UWorld Week 1 Flashcards
1
Q
what is a biliary cyst?
A
cystic dilation of the biliary tree in a kid
2
Q
what is the triad of a biliary cyst?
A
abdominal pain, RUQ mass, and jaundice….BUT can be asymptomatic
3
Q
what is imaging for a biliary cyst?
A
US
4
Q
what is therapy for biliary cyst? why
A
surgical removal to decrease risk of malignancy
5
Q
what are complications of having a biliary cyst?
A
cholangiocarcinoma
pancreatitis
acute cholangitis
6
Q
what is protein deficiency in neimann picj disease?
A
sphingomyelinase
7
Q
what is protein deficiency in tay sachs disease?
A
B hexosaminidase a
8
Q
which of tay sachs or niemann pick has hepatosplenomegaly?
A
niemann pick
9
Q
what milestones are not met in niemann pick and tay sachs?
A
will lose motor milestones
10
Q
what is TTN?
A
transient tachypnea of newborn
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
12
Q
what is cause of TTN?
A
delayed resorption of lung fluid
13
Q
when are peritonsilar abscesses common?
A
adolescents
14
Q
what is the etiology of a peritonsilar abscesS?
A
bacterial infection of region between tonsils and pharyngeal muscles
15
Q
what are the symptoms of peritonsilar abscess?
A
fever and sore throat with enlarged tonsils
16
Q
what are signs of peritonsilar abscess on exam?
A
trismus of jaw muscles, hot potato voice, uvula deviation
17
Q
what is rx for peritonsilar abscess?
A
aspirate and give abx
18
Q
what virus causes molloscum?
A
poxvirus
19
Q
in addition to polyuria and polydipsia, what else can happen in kids with DM?
A
weight loss and fatiguw
20
Q
what ages does DM onset in kids?
A
4-6 and 10-14
21
Q
how do you diagnose a TEF in a neonate?
A
placing an NG tube and it wont go down
22
Q
what is a TEF associated with?
A
called VACTERL association
23
Q
what is the VACTERL association with a TEF?
A
means there may be defects in vertebrae, anal, cardiac, tracheoesophageal, renal and limbs
24
Q
where does excess bilirubin deposit in newborn brain?
A
basal ganglia and brainstem nuclie`
25
what usually causes orbital compartment syndrome?
trauma, coagulopathy, surgery or orbital infection
26
what are signs of orbital comaprtment syndrome?
loss of vision, rock hard eyelid and proptosis
27
ingestion of what substance causes direct damage to the GI mucosa?
iron
28
what are some symptoms of iron ingestion in a kid
hematemesis, abdominal pain, nausea and vomiting
29
what type of metabolic issue does iron ingestion cause?
metabolic acidosis with anion gap
30
what is treatment of iron ingestion in kid?
desferoxamine chelation
31
how should weight and height change by 1 year old?
weight triples and height increases 50% from birth height
32
what is MC cardiac abnormality in T21?
complete AV septum defect
33
what are the auscultation findings with complete AV septum defect?
fixed split S2
| systolic ejection murmur
34
what are the two congenital melanocyte things that babies can have?
congenital dermal melanocytosis
| congenital melanocytic nevus
35
how does a congenital dermal melanocytosis appear?
blue grey in color, on multiple areas being more common in AA
36
what is a congenital melanocytic nevus? what does it have?
congenital mole...often has more hair
37
what is chiari 1 malformation?
inferior displacement of the cerebellum through the foramen magnum
38
when do sx of chiari I onset? what are they?
adolescents...HA and syringomyelia
39
what is the cutoff for hematuria on urinalysis?
3 or more RBCs
40
if you have 0-2 RBCs on urinalysis, what is likely cause?
hemolysis or rhabdomyolysis
41
what does impetigo look like?
papules and pustules with honey crusted lesion
42
what is rx for impetigo that is localized?
mupirocin...topical abx
43
what are the blood findings of diamond blackfan anemia?
macrocytic anemia, normal platelets and white cells
44
what are physical featuresof diamond blackfan anemia?
malformed thumbs, webbed neck, facial abnormalities
45
what is age range for febrile seizures?
6 mos to 5 yrs
46
what is food protein induced allergic proctocolitis?
non IgE mediated reaction in infant to protein in moms diet
47
what does baby have in food protein induced allergic proctocolitis?
painless bloody stools
48
what are the three bugs that can cause epiglottitis?
