Uworld week 2 Flashcards
1
Q
what are signs of premature adrenarche?
A
isolated pubic hair development early
2
Q
what nerves does erb duchenne palsy include?
A
C567
3
Q
what is sign of erb duchenne palsy?
A
waiters tip
4
Q
what are muscle changes in erb duchenne palsy?
A
weakness of biceps, wrist and finger extenders and deltoid
5
Q
what is MC brachial plexus injury during birth?
A
erb duchenne palsy
6
Q
what is rx for erb duchenne palsy?
A
reassurance and PT
7
Q
triad of rett syndrome
A
gait issues, loss of speech, abnormal hand movements
8
Q
other signs of rett syndrome outside of triad?
A
seizures, breathing abnormalities microcephaly
9
Q
what vaccine can cause a reaction in kids?
A
varicella
10
Q
how long after varicella vaccine can you get rash?
A
2 weeks
11
Q
what does varicella vaccine rash look like?
A
minimal number of vesicular papules on the chest
12
Q
MC bug that causes pneumonia in CF patients under 20?
A
staph A
13
Q
MC bug that causes pneumonia in CF patients over 20?
A
pseudomonas
14
Q
what is therapy for central precocious puberty?
A
GnRH agonist
15
Q
what is difference in central versus peripheral precocious puberty
A
central has high LH and FSH while peripheral has no LH/FSH
16
Q
what are the symptoms of lens dislocation?
A
poor vision and tremulous iris
17
Q
what disease is lens dislocation often associated with?
A
marfan syndrome
18
Q
what is associated with marfan that is deadly?
A
aortic root disease
19
Q
3 first line options of ITP rx
A
steroids, IVIG and anti D
20
Q
if ITP is refractory to treatment what can you do?
A
splenectomy
21
Q
what is bronchopulmonary dysplasia?
A
arrest of pulmonary development in neonate
22
Q
what is cause of bronchopulmonary dysplasia?
A
long term more than 28 days of supplemental oxygen required
23
Q
what happens to the lungs with bronchopulmonary dysplasia?
A
alveolar hypoplasia with decreased septation
24
Q
what is rx for bronchopulmonary dysplasia?
A
wean respiratory support
25
what infection has slapped cheek appearance?
parvovirus
26
how does measles rash spread?
from head to toe
27
what are symptoms of measles?
cough coryza conjunctivitis fever and rash
28
what are symptoms of kawaksaki disease
```
conjunctivitis
oral mucosa changes
rash
desquamating skin
cervical lymphadenopathy
```
29
what are patients with kawasaki at risk for?
coronary artery anuerysms
30
what are CSF finding in guillaine barre?
increased protein all else normal
31
how does weakness progress in GBS?
ascending weakness and areflexia
32
what often precedes GBS?
campylobacter or respiratory infection
33
aside from weakness and areflexia, what are other issues to watch for in GBS?
respiratory dysfxn, autonomic dysfxn
34
what is rx for GBS?
IVIG or plasmapheresis
35
what is treatment for central precocious puberty?
GnRH agonists
36
what is a sign of acute mastoiditis/
tenderness to palpation behind ear and redness/bulging of ear
37
what is RX for acute mastoidits?
IV abx
38
what infection can cause late onset of monoarticular knee pain?
lyme disease
39
what organs are hurt in Gaucher disease?
liver spleen and bone marrow
40
name three exam findings consistent with gaucher disease
hepatomegaly splenomegaly and delayed puberty
41
what are two abnormal lab values in gaucher disease?
anemia and thrombocytopenia
42
what is the hallmark xray finding of necrotizing enterocolitis?
pneumatosis intestinalis
43
what is penumatosis intestinalis?
air in bowel wall on xray
44
what causes necrotizing enterocolitis?
air producing bacteria in wall of gut
45
who gets necrotizing enterocolitis?
preterm and low birth weight babies
46
what should be done about feeding in necrotizing enterocoltis?
feeding should be stopped immediately
47
what should be given to treat necrotizing entercolitis?
