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Peds UWorld Flashcards

0
Q

Macrocytic anemia, low retic count, and congenital anomalies?

A
  • think: diamond-blackfan syndrome

- AKA: congenital hypo plastic anemia

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1
Q

5 Early Ssx of congenital syphilis?

A
  1. Hepatosplenomegaly
  2. Cutaneous lesions
  3. Jaundice
  4. Anemia
  5. Rhinorrhea
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2
Q

Metatarsus adductus: what is it? Types? Tx?

A
  • congenital foot deformity
  • more commonly seen in first born infants
  • 3 types & tx:
    1. Type I - mild, feet over correct with passive and active mvmnt
  • tx = reassurance
    2. Type II- feet correct to mid line with passive and active mvmnt
  • tx = orthosis (corrective shoes)
    3. Type III - rigid feet that do not correct at all
  • tx = serial casts
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3
Q

What cancers does breast feeding reduce the mothers risks for?

A
  1. Breast

2. Ovarian

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4
Q

Patient with Down syndrome who presents with upper motor neuron findings?

A

-think: alantoaxial instability

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5
Q

Genetics of fragile X?

A

-mutation in FMR1 gene, caused by an increased number of CGG trinucleotide repeats

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6
Q

What is Reye syndrome AKA?

A

-fatty liver encephalopathy

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7
Q

What is given to close a PDA?

A
  • indomethacin

- potent prostaglandin inhibitor

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8
Q

What is given to keep PDA open?

A

-prostaglandin E1

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9
Q

Alantoaxaial instability: what is it? Who is it commonly seen in? Ssx?

A
  • presents over a few weeks
  • commonly seen in Down syndrome
  • due to laxity of transverse ligament that causes spinal cord compression btwn the atlas and axis
  • upper motor neuron ax present
  • Ssx: behavioral changes, torticollis, urinary incontinence, & vertebrobasilar Ssx (dizziness, vertigo, diploplia)
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10
Q

Asymmetry of inguinal folds in an infant or neonate?

A
  • worry about developmental dysphasia of the hip

- get ultrasound (if < 6 mnths old) or xray ( > 6 mnths)

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11
Q

What should be done with an anyphylacyic rxn, encephalopathy, seizure, or any other CNS complication occurs within 7 days after getting DTaP?

A
  • give DT should be given instead

- adverse rxns are assumed to be from the pertussis portion

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12
Q

What is the most common cause of communicating hydrocephalus?

A

-subarachnoid hemorrhage

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13
Q

Marfan features + mental retardation + thromboembolic events + downward dislocation of lenses?

A

-homocystinuria

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14
Q

Bruton’s agammaglobulinemia: what immunoglobulin concentrations are seen?

A
  • igA, igM, igD, and igG are decreased (ALL)

- absence of B cells too!

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15
Q

Homocystinuria: what is it? Cause? Genetics? Tx?

A
  • autosomal recessive
  • caused by cystathionine synthase deficiency
  • tx: high doses of bit B6
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16
Q

4 Ssx of homocystinuria?

A
  1. Marfan’s features
  2. Mental retardation
  3. Thromboembolic events
  4. Downward dislocation of lenses
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17
Q

Tx for tricyclic antidepressant intoxication?

A

-sodium bicarbonate

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18
Q

How is chlamydial conjunctivitis prevented?

A
  • maternal prenatal testing and tx of mothers chlamydia

- ophthalmic prophylaxis given at birth does not prevent chlamydial conjunctivitis, only gonorrheal

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19
Q

5 Reasons an umbilical hernias should be referred to surgery?

A
  1. If they persist to age 3-4yrs
  2. Larger than 2 cm in diameter
  3. Causes symptoms
  4. Becomes strangulated
  5. Enlarges progressively from ages 1-2
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20
Q

Caput succedaneum?

A
  • diffuse swelling of the scalp
  • can be ecchymotic (bruised/discolored)
  • can extend across the midline and across suture lines
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21
Q

3 Complications of orbital cellulitis?

A
  1. Orbital abscess
  2. Intracranial infection
  3. Cavernous sinus venous thrombosis
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22
Q

Metaphysis?

A

-wide portion of a long bone

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23
Q

Hemarthrosis after minor trauma in a young child?

A
  • suggests bleeding disorder

- ex hemophilia

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24
Q

Tx for infants when ruling out sepsis: in a < 28 day old? In an infant > 1 mnth?

A
  • < 28 days = ampicillin & gentamicin

- > 1 mnth = vancomycin & ceftriaxone

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25
Q

Triad of HUS?

A
  1. Thrombocytopenia
  2. Anemia
  3. Renal failure
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26
Q

3 Ssx of necrotizing enterocolitis? 2 findings on xray, why?

A
  1. Increased gastric residual volume
  2. Vomiting
  3. Abdominal distention
    * *in a preterm neonate!!!!!
    - xray: pneumatosis intestinalis + portal venous air! –> air is from gas produced by bacterial overgrowth
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27
Q

3 Most common causes of acute bacterial rhinosinusitis?

A
  1. Strep pneumo
  2. Nontypeable H. Influenza
  3. Moraxella catarrhalis
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28
Q

Tx for strawberry hemangiomas?

A
  • none!

- usually regress by ages 5-8 yrs

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29
Q

Most common cause of osteomyelitis in infants and kids?

A

-staph aureus

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30
Q

What is the most common cause of cerebral palsy?

A

-cerebral anoxia

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31
Q

“Target sign” on abdominal ultrasound?

A

-intussusception

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32
Q

Classic triad of congenital toxoplasmosis?

A
  1. Chorioretinitis
  2. Hydrocephalus
  3. Intracranial calcifications
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33
Q

Tx for impetigo?

A
  1. Topical mupirocin

2. Oral erythromycin

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34
Q

What is thought to be the best way to decrease the rates of necrotizing enterocolitis in premature infants? Why?

A
  • breast feeding all premies if possible!

- why: premies intestines may have increased permeability due to immaturity, breast milk may help counteract this

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35
Q

What is the most common cause of secondary HTN in kids?

A

-fibromuscular dysplasia

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36
Q

Wiskott-Aldrich syndrome triad? Most common of the 3?

A
  1. Thrombocytopenia (most common!) –> due to decreased platelet production
  2. Eczema
  3. Recurrent bacterial infections
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37
Q

What are the 3 causes if anemia of prematurity?

A
  1. Transitions in erythropoiesis sites of the neonate
  2. Shorter lifespan of RBCs in neonates
  3. Low fetoplacental transfusion –> occurs when the baby is held above the level of the placenta after delivery
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38
Q

Iron deficiency anemia in infants: common? Presentation? 3 things that increase risk?

A
  • most common nutritional deficiency in infants and children
  • often asymptomatic
  • full term infants are born with enough iron stores to prevent them from developing deficiency until age 4-6 mnths, regardless of dietary intake
  • increase risk:
    1. Maternal iron deficiency (w/ breast feeding)
    2. Prematurity
    3. Cow’s milk before age 12 mnths
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39
Q

Describe the murmur of VSD?

