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EOR Exams > Peds EOR Exam > Flashcards

Peds EOR Exam Flashcards

1
Q

Presentation of neonatal acne

A

4 week old, comedomes, papules and pustules on the lateral aspect of the face

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2
Q

Presentation of acne vulgaris

A

14 year old boy with erythematous papules, pustules, and cysts
Atrophic scarring also seen

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3
Q

Comedomes of acne

A

Open - Blackheads
Closed - Whiteheads

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4
Q

Grade 1 acne

A

Mild with open comedomes or blackheads

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5
Q

Grade 2 acne

A

Moderate with more blemishes, papules and pustules also present

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6
Q

Grade 3 acne

A

Severe many blemishes with high risk of scarring, inflammation is more pronounced

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7
Q

Grade 4 acne

A

Cystic with severe scarring
Angry blemishes of the face and jaw line

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8
Q

Difference between acne and rosacea

A

Rosacea doe not have comedomes

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9
Q

Treatment for acne vulagaris

A

Most acne - topical retinoids

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10
Q

Treatment for cystic acne

A

Tetracyclines, then oral retinoids

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11
Q

Pregnancy testing on isotretinoin

A

Twice before starting and monthly while taking

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12
Q

Presentation of androgenetic alopecia

A

Terminal hair becomes vellus
20-40 men and 50+ women

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13
Q

Diagnosis of androgenetic alopecia

A

Biopsy showing telogen and atrophic follicles

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14
Q

Treatment for androgenetic alopecia

A

Minoxidil topical
Finasteride
Spironolactone

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15
Q

Presentation of atopic dermatitis

A

Thick, dry skin found in antecubital fossa, wrist, ankles. Family hx of asthma

Face and scalp in infants

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16
Q

Diagnosis of atopic dermatitis

A

Patch testing and allergy referral

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17
Q

Treatment for atopic dermatitis

A

Review meds
Humidifier
Benadryl
Oral steroids
Phototherapy (PUVA)

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18
Q

Acid burns

A

Coagulation, necrosis, eschar - irrigation needed

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19
Q

Alkaline burns

A

Liquifaction necrosis
Deep damage

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20
Q

4 degrees of burns

A

1 - Sunburn, erythema and blanching
2 - Red, blistered skin, tender
3 - Tough and leathery, non-tender
4 - Into bone and muscle

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21
Q

Pediatric rule of nines

A

Head - 18%
1 Arm - 9%
Chest - 18%
Back - 18%
1 Leg - 14%

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22
Q

Palmar burn method

A

Patient palm = 1% of surface area - for small burns

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23
Q

Tx for mild burns

A

Fluids!!
Clean with soap and water
Drain and debride bullae and cover with 1% silver sulfadiazine

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24
Q

Tx for moderate and severe burns

A

Cover with dry dressing, hospital admission

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25
Q

Children in need of formal fluid resuscitation for burns

A

Greater the 10% of total body surface area burned

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26
Q

Fluids for pediatric burn victims who warrant it

A

LR - 3ml x weight in kg x body surface area affected
Half over 8 hours, rest over 16 hours

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27
Q

Presentation of contact dermatitis

A

Erythematous rash with itching and potentially vescicles.
Chronic - scaling, lichenification
Well demarcated borders

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28
Q

Allergic etiology of contact dermatitis

A

Type 4 hypersensitivity
Nickle, poisin ivey, etc.

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29
Q

Diagnosis of contact dermatitis

A

Allergy referral - NO skin prick tests

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30
Q

Treatment for contact dermatitis

A

Review meds, humidifier
Antihistamine
Triamcinolone
Oral steroids

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31
Q

Presentation of diaper dermatitis

A

Rash on buttocks common from 3wks to 2yrs
Fussiness, crying w/ diaper change
Shiny erythema with dull margins
Elevated with satellite pustules

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32
Q

Dx for diaper dermatitis

A

KOH for candida
Viral for scabies
Culture for strep

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33
Q

Tx for diaper dermatitis

A

Keep dry!
Zinc oxide and petroleum jelly
Nystatin or clotrimazole for candida

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34
Q

Presentation of perioral dermatitis

A

MC in young women
Papulopustular plaques and scales
Vermillion border SPARED

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35
Q

Dx for perioral dermatitis

A

Clinical, a biopsy may help

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36
Q

Tx for perioral dermatitis

A

Mild - topical ALONE:
Pimecrolimus, Erythromycin, Metronidazole
Moderate add oral doxy

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37
Q

5 agents of drug eruptions

A

PCNs
Bactrim
Anticonvulsants
NSAIDs
Sulfonamides

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38
Q

Treatment for drug eruptions

A

Stop agent, give epinephrine for anaphylaxis

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39
Q

Epinephrine peds dosing

A

Weight based under 16 lbs
0.15 for 16-55 lbs
0.3 for 55-110 lbs
0.5 for 110+ lbs

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40
Q

Tx for SJS in children

A

Burn unit with fluids

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41
Q

Etiology of erythema multiform

A

Type IV hypersensitivity
Self limited and recurring
Herpes, mycoplasma and upper respiratory may also be drugs

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42
Q

Presentation of erythema multiforme

A

Non itchy, target/iris like and SPLOTCHY rash, blanches

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43
Q

Major erythema multiforme

A

Widesperead lesions with 2+ mucosal site affected

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44
Q

Minor erythema multiforme

A

Limited with only 1 type of mucosa affected

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45
Q

Dx of erythema multiforme

A

Target lesions with rings and dusky center
Negative nikolsky sign (skin does not slide off)

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46
Q

Tx for erythema multiforme

A

Remove offending agent
IV fluids
Systemic steroids for severe

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47
Q

Erythema infectiousum

A

Parvovirus B-19 or Fifths Disease
Slapped cheeks with lacy extremity rash SPARING palms and soles
Resolves in 2-3 weeks

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48
Q

Hand Foot and Mouth disease

A

Cocksackie
Under 10 years old
Rashes on hands, feet and mouth
Supportive tx

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49
Q

Rubeola (4Cs)

A

Measles
4 C’s - Cough, coryza, conjunctivitis, cephalocaudal spread
Brick red rash with koplik spots

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50
Q

Rubella

A

German Measles
3-day rash
Rapid cephalocaudal spread
Pink to light red
Teratogenic

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51
Q

Roseola

A

Sixth disease
Herpevirus
TRUNK first!!
High fever followed by rosy rash
Supportive

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52
Q

Presentation of impetigo

A

MCC - S aureus
Face and extremities
Red sores and honey colored crust, vescicles
Weeping

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53
Q

Presentation of bullous impetigo

A

Bullous vescicles with varnish like crust
Fever and diarrea
Also S aureus

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54
Q

Dx for impetigo

A

Gram stain and cx with negative nikolsky

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55
Q

Tx for impetigo

A

Warm soaks
Topical mupirocin 1st line (bactoban)
Keflex or erythromycin for severe
Oral abx for bullous

