Uworld Week 3 Flashcards
1
Q
define constitutional growth delay
A
patient not growing fast but staying on a growth curve
2
Q
what is bone age compared to age in constitutional growth delay?
A
bone age is younger than numerical age
3
Q
what will happen in constitutional growth delay?
A
late bloom
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
5
Q
what bug causes tinea versicolor?
A
malassezia
6
Q
what is rx for tinea versicolor?
A
topical ketoconazole or selenium sulfide
7
Q
herpangina is caused by what?
A
coxsackie a virus
8
Q
what does rash look like with herpangina?
A
grey vesicles/ulcers on oropharynx
9
Q
what are two symptoms of herpangina?
A
fever and rash
10
Q
when do kids get herpangina?
A
summer an fall
11
Q
what is rx for herpangina?
A
supportive care
12
Q
what are lab abnormalities in juvenile idiopathic arthritis?
A
leukocytosis, thrombocytosis, elevated inflamm markers
13
Q
what is rash of juvenile idiopathic arthritis?
A
evanescent rash…pink
14
Q
what are physical exam signs of juvenile idiopathic arthritis?
A
hepatosplenomegaly, lymphadenopathy and joint pain
15
Q
what causes the murmur in HCM?
A
mitral valve leaflet movement
16
Q
what is type of murmur in HCM?
A
systolic murmur at left sternal border
17
Q
what causes anemia of newborn?
A
low EPO
18
Q
when does anemia of newborn really show up?
A
2-3 months of age
19
Q
what is the triad of congenital toxoplasmosis?
A
chorioretinitis, hydrocephalus, diffuse intracranial calcifications
20
Q
what neuro finding can happen with congenital toxo?
A
seizures
21
Q
what is rx of congenital toxo?
A
pyrimethamine or sulfadiazine
22
Q
when do growing pains primarily occur?
A
at night, resolve by morning
23
Q
what is management of baby with GER who is gaining weight appropriately?
A
reassurance
24
Q
what is management of baby with GER who is not gaining weight appropriately?
A
thickened feeds and avoid cow/soy milk
25
3 cancers associated with von hippel lindau syndrome
clear cell renal carcinoma
hemangioblastoma
pheochromocytome
26
if kid has recurrent UTIs, what two tests should be done?
renal US and voiding cystourethrigam
27
what should you be concerned about in a kid with recurrent UTIs?
vesicouretal reflux
28
how long after exposure to staph aureus toxin can you develop diarrhea?
6 hours usually
29
how long after exposure to norovirus can you develop diarrhea?
36 hours
30
what type of vomiting is associated with NEC?
bilious
31
what is treatment of allergic bronchopulmonary aspergillosis?
steroids, azoles, and rx for asthma
32
what are three signs of allergic bronchopulmonary aspergillosis?
lower airway inflammation, high IgE and eosinophilia
33
what are three causes of methemaglobinemia?
dapsone, nitrites and anesthetics
34
what are signs of methemaglobinemia on exam?
cyanosis and dark chocolate blood
35
what will o2 sat be in methemaglobinemia
85
36
what will paO2 be in methemaglobinemia?
normal
37
what is rx for methemaglobinemia?
methylene blue
38
what imaging for kid with new hydrocephalus?
CT
39
what are some symptoms of hydrocephalus?
vomiting, headache, irritability, fussy, poor feeding
40
what is rx for hydrocephalus?
VP shunt
41
baby with bilious emesis and unstable needs what?
emergency laporotamy
42
what is most common presenting sign of volvulus in an infant?
bilious emesis
43
what is complication of malrotation that is emergency?
volvulus
44
what is malrotation with volvulus?
twisting of small intestine on itself
45
what are the two common causes of bloody poops in infants less than 6 mos of age?
food protein induced allergic proctocolitis or
| anal fissures
46
what is management of food protein induced allergic proctocolitis when mom is breastfeeding?
remove dairy and soy from moms diet
47
what are symptoms of baby with food protein induced allergic proctocolitis/
totally normal with bloody/mucus stool
48
what is management of food protein induced allergic proctocolitis when mom is formula feeding?
switch to hypoallergenic formula
49
what is cause of premature anemia?
low EPO
50
when do babies have nadir of RBCs? why?
