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Pediatrics > Uworld week 2 > Flashcards

Uworld week 2 Flashcards

1
Q

what are signs of premature adrenarche?

A

isolated pubic hair development early

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2
Q

what nerves does erb duchenne palsy include?

A

C567

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3
Q

what is sign of erb duchenne palsy?

A

waiters tip

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4
Q

what are muscle changes in erb duchenne palsy?

A

weakness of biceps, wrist and finger extenders and deltoid

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5
Q

what is MC brachial plexus injury during birth?

A

erb duchenne palsy

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6
Q

what is rx for erb duchenne palsy?

A

reassurance and PT

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7
Q

triad of rett syndrome

A

gait issues, loss of speech, abnormal hand movements

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8
Q

other signs of rett syndrome outside of triad?

A

seizures, breathing abnormalities microcephaly

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9
Q

what vaccine can cause a reaction in kids?

A

varicella

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10
Q

how long after varicella vaccine can you get rash?

A

2 weeks

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11
Q

what does varicella vaccine rash look like?

A

minimal number of vesicular papules on the chest

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12
Q

MC bug that causes pneumonia in CF patients under 20?

A

staph A

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13
Q

MC bug that causes pneumonia in CF patients over 20?

A

pseudomonas

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14
Q

what is therapy for central precocious puberty?

A

GnRH agonist

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15
Q

what is difference in central versus peripheral precocious puberty

A

central has high LH and FSH while peripheral has no LH/FSH

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16
Q

what are the symptoms of lens dislocation?

A

poor vision and tremulous iris

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17
Q

what disease is lens dislocation often associated with?

A

marfan syndrome

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18
Q

what is associated with marfan that is deadly?

A

aortic root disease

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19
Q

3 first line options of ITP rx

A

steroids, IVIG and anti D

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20
Q

if ITP is refractory to treatment what can you do?

A

splenectomy

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21
Q

what is bronchopulmonary dysplasia?

A

arrest of pulmonary development in neonate

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22
Q

what is cause of bronchopulmonary dysplasia?

A

long term more than 28 days of supplemental oxygen required

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23
Q

what happens to the lungs with bronchopulmonary dysplasia?

A

alveolar hypoplasia with decreased septation

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24
Q

what is rx for bronchopulmonary dysplasia?

A

wean respiratory support

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25
Q

what infection has slapped cheek appearance?

A

parvovirus

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26
Q

how does measles rash spread?

A

from head to toe

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27
Q

what are symptoms of measles?

A

cough coryza conjunctivitis fever and rash

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28
Q

what are symptoms of kawaksaki disease

A 
conjunctivitis
oral mucosa changes
rash
desquamating skin
cervical lymphadenopathy
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29
Q

what are patients with kawasaki at risk for?

A

coronary artery anuerysms

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30
Q

what are CSF finding in guillaine barre?

A

increased protein all else normal

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31
Q

how does weakness progress in GBS?

A

ascending weakness and areflexia

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32
Q

what often precedes GBS?

A

campylobacter or respiratory infection

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33
Q

aside from weakness and areflexia, what are other issues to watch for in GBS?

A

respiratory dysfxn, autonomic dysfxn

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34
Q

what is rx for GBS?

A

IVIG or plasmapheresis

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35
Q

what is treatment for central precocious puberty?

A

GnRH agonists

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36
Q

what is a sign of acute mastoiditis/

A

tenderness to palpation behind ear and redness/bulging of ear

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37
Q

what is RX for acute mastoidits?

A

IV abx

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38
Q

what infection can cause late onset of monoarticular knee pain?

A

lyme disease

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39
Q

what organs are hurt in Gaucher disease?

A

liver spleen and bone marrow

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40
Q

name three exam findings consistent with gaucher disease

A

hepatomegaly splenomegaly and delayed puberty

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41
Q

what are two abnormal lab values in gaucher disease?

A

anemia and thrombocytopenia

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42
Q

what is the hallmark xray finding of necrotizing enterocolitis?