IV abx
48
what lab should be ordered in necrotizing enterocolitis?
culture of blood and CBC
49
when do kids get VZV vaccine?
age 1 and 4
50
what to do if kid is exposed to VZV and is asymptomatic but doesnt have VZV vaccine?
give vaccine
51
what to do if kid is exposed to VZV and is asymptomatic but doesnt have VZV vaccine and is immunocompromised?
give varicella IVIG
52
what to do if kid is exposed to VZV and is asymptomatic but doeshave VZV vaccine?
reassurance and observation
53
what is infant dyschezia?
healthy infant that cries and strains when passing stools
54
what do you do for infant dyschezia?
nothing
55
when do babies with biliary atresia present?
before 2 months of age
56
what is change in poop with biliary atresia?
poop is pale/grey because of the lack of bilirubin in it
57
what can happen to the liver in biliary atresia?
liver failure
58
what is bronchopumonary dysplasia?
chronic lung disease of the newborn
59
name three risk factors for bronchopumonary dysplasia
low birth weight, NRDS, mechanical ventilation
60
what are signs of bronchopumonary dysplasia?
persistent oxygen requirement and tachypnea
61
what are imaging findings of bronchopumonary dysplasia?
haziness of lungs and decreased lung volumes
62
what is most common congenital infection?
CMV
63
what are signs of CMV in brain?
periventricular calcifications, microcephaly
64
what organ is messed up in congenital CMV?
large liver
65
what lab is abnormal in congenital CMV?
thrombocytopenia
66
what are brain changes with congenital toxoplasmosis?
hydrocephalus and diffuse brain calcifications
67
what is otitis media with effusion?
when fluid gets in middle ear
68
how will tympanic membrane appear in otitis media with effusion?
air fluid levels posterior to tympanic membrane
69
what is rx for otitis media with effusion?
nothing...reassurance
70
what are symptoms of otitis media with effusion?
ear tugging...NO fever
71
what type of diarrhea in campylobacter infxn?
usually watery diarrhea
72
what is rx for campylobacter infxn in kids?
symptomatic care...
73
preterm infants require what test? why?
head ultrasouns...at increased risk for Intraventricular hemorrhage
74
what bacteria can infect a toddlers anal area?
strep pyogenes
75
what are symptoms of perianal strep infection?
red rash around anus, painful, bloody stools
76
what is rx of perianal strep infection?
amoxicillin
77
what is a sign on physical exam of developmental dysplasia of hip?
limb length discrepancy
78
what is imaging for developmental dysplasis of hip in kid under four months?
US
79
what is imaging for developmental dysplasis of hip in kid over four months?
Xray
80
where does ewing sarcoma occur in bone?
diaphysis
81
what is classic appearance of swing sarcoma?
moth eaten or onion skinning
82
what is vision change in idiopathic intracranial hypertension?
larger blind spot
83
what is seen on eye exam in idiopathic intracranial hypertension?
papilledema
84
what is rx for idiopathic intracranial hypertension?
acetazolamide
85
what are general symptoms of idiopathic intracranial hypertension?
headache and nausea
86
what precaution for N men transmission?
droplet
87
prader willi is issue with passage of what copy of 15q11?
paternal
88
what are other symptoms of prader willi aside from hyperphagia?
hypotonia, short stature, ID, facial feature dysmorphia
89
a fever until what age gets you an immediate lumbar puncture?
28 days
90
what is most common cause of fever in infants?
UTI
91
what are symptoms of UTI in infant?
fever, fussy, abdominal tenderness
92
4 signs of PKU
ID, seizures, musty odor, hypopigmentation
93
what are signs of tetani in infant?
spasms and hypertonicity
94
what can lead to tetani in infant?
dirty delivery and no vaccinations
95
what is rx of tetani in infant?
abx and tetanus immune globulin
96
an inflammed umbilical cord should make you worried about what?
neonatal tetanus
97
what is major risk of infant tetani?
respiratory distress because of involvement of muscle of breathing
98
what is rx for intusussception?
air enema
99
what is murmur of VSD?
