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Sicular > Sicular day 1 - peds rheum, pulm, nephro,& infx > Flashcards

Sicular day 1 - peds rheum, pulm, nephro,& infx Flashcards

1
Q

super cardiac shadow –> ?

A

Total Anomalous Pulmonary Venous Return

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2
Q

cyanotic baby –> which type of congenital heart deformaties?

A

T’s!

R–> L shunts

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3
Q

Marfans has what type of murmur?

A 
aortic regurgitation (diastolic decrescendo murmur @ sternal border)
sometimes MVP
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4
Q

Diastolic murmurs = (acronym?)

A

ARMS
AR = Aortic Regurg
MS = Mitral Stenosis

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5
Q

Pansystolic apical murmur radiating to the axilla = ?

A

Mitral regurg

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6
Q

strawberry tounge = (2)?

A
  • Kawasaki

- Scarlet fever

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7
Q

Palms and Soles rash = diff dx(6)?

A
  • kawasaki
  • Syphillis (stage 2)
  • Rocky mountain spotted fever
  • Coxsackie
  • Strep + Staph –> toxic shock
  • Neisseria meningitis + gonnerhea
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8
Q

Kawaski monitoring forward?

A

Echo looking for artery aneurysms

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9
Q

Kawasaki treat?

A

IVIG + Aspirin

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10
Q

“Tibial tuberosity” - think what?

A

Osgood Schlatters

- can also be called osteochondritis

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11
Q

Best test to confirm Duchenne dx?

A

PCR DNA testing (specific)

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12
Q

confirm = think?

A

Specificity (look for specificity answers)

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13
Q

lacy redness cheeks = think?

A

Parvo B19 (esp preg women or kids)

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14
Q

Parvo B19 risky for those w/?

A
  • Hereditary spherocytosis
  • Sickle Cell Disease

*Things that cause anemia already will be worsened byt the virus

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15
Q

kid, joint problem, has Ab –> think?

A

serological spondoarthropathies

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16
Q

Most appropriate screening test to prevent morbidity from disease in JIA?

A

Slit lamp exam! (screen for uveitis)

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17
Q

screening = think?

A

Less invasive, sensitive test

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18
Q

most specific test lupus

A

Serum anti-ds DNA Ab

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19
Q

Shallow ulcers in nose =diff dx (4)?

A
  • Cocaine/drug abuse
  • Lupus
  • Behcet
  • Wegners

*Autoimmune disease v illegal drugs

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20
Q

reasons for dialysis = ?

A
  • High potassium (esp >6)

-

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21
Q

Plasmapheresis used for what hemolytic issue?

A

TTP

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22
Q

Kids with leg pain = diff dx?

A
  • Growth pains (bilateral, at night)
  • Osteoid Osteoma (unilateral, at night, aspirin relief)
  • Cancer (day pain)
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23
Q

next step = think?

A

Sensitive test, initial test

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24
Q

Best step = think?

A

Specific, confirmatory test

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25
Q

next, best step = think?

A

Next wins –> sensitive, initial test

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26
Q

WBC >50,000 in joint aspiration = think?

A

septic arthritis

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27
Q

painful joint w/ fever and high WBC joint aspiration = think?

A

septic arthritis

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28
Q

upward lens displacement/subluxation = ?

A

Marfans! (defect in fibrillin gene)

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29
Q

Adams test = is? and for what?

A

Adams test is a forward bend test to see if hips are level or not
Good Screen for scoliosis

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30
Q

minute long coughing spells = think?

A

pertussiss

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31
Q

What organism gives you a significant pulmonary xray with high lymphocytes + non-productive cough?

A

Mycoplasma!!! –> atypical walking pneumonia

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32
Q

Treat mycoplasma with what?

A

Macrolides!

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33
Q

pt allergic to penicillin and has strep, treat w/ what?

A

Erythromycin

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34
Q

Diaphragmatic Hernia steps in emergent treatment?

A
  • NG tube
  • Intubate
  • Surgery

*don’t bag mask ventilate

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35
Q

Newborn w/ breathing difficulties main two causes?

A
  • Transient Tachypnea of Newborn

- Respiratory Distress Syndrome

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36
Q

Fissural fluid in newborn w/ breathing difficulties = think?

A

Transient Tachypnea of Newborn

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37
Q

Transient Tachypnea of Newborn can be related to?

A

Delayed resorption of fetal lung fluid

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38
Q

Term breakdown of breathing difficulties? (pre, full, Post)

A

Preterm - RDS
Full term - TTN
Postterm - Meconium aspiration

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39
Q

horizontal crease over nasal bridge w/ clear rhinorrhea = think?

A

Allergies!!!

- crease b/c sneezing so often

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40
Q

Allergy treatment based on mild, moderate, or severe?

A

mild - antihistamine
mod - intranasal steroids
severe - oral steroids

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41
Q

Asthma treatment based on mild, moderate, or severe?