A

pneumatosis intestinalis

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43
Q

what is penumatosis intestinalis?

A

air in bowel wall on xray

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44
Q

what causes necrotizing enterocolitis?

A

air producing bacteria in wall of gut

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45
Q

who gets necrotizing enterocolitis?

A

preterm and low birth weight babies

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46
Q

what should be done about feeding in necrotizing enterocoltis?

A

feeding should be stopped immediately

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47
Q

what should be given to treat necrotizing entercolitis?

A

IV abx

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48
Q

what lab should be ordered in necrotizing enterocolitis?

A

culture of blood and CBC

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49
Q

when do kids get VZV vaccine?

A

age 1 and 4

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50
Q

what to do if kid is exposed to VZV and is asymptomatic but doesnt have VZV vaccine?

A

give vaccine

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51
Q

what to do if kid is exposed to VZV and is asymptomatic but doesnt have VZV vaccine and is immunocompromised?

A

give varicella IVIG

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52
Q

what to do if kid is exposed to VZV and is asymptomatic but doeshave VZV vaccine?

A

reassurance and observation

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53
Q

what is infant dyschezia?

A

healthy infant that cries and strains when passing stools

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54
Q

what do you do for infant dyschezia?

A

nothing

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55
Q

when do babies with biliary atresia present?

A

before 2 months of age

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56
Q

what is change in poop with biliary atresia?

A

poop is pale/grey because of the lack of bilirubin in it

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57
Q

what can happen to the liver in biliary atresia?

A

liver failure

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58
Q

what is bronchopumonary dysplasia?

A

chronic lung disease of the newborn

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59
Q

name three risk factors for bronchopumonary dysplasia

A

low birth weight, NRDS, mechanical ventilation

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60
Q

what are signs of bronchopumonary dysplasia?

A

persistent oxygen requirement and tachypnea

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61
Q

what are imaging findings of bronchopumonary dysplasia?

A

haziness of lungs and decreased lung volumes

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62
Q

what is most common congenital infection?

A

CMV

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63
Q

what are signs of CMV in brain?

A

periventricular calcifications, microcephaly

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64
Q

what organ is messed up in congenital CMV?

A

large liver

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65
Q

what lab is abnormal in congenital CMV?

A

thrombocytopenia

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66
Q

what are brain changes with congenital toxoplasmosis?

A

hydrocephalus and diffuse brain calcifications

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67
Q

what is otitis media with effusion?

A

when fluid gets in middle ear

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68
Q

how will tympanic membrane appear in otitis media with effusion?

A

air fluid levels posterior to tympanic membrane

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69
Q

what is rx for otitis media with effusion?

A

nothing…reassurance

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70
Q

what are symptoms of otitis media with effusion?

A

ear tugging…NO fever

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71
Q

what type of diarrhea in campylobacter infxn?

A

usually watery diarrhea

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72
Q

what is rx for campylobacter infxn in kids?

A

symptomatic care…

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73
Q

preterm infants require what test? why?

A

head ultrasouns…at increased risk for Intraventricular hemorrhage

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74
Q

what bacteria can infect a toddlers anal area?

A

strep pyogenes

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75
Q

what are symptoms of perianal strep infection?

A

red rash around anus, painful, bloody stools

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76
Q

what is rx of perianal strep infection?

A

amoxicillin

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77
Q

what is a sign on physical exam of developmental dysplasia of hip?

A

limb length discrepancy

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78
Q

what is imaging for developmental dysplasis of hip in kid under four months?

A

US

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79
Q

what is imaging for developmental dysplasis of hip in kid over four months?

A

Xray

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80
Q

where does ewing sarcoma occur in bone?

A

diaphysis

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81
Q

what is classic appearance of swing sarcoma?

A

moth eaten or onion skinning

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82
Q

what is vision change in idiopathic intracranial hypertension?

