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Peds Shelf Flashcards

1
Q

what is the murmur heard in tetrology of fallot?

A

systolic murmur along the left sternal border

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2
Q

what 4 anatomic abnormalities are seen in tetrology of fallot?

A
  1. VSD
  2. Overriding aorta over the R and L ventrivles
  3. R ventricular outflow obstruction
  4. R ventricular hypertrophy
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3
Q

what are the 3 most common bugs that cause acute bacterial rhinosinusitis? treatment of choice?

A
  1. Strep pneumo
  2. H influ
  3. Moraxella catarrhalis
    tx: amoxicillin-clavulanic acid
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4
Q

impetigo is most commonly associated with what disease?

A

post-strep glomerulonephritis

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5
Q

what 2 bugs cause impetigo? tx of choice?

A
  1. GABS
  2. Staph aureus
    tx: topical mupirocin
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6
Q

what vaccine has a weight requirement and what is that requirement?

A

Hepatitis B

must be at least 2kg before receiving it

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7
Q

what are the characteristics (4) of Edwards syndrome? trisomy 18

A
  1. Low birth weight
  2. Closed fists with the index finger overlapping the 3rd digit and the 5th digit overlapping the 5th
  3. Prominent occiput
  4. Rocker bottom feet
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8
Q

what causes cri-du-chat?

A

5p deletion

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9
Q

tx of choice for septic arthritis?

A

surgical drainage

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10
Q

pt has rapidly increasing head circumference, imaging? what is it?

A

hydrcephalus

get CT scan of brain

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11
Q

continued ear drainage for several weeks despite appropriate antibiotic therapy?

A

cholesteatoma

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12
Q

how is a cholesteatoma formed?

A

chronic middle ear disease leads to formation of a retraction pocket in the tympanic membrance which can fill with granulation tissue and skin debris

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13
Q

at what age should children follow a moving toy in the side to side AND vertical plane?

A

3 months

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14
Q

at what age does an infant maintain a seated position?

A

6-8months

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15
Q

At what age can a child copy a square?

A

4-5 years

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16
Q

what is the major morbidity of pauciarticular rheumatoid arthritis?

A

blindness: iridocyclitis (tx with steroids)

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17
Q

what is Nikolsky sign and what does it indicate?

A
  • peeling of the epidermis in response to mild shearing forces
  • Ritter disease = staph scalded skin disease
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18
Q

what are the major symptoms observed in anaphylactoid purpura? (3)

A
  1. Generalized acute vasculitis of small blood vessels
  2. Arthritis of large joints
  3. GI symptoms: colicky abdominal pain, vomiting, melena
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19
Q

what is the most serious complication of anaphylactoid purpura?

A

renal disease

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20
Q

Syrup of ipecac should not be given in what isntances?

A
  1. Ingestion of strong acid or alkali

2. Obtunded, comatose, or impending seizures

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21
Q

herald patch -> diffuse rash involving the upper extremities and trunk

A

pityriasis rosea

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22
Q

what else should be on the differential for pityriasis rosea?

A

secondary syphilis

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23
Q

at what age does neonatal acne peak?

A

2-4 weeks (due to maternal hormone transmission)

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24
Q

tx for symptomatic organophosphate poisoning in children?

A

atropine

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25
Q

what are the typical symptoms of GBS pneumonia?

A
  1. Rapid onset of respiratory distress, hypothermia, hypotension
  2. low WBC count with left shift
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26
Q

at what age do children start to pincer grasp?

A

12 months

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27
Q

what CANT you use as treatment for lice in a small infant?

A

1% lindane

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28
Q

what STD goes along with sexual abuse?

A

gonorrhea

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29
Q

in what 3 types of bites do you need antibiotic prophylaxis?

A
  1. cat
  2. human
  3. monkey bites
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30
Q

child ingests aunt’s pills, prolonged QRS and QT interval

A

TCA

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31
Q

a rash that waxes and wanes over the first days to weeks of life- examination of fluid shows eosinophils

A

erythema toxicum

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32
Q

what does the rash in erythema toxicum look like?

A

splotchy areas of erythema with a central clear pustule

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33
Q

vascular lesions that are more prominent during crying/exercise, face lesions fade over the first weeks of live, occipital and nuchal lesions remain

A

salmon patches

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34
Q

what is pustular melanosis?

