Random Flashcards

1
Q

what are the rule of 2’s in Meckel’s diverticulum?

A
2 feet from ileocecal valve 
2 in long
2 times more common in males
2% of population
2% develop complication over course of their lives
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2
Q

what conditions mimic acute appendicities

A
Yersinia enterocolitis 
mesenteric adenitis
constipation
crohn's 
meckel's 
ectopic pregnancy
UTI 
ovarian torsion
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3
Q

what murmur is associated with marfan ?

A

aortic root dilatation leading to diastolic decrescendo murmur (aortic insufficiency)

can also have mitral valve prolapse

can lead to aortic dissection

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4
Q

what is DiGeorge syndrome

A

facial features

  • low-set ears
  • eyes wide apart
  • palate anomalies
  • widened area below nasal bridge
  • short philtrum
  • micrognathia

cardiac lesion

  • abnormal heart sounds
  • murmur
  • right sided aortic arch
  • conotruncal anomalies

No thymic shadow seen on CXR

Hypocalcemia- parathyroid hypoplasia - (tetancy, seizures)

results from failure of the third and fourth pharyngeal pouches

**lots of viral and fungal infections b/c of lack of thymus

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5
Q

what are the common conotruncal anomalies associated with DiGeorge

A

transposition of great vessels, truncus arteriosus, right sided aortic arch

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6
Q

by age 12 months, infants should weigh how much compared to birth weight

A

3 times

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7
Q

what is the point of substituting medium chain triglycerides for long chain triglycerides in a babies diet?

A

if a baby has malabsorption and steatorrhea this will help because MCTs do not require bile acids for absorption.

preterm infants have steatorrhea b/c of poor absorption of fat due to small bile acid pool

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8
Q

what is a mongolian spot

A

hyperpigmentation found in 66% of all infants of hispanic, asian and native american ethnicity

sometimes mistaken for bruise

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9
Q

vomiting in a 10 month old, with lethargy, dehydration, full anterior fontanelle , no diarrhea, posturing

A

administer dexamethasone to decrease the intracranial pressure

most likely a brain tumor

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10
Q
resp tract infection
neonatal jaundice
recurrent bronchiolitis
nasal polyps
chronic diarrhea
features of malabsorption
meconium ileus
recurrent sinus infection
A

cystic fibrosis

obstructive airway disease
clubbing

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11
Q

what antibiotics do you use for CF treatment

A

tobramycin plus antipseudomonal (ticarcillin/piperacillin)

tobramycin pluse third gen cephalosporin (cefepime, ceftazidime)

tobramycin plus carbapenem (imipenem/cilastatin, meropenem)

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12
Q

what antibiotic is used to cover pasturella multocida

A

penicillin is the treatment of choice, but rare isolates with B-lactamase activity have been reported.

amoxicillin-clavulanate helps with resistance

if penicilin allergy use azithromycin

dog/cat bites
symptoms occur within a 24 hour period

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13
Q

if you suspect a lactase deficiency in a kid, what test should you do

A

lactose breath test

Its prevalence
in subjects of Asian (Far-Eastern) extraction is at least 85%

sucrase-isomaltase deficiency is the most common congenital disaccharidase deficiency

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14
Q

what is the lactulose breath test used for

A

useful in evaluation of suspected bacterial overgrowth, particularly pt’s who have undergone prior bowel surgery and present with symptoms that suggest a blind or stagnant intestinal loop

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15
Q

what are watery, acidic stools indicative of

A

carbohydrate malabsorption

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16
Q

“thumb sign”)

A

epiglottitis

lateral radiograph

Affected patients typically
present between the ages of 2 and 8 years with the rapid onset of fever,
sore throat, and the “four Ds” (drooling, dysphagia, dysphonia, and
dyspnea). Patients often assume a position of comfort by sitting upright,
leaning forward, and bracing themselves with their arms, known as the
tripod position.

