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USMLE > usmlerx peds 2 > Flashcards

usmlerx peds 2 Flashcards

1
Q

Linear erythematous plaques with slight crusting

A

Contact Dermatitis (note linear)

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2
Q

What are the rules for telling parents about their kids private information?

A

Minors are exempt from parental consent/involvement for STIs, Pregnancy, Drug Rehab

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3
Q

Newborn tests positive for HIV

A

Retest at 10 months or after -Passive maternal IgG transmission

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4
Q

Etiology: Ataxia Telengiectasia

A

Auto-recessive defective DNA repair results inmutated ATM gene

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5
Q

Ataxia telengiectasia

A

IgA deficient (often E and M too) Ataxia (

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6
Q

HLA DR5/8

A

JRA

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7
Q

HLA 17

A

Psorias (also 13 and B27)

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8
Q

Juvenile strokes; Hypercoaguable states

A

Homocysteinuria Factor 5 Leiden Protein C S defic

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9
Q

APGAR 1s

A

Appearance= +1= only limbs are blue Pulse= +1= <100 Grimace= +1= grimace to stimulate Activity= +1=some limb flexion Resp= +1=Slow, irregular

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10
Q

greasy, scaly, yellow plaques

A

Seborrheic Dermatitis

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11
Q

Tx: Seborrheic Dermatitis

A

Scalp: Emollients only corticosteroids/keto/selenium if it doesnt work OR if its not on the scalp

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12
Q

Joint pain, Hematuria, purpura on extensors and buttocks

A

HSP

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13
Q

Genital ulcers, canker sores, ocular Dz

A

Behcet’s Vasculitis

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14
Q

Tx: Preductal Aortic Coarctation

A

PGE 1 until surgery (maintains the PDA. The PDA is currently supplying the lower extremities)

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15
Q

Sx: Gaucher’s

A

Deficient Glucocerebrosidase Glucocerebrosides in Brain, Liver, Spleen, Bone “Crinkled Paper” in Marrow (Sx: hepsplenmegaly, anemia, pancyto, neuro)

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16
Q

S. Pneumo vaccine

A

23 Polysacc

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17
Q

Hib vaccine

A

Conjugate

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18
Q

Tx: 1st seizure

A

Acetaminophen -EEG for persistant seizures

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19
Q

sfx: Doxycycline

A

Tooth discoloration (for peds)

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20
Q

Complications of Kawasaki

A

Coronary Aneurysms if untreated

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21
Q

Etiology Meningitis, 0-3 mos

A

GBS

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22
Q

Radiolucent nidus surrounded by sclerotic bony formation

A

Osteoid Osteoma

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23
Q

Codman triangle with destruction of bone cortex

A

Osteosarcoma

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24
Q

Osteolysis in diaphysis

A

Enchondromas/Chondromas

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25
Q

Osteolysis with periosteal reactivity and onion skinning

A

Ewing’s Sarcoma

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26
Q

Nocturnal bone pain responding to aspirin

A

Osteoid Osteoma Or Osteosarcoma

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27
Q

Sx: Eisenmeiger’s

A

initial L?R shunt??PHTN? Reverses shunt Cyanosis, clubbing Loud systolic murmur Fixed Split S2

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28
Q

Systolic murmur loudest below L Scapula

A

Coarctation of the Aorta (ie Turners)

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29
Q

Explain Prader Willi/Angelman

A

Normal= One gene expressed, one silent(/imprinted) In angelman, the paternal gene is imprinted/silenced as normal BUT the problem is that the maternal gene is also fuucked up and thus not expressed.

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30
Q

Retinal hemorrhages can lead to

A

Amblyopia

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31
Q

delayed appearance of dermal melanocytes

A

Mongolian Spots

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32
Q

Well demarcated blue-green spots

A

Mongolian spots (more like bluish-brown in my opinion)

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33
Q

Dysplastic melanocytes

A

Dysplastic Nevus

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34
Q

Sx: Mastoiditis

A

Pain, erythema behind ear Pus conductive hearing loss

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35
Q

Sx: Cholesteatoma

A

Basically Otitis Media with facial nerve palsy, HA

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36
Q

Epitrochlear lymph node enlargement

A

EBV/Infective Mono

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37
Q

Dx: EBV

A

Monospot test (Pt’s RBCs agglutinate Horse RBCs) 2nd choice is Heterophile Antibody test for IgG/M