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56
Q

Tx for MRSA impetigo

A

Vanc

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57
Q

Presentation of lice

A

Pruritic scalp, groin, body with white specs on hair shaft
Bites and hair loss

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58
Q

Tx for lice

A

Launder in 131 F water
Permethrin shampoo or lotion

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59
Q

Presentation of lichen planus

A

Autoimmune
5 Ps - Purple, Papule, Polygonal, Pruritis, Planar
IE. Itchy flat topped bumps

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60
Q

Tx for lichen planus

A

Topical steroids

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61
Q

Presentation of pityriasis rosacea

A

Children and young adults
Herald oval patch followed by papulosquamous rash - christmas tree pattern - itchy

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62
Q

Tx for pityriasis rosacea

A

Self limiting - use topical or oral steroids
Antihistamines also useful

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63
Q

Presentation of scabies

A

Pruritic papules with S-shaped or linear burrows on the skin
INtense itching - see excoriations

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64
Q

Dx for scabies

A

Micrscopic observation of scraping - mites, eggs, feces

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65
Q

Tx for scabies

A

Topical permethrin over entire body washing after 8-14 hours
Repeat in one week
Oral ivermectin for severe

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66
Q

Presentation of SJS

A

Rash on 3-10% of the body
Started new drug (ie. phenytoin)
Positive nikolsky sign
Fever

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67
Q

Dx for SJS

A

Skin biopsy showing necrotic epithelium

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68
Q

Tx for SJS

A

Stop offending medications
IVIG
Steroids out of favor

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69
Q

Tinea

A

Superficial non-candidal fungal infections
Dx with KOH prep
Fungal hyphae with septation

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70
Q

KOH prep for candida

A

Budding yeast and pseudohyphae

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71
Q

KOH prep for tinea versicolor

A

Sphaggheti and meatballs - short hyphae with cluster of spores

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72
Q

Tinea barbae

A

Papules and pustules around hair follicles
Oral griseofulvin or terbinafine

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73
Q

Tinea pedis

A

Athletes foot
Scaly eruptions between toes
Topical azoles

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74
Q

Tinea unguium

A

Oral terbinafine for mild to moderate

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75
Q

Tinea cruris

A

Topical azoles or nystatin
Diffusely red rash of groin or scrotum

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76
Q

Tinea capitis

A

MC fungal infection in peds 3-7 years
Oral griseofulvin
Ropical selenium sulfide as adjunct may be used

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77
Q

TInea corporis

A

Topical azole for 2-4 weeks or terbinafine

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78
Q

Tinea versicolor

A

Melssezia furfur hypo or hyperpigmented macules and papules
Use selenium sulfide for 7-10 days

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79
Q

Nystatin and dermatophytes

A

NOT effective

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80
Q

Toxic epidermal necrolysis presentation

A

Like SJS - but older patients and with 30+ percent of skin involved
Admit to burn unit

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81
Q

Presentation of urticaria

A

Blanchable, pruritic, raised, erythematous papules, plaques or wheels
Darrier’s sign (urticaria with skin rubbing)
Disappears in 24 hours

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82
Q

Dx for urticaria

A

May do IgE testing for specific trigger

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83
Q

Tx for urticaria

A

Antihistamine (first gen causes sleep ie. hydroxyzine)
Steroids
Epi for anaphylaxis

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84
Q

Tx for verrucae

A

Cryotherapy,
At home salicylic acid

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85
Q

Presentation of otitis media

A

Bulging TM with 2 other signs of inflammation:
TM erythema
Fever
Ear pain

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86
Q

Tx for otitis media

A

Amoxicillin
Cephalosporin for allergies
Clinda or Z max third line
Tympanostomy for recurrent

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87
Q

Presentation of mononucleosis

A

Lymphadenopathy, splenomegaly, and positive heterophile agglutination test (monospot)
Supportive tx
PCN causes a rash

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88
Q

Presentation of strep pharyngitis w/ centor criteria (4)

A

GABS - S. pyogenes
Centor criteria:
No cough
Exudates
Fever over 100.4
Cervicle Lymphadenopathy

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89
Q

When to get a strep test or cultrue

A

Rapid strep is 3/4 centor criteria
THroat cx if negative centor

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90
Q

Tx for strep pharyngitis

A

PCN or Z-max (secondary)

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91
Q

Sport resumption in mono

A

3-4 weeks from symptom onset

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92
Q

Presentation of allergic rhinitis

A

Clear nasal drainage with plae, bluish boggy mucosa, allergic shiners, nasal crease, histamine release

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93
Q

Tx for allergic rhinitis

A

Avoid allergens
Cromolyn sodium
Nasal/systemic corticosteroids

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94
Q

Rhinitis medicamentosa

A

From using intranasal decongestants for more than 3-5 days

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95
Q

Strep/Staph conjunctivitis or M cat/ gonococcal

A

Acute and mucopurulent - gentamycin or tobramycin

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96
Q

Chlamydial conjunctivitis

A

Giemsa stain and inclusion body
scant discharge
Erythromycin to treat

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97
Q

Allergic conjunctivitis

A

Tx with azelastin, antihistamines

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98
Q

Presentation of viral conjunctivitis

A

URI and eye watering
Self limited

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99
Q

Presentation of epiglottitis

A

Dysphagia, Drooling, Respiratory Distress
EMERGENCY
Caused by HIB
Stridor

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100
Q

Dx for epiglottitis

A

THumbprint sign on lateral neck x-ray
Culture for H. flu

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101
Q

Tx for epiglottitis

A

Intubate if needed
Supportive care
Ceftriaxone

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102
Q

MC site for anterior nosebleeds

A

Kiessalbach’s plexus

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103
Q

MC site for posterior nosebleeds

A

Woodruff’s plexus
Use posterior balloon packing

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104
Q

Dx for epistaxis

A

Most do not need direct visualization
CBC, PT, PTT for frequent bleeds

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105
Q

Tx for anterior nosebleeds

A

Direct pressure and leaning forward
Abx if packing is used
Petroleum jelly

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106
Q

Presentation of mastoiditis

A

Fever, otalgia, pain and erythema posterior. Forward displacement of the ear

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107
Q

Dx for mastoiditis

A

CT scan of the temporal bone with contrast for complicated and toxic appearing

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108
Q

Tx for mastoiditis

A

IV ceftriaxone
ENT referral
Middle ear drainage

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109
Q

Presentation of oral candidiasis

A

Mouth pain and white plaques that bleed when scraped

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110
Q

Dx for oral candidiasis

A

KOH prep with budding yeast and pseudohyphae

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111
Q

Tx for oral candidiasis

A

Nystatin or oral fluconazole

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112
Q

Presentation of orbital cellulitis

A

Decreased extra-ocular movement
Pain and proptosis
Often with sinusitis
7-12 y/o

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113
Q

Dx for orbital cellulitis

A

CT scan of orbits
FOcused assessment of extra-ocular muscles

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114
Q

Tx for orbital cellulitis

A

IV-broad spectrum abx
Vancomycin!!

