U-World 4 Flashcards
What is refeeeding syndrome
Carbohydrate intake stimulates insulin activity, promoting cellular uptake of PO4, K, and Mg
arrythmias and cardiopulmonary failure
Two things to order when DiGeorge is suspected
Serum calcium levels and Ekg
Hypocalemia from hypoplasia of the parathyroid gland
Children who suffers from selective mutism are
verbal and talkative at home but refuse to speak in specific settings
2 finger vs 3 finger pincer grasp development
3 fingers at 9 months
2 fingers at 1 year
Height and weight in first year
Weight should triple and height should increase by 50%
Complex partial seizure features
Brief episodes of impaired consciousness, failure to respond to stimuli during episodes, starting spells, and post-ictal confusion
Next step in girl with primary amenorrhea if FSH is decreased
pituitary MRI
Workup for all children with recurrent episodes of nocturnal vulvar itching
Examined for pinworms and treated empirically with mebendazole
HSP leads to increased risk of
ileo-ileal intussusception
Chronic constipation is a risk factor for what in toddlers
Recurrent cystitis
Treatment of clubfoot
Stretching and manipulation of the foot followed by serial casts
Pertussis ppx for contacts of sick
Macrolides (only azithro for those under 1 month)
KUB for jejunal atresia
‘Triple bubble’ and gasless colon
what is used for CF sweat test
quantitative pilocarpine iontophoresis makes them sweat
Loss of cognitive functions post meningitis due to
Neuronal loss in the dentate gyrus of the hippocampus
Postexposure rabies prophylaxis
Rabies Ig and vaccine
Features of hereditary angioedema
Rapid onset of edema of the face, acral extremities, genitals, trachea, and abdominal organs without urticaria
C1 inhibitor def
Who should get varicella Ig
Immunocompromised hosts who are asymptomatic and non-immune
Most common Ewing’s sarcoma sites
Metaphysis and diaphysis of femur, followed by tibia and humerus
Triad of cardiac tamponade
Distant heart sounds, distended jugular veins (or scalp veins in babies), hypotension
CXR of CHF
Increased pulmonary vascular congestion and interstitial edema
Bone age in centra precocious puberty
Advanced (greater than actual age)
NF1 and NF2 mutations
NF1: Neurofibromin on C 17
NF2: Merlin on C 22
NF1 most common brain tumor
Optic pathway glioma
ADA def results in
SCID (T cell def for viral and fungal issues)
When do patients with genetic B cell def begin to develop recurrent infections
After passing 6 months of age
Lack of what predisposes pt to Giardia
IgA
Gonococcal eye infection tx
IV ceftriaxone
Chlamydial eye infection tx
Oral erythromycin (also good for chlamydia pneumonia)
Def of what leads to Pellagra
Niacin (vit B3)
Diarrhea, dermatitis, dementia
What can riboflavin def cause
Cheilosis, glossitis, seborrheic dermaatitis
How can B6 (cyanocobalamin def) cause thrombosis
By increasing serum homocysteine
2-5 years drawing
2- copies a line
3- copies a circle
4- copes a square
5- copies a triangle
First line Ab class for pertussis
Macrolides
Gold standard for HIV testing from birth to 18 months
PCR
Most viral meningitis cases in kids cause by
Echo and Coxsackievirus
Acid base status of Iron poisoning
Anion-gap metabolic acidosis
Angular cheilosis and glossitis seen with what def? CBC will show?
Riboflavin
CBC will show a normocytic anemia
What does the knee chest position in a Tet spell do
Increases systemic vascular resistance (to overpower pulmonary vascular resistance)
Large VSD murmur
Pansytolic loudest at left lower sternal border and diastolic rumble at the apex due to increased flow across the mitral valve
Pineal gland tumor symptoms
Limited upward gaze, bilateral ptosis, and bilateral lid retraction
Also symptoms of ICP
Congenital hypothyroidism signs
Apathy, hypotonia, large tongue, abdominal bloating, and umbilical hernia
Meconium ileus is virtually diagnostic for? Features of
CF
Obstruction is at the ileum and is inspissated
Drugs for absence seizures
Ethosuximide or valproate
What are growing pains
Bilateral, lower extremity pains that occur at night in children 2-12 years old
Presentation of spherocytosis
Hemolytic anemia, jaundice, and splenomegaly
Spherocytosis mutation
Ankyrin mutation causing spectrin deficiency
Glomerular damage of HSP
Mesangial deposition of IgA
Cat bite tx
5 day course of amoxicillin/clavulanate
What should be done for any child with behavioral concerns
Hearing test
MCC of acute unilateral lymphadenitis? Best tx?
S. aureus, followed by GAS
Clinda is the drug of choice (for MRSA coverage)
Always consider what in any adolescent prescient with significant emotional or school changes
Substance abuse, sexual abuse, and pregnancy
Two big suggesters for retropharyngeal abscess
Inability to extend neck
Widened prevertbral space on X-ray
Retropharyngeal abscess bugs
Polymicrobial
First two steps for newborn with diaphragmatic hernia
Endotracheal intubation
Gastric tube to decompress stomach and bowel
Hep B risk for what renal disease
Membranous nephropathy
Study to evaluate injury in chemical ingestions
Upper GI endoscopy
Two types of breath holding spells? What is often associated with them
Cyanotic- crying followed by breath holding
Pallid- minor trauma followed by LOC
* Iron def anemia often seen with *
What should be suspected in Down syndrome pt’s who present with upper motor neuron findings
Atlantoaxial instability (caused by excessive laxity in posterior transverse ligament)
Dx of fanconis anemia? symptoms
Chromosomal breaks on genetic analysis
Congenital marrow failure, poor growth, macroctyic anemia
abnormal thumbs
First step for workup in neonate with bilious emesis who is stable
Imaging (contrast enema)
Two turners heart defects
Coarctation of aorta
Bicuspid aortic valve
History of trauma to soft palate with foreign body can lead to
Internal carotid artery dissection
In SS, acute severe anemia with low or absent reticulocytes c/w?
Aplastic crisis
Serum labs of RTA? Tx?
low serum HCO3 and hyperchloremia (normal anion gap acidosis)
Tx is oral bicarb replacement
Beckwith-Widedemann syndrome features
Macrosomia, macroglossia, hemihpyerplasia and abdominal wall defects
BWS newborns monitored for?risks later?
Monitored for hypoglycemia
Risk of Wilm’s tumor and hepatoblastoma
Cri-du-chat syndrome mutation
Deletion of 5p
Edwards syndrome features
Microcephaly, prominent occupy, micrognathia, CLOSED FISTS AND ROCKER BOTTOM FEET
Reye’s syndrome liver biopsy
Micro vesicular fatty infiltration and hepatic mitochondrial dysfunction
2 diseases you can see Reye’s with
Aspirin use in setting of influenza or varicella infection
Reye presentation
Vomiting, agitation and irrational behavior progressing to lethargy, stupor,a dn restlessness
3 reasons GERD more common in babies
- Shorter esophagus
- Incomplete closure of LES
- Greater time spent in supine position
Most important step after Guillain-Barre is diagnosed
Spirometry to measure pulmonary function (FVC especially)
CBC of pertussis
Lymphocyte-predominant leukocytosis
What is Diamond-Blackfan syndrome
Microcytic pure red cell aplasia associated with short stature, webbed neck, cleft lip, triangular thumbs
