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Pediatrics M3 > UWorld Peds > Flashcards

UWorld Peds Flashcards

1
Q

tetralogy of fallot murmur–describe, rxn to squatting

A

harsh, systolic crescendo-decrescendo ejection murmur, single S2; squatting increases intensity of murmur but improves cyanosis

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2
Q

hypertrophic cardiomyopathy murmur–describe, rxn to squatting

A

systolic murmur best heard at apex and left lower sternal border; squatting decreases intensity of murmur

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3
Q

isolated ASD murmur–describe

A

systolic ejection murmur, wide-splitting of S2

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4
Q

VSD murmur–describe, rxn to squatting

A

holosystolic murmur at left sternal border; squatting increases intensity of murmur

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5
Q

Kawasaki disease symptoms (6)

A

fever, bilateral nonexudative conjunctivitis, mucositis (injected/fissured lips, injected pharynx, strawberry tongue), cervical lymphadenopathy, rash, edema and erythema of palms and soles

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6
Q

Kawasaki disease tx

A

aspirin + IVIG to prevent cardiac complications

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7
Q

Kawasaki disease complications (2)

A

coronary artery aneurysms, myocardial infarction and ischemia

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8
Q

what is reye syndrome?

A

hepatic encephalopathy that can develop in children using aspirin during influenza or varicella infections

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9
Q

rash w/”sandpaper” texture that spares palms and soles–dx and tx

A

scarlet fever (complication of untreated strep pharyngitis); amoxicillin

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10
Q

what study should be done for suspected Kawasaki disease to allow for monitoring throughout disease?

A

echo

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11
Q

rocky mountain spotted fever sx and tx

A

rash, fever, headache, GI sx after tick bite; doxycycline

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12
Q

endocardial cushion defect (i.e., atrioventricular septal defect) is associated w/ what condition?

A

down syndrome

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13
Q

midsystolic click w/late systolic murmur

A

mitral valve prolapse

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14
Q

systolic ejection murmur, wide-splitting of S2

A

ASD

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15
Q

cardiac abnormalities associated w/williams syndrome (deletions in chromosome 7)

A

supravalvular aortic stenosis, pulmonary stenosis, septal defects

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16
Q

list 3 congenital heart defects associated w/down syndrome in decreasing order of prevalence

A

complete AV septal defect, VSD, ASD

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17
Q

GI complications associated with down syndrome

A

duodenal atresia, hirschprung disease

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18
Q

endocrine complications associated with down syndrome

A

hypothyroidism, T1DM

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19
Q

sx of infant heart failure

A

diaphoresis, dyspnea w/feeds, poor appetite, lethargy, hyperactive precordium

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20
Q

complete atrioventricular septal defect tx before surgery

A

pharmacotherapy (diuretics, inotropic agents), nutritional supplementation to optimize cardiac fxn

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21
Q

what congenital infection is associated w/PDA?

A

rubella

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22
Q

what congenital heart defects are associated w/digeorge syndrome?

A

conotruncal abnormalities (truncus arteriosus, ToF, interrupted aortic arch)

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23
Q

define cyanotic vs pallid breath-holding spells

A

cyanotic: crying followed by breath-holding in forced expiration, limpness, LOC, rapid return to baseline
pallid: minor trauma followed by breath-holding, pallor, diaphoresis, lasts

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24
Q

work-up after dx of breath-holding spells in healthy infant

A

CBC, serum ferritin (IDA is often associated)

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25
Q

handgrip decreases intensity of what 3 murmurs?

A

HCM, aortic stenosis, mitral regurg

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26
Q

postpericardiotomy syndrome–sx in infants vs older children

A

infants: vomiting, decreased appetite

older children: pericardial friction rub, pleuritic CP exacerbated by inspiration or lying supine

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27
Q

complication of postpercardiotomy syndrome

A

tamponade

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28
Q

beck’s triad of tamponade

A

distant heart sounds, JVD (or distention of scalp veins in infants), hypotension

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29
Q

blunting of costophrenic angles on CXR

A

pleural effusions

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30
Q

CXR in pulmonary embolism

A

normal

31
Q

micrognathia, microcephaly, rocker bottom feet, overlapping fingers, absent palmar creases

A

edwards syndrome (trisomy 18)

32
Q

most common congenital heart defect in edwards syndrome (trisomy 18)

A

VSD

33
Q

supravalvular aortic stenosis associated w/ what syndrome?

A

williams syndrome (deletions in chromosome 7)

34
Q

congenital heart block is associated w/ what maternal condition?

