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Pediatrics > Uworld Week 3 > Flashcards

Uworld Week 3 Flashcards

1
Q

define constitutional growth delay

A

patient not growing fast but staying on a growth curve

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2
Q

what is bone age compared to age in constitutional growth delay?

A

bone age is younger than numerical age

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3
Q

what will happen in constitutional growth delay?

A

late bloom

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4
Q

what is the main difference in familial short stature and constitutional growth delay?

A

short stature has matching bone age and numerical age

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5
Q

what bug causes tinea versicolor?

A

malassezia

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6
Q

what is rx for tinea versicolor?

A

topical ketoconazole or selenium sulfide

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7
Q

herpangina is caused by what?

A

coxsackie a virus

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8
Q

what does rash look like with herpangina?

A

grey vesicles/ulcers on oropharynx

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9
Q

what are two symptoms of herpangina?

A

fever and rash

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10
Q

when do kids get herpangina?

A

summer an fall

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11
Q

what is rx for herpangina?

A

supportive care

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12
Q

what are lab abnormalities in juvenile idiopathic arthritis?

A

leukocytosis, thrombocytosis, elevated inflamm markers

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13
Q

what is rash of juvenile idiopathic arthritis?

A

evanescent rash…pink

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14
Q

what are physical exam signs of juvenile idiopathic arthritis?

A

hepatosplenomegaly, lymphadenopathy and joint pain

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15
Q

what causes the murmur in HCM?

A

mitral valve leaflet movement

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16
Q

what is type of murmur in HCM?

A

systolic murmur at left sternal border

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17
Q

what causes anemia of newborn?

A

low EPO

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18
Q

when does anemia of newborn really show up?

A

2-3 months of age

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19
Q

what is the triad of congenital toxoplasmosis?

A

chorioretinitis, hydrocephalus, diffuse intracranial calcifications

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20
Q

what neuro finding can happen with congenital toxo?

A

seizures

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21
Q

what is rx of congenital toxo?

A

pyrimethamine or sulfadiazine

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22
Q

when do growing pains primarily occur?

A

at night, resolve by morning

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23
Q

what is management of baby with GER who is gaining weight appropriately?

A

reassurance

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24
Q

what is management of baby with GER who is not gaining weight appropriately?

A

thickened feeds and avoid cow/soy milk

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25
Q

3 cancers associated with von hippel lindau syndrome

A

clear cell renal carcinoma
hemangioblastoma
pheochromocytome

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26
Q

if kid has recurrent UTIs, what two tests should be done?

A

renal US and voiding cystourethrigam

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27
Q

what should you be concerned about in a kid with recurrent UTIs?

A

vesicouretal reflux

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28
Q

how long after exposure to staph aureus toxin can you develop diarrhea?

A

6 hours usually

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29
Q

how long after exposure to norovirus can you develop diarrhea?

A

36 hours

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30
Q

what type of vomiting is associated with NEC?

A

bilious

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31
Q

what is treatment of allergic bronchopulmonary aspergillosis?

A

steroids, azoles, and rx for asthma

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32
Q

what are three signs of allergic bronchopulmonary aspergillosis?

A

lower airway inflammation, high IgE and eosinophilia

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33
Q

what are three causes of methemaglobinemia?

A

dapsone, nitrites and anesthetics

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34
Q

what are signs of methemaglobinemia on exam?

A

cyanosis and dark chocolate blood

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35
Q

what will o2 sat be in methemaglobinemia

A

85

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36
Q

what will paO2 be in methemaglobinemia?

A

normal

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37
Q

what is rx for methemaglobinemia?

A

methylene blue

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38
Q

what imaging for kid with new hydrocephalus?

A

CT

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39
Q

what are some symptoms of hydrocephalus?

A

vomiting, headache, irritability, fussy, poor feeding

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40
Q

what is rx for hydrocephalus?

A

VP shunt

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41
Q

baby with bilious emesis and unstable needs what?

A

emergency laporotamy

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42
Q

what is most common presenting sign of volvulus in an infant?

A

bilious emesis

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43
Q

what is complication of malrotation that is emergency?

A

volvulus

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44
Q

what is malrotation with volvulus?

A

twisting of small intestine on itself

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45
Q

what are the two common causes of bloody poops in infants less than 6 mos of age?

A

food protein induced allergic proctocolitis or

anal fissures

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46
Q

what is management of food protein induced allergic proctocolitis when mom is breastfeeding?

