Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

[2a] A ⼀ Step 2 OD USLME > ✅PEDS > Flashcards

✅PEDS Flashcards

1
Q

Identify possible causes of this rash - 3

A

THE STRAWBERRY TONGUE!

  1. [GASP +/- mononucleosis]
  2. Kawasaki disease
  3. Toxic Shock Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 classic Clinical Manifestations of [Tetralogy of Fallot]

A

A:

  1. [Systolic Ejection HARSH Murmur @ L Sternal 2/3 ICS] from [RVOO -R Vt Outflow Obstruction]
  2. Squatting relieves sx (INC afterload–> [DEC amount of R to L shunt]
  3. [Cyanotic lethal Tet Spells] (tx: Knee chest positioning and inhaled O2)

“VOIR is to have See + Sight & Cry”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a BRUE ?

A

Brief Resolved Unexplained Event

when there is an IDIOPATHIC sudden, brief and now resolved episode occuring in an infant < 1 yo that included at least:

  1. cyanosis
  2. breathing ∆ (absent, ⬇︎, irregular)
  3. Hyper/hypotonia
  4. altered LOC

this is a dx of exclusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s used to keep the PDA Patent?

A

Prostaglandin E1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What should you always suspect in a pediatric pt who recently had a viral illness, now p/w SOB and cardiomegaly?

A

Viral myocarditis (coxsackie B vs adenovirus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2 main sx of Bronchiolitis

________________

cause?

A
  1. [Wheezing w/respiratory distress]
  2. Fever

_________________

RSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Laryngomalacia etx

A

As a neonate, collapse of supraglottic structures during inspiration –> chronic inspiratory stridor worst when supine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

[T or F]

LAD is actually normal in kids and young adults

A

TRUE - AS LONG AS THEY’RE SOFT AND MOBILE

tx = observation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why is cessation of breast feeding in a jaundiced 20 day old pt who is lethargic not necessary?

A

Galactosemia (Conjugated Hyperbilirubenima) is unlikely considering pt is 20 days old. Sepsis should be r/o first with blood cx and px abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 major complications of Mumps

A
  1. Orchitis
  2. Aseptic Meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A child comes in with neonatal conjunctivitis

DDx?-3

________________

How do you differentiate each?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx for Neonatal Chlamydia Conjunctivitis?

________________

Tx for Neonatal Gonococcal Conjunctivitis?

A

ncC = [Macrolide PO]

________________

ncG = [CefTriaxone IM]

________________

  • nc = neonatal conjunctivitis*
  • Topical macrolides are only PX for Gonococcal conjunctivitis*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common cause of Chronic renal failure (and urinary tract obstruction) in pediatrics?

A

Posterior Urethral valves (THIS ONLY AFFECTS BOYS-including newborns)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

All kids with a febrile UTI at age 2mo-2yo should undergo ⬜ to evaluate for ⬜

A

Renal US–>[cystourethrogram if recurrent] ; Vesicoureteral reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Oligohydramnios –> ⬜ sequence.

Describe this clinical presentation for this Sequence

A

Oligohydraminos –> POTTER Sequence

Pulmonary hypOplasia

Oligohydraminos from renal agenesis/damage (cause)

[Twisted Face & Extremities]

Twisted Skin

Ears set low

Renal Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oligohydramnios –> ⬜ sequence.

Name the 3 most common causes of Oligohydramnios

A

Oligohydraminos –> POTTER Sequence

POSTERIOR URETHRAL VALVES are the most common cause of obstruction in newborn boys (which causes renal damage –> oligohydramnios during utero)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Minimal change disease is most common cause of nephrOtic syndrome in kids

Tx?

A

Prednisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Minimal change disease is most common cause of nephrOtic syndrome in kids

When is renal biopsy indicated?-2

A
  1. >10 yo
  2. Child has NOT responded well to CTS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What MAIN dx should be suspected in a neonate with painless bloody stools

________________

mngmt?