A

-pansystolic murmur that is loudest at the left lower sternal border + diastolic flow murmur at apex

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40
Q

Tx for OCD?

A
  • high-dose selective serotonin reuptake inhibitors (ex. Fluoxetine)
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41
Q

Cyclic vomiting syndrome: what is it? Etiology? Possible complications? Tx?

A
  • recurrent, self-limiting episodes of vomiting and nausea in children in the absence of any apparent cause
  • etiology: unclear, but more common in pts who have parents with migranes
  • complications: dehydration and anemia
  • tx: anti-emetics & reassurance
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42
Q

4 Common ssx of necrotizing enterocolitis? What is seen on xray?

A
  1. Feeding intollerance
  2. Increasing abdominal girth
  3. Bloody stools
  4. Vomiting
    - see pneumatosis intestinalis on xray
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43
Q

3 Ssx of niacin deficiency?

A
  1. Diarrhea
  2. Dementia
  3. Dermatitis
    * *vitamin B3 deficiency = pellagra
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44
Q

For how long is bed wetting normal?

A
  • until age 5

- boys usually do it longer than girls

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45
Q

Todd’s paralysis?

A
  • postictal paralysis that can follow generalized or focal seizures
  • motor deficit rapidly improves and is back to normal within 24 hrs
  • usually indicates a structural abnormality underlying the seizures
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46
Q

Absent or hypoplastic thumbs + depression of all cell lines? Pathophysiology?

A
  • think: fanconi anemia

- pathophysiology: spontaneous chromosomal breaks

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47
Q

Breastfeeding failure jaundice v. Breast milk jaundice: what is it? When does it present? Tx?

A

failure jaundice:
-feeding insufficiency results in insufficient caloric intake
-occurs in 1st week of life
-tx: promote and support successful breast feeding
Milk jaundice:
-factor of human milk increases bilirubin enterohepatic circulation
-unconjugated hyperbilirubinemia from third week of life on
-tx: stop breast feeding temporarily if the bilirubin level is markedly increased, otherwise no tx

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48
Q

Most common cyanotic congenital heart defect at birth?

A

-transposition of great vessels

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49
Q

4 Common facial features of fetal alcohol syndrome?

A
  1. Smooth philtrum
  2. Thin vermillion border
  3. Small palpebral fissures
  4. Microcephaly
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50
Q

Legg-Calve-Perthes disease: what is it? When is it commonly seen? How does it usually present? Dx?

A
  • what: idiopathic osteonecrosis (avascular necrosis) of the femoral head
  • when: boys 4-10 yrs, most commonly 7 yrs
  • how present: pain of insidious onset and antalgic gait
  • Dx: may take a while for changes to be shown on xray, clinical suspicion needed, and repeat xray
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51
Q

Reye syndrome: what is it? Common presentation? Tx?

A
  • rare syndrome that is seen only in children <15 who are treated with aspirin for a viral illness
  • common presentations: vomiting, agitation, and irrational behavior, progresses to lethargy, stupor, and restlessness
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52
Q

What is the most common congenital heart disease associated with Edward’s syndrome?

A

-VSD

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53
Q

What is the most common cause of pulmonary infections in CF pts? Tx?

A
  • pseudomonas aeruginosa

- tx: aminoglycoside (ex tobramycin) + antipseudomonal penicillin (ex piperacillin)

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54
Q

4 Red flags for orbital cellullitis?

A
  1. Decreased visual acuity
  2. Diplopia
  3. Opthalmoplegia
  4. Proptosis
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55
Q

Syncopal episode (w/out post-episode confusion) + hearing impairment + family hx of sudden cardiac death?

A

-think: congenital long QT syndrome

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56
Q

4 Ssx of intussusception?

A
  1. Sudden onset of abdominal pain
  2. Vomiting
  3. Red currant jelly stools that contain blood and mucus
  4. Abdominal mass
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57
Q

Tx of intussusception?

A

-air or water-soluble contrast enema

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58
Q

What are 3 classical signs of posterior urethral valves that can be seen on prenatal ultrasounds?

A
  1. Bladder distension
  2. Bilateral hydroureters
  3. Bilateral hydronephrosis
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59
Q

What embryonic structure do neuroblastoma masses arise from?

A

-neural crest cells

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60
Q

4 Ssx of cri-du-chat syndrome? Genetics?

A
  1. Microcephaly
  2. Hypotonia
  3. Short stature
  4. Cat-like cry
    - genetics = deletion of 5p!
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61
Q

Describe chronic pyelonephritis findings on IV pyelogram?

A
  1. Blunting of calices

2. Focal parenchymal scarring

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62
Q

What should be done about a swallowed battery?

A
  • if in esophagus = remove

- if distal to the esophagus = most pass uneventfully, so they only need to be observed

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63
Q

Tx for lyme dz in kids < 8 yrs old?

A

-amoxicillin

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64
Q

Tx of necrotizing enterocolitis?

A
  1. Empiric broad-spectrum antibiotics bc of the serious risk of lethal septic shock if perforation occurs
  2. Surgical intervention
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65
Q

5 Ssx of Beckwith-Wiedermann syndrome? What must they be monitored closely for?

A
  1. Macrosomia
  2. Macroglossia
  3. Umbilical hernia/omphalocele
  4. Hemihyperplasia
  5. Hypoglycemia
    - monitor closely for Wilms tumor or hepatoblastoma!!
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66
Q

What os the cause of meningitis that is accompanied by a petechial or purpuric rash?

A

-Neisseria meningitis!!!

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67
Q

What congenital heart defect is associated with William’s syndrome?

A

-supravalvular aortic stenosis

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68
Q

Myotonic congenital myopathy?

A
  • muscle weakness and atrophy (esp in the distal muscles of the upper and lower extremities)
  • myotonia
  • testicular atrophy
  • baldness
  • autosomal dominant
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69
Q

What is the most common cause of hip pain in children? Tx?

A
  • transient synovitis

- tx: NSAIDs + rest

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70
Q

What is terminal deoxynucleotidyltransferase? What is it expressed in?

A
  • TdT
  • only expresses by preB and preT lymphoblasts
  • positive in 95% of ALL pts
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71
Q

Failure to thrive, bilateral cataracts, jaundice, and hypoglycemia in newborn?

A

-think: galactosemia from galactose-1-phosphate uridyl transferase deficiency

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72
Q

5 Ssx of measles?

A
  1. Coryza
  2. Conjunctivitis
  3. Cough
  4. Koplik’s spots
  5. Maculopapular rash that begins on face
    * *5 “C” sounds!
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73
Q

3 most common manifestations of polycythemia in newborns?

A
  1. Respiratory distress
  2. Poor feeding
  3. Neurologic manifestations
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74
Q

3 Most common causes of neonatal jaundice?

A
  1. Breast milk jaundice
  2. Hematologic
  3. Sepsis –> so work up all jaundice for sepsis if you dont know the underlying cause!!
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75
Q

Drug of choice for congenital long QT syndrome?

