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Pediatric Boards > PREP 1 > Flashcards

PREP 1 Flashcards

1
Q

Early childhood dental carries present as

A

white discoloration along the gum line of the upper incisors (like the front teeth for ex) in children under 6

can then progress

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2
Q

Super low calcium think

A

hypoparathyroidism

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3
Q

In hypoparathyroidism, calcium levels are blank and phos levels are blank

A

calcium levels are LOW
and phos levels are high

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4
Q

The job of PTH is to

A

keep calcium levels normal

without it, calcium gets super low

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5
Q

What does PTH do to phosphorous levels:

A

PTH has a phosphorus-lowering effect by causing phos excretion through the kidneys.

(so in hypoparathyroidism, where PTH is low, phos will be HIGH)

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6
Q

Low calcium, high phos =

A

hypoparathyroidism

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7
Q

high calcium, low phos =

A

hypERparathyroidism

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8
Q

This hormone releases calcium from bone

A

PTH

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9
Q

What does vitamin D do for calcium levels

A

Increases calcium, because vitamin D increases absorption of calcium from the gut

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10
Q

What does PTH do to vitamin D levels

A

PTH stimulates the kidney to make active vitamin D, so PTH increases vitamin D levels

this is how PTH increases Ca absorption from the gut (through vit D, which does this)

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11
Q

Genetic disorder associated with hypoparathyroidism

A

22q11.2 deletion syndrome

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12
Q

Long term tx for hypoparathyroidism

A

Give calcium and vitamin D (must give calcitriol, the active analogue, since without PTH the kidney cannot convert other forms of vit D into the active form)

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13
Q

The activated form of vitamin D is…

A

calcitriol
(1,25-dihydroxyvitamin D)

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14
Q

Vitamin D deficiency leads to blank calcium levels

A

Low

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15
Q

What does vitamin D deficiency do to calcium and phos levels

A

both low

(low calcium means PTH is being very active trying to raise the calcium, and while being active one of the things PTH does is promote renal excretion of phos, so phos gets low)

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16
Q

What is a kerion

A

= an acute, local inflammatory reaction to a tinea capitus infection

itchy, bad inflammaed looking boil on head for ex

tx is griseofulvin (systemic)

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17
Q

Alopecia, scaling, pruritus and posterior cervical lymphadenopathy is highly suggestive of

A

Tinea capitus

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18
Q

Tinea capitus is an infection of what exactly

A

the root of the hair follicle

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19
Q

Are topical antifungals effective when treating tinea capitus

A

Nope. Because tinea capitus is an infection of the root of the hair follicle, so topical tx does not work. Need systmic oral antifungal tx.

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20
Q

Blank is an inflammatory reaction to a scalp tinea infection that presents as a large, hairless, red and boggy area over the scalp

A

kerion

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21
Q

Blank is the most common cause of tinea capitus, and blank is the second most common

A

Trichophyton, microsporum

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22
Q

Tx for tinea capitus

A

oral antifugnal, like griseofulvin, terbinafine or fluconazole

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23
Q

Define Tourette syndrome

A

= presence of vocal AND motor tics over a year

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24
Q

Type 1 error

A

= when an investigator rejects the null hypothesis when it is in fact true

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25
Q

Type 2 error

A

= when an investigator fails to reject the null hypothesis when it is in fact false

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26
Q

Type 2 error is also known as

A

beta

(beta = the ´probability of a type 2 error occuring)

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27
Q

As the probability of committing a type 2 error decreases, blank increases

A

power

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28
Q

Power =

A

1 - beta

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29
Q

The probability of accepting an alternative hypothesis when it is in fact true =

A

power

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30
Q

The probability of rejecting the null hypothesis when the null hypothesis is in fact false =

A

power

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31
Q

Atypical mycobacterium infection typically presents how?

