Peds Flashcards

1
Q

Down syndrome

A

Most common chromosomal disorder, associated with maternal age

Hypotonia, macroglosia, upslanted eyes with epicanthal folds, simian crease,
http://www.womens-health-advice.com/assets/images/photos/down-syndrome.jpg

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2
Q

Patients with Down syndrome are in increased risk for:

A

ALL

ATLANTOAXIAL INSTABILITY&raquo_space; COMPRESSION OF THE SPINAL CORD&raquo_space; UPPER MOTOR NEURON SYMPTOMS

GI: Duodenal atresia, aganglionar colon

Cardio: AV cana 60% ASDs VSDs PDAs

Neuro: Early alzheimer’s

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3
Q

Kallman syndrome

A

no gnrh secretion

anosmia, no puberty, short folks

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4
Q

Reye syndrome

A

Aspirin in children

encephalopathy + acute liver injury [microvesicular fatty liver]

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5
Q

Cat 🐱 bite

What do you do?

A

tetanus booster if > 5 y after last , amoxicillin clavulanate due to risk of p Multocida and anaerobes infection

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6
Q

Jones criteria

A

Major:
––Migratory arthritis –– Carditis ––Nodules ––Erythema marginatum –– Corea
Minor:
––Fever ––Arthralgias ––Elevated ESR, PCR ––prolonged PCR
2 major or 1 major + 2 minor

Prevention: penicillin

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7
Q

Mumps complication

A

aseptic meningitis
Orchitis
Parotiditis

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8
Q

Subperiosteal hemorrhage involving one cranial bone:

A

Cephalomahematoma

If diffuse: caput succedaneum

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9
Q

Neonate with unconjugated (indirect) hyperbilirubinemia

A

Breast milk jaundice
Gilbert’s syndrome Crigler-Najar
Erythroblastosis fetalis
Physiologic > first 24 hours

If conjugated: + Hepatomegaly : Biliary atresia

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10
Q

Tricuspid valve atresia

A

Cyanotic
Left axis deviation + absent R waves
Pulmonary under-circulation

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11
Q

Obssesive compulsive disorder treatment

A

Non pharm: Cognitive behavioral therapy
pHARM: High dose SSRIs

ALSO clomipramina or antipsychotic

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12
Q

Treating hypernatremia

A

ONLY isotonic fluids initially

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13
Q

Non-cyanotic heart defects

A

VSD
ASD
PDA

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14
Q

cyanotic newborn, tachypnea, hypoxemia, single loud S2,

A

Most commonly> transposition of great vessels

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15
Q

Encapsulated microorganism

A

Hib
S pneumoniae
Pseudomonas

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16
Q

Ataxia telangiectasia

A

Auto recessive > ATM gene> DNA repair impairment
Cerebellar ataxia / oculocutaneous telangiectasias
↑ Cancer

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17
Q

Severe combined immunodeficiency due to…

A

ADA deficiency

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18
Q

Wiskott Aldrich syndrome

A

X linked recessive
↑ IgE / IgA ↓ IgM
Thrombocytopenia
(bleeding, eczema and recurrent otitis media)

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19
Q

Chronic granulomatous disease diagnosis

A

Deficient superoxide production
Neutrophil count with
nitroblue tetrazolium

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20
Q

Partial albinism
Peripheral neuropathy
Neutropenia

A

Chediak Higashi syndrome

X recessive > defect in neutrophil chemotaxis and microtubule polymerization

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21
Q

Pilonidal disease

A

Folliculitis> mass 4-5 cm cephalad to the anus

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22
Q

Avoiding confounding

A

Matching
restriction
randomization

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23
Q

Tumor lysis syndrome

A

Hyperkalemia
hyperphosphatemia
hyperuricemia

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24
Q

Osteosarcoma

A

common in male adolescents
No systemic symptoms
Local pain and swelling
Metaphyseal lesion!