A

-beta-blockers!!!

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76
Q

What occurs in partial seizures with secondary generalizations?

A

-tonic-clonic manifestations –> diffuse muscle aches & elevated CPKs

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77
Q

Max oz of cows milk that 1-5yr olds should consume a day?

A

-20oz!

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78
Q

5 Ssx of HSP?

A
  1. Palpable purpura
  2. Hematuria
  3. Abdominal pain
  4. Arthralgias
  5. Scrotal swelling –> occasionally
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79
Q

Triad for congenital rubella syndrome?

A
  1. Sensorineurial deafness
  2. Cardiac malformations
  3. Cataracts
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80
Q

What is often the earliest manifestation of sickle cell anemia in pts?

A
  • dactylitis

- vaso-occlusion of hands and feet

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81
Q

What to do for a unimmunized pt exposed to varicella zoster?

A
  • normal = give vaccine

- immunocompromised = give varicella Ig within 10 days of exposure

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82
Q

Pertussis prevention of close contacts of an infected pt?

A

-14 days of erythromycin, no matter how old they are, their immunizations, or sx!

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83
Q

When does VSD usually present? How?

A
  • usually at 6 wks

- presents w/: tachypnea & failure to thrive

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84
Q

Parinaud’s syndrome? Where is the lesion? What is probably the cause?

A
  • syndrome = paralysis of vertical gaze, can be associated with pupillary disturbances and eyelid retraction (Collier’s sign)
  • means there is a lesion in the rostral midbrain at the lever of the superior colliculus and CN III
  • usually caused by germinomas and pinealomas
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85
Q

Which peds patients is orthostatic proteinuria common in?

A

-adolescent boys

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86
Q

Top 3 bacterial causes of otitis media (in order)?

A
  1. Strep pneumo
  2. H. Influenzae
  3. Moraxella catarrhalis
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87
Q

3 Common ssx of trachoma? Caused by? Tx?

A
  1. Follicular conjunctivitis
  2. Pannus of the cornea = neovascularization
  3. Concurrent infection of nasopharynx with nasal discharge
    - caused by chlamydia trachomatis
    - tx: topical tetracycline or oral azithromycin
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88
Q

Presentation of choledochal cysts in infants?

A
  1. Jaundice

2. Acholic stools

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89
Q

2 tx of absence seizures?

A
  1. Ethosuximide

2. Valproic acid

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90
Q

Tx of galactosemia?

A

-galactose-free diet!

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91
Q

What 3 types of seizures have loss of conciousness?

A
  1. Generalized seizures
  2. Partial seizures with generalization
  3. Complex partial seizures
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92
Q

Orbital cellulitis: what is it? 3 Ssx?

A
  • serious bacterial infection
  • Ssx:
    1. Pain with extraocular movements
    2. Visual impairments
    3. Opthamoplegia
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93
Q

Serum sickness-like rxn: what is it? When is it commonly seen?

A
  • hypersensitivity rxn that occurs 1-2 wks after administration of certain drugs
  • NOT a true drug allergy!
  • common drugs: (if given for a viral illness)
    1. Penicillin
    2. Amoxicillin
    3. Cefaclor
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94
Q

6 Ssx of compartment syndrome?

A
  1. Sever pain
  2. Pallor
  3. Poikilothermia
  4. Paresthesias
  5. Pulselessness –> late finding
  6. Paralysis –> late finding
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95
Q

Confirmatory test for SLE?

A

-anti-smith antibody test

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96
Q

Tx of clubfoot?

A
  • initially: stretching and manipulation of the foot (starting immediately!)
  • then: serial plaster casts, malleable splints, or taping
  • if unresponsive: surgery
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97
Q

What happens to benign murmurs of kids when they stand up or perform the valsalva manuver?

A

-decreases in intensity!

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98
Q

What is the most common cause of chronic inspiratory noise in infants? Tx? Prognosis?

A
  • laryngomalacia
  • tx: hold child in upright position for half an hour after feeding, and never feed child when he is lying down
  • usually resolves by 18mnths
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99
Q

What is the most common cyanotic congenital disease in kids less than 4 yrs old?

A

-tetralogy of fallot

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100
Q

Traction apophysitis of the tibial tubercle: AKA?

A

-Osgood-Schlatters Disease

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101
Q

Osgood-Schlatters Disease: AKA?

A

-traction apophysitis of the tibial tubercle

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102
Q

What are the most common fractures in pediatrics? Most common complication of this fracture?

A
  • supracondylar fractures

- complication: entrapment of the brachial artery = loss of radial a. Pulse

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103
Q

Neonate with non-bilious, projectile and persistent vomiting? What to do next?

A
  • think pyloric stenosis

- do abdominal ultrasound next

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104
Q

Common presentation for neonatal enterocolitis (3)?

A
  1. Abdominal distention
  2. Vomiting
  3. Frank blood in stools
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105
Q

What is mitral valve stenosis almost always due to?

A

-rheumatic fever as the result of a group A strep infection

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106
Q

Thymus in CXR?

A
  • thymus can be very lg on CXR of kids < 2 yrs old
  • located in the anterior, superior mediastinum, behind the sternum
  • thymus can overlap the heart un infants = “sail sign”
  • thymus can be lg and can be mistaken for: cardiomegaly, lung infiltrates, atelectasis, or a mediastinal mass
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107
Q

3 Ssx of androgen excess in males with precocious pubarche? Cause?

A
  1. Coarse axillary hair
  2. Coarse pubic hair
  3. Severe cystic acne that is resistant to tx
    - caused by late-onset (AKA: nonclassical) adrenal hyperplasia caused by 21-hydroxylase deficiency
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108
Q

6 Indications for the evaluation of neonatal jaundice?

A
  1. Hyperbilirubinemia of > 2 mg/dL
  2. Jaundice that appears in first 24-36 hrs of life
  3. Serum bili that is rising faster than 5mg/dL/24 hrs
  4. Serum bili > 12 mg/dL in full-term (esp in absence of risk factors) or of 10-14 in premeies
  5. Jaundice persists after 10-14 days of life
  6. Signs or symptoms
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109
Q

What congenital GI issue can be seen in newborns of moms who took cocaine during pregnancy?

A
  • jejunal or ileal atresia

- bc cocaine is vasoconstrictor & causes a vascular accident in utero

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110
Q

What 2 things can be seen on plain xrays and CT scans in neuroblastoma?

A
  1. Calcifications
  2. Hemorrhages
    * * most commonly in the abdomen
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111
Q

“Squirt sign”

A
  • rectal examination causes explosive expulsion of gas and stool from temporary relief of an obstruction
  • positive in hirschsprung
  • negative in meconium ileus
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112
Q

Scarlet fever v kawaski, whats the big feature that can help separate them?

A
  • scarlet fever: NO mucous membrane involvement = NO conjunctivitis
  • Kawasaki dz: mucus membrane involvement = conjunctivitis!
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113
Q

Tx/workup of simple febrile seizures?

