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Pediatrics > UWorld Week 1 > Flashcards

UWorld Week 1 Flashcards

1
Q

what is a biliary cyst?

A

cystic dilation of the biliary tree in a kid

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2
Q

what is the triad of a biliary cyst?

A

abdominal pain, RUQ mass, and jaundice….BUT can be asymptomatic

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3
Q

what is imaging for a biliary cyst?

A

US

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4
Q

what is therapy for biliary cyst? why

A

surgical removal to decrease risk of malignancy

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5
Q

what are complications of having a biliary cyst?

A

cholangiocarcinoma
pancreatitis
acute cholangitis

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6
Q

what is protein deficiency in neimann picj disease?

A

sphingomyelinase

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7
Q

what is protein deficiency in tay sachs disease?

A

B hexosaminidase a

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8
Q

which of tay sachs or niemann pick has hepatosplenomegaly?

A

niemann pick

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9
Q

what milestones are not met in niemann pick and tay sachs?

A

will lose motor milestones

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10
Q

what is TTN?

A

transient tachypnea of newborn

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11
Q

what increases risk for TTN?

A

c sxn because fluid resoprtion is increased during vaginal delivery and dont get that in a c sxn

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12
Q

what is cause of TTN?

A

delayed resorption of lung fluid

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13
Q

when are peritonsilar abscesses common?

A

adolescents

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14
Q

what is the etiology of a peritonsilar abscesS?

A

bacterial infection of region between tonsils and pharyngeal muscles

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15
Q

what are the symptoms of peritonsilar abscess?

A

fever and sore throat with enlarged tonsils

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16
Q

what are signs of peritonsilar abscess on exam?

A

trismus of jaw muscles, hot potato voice, uvula deviation

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17
Q

what is rx for peritonsilar abscess?

A

aspirate and give abx

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18
Q

what virus causes molloscum?

A

poxvirus

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19
Q

in addition to polyuria and polydipsia, what else can happen in kids with DM?

A

weight loss and fatiguw

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20
Q

what ages does DM onset in kids?

A

4-6 and 10-14

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21
Q

how do you diagnose a TEF in a neonate?

A

placing an NG tube and it wont go down

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22
Q

what is a TEF associated with?

A

called VACTERL association

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23
Q

what is the VACTERL association with a TEF?

A

means there may be defects in vertebrae, anal, cardiac, tracheoesophageal, renal and limbs

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24
Q

where does excess bilirubin deposit in newborn brain?

A

basal ganglia and brainstem nuclie`

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25
Q

what usually causes orbital compartment syndrome?

A

trauma, coagulopathy, surgery or orbital infection

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26
Q

what are signs of orbital comaprtment syndrome?

A

loss of vision, rock hard eyelid and proptosis

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27
Q

ingestion of what substance causes direct damage to the GI mucosa?

A

iron

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28
Q

what are some symptoms of iron ingestion in a kid

A

hematemesis, abdominal pain, nausea and vomiting

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29
Q

what type of metabolic issue does iron ingestion cause?

A

metabolic acidosis with anion gap

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30
Q

what is treatment of iron ingestion in kid?

A

desferoxamine chelation

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31
Q

how should weight and height change by 1 year old?

A

weight triples and height increases 50% from birth height

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32
Q

what is MC cardiac abnormality in T21?

A

complete AV septum defect

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33
Q

what are the auscultation findings with complete AV septum defect?

A

fixed split S2

systolic ejection murmur

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34
Q

what are the two congenital melanocyte things that babies can have?

A

congenital dermal melanocytosis

congenital melanocytic nevus

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35
Q

how does a congenital dermal melanocytosis appear?

A

blue grey in color, on multiple areas being more common in AA

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36
Q

what is a congenital melanocytic nevus? what does it have?

A

congenital mole…often has more hair

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37
Q

what is chiari 1 malformation?

A

inferior displacement of the cerebellum through the foramen magnum

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38
Q

when do sx of chiari I onset? what are they?

A

adolescents…HA and syringomyelia

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39
Q

what is the cutoff for hematuria on urinalysis?