A

larger blind spot

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83
Q

what is seen on eye exam in idiopathic intracranial hypertension?

A

papilledema

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84
Q

what is rx for idiopathic intracranial hypertension?

A

acetazolamide

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85
Q

what are general symptoms of idiopathic intracranial hypertension?

A

headache and nausea

86
Q

what precaution for N men transmission?

A

droplet

87
Q

prader willi is issue with passage of what copy of 15q11?

A

paternal

88
Q

what are other symptoms of prader willi aside from hyperphagia?

A

hypotonia, short stature, ID, facial feature dysmorphia

89
Q

a fever until what age gets you an immediate lumbar puncture?

A

28 days

90
Q

what is most common cause of fever in infants?

A

UTI

91
Q

what are symptoms of UTI in infant?

A

fever, fussy, abdominal tenderness

92
Q

4 signs of PKU

A

ID, seizures, musty odor, hypopigmentation

93
Q

what are signs of tetani in infant?

A

spasms and hypertonicity

94
Q

what can lead to tetani in infant?

A

dirty delivery and no vaccinations

95
Q

what is rx of tetani in infant?

A

abx and tetanus immune globulin

96
Q

an inflammed umbilical cord should make you worried about what?

A

neonatal tetanus

97
Q

what is major risk of infant tetani?

A

respiratory distress because of involvement of muscle of breathing

98
Q

what is rx for intusussception?

A

air enema

99
Q

what is murmur of VSD?

A

3/6 holosystolic

100
Q

where do you hear VSD murmur?

A

lower left sternal border

101
Q

what is bone finding in langerhans cell histiocytosis?

A

lytic bone lesions of skull and femur

102
Q

what is endocrine finding in langerhans cell histiocytosis?

A

diabetes insipidus

103
Q

what is derm finding in langerhans cell histiocytosis?

A

papules with erythematous rash

104
Q

in addition to purpura, abdominal pain and arthralgia, what can you have with henoch schonlein?

A

scrotal pain and swelling

105
Q

gestational diabetes puts infants at risk for what cardiac issue?

A

neonatal hypertrophic cardiomyopathy

106
Q

infants with neonatal hypertrophic cardiomyopathy can have what issue with heart?

A

increased IV septum thickness

107
Q

what are some findings of neonatal hypertrophic cardiomyopathy ?

A

systolic ejection murmur and respiratory distress

108
Q

3 MC drugs that induce hemolytic anemia

A

NSAIDs, cephalosporins, penicillins

109
Q

two drugs for tinea infections

A

griseofulvin and terbinafine

110
Q

what is another symptom aside from classic rash and itchy in tinea?

A

can have lymphadenopathy

111
Q

MC cause of pericarditis and myocarditis that is infection

A

coxsackievirus

112
Q

aside from an US what else can be used to diagnose biliary atresia?

A

liver biopsy

113
Q

what is legg calve perthe disease?

A

avascular necrosis of hip in kids

114
Q

what age is legg calve common in

A

boys 5-7

115
Q

what is todd paralysis?

A

post seizure paralysis

116
Q

hemiplegic migraine is what?

A

hemiplegia with migraine in adolescents

117
Q

what is the triad of sturge weber syndrome?

A

port wine stain, glaucoma and leptomeningeal capillary venous malformations

118
Q

what is test for glaucoma?

A

tonometry

119
Q

what are signs of glaucoma in kids?

A

tearing photophobia, increased globe size, erythematous conjunctiva

120
Q

how does rash of rubella appear?

A

blanching pink maculopapular rash

121
Q

where does rash in rubella start?

A

on the face then spreads down

122
Q

what are three congenitl findings of rubella infection?

A

deafness, cataracts and PDA

123
Q

what is rx for e coli diarrhea?

A

supportive care

124
Q

what is first line therapy for eczema?

A

emolients

125
Q

what is second line therapy for eczema?

A

topical steroids

126
Q

what is third line therapy for eczema?