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17
Q

steeple sign

A

AP view of croup

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18
Q

what is the treatment for acute rheumatic fever in a peds patient

A

Penicillin G or 10 days of oral penicillin even if throat culture is negative

19
Q

what are the major criteria for rhf

A
polyarthritis
carditis
subcutaneous nodules
sydenham chorea
erythema marginatum
20
Q

what are the minor manifestations for RHF

A

fever
arthralgia
prolonged PR interval on ECG
Elevated acute phase reactants (ESR, CRP)

21
Q

hyponatremia
postural hypotension
hyperkalemia
lack of response to cosyntropin stimulation test

plus

neurologic deficits -weakness, spasticity, dementia, blindness, quadraparesis

A

Adrenoleukodystrophy

x-linked disease where there is a mutation in the transportation of very long-chain fatty acids (VLCFA) into peroxisomes, thereby preventing beta-oxidation and breakdown of VLCFA
accumulation of VLCFA in neurons and adrenal cortex causes symptoms

adrenal stuff is usually detected before neuro stuff

22
Q
hypotonia
upslanting palpebral fissures
epicanthal folds
excess nuchal skin
enlarged tongue
clinodactyly of the fifth fingers
single transverse palmar crease
A

trisomy 21

23
Q
small palpebral fissures
low set ears
low birth weight
microcephaly 
rocker bottom feet
cleft lip
hypotonia
clenched hands
A

Edward syndrome (Trisomy 18)

24
Q

what are the cyanotic diseases of the newborn

A
truncus arteriosus
tricuspid atresia 
tetrology of fallot 
transposition of the great arteries
total anomalous pulmonary return and pulmonary stenosis
25
Q

what is rx for scabies

A

premethrin cream

26
Q

what anomalies are associated with diabetes during pregnancy

A
small left colon
anencephaly
meningomyelocele
cardiac- assymetric septal hypertrophy, transposition of great vessels, VSD
-sacral agenesis
renal vein thrombosis 
renal agenesis
27
Q

what heart defect is associated with turner

A

coarc of aorta

28
Q

rash that spreads from the trunk to the extremities and is particularly associated with high fevers ….

A

roseola infantum caused by human herpes virus 6

29
Q

Patient presents with short stature, webbed neck, shield like chest and widely spaced nippled, no secondary sex characteristics…. what will the levels of FSH, LH and Estradiol be? What will a buccal smear show?

A

High FSH
High LH
Low estradiol
Buccal smear shows normal appearing epithelial cells with no barr bodies

Rx: Estrogen Therapy

Turner = XO

30
Q

X-linked
causes low or absent numbers of B cells leading to panhypogammagloblulinemia

cellular immunity is intact

pt develops infections after approximately 6 months of age when maternal ab’s have decreased to low levels

recurrent infections

A

Bruton Agammaglobulinemia

31
Q

eczema
thrombocytopenia
recurrent infection

A

Wiskott -Aldrich Syndrome

32
Q

positive whiff test

A

gardnerella or bacterial vaginitis

Rx. Metronidazole

33
Q

most common cause of neonatal meningitis

A

strep agalactiae - group B strep

other common bugs are e coli and listeria monocytogenes

34
Q

consumptive thrombocytopenia

microangiopathic hemolytic anemia

fever

renal dysfunction

fluctuating neuro deficitis

A

thrombotic thrombocytopenic purpura

35
Q

anemia, thrombocytopenia, leukopenia and/or bone pain, hepatosplenomegaly, lymphadenopathy

A

ALL

36
Q

what eye findings are seen in neurofibromatosis

A

lisch nodules (iris hamartomas)

37
Q

what skin findings are seen in tuberous sclerosis

A
ash-leaf macules 
facial angiofibromas (adenoma sebaceum) and shagreen patches (connective tissue nevi) 

seizures are the most common presenting symptom

38
Q

Cerebral calcification
facial nevus
glaucoma in the ipsilateral eye
seizures contralateral to the side of the nevus

A

sturge weber

39
Q

freckling in the axillary or inguinal region

A

NF-1

40
Q
history of neonatal jaundice
recurrent bronchiolitis 
nasal polyps
chronic diarrhea
malabsorption
meconium ileus
A

cystic fibrosis

41
Q

antidote for iron poisoning

A

deferoxamine

42
Q

what is the antidote for lead poisoning

A

EDTA + either DMSA or BAL (Dimercaprol )

with encephalopathy?
EDTA + BAL

43
Q

most common pathogen in young children with CF

A

staph aureus

Rx. assume there is methicillin resistance and start vancomycin

44
Q

what drugs can be used to treat pseudomonas in CF pt’s

A

amikacin
ceftazidime
ciprofloxacin