A

newborn disease- more common in AA

- 1-2mm pustules that rupture and cause a hyperpigmented lesion

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35
Q

fine yellow-white 1-2mm lesions scattered on face and gingivae of neonate

A

milia

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36
Q

what is a sebaceous nevi?

A

small sharply edged lesions that occur on the head and neck of infants

  • yellow and orange, slightly elevated
  • hairless
  • malignant degeneration is possible after adolescence
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37
Q

greasy scaly and erythematous rash in newborn that involve the face, neck, axilla and diaper area

A

seborrheic dermatitis

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38
Q

what stage of sleep do nightmares occur?

A

REM sleep

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39
Q

what is somnambulism? when does it happen?

A

sleepwalking

occurs in stage 4 non-REM sleep

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40
Q

what is somniloquy? when does it occur?

A

sleeptalking

can occur at any sleep stage and is seen in all ages

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41
Q

age most likely for asphyxiation and choking?

A

1 year

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42
Q

age most likely to drown in a swimming pool?

A

1-3years

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43
Q

leading cause of death in children aged 5-9years?

A

pedestrian injuries

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44
Q

pellagra is a deficiency of what?

A

niacin

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45
Q

niacin is an essential component of what two enzymes?

A
  1. NAD

2. NADP

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46
Q

pellagra is most common in what areas?

A

areas that rely on corn as a basic food

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47
Q

beriberi is a deficiency of what?

A

thiamine (vitamin B1)- essencial for synthesis of acetylcholine

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48
Q

what are the clinical disturbances seen in thiamine deficiency? (3)

A
  1. Heart failure
  2. Peripheral neuritis
  3. Psychic disturbances
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49
Q

rachitic rosary, craniotabes, scoliosis, pelvic and leg deformities

A

rickets: disorder of vitamin D

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50
Q

what is Waardenburg syndrome?

A
  • Autosomal dominant
  • deafness + pigment changes
  • white forlock
  • heterochromia irides
  • uni or bilateral congenital deeafness
  • lateral displacement of the inner canthi
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51
Q

what is prader-willi syndrome?

A
  • infantile hypotonia and poor feeding
  • as get older hyperphagia and obesity
  • almond shaped eyes
  • hypogonadism
  • mild mental retardation
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52
Q

what is treacher collins syndrome?

A

Autosomal dominant

  • normal intelligence
  • facial abnormalities- malar hypoplasia
  • micrognathia, abnormally shaped ears
  • hearing loss
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53
Q

what is legg-calve-perthes disease?

A

avascular necrosis of the femoral head

  • boy around age 6-7
  • painless limp (though can have pain as well)
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54
Q

what age group do you most commonly see slipped capital femoral epiphysis?

A

adolescent- obese male

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55
Q

how does osteomyelitis typically present?

A

focal bone tenderness and fever

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56
Q

treatment of lead poisoning?

A

dimercaprol and calcium EDTA

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57
Q

treatment for acetaminophen poisoning

A

N-acetylcysteine (NAC): removes hepatotoxic metabolites

- should be given within 16 hours of ingestion, ineffective after 36 hours

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58
Q

what is the antidote for morphine/narcotic overdose?

A

naloxone

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59
Q

treatment of salicylate poisoning?

A

acetazolamide and IV sodium bicarb: enhances the urine excretion of salicylates

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60
Q

treatment of organophosphate poisoning?

A

pralidoxime

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61
Q

symptoms of iron toxicity?

A

phase 1: hematemesis, diarrhea, abdominal pain

phase 2: cardiovascular collapse after 12 hours

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62
Q

treatment of iron toxicity?

A

deferoxamine

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63
Q

methanol toxicity treatment?

A

ethanol~ saturates the enzyme systems that convert methanol to toxins

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64
Q

toxic effect of vitamin A?3

A
  1. hyperostosis
  2. Hepatomegaly
    3, Increased CSF
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65
Q

toxic effect of nicotinic acid? long term toxicity (3)?

A

erythema of skin and pruritis

longterm: tachycardia, liver damage, hyperglycemia

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66
Q

toxic effect of vitamin C?

A

kidney stones
diarrhea
cramps

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67
Q

toxic effect of vitamin D?

A

calcification of the heart/kidney/blood vessels/bronchi/stomach
also: weight loss, polyuria, diarrhea

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68
Q

toxic effect of pyridoxine?

