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1025 Cards in this Set
- Front
- Back
Q001. vaccinations given at birth
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A001. hepatitis B
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Q002. vaccinations given at 1 month
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A002. hep B, only if not given at birth
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Q003. vaccinations given at 2 months
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A003. Pediarix (HBV, DTaP, IPV); Prevnar (pneumococc); Rotavirus; Hib
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Q004. what is in pediarix
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A004. HBV; DTaP; IPV
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Q005. vaccinations given at 4 months
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A005. Pediarix; Prevnar; Hib; Rotavirus
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Q006. vaccinations given at 6 months
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A006. Pediarix; Prevnar; Hib; Rotavirus
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Q007. vaccinations given at 12 months
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A007. DTaP; Hib; MMR; VZV; Prevnar; Influenza; Hep A
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Q008. vaccinations given at 24 months
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A008. none
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Q009. vaccinations given at 4-6 yrs
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A009. DTaP; IPV; MMR; Influenza
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Q010. vaccinations given at 11 yo
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A010. Tdap; Meningococcus vaccine
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Q011. what is the schedule for well visits starting from birth
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A011. 1 mo; 2 mo; 4 mo; 6 mo; 9 mo; 12 mo; 15 mo; 18 mo; 24 mo; then annually
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Q012. why shouldn't babies drink water
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A012. because their kidneys aren't mature enough to handle the extra fluid so the babies will become hyponatremic since they can't excrete the water, and then they can have seizures
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Q013. plagylocephaly
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A013. mishapen head
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Q014. sunsetting sign
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A014. increased ICP, eyes are half closed secondary to the increased ICP on the cranial nerves
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Q015. craniosynostosis
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A015. premature closure of the fontanelles
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Q016. rash pattern in rocky mountain spotted fever
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A016. palms and soles, then spreads to trunk; petechial
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Q017. rash pattern in rubella
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A017. rash on face that spreads to the rest of the body
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Q018. rash pattern in measles
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A018. rash starts at the head and spreads downwards and disappears in the same manner
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Q019. rash pattern for erythema infectiosum
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A019. slapped cheek rash;; lacy, reticular
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Q020. VZV rash pattern
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A020. begins on trunk,; followed by head, face, and extremities
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Q021. gross motor skills at 1 mo old
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A021. raises head
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Q022. gross motor skills at 3 mo
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A022. holds head up
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Q023. gross motor skills at 4-5 mo
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A023. rolls front to back and back/front; sits supported
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Q024. gross motor skills at 6 mo
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A024. sits unsupported
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Q025. gross motor skills at 9 mo
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A025. crawls; cruises; pulls to stand
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Q026. gross motor skills at 12 mo
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A026. walks alone
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Q027. gross motor skills at 15 mo
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A027. walks backwards
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Q028. gross motor skills at 18 mo
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A028. runs
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Q029. gross motor skills at 24 mo
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A029. walks well up and down stairs
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Q030. gross motor skills at 3 yrs
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A030. rides tricycle; throws ball overhand
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Q031. gross motor skills at 4 yo
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A031. alternates feet going down stairs; skips
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Q032. fine motor skills at 1 mo
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A032. follows eyes to midline
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Q033. fine motor skills at 3 mo
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A033. hands open at rest
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Q034. fine motor skills at 4-5 mo
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A034. grasps with both hands together
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Q035. fine motor skills at 6 mo
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A035. transfers hand to hand, reaches with either hand
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Q036. fine motor skills at 9 mo
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A036. pincher grasp; finger feeds
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Q037. fine motor skills at 12 mo
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A037. throws, releases objects
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Q038. fine motor skills at 15 mo
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A038. builds 2 block tower
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Q039. fine motor skills at 18 mo
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A039. feeds self with utensils
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Q040. fine motor skills at 24 mo
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A040. removes clothing; builds 5 block tower
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Q041. fine motor skills at 3 yrs
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A041. draws circle
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Q042. fine motor skills at 4 yrs
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A042. catches ball; dresses alone
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Q043. fine motor skills at 5 yrs
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A043. ties shoes
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Q044. Simple febrile seizure
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A044. between 6mo - 6yr; tonic clonic; associated with fever >100.4; seizure lasts <15 mins; only 1 seizure in 24 hrs; minimal post-ictal state
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Q045. complex febrile seizure
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A045. 6 mo - 6 yrs; focal seizure; >15 mins; >1 seizure/24 hrs
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Q046. management of simple febrile seizure
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A046. determine the source of the fever, otherwise, no other w/u is needed
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Q047. management of complex febrile seizure
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A047. full w/u should be done, but no anti-epileptics, no eeg needed; if patient is <18 mo, LP
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Q048. eeg abnormality associated with infantile spasm
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A048. hypsarrythmia
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Q049. definition of recurrent abdominal pain
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A049. >3x in 3 mo
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Q050. #1 cause of abdominal pain
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A050. gastroenteritis
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Q051. mesenteric lymphadenitits
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A051. persistent pain following an infection
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Q052. clinical features of HENOCH-SCHONLEIN PURPURA
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A052. condition preceded by uri; non-thrombocytopenic palpable purpura; hematuria (good prognosis); proteinuria (poor prognosis); spasmodic abdominal pain; ileus, n/v; ugi/lgi bleed
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Q053. tx of Henoch-Schonlein Purpura
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A053. steroids
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Q054. complication of Henoch-Schonlein Purpura
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A054. intussusception; kidney probs
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Q055. clinical features of kawasaki
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A055. CRASH and BURN; Conjunctivitis; Rash (on trunk mostly); Aneurysm (coronary); Skin peels off, Strawberry tongue; Hands/Feet edema; BURN = FEVER (x 5d)
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Q056. phases of kawasaki disease
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A056. acute; subacute (aneurysm formation); convaslescent; takes 2-3 months to resolve
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Q057. tx of kawasaki
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A057. ASA; IVIG
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Q058. when is colicky pain associated with
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A058. constipation
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Q059. what type of stool is seen with bacterial enterocolitis
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A059. bloody, mucinous stool
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Q060. when will an appendix perforate in appendicitis
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A060. w/i 36 hrs
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Q061. which infection can clinically mimic appendicitis
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A061. yersinia; campylobacter
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Q062. what imaging study for appendicitis
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A062. ct
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Q063. meds used to tx of perforated appendix
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A063. amp, gent, flagyl
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Q064. clinical presentation of intussusception
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A064. currant jelly stools; lethargy; palpable tubular mass; paucity of gas on xr or evidence of obstruction
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Q065. imaging most specific for intussusception
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A065. barium (or air) enema; is also therapeutic
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Q066. most common location for intussusception
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A066. ileocolic; can also develop at meckel's divertic
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Q067. major complication of intussusception
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A067. there is impaired venous return so bowel edema develops -- > ischemia, necrosis --> perforation
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Q068. etiology of intussusception
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A068. ileum invaginates into colon at ileocecal valve; a previous viral infection --> hypertrophy of the peyer's patches... this can develop into a lead point; Henoch-Schonlein Purpura can be association with an ileal- ileal intussusception
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Q069. tx of intussusception
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A069. must do fluid resusc first, if needed; hydrostatic reduction with air/barium
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Q070. recurrence rate of intussusception
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A070. 0.15
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Q071. at what age would a patient present with pyloric stenosis
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A071. 1-3 mo
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Q072. which medicaation can be associated with pyloric stenosis
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A072. erythromycin
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Q073. best imaging for pyloric stenosis
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A073. u/s; will also see a string sign ugi study
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Q074. tx of pyloric stenoSIS
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A074. MUST correct fluids and lytes first!; then pyloromyotomy
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Q075. describe malrotation
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A075. small intestines rotate abnormally in utero, so there is an abnormal fixation posteriorly to the mesentary; it can twist on its vascular supply --> volvulus
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Q076. clinical presentation of malrotation
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A076. bilious emesis; possibly abdominal distention/shock; + guiac test = bowel ischemia, poor prognostic sign
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Q077. tx of malrotation
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A077. surgery ASAP
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Q078. tx for scd induced priapism
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A078. sedation
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Q079. disease that scd can mimic if htere is abdominal pain
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A079. appendecitis
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Q080. when is frontal bossing seen?
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A080. beta-thal or some other hemolytic process that requires rapid hematopoesis
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Q081. tx for beta-thal
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A081. serial transfusion + chelation therapy (desferoxamine) b/c of fe overload
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Q082. consequence of fe overload
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A082. hemochromatosis
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Q083. complications of g6pd deficiency
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A083. rbcs are destroyed but there is increased amounts of hb liberated in the process --> hb-uria
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Q084. findings in classic hemophilia
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A084. bleeding problems + hemarthrosis
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Q085. battle's sign
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A085. basilar skull fracture that leads to bleeding/bruise behind the ear
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Q086. mechanism behind bell's palsy in neonates
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A086. forceps deliver... usually resovles
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Q087. social milestones at 5 yo
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A087. competetive games; understands rules and abides by them
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Q088. social milestones at 4 yo
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A088. imaginative play
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Q089. social milestones at 3 yo
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A089. group play; shares
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Q090. social milestones at 2 yo
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A090. parallel play
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Q091. social milestones at 18 mo
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A091. plays around other children
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Q092. social milestones at 12 mo
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A092. comes when called; cooperates with dressing
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Q093. social milestones at 9 mo
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A093. pat-a-cake
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Q094. social milestones at 6 mo
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A094. recognizes strangers
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Q095. social milestones at 4-5 mo
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A095. enjoys observing environment
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Q096. social milestones at 3 mo
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A096. reaches for familiar objects/ppl
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Q097. social milestones at 2 mo
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A097. recognizes parent
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Q098. social milestones at 1 mo
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A098. fixes on face
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Q099. developmental dysplasia of the hip
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A099. abnormal relationship between head of femur and acetabulum --> instabilility and dislocation of hip joint; develops secondary to lack of contact of acetabulum and femur during intrauterine development