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115
Q

Presentation of otitis externa

A

Edema with cheesy white discharge and painful palpation of tragus
Bone conduction > ear conduction

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116
Q

Treatment for otitis externa

A

Cipro or ofloxacin for 7 days if perforation
Hospitalize for malignant (seen in diabetics)

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117
Q

Fungal otitis externa

A

Pruritis and weeping with black, yellow or gray
Acetic acid or clotrimazole to treat

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118
Q

Presentation of peritonsillar abcess

A

Hot potato voice
Uvula deviation
Severe sore throat
Strep pyogenes

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119
Q

Diagnosis for peritonsillar abcess

A

X-ray of neck when in doubt

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120
Q

Tx for pertonsillar abcess

A

Aspiration/I&D
Oral amoxicillin/augmentin/clinda
May consider tonsillectomy

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121
Q

Presentation of strabismus

A

Lazy eye
Exo - out
Eso - in
HYper - up
Hypo - down
+tropia

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122
Q

Cover test

A

For strabismus:
Cover one eye observe the other
+ test uncovered eye shifts to refixate

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123
Q

Cover-uncover test

A

For strabismus
See deviation in the affected eye

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124
Q

Tx for strabismus

A

Glasses, occlusion therapy, orthoptic exercises
Amblyopia if untreated before 2

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125
Q

TM perforation

A

Only floxin drops can be used
SHould heal on own by 2 months (needs surgery if not healed by then)

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126
Q

Treatment for mycobacterium avium

A

Fever diarrhea and weight loss
AFB and culture for dx
Clarithromycin, ethambutol +/- rifampin

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127
Q

Tx for mycobacterium kansasii

A

Rifampin and ethambutol

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128
Q

Tx and presentation for mycobacterium marinum

A

Exposure to marine mammals
Dx by culture
Tetracyclines, FQs, Macrolides, Sulfonamides for 4-6 weeks

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129
Q

Presentation of epstein barr virus (mono)

A

Fever, lymphadenopathy and pharyngitis
Saliva transmission
Splenomegaly
Malaise

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130
Q

Dx for EBV

A

Heterophile agglutination test (monospot) - may not work in first 4 weeks
Maculopapular rash with ampicillin tx
Atypical lymphocytes with enlarge nuclei

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131
Q

Tx for EBV

A

Supportive with ibuprofen
Steroids if severe

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132
Q

Presentation of erythema infectiosum

A

Fifths disease/Parvo B-19
Slapped cheeks with lacy reticular rash sparing palms and soles
Sickle cell patients may develop eplastic crisis

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133
Q

Dx for erythema infectiosum

A

Parvo B-19 antibodies on PCR
Enlarge nuclei

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134
Q

Tx for erythema infectiosum and length of course

A

Symptomatic
Resolves in 2-3 weeks

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135
Q

Presentation of hand foot and mouth disease

A

Sores on hands, feet, mouth and buttocks
Children under 10 years
Sore throat, feeling unwell, anorexia

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136
Q

Tx and length for hand foot and mouth disease

A

Supportive and anti-inflammatories
Clears in 10 days

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137
Q

HHV 3

A

Herpes of chicken pox

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138
Q

HHV 4

A

Herpes of mono

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139
Q

HHV 5

A

Herpes of CMV

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140
Q

HHV 6

A

Herpes of roseola

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141
Q

Presentation of herpes simplex ophthalmicus in newborns

A

3-15 days postpartum
Lid vescicles

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142
Q

Tx for herpes simplex ophthalmicus in newborns

A

Acyclovir 60mg/kg/day for 14 days

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143
Q

Presentation of influenza

A

Fever, coryza, cough, headache, malaise
Dx via rapid antigen test

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144
Q

Age at which influenza vaccination is given

A

6 months and up

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145
Q

Treatment for influenza

A

Mostly symptomatic
Antivirals is under 48 hours for high risk patients
Amantadine and rimantadine only treat influenza a

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146
Q

Presentation of measles

A

Cough, Coryza, and Conjunctivitis
Koplik spots
Brick red exanthem spreading cephalocaudally

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147
Q

Dx of measles

A

Koplik spots are diagnostic
IgM titer
RNA test

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148
Q

Tx for measles

A

IG administration
1 week isolation
Vitamin A

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149
Q

MMR vaccine administration

A

1st at 12-15 months
2nd at 4-6 years

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150
Q

Presentation of mumps

A

Paramyxovirus
Orchitis, Meningitis, and parotitis
May cause pancreatitis

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151
Q

Diagnosis of mumps

A

PCR, elevated amylase, CSF lymphocytes

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152
Q

Tx for mumps and duration

A

Supportive
Lasts 7-10 days
May need scrotal support

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153
Q

Presentation of pertussis

A

Cough over 2 weeks in patients under 2 years old
Cold-like symptoms followed by coughing with inspiratory whoop

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154
Q

Dx for pertussis

A

Nasopharyngeal swab for culture

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155
Q

Tx for pertussis

A

Macrolide - erythromycin or Z-max

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156
Q

Tdap vaccination schedule (5 doses)

A

2,4,6,15-18 months and 4-6 years

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157
Q

Presentation of pin worms

A

Enterobiasis
Nocturnal perianal itching
Eggs on scotch tape test

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158
Q

Tx for pinworms

A

Albendazole or mebendazole

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159
Q

Presentation of roseola

A

High fever of 102-104 followed by as red rash - maculopapular
Starts on trunk, goes to extremities
Resolves without tx

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160
Q

Presentation of rubella

A

3-day rash
Cephalocaudal spread
More rapid than rubeola
Does not darken or coalesce
No coryza (stuffy nose)!!

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161
Q

Presentation of varicella (chickenpox)

A

Cephalocaudal rash with dewdrop on rose petal lesions in differing stages
May use acyclovir in special cases

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162
Q

Schedule for varicella vaccine

A

12-15 months
4-6 years

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163
Q

Etiology of acute bronchiolitis

A

Caused by RSV - infants and young children

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164
Q

Presentation of acute bronchiolitis

A

Tachypnea, respiratory distress and wheezing with a fever in an infant/young child
Fall and winter months

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165
Q

Dx for acute bronchiolitis

A

RSV culture positive with normal CXR

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166
Q

Treatment for bronchiolitis

A

Oxygen
Ribivirin for severe dise
Supportive tx

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167
Q

Indication for hospitalization for bronchilitis

A

O2 sat under 95-96%
Age under 3 months
RR over 70
Nasal flaring
Atelectasis on CXR
ANY ONE!

