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Extra flash cards - MCCQE1 > Peds > Flashcards

Peds Flashcards

1
Q

Foreign body ingestion Rx?

A
  1. < 24 HR + no resp Sx
    Foley Cath
    Bougienage
  2. > 24 or resp Sx
    Endoscopic removal
  3. > 2wks
    Need surgical
    Risk of erosion!
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2
Q

Murmurs in:

  1. PDA
  2. Tetralogy of Fallot
  3. Tricuspid atresia
  4. Aortic coarctation
  5. Total anomalous
A
  1. PDA = continues machinery murmur at left upper sternal
  2. Tetralogy = SEM at left upper/mid-sternal + loud S2
  3. Tricuspid atresia = SEM at left lower sternal
  4. Coarctation = SEM at left upper sternal radiates to inter-scapular space + wide pulse pressure.
  5. Total anomalous = SEM + diastolic rumble + fixed wide split S2
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3
Q

Gasoline poisoning Rx?

A

CVS + Resp support
No antidote
Gasoline poorly absorbed by gut = no need for lavage or charcoal.

If Sx present = CXR 2hr post ingestion + observed in ER for 6 hrs.

Abnormal CXR = admit for blood gas + re-CXR + resp support.

Normal CXR + no Sx = discharge.

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4
Q

Organism of erythema infectiosum / 5th Dz?

A

Parvovirus B19

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5
Q

How to determine if wheeze in child is foreign body?

A

CXR:
Focal infiltration or atelectasis
+
Radio-opacities

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6
Q

Dx of Hirschsprung?

A

Rectal Bx

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7
Q

CPR in children Compression-to-Ventilation ratio.

A
  1. Single rescuer:
    30:2
    Compression = 100 bpm
  2. 2 rescuers:
    15: 2
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8
Q

What drug can be used in croup but not bronchiolitis

A

Oral steroid.

NB: neb epi is beneficial in both.

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9
Q

Apnea in infant? Rx

A
  1. If self-correcting, ass w/ feeds = no admission.

2. If sever, life-threatening = admit for observation.

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10
Q

Facts about club foot:

  • M:F
  • Deformity affects walking?
  • Rigid type Rx?
  • Corrected deformity needs long FU?
  • After Rx participate in usual activity?
A
  • 2:1
  • Rigid can be Rx w/ cast but may need surgery
  • affects walking
  • need FU, risk of recurrence
  • Go back to normal after Rx
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11
Q

Neonate hours after birth develops tachypnea + cyanosis?

Dx?

A

TTN
Supplement O2
CXR

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12
Q

What’s herpangina?

A

Ferbrile disease by Coxasackie virus.

Sx = oropharyngeal vesicles + ulcers

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13
Q

Sx of herpangina

Rx?

A

Sudden fever
Neck pain
Then 2 days later grey plaques => vesicles

Mostly on tonsillar pillars

Rx: symptomatic

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14
Q

When is the age for bladder and fecal control?

A

Bladder: 5
Fecal: 4

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15
Q

1ry vs 2ry enuresis

A

1ry: no dry period
2ry: dry period > 6months

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16
Q

Investigation in 2ry enuresis?

A

UA

R/o: DM, DI, over active bladder, cystitis, psychological, seizures.

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17
Q

Child safety seat:

  • Stage 1 (Rear facing)
  • Stage 2 (Forward)
  • Stage 3 (Booster)
  • Stage 4 (Seatbelt)
A
  • Stage 1:
    At birth
    In infant seat.
  • Stage 2:
    At least 1 Yr + 10 Kg
    Forward in infant/child seat
  • Stage 3:
    At least 18 kg
    Child/booster seat

Stage 4:
At 36 Kg and 145 cm
Seatbelt

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18
Q

Henoch-Schonlein purpura triad?

A

Purpuric rash
Abdominal pain/renal failure
Joint pain

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19
Q

Type of purpura in HSP?

A

Non-thrombocytopenic purpura

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20
Q 
Causes of neonatal jaundice by time? 
<24
1 - 3 days
3 - 4 days
> 1 week
A
  1. <24 hr:
    ABO/Rh
    Sepsis
2. 1-3:
Physiological
Breast feeding 
Hemolysis 
Sepsis
  1. 3-4:
    Physiological
    Breast feeding
    Sepsis
4. > week:
Hypothyroid 
Hepatitis 
Gilbert's : Crigler-Nijjar
Biliary obstruction 
Metabolic error
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21
Q

Rx of viral URTI in neonates?

A

Nasal rubber suction bulbs

NS nasal drops

Cool-mist humidifiers

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22
Q

MCC of anemia in children?

A

Iron deficiency

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23
Q

Average birth weight? What happens in first few days then 1-2 wks?

A

3.5 kg

Baby drops 10% (loss of excess fluid)

In 1-2 weeks baby regain weight

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24
Q

What must be supplemented in breast fed infants?

A

Vit D

Risk of rickets

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25
Q

Diarrhea by Aeromonas enteritis?