A

with subacute, unilateral cervical lymphadenopathy

swollen lymph node in well appearing child that just doesn’t go away after typical abx treatment

the treatment is to surgically remove the whole node

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32
Q

Swollen, non tender, indurated cervical lymph node that has been there for weeks in well appearing 4 yo with normal CBC is most likely due to…

A

nonTB mycobacteria infection of a lymph node

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33
Q

Top 3 bacteria that cause AOM

A

H flu
Strep pneumo
Moraxella catarrhalis

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34
Q

When treating CHRONIC supporative otitis media, you should always cover for

A

pseudomonas

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35
Q

Define chronic suppurative otitis media

A

= more than 6 weeks of ear drainage from a perfed tympanic membrane

so like just ongoing pus drainage basically

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36
Q

The most common bugs to cause CHRONIC suppurative otits media are

A

staph aureus (MRSA and MSSA)
pseudomonas**
proteus mirabilis
anaerobes

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37
Q

How to initially treat a child presenting with chronic suppurative otitis media:

A

topical abx with pseudomonal coverage
so for ex ototopical ofloxicin

and also need to clear ear debris daily in the office, ugh

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38
Q

Criteria that need to be met to clear a kid/teen to go back to playing a sport after a concussion:

A
  1. Full resolution of symptoms
  2. And still full resolution of symptoms even when doing high intensity physical activity
  3. return to baseline neurocognitive function/academic performance

NEUROPSYCH testing NOT NEEDED and should NOT guide return to play

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39
Q

Low TREC on newborn screen indicates

A

concern for a primary immunodeficiency
(or may just be a false positive in a premature infant)

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40
Q

TREC stands for

A

low T-cell receptor excision circle

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41
Q

If a baby has a truly low, confirmed TREC (repeat test still low and infant is at least 37 weeks corrected), what should your next move be?

A

to start prophylactic abx to prevent infection ASAP

(start prophylactic bactrim and fluconazole)

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42
Q

How to further work up a confirmed low TREC

A

flow cytometry for lymphocyte subsets

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43
Q

Should a baby with a confirmed low TREC continue to breastfeed?

A

No–not until it is determined WHICH immunodeficiency the baby has

This is because in some immunodeficiencies, like SCID, CMV can be transmitted through breastmilk and lead to viremia

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44
Q

Symptoms of epididymitis

A

dysuria
scrotal pain that improves with elevation
pyuria
NORMAL cremesteric reflex

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45
Q

Absent cremasteric reflex think

A

testicular torsion

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46
Q

Which pre-pubertal boys get epididymitis?

A

structural abnormalities of the urinary tract

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47
Q

What is the epididymis

A

= a curved structure at the back of the testicle, in which sperm is stored and matures

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48
Q

Sperm passes from the testicles to the vas deferens via the

A

epididymis

49
Q

How acute epididymitis presents

A

Testicular pain, scrotal redness and warmth

50
Q

In the pediatric population, who is most likely to get epididymitis?

A

adolescent boys

especially with a hx of being sexually active, any local trauma, or intense exercise

it’s an ascending infection from the urethra through the vas deferens all the way to the epididymis

51
Q

Most common bugs that cause epididymitis in sexually active adolescent boys:

A

chlamydia
neisseria
e coli

52
Q

Symptoms of adolescent boy presenting with acute epididymitis

A

dysuria
urinary frequency
discharge
scrotal pain
fever

53
Q

In epididymitis, is a normal cremesteric reflex present?

A

yes

54
Q

What will the UA show in epididymitis?

A

pyuria

55
Q

What is a varicocele?

A

dilation of the veins in the pampiniform plexus of the spermatic cord

56
Q

In the pediatric population, who is most likely to present with varicocele? How do they present?

A

adolescent boys
painLESS soft scrotal mass, decreases in size when lying down

57
Q

Treatement for ADEM

A

steroids

58
Q

The FDA doesn’t approve of cochlear implants until a baby is at least this age

A

must be at least 12 mo old

59
Q

Name 2 groups of drugs that can cause sensorineural hearing loss

A

aminoglycosides
loop diuretics!

