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MTBs Step 2CK > PEDs > Flashcards

PEDs Flashcards

1
Q

Tx of pyloric stenosis?

A

IVF! correct electrolyte abnormalities(hypochloremic, hypokalemic, metabolic alkalosis) first then do pyloromyotomy

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2
Q

6hr old baby with cyanosis of extremities since birth. temp = 97, bp 80/45, been breast feeding well. whatcha gonna do to her?

A

put her under a warming lamp!Acrocyanosis – blue hands and feet due to vasomotor instability = warm baby up and they will be fine. Often seen w/Cutis Marmorata(lattice like mottling seen when baby gets cold)

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3
Q

kid with vesicles on erythematous base in mouth(soft palate, tonsils, uvula), hands, feet & butt. dx?

A

HFMD = Coxsackie A virus

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4
Q

baby with bloody diarrhea and “pneumatosis intestinalis” on xray. dx? tx?

A

Necrotizing Enterocolitistx: NPO, TPN, IV Abx

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5
Q

DX criteria for Lupus

A

The ACR’s diagnostic criteria for SLE include the following: Malar rash Naso-oral ulcers Photosensitive rash Discoid rash Arthritis Pleuritis or pericarditis Proteinuria (>500 mg/d) or evidence of nephritis in urinalysis Hemolytic anemia, thrombocytopenia, leukopenia, or lymphopenia Seizure or psychosis Positive ANA finding Positive anti–double-stranded DNA, anti-Smith, or antiphospholipid antibody/lupus anticoagulant

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6
Q

Which vaccines can immunocomp kids not get?

A

MMRV, Live Flu, Rotavirus, yellow fever

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7
Q

what food allergies will kids often get over as they grow up?

A

wheat, soy, milk, eggs

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8
Q

kid w/unilateral ear pin, pain on palpation of pinna. dx? tx?

A

otitis externa, ciprofloxacin drops + steroids

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9
Q

7 month old w/bloody stool, FTT, vomiting, poor feeding. Babys on formula. dx? tx?

A

Milk-Protein Allergy = Ask what type of formula! its prob soy based = switch to cows milk untill 2-3 yoa

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10
Q

Intestinal atresia, rf?

A

atresia of the intestins at many locations due to VASCULAR ACCIDENT = look for this in a mom who uses vasoconstrictors(cocaine or smoking)*bilious vomiting

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11
Q

tx of SS dz

A

hydroxyurea

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12
Q

Tetanus sx + tx*how do they often get this?

A

often acquired from dirty wound, lockjaw, spastic paralysistx: intubate, sedate, Mrelaxers, IV Abx(metro), Tetanus antitoxin

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13
Q

14 yo girl never had a period, breast development at 12, high is equilvalent to that of a 8yo. bp 140/100. breast stage 2, pubic hair stage 4, weak femoral pulses. dx?

A

This is Turner syndrome. There are two tip-offs in this question: 1) She’s as tall as an 8-year-old (it actually doesn’t say bone age, it only mentions her height). 2) What you didn’t put in your excerpt is that she has decreased femoral pulses, indicative of a coarctation of the aorta. Coarctation is associated with Turner’s. In summary: Coarctation + short stature + primary amenorrhea = Turner syndrome.

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14
Q

sx of down syndrome

A

mental retardation, flat face, prominent epicanthal folds, slanted palpebral fissures, simian crease, protruding tongue, heart shit(av canal defect, endocardial cushing defect), gap in 1 & 2 toescomplications:early alzhimers, ALL, hirsprungs, duodenal atresia

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15
Q

SSD is caused by

A

substitution of glut to a val

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16
Q

Pyloric stenosis sx?

A

nonbilious vomiting in a 2-8 wk old baby who was previously normal, olive-shaped mass, visable perstaltic waves + abnormal CMP

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17
Q

MC pneumos in kids(not neonates)

A

step pneumo > haemophilus > moraxella

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18
Q

tx of gon conjunctivitis

A

IM cephalosporin

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19
Q

sx of fetal alcohol syndrome

A

mental retardation, developmental delays, SHORT palpebral fissures, SMOOTH philtrum, THIN vermillion boarders(thin upper lip), microcephaly, micrognanthia, murmer? = ASD or VSD

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20
Q

WAGR syndrome

A

Wilms tumor, aniridia, GU abnormaliites, mental retardation

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21
Q

2 month gross motor, fine motor, speech, social?

A

GM: lifts headFM: tracks past midlineSp: coosSoc: social smile

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22
Q

Retts Syndrome

A

girls who regress after a period of normal development around 6 months of age. looks like autism but results in death.

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23
Q

RDW in iron deficiency vs thalassemia

A

RDW is increased in iron but normal in thalassemia

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24
Q

What do you do for a baby who has hip laxity?

A

re-examine at 2 weeks. will usually resolve by then. if not do U/S<6m or xray >6m

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25
Q

Kid with major trauma or abuse, loss of consciousness, CT punctuate hemorrhage….dx? tx? causes?

A

Cerebral Contusion = tx w/management of ICPCause: Sport injury, football

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26
Q

common causes of meningitis in kids >11yo

A

N. Men

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27
Q

SIDS Prevention tips

A

put baby on back to sleep, dont share a bed, stop smoking, baby head flat on occiput –>baby stares at ceiling

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28
Q

Conduct Disorder vs Oppositional Defiant

A
  1. Conduct = <18, criminal, hurts ppl/animals purposely = tx w/juvy to try to correct behavior2. oppositional = punks, confronts authority but is fine wiht friends
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29
Q

What is billious Emesis in a baby? what does this mean?

A

green throw up! This means that obstruction is pass the biliary tree/distal to the ligament of trietz

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30
Q

Rotavirus…what weird GI shit u worried about?

A

Live vac, risk of intussusception & C/I if previous Intussusception

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31
Q

baby w/conjunctivitis on day 5-14. cause?

A

Chlamydia!, can be unilateral or bilatera, may be bloody! tx w/erythromycin PO

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32
Q

another name for Hemolytic uremic syndrome?

A

microangiopathic hemolytic anemia

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33
Q

how do you correct strabismus?

A

cover good eye and force brain to strengthen bad eye

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34
Q

Vaccines 12-15 months? 15-18 months?

A

Hey Very HiP MDHepA, Varicella, HiB, PVC, MMR, DTap(given 15-18m)

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35
Q

Kid comes in for check up and you find no probs other than protinuria. what do you do?

A

Recheck on 2 seperate occations. if present then workup. if not present = dx Transient Proteinuria

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36
Q

tx of Tic disorders

A

redirect or D-antagonist(antipsycotics)

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37
Q

what is serous otitis media?

A

Serous Otitis Media – nonpurplent(clear) effusions of the middle earo Usually involves hearing loss and fullnesso Typically does not have pain or fever

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38
Q

2 most common R –> L shunts?

A

Transposition of the great arteries & Tetralogy of Fallot

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39
Q

baby with chlamydia conjunctiivtis what else do you need to look for?

A

pneumonia!

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40
Q

pneumona in CF pt who is between birth - 20yoa cause…

A

S.Aureus

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41
Q

Pertussus ppx for baby

A

erythromycin

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42
Q

Which nephrotic syndrome is most associated with…1. HBV?2. HIV?3. A1AT?

A
  1. HBV = membranous2. HIV = FSGS3. A1AT = membranoproliferative
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43
Q

what else should be be on the look out for in retinopathy of prematurity?

A

intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis

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44
Q

describe a shingles rash

A

painful rash in dermatomal distrubtion of DRG, NEVER crosses midline, seen in immunocomp pt

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45
Q

dx of pinworms

A

tape on butt in am to catch eggs

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46
Q

baby with worsening jaundice @ 2 weeks of age, baby +/- phenobarbitol with no improvement, elevated direct hyperbilirubinemia +/- HIDA showing atresia. dx? tx?

A

biliary atresia, tx w/resection

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47
Q

4 yrs gross motor, fine motor, speech, social?

A

GM: hopsFM: crossSp: 4 wordsSoc: n/a

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48
Q

baby w/jaundice, elevated unconj/indirect bili, coombs +. dx?

A

Isoimmunization = Rh Dz or ABO incompatability

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49
Q

Benefits & Drawbakcs of breastmilk

A
  • improves gastric emptying due to increased Whey- lactoferrin, lysozyme and IgA to boost immunity- Lower Ca & P but body absorbs it better than regular formula- Inadequate VitD = need suppliment
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50
Q

Tay-Sachs Dzdef? inheritance?

A

AR, B-hemosaminidase A

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51
Q

Vaccines 4-6 yoa?

A

Very DIMVaricella, DTap, IPV, MMR

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52
Q

Diaphragmatic Hernia occurs more often where?

A

L > R & Back > front

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53
Q

what effect doesn PROM have on RDS?

A

decreases RDS due to increase stress = cort = help lungs mature

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54
Q

3yo comes in with 2month hx of r sided limp, most obvious when she waked up and plays. Rknee is swollen + warm but not tender. ESR is elevated. What other exam should you perform on this kid? why?