A

Short IP: 1-2 days
Watery diarrhea + fever
In developing countries

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26
Q

MCC of travelers diarrhea?

A

Enterotoxiigenic E. coli

Short IP: 1-2 days.

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27
Q

IP of giardia lambilia?

A

1-2 weeks

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28
Q

MCC of CAH?

A

21-hydroxylase

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29
Q

Signs of premature infant?

A

Scant ear cartilage
Absent breast buds
Thin skin
Hypotonic posture at rest

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30
Q

Vaccines at 2 mo

A 
DTaP
Hib 
IPV
PCV-13
Rot-1
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31
Q

Drugs cause gynecomastia

A

Antibiotics (isoniazid, ketoconazole, metronidazole)

Cimetidine

Captopril

Digoxin

Hormones

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32
Q

Assess severity of dehydration

A 
1. Mild:
HR: N or high
BP: N
Sunken eyes: no
Urine: normal
2. Moderate:
HR: high
BP: N
Eye: sunken 
Urine: low 
3. Sever:
HR: High 
BP: L
Eyes: sunken 
Urine: none
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33
Q

Accetaminophen toxicity

A

< 2 HR
Activated charcoal

< 8 HR
N-acetylcysteine (Oral > IV)

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34
Q

T/F: Rotavirus is not associated with URTI

A

T

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35
Q

MC nutritional def in kids

A

Iron def anemia

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36
Q

Sx of Atlanto-axaial instability in down

A 
Torticollis
UMN Sx (gait, DTR, clonus..)
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37
Q

What’s head tilt test?

A

Tilt patients bed to Dx syncope.

Cardio = HR < 40

Vasodepressor = HR drops <10%

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38
Q

T/F: orchitis is more common in kids than torsion

A

Testicular torsion is more common

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39
Q

MCC of otitis media

A

S. pneumonia

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40
Q

New born foot deformity:

Convex lateral border + adduction of forefoot + normal ankle

A

Metatarsus adductus

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41
Q

Facts about metatarsus adductus

A

LFT > Rt
F > M
80% spontaneous resolution w/in 1 Yr

If not resolved w/ stretches => serial casting

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42
Q

MC complication of carniopharyngioma

A

Central DI

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43
Q

Innocent murmur in strept. Infection

A

SEM
Grade < 3
Not Sx
No thrill or radiation

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44
Q 
Central DI labs?
Serum Na
Urine Na
Extra cellular fluid 
Plasma arginine vasopressin
A

High serum Na
Low urine Na
Normal ECF
Low plasma arginine

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45
Q

Source of carniopharyngioma

A

Rathke’s pouch

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46
Q

MCC of septicemia in infants

A

GBS = strep. Agalactia

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47
Q

Risks of GBS septicemia

A

Pre-mature rupture > 24 hrs before delivery

Chorioamnionitis

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48
Q 
What's syndesmotic sprain? 
Injury?
Dx?
Rx?
Complications?
A

High ankle sprain
Affects anterior, posterior, transverse tibiofibular ligaments + interosseous membrane.

Contact sports = dorsiflexion +/- inversion of ankle

Dx: squeeze test (compress fibula against tibia at mid-calf) pain if +ve.

External rotation stress test by stabilizing leg and externally rotate foot > pain if +ve

Crossed leg test: place involved ankle opposite to knee and pressure applied to medial side of ankle > pain if +ve

Rx: semirigid support

Complication: ankle instability > hypertrophic ossification

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49
Q

Fragile X mutation

A

CGG repeats on Ch X

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50
Q

MCC of inherited mental retardation

A

FXS

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51
Q

Hallmark of constitutional delay

A

Being <50th most of childhood

Bone age < real age

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52
Q

Before Dx constitutional delay what must be checked?

A

Signs of puberty by age 14.

If no Sx = needs work up

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53
Q

Bug in erythema infectiosum (5th)

A

Parvovirus B19

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54
Q

Labs in failure to thrive

A

Normal

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55
Q

MCC of UTI in kids

A

E. coli 75-90%

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56
Q

Risk factors for UTI in kids

A

Female gender

Vesicouretral reflux

Anatomical abnormalities: (posterior urethral valve, ectopic ureter)

DM

Wiping techniques

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57
Q

Approach to baby w/ UTI

A

1st time: UA + C/S

Recurrent: UA + C/S + US + VCUG

VCUG indications:
F < 2 yrs
F > 5 yrs w/ recurrent UTI 
Male w/ UTI
Febrile child w/ UTI
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58
Q

MC organism in
1. human bite

  1. Cat/dog
  2. Goat/sheep
  3. Rabbits
  4. Prairie dog/rat flea
A
  1. Human: Eikenella (G-ve rod)
  2. Cat/dog: pasturella
  3. Goat/sheep: brucella melitensis
  4. Rabbits: Francisella tularensis
  5. Prairie dog/rat flea: yresinia pestis
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59
Q

Heinz bodies are seen in what anemia?

A

G6PD

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60
Q

How to Dx accessory nipple?