3/6 holosystolic
100
where do you hear VSD murmur?
lower left sternal border
101
what is bone finding in langerhans cell histiocytosis?
lytic bone lesions of skull and femur
102
what is endocrine finding in langerhans cell histiocytosis?
diabetes insipidus
103
what is derm finding in langerhans cell histiocytosis?
papules with erythematous rash
104
in addition to purpura, abdominal pain and arthralgia, what can you have with henoch schonlein?
scrotal pain and swelling
105
gestational diabetes puts infants at risk for what cardiac issue?
neonatal hypertrophic cardiomyopathy
106
infants with neonatal hypertrophic cardiomyopathy can have what issue with heart?
increased IV septum thickness
107
what are some findings of neonatal hypertrophic cardiomyopathy ?
systolic ejection murmur and respiratory distress
108
3 MC drugs that induce hemolytic anemia
NSAIDs, cephalosporins, penicillins
109
two drugs for tinea infections
griseofulvin and terbinafine
110
what is another symptom aside from classic rash and itchy in tinea?
can have lymphadenopathy
111
MC cause of pericarditis and myocarditis that is infection
coxsackievirus
112
aside from an US what else can be used to diagnose biliary atresia?
liver biopsy
113
what is legg calve perthe disease?
avascular necrosis of hip in kids
114
what age is legg calve common in
boys 5-7
115
what is todd paralysis?
post seizure paralysis
116
hemiplegic migraine is what?
hemiplegia with migraine in adolescents
117
what is the triad of sturge weber syndrome?
port wine stain, glaucoma and leptomeningeal capillary venous malformations
118
what is test for glaucoma?
tonometry
119
what are signs of glaucoma in kids?
tearing photophobia, increased globe size, erythematous conjunctiva
120
how does rash of rubella appear?
blanching pink maculopapular rash
121
where does rash in rubella start?
on the face then spreads down
122
what are three congenitl findings of rubella infection?
deafness, cataracts and PDA
123
what is rx for e coli diarrhea?
supportive care
124
what is first line therapy for eczema?
emolients
125
what is second line therapy for eczema?
topical steroids
126
what is third line therapy for eczema?
topical calcineurin inhibitors (pimecrolimus)
127
what is a common complication of eczema?
impetigo
128
what is MC cause of childhood sensorineural hearing loss?
congenital CMV
129
what is normal liver edge in newborns?
anything less than 3.5 cm
130
what is first step in hypospadias work up?
karyotype analysis
131
what is cause of hemoglobin H disease?
loss of 3 alpha chain genes
132
what is produced in hemoglobin H disease?
gamma chain tetramers
133
what are signs of hemoglobin H disease in infants?
splenomegaly, hemolysis symptoms
134
when is rotavirus vaccine given?
2-8 months
135
when is meningococcal vaccine given?
12-13 years old
136
painless papules on posterior surface of arm is what?
keratosis pilaris
137
what is miliaria?
heat rash due to sweat gland blocking
138
who gets miliaria?
young kids and newborns
139
what is rx for measles?
supportive
140
klumpke palsy has what type of hand?
claw hand
141
what are muscle signs of klumpke palsy?
extended wrist and metacarpals
142
which of erbs or klumples palsy leads to loss of grasp reflex?
klumpke
143
what is cause of klumpke palsy?
C8/T1 injury
144
what can happen with klumpke palsy?
horner syndrome
145
where is issue in erbs palsy?
C5/C6
146
what is first line rx of pertussis?
azithromycin
147
what do you give if you have exposure to pertussis, even if vaccinated?
give post exposure azithromycin
148
what is an environmental risk factor for recurrent otitis media?
smoking
149
what is breastfeeding jaundice
when baby does not feed adequately
150
when does breastfeeding jaundice occur?
less than 1 week of age
151
what are signs of breastfeeding jaundice?
decreased oral intake, signs of dehydration
152
what is good indication for correct number of wet diapers a day in a newborn?
same number as age in days for first week
153
what are signs of breast milk jaundice?
baby is well hydrated and this occurs after 1st week of life
154
what bugs are common in CGD?
staph a, serratia, aspergillus and burkholderia
155
what type of infetions are seen in CGD?
pulmonary and skin
156
what is another name for neonatal thyrotoxicosis?
neonatal graves disease
157
what is cause of neonatal thyrotoxicosis
mom has graves disease and antibody passed to infant
158
what are signs of neonatal thyrotoxicosis?
warm, tachycardic, irritable, low weight
159
what is rx for neonatal thyrotoxicosis?
self resolves in 3 months
160
what is the specific finding for cholesteatoma in a kid?
pearly white mass in tympanic membrane
161
what are risks for getting cholesteatome?
