Rosh Stuff I Got Wrong (aka Murmurs and Derm) (Alice) Flashcards

1
Q

mc pathogen associated w. bacterial meningitis based on age

A

neonates (</= 1 mo): e. coli, GBS
children (> 1 mo - 18 yo): s. pneumo, n. meningitidis

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

tx for pediatric meningitis based on age

A

neonate (</= 1mo): cefoxatime/gentamicin PLUS ampicillin
children (> 1 mo - 18): cefotaxime/ceftriaxone PLUS vanco

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

continuous cardiac murmur heard best at the infraclavicular region - softens w. supine and intensifies w. extension of head in seated position

A

vervical venous hum

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

innocent cardiac murmur w. vibratory or musical quality - heard best over lower left sternal border

A

still murmur

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

ASD results from increased flow across the _ valve 2/2 to _ shunting

A

pulmonary valve
left to right shunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

mc congenital heart defect

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

t/f: asthma is classified as a reversible obstructive airway disease

A

t!

bronchodilators and avoidance of allergens restore airways to normal diameter

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

known asthma triggers (8)

A

-respiratory infxns
-allergens (food vs inhaled vs ocupational)
-inhaled irritants (tobacco/cold dry air)
-temp/weather
-PA
-hormonal fluctuations
-meds
-emotional stressors

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

what meds exacerbate asthma (4)

A

ASA
NSAIDs
nonselective bb
ACEI

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

what murmur is associated w. TOF

A

harsh systolic crescendo-decrescendo at LSB

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

TOF murmur is worse w _ (2)
and is caused by _ outflow obstruction

A

crying/feeding
pulmonary obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TOF murmur is relieved by

A

squatting

increases SVR

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

4 defects of TOF

A

PROVe
1. pulmonic stenosis
2. RV hypertrophy
3. overriding aorta
4. VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

mc cyanotic congenital heart dz in childhood

A

TOF

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

2 HPI hallmarks of TOF

A

cyanotic/tet spells
squatting for relief

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

mc chromosomal abnl among liveborn infants

A

down syndrome

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

8 physical characteristics of down syndrom rosh stresses

A

brushfield spots (periphery of iris)
developmental delay
heart defects
large tongue
poor muscle tone
sandal toe deformity
single palmar crease
upward slanting eyes

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

congenital heart defect mc in pt w. down syndrome

A

complete ASD

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

gene associated w. CF

A

cystif fibrosis transmembrane conductance regulator -> CFTR

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

3 complications of CF to know

A

malabsorption (ADEK)
steatorrhea
pancreatic insufficiency

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

kid w. CF might also have _ on PE

A

nasal polyps

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

management of CF (6)

A

chest physiotherapy
bronchodilators
DNAse
pancreatic enzymes
anti pseudomonas abx
lung transplant

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

what is this showing

A

figure 3 sign -> coarctation of the aorta

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

4 sx of coarctation

A

HTN
pulsus paradoxus
HF sx
systolic murmur

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

ECG finding of coarctation

A

LVH

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

3 conditions associated w. coarctation

A

turner syndrome
bicuspid aortic valve
intracranial aneurysms

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

abrupt, rapid upstroke of peripheral pulse (percussion wave) followed by rapid collapse

A

water hammer pulse -> chronic aortic regurgitation

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

pulsus alternans/alternating beats is associated w.

A

HOCM

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

pulsus paradoxus is associated w.

A

cardiac tamponade

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

systolic murmur w. apical ejection click in left axilla w. radiation to interscapular area

A

coarctation

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

mcc of mitral stenosis worldwide

A

rheumatic fever

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

mc seen valvular pathology associated w. rheumatic heard dz

A

mitral regurgitation

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

midsystolic click

A

mitral valve prolapse

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

early diastolic high frequency snap

A

mitral stenosis

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

murmur associated w. rheumatic fever/mitral regurg

A

pansystolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is this showing

A

molluscum contagiousum

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

describe molluscum contagiousum (4)

A

small skin colored papules
umbilicated
central keratin plug
+/- prurutis/inflammation

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

molluscum contagiousum is caused by a _virus

A

pox

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

molluscum contagiosum is painless and mc appears on the _ (3)

it spares the _ (2)

A

face
torso
extremeties

spares: palms/soles

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

management of pediatric molluscum contagiousm (3)