2-3 mos because RBC lifespan is 120 days and EPO not caught up yet
51
what GI issue can cause recurrent cystitis in kids?
constipation
52
what is murmur of tetralogy of fallot?
harsh murmur at left upper sternal bordr
53
what is murmur of VSD?
holosystolic at left lower sternal border
54
what is additional sound you can hear with a VSD?
diastolic rumble from increase flow across mitral valve
55
what is erythemic toxicum neonatorum?
pustules with erythemtous base on trunk and proximal extremities
56
when do you get erythemic toxicum neonatorum?
at birth
57
what is rx for erythemic toxicum neonatorum?
nothing
58
what do you give if baby born to mom with varicella infxn?
give Igs for protection
59
when does mom have to have VZV to be worried about giving post exposure prohpylaxis?
5 days before delivery and 2 days after
60
what is imaging for pyloric stenosis?
US
61
what are some non specific signs of NEC?
apnea, lethargy and vital sign instability
62
what is main risk for NEC?
low birth weight and premature
63
what are lung sounds heard in bronchiolitis?
wheezing and crackles
64
what is rx for bronchiolitis?
supportive care
65
what is cyclic vomiting syndrome?
recurrence of vomiting with no trigger and in between you are asymptomatic
66
coughing with vomiting should make you think about what?
pertussis
67
what is rx of pertussis?
macrolides
68
what are three stages of pertussis?
catarrhal
paroxysmal
convalescent
69
what is a GI sign of HIV in infants?
chronic diarrhea
70
what are two signs of transient hypogammaglobulinemia in infancy?
low IgG and good response to vaccines
71
when doestransient hypogammaglobulinemia in infancy occur?
6 months of age
72
what are the symptoms of serum sickness like reaction?
fever arthralgia urticarial rash and lymphadenopathy
73
what is a common trigger of serum sickness like reaction? when does it occur?
amoxiciliin and bactrim...5-14 days after use
74
what is outcome of serum sickness like reaction?
will resolve on its own
75
what is trigger of serum sickness?
foreign proteins in antivenom toxin and Igs
76
which of serum sickness like reaction and serum sickness forms immune complexes and has high fever?
serum sickness
77
if patient with hemophilia not getting better with transfusion, what may be the cause?
inhibitor development
78
what is WAGR syndrome
Wilms
Anridinia
genitourinary issues
retardation
79
what is anridinia?
lack of iris in eyes
80
what is first step in all patients with nocturnal enuresis?
urinalysis
81
what are some causes of secondary nocturnal enuresis?
DM, UTI and psych stressors
82
which of gon or chlamydia has conjunctivitis in first week of life?
gonorrhea is early onset
83
which of gon or chlamydia has conjunctivitis in second week of life?
chlamydia is late onset
84
what is rx for conjunctivitis in baby from chlamydia?
oral erythromycin
85
what is rx for conjunctivitis in baby from gonorrhea?
IM dose of cephalosporin
86
what is prophylaxis for conjunctivitis in newborn?
topical erythromycin
87
what is a meconium ileus?
obstruction of bowel by inspissated stool
88
what is seen on imaging with meconium ileus?
dilated small bowel and microcolon
89
what disease is associated with meconium ileus?
CF
90
what happens in meconium ileus?
no baby poo for first day or so...
