uworld peds

Question 1

what is the presentation of VSD

Answer 1

holosystolic murmur over the left border, left to right shunting, diaphoresis while feeding, diastolic rumble

Question 2

what is the presentation of tetrology of fallot

Answer 2

The four defects include a ventricular septal defect (VSD), pulmonary valve stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy).

Question 3

what happens with a long standing VSD

Answer 3

eventually the right ventricle will hypertrophy and cause eisenmenger syndrome, where there is right to left shunting and cyanosis

Question 4

what is the presentation of sturge weber

Answer 4

vascular patch over the face, generally red in color. neurocutaneous characterized by leptomeningeal capillary venous malformations of the brain and the eye. port wine stain

Question 5

what is the prenetation of von hippel lindau

Answer 5

various tumors, hemangioma of the eye, CNS tumors of the cerebellum and spinal cord. renal cell carcinoma, pheochromocytoma

Question 6

what is the presentation of glucose-6-phosphate deficiency this is von girke disease

Answer 6

doll-like facies, protuberant abdomen, failure to thrive, hypoglycemia, hyperlipidemia and uricemia, lactic acidosis, hepatomegaly.

Question 7

what is the most common cause of neonatal sepsis

Answer 7

GBS

Question 8

what are the characteristics of GBS

Answer 8

gram positive cocci in chains and pairs

Question 9

what are gamma tetramers on newborn screening

Answer 9

this is alpha thalasemia hemoglobin Barts.
the RBCs will be increased in number, but willl be hypo chromic and microcytic. this is typically associated with hydrops and in utero death
target cells on smear

Question 10

what are pencil cells

Answer 10

are red blood cells that looks like ellipses found in ellipticytosis

Question 11

what is coloboma and coanal atresia indicative of

Answer 11

CHARGE.    CHD7 mutation   patient should get an echo 
colomboma
heart defects
atresia
retardation in growth
genitourinary 
ear abnormalities

Question 12

VACTERAL syndrome

Answer 12

veterbral 
anal atresia
cardiac
tracheoesophageal fistula 
renal limb

Question 13

what bone lesion improves with aspirin and how does it prsnet

Answer 13

osteoid osteoma
round lucency small on X-ray
most common in adolescent boys

Question 14

treatment for osteoid osteoma

Answer 14

NSAIDs monitor for resolution

Question 15

what is the difference between AOM and OME

Answer 15

OME does not have a fever or TM bulging. it will have bubbles.
AOM will be bulging

Question 16

what is more common bacterial infection for CF in younger patients

Answer 16

staph aureus

Question 17

what is the more common bacteria in CF as they are oplder

Answer 17

Pseudomonas

Question 18

are the number of RBCs decreased in thalasemia

Answer 18

no

Question 19

what is the brain pathology you’d expect for hereditary telangiectasia

Answer 19

hemorrhagic stroke can be intraparenchymal, intraventricular, or subarachnoid

Question 20

diamond blackfan anemia presnetaion

Answer 20

congenital erythroid aplasia, triphalangial thumbs, webbed neck

Question 21

what is usually the cause of death in meningococcal meningitis

Answer 21

adrenal hemorrhage

Question 22

what are thee criteria for rheumatic fever

Answer 22

Major: carditis (clinical and/or subclinical), arthritis (polyarthritis), chorea, Erythema marginatum, and subcutaneous nodules.
minor: olyarthralgia, fever (≥38.5° F), sedimentation rate ≥60 mm and/or C-reactive protein (CRP) ≥3.0 mg/dl, and prolonged PR interval (unless carditis is a major criterion)

Question 23

what is serum sickness like reaction for penicillin (beta lactams)

Answer 23

joint pain, rash, fever, urticaria

Question 24

what is the cause of cyanosis that does not respond to oxygen, no murmur, hypotension, tachycardia

Answer 24

CO poisoning

Question 25

what is the treatment for CO poisoning

Answer 25

methylene blue

Question 26

what is the first step in treating AUB

Answer 26

high dose OCPs. the high dose of estrogen will stabilize the endometrium

Question 27

what is the predominant finding in people with concussion

Answer 27

headache. usually it can be tested by asking them to move their eyes back and forth between two points or the headache will come back when exposed to noise

Question 28

what is perilymphatic fistula

Answer 28

a rare complication of head trauma that causes vertigo and hearing loss

Question 29

what is the pathology of reye syndrome

Answer 29

micro vesicular fatty infiltration

Question 30

aplastic crisis

Answer 30

low reticulocytes. transient arrest of erythropoiesis. likely secondary to parvovirus B19

Question 31

what is the presentation of acute hemolytic transfusion reaction

Answer 31

usually minutes after infusion the patient will have flank pain, fever, chills, hypotension, DIC and shock

Question 32

what is the presentation of endometrial polyps

Answer 32

AUB, usually with intermenstrual bleeding

Question 33

what is the cause of AUB if everything seems normal

Answer 33

probably Von Willebrand Factor deficiency which is failure of platelet adhesion

Question 34

what are the meningitis PEP for children

Answer 34

rifampin and ceftriaxone (cipro for adults)

Question 35

Could growth plates be injured if competitively weight lifting at a young age

Answer 35

yes. | but under proper supervision, normal, lite weight training is perfectly acceptable

Question 36

what should you think about in children with stroke like symptoms

Answer 36

hemoglobin electrophoresis

Question 37

Can children have strokes d

Answer 37

yes. SCD, congenital heart disease, protrombitic disorders, bacterial meningitis, vasculitis, trauma

Question 38

what is the presentation of galactosemia

Answer 38

GALT deficiency, autosomal recessive, jaundice and hepatomegaly, vomiting and poor feeding, failure to thrive, cataracts, increased risk for E coli sepsis.

