UWorld - Peds Flashcards
1
Q
Wiskott-Aldrich syndrome:
- Mechanism
- Symptoms
A
- X-linked recessive defect in WAS protein, causing impaired cytoskeleton in leukocytes and platelets
- Eczema, thrombocytopenia, recurrent infections
2
Q
Juvenile idiopathic arthritis:
Lab findings
A
- Anemia (Low HgB)
- High Ferritin
- Thrombocytosis (High platelets)
- High gammaglobulin
- High inflammatory markers (ESR, CRP)
3
Q
Corkscrew pattern on barium swallow
A
Midgut volvulus
4
Q
Most common cause of cyanosis in neonatal period:
Dx
Tx
A
Dx = Transposition of Great Vessels Tx = Prostaglandins to keep ductus arteriosus patent
5
Q
Most common cause of viral meningitis.
A
Enteroviruses (e.g. group B coxsackievirus)
6
Q
Complete atrioventricular septal defect is most commonly associated with _________
A
Down syndrome
7
Q
Patent ductus arteriosus is strongly associated with _____
A
Congenital Rubella Syndrome
8
Q
DiGeorge is associated with what heart defect?
A
Tetralogy of Fallot
9
Q
Acute unilateral lymphadenitis in a child
A
Staph aureus
10
Q
Dx: Child with cervical paravertebral mass and Horner’s syndrome (ptosis, anhydrosis, miosis)
A
Neuroblastoma of cervical paravertebral sympathetic chain
11
Q
Dx: Positive acidified glycerol lysis test
A
The glycerol lysis test demonstrates cellular osmotic fragility. It is used to diagnose hereditary spherocytosis.
12
Q
Dx: Newborn with X-ray showing fluid in the interlobar fissures
Tx?
A
Transient tachypnea of the newborn
Tx: self resolution in 1-3 days
13
Q
Dx: genu varum
A
= bowlegged = rickets = vitD defi
14
Q
Most common cause of acute bacterial rhinosinusitis and the treatment.
A
Cause: Streptococcus pneumoniae OR Haemophilus influenzae.
Tx: amoxicillin-clavulanic acid
15
Q
Dx: Inspiratory stridor that worsens in the supine position and improves in the prone position
A
Laryngomalacia (Increased laxity of supraglottic structures)
16
Q
When to use EDTA + Dimercaprol
A
When Pb levels are above 70. OR in lead poisoning accompanied by acute encephalopathy.
17
Q
When to use succimer.
A
Chelation in Pb toxicity when Pb levels are between 45-69
18
Q
When to use ferrous sulfate
A
Tx of iron defi
19
Q
Henoch-Schonlein Purpura pathogenesis and symtpoms
A
Pathogenesis = IgA vasculitis Symptoms = Lower extremity purpura, lower extremity arthralgia, abdominal pain / intrussusception, renal disease (hematuria)
20
Q
Acute bacterial rhinosinusitis:
definition and Tx`
A
Definition = more than 10 days of symptoms Tx = amoxiciliin +/- clavulinate
21
Q
Medical abortion medication
A
Mifepristone and Misoprostol
22
Q
Medication that prevents pregnancy by delaying ovulation. Effective within 72 hours after intercourse.
A
Levonorgestrel
23
Q
Genotypical male (46 X,Y), but phenotypical female
A
Androgen insensitivity syndrome
24
Q
Inactivated vaccines
A
Polio
HepA
25
Toxoid vaccines
Diphtheria
| Tetanus
26
Live attenuated vaccines
```
Rotavirus
Measles
Mumps
Rubella
Varicella
```
27
Conjugated vaccines
```
HepB
Pertussis
Haemophilus influenzae type B
Pneumococcal
Meningococcal
Human papilomavirus
Influenza (injection)
```
28
Dx: Periosteal elevation of femur
Codman triangle, demonstrates osteosarcoma
29
Lytic lesion in bone of pediatric patient
Langerhans cell histiocytosis
30
Location of Osteosarcoma in bone
Metaphysis
31
Location of Langerhans cell histocytosis in bone
Skull, jaw, femur
32
Dx: Bone pain with hypernatremia
Central Diabetes insipidus caused by langerhans cell histocytosis
33
Dx: Blue sclerae
Osteogenesis imperfecta
34
What type of vaccine is the rubella vaccine?