A
  • no work up needed

- tx: reassurance

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114
Q

3 Ssx of cholesteatoma?

A
  1. New-onset of hearing loss
  2. Chronic ear drainage despite antibiotic tx
  3. Granulation and skin debris seen on otoscopy
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115
Q

Cholesteatoma?

A
  • destructive and expanding cystic growth in the middle ear and/or mastoid proccess
  • consists of keratinizing squamous epithelium
  • can be acquired (secondary to chronic middle ear infection) or congenital
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116
Q

3 Ssx of McCune Albright syndrome?

A
  1. Precocious puberty
  2. Cafe au lait spots (Pigment) = they are lgr than in NF, have irregular borders, and not in axilla or groin
  3. Multiple bone defects = Polyostotic fibrous dysplasia
    * * 3 Ps
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117
Q

5 Possible long term sequelae associated with bacterial meningitis?

A
  1. Hearing loss
  2. Loss of certain cognitive functions
  3. Seizures
  4. Mental retardation
  5. Spasticity or paresis
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118
Q

Pancytopenia following drug intake, exposure to toxins, or viral infection?

A

-Think: aplastic anemia!

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119
Q

When is chelation tx used in lead posioning?

A

-when the serum lead levels are 45 or greater

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120
Q

What is the cut off for small for gestational age?

A

-Birth weight less than the 10th percentile

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121
Q

What is PANDAS?

A
  • Pediatric Autoimmune Neuropsychic Disorders Associated with strep infections
  • onset of OCD ssx after a group A strep
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122
Q

3 Common features of IgA deficiency?

A
  1. Recurrent sinopulmonary infections (w/ strep & hemophilus)
  2. Recurrent GI infections (w/ giardia)
  3. Anaphylactic reactions to transfusions
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123
Q

Honey-colored crusted exudates?

A
  • impetigo!

- ALWAYS when you see those words!!!!

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124
Q

Tx for immune thrombocytopenia?

A

-corticosteroids are the drug of choice, but only if the platelet count is <30,000

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125
Q

What should be obtained when a hemophilia is suspected?

A

-factor VIII and IX levels

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126
Q

Growing pains?

A
  • bilateral lower extremity pains that occur at night in kids aged 2-12 yrs
  • no systemic ssx, normal activity levels, normal physical exam!
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127
Q

4 abnormalities in tetrology of fallot?

A
  1. VSD
  2. Overriding aorta
  3. Pulmonary stenosis
  4. RVH
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128
Q

What causes measles?

A

-paramyxovirus

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129
Q

Presentation of Late-onset CAH in females?

A
  • presents in adolescence with:
    1. Acne
    2. Irregular menses
    3. Mild hirsuitism
  • hard to distinguish from PCOS sometimes
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130
Q

Constitutional growth delays?

A
  1. Delayed growth spurt
  2. Delayed puberty
  3. Delayed bone age w
131
Q

What type of seizure is an aura indictive of?

A

-partial seizure from a specific focus of the brain

132
Q

What does RSV increase the risk for?

A

-asthma later in life

133
Q

5 Ssx of henoch-schonlein purpura?

A
  1. Palpable purpura on the lower extremities
  2. Arthralgias
  3. Abdominal pain
  4. Renal dz
  5. IgA depsition in the kidney on immunoflorescence
    * *vasculitis of small vessels
134
Q

2 Causes of “floppy baby” syndrome?

A
  1. Infant botulism

2. Werdnig-hoffman syndrome

135
Q

Tx for tinea corporis?

A
  • antifungal

- ex terbinafine

136
Q

What is a “Sunburst” on x-ray classical for?

A
  • osteosarcoma
  • most common primary bone tumor in children and young adults
  • usually seen at the metaphysis of long bones
137
Q

Preterm infant with respiratory distress that is not responding to oxygen tx? Tx?

A
  • think: hyaline membrane dz!

- tx: mechanical ventilation + surfactant

138
Q

Friedreich ataxia: what is it? What 3 organ systems are involved? 2 Most common causes of death?

A
  • most common type of spinocerebellar ataxia
  • 3 systems:
    1. Neurologic = ataxia & dysarthria
    2. Skeletal = scoliosis & foot deformities
    3. Cardiac = concentric hypertrophic cardiomyopathy
  • 2 Most common causes of death:
    1. Cardiomyopathy
    2. Respiratory complications
139
Q

What should be done in a child < 24 mnths with their first febrile UTI?

A
  • tx with 7-14 days of oral antibiotics

- renal and bladder ultrasound for any anatomical abnormalities

140
Q

Wilms tumor tx and prognosis?

A
  • lungs are the most common site metastatic spread, but children rarely present with pulmonary sx
  • tx: surgery + chemo
  • survival rates are excellent, esp in earlier stages of dz
141
Q

Tx of migraines in peds?

A
  • acetominophen or other NSAIDs

- supportive management

142
Q

Toddler with firm, smooth, unilateral mass and hematuria?

A

-think: Wilms tumor

143
Q

Most common cardio malformation in marfan’s syndrome?

A

-aortic root dilation

144
Q

What is the most common cause of polycythemia in term infants?

A
  • delayed clamping of the umbilical chord –> excess transfer of placental blood to infant
  • hematocrit > 65%
145
Q

Decreased pulmonary markings on CXR?

A

-means there is pulmonary undercirculation

146
Q

Spondylolisthesis?

A
  • developmental disorder with a forward slip of the vertebrae that mainfests in preadolescent kids
  • ssx:
    1. Back pain
    2. Neurologic dysfunction (ex urinary incontinence)
    3. Palpable “step-off” at lumbosacral area
147
Q

Failure to pass meconium within first 24 hrs?

A

-think: hirschsprung disease

148
Q

Premature pubarche: what is it? Clinical significance?

A
  • pubic hair growth < 8 yrs old

- 50% of the time associated with a CNS disorder

149
Q

Whey v. Casein in breast milk?

A
  • 70% whey
  • 30% cassein
  • whey is more easily digested & it helps to improve gastric emptying
150
Q

Chronic granulomatous disease?

A
  • defect in NADPH-oxidase system of phagocytic cells

- prone to abcesses secondary to catalase-producing organisms, like aspergillius and staphylococcus

151
Q

What is the fluid of choice when resuscitating in severe hypovolemic hypernatremia?

A

-isotonic, normal saline = 0.9% saline

152
Q

What are the most common causes of pediatric myocarditis? How do they typically present (4)?

A
  • viruses: 1. Coxsackie 2. Adenovirus
  • presentation:
    1. Lethargy
    2. Fever
    3. Signs of heart failure
    4. Viral prodrome
153
Q

Renal tubular acidosis: in general what is it?

A
  • normal anion gap metabolic acidosis
  • caused by a defect in the ability of the renal tubules to resorb bicarb or excrete hydrogen
  • there are 3 types
154
Q

Werdnig-Hoffman syndrome?

