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Step 2 > Peds Case Files and UWorld > Flashcards

Peds Case Files and UWorld Flashcards

1
Q

Most common causes of PNA in the first few days of life

A

GBS and Enterobacteriae

S. pneumonia

Listeria

S. aureus

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2
Q

Common causes of PNA in the first few months

A

C. trachomatis

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3
Q

Most common cause of PNA in a 5y/o

A

mycoplasma

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4
Q

Causes of PNA in the intubated patient

A

P. aeruginosa and Candida

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5
Q

PNA in cystic fibrosis

A

pseudomonas

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6
Q

Child from farm with drooling, tearing, obtunded, and vomiting.

Cause?

Tx?

A

Organophosphate poinsoning

Atropine and pralidoxime

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7
Q

Tx for a pt with and anal fissure

A

Dietary changes and stool softener

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8
Q

Sx associated with intussiception

A

coliky pain with episodes of lethargy

Blood in sttol

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9
Q

A premature infant with first oral intake and bloody stool is at high risk of…

A

Necrotizing enterocolitis

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10
Q

Air in bowel wall entering portal circulation on abdominal x-ray

A

necrotizing enterocolitis

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11
Q

A patient with acute otitis media fails treatment with abx and returns with a large swelling behind the ear. What is the dx and tx?

A

Mastoiditis

Myringotomy and drainage

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12
Q

Young patient (<1) with otitis media. Management?

A

Admit to hospital

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13
Q

Patient who becomes cyanotic except when crying

A

Choanal atresia

Infants are obligate nose breathers through 4mo. of age

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14
Q

Causes of nonphysiologic jaundice

A

speticemia

biliary atresia

hepatitis

galactosemia

hypothyroidism

cystic fibrosis

congenital hemolytic anemia

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15
Q

A child whose parent had a growth delay has this kind of growth delay

A

constitutional growth delay

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16
Q

Cuase of growth delay in a child whose growth rate has fallen away from the normal growth curve with normal parents

A

GH deficiency

Tx: replace GH

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17
Q

Test to run on a child with delayed growth who has a parent that also had delayed growth

A

bone age measurement

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18
Q

Typical WBC count, and CXR in GBS pneumonia

A

LOW WBC with Left shift

CXR showing infiltrates

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19
Q

Organisms common implicated in early onset sepsis

A

GBS

E. coli

H. influenszae

Listeria

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20
Q

Most common cause of neonatal sepsis from birth to 3mo

A

GBS

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21
Q

Timeline for gonoccal v chlamydial conjuctivitis

A

Gonococcal 2-5d

Chlamydial 5-14d

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22
Q

A 3mo old child presents with weezing and a new onset heart mumur. Dx?

A

VSD

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23
Q

Why does a new heart murmur in a 2-5mo old infant represent a possible non-cyanotic heart lesion like VSD?

A

between 2-5mo the pulmonary vascular resistance greatly reduces causing increased shunting of blood across the VSD

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24
Q

What is the immediate management in a patient with transposition of the great vessels?

A

PGE1

-maintain the PDA bcause TGA is ductus dependant

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25
Q

When do cyanotic heart diseases usually present?

A

When the ductus beings to close

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26
Q

classic radiographic finding of TGA

A

Egg on a string (narrowed mediastinum)

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27
Q

Exercised induced cyanosis and a systolic murmur in a young child. Dx?

A

Pulmonary stenosis

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28
Q

12 year old patient with no complains and a systolic murmur in the left second intercostal with no radiation, clicks or snaps. Dx?

A

Innocent murmur

Benign pulmonary flow murmur

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29
Q

3 year old with long standing fever, rash, lyphadenopathy, organomegaly, and PIP and DIP joint swlling as well as elevated blood counts and fever. Dx

A

Juvinile idiopathic arthritis (previously juvenile rhematoid arthritis)

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30
Q

Most common rheumatologic disorder in children?

A

juvenile idopathic arthritis

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31
Q

What is an important exam for a patient with juvenile idopathic arthritis?

A

Eye exams

anterior uveiitis is common and can lead to vision problems if not treated.

