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Peds Shelf Flashcards

0
Q

B. Pertussis tx and post exposure ppx?

A

Macrolides: azithromycin, clarithromycin, erythromycin

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1
Q

Pt is primarily breast fed, with physical findings of craniotabes, rachitic rosary, and genu varum. Dx?

A

Ricketts

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2
Q

T or F: all close contacts of a B. pertussis pt should receive macrolide ABX regardless of immunization.

A

True

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3
Q

??? is the most common cause of isolated proteinuria in children, and should be reevaluated with ???

A

Transient proteinuria. Repeat urine dipstick on 2 separate occasions

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4
Q

??? is an overgrowth disorder characterized by a predisposition to neoplasms. Physical findings include neonatal hypoglycemia, macrosomia, macroglossia, hemihyperplasia, and abdominal wall defects.

A

Beckwith-Weidemann Syndrome (BWS)

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5
Q

BWS should receive abdominal US and aFP levels to screen for most common assoc neoplasms: ?? and ??

A

Wilms tumor and hepatoblastoma

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6
Q

First step in evaluating primary amenorrhea (after neg pregnancy test)?

A

Pelvic US

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7
Q

Pelvic US of turners syndrome pt may show “??? ovaries”

A

Streak ovaries

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8
Q

A single S2 and a harsh, holosystolic murmur heard best at the LL sternal border is characteristic of ???

A

VSD.

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9
Q

Initial evaluation of VSD is ??? to determine size and location of defect.

A

ECHO

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10
Q

T or F: most small VSDs close spontaneously and require no further tx.

A

True (if SMALL defect)

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11
Q

Ascending progression of muscle weakness after “cold”: Dx? Test for most life threatening complication?

A

GBS. Spirometry to evaluate for neuromuscular respiratory failure.

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12
Q

Most common cause of urinary tract obstruction in newborn boys?

A

Posterior urethral valves

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13
Q

Oligohydramnios/low amniotic fluid restricts fetal movement, leading to physical anomalies such as flat facies and limb deformities. This process is referred to as ???

A

Potter sequence

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14
Q

Oligohydramnios from low urine production in utero can cause ??? and postnatal ???

A

Pulmonary hypoplasia; RDS

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15
Q

Encephalopathy and acute liver failure after viral illness and 2/2 ASA?

A

Reye’s syndrome

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16
Q

Pathophysiology of Reye syndrome?

A

Microvesicular fatty infiltration and hepatic mitochondrial dysfunction

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17
Q

Genetic transmission of duchenne and Becker muscular dystrophy?

A

X-linked recessive

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18
Q

Genetic transmission of myotonic muscular dystrophy?

A

Autosomal dominant (expansion of CTG)

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19
Q

Pt with testicular atrophy, dysphasia, facial weakness, and Delayed muscle relaxation (myotonia) most notable after handshake: Dx?

A

Myotonic muscular dystrophy

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20
Q

T or F: simple febrile seizures require no further work up

A

True

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21
Q

Infant with leukocoria (white reflex on Ophthalmoscopic exam) is considered ??? until proven otherwise.

A

Retinoblastoma (infants with visual problems have high suspicion for Rb)

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22
Q

Postictal paralysis, with restoration of motor function in 24 hrs

A

Todd’s paralysis

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23
Q

Legg-Calve-Perthes disease is characterized by ??? of the femoral head and an ??? gait

A

Avascular necrosis (osteonecrosis); antalgic (shorter weight bearing on affected side due to pain)

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24
Q

Pt with palpable “step-off”

A

Spondylolisthesis

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25
Q

Kawasaki Dz is Dx clinically by fever and 4/5 of following:

A

Conjunctivitis. Oral mucosa changes. Rash. Extremity changes. Cervical lymphadenopathy.

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26
Q

Kawasaki Dz most feared complication is ???, which is evaluated by ???

A

CA aneurysm; ECHO

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27
Q

Kawasaki Dz tx?

A

IV Ig and Aspirin.

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28
Q

??? has been shown to reduce morbidity/mortality of pts with measles.