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38
Q

Dx: Slipped Capital Femoral Epiphysis

A

Bilateral Hip Xrays

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39
Q

Etiology: Scissor Gait

A

Cerebral Palsy -Idio, perinatal asphyxia, premature, restricted intrauterine growth, infxn, brain malformation, neonatal cerebral hemorrhage, trauma

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40
Q

Dx: Suspected Abuse

A

Skeletal survery (all of body)

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41
Q

Tx: X Linked Agammaglobulinemia

A

Amoxicillin for infxn and IVIG

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42
Q

Blue Sclera is due to

A

Choroidal veins showing from a Collagen 1 defect in Osteogenesis Imperfecta

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43
Q

Lympadenopathy on anterior neck

A

Cat Scratch- Bartonella Henselae

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44
Q

Tx: RSV

A

Supportive (USMLERx says Ribavirin has not been proven effective except in vitro)

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45
Q

Dx: Constitutional Growth Delay

A

Bone Age Assessment also address parents puberty age, underlying causes etc

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46
Q

Dx: Developmental Dysplasia of Hip

A

U/S is most sensitive!

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47
Q

Indications for Bacterial Endocarditis Prophylaxis

A

Prosthetic Valve Unrepaired(/partially) Cyanotic Dz NO Prophylaxis is needed anymore for bicuspid, acq aortic or mitral valve Dz-MVP/MR, HCM

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48
Q

MOA Indomethacin

A

Prostaglandin Synthesis Inhibitor

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49
Q

Vaccinations at 2 mos

A

Hep B dTAP Hib IPV Pneumo

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50
Q

Bilateral abdominal masses

A

ARPKD

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51
Q

Tx: ALL

A

Vincristine and Prednisone (98%!)

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52
Q

perinatal growth acceleration, macroglossia, linear ear creases

A

Beckwith Wiedemann Syndrome

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53
Q

Complications of Beckwith Wiedemann

A

Gonadoblastoma (“Balls”) Hepatoblastoma Wilms Neuroblastoma (BeckwitH WiedemanN)

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54
Q

Exophthalmos, macroglossia, transient neonatal hypoglycemia

A

Beckwith Wiedemann Syndrome

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55
Q

Tx: Wilm’s Tumor

A

Nephrectomy and chemo

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56
Q

Complications of Varicella

A

Varicella Pneumonia

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57
Q

Full fontanelles, irritability, low BP

A

consider Lumbar puncture for Meningitis

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58
Q

Test to order when you see papilledema

A

CT of head w/o

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59
Q

Jehovah’s

A

You CAN give blood in life threatening cases to minors, regardless of parents desires

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60
Q

Chance of having another febrile seizure after the first

A

30%

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61
Q

Tx: Waterhouse Friderichsen

A

Antibiotics Hydrocortisone (for Adrenal Insufficiency)

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62
Q

Orbital Cellulitis vs. Conjunctivitis

A

Orbital will have same Sx but ALSO proptosis, painful eye movements and ophthalmoplegia

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63
Q

Duchenne Complications

A

Death due to Pulmonary Congestion due to Heart Failure

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64
Q

IGF vs. GH levels

A

GH is not useful for diagnostic because it is released in a random pulsatile fashion

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65
Q

Tx: Cardiac Hyperkalemia

A

Calcium Gluconate (Calcium antagonizes the K+ effects at membrane)

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66
Q

JRA can lead to

A

Blindness (uveitis)

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67
Q

Dx: JRA

A

Clinical presentation and also Slit lamp examination for uveitis

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68
Q

Tx: Precocious Puberty

A

GnRH AGONIST to prevent closure of epiphysis and also desensitizes the pituitary to GnRH

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69
Q

Interstitial Nephritis differs from PSGN

A

by having Eosinophils (even 5% is enough of an increase)

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70
Q

AOM Criteria

A
  1. abrupt onset inflamm and effusion 2. bulging TM, no motility, otorrhea, air fluid level 3. TM erythema
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71
Q