A

self resolves
cryotherapy
curretage

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

congenital adrenal hyperplasia is caused by a mutation of the _ gene

and a deficiency of _

A

CYP21A2
21 hydroxylase

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

tx for congenital adrenal hyperplasia

A

hydrocortisone
fludrocortisone
NaCl

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

common presentation of congenital adrenal hyperplasia (4)

A

genital atypia
labial fusion
urogenital sinus
clitoral enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

rash associated w. n meningitidis

A

macular, non blanchable rash
petechiae/purpura fulminans

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

tx for n meningitidis

A

ceftriaxone asap

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

what is this showing

A

sunburst pattern -> perisosteal rxn -> osteosarcoma

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

mc sites affected by osteosarcoma

A

long bones (mc -> least common)
1. distal femur
2. proximal tibia
3. proximal humerus
4. middle/proximal femur

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

common presentation of osteosarcoma (3)

A

localized pain x several months
pain after injury
large, ttp soft tissue mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

pt w. osteosarcoma will be _ yo

A

10-20

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

2 XR findings of osteosarcoma

A

sunburst
codman triangle

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

5 common causes of allergic contact dermatitis

A

plants
metals
topical antimicrobials
fragrances
preservatives

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

describe rash associated w. allergic contact dermatitis

A

discrete red papules w. scaling edges

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

tx for allergic contact dermatitis (3)

A

topical steroids x 2-3 weeks
> 20% skin involvement: systemic steroids
antihistamines

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

mc source of epistaxis: anterior vs posterior

A

anterior: kiesselbach plexus
posterior: sphenopalatine a

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

tx for anterior nosebleed

A
  1. direct pressure
  2. oxymetazoline
  3. silver nitrate cautery
  4. packing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

abrupt onset of severe HA, photophobia, vomiting, diarrhea, myalgia
PLUS
blanchable maculopapular reuption on palms/soles

A

RMSF (rickettsia rickettsii)

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

tx for RMSF for everyone, even kiddos

A

doxy…

always… don’t even think about anything else

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

similar to croup, but more toxic appearing

A

bacterial tracheitis

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

pathogen mc associated w. bacterial tracheitis

A

s. aureus

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

common presentation of bacterial tracheitis (7)

A

younger kid
fever
barking cough
stridor
rapid progression
pseudomembrane
mucopurulent secretions

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

management of bacterial tracheitis (4)

A

airway emergency
IV abx
IVF
bronchoscopy

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

indications for emergent care w. croup (4)

A

marked retractions
significant resp distress
stridor at rest
repeated doses of dex/epi

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

indicaton for dex/racemic epi for croup (3)

A

frequent barking cough
stridor at rest
mild-mod retractions

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

mc type of chronic obstructive airway dz

A

bronchiectasis

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

bronchiectasis makes you think of what pediatric pop

A

CF

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

common presentation of bronchiectasis

A

chronic cough w. foul smelling sputum
hemoptysis
repeated resp infxns
crackles/wheezing
CF

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

dx for bronchiectasis

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is this showing

A

tram track appearance -> thickened bronchial walls -> bronchiectasis

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

3 CT findings of bronchiectasis

A

tram tracking
signet-ring sign (jewel on the ring)
tree in bud (air trapping)

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

BMI should be used in peds starting at what age

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

overweight/obese BMI parameters for >/= 2 yo

A

overweight: 85-94th %ile
obese: >/= 95th %ile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

how to evaluate obesity in kids < 2 yo

A

height for weight
overweight: >/= 95th %ile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

presentation of SSSS

A

-fever, prodrome, rash w. peeling skin
-erythroderma, large, flaccid bullae, desquamation

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

t/f: nikolsky sign is positive w. SSSS

A

t!

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

thick perioral crusting w. dried oatmeal appearance

A

hallmark of SSSS

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

first line tx for SSSS

A

nafcilin
oxacillin

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

pathogenesis of osgood schlatter dz

A

repetitive strain at the tibial tubercle apophysis

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

common presentation of osgood schlatter (3)

A

10-15 yo athlete
knee pain while running
tenderness over tibial tubercle

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

describe paraphimosis

A

swollen glans penis w. a constricting band just proximal to the corona

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

mcc of death and disability due to child abuse

A

abusive head trauma

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

moi for abusive head trauma (2)

A

blunt trauma
shaking

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

5 red flags for abusive head trauma

A

-lethargic
-difficulty breathing
-sz
-moi inappropriate for age (ex 9 mo old climbing out of crib)
-self inflicted injury

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

parental rf for abuse (5)

A

substance use
psych illness
young parents
single parents
victims of abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

4 rf in kids for abuse

A

mental/physical disability
ftt
chronic illness
prematurity

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

_ is found in most peds who are victims of abusive head trauma

A

retinal hemorrhages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

t/f: the severity of retinal hemorrhages correlates w. likelihood of abuse

A

t!