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Q100. dx of developmental dysplasia of hip
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A100. u/s: see "false acetabulum" in lateral ileum
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Q101. tx of developmental dysplasia of hip
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A101. pavick harness (keeps hip abducted and flexed), or body casting on older pts
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Q102. complications of developmental dysplasia of hip
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A102. Avascular necrosis; degenerative arthritis of hip
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Q103. metatarsus adductus
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A103. dorsiflexion and plantarflexion are UNRESTRICTED (diff from clubfoot);; heels go out and toes go in
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Q104. tx of metatarsus adductus
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A104. stretching or a brace; surgery not usualy needed
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Q105. idiopathic talipes equinovarus (aka); appearance
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A105. congenital clubfoot; medial rotation of tibia, fixed plantar flexion, inversion of foot, forefoot adduction; CANNOT DORSIFLEX (unlike metatarsus adductus)
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Q106. tx of clubfoot
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A106. bracing; serial casting
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Q107. legg-calve-perthes disease
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A107. avascular necrosis of femoral head; ischemic bone is eventually resolved and re-ossification occurs; --> limp, pain referred to thigh/knee
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Q108. what movements are restricted in legg-calve-perthes disease
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A108. abduction; flexion; internal rotation
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Q109. tx of legg-calve-perthes disease
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A109. bracing; surgery; observation
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Q110. complications of legg-calve-perthes disease
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A110. collapse of femoral head
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Q111. SLIPPED CAPITAL FEMORAL EPIPHYSIS
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A111. gradual or acute separation of proximal femoral growth plate; fem head slipps off of femoral neck and rotates inf-post postition
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Q112. etiology of slipped capital femoral epiphysis
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A112. common during puberty, could be hormonal
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Q113. presentation of slipped capital femoral epiphysis
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A113. limp, pain in hip and groin, pain referred to knee
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Q114. dx of slipped capital femoral epiphysis
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A114. plain film frog-leg, lateral position
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Q115. tx of slipped capital femoral epiphysis
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A115. goal is to prevent further misalignment; pin fixation is done acutely; chronic cases require osteotomy
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Q116. Osgood Schlatter disease
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A116. inflammation, swelling and tenderness over tibial tuberosity secondary to tendonitis of distal insertion of infrapatellar tendon
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Q117. when does Osgood Schlatter disease occur
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A117. During growth spurt, in teens
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Q118. tx of Osgood schlatter
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A118. conservative, supportive management
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Q119. complication related to achondrodysplasia
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A119. small foramen magnum seen in homozygotes --> brainstem compression
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Q120. what is achondrodysplasia
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A120. disorder of cartilage calcifications and remodeling
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Q121. why do children have an increased risk of fracture
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A121. tendons and ligaments are stronger than bones so in kids injuries often lead to fracture when they would only cause sprain in adult
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Q122. types of fracture
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A122. spiral (twisting forces on tibia during fall); epiphyseal fracture (use salter classification); stress fracture (hairline crack from repeated activity); torus fracture (at metaphysis)
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Q123. nursemaids elbow
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A123. subluxation of radial head
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Q124. define upper airway
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A124. nose --> carina
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Q125. sx of upper airway disease
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A125. inspiratory stridor; tachypnea; respiratory distress
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Q126. choanal atresia
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A126. most proximal abnormality of airway; bony or membranous septum between 1 or both nasal passages and pharynx, preventing airflow through nose; life threatening if b/l (most young infants are obligate nose breathers); can't pass NG tube
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Q127. complications of long-term intubation
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A127. subglottal stenosis
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Q128. laryngeal or tracheomalacia
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A128. floppiness that closes off airway
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Q129. how to confirm dx of laryngeal or tracheomalacia
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A129. bronchoscopy
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Q130. ddx for wheezing and respiratory distress
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A130. asthma; bronchiolitis; foreign body aspiration; gerd; TE fistula; vascular sling
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Q131. pathophysiology of sx in CF
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A131. CFTR is abnormal --> altered cl channel; cl stays in cells and Na/water enter the cell to maintain osmotic balance --> viscous secretions
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Q132. GI effects in CF
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A132. pancreatic insufficiency; bowel obstruction; rectal prolapse; DM; cirrhosis; large bulky smelly stools; later in life stools --> distal obstruction
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Q133. Pathognomonic finding in CF
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A133. meconium ileus
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Q134. Tx of CF
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A134. chest physiotherapy; exercise; frequent cough; recombinant human dnase given through nebs to break down thick mucous complexes
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Q135. other than respiratory infection, what are some other complications of CF
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A135. hemoptysis (>500 cc/d = emergency) tx with embolization; spontaneous ptx (1/2 will recur unless sclerosis is performed, but if that is done then transplant is very difficult)
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Q136. mesenteric lymphadenitis leads to
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A136. persistent pain after infection
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Q137. GI complication from Henoch-Schonlein Purpura
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A137. ileal-ileal intussusception
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Q138. Sx of Henoch-Schonlein Purpura
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A138. non thrombocytopenic palpable purpura in dependent areas; an IgA mediated vasculitis involving GI, skin, joints, and kidneys
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Q139. what is Henoch-Schonlein Purpura usually preceded by
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A139. URI
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Q140. GI sx of Henoch-Schonlein Purpura
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A140. spasmodic pain, ileus, vomiting, ugi/lgi bleed
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Q141. Tx of Kawasaki disease
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A141. iv Ig; ASA
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Q142. 3 phases of kawasaki
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A142. acute; subacute (aneurysms form); convalescent (resolution over 2-3 mo)
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Q143. which bacterial infection can mimic appendicitis
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A143. campylobacter; Yesinia
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Q144. sx of intussusception
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A144. BOWEL OBSTRUCTION; currant jelly stools; lethargy; palpable tubular mass; paucity of gas on XR or evidence of obstruction
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Q145. dx of intussusception
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A145. barium (or air) enema
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Q146. progression of complications of intussusception
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A146. impaired venous return; bowel edema; ischemia; necrosis; perforation
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Q147. pathophys of intussusception
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A147. most are ileocecal, and occur when the ileum invaginates into colon at ileocecal valve
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Q148. lead points in intussusception
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A148. hypertrophy in Peyer's patches (often p viral infection); Meckel's divertic; intestinal polyp; lymphoma; foreign body; Henoch-Schonlein Purpura
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Q149. at what age would you expect pyloric stenosis
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A149. 1-3 months
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Q150. what medication if given is associated with pyloric stenosis
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A150. erythromycin
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Q151. dx of pyloric stenosis
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A151. u/s, see hypertrophic pyloris; UGI study shows string sign
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Q152. embryology behind omphalocele
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A152. when midgut loop fails to return to abdominal cavity; see light gray shiny sac protruding from base of umbilical cord
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Q153. embryology behind malrotation of midgut
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A153. midgut undergoes partial rotation and --> abnormal position of abdominal viscera, can be assoc with volvulus --> compromised blood flow and gangrene
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Q154. gastroschisis
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A154. weakness in abdominal wall --> herniation of bowel through the rectus muscle, usually to the right of the umbilicus
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Q155. clinical features of malrotation
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A155. bilious emesis; possible abdominal distension; XR shows gas in stomach, but no gas in intestines
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Q156. risk factors for developing GERD in babies
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A156. prematurity; esophageal disease; obstructive lung disease; overdistension of stomach from overeating; meds (theophylline)
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Q157. dx of GERD
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A157. pH probe placement in esophagus or ugi endoscopy; barium swallow to confirm normal anatomy
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Q158. tx of GER/GERD
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A158. small frequent feedings; keep head up for 20mins p eating; thicken feeds with cereal; metoclopramide (increases gastric motility); h2 blocker or PPI; last resort: nissen fundlopication (fundus of stomach is wrapped around distal esophagus to increase les pressure)
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Q159. tx of diarrhea in children
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A159. if no serious complications, feed through the diarrhea --> decreased denudement and faster return to normal stooling patterns; don't give antidiarrheals b/c --> toxic megacolon, unless salmonella, Shigella, c diff, or parasites
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Q160. when to do w/u for diarrhea in a child
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A160. in infant <3mo, do blood culture; 0-12 mo, do stool culture; do blood and stool culture if >5d of enterocolitis or salmonella exposure; any infant with + stool dx looking toxic or + blood culture should be evaluated for pyelo, meningiits, PNEUMONIA, osteo
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Q161. when should a patient with diarrhea be admitted to hospital
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A161. >5% dehydration and can't rehydrate effectively at home
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Q162. constipations and complications
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A162. no bowel movement, if after neonatal pd, #1 cause is voluntary withholding; can be caused by pain, on defecation --> fear of defecation - -> further retention; voluntary holding increases distension of rectum, decreases rectal sensation, requiring increased amounts needed to receive urge
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Q163. sx of Hirchsprung’s
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A163. h/o diarrhea, fecal spotting alternating with constipation
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Q164. how to tx functional constipation
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A164. increase fluid,; decrease junk food,; increase fiber,; increase ingestion of undiluted juice
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Q165. pathophys of Hirchsprung’s
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A165. failure of ganglion cells of myenteric plexus to migrate down colon in utero; therefore distal colon is tonically contracted and there is obstruction; usually limited to rectosigmoid colon
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Q166. when to suspect Hirchsprung’s
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A166. in any infant who doesn't pass meconium, then --> bilious vomiting, abdominal distension, and poor feeding
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Q167. tx of Hirchsprung’s
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A167. diverting colostomy with bowel that contains ganglion cells; aganglionic segment is removed by pulling ganglionic segment through rectum
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Q168. sx of Meckel's diverticulum
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A168. remnant of vitilline duct w/i 2 inches of ileocecal valve; bleeding from diverticulum; melena, obstruction (from intussusception), diverticulitis
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Q169. tx of Meckel’s diverticulum
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A169. surgical resection
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Q170. dx of Meckel’s diverticulum
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A170. technetium-99 scan p h2 antagonist to locate hemorrhagic cells
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Q171. encephalocele
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A171. projection of cranial content through bony skull defect in occiput --> severe mental retardation, seizure, movement disorder
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Q172. myelomeningocele
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A172. protrusion of neural and meningeal tissue
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Q173. meningocele
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A173. meninges protrude
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Q174. spina bifida II is associated with
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A174. Chiari II malformation
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Q175. complications of spinal bifida
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A175. caudal end of cord is tethered to distal spine and can't ascend to adult position --> scoliosis, sphincter dysfxn, LE deformities
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Q176. non-communicating hydrocephalus
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A176. block in exiting ventricles;; above blockage, ventricles are big
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Q177. causes of non-communicating hydrocephalus
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A177. secondary to narrowing at 4th ventricle/aqueduct or malformation at posterior fossa; Chiari II malformation; spina bifida occulta
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Q178. communicating hydrocephalus
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A178. subarachnoid villi are dysfunctional/obliterated
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Q179. sx of motor cerebral palsy
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A179. fixed lesion in immature brain -> nonprogressive disorder of movement and posture; spasticity is #1 type from injury to motor tracts in brain; pts are hypotonic in early months then later become spastic; CONDITION IS NOT PROGRESSIVE
