Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds UWorld > Qbank copy > Flashcards

Qbank copy Flashcards

1
Q

Next step in pt exposed w/ chickenpox w/ no prior hx?

A

If immunocompetent, varicella vaccine (not VZV immunoglobulin)
If immunodef, VZV immunoglobulin w/in 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment for mumps?

A

Supportive, cold compresses to parotid or testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors for constipation (3)

A

Initiation of solid food, toilet training, school entry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Urinary side effect of constipation

A

Impacted stool –> rectal distension –> compress bladder, urinary stasis, recurrent UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Classic triad of congenital toxoplasmosis?

A
  1. Chorioretinitis (form of posterior uveitis) 2. hydrocephalus 3. intracranial calcifications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Classic triad of congenital rubella?

A
  1. Deafness
  2. cataracts
  3. cardiac defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

FYI additional clinical sx of LAD

A

Poor wound healing, periodontitis (oft necrotizing, oral pain, bleeding & irritation of gums)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Reye’s syndrome classic features (3)

A

Rash, vomiting, liver damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Other sx of osteogenesis imperfecta apart from fractures, blue sclera

A

Dentinogenesis imperfecta: blue-gray to yellow-brown discoloration of teeth (due to discolored dentin shining through translucent, weak enamel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Contraindications to diphtheria/tetanus?

A

Anaphylaxis to vacine ingredients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Contra to pertussis?

A
  • Anaphylaxis to vaccine ingredients
  • Progressive unstable neuro disorders (uncontrolled epilepsy, infantile spasms)
  • Encephalopathy w/in week of previous vaccine dose
  • *All others are precautions but not contra!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why continuous murmur in pda?

A

Aortic pressure > pulm artery pressure in both systole, diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the contraindications to breastfeeding?

A
  • Active, untreated TB
  • HIV
  • Active illicit drug and EtOH abuse
  • Skin: herpetic breast lesions, varicella, chemo/radiation
  • Only infant condition that is a contra: galactosemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is surgery for cyrptorchidism indicated?

A

6 mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the greatest risk of the above, even w/ orchiopexy?

A

Subfertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is most common cause of chronic stridor in infants?

A

Laryngomalacia: omega shaped epiglottis, collapse of supraglottic structures
Spontaneous resolution, but increased risk of GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

FYI Ewing’s sarcoma sx

A

Really similar to osteomyelitis sx

Differentiate w/ xray: central lytic lesion, onion skinning, moth-eaten appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are 3 associated syndromes of Wilms tumor (= nephroblastoma)

A

WAGR (Wilms, Aniridia, GU anomalies, mental Retardation)
Beckwith-Wiedemann syndrome
Denys-Drash syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Site of Wilms tumor met?

A

Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Top causes of bacteremia in sickle cell

A
  1. Strep pneumo 2. H. influenza B

Get vaccine and penicillin ppx until 5 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Top cause of pneumonia in sickle cell pt

A

Strep pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hereditary spherocytosis confirmed by

A

Eosin-5-maleimide binding (flow cytometry) and acidified glycerol lysis tests
Traditional NaCl fragility test has poor sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In hereditary spherocytosis, mean corpuscular hemoglobin concentration is low or high?

A

High, due to cellular dehydration and membrane loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ddx for lytic bone lesion in child

A

Infectious: brodie abscess from osteomyelitis
Endocrine (hypercalcemia): hyperparathyroid osteitis fibrosa cystica
Neoplastic (hypercalcemia): Ewing sarcoma, Langerhans cell histiocytosis, mets
Idiopathic: benign bone cyst, aneurysmal bone cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Healthy infants lose up to 7% birth weight in how many days of life?

A

First 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Birth weight regained by

A

10-14 d.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

In the first week of life, what is healthy number of wet diapers?

A

diapers = age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pink stains or brick dust in neonatal diapers represent

A

Uric acid cristals. Commonly seen in first week as mom’s milk is coming in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Clinical presentation of leukemia?

A

Fever, weight loss, pallor, other systemic sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Osteoid osteoma

A

Limb pain (oft unilateral) that’s worse at night, repsonds to NSAIDS, common in 2nd decade. +/- limp and point tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Next step in management of breath holding spells?

A

CBC and serum ferritin
Because Fe-def anemia is oft associated w/ breath-holding spells.IF prolonged or recurrent, consider ECG (presence of arrhythmias like prolonged QT) or if pt has murmur, poor growth, or dyspnea with feeds/activity, consider echo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Ages of onset of Duchenne, Becker, and Myotonic dystrophy

A

3-5. 5-15. 12-30.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Lab findings on Duchenne muscular dystrophy?