Live attenuated
35
Congenital Rubella 3 clinical findings
- Sensorineural hearing loss
- Cataracts
- Patent ductus arteriosus
36
Congenital Toxoplasmosis 3 clinical findings
- Chorioretinitis
- Hydrocephalus
- Diffuse intracranial calcifications
37
Congenital Cytomegalovirus 2 clinical findings
- Chorioretinitis
| - Periventricular calcifications
38
Congenital varicella syndrome 3 clinical findings
- Limb hypoplasia
- Cataracts
- Distinctive skin lesions (scarring)
39
Congenital syphilis 3 clinical findings
- Nasal discharge
- Hepatomegaly
- Osteoarticular destruction
40
Treatment of pertussis if individual is not vaccinated
Macrolides
41
Treatment for iron poisoning
Whole bowel irrigation
| Deferoxamine (chelation therapy)
42
Symptoms of iron poisoning within 30 minutes to 4 days
- Abdominal pain
- Vomiting
- Diarrhea
- Hypotensive shock
- Metabolic acidosis
43
Dx when symptoms are dysphagia, drooling and respiratory distress
Epiglottitis associated with Haemophilus influenzae type b
44
Dx: Tympanic membrane with peripheral granulation and some skin debris
Cholesteatoma
45
How does Rubella present in unvaccinated adolescents (3 symptoms)?
1) Fever
2) Rash (cephalocaudal spread of maculopapular rash)
4) Arthralgias
46
How does congenital Rubella (German Measles) present (3 findings)?
1) Sensorineural hearing loss
2) Cataracts
3) Paten ductus arteriosus
47
What is the difference between preseptal cellulitis and orbital cellulitis?
Orbital cellulitis is essentially a more severe form of preseptal cellulitis. Both preseptal cellulitis and orbital cellulitis involve eyelid erythema and swelling. However, patients with orbital cellulitis also present with pain with extraocular movements and diplopia. Preseptal cellulitis is treated with oral antibiotics. However, orbital cellulitis is treated with intravenous antibiotics and sometimes surgery.
48
Sandpaper rash. Dx?
Scarlet fever from streptococcus pyogenes.
49
Scarlet fever:Cause
Cause = Strep pyogenes
50
Scarlet fever: Symptoms
Symptoms = fever, pharyngitis, tonsillary erythema/exudates, strawberry tongue, tender anterior cervical lymph nodes, sandpaper rash
51
Scarlet fever: Lab test
- rapid strep antigen test
| - throat culture
52
Scarlet fever: Tx
Tx = Penicillin
53
"slapped cheek." Dx and cause?
```
Dx = erythema infectiosum
Cause = parvovirus B19
```
54
Hand foot and moth disease cause.
Coxsackievirus
55
Criteria for diagnosis of Kawasaki
5 days of fever and more than 4 clinical criteria:
- >1.5 cm cervical node
- polymorphous rash
- edema of the hands/feet
- conjunctivitis
- mucosal changes (eg strawberry tongue, dry/cracked lips)
56
Superficial flaccid bullae on the skin of an infant. Dx?
Staphylococcal scalded skin, caused by Staph aureus
57
Symptoms of rubeola (measles) infection
Prodrom of cough, coryza, conjunctivitis, fever, Koplic spots)
Followed by maculopapular rash: cephalocaudal, sparing the palms and soles.
58
Treatment of rubeola infection for hospitalized patients
Supportive
and
Vitamin A
59
When and how to treat nasal discharge with antibiotics?
Acute bacterial rhinosinusiitis is treated with amoxicillin and clavulanate. Acute bacterial rhinosinusitis is differentiated from viral upper respiratory infection by worsening of symptoms with more than 10 days without improvement.
60
Treatment of acute otitis media.
Oral antibiotics:
Initial: amoxicillin
2nd-line: amoxicillin-clavulanic acid
61
Otitis externa. Tx?
Otic antibiotic drops
62
Most common cause of acute otitis media
Strep pneumoniae
63
Criteria for tympanostomy tube placement
More than 3 episodes in 6 months.
| More than 4 episodes in 12 months.
64
Sticky stools with streaks of blood. Dx?
Intrussusception
65
What do you see on ultrasound for instrussusception?
Target sign
66
What is the purpose of the Technetium-99m scan?
To diagnose Meckel diverticulum
67
What is the purpose of Anorectal Manometry?
To diagnose Hirschsprung disease
68
Best test for pyloric stenosis
Abdominal ultrasound
69
Triple bubble sign. Dx?
Jejunal atresia
70
Treatment of children with severe dehydration
IV normal saline
71
1 side of body is larger than the other in a baby. Dx? Complications of this Dx? How to monitor for complications?
```
Dx = Beckwith-Wiedemenn syndrome
Complications = Wilms tumor, Hepatoblastoma
Monitor = Serum alpha fetoprotein (hepatoblastoma) and Abdominal ultrasound (Wilms tumor)
```
72
Rare but potentially fatal complication of infectious mononucleosis. Tx?
Acute airway obstruction.
| Tx = corticosteroids
73
Acute rheumatic fever is a complication of ______
Group A streptococcal (GAS) pharyngitis
| aka Strep pyogenes
74
Complication of Kawasaki disease.
Coronary artery aneurysm
75
Low B lymphocyte count. Dx?
X-linked (Bruton) agammaglobulinemia (XLA)
76
Defect in dynein. Dx?
Primary ciliary dyskinesia
77
When is varicella zoster vaccine given?
2 doses at ages 1 and 4
78
When is postexposure prophylaxis with VZV vaccine indicated?