60
Q

Name an aminoglycoside

A

gentamicin

61
Q

Name a loop diuretic

A

Furosemide

aka lasix

62
Q

MOA of loop diuretics:

A

they block the reabsorption of sodium, potassium and chloride in the ascending loops of henle

63
Q

Electrolyte side effects of loop diuretics (aka lasix aka furosemide)

A

loss of sodium and water
hypokalemic metabolic alkalosis
increased calcium lossis in the urine (so you get hypocalcemic)

64
Q

1st line TREATMENT for babies with sensorineural hearing loss is what?

A

behind the ear hearing aids, can start as early as 2 months

it’s NOT cochlear implants apparently, not until age 1

65
Q

Definition of delayed puberty in girls:

A

no breast development by age 13

66
Q

LH and FSH are this type of hormone

A

gonadotropins

67
Q

How to treat short stature associated with Turner Syndrome

A

with recombinant human growth hormone

68
Q

Prenatal sign of Turner syndrome

A

cystic hygroma

69
Q

Neonatal signs of Turner Syndrome

A

small size
lymphedema of the hands and feet

70
Q

broad chest with wide spaced nipples think

A

Turner Syndrome

71
Q

Is intelligence in Turner syndrome usually normal?

A

yes

72
Q

Another name for primary ovarian failure is

A

hypergonadotrophic hypogonadism

73
Q

How to confirm a diagnosis of primary ovarian failure in a girl with Turner syndrome who has not yet showed signs of puberty

A

Get GONADOTROPIN LEVELS (FSH and LH)

If they are high, then you know the pt has hypergonadotropic hypogonadism, and you should start estrogen treatment to induce puberty

74
Q

How to induce puberty in a girl with Turner Syndrome who has hypergonadotropic hypogonadism:

A

Give estrogen
but start in low doses, and then gradually work up to what would be an adult dose (aka like a birth control pill) to try to mimic normal puberty

75
Q

Conjugated hyperbili + microcephaly thinki

A

congenital CMV

76
Q

Define conjugated hyperbili

A

= when conjugated bili is 20% or more of the total bili

77
Q

Tx drug and duration for SYMPTOMATIC congenital CMV

A

oral valgancyclovir x 6 months

tx can decrease risk of sensorineural hearing loss later on

78
Q

Risk of treatming CMV with valgancyclovir

A

gancyclovir can cause neutropenia

79
Q

Should patients admitted to the hospital for a lyme disease complication (for ex lyme carditis with complete heart block) be treated with PO doxy or with IV ceftriaxone?

A

IV ceftriaxone

bcuz apparently the book says if you are admitted to the hospital for lyme then you must use IV meds

80
Q

Monophonic wheezing + LACK of stridor localizes tracheomalacia to what physical location?

A

INTRAthoracic

81
Q

What does intrathoracic airway obstruction, whether its in the small airways or the trachea, sound like on auscultation?

A

expiratory wheezing

82
Q

What does extrathoracic airway obstruction sound like on auscultation?

A

stridor

83
Q

The AAP recommends that men who have sex with men should be screened for these STDs annually:

A

HIV
syphilis
chlamydia
gonorrhea

84
Q

Adolescent women having sex with men should be screened at least annually for

A

gonorrhea and chlamydia

85
Q

Double standard of STD screening in adolescnents:

A

AAP says women having sex with men should be screened annually for gonorrhea and chlamydia

but men having sex with women shouldn’t

wtf?

86
Q

The most common type of heart block seen in neonatal Lupus is

A

complete heart block

87
Q

Transplacental transfer of these antibodies leads to neonatal Lupus

A

anti-Ro/SSA or anti-La/SSB

88
Q

Pathophys of why neonates with neonatal lupus can get complete heart block and other cardiac problems:

A

due to anti-ro/SSA and anti-la/SS mediated injury
these antibodies injure the fetal cardiac and conductive tissue

89
Q

Screening for Hep B refers to doing what lab test exactly?

