PHM Flashcards
1
Q
name for asthma in child younger than 2 yrs
A
Reactive airway disease
2
Q
Does bronchiolitis respond with albuterol
A
no
3
Q
phenobarbital can cause
A
developmental delays
4
Q
HLH triggered by EBV Give what med?
A
Rituximab - knocks out b cells
5
Q
Mertazepine withdrawal symptoms
A
Anxiety, insomnia, depression
6
Q
Seroquel withdrawal symptoms
A
insomnia
nausea
sweating
7
Q
key lab findings on CBC
A
hyponatremia
increased transaminases
8
Q
inflammation causes hyponatremia or hypernatremia
A
hyponatremia
9
Q
treatment for typhus
A
Doxycycline
10
Q
2nd line for atypical pneumonia
A
Azithromcin
11
Q
2nd line for atypical pneumonia
A
Azithromycin
12
Q
what are you looking for on a lateral cxr
A
black space retrosternal
black triangle retrocardiac
as you go down spine should become more radiotranslucent
13
Q
which direction does the spleen grow
A
towards RLQ
14
Q
spleen grading
A
non palpable is 1
umbilicus is 4
post umbilicus is 5
15
Q
tall teen with c/o blurred vision,
eye exam shows a subluxated lens
What is on your differential
A
Marfans
Ehlers Danlos
16
Q
toddler has glaucoma and seizures with a port wine stain
what on differential
A
Sturge-Weber
17
Q
S shaped deformity to eyelid
neurofibroma
optic glioma on MRI
lisch nodules (almost 100% of cases have these present by 10 yrs old. - goes up by 10% as they get older to 10)
A
Neurofibromatosis type 1
18
Q
What is the symptom difference in NF type 1 and 2
A
Type 2 does not have lisch nodules
19
Q
Abnormal ears
Colobomas in eyes
whats on differential
A
CHARGE syndrome
20
Q
Male
Weird shape eye lens
hemorrhage
renal failure
anterior lenticonus on eye exam
A
Alport syndrome
21
Q
child with glaucoma in bilat eyes
Abnormal teeth (conical)
redundant periumbilical skin
eye exam shows posterior embryotoxon (displacement of Schwalbe’s line anterior to the limbus in the cornea)
A
Axenfeld Rieger syndrome
22
Q
facial asymmetry
eye exam reveals inferotemporal limbal dermoid
A
Goldenhar-kGorlin syndrome
23
Q
facial asymmetry
inferotemporal limbal dermoid
A
Goldenhar-Gorlin syndrome
24
Q
young adult with renal cell carcinoma
cerebellar tumor
eye finding: retinal capillary hemangioma
A
VHL (Von Hippel-Lindau syndrome)
25
10 yo AA male
acute chest
eye finding: sickle cell retinopathy
Sickle Cell
26
what is a possible eye finding in sickle cell pt
Sickle cell retinopathy
27
child development delay
ash leaf spots
eye finding: astrocytic hematoma
tubular sclerosis
28
absence of red reflex test helps screen for
need to rule out
retinal blastoma
29
helpful during testing for red reflex test
have them look at something in distance
30
male UTI risk
0-6 mos - same risk as female
6-12 months at increased risk only if uncircumsized
>1 - think about sexual abuse
31
if you have a male with UTI thats older than 1, what needs to be on the differential
sexual abuse
32
does renal etiology effect growth
yes
33
4ts for Anterior mediastinal masses
Thymoma
teratoma
terrible lymphoma
thyroid
34
middle mediastinal masses
Bronchogenic cyst
Mediastinal lymphadenopathy
Pericardial cyst
tracheal tumors
esophageal tumors
Esophageal conditions: achalasia, diverticulum, hiatal hernia
Aortic aneurysm
aortic dissection
35
posterior mediastinal masses
Neurogenic tumors
Mediastinal lymphadenopathy
Extramedullary hematopoiesis
Neuroenteric cyst
aortic aneurysm
conditions affecting paravertebral spine
36
dyspnea
face/neck swelling
distended neck veins
cough
dyspnea
orthopnea
upper extremity swelling
distended chest vein collaterals
conjunctival suffusion
headache
chest pain
Superior vena cava syndrome - medical emergency
37
which is better at compensating for the loss of the other between: Illeum and Jejunum
Illeum is better at compensating for Jejunum then the opposite
38
stool alpha 1 antitrypsin is marker of
bowel distension
39
assess for possible carbohydrate malabsorption
Stool reducing substances, pH
H2/CH4 breath tests
40
humans response to lactose
majority of humans downregulate lactase expression with age.....