A

sensory neuropathy & altered sensation of touch, pain and fever

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69
Q

Anomalies in fetus assoc with maternal diabetes? (4)

A
  1. Sacral agenesis (pathognomonic)
  2. Cardiac defects: transposition and VSD
  3. Renal defects
  4. Anencephaly
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70
Q

fetal hypoplasia of distal phalanages and nails

A

phenytoin in utero: fetal hydantoin syndrome

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71
Q

Phenytoin causes what in fetuses? Valproate?

A

Phenytoin: fetal hydantoin syndrome
Valproate: neural tube defects

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72
Q

what anomalies are seen in neonatal lupus erythematosus?

A
  1. Skin lesions

2. Cardiac abnormalities: AV block, transposition, valvular/septal defects

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73
Q

most babies with lupus erythematosus will have what kind of antibodies?

A

anti-rho

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74
Q

potential complication of impetigo?

A

poststreptococcal glomerulonephritis

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75
Q

what does the rash in molluscum contagiosum look like?

A

skin colored dome-shaped, 1-5mm

central umilication

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76
Q

classic presentation of poststreptococcal glomerulonephritis?

A
  1. Change in urine color to bloody
  2. Edema
  3. HTN
  4. Renal insufficiency
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77
Q

what vitamin should be given w isoniazid therapy?

A

pyridoxine: vitamin B6

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78
Q

what vitamin should be given to a child with measles in a developing country?

A

Vitamin A

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79
Q

pts with sickle cell disease should be given what supplement?

A

folate- bc of the ongoing compensatory erythopoiesis

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80
Q

what test is done to diagnose: Wiskott-Aldrich syndrome

A

platelet count

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81
Q

what test is done to diagnose:Asplenia

A

CBC: see howell-jolly bodies

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82
Q

what test is done to diagnose: b-cell defects

A

immunoglobulin: see low A, G, and M levels

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83
Q

what test is done to diagnose:t cell deficiencies

A

intradermal skin test

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84
Q

what test is done to diagnose: chronic granulomatous disease

A

nitroblue tetrazolium

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85
Q

what is the etiology behind marfans syndrome?

A

mutations of the fibrillin-1 gene

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86
Q

what are the differences in lens dislocation between Marfans and homocystinuria?

A

Marfans: dislocated upward
Homocystinuria: dislocated downward

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87
Q

what are the symptoms of homocystinuria?

A
  • thromboemblic events
  • osteoporosis
  • fair complexion
  • similar to marfans syndrome
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88
Q

what is congenital contractural arachnodacylyl?

A
  • autosomal dominant condition that presents with tall stature
  • arachnodactyly
  • multiple contractures involving large joints
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89
Q

why do pts with turners syndrome have swollen hands and feet?

A

congenital lymphedema: due to abnormal development of the lymphatic network

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90
Q

what two bugs are the most common causes of neonatal sepsis?

A
  1. GBS

2. Escherichia coli

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91
Q

Accentuated cupids bow of the upper lip

A

dilantin exposure

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92
Q

what are the findings of Alport syndrome in a newborn? (4)

A 
hematuria
progressive nephritis
deafness
ocular defects
(Cant see, cant pee, cant hear)
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93
Q

what drug has been used to induce glucuronyl transferase in newborn infants and can reduce neonatal jaundice?

A

Phenobarbital

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94
Q

what is the treatment of choanal atresia?

A

surgical correction with placement of nasal tubes

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95
Q

when should VZV immunoglobulin be administered to an infant immediately after delivery? (2 instances)

A

if the mother had the onset of varicella within 5 days prior to delivery
and if mom if diagnosed with chickenpox within 2 days of delivery

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96
Q

what is the gold standard for diagnosis of CMV?

A

urine viral culture for CMV

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97
Q

how does symptomatic congenital disease occur?

A

when a mother has a primary CMV infection in the first trimester of pregnancy

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98
Q

what is the apt test?

A

a test that differentiates fetal from adult (moms) hemoglobin in a bloody specimen

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99
Q

what medications are CLEARLY contraindicated in breast feeding? (6)

A
  1. Lithium
  2. Cyclosporin
  3. Antineoplastic agents
  4. Illicits: cocaine and heroin
  5. Ergotamines
  6. Bromocriptine (suppresses lactation)
100
Q

what do you find on plain radiographs in a neonate with NEC?