A

Elevated serum creatin phosphokinase nad elevated aldolase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Nikolsky sign used for dx of

A

Scalded skin syndome (S. aureus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

1 yo boy with lead level 12 ug/dL (norm <5 ug/dL). Next step?

A

Fingerstick level can have false +. Measure venous lead level:

  • Mild (5-44) –> no med, repeat test in DMSA (Meso-2,3-Dimercaptosuccinic acid)
  • Severe (>= 70) –> Dimercaprol (British Anti-Lewisite) + EDTA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

12 yo f w/ persistent left ear discharge for 3 weeks, even after 2 courses of abx, hearing loss on left. Intact TM w/ peripheral granulation and skin debris. Pt should be evaluated for

A

Acquired cholesteatoma (abn skin growth in middle ear behind eardrum) 2ndary to chronic middle ear disease –> retraction pocket in TM –> fill w/ granulation tissue and skin debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Next step after exposure to tick-infested environment?

A

Bathe immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

21 hydroxylase deficiency causes increases in

A

17-hydroxyprogesterone (NOT 17-hydroxyprogenolone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Neonate presents w/ bilious vomiting. Best next step for diagnosis after NG tube and IV?

A

Abd x-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Baby w/ bilious vomiting doesn’t have pneumoperitoneum. Best next step?

A

Contrast study (upper GI vs. enema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Best dx test for malrotation?

A

Upper GI (contrast)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

CF pt w/ dilated loops of bowel w/ no rectal air and no free air

A

Most likely meconium ileus –> see microcolon on contrast enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

When is surgery indicated for an umbilical hernia?

A
  • Persists to age 3-4 yo
  • Exceeds 2 cm diameter
  • Causes sx, strangulated, or enlarges progressively after 1 yo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a cyanotic <3 defect w/ left axis deviation and decr pulm markings on cxr?

A

Tricuspid atresia (hypoplasia of RV and pulm outflow tract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Duodenal atresia associated w/

A

Chromosomal abnormalities. Due to failure of recanalization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Jejunal and ileal atresia associated w/

A

Vascular accident in utero –> necrosis and resorption of distal fetal intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

EMG is used to eval

A

Neuromuscular system to differentiate btw peripheral nerve disorders and primary neuropathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the ddx for T-wave inversion?

A 
MI
Myocarditis
Old pericarditis
Myocardial contusion
Digoxin toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Peritonsillar abscess vs. epiglottitis

A

Both have fever, sore throat, muffled voice, drooling but peritonsillar abscess have less acute presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Progressive pancytopenia, macrocytosis, caf̩-au-lait spots, microcephaly, microphthalmia, short stature, horseshoe kidneys, absent thumbs suggest

A

Fanconi’s anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Macrocytosis (NO hypersegmentation), short stature, webbed neck, cleft lip, shielded chest, and triphalangeal thumbs suggest

A

Diamond-Blackfan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Rx for the above?

A

Corticosteroids. If unresponsive, transfusion therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Best way to prevent congenital rubella?

A

Vaccination prior to conception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Down syndrom pt w/ UMN signs, behavioral changes has

A

Atlantoaxial instability. Most commonly due to excessive laxity in posterior transverse ligament –> incr mobility btw atlas (C1) and C2 –> compression of spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Hemolytic anema, thrombocytopenia, and acute renal failure most likely indicates

A

Hemolytic-uremic syndrome

90% due to diarrheal pathogen (E.Coli, Shigella), 10% S. pneumo (pts have pneumonia or meningitis instead of diarrhea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Henoch Schonlein sx

A

Purpura on legs and buttocks, normal platelet count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Preadolescent child w/ back pain, neuro dysfn (ie. urinary incontinence), palpable “step-off” at lumbrosacral area most indicative of

A

Spondylolisthesis: a developmental disorder characterized by a forward slip of vertebrae (usu L5 over S1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is alexia?

A

Acquired disorder of reading subsequent to brain injury in person previously literate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

When is renal biopsy indicated in kids?

A

Children >10 yo w/ nephrotic syndrome

Any child w/ nephritic syndrome or MCD unresponsive to predisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

FYI: leukocoria

A

Every case is considered retinoblastoma unless proven otherwise.
Other sx:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Cause of death for retinoblastoma?

A

Liver and brain mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is used for absence seizures (2)

A

Ethosuximide or valproate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the most common cause of urinary tract obstruction in newborn boys?

