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A2 > Peds Uworld review > Flashcards

Peds Uworld review Flashcards

1
Q

If a child has incidental proteinuria on dipstick analysis, what is the appropriate next step?

A

Repeat dipstick testing on two subsequent occasions

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2
Q

What are the common causes of transient proteinuria in children? (5)

A 
Fever
Exercise
Seizures
Stress
Volume depletion
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3
Q

What is the treatment for bartonella henselae infex?

A

Z-pack

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4
Q

What is the defect in Wiskott-Aldrich syndrome?

A

XLR loss of WAS gene that regulates the cytoskeleton remodeling in response to cell signalling

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5
Q

What is the treatment for Wiskott-Aldrich syndrome?

A

Bone marrow transplant

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6
Q

What are the physical exam findings of Friedreich’s ataxia?

A

Ataxia
Loss or proprioception
Absent ankle reflexes

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7
Q

What are the EKG findings with Friedreich’s ataxia?

A

T wave inversions

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8
Q

What are the nerve conduction velocities with Friedreich’s ataxia?

A

Normal

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9
Q

How long is having an imaginary friend normal?

A

3-6 years, maybe a bit longer.

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10
Q

What is the active drug in plan B?

A

Levonorgestrel

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11
Q

Which bacteria is the most common cause of rhinosinusitis? Second and third?

A
  1. Strep pneumoniae
  2. H flu
  3. Moraxella
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12
Q

Why are patients with cyanotic congenital heart disease at risk for NEC?

A

Reduced mesenteric perfusion and/or hypotension

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13
Q

What is the classic AXR findings of NEC?

A

Pneumatosis intestinalis

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14
Q

What are the AXR findings of malrotation of the intestines with volvulus?

A

Gasless abdomen due to obstruction involving the duodenum

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15
Q

What is the classic AXR/US description of intussusception?

A

Target sign

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16
Q

What are the typical s/sx of aplastic crisis?

A

Severe anemia with low reticulocytes and NO splenomegaly

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17
Q

How do you differentiate aplastic anemia vs aplastic crisis?

A 
Crisis = only RBCs are low
Anemia = pancytopenia
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18
Q

What animal is the biggest rabies reservoir in the US?

A

Bats

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19
Q

What is anemia of prematurity?

A
  • Normally, decreased levels of EPO from a sudden increase in oxygen tension in the blood at birth causes an expected nadir at 2-3 months of age in term infants
  • Preterm infants there is low EPO and short RBC lifespan, causing much worse anemia and usually frequent phlebotomy in the NICU
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20
Q

What sort of anemia (micro, normo, macro) is anemia of prematurity? Symptoms?

A

Normocytic with low reticulocyte counts

asymptomatic usually

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21
Q

Why does sickle cell anemia take several months after birth to manifest?

A

Change from HgF to HgA

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22
Q

How much HgA is there is sickle cell disease? Sickle cell trait?

A 
Disease = 0% (all HbS)
Trait = ~50%
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23
Q

What is the next best step after assessing the ABCs in a child who has swallowed a caustic substance?

A

Remove clothing and decontaminate

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24
Q

Why should nasogastric lavage or administration of neutralizing substances be avoided in children who ingest a caustic substance?

A
  • May cause vomiting, which will worsen injury

- Also, if neutralize the acid/base, then exothermic rxn can burn

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25
Q

What is the effect of adrenal infarction in meningitis infx caused by N. Meningitidis?

A

Sudden vasomotor collapse

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26
Q

What is trachoma? S/sx? Treatment?

A
  • Chlamydia serotypes A, B, C inflammation of the eyelid, causing a roughing of the inner surface of the eyelid. THis leads to pain, breakdown of the cornea, neovascularization, and eventual blindness.
  • Watery discharge
  • Oral azithromycin
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27
Q

True or false: a small amount of vaginal bleeding and/or gynecomastia is a normal variant in newborns

A

True–maternal estrogen exposure. Routine f/u.

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28
Q

How does recurrent constipation lead to UTIs?

A

Pressure from stool causes compression of the urethra, leading to urinary stasis

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29
Q

Do UTIs usually result from sexual activity/abuse in women?