A

remove dairy and soy from moms diet

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47
Q

what are symptoms of baby with food protein induced allergic proctocolitis/

A

totally normal with bloody/mucus stool

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48
Q

what is management of food protein induced allergic proctocolitis when mom is formula feeding?

A

switch to hypoallergenic formula

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49
Q

what is cause of premature anemia?

A

low EPO

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50
Q

when do babies have nadir of RBCs? why?

A

2-3 mos because RBC lifespan is 120 days and EPO not caught up yet

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51
Q

what GI issue can cause recurrent cystitis in kids?

A

constipation

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52
Q

what is murmur of tetralogy of fallot?

A

harsh murmur at left upper sternal bordr

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53
Q

what is murmur of VSD?

A

holosystolic at left lower sternal border

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54
Q

what is additional sound you can hear with a VSD?

A

diastolic rumble from increase flow across mitral valve

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55
Q

what is erythemic toxicum neonatorum?

A

pustules with erythemtous base on trunk and proximal extremities

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56
Q

when do you get erythemic toxicum neonatorum?

A

at birth

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57
Q

what is rx for erythemic toxicum neonatorum?

A

nothing

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58
Q

what do you give if baby born to mom with varicella infxn?

A

give Igs for protection

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59
Q

when does mom have to have VZV to be worried about giving post exposure prohpylaxis?

A

5 days before delivery and 2 days after

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60
Q

what is imaging for pyloric stenosis?

A

US

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61
Q

what are some non specific signs of NEC?

A

apnea, lethargy and vital sign instability

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62
Q

what is main risk for NEC?

A

low birth weight and premature

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63
Q

what are lung sounds heard in bronchiolitis?

A

wheezing and crackles

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64
Q

what is rx for bronchiolitis?

A

supportive care

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65
Q

what is cyclic vomiting syndrome?

A

recurrence of vomiting with no trigger and in between you are asymptomatic

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66
Q

coughing with vomiting should make you think about what?

A

pertussis

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67
Q

what is rx of pertussis?

A

macrolides

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68
Q

what are three stages of pertussis?

A

catarrhal
paroxysmal
convalescent

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69
Q

what is a GI sign of HIV in infants?

A

chronic diarrhea

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70
Q

what are two signs of transient hypogammaglobulinemia in infancy?

A

low IgG and good response to vaccines

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71
Q

when doestransient hypogammaglobulinemia in infancy occur?

A

6 months of age

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72
Q

what are the symptoms of serum sickness like reaction?

A

fever arthralgia urticarial rash and lymphadenopathy

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73
Q

what is a common trigger of serum sickness like reaction? when does it occur?

A

amoxiciliin and bactrim…5-14 days after use

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74
Q

what is outcome of serum sickness like reaction?

A

will resolve on its own

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75
Q

what is trigger of serum sickness?

A

foreign proteins in antivenom toxin and Igs

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76
Q

which of serum sickness like reaction and serum sickness forms immune complexes and has high fever?

A

serum sickness

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77
Q

if patient with hemophilia not getting better with transfusion, what may be the cause?

A

inhibitor development

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78
Q

what is WAGR syndrome

A

Wilms
Anridinia
genitourinary issues
retardation

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79
Q

what is anridinia?

A

lack of iris in eyes

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80
Q

what is first step in all patients with nocturnal enuresis?

A

urinalysis

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81
Q

what are some causes of secondary nocturnal enuresis?

A

DM, UTI and psych stressors

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82
Q

which of gon or chlamydia has conjunctivitis in first week of life?

A

gonorrhea is early onset

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83
Q

which of gon or chlamydia has conjunctivitis in second week of life?

A

chlamydia is late onset

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84
Q

what is rx for conjunctivitis in baby from chlamydia?

A

oral erythromycin

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85
Q

what is rx for conjunctivitis in baby from gonorrhea?

A

IM dose of cephalosporin

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86
Q

what is prophylaxis for conjunctivitis in newborn?

A

topical erythromycin

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87
Q

what is a meconium ileus?

A

obstruction of bowel by inspissated stool

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88
Q

what is seen on imaging with meconium ileus?

A

dilated small bowel and microcolon

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89
Q

what disease is associated with meconium ileus?

A

CF

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90
Q

what happens in meconium ileus?

A

no baby poo for first day or so…

91
Q

which of hirschprung or meconium ileus has the positive squirt sign?

A

hirschprung…squirt on rectal exam

92
Q

what is a late sequelae of meocnium ileus that can occur?