Question 39

what is the presentation of food-protein induced allergic proctocolitis

Answer 39

young infant, painless bloody stools, with spit up.

Question 40

what is the management for allergic protocolitis

Answer 40

elimination of milk and soy from maternal diet in breastfed infants. hydrolyzed formula in formula fed infants

Question 41

miliaria

Answer 41

heat rash due to blockage of eccrine sweat glands in the setting of heat or humidity

Question 42

pseudofolliculitis

Answer 42

small ands painful papules caused by growth of the hair shaft into the adjacent skin

Question 43

keratosis pilaris

Answer 43

chronic skin condition of retained keratin plugs in hair follicles. painless papules with roughed skin texture, and mottled perifollicular erythema. most common on the posterior surface of the upper arm. exacerbated in cold weather and dry climates.

Question 44

folliculitis

Answer 44

inflamed hair follicles and is typically an acute erythematous pustular lesion

Question 45

what is the difference between aplastic crisis and folate deficiency in SCD

Answer 45

in aplastic crisis the anemia onset is fast, very low reticulocytes count and normocytic. Folate takes longer, is macrocytic and has low to normal reticulocytosis

Question 46

microcephaly, wide anterior fontanelle, cleft palate, hypoplasia of distal phalanges, and IUGR

Answer 46

fetal hydantoin syndrome

Question 47

what is the presentation of fetal hydantoin syndrome

Answer 47

hirsutism, cleft lip and palate, cardiac defects, hypoplasia of the distal phalanges, wide anterior fontanelle, neural tube defects,

Question 48

what is the presentation of cocaine baby

Answer 48

IUGR, placental abruption, preterm delivery

Question 49

what is the presentation of fetal alcohol syndrome

Answer 49

microcephaly, midface hypoplasia,

Question 50

gonococcal conjunctivitis

Answer 50

copious purulent exudate with eyelid swelling typically apparent within the first 2-5 days of life.

Question 51

what is the treatment for gonococcal conjunctivitis

Answer 51

ceftriaxone or cefotaxime

Question 52

chlamydial conjunctivitis

Answer 52

typically arises within the first 5-14 days. much more mild presnetation than gonococcal with eyelid swelling, usually watery discharge, but can be purulent

Question 53

what is the most common risk factor for orbital cellulitis

Answer 53

bacterial sinusitis

Question 54

what is the presentation of orbital cellulitis

Answer 54

fever, pain with eye movement, vision changes

Question 55

what is the most common cause of meningitis in children and young adults

Answer 55

N. meningitidis

Question 56

does pneumococcal meningitis cause a petechial rash

Answer 56

not usually

Question 57

what type of precautions are used for meningitis infection droplet or airborne

Answer 57

droplet

Question 58

what is the presentation of measles

Answer 58

cough, coryza, conjunctivitis. high fever. cephalocaudal rash that coalesces and appears hemorrhagic and nonblanching.

Question 59

what is the presentation of mumps

Answer 59

parotitis and orchitis

Question 60

presentation of rubella

Answer 60

fever, cephalocaudal spread of maculopapular rash. | arthalgias or arthritis may be present, especially in females. lymphadenopathy and koplik spots

Question 61

what is the presentation of congenital rubella

Answer 61

sensorineural hearing loss, cataracts, patent ductus arteriosis

Question 62

do you treat campylobacter coli infections

Answer 62

supportive care only unless severe or high risk cases | usually self limited.

Question 63

what are the complications of campylobacter coli infection

Answer 63

GBS

Question 64

where do you find campylobacter/where is it contracted from

Answer 64

under cooked poultry

Question 65

optic disk pallor, trouble seeing at night, attenuation of retinal vessels with focal areas of discoloration bilaterally, midperiphery field defect.

Answer 65

retinitis pigmentosa

Question 66

treatment for retinitis

Answer 66

omega three fatty acids

Question 67

course/prognosis of retinitis

Answer 67

blind by 40

Question 68

what are the minor criteria for rheumatic fever

Answer 68

fever, ESR, arthralgias, prolonged PR interval.

Question 69

what is the treatment for long QTc syndrome

Answer 69

propanolol and pacer

Question 70

what is the treatment for chlamydial conjunctivitis

Answer 70

azithromycin

Question 71

what is the next step if rapid strep test is negative

Answer 71

throat culture