For incompletely immunized child age >1 year who was exposed to chicken pox within the last 5 days.
79
When do you administer varicella immunoglobulin?
Varicella vaccine is made from a live virus, so it is contraindicated in pregnant women, immunocompromised hosts and neonates. In these populations varicella immunoglobulin is used instead (within 10 days of exposure to chicken pox).
80
Lateral neck X-ray demonstrates widened prevertebral space. Dx?
Retropharyngeal abcess (RPA)
81
What coagulation problem do patients with cystic fibrosis develop?
Vitamin K deficiency, due to CF patient's exocrine pancreas insufficiency, they cannot absorb the fat-soluble KADE vitamins.
82
What clotting factors are associated with Vitamin K?
Factors II, VII, IX, X, proteins C and S
83
Tinea corporis (ringworm). Tx?
Clotrimazole (topical antifungal)
84
Diaper dermatitis. Cause? Tx?
```
Cause = candida
Tx = topical nystatin
```
85
Teeth appear translucent and gray. Dx?
Dentinogenesis imperfecta, due to osteogenesis imperfecta
86
CBC in idiopathic juvenile arthritis
High WBC
High PLT
Low HgB
87
Limited upward gaze. Dx?
Parinaud (dorsal midbrain) syndrome, due to Pinealoma
88
Respiratory distress syndrome (RDS) in neonate.
Cause?
Risk factors?
Cause: immature lungs & lack of surfactant
| Risk factors: Prematurity & Gestational Diabetes
89
Low platelets after a viral infections. Dx?
Immune Thrombocytopenia (ITP)
90
Cough with vomiting. Dx? Tx?
```
Dx = Bordetella pertussis
Tx = Macrolide (azithromycin, clarithromycin)
```
91
Dx? Newborn with left axis deviation on EKG and decreased pulmonary markings on chest radiograph.
Tricuspid valve atresia
92
What heart defect is diGeorge syndrome associated with?
Truncus arteriosus, where the aorta and pulmonary artery have a common outflow.
93
CD3+ is what cell type?
T cells
94
Diagnosis:
| Child with abscess that is filled with neutrophils
Chronic granulomatous disease
95
Organisms associated with chronic granulomatous disease
```
Catalase Positive organisms:
Staphylococcus aureus
Aspergillus
Burkholderia
Serratia
```
96
What is the defect and chronic granulomatous disease?
Deficiency of oxidative burst (Hydrogen peroxide formation)
97
What lab testing is used for the diagnosis of chronic granulomatous disease?
Neutrophil function testing:
1) Nitroblue tetrazolium test
2) Dihydrorhodamine 123 test
98
Age of three finger grasp and age of two finger grasp.
Three finger grasp at nine months.
| Two finger grasp at 12 months.
99
At what age should a baby be able to turn head to its name.
Six months
100
Yellow, oily scaling on face and scalp. Dx? Tx?
Dx = Seborrheic dermatitis, associated with colonization by Malassezia species
Tx primary = Emolient, non-medicated shampoo
Tx secondary = Topical antifungal or glucocorticoids
101
Recurrent severely pruritic rash not related to any contact, associated with family history of asthma or allergies. Dx?
Atopic dermatitis.
102
Recurrent severely pruritic rash that is related to some contact and may be associated with family history of asthma or allergies. Dx?
Contact dermatitis
103
Scaly lesions that form round or oval plaques typically on elbows and knees. Dx?
Psoriasis
104
Fine white scales on scalp only. Dx?
Tinea capitis
105
Painful, non-pruritic pustules with honey-crusted adherent coating. Dx? Organism?
Impetigo
- Staph aureus
- Strep pyogenes (Group A Strep)
106
Painful vescicular rash with "punched-out" erosions and hemorrhagic crusting. Dx? Organism?
Eczema herpeticum
| - Herpes simplex type 1
107
Flesh-colored papules with central umbilication. Dx? Organism?
Molluscum contagiosum
- Poxvirus
(NOT chicken pox, which is caused by varicella zoster)
108
Pruritic circular patch on body with central clearing and raised, scaly border. Dx? Organism?
Tinea corporis
| - Trichophyton rubrum
109
Fever, blisters, epidermal shedding with light pressure. But NO involvement of mucous membranes. Dx? Organism?
Staphylococcal Scalded Skin Syndrome
| - Staph aureus
110
Pt with fever and well demarcated area of erythema, but NOT epidermal shedding. Dx? Organism?
Erisypelas
| - Strep pyogenes (group A strep)
111
Pink sand-paper rash in a child that has recently had pharyngitis. Dx? Cause?
Scarlet fever
| - Strep pyogenes (Group A Strep)
112
Skin blistering that covers >30% of body with involvement of mucous membranes, after starting a new medication. Dx?
Toxic epidermal necrolysis
113
Sharply defined perianal rash. Dx? Organism?