A

pneumatosis intestinalis

101
Q

when should you consult surgery in a pt with NEC?

A

when theres presence of free air under the diaphragm on XR indicating perforation or if infant clinically worsens with medical management

102
Q

what are the symptoms of NEC? (3)

A
  • usually prematurely born infant
    1. feeding intolerance
    2. distended abdomen
    3. grossly bloody stool
103
Q

breast milk has insufficient ____ and ___ for catch-up growth in premies?

A

Calcium and Phosphorus

104
Q

what are the major pulmonary problems found in small-for-date infants?

A
  1. Neonatal asphyxia

2. meconium aspiration syndrome -> pneumothorax, pneumomediastinum or pulmonary hemorrhage

105
Q

what is periodic breathing in low birth weight babies?

A

recurrent breathing pauses of 3-10 seconds

106
Q

what are apneic episodes?

A

absence of respirations for more than 20s
+ bradycardia
+ cyanosis

107
Q

what is the main cause of hypothyroidism in neonates?

A

thyroid dysgenesis

108
Q

what can untreated hypothyroidism lead to?

A

cretinism

109
Q

what does the neonatal metabolic screen test for?

A

PKU and hypothyroidism

110
Q

what nerves does erb duchenne paralysis affect?

A

C5 & C6

111
Q

what is klumpke paralysis?

A

injury to C7, C8 & T1

- palsy to the hand and can produce Horner’s syndrome

112
Q

how do you check for suspected phrenic nerve palsy in a pt with Erb-duchenne or Klumpke’s palsy?

A
  • CXR: paralyzed diaphragm can be noted to remain elevated during deep inspiration, cannot see this on expiration
  • Fluoroscopy: shows unilateral paralysis of diaphragm
113
Q

tx of erb duchenne or klumpke?

A

frequently improve spontaneously

114
Q

what are common outcomes of SGA infants born to moms w toxemia?

A
  1. Hypoglycemia

2. Polycythemia

115
Q

Manifestations of Polycythemia in a newborn

A

definition: Hct >65% persistently
- increases blood viscosity causing hyperviscosity syndrome: tremulousness that can progress to seizures
- renal vein thrombosis
- NEC
- tachypnea

116
Q

tx of polycythemia in newborn?

A

partial exchange transfusion with albumin prior to significant symptoms

117
Q

what is the etiology based on time frame of development of opthalmia neonatorum:

  1. 6-12hrs
  2. 2-5 days
  3. 5-15 days
A
  1. 6-12 hrs: Chemical conjunctivitis (from use of silver nitrate or erythromycin ppx)
  2. 2-5 days: Gonococcal conunctivitis
  3. 5-14 days: Chlamydial conjunctivitis
118
Q

treatment of chlamydial conjunctivitis?

A

systemic antibiotics for pt and both parents to prevent risk of chlamydial pneumonia

119
Q

what do you do w a healthy infant born to an HIV positive mom who received HAART therapy for the weeks prior to delivery?

A

give a course of zidovudine

120
Q

when can you expect a mongolian spot to disappear?

A

1-2 years of age

121
Q

babies not given vitamin K and are fed breast milk start showing hemorrhagic manifestations when? what are these symptoms? (4)

A

2nd-7th day of life

  1. Melena
  2. Hematuria
  3. Bleeding from the circumcision
  4. Intracranial Hemorrhage/shock (severe)
122
Q

what are the complications of bilateral cleft lip and palate?

A

recurrent otitis media
hearing loss
speech impairment

123
Q

when is cleft lip repaired versus cleft palate?

A

Cleft lip: first 2-3 months

Cleft palate: 6months-5years

124
Q

what does the CXR show in TTN? (3)

A
  1. Prominent pulmonary vascular markings
  2. Fluid in fissures
  3. Hyperexpansion of lungs (flat diaphragms)
125
Q

Symptoms of untreated congenital syphilis? (5)

A
  1. Infiltrative maculopapular PEELING raash on face, palms, and soles (scrapings contain treponemes)
  2. Rhinitis (blood tinged)
  3. Hepatosplenomegaly
  4. Lymphadenopathy
  5. Early jaundice
126
Q

late manifestation of congenital syphilis?

A

Interstitial heratitis:

  • photophobia
  • corneal haziness
  • lacrimation
  • eventual scarring
127
Q

fifth finger polydactyly in a white child warrants what?