tubes placed, recurrent ear infections, chronic middle ear effusion
162
what is rx for cholesteatoma?
surgery
163
what are signs of vitamin b2 (riboflavin deficiency?
angular chelosis, stomatitis, seborrheic dermatitis, normocytic anemia
164
where do we get vitamin b2 iriboflavin?
dairy, eggs meat green veggies
165
what are signs of niacin deficiency?
dermatitis, diarrhea, glossitis, dementia
166
where do we get niacin?
meat whole grains and legumes
167
what are the two main risk factors for an IVH?
prematurity and low birth weight
168
what happens in IVH?
rupture of germinal center vessels
169
what is diagnostic test for IVH? what is seen?
head ultrasound shows hyperechoic material in germinal center
170
two signs of IVH?
seizures and acute anemia
171
what is inheritance of tuberous sclerosis?
AD
172
what are skin signs of tuberous sclerosis?
ash leaf spots and shagreen patches
173
what are two CNS things in tiberours sclerosis
subependymal tumors and infantile spasms
174
what is sign of lesch nyhan disease in infancy?
hypotonicity
175
what are symptoms of lesch nyhan in childhood?
dystonia, chorea, spasticity and hyperreflixia then self mutiliating behaviors
176
self mutilating behaviors should make you think of what?
lesch nyhan
177
what is issue in lesch nyhan?
hypoxanthine guanine transferase dfeiciency so uric acid builds up
178
if patient is developing totally normal and has microcephaly, what is most likely cause?
familial micro
179
what congenital infection can cause microcephaly?
CMV
180
what is issue in alport syndrome?
collagen type IV
181
what are two organs involved in alport syndrome?
sensorineural hearing loss and nephritic disease
182
how is alport syndrome acquired?
X linked
183
what does glomerular basement membrane look like in alport syndrome?
longitudinal splitting
184
what is rash of scarlet fever like?
sandpaper erythematous papular rash
185
where is rash of scarlet fever?
usually in skin folds and trunk
186
what are symptoms of scarlet fever?
fever, sore throat, tonsillar exudates and lymphadenopathy and strawberry tongue
187
what is rx for scarlet fever? what bug?
penicillin...strep pyo
188
what are the physical characteristics of trisomy 18?
rocker bottom feet, overlapping fingers, clenched fist, micrognathia, large occiput head,
189
what is cardiac defect associated with trisomy 18?
VSD
190
how is friedrichs ataxia inherited?
AR
191
what is genetic change in friedrichs ataxia?
trinucleotide repeat of GAA
192
what are the three changes seen in friedrichs ataxia?
cardiomyopathy, neurologic dysfxn and diabetes
193
what are the neuro findings in friedrichs ataxia?
gait and limb ataxia with loss of position and vibratory sensation
194
what is first line therapy for labial adhesions?
topical estrogen
195
if patient has congenital QT prolongation, what increases risk of torsades?
exercise...anything that increases sympathetic activity
196
what is treatment of congenital QT prolongation?
beta blockers
197
how should you measure lead levels? what type of vessel?
venous
198
what lead level do you start chelation?
45
199
what are symptoms of lead poisoning?
abdominal pain, constipation, pica, encephalopathy
200
what is risk of chronic transfusion therapy?
iron overload so chelate
201
what thalassemia presents with A2 Hb and lots of fetal Hb
beta major
202
when does beta thalassemia major onset? why?
6-8 months because losing fetal hb then and cant make adult
203
what are the main symptoms of reye syndrome?
cerebral edema, acute level failure, encephalopathy
204
what labs aside from liver enzymes are elevated in reye syndrome?
PT/PTT
205
breastfeeding reduces moms risk of what?
breast and ovarian cancer
206
breastfeeding protects infant from what infections?
Otitis media and GI and respiratory
207
what is rx for minimal change disease?
corticosteroids
208
what is MC cause of painless GI bleed in 2 year old?
meckel diverticulum
209
what is cause of meckel diverticulum?
remnant of vitelline duct
210
what is diagnosis of meckel diverticulum?
techinitium 99 scan
211
what is the rule of 2s in meckel diverticulu,
2 years old, 2 feetfrom ileocecal valve, 2% prevalence, 2:1 male to female