Streptococcal perianal dermatitis
| - Group A Strep (Strep Pyogenes)
114
Perianal rash with satellite lesions. Dx?
Candida dermatitis
115
Treatment of Lyme in child vs. adult
Child under 8 = amoxicillin
| Over 8 = doxycycline
116
Child with maculopapular rash that spares the palms and soles. Dx? Tx?
```
Dx = measles (rubeola)
Tx= Vit A + Supportive
```
117
Koplik spots. Dx?
Dx = measles (rubeola)
118
What test to perform if child has psychosis but also proteinuria and hematuria?
Test for antinuclear antibodies
BECAUSE child may have
Systemic Lupus Erythematosus
119
Mnemonic and list of findings in SLE
```
RASH OR PAIN:
Rash (malar or discoid)
Arthritis
Serositis (pleuritis, pericarditis)
Hematologic disorders (cytopenias)
Oral/nasopharyngeal ulcers
Renal disease
Photosensitivity
Antinuclear antibodies
Immunologic disorder (anti-dsDNA, anti-Sm, antiphospholipid)
Neurologic disorder (seizures, psychosis)
```
120
What type of kidney injury is associated with Sickle Cell Trait?
Acute Papillary Necrosis
121
Children aged ________ must receive a renal and bladder ultrasound after a UTI to assess for anatomic abnormalities.
< 2 yrs
122
The clinical manifestations of Henoch-Schonlein purpura.
- Palpable purpura
- Arthritis/arthralgia
- Abdominal pain - intrussusception
- IgA nephropathy
123
At what age do symptoms of pyloric stenosis usually present?
3-5 wks
124
Keratomalacia.
Definition?
Dx?
```
Keratomalacia = wrinkling, cloudiness of cornea
Dx = Vit A deficiency
```
125
Pancreatic pseudocyst is a complication of _________.
Pancreatitis
126
Biliary cysts present at what age?
< 10 yrs old
127
Classic Triad of symptoms for Biliary cysts.
1) RUQ pain
2) Jaundice
3) Palpable mass
128
Anti-tissue tranglutaminase antibody assay.
| - Used for diagnosis of what?
Celiac disease
129
How to diagnose baby colic.
Baby colic is a type of pain that starts and stops abruptly, often occurs at the same time every day. Diagnostic features: Crying for more than three hours per day, more than three days per week, more than three months.
130
Hematochezia and eczema in a one month old infant. Diagnosis?
Milk or soy protein induced enterocolitis.
131
Three reasons for physiological jaundice in a newborn.
1) Low hepatic UGT activity
2) Low red blood cell lifespan
3) high enterohepatic recycling of bilirubin
132
If an infant has tracheoesophageal fistula, what other conditions are associated with this?
```
Mn* VACTERL
Vertebral
Anal atresia
Cardiac
Tracheoesophageal fistula
Renal Limb
```
133
Next step in management, if you suspect UTI in an infant that wears diapers.
1) BUN/CR
2) Catheterization
3) Urinanalysis
4) Urine culture
134
Newborn with flattened facies, abdominal distension, clubfeet and decreased aeration of lungs. Dx? Mechanism of disease?
```
Potter Sequence
Urinary tract anomaly (most often posterior urethral valves) cause oliguria (small urine production) in utero, which causes oligohydramnios (deficiency of amniotic fluid), which causes the 3 findings:
1) Pulmonary hypoplasia
2) Flat facies
3) Limb deformities
```
135
define: Hypospadias
A congenital abnormality where the penile urethra opens on the ventral side of the penis rather than the tip.
136
Most common cause of urinary tract obstruction in newborn boys
Posterior urethral valves
137
Normal Urine pH
4.5 - 8
138
Normal specific gravity of urine
1.01 - 1.03
139
define:Hyposthenuria
Inability of the kidneys to concentrate urine, causing low urine specific gravity.
140
Normal Serum Sodium
Low Urine Specific Gravity
Dx?
Sickle cell trait
| - response to poor renal perfusion is hyposthenuria, but intact ADH results in normal serum sodium.
141
High Serum Sodium
Low Urine Specific Gravity
Dx?
Diabetes Inspidus,
| - due to insufficient ADH production (central) or poor ADH response (nephrogenic).
142
How to diagnose the type of Diabetes Insipidus. Central vs. Nephrogenic?
Water deprivation test
- hold water, administer ADH
- measure urine osmolarity in response to ADH
143
After pediatric UTI -- what are the indications to perform a renal and bladder ultrasound?
If the first UTI is at age 2-24 months
OR
If this is the second or more -- UTI
144
Urinary test for Cystinuria
Cyanide-Nitroprusside test
145
Severe periodontal infections. What is the immunodeficiecy?
Leukocyte Adhesion Deficiency
146
What conditions are associated with cafe-au-lait macules?