A
  • degeneration of anterior horn cells and cranial nerve motor nuclei
  • causes floppy baby syndrome
  • autosomal recessive
155
Q

2 Ssx of aplastic crisis in sickle cell anemia? What is it? What can cause it? Tx?

A
  1. Acute severe anemia
  2. Low or absent reticulocytes
    - arrest of erthropoiesis
    - can be caused by infections, ex. Parvovirus B19
    - tx: blood transfusion
156
Q

Describe the ventricular septal defect ,urmur?

A

-holosystolic murmur that is the loudest at the left lower sternal border

157
Q

Tx of pertussis?

A
  • macrolides (ex amoxicillin)

- tx should be based on clinical suspicion, dont wait for the confirmatory dx

158
Q

Pediatric CNS tumors: what is more common supratentorial or infratentorial? What is the most common type?

A
  • infratentorial is more common

- astrocytomas are the most common histologic type

159
Q

What is the nursemaid’s elbow? Ssx?

A
  • subluxed radial head that results from a pulling injury

- ssx: child keeps hand in pronated position and cries/refuses attempted forearm supination

160
Q

Serum iron and TIBC in iron deficiency anemia?

A
  • serum iron is decreased

- TIBC is increased

161
Q

Glucose in CSF for bacterial v viral meningitis?

A
  • bacterial = low glucose

- viral = normal glucose

162
Q

Olive-sized mass palpable in the abdomen?

A

-pyloric stenosis!!

163
Q

What does posterior vermis syndrome cause?

A

-truncal dystaxia

164
Q

Juvenile angiofibroma: tx?

A
  • some dont need tx
  • bc can bleed easily, should only be touched by specialists
  • tx is required if its:
    1. Enlarging
    2. Obstructing airway
    3. Causing chronic nosebleeds
165
Q

Niemann-Pick’s disease?

A
  • sphingolipidosis due to a deficiency in sphingomyelinase

- sphingomyelin accumulates in the reticuloendothelial cells of the liver, spleen, bone marrow, and brain

166
Q

Most common heart defect in infant of GDM?

167
Q

Most common cause of sepsis in a sickle cell anemia pt? Why?

A
  • strep pneumo

- its encapsulated and they are functionally asplenic

168
Q

What are 2 important predisposing factors of brain abcesses?

A
  1. Congenital heart disease

2. Recurrent sinusitis

169
Q

Ssx of Riboflavin deficiency?

A
  • non-specific and usually mild
  • rarely seen in industrialized countries!
  • B2
  • Ssx: sore throat, hyperremic and edematous oropharyngeal membranes, cheilitis, stomatitis, glossitits, normocytic-normochromic anemia, seborrheic dermatitis, and photophobia
170
Q

Precocious puberty, cafe au lait spots, and multiple bone defect?

A

-McCune-Albright syndrome

171
Q

Cradle cap?

A

-seborrheic dermatitis

172
Q

Inspiratory “whoop”?

A
  • pertussis

- AKA: “whooping cough”

173
Q

If an infant is infected with Hep B via vertical transmission, what is the chance that they will progress to chronic hepatitis?

A

-90% chance

174
Q

What is commonly seen with complex partial seizures?

A

-automatisms during loss of conciousness

175
Q

Normal anion gap metabolic acidosis in infants that causes a FTT?

A

-renal tubular acidosis

176
Q

What does it mean if a murmur changes with position?

A

-its probably an innocent murmur

177
Q

What is the deficiency in Lesch-Nyhan syndrome?

A
  • hypoxanthine-guanine phosphoribosyl transferase (HgPRT)

- think: “he’s got purine recovery trouble”

178
Q

First-line tx of bacterial OM?

A

-10 day course of amoxicillin

179
Q

Most common cardio congenital defect in down syndrome?

A

-endocardial cushion defect

180
Q

5 Possible complications of small for gestational age?

A
  1. Hypoxia
  2. Polycythemia
  3. Hypoglycemia
  4. Hypothermia
  5. Hypocalcemia
181
Q

Genes coding for what are mutated in osteogenesis imperfecta?

A

-type I collagen

182
Q

What is the most common presentation for meckle’s diverticulum? In what ages?

A
  • painless melena

- 2-3 yr old kids

183
Q

Tx of preseptal cellulitis v orbital cellulitis?

A
  • preseptal cellulitis = outpatient oral antibiotics

- orbital cellulitis = inpatient IV antibiotics

184
Q

Most common early symptom of Cavernous sinus thrombosis?

A

-headache that eventually becomes unbearable

185
Q

Hemophilic arthropathy?

A
  • consequence of recurrent hemarthrosis
  • seen in hemophilia A & B
  • associated with hemosiderin deposition in the joint space –> synovitis and fibrosis
186
Q

Typical features of glucose-6-phosphatase deficiency?

A
  • 3-4mnth child presenting with:
    1. Hypoglycemia
    2. Lactic acidosis
    3. Hyperuricemia
    4. Hyperlipidemia
    5. Characteristic doll-like face (fat cheeks)
    6. Thin extremities
    7. Short stature
    8. Protuberant abdomen (from enlarged liver)
187
Q

Left axis deviation on EKG and decreased pulmonary marking on CXR in a neonate?

A
  • think: tricuspid valve atresia
  • will see cyanosis in child
  • normally infants are born with a large right ventricle, which will be seen as right axis deviations on EKG
188
Q

Ewing sarcoma: what is it? Who is it usually seen in? Common x-ray findings?

A
  • What: second most common primary bone malignancy in kids
  • who: most commonly seen in adolescent boys
  • xray: osteolytic lesions + periosteal rxn that looks like “onion skin”
189
Q

What portion of the bowel is usually affected in hirschsprung disease?

A

-rectosigmoid

190
Q

Acute fever, joint pain, turbid synovial fluid, neutrophil-predominant leukocytosis? Tx?

A
  • think: septic arthritis

- tx: emergency surgical drainage + IV antibiotics

191
Q

Tx for an infant born to a mom with active hep B?

A
  • passive immunization at birth with hep B immune globulin

- plus recombinant HBV vaccine

192
Q

Most common predisposing factor for orbital cellulitis? 2 Reasons why?

A
  • bacterial sinusitis
  • why:
    1. Proximity
    2. The orbital venous system is valveless!!
193
Q

Tx of cat bites?

A

-should be tx prophylactically with a five-day course of ammoxicillin/clavulante (augmentin)

194
Q

5 Major criteria for rheumatic fever?

A
  • use Jones criteria (think “J<3 - carditis
    3. subcutaneous Nodules
    4. Erythema marginatum
    5. Sydenham chorea
195
Q

Treatment of TET spell?

A
  • knee-chest position

- beta-blocker to decrease afterload

196
Q

Strawberry v. Cherry hemangioma?

A
  • strawberry in infants

- cherry in adults

197
Q

5 Common physical features of Edward’s syndrome?

A
  1. Micrognathia
  2. Microcephaly
  3. Rocker bottom feet
  4. Overlapping fingers
  5. Absent palmar creases
198
Q

3 Main Ssx of prader-willi syndrome?

A
  1. Hypotonia
  2. Hyperphagia
  3. Obesity
199
Q

What is the best thing to do with a child who is reluctant to potty training?