41
Glucose increases or decreases absorption of fructose
increases
42
FODMAP
avoid
fermentable
oligosaccharides
disaccharides
monosaccharides
Polyols (short chain carbohydrates (sugars) that the small intestine absorbs poorly
43
What are some foods to avoid on FODMAP
Dairy based milk
yogurt
ice cream
wheat based products such as cereal, bread, crackers
beans and lentils
some vegetables such as artichokes, asparagus, onions and garlic
some fruits such as apples, cherries, pears, peaches
44
examples of low FODMAP foods
eggs
meat
certain cheeses (brie, camembert, cheddar, feta)
almond milk
rice
quinoa
oats
eggplant
potatoes
tomatoes
cucumbers
zucchini
grapes
oranges
strawberries
blueberries
pineapples
45
non celiac patient who notices they do better on a gluten free diet. What do they have problems digesting
Fructans - oligo or polysaccharides that include short chains of fructose units with a terminal glucose molecule
most common structural forms of fructan are inulin, levanare and geraminan
46
foods high in fructans
wheat products such as pasta and bread
onions
shallots
garlic
barley
cabbage
broccoli
pistachio
artichoke
chicory root
asparagus
ripe bananas
beans/legumes
grapefruit
nectarine
persimmon
plum
pomegranate
watermelon
cabbage
snow peas
rye
pumpernickel bread
47
fecal calprotectin is a marker of
GI inflammation
48
Test for SIBO
H2/CH4 breath test
49
some GI dx celiac if TTIGA is >
100 or 10xs upper limit of normal.
50
on endoscopy in a celiac pt you will see
villous atrophy
51
what rash
plaques with central clearing
not itchy
Erythema marginatum
52
What criteria is used for Acute rheumatic fever
Jones
either 2 major or 1 major and 2 minor
major
carditis
polyarthritis
EM rash
subcutaneous nodules
Minor
fever
ESR>60
CRP >30
Prolonged PR
53
high prolonged fevers
salmon colored rash that is evervescent with fevers
systemic JIA
54
what joints are most commonly affected in JIA
C1, C2 - not turning head
TMJ
55
Headache
Non billious vomiting
lymphadenopathy
arthritis/arthralgias
rat bite fever
56
bacteria for rat bite fever
streptobacillus moniliformis
57
how to dx rat bite fever
blood cultures
58
how to treat rat bite fever
PCN G x 7 days
59
macular rash first on ankles and wrists, spreads
becomes petechial and pururic
ill appearing
hyponatremic
Rocky mountain spotted fever
60
treatment for rocky mountain spotted fever
doxy 7-10 days
61
where does the rash start in Murine typhus
starts on trunk and spreads
spares palms and soles
62
rash distribution in Meningococcemia
early lesions macular that become petechial and purpuric
starts on extremities and tends to spare trunk, palms and soles
63
what is a variant of HSP in kids < 1 yr
Acute hemorrhagic edema of infancy
64
symptoms in acute hemorrhagic edema of infancy
fever
edema and round shaped purpura primaily over face and extremities.
generally well appearing infant
not associated with HSP symptoms of msk, renal and GI
65
fancy name for measles like maculopapular exanthem
morbilliform
66
what exam findings in a rash pt would make you think this is not viral exanthem
facial edema
hepatosplenomegaly
67
what score for DRESS
RegiSCAR
-Latent period between onset of drug intake and appearance of symptoms (more than 3 weeks)
-Prolonged clinical symptoms after withdrawal of the offending drug
-Fever
-1. Maculopapular rash
-two of the four features among facial edema, rash resolving with psoriasiform desquamation, infiltrated skin lesions, and purpuric lesions on areas other than legs.
