Uworld12 Flashcards
kidney: Podocyte fusion on electron microscopy
minimal change disease
kidney:Localized area os mesangial sclerosis and collapse.
focal segmental glomerulosclerosis
kidney: glomerular basement membrane thickening
membranous nephropathy
kidney: glomerular basement membrane thinning
alport syndrome
change in electrolyte in hypertrophic pyloric stenosis
Hypochloremic, hypokalemic
metabolic alkalosis
Minimal change disease is the most common cause of nephrotic syndrome in what patient population
preadolescent children (NOT teenagers)
Clinical association with membranoproliferazive glomerulonephritis
Hepatitis B and C
Treatment for minimal change disease
steroids
management of a child with proteinuria
repeat urine dipstick testing on 2 separate occasions
Primary defect in renal tubular acidosis 1
poor hydrogen secretion into urine
basic urine
primary defect in renal tubular acidosis 2
poor bicarbonate resorption
acidic urine
Primary defect in renal tubular acidosis 4
aldosterone resistance
postassium levels in renal tubular acidosis
1-2: low-normal
4: high
Hyposthenuria
polyuria because inability of kidneys to concentrate urine
sickle cell disease
how do you get a clean specimen from a child
diapers: straight catheterization
potty trained: mid-stream clean-catch urine specimen
when should a renal and bladder ultrasound be done in a child with UTI
less than 2 years, first febrile UTI
Recurrent UTI
Do no respond to abs
when is voiding cystourethrogram done for child UTI
abnormalities on ultrasound
less than 1 month old
children less than 2 with recurrent UTI
UTI from an organism other than E. coli
Toddler with a firm, unilateral abdominal mass and hematuria
Diagnosed between age 2-5
asymptomatic abdominal mass
Wilm’s tumor
Management of Wim’s tumor
CT first
then chest CT to tule out Mets
Clinical finding in neuroblastoma
abdominal mass that crosses the midline
common in first year of life
APGAR score
Appearance Pulse Grimmace/reaction Activity/muscle tone Respiratory effort
score of what APGAR requires further evaluation
7
Bacterial tracheitis
life-threatening sequela of viral laryngotracheobronchitits
- several days of viral URI, acute elevation of temp and increase in respiratory distress
what type of breathing diagnosis croup
inspiratory stridor
-Biphasic stridor and high fever =something else
At what age do you start presenting with sickle cell anemia
6 months
almost all male patients with cystic fibrosis have?
congenital bilateral absence of vas deferens
due to accumulation of inspissated mucus
infertility
difference between cystic fibrosis and primary ciliary dyskinesia
pancreatic insufficiency - poor growth, deficiency of fat-soluble vitamins
only in cystic fibrosis
most common cause of bacterial pneumonia in young children with cystic fibrosis ( age less than 20)
age less than 20: Staph. aureus
age greater than 20: Pseudomonas aeruginosa
First step in management of newborn with respiratory compromise and suspected congenital diaphragmatic hernia
endotracheal intubation
gastric tube to decompress the stomach and bowel
what would be on the differential for congenital diaphragmatic hernia
concave abdomen and barrel-shaped chest
Next step in management of foreign body aspirations
immediate bronchoscopy
ultrasound or fluoroscopy of chest reveals asymmetric diaphragmatic motion in a seesaw manner in a big baby just delivered
phrenic nerve paralysis `
What are lab values for Group B strep. meningitis in normal newborn
low WBC with left shift
thrombocytopenia
clubbing and sudden-onset joint arthropathy in a chronic smoker. next step?