A

This child presents with pauciarticular juvenile rheumatoidarthritis (JRA). Characteristics of pauciarticular JRA include chronic asymmetric arthritisof four or less large weight-bearing joints. Systemic features are uncommon, but themost feared complication is the development of asymptomatic iridocyclitis, which cancause blindness if untreated. Iridocyclitis/uveitis may be present in all subtypes of JRA,but it is particular to the pauciarticular disease of early childhood, in which approximately30% of patients develop the complication. All children with JRA should have regularophthalmologic examinations, including slit lamp examinations,to ensure promptmanagement with corticosteroids.

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55
Q

tx for kid with hip dysplasia?

A

Pavlik hip harness if <6 months if >6m surgery

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56
Q

Is meckels diverticulum a true or false diverticulum?

A

true!

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57
Q

tx of chemical conjunctivitis?

A

lube

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58
Q

What is the APGAR Score? How do you score it? (1 pt vs 2pts)

A

*Appearance = 1:Acrocyanosis, 2: pink*Pulse = 1: <100, 2:>100*Grimace = 1:with HIGH stim, 2: w/stim*Activity = 1: Flexion, 2: extension*Respiration = 1: irregular, 2: strong/regular0 = shits absentnormal = 7-10

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59
Q

dx + tx of annular pancreas?

A

dbl bubble + no distal air on baby gram. tx w/surgery to reconnect*same as duodenal atresia = cant tell them apart untill surgery!

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60
Q

when does T1 DM usualy present?

A

4-6 yo or early puberty

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61
Q

how do you repair ASD?

A

Catheter-directed device closure

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62
Q

What can you give to close the PDA?

A

indomethacin

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63
Q

how long should you wait for a un-descended testicle to descend before doing surgery?

A

6m then do surgery.*increased risk for cancer

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64
Q

6month old kid with 1 wk hx of unprovoked startle-like movements. sudden quick flexion of the head,arms and legs/ cries during these movements which usually occur in clusters after awaking from sleep. heart murmer since birth. father has mental impairment. PE: 3 areas of skin hypopigmentation. for periventicular nodules that disort the normally smooth venticular margins on CT. dx?

A

F. Tuberous sclerosis – hamartomas of skin and CNS. MR is the murmur heart (holosystolic high-pitched blowing murmur). Cardiac rhabdomyoma. Mental retardation (seen in father)

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65
Q

what is pellagra?

A

def of B3 - Niacin = dermatitis, dementia, diarrhea

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66
Q

Sx of Intussusception

A

abrupt onset of colicky abdominal pain, knee to chest position, sausage shaped mass in abdomen, currant jelly diarrhea

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67
Q

kid who is 16 and never started puberty. what do you do?

A

measure FSH and LH

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68
Q

baby with bloody diarrhea + fever. dx? tx?

A

infectious colitis(salmonella, E.Coli, Yersinia, Shigella, etc)tx: hydration + electrolytes

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69
Q

common presentation of cerebral palsy in infants

A

Spastic Diplegia = hypotonia, hyperreflexia, equinovaris, resistance to movement

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70
Q

DTap vs Tdap vs Td

A

DTap = for kids + comes in 5 doses and is higher doseTdap = for adutls and given 1xTd = booster for Tdap

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71
Q

Breast feeding jaundice

A

baby isnt being fed enough = decrease bowel movment = baby reabsorbes crap(conjugated bilirubin) = turns yellow

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72
Q

Erythema Toxicum Neonatorum(ETN) symptoms

A

asymptomatic, blotchy, erythematous papules and pustles seen in neonates = BENIGN! can change color and always spares palms and sole.dnt know cause but it will go away so just reassure parents

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73
Q

Classic sx for Henoch-Schonlein Purpura

A

usually follows viral illness, rash, joint pain, abdominal pain, hematuria

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74
Q

What is imperforate Anus? whats it part of?

A

imperforate anus, can be either low = close ot anus or high = away from anus; part of VACTERL

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75
Q

What is a PDA?

A

aorta to pulmonary artery connection = machine like/multi-phase murmer

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76
Q

What is FTPM?

A

failure to pass meconium after 48h

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77
Q

What is adequate breastfeeding?

A

breastfeeding 8-12 times a day every 2-3 hrs for about 10-20 min per breast during the 1st month

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78
Q

baby w/conjunctivitis on day 2-7. cause?

A

gonorrhea!, usually bilateral tx with ceftriaxone IM or erythromycin ppx

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79
Q

Tx of tracheoesophageal fistula?

A

surgery!

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80
Q

Dx of intestinal atresia?

A

babygram = dbl bubble, air fluid levels throughout bowel == atresia can happen at multiple locations at different points in time due to vascular accident(excessive vasoconstriction)

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81
Q

Biggest RF for meconium ileus? cause? sx?

A

cystic fibrosis, meconium is too thick to be passed due to pancreatic insufficiency. FTPM, bilious vomiting

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82
Q

Chronic Granulomatous Diseaseinheritance?

A

XLR

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83
Q

SIDS prevention

A

Sleep on back, Dont share beds, smoking cessation

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84
Q

Fragil X syndrome sx? inheritance?

A

XL mutation, anticipationsx: flatfooted, flexable joints, low muscle tone, long face, prominent forhead and chin, large ears, macrocephaly, large testicles, MVP

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85
Q

Pt presents w/a wheel, erythema and is normotensive. dx? tx?

A

urticaria, tx w/ removal of offending agent, 2nd gen H1 blockers(cetirizine, loratadine, fexofenadine)

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86
Q

How do you work up and treat osteomyelitis in kids?

A
  1. if toxic give abx then xray + bx 2. but if not toxic do Xray, if neg do MRI then bx then do abx
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87
Q

14 yo girl w/lower ab pain, intermittent pain in knee & hips for 6wks, cramps relieved by bowel movements. 6-10 urgent, bloody bowel movments daily. PE: swollen, tender L knee. WBC 16K, Platelet 790,000 joint fluid: straw colored, wbc = 2000. dx?

A

UC! = bloody stools, leukocytosis, thrombocytosis, ab pain, arthralgias.Any of the IBDs can be associated with joint pain & can be relieved with bowel movement!*knee aspirate <10,000 = not likely infectionNormal Synovial Fluid = ~200 wbc & <25%PMNNon-inflammatory = 200-2,000Inflamm = 5,000-50,000Septic = >50,000

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88
Q

pregnant women gets infected with parvo…whats the comp?

A

hydrops fetalis for baby =(

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89
Q

Klumpke Paralysis

A

C7-C8 nerve roots, useles hand on useful arm, can have ipsilateral ptosis and miosis*claw hand

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90
Q

Enuresis is normal up untill…definition?

A

age 7. >2x per week for 3 months or >5yoa

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91
Q

HR and RR do newborn?

A

Rr = 40-60HR= 120-160

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92
Q

1 yr gross motor, fine motor, speech, social?

A

GM: walkFM: pincer graspSp: 1 wordSoc: separation anxiety

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93
Q

How do you check to see if the bloody stool is blood from mom baby swallowed or an actual GI bleed?

A

Apt test

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94
Q

Chronic Granulomatous Diseaseinfections with which type of organisms? what will you see on bx?

A

catalase +, numerous organism filled segmented neutrophils

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95
Q

what type of lymph nodes should just be observed in kids?

A

<1cm, soft mobil, cervial.*any supracavicular nodes shoudl be investigated no matter what

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96
Q

how can you distinguish central/hypothalamic/pituitary 1 ammenorhea vs peripheral/gonadal

A

check FSH!- decrease FSH = central = do MRI-increased FSH = peripheral = gonadal prob

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97
Q

Prader Willi vs Angelman Syndrome

A

PW: dad deletion, fat, dumb, hypothalamic Angelman: maternal deletion, happy, ataxia(puppet), severe MR

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98
Q

can adults get kernicterus?

A

nope! effects babies bc brain is still developing

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99
Q

CXR of croup look like?

A

clear lungs with steeple sign = subglottic narrowing

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100
Q

What is Malrotation/volvus? Cause?

A

incorrect alignment of the intestines due ot failure to rotate during development. =kink in gut causes billious vomiting after birth*seen in mom w/normal prenatal course

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101
Q

Posterior font. Closes @…

A

2-6m

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102
Q

3 important L–>R shunts in peds

A

ASD, VSD, PDA = all have D!

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103
Q

ss pt with low hg and low hct. dx?

A

aplastic crisis!

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104
Q

Diptheria sx + tx?

A

high fever, dyspnea, dysphagia + gray pseudomembrane

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105
Q

Absance seizures can be triggered by…

A

hyperventilating!

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106
Q

hypersensitivity reactions

A

ACIDT1 = anaphylaxis = IgET2 = Cytotoxic/AI = IgG & IgM auto-antibodiesT3 = Immune complex = Ab-AgT4 = Delayed = Tcells and macrophages

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107
Q

tx of childhood lead poisoningmoderate vs severe

A
  • moderate(45-69): Meso-2,3-dimercaptiosuccinic acid(DMSA)- severe(>70): DMSA + Calcium disodium edetate(EDTA)
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108
Q

non-organic causes of FTT?

A

Formula, Feeding, Frequency

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109
Q

Common organic causes of FTT?

A

Genetic(CF), Cardiac Disease, Pyloric Stenosis, GERD

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110
Q

Marfans vs Homocystauriawhich one has mental retardation?