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

knee pain in a rapidly growing adolescent

A

osgood schlatter

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

scarlet fever/scarlatina triad

A

cirumoral pallor
strawberry tongue
pastia lines

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

what is this showing

A

pastia lines -> scarlet fever

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

scarlet fever is caused by

A

strep pyogenes

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

what type of rash is associated w. scarlet fever

A

sandpaper

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

2 complications of scarlet fever

A

PSGN
rheumatic fever

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

what med reduces fetus mortality/morbidity in hyaline membrane dz

A

dexamethasone

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

3 core features of anorexia

A

restriction -> low body weight
intense fear of gaining wt -> behavior mods
disturbance in body image

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

pathophys of refeeding syndrome

A

high BG -> high insulin -> increased cellular reuptake of phosphate -> hypophosphatemia

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

sx of refeeding syndrome

A

hypophosphatemia
hypokalemia
thiamine deficiency
HF
peripheral edema

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

5 types of erythema rashes

A

multiforme -> target
marginatum -> central clearing
nodosum -> nodules
migrans -> bull’s eye
infectiousum -> slapped cheek

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

erythema multiforme is associated w. (3)

A

infectious
meds
AI

99
Q

erythema marginatum is associataed w.

A

rheumatic fever

100
Q

erythema migrans is pathognomonic for

A

lyme dz

101
Q

erythema infectiousum is associated w.

A

parvovirus

102
Q

common drugs that cause erythema multiforme

A

SOAPS:
sulfa
oral hypoglycemics
anticonvulsants
pcn
nsaids

103
Q

mcc of erythema multiforme

A

HSV

104
Q

erythema multiforme minor vs major

A

minor: localized w/ minimal/no mucosal involvement
major: one or more mm involved

105
Q

estimating infant burn BSA

A
106
Q

estimating child burns BSA

A
107
Q

dx criteria for kawasaki

A

fever >/= 5 days
PLUS
4/5 CRASH:
conjunctivitis
rash
adenopathy
strawberry tongue
hand/foot edema

108
Q

tx for kawasaki

A

IVIG
PLUS
asa

109
Q

mc complications of varicella (chickenpox)

A
  1. bacterial skin infxn
  2. pneumonitis
  3. encephalitis
110
Q

acyclovir can be used for varicella starting at age

A

> 12 yo

111
Q

HOCM is autosomal _

A

dominant

112
Q

describe HOCM murmur (3)

A

crescendo-decrescendo systolic
increases: valsalva
decreases: squatting

113
Q

pharm for high risk HOCM pt’s (2)

A

bb
ccb

114
Q

what murmurs increase w. inspiration

A

right sided:
tricuspid stenosis
pulmonary regurg

115
Q

what is this showing

A

preseptal cellulitis
same same preorbital cellulitis

116
Q

how to differentiate periorbital/preseptal cellulitis from orbital/septal cellulitis

A

preseptal does NOT involve the globe

117
Q

tx for preseptal cellulitis

A

bactrim vs clinda
PLUS
amoxicillin vs augmentin vs cefpodoxime

118
Q

mc route of infxn for preseptal/septal cellulitis

A

ethmoid sinuses

119
Q

what is this showing

A

lichen planus

120
Q

4 p’s of lichen planus

A

pruritic
purple
polygonal
papules

121
Q

colarette scale

A

pityriasis rosea

122
Q

where does lichen planus mc present (2)

A

ankles
wrists

123
Q

wickham striae

A

white lines in rash -> lichen planus

124
Q

tx for lichen planus

A

steroids

125
Q

5 precipitating factors for DKA

A

infxn
nonadherence to insulin
MI
cocaine
SGLT2 inhibitors

126
Q

dx criteria for dka (3)