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Q180. sx of extrapyramidal cerebral palsy; etiology
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A180. from basal ganglia damage --> choreoathetoid movement, postural ataxia, spasticity; kernicterus, there is usually some sort of brain insult
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Q181. what gcs is required for a head ct to be obtained
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A181. <12
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Q182. #1 cause of ICH in kids
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A182. Arteriovenous malformation
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Q183. what meds are associated with pseudotumor cerebri
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A183. tetracyclines; corticosteroids
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Q184. define encephalopathy
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A184. generalized cerebral dysfxn, ms change, disorientation
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Q185. risk factors for developing retinopathy of prematurity
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A185. Body weight <1250 g; age <32 weeks; mechanical ventilation; need for supplemental o2
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Q186. causes of leukocoria
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A186. retinoblastoma (--> death and visceral metastasis in all cases); cataracts (most common cause); retinopathy of prematurity
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Q187. amblyopia
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A187. visual impairment not corrected by glasses and not due to an ocular lesion; often from strabismus
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Q188. tx of amblyopia
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A188. occlusion of better seeing eye forces development of affected eye and visual cortex of affected eye
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Q189. at what age will tx not be successful in ambylopia
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A189. after 8yo
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Q190. tx of retinoblastoma
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A190. enucleation (removal of the affected eye); radiation tx; chemo
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Q191. complications of neonatal cataracts
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A191. if not remoed by 3-4 months, there is irreversible amblyopia
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Q192. course of retinopathy of prematurity
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A192. most regress spontaneously; if not, cryotherapy can be performed to reduce progression; are still at risk for amblyopia even if treated
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Q193. dacryostenosis
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A193. congenital nasolacrimal duct obstruction; causes overflow tearing - 6% of neonates; secondary to failure of distal membranous end of nasolacrimal duct to open
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Q194. tx of dacryostenosis
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A194. probing of nasolacrimal dut at 12-15 mo; although most resolve spontaneously by 1 yo (in 96% of infants)
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Q195. ophthalmia neonatorum
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A195. conjunctivitis occurring in first month of life; p/w eyelid edema, conjunctival hyperemia and ocular d/c
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Q196. when is it normal for there not to be tears
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A196. in the first few weeks of life
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Q197. age of onset of gonococcal ophthalmia neonatorum
|
A197. 2-4 days
|
|
Q198. age of onset of chlamydia ophthalmia neonatorum
|
A198. 4-10 days
|
|
Q199. clinical features of gonococcal ophthalmia neonatorum
|
A199. eyelid edema; chemosis; purulent d/c
|
|
Q200. complications of gonococcal ophthalmia neonatorum
|
A200. sepsis; meningitis; arthritis; corneal ulceration; blindness
|
|
Q201. complications of chlamydia ophthalmia neonatorum
|
A201. corneal scarring; PNEUMONIA
|
|
Q202. tx of chlamydia ophthalmia neonatorum
|
A202. oral and topical erythromycin; tx parents; tx with erythromycin despite the risk of developing pyloric stenosis
|
|
Q203. tx of gonococcal ophthalmia neonatorum
|
A203. topical erythromycin; IV cefotaxime; tx parents
|
|
Q204. when should steroid containing eye drops not be given in conjunctivitis
|
A204. if hsv-1 is suspected etiology; can make disease worse
|
|
Q205. hordeolum
|
A205. acute infection of sebacous tarsal glands; staph aureus is usually cause
|
|
Q206. tx of hordeolum
|
A206. warm compresses
|
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Q207. chalazion
|
A207. area of sterile lipogranulomatous reaction within meibomian glands that can enlarge; can be chronic and recurrent
|
|
Q208. is periorbital or orbital cellulitis an emergency
|
A208. orbital cellulitis
|
|
Q209. sx of periorbital cellulitis
|
A209. skin around eye is indurated, warm, and tender; no eye pain; may have si/sx of sinus infection
|
|
Q210. sx of orbital cellulitis
|
A210. severe pain with eye movement; proptosis; vision changes; decreased ocular mobility
|
|
Q211. dx of orbital cellulitis
|
A211. ct scan
|
|
Q212. organisms to cover with orbital cellulitis
|
A212. strep; H. flu; M. cat
|
|
Q213. tx of periorbital cellulitis
|
A213. iv antibiotics; can --> meningitis, tx aggressively with vanco, PCN, 1st generation cephalosporin
|
|
Q214. orgs to tx in periorbital cellulitis
|
A214. strep; h flu; m cat
|
|
Q215. features of fragile x syndrome
|
A215. hyperactive; mental retardation; large body; long face; prominent jaw and ears; thickened nasal bridge; large testes; +/- autism
|
|
Q216. facial features of 47 XYY
|
A216. long asymmetric ears; increased length: breadth in hands, feet, and cranium
|
|
Q217. nutritional deficiencies in goat's milk
|
A217. decreased vit d, iron, folate, b12
|
|
Q218. infectious disease associated with drinking raw cow's milk
|
A218. brucellosis
|
|
Q219. what supplements should moms receive if they are vegan
|
A219. b12 to prevent buildup of mma
|
|
Q220. effects of excess vit D
|
A220. hypercalcemia; azotemia; poor growth; n/v/d
|
|
Q221. vit E deficiency in premies -->
|
A221. hemolytic anemia
|
|
Q222. b1 deficiency -->
|
A222. beriberi; (neuritis, edema, CHF); hoarseness; anorexia
|
|
Q223. b2 deficiency -->
|
A223. photophobia; cheilosis; glossitis; corneal vascularity
|
|
Q224. b3 deficiency -->
|
A224. pellagra (dermatitis, dementia, diarrhea)
|
|
Q225. pathophys of primary hypophosphatemia
|
A225. defective po4 resorption; no conversion of 25-vit D --> 1,25-vit D in proximal tubules
|
|
Q226. lab studies in primary hypophosphatemia; ca; po4; alkaline phosphatase
|
A226. low/normal; low; high
|
|
Q227. clinical findings in primary hypophosphatemia
|
A227. smooth LE bowing (not angular, as is seen in Ca deficiency); intraglobulin dentin deformities (ca deficiency --> enamel defects); coarse trabecular bone and fraying
|
|
Q228. somogyi phenomenon
|
A228. nocturnal hypoglycemia manifested as night terrors, early am sweating, then later has hyperglycemia, ketonuria, glucosuria (sugars increase because of glucagon release)
|
|
Q229. what is an absolute contraindication for DTaP
|
A229. if first dose --> encephalopathy or encephalitis
|
|
Q230. clinical presentation of pb poisoning
|
A230. emotional lability; abdominal pain; achy bones; intermittent vomiting and constipation
|
|
Q231. at what BLL should tx be initiated
|
A231. >45
|
|
Q232. clinical presentation of acute hg poisoning
|
A232. GI pain; fever; chills; HA; visual changes; cough; cerebral palsy
|
|
Q233. clinical presentation of chronic hg poisoning
|
A233. gingivostomatitis; tremor; neuropsych features
|
|
Q234. clinical presentation of acute arsenic poisoning
|
A234. n/v/d, abdominal pain; 3rd spacing; hemorrhage; hypovolemic shock; Ventricular tachycardia; QT prolongation
|
|
Q235. narcosis
|
A235. deep stupor, unconsciousness
|
|
Q236. clinical presentation of cerebral palsy
|
A236. postural hypotonia; failure ot reach for toys; gross and fine motor delay; cognitive and sensory deficits
|
|
Q237. complications of cerebral palsy
|
A237. seizure; mental retardation
|
|
Q238. differences in etiology for quadriplegia and paraplegia
|
A238. quadriplegia results from UMN damage; paraplegia results from LMN or spinal cord damage
|
|
Q239. most likely organisms Otitis --> pneumnia in CF
|
A239. staph or pseudomonas
|
|
Q240. clinical presentation of meconium ileus
|
A240. vomiting; abdominal distension; distended bowel loops; "soap bubble" on XR
|
|
Q241. pathophys of meconium ileus
|
A241. obstruction begins in utero --> underdeveloped distal lumen
|
|
Q242. tx of meconium ileus
|
A242. surgical emergency; gastrograffin enema
|
|
Q243. vitamin a deficiency -->
|
A243. pseudotumor cerebri (among other things); will see bulging fontanelles, headache, n/v; may be seen as first presenting sign in a patient with CF
|
|
Q244. what effect does phenobarb have on jaundice
|
A244. it improves it by increasing gluocoronyl transferase
|
|
Q245. cancer that is associated with (germline) retinoblastoma
|
A245. osteosarcoma is most common; melanoma; squamous cell ca
|
|
Q246. conditions associated with aniridia
|
A246. congenital glaucoma; surge-weber; marfan; neurofibromatosis
|
|
Q247. presentation of malrotation
|
A247. obstruction; typically normal for first few days of life than malrotation worsens --> abdominal fullness, especially in ruq --> bilious vomiting --> ischemia and necrosis
|
|
Q248. #1 malrotation
|
A248. volvulus
|
|
Q249. pathophys of volvulus
|
A249. cecum fails to move to right lower quadrant and never adheres to abdominal wall; mesentary and SMA are tethered to narrow stalk and twist about itself; band of adhesive tissue can extend from cecum to ruq -> duodenal obstruction
|
|
Q250. presentation of children with secondary HTN
|
A250. ha; epistaxis; visual sx; easy fatiguability
|
|
Q251. describe how biliary atresia can occur post-natally
|
A251. from scarrin gan dinflammation of intrahepatic or extrahepatic biliary ducts; etiology is unclear
|
|
Q252. describe findings of prenatal biliary atresia
|
A252. Gallbladder is absent
|
|
Q253. sx of congenital toxoplasmosis
|
A253. chorioretinitis; hydrocephalus; intracranial calcifications
|
|
Q254. complement levels in post-strep GN
|
A254. decreased c3
|
|
Q255. what are "currant jelly stools"
|
A255. bloody stools; indicative of intussusception
|
|
Q256. germinal matrix
|
A256. embryonic tissue present near caudate nucleus, often gets damaged by hypoxia/ischemia; #1 place for intraparenchymal bleed
|
|
Q257. progression of intraparenchymal bleed in a newborn
|
A257. blood can flow into ventricles w/i 3 days of life
|
|
Q258. what blood vessels are damaged in shaken baby syndrome
|
A258. bridging veins
|
|
Q259. what blood vessels are involved in SAH
|
A259. circle of willis
|
|
Q260. signs of SVT
|
A260. Heart rate 220-270; no P waves
|
|
Q261. pathophys of strawberry hemangioma
|
A261. vascular tissue fails to communicate with adjoining tissue; enlarges --> raised tumor
|
|
Q262. most common causes for pneumonia in a child > 6 yo
|
A262. mycoplasm; strep pneumo
|
|
Q263. cardiac complications in Marfan syndrome
|
A263. aortic root dilatation,; aortic dissection; MVP
|
|
Q264. most common orgs in peritonsillar abscess
|
A264. anaerobes; GAS
|
|
Q265. physical findings of Patau syndrome
|
A265. forebrain fails to develop (holoprosenceph); midface developmental abnormalities; abnormal genitalia; severe mental retardation
|
|
Q266. which chromosomes are associated with; 1. Edwards; 2. Patau
|
A266. Edwards = Election age (18); Patau = Puberty age (13)
|
|
Q267. porencephaly
|
A267. cyst/cavity in brain that communicates with ventricles
|
|
Q268. causes of euvolemic hyponatremia
|
A268. SIADH; glucocorticoid deficiency; hypothyroid; water intoxication
|
|
Q269. features of neonatal listerosis
|
A269. respiratory distress at 5 days; meningitis
|
|
Q270. clinical presentation of congenital hypothyroid
|
A270. constipation; jaundice; FAILURE TO THRIVE; enlarged fontanelle; umbilical hernia
|
|
Q271. presentation of neuroblastoma
|
A271. asymptomatic abdominal mass; Horner’s; dancing eyes; dancing feet; blueberry muffin lesions; HTN
|
|
Q272. Patau's or Edwards syndrome:; microcephaly
|
A272. Patau
|
|
Q273. Patau’s or Edwards syndrome; prominent occiput
|
A273. Edwards
|
|
Q274. Patau’s or Edwards syndrome; narrow forehead
|
A274. Edwards
|
|
Q275. Patau’s or Edwards syndrome; microphthalmia
|
A275. Patau
|
|
Q276. Patau’s or Edwards syndrome; cutis aplasia
|
A276. Patau
|
|
Q277. Patau’s or Edwards syndrome; micrognathia
|
A277. Edwards
|
|
Q278. Patau’s or Edwards syndrome; low-set malformed ears
|
A278. Edwards
|
|
Q279. Patau’s or Edwards syndrome; cleft lip
|
A279. Patau
|
|
Q280. Patau’s or Edwards syndrome; congenital heart disease
|
A280. both
|
|
Q281. Patau’s or Edwards syndrome; omphalocele
|
A281. Patau
|
|
Q282. Patau’s or Edwards syndrome; clenched hands with overlapping fingers
|
A282. both
|
|
Q283. Patau’s or Edwards syndrome; rocker bottom feet
|
A283. Edwards
|
|
Q284. Patau’s or Edwards syndrome; polydactyly
|
A284. Patau
|
|
Q285. Patau’s or Edwards syndrome; polycystic kidney disease
|
A285. Patau
|
|
Q286. Patau’s or Edwards syndrome; horseshoe kidney
|
A286. Edwards
|
|
Q287. Patau’s or Edwards syndrome; crytorchidism
|
A287. Patau
|
|
Q288. Patau’s or Edwards syndrome; agenesis of corpus callosum
|
A288. Patau
|
|
Q289. genetic changes in Prader Willi
|
A289. paternal deletion, 2 defective maternal chromosomes
|
|
Q290. physical appearance of pts with Prader Willi
|
A290. obese; almond shaped eyes; downturned mouth; small hands and feet
|
|
Q291. genetic changes in Angelman's
|
A291. maternal deletion, 2 defective paternal chromosomes
|
|
Q292. physical appearance of Angelman’s
|
A292. large mouth; short stature; tiptoe walk; seizures
|
|
Q293. galactosemia
|
A293. galactose 1-p builds up and accumulates in liver and brain
|
|
Q294. complications of galactosemia
|
A294. increased risk of e coli sepsis; LD; premature ovarian failure
|
|
Q295. tx of galactosemia
|
A295. eliminate galactose containing foods from diet
|
|
Q296. complications of PKU during pregnancy
|
A296. if diet not followed, baby can develop microcephaly, mental retardation, and congenital heart disease
|
|
Q297. physical features of homocystinemia
|
A297. Marfan like appearance; dislocated lens
|
|
Q298. what effect does sepsis have on bilirubin
|
A298. disrupts the BBB so it can cause diffusion of bili into the brain
|
|
Q299. what effect does temp have on bili
|
A299. cold temperature can --> bili dissociation from albumin
|
|
Q300. protocol for neonates whose mom developed varicella infection just after delivery
|
A300. if mom develops sx within 2 days of delivery or during end of pregnancy, treat baby with iv Ig and acyclovir. if greater amt of time is lapsed, no tx needed
|
|
Q301. consequences of neonatal asphyxia
|
A301. cerebral edema; irritability; seizure; cardiomegaly; renal and heart failure; DIC; RDS
|
|
Q302. what is the apt test
|
A302. used to differentiae fetal from maternal blood
|
|
Q303. which drugs are contraindicated for breastfeeding
|
A303. lithium; cyclosporin; antineoplastic drugs; ergots; bromocriptine; tetracyclines
|
|
Q304. classic finding on XR for necrotizing enterocolitis
|
A304. pneumanitis intestinalis
|
|
Q305. consequences of cold temperature in a premie
|
A305. increased metabolic rate in order to raise body temp, but their ventilation rate increased as well; but, because of respiratory problems in premies they can't oxygenate enough so lactic acid accumulates --> metabolic acidosis
|
|
Q306. which is worse:; ABO incompatibility or Rh incompat
|
A306. Rh incompatibility
|
|
Q307. lab findings in ABO incompat
|
A307. increased reticulocyte count; weakly + coomb's
|
|
Q308. lab findings in Rh incompat
|
A308. strongly + coombs
|
|
Q309. pathophys of transient apnea of the newborn
|
A309. immature respiratory centers, especially in premies
|
|
Q310. how to id the underlying cause of congenital hypothyroid
|
A310. iodine uptake scan
|
|
Q311. late development of clavicle fracture during delivery... when does this occur?
|
A311. callous formation in anterior shoulder; 1 week
|
|
Q312. physical findings of subgaleal hemorrhage
|
A312. feels like cephalohematoma that crosses midline; can lose 1/3 of
|
|
Q313. onset of gonococcal conjunctivitis in a newborn
|
A313. DOL 2-5
|
|
Q314. onset of chlamydia conjunctivitis
|
A314. DOL 5-14
|
|
Q315. what effects does surfactant deficiency have on lung compliance and lung volume; cardiac effect
|
A315. decreases both; R-->L shunt
|
|
Q316. what should be given to newborns whose moms are infected with Hep B
|
A316. Hep B Ig and HBV
|
|
Q317. effect of propanolol in utero
|
A317. IUGR; decreased ability of asphyxiated newborn to increase heart rate and CO; associated with hypoglycemia and apnea
|
|
Q318. when is surgery for cleft lip done
|
A318. 3 mo
|
|
Q319. when does transient tachypnea of newborn resolve
|
A319. DOL #3
|
|
Q320. significance of 5th finger polydactyly
|
A320. in black infants, no consequence; in white infants, can be associated with cardiac abnormalities, must do an echo
|
|
Q321. twin twin transfusion
|
A321. donor twin --> oligohydramnios, anemia, hypovolemia; recipient twin --> polyhydramnios, larger size (20% difference in body weight), hyperviscocity, respiratory distress, hyperbili, hypocalcemia, renal vein thrombosis
|
|
Q322. when does serum bilirubin peak
|
A322. DOL 3-5
|
|
Q323. Top Childhood Cancers - What are they
|
A323. 1. Leukemia (ALL); 2. CNS tumors; 3. Lymphoma; 4. Neuroblastoma
|
|
Q324. Neuroblastoma - What is it; Associated with?
|
A324. Embryonal tumor of; neural crest cell origin; MC cancer in infants; more than 1/2 kids < 2 y/o; associations - neurofibromatosis; Hirchsprung’s; n-myc oncogene
|
|
Q325. Neuroblastoma - History/PE
|
A325. Can occur anywhere; Sx vary with location; nontender abdominal mass; (may cross midline); Horner's syndrome; HTN; cord compression; anemia; FAILURE TO THRIVE; fever; site-specific metastasis can cause proptosis; periorbital bruising; subq tumor nodules; bone pain with pancytopenia; opsoclonus/myoclonus; "dancing eyes, dancing feet"
|
|
Q326. Neuroblastoma - Dx
|
A326. Abdominal CT; 24-hr urinary catecholamines; assess extent of disease - CXR; bone scan; CBC; LFTs; BUN/Cr; coag panel
|
|
Q327. Neuroblastoma - Tx
|
A327. Excision - localized tumors; chemo includes – cyclophosphamide, doxorubicin; adjunctive radiation - if tumor spread beyond origin; prognosis improved for kids with low-risk dis., < 1 y/o, no N- myc amplification, localized
|
|
Q328. Wilms' Tumor - What is it; Associated with?