A

[Milk/Soy ALLERGIC proctocolitis]

________________

[Hematochezia cessation in 2 wks] >

these pts usually also have eczema and regurgitation from Milk/Soy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

DDx for neonatal rectal bleeding - 4

A
  1. [**Milk/Soy ALLERGIC Proctocolitis** = PAINLESS]
  2. Meckel Diverticulum = PAINLESS
  3. Volvulus (bloody stool from intestinal ischemia)
  4. Intussuception (dx= AIR contrast enema)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cp for neonatal Lactose Intolerance - 3

A
  1. NONBLOODY diarrhea
  2. flatulence
  3. crampy abd pain

Lactose Intolerance = no Lactase ➜ NONBloody Flatulence & Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

etx for Choanal atresia in kids

________________

cp

A

Congenital falure of posterior nasal passage to canalize –> bony obstruction instead

________________

cyanotic infant whose cyanosis worsens with feeding and relieves by crying

Dx = inability to pass catheter thorugh nares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Demographic for Hypertrophic pyloric stenosis

A

First Born boys [3-5 wks old]

image showing “oilive mass”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pts with Beckwith-Wiedemann syndrome should be monitored for what 2 CA?

A
  1. Hepatoblastoma
  2. Wilms tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cp for Reye syndrome - 2

A
  1. [encephalopathy from ⬆︎ICP –> seizure, vomiting, lethargy –>eventually DEATH]
  2. liver dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Dx? ; Mngmt?

A

Congenital Diaphragmatic Hernia ; Intubation without any preceding bag mask ventilation

Image = Scaphoid concave abdomen with Barrel Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why do pts with this condition often have polyhydramnios?

A

Hernia of Diaphragm compresses esophagus –> polyhydramnios

Congenital Diaphragmatic Hernia

Image = Scaphoid concave abdomen with Barrel Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Constipation is common in Toddlers

Why? - 3

A
  1. Transition to solid food and cow’s milk
  2. toilet training
  3. school entry

Tx = PO Laxatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When should ingested batteries be emergently and endoscopically removed?

A

ONLY when the battery is still IN the esophagus and not distal to it. If distal –> obs

this also includes sharp objects, or multiple magnets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

[T or F] Gastroesophageal reflux is common in infants

Why or why not? ;

A

TRUE

  1. More time spent supine
  2. Shorter esophagus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Physiological Gastroesophageal reflux is common in infants

What is the mngmt for this?-3

________________

When should you be concerned for GER Disease in infants?-2

A

*REASSURANCE

*[hold infant upright after feeds]

*[(if GERD) = thicken feeds with oatmeal + PPI]

________________

GERD =

  • failure to thrive
  • opisthotonic posturing after feeds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the mngmt for an ingested coin? - 3

A
  1. Obs for up to 1 day after ingestion UNLESS
  2. Pt is symptomatic = flexible endoscopy
  3. Pt has no recollection of ingestion time = flexible endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Zollinger Ellison etx ; cp-2

A

gastrin producing tumor in pancreas or duodenum –> ⬆︎⬆︎gastric acid > 1000 –>

  1. multiple duodenal/jejunal ulcers REFRACTORY to PPI
  2. steatorrhea from pancreatic enzyme inactivation

Be sure to screen Zollinger Ellison pts for MEN1 using PTH, Ca+ and Prolactin studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is Hepatic Hydrothorax

A

Liver Disease pts cause damage to R diaphragm –> small defects that allows R pleural effusions to form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

[T or F]

UNILATERAL cervical LAD in kids (typically from ⬜ bacteria ) is not common and needs further workup

A

FALSE!

________________

ped uL cervical LAD (typically from Staph > GASP) is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

cp for Bronchiolitis in neonates - 3 ; px for this?

A
  1. Wheezing and/or Crackles
  2. URI sx
  3. Respiratory distress eventually –> APNEA

Px = Palivizumab for kids<2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What does APGAR stand for? ; How is it done? ; How is it used?

A

Appearance, Pulse, Grimace(reflex irritability), Activity(tone), Respiration

Performed at 1 and 5 min postpartum, All scaled from 0 to 2 and then added together

[< 3 = Critical] / [4-6 = fair: PPV] / [7-10 = normal: No intervention]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

APGAR is used to assess newborn status immediately postpartum

Describe the grading system for Respiration?

A

APGAR

0 = not breathing

1 = breathing slow/irregular

2 = crying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

APGAR is used to assess newborn status immediately postpartum

Describe the grading system for Pulse?

A

APGAR

0 = No HR

1 = < 100 bpm

2 = > 100 bpm

40
Q

APGAR is used to assess newborn status immediately postpartum

Describe the grading system for Activity & tone?

A

APGAR

0 = no motion

1 = arms & legs flexed but not active

2 = Active Motion of extremities

41
Q

APGAR is used to assess newborn status immediately postpartum

Describe the grading system for Grimace & reflex irritability?