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168
Q

Presentation of asthma

A

Attacks of breathlessness and wheezing
Hx of allergies or eczema

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169
Q

Dx for asthma

A

Decreased FEV1/FVC (under 75-80%) with over 10% increase with bronchodilator therapy

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170
Q

Intermittent asthma

A

Less than 2 times per week with less than 2 night symptoms per month
SABA PRN - Albuterol

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171
Q

Mild persistent asthma

A

More than 2 times per week or 3-4 nigt symptoms per month
Low dose ICS

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172
Q

Moderate persistent asthma

A

Daily symptoms or more than 1 nightly episode per week
Low/medium dose ICS and LABA - ie. budesonide

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173
Q

Severe persistent asthma

A

SYmptoms several times a day and nightly
High dose ICS and LABA and steroids maybe

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174
Q

Acute asthma tx

A

Oxygen, Nebulizer, Ipratropium bromide, Oral steroids

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175
Q

Presentation of croup

A

Parainfluenza virus
6mo. to 3 years
Barking cough, stridor and steeple sign

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176
Q

Tx for croup

A

Supportive
For severe - racemic epinephrine, steroids

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177
Q

Cystic fibrosis inheritance

A

CFTR mutation
Autosomal recessive

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178
Q

Presentation of cystic fibrosis

A

THick mucous and pseudomonas infections
Steatorrhea
Growth retardation and foul smelling stools
Atelectasis

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179
Q

Dx for cystic fibrosis

A

Sweat chloride test

180
Q

Tx for CF

A

Physiotherapy, SUpplement fat soluble vitamins with High fat diet

181
Q

MC site for aspirated foreign body

A

RIght bronchus

182
Q

Presentation of bronchial FB

A

Inspiratory stridor or wheezing
with decreased breath sounds below
Hyperinflation of affected side on CXR

183
Q

Tx for bronchial FB

A

Remove with bronchoscope
RIGID bronchoscope is preferred in children

184
Q

Presentation of nasal FB

A

Persistent unilateral foul smelling nasal discharge

185
Q

Tx for nasal FB

A

Oxymetazoline drops to shrink mucous membrane prior to removal

186
Q

Tx of otic FB

A

Topical pain agents and flushing
Insects MUST be immobilized with mineral oil or lidocaine

187
Q

Management for ocular FB

A

Metallic objects may leave a rust ring
CT for globe penetration
May irrigate to remove corneal FB

188
Q

Hyaline membrane disease

A

Seen in premature infants
Atelectasis due to lack of surfactant production

189
Q

Presentation of hyaline membrane disease

A

Infant born before 30 weeks
Develops shallow respirations at 60/min
Grunting, retractions, cyanosis

190
Q

Dx of hyaline membrane disease

A

Ground glass lungs and air bronchogram

191
Q

Tx for hyaline membrane disease

A

Antenatal steroid 24-48 hours before birth
ET tube surfactant
PP mechanical ventilation

192
Q

MCC of viral pneumonia in kids

A

RSV

193
Q

Dx for viral pneumonia

A

CXR with bilateral interstitial infiltrates
POsitive RSV rapid antigen testing

194
Q

Tx for viral pneumonia

A

B2 agonists, fluids, rest

195
Q

Presentation of bacterial pneumonia

A

Fever, dyspnea, tachycardia, cough with or without sputum

196
Q

Dx and labs for bacterial pneumonia

A

CXR with patchy, segmental or lobar consolidation
Get gram stain and blood cultures x2

197
Q

Outpatient tx for pneumonia

A

Doxy or macrolides

198
Q

Inpatient tx for pneumonia

A

Ceftriaxone and Azithromycin/Levaquin

199
Q

Presentation of rheumatic fever

A

Fever with skin lesions, joint nodules, hx of sore throat some weeks ago with positive antistreptolysin titer

200
Q

Valves MC to be infected in rheumatic fever

A

MC - mitral
2nd - aortic
3rd -tricuspid

201
Q

M-protein

A

Present in rheumatic fever - antibodies against M protein may cross react with heart tissue

202
Q

5 major JONES criteria for rheumatic fever

A

Carditis
Chorea
Erythema marginatum
Polyarthritis
SQ nodules

203
Q

Erythema marginatum

A

Pink patches outlined with red

204
Q

5 minor jones criteria for rheumatic fever

A

Arthralgia
Elevated ESR/CRP
Fever
Increased PR interval
Leukocytosis

205
Q

Tx for Rheumatic fever

A

PCN and ASA

206
Q

Presentation of an ASD

A

Wide fixed, split second heart sound
Systolic ejection murmur
Failure to thrive

207
Q

Dx for ASD

A

Diagnosed by passing a catheter through the defect

208
Q

Tx for ASD

A

Diuretics, ACEI, Digoxin
Surgical closure - under 5 mm may close on own

209
Q

Presentation of aortic coarctation

A

Elevated BP in arms with low BP in legs
Pulses in legs also diminished
Aortic ejection murmur radiating to the back

210
Q

Dx of aortic coarctation

A

EKG - LVH
CXR - Notching of the ribs causing a figure of 3 sign

211
Q

Tx for aortic coarctation

A

Balloon angioplasty, stent placement or surgical correction usually performed between 2 and 4

212
Q

Pharm for neonatal aortic coarctation

A

Prostaglandin E1

213
Q

Presentation of hypertrophic CM

A

SOB, chest, pain and near syncope in young athletes
Systolic murmur louder with vlasalva quiet with squatting

214
Q

Dx and Tx for hypertrophic CM

A

Echo to diagnose
BB and CCB
NO diuretics!!

215
Q

Presentation of Kawasaki disease

A

CRASH and burn
Conjunctival injection
Rash - all over
Adenopathy - cervical
Strawberry tonggue
Hand and foot swelling
FEVER! 5 days without response to antipyretics

216
Q

Demographics of kawasaki disease

A

Kids under 5
MC in boys

217
Q

Dx for kawasaki disease

A

4 CRASH symptoms with 5+ day fever
Echo for cardiac issues

218
Q

Tx for kawasaki disease

A

Autoimmune
IVIG and ASA
Resolves in 6-8 weeks
25% risk of heart complications if untreated

219
Q

Presentation of PDA

A

3-6 week infants with tachypnea, diaphoresis, and FTT
Machinery murmur in late systole at pulmonic post

220
Q

Dx for PDA

A

Echo

221
Q

Tx for PDA

A

Indomethacin to help close (NSAIDs CI in pregnancy because they close it in utero)

222
Q

Dx criteria for orthostatic hypotension

A

20mmHg drop systolic of 10mmHg drop in diastolic after standing

223
Q

Tx for POTS

A

Patient education to avoid triggers
Exercise conditioning
No approved drugs

224
Q

4 features of tetralogy of fallot

A

VSD
Pulm stenosis
RV hypertophy
Overriding aorta

225
Q

Presentation of terology of fallot

A

Difficulty feeding and FTT
CYanosis and loss of conscienceness when crying (TET spells)
Crecendo decrescendo holosystolic murmur at LSB radiating to back

226
Q

Imaging for tetrology of fallot

A

Boot shaped heart

227
Q

Presentation of VSD

A

Noncyanotic
Tires easily
Loud, harsh holosystolic murmur on LLSB without radiation
MC pathologic childhood murmur

