Peds EOR Flashcards
True or false: the height and weight of twins are less than singletons on average at 12 months of age
True. On average, the height and weight of twins are lower until 30 months of age.
What is the gold standard test to diagnose lactose intolerance?
Upper GI endoscopy
What may be seen on laryngoscope of a patient with epiglottitis?
A cherry-red epiglottis.
Treatment for moderate croup?
Single dose of dexamethasone and nebulized epi.
Treatment for pyloric stenosis?
Pyloromyotomy
What is the primary diagnostic test for symptomatic patients suspected for EBV?
Heterophile antibody test (Mononucleosis spot)
What EEG findings are diagnostic of absence seizures?
3Hz spike and wave activity.
Prognosis for lichen planus?
Self limiting, resolves in up to 2 years. Treatment can shorten time to resolution.
What physical exam finding is present in most patients with abusive head trauma?
Retinal hemorrhages
Name 3 gluten containing grains.
Wheat, rye, barely
What symptoms are suspicious for chlamydia conjunctivitis?
Infection occurring 5-14 days of life, a pseudomembrane adherent to the orbital surface, chemosis
Large VSDs present with what other manifestations?
Frequent respiratory infections, slow weight, gain, dyspnea, diaphoresis, and fatigue.
What is the most likely causative organism of Tinea versicolor?
Malassezia furfur
A sweat chloride test > __ is diagnostic of cystic fibrosis.
60 mEq/L
What is Jaccoud arthropathy?
A rare late manifestation of rheumatic fever involving painless loosening and lengthening of the joints in the hands and feet.
What vitamin deficiency is associated with the use of isoniazid?
Vitamin B6 (pyridoxine).
What is the most common factor contributing to acute otitis media?
Eustachian tube dysfunction.
What are risk factors for developing oral cadidiasis?
Recent antibiotic use or inhaled glucocorticoids
Status epilepticus is characterized by > __ minutes of continuous seizure.
5
Describe the physical features associated with down syndrome.
Upslanting palpebral fissures, prominent epicanthic folds, brachycephaly, excess skin at the nape of the neck, a flat facial profile, protruding tongue, sandal toes.
When should eruption of all 20 primary teeth occur by?
30-36 months
Which parasite is most commonly associated with bladder cancer?
Schistosoma haematobium.
What condition is described as purple, pruritic, polygonal, papular, and plaques?
Lichen planus
What is the Nikolsky sign?
Epidermal detachment secondary to gentle lateral pressure.
What is a bell clapper deformity and what is likely to happen with this deformity?
A bell clapper deformity is when the testis is not fixed to the tunica vaginalis.
Testicular torsion is likely to occur
Treatment for pinworms in pregnancy?
Pyrantel pamoate
What is the first line pharmacologic therapy for enuresis?
Desmopressin
Which time of wart presents as a exophytic, dome-shaped papule frequently occurring on the fingers, dorsal hands, knees or elbows?
Common warts
What is the rash associated with fifth disease?
Slapped-cheek rash
First line treatment for pinworms?
Albendazole
What ear condition was historically associated with Mycoplasma pneumoniae infection?
Bullous myringitis.
Measles is also know as _______.
rubeola
What is the most important triggering factor for asthma?
Viral upper respiratory infection.
What is the name of the vertical fissures located in the anterior portion of the external auditory canal cartilage that may be a site of infectious extension in malignant otitis externa?
Fissures of Santorini.
First line treatment for symptomatic hypertrophic cardiomyopathy?
Beta blockers
What are the findings on a wright-stained smear of a pustule from erythema toxicum neonatorum?
Numerous eosinophils and occasional neutrophils.
Wilson disease is a disorder of the metabolism of ______.
Copper
What X-ray finding would be noted for a patient with laryngotracheitis, also known as croup?
Steeple sign, which is narrowing of the trachea.
What physical exam finding would you document in a 5 month old infant with shortening of the left femur?