Neurofibromatosis Type 1
| McCune-Albright
147
Symptoms of McCune-Albright syndrome
Cafe-au-lait spots (unilateral)
Polyostotic fibrous dysplasia
Precocious puberty
Multiple endocrine abnormalities
148
Solitary hyperpigmented lesion with density of overlying dark, coarse hairs. Dx?
Congenital Melanocytic Nevus
149
Newborn with gray-blue patches that are poorly circumscribed. Dx?
Congenital dermal melanocytosis (Mongolian spots)
| - these fade with time
150
What is nevus flammeus?
Port-wine-stain
151
Scaly erythematous patch with hair loss on scalp. Also pt has tender lymphadenopathy. Dx? Tx?
```
Dx = Tinea capitis (dermatophyte infection)
Tx = Griseofulvin or Terbinafine
```
152
What kind of rash presents with acute rheumatic fever?
Erythema marginatum
153
Describe the rash in that occurs in Scarlet Fever.
"Sandpaper" rash
154
What kind of imaging is performed to diagnose hip dysplasia?
Age < 4 mo = Hip ultrasound
| Age > 4 mo = Hip radiograph
155
X-ray of femur demonstrates cortical layering and a "moth eaten" appearance. Dx?
"onion skinning" and "moth eaten" bone = Ewing Sarcoma
156
Where does Ewing Sarcoma present?
Diaphyses of long bone
157
A lytic lesion in bone surrounded by concentric layers of new bone. Dx?
"Onion Skinning" = Ewing Sarcoma
158
Tumor in the epiphysis with "soap bubble" appearance. Dx?
Giant Cell Tumor
159
Most common cause of pneumonia in otherwise healthy patients.
Strep pneumoniae
160
Nocturnal perianal pruritis. Dx? Test? Tx?
```
Dx = Helminth infection (Enterobius vermicularis)
Test = Tape test
Tx = Albendazole or Pyrantel Pamoate
```
161
Suspect this diagnosis if individual develops a maculopapular rash after amoxicillin.
Infectious mononucleosis (Epstein-Barr virus)
162
What type of rash occurs in acute rheumatic fever?
Erythema marginatum
163
Describe the rash of Erythema Infectiosum
Erythema infectiosum = rash initially involving the face (slapped cheek) progressing to entire body
164
How to diagnose Acute Lymphoblastic Leukemia.
Bone marrow biopsy with >25% lymphoblasts
165
Pediatric patient with fever and mediastinal mass on X-ray. Dx?
Hodgkin lymphoma
166
Rouleaux formation on blood smear. Dx?
Multiple Myeloma
167
Lymphadenopathy, tenderness of bones, splenomegaly, petichiae. Dx?
Acute Lymphoblastic Leukemia
168
Franconi Anemia. Mechanism? Symptoms?
```
Mechanism = Inherited DNA repair defect
Symptoms:
- Short stature
- Hypo/hyper-pigmented macules
- Abnormal thumbs
- Genitourinary malformations
```
169
Lab findings for Fanconi Anemia
- Pancytopenia
- Diagnosis of Fancioni Anemia is made by exposing DNA to interstrand crosslinking agents, demonstrating chromosomal breakage
170
Until what age is it normal to see the thymus on X-Ray?
< 3 yrs old
171
When to use Palivizumab?
Palivizumab is a monoclonal antibody against RSV, used for prophylaxis of children under 2 years old who are at exceptionally high risk. High risk individuals:
- Preterm <29 wks gestation
- Chronic lung disease of prematurity
- Hemodynamically significant congenital heart disease
172
If an infant < 2 months has bronchiolitis -- then what complication is the infant at greatest risk for?
Apnea (temporary cessation of breathing)
173
First step in management of a newborn with suspected congenital diaphragmatic hernia.
Endotracheal intubation to stabilize breathing.
174
Congenital absence of bilateral vas deferens is associated with what condition?
Cystic fibrosis
175
Opacification of ocular lens is associated with what condition?
Intrauterine rubella infection
OR
Galactosemia
176
Which pediatric tumor crosses the midline and which one does NOT?
Neuroblastoma may cross the midline
| Wilms tumor does not
177
Neuroblastoma stymptoms
Abdominal mass that may cross the midline
Periorbital ecchymosis
Opsoclonus-myoclonus
178
"Owl eyes" on lymph node biopsy.
Hogkin lymphoma
179
Bone pain and pancytopenia in Pediatric pt. Dx?
Acute Lymphoblastic Leukemia
180
What drug to avoid in G6PD deficiency if trying to treat UTI.
Nitrofurantoin
181
Ear canal is red and swollen. Diagnosis? Mechanism?
```
Diagnosis = Otitis externa
Mechanism = infection with Pseudomonas aeruginos OR Staph aureus, most commonly due to water exposure ("swimmer's ear")
```
182
Treatment of Epiglottitis
Infection with Haemophilus influenzae type b.
| Tx = ceftriaxone (against haemophilius influenzae type b and streptococcus species) and vancomycin (against MRSA)
183
What antibiotic to use to treat whooping cough?