A

Vitamin A

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29
Q

Newborn with cyanosis that is aggravated by feeding and relieved by crying. Also failure to pass catheter through nose into pharynx. Likely Dx?

A

Choanal artesian

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30
Q

Child with nocturnal vulvar itching should receive what Dx test? And likely Tx?

A

Scotch tape test for pinworms. Mebendazole

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31
Q

Infants are labeled SGA when birth weight is below the ?? percentile for GA

A

10th

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32
Q

Pt presenting 1-2 wks post-penicillin tx for URI; with fever/urticarial rash/polyarthralgia/lymphadenopathy. Dx?

A

Serum sickness-like rxn (drug-induced rxn, but not a true allergy)

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33
Q

Pt presents with hypovolemic vs. septic shock requiring emergency fluid resuscitation: when IV access can’t be obtained, ?? access should be attempted

A

IO

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34
Q

Immune-mediated vasculitis that often occurs after mild illnesses, presenting with abdominal pain, palpable purpura on LE, arthralgias, renal Dz, scrotal pain/swelling. Dx?

A

Henoch-Schonlein purpura

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35
Q

Pt with “currant jelly” or bloody stools, palpable tube/sausage shaped mass, and target sign on US?

A

Intussusception

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36
Q

Classic x-Ray findings of “sunburst” periosteal rxn and Codman triangle

A

Osteosarcoma

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37
Q

Classic x-Ray finding of “onion skin” periosteal rxn?

A

Ewing Sarcoma

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38
Q

The AAP recommends exclusive breast feeding until ???

A

6 mos

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39
Q

Puréed foods are introduced at ???, cows milk introduced at ???

A

6 mos; 1 year

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40
Q

Preterm infants are at increased risk for ???

A

Iron deficiency anemia

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41
Q

Malformation seen in Down syndrome pts presenting with UMN findings?

A

Atlantoaxial instability

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42
Q

Pt presenting with follicular conjunctivitis and pannus (neovascularization) formation in cornea. Most likely Dx? Tx?

A

Trachoma (via chlamydia serotypes A-C). Topical tetracycline of oral azithromycin

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43
Q

??? conjunctivitis presents 5-14 days after birth, and ??? conjunctivitis presents 2-5 days after birth.

A

Chlamydial; gonococcal

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44
Q

FAS is characterized by 3 pathognomonic facial dysmorphisms:

A

Small palpebral fissures, smooth philtrum, thin vermilion (upper lip) border.
*microcephaly too

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45
Q

Most common anatomic abnormality in infants with bladder exstrophy?

A

Epispadias

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46
Q

Preferred initial tx for Partial seizures?

A

Phenytoin

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47
Q

Symptoms of orbital cellulitis:

A

Proptosis, ophthalmoplegia, diplopia

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48
Q

Most common predisposing factor for orbital cellulitis?

A

Bacterial sinusitis

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49
Q

Management of child who ingested a battery: if battery is located in esophagus? Battery located distal to esophagus?

A

Immediate endoscopic removal.

Observation and stool examination

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50
Q

Racemic epinephrine should always be tried prior to endotracheal intubation in pts with ???, but has no role in management of ???.

A

Croup; Asthma

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51
Q

Rash described as “Sandpaper like”

A

Scarletina (from GAS infection)

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52
Q

CSF findings in viral meningitis:

A

normal glucose, normal to elevated protein, elevated mononuclear WBCs (lymphocytes)

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53
Q

Non-cyanotic congenital heart defect that has a loud/harsh holosystolic murmur at the LLSB

A

VSDS

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54
Q

Pt presenting with persistent productive cough and steatorrhea, likely Dx?

A

CF

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55
Q

Most specific test for muscular dystrophy?

A

Serum creatine phosphate (elevated in MD)

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56
Q

Pts with nephrotic syndrome are at increased risk of infection, particularly by ???

A

Encapsulated organisms (SHiN SKiS = strep pneumo, H.inf, Neisseria, Salmonella, Klebsi, strep agalactiae/GBS)

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57
Q

Infant rash with microscopic scraping showing prominent eosinophilia, likely Dx?