A positive Galeazzi sign
What is the inheritance pattern of sickle cell disease?
Autosomal recessive
What criteria is used to diagnose acute rheumatic fever?
Jones criteria
When should strabismus be referred to an ophthalmologist?
Constant strabismus, or intermitent after 4-6 months of age, asymmetric pupils, torticollis, diplopia, or fatigue.
What is the most common kidney malignancy in teenagers aged 15–19?
Renal cell carcinoma.
What is Todd paralysis?
The presence of focal weakness after seizure activity, typically lasting up to 24 hours.
At what tanner stage does penis girth enlarge?
Stage 4
What is the first line therapy for children with absence seizures?
Ethosuximide
Lymphadenopathy of what nodes is characteristic of rubella?
Posterior cervical and posterior auricular
What are Koplik spots?
small white or gray elevations on the buccal mucosa that develop in individuals with measles 48 hours prior to the exanthem.
What are the most common congenital defects in congenital rubella syndrome?
Sensorineural hearing loss, cataracts of glaucoma, and heart disease
What are the most common bacterial pathogens of mastoiditis?
Strep pneumo, strep pyo, staph aureus
What medication can aid in the passage of a food bolus in adults but is not recommended for use with children?
Glucagon.
What are the findings of an ultrasound on a patient with pyloric stenosis?
Target sign on transverse view and increased pyloric muscle thickness
Which rare complication of Kawasaki disease is characterized by activation and proliferation of macrophages and T cells?
Macrophage activation syndrome.
Second line treatment for GAS pharyngitis?
Macrolide
What are other osteochondroses, in addition to Osgood-Schlatter disease, that affect children and adolescents?
Sever disease, which involves the calcaneal apophysis, and Sinding-Larsen-Johansson syndrome, which involves the proximal insertion of the patellar tendon at the inferior pole of the patella.
Which human papillomavirus strains typically cause common warts?
Types 2 and 4.
What is the causative agent of erythema infectiosum, also known as fifth disease?
Parvovirus B19
What are the symptoms of Waterhouse-Friderischsen syndrome?
Rapidly spreading ecchymosis, gangrene of extremities, bilateral adrenal hemorrhage and fulminant meningosepticemia.
A 9-year-old boy presents to the clinic for behavioral evaluation. He was recently suspended from school for the third time following a fight with another classmate. His mother states he refuses to listen to her, and he is persistently lying to her and his father. What is the most likely diagnosis?
Conduct disorder
Oppositional defiant disorder typically does not have any violent outbursts.
Necator americanus causes what disease?
Hookworm disease
Describe the murmur of a PDA.
Continuous, rough, machinery-like murmur heard best in the first interspaces of the left sternal border
What is the Samter triad?
A condition defined by aspirin sensitivity, nasal polyps, and asthma.
Which patients are more likely to have coronary complications?
Children younger than 1 year, patients older than 6 years, boys, and those unresponsive to or who received a smaller dose of intravenous immune globulin.
What laboratory findings are common in pyloric stenosis?
Hypochloremia and metabolic alkalosis.
What is the alternative medical term for scalp seborrheic dermatitis or dandruff?
Pityriasis sicca.
True or false: the probability of herpes simplex virus (HSV) recurrence is much higher with HSV-2 than HSV-1 infections.
True.
Which developmental reflexes should have resolved by age 4 months?
Galant reflex, asymmetric tonic neck reflex, and rooting.
What can be ordered if you’re concerned for constitutional delay of growth and puberty?
Bone age determination by radiograph of the hand and wrist
Which class of blood pressure medication is most often associated with drug-induced angioedema?
Angiotensin-converting enzyme inhibitors.
What murmur is described as a continuous murmur heard best over the left or right upper sternal border that is accentuated with head extension while seated?
Cervical venous hum
Describe the distribution over time of the rash caused by Rubella.