91
which of hirschprung or meconium ileus has the positive squirt sign?
hirschprung...squirt on rectal exam
92
what is a late sequelae of meocnium ileus that can occur?
bilious emesis
93
what does imaging show in hirschprung/
dilated proximal colon and small bowel, narrow rectosigmoid
94
a patient with unilateral nasal rhinorhea that is purulent and does not have any other sx most likely has what?
nasal foreign body
95
what sx are associated with sinusitis in kids?
fever, cough, purulent nasal discharge
96
aside from macrosomia and hypoglycemia, what else can maternal diabetes cause in neonate?
hypocalcemia
97
what are sx of hypocalcemia in neonate with mom that has diabetes?
jittery baby with respiratory distress (sometimes)
98
what is decreased with calcium in baby from mom with gestational diabetes?
hypomagnesia too
99
what are features of a heart murmur in infant that mean you get a work up?
holosystolic, diastolic, harsh sound, 3/6 or higher in intensity,
100
what is post transplant lymphoproliferative disorder?
when you get transplant and then it gives you a viral infection since T cells are knocked down
101
what bug is most commonly associated with post transplant lymphoproliferative disorder?
EBV
102
explain what happens in post transplant lymphoproliferative disorder?
T cells are knocked down due to immunosuppresants and allows virus to run rampant and induce B cell immortality
103
what are signs of post transplant lymphoproliferative disorder?
lymphadenopathy, hepatosplenomegaly, leukopenia
104
what is rx for post transplant lymphoproliferative disorder?
rtiuximab and lower immunosuppression
105
what can occur with persistent pulmonary HTN of newborn?
right to left shunt across PDA
106
what are some risk factors for persistent pulmonary HTN of newborn?
infection, pulmonary dysplasia, meconium aspiration
107
anaerobic bug in lymphadenopathy of cervical chain is caused by what?
dentists
108
when do preterm infants get their vaccines?
same schedule as term infants
109
what is issue in marfan syndrome? inheritance?
defective fibrillin 1 gene, AD
110
aside from high bilirubin and low sugar, what can galactosemia cause with labs?
elevated liver enzymes
111
what are clinical findings of galactosemia?
vomiting, jaundice, hepatomegaly, cataracts
112
what are kids with galactosemia at an increased risk for?
E coli sepsis
113
pigmented macules in setting of microcytic anemia should make you think what?
peutz jehgers syndrome
114
where are pigmented macules found usually in peutz jehgers syndrome?
oral mucosa
115
what is often cause of anemia in peutz jehgers syndrome?
occult bleeding in GI tract
116
what work up should be done for person with peutz jehgers syndrome/
upper and lower endoscopy
117
what cancers are people with peutz jehgers syndrome at increased risk for
colon, GU, and breast
118
what is cause of myotonic dystrophy?
AD CTG repearts
119
what are early symptoms of myotonic dystrophy?
cognitive impairment, ID, ADHD and sleepiness
120
when does myotonic dystrophy onset?
by age 10, start with behavioral and sleep sx
121
what are some associated findings with myotonic dystrophy?
arrythmias, sleepiness, cataracts
122
what is mc cause of congenital hypothyroid?
thyroid dysgenesis
123
what are sx of congenital hypothyroid?
jaundice, poor feeding, pot belly, puffy face, large anterior fontanelle , protruding tongue
124
what is sign of hydrocele?
transillumination of scrotum
125
what is rx for hydrocele in infant?
reassurance
126
what is ambylopia?
functional reduction in vision due to visual disturbances in early childhood
127
what is usual cause of ambylopia?
uncorrected refractive error leads to one eye dominating and lose vision in the other eye
128
how do you correct ambylopia?
patch over good eye
129
what abx for cat scratch disease?
azithromycin
130
what abx for unilateral acute cervical lymphadenitis?
clindamycin
131
what is most likely cause of unilateral acute cervical lymphadenitis in kids?
staph a or strep pyogenes
132
describe the nodes in unilateral acute cervical lymphadenitis
enlarged erythematous and tender
133
what are the findings of mccune albright syndrome?
precocious puberty, bone fractures and cafe au lait
134
what is cause of mccune albright syndrome?
overactive g protein leads to overproduction of all pituitary hormones
135
what is a GI risk in HSP?
intususscepton
136
what is BHS?
breath holding spell
137
what ages have BHS?