A

In older women, yes

In children, no

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30
Q

How does persistent coughing lead to a pneumothorax?

A

SQ emphysema from increased alveolar pressure

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31
Q

WIth a SCFE, how is the leg held, and what motions are restricted?

A

Held in passive external rotation

Decreased internal rotation, abduction, and flexion

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32
Q

What is the treatment for a SCFE?

A

Surgical screw placement

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33
Q

What is metatarsus adductus? Treatment?

A
  • Medial deviation of the forefoot with a normal, neutral position of the hindfoot
  • “Correctable” with passive movement
  • Reassurance
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34
Q

Does hypocalcemia cause focal neurologic deficits?

A

No

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35
Q

What is the classic triad of s/sx of a brain abscess?

A
  • Fever
  • Morning HAs
  • Focal neurologic changes
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36
Q

What are the histologic characteristics of the liver with Reye’s syndrome?

A

Microvesicular fatty infiltration

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37
Q

What are the s/sx of diamond blackfan anemia?

A
  • Congenital anomalies
  • Macrocytic anemia
  • Low reticulocyte count
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38
Q

What cell line(s) are affected with diamond blackfan anemia?

A

Only RBCs–pure red cell aplasia

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39
Q

What cell line(s) are affected with Fanconi anemia?

A

Pancytopenia

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40
Q

What are the congenital deformities of Fanconi anemia? (5)

A
  • Cafe-au-lait spots
  • microcephaly
  • Microphthalmia
  • Short statues
  • Absent thumbs
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41
Q

What is the classic tetrad of s/sx for HSP?

A
  • Palpable purpura
  • Arthralgias
  • Abdominal pain
  • Renal disease
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42
Q

true or false: HSP is characterized by thrombocytopenia

A

False–normal platelet levels. Thrombocytopenia is suggestive of ITP

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43
Q

What is the most common nutritional deficiency in infants?

A

Fe

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44
Q

What are the three major risk factors for Fe deficiency in infants?

A
  • Preterm (lower stores)
  • Cow’s milk before 12 months of age
  • Maternal Fe deficiency
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45
Q

What is the most common cause of pneumonia in CF pts below 20 years of age? Over?

A

Under 20 = Staph Aureus

Over = pseudomonas

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46
Q

What are bitot spots, and what do they indicate?

A

Dry, silver-gray plaques on the bulbar conjunctiva that indicate Vit A deficiency

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47
Q

What is the most common predisposing factor for bacterial sinusitis in kids?

A

Preceding viral URI d/t impaired ciliary clearance

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48
Q

What organ is responsible for premature adrenarche in children? Thelarche?

A 
Adrenarche = Adrenal androgen secretion
Thelarche = pituitary or ovaries
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49
Q

Which cancers can breastfeeding help prevent in the mother?

A

Breast and ovarian–NOT endometrial

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50
Q

True or false: breastfeeding is associated with a reduced incidence of AOM in children

A

True

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51
Q

For a cyanotic congenital heart defect, do you want to maintain a PDA, or close it?

A

Maintain it with PGE2

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52
Q

What may be seen with the carotid upstroke with HOCM?

A

Seemingly dual upstroke

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53
Q

What findings in the iris is characteristic of Down syndrome?

A

Brushfield spots (white-gray spots on the periphery)

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54
Q

Retinal hemangioblastomas are associated with what neurocutaneous disorder?

A

VHL

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55
Q

Onion skinning and Moth eaten appearance of bone on x-ray = ?

A

Ewing’s sarcoma

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56
Q

What is the classic presentation of midgut volvulus?

A

Bilious vomiting and abdominal distention

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57
Q

What is the best first diagnostic step in evaluating a suspected midgut volvulus?

A

AXR to r/o pneumoperitoneum, followed by Upper GI series

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58
Q

What will an upper GI series reveal with a midgut malrotation? Volvulus?

A

Ligament of Treitz on the right side of the abdomen = malrotation

Volvulus = corkscrew pattern with contrast

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59
Q

What are the contraindications to the rotavirus vaccination?

A
  • h/o intussusception
  • immunodeficiency (it’s a live attenuated vaccine
  • Uncorrected congenital malformation of the GI tract
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60
Q

What are the three major cardiovascular malformation associated with Turner’s syndrome?

