U-World 1 Flashcards
Who should get tested for GC
All sexually active women 24 and younger
Best GC test
Nucleic acid amplification test
What is social communication disorder
Impaired communication without evidence of restricted interests or repetitive
Electrolytes in 21-hydroxlyase def
Hypotension, hyponatremia, hyperkalemia
Croup presentation
Children younger than 3 years with hoarseness, barking cough, and respiratory distress
What do you suspect in a young boy with gout
Lesch-Nyhan
Rotavirus vaccine contraindications
Hx of intussusception
Hx of uncorrected congenital GI tract issue
SCID or anaphylaxis to vaccine ingredients
MCC of gastroenteritis in infants and young children worldwide
Anaphylaxis
Respiratory distress syndrome CXXR
diffuse, fine reticular granularity and perihilar linear opacities bilaterally
Milk protein enterocolitis presentation
Severe reflux or vomiting and/or painless bloody stools
some may need hydrolyzed formula
Marfan’s mutation? most life threatening finding
AD fibrillin-1 gene
Aortic route dilation is most life treating finding
What is osmotic fragility test
For Hereditary spherocytosis on acidified glycerol lysis test
Triad of spherocytosis
Coombs neg hemolytic anemia, jaundice, and splenomegaly
T and B lymphocyte cell markers? Brutons is low in? Tx?
T is CD3, B is CD 19 (low in bruton’s)
Tx is IVIG
Why are CF patients infertile
Congenital bilateral absence of vas deferens –> accumulation of inspissated music in fetal genital tract obstructs
Classic triad of brain abscess
Fever, severe headaches (morning or nocturnal) and focal neurologic changes
2 risks for increased brain abscesses in kids
Cyanotic congenital heart disease
Recurrent sinusitis
RSV prophylaxis med
Palivizumab
Infants with bronchiolitis lung sounds? cause? risk?
Wheezing and crackles (and URI symptoms)
Usually RSV
Risk is apnea and respiratory failure
Serum sickness like reaction features
Fever, urticaria and polyarthralgia 1-2 weeks after first exposure
NO mucosal involvement
Why is contrast in a head CT looking for injury bad
Can appear white and look like acute blood
First step if epiglottitis is highly suspected
Take PT to or to be able to ensure patients airway (if patients seem to be unstable)
Two most common complications of sickle cell trait
Hematuria
Isosthenuria (impairment of concentrating ability –> nocturia and polyuria)
Things that decrease preload
Valsalva
Abrupt standing
Nitroglycerin
Heart exam of HCM
Carotid pulse with a dual upstroke due to mid systolic obstruction during cardiac concentration
Next step after vaginal foreign body found in young girl
Removal with calcium alginate swab or irrigation with warm fluid after topical anesthetic has been applied
Neonatal abstinence syndrome features? Tx?
Irritability, high pitched cry, poor sleeping, sweating, poor feeding
Tx: Morphine given and slowly weaned
Chronic granulomatous disease defect
Defect of phagocytic cells due to dysfunction of NADPH oxidase
Infections w/ catalase pos organisms (S. aureus, serrate, klebsiella)
CGD test
Nitroblue tetrazolium slide test or cytochrome C reduction
Hallmark of leukocyte adhesion defect
Neutrophilic without polymorphs in the infected tissue or pus
Delayed separation of the umbilical chord
Glucose 6 phosphatase def features
3-4 months of age with hypoglycemia, lactic acidosis, hyperuricemia and hyperlipidemia
-Doll like face, think extremities, protuberant abdomen
Pompe’s disease def and features
Acid maltase - hepatomegaly and heart failure with floppy baby
Niemann-Pick vs Tay-Sachs
NP: Sphingomyelinase def, hepatosplenomegaly and areflexia
TS: B-hexosamindiase A def hyperreflexia
What causes gynecomastia in young teenage boys? mgmt?
Transiently increased estrogen
Tx is reassurance, as most will resolve
can be unilateral, seen up to 2/3 boys
Gynecomastia in what syndrome increases risk of breast Ca
Klinefelters
Pink stains in neonatal diapers is
Uric acid crystals - high at birth and decreases until adolescence
Asymptomatic scattered erythematous macules and papules all over body in neonate is? tx?