A

bilious emesis

93
Q

what does imaging show in hirschprung/

A

dilated proximal colon and small bowel, narrow rectosigmoid

94
Q

a patient with unilateral nasal rhinorhea that is purulent and does not have any other sx most likely has what?

A

nasal foreign body

95
Q

what sx are associated with sinusitis in kids?

A

fever, cough, purulent nasal discharge

96
Q

aside from macrosomia and hypoglycemia, what else can maternal diabetes cause in neonate?

A

hypocalcemia

97
Q

what are sx of hypocalcemia in neonate with mom that has diabetes?

A

jittery baby with respiratory distress (sometimes)

98
Q

what is decreased with calcium in baby from mom with gestational diabetes?

A

hypomagnesia too

99
Q

what are features of a heart murmur in infant that mean you get a work up?

A

holosystolic, diastolic, harsh sound, 3/6 or higher in intensity,

100
Q

what is post transplant lymphoproliferative disorder?

A

when you get transplant and then it gives you a viral infection since T cells are knocked down

101
Q

what bug is most commonly associated with post transplant lymphoproliferative disorder?

A

EBV

102
Q

explain what happens in post transplant lymphoproliferative disorder?

A

T cells are knocked down due to immunosuppresants and allows virus to run rampant and induce B cell immortality

103
Q

what are signs of post transplant lymphoproliferative disorder?

A

lymphadenopathy, hepatosplenomegaly, leukopenia

104
Q

what is rx for post transplant lymphoproliferative disorder?

A

rtiuximab and lower immunosuppression

105
Q

what can occur with persistent pulmonary HTN of newborn?

A

right to left shunt across PDA

106
Q

what are some risk factors for persistent pulmonary HTN of newborn?

A

infection, pulmonary dysplasia, meconium aspiration

107
Q

anaerobic bug in lymphadenopathy of cervical chain is caused by what?

A

dentists

108
Q

when do preterm infants get their vaccines?

A

same schedule as term infants

109
Q

what is issue in marfan syndrome? inheritance?

A

defective fibrillin 1 gene, AD

110
Q

aside from high bilirubin and low sugar, what can galactosemia cause with labs?

A

elevated liver enzymes

111
Q

what are clinical findings of galactosemia?

A

vomiting, jaundice, hepatomegaly, cataracts

112
Q

what are kids with galactosemia at an increased risk for?

A

E coli sepsis

113
Q

pigmented macules in setting of microcytic anemia should make you think what?

A

peutz jehgers syndrome

114
Q

where are pigmented macules found usually in peutz jehgers syndrome?

A

oral mucosa

115
Q

what is often cause of anemia in peutz jehgers syndrome?

A

occult bleeding in GI tract

116
Q

what work up should be done for person with peutz jehgers syndrome/

A

upper and lower endoscopy

117
Q

what cancers are people with peutz jehgers syndrome at increased risk for

A

colon, GU, and breast

118
Q

what is cause of myotonic dystrophy?

A

AD CTG repearts

119
Q

what are early symptoms of myotonic dystrophy?

A

cognitive impairment, ID, ADHD and sleepiness

120
Q

when does myotonic dystrophy onset?

A

by age 10, start with behavioral and sleep sx

121
Q

what are some associated findings with myotonic dystrophy?

A

arrythmias, sleepiness, cataracts

122
Q

what is mc cause of congenital hypothyroid?

A

thyroid dysgenesis

123
Q

what are sx of congenital hypothyroid?

A

jaundice, poor feeding, pot belly, puffy face, large anterior fontanelle , protruding tongue

124
Q

what is sign of hydrocele?

A

transillumination of scrotum

125
Q

what is rx for hydrocele in infant?

A

reassurance

126
Q

what is ambylopia?

A

functional reduction in vision due to visual disturbances in early childhood

127
Q

what is usual cause of ambylopia?

A

uncorrected refractive error leads to one eye dominating and lose vision in the other eye

128
Q

how do you correct ambylopia?

A

patch over good eye

129
Q

what abx for cat scratch disease?

A

azithromycin

130
Q

what abx for unilateral acute cervical lymphadenitis?

A

clindamycin

131
Q

what is most likely cause of unilateral acute cervical lymphadenitis in kids?

A

staph a or strep pyogenes

132
Q

describe the nodes in unilateral acute cervical lymphadenitis

A

enlarged erythematous and tender

133
Q

what are the findings of mccune albright syndrome?

A

precocious puberty, bone fractures and cafe au lait

134
Q

what is cause of mccune albright syndrome?