A

APGAR

Test response to stimulation (i.e. pinch)

0 = no rxn

1 = grimace

2 = grimace AND cough/cry/sneeze

42
Q

APGAR is used to assess newborn status immediately postpartum

Describe the grading system for Appearance?

A

APGAR

0 = entirely blue

1 = pink with blue extremities

2 = entriely pink

43
Q

In a neonate, when should compressions be started?

A

HR <60

44
Q

Neonatal Respiratory Distress Syndrome is caused by ⬜

What are the major risk factors?-2

A

Surfactant Deficiency

  1. Prematurity
  2. Maternal DM
45
Q

Enuresis (nocturnal urinary incontinence/bed wetting) tx - 3

Dx criteria: occurs ≥2/week AFTER 5 yo

A
  1. LIfestyle change (no fluids at bedtime/void before bedtime/reward system)
  2. Enuresis alarm
  3. Rx: DESMOPRESSIN –> add Oxybutynin if minimal change
46
Q

Any neonate who presents with Bilious emesis should be worked up for _____

A

Bowel Obstruction!

AbdXray (r/o perf bowel) –> water-soluble contrast enema

47
Q

A Contrast enema demonstrating microcolon is indicative of what condition? ; etx?

A

Meconium iLeus 2/2 Cystic Fibrosis

viscous meconium accumulation obstructs terminal iLeum –> underused colon –> contracted microcolon

48
Q

In regards to timing, what is the difference between Breastfeeding Failure jaundice and Breast Milk jaundice?

A
49
Q

In terms of physical exam, what is a difference between Breastfeeding Failure jaundice and Breast Milk jaundice?

A

In BreastFeeding Failure jaundice there will be clinical signs of Failure to thrive/dehydration

these dehydrated neonates may have brick red urate crystals in their diapers from dehydration

50
Q

In terms of etiology, what is a difference between Breastfeeding Failure jaundice and Breast Milk jaundice?

A

BFF jaundice within the First week of life: inadequate feeding –> inadequate stooling –> ⬇︎bilirubin elimination –> ⬆︎Unconjugated bilirbuin recycling with Failure to thrive/dehydration

51
Q

Tx for BreastFeeding Failure jaudice - 3

A
  1. Optimize lactation
  2. ⬆︎BreastFeeding frequnecy
  3. Supplement with Cow’s formula ONLY if mom’s milk is inadequate
52
Q

Why is human milk better absorbed than formula?

A

Protein Whey in human milk is more easily digested than casein which –> ⬆︎absorption and ⬆︎gastric emptying

53
Q

cp for Physiological Jaundice ; etx?-2

A

Unconjugated hyperbilirubinemia that appears the first 24 hours of life and resolves by the end of that week ; comes from ⬇︎hepatic UGT activity and ⬆︎bilirubin production

54
Q

Describe Metatarsus Adductus

A

Most common congenital foot deformity in which there is BL medial deviation of the forefoot usually in 1st born infants

Tx = this corrects spontaneously

55
Q

[Atlantoaxial joint] Instability MOD

________________

Which demographic are at most risk for this?

A

excessive laxity in the Posterior transverse ligament ➜ ⬆︎mobility between [C2 aXis: dens] and the [C1 atlas] –> spinal cord compression ➜ UMN signs

________________

Down Syndrome (remember pts with down syndrome are usually hypOtonic but not with Atlantoaxial instability!)

56
Q

Tx for Croup-2

A
  1. Mild = Humidified air +/- CTS
  2. > Mild = CTS +/- Racemic Epi nebulized

Croup = paraflu that –> subglottic edema and narrowing

57
Q

Dx for Intussuception

A

AIR contrast enema ultrasound guided

Intussuception age = 3-36 mo

Look for the Target Sign on US!

58
Q

Diagnostic Criteria for Colic - 4 ; tx

A

Colic = the 3’s

excessive crying during first 3 weeks of life that’s

≥3hrs/day (usually evenings) for

≥3days / week for

≥3weeks in a healthy infant

Tx = Soothing and feeding techniques

59
Q

Necrotizing Enterocolitis cp - 3

________________

X ray finding?