To treat Bordetella pertussis, use Azithromycin
184
Empiric therapy for neonatal sepsis
Ampicillin and gentamycin
185
Tx for atypical pneumonia.
Organisms of atypical pneumonia = Mycoplasma pneumoniae, Clamydia pneumoniae)
Tx = Azithromycin
186
How to treat pulmonary infection in cystic fibrosis.
CF patients are susceptable to Pseudomona aerguinosa.
| Tx = Piperacillin-tazobactam
187
Osteosarcoma
vs
Ewing sarcoma
on X-ray
Osteosarcoma = "sunburst" periosteal reaction and Codman triangle
Ewing sarcoma = "onion-skin" appearance
188
Newborn patient demonstrates a preference to tilt hear head to the left while rotating the chin to the right. Dx?
Dx = Congenital torticolis
This is a postural deformity of the neck in which the sternecleidomastoid muscle is tight and contracted, likely due to intrauterine crowding.
189
Cystic hygroma
A congenital lymphatic malformation located in the posterior triangle of the neck
190
Craniosynostosis
Premature closure of cranial sutures, which results in skull deformity
191
Treatment of child with UTI
3rd gen cephalosporin
- Ceftriaxone
- Cefotaxime
- Cefpodoxime
- Ceftazidime
- Cefixime
192
Age milestone: Babbling
6 months (language development)
193
Age milestone: Pincer grasp
12 months (motor development)
194
Age milestone: hops and balance on one foot
4 years
195
Age milestone: jumps with 2 feet
2 years
196
How to treat E Coli O157:H7?
| What medications to avoid? Why?
Treat with supportive care.
Avoid: Antibiotics and Antimotility meds (loperamide), because they increase the chance of developing Hemolytic Uremic Syndrome
197
Complication of giardia infection.
Lactose intolerance
198
Giardia treatment
Metronidazole
199
Tx for beta thalassemia major.
Transfusion + Chelation
200
What are the key unique features of Rubella infection in children and what are the key features of Measles infection in children?
Rubella (German Measles) = Lymphadenopathy, specifically suboccipital, posterior auricular and posterior cervical.
Measles (Rubeola) = 3 Cs = Cough, Coryza, Conjunctivitis. Higher fever (40 C).
201
Which one is a Torches infection -- Measles OR Rubella? What are the manifestations?
Rubella
| Manifestations = Cataracts, Deafness, Patent Ductus Aretriosus
202
If pt has UTI. What is the indication for an ultrasound? What is the indication for a voiding cystourethrogram?
Ultrasound = IF fever does not improve with 2 days of antibiotics
Voiding Cystourethrogram = IF 1 of the following is met:
(1) Ultrasound shows abnormality (e.g. hydronephrosis)
(2) Unusual pathogen (Not E. coli)
(3) Chronic kidney injury (Hypertension, Poor growth)
(4) 2 or more febrile UTIs
203
Abdominal pain, diarrhea, seizures in a child.
Shigella gastroenteritis
204
What are the values of the pleural fluid analysis that tells you whether the parapneumonic effusion is uncomplicated or complicated? What is the Tx of uncomplicated vs complicated?
Uncomplicated = pH >7.2, Glucose>60, WBC<50k
Complicated = pH<7.2, Glucose<60, WBC>50k
Uncomplicated Tx = Antibiotics
Complicated Tx = Antibiotics + drainage
205
Criteria to place ear tubes for patients with Acute Otitis Media.
- 3 or more AOM episodes in 4 months
| - 4 or more AOM episodes in 12 months
206
Criteria to give antibiotics to patients with Acute Otitis Media.
- Bilateral AOM
- High Fever
- Severe pain
207
Compare the skin findings of Neurofibromatosis type 1, Tuberous Sclerosis and Sturge-Weber
Neurofibromatosis type 1 = Neurofibromas, cafe-au-lait spots, axillary freckling
Tuberous Sclerosis = Angiofibromas, Shagreen patches, Ash-leaf spots
Sturge-Weber = port wine stain (along trigeminal nerve distribution)
208
Dimercaprol treats...
Lead poisoning
209
Fomepizole treats...
Methanol or ethylyne glycol poisoning
210
Glucagone treats...
Beta blocker or Ca2+ channel blocker poisoning
211
Methylene blue treats...
Methemoglobinemia (exposure to dapsone, nitrates, topical anesthetics)
212
Pralidoxime treats...
```
Organophosphate poisoning
(use pralidoxime together w/ atropine)
```
213
Perianal pruritis at night. Dx?
Pinworm = Enterobius vermicularis
214
Ivermectin treats...
- Strongyloides (intestine and lung)
| - Onchocerca (river blindness)
215
Metronidazole treats...
- Trichomoniasis and bacterial vagenosis (Vagina)
- Giardia (GI)
- Entamoeba (GI --> liver abscess)
216
Praziquantel treats...