|
A328. Embryonal cancer of kidney; MC renal tumor in kids; 2-4 y/o; associated with - family History, Beckwith-Wiedemann syndrome, WAGR, neurofibromatosis
|
|
Q329. Wilms' Tumor - History/PE
|
A329. Painless, palpable abdominal mass; does not cross midline; n/v; fever; weight loss; hematuria; HTN
|
|
Q330. Wilms' Tumor - Dx
|
A330. Abdominal CT or US - intrarenal mass; check for metas – CXR, chest CT; CBC; LFTs; BUN/Cr
|
|
Q331. Wilms' Tumor - Tx
|
A331. Transabdominal nephrectomy; postsurgical chemo – vincristine, dactinomycin; flank irradiation (for some); prognosis good - depends on staging & histo
|
|
Q332. RDS - What is it
|
A332. MCC of respiratory failure in premies; surfactant deficiency => increased surface tension (poor lung compliance); and alveolar collapse (atelectasis); surfactant made by T2 pneumocytes, mainly ~35th week; dipalmitoyl phosphatidylcholine; risk factors - maternal diabetes, males, 2nd born of twins
|
|
Q333. RDS - History/PE
|
A333. Presents in 48-72 hrs of life; RR > 60/min; intercostal retractions; expiratory grunting; nasal flaring; cyanosis; progressive hypoxemia
|
|
Q334. RDS - Dx
|
A334. ABGs; CBC (to rule out infection); BC (to rule out infection); CXR - bilateral diffuse atelectasis, causing ground-glass appearance with visible air bronchograms; lecithin:sphingomyelin ratio < 2
|
|
Q335. RDS - Tx
|
A335. CPAP or intubation and mechanical ventilation; artificial surfactant to prevent - mom gets corticosteroids; monitor fetal lung maturity (L:S ratio)
|
|
Q336. RDS - Complications
|
A336. Persistent PDA; bronchopulmonary dysplasia; retinopathy of prematurity; intraventricular hemorrhage; NEC
|
|
Q337. Intussusception - What is it
|
A337. MCC of bowel obstruction in 1st 2 yrs. of life; males > females; usually proximal to ileocecal valve; cause – idiopathic, in older kids - mass or intestinal abnormality triggers the telescoping:; adenovirus or rotavirus; parasites; CF; celiac disease; polyps; intestinal lymphoma; Meckel's diverticulum; Henoch-Schonlein purpura
|
|
Q338. Intussusception - History/PE
|
A338. History - colicky abdominal pain in apparently healthy kids; n/v; too young to talk - cry; draw knees up to chest; dyspnea with pain; advanced signs - red "current jelly" stool; lethargy; fever; PE - abdominal tenderness, positive stool guaiac, palpable "sausage-shaped", RUQ abdominal mass
|
|
Q339. Intussusception - Dx
|
A339. Abdominal XR; abdominal US; air contrast barium enema; CBC
|
|
Q340. Intussusception - Tx
|
A340. Correct volume & electrolytes; check CBC; air-contrast barium enema - diagnostic and therapeutic; surgical reduction or resection (if gangrenous)
|
|
Q341. Pyloric Stenosis - What is it
|
A341. Hypertrophy of pyloric sphincter; 1st-born males more affected
|
|
Q342. Pyloric Stenosis - History/PE
|
A342. 1st 2 wks - 4 mos. of life; nonbilious emesis => projectile emesis after each feeding; so, babies feed well initially => malnutrition & dehydration; palpable olive-shaped, mobile, NT epigastric mass; visible gastric peristalsis
|
|
Q343. Pyloric Stenosis - Dx
|
A343. Abdominal US - diagnostic; barium studies - string sign, pyloric beak; hypochloremic, hypokalemic; metabolic alkalosis
|
|
Q344. Pyloric Stenosis - Tx
|
A344. First - hydration; correct acid-base & electrolyte abnormalities; NG tube - possible; longitudinal pyloromyotomy
|
|
Q345. Child Abuse - What is it
|
A345. Neglect; physical abuse; sexual abuse; emotional abuse; suspect - if History doesn't match physical findings, if there was a delay in getting medical care
|
|
Q346. Child Abuse - History/PE
|
A346. Infants may have apnea, seizures, FAILURE TO THRIVE Exam findings include; cutaneous - ecchymoses of varying ages, patterned injuries; skeletal - spiral fractures of femur and humerus in kids < 3 = abuse unless prove else; epiphyseal/metaphyseal injuries - can happen in infants from pulling/twisting limbs; rib injuries < 2 y/o; sexual abuse - STDs or genital trauma
|
|
Q347. Child Abuse - Dx
|
A347. Rule out conditions that mimic skeletal survey & bone scan; can show fractures in various stages of healing; if sexual abuse suspected - test for gonorrhea, chlamydia and HIV; to rule out shaken baby syndrome - check for retinal hemorrhages; CT for subdural hemorrhages; MRI for white matter changes
|
|
Q348. Child Abuse - Tx
|
A348. Document injuries; notify child protective services; hospitalize if necessary
|
|
Q349. Epiglottitis - What is it
|
A349. Serious, rapidly progressive infection of supraglottic; before immunization - from H influ type B; now – Streptococcus, nontypable H flu, viral agents
|
|
Q350. Epiglottitis - History/PE
|
A350. Sudden-onset high fever; dysphagia; drooling; muffled voice; soft stridor; cyanosis; "sniffing dog" position; "tripod" position; insist on sitting up in bed; untreated - life-threatening
|
|
Q351. Epiglottitis - Dx
|
A351. Clinical; DON'T EXAMINE THROAT unless anesthesiologist present; definitive Dx - direct fiberoptic visual of cherry-red, swollen epiglottis & arytenoids; lateral XR - thumbprint sign
|
|
Q352. Epiglottitis - Tx
|
A352. Emergency; call anesthesiologist; transfer patient to OR; endotrach intubation or trach; IV Antibiotics - ceftriaxone or cefuroxime
|
|
Q353. Croup (Laryngotracheobronchitis) - What is it
|
A353. Inflammation of larynx and upper airway, mainly subglottic space => narrowing of airway; kids 3 mos. - 3 yrs. MCC - parainfluenza virus 1, also - PIV-2, PIV-3, RSV, rubeola, influenza, adenovirus, Mycoplasma pneumonia
|
|
Q354. Croup (Laryngotracheobronchitis) - History/PE
|
A354. Prodrome - URI Sxs 1-7 days; stridor - worse by agitation; fever - low grade; hoarseness; barking cough
|
|
Q355. Croup (Laryngotracheobronchitis) - Dx
|
A355. Clinical; XR - steeple sign
|
|
Q356. Croup (Laryngotracheobronchitis) - Tx
|
A356. Mild - cool mist; moderate - oral corticosteroids; severe - (respiratory distress at rest), admit, nebulized racemic epinephrine
|
|
Q357. Bronchiolitis - What is it
|
A357. Acute inflammation of smallest airways; acute viral bronchiolitis; MCC - RSV; infants & kids < 2 y/o; can progress to respiratory failure; risk for severe RSV - < 6 mos. old, premies, heart or lung dis., immunodeficiency
|
|
Q358. Bronchiolitis - History/PE
|
A358. History - low-grade fever, rhinorrhea, cough, apnea - young infants; PE – tachypnea, wheezing, hyperresonance to percussion
|
|
Q359. Bronchiolitis - Dx
|
A359. CXR - hyperinflation of lungs; interstitial infiltrates; atelectasis; ELISA of nasal washings, for RSV - high sensitivity & specificity
|
|
Q360. Bronchiolitis - Tx
|
A360. Mild – outpatient, fluids, nebulizers, O2 if needed; admit if - marked respiratory distress, O2 saturation < 95%, toxic appearance, dehydration/poor oral feeding, premie (< 34 wks), < 3 mos. old, underlying cardiopulmonary dis., unreliable parents; inpatients - contact isolation, hydration, O2, ribavirin; RSV prophylaxis - RespiGam or Synagis, high-risk patients in winter
|
|
Q361. Otitis Media - What is it; Risk Factors
|
A361. Middle ear infection; MCC - #1 - S. pneumoniae, #2 - H. Flu, #3 - Moraxella catarrhalis; kids predisposed - eusta tube; risk factors - viral URIs, trisomy 21, CF, immunodeficiency, smoke exposure, day-care attendance, bottle feeding, cleft palate, prior otitis media
|
|
Q362. Otitis Media - History/PE
|
A362. Fever; ear tugging; hearing loss; irritability; Erythema; bulging; decreased mobility of tympanic membrane; loss of light reflex and bony landmarks; tympanic membrane may be perforated
|
|
Q363. Otitis Media - Dx
|
A363. Clinical
|
|
Q364. Otitis Media - Tx
|
A364. Amoxicillin - 10 days; Tx failure after 3 days - switch to amoxicillin-clavulanic acid, ceftriaxone or cefuroxime
|
|
Q365. Otitis Media - Complications
|
A365. Mastoiditis; meningitis; hearing loss; cholesteatoma; tympanosclerosis; chronic suppurative OM
|
|
Q366. Kawasaki Disease; (Mucocutaneous Lymph Node Syndrome) - What is it
|
A366. Multisystem acute vasculitis; usually kids < 5 y/o, especially Asian; at risk for coronary artery; aneurysms => MI
|
|
Q367. Kawasaki Disease; (Mucocutaneous Lymph Node Syndrome) - History/PE
|
A367. "CRASH and Burn"; Conjunctivitis - b/l; Rash; Adenopathy - cervical lymph; Strawberry tongue; Hands and feet - swollen, red, desquamation; fever > 40C for > 5 days
|
|
Q368. Kawasaki Disease; (Mucocutaneous Lymph Node Syndrome) - Dx
|
A368. Clinical; thrombocytosis - wk 2 or 3; increased ESR
|
|
Q369. Kawasaki Disease; (Mucocutaneous Lymph Node Syndrome) - Tx
|
A369. High-dose aspirin; IVIG - to prevent aneurysms; corticosteroids are contraindicated (they may increased aneurysms)
|
|
Q370. FAILURE TO THRIVE - What is it
|
A370. Persistent weight; below 3rd to 5th percentile or falling off growth curve; organic - medical condition; nonorganic - psychosocial; nonorganic is MC; risk factors - chronic illness, poverty, low maternal age, chaotic environment, genetic dis. (CF), inborn errors of metabolism, HIV
|
|
Q371. FAILURE TO THRIVE - History/PE
|
A371. Low weight for age and height; minimal weight gain or weight loss; plot on growth chart; check for signs of systemic dis. diet History; observe caregiver-child interaction
|
|
Q372. FAILURE TO THRIVE - Dx
|
A372. Calorie count; CBC; electrolytes; Cr; albumin; total protein; sweat chloride test; UA/UC; stool culture; O&P; assess bone age
|
|
Q373. FAILURE TO THRIVE - Tx
|
A373. Tx depends on cause; supplement nutrition if breastfeeding inadequate; admit if – neglect, severe malnourishment
|
|
Q374. Atrial Septal Defect (ASD) - What is it
|
A374. Opening in atrial septum lets blood flow bet. atria; L to R shunting due to lower R pressure; blood flow to lungs increased
|
|
Q375. Atrial Septal Defect (ASD) - History/PE
|
A375. History - usually presents in late childhood or early adult onset & severity depends on size; large defect - tire easy (DOE); freq. respiratory infections; FAILURE TO THRIVE => CHF => cyanosis; PE - RV heave, wide, fixed split S2, systolic ejection murmur; upper left sternal border
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|
Q376. Atrial Septal Defect (ASD) - Dx
|
A376. Echo with color flow Doppler - diagnostic; ECG - right-axis deviation; CXR - cardiomegaly and increased pulmonary vascular markings
|
|
Q377. Atrial Septal Defect (ASD) - Tx
|
A377. Small defects may close spontaneously (no Tx needed); Antibiotics prophylaxis before dental procedures; surgical closure - infants with CHF, patients > 2:1 pulmonary to systemic blood flow; correct early to prevent – arrhythmia, RV dysfunction, Eisenmenger's syndrome
|
|
Q378. Ventric Septal Defect (VSD) - What is it
|
A378. MC congenital heart defect; More common in patients with - Apert's syndrome; Cri-du-chat; Trisomies 13 & 18
|
|
Q379. Ventric Septal Defect (VSD) - History/PE
|
A379. History - Sxs depends on degree of shunting; small defect usually asymptomatic at birth; large defect – CHF, freq respiratory infections, FAILURE TO THRIVE; PE - pansystolic murmur - lower left sternal border, loud pulmonic S2, in severe defects - systolic thrill, cardiomegaly, crackles
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|
Q380. Ventric Septal Defect (VSD) - Dx
|
A380. Echocardiogram - diagnostic; EKG - may show RVH or LVH; normal with small VSDs
|
|
Q381. Ventricular Septal Defect (VSD) - Tx
|
A381. Most small defects close spontaneously (no Tx needed); Antibiotics prophylaxis before dental or pulmonary procedures; surgical closure - correct early to prevent - Eisenmenger's syndrome, et al; Tx CHF & respiratory infections
|
|
Q382. Patent Ductus Arteriosus (PDA); What is it
|
A382. Failure of DA to close => L-to-R shunt (aorta to pulmonary artery); risk factors - high altitude (low O2), 1st trimester rubella in mom, premies, females (more common)
|
|
Q383. Patent Ductus Arteriosus (PDA); History/PE
|
A383. History - typically asymptomatic (small PDA); slowed growth; recurrent lower respiratory infections; lower extremity clubbing; CHF Sxs; PE - wide pulse pressure, continuous machine murmur, loud S2, bounding peripheral pulses
|
|
Q384. Patent Ductus Arteriosus (PDA); Dx
|
A384. Small - often no signs of cardiomegaly; Large – echocardiogram - LA & LV enlarged; EKG - LVH; CXR - cardiomegaly; color-flow Doppler- diagnostic
|
|
Q385. Patent Ductus Arteriosus (PDA); Tx
|
A385. Indomethacin; (unless need PDA for survival); if indomethacin fails or; child > 6-8 mos. old - surgical closure preferred
|
|
Q386. Coarctation of the Aorta - What is it
|
A386. Narrowing proximal or distal to DA => increased flow above, decreased flow below coarctation; more common in males; Turner's, 25% have bicuspid aortic valve
|
|
Q387. Coarctation of the Aorta - History/PE
|
A387. History - often presents in childhood with asymptomatic HTN, headache, syncope, epistaxis, DOE, claudication; PE - systolic BP higher in upper extremities, may be greater in right arm; femoral pulses weak or delayed; late systolic murmur in left axilla; apical impulse forceful; advanced cases - well-developed upper body, lower extremities wasting
|
|
Q388. Coarctation of the Aorta - Dx
|
A388. EKG - LVH; echocardiography; color-flow doppler; CXR - "3" sign: rib notching; aortography – diagnostic (cardiac catheterization)
|
|
Q389. Coarctation of the Aorta - Tx
|
A389. Surgery or balloon angioplasty; endocarditis prophylaxis
|
|
Q390. Transposition of the; Great Arteries - What is it
|
A390. Pulmonary & systemic circulation in parallel; aorta connected to RV; pulmonary artery connected to LV; incompatible with life unless septal defect or PDA; risk factors - babies of DM moms, Apert's syn, Down's, cri- du-chat, Trisomies 13 & 18
|
|
Q391. Transposition of the; Great Arteries - History/PE
|
A391. Critically ill; cyanosis immediately after birth; tachypnea; progressive respiratory failure; CHF (some patients)
|
|
Q392. Transposition of the; Great Arteries - Dx
|
A392. Echocardiography; CXR - "egg-shaped sihouette", "egg on a string", "apple on a string"
|
|
Q393. Transposition of the; Great Arteries - Tx
|
A393. Prostaglandin E1 (PGE1) - to keep PDA open; balloon atrial septostomy; arterial or atrial switch op
|
|
Q394. Tetralogy of Fallot - What is it
|
A394. VSD; pulmonary stenosis; RVH; overriding aorta; right-to-left shunting => early cyanosis; risk factors - Down's, cri-du-chat, Trisomies 13 & 18
|
|
Q395. Tetralogy of Fallot - History/PE
|
A395. History – cyanosis, dyspnea, fatigability; profound cyanosis = tet spell; squatting for relief; hypoxemia => FAILURE TO THRIVE, mental status changes; PE - SEM at left sternal border, RV lift, single S2, CHF signs possible
|
|
Q396. Tetralogy of Fallot - Dx
|
A396. Echocardiography; catheterization; CXR - boot-shaped heart, decreased pulmonary vascular markings; EKG - right-axis deviation; RVH
|
|
Q397. Tetralogy of Fallot - Tx
|
A397. PGE1 - keep reopen PDA; for cyanotic spells - O2, propranolol, knee-chest position, fluids, morphine; balloon atrial septostomy before surgical correction
|
|
Q398. Cerebral Palsy (CP) - What is it
|
A398. Group of nonprogressive, nonhereditary neurological disorder; disorder in movement and posture; MC movement disorder in kids; MCC unknown - prenatal, perinatal and post insults; risk factors – prematurity, perinatal asphyxia, intrauterine growth retardation, early infection or trauma, brain malformation, neonatal cerebral hemorrhage
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|
Q399. Cerebral Palsy (CP) - What are the categories
|
A399. Spastic (pyramidal) - spastic paresis of any limb, 75% of cases, MENTAL RETARDATION up to 90%,; athetoid - extrapyramidal, b. ganglia, uncontrollable jerking, writhing, worse with stress, disappears during sleep; ataxic – cerebellum, hard to coordinate movement, wide- based gait; mixed
|
|