A
  1. Bloody stools
  2. feeding intolerance
  3. abd distension

X-ray = Pneumotosis Intestinalis

Risk factors= prematurity, congenital heart disease, hypotension

60
Q

Dx

A

X-ray = Psuemoatosis Intestinalis

Necrotizing Enterocolitis

61
Q

What are the risk factors for Necrotizing Enterocolitis cp - 3

A
  1. Congenital heart disease
  2. Prematurity
  3. hypotension

X-ray = Psuemoatosis Intestinalis

62
Q

Why should a pediatric pt with fever and rash who received MMR 1 week prior only receive reassurance

A

small fraction of pts who receive MMR may develop fever and mild rash that are self-limited

63
Q

What Mothers are at high risk of having Neonates with [TGA - Transposition of Great Arteries]?

A

Diabetic Mothers

64
Q

What is the most common congenital cyanotic heart defect in the neonatal period?

A

Transposition of Great Vessels

Look for the single Loud second heart sound!

65
Q

A: Clinical Manifestations of DiGeorge Syndrome (5)

B: Genetic Cause

A

“CATCH 22 & Pa3”

Cardiac (Aortic Arch abnormalitites, Tetralogy of Fallot)

Abnormal face (Bifid Uvula/low set ears)

Thymus Aplasia

Cleft Palate

[HypOcalcemia from PTH deficiency] may–> Carpopedal Spasms

22q.11.2 deletion

Pharyngeal arch - 3rd/4th both fail to develop

66
Q

What does Constitutional Short Stature refer to

A

“late bloomer” but will attain normal adult height later

pts have normal birth wt and ht but ht velocity slows between 6 mo-3 yo, picks back up after and slows again at adolescence. bone radiographs will show delayed bone age

67
Q

What is the most common cause of hip pain in kids?

________________

Dx?

A

Transient Synovitis

________________

Clinical but obtain Xray to r/o Legg Calve Perthes

may have ⬆︎inflammatory markers but xrays will be normal

68
Q

Transient Synovitis is the most common cause of hip pain in kids

Tx for Transient Synovitis - 2

A

obtain Xray to r/o Legg Calve Perthes

Tx = NSAID and rest

69
Q

Cerebral Palsy is a group of clinical syndromes generally characterized as ⬜

How does it present? - 3

A

Nonprogressive motor dysfunction (Prematurity>EtOH = RF) ;

Cerebral Palsy is SAD

  1. BL equinovarus club feet (image)
  2. UMN signs LE >UE
  3. Mental Retardation

Greatest RF = prematurity ( < 32 wks gestation)

70
Q

Mangement for [Equinovarus Clubfoot] - 3

A

START THIS MNGMT IMMEDIATELY!

1st: Stretch and Manipulate [equinovarus club foot] –>
2nd: [serial plaster cast, malleable splints or taping]
3rd: Surgery between ages 3-6 mo if refractory to #1-2

71
Q

Langerhans cell histiocytosis cp - 3

A
  1. solitary painful lytic bone lesion in child
  2. overlying swelling
  3. hypercalcemia
72
Q

Craniopharyngiomas and Pituitary adenomas both can cause bitemporal hemianopsia

How can you differentiate the two? - 2

A
  1. Craniopharyngiomas are calcified (show up white on CT)
  2. Craniopharyngiomas results in pituitary hormonal deficiency (adenomas result in pituitary hormone ⬆︎)

Craniophyarngiomas are calcified epithelial remnants of Rathke’s pouch that reside in the SUPRAsellar region

73
Q

Craniopharyngioma etx

A

Calcified low grade malignancy dervied from epithelial remnants of Rathke pouch within the pituitary stalk and reside in the SUPRAsellar region

74
Q

What is Erythema Toxicum Neonatorum ; tx?

A

benign neonatal rash with blanching erythematous papules and/or pustules ; self limited to 2 weeks after birth

75
Q

Malrotation and Volvulus are both diagnosed with ⬜

Describe how both would look on this diagnostic?

A

Upper GI Series barium swallow

________________

Malrotation = Ligament of Treitz on the R side of the abd in a gasless abd

________________

Volvulus = corkscrew image on barium swallow Upper GI series

76
Q

Malrotation and Volvulus are both diagnosed with ⬜

What would Volvulus look like on this diagnostic?