A

BG > 250
anion gap metabolic acidosis
positive urine and plamsa ketones

127
Q

2 lab findings of DKA

A

venous pH < 7.3
bicarb < 15

128
Q

management of DKA

A
  1. NS
  2. add dex once BG < 200
  3. replenish K+
  4. IV insulin until anion gap closes
  5. subq insulin 2 hr prior to stoppin IV insulin
129
Q

contraindication for IV insulin w. DKA

A

K + < 3.3

130
Q

5 rf for AOM

A

viral URI
fam hx
daycare
tobacco smoke exposure
pacifier use

131
Q

known protective factor for AOM

A

bf’ing

132
Q

tx for AOM + TM perf

A

oral amoxicillin vs augmentin

133
Q

mcc of intestinal obstruction in infants btw 6-36 mo old

A

intussusception

134
Q

tx for intussusception

A

air or hydrostatic (contrast vs saline) enema

135
Q

3 stages of lyme dz

A
  1. erythema migrans (viral prodrome)
  2. myocarditis, bilat bells palsy
  3. chronic arthritis, chronic encephalopathy
136
Q

tx for lyme dz in peds

A

amoxicillin vs doxy (if used < 21 days)

137
Q

2 pathognomonics for lyme

A

erythema migrans
bilat facial nerve palsy

138
Q

scoliosis is caused by an idiopathic _ curvature of the spine

A

lateral

139
Q

tx for scoliosis

A

cobb angle < 20: obs
cobb angle 20-49: bracing
cobb angle >/= 50: surgery

140
Q

describe erythema multiforme

A

-target like rash
-central dark papule surrounded by a pale area and a halo of erythema

141
Q

3 hallmarks of congenital toxoplasmosis

A

chorioetinitis
hydrocephalus
intracranial calcifications

142
Q

prevention of congenital toxoplasmosis (3)

A

no raw/undercooked meat
wash f/v
do not change cat litter

143
Q

tx for congenital toxoplasmosis

A

pyrimethamine
PLUS
sulfadiazine
PLUS
leucovorin

for baby and mom

144
Q

rash that begins after a fever resolves

A

roseola infantum

145
Q

blanching macular or maculopapular rash w. a distribution at the neck and trunk region that spreads to the face/extremities

A

roseola

146
Q

pathogen associated w. peritonsillar abscess

A
  1. GAS
  2. s. aureus
147
Q

5 characteristics of innocent murmurs

A

grade </= 2 intensity
relieved when supine
short systolic
minimal radiation
musical/vibratory

148
Q

murmurs w. </= 2 intensity can be described as (2)

A

still
flow

149
Q

what med when taken during pregnancy is associated w. pyloric stenosis

A

erythromycin

150
Q

reduction of nursemaid’s elbow (2)

A

hyperpronate
vs
supinate-flex

151
Q

flu vaccination recs

A

> /= 6 mos: annually
6 mos - 8 yo: 2 doses for first season of vaccination

152
Q

dx of vitamin D deficiency is made through what test

A

25OHD (serum 25-hydroxyvitamin D) < 12

153
Q

tx of vitamin D deficiency in kids > 12 mo old

A

initial: vit D 50 mcg qd x at least 6 weeks
maintenance: 600-1,000 IU qd

154
Q

dx criteria for CF

A

clinical features
PLUS
elevated sweat chloride > 60

155
Q

dx criteria for systemic juvenile idiopathic arthritis

A

persistent, unexplained arthritis in >/= 1 joint x 6 weeks in kid < 16 yo

fever x at least 2 weeks

156
Q

which juvenile arthritis is associated w. uveitis

A

oligoarticular

157
Q

describe the rash associated w. systemic juvenile idiopathic arthritis

A

salmon colored
transient w. fever
evanescent

158
Q

what does quotidian fever + joint pain make you think of

A

systemic juvenile idiopathic arthritis

159
Q

complication of systemic juvenile idiopathic arthritis

A

macrophage activation syndrome

160
Q

common complication of influenza

A

AOM

161
Q

infants should double their birthweight in _ mos,
and triple their birthweight in _ mos

A

double: 4 mos
triple: 12 mos

162
Q

when should the modified checklist for autism in toddlers (MCHAT) be administered

A

18 mos
24 mos

moderate risk kids should get second stage of questionaire

163
Q

what are the two autism screening tools to know

A

MCHAT: 18 mos, 24 mos
developmental behavior checklist: 4-18 yo WITH disabilities