A

Erythema toxicum

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58
Q

Psych term for parent inducing illness in child in order to play sick role by proxy

A

Münchausen syndrome by proxy

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59
Q

??? disorder is seen only in girls and characterized by normal development followed by Regression.

A

Rett’s disorder

60
Q

Therapy of choice in Wilsons dz

A

Penicillamine

61
Q

Birth trauma injury that presents as swelling that is limited by the suture lines

A

Cephalohematoma

62
Q

Child with cognitive impairment, dystonia, and self-mutilating behavior: likely Dx? Pathophysiology of dz?

A

Leech-Nyhan syndrome. X-linked deficiency in HGPRT, leading to hyperuricemia.

63
Q

Every pt with osteosarcoma should undergo a ??? to r/o metastatic dz

A

Chest CT (lungs most common site)

64
Q

Tx for sickle cell pts with recurrent vasocclusive events?

A

Hydroxyurea

65
Q

Preferred tx of intussusception?

A

Air enema

66
Q

The classic triad of ??? is situs inversus, recurrent sinusitis, and bronchiectasis

A

Kartagener’s syndrome

67
Q

Two important risk factors for RDS?

A

Prematurity and maternal diabetes mellitus

68
Q

Henoch-Schonlein purpurA is associated with Ig? deposition in affected organs

A

IgA

69
Q

Fetal hydantoin syndrome is characterized by:

A

Nail and digit hypoplasia, dysmorphic facies, and mental retardation

70
Q

This is an AR disorder presenting with frequent feedings, rapid breathing, characteristic doll-like face with thin limbs, hypoglycemia, and elevated lactate/uric acid?

A

Von Gierke’s dz (glycogen storage disorder 1)

71
Q

In maple syrup urine disorder, what AA’s are elevated?

A

BCAAs: isoleucine, leucine, valine

72
Q

Pt with transposition of great arteries must receive ??? to keep the ??? open.

A

PGE1; ductus arteriosus

73
Q

Fetal exposure to valproate can cause:

A

Neural tube defects, cardiac anomalies, cleft lip, mid face hypoplasia, depressed/broad nasal bridge, long philtrum

74
Q

Classic presentation of infectious mononucleosis:

A

Fever, exudative tonsillitis/pharyngitis, and posterior or diffuse cervical lymphadenopathy

75
Q

Doxycycline is CI in kids <8 and pregnant moms, so must use ??? or ??? to tx Lyme dz in this population

A

Amoxicillin or cefuroxime

76
Q

Pt with throat pain, fever, and malaise presenting with rash after ampicillin/amoxicillin use. Likely Dx?

A

IM

77
Q

Most common anatomic abnormality in infants with bladder exstrophy?

A

Epispadias

78
Q

Webbed neck, broad chest/widely spaced nipples, horseshoe kidney, streak ovaries, low set ears, coarctation of aorta, bicuspid aortic valve, and short stature are all sequelae of ???

A

Turner syndrome

79
Q

Pt presenting with delayed umbilical cord separation (>30 days), poor wound healing, recurrent skin and mucosal bacterial infections. Likely dx?

A

Impaired leukocyte adhesion

80
Q

Test to Dx pyloric stenosis? Test to Dx duodenal atresia?

A

Abdominal US; Abdominal X-ray

81
Q

Patient presenting with knee pain and hip/leg is externally rotated. Radiographs show posterior and medial displacement of femoral head. Likely Dx?

A

Slipped capital femoral epiphysis

82
Q

CAH pts are deficient in what enzyme?

A

21-hydroxylase

83
Q

Undescended testes carry increased risk of ??? and ???

A

Germ cell tumors(Seminoma) and Infertility

84
Q

Deficiency in ???, which inhabits the GI tract, predisposes to Giardia infection

A

IgA

85
Q

Low serum albumin and elevated urine protein with oval fat bodies point to a ??? syndrome

A

Nephrotic

86
Q

Most common form of nephrotic syndrome in children and its treatment?

A

Minimal change dz, tx with corticosteroids

87
Q

A ??? hemorrhage crosses suture lines, grows slowly over first day of life, related to birth trauma/vacuum assist, can lead to hemorrhagic shock(tachycardia)

A

Subgaleal

88
Q

Henoch-Schonlein purpura symptoms are caused by?