A

SLE

35
Q

coronary artery aneurysms

A

Kawasaki disease

36
Q

URI followed by worsening respiratory distress, syncope, N/V, hepatomegaly, holosystolic murmur, cardiomegaly/pulmonary edema on CXR in a child

A

pediatric viral myocarditis

37
Q

most common viruses causing pediatric viral myocarditis

A

adenovirus, coxsackie B virus

38
Q

appearance of endomyocardial biopsy for pediatric viral myocarditis

A

inflammatory infiltrate of myocardium w/myocyte necrosis

39
Q

pediatric viral myocarditis tx

A

diuretics and inotropes in ICU due to risk of shock and fatal arrhythmias

40
Q

acute rheumatic fever is less likely in children younger than what age? why?

A

3; they have fever epithelial cell attachment sites in throat

41
Q

“egg on a string” on CXR

A

transposition of great vessels

42
Q

cyanosis within first 24hrs of life

A

transposition of great vessels

43
Q

“snowman sign” on CXR

A

total anomalous pulmonary venous return w/obstruction

44
Q

“boot-shaped heart” on CXR

A

ToF

45
Q

rib-notching on CXR

A

coarctation of aorta

46
Q

murmur of coarctation of aorta–describe

A

mild, continuous murmur heard all over chest (collaterals between hypertensive and hypoperfused vessels), systolic ejection murmur at left paravertebral interscapular area

47
Q

CATCH mnemonic–what disease, what it stands for

A

digeorge syndrome; conotruncal cardiac defects, abnormal facies, thymic aplasia, cleft palate, hypocalcemia

48
Q

____penia is a feature of digeorge syndrome

A

lymphopenia (NOT neutropenia)

49
Q

list 2 congenital heart defects associated w/turner syndrome in decreasing order of prevalence

A

bicuspid aortic valve, coarctation of aorta

50
Q

mitral valve prolapse is more prevalent in pts w/__________

A

connective tissue disorders (i.e., ehlers-danlos, marfan, osteogenesis imperfect)

51
Q

characteristics of benign murmurs

A

no significant family hx, early or mid-systolic, grade I/II that decreases on standing and valsalva

52
Q

upper limits for QT intervals for males vs females

A

males:

53
Q

family hx of long QT, congenital sensorineural deafness

A

jervell and lange-neilsen syndrome

54
Q

jervell and lange-neilsen syndrome–inheritance, pathophysiology

A

autosomal recessive congenital long QT syndrome caused by molecular defects in K+ channels; associated w/congenital sensorineural deafness

55
Q

long QT syndrome tx for asymptomatic vs symptomatic (or hx of syncope)

A

asymptomatic: beta-blocker (except sotalol)

symptomatic or hx of syncope: beta blocker + long-term pacemaker

56
Q

pharmacotherapy for HCM

A

beta blockers or calcium channel blockers

57
Q

episodes of cyanosis in a child during feeding or crying

A

“tet” spells of ToF

58
Q

tx for tet spells

A

knee-chest positioning (increases SVR), inhaled O2

59
Q

central cyanosis (mucous membranes cyanotic) and heart failure in first few weeks of life, no murmurs

A

hypoplastic left heart syndrome

60
Q

ddx of new-onset HTN in children

A

fibromuscular dysplasia, autosomal polycystic kidney disease, wilms tumor

61
Q

systolic ejection murmur at left paravertebral interscapular area

A

coarctation of aorta

62
Q

tachypnea, poor feeding, lethargy, prolonged capillary refill, metabolic acidosis, and decreased urine output on 3rd day of life

A

coarctation of aorta (due to closure of ductus arteriosus)

63
Q

palpable abdominal mass, hepatomegaly, and blue nodules in an infant

A

neuroblastoma

64
Q

new-onset HTN, bilateral palpable abdominal masses in an infant

A

autosomal polycystic kidney disease (dilations of renal collecting ducts)

65
Q

new-onset HTN, unilateral palpable abdominal mass, microhematuria, fever in an infant

A

wilms tumor

66
Q

wilms tumor pathophysiology

A

proliferation of metanephric blastema

67
Q

___ axis deviation is never normal on neonatal ECG

A

left

68
Q

left axis deviation on ECG and decreased pulmonary markings

A

tricuspid valve atresia

69
Q

infant

A

vascular ring

70
Q

most common cause of stridor in infants/children between 6mo-6yrs

A

croup

71
Q

laryngomalacia causes ____ that improves in ____ position and worsens in ____ position; most commonly seen in age ____

A

laryngomalacia causes stridor that improves in prone position and worsens in supine position; most commonly seen in age 4-8mo

72
Q

stridor in infants/children that improves w/corticosteroids and racemic epi

A

croup

73
Q

PDA-dependent congenital heart diseases

A

coarctation of aorta, transposition of great arteries, hypoplastic left heart syndrome, TAPVR, tricuspid atresia

Pediatrics M3 (2 decks)

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