164
Q

when should PHQ be used in kids

A

> /= 12 yo

165
Q

when is the pediatric symptom checklist used

A

3-18 yo
identifies emotional/behavioral probs

166
Q

describe uticaria

A

raised, erythematous plaques

167
Q

uticaria is _ cell mediated rxn to an allergen

A

IgE

168
Q

when would you use steroids for uticaria

A

if associated w. angioedema

169
Q

pansystolic murmur best heard at the LSB in the 3rd/4th ICS

A

VSD

170
Q

tx for VSD

A

most close spontaneously by adulthood

171
Q

pathogens associated w. bacterial endocarditis: R vs L

A

R: s. aureus
L: strep viridans, s. aureus

172
Q

what is this showing

A

blotchy, erythematous patches w. central pustules -> erythema toxicum neonatorum

173
Q

dx for erythema toxicum neonatorum

A

wright-stained smear showing numerous eosinophils

174
Q

white papules on neonates caused by retention of keratin and sebaceous material in pilosebaceous follicles

A

milia

175
Q

what increases the murmur heard w. VSD

A

increases: hand gripping/squatting

176
Q

malignant otitis externa is caused by

A

pseudomonas

177
Q

resolution of reflexes:
moro:
palmar grasp:
rooting:
parachute:

A

rooting: 2-3 mos
palmar grasp: 3-4 mos
moro: 3-6 mos
parachute: persists throughout life

178
Q

infant is held upright w. back to examiner - body is rotate quickly forward as if falling - infant reflexively extends upper extremities towards the ground as if to break a fall

A

parachute reflex

179
Q

prominent LAD plus cephalocaudal spreading rash

A

rubella

180
Q

rash, microcephaly, IUGR, heaptosplenomegaly

A

congenital CMV

181
Q

sensorineural hearing loss, periventricular calcifications, blueberry muffin rash

A

congenital CMV

182
Q

what is this showing

A

thrombocytopenia, petechiae, purpura -> blueberry muffin rash -> congenital CMV

183
Q

3 complications of congenital rubella

A

senosirneural hearing loss
heart dz
congenital cataract

184
Q

what is this showing

A

wilms tumor

185
Q

describe wilms tumor

A

hard, round, smooth, nontender mass that does not cross midline

186
Q

what 3 congenital abnl’s are associated w. wilms tumor

A

WAGR
denys-drash syndrome
beckwith-wiedemann syndrome

187
Q

age range associated w. wilms tumor

A

< 15 yo

188
Q

<15 yo kid w. abd pain, anorexia, abd distension, vomiting, hematuria

A

wilms tumor

189
Q

mc solid kidney tumor of childhood

A

wilms tumor

190
Q

newborns shold pass meconium w.in

A

48 hr

191
Q

by what age should kids have a daily BM

A

3 yo

192
Q

absent stool in vault makes you think

A

hirschprung

193
Q

common presentation of functional constipation (4)

A

toilet training
stool withholding behaviors
painful BM
large bulky stool

194
Q

tx for functional constipation (3)

A

osmotic laxatives: polyethylene glycol, lactulose
stimulants: senna, bisacodyl
stool softeners: docusate

195
Q

t/f: fleet enema is contraindicated in infants

A

t!

due to hypocalcemia

196
Q

fever followed by rash =

A

roseola

why can’t i remember this

197
Q

tx for varicella

A

< 12 yo: supportive
immunocompromised OR > 12 yo: acyclovir

198
Q

mc pna pathogen by age

A

0-3 wk: GBS, e.coli, listeria, s.aureus
3wk-3 mos: chlamydia trachomatis
1 mo-5 yo: RSV
6-8 yo: mycoplasma pna

199
Q

early s/sx of autisim

A

-parental concerns about social skills/language/behavior/tantrums/intolerance to change
-delayed language/communication skills
-no babbling by 9 mos
-no pointing/gestures by 12 mos
-lack of orientation to name by 12 mos
-no single words by 16 mos
-lack of pretend/symbolic play by 18 mos
-no spontaneous/meaningful 2 word phrases by 24 mos
-any loss of language/social skills at any age

200
Q

2 screenings recommended in pt w. suspected autism or developmental delay

A

audiologic
lead

201
Q

mcc of anemia in infants btw 6-9 weeks old

A

physiologic anemia

202
Q

suspect _ toxicity in victims of industrial fires

A

CN

203
Q

describe parotitis associated w. mumps

A

unilateral parotid swelling and tenderness that becomes bilateral

204
Q

physical characteristics of fanconi anemia (8)

A

absent or hypoplastic thumb
short stature
low set ears
deafness
strabismus
skin hyper vs hypopigmentation
cafe au lait spots
kidney abnl