A

-take a break from potty training for a couple months and let him/her get interested in potty training on their own

200
Q

What is the most common cause of intestinal obstruction during the first two years of life?

A

-intussusception

201
Q

Collier’s sign?

A
  • eyelid retraction

- usually due to a lesion in the rostral midbrain

202
Q

Tx for kawasaki dz?

A
  1. Aspirin

2. IV Ig

203
Q

Gastroschisis: what is it? How does it present? Initial tx?

A
  • congenital abdominal wall defect
  • bowel protrudes through defect
  • bowel is not covered by membrane
  • bowel looks “angry” & matted
  • usually not associated with any other abnormalities
  • tx: cover bowel with sterile dressings ASAP!
204
Q

What leukemia has a strong PAS rxn?

205
Q

2 most common organisms that cause orbital cellulitis?

A
  1. Strep pneumo

2. Staph aureus

206
Q

What is the most common cause of anemia in sickle cell patients?

A

-chronic hemolysis

207
Q

Fibromuscular dysplasia: physical exam? Which side is more often effected? What is seen on angiogram?

A
  • PE: hum or bruit in costovertebral angle due to well-developed collaterals
  • right renal a. is often more affected than left
  • angiography: see “string of beads” sign
208
Q

7 Ssx of congenital hypothyroidism?

A

Normal at birth & gradually develop:

  1. Apathy
  2. Weakness
  3. Hypotonia
  4. Large tongue
  5. Sluggish movements
  6. Abdominal bloating
  7. Umbilical hernia
209
Q

Diagnostic study of choice for an acute alkali ingestion?

A

-upper gastrointestinal endoscopy

210
Q

Common Wilms tumor presentation?

A
  • age 2-5 yrs old
  • asymptomatic abdominal mass found incidentally
  • most often unilateral
211
Q

2 Complications of HSP?

A
  1. Intussusception –> bc of bowel wall edema

2. Gastrointestinal hemorrhage

212
Q

What type of seizures has automatisms?

A

-complex partial seizures

213
Q

What is the most common cause of acute and recurrent headaches in kids?

A

-migraines

214
Q

What should be done when intravenous access cannot be obtained in an emergent peds case?

A

-intraosseous access should be tried next!

215
Q

Sfx of desmopressin?

A
  • if too much water is consumed it can cause hyponatremia and seizures!
  • used for enuresis
216
Q

Inflamed, fluctuant cervical lymph nodes are cause by which 2 bacterial infections usually? Tx?

A
  1. Strep
  2. Staph
    - tx: dicloxacillin
217
Q

Langerhans histiocytosis: how does it present? Prognosis? Tx?

A
  • solitary, lytic, long bone lesion
  • lesions can be painful, have overlying tender swelling, and can cause pathological fractures
  • prognosis: can be locally destructive, but typically resolve spontaneously
  • tx: conservative
218
Q

Tx of choice for strep pharyngitis?

A

-penicillin

219
Q

Dx of pertussis?

A

-Cultures and/or PCR of nasopharyngeal secretions

220
Q

Osteosarcoma: what is it? Who is it typically seen in? Where? How does it typically present? What does it look like on x-ray?

A
  • What: most common primary bone tumor in children and young adults
  • who: boys ages 13-16 are most at risk
  • where: usually involves the metaphyses of long bones
  • presentation: large tender mass on PE, may also have elevated alk phos and lactate dehydrase (from turnover of damaged osteocytes –> worse prognosis)
  • xray: classically see “sunburst” pattern
221
Q

4 Most common causes of aquired torticollis? First thing for dx?

A
  1. URIs
  2. Minor trauma
  3. Cervical lymphadenitis
  4. Retropharyngeal abscess
    - dx: cervical spine radiograph to make sure there is no fracture or dislocation!
222
Q

What to do with a child who has a serum lead level of less than 20?

A
  • recheck the level in one month

- council the parents on lead safety

223
Q

Most common CAH?

A

-21 hydroxylase deficiency

224
Q

What can be a consequence of trauma to the soft palate by a foreign body?

A

-internal carotid artery dissection that causes a stroke in children

225
Q

Describe the murmur of mitral stenosis?

A

-loud first heart sound and mid-diastolic rumble

226
Q

What congenital infection is the “blueberry muffin” rash seen in?

A

-congenital rubella

227
Q

Post-tussive emesis?

A
  • pertussis

- AKA: whooping cough

228
Q

6 Ssx of cavernous sinus thrombosis (CST)?

A
  1. Headache –> early sign
  2. Periorbital edema –> usually starts unilaterally, but then becomes bilateral
  3. Exopthalmos
  4. Chemosis (= edema of conjunctiva)
  5. Papilledema
  6. Dilated tortuous retinal veins
229
Q

Abnormal B-lymphocyte maturation?

A
  • present after 6 mnths of age (when the levels of maternal antibodies drop)
  • predisposed to recurrent sinopulmonary infections with encapsulated organisms, like H. Influenza & strep. Pneumo
  • also have a deficiency in IgA = predisposes to giardia GI infections
230
Q

Chemosis?

A

-swelling of the conjunctiva

231
Q

Where is Lyme disease most common in the US?

A

-northeastern or upper midwestern United States

232
Q

What is the expected weight and height of a child at 12 months?

A
  • weight should triple from birth

- height should increase by 50% from birth

233
Q

2 most common causes of microcytic anemia in children?

A
  1. Iron deficiency anemia

2. Thalasemmia minor

234
Q

What PCO2 level is suggestive of impending respiratory failure?

A

-PCO2 > 40

235
Q

What is a thrill? Grade?

A
  • its a palpable murmur

- at least grade 4

236
Q

What 2 ssx does Niemann-Pick’s disease have that Tay-Sach’s doesnt?

A
  1. Hepatosplenomegaly

2. Cervical lymphadenopathy

237
Q

When does vascular ring stridor present? What improves it? What else can it be associated with?

A
  • presents before age 1
  • persistent stridor that improves with neck extension
  • associated with cardiac abnormalities
238
Q

Most common cardiovascular abnormalities in Turner’s syndrome?

A
  • coarctation of the aorta

- aortic valve abnormalities

239
Q

Transient proteinuria: what is it? Dx?

A
  • Proteinuria that is intermittent, common in school-aged kids
  • can be caused by fever, exercise, seizures, stress, or volume depletion
  • dipstick test shows protein in urine –> check for hematuria –> if negative, repeat dipstick 2 other times
240
Q

What does it mean to have a leukocyte adhesion deficiency?

A
  • the leukocytes are unable to exit the vasculature and migrate to areas of infection or inflammation
241
Q

Blood-stained eye discharge in a newborn?

A

-highly characteristic of chlamydial comjunctivits!

242
Q

Cyanosis, single loud second heart sound, and no murmur in the first few hours of life? Explain why?