A

careful examination of the cardiac system

128
Q

what is Harlequin syndrome?

A

transient change in the skin color of an otherwise asymptomatic premature newborn
- dependent side of the entire body turns red while the upper side remains pale

129
Q

when should you suspect twin-twin transfusion syndrome?

A

when the Hct of twins differs by more than 15mg/dL

130
Q

Polyhydramnios is associated with what?

A
  1. Duodenal atresia
  2. TEF
  3. Trisomy 18
  4. Anencephaly
131
Q

Oligohydramnios is associated with what?

A

Renal agenesis: inhibit formation of fetal urine

132
Q

Treatment of RSV in children?

A

inhaled epinephrine

133
Q

Treatment of pt with pertussis?

A

isolated with droplet precautions

134
Q

what is the most common cause of short stature and pubertal delay in adolescents?

A

Constitutional growth delay

135
Q

what is constitutional growth delay?

A
  • pts have normal birth weight and heigh but between 6mnths-3yrs their growth slows and follows the curve at the 5th-10th percentile
  • puberty and growth spurt are delayed but eventually occur
136
Q

which 3 congenital heart defects cause cyanosis and require a patent ductus arteriosus?

A
  1. Pulmonary atresia
  2. Tricuspid atresia
  3. Tetrology of Fallot
137
Q

when should you get surgery for an umbilical hernia? (5)

A
  1. Persists to 3-4 years
  2. Exceeds 2cm in diameter
  3. Causes symptoms
  4. Becomes strangulated
  5. Progressively enlarges after the age of 1-2 years
138
Q

what are the 4 parts of tetrology of fallot?

A
  1. Overriding aorta
  2. Right Ventricular Hypertrophy
  3. Subpulmonary stenosis (single S2)
  4. VSD (pansystolic murmur)
139
Q

stridor in a pt 4-8 months that worsens in supine and improves in the prone position

A

Laryngomalacia

140
Q

stridor that improves with neck extension

A

vascular ring

141
Q

what is laryngomalacia?

A

increased laxity of the supraglottic structures that results in collapse during the inspiratory phase

142
Q

what is the treatment of Kawasakis disease?

A

Aspirin plus IVIg

- get baseline ECG and f/u in 6-8 weeks

143
Q

what are two complications of kawasakis disease?

A
  1. Coronary Artery Aneurysm

2. Myocardial infarction and ischemia

144
Q

How do you diagnose Kawasakis disease?

A
  • Fever for >5days plus >4 of:
    1. Bilateral nonexudative conjunctivitis
    2. Mucositis
    3. Cervical lymphadenopathy
    4. Erythematous polymorphous rash
    5. Extremity changes (edema & erythema)
145
Q

Describe the rash in scarlet fever and what is the treatment?

A
  • sandpaper texture that spares the palms and soles

- amoxicillin and throat culture are necessary

146
Q

Symptoms of rocky mountain spotted fever? treatment?

A
  • Rash on the palms and soles
  • HA
  • GI symptoms
    tx: doxycyline for 5-7 days
147
Q

What are some potential complications of the pertussis component of the DTaP?

A
  1. Immediate anaphylactic reaction
  2. Encephalopathy
  3. CNS like seizures
148
Q

what is atlantoaxial instability? association?

A
  • associated with Downs syndrome
  • pts have excessive laxity in the posterior transverse ligament which causes increased mobility between the atlas and axis
149
Q

at what age should toilet training begin and how do you know when to start?

A

2-4 years

- the kid should be able to communicate the need to urinate and can withold potty for a brief period of time

150
Q

MOA of hydroxyurea in sickle cell and side effects?

A 
- Increases fetal hemoglobin
Side effects:
1. Leukopenia
2. Anemia
3. Thrombocytopenia
151
Q

What is diamond-blackfan anemia? how does it present?

A

Congenital pure red cell aplasia

  • presents in the first 3 months with pallor and poor feeding
  • CBC= normocytic or macrocytic anemia with reticulocytopenia
152
Q

What is the most common causes of death in pts with Friedreich ataxia?

A

Cardiomyopathy & Respiratory complications

153
Q

what two conditions should you think of with delayed meconium passage in neonates?

A
  1. Hirschsprung disease

2. Meconium Ileus

154
Q

how does trachoma present? cause?