A

Hep B surface antigen (HBsAg)

90
Q

When should you test new immigrant children for Schistosoma and Strongyloides species?

A

when their stool ova and parasites are negative but they have eosinophilia

91
Q

ALL new immigrant / international adoptee children should receive these screenings when they arrive in the US:

A

Hep B surface antigen (regardless of Hep B vaccination status)
Syphilis
HIV
CBC
Stool ova and parasites (check for Giardia and cryptosporidium)
Tb skin test or interferon-gamma release assay

92
Q

The first sign that a young child may go on to be diagnosed with intellectual disability is a delay in this area

A

receptive language

93
Q

Adaptive skills refers to

A

skills involve in self-management and independent living

so things like self care, navigating relationships, work, money management etc.

94
Q

A diagnosis of ID (intellectual disability) can be made in a child of what age, in what situation?

A

Age 5 or older
when the child is significantly below age expectations for both cognitive and adaptive development

95
Q

Planning, reasoning, problem-solving and learning all fall under this umbrella term

A

Cognition

96
Q

Blank is an important early indicator of cognition, and a lack of it can indicate increased likelihood of future intellectual disability

A

Receptive language

97
Q

The first rotavirus vaccine needs to be give by this age, or else an infant should not get the vaccine series

A

needs to be given BEFORE 15 weeks, zero days of life

98
Q

When should the first rotavirus vaccine be administered?

A

Between 6 weeks and 14 weeks, 6 days of life

99
Q

The last rotavirus vaccine dose cannot be given after his age

A

8 months, zero days

100
Q

MCV over what is macrocytic

A

Unclear
Varies by age

101
Q

most common source of vitamin B12 is

A

animal fats

102
Q

Neuro findings associated with folate deficiency

A

loss of developmental milestones

103
Q

Causes of macrocytic anemia

A

B12 or folate deficiency

104
Q

Loss of deep tendon reflexes + macrocytic anemia =

A

B12 deficiency

105
Q

Common ish cause of both B12 and folate deficiency

A

Celiac disease

106
Q

Neuro findings of B12 deficiency can include

A

hypotonia
ataxia
seizure
activity
loss of deep tendon reflexes

107
Q

Symptoms of vitamin B12 deficiency

A

fatigue
generalized weakness
irritability, poor appetite
FTT
neuro symptoms (ataxia, low tone, loss of deep tendon reflexes… even seizures in extreme cases)

108
Q

Vitamin B12 is also called

A

Cobalamin

109
Q

Define enteropathy

A

= ongoing damage, irritation and;or swelling of the small intestine

110
Q

Tx for nasal polyps

A

Due to allergies. Treat with intranasal steroids, nasal saline rinses, or systemic steroids.

If refractory, can be surgically removed.

111
Q

Children with these conditions have a higher risk of developing nasal polyps

A

CF
PCD (primary ciliary dyskinesia)

112
Q

Polyps are rare in children under this age

A

rare under age 10

113
Q

What causes acute tubular necrosis

A

ischemia or exogenous or endogenous toxins

114
Q

BLANK results from damage to renal tubular cells, either from ischemia (like from hypotension) or from toxins (endogenous or exogenous)

A

Acute tubular necrosis

115
Q

What will urinalysis show in ATN

A

muddy brown granular casts
mild pyuria
low-grade proteinuria

urine can be dilute in ATN

116
Q

Urine spec grav in PRE renal AKI

A

so this is when the kidneys just are not being perfused
so, urine should be very concentrated
spec grave will be > 1.02

117
Q

Normal urine spec grav

A

1.005 - 1.030

118
Q

What is considered a low spec grav, and what is considered a high spec grav

A

Low is < 1.005
High is >1.03

Pediatric Boards (9 decks)

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