A

Remnants on mammary line

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61
Q

Salt wasting variant of congenital adrenal hyperplasia

  • Enzyme missing
  • Sx
A
  • 3B-hydroxysteroid dehydrogenase
  • infancy => vomiting, diarrhea, dehydration, arrhythmia, cyanosis, ambiguous genitalia
    ( hypospadias, bifid scrotum, cryptorchidism)
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62
Q

Sleep apnea test

A

Polysomnography

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63
Q

Most helpful labs in assessment of acute asthma in kids?

A

FEV1
PEF
Pulse oximeter

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64
Q

Prolonged bleeding after circumcision in otherwise healthy

A

Hemophilia A

Factor 8 doesn’t cross placenta => early Sx

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65
Q

MC Sx in spondylosis

A

Low back pain radiates to buttocks / posterior thigh.

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66
Q

Otitis media Rx contraindicated in kids

A

Fluoroquinolones

Cipro, levo, fluxa,

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67
Q

Prophylaxis to HiB

A

Rifampin

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68
Q

Klinefelter (KLINE)

Turner (TURNER)

Edwards (EDWARDS)

Prader Willi (PRADER)

Fragile X (FRAGILE)

A 
Klinefelter 47 XXY
Killer (aggressive + antisocial)
Large breast 
Non disjunction 
Elevated (tall)
Tuner 45XO
Tight aorta (coarctation)
Undersized (short)
Renal (horseshoe)
Nipple spacing
Edema 
Reproductive failure (ovarian)
Edwards trisomy18 
Eighteen 
Digit overlapping flexion 
Wide head 
Absent intellect 
Rocker-bottom feet
Diseased heart
Small jaw 
Praderwilli 
Imprinted 15q 
Paternal
Runt (short)
Almond eye 
Delay (mental)
Eats lots 
Rt HF
Fragile X
FMR1 gene 
Repetitive behavior 
Anticipation CGC 
Gnathism (protruded jaw)
Intellectual impairment 
Large ears
Everted ears
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69
Q

Incidence of nasolacrimal duct obstruction?
Path?
Dx?
Sx?

A

5% infants

Obstruction at valve of Hasner (distal end)

Dye disappearance test (all fluorescein drains in 5 min)

Sx: tearing

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70
Q

Causes of nasolacrimal obstruction

A

Congenital

Acquired (sarcoidosis + wegners)

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71
Q

Rx of nasolacrimal obstruction

A

Massage duct area

90% spontaneous resolution

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72
Q

What can babies eat at
4-6 mo
12-18 mo
18 mo - 3yr

A

4-6 mo
Solid food + juices

12-18 mo
Egg, potatoes, iron-fortified cereal margarine

18 mo - 3yr
Meat, bread, fruit

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73
Q

Baby
Holosystiloc murmur at lower left sternum

Can’t breath
Can’t feed

Infections

A

VSD

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74
Q

MCC of hearing loss in infants

A

Genetic

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75
Q

Rx of sinusitis

A

Amoxicillin
Cefuroxime

Allergic = clarithromycin or azithromycin

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76
Q

Role of fundal exam in seizure

A

To see if it’s the 1st seizure

Papilledema, retinal hemorrhage = repetitive seizures

If febrile seizures to confirm it’s one time only.

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77
Q

Vaccines at 2 mo

A 
DTaP
IPV 
HiB
Pneumococcal C-14
Rotavirus
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78
Q

Vaccines at 4 mo

A 
DTaP
IPV
HiB
Pneumo-C-13
Rotavirus

Same as 2 mo

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79
Q

Vaccines at 6 mo

A

DTaP-
IPV
HiB
Flu

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80
Q

Vaccines at 12 mo

A

Meningococcal
Pneumococcal C13
MMR

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81
Q

Vaccines at 15 mo

A

Varicella; chicken pox

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82
Q

Vaccines at 18 mo

A

DTaP
IPV
HiB

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83
Q

Vaccines 4-6 yr

A

MMRV
Tdap
IPV

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84
Q

Cow milk should be avoided until baby reaches?

Why

A

12 mo

Low Vit E, iron, FFA
High protein, Na, K

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85
Q

What Sx is a must in necrotizing enterocolitis

A

Bloody diarrhea

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86
Q

MCC of HTN in adolescent

A

Essential 85-95%

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87
Q

When to do cryptorchidism for undescended testis?

Why

A

At 1 Yr

To preserve spermatogenesis.
100% chance of infertility if > 1yr

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88
Q

Galactosemia
Path?
Sx?

A

Galactose-1-phosphate uridyltransferase deficiency

Sx:
Jaundice 
Cataract 
Failure to thrive 
Vomiting, diarrhea
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89
Q

What’s Developmental dysphasia of hip?