A

Posterior urethral valves (obstructing membrane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Copious purulent ocular drainage, eyelid swelling in 2- to 5-d.o.

A

Gonococcal conjuctivitis

Rx: topical erythromycin w/in 1 hr of birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Milder conjunctivitis 5-14 days after birth

A

Chlamydia conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Rx for Erb-Duchenne palsy?

A

Gentle massage and PT to prevent contractures. 80% pts have recovery w/in 3 mo, surgery if no improvement by 6 mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Characteristics for constitutional growth delay

A
  1. Delayed growth spurt, 2. Delayed puberty, 3. Delayed bone age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is the most common cause of pneumonia in CF child?

A

NOT pseudomonas, but staph aureus.

Empiric rx: IV vanc (assume MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the empiric drug of choice for CAP?

A

High-dose oral amoxicillin for s. pneumo, doesn’t cover S. aur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Normal ECG on newborn shows

A 
# Right axis deviation
# R waves in V1-V3 due to larger RV since blood is shunted from lungs (PDA) and circulation relies on right heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Ddx of neonatal jaundice?

A 
# breastfeeding jaundice
# breast milk jaundice
# heme conditions
# sepsis: see sx of poor feed, lethargy, vomiting, hypothermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Sx of neonatal meningitis?

A

Not h/a or neck stiffness, but

  • temp instability (fever >38 or hypothermia <36)
  • poor feed
  • irritable, lethargy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Triple bubble sign indicates

A

Jejunal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Pt w/ fever, drooling, neck stiffness, muffled voice, also w/ inability to extend neck and widened prevertebral space

A

Retropharyngeal abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Pathogenesis of retropharyngeal abscess?

A

Pre-excisting URI, pharyngitis, tonsilits, AOM, sinusitis –> direct spread. Usu polymicrobial (S. pyogenes, S. aureus, anaerobes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Language level of a 2 yo?

A

Speak in 2 word phrases, follow 2 step commands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Most common pathogen of septic arthritis in kids?

A

S. aureus (Empiric rx: IV vanc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

When does the ductus arteriosus close?

A

3 days old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the <18 form of antisocial personality disorder?

A

Conduct disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the most common cause of proteinuria in children/

A

Transient proteinuria (caused by fever, exercise, seizures, stress, volume depletion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

5 yo w/ 3 days of fever, sore throat. Multiple 1mm vesicles on anterior tonsillar pillars. Grayish ulcerated lesions in posterior oropharynx. Bilateral palpable cervical l.n.

A

Herpangina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

6 mo male w/ low B and T lymphocytes, absent thymic shadow

A

SCID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What are risk factors for AOM?

A 
# 6 - 36 mo
# formula intake
# exposure to cigarette smoke
# allergic rhinitis or viral URI
# craniofacial anomalies
# chronic middle ear effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

If AOM returns w/in a month of initial abx, us

A

Amoxicillin-clavulanic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

3 associations of celiac disease

A
  1. Fe def anemia 2. Type 1 diabetes 3. Dermatitis herpetiformis (itchy vesicles on extensor surfaces of elbows/knees)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

If celiac disease is suspected, what is a highly sensitive test?

A

IgA anti-tissue transglutaminase antibody. Confirm w/ upper GI endoscopy w/ SI biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Disorder in which pts display severe, pervasive irritability and poor frustration tolerance –> frequent temper outburst

A

Disruptive mood dysregulation disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Disorder in which pts have patterns of angry/irritable mood and argumentative/defiant behavior towards authority.

A

Oppositional defiant disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Pt has 1. Rapid onset of edma (of face, limbs, genitalia, laryges, intestines causing colicky abd pain), 2. no evidence of urticaria

A

Hereditary angioedema. Episodes usu follow infx, dental work, or trauma. Dysfn C1 inhibitor –> elevated C2b, bradykinin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

1 mo w/ harsh III/VI holosystolic murmur of left lower sternal border most likely

A

VSD (Next step: echo to determine size of defect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

6 yo boy w/ insidious-onset hip or knee pain, antalgic gait (sx >1 mo)

A

Legg-Calve-Perthes disease: osteonecrosis of femoral head typically in boys 4-10 yo. Idiopathic, but underlying thrombophilia may be predisposing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

13 yo boy w/ insidious-onset hip pain and limp

A

Slipped capital femoral epiphysis. Assoc w/ obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Limping when a toddler is learning to walk suggests

A

Developmental dysplasia of hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Rate of normal saline IV for dehydration?