- Cestodes (tapeworms) like Taenia solium from pork or Diphyllobothrium from fresh fish
- Tematodes (flukes) like Schistosoma (which can lead to bladder cancer) from fresh water or Chlonorchis sinesis (which can lead to gallbladder cancer)
217
Permethrin treats...
Scabes
218
Pyrantel pamoate treats...
Enterobius vermicularis (pinworm) that causes anal pruritis
219
When is MMR vaccine given?
1 year
and
4 years old
220
What rheumatological comorbidity is associated with Down's syndrome?
Atlantoaxial instability (laxity between C1 and C2)
221
Treatment for lead poisoning depending on lead level.
Less than 45 = remove from environment
45 - 70 = Succimer (Dimercaptosuccinic acid
> 70 or sings of encephalopathy = EDTA + Dimercaprol (British anti-Lewisite)
222
Hamartomas on the iris --> what is the genetic condition?
Lisch nodules = NF1
223
White-grey spots on periphery of the iris - what is the genetic condition?
Brushfield spots = Down's
224
Renal angiomyolipoma - what is the genetic condition?
Tuberous sclerosis
225
Retinal hemangioblastoma - what is the genetic condition?
von Hippel-Lindau
226
What are the 3 conditions that have cafe-au-lait spots? What symptoms help to differentiate between the two?
NF1 (iris hamartoma - Lisch nodules, cutaneous neurofibromas)
and
McCune-Albright (multiple endocrine abnormalities, precocious puberty)
and
Fanconi anemia (thumb defect, anemia)
227
Skin condition associated with Celiac disease
Dermatitis herpetiformis
228
What is the difference between the location,symptoms and treatment of preseptal cellulitis and orbital cellulitis?
Preseptal cellulitis is anterior to the orbital septum, while orbital cellulitis is posterior.
Symptoms that point to orbital cellulitis are extraocularr muscle defect like painful or weak eye movements AND proptosis (bulging eyes).
Treat preseptal with oral antibiotics, treat orbital with IV antibiotics and possible surgery.
229
What can cause megaloblastic anemia other than B12/Folate deficiency? What other symptoms to look for and mechanism of disease.
```
Fanconi anemia (DNA repair defect leads to PANcytopenia, not just anemia; Also look for thumb defect, cafe-au-lait spots)
AND
Orotic aciduria (UMP synthase defect, which leads to orotic acid in urine)
```
230
Anal fissure in a toddler. Dx? Tx?
```
Dx = pediatric constipation
Tx = laxative (e.g. polyethylene glycol, mineral oil)
```
231
Most common complication for patients with Sickle Cell Trait.
Humaturia
and
Hyposthenuria (impairment in urine concentrating ability, which can present as nocturia and polyuria)
232
Glomerular basement membrane thickening. Dx? Symptoms?
```
Dx = Membranous nephropathy
Symptoms = Edema, proteinuria
```
233
Glomerular basement membrane thining. Dx? Symptoms?
```
Dx = Alport Syndrome
Symptoms = Hearing, Vision problems
```
234
Linear deposition of IgG on basement membrane. Dx? Symptoms?
```
Dx = Goodpasture syndrome
Symptoms = Pulmonary hemorrhage, glomerulonephritis
```
235
Localized areas of mesangial sclerosis. Dx? Symptoms?
```
Dx = Focal Segmental Glomerulosclerosis (FSGS)
Symptoms = Edema, proteinuria
```
236
Mesangial deposition of IgA. Dx? Symptoms?
```
Dx = Henoch-Schonlein Purpura
Symptoms = Abdominal pain (intrususeption), Renal disease, Arthralgias, Lower extremity rash
```
237
Podocyte fusion. Dx? Symptoms?
```
Dx = Minimal Change Disease
Symptoms = Edema, proteinuria
```
238
Limited upward gaze. Where is the tumor?
Pinealoma
239
Special organisms associated with Chronic Granulomatous disease.
Serratia
Burkholderia
Aspergillus
240
Tests used to diagnose Chronic Granulomatous Disease
Dihydrhodamine 123 Test
Nitbroblue Tetrazolium Test
(These are tests for neutrophil function)
241
Medications for Tourette Disorder
```
Alpha-2 agonists (Guanafacine, Clonidine)
Dopamine depleter (Tetrabenazine)
Antipsychotic (Risperidone, Haloperidol)
```
242
Common causes of anion gap metabolic acidosis
```
Mn* MUDPILES
Methanol
Uremia
Diabetic Ketoacidosis
Propylene glycol/paraldehide
Isoniazid / Iron
Lactic Acidosis
Ethylene glycol (antifreeze)
Salicylates (aspirin)
```
243
Most common cause of pneumonia in healthy patients vs Cystic Fibrosis patients.
Healthy patients = Strep pneumoniae
CF before 20 months of age = Staph aureus
CF after 20 months of age = Pseudomonas
244
Until what age is bed wetting OK?
5 years. After 5 years old start enuresis alarm therapy.
245
Until what age is genu varum normal?
Age 2
246
Percent Fetal Hemoglobin in Sickle Cell Disease.
SCD pts = 5-15% HgF
| SCD pts on Hydroxyurea = > 15%
247
What therapy should be used in strabismus and at what age?
Until 4 months strabismus is OK. Afterwards need therapy such as eye patch on the good eye
248
What medications are used as emergency contraceptives to prevent pregnancy by delaying ovulation? Timeline to take.
Levonorgestrel (Plan B) - within 72 hrs of unprotected intercourse
Ulipristal - within 5 days
249
Most common cause of meningitis depending on age.
Before 6 months = Group B Strep
| After 6 months - to old age/death = Strep pneumoniae
250
Longitudinal splitting of glomerular basement membrane. Dx?
Alport syndrome
251
Why does bruising and epistaxis occur in cystic fibrosis patients?
Cystic fibrosis patients have pancreatic insufficiency. This leads to decrease absorption of fat soluble vitamins K A D E. Lack of vit K increases PTT, which increases bruising and epistaxis.
252
Retinal hemorrhages on fundoscopy. Dx?
Dx = shaken baby syndrome (Subdural venous shearing)
253
Cystinuria. What type of crystal in nephrolythiasis? What is the diagnostic test?
Crystals = hexagonal
| Diagnostic test = Cyanide-nitroprusside
254
Tourette syndrome often presents with what 2 other comorbid conditions?
1) ADHD
| 2) Obsessive-compulsive disorder
255
Treatment of UTI in pediatric patient.
Third gen cephalosporin.
| Cefixime, Ceftriaxone, Cefotaxime, Cefpodoxime, Ceftazidime
256
What are the two conditions that cause cherry-red macula? What is their mechanism? What symptoms help you to differentiate between the 2 conditions?
Niemann-Pick and Tay-Sachs have cherry-red macula.
Niemann Pick is Sphingomyelinase deficiency.
Tay-Sachs is beta-hexosaminidase A deficiency.
Niemann Pick symptoms = Heptosplenomegaly and Arreflexia
Tay-Sachs symptoms = NO hepatosplenomagaly and Hyperreflexia.
257
Patient with hip pain after a mild viral illness. CBC is normal. Patient can bear weight on the affected leg. Dx? Prognosis?
Transient synovitis
| Prognosis = Full recovery in up to 4 weeks
258
Timing of IgA nephropathy vs Poststreptococcal glomerulonephritis.
IgA nephropathy = 1-2 days after URI
| Poststrep Glomerulonephritis = 1-4 wks after URI
259
Another name for "Eczema"
Atopic Dermatitis
260
An antibiotic that will cover both pseudomonas and MSSA.
Cefipime (4th gen cephalosporin)
261
Mechanism of Reye syndrome
Aspirin is a mitochondrial toxin. Causes liver damage. Results in microvesicular steatosis on liver biopsy.
262
Aspirin is usually contracindicated in children except in the treatment of what?
```
Kawasaki Disease
Rheumatologic disease (e.g. juvenile idiopathic arthritis)
```
263
Complications of infectious mononucleosis
Splenic rupture
Acute airway obstruction
Autoimmune hemolytic anemia and thrombocytopenia
264
Criteria to diagnose Acute Rheumatic Fever
```
JONES (major) + (minor)
Joints (mygratory arthritis)
O Carditis
Nodules (subcutaneous)
Erythema marginatum
Sydenham chorea
+ High CRP/ESR
+ High PR interval
+ Fever
+ Arthralgia
```
265
Turner syndrome: Estrogen, FSH and LH (high or low?)
Low Estrogen, High FSH, High LH
266
Kallman syndrome: Estrogen, FSH and LH (high or low?)
Normal Estrogen, Low FSH, Low LH (due to Low GnRH)
267
Androgen Insensitivity syndrome: FSH and LH (high or low?)
Normal to high FSH and LH
268
5 alphar reductase insufficiency: FSH and LH (high or low)
Normal to high FSH and LH
269
How to tel Androgen Insensitivity Syndrome from 5 alpha reductase, since they are both 46XY?
Androgen Insensitivity Syndrome will have breast development. 5-alpha reductase deficiency will NOT have breast development. 5-alpha reductase deficiency will have Virilization.
270
APGAR scoring system
Appearance: - +2 pink; +1 blue extremities; 0 all blue
Pulse: +2 >100; +1 <100; 0 absent
Grimace: +2 crying; +1 to grimace; 0 absent
Activity: +2 active; +1 some flexion; 0 limp
Respiratory: +2 good dry; +1 weak cry; 0 absent
271
When infant is crying or eating cyanosis appears. Dx?
This is a "tet spell" of Tetralogy of Fallot
272
The tetralogy of Tetralogy of Fallot
1) Ventricular septal defect (VSD)
2) Overriding aorta
3) Right Ventricle Hypertrophy
4) Right Ventricle Outflow Obstruction (pulmonary stenosis)