228
Q

Tx for VSD

A

Small or medium close by 6 years
Surgery for large defects

229
Q

Presentation of appendicitis

A

Colicky pain around the unbilicus that moves to the RLQ
Rebound tenderness
Rovsing, Obturator, and Psoas signs

230
Q

Dx for appendcitis

A

US or CT
Neutrophillia on CBC
Tx - appendectomy

231
Q

Presentation of colic

A

Severe paroxysmal crying peaking at 2-3 months, ending around 4 months
Exterme fussiness and drawing knees to abdomen

232
Q

Dx for colic

A

Rule of 3’s
3hrs per day
3 days/wk
for 3 weeks

232
Q

Management of colic

A

Don’t shake baby
Will likely stop around 4 months
Possible formula switch

233
Q

Presentation of childhood constipation

A

Under two BMs per week, 1 or more encopresis episodes per week
Hard painful BMs
Fecal mass in rectum
Toilet obstruction

234
Q

MC triggers for childhood constipation

A

Transition to solid foods
Potty training
Reduced fiber d/t solid foods

235
Q

Treatment for childhood constipation

A

Increase fiber 11-24 g/day
Decreased milk
Mineral oil or Miralax (polyethylene glycol)

236
Q

Presentation of pediatric dehydration

A

Prolonged cap refill
Poor skin turgor
Abnormal breathing
Dry mucous membranes

237
Q

Signs that dehydration is severe

A

Lethargy and unconsciousness
Absent tears
Thready pulse

238
Q

Tx for pediatric dehydration

A

Oral rehydration in small amounts - 5 mL every 1-2 mins
Use IV if that fails

239
Q

Presentation of duodenal atresia

A

Closure or absence of the duodenal lumen
Causes increased amniotic fluid as a baby
Early billious emesis
Associated with Down syndrome

240
Q

Dx for duodenal atresia

A

Double bubble on XR
Commonly caught prenatally
Corkscrew formation

241
Q

Tx for duodenal atresia

A

Suction and drain secretions
IV glucose and abx
SURGERY!

242
Q

Presentation of encopresis

A

Repetetive involuntary stooling in children 4+
Associated with constipation
Loose stools

242
Q

Dx for encopresis

A

Rectal exam and KUB US

243
Q

Tx for encopresis

A

Miralax
Suppository of glycerin
ELiminate cows milk
Laxatives for 6-12 months
5-10 minutes toilet sitting after meals

243
Q

Tx for FB swallowing in peds - button batteries

A

Remove all button batteries past the esophagus

243
Q

Tx for FB swallow - sharp object

A

Monitor with serial imaging if beyond pylorus

244
Q

Tx for swallowed small blunt object

A

Remove if stuck at pylorus for 3-4 weeks

244
Q

Management for over 3cm object ingestion

A

Remove if before pylorus, monitor with serial imaging after pylorus

245
Q

Tx for acid or alkaline ingestion

A

Do not induse vomiting
ABCs
Endoscopy after 2-3 weeks

246
Q

Presentation of gastroenteritis

A

Diarrhea, anorexia, vomiting and abdominal pain
MCC - virus (rotavirus) can be bacterial (campylobacter/e coli), fungal, etc.

246
Q

Dx for gastroenteritis

A

Clinical
Stool cultures if under 5

246
Q

Management for gastroenteritis

A

HYdration status (are they crying/peeing)
Abx for children with bloody diarrhea - Cipro, Doxy, Zmax, Bactrim

247
Q

Rotavirus vaccination schedule

A

2,4,6 months (rotarix only 2 and 4; rotateq at 2,4,6)

248
Q

Presentation of GERD

A

A small amount is normal in infants
FTT, Pneumonia, choking, apneic episodes
Emesis with meals

249
Q

MCC of gerd

A

Overfeeding

249
Q

CMP for GERD

A

hypochloremic, hypokalemic, metabolic alkalosis

250
Q

Tx for GERD

A

Smaller frequent feedings
Tickened feeds
PPI for esophagitis

251
Q

Presentation of neonatal hepatitis

A

Jaundice, acholic stools, hepatomegaly and FTT
Slef limited disease
Exclusion of other dx

252
Q

Tx for neonatal hepatitis

A

Triglyceride containing formulas
Fat soluble vitamins
Orsodeoxycholic acid
Liver transplant if severe

253
Q

Presentation of viral hepatitis

A

Malaise, jaundice, vomiting
Scleral icterus

254
Q

Dx for viral hepatitis

A

Uniformly elevated liver enzymes
anti-HAV antibodies

254
Q

Hepatitis titers of acute HBV infection

A

Positive HBsAg and Anti HBc positive early on HBeAg

255
Q

Hepatitis titers of resolve hepatitis

A

Positive Anti HBs, HBc, and HBe

256
Q

Hepatitis titers for chronic HBV infection

A

Positive HBs and anti-HBc
HBe and anti-HBe may or maynot be positive

257
Q

Tx for viral hepatitis

A

IVIG for HAV within 14 days of exposure
Refer for chronic elevation of ALT

257
Q

Immunization schedule for HBV

A

Birth, 1-2 months, 6-18 months

258
Q

Immunization schedule for HAV

A

12 and 18 months (second dose before 2 years)

259
Q

Presentation of hirschprungs disease

A

Contraction of distal segment of the colon due to lack of ganglion migration
Inability to pass meconium in first 48 hours of life
Constipation, vomiting, abdominal distension

260
Q

Dx of hischprungs disease

A

Rectal suction biopsy revealing paucity of ganglion cells
Barium radiography
DRE

260
Q

Tx for hirschprung’s disease

A

Resection of bowel or colostomy

260
Q

Dx for inguinal hernia

A

Ultrasound if no bulge seen of PE

260
Q

Tx for inguinal hernia

A

Surgical repari within 14 days recommended
Emergent referral for incarceration

261
Q

Presentation of intussisception

A

MC at 5-9 months
After viral infections
Crampy, colicky abdominal pain with legs drawn to chest
Sausage shaped mass and currant jelly stools

261
Q

Diagnosis/Treatment for intussusception

A

Barium enema - treats
Crescent sign or Bull’s eye on XR
Operation if enema fails

262
Q

Presentationof neonatal jaundice

A

Total billirubin over 2 mg/dL

262
Q

Physiologic jaundice parameters

A

Isolated and Unconjugated
Rises slower than 0.2 mg/dL per hour or 5 mg/dL per day
Remains lower than 18 mg/dL

262
Q

Diagnostics for jaundice

A

Coombs test for ABO/Rh incompatibility
Hemoglobin for hematomas
Reticulocytes for hemolysis
If all three are normal likely breast milk jaundice

263
Q

Presentation of lactose intolerance

A

Abdominal pain, bloating, borborygmy, nausea
TYpical within 30 minutes of dairy consumptoms
May have low calcium

