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Uworld/shelf > Peds > Flashcards

Peds Flashcards

1
Q

most common bugs in Retropharyngeal abscess

A

Strep pyogenes
Staph aureus
oral aneaerobes

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2
Q

retropharyngeal abscess is an infection of what space

A

space between pharynx and vertebral fascia

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3
Q

widening of prevertebral space on neck XR

A

suggests retropharyngeal abscess

confirmed by CT with contrast

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4
Q

thumb sign on lateral neck XR

A

epiglottitis

swollen epiglottis

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5
Q

what pts get Pvalizumab for RSV ppx?

A

children <2 years and have

  • preterm <29 wks
  • chronic lung disease of prematurity
  • HD signific congenital heart disease
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6
Q

complications of bronchiolitis

A

apnea, respiratory failure

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7
Q

most middle ear infections are caused by what bugs

A

strep pneumo
moraxella
H flu

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8
Q

treatment for history of acute rheumatic fever now with MR but otherwise healthy?

A

IM penicillin every 3-4wks for secondary prevention of ARF

pts with h/o ARF at high risk for recurrence and progression of rheumatic heart disease with subsequent group A strep infection

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9
Q

total iron binding capacity is a measure of

A

transferrin

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10
Q

stranger anxiety timing

A

starts 6 months
peaks 8-9 months
resolves 2 years

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11
Q

separation anxiety resolves when

A

18-24 months

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12
Q

Kawasaki diagnosis

A

fever >= 5 days and at least four of:

  1. conjunctivitis
  2. mucositis (erythematous fissured lips, strawberry tongue)
  3. rash
  4. extremity changes
  5. cervical LAD >1.5cm
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13
Q

lab findings supportive of kawasaki

A 
high CRP
hypoalbuminemia
sterile pyrua
anemia
thrombocytosis
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14
Q

describe the three types of renal tubular acidosis

A

1 (distal)

  • poor hydrogen secretion
  • high urine pH

2 (proximal)
-poor bicarb resorption

4
-aldosterone resistance

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15
Q

hexagonal crystals on UA

A

cystinuria

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16
Q

maneuvers to fix radial head subluxation

A

apply pressure to radial head and

forearm hyperpronation
or supination plus flexion

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17
Q

kid with radial subluxation keeps hand in __ position

A

pronated

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18
Q

Crigler Najjar

A

absent uridine diphosphate glucuronosyl transferase

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19
Q

Gilbert

A

mild deficiency uridine diphosphate glucuronosyl transferase

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20
Q

rash on trunk –> groin, axilla –> peeling hands and feet

with headache, fever, sore throat

A

scarlet fever - strep pyogenes

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21
Q

bilirubin threshold for phototherapy

A

20

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22
Q

tx minimal change disease

A

corticosteroids

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23
Q

WAGR

A

wilms tumor
aniridia
GU abnormalities
retardation

screening u/s for wilms q3mo

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24
Q

signs/sxs HUS

A

thrombocytopenia
microangtiopathy hemolytic anemia
AKI

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25
Q

Atomoxetine moa

A

selective NE reuptake inhibitor

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26
Q

most common heart defect in Down’s syndrome

A

complete atrioventricular septal defect

failure of endocardial cushions to merge –> both ASD and VSD

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27
Q

Tetralogy of Fallot

A
  • pulmonic stenosis
  • overriding aorta
  • VSD
  • RV hypertrophy
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28
Q

clinical findings of complete atrioventricular septal defect

A
  • heart failure (blood mixing between chambers and severe AV valve regurg leading to vol overload)
  • fixed split S2 (delayed pulm valve closure from flow across ASD)
  • systolic ejection murmur due to increase pulmonic flow from the atrial septal defect
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29
Q

what happens to most innocent murmurs upon valsalva or standing?

A

decreased intensity with maneuvers that decr blood flow to the heart

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30
Q

lymphocyte predominant leukocytosis

A

bordatella pertussis

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31
Q

firstline therapy for immediate effects on night time enuresis

A

desmospressin; decreases urine production

enuresis alarm is best but takes 3-4 months

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32
Q

what should you counsel pts on desmopressin?

A

minimize water intake to prevent hyponatremia

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33
Q

how to differentiate peripheral from central precocious puberty?

A

central has high LH

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34
Q

path and symptoms of intussception

A

ileum telescopes into cecum -> pain, obstruction edema -> compression of blood vessels -> bowel ischemia -> rectal bleeding (currant jelly stools)

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35
Q

well appearing infant with painless, bloody stools

A

suspect food-protein induced allergic proctocolitis

manage by eliminating maternal consumption of diary and soy

or switch to hydrolyzed formula

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36
Q

risk factors for baby intraventricular hemorrhage

A

prematurity (highest risk <32 wks; germinal matrix involutes at 32wks)

very low birth weight

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37
Q

imaginary friends are most common at what ages?