Starts on face, spreads to trunk and extremities within 24 hours
What is the deeper form of impetigo called?
Ecthyma.
Is oral or topical antifungals preferred treatment for tinea capitis?
oral
Which reaction is characterized by the development of a generalized dermatitis distal to the original site of allergic contact dermatitis 1 week after the initial reaction?
Autoeczematization, or an id reaction.
How is fifth disease diagnosed?
Clinically, although if aplastic anemia is present, NAAT may be preformed.
What are some vaccinations that should be given to patients before undergoing a splenectomy?
Vaccinations against encapsulated organisms such as Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae.
What is the first line choice of antibiotics for a patient with mastoiditis and no recent antibiotic use?
Vancomycin alone
What disorder is characterized by at least 2 weeks of a major depressive episode and at least one hypomanic episode?
Bipolar 2 disorder.
What is the first line antibiotic for SSSS?
IV nafcillin (or oxacillin)
What skin disorder has appearance similar to acute hot water burns?
Staphylococcal scaled skin syndrome (SSSS)
What are examples of mast cell stabilizers that can be used to treat allergic conjunctivitis?
Cromolyn sodium 4% solution, nedocromil 2% solution, and pemirolast potassium 0.1% solution.
Treatment for scabies?
Topical permethrin
Treatment of Hirschsprung disease?
Surgical resection of the affected bowel
Name some conditions commonly present in patients with down syndrome.
Autism, congenital heart disease, GI tract abnormalities, ophthalmologic disorders
Treatment for allergic rhinitis?
Intranasal corticosteroids and second generation antihistamines
Describe the rash of dermatitis herpetiformis.
Papulovesicular rash on elbows, knees, buttocks, or scalp
Which infection is associated with guttate psoriasis?
Streptococcal pharyngitis.
First line treatment for pinworm infection?
Mebendazole, pyrantel pamoate, albendazole
Which syndrome with an autosomal dominant inheritance pattern can cause patent ductus arteriosus to occur in many members of the same family?
Char syndrome.
What is the duration of antimicrobial therapy for mycobacterium marinum?
1-2 months after symptom resolution for a total of 2-3 months
A patient with a sore throat and development of a rash with a sandpaper like quality is most likely what diagnosis?
Scarlet fever
The double bubble sign on ultrasound is a classic imaging finding of ?
Duodenal atresia
Treatment options for cutaneous warts?
Salicylic acid or cryotherapy
What disease causes mucocutaneous vasculitis most frequently in children between the ages of 3 months and 5 years?
Kawasaki disease
Infantile hypertrophic pyloric stenosis is associated with what medications by the mother or infant?
Macrolide antibiotics
When should the Modified Checklist for Autism in Toddlers (MCHAT) screening questionnaire be given?
18 and 24 months
What are the 3 C’s of Measles (Rubeola)?
Cough, coryza, conjunctivitis
What oral medication used to treat severe acne is associated with an increased risk of birth defects?
Isotretinoin.
What is the most common kidney malignancy in teenagers aged 15–19?
Renal cell carcinoma
What is the treatment for Gilbert syndrome?
Treatment is not required
What is the pathogenesis of infertility in men with cystic fibrosis?
Patients with cystic fibrosis are missing the vas deferens bilaterally, which results in obstructive azoospermia and infertility.
Treatment for bacterial tracheitis?
Broad spectrum antibiotics such as clindamycin or vancomycin plus a second generation cephalosporin.
intubation if indicated
What is the treatment for bacterial meningitis in children 1-18 years?
Ceftriaxone + vancomycin
OR
Cefotaxime + vancomycin
What is the medical term for the fecal pellets present in scabies infection?
Scybala.
When does colic typically resolve?
9 weeks of ago.
How is diagnosis of epiglottitis made?
Direct visualization with a laryngoscope.
Tissue biopsy demonstrates what type of cells in Hodgkin lymphoma?
Reed-sternberg cells
What is the first line antibiotic therapy for whooping cough?