M:F

Ass

A

Subluxation + dislocation of hip

F> M

1st born F
Breech
Oligohydramnois

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90
Q

DDH Rx

A

Close reduction + pavlik harness + US

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91
Q

T/F: DDH Dx by hip X-ray

A

F

Not shown on X-ray need US

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92
Q

T/F: normal ESR + CRP role out septic arthritis

A

T

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93
Q

Teratogenicity in DM

A
  1. Sacral agenesis + lumbar vertebral anomalies (esp. caudal region)
  2. Macrosomia
  3. Congenital heart defects
  4. Anencephaly + neural tube, myelomenigocele, hydrocephalus, microcehalus
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94
Q

Rectal prolapse in kids

A

CF

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95
Q

Labs in anorexia

A

Low LH+ FSH

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96
Q

What sleep disorders occur at 1-2 HR and 2nd half of night

A

1-2 hr => parasomnia
Sleep walk and sleep terrors

Late => nightmares

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97
Q

Rx of idiopathic thrombocytopenic purpura

A

Observe

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98
Q

Sx of idiopathic thrombocytopenic purpura

A

Bruise

Hx of infection

PLT < 100 + large PLT on smear

Normal Hg + WBC

Normal coagulation profile

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99
Q

Pneumonia in infants < 6mo

At winter

A

Resp syncytial virus

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100
Q

Drug cause acne

A 
Phenytoin 
Steroids 
Anabolic steroid 
DHEAS
OCP
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101
Q

Baby with low Hg + no lead

A

Trial of iron for 1 mo

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102
Q

RSV vs C. Trachomatis

A 
- C. Trachomatis:
Conjunctivitis 50%
Hyperinflation + diffuse infiltrates. 
Wheeze + rales
Eosinophilia
  • RSV:
    Rhinorrhea + pharyngitis
    Hyperinflation
    Wheeze + rales
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103
Q

EEG of absence seizure

A

Generalise symmetric three per second spike

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104
Q

Risks for deafness in newborn

A 
FHx
Gentamicin 
CMV, toxo or herpes
Low apgar score 
Low birth weight 
Oxygen deprivation in birth
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105
Q

Risks for sudden infant death

A

Sleep in prone position or on side.
Sleep on soft bedding
Sleep with stuffed toys
Bed sharing

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106
Q

T/F: sleeping with pacifiers reduce risk of sudden infant death

A

T

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107
Q

Rx of nursemaid elbow fracture

A

Subluxed Radial head reduction (hyperprobation > flexion)

Sling is helpful
No wrist splint
No long arm cast

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108
Q

Familial vs constitutional vs growth hormone deficiency (short stature)

A 
Constitutional;
Delayed bone age 
Delayed puberty 
Normal velocity 
FHx

Familial:
Normal bone age
Puberty on time

Growth hormone:
Delayed bone age
Growth <3rd percentile
Low growth velocity

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109
Q

MCC of epistaxis in kids

A

Nose picking > mucosal irritation (allergic rhinitis)

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110
Q

Sx of osteogenesis imperfecta

A 
Blue sclera 
Multiple fracture 
Barrel chest 
Joint laxity 
Microcephaly 
Translucent teeth (opalescent)
Hearing loss
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111
Q

Defect in osteogenesis imperfecta

A

De novo mutation in collagen 1

Sometime FHx

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112
Q

MC sequela of congenital CMV

A

Hearing loss

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113
Q

What’s an innocent murmur

A

At 2-6 yr
Systolic grade 1-2
Pitched murmur at lower left sternum

Changes with sitting and standing

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114
Q

Complication of stills murmur

A

None its innocent

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115
Q

Pathology in total anomalous pulmonary venous return

A

Pulm. veins don’t connect to left atrium

Pulm. venous return enters systemic venous circulation via embryonic connection

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116
Q

Sx of TAPVR

A

Pulm HTN + edema
Cyanosis
Parastenal loud S2

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117
Q

Bilateral parotid gland enlargement

A

Bulimia

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118
Q

Russell sign in bulimia

A

Callosities on knuckles

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119
Q

Rx pediculosis in kids

A

Permethrin 1%

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120
Q

Bacterial conjunctivitis is infectious until?

A

Rx started

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121
Q

Viral infection has late neuro complication (baby seizure, ataxia, quadriplegic)

A

Measles

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122
Q

Sx of perinatal asphyxia

A

Hypotonia + low movement
Loss of primitive reflexes
Seizures
Abnormal posture

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123
Q

Koplik spots

A

Measles

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124
Q

Infant suddenly flexes arms + forward lean of trunk + extends legs

5 sec

A

Infantile spasm

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125
Q

T/F: infantile spasm asso. with other seizure

A

True

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126
Q

What’s rabies

A

Viral infection in saliva and peripheral nerve

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127
Q

Sx of rabies

A

Pain at site of bite
Encephalitis, confusion, hallucination,

Hydrophobia = can’t drink because of laryngeal spasm.

Paralysis.