A
  • caused by chlamydia trachomatis serotype A-C
  • follicular conjunctivitis
  • pannus (neovascularization)
  • concurrent infection occurs in the nasopharynx
155
Q

how do you diagnose trachoma?

A

giemsa stain examination of conjunctival scrapings

156
Q

tx of trachoma?

A

topical tetracycline or oral azithromycin

157
Q

tx of choice for absence seizures? (2)

A

ethosuximide

valproic acid

158
Q

most common congenital cause of aplastic anemia?

A

Fanconi anemia

  • autosomal recessive/X-linked disorder
  • caused by chromosomal breaks
159
Q

treatment of aplastic anemia?

A

hematopoietic stem cell transplantation

160
Q

what is the appearance of a pt w fanconi anemia? (5)

A
  1. Short stature
  2. Microcephaly
  3. Abnormal thumbs
  4. Hypogonadism
  5. Hypo/Hyperpigmented areas, cafe au lait spots, large freckles
161
Q

what industrial chemical can cause aplastic anemia?

A

benzene

162
Q

symptoms of henoch-schonlein purpura? pathogen?

A
  • IgA mediaed vasculitis
  • palpable purpura symmetric over legs, buttocks and arms
  • arthralgias/arthritis
  • colicky abdominal pain
163
Q

biopsy of a pt with HSP?

A

deposition of IgA in the mesangium

164
Q

linear deposition of IgG on the basement membrane of kidney

A

Goodpasture syndrome

165
Q

edema + hematuria

- EM shows flattening of the podocytes

A

minimal change disease

166
Q

what is the best diagnostic test for meckels diverticulum?

A

technetium-99m pertechnetate scan (meckels scan)

167
Q

What are the symptoms of Rubella in neonates exposed in utero? (8)

A
  1. Hepatosplenomegaly
  2. Deafness
    3 Microcephaly
  3. Growth retardation
  4. Chorioretinitis
  5. Thrombocytopenia
  6. Blueberry muffin appearance (purpura)
  7. Sensorineural hearing loss
168
Q

purpura w a blueberry muffin appearance

A

Rubella as a TORCH

169
Q

what is the most common predisposing factor to orbital cellulitis?

A

bacterial sinusitis

170
Q

what are the 4 key symptoms of orbital cellulitis?

A
  1. Pain with eye mvmts
  2. Proptosis
  3. Ophthalmoplegia
  4. Diplopia
171
Q

if the heart rate of a newborn drops below ___, chest compressions should be performed

A

60

172
Q

what are the most common causes of torticollis in a child? (4)

A
  1. URI
  2. Minor trauma
  3. Cervical lymphadenitis
  4. Retrophayngeal abscess
173
Q

why are patients with turners syndrome (XO) at a higher risk of osteoporosis & bone fractures?

A

low estrogen levels from gonadal dysgenesis

174
Q

if you cant get IV access via a peripheral site, what is the best site to obtain IV access?

A

intraosseous

175
Q

what are the two infections most commonly seen in hyper-IgM syndrome?

A
  1. Recurrent sinopulmonary

2. Pneumocystis jiroveci pneumonia

176
Q

what are the 4 findings of X linked agammaglobulinemia (XLA)?

A
  1. Recurrent bacterial infections <5yrs
  2. Low serum IgG, IgM and IgA
  3. Absent isohemagglutinins or poor response to vaccines
  4. Less than 2% CD19+ B cells
177
Q

How is Common variable immunodeficiency different from XLA?

A
  1. Low IgG, IgM and IgA but not as severe as XLA

2. do not become symptomatic until 15-35 years of age

178
Q

what is the most common cause of hip pain in children, esp in boys aged 3-10?

A

transient synovitis: usually follows a viral infection or mild trauma

179
Q

what is the testicular volume in prepubertal boys?

A

<3 mL

180
Q

what is the diagnostic study of choice when a patient presents with accidental alkali ingestion?

A

upper GI endoscopy

181
Q

what are the symptoms of neonatal tetanus?

A
  1. Poor suckling and fatigue followed by rigidity, spasms and opisthotonus
182
Q

what causes mortality in neonatal tetanus in the first week versus second week?