A

20 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the gold standard for confirmation of Duchenne MD?

A

Genetic studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What drug is used for congenital long QT, and why?

A

Beta blockers to blunt exertional heart rate (pts should avoid vigorous exercise) and shorten QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

ECG of hypertrophic cardiomyopathy?

A

aVL: tall R wave (due to LV hypertrophy)
V3: deep S wave (due to LV hypertrophy)
I, aVL, V4, V5, V6: repolarization changes

98
Q

How does a newborn present with hypothyroidism?

A

Initially appear normal at birth, but gradually develop apathy, weakness, hypotonia, large tongue, sluggish movement, abd bloating, umbilical hernia
Newborn screening is performed in all states

99
Q

5 yo w/ fever, hip pain unable to bear weight, WBC >12,000, ESD >40, CRP >2

A

Septic arthritis
Get arthrocentesis and IV abx

100
Q

5 yo w/ hip pain usu after viral infx or mild trauma, decreased range of motion, limping. W/ hip flexed, slightly abducted, externally rotated

A

Transient synovitis
Rest and get NSAIDs

101
Q

Congenital sx of syphilis

A 
# Hepatosplenomegaly
# Cutaneous lesions
# Jaundice
# Anemia
# Rhinorrhea
102
Q

By when has the spleen autoinfarcted due to SCD?

A

First 18-36 mo of life

103
Q

Acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia, fever w/ schistocytes

A

HUS after diarrheal illness

104
Q

First line for bedwetting?

A

Desmopressin (before Imipramine)

105
Q

Infant with weight in 5th percentile, height in 5th percentile, head circumference in 10th percentile labeled

A

Small for gestational age (birth weight < 10th percentile for gestational age)

106
Q

Follicular conjunctivitis and cornea pannus (neovascularization)

A

Trachoma (caused by Chlamydia trachomatis A-C). May also see concurrent infx in nasopharynx –> nasal discharge

107
Q

How to diagnose trachoma?

A

Giemsa of conjunctival scrapings

108
Q

What distinguishes Henoch Schonlein purpural kids’ labs?

A

Normal platelet count, unlike other causes of purpura

109
Q

Classic tetrad of Henoch Schonlein purpura?

A

Lower extremity palpable purpura, arthralgia, abd pain (usu colicky), renal disease

110
Q

Measles vs. rubella?

A

Measles are more severe (fevers up to 104), coryza, malaise, and rash spreads more gradually (rubella rash spreads in <3 days) and are darker

111
Q

Common cause of knee pain in adolescent male athletes

A

Osgood-Schlatter disease = traction apophysitis of tibial tubercle

112
Q

What are 2 common complications of sickle cell trait?

A
  1. Microscopic or gross hematuria 2. Isosthenuria (impairment in concentration)
113
Q

What is the best empiric therapy (apart from incision and drainage) of unilateral cervical lymphadenitis?

A

Clindamycin b/c it covers both strep and staph (including MRSA), has good l.n. penetration. **Staph produces beta lactamase

114
Q

Short palpebral fissures, indistinct philtrum, thin upper lip

A

Fetal alcohol syndrome

115
Q

Rx for non-TB mycobacterial infx?

A

Azithromycin + rifampin

116
Q

Ddx for aquired torticollis?

A 
# URI# Minor trauma
# Cervical lymphadenitis
# Retropharyngeal abscess
# Atlantoaxial subluxation
117
Q

Sx of vitamin B3 deficiency?

A

Diarrhea, dermatitis, dementia (Pellagra)

118
Q

First 3 steps in caustic ingestions?

A
  1. ABCs 2. Remove clothing 3. Upper GI endoscopy w/in 24 hrs to assess injury
119
Q

What is eczema herpeticum?

A

A form of primary herpes simplex associated w/ atopic dermatitis. Usu superimposed on healing atopic dermatitis (eczema) after exposure to herpes simplex. Can be life threatening in infants!

120
Q

What are the sx of eczema herpeticum?

A

Fever, adenopathy, umbilicated vesicles

121
Q

What are sx of UTI during infants?

A 
Nonspecific and vague: 
# fever
# fussiness
# decr UOP** Clean-catch is hard for kids in diapers --> straight cath instead
122
Q

What are risk factors for pyloric stenosis?

A 
# First-born boy
# Erythromycin
# Formula feeding
123
Q

Sx of orbital cellulitis?