H flu, staph a and strep
49
what is abx choice for epiglottitis?
vancomycin and ceftriaxone
50
what situations should you give prophylaxis for tick bites?
deer tick identified and tick attached for more than 36 hours
51
what is abx prophylaxis for lyme disease?
single dose doxycycline
52
what are two risk factors for atraumatic splenic rupture?
prior infection and malignancy
53
how does patient appear with atraumatic splenic rupture?
appears in shock, free fluid in abdomen
54
what is PE sign for atraumatic splenic rupture?
LUQ tenderness
55
can babies with down syndrome have hypotonia?
you betcha
56
what is congenital nasolacrimal duct obstruction?
duct is blocked at birth
57
what are signs of congenital nasolacrimal duct obstruction?
persistent eye discharge, increased tearing
58
what is abx of choice for otitis media?
amoxicillin
59
if patient with otitis media allergic to penicillin, what can you give?
clinda or azithromycin
60
what should always be suspected in infant with bilious vomiting?
malrotation with midgut volvulus
61
what happens in malrotation with midgut volvulus ?
small bowel twists around the superior mesenteric artery
62
what is diagnostic tool for malrotation with midgut volvulus ?
abdominal Xray
63
what is intervention for malrotation with midgut volvulus ?
emergency laporotamy
64
what is X ray sign for malrotation with midgut volvulus
corkscrew
65
what are PE signs of malrotation with midgut volvulus ?
no bowel sounds, abdominal distension, and tenderness
66
what is gold standard diagnostic tool for ALL?
bone marrow biopsy
67
what is diagnostic criteria of bone marrow biopsy in ALL?
25% blasts
68
what are signs of heat exhaustion in peds patients?
weakness, profuse sweating, N/V,
69
three nutritional deficiencies with being vegan?
low B12, calcium and vitamin D
70
what is rx of meningococcal meningitis?
ceftriaxone
71
what are physical signs of meningococcal meningitis?
petechiae/purpura and meningeal signs with AMS
72
what are symptoms of meningococcal meningitis?
fever, HA, vomiting, myalgias
73
discrete firm and rubbery nodules in a mouth are what?
mucosal neuromas
74
what are mucosal neuromas associated with?
MEN2b...
75
what things are included in MEN2b?
medullary thyroid cancer, pheochromocytoma, mucosal neuromas
76
what Abs are low in CVID?
IgG, IgA, IgM
77
what is management therapy of CVID?
Ivig
78
what should alert you for CVID in someone?
recurrent pulmonary and GI infections of unknown etiology
79
when does vitamin A deficiency onset in kids?
2-3 years old
80
what are sx of vitamin A deficiency?
impaired adaptation to darkness, photophobia, dry scaly skin, dry conjunctiva
81
what is treatment of bed bugs?
symptomatic with topical steroids and antihistamines
82
what do bed bug bites look like?
small puncta and maculopapules in linear groupings
83
pink diapers in first week of life are from what?
uric acid crystals coming out
84
what does apnea of prematurity look like?
intermittent phases of apnea that lasts for 20 seconds and can have bradycardia and desaturation
85
what is rx for apnea of prematurity?
caffeine
86
what are two infectious features of Xlinked agammaglobulinemia?
enteroviral meningitis and recurrent pneumonia
87
what is the lab finding in Xlinked agammaglobulinemia?
low levels of all Igs
88
two common causes of bilious emesis in infant?
malrotation and intussusception
89
what are the levels of FSH/LH in Kallman syndrome?
low
90
what is karyotype in Kallman syndrome?
46XX
91
what are signs for Kallman syndrome?
short female with primary amenorrhea, normal internal female organs
92
what is an additional symptoms of Kallman syndrome?
lack of smell
93
what is most common cause of stridor in infants?
laryngomalacia
94
what is laryngomalacia?
supraglottic tissues are floppy and collapse on inspiration
95
patient has stridor when supine but not when upright, what is most likely cause?
laryngomalacia
96
what is often associated with laryngomalacia?
GER
97
what is most common vasculitis in kids?
henoch schonlein
98
what is triad of symptoms in henoch schonlein?
petechiae/purpura, abdominal pain and arthralgia
99
what organ can be affected in henoch schonlein?
renal disease
100
what are platelet and coagulation studies in henoch schonlein?
all normal
101
what deposits in vessels in henoch schonlein?
IgA and C3
102
what is therapy for henoch schonlein?