A

3-6 years

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38
Q

overlapping fingers

retrognathia

A

edwards syndrome

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39
Q

kid with recurrent staph abscesses

A

CGD

impaired NADPH oxidase complex
can’t form hydrogen peroxide

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40
Q

risk factors for acute OM

A

young age (6-18mo)
smoke exposure
daycare
no breastfeeding

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41
Q

common bugs bacterial rhinosinusitis

A

H flu

Strep pneumo

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42
Q

treatment bact rhinosinusitis

A

amox + clavulanate

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43
Q

diagnostic criteria bact rhinosinusitis

A

1 of any:

  • persistent sxs >=10 days without improvementt
  • severe onset (fever >102.5 and drainage) for 3 or more days
  • worsening sympttoms after initial improvemen
44
Q

osteoid osteoma

A
  • worse at night, unrelated to activity
  • classic: responds to NSAIDs
  • single small round lucency
45
Q

Ewing sarcoma

A
  • onion skinning
  • worse with activity
  • doesn’t improve with NSAIDs
46
Q

osteosarcoma

A
  • chronic localized pain
  • soft tissue mass
  • XR bony destruction with sunburst pattern of periosteal reaction
47
Q

high fever, cramping, diarrhea that becomes bloody

A

shigella

48
Q

key lab finding of hereditary spherocytosis

A

elevated MCHC

49
Q

microcytic anemia, elevated retics

A

thalassemia

50
Q

list the 4 types of hypersensitivity reactions, underlying immunology, and example causes

A

Type I (immediate): IgE, anaphylaxis, urticaria

Type II (cytotoxic): IgG, IgM autoantibody; autoimmune hemolytic anemia, Goodpasture

Type III (immune complex): antibody-antigen complex deposition; serum sickness, post strep glomerulonephritis, lupus nephritis

Type IV: T cell and macrophage; contact dermatitis, tb skin test

51
Q

fever, weight loss, Horner’s syndrome; MRI with cervical paravertebral mass

A

Neuroblastoma

most common extracranial solid tumor of childhood!

tumor of neural crest cells, which give rise to adrenal medulla and sympathetic ganglia

52
Q

swimming pool, large macules - name of condition and causative organism?

A

tinea versicolor - Malessezia

53
Q

cause of hand and foot swelling in turner syndrome

A

lymphatic dysgenesis (occurs in half of Turner pts)

54
Q

ppx options for close contacts of meningitis

A

ceftriaxone, ciprofloxacin, rifampin

55
Q

pathophys hereditary angioedema

A

C1 inhibitor deficiency -> elevated bradykinin -> edema

autosomal dominant

56
Q

joint effusion after minor trauma, suspect _

A

hemophilia

get coags = prolonged PTT, normal PT and platelets

57
Q

Hemolytic Uremic Syndrome triad

A
  • hemolytic anemia
  • acute kidney injury
  • thrombocytopenia
58
Q

stable pt can be observed with repeat imaging in 12-24hr if a sharp FB is distal to the __

A

proximal duodenum (at this point, usu will be excreted uneventfully)

59
Q

bedwetting is normal until age _

A

5

60
Q

what screening tests should be done at time of Duchenne muscular dystrophy diagnosis?

A

Echo and EKG

absent dystrophin in cardiac muscle can lead to dilated CM and conduction abnormalities

61
Q

when should you consider tympanocentesis with culture

A

> =3 AOM in 6 months

persistent >3 mo middle ear effusion with hearing loss

62
Q

why can refeeding syndrome be fatal?

A

feeding stimulates insulin release

insulin promotes cellular uptake of electrolytes (eg phosphorus, Mg) resulting in electrolyte deficiency which can cause cardiac arrythmia

63
Q

definition primary amenorrhea

A

14yo with no secondary sexual char

15yo with secondary sexual char

64
Q

when do electrolyte abnormalities manifest in infants w/ CAH?

A

1-2 weeks

earlier than that, normal levels bc of maternal adrenal hormones

65
Q

bruising, petechiae, bleeding, hepatosplenomegaly, nontender lymphadenopathy
bone pain

nonspecific sxs- fever, fatigue, weight loss

A

ALL

nonspecific systemic symptoms

66
Q

post concussive syndrome definition, cause, time to resolution

A

> 4 weeks concussion sxs (HA, sleep disturbance)

due to not following gradual return to play protocol
most pts improve within 3 months

67
Q

symptomatic management of conscussion

A
  • headache (eg amitriptyline)
  • CBT (for insom, anxiety)

reassurance if mild sxs

68
Q

liver biopsy Reye syndrome would show

A

microvesicular fatty infiltration

69
Q

triple bubble

A

jejunal atresia

not a/w chromosomal abnormalities
due to vascular insult eg maternal cocaine use

70
Q

long limbs, scoliosis, joint hypermobility
lens dislocation
aortic root dilation

condition? biochemical cause?