A

mild - bronchodilators
mod - inhaled steroids
severe - oral steroids

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42
Q

OSA treatment for adult, steps ?

A

1) CPAP

2) Surgery (uvulopalatopharyngoplasty)

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43
Q

OSA treatment for kids, steps?

A

1) Surgery (adenotonsillectomy)

2) CPAP

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44
Q

when you treat strep throat what complication may still arise?

A

Glomerulonephritis

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45
Q

inspiratory stridor = diff dx?

A
  • Laryngomalacia (neonate/newborn)
  • Croup (HAS COUGH, infectious indications, 1-3yo, aka Acute laryngotracheobronchitis, steeple sign)
  • Aspiration of foreign body (1-2yo, no other infx symp)
  • Epiglottitis (drooling, thumb print sign, unimmunized)
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46
Q

If need to give fast dose of penicillin what do you give?

A

Single dose Benzathine Penicillin G intramuscularly

oral is multi day, procaine PN multiple IM doses

47
Q

crying breathing improves in neonate = think?

A

choanal atresia

48
Q

2 ways to test for choanal atresia are?

A
  • Insert catheter through nose (initial dx)

- CT scan w/ contrast of the head (confirm dx)

49
Q

Bronchiectasis = diff dx?

A
  • Cystic Fibrosis
  • Primary ciliary dyskinesia (Kartagener’s)
  • Allergic bronchopulmonary aspergillosis
50
Q

Bronchiectasis, failure to thrive, repeat infx = think?

A

Cystic Fibrosis

51
Q

Tests for cystic fibrosis (screening, confirmatory)?

A 
Screening = sweat test
Confirmatory = DNA
52
Q

Avoid what exam in epiglottitis?

A

Examining oropharynx – finger in passage can make worse.

53
Q

Dystrophin found where?

A

plasma membrane on muscle fibers

54
Q

choanal atresia, low set ears, cruptorchidism, b/l optic disc clefts = think?

A

CHARGE syndrome

55
Q

Chonal atresia associated w/ ?

A

CHARGE syndrome

56
Q

CHARGE syndrome =?

A 
C
H
A
R
G
E
57
Q

Ataxia telangiectasia would have absence of what Ig?

A

low IgA and IgE

58
Q

Wiskot Aldrich syndrome has what issues with Ig?

A

High IgA and IgE

59
Q

Ataxia telangiectasia and Wiskot aldrich are opposites how?

A

AT - LOW IgA and IgE

WA - HIGH IgA and IgE

60
Q

Preme issues by system?

A

GI - think NEC
Pulm - think RSD
Eyes - think retinopathy of prematurity
Brain - think Germinal matrix hemorrhage

61
Q

Child abuse steps?

A

1) Dx labs - CT scan, skeletal survey, CBC, Chem panel, fundoscopy, coag studies. – NEED TO PROVE
2) Immediate hospitalization
3) Report to Child Protection Services

62
Q

Gaucher Disease = clinical findings?

A

…

63
Q

Enlarged liver and spleen, osteopenia of vertebral bodies, undertubulation (flaring) of distal femurs = think?

A

Gaucher disease

64
Q

Flaring of femurs (erlenmyer flask flaring of femur) = think?

A

Gaucher disease

65
Q

Neimann-Pick disease = classic finding?

A

cherry red spot on macula

66
Q

Hunter disease = classic finding?

A

Cataract

67
Q

CP patients are at an inc risk of dev what?

A
  • Constipation
  • Contractures
  • Urinary retention
68
Q

Fetal alcohol syndrome, distinguishing feature?

A

Dysmorphic facial features

69
Q

Barbituates effect on neonates, distinguishing feature?

A

dec breathing at birth

70
Q

Cocaine vs Opiates in neonates?

A

Both irritable, tremulous, inconsolable, small baby, & high pitched cry

Main difference b/t 2 – Opiates have additional weird symp
Opiates - GI problems (diarrhea), parasympathetic effects (tachycardia), yawning/sneezing a lot, tired

71
Q

39wkr born to mom w/ DM, hypOthyroid, cocaine use found to have neural tube defect, heart murmur, rib & vertebral column malformations, low-set ears – Cause?

A

DM I/II (not gestational)
heart - transposon defect
spinal - sacral agenesis, other neural tube + vertebral defects

72
Q

Mom w/ hypothyroidism effects or doesn’t effect baby?

A

DOESN’T bc baby has own thyroid

73
Q

Iodine deficiency in utero –> ?

A
  • criatism

- Mental retardation, small, umbilical hernia, big tongue, jaundice

74
Q

Fragile X carriers can or cannot present w/ disease (ie girl)?

A

YES! Women can have even just as carriers bc can have skewed X inactivation –> nL X inactivated –> defective X causes disease

75
Q

Confirmatory test for lisch-nyhan?