A

First week: apnea

Second week: septicemia from infection orinally from umbilical stump

183
Q

Clinical features of iron poisoning:

  1. Within 30min - 4 days
  2. Within 2 days
  3. Within 2-8 weeks
A
  1. abdominal pain, hematemesis, melena, hypotensive shock, metabolic acidosis
  2. Hepatic necrosis
  3. Pyloric stenosis
184
Q

diagnostic findings of iron poisoning?

A
  1. Anion gap metabolic acidosis
  2. Radiopaque pills
  3. Measure serum iron levels
185
Q

Treatment of iron poisoning?

A
  1. Whole bowel irrigation
  2. Deferoxamine
  3. Supportive care for circulation, airway, breathing
186
Q

Symptoms of acute acetaminophen poisoning?

A

Asymptomatic for first 24 hours

then nausea and vomiting

187
Q

symptoms of acute aspirin poisoning?

A
  1. Tinnitus
  2. Fever
  3. Hyperpnea (resp alkalosis, metabolic acidosis_
    * not radiopaque and cannot see on xx ray
188
Q

symptoms of lead poisoning in children?

A
  1. Abdominal pain
  2. Vomiting
  3. anemia
  4. Behavioral problems
    - radiopaque on xray
189
Q

seizures, mental retardation, port wine stain or nevus flammeus along territory of trigeminal nerve

A

sturge weber synrome

190
Q

Diagnostic study of choice for pyloric stenosis?

A

Ultrasound of the abdomen

191
Q

what two things can cause HYPERvolemic hypernatremia?

A
  1. Exogenous sodium intake

2. Mineralocorticoid excess (eg hyperaldosteronism)

192
Q

what is the most common cause of croup?

A

parainfluenza virus

193
Q

what are the 3 characteristic findings on lateral neck x ray for epiglottitis?

A
  1. Swollen epiglottis (thumb sign)
  2. Thickened aryepiglottic flods
  3. Obliteration of the vallecula
194
Q

What are 3 complications of prolonged Cystic fibrosis?

A
  1. Gallstones
  2. Cirrhosis with portal hypertension
  3. Pancreatic fibrosis
195
Q

what is the protein excretion cutoff for diagnosis nephrotic syndrome?

A

Greater than 3g/day

196
Q

what nephrotic syndrome is associated with Hepatitis B infection?

A

membranous glomerulonephritis

197
Q

Describe the rash of scarlet fever?

A
  • starts initially on neck, axilla, and groin within 12-48 hours and subsequently generalizes within 24 hours of rash onset
  • finely papular texture “sandpaper like”
198
Q

how often and how much should a baby be breastfeeding and stools/diapers?

A
  • 15-20minutes on each breast eight times/day (q3H)
  • 4-6 wet diapers mixed with
  • 8-12 stools/day
199
Q

Difference between duchenne and beckers muscular dystrophy?

A

age of presentation- Duchennes presents before the age of 5 and beckers presents around the age of 12

200
Q

what is and when do you see peptostreptococcus?

A

anaerobic bacteria that causes unilateral lymphadenitis

- usually in older children with a hx of periodontal disease

201
Q

what is the theorized pathophys of jejunal or ileal atresia?

A

vascular accident in utero
risk factors include poor fetal gut perfusion from maternal use of vasoconstrictive medications or drugs like cocaine and tobacco
- not associated with chromosomal abnormalities

202
Q

when does cocaine withdrawal in a newborn usually present?

A

day 2-3 of like

203
Q

what is the cause of duodenal atresia?

A

failure of the duodenum to recanalize

204
Q

what are the 3 most common bacteria of acute otitis media? 2 viruses?

A
  1. Strep pneumo (40%)
  2. H flu (25-30%)
  3. Moraxella catarrhalis (10-15%)
    viruses:
  4. RSV
  5. Rhinovirus
205
Q

what does light microscopy show in minimal change disease?

A

normal renal architecture

206
Q

what does electron microscopy show in minimal change disease?

A

diffuse effacement of foot processes of podocytes

207
Q

treatment of minimal change disease?

A

4-6 weeks of steroids

208
Q

erb duchenne palsy involves what nerves?

A

C5, C6 and sometimes C7

209
Q

marfans features + thromboembolic events

A

classic homocystinuria

210
Q

difference in lens dislocation between marfans and homocystinuria?

A 
marfans = dislocated upward
homocystinuria = dislocated downward
211
Q

bullous type impetigo is caused by what?