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25
Q

Hyper IgM syndrome

A

X linked / defect in the CD40 ligand
↓ IgG IgA
↑IgM

26
Q

Igs in Humoral immunodeficiencies

A

Bruton: ↓ Igs / low or absent B Lymphs
Common variable: Normal B lymphs, ↓ Igs ALL
hyper IgM: Normal lymphs ↑ IgM ↓ IgG IgA

27
Q

Newborn with bilious emesis/ No gas in abd Xray

A

Rule out malrotation and secondary volvulus > upper GI series > corkscrew pattern

28
Q

Lead poisoning diagnostic clue

A

GI: Abdominal pain, constipation, anorexia
Neuro: peripheral neuropathy
Hemato: anemia
DX: Lead leves / basophilic stippling

29
Q

Lead poisoning pathophysiology

A

Disrupt heme synthesis

impaired purine metabolism > hyperuricemia

30
Q

Popliteal cyst rupture

A

Calf pain
Resembling DVT
Arc of ecchymosis in the medial malleolus

31
Q

Boerhaave syndrome

A

Transmural tear
Esophagography with gastrofin or CT: leakage
Pleural effusion: exudate, very high amylase, low pH

32
Q

Duodenal atresia highly associated with

A

Down syndrome

33
Q

Acute interstitial nephritis

A

New drug > penicillins, TMP SMX, cephalosporin
Rash / fever / new drug exposure / arthralgias
AKI, EOSINOPHILIA, urinary eosinophils, WBC casts

34
Q

Huntington’s chorea

A

Auto dominant
Chorea/behavioral changes/dementia
Atrophy of the caudate nucleus (neuroimaging> enlarged lateral ventricles)

35
Q

Superficial unilateral hip pain

exacerbated by external pressure to the upper lateral thigh

A

Trochanteric bursitis

36
Q

Neurofibromatosis type I

A
Autosomal dominant 
Café au lait spots 
lisch nodules
NEUROFIBROMAS 
optic glioma
37
Q

Pseudocyesis

A

Somatization
Early pregnancy symptoms > negative paraclinics
PSYCH

38
Q

Ureteral stones <10 mm treatment

A

Supportive

consider alpha blocker > Tamsulosin alpha 1 blocker

39
Q

Hoarding disorder

A

OCD
accumulation
Tx: Cognitive behavioral therapy

40
Q

Beckwith Wiedemann syndrome (clues and complications)

A

overgrowth syndrome
Macroglossia/ hemihyperplasia / umbilical hernia
↑Risk > Wilms tumor hepatoblastoma > abd US and AFP

41
Q

Strabismus after 4 months treatment

A

Occlusion of normal eye

42
Q

Renal carcinoma

A

flank pain
scrotal varicocele
paraneoplastic > anemia, thrombocytosis, fever, hypercalcemia, cachexia

DX: Abdomen CT

43
Q

Chronic prostatitis

A

Pain in pelvis perineum or genitalia
irritative voiding symptoms
pain with ejaculation
sterile urine symptoms

44
Q

Mini mental state examination: dementia when

A

<24 / 30

45
Q

Alzheimer’s brain imaging findings

A

Early findings: normal

late stages: cortical and subcortical atrophy (worse in parietal, temporal and hippocampi)

46
Q

After diagnosing brain death doctors needslegal authorization to stop vital support?

A

No

Brain death is a legally acceptable definition of death

47
Q

Pinworm (entrobius vermicularis) treatment

A

Albendazon OR pyrantel pamoate

48
Q

Parkinsonism with risperidone treatment

A

Low dose
If not effective>
Benztropine (Anticholinergic) or amantadine

49
Q

Acute dystonia treatment

A

Benztropine
OR
diphenhydramine

50
Q

Positive first trimester aneuploidy screening, next step:

A

15 weeks: Amniocentesis

10-13 weeks: chorionic villus sampling

51
Q

Systolic ejection murmur in pregnancy, workup?

A

No

Normal

52
Q

Mitral regurgitation murmur in pregnancy

A

Echo

53
Q

Histoplasma capsulatum prophylaxis in HIV

A

<150 CD4 and Ohio Mississippi river valleys areas

54
Q

Respiratory alkalosis causes:

A

Hyperventilation
high altitude
salicylate intoxication

55
Q

Osteogenesis imperfecta clues

A

Blue sclerae
hearing loss
recurrent fractures
opalescent teeth

56
Q

History of preterm labor, intervention?

A

Progesterone injections and TVUS-Cervical Length till week 24

57
Q

Fibromyalgia with no improvement after exercise program

A

Tricyclic antidepressants > if not improvement

SNRI (duloxetine, milinacipran) OR pregabalin

58
Q

Aspirin exacerbated respiratory disease

A

Asthma
Chronic rhinosinusitis
Nasal polyposis
exacerbation if NSAIDS or aspirin

59
Q

Other findings in hypothyroidism

A

Hypercholesterolemia
hyponatremia
↑ CK and Transaminases

60
Q

Acute angle closure glaucoma

A

sudden onset eye pain
headache
nausea