A

homocystauria

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111
Q

MCC of sepsis in SS dzWhat can you do for them?

A

S. Pneumo = pplx with PCN till the age of 5

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112
Q

how do you dx tracheoesophageal fistula?

A

coiled NG tube on Xray

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113
Q

Kid with singly hot, swollen, tender joint. what do you do 1st?

A
  1. Arthrocentesis, WBC >50,000 = septic, culture with chocolate agar2. drain + abx
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114
Q

Between birth - 1 min what do you do? normal?

A
  1. Stimulate baby via rubbing back wiht towel + tap feets(1 apnea)2. O2(2nd apnea)–O2 = 60-65% - suction nose and mouth *PPV or intubate?3. HR– >100 = good!– <100 = PPV - baby may not be getting enough air immediately
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115
Q

common causes of meningitis in kids <3m

A

GBS, Ecoli, Listeria, HSV

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116
Q

Kid whose 6 months of age presents with FFT and hematochezia + some IgE symptoms…what are you thinking this could be? what could you do to fix it?

A

Milk-Protein Allergy!switch to hydrolyzed formula! = bloody diarrhea will resolve*usually outgrow around age 2-3

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117
Q

sx of galactosemiatx?

A

Sx:Enlarged liver(galactose accum)Vomiting, nausea, irritabilityMental retardation(gala in brain)Cataracts if dnt stop feeding baby shitThe urine tests positive for reducing substances, indicating the presence of sugars with aldehyde groupsTx:Remove galactose & lactose(dairy, breast milk)Start on soy

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118
Q

sx of scabies

A

burrows in skin, located in webs of hands and genitals,

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119
Q

Absence Seizures sx?

A

<20sec, utually 4-10yo, may be accompanied by simple AUTOMATISMS(eye fluttering, lip smacking)

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120
Q

Intraventricular Hemorrhage(IVH)path? dx? tx?

A

Path: @34 wks intraventricular lining vascular involutes. before this any changes in BP(birth, sepsis, RDS, BPD) can cause hemorrhagedx: <30 wks gets cranial U/Stx: craniotomy, VP shunt + F/U 36-40 U/S

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121
Q

9 yo kid with T1 DM, lethargy, labored breathing, vomiting, flushed appearance and appears severly dehydration, fruity odor to breath, blood glucose is >500. Tx? why high glucose?

A

DKA = def of insulin = glucose builds = body tries to remove by peeing it out + body hungry = making ketones trying to produce glucose for bodyManagement:REPLACE FLUIDS = isotonic salineWhen glucose reaches 200 give dextrose + salineIf K <3.3 give K + IVFIf K is above 3.3 and pt is not volume deplete you can give insulin

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122
Q

HUS causes hematuria by….

A

vascular dmg causing microthrombi = mechanical dmg

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123
Q

complications of premature baby

A

hypocalcemia, hypoglycemia, hypothermia, polycythemia, IVH, ret of premat, mercon asp, perinatal asphix, hypoxia

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124
Q

Gaucher Dzdef? inheritance?

A

AR, glucocerebrosidase

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125
Q

tx of Slipped Capital Femoral Epiphysis

A

surgery to fix

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126
Q

Tx of lyme in kid <8 yo. why?

A

amox! bc doxy has bone shit and you dnt wannt fuck with their bones

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127
Q

dx of scabies

A

scrap skin to see eggs on scope

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128
Q

Kid who gets kicked in head at MMA match and has some FND, LOC >60 sec, headache, some amnesia….dx? what do you do?

A

concussion, do CT to assure its just a fucking concussion adn not some other weird ass shit

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129
Q

Anterior font closes….

A

12-18m –> midway though year 2

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130
Q

koplik spots vs forchheimer spots

A

koplik = white spots in mouth = measlesforchheimer = red spots my be blochy in mouth = rubella

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131
Q

Dx of Malrotation/volvus?

A

baby gram –> dbl bubble + normal gas, upper GI series may show abrupt cut off point, contrast enema will show abnormal cecum position*bilious vomiting

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132
Q

onion skin bone tumor

A

ewings sarcaoma

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133
Q

5d old baby comes in whos list 4oz in weight, has hands+feet that are peeling and “brick dust/pink stain” in diaper. baby is not cranky and has been breastfeeding normally, urinating and poopin normally and sleeping well. dx?

A

normal!- peeling hands and feet = dry skin, babys skin is adjusting to the enviroment- babies loose 7% of body weight in the first 5 days but gain it back by d10-14- pink = uric acid crystals! this is normal in babies and will decrease. only think lesch nyhan if baby wasnt feeding well or not urinating normally.

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134
Q

what is Developmental Dysplasia of the Hip? how do you dx?

A

click on well-baby exam of a newborn. Dx w/4-6 week follow up reexamination + U/S if still present = put kid in harness

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135
Q

Gaucher Dzsx?

A

anemia, thrombocytopenia, HEPATOSPLENOMEGLY, no regression just fatigue and usually appears older kids.*both this and neimann-pick have hepatosplenomeg but np appears 2-6m w/o blood shit

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136
Q

tx of pneumonia in kids. typical vs atypical?

A

typical = amoxatypical = azith

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137
Q

What is VACTERL? How do you f/u?

A

Vertebral Anomalies = Sacral U/SAnus Imperforate = cross table baby gramCardiac defects = echoTE fistula = NG tubEsophageal atresia = NG tubeRenal Anomalies = voiding cystourethral gram(VCUG)Limb Anomalies = xray*must look for this before you correct imperforate anus

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138
Q

Kid with major trauma or abuse, loss of conciousness & stay in coma, CT crescent concave….dx? tx? causes?

A

Subdural hematoma = tx w/evacuation and ICP managementcauses: Peds struck, MVA, Abuse

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139
Q

what are allergic shiners?

A

venous congestion underneath the eyes

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140
Q

2 characteristics of Autism Spectrum Disorder

A
  1. impaired social communication = failure to meet social milestones, failure to maintain eye contact and relationships2. Restrictive Repetitive Behaviors = stereotypes movements, insistence on sameness, preoccupation with particular objects
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141
Q

adolescent with muffled voice, drooling, sore throat + on PE = displaces uvulua to one side… dx?

A

peritonsillar abscess = I&D + abx

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142
Q

What are the rules of 2 for meckels diverticulum?

A

<2 yo, 2x MC in males, 2 inches in length, 2 feet from ileocecal valve, 2% of the population

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143
Q

bulging fontanels in a baby is indicative of…

A

increased ICP

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144
Q

how do you dx intussusception?

A

U/S to look for it

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145
Q

Bone tumor associated with retinoblastoma?

A

Osteogenic sarcoma

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146
Q

Cephalohematoma/subperiosteal hemorrhage

A

hematoma that does not cross the suture lines. no discoloration of scalp, resolves in weeks to months.

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147
Q

Erythematous plaques with yellow oily scales around scalp, eyebrows, eyelids, behind ear, nasolabial folds, umbilicus & diaper dx?

A

seborrheic dermatitis

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148
Q

tx of chalmy conjunctivitis

A

PO Macrolide

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149
Q

congenital hypothyroidism

A

Thyroid Dysgenesis(Cretinism) – Increased TSHDecrease T4Normal APGARProlonged Jaundice/indirect hyperbiliLarge posterior fontanelle6-12 weeks:Poor feedingLethargyHypotoniaCoarse facial featuresLARGE PROTRUDING TONGUEDevelopmental delay**TX by replacing hormone!!

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150
Q

Neurofibromatosis T2sx?

A

NF2 mutation = bilateral acoustic neuromas

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151
Q

causes of bilious vomiting in newborn

A

Duodenal Atresia, Annular Pancreas, Malrtoation/volvus, Intestinal Atresia

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152
Q

Ureteropelvic junction obstructionwhat do you need to do to work this up?

A

exactly what it sounds like. colicky pain, usually see with kid who binge drinking, dx with U/S and check UCUG for contralateral reflex

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153
Q

Why do kids with VSD squat?

A

increase venous return and increase SVR to overcome pulmonary HTN

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154
Q

2 yrs gross motor, fine motor, speech, social?

A

GM: stepsFM: circleSp: 2 wordsSoc: 2 step commands

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155
Q

what is premature 2nd sex development in girls and bosy?

A

girls <8; boys <9

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156
Q

sx of pinworms

A

itchy butt

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157
Q

Describe ring worm lesion

A

scaly, erythematous, pruritc patches that spread centrifugally

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158
Q

posterior urethral valves tx?

A

catheritization, confirm sx with VCUG, surgery

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159
Q

2yo boy w/fever, r elbow pain + swelling and redness. HX of GBS @5m & septic arthrits caused by HFlu B @9yoa. Had a brother and 3 uncles taht died in infancy of septicemia. all immunization are up to date. Luekocytes = 34,000. Seg Nutrophils = 60% Bands = 15%, Lymphocytes = 15% dx?

A

history of effecting males! + has bacteria infections = B, Boys, Bacteria BURTONS!Burtons XL Agammaglob

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160
Q

what population will have complications with a parvo infection?

A

those with SS or other hemoglobinopathies = aplastic crisis

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161
Q

Tx of Malrotation/Volvus?