A

overactive g protein leads to overproduction of all pituitary hormones

135
Q

what is a GI risk in HSP?

A

intususscepton

136
Q

what is BHS?

A

breath holding spell

137
Q

what ages have BHS?

A

6mos to 2 years

138
Q

what is cause of BHS?

A

often minor trauma/fear or intense crying

139
Q

what happens in BHS?

A

bradycardia, apnea, cyanosis and LOC

140
Q

what is result of BHS?

A

normal return to baseline in few minutes

141
Q

5 finding in kawasakis

A

mucositis, cervical lymphadenopathy, swelling/erythema of hands/feet, rash, and conjunctivirs

142
Q

what happens to platelets in splenic sequestration crisis in sickle cell?

A

they get trapped in there too

143
Q

what is issue in osteogenesis imperfecta?

A

collagen type 1 problem

144
Q

how is osteogenesis imperfecta inherited?

A

AD

145
Q

what are signs of osteogenesis imperfecta?

A

recurrent bone fractures, blue grey teeth, blue sclera joint laxity

146
Q

what sensation can have issue in osteogenesis imperfecta?

A

hearing loss

147
Q

when does hereditary angioedema onset?

A

late childhood/adolescence

148
Q

what areas of body are involved in hereditary angioedema?

A

face, hands genitalia

149
Q

is hereditary angioedema itchy?

A

NO

150
Q

what are diagnostic criteria for chronic supporative otitis media?

A

6 weeks of purulent otorrhea, hearing loss and no ear pain

151
Q

what can happen to ear drum in chronic supporative otitis media?

A

can rupture

152
Q

what two bugs cause chronic supporative otitis media?

A

staph a and pseudomona

153
Q

what is rx for chronic supporative otitis media?

A

topical fluoroquinolone

154
Q

what is photokeratitis? what is cause?

A

acute superficial corneal injury caused by excessive UV light exposure

155
Q

what is a situation that increases UV light exposure?

A

snow and sand

156
Q

what are sx of photokeratitis?

A

eye pain, photophobia, conjunctival erythema and foreign body sensation

157
Q

how do you dx photokeratitis?

A

punctate corneal staining with fluorscein die

158
Q

how do you rx photokeratitis?

A

supportive

159
Q

what two sx are associated with wilms tumor?

A

hematuria and abdominal pain

160
Q

what age gets wilms tumors?

A

3-5 year olds

161
Q

what is rx for wilms tumor?

A

surgery and chemo

162
Q

what abx for UTI in kid under 2?

A

3rd gen cephalosporin

163
Q

what else should be done for kid under two with first UTI?

A

renal/bladder US

164
Q

what are the maternal estrogen effects on newborns?

A

breast hypertrophy, swollen labia, uterine bleedinf

165
Q

what is most common cause of CAH? inheritance?

A

21 hydroxylase deficiency, AR

166
Q

what are levels of cortisol and aldosterone in 21 hydroxylase deficiency?

A

low!!

167
Q

what hormone is high in 21 hydroxylase deficiency?

A

17-hydroxyprogesterone

168
Q

what happens to the excess 17 hydroxyprogesterone in 21 hydroxylase deficiency?

A

converted to testosterone

169
Q

what is karyotype and genitalia of 21 hydroxylase deficiency?

A

karyotype is XX or XY, in females they have ambiguous external genitalia

170
Q

aside from ambiguous genitalia in females, what else can 21 hydroxylase deficiency cause?

A

electrolyte abnormalities…low sodium and high potassium

171
Q

what is rx for 21 hydroxylase deficiency?

A

steroids and mineralocorticoids and high salt diet

172
Q

what is the triad of kartagener syndrome

A

situs inversus, recurrent pulmonary infections, bronchiectasis

173
Q

what 3 bugs cause acute bacterial sinusitis?

A

H flu, strep pneumo, moraxella

174
Q

when is bedwetting normal until

A

5 years old

175
Q

what is an MSK issue found in DS

A

atlantoaxial instability

176
Q

what happens in atlantoaxial instability ?

A

c1/c2 are not in great contact, can get spinal compression

177
Q

what are some common issues in atlantoaxial instability ?

A

abnormal gait, urinary incontinence, weakness

178
Q

are there upper or lower motor neuron signs in atlantoaxial instability ?

A

upper motor neurons

179
Q

what is imaging to confirm atlantoaxial instability ?

A

lateral cervical X ray

180
Q

what is most common issue in sickle cell trait?