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32
Q

Treatment for juvinie idipathic arthritis

A

NSAIDs

Steroids

Methotrexate

Immunosuppressive drugs

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33
Q

Infants fed on solely goat’s milk are at increased risk for deficiecy of

A

Vit B12

Folate

Brucellosis infection

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34
Q

Anorexia, hyperirritability, altered sleep, decreased play, abdominal pain (constipation, vomiting, colic), ataxia, AMS, and seizures are all signs and symtoms of what in a child?

A

Lead poisoning

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35
Q

Tx of lead poisoning

A

Chelation with:

EDTA

DMSA

Succimer

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36
Q

Signs of methyl mercury poisoning

A

ataxia, tremor, dysarthria, memory loss, altered sensorium (smell, taste, sight)

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37
Q

Baby with microcephaly, low birth weight, and seizures with parents who are showing CNS probs was exposed in utero to….

A

Mercury

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38
Q

Boy with hematuria (2+ protien and RBC casts) and hx of fever and sore throat two weeks ago. Dx?

A

APSGN

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39
Q

APSGN C3 and C4 levels

A

C3 LOW

C4 usually normal

40
Q

If a patient has suspected APSGN and the C3 does not reurn to normal and the hematuria continues over weeks, what Dx must be considered??

A

SLE lupus nephritis

41
Q

What drug is used to control HTN in a child with APSGN?

A

Calcium channel blockers

42
Q

Recurrent painless gross hematuria, frequently associated with a URI.

A

IgA Nephropathy

43
Q

Patient with persistent hematuira and biopsy shows a thinned basement membrany in the kidney. Dad has same problem. Cause?

A

Beningn familial hematuria

autosomal dominant condition

44
Q

puritic, boggy or vesicular round lesions that erupt on the extremities, buttocks, and shoulders. Can lead to lichenification.

A

Nummular Dermatitis

45
Q

Psoriatic lesions on a child with a URI

A

Guttate psoriasis

Psoriasis in a patient with a streptococcal infection. Abx for the strep will result in marked improvement of the psoriasis.

46
Q

Common causes of meningitis in neonates.

A

E. coli

GBS

47
Q

Common causes of meningitis in an older vaccinated child?

What is added if the child has not been vaccinated?

A

S. pneumo

N. gonorrhea

Unvaccinated: H. influenszae type B

48
Q

Most common long term sequlae of meningitis in children?

A

Hearing loss

49
Q

Major CBC difference between shigella and salmonella

A

Shigella: normal WBC count with remarkable left shift

Salmonella: Leukocytosis

50
Q

Yersernia infection can mimic what in children?

A

Acute appendicitis

51
Q

How long after O157:H7 does HUS develop?

A

1 to 2 weeks.

52
Q

Child with bloody diarrhea and tubular mass in the RUQ. Dx?

A

Intussiception

Air contrast enema is test and possible Tx

53
Q

Precocious puberty, cafe-au-lait spots, bone defects, and moon facies are all common presentations of…

A

McCune-Albright disease

54
Q

Newborn with turner syndrome and lymphadema. Cased by?

A

Lyphatic dysgensis

55
Q

common cause of intussiception in a young child following a viral/bacterial illness?

A

Peyer patch hypertrophy

56
Q

Patient with recurrent intussiception likely has?

A

Meckel diverticulum

57
Q

Patient with failure to thrive and musty odor. Dx?

What enzyme is lacking?

What builds up?

A

PKU

Phenylalanine hydroxylase

Phenylalanine builds up because it is not changed to tyrosine

58
Q

How does maternal diabetes cause RDS?

A

High glucose–> high insulin which antagonizes cortisol–> cortisol noramlly increases surfactant

59
Q

NF1 v. NF2?

A

NF1= short stature, learning diabilities, cafe-au-lait, neurofibromas

NF2= bilateral acoustic schannoma

60
Q

6 year old boy with high grade fever and rash starting of face and spreading to trunk is in the ER. (unvaccinated/foreign/whateverfromanotherplanet) What vitamin has been shown to decrease mortality in this patient?

A

Measles

Vitamin A

61
Q

Pathophys of breakfeeding failure jaundice

A

lack of breast feeding leads to an increase unconjugated bilirubin through inadequate stooling=lack of elimination

62
Q

Hepatitis is a significant risk factor for this kidney disorder

A

membranous nephropathy

63
Q

Most common cause of intestinal obstruction ages 6-36 mo.?