264
Q

Dx of lactose intolerance

A

Lactose hydrogen breath test - definitive
Stool acidity
Usually clinical

264
Q

Presentation of niacin deficiency

A

4 Ds - Diarrhea, dementia, dermatitis, death
Corn staple diets are a risk factor

265
Q

NIacin RDAs

A

9-13 - 6-12mg
Preg - 18 mg
Lact - 14 mg

265
Q

Dx for niacin deficiency

A

N-methylnicotinamide levels
or erythrocyte NAD:NADP ratio

266
Q

Presentation of pyloric stenosis

A

Under 3 months
Nonbilious projectile vomiting with every feed
Olive shaped mass in abdomen

267
Q

Dx of pyloric stenosis

A

Pyloric US with double track
Barium string or shoulder sign
HYpochloremic, Hypokalemic metabolic alkalosis

268
Q

Tx for pyloric stenosis

A

Pylormyotomy

269
Q

When to refer umbilical hernia to surgery

A

If it persists beyond 2 years of life

270
Q

Presentation of vitamin A deficiency

A

Dry eyes, Night blindness, impaired immunity
Egg yolk, butter, leafy vegetables

271
Q

Dx for vitamin A deficiency

A

Serum retinol levels under 20 mcg/dL

272
Q

Presentation of vitamin C deficiency

A

Swollen gums, bruising, petechiae, poor wound healing
Infants fed evaporated/boiled cows milk

273
Q

Dx for vitamin C deficiency

A

Plasma leukocyte vitamin C levels

274
Q

Vitamin A dietary recommendation

A

100K IU 6-12 months
200k after

275
Q

Peds vitamin C recommendation

A

100 mg 3 times daily for deficiency

276
Q

Presentation of vitamin D deficiency

A

Rickets - bowed legs with increased fractures
Dark pigmentated individuals who are exclusively breast fed

277
Q

Dx of vitamin D deficiency

A

Serum 25OHD levels
Insufficient - 12-20 ng/mL
Deficient - Under 12 ng/mL

277
Q

Vitamin D supplementation for breastfed infants

A

400 IU daily

278
Q

2 month milestones

A

Alert to sounds
Recognizes parent
Eyes track past midline

279
Q

4 month milestones

A

Rolls front to back
Laughs
Grasps rattle

280
Q

6 month milestones

A

Sits
Babbles
Feeds self

281
Q

9 month milestones

A

Pincer grasp
Mama/Dada
Bye bye
Bangs objects

282
Q

12 month milestones

A

Stands/Walks on own
Fine pincer
Follows 1 step commands

282
Q

15 month milestones

A

Stoops and recovers
Scribbles
3-5 words
Turns pages

283
Q

18 month milstones

A

Runs
3 cube tower
Points to body parts

284
Q

24 month milestones

A

Kicks ball
50+ words
Undresses

285
Q

36 month milestones

A

Pedals tricycle
Copy circle
Brushes teeth

286
Q

48 month milestones

A

Copies square
100% intelligible
Knows 4 colors

287
Q

60 month milestones

A

Skips
Copies triangle
Defines words and uses 5 word sentences

288
Q

Neonatal guidance

A

Breast feed every 2-3 hours
Crib safety

288
Q

2-4 week guidance

A

Tummy time when awake for 5-10 mins 2-3 time per day
2 weeks should be back to birth weight

289
Q

Guidance for 2 months

A

After 3 months no more nocturnal eating
Parent return to work

290
Q

4 month guidance

A

Introduce solid food
Back to sleep and choking

291
Q

6 month guidance

A

Start water and baby food

292
Q

9 month guidance

A

NO honey before 1
Avoid juice

293
Q

12 month guidance

A

Introduce cows milk
Timeout vs. corporeal punishment

293
Q

15 month guidance

A

Less eating with slower growth

294
Q

18 month guidance

A

Prep for toilet training

295
Q

2 year guidance

A

Forward facing car seat
TOilet training

296
Q

4 year guidance

A

Bike helmet

297
Q

5 year guidance

A

DIscuss rules and consequences

298
Q

7-10 year guidance

A

Lap and shoulder belt no back seat until 13

299
Q

5 features of down syndrome

A

Single palmar crease
ASD
Umbilical hernia
Hypotonia
Abundant neck skin

300
Q

Sterility in down syndrome

A

Males are sterile

301
Q

Testing for downs

A

Amniocentesis at 15th week
CVS at 10th-12th week
Quad screen

302
Q

Quad screen positive for downs

A

Increase bHCG and Inhibin A
Decreased Unconjugated estriol and alpha fetoprotein

303
Q

Presentation of febrile seizure

A

Convulsions associated with temperature above 100.4 F
Between 6 months and 5 years
Viral in fections MC

303
Q

Dx for febrile seizure

A

Lumbar puncture is meningitis suspected
Clinical

303
Q

Tx for febrile seizure

A

Reassure
Benzo if over 5 minutes
May get an EEG do not have to

304
Q

Tdap vaccination schedule

A

2 months
4 months
6 months
15-18 months
4-6 years
Boosters start at 11

305
Q

HIB vaccination schedule

A

2 months, 4 months, 12-15 months

305
Q

Prevnar vaccine schedule

A

2 months, 4 months, 6 months, 12-15 months

306
Q

Polio vaccine schedule

A

2 months, 4 months, 6-18 months, 4-6 years

307
Q

HPV vaccine schedule

A

Two doses between 9-14, three if above 15
Given at 0 months, 1-2, and then 6 month intervals

307
Q

Meningococcal vaccine shcedule

A

11-12 years
16 years

307
Q

Presentation of meningitis

A

Headache, Fever, Nuchal rigidity
No mental status change (unlike enchephalitis

308
Q

MCC of neonatal meningitis

A

E. coli and Group B strep

309
Q

Most people MCC of meningitis

A

S. Pneumo, N. meningiditis

309
Q

Tx for menigitis

A

Dexamethasone with empiric abx:
Cephalosporin, Vanc, PCN)
Acyclovir for HSV

310
Q

Treatment for focal seizures

A

Phenytoin or Carbamazepine

311
Q

Tonic seizure

A

Seizure presenting with rigidity

312
Q

TX for status epilepticus

A

Benzodiazepines (lorazepam) followed by phenytoin

312
Q

Benign myoclonus of infancy

A

Seizure disorder in a neonate with a NORMAL EEG
Valproate is the drog of choice

313
Q

Characteristics of a pseudoseizure

A

TOngue biting
No incontinence
Will stop hands from hitting face

314
Q

When to treat epilepsy

A

After two unprovoked seizures

314
Q

General maintainance for focal seizures

A

Lamictal

315
Q

General tx for generalized seizures

A

Valproate or Levetiracetam

316
Q

Presentation of teething

A

6-24 months of age
Drooling, CHewing, Irritability, Elevated temp but not fever

316
Q

Tx for teething

A

Chilled teething ring
AVOID Lidocaine
Tylenol or Ibuprofen

316
Q

Presentation of turner syndrome

A

45, XO
Short stature, webbed neck, heart/kidney defects, shield chest, amennorhea