A
  • Bicuspid aortic valve
  • Coarctation of the aorta
  • Aortic root dilation
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61
Q

47 XXY genotype = ?

A

Klinefelter

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62
Q

What is hemihyperplasia, and what disease is it associated with?

A

Overgrowth of one side of the body

Beckwith-Wiedemann syndrome

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63
Q

What are the s/sx and associations with cyclic vomiting syndrome in children?

A
  • Recurrent episodes of emesis that resolve spontaneously in an otherwise normal child
  • Associated with a family h/o migraines, since it is thought that this is an “abdominal migraine”
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64
Q

What is the treatment for cyclic vomiting syndrome?

A

Antiemetics

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65
Q

What is the causative agent of herpangina? S/sx? Age range affected? Treatment?

A
  • Coxsackie virus A
  • 3-10 years old
  • Fever, pharyngitis, gray vesicles/ulcers on posterior oropharynx
  • Supportive treatment
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66
Q

What is the causative agent of Herpetic gingivostomatitis? Age ranged affected? S/sx? Treatment?

A
  • HSV-1
  • 6 mo -5 years
  • Fever, pharyngitis, clusters of small vesicles on anterior oropharynx
  • Acyclovir
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67
Q

What disease are pts with absence seizures predisposed to developing?

A

ADHD

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68
Q

What is cataplexy, and what disease is it classically seen in?

A
  • Sudden, intermittent muscle weakness triggered by strong emotions
  • Narcolepsy
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69
Q

Are SGA infants at risk for hyper or hypocalcemia?

A

Hypocalcemia

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70
Q

What hemodynamic problem are SGA infant at risk of developing? Why?

A

Polycythemia

Increased EPO secretion in response to hypoxia

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71
Q

What is the prophylaxis for pertussis exposure?

A

Macrolide abx + immunization if not already immunized

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72
Q

Erythromycin use in neonates is associated with what disease?

A

Pyloric stenosis

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73
Q

What is the first and second line treatment for scarlet fever?

A
  • PCN V

- Erythromycin or clindamycin if PCN allergy

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74
Q

What are the memorable symptoms of opiate withdrawl in the neonate?

A
  • Sneezing
  • Tachypnea
  • Sweating
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75
Q

What are the memorable symptoms of cocaine withdrawl in the neonate?

A
  • Jitteriness
  • Excessive sucking
  • Hyperactive moro reflex
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76
Q

What are the s/sx of a pineal gland tumor?

A
  • Limited upward gaze
  • Upper eyelid retraction
  • Pupils are non-reactive to light, but reactive to accommodation
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77
Q

What is the tick that harbors Lyme disease?

A

Ixodes scapularis

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78
Q

Who should receive a screening test for GC/chlamydia?

A

All sexually active women less than 25 years old

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79
Q

What causes a UTI with sex?

A

AScending bacteria that are introduced from sex

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80
Q

What is the most common pathogen with acute unilateral lymphadenitis?

A

Strep or staph

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81
Q

Which immunodeficiencies have absent lymphoid tissue?

A
  • Bruton’s agammaglobulinemia

- SCID

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82
Q

Which viruses commonly cause aseptic meningitis?

A

Echovirus

Coxsackie

83
Q

True or false: focal neurologic signs are not found with meningitis

A

True

84
Q

After a diagnosis of Guillain-barre is made, what is the next most important step? Why?

A

Spirometry to determine impending respiratory failure

85
Q

What causes the sloughing off of skin with staph scalded skin syndrome?

A

Exfoliative toxin from staph destroys the desmoglein 1 protein, which is responsible for keratinocyte adhesion in the superficial epidermis

This is a toxin mediated process

86
Q

Fair hair and skin
MR
CVA or other clotting events = ?

A

Homocystinuria

87
Q

How does torticollis present?

A

Head tilting + palpable, non-transilluminating mass just posterior to the SCM

88
Q

What is a major consequence of untreated torticollis?

A

Positional plagiocephaly

89
Q

Fluctuant mass in the posterior neck of an infant that transilluminates = ?

A

Cystic hygromas (congenital malformation of the lymphatic system)

90
Q

What is the usual cause of croup?