A 
# Pain w/ mvmt
# Proptosis
# Ophthalmoplegia
# Diplopia
124
Q

6 mo w/ poor feeding, fussiness, bulging anterior fontanelle, widely spaced sutures, prominent scalp veins?

A

Suspicious for hydrocephalus –> get CT scan

125
Q

Mitral stenosis in kids is almost always due to

A

Rheumatic fever.

126
Q

Rx for pts w/ hx of rheumatic fever?

A

Continuous penicillin ppx every month to prevent strep pyogenes pharyngitis and limit progression of rheumatic heart disease

127
Q

What are common pathoens in CF pneumonia?

A 
# Pseudomonas
# Burkholderia cepacia (gram neg rod)
# Stenotrophomonas maltophilia (gram neg rod)
# H. influenza (gram neg coccobacilli)
# S. pneumo
# S. aureus (**Most common in infants, young kids**)
128
Q

What is the most common org for CF pneumo in babies?

A

S. aureus

129
Q

Why is C. diff colitis rare in infants?

A

Lack of intestinal receptors to toxin until ~2 yo

130
Q

What are the clinical features of milk-/soy-induced colitis?

A

Regurgitation or vomiting +/- painless bloody stools +/- eczema (oft family hx of allergies, eczema, asthma)

131
Q

What are 2 red flags for intracranial pathology?

A 
ie. for temporal brain abscess, since ICP increases in supine
# morning vomiting
# nocturnal h/a
132
Q

What is Beckwith-Wiedemann syndrome?

A

Overgrowth disorder characterized by predisposition to neoplasms (Wilms tumor, hepatoblastoma).

133
Q

What is cause and pathogenesis of Beckwith-Wiedemann syndrome?

A

Alteration of chrom 11p15 that includes genes that encode ILGF2. So at birth, babies have macrosomia, macroglossia, hemihyperplasia, medial abdominal wall defects.

134
Q

What are the rx for TCA o/d?

A 
# First step: ABCs
# Sodium bicarb for cardiac toxicity (prolonged QRS, ventricular arrhythmia) and metabolic acidosis
# Benzos for seizures
# Nothing for anticholinergic sx
135
Q

Widened QRS due to a drug puts pt at risk for

A

Fatal ventricular arrhythmias

136
Q

Presentation of intraventricular hemorrhage in newborn (increased risk with premies)?

A 
# Lethargy
# Hypotonia
# High-pitched cry
# Rapidly increasing head circumference
# Bulging fontanels
137
Q

What is next step in management of Guillain Barre?

A

Spirometry to measure FVC (gold standard) to check for respiratory failure

138
Q

What are the 3 reasons for cow’s milk causing Fe anemia?

A
  1. Low Fe content of milk
  2. Poor bioavailability of Fe from milk
  3. Increased intestinal blood loss from cow milk protein colitis
139
Q

One lab way to diff btw Fe def anemia and thalassemia?

A

RDW >20% most likely Fe def.

140
Q

FYI viral meningitis

A

Can present with a viral prodrome of constitutional/URI sx w/ low-gr fever.

141
Q

Top 2 orgs for bacterial lymphadenitis?

A
  1. Staph aureus
  2. Group A strep
142
Q

What is suspicious for nephrotic disease in pt from China?

A

Membranous nephropathy - can be seen in adolescents w/ hep B

143
Q

What should precede intubation in pts with croup?

A

Racemic epi

144
Q

Ddx of maroon-colored stool in 2 yo (5)?

A 
# hemorrhoids
# infectious colitis
# intussuception
# Meckel's 
# IBD
145
Q

Workup of intussusception with

A

Abd ultrasound

146
Q

Pt with reactive airway disease w/ altered mental status, “silent chest” (absent air entry on exam), hypoxemia, CO2 retention are signs of

A

Impending respiratory failure from unremitting asthma –> intubation and vent

147
Q

What is adequate stooling in a newborn?

A 
# First 2 days: dark, sticky meconium
# Afterwards: yellowish (yellow-seedy) or green stool
148
Q

What is adequate urination in first week of life?

A

Number of wet diapers >= Infant’s age in days

149
Q

What are the 3 cardiac anomalities of Turner syndrome?

A
  1. Coarctation of aorta 2. Bicuspid aortic valve 3. Aortic root dilation
150
Q

What is the most common population for serum sickness?

A

Young children following rx of viral infections with abx.