A

3 or more RBCs

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40
Q

if you have 0-2 RBCs on urinalysis, what is likely cause?

A

hemolysis or rhabdomyolysis

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41
Q

what does impetigo look like?

A

papules and pustules with honey crusted lesion

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42
Q

what is rx for impetigo that is localized?

A

mupirocin…topical abx

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43
Q

what are the blood findings of diamond blackfan anemia?

A

macrocytic anemia, normal platelets and white cells

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44
Q

what are physical featuresof diamond blackfan anemia?

A

malformed thumbs, webbed neck, facial abnormalities

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45
Q

what is age range for febrile seizures?

A

6 mos to 5 yrs

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46
Q

what is food protein induced allergic proctocolitis?

A

non IgE mediated reaction in infant to protein in moms diet

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47
Q

what does baby have in food protein induced allergic proctocolitis?

A

painless bloody stools

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48
Q

what are the three bugs that can cause epiglottitis?

A

H flu, staph a and strep

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49
Q

what is abx choice for epiglottitis?

A

vancomycin and ceftriaxone

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50
Q

what situations should you give prophylaxis for tick bites?

A

deer tick identified and tick attached for more than 36 hours

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51
Q

what is abx prophylaxis for lyme disease?

A

single dose doxycycline

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52
Q

what are two risk factors for atraumatic splenic rupture?

A

prior infection and malignancy

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53
Q

how does patient appear with atraumatic splenic rupture?

A

appears in shock, free fluid in abdomen

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54
Q

what is PE sign for atraumatic splenic rupture?

A

LUQ tenderness

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55
Q

can babies with down syndrome have hypotonia?

A

you betcha

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56
Q

what is congenital nasolacrimal duct obstruction?

A

duct is blocked at birth

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57
Q

what are signs of congenital nasolacrimal duct obstruction?

A

persistent eye discharge, increased tearing

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58
Q

what is abx of choice for otitis media?

A

amoxicillin

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59
Q

if patient with otitis media allergic to penicillin, what can you give?

A

clinda or azithromycin

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60
Q

what should always be suspected in infant with bilious vomiting?

A

malrotation with midgut volvulus

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61
Q

what happens in malrotation with midgut volvulus ?

A

small bowel twists around the superior mesenteric artery

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62
Q

what is diagnostic tool for malrotation with midgut volvulus ?

A

abdominal Xray

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63
Q

what is intervention for malrotation with midgut volvulus ?

A

emergency laporotamy

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64
Q

what is X ray sign for malrotation with midgut volvulus

A

corkscrew

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65
Q

what are PE signs of malrotation with midgut volvulus ?

A

no bowel sounds, abdominal distension, and tenderness

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66
Q

what is gold standard diagnostic tool for ALL?

A

bone marrow biopsy

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67
Q

what is diagnostic criteria of bone marrow biopsy in ALL?

A

25% blasts

68
Q

what are signs of heat exhaustion in peds patients?

A

weakness, profuse sweating, N/V,

69
Q

three nutritional deficiencies with being vegan?

A

low B12, calcium and vitamin D

70
Q

what is rx of meningococcal meningitis?

A

ceftriaxone

71
Q

what are physical signs of meningococcal meningitis?

A

petechiae/purpura and meningeal signs with AMS

72
Q

what are symptoms of meningococcal meningitis?

A

fever, HA, vomiting, myalgias

73
Q

discrete firm and rubbery nodules in a mouth are what?

A

mucosal neuromas

74
Q

what are mucosal neuromas associated with?

A

MEN2b…

75
Q

what things are included in MEN2b?

A

medullary thyroid cancer, pheochromocytoma, mucosal neuromas

76
Q

what Abs are low in CVID?

A

IgG, IgA, IgM

77
Q

what is management therapy of CVID?

A

Ivig

78
Q

what should alert you for CVID in someone?

A

recurrent pulmonary and GI infections of unknown etiology

79
Q

when does vitamin A deficiency onset in kids?