Erythema toxic neoatorum
Tx is none, resolves on own within 2 weeks after birth
Not on palms and soles
JONES criteria
J- joints (migratory arthritis)
Next step if screening capillary lead level is >5
Confirmatory venous lead levels
What do you give for lead levels 45-69
DMSA
EDTA for > 70
What bone tumor pain is typical relieved by NSAIDs
Osteoid osteoma
Pt’s w/ hx of rheumatic fever should get what
Continuous penicillin prophylaxis
Primary predisposing factor for volvulus in children
Malrotation
Presentation of midgut volvulus in neonate
Bilious vomiting
Gold standard for malrotation dx
Upper GI contrast study
What is the most common GI anomaly and should be suspected in kids w/ recurrent intussusception
Meckel’s diverticulum
What patients should you suspect inspissated stool
CF
1st and 2nd line OM drugs
1: Amoxicillin (10 days)
2: Amox-clavulanic acid
Bilateral congenital deafness kids, worry about?
Congenital long QT syndrome
Pathognomonic radiologic finding for NEC
Pneumatosis intestinalis –> extravasation of bowel gas into damaged bowel wall
When should NEC be suspected? Risk factors?
Newborn with feeding intolerance, abdominal distention, and bloody stools
Risks: prematurity, hypotension, and congenital heart disease
Cause of hyper-IGM
X-linked defect in CD40 ligand
Why high risk of osteoporosis in turners
45 XO leads to lower levels of estrogen
Features of benign murmers in kids
Changes in position (esp dec w/ dec preload)
Early or mid-systolic in timing
Gold standard for dx of MD
Genetic studies
What causes long bleeding in CF? what factors affected
Vit K def (Factors II, VII, IX, and X)
Also C and S
Topical erythromycin vs oral for conjunctivitis in neonates
Topical for gonococcal ppx
Oral for chlamydial infection (5-14 days)
Blood stained eye discharge in neonate highly characteristic of
Chlamydial conjunctivitis
Guillab Barre pathophys
Demyelination of perisperhal motor nerves
Breastfeeding failure jaundice vs breast milk jaundice
Failure in first week, lactation failure causes decreased bilirubin elimination and baby will show signs of dehydration
Breast milk peaks at 2 weeks, high levels of B-glucuronidase in breast milk deconjugate bilirubin
Normal breast feeding schedule
15 minutes per side every 2-3 hours
MCC or acquired torticollis
URI, minor trauma, and cervical lymphadenitis
CXR is first step
Most common intraosseous line site
proximal tibia
2 MCC of neonatal sepsis
GBS and E. coli
non neoplastic cause of single lytic long bone lesion with overlying hypercalcemia and swelling in a child
Langerhan’s cell histiocytosis
Complications of severe vesicoureteral reflux? Def dx?
Parenchymal scarring, HTN, and renal insufficiency
Def dx by voiding cystourethrogram
Turner syndrome heart defect
Bicuspid aortic valve
also coarctation
Increasing head circumference and signs of increased ICP in children should be evaluated with?
CT brain
2 diseases where Reys syndrome can be seen
Influenza or varicella
What should prompt UTI evaluation in any child under 3
Fever > 39 C (102.2)
What are mongolian spots
Flat patches that look like bruises on back and butt that fades during first decade of life
Brutons agammaglobulinemia defect? Why does it take 6 months to present
Tyrosine kinase in B cells
Maternal IgG works for first 6 months
3 reasons babies normally jaundices
- Hct high with shorter life span and higher turnover
- Decreased UGT (esp asians)
- Sterile newborn gut that can’t break down bilirubin
DMD vs BMD age of onset
DMD age 2-3
BMD 5-15
Central precocious puberty caused by? tx?
Early activation of HPA axis
high FSH and LH
Tx w/ GnRH analog
What causes thrombocytopenia in WAS
Decreased platelet production
Few platelets seen are small
MC elbow fracture in kids? Xray of it?
Supracondular humerus fracture
X-ray will show large triangular anterior fat pad and posterior fat pad
Vitamin shown to reduce morbidity and mortality in measles
Vitamin A
What is Eczema herpeticum
Primary HSV associated with atopic dermatitis
Tx with acyclovir
Most common predisposing factor for orbital cellulitis
Bacterial sinusitis
VSD murmer
holosytolic over the left lower sternal border
Typical innocent flow murmer of childhood
grade I or II mid systolic ejection murmur
What should be suspected in a newborn with cyanosis that is aggravated by feeding and relieved by crying? how to dx?
Choanal atresia
Dx by failing to pass a catheter into the nose is suggestive of, CT for complete
Initial mgmt in children with speech delay
Audiology evaluation
Fluid for severe hypovolemic hyperatremia
Isotonic solutions (0.9% NaCl)
Tx for ITP in children if not bleeding
Observation (regardless of platelet count)
Rubella in children
Low grade fever, tender lymphadenopathy, and rash that spreads cephalocaudally
fever lower than measles and rash is lighter
Dry beriberi presentation
Thiamin def - symmetrical perp with sensory and motor def in distal extremities
Most common pediatric tumor
Astrocytomas
Infratentorial most common