A

NG tube to decompress and relieve baby of gas then do surgery to correct

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162
Q

3m-3yo kid whos sick with a URI, presents with cough, inspiratory stridor. dx? tx?

A

Croup! = bark-like cough, steeple sign on xray, give EPI to help, steroids, and O2

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163
Q

What is sail sign?

A

thymus visable on xray till age of 3

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164
Q

Tx of nursemaids elbow?

A
  1. Hyperpronation of forarm(better)or 2. supination of forearm and flexion of elbow
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165
Q

dafuq is Diamon-Blackfan Anemia?

A

sportation mutation causing defect in progen cells = early apoptosis*neonate who presents with pallow ~3m, webbed neck, cleft lip, sheilded chest, triphalangeal thumbs

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166
Q

Retinopathy of Prematurity(ROP)path? rf? tx?

A

path: abnormal growth of capillaries in eyes = neovasculizationRF: prematurity, worsened by high O2 delivery(may see in baby tx for RDS or BPD!)tx: laser photocoagulation**F/U for Glaucoma development!

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167
Q

Kawasaki Disease diagnosis criteriawhat are they at increased risk for?

A

fever >5d +4 or more:1. conjunctivitis2. mucositis(strawberry tongue)3. cervical lymphadenopathy4. rash5. erythema & edema of the hands and feet*increased riks of coronary artery aneuryms

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168
Q

What are you worried about with diaphragmatic hernia?

A

hypoplastic lungs! = give surfactant and stablize before surgery

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169
Q

Neoblastoma Vs Wilms Tumor

A

*Neuroblastoma = MC extracranial tumor in children. Commonly presents as an abdominal mass.Often calcifiedDoesn’t invade vascularPoorly marginatedMay extend to chestElevated aorta away from vertebraMore commonly will cross the midlineNephroblastoma(Wilms Tumor)Usually not calcifiedDisplaces structesWell circumscribed“Claw Sign” w/kidney May invade vascular = IVC/Renal vein

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170
Q

baby born normal and a day or so later develops milky white apearance in front of the eye…cause, dx?

A

catarcts, galactosemia

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171
Q

long term complication of shingles. tx?

A

postherpetic neuralgia after rash has resolvestx: TCA or gabapentin

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172
Q

Scoliosis tx?

A

brace back or if severe do rod placement

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173
Q

5 yrs gross motor, fine motor, speech, social?

A

GM: skipsFM: triangleSp: 5 wordsSoc: n/a

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174
Q

What do you have to check immediately after birth (assuming baby is 7+ APGAR)?

A
  1. umbilical cord(2a +1v)2. Weight3. Length4. head circumference5. glucose6. shots and drops(Vit K, Hep B, PPx of conjunctivitis w/erythromycin unless another organism already ID.)
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175
Q

T/F when you do shit for abuse..tell parent what your doing and why your doing it and that you are required by law to do so.

A

T

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176
Q

what peds population would you see anal fissures in?

A

children or teens with a history of constipation = tear anal mucosa. or those with IBD

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177
Q

kid with previous runny nose now has fever, resp distress, wheezes, murmer, hepatomegaly, CXR shows enlarged heart. dx?

A

viral myositis

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178
Q

what vitamin can you give that will decrease mortality in measles?

A

vitamin A

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179
Q

4 month gross motor, fine motor, speech, social?

A

GM: roll overFM: clumsy graspSp: laughs, squealsSoc: looks around

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180
Q

tx of allergic conjunctivitis?

A

artificial tears, mast cell stablizes and antihistamines

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181
Q

Kid with toothache has been using numbing cream to treat. now presents w/cyanosis, pulse ox 85%. dx? why? tx?

A

methemoglobinemia, caused by oxidizing agents = dapson, nitrates, topical anesthetics(benzocaine & lidocaine)*will see normal PaO2, saturation gap, normal arterial partial pressuretx: methylene blue

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182
Q

def of vita B2/riboflavin sx

A

cheilosis, ocular(keratitis, conjunctivitis), anemia, dermatitis, photophobia

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183
Q

which congential cardiac defect will have a harsh holosystolic murmer, FTT, right sided hypertrophy and increased R heart pressure?

A

VSD

184
Q

What is the big risk factor for transposition of the great arteries?

A

Pre-existing diabetes in prego mom = @ week 8 when heart twists = failure!

185
Q

Which defect is associated with Fixed wide split S2?

A

ASD

186
Q

Achrondroplasia, Marfans, Ehlers-danlos syndrome mutation?

A

A: FGFR3 M: FBN1 ED: T1 Collagen

187
Q

Define Amblyopia

A

cortical blindness and defect in development = can be one or both eyes

188
Q

Vaccines @ birth?

A

Hep B

189
Q

after you tx meconium ileus what else do you need to do for the baby?

A

F/U w/sweat test, check ADEK, pan enzymes, pulmonary toliet all to check for CF + tx

190
Q

common causes of Amblyopia

A

Strabismus and congenital cataracts

191
Q

2 yo girl w/hx of irritabiltiy, poor appetitis, occational cough & reluctance to walk, 4.4lb weight loss over last 6 months, fever, bluish discoloration under eyelids. low neutrophils, elevated lymphocytes + mass in posterior mediastinum. dx?

A

Neuroblastoma = posterior mediastinum massvsthymoma = anterior mediastinum mass

192
Q

Vaccines @ 2,4,6 months?

A

HI HiP DR!*Hep B skips 4 months HepB, IPV(polio), HiB, PVC, DTap, Rota

193
Q

What is the most common CYANOTIC cardiac defect in NEWBORN?

A

Transposition of the Great Arteries

194
Q

Tx of meconium ileus

A

Gastrografin enema = water soluble to break down obstruction and pass; sometimes surgery

195
Q

CF infertility in men. why?

A

congential absence of vas def

196
Q

GI “target sign” is associated with….

A

intusseption

197
Q

epispadias

A

kid pees in his own face *dnt circumsize as you need the tissue to reconstruct

198
Q

kid with cyanosis in the first 24 hrs, normal S1 but single loud S2 + narrow mediasteinum. dx? tx?

A

transposition of the great arteries - give PG to keep PDA open till you can operate!

199
Q

Galactosemia inheritance pattern? defect?

A

Galactosemia – AR absence of Galactose-1-P = accumulation in liver, kidney, & brain.

200
Q

Spondylolisthesis

A

developmental disorder resutling in forward slip of vertebra causing: slowly developing back pain, neurologic dysfunction, palpebal step off

201
Q

Subgaleal hemorrhage/subaponeurotic Hemorrhage

A

superficial edema or hematoma that crosses suture lines, suually located on crown.*head feels squishy, tachycardia due to hypovolemia, looks like cephalohematoma but crosses midline.tx: IVF ressuscitation and observation

202
Q

Dx of Duodenal Atresia? tx?

A

dbl bubble + no distal air on baby-gram. tx w/surgery to reconnect

203
Q

why the increased risk of intussusecption after GI infection?

A

hypertrophied peyers patches = increase risk

204
Q

SS trait causes spontaneously resolving hematuria due to….

A

microthrombi causing renal papillary necrosis

205
Q

pt with retinoblastoma need to be monitored for what in the future?

A

osteoscarcoma

206
Q

Friedreich Ataxia sx?

A

ataxia, dysarthria, degradation of spinocerebellar tracts, hypertrophic cardiomyopathy, diabetes, skeletal deformities(kyphosis, scoliosis)

207
Q

classic urine color for glomerular causes of hematuria vs post-glomerular causes?

A

glomerular = RBC casts + dysmorphic rbc+ Coca-cola colored urinepost-glomerular = red/pink urine + normal rbc

208
Q

what is zyrtec?

A

Cetirizine = 2nd gen H1 blocker

209
Q

What is an Apparent Life Threatening Event(ALTE)?

A

change in baby color, tone & breathing

210
Q

what would a radiograph of sinusitis show?

A

air-fluid levels on XR and opacification on CT

211
Q

kid with nasal congestion and LOW grade fever, + copious clear rhinorrhea thats <10 days…whats the probable dx?

A

viral cold = just ride it out

212
Q

causes of nonbilious vomting in a newborn

A

pyloric stenosis, tracheoesophageal fistula

213
Q

kid with ss needs to be on…

A

PCN if <5 and possible till age 18 to prevent pneumococcal infection

214
Q

Dx of pyloric stenosis?

A

U/S showing Donut Sign

215
Q

Werdnig Hoffman dz vs Botulism

A

WH: anterior horn degen; upper ext > lower, lacks eye shitBot: hx of ingestion; Ptosis, sluggish pupillary light reflexBOT SPORES: no hx of ingestion, kid will be breast fed; Ptosis, sluggish pupillary light reflex

216
Q

Transient Synovitiswhat will you see on xray?tx?

A

synovial inflammation seen up to 4 weeks after URI or GI viral illness, no fever, no leukocytosis, decreased inflammatory markers, Xray looks normaltx: supportive

217
Q

What is Right Middle Lobe Syndrome? causes?