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128
Q

Dx of rabies

A

Skin biopsy form neck

Animal brain tested

129
Q

Rx of rabies

A

Death in 3-10 day if not Rx

Prevention:
- pre-exposure: vaccine

  • post-exposure:
    Clean area w/ soap + water
    Vaccine + IG
130
Q

Rabies post-exposure

A
  1. Demotic animal + no Sx
    Observe animal 10 days:
    No Sx = nothing
    Sx = vaccine + IG
  2. Domestic + Sx
    Vet check animal to Dx
    If confirmed => vaccine + IG
  3. Wild animal
    Capture + kill animal + test brain for rabies.
    If + => vaccine + IG
  4. Wild animal
    Can’t capture => give vaccine + IG
131
Q

Infantile colic criteria

A

Excessive crying >3 Hr day > or = 3x week for 3 weeks

132
Q

T/F: premature infants should use safety seats with restraints that don’t have shields, pads, arm rests.

A

T

Case neck injury during impact

133
Q

T/F: safety seat is secure if it moves < 5 cm in each direction

134
Q

Pyloric stenosis facts:

  1. M:F
  2. MC age
  3. Rarely affects babies older than
A

M > F

MC at 3-5 wks

Rare after 12 wks

135
Q

MCC of unilateral breast mass in males < 12

A

Breast development

Assure + repeat in 1 yr

136
Q

Papile Grading system for internevtricular hemorrhage + ventricular dilatation

A

Grade 1:
Subependymal
Mostly asymptomatic

Grade 2:
Intraventricular w/o ventricular dilatation

Grade 3:
Intraventricular + dilatation

Grade 4:
Intraventricular + parenchyma

137
Q

Strider when baby lies down

A

Laryngialacia

Immature cartilage = collapse of airway in inspiration

138
Q

Dx laryngiomalacia

139
Q

Cause of neonatal physiological jaundice

A

Temporarily impaired hepatic clearance of bilirubin

140
Q

Congenital hypothyroid Sx

A 
Hypotonic 
Big tongue 
Big forehead 
Umbilical hernia
Dry yellow skin
Brittle hair
141
Q

Jones criteria for rheumatic fever

A 
Major:
Joint 
Carditis (MV)
Nodules 
Erythema marginatum 
Sydenham chorea
142
Q

Antiviral contraindicated in babies < 7

143
Q

Antiviral not for influenza A

A

Amantadine

Rimantadine

144
Q

Rx of derm herpitiformis

A

Dapsone

Gluten free diet

145
Q

Scaly papular rash after pharyngitis

A

Guttate psoriasis

146
Q

Peak age for febrile seizure

A

6 mo - 5 yrs

147
Q

Rx of impetigo

A

Dicloxacillin

Cephalexin

148
Q

Skin infection and its fluctuant area? Rx

A

IV vanco for MRSA

Till culture result

149
Q

Complication of meningitis

A

Sensorineural deafness 6 wks post Rx

150
Q

Resp distress in neonate CXR

A

Ground glass atelectasis

Air bronchogram

151
Q

How to divert child attention during abd. exam

A

Place child hand on top of yours give him sense of control

152
Q

T/F: kids 2-6 Yrs feel responsible for death of loved ones

153
Q

Can 2-6 Yr olds attend funerals

A

Yes but must be accompanied by adults for support

154
Q

Minor jones criteria

A 
Arthralgia 
Fever 
ESR 
CRP
Prolonged PR
155
Q

Heart X-ray in tetralogy of fallot

A

Boot shaped heart

156
Q

Malformations tetralogy of fallot

A

Pulm valve stenosis
VSD
Overriding aorta
Rt ventricular hypertrophy

157
Q

Cause of systolic murmur tetralogy of fallot

A

Pulm. stenosis

158
Q

MCC of scoliosis

A

Idiopathic

159
Q

Inheritance in hemophilia A + B

A

XL-recessive

160
Q

XL-recessive transmission to kids

A

All girls carries

No boy affected

161
Q

MC child abuse in Canada

A

Child neglect

162
Q

When is scoliosis significant

A

> 10 degrees

163
Q

Rx of functional abdominal pain

A

Spontaneous resolution in 2 wks.

Remain active
Address emotional stress
Cope with Sx and prevent 2dry gain of child.

164
Q

Rx of primary enuresis

A

Motivational + positive reinforcement for 6 mo

165
Q

Nasal polyps in child Dx?

166
Q

Athlete with proteinuria

A

Exercise induced

Transient + nonpathological

167
Q

Approach to exercise induced proteinuria

A

UA repeated 48-72 HR from exercise

168
Q

New born in distress

CXR: fluid in fissure

169
Q

NSAIDs SE?

A 
N/V
Diarrhea / constipation 
Low appetite 
Rash
Dizziness + headache 
Tinnitus 
Edema 
Kidney failure, liver failure 
Ulcer
170
Q

Rx tet spells

A

Rt-Lt shunt => cyanosis

Rx;
Neosynephrine
Knee-chest
IV morphine (last)

171
Q

Nitroglycerin in tet spells

172
Q

T/F: pertussis vaccine could cause infantile spasm

173
Q

MCC of poor weight in babies

A

Inadequate caloric intake

174
Q

Survival rate in patau

A

90% die in first year

175
Q

1st line Rx impetigo

A

Topical Abx

176
Q

Head banging in kids
Prevalence?
Age?
Prognosis?