6mos to 2 years
138
what is cause of BHS?
often minor trauma/fear or intense crying
139
what happens in BHS?
bradycardia, apnea, cyanosis and LOC
140
what is result of BHS?
normal return to baseline in few minutes
141
5 finding in kawasakis
mucositis, cervical lymphadenopathy, swelling/erythema of hands/feet, rash, and conjunctivirs
142
what happens to platelets in splenic sequestration crisis in sickle cell?
they get trapped in there too
143
what is issue in osteogenesis imperfecta?
collagen type 1 problem
144
how is osteogenesis imperfecta inherited?
AD
145
what are signs of osteogenesis imperfecta?
recurrent bone fractures, blue grey teeth, blue sclera joint laxity
146
what sensation can have issue in osteogenesis imperfecta?
hearing loss
147
when does hereditary angioedema onset?
late childhood/adolescence
148
what areas of body are involved in hereditary angioedema?
face, hands genitalia
149
is hereditary angioedema itchy?
NO
150
what are diagnostic criteria for chronic supporative otitis media?
6 weeks of purulent otorrhea, hearing loss and no ear pain
151
what can happen to ear drum in chronic supporative otitis media?
can rupture
152
what two bugs cause chronic supporative otitis media?
staph a and pseudomona
153
what is rx for chronic supporative otitis media?
topical fluoroquinolone
154
what is photokeratitis? what is cause?
acute superficial corneal injury caused by excessive UV light exposure
155
what is a situation that increases UV light exposure?
snow and sand
156
what are sx of photokeratitis?
eye pain, photophobia, conjunctival erythema and foreign body sensation
157
how do you dx photokeratitis?
punctate corneal staining with fluorscein die
158
how do you rx photokeratitis?
supportive
159
what two sx are associated with wilms tumor?
hematuria and abdominal pain
160
what age gets wilms tumors?
3-5 year olds
161
what is rx for wilms tumor?
surgery and chemo
162
what abx for UTI in kid under 2?
3rd gen cephalosporin
163
what else should be done for kid under two with first UTI?
renal/bladder US
164
what are the maternal estrogen effects on newborns?
breast hypertrophy, swollen labia, uterine bleedinf
165
what is most common cause of CAH? inheritance?
21 hydroxylase deficiency, AR
166
what are levels of cortisol and aldosterone in 21 hydroxylase deficiency?
low!!
167
what hormone is high in 21 hydroxylase deficiency?
17-hydroxyprogesterone
168
what happens to the excess 17 hydroxyprogesterone in 21 hydroxylase deficiency?
converted to testosterone
169
what is karyotype and genitalia of 21 hydroxylase deficiency?
karyotype is XX or XY, in females they have ambiguous external genitalia
170
aside from ambiguous genitalia in females, what else can 21 hydroxylase deficiency cause?
electrolyte abnormalities...low sodium and high potassium
171
what is rx for 21 hydroxylase deficiency?
steroids and mineralocorticoids and high salt diet
172
what is the triad of kartagener syndrome
situs inversus, recurrent pulmonary infections, bronchiectasis
173
what 3 bugs cause acute bacterial sinusitis?