Operate on ASDs if

A

symptomatic or after age 2

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72
Q

Eisenmeiger’s leads to

A

Tacchyarrhythmias PHTN

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73
Q

Hi fever, desquamating rash, extraordinary tenderness

A

Staph Scalded skin Syndrom (aka Ritter’s)

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74
Q

Tx: Cerebral Palsy

A

Baclofen

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75
Q

Indications for emergent fasciotomy

A

Pain with passive motion Increasing pain after cast pain out of proportion

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76
Q

Tx: Croup

A

Hospitalize and Racemic epinephrine

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77
Q

Tx: Wiskott Aldrich

A

IVIG and prophylactic antibiotics

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78
Q

Erythema toxicum

A

Rash in first 48 hours benign, self limiting often starts on face or trunk Eosinophilia No known etiology

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79
Q

Hallmark of Munchausen by proxy

A

Symptoms go away when parent leaves

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80
Q

Pallor, Leukophilia, Marrow shows increased cellularity and lymphoblast predominance

A

ALL

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81
Q

TTN vs NRDS

A

NRDS is more deadly TTN doesnt require more than 40% O2 and resolves in 3 days

82
Q

Erythrocytes in alveoli and interstitial spaces

A

Pulmonary Hemorrhage

83
Q

Tx: NRDS

A

Surfactant after birth Use corticosteroids in ante natal care -produces surfactant and phospholipids and matures fetal lung

84
Q

Excessive saliva, Dry cough, quick onset

A

Inhaled foreign body

85
Q

Clear lungs with decreased pulmonary vascular markings

A

Persistant Pulmonary HTN

86
Q

Perihilar streaking in the interlobular fissures

87
Q

Hyperinflation with coarse infiltrates

A

Meconium Aspiration (or RSV???)

88
Q

Dx: Bronchiolitis

A

no tests unless its severe and the baby is getting admitted,

89
Q

Tx: Bronchiolitis

A

self limiting

90
Q

Dx: Bronchiolitis vs Croup

A

Croup has a barking cough and inspiratory stridor

91
Q

Tx: Epiglottitis

A

Nasotracheal intubation!! Antibiotics (ceftriaxone)

92
Q

widened nose bridge, nasal polyps, chronic sinusitis

93
Q

Nebulizers for bronchiolitis contains

A

racemic epinephrine

94
Q

Retinopathy of Prematurity occurs from

A

giving O2 (usually >.7) to premature babies

95
Q

Organism Pulm infections of CF Pts

A

Babies/toddlers= S. Aureus Teens= P. Aeruginosa

96
Q

Rb Gene

A

Tumor Suppressor, loss leads to Retinoblastoma (autodom 2-hit hypothesis)

97
Q

conjunctival pallor, ab pain, cognitive impairment, behavioral problems, anemia, basophilic stippling

A

Lead Poisoning

98
Q

Tx: Cryptochordism

A

Orchiopexy after 1 yoa

99
Q

Sx: Congenital Hypothyroidism

A

CUMJEL Coarse facies/Cry (hoarse), Umbilical hernia, Macroglossia, Jaundice, Enlarged fontanelles, Lanugo

100
Q

Etiology of Congenital Hypothyroidism

A

Idiopathic or PTU/Methimazole

101
Q

Sx: 5 alpha reductase

A

incomplete virilization Boy that looks like a manly woman

102
Q

G+ cocci in pairs and chains

103
Q

Developmental Dysplasia of Hip leads to

A

Osteoarthritis as an adult

104
Q

Fever, bacteruria, pyuria

A

Vesicoureteral reflux (more common than posterior urethral valves)

105
Q

HLA-DR2

A

Goodpasture’s MS

106
Q

HLA-DR3

A

DM1 SLE Grave’s

107
Q

HLA-B27

A

Ank Spond, Reiter’s

108
Q

HLA-51

A

Behcet’s

109
Q

HLA-D11

A

Hashimoto’s

110
Q

Sx: Angioedema

A

Eyes, cheeks, lips swell up Pulmonary conditions are often unresponsive to meds

111
Q

arm rash with clear center

112
Q

Tx: Lyme’s Dz

A

Amoxicillin

113
Q

Genetics: Duchenne’s

A

X linked recessive

114
Q

Tx: PDA

A

Indomethacin

115
Q

Age: Writes first name

116
Q

Age: Rides a tricycle

117
Q

Age: Hop, skip, jump

118
Q

Age: recites poems, songs

119
Q

Plasminogen Activator Inhibitor-1 is elevated in

120
Q

newborn with fleshy sac on sacral spine

A

Neural Tube Defect/Spina Bifida (teratogenic drugs, ie Carbamazepine)