A

Parainfluenza virus

91
Q

What is the henderson-Hasselbalch equation for the bicarb buffer in blood?

A

pH = 6.1 + log(HCO3/0.03*PaCO2)

92
Q

What is the appropriate imaging type to screen for suspected spinal malignancy without nerve s/sx or concern for epidural abscess? What labs should be obtained (2)?

A

x-ray

ESR and CRP

93
Q

What are the red flags for back pain 2/2 CA? (6)

A
  • Over 50 years
  • H/o CA
  • Constitutional s/sx
  • Nocturnal pain
  • No response to treatment
  • Significant or progressive neuro deficits
94
Q

What are the typical fundoscopic findings of CRAO?

A

White retina with a cherry red spot

95
Q

What is the role of thrombolytics in CRAO?

A

Useful if initiated within 4-6 hours of visual loss. Given intraarterially.

96
Q

What are the differences on nasal inspection of allergic vs nonallergic rhinitis?

A
  • Allergic = Pale mucosa

- Nonallergic = erythematous mucosa

97
Q

What is the role of NSAIDs in IBDs?

A

May worsen s/sx

98
Q

What is the most common congenital cyanotic heart condition in the neonatal period, and what are the heart sounds and CXR findings associated with this?

A
  • Transposition
  • Single, loud S2
  • “egg on a string”
99
Q

What happens to mitral valve motion with HOCM?

A

Systolic anterior motion

100
Q

What is thought to be the pathogenesis of necrotizing enterocolitis?

A

Lack of proper gut motility, along with lack of gut flora causes an overgrowth

101
Q

What sort of LAD is nearly pathognomonic for secondary syphilis?

A

Epitrochlear (“sailor’s handshake”)

102
Q

What is the treatment for stroke 2/2 septic emboli from endocarditis?

A

Abx (no need for anticoagulation or antiplatelet therapy)

103
Q

What is the screening test for bladder CA?

A

There is none. Low benefits.

104
Q

What is the most common cause for the s/sx of spinal stenosis?

A

Spinal osteoarthritis

105
Q

What movement is limited in pts with Avascular necrosis of the femoral head?

A

Cannot internally rotate, or abduct.

106
Q

What is the age range for pts with AVN of the femoral head vs SCFE?

A 
AVN = 4-10 years
SCFE = 12+ years
107
Q

What are the classic head CT findings of alzheimer’s disease?

A

-Diffuse cortical and subcortical atrophy which is disproportionately greater in the temporal and parietal lobes

108
Q

What are the two major adverse effects of PTU?

A
  • Agranulocytosis

- Hepatic injury

109
Q

What is the first and second line therapy for restless leg syndrome? MOA?

A
  • Ropinirole (Dopamine agonist)

- Gabapentin (alpha-2-delta Ca channel blocker

110
Q

What happens to platelets levels with a sickle cell crises? Why?

A

Decreased d/t splenic trapping

111
Q

Which abx used in the treatment of acne classically causes photosensitivity? How?

A

Doxycycline (or other tetracyclines) causes ROS generation

112
Q

What is the role of corticosteroids in the treatment of spinal cord compression?

A

Reduces inflammation of the epidural venous plexus, which contributes to cord compression

113
Q

What serum albumin-to-ascites gradient is indicative of portal HTN?

A

More than 1.1

114
Q

How many PMNs in ascitic fluid is diagnostic of peritonitis?

A

More than 250

115
Q

What do the following colors of ascitic fluid usually indicate as an etiology:

  • Bloody
  • Milky
  • Turbid
  • Straw color
A
  • Bloody = malignancy, trauma, or TB
  • Milky = chylous, pancreatic
  • Turbid = infx
  • Straw = benign causes
116
Q

What level of ascitic protein is high vs low? What does each indicate?

A

High = over 2.5. This indicated CHF, pericarditis

Low = less than 25. This indicates cirrhosis, or nephrotic syndrome

117
Q

What is the 2nd line treatment for PCP prophylaxis if pts cannot tolerate Bactrim?

A

Pentamidine

118
Q

What is the treatment for traveler’s diarrhea?

A

Cipro

119
Q

What is the diagnostic test of choice for giardia?