A

2-3 years old

80
Q

what are sx of vitamin A deficiency?

A

impaired adaptation to darkness, photophobia, dry scaly skin, dry conjunctiva

81
Q

what is treatment of bed bugs?

A

symptomatic with topical steroids and antihistamines

82
Q

what do bed bug bites look like?

A

small puncta and maculopapules in linear groupings

83
Q

pink diapers in first week of life are from what?

A

uric acid crystals coming out

84
Q

what does apnea of prematurity look like?

A

intermittent phases of apnea that lasts for 20 seconds and can have bradycardia and desaturation

85
Q

what is rx for apnea of prematurity?

A

caffeine

86
Q

what are two infectious features of Xlinked agammaglobulinemia?

A

enteroviral meningitis and recurrent pneumonia

87
Q

what is the lab finding in Xlinked agammaglobulinemia?

A

low levels of all Igs

88
Q

two common causes of bilious emesis in infant?

A

malrotation and intussusception

89
Q

what are the levels of FSH/LH in Kallman syndrome?

A

low

90
Q

what is karyotype in Kallman syndrome?

A

46XX

91
Q

what are signs for Kallman syndrome?

A

short female with primary amenorrhea, normal internal female organs

92
Q

what is an additional symptoms of Kallman syndrome?

A

lack of smell

93
Q

what is most common cause of stridor in infants?

A

laryngomalacia

94
Q

what is laryngomalacia?

A

supraglottic tissues are floppy and collapse on inspiration

95
Q

patient has stridor when supine but not when upright, what is most likely cause?

A

laryngomalacia

96
Q

what is often associated with laryngomalacia?

A

GER

97
Q

what is most common vasculitis in kids?

A

henoch schonlein

98
Q

what is triad of symptoms in henoch schonlein?

A

petechiae/purpura, abdominal pain and arthralgia

99
Q

what organ can be affected in henoch schonlein?

A

renal disease

100
Q

what are platelet and coagulation studies in henoch schonlein?

A

all normal

101
Q

what deposits in vessels in henoch schonlein?

A

IgA and C3

102
Q

what is therapy for henoch schonlein?

A

NSAIDs and steroids if bad

103
Q

what age are SCFEs more common?

A

adolescent

104
Q

what is X ray finding of a SCFE?

A

posterior displaced head of femur

105
Q

what type of movement is limited in SCFE?

A

internal rotation of hip

106
Q

what is Rx for SCFE?

A

limit weight bearing and surgical pinning

107
Q

two complications of SCFE

A

avascular necrosis and osteoarthritis

108
Q

describe GBS (strep agalactiae)

A

gram positive cocci in chains

109
Q

what is definitive therapy for GBS infection?

A

penicillin

110
Q

early onset GBS occurs when?

A

within 7 days of birth

111
Q

late onset GBS occurs when?

A

age 4-5 weeks

112
Q

what types of infection are GBS early infection associated with?

A

meningitis, pneumonia and sepsis

113
Q

what types of infection are GBS late infection associated with?

A

bacteremia, meningitis and focal infection like cellulitis

114
Q

what is transmission in late GBS?

A

horizontal from colonized individual

115
Q

what is mastoiditis? what causes it?

A

infection of mastoid air cells…caused by chronic ear infection

116
Q

what are some complications of mastoiditis?

A

brain abscess, meningitis, facial nerve palsy, hearing loss

117
Q

what is treatment of mastoiditis?

A

IV abx and mastoidectomy to drain if needed

118
Q

what is common sign of a brain abscess?

A

nocturnal headaches that dont respond to rx

119
Q

what two bugs cause otitis externa?

A

pseudomonas and staph A

120
Q

what is Rx for otitis externa?

A

topical fluoroquinolone…like ciprofloxacin

121
Q

PSGN in nephritic or nephrotic?

A

nephritic…RBCs

122
Q

if patient with PSGN is volume overloaded, has high BP, what should you give?

A

furosemide..diuretics

123
Q

what is inheritance of tuberous sclerosis complex?