316
Q

Diagnostics for turner syndrome

A

Low AMH
Karyotype
GI telangiectasias

316
Q

Tx for turner syndrome

A

GH therapy and Sex hormone therapy

317
Q

Presentation for GAD

A

Excessive worry pertaining to multiple domains for 6+ months

318
Q

Tx for GAD

A

SSRIs first line or venlafaxine
Buspirone
Benzos short term
THerapy

319
Q

Presentation of panic disorder

A

Unexpected, recurrent panic attacks for 1+ months
Peak in 10 minutes

320
Q

Tx for panic disorder

A

SSRI
Benzos for acute
CBT

320
Q

First line tx for specific phobia

A

Exposure therapy
SSRI for agoraphobia

321
Q

Presentation of ADHD

A

Hyperactivity, impulsivity, or inattentiveness manifesting before 12 years
6 symptoms for 6 months
More than 1 setting

321
Q

1st line Treatment for ADHD - 4 meds

A

Methylphenidate (Ritalin, Concerta, Daytrana)
Dexmethylphenidate (Focalin)
Amphetamine (Adderall, Dexedrine)
Atomoxetine (Strattera)

322
Q

2nd line tx for ADHD - 4 meds

A

Guanfacine, Clonidine, Bupropion, Venlafaxine

322
Q

Presentation of autism spectrum disorder

A

Social communication defecit
Restricted or repetetive behavior
Symptoms present in early development

323
Q

Management for autism spectrum disorder

A

SLP referral
THerapy
Abilify/Risperidone for mood
SSRI for stereotyped behavior

323
Q

5 Red flag injuries for child abuse

A

Spiral fracture
Stocking glove or doughnut burns
Conflicting history
Various stages of healing
Face back and buttock regular injuries

324
Q

What can be considered neglect

A

Minor allowed to engage in harmful behavior
Child under 13 unattended

324
Q

Management for child abuse

A

Care for immediate injuries
Report to CPS
INvolve social work

325
Q

Presentation of MDD

A

5+ symptoms for 2+ weeks with either depressed mood and or anhedonia

326
Q

SIG E CAPS of depression

A

Sleep disturbances
Interest loss
Guilt
Energy loss
Concentration difficulty
Appetite changes
Psychomotor
Suicidal thoughts

326
Q

Persistent depressive disorder

A

Symtpms for 2+ years
SSRI tx and exercise

326
Q

Premenstrual dysphoric disorder

A

Depression the week before menstruation, absent during menstruation
Must include one of - Affective lability, conflict, depressed mood, anxiety
SSRI and birth control

327
Q

Conduct disorder criteria

A

Three criteria in past 12 months and one in the past 6

327
Q

Criteria of ODD

A

Irritable and angry mood with 4 symptoms for 6 months
Not aggressive and destructive like conduct disorder

328
Q

Tx for ODD and CD

A

CBT and family therapy
May use antipsychotics for symptoms

329
Q

Presentation of anorexia

A

BMI under 17 with preoccupation about weight (ie. weighting self multiple times, etc.)
Binge purge OR restrictive

329
Q

Management of anorexia

A

Therapy is mainstay
Hospitalization if weight is under 75% expected

330
Q

Bullimia

A

Mass eating followed by purging, feel out of control
Compensatory behaviors at least once a month for 3 months
FLuoxetine to treat

331
Q

Presentation of avascular necrosis of the femur

A

Insidious onset pain in the groin, lateral hip, buttocks

332
Q

Causes of avascular hip necrosis

A

Trauma, Steroid, SIckle cell disease
Legg-Calve Perthes disease for peds

333
Q

Age of presentation for Legg Calve Perthe disease

A

2-11 with peak incidence at 4-8 years

334
Q

Dx for avascular hip necrosis

A

MRI of the hip demonstrating necrosis effusion

334
Q

Treatment for avascular hip necrosis

A

Conservative to hip replacement

334
Q

Presentation of congenital hip dysplasia

A

Assymetric thigh creases
Positive barlow test with a clunk on ortelani
Limping, waddling, or unequal length

335
Q

TX for congenital hip dysplasia

A

Pavlikc harness under 6 months
Hip spica cast 6-15 months
Open reduction and hip spica cast 15-24 months

335
Q

Presentation of juvenile idiopathic arthritis

A

Begins before 16
Morning stiffness and stiffness after inactivity

336
Q

3 types of JIA

A

Oligoarticular - 1-4 joints during first 6 months of disease
Polyarticular 5+ joints (RF negative have better prognosis
SYstemic - With fever, etc.

337
Q

Management of JIA

A

Test for RF, ANA, HLA-B27
NSAIDs, Intra-articular steroids, methotrexate

337
Q

Presentation of osteosarcoma

A

10-14 years - MC
Night pain, bone pain, and joint swelling
May look like growing pains

338
Q

Dx and metastasis sites of osteosarcoma

A

XR with sunburst or hair on end appearance
Lung = MC site of mets

339
Q

Tx for osteosarcoma

A

Limb sparing resection or amputation

340
Q

Presentation of ewing sarcoma

A

5-25 years
Fever - like infection
Palpable mass
Swelling
Local tenderness

340
Q

Diagnosis and tx for ewing’s sarcoma

A

Lytic lesion with onion skinning appearance on XR
Chemo, surgery, and radiation

341
Q

Presentation of osteochondroma

A

Benign lesion mostly in 10-20 y/o males
Pedunculated stalk on XR
Resect if becomes painful

341
Q

Presentation of nursemaid’s elbow

A

Ages 1-3
Child lifted by arm
Holds it slightly bent and close to the body

342
Q

Treatment for nursemaid’s elbow

A

Supination-flexion technique for subluxed radial head

343
Q

Presentation of Osgood-Schlatter disease

A

9-14 year old male MC
Tenderness over tibial tubercle assoc with sports that involve running
US may show swelling around tuberosity

344
Q

Tx for osgood schlatter disease

A

Ice, NSAIDs, rest
Ossicle resection in severe cases

345
Q

Presentation of scoliosis

A

Cobb angle of over 10 degrees
MC to begin at 8-10 years of age
Assymetry noted

345
Q

Dx for scoliosis

A

Adams test - forward bending to reveal assymmetry
PA and lateral radiographs
May use PFT or MRI

346
Q

4 treatments of scoliosis depending on degree of curvature

A

10-15 degrees - 6-12 month follow up for XR
15-20 degrees 3-4 month follow ups (6-8 in patients almost grown)
20-40 degrees - PT and bracing (refer to ortho
40+ - Surgery - refer to ortho

347
Q

Slipped capital femoral epiphysis

A

TYpical patient - obese boy, 10-16 years old
Head of the femur slps of neck of the femur inferiorly and posteriorly