Q400. Cerebral Palsy (CP) - History/PE
|
A400. May be associated with - seizure disorder, behavioral disorder; hearing or vision impaired; learning disabilities; speech deficits; hyperreflexia; Babinski; increased tone/contractures; weakness; underdevelopment; toe walking; scissor gait; hip dislocations; scoliosis
|
|
Q401. Cerebral Palsy (CP) - Dx
|
A401. Clinical; rule out metabolic disorder, cerebellar dysgenesis, spinocerebellar degeneration; EKG (if seizures)
|
|
Q402. Cerebral Palsy (CP) - Tx
|
A402. Special education; physical therapy; braces; surgical relief of contractures; for spasticity – diazepam, dantrolene, baclofen; for severe contractures - baclofen pumps, posterior rhizotomy
|
|
Q403. Febrile Seizures - What is it
|
A403. In kids 6 mos. - 6 y/o; no evidence of intracranial infection or other cause; risk factors - rapid rise in temp, History in close relative
|
|
Q404. Febrile Seizures - History/PE
|
A404. Most are simple seizures; simple - high fever, fever onset within hrs of seizure; generalized seizure, lasts < 15 min., 1 in a 24-hr period; complex - low-grade fever, fever for several days before seizure onset, seizure has focal features, can have postictal paresis, lasts > 15 min., > 1 in a 24-hr period
|
|
Q405. Febrile Seizures - Dx
|
A405. Find source of infection; LP - if signs of CNS infection; No labs if presentation consistent with febrile seizure; Atypical presentation – electrolytes, glucose, BC, UA, CBC with diff, EEG & MRI - complex seizures
|
|
Q406. Febrile Seizures - Tx
|
A406. Simple - aggressive antipyretics; tx underlying illness; complex - thorough neuro exam, chronic anticonvulsants may be necessary
|
|
Q407. Febrile Seizures - Complications
|
A407. Febrile Seizure will recur in 30%; no increased risk of epilepsy, developmental, intellectual or growth abnormality; those with complex seizures - 10% risk of developing epilepsy
|
|
Q408. Neonatal Jaundice - What is it; What are the types; What is kernicterus
|
A408. Increased serum bilirubin from increased production or decreased excretion; conjugated - always pathologic; unconjugated - patholog or physiolog; physiologic jaundice - not present until 72 hrs after birth, bilirubin peaks < 15 mg/dL, resolves by 1 week in term, resolves by 2 weeks in premies; pathologic jaundice - present in 1st 24 hrs of life, bilirubin rises to > 15 mg/dL, persists past 1 week in term, persists past 2 weeks in premies; kernicterus - unconjug hyperbilirubinemia, bilirubin deposits in pons, basal ganglia, cerebellum, irreversible, can be fatal; risk factors – premies, asphyxia, sepsis
|
|
Q409. Neonatal Jaundice - History/PE
|
A409. History - child breastfed or formula? intrauterine drugs; family History of – hemoglobinopathies, enzyme deficiency, RBC defects; Sxs - abdominal distention, delayed passage of meconium, light-colored stools, dark urine, low Apgar scores, weight loss, vomiting; kernicterus – lethargy, poor feeding, high-pitched cry, hypertonicity, seizures; jaundice may be cephalopedal; check for signs of - infection, congenital malformations, cephalohematomas, bruising, pallor, petechiae, hepatomegaly
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|
Q410. Neonatal Jaundice - Dx
|
A410. CBC; periph blood smear; blood type mom and baby; Coombs' test; bilirubin levels; direct hyperbilirubinemia - LFTs; bile acids; Blood culture; sweat test; tests for aminoacidopathies & a1-antitrypsin deficiency; Sepsis w/u and ICU – jaundice, febrile, hypotensive and/or tachypneic
|
|
Q411. Neonatal Jaundice - Tx
|
A411. Tx underlying cause; unconjugated - severe - exchange transfusion; if mild – phototherapy, start earlier for premies (start at 10- 15 mg/dL)
|
|
Q412. Down Syndrome - What is it
|
A412. Trisomy 21, MC chromosome disorder; #2 cause of congenital MENTAL RETARDATION; risk increased with mom's age, but 80% of kids are born to women < 35 y/o; flat facial profile; prominent epicanthal folds; simian crease; decreased levels of AFP; brushfield spots; duodenal atresia - double bubble on US/XR; congenital heart disease - septum primum-type ASD due to endocardial cushion defect; Alzheimer's > 35 y/o; increased risk of ALL; meiotic nondisjunction
|
|
Q413. Edwards' Syndrome - What is it
|
A413. Trisomy 18 (election age=18); severe MENTAL RETARDATION; rocker bottom feet; low-set ears; micrognathia; congenital heart disease; clenched hands; prominent occiput; death usually < 1 y/o
|
|
Q414. Patau's Syndrome - What is it
|
A414. Trisomy 13 (puberty=13); severe MENTAL RETARDATION; microphthalmia; microcephaly; cleft lip/palate; abnormal forebrain; polydactyly; congenital heart disease; death usually < 1 y/o
|
|
Q415. Klinefelter's Syndrome - What is it
|
A415. XXY (male); inactivated X (Barr body); 1 of MCC of male hypogonadism testicular atrophy; eunuchoid body shape, long extremities; gynecomastia; female hair distribution
|
|
Q416. Turner' Syndrome - What is it
|
A416. XO (No Barr body); short stature; ovarian dysgenesis; webbing of neck; cystic hygroma; coarctaton of aorta; MCC of primary amenorrhea
|
|
Q417. Double Y males - What is it
|
A417. XYY; phenotypically normal; very tall; severe acne; antisocial behavior
|
|
Q418. Phenylketonuria (PKU) - What is it
|
A418. Phenylalanine => tyrosine; In PKU, decreased phenylalanine hydroxylase or tetrahydrobiopterin cofactor; tyrosine becomes essential; phenylalanine builds up => excess phenylketones, phenylketones – phenylacetate, phenyllactate, phenylpyruvate; MENTAL RETARDATION; fair skin; eczema; musty body odor; screened for at birth; Tx - decreased phenylalanine (in Nutrasweet) and increased tyrosine in diet
|
|
Q419. Fabry's Disease - (lysosomal storage disease); What is it
|
A419. X-linked recessive; defect of a-galactosidase A; ceramide trihexoside accumulates; renal failure
|
|
Q420. Krabbe's Disease - (lysosomal storage disease); What is it
|
A420. AR (autosomal recessive); deficiency of B-galactosidase; galactocerebroside accums; in the brain; optic atrophy; spasticity; early death
|
|
Q421. Gaucher's Disease - (lysosomal storage disease); What is it
|
A421. AR; deficiency of B-glucocerebrosidase; glucocerebroside accums in; brain, liver, spleen, bm; Gaucher's cells - "crinkled paper" enlarged; cytoplasm; Type I - more common, compa-; tible with normal life span
|
|
Q422. Niemann-Pick Disease - (lysosomal storage disease); What is it
|
A422. AR; deficiency of sphingomyelinase; sphingomyelin and cholesterol; build up in reticuloendo-; thelial & parenchymal cells; cherry-red spot on macula; death by age 3
|
|
Q423. Tay-Sachs Disease - (lysosomal storage disease); What is it
|
A423. AR; absence of hexosaminidase A; GM2 ganglioside accums; cherry-red spot on macula; death by age 3; MC lysosomal storage disease; that causes MENTAL RETARDATION
|
|
Q424. Metachromatic leukodystrophy - (lysosomal storage disease); What is it
|
A424. AR; deficiency of arylsulfatase A; sulfatide accums in brain,; kidney, liver, periph n.
|
|
Q425. Hurler's Syndrome - (lysosomal storage disease); What is it
|
A425. AR; deficiency of a-L-iduronidase; corneal clouding; MENTAL RETARDATION
|
|
Q426. Hunter's Syndrome - (lysosomal storage disease); What is it
|
A426. X-linked recessive; deficiency of iduronate sulfatase; mild form of Hurler's; no corneal clouding; mild MENTAL RETARDATION
|
|
Q427. Fragile X Syndrome - What is it
|
A427. X-linked; 3rd MCC of MENTAL RETARDATION; FMR1 gene affected; anticipation; triple repeat of CGG; autism; large testes, jaw, ears; floppy/prolapsed mitral valve
|
|
Q428. APGAR Score - Chart
|
A428. Appearance - skin color 0 = blue all over, 1 = blue at extremities, 2 = normal; Pulse - 0 = none, 1 = < 100, 2 = > 100; Grimace - reflex irritability, 0 = none, 1 = grimace, feeble cry, 2 = sneeze, cough, pull away; Activity - muscle tone, 0 = none, 1 = some flexion, 2 = active movement; Respiration - 0 = none, 1 = weak or irreg, 2 = strong
|
|
Q429. APGAR Score - What do total scores mean
|
A429. Score at 1 min. after birth; then at 5 min. score 8-10 - good cardiopulm adaptation; score 4-7 - possible need for resus; observe; stimulate; possible need for vent support; score 0-3 - resus immed
|
|
Q430. Erythema Infectiosum - (Fifth Disease); Cause; Characteristics
|
A430. Cause - parvovirus B19; prodrome none; fever absent or low-grade; "slapped cheek" erythematous; pruritic; maculopapular rash; goes to arms; spreads to trunk and legs; worse with fever and sun
|
|
Q431. Erythema Infectiosum - (Fifth Disease); Complications
|
A431. Arthritis; hemolytic anemia - aplastic crisis in sickle cell; encephalopathy; associated c hydrops fetalis
|
|
Q432. Measles - Cause; Characteristics
|
A432. Paramyxovirus; prodrome - low-grade fever; conjunctivitis; coryza; cough; Koplik's spots - buccal mucosa after 1-2 days; maculopap rash from ears down
|
|
Q433. Measles - Complications
|
A433. Giant cell pneumonia; otitis media; laryngotracheitis; rare - subac scleros. panencephalitis
|
|
Q434. Rubella - Cause; Characteristics
|
A434. Rubella virus; prodrome - asymptomatic or; tender, generalized; lymphadenopathy; erythematous, tender,; maculopapular rash; slight fever; polyarthritis in adolescents
|
|
Q435. Rubella - Complications
|
A435. Encephalitis; thrombocytopenia; congenital infections associated; with congenital anomalies
|
|
Q436. Roseola Infantum - Cause; Characteristics
|
A436. HHV-6; prodrome - acute onset of high fever; no other Sxs for 3-4 days; maculopap rash as fever breaks; starts on trunk; => face and extremities; often lasts < 24 hrs
|
|
Q437. Roseola Infantum - Complications
|
A437. Rapid fever onset =>; febrile seizures
|
|
Q438. Rotavirus - Characteristics
|
A438. Primary cause of diarrhea; in kids < 2; fever and vomiting; then diarrhea; upper respiratory Sxs; lasts < 1 wk; infection confirmed by Elisa; oral rehydration sufficient
|
|
Q439. Varicella - Cause; Characteristics
|
A439. VZV; prodrome - mild fever; anorexia; malaise; precedes rash by 24 hrs; generalized, pruritic,; "teardrop" vesicular rash; starts on trunk; spreads to periphery; lesions often at different; stages of healing; infectious from 24 hrs; before eruption til; lesions crust over
|
|
Q440. Varicella - Complications
|
A440. In immunocompromised kids - progressive varicella with; meningoencephalitis; and hepatitis; congenital infections =>; congenital anomalies
|
|
Q441. Varicella Zoster - Cause; Characteristics
|
A441. Prodrome - reactivation of Varicella; infection; starts as pain along affected; sensory n. pruritic "teardrop"; vesicular rash; in dermatomal distribution; uncommon unless immunocomp
|
|
Q442. Varicella Zoster - Complications
|
A442. Encephalopathy; aseptic meningitis; pneumonitis; TTP; Guillain-Barre; cellulitis; arthritis
|
|
Q443. Hand-Foot-and-Mouth Disease - Cause; Characteristics
|
A443. Coxsackie A; prodrome - fever; anorexia; oral pain; rash - oral ulcers; maculopap vesicular rash on; hands, feet, buttocks
|
|
Q444. Hand-Foot-and-Mouth Disease - Complications
|
A444. None; (self-limited)
|
|
Q445. Tracheoesophageal Fistula - What is it
|
A445. Tract between trachea & esoph; associated with esoph atresia; & VACTERL anomalies - vertebral; anal; cardiac; tracheal; esophagus; renal; limb
|
|
Q446. Tracheoesophageal Fistula - Caused by; Presentation
|
A446. Polyhydramnios in utero; increased oral secretion; inability to feed; gagging; respiratory distress
|
|
Q447. Tracheoesophageal Fistula - Dx
|
A447. CXR after NGT; air in GI tract; bronchoscopy - to confirm
|
|
Q448. Tracheoesophageal Fistula - Tx
|
A448. Surgical repair
|
|
Q449. Congenital Diaph Hernia - What is it
|
A449. GI tract segment protrudes; thru diaph into thorax; 90% are post. lt. Bochdalek
|
|
Q450. Congenital Diaph Hernia - Presentation
|
A450. Respiratory distress from - pulmonary hypoplasia; pulmonary HTN; sunken abdomen; bowel sounds over; lt. hemithorax
|
|
Q451. Congenital Diaph Hernia - Dx
|
A451. US in utero; postnatal CXR - to confirm
|
|
Q452. Congenital Diaph Hernia - Tx
|
A452. Hi-freq ventilation or; extracorporeal membrane; oxygenation (ECMO); (to manage pulmonary HTN); surgical repair
|
|
Q453. Gastroschisis - What is it
|
A453. Herniation of intestine; thru abdominal wall; next to umbilicus; (usually on right); with no sac
|
|
Q454. Gastroschisis - Caused by; Associated with
|
A454. Polyhydramnios in utero; often premie; associated with - GI stenoses; GI atresia
|
|
Q455. Gastroschisis - Tx
|
A455. Surgical emergency; single-stage closure possible; in only 10%
|
|
Q456. Omphalocele - What is it
|
A456. Herniation of abdominal viscera; thru abdominal wall; at umbilicus; into sac covered by; peritoneum and amniotic memb
|
|
Q457. Omphalocele - Caused by; Associated with
|
A457. Polyhydramnios in utero; often premie; associated with; other GI & cardiac defects
|
|
Q458. Omphalocele - Tx
|
A458. C-section - to prevent sac rupture; if sac intact - postpone surg correction; until patient fully resuscitated; keep sac covered/stable; with petroleum & gauze; intermittent NG suction - to prevent abdominal distention
|
|
Q459. Duodenal Atresia - What is it
|
A459. Complete or partial failure; of duodenal lumen; to recanalize; during gestational wks 8-10
|
|
Q460. Duodenal Atresia - Presentation; Caused by; Associated with
|
A460. Bilious emesis within hrs; after 1st feeding; polyhydramnios in utero; associated with - Down's; other cardiac/GI anomalies:; annular pancreas; malrotation; imperforate anus
|
|
Q461. Duodenal Atresia - Dx
|
A461. Double-bubble sign on XR; (prox to site of atresia)
|
|
Q462. Duodenal Atresia - Tx
|
A462. Surgical repair
|
|
Q463. Meckel's Diverticulum - What is it
|
A463. MC congenital GI tract anomaly; vestigial remnant; of omphalomesenteric duct; rule of 2's - 2x's as many males; 2 ft. from ileocecal valve; 2% of people affected; 2 types of mucosa - gastric; pancreatic
|
|
Q464. Meckel's Diverticulum - Presentation
|
A464. MC presentation - painless rectal bleeding; painful diverticulitis; intest. obstruction from - intussusception or volvulus
|
|
Q465. Meckel's Diverticulum - Dx
|
A465. Meckel's scan - for ectopic gastric mucosa; uses IV technetium; pertechnetate
|
|
Q466. Meckel's Diverticulum - Tx
|
A466. Surgery
|
|
Q467. Hirschsprung's Disease - (Congenital Aganglionic Megacolon); What is it
|
A467. Absence of autonomic; innervation of bowel wall; inadeq relaxation; and peristalsis; => intest. obstruction
|
|
Q468. Hirschsprung's Disease - (Congenital Aganglionic Megacolon); Presentation
|
A468. Abdominal distention; bilious vomiting; fail to pass meconium in; 1st 24 hrs of life
|
|
Q469. Hirschsprung's Disease - (Congenital Aganglionic Megacolon); Dx
|
A469. Barium enema - dilated prox segment; narrowed distal segment; rectal Bx - to confirm
|
|
Q470. Hirschsprung's Disease - (Congenital Aganglionic Megacolon); Tx
|
A470. Colostomy prior to; corrective surgery
|
|
Q471. Hypospadias - What is it
|
A471. Abnormal urethral opening; on ventral surface of penis; due to incomplete dev of; distal urethra
|
|
Q472. Hypospadias - Presentation; Associated with
|
A472. Chordee; associated with - hernias; cryptorchidism
|
|
Q473. Hypospadias - Tx
|
A473. Circumcision contraindicated; surgical repair uses; preputial tissue
|
|
Q474. X-linked Agammaglobulinemia; (Bruton's Disease) - What is it
|
A474. B-cell defect; boys only; may present < 6 mos. of age; at risk for life-threatening Pseudomonas infections
|
|
Q475. X-linked Agammaglobulinemia; (Bruton's Disease) - Dx
|
A475. No B cells; low levels of all Ab classes
|
|
Q476. X-linked Agammaglobulinemia; (Bruton's Disease) - Tx
|
A476. IVIG; prophylactic Antibiotics
|
|
Q477. Common Variable Immunodeficiency - What is it
|
A477. Ig levels drop in 2nd-3rd decade of life; increased risk of lymphoma; increased risk of autoimmune dis.