A

AD

124
Q

what does tuberous sclerosis complex cause to grow?

A

hamartomas

125
Q

what are the three skin findings in tuberous sclerosis complex?

A

ahs leaf spots, shagreen patches and periungual fibromas

126
Q

what is a periungual fibroma?

A

growth underneath nail fold

127
Q

what are two neuro findings in tuberous sclerosis complex?

A

subependymal nodules, seizures

128
Q

what is NAS? what causes it?

A

neonatal abstinence syndrome, intrauterine exposure to heroin

129
Q

what are symptoms of NAS?

A

irritable, high pitched cry, feeding difficulty, D/V

130
Q

when does NAS present?

A

48-72 hrs after birth

131
Q

what is rx for NAS?

A

give opiates

132
Q

what is a common hematologic finding with celiacs?

A

microcytic anemia bc hard time absorbing iron

133
Q

what worm causes perianal itching?

A

pinworm, enterobius vermicularis

134
Q

what is rx for pinworms?

A

pyrantel pamoate or albendazole

135
Q

what are four risk factors for respiratory distress syndrome in infants?

A

prematurity, maternal diabetes, c sxn without labor and male sex

136
Q

what is polycythemia cutoff in newborns?

A

hematocrit greater than 65%

137
Q

what are some causes of newborn polycythemia?

A

intrauterine hypoxia from HTN, diabetes, or smoking

138
Q

what are some symptoms of newborn polycythemia?

A

can be in respiratory distress with cyanosis, irritable

139
Q

what can happen to levels of sugar and bilirubin in neonatal polycythemia?

A

increase bili and low sugar

140
Q

what is therapy for neonatal polycythemia/

A

fluids, glucose and exchange transfusion if needed

141
Q

what is presentation of transient synovitis?

A

patient with new joint pain, but able to bear weight

142
Q

what age gets transient synovitis?

A

3-8

143
Q

what are cell markers for transient synovitis?

A

slightly elevated white count, normal CRP and inflammatory markers

144
Q

what is seen on ultrasound with transient synovitis?

A

joint effusions

145
Q

where is issue in transient synovitis? where do patients feel it?

A

issue is in hips..pain referred to knees

146
Q

what is rx of transient synovitis?

A

conservative…will go away

147
Q

what is cause of transient synovitis?

A

new exercise or viral illnesses

148
Q

child with a bloody diarrhea and Gi illness has a seizure, what bug?

A

shigella

149
Q

where do shigella breakouts occur?

A

at daycares

150
Q

what four bugs cause bloody diarrhea?

A

E coli 0157H7
Shigella
campylobacter
salmonella

151
Q

how do kids get campylobacter?

A

ingestion of raw meat

152
Q

how do kids get shigella?

A

ingestion of contaminated food or water

153
Q

when do you find howell jolly bodies on blood smear?

A

functional asplenia

154
Q

what is another name for schistocytes?

A

helmet cells

155
Q

what is Rx for galactosemia?

A

soy based formula

156
Q

when does galactosemia present?

A

first week of life

157
Q

what are common presenting symptoms of galactosemia?

A

seizures, vomiting, hypoglycemia

158
Q

what happens to sugar levels in galactosemia?

A

LOW

159
Q

what are physical exam findings of galactosemia?

A

jaundice hepatomegaly and cataracts

160
Q

what type of bilirubin is elevated in galactosemia?

A

direct

161
Q

what is a lab abnormality that is specific for galactosemia?

A

reducing substance in urine

162
Q

how does squatting help decrease cyanosis in tet spells?

A

increase SVR so decrease shunting from right to left

163
Q

how does hereditary spherocytosis present?

A

triad of jaundice, splenomegaly and anemia

164
Q

what two blood lab values are increased in hereditary spherocytosi?

A

MCHC and reticulocytes

165
Q

what is test that is specific for hereditary spherocytosis?

A

eosin 5 maleinide test and increased osmotic fragility test

166
Q

what is treatment for hereditary spherocytosis?

A

folic acid supplement, splenectomy and transfusion

Pediatrics (4 decks)

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