Macrolides
True or false: recovery from strabismus surgery is rapid, and serious complications are rare
True.
What is the most common cause of meningitis in children >10 years?
Neisseria meningitidis
What murmur is described as a vibratory or musical like murmur heard best over the lower left sternal border?
Still murmur
What coagulation factor is deficient in patients with Hemophilia B?
Factor IX
What is congenital dacryocystocele?
It is an obstruction of the proximal and distal portions of the nasolacrimal duct that results in the distention of the lacrimal sac and duct.
What is the treatment for scoliosis with a Cobb angle <20 degrees?
Observation and serial x rays
When is chronic suppressive therapy recommended for genital herpes?
Six or more recurrences within 1 year
What is the first line empiric therapy for pediatric patients with pyelonephritis?
Cephalosporins and aminoglycosides
What antibiotics are used to treat confirmed mycobacterium marinum?
Macrolides, rifampin, ethambutol, or tmp-smx.
What is the most common chromosomal disorder?
Down syndrome 0.5% of all human conceptions
What is the criterion standard for obtaining urine specimens in children who are not yet toilet trained?
Suprapubic aspiration.
What is the inheritance pattern of cystic fibrosis?
Autosomal recessive
What is used to diagnose erythema toxicum neonatorum?
Wright-stained smear of pustular contents.
What exanthema is teratogenic in the first trimester and may result in fetal hearing impairment, infantile glaucoma, and cardiac disease?
Rubella
Its the R in TORCH infections
What is the scientific name for pinworms?
Enterobius vermicularis
What is the most common cause of acute bacterial sialadenitits?
Staph aureus
The absence of which structure is responsible for most cases of male infertility associated with cystic fibrosis?
Vas deferens.
Is PDA more common in males or females?
2:1 females:males
How long after a strep infection does acute rheumatic fever typically occur?
2-4 weeks
What was a serious complication of measles that caused blindness before widespread use of the measles vaccine?
Keratoconjunctivitis.
What should you do if a patients lead level is 25?
Repeat lead levels in 1-4 weeks for levels 15-44
Which syndrome is characterized by the presence of infantile hypertrophic pyloric stenosis and hyperbilirubinemia?
Icteropyloric syndrome
A pediatric cystic fibrosis patient presents with steatorrhea and bulky foul smelling stools should be given what therapy?
Supplement fat-soluble vitamins A, D, E, and K
What are the diagnostic criterion for Kawasaki disease?
Fever of at least 5 days with any four of the following: bilateral nonexudative conjunctivitis, oral changes, peripheral extremity changes, polymorphous rash, or cervical LAD.
How do you reduce a nursemaid elbow?
Pressure over the radial head and hyperpronate the arm
OR
Supinate and fully flex the elbow while applying pressure to the radial head and gentle traction
What congenital infection increases the risk of PDA?
Congenital rubella
Nursemaid elbow involves what ligament?
Annular ligament
Pinworms are tested for with which test?
Cellophane tape test (scotch tape test)
What is the empiric treatment for possible skin infection with mycobacterium marinum?
A macrolide and either a fluoroquinolone, doxycycline, or tmp-smx.
Treatment for severe croup?
Single dose of dexamethasone and repeated doses of nebulized epi. Need admission.
What is the most severe complication of parvovirus B19?
Transient aplastic crisis causing severe anemia in patients with disorders affecting red blood cells.
What is the most common cause of intestinal obstruction in infants between 6 and 36 months of age?
Intussusception
At what lead level is chelation therapy indiciated?
> 45
What are the major(5) and minor(4) Jones criteria?
Major: Carditis, erythema marginatum, syndemham chorea, polyarthritis, and subcutaneous nodules.
Minor: fever, arthralgia, elevated acute phase reactants, and prolonged PR interval on electrocardiogram.
Fine white lines on the surface of lichen planus lesions are known as?