A

Deposition of IgA and C3 in small vessels

89
Q

What can develop after a mumps infection?

A

Pancreatitis

90
Q

A child with fair skin, growth retardation, MR, mousy body odor and eczema. Likely dx?

A

PKU (disorder of AA metabolism)

91
Q

To prevent MR in PKU pts, must restrict ??? and supplement ???

A

Phenylalanine; Tyrosine

92
Q

??? manifests as unconjugated hyperbilirubinemia and dehydration in first week of life

A

Breastfeeding failure jaundice

93
Q

Fever, dysphagia, trismus, inability to extend neck and widened prevertebral space on lateral X-ray suggest dx of ???

A

Retropharyngeal abscess

94
Q

Classic triad of congenital toxoplasmosis:

A

Chorioretinitis, hydrocephalus, and intracranial calcifications

95
Q

What is the most common predisposing factor for bacterial sinusitis?

A

Viral URI

96
Q

??? is indicated for all premature and LBW newborns to r/o IVH

A

Transfontanel US

97
Q

??? occurs due to laxity of supra glottis structures and presents as inspiratory stridor that worsens when supine, crying or feeding; improves in prone position

A

Laryngomalacia

98
Q

Pt presenting with thrombocytopenia, h/o eczema and multiple bacterial infections: likely dx? Pathophys?

A

Wiskott-Aldrich syndrome (WAS); impaired platelet production

99
Q

ADHD symptoms present before age ??? and occur in at least ??? settings

A

Age 12; 2

100
Q

Hallmark X-ray finding in NEC?

A

Pneumatosis intestinalis (bowel gas in bowel wall)

101
Q

Dx of Meckels Diverticulum?

A

Technetium-99m pert scan

102
Q

Infant appeared normal at birth, but gradually developed weakness, hypotonia, large tongue, abdominal bloating, umbilical hernia, and sluggish movement: Dx?

A

Congenital hypothyroidism

103
Q

Tx of gonococcal conjunctivitis? Tx of chlamydial conjunctivitis?

A

IV or IM ceftriaxone/cefotaxime;

Oral erythromycin

104
Q

Clinical features of Prader-Willi syndrome? Dx/path?

A

Hypotonia, hyperphagia/obesity, hypogonadism, almond shaped eyes.
Deletions on paternal 15q11-q13

105
Q

Most common cause of congenital hypothyroidism?

A

Thyroid dysgenesis

106
Q

Screening for developmental dysplasia of the hips: 2 wks-6 mos? >6 mos?

A

Hip US; Hip X-ray

107
Q

Complications of bronchiolitis 2/2 RSV? Prophylaxis for children <2 yo at high risk?

A

Apnea, respiratory failure;

Palivizumab

108
Q

In an infant with meningococcemia, watch out for ???, which is characterized by sudden vasomotor collapse and skin rash(purpura/Petechia) due to adrenal hemorrhage

A

Waterhouse-Friderichsen syndrome

109
Q

??? is a rare condition characterized by precocious puberty, cafe au lait spots, and multiple bone defects

A

McCune-Albright syndrome

110
Q

Pt with recurrent catalase positive infections and abnormal nitroblue tetrazolium test: Dx? Tx?

A

Chronic granulomatous disease; daily bactrim and gamma interferon 3x/wk (BMT is experimental/curative)

111
Q

Patient with recurrent UTIs should receive???

A

Voiding cystourethrogram

112
Q

21-hydroxylase deficiency presents with ambiguous genitalia, ???, and increased ???

A

Salt wasting(hypotension, decreased Na, increased K); 17-hydroxyprogesterone

113
Q

11beta-hydroxylase deficiency presents as ambiguous genitalia, ???, and increased ???

A

Fluid/salt retention(HTN); 11-deoxycorticosterone and 11-deoxycortisol

114
Q

Most common complication of sickle cell trait ?

A

Hematuria

115
Q

Stridor that improves with neck extension, condition is associated with cardiac abnormalities: Dx?