A

hematuria

181
Q

what is prognosis for sickle cell trait?

A

normal life

182
Q

what are the three signs of neonatal displaced clavicle fracture?

A

crying with arm movement, decreased moro reflex, crepitus over clavicle

183
Q

what is rx for neonatal displaced clavicle fracture??

A

supportive care and gentle handling

184
Q

myelomeningocele is associated with what brain abnormality?

A

chiari 2

185
Q

what is main finding of chiari II?

A

cerebellum and medulla inferior displacement into the foramen magnum

186
Q

what is the greatest risk factor for primary enuresis?

A

family history of bedwetting

187
Q

kid with hypoglycemia, seizures and lactic acidosis, should think what?

A

glucose 6 phospohotase, von gierke disease

188
Q

what is issue in von gierke disease/

A

cant make glycogen into glucose

189
Q

what organs are affected in von gierke?

A

mucosal surfaces, liver and kidneyes

190
Q

what are findings on physical exam of kid with von gierke disease?

A

doll like face, rounded cheeks, hepatomegaly, short stature and thin limbs

191
Q

what is cause of neonatal hypertrophic cardiomyopathy in babies from diabetic moms?

A

glycogen and fat deposition in IV septum

192
Q

what is calcaneal apophysitis

A

overusee injury caused by repetitive microtrauma to calcaneal growth plate

193
Q

who gets calcaneal apophysitis?

A

kids 8-12 that are very active

194
Q

is calcaneal apophysitis uni or bilateral?

A

bilateral

195
Q

what is rx for calcaneal apophysitis?

A

rest and NSAIDs

196
Q

a white eye reflex is concerning for what?

A

retinoblastoma or cataract

197
Q

two torch infections that cause cataracts

A

CMV and rubella…bilateral

198
Q

what are the key features of congenital toxoplasmosis?

A

chorioretinitis, diffuse calcifications, hydrocephalus

199
Q

what are the key features of congenital syphilis?

A

rhinorrhea, skeletal abnormalities and desquamating rash

200
Q

what are the key features of congenital rubella?

A

cataracts, deafness, PDA,

201
Q

what are the key features of congenital CMV?

A

microcephaly, hearing loss, periventricular calcifications

202
Q

what is most common cause of croup?

A

parainfluenza

203
Q

severe croup is treated with what two things?

A

roids and racemic epi

204
Q

mild croup is treated with what?

A

roids

205
Q

three medications that can raise intracranial pressure

A

retinoids, growth hormone, tetracycline

206
Q

how does headache from increased ICP change with position?

A

worse when lying down

207
Q

what is long term effect of vesicouretal reflux/

A

fibrosis of renal interstitum

208
Q

what is rx for vesicouretal reflux in kids?

A

abx prophylaxis or surgical fix

209
Q

how does an umbilical hernia change with crying? what about when pressed on?

A

cryign increases abdominal pressure and it comes out, pressed on and it is reducible

210
Q

what is rx for umbilical hernia?

A

observation

211
Q

neuroblastoma is a tumor of what?

A

neural crest cells that involves the adrenal medulla

212
Q

what is age of onset for neuroblastoma?

A

2 years or younger

213
Q

what is found in belly with neuroblastoma?

A

abdominal mass

214
Q

what is a facial finding in neuroblastoma? why?

A

periorbital ecchymosis from metastasis

215
Q

impaired growth velocity with delayed bone age should make you think about what class of issues?

A

endocrine problems

216
Q

what endocrine issues could cause impaired growth velocity with delayed bone age ?

A

hypothyroid and GH deficiency

217
Q

what are symtpoms of hypothyroid around puberty?

A

delayed breast growth, but normal hair growth because under adrenal control

218
Q

what systemic diseases can cause impaired growth velocity?

A

celiac and IBD

219
Q

what type of fracture is common in NAT?

A

metaphyseal corner fracture

220
Q

cyanosis with feeding that is relieved with crying should make you think what?

A

choanal atresia

221
Q

how do you diagnose choanal atresia?

A

cant pass catheter through nasopharynx

222
Q

what is managemtn of choanal atresia

A

surgery if bilateral

223
Q

hypoxic ischemic brain injury leads to what issue in brain?

A

neuronal cell death and edema…leading to increased ICP

224
Q

what does the body do in hypoxic brain injury with acute ICP elevation to help restore brain blood flow?

A

acute hypertension and bradycardia

Pediatrics (4 decks)

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