A

This is “RIGHT MIDDLE LOBE SYNDROME”Clinical presentation:Most pt present w/chronic coughHaemoptysisChest painDyspneaPath: largely unknown!Chronic bronchitis, Bronchiectasis, granulomatous inflame, pneumoniaRadiographic Shit:Right middle lobe collapse – linear consolidation, wedge-shaped densityBronchiectasis obstructing bronchial lesion is usually not found

218
Q

MCC of congenital cyanosis?

A

transposition of the great arteries

219
Q

causes of baterial rhinosinusitis

A

Strep. Pneumo > H. Influenza > Moraxella Cat

220
Q

tx of pinworms

A

albendazole

221
Q

sx of tracheoesophageal fistula?

A

nonbilious vomiting, bubbling and gurgling with respirations –> this is bc baby is breathing into stomach as well.

222
Q

Transient Tachypnea of the Newborn(TTN)

A

abnormal rapid breathing w/grunting + hyperexpanded and wet appearing CXR. due to delayed clearance of fetal lung fluid, usually seen with C-sections. Usually resolves w/in 6hrs but may be present for up to 48h.tx: Supplemental O2, CPAP/intubate is needed

223
Q

MCC of osteomyelitis in kids? What about a kid with SS?

A

Staph Aureus unless they have SS then think Salmonella

224
Q

pediatric stroke mc cause?

A

SSD

225
Q

What are Shots & Drops?

A

Vit K, Hep B, PPx of conjunctivitis w/erythromycin unless another organism already ID–> given to baby w/ APGAR 7+

226
Q

what was silver nitrate used for with babies?

A

thought it prevented chlamydia in babies but it doesnt =/ we use erythromycin topical instead

227
Q

dx of lice

A

comb through hair to see

228
Q

Caput Seccedaneum

A

edema that can cross suture lines, soft tissue swelling of the scalp that involves the presenting delivery potion of the head, can be ecchymotic.*resolves in a few days

229
Q

which cardiac defect requires a patent PDA for the kid to live untill surgery?

A

transposition of the great arteries

230
Q

what is Claritin?

A

Loratidine = 2nd gen H1 blocker

231
Q

Osgood-Schlatter Disease/Osteochrondrosistx?

A

teenage athletes, painful knee with swelling over the tibial tubercletx: 1. play thorugh it = taes a long as time to heal2. stop & rest and let heal

232
Q

person ate meat + egg salad 1 hr ago and now is puking. bug?

A

s.aureus = 1-6h

233
Q

CMP for pyloric stenosis

A

Hypochloremic, hypokalemic, metabolic alkalosis

234
Q

Kid previously had HiB. Does this mean they dnt need the vaccine?

A

Nope! Getting HiB doesnt confer immunity in those <2 yoa.

235
Q

How do you treat infantile spasms?

A

ACTH helps wiht spams

236
Q

dx of Slipped Capital Femoral Epiphysis

A

xray

237
Q

causes of septic arthritis in peds pts?

A

sexually active? = gonorrhea(hematogenous spread)not sex active = staph(direct inoculation)

238
Q

Exstrophy of the bladder

A

midline defect thats bright red, shiny & wet with urine*bladder is out of belly

239
Q

screen <5 yrs old for tb? screen >5 yo for tb?

A

<5 = ppd>5 = interferon gama release assay

240
Q

hypospadis

A

kid pees on his feet *dnt circumsize as you need the tissue to reconstruct

241
Q

Pertussis(Whooping Cough) sx + Tx?

A

begins w/general illness = looks like common cold. Then…kids develops alot of coughing w/big wheezes(inspiratory whoop).tx: supportive, Erythromycin

242
Q

Define Strabismus

A

lazy eye

243
Q

dx hirschsprungs dz?

A
  1. contrast enema shows transition zone followed by bx2. child presents w/overflow incontinence +/-encopresis & has stool eruption on DRE, anorectal manometry shows INCREASED TONE.
244
Q

What heart shit is characterized by “boot shapped heart”, and associated with down syndrome and DiGeorges?

A

tetralogy of fallot

245
Q

When’s the baby get teeth?

A

9-12m

246
Q

Kid has high lead on capillary finger stick. What do you do?

A

Draw venous lead levels bc cap can be false.

247
Q

MC pneumos in neonates

A

Ecoli, GBS, Chlamydia

248
Q

tx of pharyngitis?

A

amox-clav == always do rapid strep and treat bc ur worried about rheumatic fever!

249
Q

HTN emergencies tx

A
  • Sodium Nitroprusside = #1 for HTN emergencies
250
Q

Causes of Seizures mnemonic

A

VITAMINS: Vascular, Infection, Trauma, Autoimmune, Metabolic, Idiopathic, Neoplasm, Syndromes

251
Q

Which type of cardiac shunts have increased vascular markings?

A

L to R

252
Q

test for chronic granulomatous disease?

A

check for neutrophils w/dihydrorhodamine 123 tests & nitroblue Tetrazolium test

253
Q

RF for RDS in newborns?

A

Prematurity, male sex, perinatal asphyxia, maternal DM, C-section w/o labor

254
Q

When do you fix an umbilical hernia in baby?

A

3-4 yoa if >2cm or probs. usually will resolve on own in 1 year

255
Q

Club Foot on PE what do you do?

A

serial casts and stretching at first if that doesnt work surgery between 3-6m and always before 1yr

256
Q

what bug causes “Hand-Foot-Mouth Disease(HFMD)”?

A

Coxsackie A virus

257
Q

What is the most common cause of constipation in kids? tx?

A

voluntary constipation due to kid holding it in either bc they are embarrassed or bc of paintx: disimpaction in OR + education

258
Q

Physiologic jaundice vs beastmilk vs biliary atresia

A
  1. Physiologic jaundice: CONJUGATED within 24hr2. Breast milk jaundice: UNCONJ/indirect in 2nd week3. Biliary atresia: initially ok then within 2m develops CONJ bili
259
Q

which type of cardiac shunts has cyanosis?

A

R to L

260
Q

baby w/jaundice, elevated unconjugated bili, coombs -, hgb high. dx?

A

blood transfusion! = twin-twin transfusion syndrome, material-baby transfusion, delayed cord clamping

261
Q

kid with unilateral ear pain that is relieved by pulling on pinna, moderatly bulging tympaic membrane. dx? tx?

A

otitis media1. amox-clav2. cefdinir3. axithromycin

262
Q

why should you try to avoid transfusions in a pt with ss?

A

iron overload. if you do give deferoxamine also

263
Q

baby w/conjunctivitis on day 1. cause?

A

chemical! caused by use of silver nitrate

264
Q

Erb-Duchene Paralysis

A

C5-C6 nerve roots –>usefl hand on useless arm(unable to abduct shoulder or externally rotate and supinate arm)*waiters tip

265
Q

bedwetting is normal before the age of….

A

5 = wait to treat untill then.

266
Q

Juvenile Idiopathic Arthritis

A

>6wk multiple joint pain, morning stiffness +/- hepatospleo, salmon rash, serositisElevated CRP, ESR, Ferritin, gammaglobin, thrombocystosis*anemia due to chronic infllamation

267
Q

What is Hand-Foot Syndrome in SSD?

A

early manifestation of vaso-occlusion in 6m-4yo causing swelling of hands and feet

268
Q

Legg-Calve-Perthe Diseasetx?

A

~6yoa, avascular necrosis of the hip = insidious onset, knee pain, antalgic gait.dx: xray and tx w/cast

269
Q

complication of measles later in life?

A

subacute sclerosing panencephalitis

270
Q

Septic Hipdx? tx?

A

any age group with previous or current febrile illness who is now complaining of joint paindx: xray then aspiration/culturetx: abx + drain

271
Q

3 food poisoning bugs that are mostly vomiting.

A

s.aureus, Bcereus, Norovirus

272
Q

baby born with milky white apearance in front of the eye…cause, dx?

A

TORCH, cataracts

273
Q

What is the allergic salute?

A

transverse nasal crease

274
Q

tx cat bite vs cat scratch

A

bite = augmentinscratch = azithromycin

275
Q

Which vaccines can not be given to ppl with egg allergies?

A

Yellow Fever, some influenza

276
Q

kid w/purulent nasal discharge, congestion, sinus tenderness, that >10d old, high fever. dx? tx?

A

sinusitis = amox-clav or cefdinir

277
Q

which type of NTD is associated with a chiari malformation?

A

myelomeningocele = chiari 2 malformation

278
Q

What is a Brief Resolved Unexplained Event(BRUE)?

A

<1yo w/<1 min duration of change in color, tone, respirations

279
Q

Metatarsus adductus on PE what do you do?

A

toes curled inward on PE, if overcorrect w/abduction just reassure parent, if not needs orthosis or corrective shoes

280
Q

Infantile Spasm definition

A

<1 yo with SYMMETRIC JERKING without fever.

281
Q

If they have a family history of adverse reaction to a vaccine can they still get that vaccine?

A

yes! only personal history matters

282
Q

How do you repair VSD?

A

open surgical repair

283
Q

tx of hirschsprungs dz?

A

resect + connect and if severe = colostomy

284
Q

17 yo kid who has never started puberty with an elevated FSH. whatcha thinking?

A

due to hypergonadotropic = karyotype to check for turners, resistant ovaries

285
Q

kid w/drooling, muffled voice, high fever + rapid onset, no vaccines. dx? tx?