A

[Upper GI series barium swallow]

corkscrew image

Try not to use CT scans in kids

77
Q

cp for Meckel’s Diverticulum

________________

dx

A

PAINLESS hematochezia

________________

technetium 99 pertechnetate scan

78
Q

Describe general characteristics of intentional child scald burns - 3

A
  1. uniform depth
  2. sparing of flexor surfaces
  3. sharp lines of demarcation
79
Q

[Strabismus ocular misalignment] after the age of ⬜ is abnormal and requires intervention to prevent ⬜

________________

Which intervention is employed for this? - 3

A

4 mo ; Amblyopia(vision loss from disuse of the deviated eye)

  1. CTL eye patch to strengthen deviated eye OR
  2. CTL cycloplegic eye drops (blurs normal eye to strengthen deviated eye)
  3. Corrective lens

Dx = asymmetric corneal light reflex

80
Q

What is Legg Calve Perthes Disease?

________________

Demographic?

________________

mngmt-2?

A

Avascular necrosis of the Capital Femoral Epiphysis ; [Boys 4-10 yo) ;

  1. Self limited but can –>deformity/degeneration
  2. contain femoral head within acetabulum during encounter
81
Q

Slipped Capital Femoral Epiphysis is a complication of childhood obesity

When does this present?

________________

How does this present?

________________

dx?

A

puberty (most common hip disorder in fat teens!)

________________

[M: Months of vague hip/knee pain] without acute onsets

________________

pelvis XRay

posterior displaement of capital femoral epiphysis thru cartilage growth plate

82
Q

Risk factors for Developmental Dysplasia of Hip - 3

________________

when should you stop screening for this?

A
  1. Breech Delivery - GET HIP IMAGING IF FEMALE AND BREECHED
  2. Female - GET HIP IMAGING IF FEMALE AND BREECHED
  3. Fam hx

12 months old

83
Q

pediatric pt presents with apparent leg length discrepancy and is diagnosed with ⬜

________________

What is the work up for this?-2

A

Developmental Dysplasia of Hip

________________

hip ultrasound < 4 mo < hip xray

84
Q

What is the treatment for Developmental Dysplasia of Hip?

A

Pavlik Harness that holds hip in flexion and ABduction

85
Q

Newborns with congenital hypothyroidism appear normal because ⬜

________________

Describe Physical Exam for [congenital hypothyroidism] ? - 10

A

protected by maternal thyroid hormone for 6 wks;

  1. G: ⬇︎Feeding
  2. G: ⬇︎Activity
  3. P: Mental retardation (check for Down Syndrome)
  4. H: Large Fontannel
  5. H: Macroglossia
  6. H: Puffy Face
  7. A: Umbilical Hernia
  8. A: Constipation
  9. S: Jaundice
  10. S: Skin Mottling

EARLY DETECTION IS KEY, AS NORMALIZING TSH BY 1-2 MONTHS OLD PREVENTS NEURO DAMAGE!

86
Q

Common characteristics of Down Syndrome pts - 7

A

the SHEEPPS of genetics

  1. Skin excessive at the nape of the neck = nuchal skin
  2. HypOtonia w/ ⬇︎ Startle Moro reflex
  3. Epicanthal folds
  4. Ears that are small
  5. Protruding tongue w/flat face
  6. Palpebral fissures are upslanted
  7. Single palmar crease

these pts also have ⬆︎risk for hypothyroidism

87
Q

cp for Laryngomalacia

________________

dx?

________________

tx?

A

[P2: inspiratory stridor that improves when prone]

________________

Direct laryngoscopy

________________

self limited to 18 mo

88
Q

tx for Physiological Jaundice

A

Phototherapy

Unconjugated hyperbilirubinemia that appears the first 24 hours of life and resolves by the end of that week

89
Q

What is the most common pediatirc renal cancer?

A

Wilms tumor

unilateral abd mass with hematuria

90
Q

⬜ is a [pediatric renal tumor that crosses the midline] and presents in the ⬜ year of life

A

Neuroblastoma

________________

first

91
Q

What is the major (and contraindicating) side effect of the Rotareovirus vaccine?

A

Intussuception

Live attenuated vaccine

92
Q

Both Croup Laryngotracheitis and Epiglottitis can cause inspiratory stridor

How do you discern the two?

A

Epiglotitis causes Drooling!

93
Q

Pink Stains or Brick Dust in neonatal diapers indicates the presence of ⬜

A

Uric Acid Crystals

94
Q

At what age does Bedwetting start to become pathological for kids?

A

5 yo

95
Q

Infants that are Small for Gestational Age (SGA) are at risk for developing what complications? - 4

A

“I’m small, GOT Calcium?”

  1. low Glucose
  2. [low Oxygen –> (high RBC polycythemia)]
  3. low Temperature
  4. low Calcium

[2a] A ⼀ Step 2 OD USLME (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions