Random Flashcards
1
Q
Potential energy from dietary fat
A
9 kcal/g
2
Q
Potential energy from carbs
A
4 kcal/g
3
Q
Potential energy from protein
A
4 kcal/g
4
Q
How many half lives for a drug to reach steady state (97%)
A
5 half lives
Ex: drug with 6hr half life x5 = 30 hours to reach steady state
5
Q
47, XXY
A
Klinefelter syndrome
Barr body (inactive X chromosome)
-Gynecomastia
-Small, fibrotic testes
-Eunuchoid body shape, female hair pattern
-Tall with long extremities but normal arm span
-Low testosterone, high FSH and LH and estrogen
6
Q
Aplasia cutis congenita Cleft lip/palate Microcephaly Polydactyly, overlapping fingers GU anomalies
A
Trisomy 13 (Patau) C/b meiotic nondisjunction
7
Q
Supravalvular aortic stenosis / PPS Cocktail party personality Elfin facies Hypersensitive to sound Hypercalcemia
A
Williams syndrome
8
Q
Infant <6mo Irritable Fever Soft tissue swelling Xray: cortical hyperostosis of the mandible (also ulna, rib, clavicle, scapula, skull, ilium)
A
Caffey disease
Infant cortical hyperostosis
9
Q
Baby at birth with:
- Hypoglycemia
- Micropenis
- Direct hyperbili
- Normal wt/length
A
Congenital growth hormone deficiency
10
Q
When is chickenpox contagious
A
1-2d prior to the rash and until the lesions are crusted over
11
Q
Who needs prophylaxis for meningococcal disease and what is the ppx
A
- Same household
- Child care contacts within previous 7d
- Direct secretion exposure (kissing, sharing utensils, intubating, mouth to mouth) within previous 7d of <24h of starting abc
- Passenger on a flight >8h sitting directly next to them
Rifampin 600mg BID x2d
(or rocephin x1, cipro x1)
12
Q
Progressive distal weakness and sensory loss
No DTRs
High arched feet (pes cavus)
Muscle atrophy and “stork legs”
A
Charcot-Marie-Tooth (CMT) disease
13
Q
Birth weight doubles
A
5 mo
14
Q
birth weight triples
A
1 year
15
Q
Birth length doubles
A
4 years
16
Q
Average birth length
A
50cm
17
Q
What and when to do autism screening
A
MCAT
18 and 24 months
18
Q
Average birth head circumference
A
35 cm
19
Q
Craniosynostosis (coronal sutures)
Midface hypoplasia
Proptosis
A
Crouzon syndrome
20
Q
Craniosynostosis
Syndactyly
Mitten hands
Intellectual disability
A
Apert syndrome
21
Q
Rooting reflex
A
Present at birth
Gone by 4 mo
22
Q
Parachute reflex
A
Present 6-9 mo
Stays for life
23
Q
Moro reflex
A
Present at birth
Gone by 3-6 mo
24
Q
Babinski
A
Upgoing until 12mo is normal
Still upping after 2-3 years: CNS lesion
25
Tonic neck response
Fencing reflex
Present at 35 weeks gestation
Most prominent at 1mo
Gone by 6 mo
26
Stepping reflex
Gone by ~2mo
27
Palmar grasp reflex
Gone by 3-4mo
28
Calculate age based on kids drawing of a person
1/4 point for each:
2 eyes, 2 ears, nose, mouth, hair, 2 arms, 2 legs, 2 hands, 2 feet, neck, trunk.
Base of 3 then add points
29
MC type of craniosynostosis
Scaphocephaly / dolichocephaly
Premature fusion of the midline sagittal suture
Long narrow skull
30
Mid parental height for a boy
(Dad + Mom + 5in)/2
| (Dad + Mom + 13cm)/2
31
Mid parental height for a girl
(Dad + Mom - 5in)/2
| (Dad + Mom - 13cm)/2
32
Eyes follow 180 degrees
2 mo
33
Cooing
2 mo
34
Lifts head and chest prone
2 mo
35
Laughs
4 mo
36
Rolls front to back
4 mo
37
Voluntary grasp
5 mo
38
Babbles
6 mo
39
Rolls back to front
6 mo
40
Sits
6 mo
41
Transfers toys hand to hand
6 mo
42
Rakes with 4 fingers
6 mo
43
Object permanence
9 mo
44
Stranger anxiety
9 mo
45
Babbles
9 mo
46
Dada/mama nonspecific
9 mo
47
Crawls
9mo
48
Pulls to stand
9 mo
49
Pincer grasp (immature)
9 mo
50
Pincer grasp (mature)
12 mo
51
Points
12 mo
52
Dada/mama specific
12 mo
53
1-2 words
12 mo
54
First independent steps
12 mo
55
Walks well independently
15 mo
56
Squats to pick up
15 mo
57
Crawls up steps
15 mo
58
Drops objects in and take out of container
15 mo
59
3 cube tower
15 mo
60
4 cube tower
18 mo
61
6 cube tower
2y
62
Name 2-4 body parts
18 mo
63
10-25 words
18 mo
64
Scribbles
18 mo
65
Throws ball while standing
18 mo
66
Parallel play
2y
67
Scoops well with spoon
2y
68
50 words
2y
69
50% understandable
2y
70
2 word phrases
2y
71
Jumps with 2 feet
2y
72
Runs well
2y
73
Throws ball overhand
2y
74
Stairs 2 feet per step
2y
75
Walks up stairs alternating feet
3y
76
3 word sentences
3y
77
75% understandable
3y
78
Draws a circle
3y
79
9 cube tower
3y
80
Imaginative play
3y
81
Cooperative play
3y
82
Dress/undresses
4y
83
100% understandable
4y
84
Counts to 4
4y
85
Names 4 colors
4y
86
Draws cross
4y
87
Buttons
4y
88
Walk backwards
5y
89
Pneumococcal routine series
PCV13
4 doses
2, 4, 6, 12-18mo
90
PCV13 catch up for healthy kids
1 dose for age 2-5yo with any incomplete PCV13 series
91
PCV13 catch up for at risk kids
2 doses 8 weeks apart
| At risk=SCD, asplenia, CSF leaks, cochlear implants, HIV
92
Who gets PPSV23, when, how many
```
Give 8 weeks after last PCV13
1 dose: SCD, asplenia, HIV, CSF leaks, cochlear implants, chronic heart/lung, DM
2 doses (5y later): SCD, asplenia, HIV, immunocompromised
```
93
Rotavirus routine schedule
2, 4, +/- 6 mo
94
Rotavirus contraindications
Hx of intussusception
| SCID
95
Rotavirus age limitations
First dose: 6wks to <15wks
| Finish by 8mo
96
IM needle sizes
Newborn: 5/8"
Infants: 1"
Adolescents: 5/8-1.5"
97
Varicella routine series
12mo, 4y
98
Varicella catch up
2 doses at least 3mo apart for age <12y
| (>12y: 2 doses 4 wks apart)`
99
Age when you only need 1 dose of flu for the first time instead of 2
Starting at 9yo
| Ages 6mo-8yo require 2 doses 4 wks apart for the first year
100
When can HIV+ get MMR and varicella shots
If CD4 >= 15% x 6mo
| Or CD4 >= 200 for kids >5yo
101
Which vaccine is contraindicated with hx of anaphylaxis to neomycin or gelatin
MMR
102
Patient got IVIG: What shots need to be delayed and how long
MMR, Varicella, MMRV
| Delayed by 8-10 mo following IVIG
103
Patient got steroids: What shots need to be delayed for what doses of steroids?
High dose PO steroids for >14d (2 mg/kg/d or 20mg/d)
| Delay MMR and varicella by 1mo
104
Vaccine required to be stored in a freezer (-50 to -15 degrees C)
Varicella containing (varicella or MMRV)
105
Vaccine contraindicated if the kid is living with an immunocompromised person
live attenuated flu
106
Vaccines given subcu
MMR, var, MMRV
107
Vaccines given subcu or IM
IPV, PPSV23
108
Vaccines given nasally
LAIV
109
Vaccines given orally
Rota
110
White lines across the teeth, chalk-brown enamel discoloration, dental pitting
Fluorosis
111
Blue line along the gums with bluish-black edging to the teeth
Burton lines
| Chronic lead poisoning
112
Dyslipidemia screening
Universal: 9-11y and again at 17-21y
113
First primary tooth to erupt
Mandibular central incisors
114
First permanent tooth to erupt
Lower central incisors and 1st molars (6y molars)
115
Timeline of primary teeth eruption
Begin at 6mo (5-10mo), complete by 24-36mo
116
Timeline of permanent teeth eruption
Begin at 6-7yo, complete by 13-14yo
117
Number of primary teeth rule
```
7+4 rule
7mo: 1st tooth
11mo: 4 teeth
15mo: 8 teeth
......
27mo: 20 teeth
```
118
When to refer to dentist if no primary teeth
18 mo
119
Total number primary teeth
20
120
Measles prophylaxis for infants traveling abroad
All infants 6-11mo should get one dose of MMR vaccine (does not count toward regular 2 dose series)
121
Vaccine adverse effect: extreme irritability and crying >3h
Pertussis containing vaccine
122
Vaccine adverse effect: thrombocytopenia
MMR
123
How long after thelarche can you expect menarche
2-2.5y
124
Cardiac complication associated w/ anorexia and what is the PE finding
Mitral valve prolapse
| Late systolic murmur at the apex preceded by a click
125
First sign of puberty in boys
Increase in testicular volume
126
Peak height velocity in boys: average age and what SMR
13.5y
| SMR 3-4
127
Peak height velocity in girls: average age and what SMR
11.5y
| SMR 2-3
128
Asymptomatic genital ulcer
Inflamed superficial and deep inguinal nodes ("groove sign")
Buboes (unilateral painful inguinal lymph nodes)
Fistulas
```
Lymphogranuloma venereum (LGV)
C/b L1, L2, L3 servers of Chlamydia trachoomatis
```
129
Lymphogranuloma venereum treatment
Doxy 100mg PO BID x3 weeks
130
Treatment of primary syphilis
Penicillin G benzathine 2.4 M units IM x1
131
Treatment of tertiary and late latent syphilis
Penicillin G benzathine 2.4 M units IM weekly for 3 weeks
132
Treatment of uncomplicated chlamydia
Azithromycin 1g PO x1
OR
Doxy 100mg PO BID x7d
Retest in 3 months
133
Painful grouped vesicles that rupture to form shallow, painful ulcers
Herpes genitalis c/b herpes simplex virus
134
Painless ulcer, "punched out", clean appearing ulcer with sharp, firm, slightly elevated borders
Primary syphilis chancre
135
Rash: scaly, hyperkeratotic palmar skin rash with lesions on the trunk that follow lines of cleavage
Rash of secondary syphilis
136
Treatment of neurosyphilis
Penicillin G 3-4 M units IV q4h for 10-14d
137
Painful, shallow, soft, friable ulcer with ragged margins and a foul-smelling necrotic purulent exudate
Chancroid
| Haemophilus ducreyi
138
Treatment of chancroid (H ducreyi)
Azithromycin 1g PO x1
or
Ceftriaxone 250 mg IM x1
139
Painless, friable, progressive, beefy-red ulcerative lesion
Granuloma inguinale
Donovanosis
Klebsiella granulomatis
140
Treatment of granuloma inguinale
```
azithro
or
doxy
or
cipro
```
141
Wright stain: rod shaped, oval, deep purple intracellular inclusions
Safety pin shaped encapsulated bacilli
Donovan bodies
Klebsiella granulomatous
Granuloma inguinale (Donovanosis)
142
Painless genital ulcer
| Unilateral tender inguinal and/or femoral LAD ("groove sign")
Lymphogranuloma venereum
| Chlamydia trachoma's L1, L2, L3
143
Treatment of lymphogranuloma venereum
doxy
| or erythro or azithro
144
Female athlete triad
Disordered eating
Menstrual dysfunction
Low bone mineral density
145
Female athlete triad: labs
Loss of pulsatile GnRH secretion
| Low LH, FSH, and estrogen
146
Diagnostic criteria for Tourette syndrome
Multiple motor and vocal tics for at least 1 year
No tic-free interval >3mo
Onset prior to 18yo
No underlying medical cause
147
OTC can cause false positive UDS
Ibuprofen can cause positive screening for PCP, cannabinoids, barbiturates, bentos
PPIs can cause false positive for cannabis
148
```
Dilated pupils
Hyperthermia
Tachycardia
HTN
Profuse diaphoresis
Flushing
```
LSD ingestion
149
```
Slurred speech
Lacrimation
Salivation
Perioral rash
Stupor
```
Inhalant abuse
150
Ataxia
Diplopia
Lateral nystagmus
Euphoria
Barbiturates
151
Bruxism
Hyperthermia
Muscle rigidity
Anxiety
MDMA
152
Excessive salivation
Involuntary tongue and limb movements
Anxiety
Laryngospasm
Ketamine abuse
153
```
Increased energy
Alertness
Euphoria
Insomnia
Weight loss
Dry mouth
Tooth decay
Irritability, aggression
Anxiety
Suspicious, paranoid
Hallucinations
```
Methamphetamine use
154
```
Increased alertness
Extreme pleasure
Confidence
Hallucinations
Psychosis
Seizures
Headaches
Cerebral hemorrhage
Focal neuro symptoms
Coma
Tachycardic
HTN
Dysrhythmias
Ischemia
MI
```
Cocaine abuse
155
```
AMS
Drowsiness
Hypotension
Hypotonia
Nystagmus
Ataxia
Resp depression
```
Benzo overdose
156
Inheritance pattern of Duchenne muscular dystrophy
X linked recessive
157
Acute GI illness after eating pork intestines ("chitterlings" or "chitlins")
Yersinia enterocolitica gastro-enteritis