A

3-15% of 5-11 mo old

Sx resolve spontaneously by age 3

177
Q

T/F: head banging is higher in developmental delay syndrome

A

T

More in down , autism , leach-nyhan

178
Q

IP of varicella (chickenpox)?

A

10-20 days

179
Q

T/F: chickenpox patient should be in resp isolation till no new lesions appear

180
Q

When is varicella not infectious

A

Lesions are crusted

181
Q

Labs in bone age < real age

182
Q

Age of anterior fontanelle closure

183
Q

FU of early anterior fontanelle closure

A

Head measurements to R/o: craniosynostosis + abnormal brain development.

184
Q

When to give Abx in sinusitis

A
  1. Sx for 2 weeks
  2. Fever 39
  3. Facial pain / swelling
185
Q

MCC of pneumonia in kids?

Rx?

A

M. Pneumonia

Macrolides

186
Q

MCC of otitis externa

A

P. Aruginosa

187
Q

MC congenital abnormality of small bowel

188
Q 
What's spermatocele?
Dx?
Contents?
Rx?
Fertility?
A

Spermatic cyst

Cyst on upper pile of testis next to epididymis
Painless
Benign

Clear fluid
Dead sperms

No Rx

No effect on fertility

189
Q

MCC of leukocoria in well newborn

A

Cataract

DDx: retinoblastoma

190
Q

Rx of neonatal lupus heart block

191
Q

Antibodies in neonatal lupus

A

Anti-SSA/Ro

192
Q

Chubby 10 YO with hip pain
+ / - referred knee pain
Comfort in external rotation

A

Slipped capital femoral epiphysis

193
Q

Which one improves nutrition:

  • Play feeding games w/ healthy meals
  • healthy food for all meals including snack
A

Healthy food all day erry day

194
Q

T/F: stool culture is not part of septic work up

195
Q

Prepubertal with labial adhesions!
Cause?
Sx?
Rx?

A

Idiopathic

Girl fails pulled, can’t pee, UTI

Rx: topical estrogen

196
Q

Can bacterial conjunctivitis cause permanent damage

197
Q

What ophthalmological risk premature infants are at high risk of?

A

Retinopathy of prematurity

198
Q

Eye problem in cerebral palsy

A

Strabismus

199
Q

T/F: 5% permethrin is safe in 2 month baby

200
Q

1st sign of puberty in boys

A

Testicular enlargement

201
Q

At what tanner stage boys reach adult height

202
Q

What do you tell a short boy tanner <4?

A

He’ll grow taller

203
Q

Rx of vW disease

A

DDAVP

Cryoprecipitate

Factor 8

204
Q 
Baby with:
Nasal polyps 
Rectal prolapse 
Malnutrition 
Infertile

Dx?

205
Q

How much do babies with CF need to eat?

A

120-140% of daily recommended calorie intake

206
Q

T/F: inguinal hernia in kids closes spontaneously

207
Q

When to Rx inguinal hernia in kids?

A

ASAP

Risk of Ca and necrosis

208
Q

MCC of unilateral blindness in kids

209
Q

When does autospleenoectomy occurs in Sickle cell?

210
Q

Shaving vs permethrin 1% I. Pediculosis

A

Permethrin 1% is better

211
Q

What disease cause disproportionate short stature

212
Q

T/F: teratogens cause disproportionate short stature

A

F

Proportionate

213
Q

MCC of proportionate short stature

A

Constitutional delay

214
Q

MCC of HTN in < 10 Yrs

A

Renal disease = UA, US, Culture

215
Q

Most specific sign of peritonsillar abscess

A

Can’t open mouth = trismus

216
Q

Organism of cut. larva migrans

A

Hookworm from dogs + cats

217
Q

MCC of chronic otitis media in kids

A

Environmental i.e daycare + smoking + crowds + cleft palate

218
Q

Rx of absence seizure

A

Ethosuximide

219
Q

Occult bacteremia Sx

A

Fever only

220
Q

Palivizumab uses

A

RSV prevention in high-risk kids

Qmonths for 4mo starting nov - feb

221
Q

T/F: Norwalk virus sheds even after acute illness

222
Q

Is Norwalk virus resistant to environmental factors?

A

Yes! Even cont to shed after illness

223
Q

MCC of viral diarrhea in adults

224
Q

Best Rx in obese kids

A

Family-based + behavior-oriented programs

225
Q

Mom with DM

When to start screening her kids

A 
At 10 Yrs if have other risks the q2yr
 i.e obese 
FHx 
Black 
Sx of DM
226
Q

What’s little league elbow

A

Medial epicondyle

227
Q

T/F: preschool speech screening is strongly recommended

A

F

There’s no enough evidence to not do it but not very helpful.