205
Q

lab findings of fanconi anemia

A

macrocytic anemia
elevatee fetal Hgb

206
Q

mc form of inherited aplastic anemia

A

fanconi anemia

207
Q

what is this showing

A

SJS

208
Q

drugs associated w. SJS

A

sulfas
antiepileptics
allopurinol
nsaids

209
Q

prodrom of SJS (4)

A

cutaneous lesions
mucosal lesions
urethritis
flu-like

210
Q

h/o recent viral infxn
non-blanching petechiae/purpura
gingival bleeding
thrombocytopenia

A

primary immune thrombocytopenia

211
Q

tx for primary immune thrombocytopenia (4)

A

activity restriction
obs
glucocorticoids + IVIG
severe: IV anti-D

212
Q

what med exacerbates hypercalcemia

A

hctz

213
Q

hallmark hpi clue for rubella

A

child born to mom who immigrated

214
Q

mc congenital anomaly of the GIT

A

meckel diverticulum

215
Q

incomplete obliteration of the omphalomesenteric (vitelline) duct during the 7th week of gestation

A

meckel diverticulum

216
Q

gs dx for meckel diverticulum

A

technetium scan

217
Q

rule of 2’s for meckel diverticulum (5)

A

2 yo
2 ft from ileocecal valve
2” long
2% of population
2 epithelial types (gastric vs pancreatic)

218
Q

presentation of meckel diveritculum

A

< 5 yo
painless rectal bleeding

219
Q

APGAR score

A
220
Q

when is apgar calculated

A

1 and 5 min after birth

221
Q

HPV vaccination schedule

A

9-14 yo: 2 doses -> 0, 6-12 mo
15-45 yo: 3 does -> 0, 2, 6 mo

222
Q

moa for ethosuximide

A

inhibits firing patterns by binding to t-type voltage sensitive calcium channels that mediate the entry of calcium ions into excitable cells

223
Q

only oral DM med approved for kiddos

A

metformin

224
Q

moa for metformin

A

-decreases hepatic glucose production and intestinal glucose absorption
-increases insulin sensitivity

225
Q

moa for fetal coarctation of the aorta in utero

A

blood flow thru the PDA bypasses aortic coarctation -> results in hemodynamic instablity

226
Q

2 rf for cryptochordism

A

low birth weight
prematurity

227
Q

indications for emergent surgery w. inguinal hernias (4)

A

toxic
peritonitis
intestinal obstruction
gangrenous bowel

otherwise try to manually reduce

228
Q

rapid fire repetitive coughing followed by an inspiratory stridor and post tussive emesis

A

pertussis

229
Q

indications for emergent hospitalization w. suicidal ideations (4)

A

having a plan
expressing imminent intent for self harm
access to planned means to attempt suicide
inability to contract for safety

230
Q

rf for suicide

A

sad persons:
sex - male
age - teenage vs >/= 45
dpn
previous attempt
ethanol or drugs
rational thinking loss
social support lacking
organized plan
no spouse
sickness

231
Q

2 protective factors against suicide

A

marriage
pregnancy

232
Q

most completed suicides involve what means

A

firearms

233
Q

hearing screening test for kids 4-21 yo (3)

A

pure tone audiometry
OAE testing
tympanometry

one at every WCC

234
Q

all infants w. sensorineural hearing loss should be tested for

A

cmv

235
Q

what PE test for hip dysplasia shows uneven knee heights

A

galeazzi

236
Q

3 indications for US at 4-6 weeks to evaluate for hip dysplasia

A

breech at > 34 weeks
FH DDH
hx clinical instability on exam

237
Q

mcc of developmental hip dysplasia

A

decreased pressure of femoral head against acetabulum -> shallow socket

238
Q

tx for otitis conjunctivitis syndrome

A

augmentin

239
Q

tx for cystitis in kiddos

A
  1. cephalosporins
  2. bactrim if pcn allergy
240
Q

tx for enterobiasis/pinworm

A

albendazole

241
Q

tx for poison ivy dermatitis

A

clobetasol propionate 0.05% ointment bid x 14 days

low dose topical steroids won’t work

242
Q

4 mc agents associated w. allergic contact dermatitis

A

nickel
poison ivy
soaps
neomycin

243
Q

5 irritants mc associated w. irritant contact dermatitis

A

water
detergents
solvents
acids
alkali

244
Q

lab value associated w. adult RA, but rarely seen in idiopathic juvenile arthritis

A

RF