A

Stool antigen assay

120
Q

What is the biggest risk factor for cerebral palsy?

A

Prematurity

121
Q

Besides anaphylaxis, what are the two major contraindications to the pertussis vaccine?

A
  • Progressive neurologic disorder

- Encephalopathy within a week pf previous vaccine dose

122
Q

Which two abx classically cause serum sickness?

A

PCNs and Bactrim

123
Q

What are the s/sx of serum sickness?

A

Fever
Urticaria
arthralgias

124
Q

What is the gene that is affected with NF1 and NF2? What chromosome?

A 
NF1 = neurofibromin = 17
NF2 = merlin = 22
125
Q

What is the classic exposure to Arsenic? S/sx (4)?

A
  • Working with old wood

- Polyneuropathy, pancytopenia, mild increase in LFTs, variety of skin lesions

126
Q

What are the major differentiating factors between Arsenic poisoning and Pb?

A 
Ar = skin manifestations
Pb = GI manifestations
127
Q

What is the genetic defect in hyper IgM syndrome?

A

Lack of or defect in CD40 ligand

128
Q

What is the long term treatment for hyper IgM syndrome?

A

Prophylactic abx and IVIG

129
Q

What is the long term therapy for children with acute rheumatic fever?

A

IM PCN G until adulthood

130
Q

Which two antiepileptic drugs are used as migraine prophylaxis?

A

Topiramate

Divalproate

131
Q

What are the indications for pharmacologic migraine prophylaxis?

A
  • More than 4/month or more than 12 hours
  • Disabling
  • Refractory to other meds
132
Q

Children under what age with a first febrile UTI should receive imaging? What is the imaging of choice?

A

Under 2 years, renal and bladder US

133
Q

When are children ok to drink cow’s milk? How much are they allowed to drink?

A

Not until 1 year old
No more than 24 oz.

If not, then Fe deficiency can develop

134
Q

In a woman with complete androgen insensitivity, when should the testicles be removed, and why?

A

After puberty, to allow for hormone production (estrogen) to continue normal development

135
Q

What causes the increased incidence of intussusception after a recent GI illness?

A

Hypertrophy of Peyer’s patches serve as a latching point

136
Q

What causes the increased risk of intussusception with HSP?

A

Bowel wall edema and localized hemorrhage, which can act as lead points

137
Q

What is an odd but very rare presentation of HSP?

A

Scrotal pain and swelling

138
Q

Where are medulloblastomas usually found in the brain? What s/sx can this cause (2)

A
  • Cerebellum
  • Cerebellar signs
  • Proximity to 4th ventricle means hydrocephalus
139
Q

Eyelid retraction is caused by a brain tumor where?

A

In the pretectal region–usually the Pineal gland

140
Q

Why might total T3 and T4 levels be low in a cirrhosis pt, but with normal TSH

A

Total down because bindings proteins down. Effective T3/T4 fine however

141
Q

What is respondent bias?

A

When outcome is obtained by the patient’s response, and not by objective diagnostic methods

142
Q

What is recall bias?

A

Inaccurate recall of past exposures by pts

143
Q

What is selection bias?

A

Nonrandom selection of test subjects

144
Q

Immunofluorescent staining of skin bullae showing Linear IgG and C3 depositions at the dermal-epidermal junction = ?

A

Bullous pemphigoid

145
Q

What is the pharmacologic treatment of stress incontinence? Neurogenic bladder?

A
  • Oxybutynin for stress incontinence (anticholinergic)

- Bethanechol for neurogenic (cholinergic)

146
Q

What drug can cause methemoglobinemia? (3)

A

Topicals (e.g. benzocaine), dapsone, and nitrates

147
Q

What is methemoglobinemia?

A

Fe2+ to Fe3+ causes an increased binding affinity for Oxygen, causing hypoxia

148
Q

Which oxygen sat is usually artificially elevated with methemoglobinemia: the ABGs or pulse oxy? Why?

A

ABGs since sat is calculated, whereas pulse ox is wavelength of light dependent, which is different with methemoglobin

149
Q

With decreasing renal function, and thus decreasing ability to secrete H+, how do the remaining tubules adapt to maintain a physiologic pH?