A

Intussiceoption

64
Q

This ligand is defficient in children with hyper-IgM syndrome

A

CD40

65
Q

Patient with lyphadenopathy, pharyngeal exudates, elevated LFT and thrombocytopenia. Dx?

A

Infectious mononucleosis

EBV

66
Q

EBV is associated with these cancers

A

burkitt lymphoma

Hodgkin lymphoma

67
Q

Super special name for pinworm

A

Enterobius vermicularis

68
Q

Tx of pinworm

A

mebendazole

pyrantel pamoate

albendazole

69
Q

Which intracranial bleed is more common in children <1yo?

Older?

A

Subdural if <1

Epidural if >1

70
Q

In which kind of brain bleed (sub/epi) are seizures more common?

A

Subdural

71
Q

Most common congenital heart defect in edwards syndrome

A

VSD

72
Q

What is dentogenisis imperfecta?

A

Discoloration of the teeth in patient with ostegenisis imperfecta

73
Q

In a patient with suspected meconium ilius, what is the next best step in Dx after abdominal xray showing sitended loops of bowel with no free air?

A

Barium enema

74
Q

Cyanotic infant with left axis deviation and small R waves with prro progression. Dx?

A

Tricuspid atresia

75
Q

PAS positivity is specific for what form of leukemia?

A

Lymphoblastic leukemia

76
Q

12 year old girl with recurrent middle ear infections and drainage from the ear with peripheral granulation on otoscopy

A

cholesteatoma

77
Q

Should premature infants be given vaccines according to chonologic or gestational age?

A

Chronologic

78
Q

What is the pathology of a patient that has been starving (anorexia) and resumes feedings?

A

Resumed feeding causes a spike in insulin which leads to cellular uptake of electrolytes (mag, phos, potassium) for energy metabolism. This leads to derangements in these electrolytes and puts the patient at extreme risk for cadiopulmonary failure as well as cardic arrhythmias

79
Q

Young patient presenting with acidosis and recurrent kidney stones

A

RTA

Most likely type II (excess loss of bicarb

80
Q

most common cause of sepsis in a sickle cell patient

A

S. pneumo

81
Q

Tripple bubble sign with gases colon in a patient of a cocaine mom

A

Jejunal atresia

82
Q

inheritance patternt of myotonic muscular dystrophy

A

autosomal dominant

83
Q

next step in management in a patient with leukocytosis, fever, high crp and esr, and inflammed joint with a URI 2 weeks previous

A

arthocentesis (septic joint) therapeutic and diagnositic

84
Q

What do we give to children <8yo for lyme

A

amoxicillin

85
Q

Patient with fair hair, blue eyes, and mrphanoid body habitus. Dx?

Increased risk for?

A

Homocysteinuria

CVA

86
Q

Who gets a bladder and ureter ultrasound after a UTI

A

Pt who is less than 24mo

87
Q

What treatment should be attempted before intubating a patient with croup?

A

Epinepherine

88
Q

What is the next best way to follow a patient who has guillian barre syndrome?

A

Serial PFT and spriometry to evaluate for respiratory failure

FVC is the most indicative

89
Q

Triad of congenital rubella syndrome

A

Cataracts

Sensory-neural hearing loss

PDA

90
Q

15 day old with bilious vomiting and blood stools? Dx?

Best first test? Most accurate test?

A

Malrotation with volvulous

First: Xray abd

Best: Upper GI series

91
Q

How to tell larygeomalacia from a vascular ring?

A

Laryngeomalacia worsens in the supine position and gets better prone

Vascular ring improves with extension of the neck

92
Q

Most common cause of thrombocytopenia in a well child aged 2-10 years?

A

Immune thrombocytopenic purpura

gpIIb/IIIa

93
Q

suspect abuse…next best step?

A

Skeletal survey

94
Q

Roughy 90% of viral meningitis in kiddies is caused by…

A

Echovirus and coxsackie

95
Q

Child with tramatic injury to the palate presenting with stroke like symtoms. Dx?

A

Internal carotid artery dissection

96
Q

Patient with malaise and throat pain takes amoxicillin and gets a rash. Dx?

A

EBV

Mono

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