121
Q

Etiology of Otitis Media

A

S. Pneumoniae nontyp H. Influ

122
Q

Age: Pulls to a stand

123
Q

salmon colored macular rash, spiking fever, lymphadenopathy, hepatosplenogmegaly

124
Q

Sx: Osteogenesis Imperfecta

A

Fragile Bones Hearing Loss Blue Sclera

125
Q

Trisomy 21 is associated with

A

ALL and Alzheimer’s

126
Q

Tx: Septic Hip

A

Immediate IV antibiotics Surgical irrigation and debridement

127
Q

Dimpled/Umbilicled center papules

A

Molluscum Contagiosum

128
Q

Prognosis: Tay Sachs

A

death by 4-5 usually

129
Q

Papilledema, meningitis

A

Do CT of head first!! to prevent a cerebral herniation from doing a lumbar puncture

130
Q

Renal Angiomyolipoma associated with

A

Tuberous Sclerosis

131
Q

Sx: Tuberous Sclerosis

A

Hamartomas in CNS and skin -Adenoma sebaceum (cutaneous angiofibroma) -Mitral regurg -Ash-leaf spot of hypopigmentation -Rhabdomyoma (cardiac) -Tuberous sclerosis -autOsomal dominant -Mental retardation -renal Angiomyolipoma -Seizures

132
Q

Anaphylactoid Rxn in blood transfusions

A

IgA deficiencies (anti IgA antibodies)

133
Q

Tx: RTA 1

A

Potassium Bicarbonate

134
Q

Tx: RTA 2

A

Potassium Bicarbonate

135
Q

posterior and occipital lymphadenopathy

136
Q

Indications for Tympanostomy

A

> 3 ear infections in 6 mos, or 4 in one year

137
Q

Etiology Meningitis, 1-3 mos

A

E. Coli Meningococci

138
Q

Normal C3; IgA deposits in kidney

A

Berger’s/IgA nephropathy

139
Q

Tx: Scabies

A

Permethrin

140
Q

Steeple Sign with subglottic narrowing

141
Q

A kid with Tetralogy is not cyanotic IF…

A

he has a large VSD with minimal right ventricular outflow obstruction

142
Q

atopic dermatitis, infections, low platelets

A

Wiskott (T.I.E.)

143
Q

Skull fractures crossing suture lines

A

are complex fractures and very rare except in abuse cases

144
Q

Rathke’s pouch, MC supratentorial tumor

A

craniopharyngioma

145
Q

small blue poorly differentiated cells in Homer-Wright Rosettes

A

Medulloblastoma

146
Q

pinkish gray mass in vermis, papilledema, vomiting

A

Medulloblastoma

147
Q

Rash secondary to HSV, mycoplasma

A

Erythema Multiforme

148
Q

Target-like pink rash

A

Erythema Multiforme

149
Q

Gram -, rod

A

Pseudomonas Aeruginosa

150
Q

Acute Pharyngotonsillitis can result in

A

Peritonsilar abscess with Group A Strep

151
Q

Sx: West’s Syndrome

A

Infantile spasms arrested psychomotor development hypsarrhythmia on EEG

152
Q

Etiology: Impetigo

153
Q

Lumpy Bumpy Immunoflourescence

A

Acute PSGN (Group A Strep)