151
Q

Fever, rash, joint pain, lymphadenopathy 1-2 weeks after penicillin suggests

A

Serum sickness

152
Q

In a neonate: poor oral intake, irritability, hyper/hypothermia, respiratory distress, vomiting, jaundice suggests

A

Neonatal sepsis. Empiric rx: ampicillin + gentamicin

153
Q

Full/bulging fontanelles suggests

A

Neonatal meningitis

154
Q

Which organism causes sepsis in premies?

A

Enterococcus

155
Q

Two diff btw Niemann-Pick and Tay-Sachs?

A

Niemann-Pick pts can show hepatosplenomegaly and areflexia, vs. Tay-Sachs no hepatosplenomegaly and hyperreflexia

156
Q

Dx of ADHD by

A

Clinical eval of sx and associated impairment in 2 diff settings (teacher evals are important)

157
Q

What is the ddx of rash in the neonate?

A 
# Erythema toxicum neonatorum - asymptomatic. Macules/papules/pustules throughout body w/o palms + soles
# Neonatal HSV
# Neonatal varicella
# Staph scalded skin syndrome
158
Q

What are the 3 patterns of neonatal HSV?

A
  1. Vesicular clusters on skin, eyes, mucous membranes 2. CNS infx 3. Fulminant, diseeminated multi-organ disease
159
Q

What is the rx for staph scalded skin syndrome (3)?

A

Oxacillin, nafcillin, or vancomycin

160
Q

Which vitamin can reduce morbidity and mortality of measles?

A

Vit A

161
Q

What CBC findings can be seen with measles (2)?

A

Leukopenia, thrombocytopenia

162
Q

Cause of intusseption in CF pt

A

Inspissated stool

163
Q

Cause of intusseption in pt <2 yo

A

Viral illness –> hypertrophy of Peyer patches

164
Q

Cause of intusseption in kids >2 yo

A

Meckel’s diverticulum

165
Q

What factors decrease risk of RDS?

A 
# IUGR
# Maternal htn
# Prolonged rupture of membranes (chronic IU stress)
166
Q

What factors increase risk of RDS?

A 
# male
# perinatal asphyxia
# maternal diabetes
167
Q

52 hr pt w/ narrow colon, dilated loops of small bowel, air in large intestine, rectum. Can’t pass meconium. Ddx (2)

A
  1. Hirschsprung disease (assoc w/ Down) - obst in rectosigmoid
  2. Meconium ileus (pathogn. for CF!!!!) - obst in ileum
168
Q

Infants <2 mo at great risk of dvlpg what with RSV infx?

A

Apnea and resp failure b/c can have upper AND lower resp tract involvement

169
Q

Two additional manifestations of Henoch-Schonlein purpura

A
  1. Scrotal pain + swelling 2. Intussusception (ileo-ileal)
170
Q

Housing before which year increases risk for lead exposure?

A

1978

171
Q

When should visual acuity test be performed?

A

At every well-child visit starting at age 3

172
Q

What are indications for renal and bladder u/s for UTI (4)?

A
  1. t respond to abx
173
Q

What are indications for voiding cystourethrogram for UTI?

A

If hydronephrosis or scarring seen in renal ultrasound.

174
Q

What is guanfacine MOA and what is it used for?

A

Alpha2 agonist in CNS –> used in
1. htn (decr both systolic and diastolic)
2. ADHD

175
Q

What is Kasabach-Merritt syndrome?

A

A platelet consumption disorder associated w/ large or multiple hemangiomas

176
Q

What are the 3 Ps of McCune-Albright?

A

Precocious puberty
Pigmentation
Polyostotic fibrous dysplasia

177
Q

Rx for H influenza type b meningitis?

A

Dexamethasone

178
Q

Empiric therapy for meningitis?

A

IV Ceftriaxone (S. pneumo, N. menin) + Vanc (resistant S. pneumo) OR cefotaxime

179
Q

10 yo boy w/ abd pain, bloody diarrhea, jaundice, pedal edema. Labs show anemia, thrombocytopenia, renal insufficiency. What is most likely organism?

A

HUS caused by E. Coli (EHEC). Or Shigella

180
Q

Rx for HUS?

A

Generally supportive, w/ plasmapheresis, dialysis if needed, steroids. No abx indicated.

181
Q

Bedwetting is normal before age

A

5

182
Q

What is the pathogenesis of physiologic jaundice of newborn?

A

Slow bili clearance from decreased uridine diphosphogluconurate glucuronosyltransferase (UGT) activity

183
Q

In which disease do pts have normal CD3+ but very low CD19+ cells?

A

X-linked (Bruton’s) agammaglobulinemia

184
Q

Which org associated with cat bites, and ppx rx is?