Wickham striae
Is a cervical venous hum an innocent murmur?
Yes
What stool test can be used to rule out inflammatory bowel disease?
Fecal calprotectin.
Wilms tumors are associated with?
Congenital abnormalities
Why is cephalexin preferred over nitrofurantoin in children with UTIs?
Nitrofurantoin is dosed QID
Which acid and base abnormality is most common in children with diarrhea?
Metabolic acidosis because of the bicarbonate lost in stool.
What is the classic progression of symptoms in rocky mountain spotted fever?
Headache, fever, and myalgias with blanching, erythematous, macular rash on wrists and ankles 3-5 days into illness.
What is the most common cause of congenital nasolacrimal duct obstruction?
Incomplete canalization at the end closest to the nose
What is used to measure the magnitude of the curve in scoliosis?
The Cobb angle
Which complication can result from nasal packing and is characterized by fever, hypotension, desquamation, and mucosal hyperemia?
Toxic shock syndrome.
What is the preferred diagnostic test to confirm pyloric stenosis?
Abdominal ultrasound
What are the common manifestations of scarlet fever?
Rash starting in axillae and groin, circumoral pallor and strawberry tongue, linear petechiae over the AC fossa and axillary folds known as Pastia lines.
What virus causes mumps?
Paramyxovirus
Other than supportive care, what should patients diagnosed with EBV be counseled on?
Refraining from contact sports for 4 weeks to prevent splenic rupture
When should the varicella vaccine administered?
12-18 months and again at 4-6 years
What is the allergic salute?
A transverse nasal crease from repeatedly rubbing the tip of the nose with the hand.
A harsh, holosystolic murmur with a palpable thrill describes what murmur?
VSD
What score can be used to assess severity of croup?
Westley croup severity score
What is the treatment for developmental dysplasia of the hip?
Pavlik harness
What is the most common cause of epiglottitis in a child?
H. influenza type B
What finding would you note on a lateral cervical X-ray in a patient with acute epiglottitis?
Thumbprint sign.
What common kidney malignancy found in children is associated with congenital abnormailities?
Wilms tumor
What is Auspitz sign and what is it a sign of?
Punctate bleeding spots when psoriasis scales are scraped off.
What is the most common cause of viral conjunctivitis?
Adenovirus
What is the most important factor in reducing the risk of developing mastoiditis?
Early and sufficient treatment of acute otitis media.
Genital herpes has traditionally been associated with what type of HSV?
Type 2
T/F? Strabismus can be a presenting sign of retinoblastoma.
True
A sweat chloride test > __ is confirmatory for cystic fibrosis.
60mmol/L
What therapeutics are used for chelation therapy?
Succimer, calcium disodium edetate, or penicillamine.
What are allergic shiners?
Infraorbital edema with darkening under the eyes due to venodilation
What is the most common cause of a peritonsillar abscess?
Strep pyogenes
Treatment for psoriasis <10% of BSA?
Topical corticosteroids such as betamethasone dipropionate or triamcinolone acetonide
What is the first line antibiotic choice for a patient with mastoiditis and recent antibiotic use?
IV vancomycin plus a cephalosporin such as ceftazidime or cefepime.
If the seizure persists for 10 minutes after two doses of lorazepam have been given, what medication is indicated?
Phenytoin, valproic acid, or levetriacetam.
What in utero infection is associated with a patent ductus arteriosus?
Rubella.
What is the treatment for seborrheic dermatitis?
Gentle removal of scale with warm olive or mineral oil and a low strength corticosteroid.
What scale is used to classify androgenic alopecia?
The Hamilton-Norwood scale.
What is the treatment for anorexia nervosa?
Nutritional rehabilitation
What is the genetic inheritance pattern of Wilson disease?
Autosomal recessive.
What antibiotic can be used in a patient with a penicillin allergy who has acute bacterial sinusitis?
Doxycycline or a third-generation cephalosporin.