228
Q

Flank painless mass in < 5 Yr DDx

A

Willms tumor

229
Q

What kind of Ca is willms tumor

230
Q

MCC of wheeze in infants

231
Q

T/F: infantile GERD resolves at 1 year

232
Q

Most effective Rx for asthma

A

Inhaled steroids

233
Q

In asthma leukotriebne vs LABA

A

LABA are more effective

234
Q

In allergic rhinitis:

Intranasal steroids vs leukotriene inhibitors

A

Intranasal steroids more effective

235
Q

What vaccine associated with egg allergy

A

Yellow fever > flu or MMR

236
Q

Fetal Alcohol syndrome Sx

A 
Smooth philtrum 
Thin upper lip 
Flat nose 
Clinodactyly (bent finger) 
Wide palmar crease end b/w 2-3 fingers 
Railroad ears 
Small eyes
237
Q

Anemia of lead poisoning

A 
Abdominal pain 
Neuro Sx (wrist drop)
Micocytic anemia
238
Q

Normal stages of puberty in F

A

Thelarche (breast)
Pubarche (hair)
Height peak
Menarche

239
Q

T/F: ovulatory cycles start 2 yrs after menarche

240
Q

What’s Dance Sign in intussusception

A

Rt hypochondrium sausage-shaped mass + empty RLQ

241
Q

Risks for sudden infant death

A
  1. Prone sleep
  2. Overheating (clothes, blankets)
  3. Cold weather
  4. Soft bedding
  5. Stuffed toys
  6. Smoke
242
Q

Best estimate of volume loss in dehydration

A

Weight change since disease.

243
Q

Lab indicates sever iron deficiency

A

High free erythrocyte protoporphyrin

244
Q

Roseola Sx

A

3 days of high fever then rash that fades in 2 days

245
Q

Rash in roseola

A

Maculopapular
Starts on trunk
Not itchy
Blanching

246
Q

HIV screen in babies of HIV+ mom

A

HIV DNA PCR at 48 HR, 2mo, 6mo

247
Q

Erb’s palsy effect on normal baby reflexes

A

Grasp reflex: not affected

Moro, biceps, radial reflexes: absent

248
Q

Is Philadelphia chromosome a good or bad prognostic sign in ALL

249
Q

Rx of bullous impetigo

A

Oral cephalexin

250
Q

What’s DEET N,N-diethyl-3-methylbenzamide

A

Insect repellant

251
Q

Safety of DEET in kids

A

Not safe in kids < 6mo

252
Q

How to use DEET

A

Spray least concentrated 10%

Avoid hands + face

3x/d max

253
Q

BB antidote?

MOA?

A

Glucagon

Increase intercellular cAMP independent of blocked beta receptors.

254
Q

Mastoiditis on CT scan

A

Clouding to destruction of septa b/w mastoid cells and soft tissue swelling

+/- temporal bone destruction

255
Q

MCC of neonatal death in babies with DM mom?

A

Congenital anomalies esp. cardiac + CNS

256
Q

Vaginal exam in prepubertal girls
> 2 yr
< 2 yr
Adolescent

A

> 2 yr
Knee-chest on exam table
Without instrument

< 2 yr
Lying supine in mom lap

Adolescent
Knee spread apart
Exam table

257
Q

Rx of croup

A

Dexamethasone single dose

Racemic epi

258
Q

MCC of ambylopia

A

Strabismus

259
Q

What’s amblyopia

260
Q

T/F: in acute asthma ipratropium + inhaled SABA reduce hospitalization rate

261
Q

MCC of occult bacteremia in kids

A

Strep. Pneumonia

262
Q

Boy with itchy anus at night

A

Enterobiasis

Pinworm helminth

263
Q

Name of enterobiasis pinworm?
Where does it live in bowel?
How does it cause itchiness?

A

Enterobious vermicualris

In ileocecal region

Itchiness from egg deposit in anus at nighttime
Egg survives 3 wk before hatching

264
Q

How’s pinworm Dx + Rx

A

Tape at anus at early morning = see worms under microscope

Rx: albendazole or mebendazole

265
Q

What can mom do to cause her baby necrotizing enterocolitis?

266
Q

Snowman in a storm on CXR

267
Q

MCC of osteomyelitis in kids

Rx?

A

Staph aureus

Rx IV Vanco

268
Q

Sx of retinitis pigmentosa

A

Night blindness

269
Q

Role of ABG in dehydration

270
Q

Cause of encephalopathy in Reye’s syndrome (ASA)

A

High ammonia

271
Q

Rx of genu varus

A

Observation

Spontaneous correction in 2 yrs

272
Q

How a bay holds arm in nursemaid fracture

A

Adducted + pronated + flexed elbow

273
Q

MCC of buckle/torus fracture

A

Fall on outstretched hand

274
Q

What’s buckle, greenstick fractures

A

Buckle: compression

Greenstick: incomplete

275
Q 
Whats osgood-schlatter disease?
Age?
X-ray?
Uni or bilateral?
Rx?
A

It’s apophysitis of tibial tubercle
In athletic kids esp. jumping

Almost exclusive to kids

No need for X-ray
If done = irregular tubercle + hazy metaphyseal border

Rx: self-limited
Rest, ice, NSAIDs
Can resume activity in 2-3 wk

276
Q

Pathophysiology of omphalocele?

