Peds II- Exam 1 Quick Review Flashcards

1
Q

Two types of circumcision

A

Gomco (surgical removal)

Plastibell (cut off circulation, falls off naturally)

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2
Q

Epispadias

A

DORSAL

Bladder

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3
Q

Hypospadias

A

VENTRAL

Chordee

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4
Q

Cryptor should be a concern after

A

4 months

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5
Q

Cryptor increases risk of 3 things

A

Testicular torsion
Subfertility
Testicular CA

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6
Q

Orchipexy done to fix

A

Cryptor- ideal to be done before 2 YO

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7
Q

2 peak times for Testicular torsion to occur

A

Neonatal

Puberty 12-18

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8
Q

Testicular torsion

A

“high riding”
Negative Prehn
Absent Cremasteric reflex

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9
Q

TOC for Testicular Torsion

A

Doppler US

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10
Q

1st line tx for UTI

A

Cephalosporin
Febrile: 10 d
Afebrile: 3-5 d

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11
Q

When to order RBUS

A
<2YO First febrile UTI
Any age UTI AND
-FH renal issue
- poor growth or HTN
-not responding to Abx
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12
Q

Horseshoe kidney

A

increased risk for Wilms tumor

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13
Q

Manage horseshoe kidney

A

If creatinine is normal and No hydronephrosis: do nothing

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14
Q

If Horseshoe kidney AND VUR

A

Consider prophylactic Abx

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15
Q

Ultrasound is TOC

A

Testicular torsion
Pyloric Stenosis
Intussusception

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16
Q

VCUG test of choice for

A

VUR

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17
Q

Order VCUG if:

A
  • any age with 2 or more febrile UTIs
  • any age first Febrile UTI AND
  • another anomaly seen on RBUS
  • temp >/ 102.2 and pathogen other than EColi
  • poor growth and HTN
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18
Q

Post strep GN

A
7-14 d after
"throat, bloat, coke"
Edema
Cola urine
HTN
Renal insuff
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19
Q

Tetrad of Post strep GN

A

Abd pain
Renal dz
Palpable purpura
Arthritis/algia

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20
Q

Tetrad of HUS

A

Hemolytic anemia
AKI
Thrombocytopenia

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21
Q

What to consider with HUS?

A

Did person have GI bug 5-10 d before HUS sx occurred?

SHIGATOXIN E.Coli

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22
Q

Proteinuria Nephrotic syndrome 4 cardinal sx

A

Nephrotic range proteinuria
Hypoalbuminemia
Edema
Hyperlipidemia

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23
Q

Meds for GERD

A
PPI (Omeprazole)
H2 blocker (Ranitidine)
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24
Q

Hypertrophic Pyloric Stenosis

A

Did baby have Macrolide use in first few wks of life?

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25
Q

Pyloric Stenosis

A

Non bilious
Forceful vomiting
Hungry Vomiter
“OLIVE LIKE MASS:

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26
Q

Test of choice for Pyloric Stenosis

A

Ultrasound

can also do UGI: shows “string sign”

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27
Q

Congenital Atresia (blockage)

A

Duod: most common site

BILIOUS vomiting, abd distension, failure to pass meconium

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28
Q

Test of choice for Congenital Atresia

A

X Ray: Double Bubble!!! if duod is the site

Ileum or Jej: dilated air loops

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29
Q

Midgut malrotation with volvulues

A

Volvulus is small bowel twisting around the Superior Mesenteric Artery

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30
Q

Sx of Midgut malrotation with volvulus

A

BILIOUS VOMITING
abd pain
Hemodynamically unstable OHSHIT
Hematochezia

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31
Q

Test of choice for Midgut malrotation

A

Upper GI

to detect rotation
“corkscrew appearance”

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32
Q

Intussusception

A

most common abdominal emergency in kids <2 YO

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33
Q

Intussusception can lead to

A

Obstruction

34
Q

sx of intussusception

A
Intermittent, crampy pain
drawing legs up
inconsolable
"Lead point" cause -Meckels
-ROTAVIRUS
35
Q

Test of choice for Intussusception

A

Ultrasound
“target sign”
“coiled spring”

36
Q

Triad of Intussusception

A

Jelly stool
Abd mass (sausage shaped)
Abd pain

37
Q

Hydrostatic/Pneumatic Enema

A

Diagnostic and Therapeutic for Intussusceptin

38
Q

Crohns

A
branch of IBD
whole tract
skip lesions
deeper-transmural
colonoscopy or endoscopy
"cobblestone"
39
Q