A

epiglottitis = OR for intubation + abx

286
Q

Umbilical cord will fall off…

A

7-10d ; turns bluish then falls off—> come in if pus or red

287
Q

kid with unilateral ear pain for the last few days now comes in with swelling behind the ear and anteriorly rotated ear. dx? tx?

A

mastoiditis, surgical consult for decompression

288
Q

kid w/drooling, muffled voice, fever + refusal to move neck, unilateral cervical lymphadenopathy + tender area of neck. dx? tx?

A

retropharyngeal abscess = CT scan, surgical for I&D + culture + abx

289
Q

tx of acute ss crisis?

A

IVF, pain control, oxygen

290
Q

causes of constipation in newborn

A

Hirschsprungs, voluntary holding, baby whos mom got opiates or Mg for preeclampsia, electrolyte derangements(hypoglycemia, hypokalemia, hypermagnesemia, hypercalcemia)

291
Q

kid comes in with obviouse Guillian-barre what is an important test for you to run? why?

A

spirometry to assess respiration = GB pts are at high risk for respiratory failure

292
Q

Trendelenburg Gait

A

hip drop due to dmg to superior gluteal N = weak gluteus muscles

293
Q

6 month gross motor, fine motor, speech, social?

A

GM: sit upFM: rakesSp: babblesSoc: stranger anxiety

294
Q

Components of Tetralogy of Fallot

A
  1. VSD2. Overriding aorta3. Pulmonary Stenosis4. RV hypertrophy
295
Q

tx of imperforate anus

A

Low/close to anus = dilation or minor sugical procedureHigh/away from anus= colostomy with future correction

296
Q

kid <8 yo has breast buds or axially hair. 1st test you do to work this up?

A

xray to check bone age! if >2 yrs older than you need to do GnRH test

297
Q

what is the most common congential heart defect?

A

VSD

298
Q

Tay-Sachs Dzsx?

A

loss of motor milestones around 2-6m, hypotonia, feeding difficulties, cherry red macula, HYPERFLEXIA

299
Q

Rota virus vaccine C/I?

A

immunocomp & personal history of intussusception as rotat can cause intussusception

300
Q

kid with joint hypertrophy and “ping-pong skull”(soft skull wiht wide fonts) whatcha thinking?

A

vita D deficiency!

301
Q

Neurofibromatosis T1(T1 von rec)mutation? sx?

A

NF1 gene; 1. cafe-au-lait spots2. axillary freckling3. monocular eye proptosis & visual changes = OPTIC TRACT GLIOMA4. lisch nodules5. neurofibromas

302
Q

Hirschsprungs Dzpath? sx?

A

failure of meissner and auerbach INHIBITORY neurons to migrate to distal colon = distal is always contracted. can present as constipation later in life or as FTPM. Look for Xray showing dilated proximal colon= normal & normal looking distal colon = abnormal.

303
Q

Marfans vs Homocystauriawhich one has fair complection?

A

homocystauria

304
Q

What is Failure to Thrive(FTT)? What goes first?

A

<5th percentile for age.Weight > Height > head Circumference

305
Q

normal rr for babies & toddlers

A

babies = 40-60 toddlers = 12-14

306
Q

Ped tx for Meningitis in kids <30days? why not ceftriaxone?

A

Vanc, Steroids + Ampicillin(cover listeria) & ceftaximine*not ceftriaxone bc it can cause hyperbilirubinemia in babies

307
Q

Which type of bilious vomiting is associated with down syndrome?

A

duodenal atresia & annular Pancreaus

308
Q

what medications given to mom can cause constipation in newborn?

A

Mg for preeclampsia or Opiates

309
Q

baby whose blue at rest and pink when crying. dx? tx?

A

choanal atresia = anatomically stenosed connection between nose and mouth = needs surgery to fix

310
Q

liver bx of kid with reye’s syndrome would show?

A

microvascular fatty infiltrate of the liver

311
Q

Coxsackie A pharyngitis vs Herpes pharyngitis

A

Coxsackie = gray vesicles/ulcers on posterior oropharynxHerpes = clusters of small vesicles on anterior oropharynx + ginival involvement

312
Q

Necrotizing Enterocolitis(NEC)rf? presentation? dx? tx?

A

RF: premature, aspirationPresentation: baby w/bloodly bowel movementdx: Xray = “pneumatosis intestinalis, air in the wall of the bowels”tx: NPO, IV Abx(amp,gent, metro), TPN

313
Q

Sx of Lyme dz infection

A

mild pain + joint stiffness that may be on and off, flu like symptoms, fatigue, variable joint pains

314
Q

Primary Ciliary Dyskinesia vs CF

A

Both have: chronic sinus infections, nasal polyps, bronchiectasis, digital clubbingCF: pancreatic insuff like vit K def(brusising), vit D def, poor growth

315
Q

Sx of ALL in 4 yo kid?

A

fever, recurrent infections, bleeding(bone marrow failure) fatigue, mediastinal mass due ot thymus infiltration, hepatosplenomegaly, lymphadenopathy, TdT+(pre B/T cell marker)

316
Q

Criteria for a Febrile Seizure

A
  1. generalized = total body + LOC2. <15 min duration3. Single episode in 24hr4. no underlying neuro prob*MUST HAVE ALL!
317
Q

Neimann-Pick Dz sx?

A

loss of motor milestones about 2-6m, hypotonia, feeding difficulty, cherry red macula, HEPATOSPLENOMEGLY, AREFLEXIA

318
Q

3 yrs gross motor, fine motor, speech, social?

A

GM: TrikeFM: circleSp: 3 wordsSoc: n/a

319
Q

Scarlet Fever sx + tx?

A

*seen w/untreated strep shitfever, chills, sore throat, strawberry tongue, rash(sunburn w/goosebumps or sandpaper or rough texture)

320
Q

15 month old girl with 1day hx of rash & fever for the last 3 days. got MMR vaccine 10 days ago. dx?

A

normal! this is just the replication of the live vaccine virus strain. it will pass

321
Q

When can I give solid foods to baby?

A

4-6m

322
Q

mom gives birth to kid who initially is fine but later is the day the kid starts turning blue. what should you do asap? how can you dx?

A

PROSTAGLANDINS to maintain PDA, Dx transposition of great arteries with U/S

323
Q

normal hg for ss pt

A

7-9

324
Q

pt presents with swelling of airway + generalized edema n shit, hx of C1 esterase def. dx? tx?

A

angioedema = c1 esterase or acei is causing this(usually)tx: remove, intubate, H1/H1 blocks and if hereditary angioedema = FFP

325
Q

kid with HIGH fever (104) then fever goes away and rash starts on trunk and spreads, kid had a seizure yesterday. dx?

A

Roseola = HHV-6

326
Q

Tx for TB if PPD+ but CXR-. dx?

A

thsi is latent TB = tx with INH for 6-9months

327
Q

Anemia of Prematurity

A

due to decrease in EPO, short RBC life & multiple blood draws in NICU

328
Q

leuprolide stim test shows no change in LH in <8 yo kid with breast buds. what you thinking? ddx?

A

peripheral = do U/S, testosterone, DHEA, 17OH progest all looking for tumor, CAH, or cysts

329
Q

Standard regimen of care for TB

A

4 for 2 then 2 for 4.So start INH, Rifam, Pyrazin, Etham. stop pyra+etham after 2 months and continue INH + Rif for another 4 months.

330
Q

What is annular pancreas?

A

failure of apoptosis of panreaus causing it to constrict the duodenum = looks IDENTIAL to duodenal atresia*bilious vomiting

331
Q

pt with hypotension, hives, wheezing. tx? additional tx?

A

anaphylaxis!1:1000 epi IM immediatly! then can do H1/H2 blocks and albuterol to help after epi

332
Q

What is a long term consequence of intestinal atresia? why?

A

Short Gut Syndrome = diarrhea + malnutrition. this is bc in order to repair you have to remove atretic areas and reconnect bowel

333
Q

common causes of meningitis in kids 3m-10yo

A

S.pneumo, N. Men

334
Q

How do you dx intussusception if you have a really high suspicion of it? what else is this good for?

A

Air-contrast Barium Enema = also used to cure intussusception bc air will push out bowel. If this doesnt work then surgery will be needed

335
Q

What is a normal reaction to vaccine?

A

Temp <104, Erythema, tenderness but consolable*if temp high or not consolable or obv anaphylaxis = dnt give that vaccine again! but can still get other vaccines

336
Q

defect in which vitamin causes increase in ICP

A

vitamin A

337
Q

you look in kids ear and see peripheral granulation tissue w/debri near ear drum. dx?

A

cholesteatoma

338
Q

Pathogenesis & Tx of Retinopathy of Prematurity

A

premature babies w/hypoplastic lungs need O2, this increase in O2 causes forming blood vessels in eyes to proliferate = retinopathytx: lazer ablation

339
Q

Cervical Lymphadenopathy in children

A

mcc S.aureus = enlarged, tender, erythematous lymph nodes

340
Q

12 yo boy is concered he is the shortest kid in the class. father says he was short untill his senior year in high school. Which test would you do to confirm the dx?

A

check bone age to distinguish constitutional vs familial

341
Q

How do you confirm Infantile Spasms?

