A

epiglottitis (HiB or s. aureus)

-ABX: Vanco or Clinda + Ceftriaxone or Cefotaxime

73
Q

Tx of pertussis?

A
  • Azithromycin (5days) or Bactrim (14 days)

* PPX azithromycin to all close contacts

74
Q

What medications are effective in RSV bronchiolitis?

A
  • NOTHING
  • steroids, antibiotics and anti-vitals are not helpful
  • Mostly supportive care
75
Q

What medication is given to premature infants to decrease the risk of hospitalization 2/2 RSV?

A

Palivizumab

76
Q

How do you confirm the diagnosis of pertussis?

A

nasopharyngeal swab with PCR assay

77
Q

Congenital infection with a “blueberry muffin” rash?

A
  • Rubella

- Can also be in CMV

78
Q

Prodrome of fever, conjunctivitis, coryza, and cough followed by a rash from the head down?

A

Measles (Rubeola)

79
Q

What might be effective in the treatment of measles?

A

Vitamin A! (still being studied by recommended to patients who get measles)

80
Q

How does the rash differ between measles and Rubella (German measles)?

A
  • Both start on the face/head and then generalize.

- Rubella will not darken or coalesce

81
Q

Sudden, high fever for 3-4 days followed by a rash when the fever dissipates?

A

Roseola infantum (HHV-6)

82
Q

Coarse rash (“sandpaper-like”) that is erythematous and blanching (sunburn-like)?

A

Scarlet fever

caused by streptococcus Pyogenes

83
Q

Possible causes of desquamation of the hands and feet?

A
  • Kawasaki
  • Scarlet Fever
  • Toxic shock syndrome
  • Steven Johnson syndrome
  • mercury toxicity (acrodynia)
84
Q

Jaundice and hyperbilirubinemia in the first 24 hours of life?

A

Hemolytic disease of the newborn

85
Q

Pancytopenia, short stature, hypo pigmented spots, abnormal thumbs?

A

Fanconi anemia

86
Q

How is fanconi anemia diagnosed?

A
  • Increased chromosomal breakage in lymphocytes

- Also: pancytopenia, alpha-fetoprotein, hypocellularity in bone marrow

87
Q

Most common adrenal medulla tumor in children?

A

Neuroblastoma

88
Q

Labs with Neuroblastoma?

A

VMA and homovanillic (HVA) acid elevations

89
Q

Best test in suspected rhabdomyosarcoma?

A

MRI

90
Q

Kiddo with low hemoglobin and normal WBC count and platelet count. Bone marrow biopsy shows decreased erythroid precursors?

A

Diamond-Blackfan anemia

91
Q

Overweight teen boy limping, pain on hip moment, limited internal rotation and abduction of the hip? Tx?

A
  • SCFE (slipped capital femoral epiphysis)

- Surgery

92
Q

Who should be screened for developmental dysplasia of the hip (even with normal PE findings)?

A
  • any baby born breech

- females with a FMHX of DDH

93
Q

Avascular necrosis of the capital femoral epiphysis?

A

Legg-Calve-perthes disease

-Tx: non-weight bearing

94
Q

Young child holding arm pronated and partially flexed or extended at the elbow?

A

Radial head subluxation (Nursemaid’s elbow)

95
Q

Tx of radial head subluxation?

A

supination/flexion or hyperpronation

96
Q

What is the recommended Vit D supplementation for all babies?

A

400 IU/day

97
Q

What is the most common location for spondylolisthesis?

A

L5-S1

98
Q

What are the 3 types of juvenile idiopathic arthritis?

A
  • Pauciarticular (few joints, mostly large)
  • Polyarticular (many joints)
  • systemic onset JIA (AKA “Still’s disease)
99
Q

What is the recommended folic acid supplement for a pregnant woman?

A

0.4mg (400mcg/day)

100
Q

What is the most common type of Arnold-Chiari Malformation? What is the presenting symptom?

A
  • Type I
  • Normally asymptomatic
  • can present with headache or cerebellar symptoms later in life (18yo)
101
Q

Cherry red spot on retina?

A
  • Tay-Sachs
  • Neimann pick
  • Retinal artery occlusion
102
Q

What 2 things does an Rb gene mutation predispose someone to?

A

retinoblastoma and osteosarcoma

103
Q

What imaging do you want to do in a suspected retinoblastoma?

A

MRI (other forms of imaging have radiation that increases the risk of another gene mutation)

104
Q

Incomplete closure of the dorsal ventral arches, often at the lumbosacral junction?

A

Spina bifida occulta

105
Q

Neural tube defect with herniation of the meninges?

A

Meningocele

106
Q

Neural tube defect with herniation of the meninges and spinal cord?

A

myelomeningocele

107
Q

Heart defect associated with chromosome 22q11 deletion?

A

Truncus arteriosus and tetralogy of Fallot

108
Q

Heart defect associated with congenital Rubella?

A

PDA and pulmonary artery stenosis

109
Q

Heart defect associated with Marfan syndrome?

A

aortic regurgitation

110
Q

At what age can you begin treating nocturnal enuresis? What medication can be used?

A
  • 7yo

- DDAVP

111
Q

By what age should an undescended testicle be relocated to the scrotum?

A

6-12 months

112
Q

Kiddo between 2-4yo and a palpable flank mass?

A

Wilms tumor

113
Q

What is WAGR syndrome?

A
  • Wilms tumor
  • Aniridia
  • GU abnormalities
  • Retardation
114
Q

What are the recommendations for VCUG in pediatric UTI patients?

A
  • any child with >2 febrile UTIs

- Any child with first UTI and anomalies on the US, temp >39, pathogen other than E.coli, poor growth, or HTN

115
Q

What are the recommendations for renal and bladder US in a child diagnosed with a UTI?

A

-child

116
Q

What is required for the diagnosis of ADHD?

A

-6 symptoms (attention deficit of hyperactivity) before the age of 12 present in multiple environments

117
Q

What are some pharmacological treatment options for Tourette syndrome?

A
  • Clonidine (alpha 2 agonist)

- Neuroleptics (Fluphenazine or pimozide)

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