A

Pasturella multocida. Amoxicillin+clavulanate

185
Q

2 yo w/ initial viral prodrome (ie. URI) –> worsening respiratory disress (from acute LH failure, pulm edema), holosystolic murmur, hepatomegaly suggests

A

Viral myocarditis (latter signs are signs of heart failure)

186
Q

2 most common viral myocarditis etiologies?

A
  1. Coxsackie B, 2. Adenovirus
187
Q

What is the difference between pericardial effusion and cardiac tamponade?

A 
Pericardial effusion with enough pressure to affect cardiac function = cardiac tamponade
# pericardial effusion may be transudative, exudative, hemorrhagic, malignant
188
Q

What is the triad characterizing progression to tamponade?

A

Beck’s triad: 1. distant heart sounds 2. distended jugular veins (or scalp veins in infants) 3. hypotension

189
Q

What is the first step in management of gonadotropin-dep (central) precocious puberty?

A

Brain MRI (must be ruled out, even though GDPP is idiopathic in 80% of pts), even with no neuro deficits

190
Q

What is danazol, and what is it used to treat?

A

Testosterone derivative, endometriosis

191
Q

What is a tet spell (pathogenesis)?

A 
Complete obstruction of RV outflow tract from sudden spasm dur exertion or agitation --> Sudden hypoxemia, cyanosis.
# obstruction also causes harsh systolic ejection murmur and single s2 (no pulm blood flow)
192
Q

14 d.o. m infant presents w/ spasms, had no antenatal care

A

Neonatal tetanus (4 types: generalized, localized, cephalic, noenatal), oft following umbilical stump infx

193
Q

What is infant botulism caused by?

A

Ingestion of C. botulinum spores in honey but also soil esp in Cali, Penn, Utah

194
Q

What is the most common symptom and PE finding for osteosarcoma?

A

Joint pain and swelling (not constitutional sx), tender soft-tissue mass

195
Q

What are 4 sx of acute iron poisoning?

A
  1. abd pain, 2. hematemesis (Fe is corrosive to GI mucosa), 3. anion gap met acidosis (Fe is vasodilator and causes accumulation of lactic acid) 4. shock (overall Fe disrupts basic cell processes)
196
Q

What is used to prevent gonococcal ophthalmia?

A

Silver nitrate in eyes

197
Q

What is the most common complication of a male CF pt?

A

> 95% have obstructive azoospermia (good sperm production, but they have congenital bilateral absence of vas)

198
Q

FYI CF pts with early pancreatic insufficiency

A

Rarely have pancreatitis

199
Q

Hip creases that extend beyond normal in a baby may indicate

A

Developmental dysplasia of the hips

200
Q

If a baby has asymmetric hip creases with negative Barlow & Ortolani signs, what imaging should he get?

A 
# If 2 wk: wait as hip laxity at birth usu resolves
# If 2 wk - 6 mo: hip ultrasound
# If >= 4-6 mo: hip x-ray (after femoral head/acetabulum have ossified)
201
Q

Leg-length discrepancy in a baby may indicate

A

Developmental dysplasia of hips

202
Q

What is the rx of for dvlpmtl dysplasia of hip in baby <6 mo?

A

Pavlik hip harness

203
Q

Recurrent sinopulm infx, chronic cough, nasal polyps, clubbing

A

CF

204
Q

What are 3 EKG characteristics of Wolff-Parkinson-White?

A
  1. shortened PR interval, 2. delta waves, 3. wide QRS
205
Q

What is kidney manifestation of HSP?

A

IgA nephropathy (Berger) - mesangial deposition

206
Q

Mongolian spots vs. bruises from coagulopathy or child abuse?

A

The latter are painful.

207
Q

Newborn in respiratory distress after pre-term vaginal delivery, prenatal had polyhydramnios, O2 sat 82%, w/ nasal flare, grunt, barrel-shaped chest, scaphoid abdomen. Absent breath sounds on left, right sided heart sounds. Most likely

A 
Diaphragmatic hernia. Herniation --> Pulm hypoplasia and pulm hypertn.
# Don't bag-mask ventilate as it may increase air into GI!
208
Q

What is the rx for strep throat and its benefits?

A

Penicillin or amoxicillin. Hastens recover, reduces risk of rheumatic fever, and prevents transmission to close contacts.

209
Q

What is the squirt sign of Hirschsprung?

A

Rectal exam can provide temp relief –> explosive expulsion of gas and stool. Not seen in meconium ileus as the meconium is inspissated.