A

EEG showing HYPSARRHYTHMIA

342
Q

tx of lice

A

permethrin, malathion

343
Q

looks like hypothyroid in newborn baby + “Horse cry”

A

thyroid dysgenesis

344
Q

What’s neonatal acne?

A

Acne peaks between 2 to 4 weeks occurs due to maternal hormone transmission

345
Q

18 hr old f has jaundice, difficulty feeding, no bowel movement and dark urine. Tbili = 11. direct = 0.1. is this physiologic jaundice or hemolytic dz of the newborn? why?

A

HEMOLYTIC DZ OF THE NEWBORN! = <24 hrs!!!!*physiologic will only present >24h

346
Q

What’s a herald patch?Tx?

A

Pityriasis Rosea ! Associated w/HSV 6/7 but not sure which. Lasts 2-12 weeks tx w/topics steroids

347
Q

causes of failure to pass meconium

A

Imperforate anus, meconium ileus, hirschsprungs, bilious emesis(duodenal atresia, annular pancreas, malrotation, intestinal atresia)

348
Q

whats the biggest difference between rubella and measles?

A

rubella has a prodrome generalized tender lympadenopathy

349
Q

2yo boy, 2hr onset fever + difficulty breathing, Rhinorrhea for the past 24 hrs. noisy breathing most noticabble when inhalation, sx improved when she took him outside to come to teh ED, supraclavicular retraction, inspiratory stridor. wheres the edema? epiglottis edema? or subglottic edema?

A

LOOK AT THIS KIDS AGE!!! He is only 2yo.Edema of the epiglottis = HiB/epiglottisSubglottic edema = croup! + cold air imporves sx

350
Q

sx of HUS

A

microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury

351
Q

Premature baby give vaccinations according to —– age. What the exception?

A

chronological; exc: HepB! baby must be >2kg for this vaccination

352
Q

17 yo Low WBC, splenomegaly, hepatomegly, lymph nodes enlarged, and now has diarrhea.Leukocytes = 2100IgA 340(low) others are normalPlatelet 180,000dx?

A

Low WBC, splenomegaly, hepatomegly, lymph nodes enlarged, and now has diarrhea! = immunocomp! Since hes 17 its prob due to HIV

353
Q

McCune-Albright Syndrome

A

de novo mut in G-protein cAMP(GNAS)Triad: precocious puberty, cafe-au-lait spots, fibrous dysplasia of bones + HYPERENDOCRINE due to increased cAMP activity = elevated cortisol = cushing symptoms

354
Q

Trachoma

A

chlamydia infection in the eye that can spread in unsanitary condition like a refugee camp.1. conjunctival injection2. tarsal inflammation(eye lid)3. pale follicles(bumps under eye lid)4. often seen w/rhinorhea, pharyngitistx: azithromycin

355
Q

when do you do pox parties?

A

NEVER! get vaccinated(MMRV)! bc now we know singles is fucking shit

356
Q

leuprolide stim test shows elevated LH in <8 yo kid with breast buds. what you thinking? ddx?

A

central prob! needs MRI to look for tumor or constitutional

357
Q

Flonase & Nasacort are….

A

Flonase = flucortizone, nasacort = steroid*both are intranasal steroids for allergic rhinitis

358
Q

Breast milk storage?

A

3-6m

359
Q

You should be concerned about —– murmers in kid or murmers that are grade — +.

A

diastolic, 3

360
Q

Sx of kid with Posterior Urethral Valves

A

potters sequence + hydroureter/nephrosis, usually seen in males

361
Q

What is Duodenal Atresia? sx?

A

Duodenum failes ot recanalize in utero. will have polyhydramnios.*bilious vomiting*assoc w/down syndrome

362
Q

which type of conjunctivitis of the newborn can be bloody?

A

chlamydia

363
Q

babys drinking only cows milk. what do you need to give them?

A

iron! cows milk is low in iron

364
Q

Tetralogy of Fallot is associated with…

A

down syndrome

365
Q

Posterior Urethral Valvessx?

A

MC in males, low to no urine output + palpable bladdder, due to redundent tissue, hx of oliohydraminos

366
Q

viral prodrome and rash that distrubted along lines of tension, puritis + herald patch

A

pityriasis rosea

367
Q

Criteria for Physiologic Jaundice

A

Physiologic: Appears 2-3 dayPeaks 2-3 dDisappears by day 7Peak bilirubin <13Rate of bilirubin rise <5

368
Q

baby with red cheeks rash + fever for the last few days that now has lacy or reticular rash on arms and trunk. dx?

A

parvovirus B19

369
Q

VSD is associated with what congenital disorder?

A

Down syndrome

370
Q

blood smear of G6PD vs SSD

A

G6PD = bite cells & heinz bodiesSSD = howell-jolly bodies

371
Q

sx of rubella

A

rash + fever that starts at head and moves down body = faster than measles, forchheimer spots = red spots in mouth*prodrome = tender generalized lymphadeopathy

372
Q

where is the obstruction if you have an inspiratory stridor?

A

extrathoracic obstruction

373
Q

HSV vs Impetigo

A

HSV only around oralabial region, impetigo all around face

374
Q

use a rear-facing car seat for ages —– then use booster seat untill—-.

A

0-2yo, until 4’9’’ and 8-12 yoa

375
Q

When do you do an exchange transfusion for jaundice?

A

Bilirubin >20 do exchange is sx. Bilirubin >25 = do exchange. This case the bilirubin is approaching 25 = should prob just do the exchange

376
Q

2 kids come in with rashes. one has rash on face the other has it on the trunk and it has begun to spread outward. PE: vescular rash on erythematus base in various stages of healing. dx?

A

Chicken pox! = Varicella zoster virus

377
Q

4yo girl with vaginal bleeding for 12 hours, 3m history of purulent vaginal discharge. pubic hair stage 1. dx?

A

vaginal foreign body

378
Q

3m old kid has hypoglycemia, hyperlipidemia, doll like face, round cheeks, thin extremities, short statues, protuberant abdomen(hepatomegaly). dx?

A

T1 glycogen storage dx(von gierk) = G6PD def causing impaired glycogen –> glycose

379
Q

CHARGE syndrome

A

Coloboma

380
Q

physiologic jaundice vs. pathologic jaundice

A

physiologic(uncon): 1-7 days onset, slow rise, <10% direct bili, resolves by day 10Pathologic(conj): <24h onset, rapid rise, direct bili >20%, lasts >2 wks

381
Q

gynocomastic in boys is normal till….

A

Normal in prepubertal boy! Usually subsides within 1 year. If mass doesn’t regress by 16-17 yoa then it should be removed.

382
Q

7yo girl, fainting during feild trip, progressive lethargy over the past winter + darkened complextion. bp 80/40. what test to determine dx?

A

plasma cortisol = this is addisons! = adrenal insufficiency*ACTH stim test to see if there is a change in cort. a + test will be no change in cort = addisons

383
Q

Kid whos sick with URI, cough, inspiratory stridor who was given epi but doesnt respond. what do you do next? dx?

A

prob bacterial tracheitis = scope + culture = abx

384
Q

how do you tx febrile seizures? what infectious rash is this associated with?

A

Benzos for seizures & acetomenophen for fever! (do not use ASA as it will cause ryes syndrome!)HHV6 = Roseola

385
Q

7yo boy with progressively worsening HA, difficult walking over the past 6 weeks, bilateral papilledema, right abductions palsy & gait ataxia. dx?

A

Medulloblsatoma can impair CSF flow = causing the papilledema

386
Q

Cleft Lip/Cleft Palate presentation

A

shit fails to close w/ FTT, mostly cosmetic. May be associated with recurrent infections.tx? fix surgically!

387
Q

Vaccines 12 yoa?

A

HPV, Meningiococcal

388
Q

can diastolic murmers be innocent?

A

never!

389
Q

Risk factors for abuse of child in kid? in parent?

A

kid: intellectual disability, premature birth, physical disability, cognitive disabilityparent: single parent, young parent, low SES, non-biological care-giver

390
Q

bilateral parotid swelling and orchitis in pebertal males. dx?

A

mumps

391
Q

when should strabismus be corrected

A

should be corrected around 6 months

392
Q

Whats normal baby spit up?

A

small volume, nonprojectile, formula colored

393
Q

if you have jaundice which type of bilirubin do u want to have(better of two evils)? why?

A

conjugated/direct! bc this will not cross the BBB & can be peed out.

394
Q

Friedreich Ataxiamutation? inheritance?

A

AR mut in fraxtin = GAA triplet

395
Q

Neimann-Pick Dz def? inheritance?

A

sphingomyelinase, AR

396
Q

baby w/jaundice, elevated unconjugated bili, coombs -, hgb low, rectic count high. dx?

A

hemolysis! = spherocytosis, G6PD def, Pyruvate kinase def, hematoma bleed, ccephalohematoma

397
Q

When do you get Tetanus Ig? (TIG)

A

*If <3 doses + dirty wound = Tdap + TIG*if >3 doses do not need TIG only Tdap if >10 w/clean or >5 w/dirty

398
Q

CAP tx

A

ceftriaxone and azithromycin

399
Q

when would you see sx of galactosemia?

A

1st week of life!