348
Q

Presentation of SCFE

A

Dull groin pain
Worse with physical activity
Recent growth spurt
Limp
Obese

349
Q

Dx for SCFE

A

AP, Frog Leg, and Lateral XR
MRI if radiographs are negative

350
Q

Tx for SCFE and one potential complication of the condition

A

Surgical fixation with screw
May consider prophylaxis in other hip
Avascular necrosis is a potential complication

351
Q

Presentation of type 1 diabetes in children

A

Weight loss, polydipsia, polyphagia, and polyuria
Diffuse abdominal pain
Rapid breathing
Fruity breath

351
Q

Dx for type 1 diabetes

A

Random blood glucose over 200 mg/dL
2 fasting glucoses over 126mg/dL
2 hour OGTT over 200
A1C over 6.5

LOW C-Peptide differentiating from T2DM

351
Q

3 Antibodies potentially present in T1DM

A

Insulin, GAD65, and IA-2 antibodies -if present, presume T1DM

352
Q

Tx for T1DM

A

Insulin therapy with fingerstick monitoring 4 times per day

353
Q

Short acting insulins

A

Lispart, Aspart, Glulisine
30 minonset with 1-3 hour peak

354
Q

Long acting insulin

A

Glargine, Degludec, Detemir

355
Q

Presentation of hypercalcemia

A

FTT - often found on chemistry panel
May have hyperparathyoidism
Bisphosphonates for bone resorption
Surgery for hyperparathyroidism

356
Q

Presentation of hyperthyroidism

A

Heat intolerance, restlessness, emotional lability, sweating, looses stools, etc.
OFten neonatal graves

356
Q

Dx and Tx for hyperthyroidism

A

Elevated T4/T3 with suppressed TSH
Methimazole
LIfelong monitoring

357
Q

Presentation and MCC of hypothyroidism

A

Hashimotos - MCC
Choking, lethargy, hoarseness, Floppiness, Low weight
Tx with synthroid

358
Q

Normal weight BMI percentile

A

5-85th percentile for age and sex
Obese is over 95th percentile

358
Q

XR for bone age

A

AP of left wrist taken to assess

359
Q

Tanner stage 1 for males females and both

A

Hair - No hair
Fem - No galndular breast tissue palpable
Male -Testicular vol under 4mL axis under 2.5 cm

359
Q

Tanner stage 2 for males females and both

A

Hair -DOwny hair
Fem - Breast bud palpable
Male - 4-mL or 2.5-3.3 cm

360
Q

Tanner stage 3 for males females and both

A

Hair - Scant terminal hair
Fem - Breast bud outside of areola
Male - 9-12 mL 3.4-4.0 cm

361
Q

Tanner stage 4 for males females and both

A

Hair - Triangle of terminal hair
Fem - Elevated areola formin “double scoop”
Male - 15-20 mL 4.1-4.5 cm long

362
Q

Tanner stage 5 for males females and both

A

Hair beyond inguinal crease
Single breast contour with nipple protrusion
Over 20 mL or over 4.5 cm

362
Q

Astrocytoma

A

MC primary CNS tumor in children
Often benign - morning headaches, vomiting, lethargy
Resection with radiation and chemo

363
Q

Medulloblastoma

A

Malignant posterior fossa tumor
Mets through CSF
3-4 years pr 8-10 years
Vomiting, HA, visual changes
Surgery, radiation, chemo

364
Q

Ependymoma

A

3rd MC tumor in children
Mean age is 6 years
Intercranial pressure
Resect, chemo, radiation

365
Q

Retinoblastoma

A

Leukoria, surgical enuecleation and chemo

366
Q

Two forms of hemophilia

A

Hemophilia A - Factor VIII
Hemophilia B - Factor IX
X linked recessive

367
Q

Presentation of lead posoning

A

FTT
Abdominal pain
Lives in an older home
Lethargy

368
Q

Diagnosis of lead poisoning

A

Serum lead level of 10mcg/dL
Basophilic stippling
Low MCV and MCH
Hemolysis

368
Q

Management for lead poisoning

A

CHelation therapy - indicated for levels 45+
Dimercaprol
Hospitalize if levels over 70

369
Q

Presentation of ALL

A

Lymphadenopathy, bone pain, bleeding, fever
Over 20% blasts in marrow
Peak age 3-7 years
ANC over 1000
Chemo

370
Q

Presentation of AML

A

MC in males
Soft tissue tumor - chloroma in skin or spinal cord with green hue
Smear Auer rods
Bone pain, palor, ecchymosis

371
Q

Tx for ALL and AML

A

Chemo for both, bone marrow transplant for AML

371
Q

Presentation of hodgkin lymphoma

A

15-35 years
Painless cervical lymphadenopathy
Mediastinal nodes
B symptoms (fever, night sweats, weight loss)

372
Q

Dx for hodgkin lymphoma

A

CXR mediastinal mass
Reed sternberg cells - pathognomic

372
Q

Tx for hodgkin lymphoma

A

CHemo, radiation. Better prognosis than non-hodgkin

373
Q

Presentation of non-hodgkin lymphoma

A

Painless lymphadenopathy with GI, bone marrow, and spinal cord lesions
Non contiguous spread
NO reed sternberg cells

374
Q

Neutropenia

A

ANC under 1,000
Fever with hx of chemo

375
Q

Therapies for outpatient, psuedomonas, and unstable neutropenia

A

Outpatient - Cipro and AUgmentin
Mono (psuedomonas) - Cefepime, Imipenem, or Augmentin
Unstable - Add vanc or metronidazole

375
Q

Cryptorchidism treatment

A

Testes should be descended in full term infant
Correct as soon as possible after 4 months of age

375
Q

Tx for cystitis in peds

A

Keflex (1st gen) if no kidney involvement
Cefuroxime (2nd gen) if kidney involvement

375
Q

Normal age of bladder control

A

2-3 years

376
Q

Age at which bed wetting becomes concerning

A

5 years

376
Q

Medication for bed wetting

A

Desmopressin to produce less urine

377
Q

Postinfectious group a strep glomerulonephritis

A

10-14 days after infection with elevated ASO titers and low complement
Abx and supportive tx, steroids

377
Q

IgA nephropathy

A

24-48 hours after a URI of GI infection
Berger disease

377
Q

Alport’s syndrome

A

Isolated, painless hematuria
Renal failure and hearing loss
Conical lens of eye exam

378
Q

Management of a hydrocele

A

Most resolve by 1 year on own
Needle aspiration of surgeyr can be done

379
Q

Management for hypospadias

A

Don not circumcise, surgery

380
Q

Window for testicular torsion surgery

A

4-6 hours

380
Q

Prehns sign

A

Negative in testicular torsion -elevation does not help

381
Q

Vesicoureteral reflux

A

Recurrent UTIs with pyelonephritis
Dx via VCUG
Mild may resolve, surgery and prophylactic abx for less mild

EOR Exams (3 decks)

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