|
|
Q478. Common Variable Immunodeficiency; Dx
|
A478. Ig levels; antibody titers
|
|
Q479. Common Variable Immunodeficiency; Tx
|
A479. IVIG; prophylactic Antibiotics
|
|
Q480. IgA Deficiency - What is it
|
A480. MC immunodeficiency; usually asymptomatic; may have recurrent infections
|
|
Q481. DiGeorge Syndrome; (Thymic aplasia) - What is it
|
A481. CATCH-22; Cardiac defects; Abnormal facies; Thymic hypoplasia; Cleft palate; Hypocalcemia; 22 - microdeletions in chrom22; tetany in first days of life
|
|
Q482. DiGeorge Syndrome; (Thymic aplasia) - Dx
|
A482. Absolute lymphocyte count,; mitogen stimulation response; and delayed hypersensitivity; skin testing
|
|
Q483. DiGeorge Syndrome; (Thymic aplasia) - Tx
|
A483. BMT - if severe; IVIG; thymus transplant
|
|
Q484. Ataxia-Telangiectasia - What is it
|
A484. DNA repair defect; oculocutaneous telangiectasias; progressive cerebellar ataxia
|
|
Q485. Ataxia-Telangiectasia; Tx
|
A485. No effective Tx for CNS abnorm; neuro deterioration progresses; death by 30 y/o
|
|
Q486. Severe Combined; Immunodeficiency (SCID) - What is it
|
A486. Severe lack of B & T cells; frequent severe bacterial infections; chronic Candidiasis; opportunistic organisms
|
|
Q487. Severe Combined; Immunodeficiency (SCID) - Tx
|
A487. BMT or stem cell transplant; IVIG; PCP prophylaxis until BMT; gene therapy may be; future option
|
|
Q488. Wiskott-Aldrich Syndrome - What is it
|
A488. X-linked recessive; T & B cell dysfunction; thrombocytopenia; small-sized platelets; eczema; high IgE; high IgA; low IgM; bloody diarrhea; bleeding gums; prolonged nosebleeds
|
|
Q489. Wiskott-Aldrich Syndrome - Tx
|
A489. Protective helmet; IVIG; aggressive Antibiotics for infections; HLA-identical BMT; if no BMT - rarely survive to adulthood
|
|
Q490. Chronic Granulomatous Disease-; (CGD); What is it
|
A490. X-linked or AR; deficient superoxide production by PMNs & M0s; usual sites of infection – skin, lungs (pneumonia), lymph nodes, liver (abscesses, hepatitis), bones (osteomyelitis); swollen collections of infected tissue obstruct intestines (IBD) and urinary tract (UTIs)
|
|
Q491. Chronic Granulomatous Disease-; (CGD); Dx
|
A491. Absolute neutrophil count and adhesion assays – chemotaxic, phagocytic, bactericidal; diagnostic - negative nitroblue tetrazolium dye reduction test (NBT)
|
|
Q492. Chronic Granulomatous Disease-; (CGD); Tx
|
A492. Daily TMP-SMX; judicious Antibiotics use during infections; IFN-g - can decreased incidence of serious infection
|
|
Q493. Chediak-Higashi - What is it
|
A493. AR; giant lysosomal granules dev. in neutrophils lysosomes can't fuse with phagosomes => ingested bact. can't be lysed; oculocutaneous albinism; neuropathy; neutropenia
|
|
Q494. C1 Esterase (Inhib) Deficiency - (Hereditary Angioedema); What is it
|
A494. C1 inhibitor - acute phase protein inhibits proteinases of: complement pathway, clotting pathway, kinin generator pathway, fibrinolytic pathway; deficiency => hereditary angioedema; AD; can affect - hands & feet - local edema, bowel - extreme abdominal pain, mouth/airway - life-threatening edema; usually lasts 3 days; can be precipitated by trauma, virus; aggravated by stress
|
|
Q495. C1 Esterase (Inhib) Deficiency - (Hereditary Angioedema); Dx
|
A495. Total hemolytic C' assay- CH50; if defect in one component - no CH50 reduction, then detect which component
|
|
Q496. C1 Esterase (Inhib) Deficiency - (Hereditary Angioedema); Tx
|
A496. Daily prophylactic danazol; purified C1 esterase and FFP - prior to surgery
|
|
Q497. Terminal Complement Deficiency; (C5-C9) - What is it
|
A497. AR; recurrent N. meningitides & disseminated gonorrhea infections; rarely - systemic lupus
|
|
Q498. Terminal Complement Deficiency; (C5-C9) - Tx
|
A498. Meningococcal vaccine; appropriate Antibiotics
|
|
Q499. Hyper IgM Syndrome - What is it
|
A499. MC - deficiency in CD40 ligand in T Helper => can't class switch; normal or high IgM; low IgG, IgA, IgE; XL recessive (most common), AR (others); severe upper & lower respiratory; diarrhea - Cryptosporidium
|
|
Q500. Hyper IgM Syndrome - Tx
|
A500. IVIG; PCP prophylaxis - TMP-SMX
|
|
Q501. What is the most common cause of bowel obstruction in the first two years of life?
|
A501. Intussusception
|
|
Q502. What is the classic triad for intussusception
|
A502. Abdominal pain, vomiting, blood per rectum
|
|
Q503. Red currant-jelly stools are indicative of what?
|
A503. Intussusception
|
|
Q504. What is diagnostic for intussusception
|
A504. Air-contrast barium enema
|
|
Q505. The string sign on a barium study indicates what?
|
A505. Pyloric stenosis
|
|
Q506. What type of acid/base abnormality can occur with persistent emesis, such as that seen with pyloric stenosis?
|
A506. Hypochloremic, hypokalemic metabolic alkalosis
|
|
Q507. What type of immunodeficiency presents after six months of age with recurrent sinopulmonary, GI, and urinary tract infections with encapsulated organisms (H. influenzae, Streptococcus pneumoniae, Neisseria meningitidis)?
|
A507. B-cell deficiencies
|
|
Q508. What immunodeficiency is seen in boys only and presents with frequent pseudomonas infections?
|
A508. X-linked agammaglobulinemia (Bruton's)
|
|
Q509. With what immunodeficiency will there be a drop in immunoglobulin levels to the 20s and 30s, increased pyogenic upper and lower respiratory diseases, and increased risk of lymphoma and autoimmune disease?
|
A509. Common variable immunodeficiency
|
|
Q510. What is the most common immunodeficiency
|
A510. IgA deficiency
|
|
Q511. What does CATCH-22 stand for in DiGeorge syndrome?
|
A511. Congenital heart disease,; Abnormal facies,; Thymic aplasia,; Cleft palate,; Hypocalcemia,; 22q deletion
|
|
Q512. With what immunodeficiency syndrome will patients have increased infections with fungi and PCP?
|
A512. Thymic aplasia; (DiGeorge syndrome)
|
|
Q513. With what immunodeficiency will patients present with cerebellar ataxia and increased incidence of non-Hodgkin's lymphoma and gastric carcinoma?
|
A513. Ataxia-telangiectasia
|
|
Q514. With what immunodeficiency will patients have severe, frequent bacterial infections; chronic candidiasis, and opportunistic organisms?
|
A514. Severe combined immunodeficiency
|
|
Q515. What is the treatment for SCID?
|
A515. PCP prophylaxis,; bone marrow transplant or stem cell transplant,; IVIG for antibody deficiency
|
|
Q516. With what immunodeficiency will patients present with eczema, increased IgE/IgA, decreased IgM, and thrombocytopenia?
|
A516. Wiskott-Aldrich syndrome
|
|
Q517. What is the classis presentation of Wiskott-Aldrich syndrome (3)
|
A517. Bleeding,; eczema,; recurrent otitis media
|
|
Q518. With what immunodeficiency will patients present with anemia, lymphadenopathy, hypergammaglobulinemia, and infections with catalase-positive organisms?
|
A518. Chronic granulomatous disease
|
|
Q519. Pts with chronic granulomatous disease require daily treatment with what antibiotic?
|
A519. TMP-SMX
|
|
Q520. With what immunodeficiency will patients present with oculocutaneous albinism, neuropathy, neutropenia, and increased incidence of overwhelming infections with S. pyogenes, S. aureus, and Pseudomonas?
|
A520. Chediak-Higashi syndrome
|
|
Q521. What is the defect in Chediak-Higashi syndrome?
|
A521. Neutrophil chemotaxis (Autosomal recessive)
|
|
Q522. What is the diagnostic test for chronic granulomatous disease?
|
A522. Nitroblue tetrazolium test
|
|
Q523. What immunodeficiency presents with recurrent episodes of angioedema lasting 2-72 hours and provoked by stress or trauma
|
A523. C1 esterase deficiency (autosomal dominant)
|
|
Q524. What type of immunodeficiencies tend to present at 1-3 months?
|
A524. T-cell deficiencies
|
|
Q525. With what immunodeficiency are patients unable to form membrane attack complexes
|
A525. Terminal compliment deficiency (C5-C9)
|
|
Q526. With what immunodeficiency will patients get recurrent miningococcal or gonococcal infections?
|
A526. Terminal compliment deficiency (C5-C9)
|
|
Q527. What type of immunodeficiencies are characterized by mucous membrane infections, gram-negative enteric organisms, and delayed umbilical cord separations?
|
A527. Phagocyte deficiencies
|
|
Q528. What type of immunodeficiencies are characterized by recurrent bacterial infections with encapsulated organisms
|
A528. Complement deficiencies
|
|
Q529. What are the subacute-phase manifestations of Kawasaki disease? (2)
|
A529. Thrombocytosis and increased ESR
|
|
Q530. What are the acute-phase manifestations of Kawasaki disease? Hint: Crash and Burn
|
A530. Conjunctivitis,; Rash,; Adenopathy,; Strawberry tongue,; Hands and feet (red, swollen, flacky skin),; AND Burn=fever >40 for 5 days
|
|
Q531. What is the treatment for Kawasaki disease?
|
A531. High-dose aspirin and IVIG
|
|
Q532. What treatment is contraindicated with Kawasaki disease?
|
A532. Corticosteroids; (may increase aneurysm formation)
|
|
Q533. Untreated patients with Kawasaki disease are at risk for what complications?
|
A533. Coronary artery aneurysms and MI
|
|
Q534. What disease is defined as an acute inflammatory illness of the small airways that primarily affects infants and children under 2?
|
A534. Bronchiolitis; (RSV most common)
|
|
Q535. What disease is characterized by the classic barking cough (usually at night)?
|
A535. Croup; (Laryngotracheobronchitis)
|
|
Q536. What is the steeple sign?
|
A536. Subglottic narrowing of the airway,; commonly seen with Croup
|
|
Q537. With what disease will patients age 3-7 present with muffled voice and drooling?
|
A537. Epiglottitis
|
|
Q538. The thumbprint sign on lateral film is characteristic of what?
|
A538. Epiglottitis
|
|
Q539. What three organisms commonly cause otitis media?
|
A539. S.pneumoniae,; H.influenzae,; Moraxella catarrhalis
|
|
Q540. What disease is characterized by a slapped-cheek rash that is worse with fever and sun exposure?
|
A540. Erythema infectiosum,; caused by Parvovirus B19
|
|
Q541. What disease has an acute onset of high fever followed by a maculopapular rash that appears as the fever breaks?
|
A541. Roseola infantum (HSV-6)
|
|
Q542. An abdominal radiograph showing the "double-bubble" sign indicates what?
|
A542. Duodenal atresia
|
|
Q543. What is the most common cause of respiratory distress in infants?
|
A543. Respiratory distress syndrome
|
|
Q544. Ground-glass appearance and air bronchograms on CXR in an infant indicate what disease?
|
A544. Respiratory distress syndrome
|
|
Q545. What are the five Ts and 1P of cyanotic heart disease?
|
A545. 1. Truncus arteriosus; 2. Transposition of the great arteries; 3. Tricuspid atresia; 4. Tetralogy of Fallot; 5. Total anomalous pulmonary venous return 6. Pulmonary atresia
|
|
Q546. What congenital heart defect presents with a harsh holosystolic murmur heard best at the lower left sternal border?
|
A546. VSD
|
|
Q547. What congenital heart defect presents with a wide and fixed split S2 and a systolic ejection murmur heard best at the upper left sternal border?
|
A547. ASD
|
|
Q548. What drug is given to close a patent ductus arteriosus?
|
A548. Indomethacin
|
|
Q549. What congenital defect often presents in childhood with asymptomatic hypertension?
|
A549. Coarctation of the aorta
|
|
Q550. What is the most common childhood malignancy?
|
A550. ALL
|
|
Q551. household and sex contacts of kids/teens with hepatitis A should receive what?
|
A551. immunoglobulin to prevent hep A
|
|
Q552. intracranial trauma without obvious external findings in baby; think?
|
A552. shaken baby syndrome
|
|
Q553. person who gets hives after bee sting. what NSiM?
|
A553. give Epi-pen at all times (bc had systemic reaction) as well as give prescription for diphenydramine
|
|
Q554. hyponasal speech plus mouth breathing, think?
|
A554. NASAL POLYP
|
|
Q555. urinalysis of > 1.015 makes what highly unlikely?
|
A555. diabetes insipidus
|
|
Q556. primary vs secondary enuresis
|
A556. secondary = bedwetting after 3 or more months of dry nights;; is usually due to psych factors or changes
|
|
Q557. therapy for child over 6 with enuresis?
|
A557. consider conditioning therapy with bedwetting alarm (works in 30-60%)
|
|
Q558. any UTI in baby with vomiting and dehydration, think? caused by? tx with ? what follow up tests?
|
A558. pyelonephritis;; e coli; ceftriaxone; need to follow up ANY UTI in girl under 5 and any boy, with renal US and VCUG to rule out v-u reflux
|
|
Q559. rash post GAS pharyngitis, think?