A

Increase NH3 production to secrete H+

150
Q

What are the appropriate precautions for measles outbreak?

A

Airborne

151
Q

What three major infections need airborne precautions?

A
  • TB
  • Measles
  • Varicella
152
Q

What happens to RDW with Fe deficiency anemia? Why?

A

Over 20%–this is the first lab abnormality with Fe deficiency*
Since nutrient availability varies throughout the day, the marrow will produce RBCs of varying sizes.

153
Q

What will prenatal US show with gastroschisis?

A

Intestines free floating in amniotic fluid, and all edematous and stuff

154
Q

How often is gastroschisis an isolated defect?

A

90% of the time

155
Q

What are the LFTs and alk phos levels with Rotor’s syndrome?

A

Normal

156
Q

How can you differentiate Rotors/dubin johnson syndrome from Gilbert’s?

A

the former two will have elevated conjugated bili, whereas Gilbert’s has unconjugated hyperbilirubinemia

157
Q

Over what age should pts with nephrotic range proteinuria suspected of having MCD get a bx?

A

Over 10

158
Q

What is the classic presentation of spondylolisthesis?

A
  • Back pain
  • Enuresis
  • Palpable step off
  • Decreased perineal sensation
159
Q

What is the classic RBC morphology with EPO deficiency?

A

Burr bodies (cytoplasmic projections on RBCs)

160
Q

What are the foods that should be avoided in gout?

A
  • Alcohol
  • Meats
  • Seafood
  • Fructose containing foods
161
Q

What lung volume curve is characteristic of an upper airway obstruction?

A

Flow limited with expiration and inspiration

162
Q

What are the surgical indications for removal of a swallowed battery?

A

Hematochezia
Melena
Severe abdominal pain

163
Q

What sort of mattress can be used to prevent SIDs?

A

firm mattress

164
Q

What is the role of pacifiers with SIDS?

A

Help prevent

165
Q

Homes built before what year are risk factors for Pb poisoning?

A

1978

166
Q

What is the screening test for Pb poisoning? confirmatory?

A

Capillary finger prick testing is screening, but need venous levels to confirm, since high false positive rate

167
Q

What is the treatment for Pb poisoning, given various Pb levels?

A

(0,45) = Recheck in 1 month
[45, 70) = DMSA
70+ = DMSA + EDTA

168
Q

Beckwith-wiedemann syndrome looks like what condition? What are the signs that can differentiate it?

A

Looks like congenital hypothyroidism, but has hemihypertrophy hypoglycemia, and macrosomia

169
Q

What tests should be ordered for kids with Beckwith-Wiedemann syndrome?

A

Abdominal US and AFP to assess for Wilms tumors and hepatoblastomas

170
Q

What is the role of formula feeding with pyloric stenosis?

A

Increases risk

171
Q

What maneuvers can be used to differentiate between vascular rings vs laryngomalacia?

A

Laryngomalacia = Stridor is worse when supine, improves when prone

Vascular rings = Biphasic stridor that improves with neck extension

172
Q

What type of stridor is present with laryngomalacia vs vascular rings?

A

Laryngomalacia = inspiratory

vascular rings = biphasic stridor

173
Q

Why does the stridor with vascular rings improve with neck extension?

A

decreases tracheal compression

174
Q

True or false: in children whose parents are divorced but have joint custody, both must agree with the child’s treatment

A

False-only one

175
Q

What is the pharmacotherapy for neuropathic pain 2/2 DM neuropathy?

A
  • either TCAs (if young)

- or antiepileptics drugs (pregabalin)

176
Q

Large volume rectal bleeding without abdominal TTP = ?

A

Most likely diverticulitis

177
Q

What sort of GI bleeding is characteristic of angiodysplasia?

A

Slow, painless bleed

178
Q

What is the treatment for cryptococcal meningitis?

A

Amp B + flucytosine

179
Q

What are the classic CSF findings of cryptococcal meningitis?

A
  • elevated opening pressure
  • Pleocytosis
  • Elevated protein
  • Low glucose
180
Q

What medications classically precipitate acute angle closure glaucoma?

A

Sympathomimetics

181
Q

What is the appropriate care for frostbite?