A

topical calcineurin inhibitors (pimecrolimus)

127
Q

what is a common complication of eczema?

A

impetigo

128
Q

what is MC cause of childhood sensorineural hearing loss?

A

congenital CMV

129
Q

what is normal liver edge in newborns?

A

anything less than 3.5 cm

130
Q

what is first step in hypospadias work up?

A

karyotype analysis

131
Q

what is cause of hemoglobin H disease?

A

loss of 3 alpha chain genes

132
Q

what is produced in hemoglobin H disease?

A

gamma chain tetramers

133
Q

what are signs of hemoglobin H disease in infants?

A

splenomegaly, hemolysis symptoms

134
Q

when is rotavirus vaccine given?

A

2-8 months

135
Q

when is meningococcal vaccine given?

A

12-13 years old

136
Q

painless papules on posterior surface of arm is what?

A

keratosis pilaris

137
Q

what is miliaria?

A

heat rash due to sweat gland blocking

138
Q

who gets miliaria?

A

young kids and newborns

139
Q

what is rx for measles?

A

supportive

140
Q

klumpke palsy has what type of hand?

A

claw hand

141
Q

what are muscle signs of klumpke palsy?

A

extended wrist and metacarpals

142
Q

which of erbs or klumples palsy leads to loss of grasp reflex?

A

klumpke

143
Q

what is cause of klumpke palsy?

A

C8/T1 injury

144
Q

what can happen with klumpke palsy?

A

horner syndrome

145
Q

where is issue in erbs palsy?

A

C5/C6

146
Q

what is first line rx of pertussis?

A

azithromycin

147
Q

what do you give if you have exposure to pertussis, even if vaccinated?

A

give post exposure azithromycin

148
Q

what is an environmental risk factor for recurrent otitis media?

A

smoking

149
Q

what is breastfeeding jaundice

A

when baby does not feed adequately

150
Q

when does breastfeeding jaundice occur?

A

less than 1 week of age

151
Q

what are signs of breastfeeding jaundice?

A

decreased oral intake, signs of dehydration

152
Q

what is good indication for correct number of wet diapers a day in a newborn?

A

same number as age in days for first week

153
Q

what are signs of breast milk jaundice?

A

baby is well hydrated and this occurs after 1st week of life

154
Q

what bugs are common in CGD?

A

staph a, serratia, aspergillus and burkholderia

155
Q

what type of infetions are seen in CGD?

A

pulmonary and skin

156
Q

what is another name for neonatal thyrotoxicosis?

A

neonatal graves disease

157
Q

what is cause of neonatal thyrotoxicosis

A

mom has graves disease and antibody passed to infant

158
Q

what are signs of neonatal thyrotoxicosis?

A

warm, tachycardic, irritable, low weight

159
Q

what is rx for neonatal thyrotoxicosis?

A

self resolves in 3 months

160
Q

what is the specific finding for cholesteatoma in a kid?

A

pearly white mass in tympanic membrane

161
Q

what are risks for getting cholesteatome?

A

tubes placed, recurrent ear infections, chronic middle ear effusion

162
Q

what is rx for cholesteatoma?

A

surgery

163
Q

what are signs of vitamin b2 (riboflavin deficiency?

A

angular chelosis, stomatitis, seborrheic dermatitis, normocytic anemia

164
Q

where do we get vitamin b2 iriboflavin?

A

dairy, eggs meat green veggies

165
Q

what are signs of niacin deficiency?

A

dermatitis, diarrhea, glossitis, dementia

166
Q

where do we get niacin?

A

meat whole grains and legumes

167
Q

what are the two main risk factors for an IVH?

A

prematurity and low birth weight

168
Q

what happens in IVH?

A

rupture of germinal center vessels

169
Q

what is diagnostic test for IVH? what is seen?

A

head ultrasound shows hyperechoic material in germinal center

170
Q

two signs of IVH?

A

seizures and acute anemia

171
Q

what is inheritance of tuberous sclerosis?