400
Q

Riboflavin B2 deficiency

A

Chelioliss, Glossitis, seborrhetic dermatitis, pharyngitis,

401
Q

Sturge-Weber Syndrome sx?

A

focal or generalized seizures, mental retardation, “Port-wine” stain, IC calcifications

402
Q

Retinoblastomatx?

A

tumor in BACK of eye = pure white retinatx: resect

403
Q

baby w/jaundice, elevated unconjugated bili, coombs -, hgb low/normal, rectic count normal. dx?

A

reabsorption prob! = hemorrhage, breast feeding jaundice, breast milk jaundice

404
Q

sunburst bone tumor

A

osteogenic sarcoma

405
Q

Fanconi anemiasx?

A

XLR aplastic anemia with progressive bone marrow failure, short stature, hypergonadism, hypo pigmentation, low set ears, deafness, abnormal thumbs, microcephaly, cafe au lair spots

406
Q

What is a “tet” spell? what is this associated with?

A

cyanosis relieved by squatting. seen with tetralogy of fallot

407
Q

what food allergies are kids at higher risk of developing anaphlaxis too?

A

nuts, fish

408
Q

ddx for BRUE?

A

GERD, Lower Airway Infection, Seizure, Spesis, Heart Disease, Abuse

409
Q

What is the most common CYANOTIC cardiac defect in CHILDREN?

A

Tetralogy of Fallot

410
Q

tx of scabies

A

cover head to tow in permethrin or lindane

411
Q

Tuberous Sclerosis sx?

A

Angiofibromas, Ash-leaf spots(pale patches), Cortical Tubers on CT + severe intellectual disability & seizures

412
Q

Marfans vs Homocystauriawhich one has aortic root dilation?

A

marfans

413
Q

kid who doesnt have MMR vac comes in with rash on face + fever that is starting to spread to the rest of hte body…what do you need to look for to dx?

A

tender lymphadenopathy! = this will tell u rubella vs measles

414
Q

Describe Dermatatitis Herpetiformis. What its associated with?

A

“red spots on arms and legs filled with clear fluid that later crusts over”

415
Q

kid brought in by baby sitter with appendicitis. do you need consent to operate?

A

nope! this is an emergency

416
Q

Barlow vs Ortolani exam

A

barlow = adduction and push lowortolani = abduction and push up

417
Q

Henoch-Scholein Purpura sx

A

low grade fever, cough, nonblanching rash on butt and legs, arthralgias, abdominal pain, intussecption, kidney shit

418
Q

baby being fed cows milk can be deficient in what…

A
  • Cows milk is a poor source of iron = can cause iron deficiency anemia in children strictly fed this
419
Q

absence seizures will increase the risk of developing what later in life?

A

anxiety and ADHD

420
Q

what is elevated with NTD?

A

AFP

421
Q

what type of kid would you see meconium ileus in?

A

one with CF, baby whos mom recieved no prenatal care or testing for CF

422
Q

What can you give to maintain PDA?

A

prostaglandins if needed for transposition of the great arteries

423
Q

sx of measles?

A

fever +rash, cough, runny nose that starts at head and moves down the body. + Koplik spots = white spots on buccal mucosa

424
Q

tx of hydrocele

A

observation! = usually resolves in 12m if not need surgery

425
Q

Retinoblastomamut? sx?

A

mut Rb; optic nerve retinoblastoma*associated with osteosarcoma

426
Q

sx of lice

A

itchy scalp

427
Q

what are 2 complications of chickenpox?

A

scarring and scondary infectiosn with staph and GAS.

428
Q

7 yo girl w/7day hx of bloody diarrhea, fatigue, no fever, pallow, scleral icterus, normal liver, Hg 6, MCV 80, Leukocytes 18,000, retic 12%, platelets 50,000. dx?

A

Bloody diarrhea + hemolysis + low platelets = HUS. This patient probably had enterohemorrhagic E. Coli (O157:H7 blablabla) colitis. The picture of icterus, anemia, and increased reticulocytes showed you hemolysis was occurring. ALL is suggested against by a leukocytosis better explained by hemorrhagic diarrhea and a bone marrow that is responding well with reticulocytosis.

429
Q

Strawberry Hemangiomas in children vs Cherry Hemangiomas in adults

A

strawberry = benign vascular tumors of children, regress by 5-7 yoacherry = benign vascular tumors of adutls that are small and red but do not regress

430
Q

how do food allergies often present?

A

NVDiarrhea

431
Q

Tx of tourettes

A

1st line = A2 ag: Clonidine or Guanfacine2nd line = antipsychotics: Risperidone

432
Q

pale boogy nasal mucosa, polyps, cobblestoning in posterior oropharynx…what is this describing?

A

allergic rhinitis

433
Q

why does voluntary constipation cause diarrhea & encopresis?

A

kid holds in stool = absorbs water = bc hard. only stool that can get past this rock is soft/liquid = diarrhea + encopresis.

434
Q

where is the obstruction if you have an expiratory wheezing?

A

intrathoracic obstruction

435
Q

what is the most common congenital heart defect in kids with DS?

A

complete AV septal defect

436
Q

>5 yo kid has nocturesis & all other treatment has failure…what do you do?

A

give desmopressin

437
Q

Respiratory Distress Syndrome of Newborn(RDS)

A

usually due to surfactant deficiency causing atelectasis. baby is usually premature. CXR: low lung volumes and uniform granular pattern.tx: surfactant + mechanical ventilation

438
Q

baby acute onset w/LRQ pain + bloody diarrhea bug?

A

yersinia = 24-48 hr and mimic diarrhea

439
Q

Kids with juvenile idiopathic arthritis obv have arthritis but also have chronic ——. Complications? Tx?

A

Chronic uveitis! Can go blind! Tx w/steroids

440
Q

Between 5 - 10 min what do you do? normal?

A
  1. APGAR2. O2(2nd apnea)–O2 = 90-95% is good*FiO2 to improve! = supp O2*PPV or intubate?3. HR– >100 = good!– 60-100 = PPV–<60 = CPR 3:1 + Epi ==> run code
441
Q

Krabbe Dzdef? inheritance?

A

AR galactocerebrosidase

442
Q

Between 1 - 5 min what do you do? normal?

A
  1. APGAR2. O2(2nd apnea)–O2 = 80-85%*FiO2 to improve! = supp O2*PPV or intubate?3. HR– >100 = good!– 60-100 = PPV–<60 = CPR 3:1 + Epi ==> run code
443
Q

Bow legs is normal till…

A

2y

444
Q

breast milk jaundice

A

moms milk isnt allowing conjucation of bilirubin = elevated unconjugated bilirubin! = switch to formula for a bit then can go back to breastfeeding.

445
Q

Long term consequence of vesicouretral reflux?

A

Renal scarring

446
Q

Slipped Capital Femoral Epiphysis

A

adolescent who is obese or under going a growth spirt

447
Q

Kid with temple trauma, loss of conciousness w/lucid interval, CT biconvex lens….dx? tx? causes?

A

epidural hematoma = tx w/evacuation and ICP managmentcauses: ball sports, skiing

448
Q

heat exhaustion vs Heat stroke

A

Heat exhaustion is the precursor to heat stroke. Body tries to compensate for excess body heat.Profuse sweatingWeaknessNV, HA, lightheadednessM crampsHeat stroke is a failure of the body to compensate for excess heat = temp will be above 40.AMSLethargicSeizure>40 C

449
Q

Bronchopulmonary Dysplasia(BPD)path? cxr? tx? if not fixed what can this cause?

A

path: underdeveloped lungs + lack of surfactantCXR: ground granular opacitiesTx: dnt let it progress to DPLD! = Decrease FiO2, Ante-natal steroids, Perinatal Surfactant, try to avoid premature birth

450
Q

Breast Milk Jaundice vs Breasfeeding Failure Jaundice

A
  1. breast milk jaundice: appears in week 1, seen with adequate breastfeeding, normal exam, due to increase conjugate intestinal bilirubin.2. breastfeeding failure jaundice: appears in week 1, due to decrease lactation and increase bili, seen w/suboptimal breastfeeding, sx of dehydration = tx by increaseing feeding
451
Q

Pellagra

A

Niacin B3 def = diarrhea, dermatitis, dementia, glossitis

452
Q

which type of bilirubin can cross the BBB? what can this cause in a neonate?

A

unconjugated bilirubin/indirect bilirubin = lipid soluble can cause life-threatening Kernicterus(in baby only bc brain is sitll developing) = bilirubin deposits in basal ganglia and pons

453
Q

17 yo kid who has never started puberty with an normal FSH. whatcha thinking?

A

hypogonadism = check prolactin, TSH, T4, CBC, ESR, LFT, MRI

454
Q

If kid is sick can they still get vac?

A

yes

455
Q

How long does it take for PDA to close on its own?

A

about 7 days. beyond this is abnormal

456
Q

Causes of conjunctivitis in newborn at d1, d2-7, d7+, 3+ weeks?Tx?

A

Day 1 = chemical irritation due to silver nitrateDay 2-7 = gonorrheaeDay 7+ = chlamydiaWeek 3+ = herpes *erythromycin or silver nitrate

MTBs Step 2CK (20 decks)

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