A

staphylococcus

212
Q

genetic defect and inheritance of Osteogenesis imperfecta?

A

autosomal dominant mutation of COL1A1

213
Q

complications of prader willi syndrome?

A
  1. Sleep apnea
  2. DM type 2
  3. Gastric distension/rupture
  4. Death by choking
214
Q

How do you confirm diagnosis of ALL?

A

bone marrow biopsy shows presence of >25% lymphoblasts

215
Q

What is the classic triad of Hemolytic Uremic syndrome? (HUS)

A
  1. Uremia
  2. Thrombocytopenia
  3. Hemolytic Anemia
216
Q

maternal lupus is associated with what?

A

first degree AV block

217
Q

what does apgar stand for?

A 
Activity
Pulse (0 points for 0 pulse, 1 point for less than 100)
Grimace
Appearance
Respiration
218
Q

Large anterior fontanelle is seen in what instances?

A
  1. Hypothyroidism
  2. Osteogenesis imperfect
  3. Some chromosomal abnormalities
219
Q

When does the anterior fontanelle close?

A

9-12months

220
Q

large tongue in newborn assoc w what 3 disease?

A
  1. Downs
  2. Hypothyroidism
  3. Beckwith Wiedemann syndrome
221
Q

omphalocele versus gastroschisis- main difference?

A

omphalocele is covered by an amnioperitoneal membrane!

222
Q

immediate care of newborn with omphalocele or gastroschisis?

A

sterile wrapping of the bowel to preserve heat and minimize insensible fluid loss

223
Q

omphalocele versus gastroschisis- which one is assoc with other congenital abnormalities?

A

omphalocele

224
Q

what is the most common cause of infantile febrile seizures?

A

HHV-6 aka Roseola aka Exanthema subitum aka sixth disease

225
Q

what is the most common extracranial solid tumor of childhood?

A

neuroblastoma NBL (median age of diagnosis = 2)

226
Q

in TOF what is the most important factor in determining the severity of symptoms?

A

the degree of pulmonary stenosis

227
Q

which vaccine is most likely to cause delayed fever?

A

MMR

228
Q

what is the most common long-term sequelae of meningitis?

A

hearing loss

229
Q

what is the causative organism of congenital rubella infection?

A

toga virus

230
Q

what are the 3 symptoms seen in McCune-Albright syndrome?

A
  1. Precocious puberty
  2. Cafe au lait spots
  3. multiple bone defects
    + endocrine disorders
231
Q

What are craniopharyngiomas derived from?

A

epithelial remnants of Rathkes pouch

232
Q

cyclical vomiting syndrome is high in pts who have what family history?

A

parentts have migraines!

233
Q

how does one differentiate between transient synovitis and legg-calve-perthes disease?

A

transient synovitis usually follows a viral infection and symptoms resolve within 1-4 weeks, LCP have symptoms for >1 month

234
Q

what is the classic triad of a brain abscess?

A
  1. Fever
  2. Nocturnal or morning HA severe
  3. Focal neurologic changes
235
Q

inheritance of duchennes MD?

A

x-linked recessive

236
Q

when does beta thalassemia usually present? ie what age?

A

presents at 6-12 months of age

237
Q

at what age does sickle cell disease usually present? why?

A

after 6 months, bc the presence of HgF protects the infants from sickling during the first 4-6 months of life

238
Q

what is the treatment for immune thrombocytopenia and when should you intervene?

A

Corticosteroids: used in all age groups for thrombocytopenia less than 30,000 and/or for severe symptoms

239
Q

what is a side effect of oral erythromycin in newborns?

A

hypertrophic pyloric stenosis

240
Q

what are 3 earlier complications of measles? what are 2 late complications?

A 
Earlier:
1. Pneumonia
2. Vitamin A deficiency
3. Bronchiectasis
Late:
1. Immunosuppression
2. Subacute sclerosing panencephalitis
241
Q

What virus causes measles?

A

paramyxovirus

242
Q

WHat virus causes roseola infantum?

A

HHV-6

243
Q

What virus causes rubella?

A

togavirus

244
Q

what virus causes erythema infectiosum?

A

parvovirus

245
Q

what virus causes croup?

A

parainfluenza virus type 1 (most commonly)

246
Q

almost 90% of viral meningitis are caused by what two viruses?

A

non-polio enteroviruses like

  1. Echovirus
  2. Coxsackie

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