-organ involvement
->5% atypical lymphocytes in peripheral smear
-Absolute eosinophil count >1500 cells/mm3
-Generalized lymphadenopathy
68
DRESS symptoms
Fever >38.5
lymphadenopathy
eosinophilia
maculopapular rash
69
measles symptoms
prodromal illness
cough
congestion
coryza
exanthem 1-2 days after koplik spots
It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet.
70
distribution of measles rash
It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet.
71
sandpaper rash
scarlet fever
72
this rash is seen on toddlers
central clearing
trunk
not on palms or soles
swelling
itches
Giant Urticaria (Urticaria multiforme)
73
How do you treat Giant Urticaria (Urticaria multiforme)
benadryl
Atarax
74
when do you usually see Giant Urticaria (Urticaria multiforme)
when a virus is treated with antibiotics (frequently amox)
75
target lesion (3 layers)
Erythema Multiforme (EM)
76
In older kids that have KD, what needs to be on radar
Toxic shock syndrome
77
2 common culprits of toxic shock syndrome
Staph and strep
78
Treat for toxic shock syndrome
vanc
ceftriaxone
+/- doxy to cover for maurine typhus
79
pronounced facial edema and rash ...potential clues for what
SSS and DRESS
80
Lymphadenopathy differences in KD vs DRESS
KD unilateral >1.5
DRESS Bilataral >1cm
81
rash + posterior pharyngitis clues you into
Scarlet Fever & TSS
82
Rash + strawberry tongue clues you into
Scarlet fever
KD
TSS
83
Rash + hypotension and shock
TSS
KD
84
Rash progresses to vesicles with bulla with desquamation in acute phase...whats on differential
SSS
SJS
TEN
85
Progress to desquamation in convalescent phase
KD
TSS
Scarlet fever
86
when you have abdominal pain, decreased PO with tachycardia....what needs to be on your differential
Cardiogenic shock
87
what happens in joints in septic arthritis
joint destruction
88
what joints are more dangerous with a septic arthritis or joint inflammation/effusions
closed joints such as hips and shoulders
89
Bactrim can suppress _____
WBC
90
Right sided heart lesions
Intellectual disability
pulmonary vein stenosis
Autosomal dominant
affects males and females
Noonan syndrome
91
Red eye
preauricular or axillary node
granuloma
fever > 3 days
vomiting
Bartonella henselae or Cat schratch disease
92
an infection of the cornea is called ____ from ____
keratitis
HSV
93
tender lesions
shin or pretibial
associated with: Crohns, UC, sarcoidosis
Erythema nodosum
94
bugs that cause erythema nodosum
GAS
TB
Mycopneumoniae
95
rocky mountain spotted fever is caused by what?
Tick bite
Ricketsia
96
what season do you see Rocky mountain spotted fever?
summer
97
describe rash for Rocky mountain spotted fever
maculopapular rash around wrists and on hands and spreads centrally
98
Treatment for Rocky mountain spotted fever
Doxy
99
Doxy risks
dental staining <8 yo
risk is increased for more then 14 days of treatment
100
okay MCV for baby vs adolescent
70 in a baby is fine
adolescent 80-100
101
what does red cell distribution tell us about anemia
chronic vs acute
102
RDW is larger if the anemia is
newer
103
retic looks at
marrow response to anemia
104
in a less than 3 yr old with microcytic or normocytic anemia treat with
iron 1 x every other day (not with milk)
105
In thalasemias, sideroblastic anemia or anemia of chronic disease, the mcv is
decreased
106
what does Hgb do in 6-8 wk old
it plummets then recovers (the plummet stimulates bone marrow to being making own hgb)
107
Normocytic MCV with anemia....retic is low so this is
acute
-infection
-drug rx
-blood loss
-renal disease
108
poor production of red cells that is benign and occurs in early childhood characterized by sudden onset of pallor
transient erythroblastopenia of childhood
109
what happens with MCV and retic in a normal bone marrow response to anemia
Normal MCV
increased retic
110
spherocytes are seen in
Hereditary spherocytosis
111
Helmet cells and schistocytes seen in
MAHA
112
Heinz bodies seen in
G6PD
113
In Macrocytic anemia the MCV is
increased
114
Vitamin deficiencies that can cause anemia
B12 and Folate
115
What drugs can cause anemia
Methotrexate