NSAIDs and steroids if bad
103
what age are SCFEs more common?
adolescent
104
what is X ray finding of a SCFE?
posterior displaced head of femur
105
what type of movement is limited in SCFE?
internal rotation of hip
106
what is Rx for SCFE?
limit weight bearing and surgical pinning
107
two complications of SCFE
avascular necrosis and osteoarthritis
108
describe GBS (strep agalactiae)
gram positive cocci in chains
109
what is definitive therapy for GBS infection?
penicillin
110
early onset GBS occurs when?
within 7 days of birth
111
late onset GBS occurs when?
age 4-5 weeks
112
what types of infection are GBS early infection associated with?
meningitis, pneumonia and sepsis
113
what types of infection are GBS late infection associated with?
bacteremia, meningitis and focal infection like cellulitis
114
what is transmission in late GBS?
horizontal from colonized individual
115
what is mastoiditis? what causes it?
infection of mastoid air cells...caused by chronic ear infection
116
what are some complications of mastoiditis?
brain abscess, meningitis, facial nerve palsy, hearing loss
117
what is treatment of mastoiditis?
IV abx and mastoidectomy to drain if needed
118
what is common sign of a brain abscess?
nocturnal headaches that dont respond to rx
119
what two bugs cause otitis externa?
pseudomonas and staph A
120
what is Rx for otitis externa?
topical fluoroquinolone...like ciprofloxacin
121
PSGN in nephritic or nephrotic?
nephritic...RBCs
122
if patient with PSGN is volume overloaded, has high BP, what should you give?
furosemide..diuretics
123
what is inheritance of tuberous sclerosis complex?
AD
124
what does tuberous sclerosis complex cause to grow?
hamartomas
125
what are the three skin findings in tuberous sclerosis complex?
ahs leaf spots, shagreen patches and periungual fibromas
126
what is a periungual fibroma?
growth underneath nail fold
127
what are two neuro findings in tuberous sclerosis complex?
subependymal nodules, seizures
128
what is NAS? what causes it?
neonatal abstinence syndrome, intrauterine exposure to heroin
129
what are symptoms of NAS?
irritable, high pitched cry, feeding difficulty, D/V
130
when does NAS present?
48-72 hrs after birth
131
what is rx for NAS?
give opiates
132
what is a common hematologic finding with celiacs?
microcytic anemia bc hard time absorbing iron
133
what worm causes perianal itching?
pinworm, enterobius vermicularis
134
what is rx for pinworms?
pyrantel pamoate or albendazole
135
what are four risk factors for respiratory distress syndrome in infants?
prematurity, maternal diabetes, c sxn without labor and male sex
136
what is polycythemia cutoff in newborns?
hematocrit greater than 65%
137
what are some causes of newborn polycythemia?
intrauterine hypoxia from HTN, diabetes, or smoking
138
what are some symptoms of newborn polycythemia?
can be in respiratory distress with cyanosis, irritable
139
what can happen to levels of sugar and bilirubin in neonatal polycythemia?
increase bili and low sugar
140
what is therapy for neonatal polycythemia/
fluids, glucose and exchange transfusion if needed
141
what is presentation of transient synovitis?
patient with new joint pain, but able to bear weight
142
what age gets transient synovitis?
3-8
143
what are cell markers for transient synovitis?
slightly elevated white count, normal CRP and inflammatory markers
144
what is seen on ultrasound with transient synovitis?
joint effusions
145
where is issue in transient synovitis? where do patients feel it?
issue is in hips..pain referred to knees
146
what is rx of transient synovitis?
conservative...will go away
147
what is cause of transient synovitis?
new exercise or viral illnesses
148
child with a bloody diarrhea and Gi illness has a seizure, what bug?
shigella
149
where do shigella breakouts occur?
at daycares
150
what four bugs cause bloody diarrhea?
E coli 0157H7
Shigella
campylobacter
salmonella
151
how do kids get campylobacter?
ingestion of raw meat
152
how do kids get shigella?
ingestion of contaminated food or water
153
when do you find howell jolly bodies on blood smear?
functional asplenia
154
what is another name for schistocytes?
helmet cells
155
what is Rx for galactosemia?
soy based formula
156
when does galactosemia present?
first week of life
157
what are common presenting symptoms of galactosemia?
seizures, vomiting, hypoglycemia
158
what happens to sugar levels in galactosemia?
LOW
159
what are physical exam findings of galactosemia?
jaundice hepatomegaly and cataracts
160
what type of bilirubin is elevated in galactosemia?
direct
161
what is a lab abnormality that is specific for galactosemia?
reducing substance in urine
162
how does squatting help decrease cyanosis in tet spells?
increase SVR so decrease shunting from right to left
163
how does hereditary spherocytosis present?
triad of jaundice, splenomegaly and anemia
164
what two blood lab values are increased in hereditary spherocytosi?
MCHC and reticulocytes
165
what is test that is specific for hereditary spherocytosis?
eosin 5 maleinide test and increased osmotic fragility test
166
what is treatment for hereditary spherocytosis?
folic acid supplement, splenectomy and transfusion