A

HPRT enzyme level

76
Q

neurofibromatosis type I pneumonic =?

A

CaFe O’Lait Spots!

Ca- cafe o'lait spots
Fe - Freckles 
O - Optic gliomas
La - Lish nodules
Sp - Sphynoid displasia
77
Q

Tuberous sclerosis has what classic finding?

A

Ash-Leaf Spot (pale spots – find w/ black light)

78
Q

Sturge Weber classic findings (2)?

A
  • Port wine stain

- Cerebral calcifications

79
Q

Neck things in kids = (4)?

A
  • Torticollis (muscle hypertrophy pull head to one side)
  • Cystic hygroma (fluid dense, associated w/ turner’s syndrome)
  • Branchial cleft cyst (lateral fluid dense structure next to sternoclidomastoid m.)
  • Thyroglossal duct cyst (midline fluid dense structure)
80
Q

maximal impulse felt on the RIGHT side = think?

A

primary dyskinesia (Kartagener’s)

81
Q

smiling in neonates when?

A

2mo

82
Q

Laughing in neonates when?

A

4mo

83
Q

Night terrors vs Nightmares?

A

Night terror - don’t remember, moving, stage 4 problem

Nightmare - remembers, REM problem

84
Q

Reyes syndrome =?

A

Aspirin to kids –> reye’s –> effects liver –> elevated ammonia

85
Q

Reye’s syndrome measure what?

A

Serum ammonia level

86
Q

Alport main 2 clinical findings (generally)?

A
  • Kidney issues

- Hearing issues

87
Q

Alport inherted how?

A

X-linked Dominant

88
Q

X-linked dominant (2)?

A
  • Alport Syndrome

- Hyperphosphatemia Ricketts

89
Q

posterior urethral valves in 1st day of life causing urinary retention –> next step management?

A 
Urethral catheter (prevent kidney damage)
after, confirm w/ VCUG
90
Q

retrograde urethrogram for?

A

adults w/ penile trauma

91
Q

primary hyperaldosteronism, electrolytes levels?

A

High Na

Low K

92
Q

Bartter syndrome = ?

A

Idiopathic renin syndrome

93
Q

Abdominal undescended testis –> orchipexy, why?

A

need to palpate to screen for testicular CA

94
Q

kid w/ multiple UTIs –> test w/?

A

U/S of urinary tract + VCUG

95
Q

Wilms tumor associations?

A
  • Beckwith Wederman

- WAGR

96
Q

Wilms tumor caused by?

A

Deletion on chromosome 11

97
Q

Transillumination test –>

A

Just tells you there is fluid there (sensitive)

  • clear = hydrocele
  • bloody = hematocele
  • Could be hernia too
98
Q

hexagonal crystals =?

A

cystine stones

6 sides = 6stine (“sixtine”)

99
Q

micorhematuria in kids –> manage how?

A

Urologic workup starting w/ sonogram

Microhematuria is NOT normal and needs to be followed up (unlike mild proteinuria)

100
Q

musty smelling urine = think?

A

PKU, can’t process phenylalanine

101
Q

minimal change disease, treatment?

A

Prednisone

102
Q

Trichomoniasis testing (confirmatory vs initial)?

A

Initial: vaginal discharge microscopy
Confirmatory: vaginal culture

103
Q

Treat trichomoniasis w/?

A

Metronidazole (for partner too!!!)

104
Q

Most serious complication of varicella?

A

Pneumonia!

105
Q

red crusty patches = think?

A

eczema

106
Q

First line treatment for eczema?

A

cutaneous hydration w/ emollients

107
Q

myringotomy is what?

A

cutting the tympanic membrane to allow fluid out

108
Q

Go to Mexico and now have diarrhea, think?

A
  • E.coli infx

- Entamoeba histolytica infx (abscess in liver)

109
Q

Entomebic infx treat w/?

A

Metronidazole

110
Q

What is metronidazole 1st line for?

A

GET BACk to the METRO

G- gardnerella, giardia
E - entamoeba
T- trichomonis
Ba - bacteroides
C - c diff
111
Q

Dx entamoeba histolytica how?

A

Serum antibody

112
Q

infx –> abx –> skin response, what is it?

A

mild - erythema multiforme (only skin rash)
moderate - Stevens- Johnson (rash + ulcers in mouth)
severe - Toxic epidermal necrolysis (skin falling off + ulcers)

113
Q

Kids w/ rash in diaper area =diff dx (2)?

A

1) candidiasis (creases affected)

2) irritant contact dermatitis (creases unaffected)

114
Q

Absence of thymic shadow = diff dx (2)?

A
  • SCID (absence of B and T cells –> bacterial, viral , & fungal infx)
  • DiGeorge (absence of T cells –> viral & fungal infx)

low B cell –> bacterial infx
low T cells –> viral & fungal infx

Sicular (9 decks)

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