154
Q

Tram- track double layered membrane

A

Membranoproliferative nephropathy

155
Q

Spike and dome with IgG C3 deposits

A

Membranous Nephropathy

156
Q

Linear anti glomerular basement membrane deposits

A

Goodpasture’s

157
Q

Renal Dz associated with Hep C

A

Membranoproliferative Nephropathy

158
Q

Renal Dz associated with Hep B

A

Membranous nephropathy

159
Q

Renal Dz associated with SLE

A

Membranoproliferative Nephropathy

160
Q

Circumision is contraindicated in

A

Hypo/epispadias

161
Q

Tx: Vesicoureteral Reflux

A

Ureteral stents if not repaired by puberty age

162
Q

Tx: Ebstein’s

A

Leads to SVTs. Need to radiofrequency ablate

163
Q

Tx: Spastic Cerebral Palsy

A

Diazepam (Muscle relaxant) and PT

164
Q

Maternal Diabetes puts child at risk for

A

Macrosomia Shoulder Dystocia

165
Q

Silvery hair

A

Chediak Higashi

166
Q

velvety dark thickening of skin around neck, axillae and groin

167
Q

Labs: Tumor Lysis Syndrome

A

Hyperkalemia Hypocalcemia Hyperuricemia

168
Q

Tx: Tumor Lysis Syndrome

A

Allopurinol day before chemo

169
Q

Spiral Fracture of Humerus

A

Child abuse

170
Q

CSF for bacterial meningitis

A

Hi Neuts Hi Proteins Lo Glucose

171
Q

X-Linked Immunedeficiencies

A

Chronic Granulomatous Dz Wiskott

172
Q

S. Aureus, Aspergillus infxns

A

Catalase positive, think CGD

173
Q

Tetralogy of Fallot

A

VSD Overriding Aorta RVH RV Outflow obstruction

174
Q

Sickle Cell is associated with inxfns by

A

Salmonella

175
Q

Breast Feeding Jaundice vs. Breast Milk Jaundice

A

Breast Feeding Jaundice= inadequate intake leads to fewer BMs so less bilirubin is removed Breast Milk Jaundice= Biochemical, the milk inhibits Glucuronyl Transferase and other aspects leading to increased indirect bilirubin

176
Q

Sx: NEC

A

in first 2 weeks Abdomen distention Gas/Bubbly bowels (Pneumatosis intestinalis) Bloody Stools/Melena

177
Q

Bloody Stools

A

NEC, Intussusception, Meckel’s

178
Q

Bull’s Eye

A

Intussusception

179
Q

Currant Jelly stools

A

Intussusception

180
Q

Double Bubble

A

Duodenal Atresia

181
Q

Double Track

A

Pyloric Stenosis

182
Q

Phenylalanine is a precursor to

A

Tyrosine (so supplement with tyrosine in PKU)

183
Q

Failure to pass meconium in first 72 hours

A

Meconium Ileus (part of CF)

184
Q

Tx: GERD

A

Positional Change first! Then PPIs

185
Q

Tx: Intussusception

A

Air contrast barium enema

186
Q

RUQ mass, ? BMs, Vomiting

A

newborn= Pyloric Stenosis Older babies= Intussusception

187
Q

Breast Milk Jaundice Starts Peaks Subsides

A

~3 days 2 weeks 1-3 Month

188
Q

Level to treat Jaundice

A

> 20 Bilirubin

189
Q

bilious, nonbloody vomiting hours after first feeding

A

Duodenal Atresia

190
Q

nonbilious, nonbloody vomiting after feedings

A

Pyloric Stenosis

191
Q

Complications of Meckel’s Diverticulum

A

MC= Intussusception -also bleeding, volvulus, obstrxn Most Feared= Perforation (rare)

192
Q

Tx: Omphaloceles

A

Surgery when stable -Cover it with jelly and gauze

193
Q

Gastroschisis vs. Omphalocele

A

Omphacele has a sac/membrane Both present with polyhydramnios in utero

194
Q

Dx: Conjugated Hyperbilirubinemia

A

Abdominal U/S (ie biliary atresia, lack of GB)

195
Q

Polyhydramnios

A

in ability to swallow the amniotic fluid -Omphacele -Gastroschisis -Duodenal Atresia -Potter’s Syndrome

196
Q

Tx: Duodenal Atresia

A

NG tube, fluids, and then surgery

197
Q

Level for Physiologic Jaundice

A

always < 14 total bilirubin

198
Q

Dubin Johnson Syndrome

A

Conjugated Hyperbilirubinemia

199
Q

Rotor Syndrome

A

Conjugated Hyperbilirubinemia

200
Q

Gilbert’s Syndrome

A

Unconjugated Hyperbilirubinemia

USMLE (4 decks)

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