A

Persistence of normal physiological herniation b/c abdomen too small for mid gut formation / liver

Herniation occurs at 6 wks
Return should occur at 10 wks

277
Q

Pathophysiology of gastrochosis

A

Failure of lateral abdominal fold to fuse

278
Q

Cause of umbilical hernia

A

Herniation through linea alba

279
Q

T/F: APGAR Score correlates with risk of necrotizing enterocolitis

280
Q

T/F: HTN causes necrotizing enterocolitis

281
Q

MC complication of sinusitis

A

Orbital cellulitis

282
Q

MC cause of pneumonia in preschool kids?

283
Q

T/F: pulmonary hemosiderosis associated with milk allergy?

284
Q

CXR in pulmonary hemosiderosis

A

Fluffy infiltrates

285
Q

Lung Bx in pulm hemosiderosis

A

Hemorrhage with hemosiderin laden macrophages

286
Q

Rx of Lyme in kids

A

Amoxicillin

287
Q

Chubby boy with painful hip

A

Slipped capital femoral epiphysis

288
Q

Slipped capital femoral

Dx?
Rx?

A

Dx: X-rays frog-leg
Wide epiphyseal line
Displacement of femoral head

Rx: urgent surgery = screw fixation

289
Q

What’s in the urine of a baby with galactosemia

A

Lots of reduced substance

No ketone bodies

290
Q

Neonate + reduced substance + low glucose

A

Galactosemia

291
Q

MCC of diarrhea in kids?

A

Rotavirus
60% clod weather
50% tropicals

292
Q

Dx unilateral renal agenesis

A

Doppler US

293
Q

When can baby mobilized arm after Rx of nursemaid fracture

294
Q

What’s flexible flat foot

Rx?

A

Arched when not bearing weight

Flat when bares weight

Rx: none corrects in 1 year of walking

295
Q

What’s tarsal coalition?
Dx?
Rx?

A

Fusion of tarsal bones
50% bilateral

Dx: 
Asymptomatic 
Tenderness on subtalar joint / ankle
Rigid flat foot
Peroneal tightness

Rx:
Conservative

296
Q

Associations in nephroblastoma / willms

A

Willms tumor
Aniridia
GU abnormalities
Mental retardation

297
Q

Sx of willms

A

Abdominal mass
Doesn’t cross midline
Asymptomatic

298
Q

Becker + Duchenne inherence

299
Q

14 + no period + no 2 sexual approach

A

FSH + LH => high > karyotype

FSH + LH => low > wait till 16 (constitutional delay)

300
Q

14 + no periods + has 2 sexual

301
Q

MCC of recurrent acute otitis media

A

Penicillin resistant strep. Pneumonia

302
Q

Foreign body removal from ear?

A

Water irrigation
Fast acting glue
If not work or baby not cooperative send to ENT to do it under GA

303
Q

T/F: congenital umbilical hernia resolve spontaneously

A

T

Surgery if not at 2-3 years

304
Q

Rx of PKU?

A

Phenylalanine free diet

Sapropterin tetrahydrobioterin (BH4) helps in 50%

305
Q

If mom gives birth to baby with PKU,

Chances of having another baby with PKU?

A

25%

It’s AR

306
Q

Risks for CMV in preggo

A

Poor mom
Hx of STDs
Hx of cervical dysplasia

307
Q

Baby with Hg < 4?

A

Transfuse PRBC

308
Q

Complications of juvenile idiopathic arthritis

A

Micrognathia (2/2 early closure of mandibular epiphysis)

Iridocyclitis => scarring + glaucoma

309
Q

Storage of breast milk

A

Stored to 4 HR at room temperature.

Stored 48 HR in refrigerator

Stored for 3 mo frozen
If frozen must be thawed slowly to preserve nutrients

310
Q

Tropical disease could present months after travel?

311
Q

Neonate + fever + resp Sx + CXR peribronchiolar edema

A

RSV

Rx: supportively

312
Q

MCC of bleeding in Meckel’s

A

Ulceration of small bowel 2/2 acid of ectopic gastric mucosa

313
Q

Helpful imaging modality in septic arthritis?

314
Q

Storage of breast milk

A

Stored to 4 HR at room temperature.

Stored 48 HR in refrigerator

Stored for 3 mo frozen
If frozen must be thawed slowly to preserve nutrients

315
Q

T/F: lactose intolerance should avoid all dairy products

A

F
Only lactose containing
Can add probiotic

316
Q

1st line Rx of head lice / pediculosis

A

Permethrin 1%
Malathion 0.5%
Pyrethrins 0.33% pipernyl butoxide 4%

317
Q

Chances of having a 2 baby with cleft lip

A

Both genders 3%
M sibling 4%
F sibling 2.5%

318
Q

Rx of internal tibial intoeing

Cause?

A 
No Rx (not even stretches) 
No prone sleep

Cause = prone sleep + sitting in feet

319
Q

Fire ant bite

A

Clean with soap + water only

Extra flash cards - MCCQE1 (12 decks)

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