A
  • transposition of the great vessels
  • cyanosis: deoxygenated blood comes from the body and goes into the RA and goes back into the aorta = 2 separate, unconnected circuits
  • loud single S2: aorta is closer to the anterior chest wall, so its better heard than the soft s2 of the pulmonic valave
  • no murmur: foramen ovale and ductus arteriosus have closed
243
Q

Jervell-Lange-Nielson syndrome?

A
  • congenital long QT syndrome
    1. Congenital deaftness
    2. Syncopal episodes
    3. Family Hx = autosomal recessive
  • molecular defects in ion channels
244
Q

Seborrheic dermatitis: common locations? Tx? What can severe cases suggest?

A
  • common locations:
    1. Eyebrows
    2. Nasolabial folds
    3. Bases of eyelashes
    4. Paranasal skin
  • tx: moisturizers, topical antifungals, anti-dandruff shampoos, and topical steroids
  • severe cases can = immunodeficiency
245
Q

Presentation of jejunial atresia? What is seen on Xray? What is one main risk factor?

A
  • presentation:
    1. Bilious vomiting
    2. Abdominal distention
  • Xray = triple bubble sign
  • risk = maternal use of cocaine and other vasoconstrictive drugs
246
Q

The rash of what disease is described as “sandpaper-like”?

A

-scarlet fever

247
Q

When is Guillain-Barre syndrome seen? Pathology?

A
  • Ascending polyneuropathy typically seen one week after a viral infection
  • pathology: involves mainly the peripheral motor nerves, but sensory and automatic can also be affected
248
Q

X-linked agammaglobinemia: what is it? What is commonly seen in these pts? What is typically seen in the labs? Tx?

A
  • what: inherited immune deficiency
  • recurrent bacterial infections early in life
  • labs: normal amnt if T lymphocytes, but low or absent amnt of B lymphocytes
  • tx: regular infusions of IVIg
249
Q

7 Contraindications to breast feeding?

A 
Maternal:
1. Active, untreated TB
2. HIV infection
3. Herpetic breast lesion
4. Varicella infection
5. Specific meds/chemo tx
6. Street or alcohol abuse
Infant:
7. Has galactosemia
250
Q

2 Ssx of Waterhouse-Friderichsen syndrome?

A
  1. Sudden vasomotor collapse
  2. Large purpuric lesions on flanks p
    * *both due to adrenal hemorrhage
251
Q

What has been shown to reduce the morbidity and mortality with measles?

A

-vitamin A

252
Q

Cause of transient synovitis?

A

-unknown, but usually follows a viral infection or mild trauma

253
Q

When is croup most common? What are 4 common symptoms?

A
  • most common btwn 6 mnths - 6 yrs
  • ssx:
    1. “Barky” cough
    2. Fever
    3. Rhinorrhea
    4. Congestion
254
Q

What is not required in neonates before an LP that is required in older kids? Why?

A
  • head CT is not needed to look for ICP

- bc the fontanelles are still open, it is very rare that a neonate will herniate after an LP!

255
Q

Choledochal cysts? How many types? Most common tupe?

A
  • congenital abnormality of biliary ducts
  • dilation of intra or extra-hepatic biliary ducts, or both
  • 5 types, most common = type 1–> dilation of entire common hepatic and common bile ducts or segments of each
256
Q

What acid/base abnormality and electrolyte disturbances are usually seen in pyloric stenosis?

A

-hypochloremic, hypokalemic, metabolic alkalosis

257
Q

Neonatal abstinence syndrome: what is it? When does it usually present? Ssx? Tx?

A
  • NAS = infant withdrawal to opiates
  • usually presents in the first few days of life
  • ssx:
    1. Iritability
    2. High-pitched cry
    3. Poor sleeping
    4. Tremors
    5. Seizures
    6. Sweating
    7. Sneezing
    8. Tachypnea
    9. Poor feeding
    10. Vomiting
    11. Diarrhea
258
Q

4 Common ssx of orbital cellulitis?

A
  1. Pain with eye mvmnts
  2. Proptosis
  3. Opthalmoplegia
  4. Diplopia
259
Q

What is the most common cause of anemia in kids with sickle cell dz?

A

-hemolytic anemia

260
Q

What fluid should be given for moderate to severe dehydration in children?

A
  • iV bolus of isotonic fluid
261
Q

Other than new born screening, how can you test for PKU?

A

-Guthrie test of urine = coloration test that detects the presence of metabolic products of phenylalanine in urine

262
Q

Diastolic murmurs are always what?

A

-pathologic!

263
Q

Recurrent sinopulmonary infections, recurrent GI infections, & anaphylactic rxn to transfusion?

A

-think: IgA deficiency!

264
Q

Postpericardiotomy syndrome?

A
  • pleuropericardial disease that occurs days to months after cardiac surgery or injury
  • inflammation from surgical site can lead to reactive pericarditis, pericardial effusion, or even cardiac tamponade
  • difficulty feeding can be a sx in infants
265
Q

What are the three phases of pertussis? How long do they last if untreated?

A
  1. Catarrhal phase = nonspecific sx of malaise, mild fever, cough, rhinorrhea, etc –> lasts 1-2 wks
  2. Paroxysmal phase = severe paroxysms of coughing spells that can lead to post-tussive emesis + can have “inspiratory whoop”
  3. Convalescent phase = gradually decreasing frequency and severity of cough
    * *can last for 3 mnths total if untreated!
266
Q

Cystic calcified parasellar lesion on MRI is almost diagnostic of what?

A

-craniopharyngioma

267
Q

Most common viral cause of myocarditis?

268
Q

Two top viral causes of otitis media?

A
  1. RSV

2. Rhinovirus

269
Q

What type of hypersensitivity rxn is allergic contact dermatitis?

A
  • cell-mediated hypersensitivity
  • type IV
  • delayed
270
Q

Tx for enuresis?

A
  • desmopressin

- used only after behavior modifications and bed alarms havent worked!

271
Q

When should chronic granulomatous disease be considered?

A

-with recurrent or unusual lymphadenitis, hepatic abcesses, osteomyelitis at multiple sites, or unusual infections with catalase-positive organisms

272
Q

Abnormality in Marfan’s?

A

-mutation in fibrillin-1 gene

273
Q

2 tx for enterobiasis?

A
  • AKA: pinworm
    1. Albendazole
    2. Mebendazole
274
Q

What is the next step when meconium ileus is suspected in a newborn?

A
  • barium enema –> can break up the obstruction

- surgery required if the enema is unsuccessful

275
Q

Most common cause of congenital hypothyroidism in the US?

A

-thyroid dysgenesis

276
Q

How does infantile corarctation usually present?

A
  • after child goes home the PDA closes and causes a left sided obstructed lesion in the heart
  • child presents with heart failure and shock!
277
Q

What does it mean when there is delayed umbilical cord separation?

A

-leukocyte adhesion deficiency type I

278
Q

Adult botulism v infantile botulism?

A
  • adult = ingestion of preformed toxin

- infantile = ingestion of the organism via food (ex honey) and produces the toxin in the intestinal tract

279
Q

Presentation of choledochal cysts in children?