A

Marfan’s

mutation in fibrillin 1 gene

71
Q

cause of methemoglobinemia

A

Hemoglobin gets oxidized to Methemoglobin (which can’t transport O2) by an oxidizing agent (eg lidocaine prilocaine)

low SpO2 that doesn’t improve with oxygen (will stay same bc the way methemoglobin is measured on pulse ox)

falsely normal PaO2 (bc only measures unbound arterial oxygen)

saturation gap - more than 5% diff between pulse ox and ABG

72
Q

treatment of methemoglobinemia, how does it work

A

IV methylene blue, helps reduce the methemoglobin

high dose vitamin C is reducing, can be used when don’t have methylene blue or contraindicated (eg G6PD deficiency)

73
Q

anemic child with history of ileum resection from nec enterocolitis most likely deficient in __. why?

A

B12

IF-B12 complex absorbed when it binds receptors in distal ileum

74
Q

juvenile pernicious anemia cause

A

can’t secrete intrinsic factor

75
Q

maternal B12 from placenta lasts __

A

1-2 years

76
Q

pts w/ Beckwith-Weidemann should get what tests routinely and why?

A

from birth to age 4:
abdominal u/s - wilm’s tumor
AFP- hepatoadenoma

from age 4-8:
renal ultrasound

77
Q

what are howell jolly bodies

A

RBC nuclear remnants

78
Q

what is in basophilic stippling

A

precipitated ribosomal ribonucleic acid

79
Q

most effective med for Tourette (after failure of habit reversal therapy)

A

antidopaminergic (Tetrabenazine, antipsychotics w antidopa)

80
Q

palpable purpura
abdominal pain
arthritis
nephropathy, hematuria

A

Henoch Schonlein Purpura

81
Q

path of Henoch Schonlein Purpura

A

IgA immune complex deposition

82
Q

type of stridor in laryngeomalacia vs tracheomalacia and why

A

laryngeomalacia - inspiratory stridor (decr pressure beyond larynx leads to airway narrowing)

tracheomalacia- expiratory stridor (increased intrathoracic P during expiration)

83
Q

most common pneumonia isolate in children and infants with CF

A

staph aureus!

84
Q

paroxysmal phase of pertussis can last ___

A

4-6 weeks

85
Q

vit K important in hepatic activation of what factors?

A

2, 7, 9, 10, proteins C and S

86
Q

children age __ should get renal and bladder u/s after first febrile UTI

A

<2

87
Q

myelomeningocele is a/w with what abnormality

A

chiari II malformation

loss of CSF thru the neural tube defect –> collapse of cranial structures –> small posterior fossa –> medulla and cerebullum get displaced downward

88
Q

pathogenesis post strep glomerulonephritis

A

deposition of antibody-antigen complexes in mesangium and BM

89
Q

tanner stage when breast forms secondary mound

A

IV

90
Q

treatment von willebrand and mechanism

A

desmopression (IV or intranasal) - causes release of vWF from endothelial cells

91
Q

first sign of puberty in a boy

A

testicular enlargement

92
Q

DKA lab findings

A
  • low Na (dilutional and renal losses)

- high Cr (hypovolemia)

93
Q

how do you calculate anion gap

A

Na - (HCO3 + Cl)

94
Q

what is considered elevated AG

A

> 12

95
Q

Diagnostic criteria for DKA

A

3 criteria:

  • random BG >200
  • venous pH <7.3 or bicarb <15
  • mod/large ketonuria or ketonemia
96
Q

Diagnostic criteria for DM

A

-A1C >=6.5%
-fasting gluc >=126
-2 hour gluc >= 200
(all above need repeat testing)

OR
classic sxs hyperglycemia and random gluc >=200

97
Q

oily nonbloody foul smelling diarrhea

A

giardiasis

98
Q

mechanism giardiasis

A

disrupts tight junctions between small intestine enterocytes –> malabsorption lasting up to a month

99
Q

diagnostic test for PKU for a baby that didn’t get screened

A

quantitative amino acid analysis (elevated Phenylalanine levels)

100
Q

most Duchenne’s patients die from what

A

cardiac/respiratory failure

101
Q

painless rectal bleeding

A

Meckel diverticulum

102
Q

diagnosis of Meckel

A

technetium 99 scan

103
Q

brain tumor: ataxia, truncal instability

A

medulloblastoma

104
Q

preteen irritable
doesn’t want to hang out with friends
leave me alone
grades going down

A

Major depressive disorder

105
Q

microcephaly
cleft lip
distal phalange hypoplasia
wide anterior fontanelle

A

fetal hydantoin syndrome, from exposure to antiepileptics in utero

106
Q

in dehydrated child, what is the ratio of acute weight loss to fluid loss?

A

1kg = 1L

107
Q

disruptive mood dysregulation disorder

A

PERSISTENTLY irritable, not episodic

easily set off, out of proportion responses

Uworld/shelf (5 decks)

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