A

Dunk in warm water, only if there is no chance of secondary refreezing

182
Q

What is the pathophysiology of TTP?

A

Deficiency of plasma protease ADAMS13 (due to the formation of an autoantibody), causing long chains of vWF to accumulate on endothelial walls, trapping platelets and generating thrombi

183
Q

What is the classic pentad of TTP?

A
  • Thrombocytopenia
  • Microangiopathic hemolytic anemia
  • Renal insufficiency
  • Neurologic changes
  • Fever
184
Q

What is the treatment for an acute episode of TTP?

A

Plasma exchange

185
Q

What are the PBS findings of TTP? What about D-dimer levels?

A

Schistocytes and RBC fragments

D-dimer levels are normal

186
Q

True or false: the ANS is unaffected with GBS

A

False– it is affected, and can cause autonomic s/sx

187
Q

What sort of WBCs characterize a leukemoid reaction compared to CML?

A

Predominance of late PMN precursors:

  • Metamyelocytes
  • bands

NOT promyelocytes and myelocytes

188
Q

What sort of WBCs characterize CML?

A

-Basophilia
-predominance of:
promyelocytes and myelocytes

189
Q

What is De Quervain’s tenosynovitis (which two tendons are affected), and in whom is it classically seen?

A
  • Inflammation of the abductor pollicis longus and extensor pollicis brevis tendons as the pass through a fibrous sheath at the radial styloid process
  • New mother who hold child with outstretched thumb
190
Q

What is the classic presentation of acute papillary muscle rupture?

A

inferior wall MI leading to new holosystolic murmur over the apex

191
Q

New onset edema in the hands and feet of an african child = ?

A

Dactylitis 2/2 vasoocclusive crisis from sickle cell disease

192
Q

What is the PEP for varicella in a child under 13 years?

A

Vaccination if not completely vaccinated. IVIG if they cannot have Live attenuated vaccines

193
Q

When should a battery be removed endoscopically if ingested?

A

If still in the esophagus, since it may erode here. If past the esophagus, 90% of the time it will pass without incident.

194
Q

What is ichthyosis vulgaris?

A
  • Inherited skin disorder caused by a mutation in the filaggrin gene.
  • Causes scaly, dry skin that is worse in the winter. Initially mild but with aging looks like severe dryness.
195
Q

What is the pathophysiology, presentation, treatment, and prognosis for milk-protein-induced enterocolitis?

A
  • non-IgE mediated immune rxn to proteins in milk that causes rectal inflammation
  • Presents as painless bloody stools with eczema and vomiting
  • Treatment is elimination of milk and soy from mother’s diet if breastfeeding.
  • Excellent prognosis, and most children do not develop allergies to milk/soy
196
Q

What are the two types of breath-holding spells?

A

Cyanotic = crying followed by breath holding

Pallid = minor trauma followed by breath holding and LOC

197
Q

What age range typically manifests breath-holding spells?

A

6 months to 2 years

198
Q

What is the treatment for pertussis?

A

Macrolides

199
Q

What are strawberry angiomas?

A

Angiomas seen in infants that initially grow in size, but then resolve by age 5-8.

200
Q

What are biliary cysts, how do they present, and how are they treated?

A
  • Congenital dilatations of the biliary duct/tree
  • Present with mild abdominal pain with mass, jaundice, and elevated bilirubin (direct and indirect)
  • Surgical resection d/t risk of cholangiocarcinoma development
201
Q

What is the difference in the rash between Varicella vs HSV-1 (eczema herpeticum)?

A

HSV-1 have a “Punched out” erythematous base with hemorrhagic crusting, and are localized

Varicella has vesicular, pruritic vesicles/pustules in crops in varying stages.

202
Q

What is the most common predisposing factor for orbital cellulitis?

A

Sinusitis

203
Q

What is the classic tetrad of symptoms of orbital cellulitis?

A
  • Painful eye movements
  • Proptosis
  • Ophthalmoplegia
  • diplopia
204
Q

What are the indications for abx treatment of sinusitis? (3)

A
  • Over 10 days
  • Severe features
  • Worsening s/sx for more than 5 days after initial improvement

A2 (26 decks)

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