Ulcerative Colitis

A
superficial
colon and rectum
colonoscopy
continuous
risk of CA!!
40
Q

Meckels

A

Tach-99 scan

41
Q

Hirchsprung

A

SQUIRT sign

lack of ganglionic cells- bowel isnt moving correctly –> obstruction

42
Q

signs of Hirchsprung

A

Abd distension
failure to pass mec
BILIOUS vomiting

same as Atresia (obstruction)

43
Q

Dx of Hirchsprung

A

Rectal biopsy

44
Q

ALL

A
most common CA of kids
Immature lymphoblasts
B cells
Down synd
Virus and Radiation
Chemo and Stem Cell from sibling
45
Q

CML

A
Mature cells goin crazy
PHILLY CHROMOSOME
Thrombocytosis and Leukocytosis
Radiation
Cure: STEM CELL
Control: Tyroskine Kinase Inhb
46
Q

AML

A

stuck in myeloid phase
(!)Hyperleukocytosis
Auer Rods!!!
Dx reqiures 2 things: >20% blasts, of myeloid origin

47
Q

Hodkin lymph

A

Reed Sternberg B cells
Painless cervical and supraclavicular
Secondary malignancy
Starts in nodes –> closeby tissue

48
Q

Non-Hod lymph

A

Starts anywhere –> distant nodes
Congenital, immunodeficient, EBV
FAST PROGRESSION in KIDS

Beware of Tumor Lysis Synd

49
Q

Brain tumor

A

Morning HA
Papilledema
Vomiting

50
Q

Non glial Brain tumor

A

usually the Cancerous type

-Medulloblastoma

51
Q

Neuroblastoma

A

most common abdominal tumor

CROSSES midline

52
Q

Neuroblastoma labs

A

Urinary catecholamines and METS to bone

Anemic 60%

53
Q

Osteosarcome

A

Long bone- metaphysis

Male, age 13-16

54
Q

Ewing

A

Male 20s

Diaphysis of bone (long part)

55
Q

Rhabdo

A

Infant: GU

young: head and neck
teen: extremities

56
Q

Liver tumor

A

a-fetoprotein
Usually come in d/t enlarging abdomen
2/3 liver masses ARE MALIGNANT
COMPLETE resection essential for survival

57
Q

Microcytic Hypochromic

A

Thalassemia
Iron def
Lead

58
Q

Fanconi

A
Bone marrow failure
Progressive pancytopenia
-pigmented skin
-short stature
-skeletal malform

Anemia –> Severe aplastic anemia

Tx: supportive, STEM CELL

Risk: ADL, AML

59
Q

Acquire aplastic anemia

A

Periph Pancytop
everything low
Purpura, petechiae
FREQUENT infections and severe hemorrhage: cause of death

60
Q

Aplastic anemia tx of choice

A

STEM CELL TRANSPLANT

61
Q

Iron def

A
Pica
screen @ 12 months
Microcytic hypochromic
Hgb <11
Ferritin <12
62
Q

megaloblastic
B12
Folate

A

hypersegmented neutrophills

63
Q

Thalassemia

A

Microcytic
RDW is normal
Severe beta- stem cell
Iron chelatin

64
Q

Lead

A

basophillic stippling

tx: chelation

65
Q

PT Extrinsic

A

factor 7

“I have physical therapy at 7 am”

66
Q

ITP

A
most common
AFTER VIRUS
Immune mediated
Spleen eats platelets
Thrombocytopenia
67
Q

VWF

A

most common inherited bleeding disorder

68
Q

VWF

A

Factor 8
aPTT
bleeding from mucosal surfaces, prolonged bleeding time
Tx: Desmopressin and VWF replacement

69
Q

Hemophilia A

A

factor 8

70
Q

Hemophilia B

A

factor 9

71
Q

Hemophilia labs

A

aPTT
bleed into joints and muscle
Spontaneous hemarthrosis- bone destruction

72
Q

Hemophilia A tx

A

Desmopressin

73
Q

Platelet levels for Vit K def

A

normal

74
Q

Platelet levels for Liver

A

normal or low

75
Q

DIC all labs fudged up

A

Increased D-dimer and FDPs
Decreased fibrinogen
prolonged PT and aPTT
Decreased platelet

76
Q

Protein C and S

A

factor 5 and 8

Warfarin induced skin necrosis

77
Q

Thrombotic disorders: CLOT RISk

A

Protein C and S
Factor 5 Leidin
Antithrombin

78
Q

HSP vasculitis

A

boys 2-7
URI precedes!
deposition of IgA

79
Q

HSP 4 sx

A

Palpable purpura
Renal dz
Abdominal pain
Arthritis

80
Q

Labs for HSP

A

ASO
Hemoccult
UA hematuria and proteins