210
Q

Recurent sinopulmonary infx are concerning for

A

humoral deficiency

211
Q

What is the pathogenesis of lymphadenopathy and hepatosplenomegaly in ALL?

A

Extramedullary leukemic spread (may even see widened mediastinum from hilar lymphadenopathy)

212
Q

What’s an option for bee sting allergies to decr repeat anaphylaxis risk from 30 to <5%?

A

Venom immunotherapy

213
Q

Do apgar scores correlate with prognosis?

A

No. Many babies who initially need pos press ventilation respond well.

214
Q

What are the characteristics of ALL blasts?

A 
# Lack peroxidase positive granules
# Oft contain cytoplasmic aggregates of periodic acid Schiff (PAS)
215
Q

What are the presenting sx for Conn’s syndrome?

A

Excess aldosterone (aldosterone-secreting adenoma, bilat adrenal hyperplasia) –> hypokalemia, htn

216
Q

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

A 
Fibromuscular dysplasia, a non-inflammatory, non-atherosclerotic vascular disease (intimal form is most common in kids)
# presents as new onset htn, may hear bruit at costovertebral
217
Q

Neonate exposed to a drug has irritability, high-pitched cry, poor sleeping, tremors, seizures, sweating, sneezing, tachypnea, poor feeding, vomiting, diarrhea. Due to

A

Neonatal abstinence syndrome (infant w/drawal opiates)

218
Q

Rx for neonatal opiate w/drawal?

A

Supportive care, morphine

219
Q

Difference btw presentation of neuroblastoma vs. pheo

A

Even though elevated catecholamines, HVA, VMA, pts don’t have fainting spells, sweating, palpitations, htn.

220
Q

What is seen on imaging of neuroblastoma?

A

Renal calcifications and hemorrhages

221
Q

Why does standing increase the murmur for hypertrophic cardiomyopathy?

A

It decrease preload –> decrease ventricular cavity size –> increase LV outflow obstruction

222
Q

Stridor in infant <1 yo ddx (2)?

A
  1. Laryngomalacia - worsens in supine
  2. Vascular ring - worsens in prone, improves w/ neck extension, 50% associated w/ cardiac abnorm
223
Q

Describe the rash of measles.

A

Blanching, reddish-brown, maculopapular, cephalocaudal and centrifugal spread

224
Q

Pt after elbow fracture with increasing pain concerning for

A

Compartment syndrome

225
Q

What is the pathogenesis of scarlet fever?

A

Erythrogenic exotoxins, following strep pharyngitis, wound infx, burns, strep skin infx.

226
Q

Rash, erythematous pharynx with gray-white exudates, circumoral pallor. Later in week, desquamation

A

Scarlet fever (may also see strawberry tongue)

227
Q

What is the pathogenesis of anemia of prematurity?

A
  1. Transition in erythropoiesis sites of neonate
  2. Shorter life span of RBCs in neonates
  3. Diminished fetoplacental transfusion (when baby held above level of placenta after delivery)
228
Q

What is rx for anemia of prematurity?

A

Fe supplementation, periodic Hb check, blood transfusion. Epo not used

229
Q

What is the diff btw AOM and OM w/ effusion?

A

The latter has middle ear effusion WITHOUT acute inflamm

230
Q

What are serous liquid-filled blisters on the TM called?

A

Bullous myringitis

231
Q

Definitition of conjugated hyperbilirubinemia (2)?

A

> 2 mg/dL of direct bili or direct bili >20% of total

232
Q

What is the next step for eval of biliary atresia?

A

Abd u/s (may show absent/abn gallbladder)

233
Q

What is the gold standard for eval of biliary atresia?

A

Cholangiogram

234
Q

What is the rx for biliary atreisa?

A

Kasai procedure, eventual liver transplant

235
Q

Most common cause of congenital hypothyroid in US?

A

Thyroid dysgenesis (85%)

236
Q

What is the primary murmur in tetralogy of Fallot?

A

Harsh, systolic ejection murmur over left upper sternal border from pulm stenosis

237
Q

What is the cause of apical diastolic rumble in VSD?

A

Relatively incr flow across mitral valve

238
Q

Caf_-au-lait, macrocephaly, feeding problems, short stature, learning disabilities suggest

A

NF1

239
Q

Vocabulary of several hundred words found in a child aged

A

2 yo

240
Q

What is the rx for scarlet fever?

A

Penicillin V (for allergies: erythromycin, clinda, 1st gen ceph)

Peds UWorld (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions