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My Step 3 > Peds/OB > Flashcards

Peds/OB Flashcards

1
Q

Abdominal mass benign in kid

A

most commonly Neuroblastoma

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2
Q

Sxs of neuroblastoma

A

abdominal mass in kid, mainly benign. periorbital echhymosis, flushing (catecholamine release), hypertension (presses on renal a), opsoclonus-myoclonus, spinal cord compression

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3
Q

most common renal tumor kids

A

Wilms tumor; age <5; usually painful, along with hypertension and hematuria; no flushing or sweating

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4
Q

When can you have Rh incompatibility

A

Rh(D) negative mother + positive father. Prior pregnancy with RhD + fetus = antibodies that can cross placenta and destroy RhD postive fetal rbcs = Hemolytic disease of the newborn

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5
Q

aplastic crisis

A

from Parvo b19; sudden drop in Hgb and v low reticulocyte count; transient arrest of hematopoeisis

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6
Q

when do you get DTaP vaccine?

A

5 doses at 2, 4, 6 months; 15-18 months; 4-6 years

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7
Q

contraindications to DTaP vaccine

A

Encephalopathy after previous dose or anaphylaxis to vaccine component. If they are on steroids, have some minor illness/infection, give it anyways

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8
Q

first line treatment for allergic rhinitis

A 
allergen avoidance 
intranasal corticosteroids (not decongestant)
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9
Q

contraindications to MMR vaccine

A

anaphylaxis to MMR, neomycin or gelatin
immunodeficiency
pregnancy

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10
Q

diagnostic criteria for kawasaki dz

A

fever >5 days with 4 of the following:

  • conjunctivitis
  • mucous membrane changes
  • rash
  • lymphadenopathy
  • extremity edema/erythema
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11
Q

complications of kawasaki dz

A

coronary artery aneurysms (by day 10), MI and ischemia

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12
Q

tx of kawasaki dz

A

Aspirin + IVIg; all kids get an Echo;

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13
Q

Developmental dysplasia of the hip is characterized by abnormal _____ _____. Prognosis is

A

Acetabular development (=shallow hip socket, poor support femoral head). Prognosis is excellent, 95% pts have reduction of a dislocated hip.

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14
Q

adolescents with leg-length discrepancy, gait abnormalities (toe walking, Trendelenburg gait), activity related pain

A

DDH. Can result in chronic, activity related hip pain and osteoarthritis in adolescents and young adults

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15
Q

avascular necrosis of femoral head in children 5-7

A

Legg-Calve-Perthes dz. Caused by idiopathic interruption of blood supply.

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16
Q

sxs of JIA

A

fever, joint pain and rash

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17
Q

precocious puberty

A

onset of secondary sex characteristics:

<9 boys, <8 girls

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18
Q

Sxs of Congential Adrenal Hyperplasia (decreased 21-hydroxylase on ACTH stim test)

A 
early pubic/axillary hair growth
severe acne
hisutism and oligmenorrhea in girls
increased growth velocity and bone age
increased 17-hydroxyprogesterone
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19
Q

Tx of Congenital Adrenal Hyperplasia

A

Hydrocortisone

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20
Q

Target glucose levels gestational diabetes

A

Fasting <95
1 hour postprandial <140
2 hour postprandial < 120
–>can use most anti-hypoglycemic i.e. insulin, metformin or glyburide

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21
Q

when do you screen for gestational diabetes?

A

usually 24-28 weeks; earlier if there are risk factors (obesity, prior macrosomic infant) at initial prenatal even

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22
Q

Hyperthyroidism tx in pregnancy

A

1st trimester: PTU preferred (teratogenic effects methimazole)
2nd/3rd trimester: Methimazole preferred (hepatotoxiciy of PTU)

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23
Q

when is post partum thyroditis?

A

<1 year following pregnancy. associaed with thyroid peroxidase antibody

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24
Q

test to differentiate Graves from postpartum and silent thyroiditis

A

Radioactive iodine uptake. graves (high) from increased thyroid hormone synthesis; PT and silent (low RAIU) from thyroid peroxidase antibody.

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25
Q

Absent testicular enlargement at age ____ = delayed puberty

A

14

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26
Q

test if you’re worried about primary hypogonadism

A

Karyotype: Klinefelter = 47XXY

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27
Q

insulin is recommended in t2dm with ______

A

a1c>9, esp if + sxs

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28
Q

screening for gestational diabetes

A
  1. administer 50g oral glucose test and check glucose after 1 hour: >140 then next step (challenge)
  2. Admnister 100g oral glucose, check fasting each hour for 3 hr (glucose tolerance test)
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29
Q

when do you screen for gestational diabetes?

A

usually 24-28 weeks; earlier if there are risk factors (obesity, prior macrosomic infant) at initial prenatal even

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30
Q

how do you prevent neonatal rubella?

A

admin of MMR vaccine pre-conception (live vaccine so not during pregnancy)

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31
Q

baby born with hearing loss, no red reflex, heart murmur

A

congenital rubella

sxs include sensorineural hearing loss, cataracts, PDA

32
Q

vertebral osteomyelities in traveler with cavitary pulm lesion

A

Pott’s disease: TB betch

33
Q

How long is patient with active pulm TB infectious with aerosolized droplets prior to onset of sxs?

A

3 months

34
Q

Peds oropharyngeal lesions on anterior oral mucosa

A

apthous stomatitis (canker sores, recurrent) and Herpes gingivostomatitis (vesicles, ulcers, fevers)

35
Q

peds tonsillar exudates

A

GAS (anterior cervical ln)

Mono (diffuse cervical ln, +/- hepatosplenomegaly)

36
Q

peds oropharyngeal lesions on posterior oral mucosa

A

Herpangina (Coxsackie; vesicles, ulcers, painful pharyngitis, prevent by hand washing)

37
Q

most common causes viral CNS infections

A

Enteroviruses (Coxsackie, Echovirus), then herpesvirus and arbovirus

38
Q

tx for gastroparesis

A

dietary modification: smaller more frequent meals

39
Q

common offenders for erosive esophagitis

A

Tetracyclines (Doxy), Bisphosphonates

40
Q

best initial test for esophageal perforation

A

esophagram with water-soluble contrast

41
Q

how do you dx painless bleeding in 2 year old?

A

Meckels diverticulum: need a Tech-99m pertechenate scan

42
Q

failure of vitelline duct to obliterate during 1st 8 weeks of gestation

A

Meckel’s diverticulum (common cause painless bleeding 2yo)

43
Q

tx for diffuse esophageal

A

CCB

44
Q

solid and liquid dysphagia, can be triggered by hot/cold liquids or gerd

A

diffuse esophageal spasm

45
Q

first line tx for toxic megacolon (IBD)

A

steroids to treat underlying inflammatory bowel disease; if perforation then surgery

46
Q

management of pt with gallstones and biliary colic

A

elective lap chole

47
Q

weight loss + fat, bulky stools

A

fat malabsorption

48
Q

labs for pyloric stenosis pt

A

hypokalemic, hypochloremic metablic alkalosis

49
Q

who gets pyloric stenosis?

A

boys 3-6 weeks old, especially if first-born, bottle fed or preterm. azithromycin/erythromycin (macrolides) increase risk also

50
Q

who gets hepatic adenoma?

A

young females on OCP, can improve with cessation of OCP if <5cm

51
Q

breast milk jaundice

A

beta-glucuronidase in breast milk deconjugates = unconjugated bili,

52
Q

tx for breast milk jaundice

A

continue breast feeding exclusively, will self resolve by month 3

53
Q

isolated gastric varices

A

hallmark of splenic vein thrombosis (usually hx of pancreatitis)

54
Q

screening test for Marfans kid

A

echo: high risk of SCD from aortic root dz

55
Q

most common congenital heart defect Down’s syndrome

A

endocardial cushion defect (get an echo)

56
Q

for acute MR, is it the papillary muscle or chorda tendinae?

A

chorda tendinae, i.e. connective tissue disorder. CT-CT.

papillary muscle rupture can happen 2-5 days post MI

57
Q

echo is needed at time of dx and annually afterwards for this connective tissue disease

A

Marfan’s Syndrome: majority of pts develop aortic root disease (dilation, dissection)

58
Q

Berry aneurysms occur in this connective tissue dz

A

Ehlers-Danlos

59
Q

prevention of preeclampsia in higher risk patients

A

aspirin at 12 weeks gestation

60
Q

preventing preterm delivery if hx of preterm delivery

A

intramuscular hydroxyprogesterone

61
Q

Rh(D) women with negative anti-D antibody

A

Anti-D immune globulin at 28 weeks and <72 hours after delivery

62
Q

neonatal erbs palsy

A

brachius plexus injury from fetal macrosomia causing shoulder dystocia

63
Q

breech positioning causes increased risk of

A

DDh

64
Q

protracted labor

A

<1cm/2 hours after 6cm dilation

65
Q

variable decelerations

A

abrupt drops in fetal HR <2 minutes; from umbilical cord compression; tx with amnioinfusion

66
Q

what is misoprostol used for in pregnancy?

A

PGE1 analog, used for cervical ripening and induction of labor

67
Q

when does unknown GBS status require tx?

A

delivery <37 weeks; intrapartum fever; rupture of membranes >18 hours

68
Q

when do you screen for GBS

A

36-38 weeks via rectovaginal culture

69
Q

what do you test at 24-28 week preconception visit?

A

Hgb/Hct; antibody screen if Rh(D) negative; 50g 1 hour gct

70
Q

what do you test at 35-37 weeks?

A

GBS

71
Q

why do you need intramuscular betamethasone if delivery <37 weeks?

A

decrease risk of necrotizing enterocolitis, neonatal respiratory distress, and intraventricular hemorrhage of prematurity

72
Q

what bHCG is pregnancy visible on US

A

1500

73
Q

how do you treat ectopic pregnancy

A

methotrexate or surgery

74
Q

postexposure prophy after sexual assault

A

GC (Cef), Chlamydia (Azithro), HIV (HAART), Trichomonas (Metronidazole), Hep B (vaccine +/i immunoglobulin if not immunized)

75
Q

most common cause of pathologic nipple discharge

A

papilloma

76
Q

unilateral breast discharge eval

A

<30: US +/- mammogram

>30: US + mammogram

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