A

Vascular ring

116
Q

First step in managent of gastroschisis?

A

Sterile wrapping of exposed bowel

117
Q

Pinealomas present with features of ???

A

Parinaud syndrome(limited upward gaze, ptosis, pupillary abnormalities), HA/V, central precocious puberty

118
Q

Congenital rubella infection presents with infant symptoms of ???

A

Hearing loss, cardiac anomalies, cataracts/glaucoma

119
Q

Early symptoms of congenital Syphilis infection:

A

Hepatosplenomegaly, jaundice, anemia, rhinorrhea, and cutaneous lesions on palms/soles

120
Q

Late symptoms of Syphilis infection:

A

High arched palate, hutchinson teeth, perioral fissures, saddle nose

121
Q

Pt with recurrent catalase positive infections and abnormal nitroblue tetrazolium test: Dx? Tx?

A

Chronic granulomatous disease; daily bactrim and gamma interferon 3x/wk (BMT is experimental/curative)

122
Q

??? vesicles localize to anterior oropharynx/lips; whereas ??? vesicles localize to posterior oropharynx/tonsillar pillars.

A

HSV gingivostomatitis; Herpangina (coxsackie A)

123
Q

??? is radiopaque, and infested tablets can be seen on X-ray

A

Iron

124
Q

The standard of care for both diagnosis and treatment of foreign body aspiration is???

A

Bronchoscopy

125
Q

Tinea capitis tx?

A

Griseofulvin or oral terbinafine

126
Q

Minimal Change Disease histopathology? Tx?

A

Normal histopathology; steroids

127
Q

Overuse injury in runners, Pt presents with anterior knee pain that’s worse when descending steps/hills: Dx?

A

Patellofemoral stress syndrome

128
Q

A traction apophysitis of the tibial tubercle. Pain is reproduced by knee extension against resistance. Mass may be felt: Dx?

A

Osgood-Schlatter dz

129
Q

Congenital hypothyroidism has typical findings of:

A

Poor feeding, constipation, low tone, macroglossia, umbilical hernia, large anterior fontanelle

130
Q

Low levels of thyroid hormone can lead to:

A

MR, poor linear growth, failure of bone maturation

131
Q

??? begins with URI symptoms and progresses to whooping cough. Post-tussive emesis is common.

A

Pertussis

132
Q

Common feature of Retts Disorder?

A

Seizures

133
Q

HepB infection is a significant risk factor for this less common nephrotic syndrome in kids?

A

Membranous nephropathy

134
Q

Lyme Dx tx if 8 ???

A

Amoxicillin; doxycycline

135
Q

Impetigo tx?

A

Muciprocin

136
Q

Pertussis tx?

A

Erythromycin

137
Q

Definitive tx for compartment syndrome? *done within 6 hours to preserve tissue/avoid amputation

A

Fasciotomy

138
Q

Why sickle cell pts at high risk of developing gallstones?

A

Hemolysis, increased bilirubin metabolism

139
Q

US findings in cholecystitis?

A

Pericholecystic fluid, thickened GB wall, gas within GB

140
Q

Malignant hyperthermia 2/2 anesthetic/depolarizing agents, presents clinically as:

A

Hyperthermia, tachycardia, muscular rigidity, metabolic acidosis, skin mottling

141
Q

Heparin type given for suspected PE?

A

Unfractionated or LMW

142
Q

Hiatal hernia, EGD revealed metaplasia. Tx?

A

Nissen Fundoplication

143
Q

Loss of vision described as: bright flashes/floaters with “curtain pulled over eye” loss of vision

A

Retinal detachment

144
Q

Pts should ??? daily dose of steroids prior to surgery

A

Increase (“stress dose”)

145
Q

Parkland formula for fluid resuscitation in burn victims:

A

4 mL • %TBSA • weight kg

146
Q

How much fluids resuscitated during first 8 hours for burn victims?

A

Half of parkland total fluids. The other half is given over following 16 hours

147
Q

Gastrin secreting tumor of pancreas that presents as diarrhea, malabsorption, and refractory PUD

A

Zollinger-Ellison Syndrome

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