A
  1. Abdominal pain
  2. Jaundice
  3. Attacks of recurrent pancreatitis w/ increased amylase and lipase levels
280
Q

4 Manifestations of osteogenesis imperfecta?

A
  1. Blue sclera
  2. Hearing loss
  3. Recurrent fractures
  4. Opalescent teeth
281
Q

What 3 conditions are early childhood vision screens looking for? What are the recommended ages to do theses screens?

A
  1. Strabismus
  2. Amblyopia
  3. Refractive errors
    - recommended to screen ages 0-5yrs
282
Q

What is the most common pathogen that causes unilateral cervical lymphadenopathy?

A

-staph aureus

283
Q

Dx of meckle’s diverticulum?

A

-technetium-99m pertechnetate scanning –> taken up by the heterotrophic gastric mucosa

284
Q

Cephalohematoma: what is it? Presentation? Tx?

A
  • subperiosteal hemorrhage
  • presents a few hours after birth
  • scalp swelling limited to one cranial bone
  • tx: none, usually resolves in 2 wks - 3 mnths depending on the size
285
Q

What 2 types of seizures can have an aura?

A
  1. Simple partial seizures

2. Complex partial seizures

286
Q

What is the most common nutritional deficiency in infants?

A

-iron deficiency anemia

287
Q

What should be done if a finger stick blood test for lead level is positive?

A

-should check the serum lead level, since the capillary test can give false positives

288
Q

What screening test should be done in all children with behavioral concerns?

A
  • hearing test

- undetected hearing impairment can often get confused with a behavioral disorder

289
Q

5 Ssx of Niemann-Pick’s disease?

A
  1. Cherry red macula
  2. Protruding abdomen
  3. Hepatosplenomegaly
  4. Lymphadenopathy
  5. Regression of developmental milestones
290
Q

Triple bubble sign and has less colon on abdominal X-ray?

A

-think: jejunal atresia!

291
Q

Paroxysmal cough?

A
  • pertussis

- AKA: whooping cough

292
Q

When is laryngomalacia stridor most common? What worsens it? Improves it?

A
  • most severe at ages 4-8 mnths

- persistent stridor that WORSENS in SUPINE and IMPROVES in PRONE position

293
Q

Osteonecrosis?

A

-AKA avascular necrosis!

294
Q

Cause of 80% of nephrotic syndrome in kids < 16 yrs old? Tx?

A
  • minimal change dz

- steroids

295
Q

What is the key feature in myotonic muscular dystrophy?

A
  • Delayed muscle relaxation

- ex unable to release hand after a handshake

296
Q

Beck’s triad?

A
  • for tamponade
    1. Distant heart sounds
    2. Distended jugular veins (or scalp veins in infants)
    3. Hypotension
297
Q

What is the most common complication of HUS?

A

-renal damage

298
Q

What conditions are pts with sickle cell trait at an increased risk for?

A
  • Increased risk for renal issues –> most common = painless microscopic or gross hematuria –> caused by sickling in the renal medulla
  • isosthenuria can also occur = inability to concentrate urine = nocturia or polyuria
299
Q

Who can give consent in a child with divorced parents who have joint custody?

A
  • only one parent is needed

- this is especially true when the decision is clearly in the child’s best interest

300
Q

4 Ssx of serum sickness-like rxn to medications?

A
  1. Fever
  2. Urticarial rash
  3. Polyarthralgia
  4. Lymphadenopathy
301
Q

Adult presentation of choledochal cysts?

A
  1. Vague epigastric or right upper quadrant abdominal pain

2. Cholangitis

302
Q

What can be seen on a lateral neck Xray with retropharyngeal abcess?

A
  • widened prevertebral space

- normally the prevertebral soft-tissue space should be narrower than the vertebral bodies

303
Q

Infantile colic?

A
  • presents by 3 wks of age
  • excessive crying for more than 3 hrs a day
  • more than 3 days a week
  • more than 3 times a month
  • usually resolves by 4 mnths
304
Q

Triad of ssx of brain abcess?

A
  1. Fever
  2. Severe headaches (nocturnal and morning)
  3. Focal neurologic changes
305
Q

Premature adrenarche: what is it? Organ involved? Clinical significance?

A
  • isolated apperance of axillary hair < 6 yrs old
  • generally benign, with no clinical significance
  • adrenal glands are involved
306
Q

What nutrient suppliment(s) should breast feed infants be given?

A

-vitamin D!

307
Q

Most common cause of nephrotic syndrome in kids? Tx?

A
  • minimal change dz

- steroids! Highly responsive!

308
Q

When does infantile colic usually resolve by?

A

-usually resolves by four months

309
Q

2 first line Tx for pinworm?

A
  1. Albendazole

2. Mebendazole

310
Q

What are the 2 most common bacterial causes of osteomyelitis in sickle cell patients?

A
  1. Salmonella

2. Staph aureus

311
Q

What age is it recommended to do meningicoccal vaccination?

A

-btwn ages 11-12 yrs

312
Q

Purulent, foul-smelling vaginal discharge, and bleeding?

A

-think: vaginal foreign body

313
Q

Juvenille angiofibroma: what is it? 3 Common ssx? Who is it more commonly seen in?

A
  • benign growth that is capable of eroding and locally invading
  • ssx:
    1. Nasal obstruction
    2. Visible nasal mass
    3. Frequent nose bleeds
  • more common in adolescent males
314
Q

Presentation of a milk protein intolerance in a neonate?

A
  • vomiting and bloody diarrhea
  • stools may have RBCs and eosinophils
  • can have family hx of atopic disorder
315
Q

What 2 types of newborns is respiratory distress syndrome common in?

A
  1. Premature infants

2. Infants of DM mothers

316
Q

Active hep B & subsequent nephrotic syndrome?

A
  • membranous glomerulonephritis

- usually secondary to deposition of HBeAg in the glomeruli

317
Q

3 Ssx of acute iron poisoning?

A
  1. Abdominal pain
  2. Hematemesis
  3. Metabolic acidosis
318
Q

2 Most common causes of viral meningitis?

A
  1. Echovirus
  2. Coxsackievirus
    * *bot non-polio enteroviruses
319
Q

What tx should precede intubation in a pt with croup?

A
  • racemic epi

- often decreases need for intubation

320
Q

What 2 types of infections are typically seen in pts with complement deficiency?

A
  1. Gonococcal

2. Meningococcal

321
Q

Tx for rheumatic fever? Why?

A
  • antibiotics (usually penicillin) regardless of whether or not pharyngitis is present at the time of exam –> prevents recurrent GAS infections
  • bc of risk for developing and the progression of rheumatic heart dz
322
Q

How to dx 21-hydroxylase deficiency?

A

-measure 17-hydroxyprogesterone –> will be increased!!

323
Q

Tx of acute bacterial rhinitis?

A

-amoxicillin-clavulanic acid

324
Q

When does separation anxiety usually occur?

A

-btwn 9-18 mnths

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