|
A559. Scarlet fever!
|
|
Q560. boggy mass on scalp? tx?
|
A560. most likely kerion = inflammatory form of tinea capitis (Trich. tonsurans or Microsporum canis). tx = 8-12 weeks oral griseofulvin and shampooing with selenium sulfide
|
|
Q561. oral, feet, and mouth ulcers, think?
|
A561. hand foot and mouth disease!; coxsackie A16
|
|
Q562. ehrlichosis contracted how?
|
A562. by tick bite
|
|
Q563. adults with e. infectiousum may also have what sx?
|
A563. ARTHROPATHY
|
|
Q564. parvovirus B19 ( slapped cheek/ E. infectiousum )in hemolytic anemias may cause?
|
A564. aplastic anemia
|
|
Q565. high and persistent fever that is not very responsive to normal doses of paracetamol; with red cracked lips and red mucous membranes?
|
A565. kawasaki's disease
|
|
Q566. swelling of one eyelid + proptosis, limited ocular movements?
|
A566. orbital cellulitis;; if just swelling of eyelid think periorbital cellulitis
|
|
Q567. 1 y/o black baby solely breastfed may develop?
|
A567. ricketts due to VitD def in breast milk and poor skin conversion of vit D
|
|
Q568. torsion of testicular appendix vs torsion of testicle?
|
A568. Torsion of testicle: in kids over 12; testicular appendix: in kids 2-11
|
|
Q569. acute pain in scrotum of sexually active teen, think?
|
A569. epididymitis
|
|
Q570. m/c pathogens of otitis media?
|
A570. S pneum,; H influ,; M catarrhalis
|
|
Q571. what constitutes increased risk for post-traumatic seizure? what % get? tx if these?
|
A571. depressed cranial fracture; intracranial hemorrhage; cerebral contusion; or unconscious > 24 hrs. 75% of these will seizure; so must tx with anticonvulsants prophylactically
|
|
Q572. main pathogen causing croup? epiglotitis?
|
A572. parainfluenza;; s pneum,; aureus or GBS; H influenzae in non vaccinated
|
|
Q573. cow milk feeding causes?
|
A573. iron def anemia!
|
|
Q574. hirsutism, deepened voice, acne, clitoromegaly, think?
|
A574. CAH
|
|
Q575. can you have allergic rhinitis that presents with rhinitis with NO seasonal variation?
|
A575. YES = perenial allergic rhinitis ie exposure to house dust, pet danders that are there year round
|
|
Q576. bilateral PURULENT discharge with fever, cough, sinus tenderness?
|
A576. sinusitis
|
|
Q577. 3 common pathogens in human bites?
|
A577. eikenella corrodens; peptostreptococcus; alpha streptococcus
|
|
Q578. during Antibiotics tx , diaper rash due to?
|
A578. candida dermatitis!
|
|
Q579. m/c cause of round pneumonia?
|
A579. strep pneumonia
|
|
Q580. HUS is most common in what age?
|
A580. under 2 y/o's!
|
|
Q581. live vaccines?
|
A581. MMR; varicella
|
|
Q582. Guillan Barre has what CSF finding?
|
A582. increased protein;; mild mononuclear pleocytosis (<10 cells/ml)
|
|
Q583. when do you treat lead poisoning with chelation?
|
A583. only if levels over 45 ug/mL !; otherwise just treat by removing source, ie investigating house for lead content, etc
|
|
Q584. name 4 advantages of OPV? 1 of IPV?
|
A584. OPV:; costs less; increased mucuosal immunity; fewer shots; herd immunity through secondary transmission; still recommended for global polio eradication; IPV: less paralytic polio
|
|
Q585. m/c cause of HTN in kids?
|
A585. secondary (not essential) Renal causes!! ie infection, PCKD, glomerulonephritis, vascular anomalies, tumors
|
|
Q586. 2 tx's for Increased ICP
|
A586. intubation with hyperventilation; Mannitol to induce osmotic shift
|
|
Q587. after what type of wounds/pts do you give Td, vs Td + Tet Immune Globulin, vs DTaP?
|
A587. DTaP: give only in kids under age 7; Td only: if patient has had < 3 immunizations or status unknown AND: minor wound w/o contamination; Td + TIG: if patient has had < 3 immunizations or status unknown AND contaminated wounds
|
|
Q588. only 2 exceptions to IC kids NOT receiving varicella vacc (b/c it is live)
|
A588. ALL kid in remission with lymphocyte count over 700;; HIV infected kid in CDC class I =CD4 lymphocytes>25%. All other immunodeficiencies, don’t give!!
|
|
Q589. live viruses not to be given to ?
|
A589. IC pts (see exceptions above) or pregnant women
|
|
Q590. m/c organism causing ANY otitis externa?
|
A590. P. aeruginosa
|
|
Q591. causes of intoeing?
|
A591. adducted great toe,; metatarsus adductus,; medial tibila torson,; femoral anteversion
|
|
Q592. m/c back deformity in kids?
|
A592. idiopathic scoliosis
|
|
Q593. tx of b pertussis?
|
A593. e-mycin
|
|
Q594. hacking cough + absolute lymphocytosis, + thick, clear n/p mucus?
|
A594. think b pertussis
|
|
Q595. TCA poisoning?
|
A595. anticholinergic sx,; mental status changes,; arrhythmias
|
|
Q596. otherwise normal 7 y/o with hypospadias. What next step in tx?
|
A596. renal US to check for enlarged prostatic utricle which predisposes to UTI's
|
|
Q597. snuffles =?; acral rash?
|
A597. mucocutaneous lesions producing persistent, purulent, often bloody nasal discharge!!; acral = on extremities ie hands and feet = syphilis
|
|
Q598. febrile seizures do/don’t increase risk for epilepsy?
|
A598. DO! but by only 7%
|
|
Q599. painful swollen fingers and toes for 2 days?
|
A599. think sickle cell hand-foot syndrome
|
|
Q600. most common manifestation of sickle cell disease?
|
A600. acute PAINFUL episodes ie in legs, arms, in younger kids;; head, chest, back, abdomen in older kids
|
|
Q601. shortness from GH deficiency usually shows by how many yrs?
|
A601. 3 yrs old!
|
|
Q602. chest pain in young 12 y/o girl athlete during exercise?
|
A602. asthma!; give inhaled albuterol
|
|
Q603. 5 days of high fever; bilateral bulbar non-exudative conjunctivitis, rash, hand and foot edema-->desquamation, strawberry tongue and mouth erythema, cervical lad?
|
A603. kawasaki's!
|
|
Q604. m/c cyanotic heart disease in newborn?
|
A604. Transposition!
|
|
Q605. presentation of transposition?
|
A605. blue baby with low sat, no change with 02 given, otherwise looks in no distress; egg on string (narrow mediastinum) chest x-ray...
|
|
Q606. a typical, physiological "flow" murmur?
|
A606. Still's murmur - heard at left lower sternal border
|
|
Q607. systolic murmur heard in ASD is really what?
|
A607. increased flow across pulmonic valve and tricuspid regurgitation
|
|
Q608. systole ejection murmur heard best at upper sternal border but radiating to axilla and back? vs carotids?
|
A608. axilla and back = peripheral pulmonic stenosis (due to flow past sharp angle of pa and its branches = resolves in 6 mo; carotids = aortic stenosis/bicuspid aortic valve
|
|
Q609. Most common congenital heart lesions?
|
A609. VSD
|
|
Q610. what's a positive PPD?
|
A610. 5mm if CLOSE CONTACTS w/known or suspected cases; 10mm if greater risk for disseminated disease ie <4y/o's, DM, CKD, malnourishment, lymphoma, or at greater risk of exposure to TB, ie born in, parents born in high prevalent regions, travel to these regions, exposure to adults at high risk, (ie HIV infected, homeless, drug abusers); 15mm in normal, age over 4 w/o any risk factors
|
|
Q611. What are the 5 portions of the APGAR score?
|
A611. Appearance; Pulse (HR); Grimace; Activity; Respirations
|
|
Q612. Dx:; A lump on the face after a foreceps delivery
|
A612. Subcutaneous Fat Necrosis
|
|
Q613. Dx:; rash that starts after the first day of life as a flat reddish area with a central papule that becomes a pustule and persists for a couple of weeks; Test?
|
A613. Erythema Toxicum; test: Wright stain of vesicular fluid will show Eosinophils
|
|
Q614. Dx;; Strawberry rash of newborn with difficulty breathing
|
A614. Epiglottic Hemangioma
|
|
Q615. Dx:; sharply demarcated bruise-like appearance on sacral area of newborn
|
A615. Mongolian spots; (do not confuse w/ Abuse, which is not sharply demarcated)
|
|
Q616. Dx:; orange/yellow warty lesion on the scalp in newborn that displaces hair growth; Tx?; what can it lead to?
|
A616. Nevus sebaceous; Tx: leave alone until Adolescence (should go away); leads to: 15% chance to become malignant
|
|
Q617. Dx:; scalp swelling that crosses suture lines and goes away in a few days
|
A617. Caput
|
|
Q618. Dx:; scalp swelling that does not cross suture lines and goes away in a couple of months; cause?
|
A618. Cephalohematoma; cause: Subperiosteal bleed
|
|
Q619. When do anterior fontanels normally open and close?; Posterior?
|
A619. Anterior: opens: birth; closes: 9 - 18 months; Posterior: opens: sometimes at birth; closes: 4 - 5 months
|
|
Q620. what is possible diagnosis if:; 1. both fontanels are enlarged?; 2. One fontanel only is enlarged?
|
A620. 1. Hydrocephalus; 2. Hypothyroidism
|
|
Q621. Newborn eye:; White reflex
|
A621. Retinoblastoma; (another source: MCC is Congenital Cataracts)
|
|
Q622. Newborn eye:; lens opacity
|
A622. Cataracts; (possible Galactosemia)
|
|
Q623. Newborn eye:; Aniridia and hemihypertrophy (one side of body larger then other)
|
A623. Wilms Tumor
|
|
Q624. Dx:; blue baby pinks up on crying; confirmatory test?
|
A624. Choanal Atresia; test: Catheter doesn’t pass thru nose
|
|
Q625. MC abdominal mass in newborn
|
A625. Polycyctic Kidney disease
|
|
Q626. when should an umbilical hernia close?
|
A626. by 5 months
|
|
Q627. which has a sac--Omphalocele or Gastroschisis?
|
A627. Omphalocele; (“O” is like a closed sac)
|
|
Q628. what should be avoided in a patient with Epispadias or Hypospadias?
|
A628. do NOT circumsize
|
|
Q629. how long can undescended testis remain undescended before you need to bring them down?
|
A629. one year
|
|
Q630. MC type of Ambiguous genitalia
|
A630. Congenital Adrenal Hyperplasia; (21-hydroxylase deficiency is the MC of the CAH)
|
|
Q631. Dx:; newborn has a mass on the right anterior, superior chest and crepitus on exam; Tx?
|
A631. Clavicle fracture (MC newborn fracture); Tx: None (will heal on its own)
|
|
Q632. MC birthing brachial plexus injury?; what nerve roots?; another name for this injury?
|
A632. Erb-Duchenne; roots: C5-C6 (C4: if ipsilateral diaphragmatic paralysis also); another name: “waiter’s tip” – wrist flexed
|
|
Q633. birthing injury where baby has hand extended and fingers flexed; what nerve roots?; another name for this injury?
|
A633. Klumpke; roots: C8-T1; another name: “claw hand”
|
|
Q634. What are the (3) 'diseases' tested for during a newborn screening?
|
A634. 1. PKU; 2. Galactosemia; 3. Hypothyroidism
|
|
Q635. Dx:; baby born with Mental retardation, Eczema, musty odor, fair hair, fair skin and blue eyes
|
A635. PKU
|
|
Q636. Dx:; baby born with Jaundice, Hypoglycemia, and Cataracts; genetic inheritance?; what is contraindicated in this baby?
|
A636. Galactosemia; (Autosomal Recessive); Contraindication: Breastfeeding
|
|
Q637. Dx:; Newborn with Jaundice, mottled, constipation, Large tongue, Umbilical hernia; what is seen on blood test?
|
A637. Hypothyroidism; blood test: high TSH, low T4
|
|
Q638. Dx:; pre-term baby with ground glass appearance on CXR; Tx? (2 in order)
|
A638. Respiratory Distress Syndrome Tx:; 1. Surfactant; 2. Ventilation
|
|
Q639. Dx:; baby delivered by C-section has a Rapid respiratory descent but after 72 hours of Tachypnea, then gets better; CXR shows possible fluid in the fissure
|
A639. Transient Tachypnea of newborn; (when delivered by C-section that do not get a vaginal squeeze and then don’t expel amniotic fluid); patient does not need respiratory support; (a main way to differentiate)
|
|
Q640. What are the 3 differences b/t physiologic and pathologic jaundice?
|
A640. Physiologic:; 1. Appears >24 hours of age; 2. peaks at or below 12.9 by 3 days; 3. resolves by 1 week Pathologic:; 1. Within first day of life; 2. Level >13; 3. Lasts > 1 week
|
|
Q641. MC type of pathologic Jaundice?; Tx?
|
A641. Hemolysis (Rh or ABO incompatibility); Tx: Phototherapy
|
|
Q642. Dx:; newborn with Jaundice within 8 hours of birth, a Direct bilirubin increase; Acholic (or clay-colored) stools
|
A642. Biliary Atresia
|
|
Q643. Aside from certain meds, what are the (6)* main contraindications of offering newborn breast milk?
|
A643. “A Healthy Toddler Gladly Sucks Vitamins”:; AIDS;; Herpes if breast lesions;; TB (active, untreated);; Galactosemia;; Syphilis;; Varicella
|
|
Q644. How many calories are in baby formula?; When can Whole milk be started?; When should Iron supplementation begin?
|
A644. Formula: 20 cal/oz; whole milk: > 1 year-old; Iron: > 6 months old
|
|
Q645. What test can be done in newborn to test for Turner's syndrome?
|
A645. Buccal smear; (to test for Barr Bodies)
|
|
Q646. definition:; child is short but expect a growth spurt at a later age
|
A646. Constitutional Delay
|
|
Q647. MCC for childhood obesity?
|
A647. take in too many calories and don't burn enough off; (don't be tricked and look for a pathologic cause)
|
|
Q648. when do most reflexes disappear?; which (2) don't at this time?; what time do they disappear?
|
A648. reflexes disappear: 4 - 6 months; except: Babinski: until 18 months; Parachute: never
|
|
Q649. Rule for Cube stacking in child; (give 3 milestones)
|
A649. 3 cubes at 15 months; 4 cubes at 18 months; 7 cubes at 24 months
|
|
Q650. MCC for Enuresis; First Tx?
