Prep Q’s Flashcards
How does GER differ from GERD?
What is the normal formula volume recommended and timing for full-term newborns?
About how much is added per feed for every month above one month
G ER consist of spitting up, regurgitation or even emesis, GER is associated with pain, poor weight gain or dysphasia
2 ounces every 3–4 hours
About ounce – 2 ounces per feed up to 8–12 months and feeds become less frequent
How is GER treated/managed
How does pyloric stenosis present and about what age?
Reduce the feeding, increase the feeding frequency, avoid seated and supine positions after feedings as well as burping
Forceful often projectile non-bloody non-bilious emesis at about 3–4 weeks of age
With respect to mechanical ventilation, oxygenation is a function of mean, airway pressure, which three things are the main drivers of main airway pressure
Ventilation is the clearance of CO2 from the body, minute ventilation can be calculated how?
PIP, PEEP, inspiratory time fraction
Respiratory rate times title volume 
Should all infants with HIV receive the Rothe virus vaccine?
which eight groups of children are at a high-level immuno suppression and should not receive live vaccines
Yes
Ages one – 13 with HIV and a CD4 count less than 15%
14 and older with a CD 4 count less than 200
cancer receiving chemotherapy
Combined B and T cell lymphocyte disorders like SCID
Children on high daily doses of steroids.
Receiving certain biologic agents like TNF antagonist.
Receipt of a solid organ transplant in the last two months receipt of a stem cell transplant in the last two months
Lymphadenopathy where is highly concerning form malignancy
If you see a child with this, which specialist should you refer them to?
Investigation of lymphadenopathy should include which 6 tests
Supraclavicular, cervical is very common
ENT
CBC with differential, EBV and CMV titers, ESR/CRP, LFTs (if positive, support, viral infection, or infiltrative process), LDH, uric acid levels (elevation indicates high cell turnover seen in malignancy)
If there is concern for lymphoma, which type of biopsy is preferred?
If abdominal ultrasound demonstrates the characteristic target sign along with abdominal pain, nausea, vomiting, in a child three months to three years what is the likely diagnosis?
Excisional, not FNA
Intussusception
In intussusception, what is the initial treatment that can be diagnostic and therapeutic if there are no signs of peritonitis or free air?
What should be done if free is visualized or there is evidence of peritonitis
Air enema.
Emergency laparotomy
Which imaging is preferred if Malrotation with midgut volvulus is suspected
Which part of the bowel is most commonly affected by intussusception?
It commonly affects children aged ____ to ___
Upper G.I. series with small bowel series
Iliocecal junction (90%)
Three months to three years
If there is abdominal tenderness and a palpable sausage shaped mass in the right lower quadrant in a child with altered mental status, think of what diagnosis?
Describe the stool that is usually associated with.
Intussusception
Current jelly stool, which is blood mixed with mucus
What is the term for a preventable error that did not result inpatient harm?
What is an event that implies that the patient was harmed as a result of an intervention?
What is an event that is an error that leads to a patient’s death or serious injury?
Medical error.
Adverse event.
Sentinel event
Severe hypocalcemia due to vitamin D deficiency that is so severe that the child presents with seizure should be treated with which three things?
Breastmilk does not provide adequate amounts of which vitamin and needs to be supplemented?
What dose in international units per day do they recommend supplementing
Calcium, vitamin D, calcitriol, which is one, 25 dihydroxy vitamin D, which is the active form
Vitamin D
At least 400 international units daily
In vitamin D, deficiency and hyperparathyroidism, why does phosphorus become low
Why is it difficult to correct calcium if magnesium is low?

Because PTH causes wasting in the kidneys
Magnesium is required for a normal PT response to low calcium levels
An early onset sepsis, which to antibiotics are the empiric antibiotic choice? Which bacteria are covered
In late onset sepsis after six days of life which two should be used? Which bacteria are covered
Ampicillin and gentamycin covers GBS, E. coli, listeria.
Vancomycin and gentamycin, covers coagulation negative staph, E. coli, klebsiella, the main difference is vanc to cover the coag negative staph
An early sepsis in the first week of life, how are organisms usually acquired?
If an otherwise healthy 10-year-old with cystic fibrosis has a positive culture for pseudomonas without any symptoms how should this be managed?
Through vertical transmission
A 28 day course of inhaled tobramycin, studies demonstrate proactive treatment to a eradicate pseudomonas from the airway with CF helps preserve lung function
What is the standard of care with respect to airway cultures in children with cystic fibrosis?
What are three cardinal features of Ehlers Danlos syndrome?
How is the syndrome inherited?
It is recommended to do quarterly airway cultures
Joint hypermobility, skin hyperextensibility, tissue fragility
Autosomal dominant
Which developmental disability demonstrates impairments in cognitive and adaptive skills?
Which is defined by social communication defects, including nonverbal communication?
In addition to defects in social communication, which two other things are required for a diagnosis of autism.
Intellectual disability
Autism spectrum
Repetitive and restrictive behaviors, like not making eye contact
Which test is crucial for evaluation of children thought to have language delays or concerns for autism?
Adolescence, using medication’s for non-medical reasons are likely to obtain them how?
Audiology evaluation
From a friend or family member
If a patient has bloody diarrhea with exposure to well water, which bacteria is the most common pathogen?
If a patient has a Peri tonsillar abscess, what is the most appropriate first step in treatment?
What are the two most common bacteria to cause a PTA?
E. coli
Drainage of the abscess
Streptococcus and fusobactrium
What are six common presenting findings with a peritonsillar abscess
What is the treatment of an uncomplicated PTA?
Fever, sore throat, dysphasia, muffled voice, asymmetric, tonsils, uvula deviation
Incision and drainage with a 10 day course of oral antibiotics
What are eight reasons for hospital admission for peritonaillar abscess
Complications, including airway obstruction
Aspiration, ammonia
Carotid artery, pseudo, aneurysm or rupture.
Septic thrombophlebitis of the IJ vein
Need for intravenous hydration due to poor oral intake.
Pain management
No reliable outpatient follow up
Management severe bleeding
Management of respiratory distress, secondary to aspiration of abscess contents
Which cardiac pathology presents with tachycardia, a gallop rhythm, signs of pulmonary edema, and hepatomegaly with chest pain?
What would be the first imaging test that should be done?
Myocarditis
TTE