chest x-ray to rule out malignancy
What is Heiner syndrome and what is it associated with
sensitive to cow’s milk
Idiopathic pulmonary hemosiderosis
Triad for primary ciliary dyskinesia
- recurrent sinopulonary infection
- Bronchiectasis
- Situs inversus
What causes subglottic edema
Laryngotracheobronchitis
treatment for laryngotracheobronchitis
corticosteroids and nebulizer epinephrine
complete white out on X-ray? most common causes
lung empyema
S. aureus
S. pneumonia
S.pyogenes
when is a large thyme silhouette a normal finding in a child
age less than 3 years
treatment for neonatal respiratory distress syndrome
early continuous positive air pressure vent
chest x-ray for transient tachypnea of newborn
bilateral perihilar linear streaking
what is the next step for for someone who has suspected subcutaneous emphysema
Chest x-ray to rule out pneumothroax
complications of positive pressure ventilation
alveolar damage
pneumothorax
hypotension
management of small pleural effusion in an asymptomatic child
oral abs and close outpatient follow up
2 risk factor for neonatal respiratory distress syndrome
prematurity
maternal diabetes mellitus
2 complications of RSV
apnea (especially if less than 2 months)
respiratory failure
treatment for toxocara canis
albendazole
what sinus has pus from superior meatus of nose
sphenoid or posterior ethmoid
differentiate respiratory distress syndrome and transient tachypnea of newborn
RDS: low lung volumes (TTN has retained fetal lung fluid)
ground-glass opacities
air bronchograms on chest x-ray
treatment for neonatal clavicle fracture
it will heal on its own
before what age must ADHD be diagnosed
before 12
what happens 12-48 hours after alcohol withdrawal
seizures alcoholic haluccinosis (intact orientation)
Alexia
inability to read
Agnosia
inability to recognize objects despite intact senses
if a child has a tic… can they still use stimulant ADHD medications
yes
conduct disorder vs. oppositional defiant disorder
conduct disorder: aggression and violation of rules
ODD: disobedience toward authority figures
first line of treatment of OCD in children
SSRI and CBT
Transient distress on initial separation from major attachment figures is age appropriate in children at what age
9-18 months
when does stranger anxiety occur
6-12 months
repeated object insertion into vagina or anus in a child. normal or not
not normal
Sex play involving genital-genital, oral genital, or anal-genital contact, normal or not normal
not mortal
masturbatory movements. normal or not normal
normal
first line treatment for Tourette disorder
clonidine
other: 2nd generation psych
side effect of clonidine
sedation
what is the triad with tourette
ADHC or OCD
triad of arsenic poisoning
abdominal pain
hematuria
jaundice
systemic manifestations of iron poisoning
abdominal pain
hematemesis shock
metabolic acidosis
initial screening for lead poisoning? diagnostic?
capillary (finger stick) blood specimens
confirmed with venous blood draw
methemoglobinemia
iron changes in RBC
treatment for methemoglobinemia
cyanosis and dark chocolate-colored blood
what causes methemoglobinemia
oxidizing agents (dapsone, nitrites/topical anesthetics)
what is used to treat seizure overdose from TCA
benzodiazepines
which type of ocular conjunctivitis has ocular pruritus
allergic
dacryostenosis
obstruction of lacrimal duct
what is trachoma
chlamydia trachomatis
when does chemical neonatal conjunctivitis occur?
Gonorrhea ?
Chlamydial?
less than 24 hours of birth
g: 2-5 days old
CH: 5-14 days old
management of dacryostenosis
massaging the nasolacrimal ducts
treatment for gonococcal conjunctivitis
one dose of intramuscular ceftriaxone or cefotaxime
trachomatis
chlamydia
neurofibromatosis type 1 eye problem
optic pathway glioma
neurofibromatosis type 2
acoustic neuromas
when is strabismus abnormal in a child
after age 4 months
when is the visual acuity test started in a child
age 3
Stabismus, or ocular misalignment, can cause an asymmetric red reflex with increased intensity in the deviated eye. in retinoblastoma what will be the corneal light reflex
symmetric
biggest risk factor for Cryptorchidism
testicular cancer
treatment for testicular hydrocele
observation, most resolve by age 1 year
What is genetic testing for duchess muscular dystrophy
absent dystrophin gene and undetectable dystrophin protien
what confirms the diagnosis of Duchenne muscular dystrophy? What is gold standard therapy for?
muscle biopsy
gold: genetic studies
3 categories of clinical symptoms of friedriech ataxia
neurologic
skeletal
cardiac
What is the most common cause of death for friedriech ataxia
cardiomyopathy and respiratory complications
Cardiac rhabdomyomas and renal angiomyolipomas and intellectual problems
tuberous sclerosis
difference between central and peripheral Bell’s Palsy
Central: spares forehead
What is procedure is contraindicated with nocturnal headaches and morning vomiting?
signs of elevated intracranial pressure
lumbar puncture is contraindicated
Most common type of brain tumor in children
astrocytoma
second most common tumor of posterior fossa in children
medulloblastoma
“firm, well-demarcated swelling on the right parietal scalp with no discoloration and no apparent tenderness
cephalohematoma:scalp swelling that does not cross suture lines
biggest risk factor for cerebral palsy
prematurity
if you fall with an object in your mouth. What is the most likely deformity
traumatic carotid injuries or thrombus formation
Most common cause of death from child abuse
shaken baby syndrome