H flu, strep pneumo, moraxella
174
when is bedwetting normal until
5 years old
175
what is an MSK issue found in DS
atlantoaxial instability
176
what happens in atlantoaxial instability ?
c1/c2 are not in great contact, can get spinal compression
177
what are some common issues in atlantoaxial instability ?
abnormal gait, urinary incontinence, weakness
178
are there upper or lower motor neuron signs in atlantoaxial instability ?
upper motor neurons
179
what is imaging to confirm atlantoaxial instability ?
lateral cervical X ray
180
what is most common issue in sickle cell trait?
hematuria
181
what is prognosis for sickle cell trait?
normal life
182
what are the three signs of neonatal displaced clavicle fracture?
crying with arm movement, decreased moro reflex, crepitus over clavicle
183
what is rx for neonatal displaced clavicle fracture??
supportive care and gentle handling
184
myelomeningocele is associated with what brain abnormality?
chiari 2
185
what is main finding of chiari II?
cerebellum and medulla inferior displacement into the foramen magnum
186
what is the greatest risk factor for primary enuresis?
family history of bedwetting
187
kid with hypoglycemia, seizures and lactic acidosis, should think what?
glucose 6 phospohotase, von gierke disease
188
what is issue in von gierke disease/
cant make glycogen into glucose
189
what organs are affected in von gierke?
mucosal surfaces, liver and kidneyes
190
what are findings on physical exam of kid with von gierke disease?
doll like face, rounded cheeks, hepatomegaly, short stature and thin limbs
191
what is cause of neonatal hypertrophic cardiomyopathy in babies from diabetic moms?
glycogen and fat deposition in IV septum
192
what is calcaneal apophysitis
overusee injury caused by repetitive microtrauma to calcaneal growth plate
193
who gets calcaneal apophysitis?
kids 8-12 that are very active
194
is calcaneal apophysitis uni or bilateral?
bilateral
195
what is rx for calcaneal apophysitis?
rest and NSAIDs
196
a white eye reflex is concerning for what?
retinoblastoma or cataract
197
two torch infections that cause cataracts
CMV and rubella...bilateral
198
what are the key features of congenital toxoplasmosis?
chorioretinitis, diffuse calcifications, hydrocephalus
199
what are the key features of congenital syphilis?
rhinorrhea, skeletal abnormalities and desquamating rash
200
what are the key features of congenital rubella?
cataracts, deafness, PDA,
201
what are the key features of congenital CMV?
microcephaly, hearing loss, periventricular calcifications
202
what is most common cause of croup?
parainfluenza
203
severe croup is treated with what two things?
roids and racemic epi
204
mild croup is treated with what?
roids
205
three medications that can raise intracranial pressure
retinoids, growth hormone, tetracycline
206
how does headache from increased ICP change with position?
worse when lying down
207
what is long term effect of vesicouretal reflux/
fibrosis of renal interstitum
208
what is rx for vesicouretal reflux in kids?
abx prophylaxis or surgical fix
209
how does an umbilical hernia change with crying? what about when pressed on?
cryign increases abdominal pressure and it comes out, pressed on and it is reducible
210
what is rx for umbilical hernia?
observation
211
neuroblastoma is a tumor of what?
neural crest cells that involves the adrenal medulla
212
what is age of onset for neuroblastoma?
2 years or younger
213
what is found in belly with neuroblastoma?
abdominal mass
214
what is a facial finding in neuroblastoma? why?
periorbital ecchymosis from metastasis
215
impaired growth velocity with delayed bone age should make you think about what class of issues?
endocrine problems
216
what endocrine issues could cause impaired growth velocity with delayed bone age ?
hypothyroid and GH deficiency
217
what are symtpoms of hypothyroid around puberty?
delayed breast growth, but normal hair growth because under adrenal control
218
what systemic diseases can cause impaired growth velocity?
celiac and IBD
219
what type of fracture is common in NAT?
metaphyseal corner fracture
220
cyanosis with feeding that is relieved with crying should make you think what?
choanal atresia
221
how do you diagnose choanal atresia?
cant pass catheter through nasopharynx
222
what is managemtn of choanal atresia
surgery if bilateral
223
hypoxic ischemic brain injury leads to what issue in brain?
neuronal cell death and edema...leading to increased ICP
224
what does the body do in hypoxic brain injury with acute ICP elevation to help restore brain blood flow?
acute hypertension and bradycardia