A

AD

172
Q

what are skin signs of tuberous sclerosis?

A

ash leaf spots and shagreen patches

173
Q

what are two CNS things in tiberours sclerosis

A

subependymal tumors and infantile spasms

174
Q

what is sign of lesch nyhan disease in infancy?

A

hypotonicity

175
Q

what are symptoms of lesch nyhan in childhood?

A

dystonia, chorea, spasticity and hyperreflixia then self mutiliating behaviors

176
Q

self mutilating behaviors should make you think of what?

A

lesch nyhan

177
Q

what is issue in lesch nyhan?

A

hypoxanthine guanine transferase dfeiciency so uric acid builds up

178
Q

if patient is developing totally normal and has microcephaly, what is most likely cause?

A

familial micro

179
Q

what congenital infection can cause microcephaly?

A

CMV

180
Q

what is issue in alport syndrome?

A

collagen type IV

181
Q

what are two organs involved in alport syndrome?

A

sensorineural hearing loss and nephritic disease

182
Q

how is alport syndrome acquired?

A

X linked

183
Q

what does glomerular basement membrane look like in alport syndrome?

A

longitudinal splitting

184
Q

what is rash of scarlet fever like?

A

sandpaper erythematous papular rash

185
Q

where is rash of scarlet fever?

A

usually in skin folds and trunk

186
Q

what are symptoms of scarlet fever?

A

fever, sore throat, tonsillar exudates and lymphadenopathy and strawberry tongue

187
Q

what is rx for scarlet fever? what bug?

A

penicillin…strep pyo

188
Q

what are the physical characteristics of trisomy 18?

A

rocker bottom feet, overlapping fingers, clenched fist, micrognathia, large occiput head,

189
Q

what is cardiac defect associated with trisomy 18?

A

VSD

190
Q

how is friedrichs ataxia inherited?

A

AR

191
Q

what is genetic change in friedrichs ataxia?

A

trinucleotide repeat of GAA

192
Q

what are the three changes seen in friedrichs ataxia?

A

cardiomyopathy, neurologic dysfxn and diabetes

193
Q

what are the neuro findings in friedrichs ataxia?

A

gait and limb ataxia with loss of position and vibratory sensation

194
Q

what is first line therapy for labial adhesions?

A

topical estrogen

195
Q

if patient has congenital QT prolongation, what increases risk of torsades?

A

exercise…anything that increases sympathetic activity

196
Q

what is treatment of congenital QT prolongation?

A

beta blockers

197
Q

how should you measure lead levels? what type of vessel?

A

venous

198
Q

what lead level do you start chelation?

A

45

199
Q

what are symptoms of lead poisoning?

A

abdominal pain, constipation, pica, encephalopathy

200
Q

what is risk of chronic transfusion therapy?

A

iron overload so chelate

201
Q

what thalassemia presents with A2 Hb and lots of fetal Hb

A

beta major

202
Q

when does beta thalassemia major onset? why?

A

6-8 months because losing fetal hb then and cant make adult

203
Q

what are the main symptoms of reye syndrome?

A

cerebral edema, acute level failure, encephalopathy

204
Q

what labs aside from liver enzymes are elevated in reye syndrome?

A

PT/PTT

205
Q

breastfeeding reduces moms risk of what?

A

breast and ovarian cancer

206
Q

breastfeeding protects infant from what infections?

A

Otitis media and GI and respiratory

207
Q

what is rx for minimal change disease?

A

corticosteroids

208
Q

what is MC cause of painless GI bleed in 2 year old?

A

meckel diverticulum

209
Q

what is cause of meckel diverticulum?

A

remnant of vitelline duct

210
Q

what is diagnosis of meckel diverticulum?

A

techinitium 99 scan

211
Q

what is the rule of 2s in meckel diverticulu,

A

2 years old, 2 feetfrom ileocecal valve, 2% prevalence, 2:1 male to female

Pediatrics (4 decks)

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