|
A650. Primary Nocturnal (usually a male child that is just a deep sleeper); Tx:; 1. Give it Time; 2. Alarms; 3. Meds (Imipramine; DDAVP)
|
|
Q651. In the severely immunocompromised, what vaccination do you not give?
|
A651. MMR
|
|
Q652. what 3 vaccinations are contraindicated with an allergy to neomycin?
|
A652. 1. IPV; 2. MMR; 3. Varicella
|
|
Q653. which vaccination do you give:; child > 2 yo who has not been vaccinated if they have immunodeficiency of any kind, are asplenic or lack splenic function (sickle cell)
|
A653. Pneumococcus spp.
|
|
Q654. which vaccination is contraindicated in patient who has streptomycin allergy?
|
A654. IPV; (also CI if they have neomycin allergy)
|
|
Q655. what 2 additional vaccinations are required specifically if patient is asplenic?
|
A655. 1. Meningococcal; 2. Pneumococcus spp.
|
|
Q656. MCC of Meningitis in:; Neonate
|
A656. Group B Strep; (from mother)
|
|
Q657. MCC of Meningitis in:; Patient > 2 months old
|
A657. Pneumococcus
|
|
Q658. MCC of Meningitis in:; College or Military; (sexually active)
|
A658. N. Meningococcus
|
|
Q659. What is the first step in a suspected meningitis of any age?
|
A659. IV Ceftriaxone
|
|
Q660. MCC of Meningitis in:; Elderly, HIV+, steroid user; (immunocompromised)
|
A660. Listeria
|
|
Q661. When should Ampicillin be added to the treatment of meningitis?; (2); When should Vancomycin be added?
|
A661. Ampicillin:; 1. Listeria (as bug); 2. Neonates; Vancomycin: Pneumococcus
|
|
Q662. Dx:; Lymphocytic meningitis, rash on wrists and ankles moving centrally; Tx?
|
A662. Rocky Mountain Spotted Fever; Tx: Doxycycline (and Ceftriaxone for meningitis prophylaxis)
|
|
Q663. Differential for Lymphocytic meningitis and next test for each; (3)
|
A663. Test: IgG and IgM Serology; 1. Rocky Mt. Spotted Fever; 2. Lyme disease; Test: India Ink (or cryptococcal antigen); 3. Cryptococcus
|
|
Q664. Treatment for meningitis caused by Cryptococcus
|
A664. Amphotericin; (then Fluconazole to take home)
|
|
Q665. What are the causes of CSF with very high protein and very low glucose?; (2)
|
A665. 1. TB; 2. fungal
|
|
Q666. What should be given prophylactically for a sneaker puncture of a pin that enters the foot?; For what bug?
|
A666. TMP-SMX; for: Pseudomonas
|
|
Q667. Bug causing septic arthritis from a dog or cat bite?
|
A667. Pasturella
|
|
Q668. Pediatric patient without immunization history has coughing spasms, inspiratory whoop, facial petechiae and leucocytosis with lymphocytosis. (2) possible confirmatory tests; Tx?
|
A668. Pertussis; tests:; 1. Positive cultured Nasopharyngeal washings; 2. Rapid Fluorescent antibody stain; Tx: Erythromycin
|
|
Q669. What can Fifth's disease lead to?; what can it cause in unborn child if mother has it?
|
A669. leads to: Aplastic Anemia; in unborn child: Hydrops
|
|
Q670. Dx:; three-day rash and lymphadenopathy
|
A670. Rubella
|
|
Q671. what 2 test should be run if suspecting acetaminophen toxicity?
|
A671. 1. Acetaminophen level in blood; 2. LFTs
|
|
Q672. A child swallowed a bottle with no lable and has Sx of:; Hypernea/Tachypnea, Fever, N/V, Dehydration, Seizures, agitation, tinnitus; Fastest diagnostic test?
|
A672. Aspirin toxicity; fastest test: Urine Ferric Chloride Test
|
|
Q673. what acid/base problems does Aspirin toxicity cause in a child?
|
A673. Respiratory Alkalosis w/ Metabolic Acidosis; (high pH, low pCO2 and bicarb); Tx: Charcoal
|
|
Q674. A child swallowed a bottle with no lable and has Sx of:; Tachycardia, HTN to Hypotension, confusion, drowsiness, dilated pupils, Seizures, Widened QRS; Ventricular arrhythmia; Tx? (2)
|
A674. Tricyclic Antidepressant toxicity; Antidote/Tx:; (1) Gastric Lavage/Charcoal; (2) Sodium Bicarbonate (to alkalinize blood for arrhythmias)
|
|
Q675. What is the first test if you suspect a TCA toxicity?
|
A675. ECG; (will show Widened QRS, Ventricular arrhythmia)
|
|
Q676. A child presents with swallowing kerosene. What is the primary objective?; What are the first (2) tests?; What are (2) Tx?
|
A676. objective: Prevent Aspiration resulting in Chemical Pneumonitis; tests:; 1. CXR; 2. Blood Gas; Tx:; 1. Prevent aspiration; 2. avoid gastric lavage
|
|
Q677. a child swallows something from an unlabled bottle:; diarrhea, excessive urination, miosis, bradycardia; Test?; Tx?
|
A677. Organophosphate (insecticide) toxicity; test: Plasma Cholinesterase activity; Tx: Atropine w/ Pralidoxime chloride
|
|
Q678. a child swallows an unlabled bottle of pills:; drowsey, delirius, hallucinate, N/V, DRY state, dilated pupils; Test?; Tx?
|
A678. Antihistamines; Test: Drug screen; Tx: Physostigmine (if severe)
|
|
Q679. a child swallows an unlabled bottle of pills:; signs of hemorrhagic gastroenteritis (bloody diarrhea), N/V, diarrhea, acute liver failure, shock, coma; Test?; Tx?
|
A679. Iron pill overdose; test: Serum Iron level; Tx: Deferoxamine
|
|
Q680. MCC of conjunctivitis in newborn (less then 24 hours-old)
|
A680. Chemical; (from Silver Nitrate drops)
|
|
Q681. MCC of infectious conjunctivitis in newborn
|
A681. Chlamydia
|
|
Q682. Medical term:; Conjunctivitis within the first month of life
|
A682. Ophthalmia Neonatorum
|
|
Q683. Difference in presentation b/t viral vs. bacterial conjunctivitis
|
A683. Viral: Crusting of eyelid; Clear discharge; Bacterial: Mucopurulent discharge
|
|
Q684. At what age is strabismus still normal?; What can it lead to if it is prolonged?
|
A684. Normal: up to 4 months old; leads to: Amblydopia
|
|
Q685. Dx:; 2 yo child has a "lazy eye"; Dx tests? (2); Tx?
|
A685. Amblydopia; tests:; 1. Hirschberg test (shine light directly into eye and look to see if it falls at an angle); 2. Cover test (cover good eye and lazy eye will move straight ahead); Tx: Patch good eye (causes patient to use lazy eye; must be done early in life)
|
|
Q686. Child presents with a painful buldging eye; eyeball does not move when testing muscles; Dx test?; Tx? (2 possible)
|
A686. Orbital Cellulitis; Dx test: CT Scan; Tx:; 1. Cefuroxime with Clindamycin, or; 2. Ampicillin/Sulbactam
|
|
Q687. Child presents with swelling of eyelids and surrounding tissue; eye moves when checking ROM
|
A687. Preorbital cellulitis
|
|
Q688. Tx for a large Retinoblastic tumor of the eye
|
A688. Enucleation
|
|
Q689. Definition:; Otitis Media w/ Osteomyelitis of the bony canal or mastoid; Bug?; what Disease is it associated with?
|
A689. Malignant Otitis Media; bug: Pseudomonas; Assoc Disease: Diabetes
|
|
Q690. What is the specific bug that produces a positive on throat swab culture?; Tx? (3 possible); (2) possible complications?
|
A690. Group A Strep (A not B); Tx:; 1. Penicillin; 2. Erythromycin; 3. Clindamycin; complications:; 1. Rheumatic Fever; 2. Glomerulnephritis
|
|
Q691. Dx:; High fever, tonsil bulges, uvula deviates to non-involved side, "hot potato voice"; Bug?; Tx? (2 together)
|
A691. Peritonsillar Abscess; bug: Group A Strep; Tx:; 1. Drain abscess; 2. Penicillin (Erythromycin if allergy)
|
|
Q692. Dx:; High fever, sore throat and ulcers scattered on the soft palate, tonsils and pharynx; cause?; Tx?
|
A692. Herpangina; cause: Coxsackievirus; Tx: None...will go away
|
|
Q693. Dx:; High fever, sore throat and ulcers scattered on the soft palate, tonsils and pharynx, plus similar lesions on palms and soles
|
A693. Hand-Foot-and-Mouth disease; (Coxsackievirus)
|
|
Q694. Dx:; child with sudden onset respiratory distress, wheezing; hyperinflated lung on one side and tracheal deviation to the opposite side
|
A694. Foreign body aspiration
|
|
Q695. Dx:; 4 year-old that presents with a Barking cough with Inspiratory stridor; Dx Test?; Tx? (2 together); Tx if advanced or an emergency?
|
A695. Croup (Parainfluenza virus); Test: P/A neck film: STEEPLE SIGN; Tx:; (1) Humidified air; (2) Steroids beneficial; Emergency: Racemic Epinepherine
|
|
Q696. Dx:; Dysphagia, Drooling, muffled voice, leaning forward to maximize air entry; Bug?; Dx test?; Tx? (2)
|
A696. Epiglottitis (EMERGENCY); Cause: H. flu type b (HIB); Dx Test: Lateral Neck: THUMBPRINT SIGN; Tx:; (1) Secure Airway: CHERRY RED EPIGLOTTIS (seen w/ intubation); (2) antibiotics
|
|
Q697. Dx:; patient less then 2yo had a cold, then Wheezing, rales, tachypnea, Accessory muscles are used during respiration; MCC?; Dx test? (2); Prevention (for those predisposed)?
|
A697. Bronchiolitis; MCC: RSV; Dx test:; (1) Rapid assay from Nasal secretions; (2) CXR (Hyperinflation); Prevention: Palivizumab – Monoclonal antibodies
|
|
Q698. MCC of death in 1 - 12 month-old children
|
A698. SIDS
|
|
Q699. What are the (3) main Right-to-Left shunt developmental Heart disorders?
|
A699. 1. Tetralogy of Fallot;; 2. Transposition of the great vessels;; 3. Tricuspid Atresia
|
|
Q700. What are the (3) main Left-to-Right shunt developmental Heart disorders?
|
A700. 1. VSD; 2. ASD; 3. PDA
|
|
Q701. What are the (3) main "Mixed" developmental Heart disorders?
|
A701. 1. Truncus Arteriosus; 2. TAPVR; 3. Hypoplastic LH
|
|
Q702. Dx:; Continuous murmur w/ wide pulse pressure heard in the upper left sternal border; Tx?
|
A702. PDA; Tx: Indomethicin
|
|
Q703. Dx:; Apical Click followed by a late-systolic murmur
|
A703. Mitral Prolapse
|
|
Q704. Dx:; Holosystolic murmur best heard at the Apex
|
A704. Mitral Regurgitation
|
|
Q705. Dx:; Mid-diastolic murmur followed by opening Snap
|
A705. Mitral Stenosis
|
|
Q706. Dx:; Systolic ejection murmur best heard at the left upper sternal border and a mid-diastolic murmur at the lower left sternal border; Fixed S2
|
A706. ASD
|
|
Q707. Dx:; Loud harsh pansystolic murmur heard in the Lower left sternal border; What can it lead to?
|
A707. VSD (MC heart defect); Leads to: Eisenmenger’s syndrome; (VSD shunt reverses right to left when the PVR exceeds the SVR)
|
|
Q708. Dx:; VSD shunt reverses right to left when the PVR exceeds the SVR
|
A708. Eisenmenger’s syndrome
|
|
Q709. Dx:; CHF early in life including a feeding difficulty, sweat while feeding and tachypnea; loud harsh pansystolic murmur heard in the Lower left sternal boarder; What is it Associated with?
|
A709. Endocardial cushion defect; (Subclass of VSD and ASD; also known as “Common AV canal”); Assoc w: Down's Syndrome
|
|
Q710. Dx:; Weak/delayed/absent lower extremity pulses, HTN; What is seen on CXR?; What Disease is it assoc with?
|
A710. Coarctation of the Aorta; CXR: Rib notching; Disease: Turner's Syndrome
|
|
Q711. (4) heart defects of the Tetralogy of Fallot; MC presenting Sx?
|
A711. "PROVe"; 1. Pulmonary stenosis; 2. RV hypertrophy; 3. Overriding Aorta; 4. VSD; MC presenting Sx: Cyanosis
|
|
Q712. Dx:; Cyanosis; Single second heart sound; Murmur Heard in Upper left sternal border; What is seen on CXR?
|
A712. Tetralogy of Fallot; CXR: Boot-shaped heart
|
|
Q713. Dx:; MCC of cyanosis in the first 24 hours of life; loud single S2; What is seen on CXR?; Tx (aside from airway) until surgery?
|
A713. Transposition of Great Vessels; CXR: "Egg on a string"; (ECG will show right axis deviation and RVH); Tx: Prostaglandin (to keep PDA open until surgery)
|
|
Q714. Dx:; CHF w/i weeks of birth; Systolic Ejection murmur in the Left sternal border; Single S2; Wide Pulse Pressure; bounding arterial pulses; What Disease is it assoc with?
|
A714. Truncus Arteriosus (Single arterial vessel arising from the base of the heart that goes to the coronary, systemic AND pulmonary circulation); Assoc with: DiGeorge Syndrome (22q11 microdeletion)
|
|
Q715. Dx:; single S2 pansystolic murmur with a CXR showing a Heart that looks like Snowman or Figure 8
|
A715. Total Anomalous Pulmonary Venous Return; (TAPVR)
|
|
Q716. Dx:; Loud, palpable S2 without murmur; Common cause of heart failure in first week of life. What can Patient develop?
|
A716. Hypoplastic Left Heart; (Underdevelopment of left cardiac chambers, atresia or stenosis of aortic and/or mitral orifices, and hypoplasia of the aorta); Patient develops Metabolic Acidosis
|
|
Q717. What are the (5) parts of the Major criteria for Rheumatic Fever?; What is Ailment is it assoc with?
|
A717. Major (JONES) Criteria: (2 of these = Rheumatic fever); J = Joints; O = carditis (O looks like a heart); N = Nodules (subcutaneous); E = Erythema marginatum; S = Sydenham’s chorea; Association with: Strep throat (GAS)
|
|
Q718. MCC of HTN in infants or children?
|
A718. Renal disease
|
|
Q719. MCC of Diarrhea in children
|
A719. Rotavirus
|
|
Q720. Dx:; watery to bloody Diarrhea, N/V, fever, possible neurologic Sx, caused by ingesting poultry or raw eggs; Tx?
|
A720. Salmonella; Tx: Hydration only (no Antibiotics - they prolong Disease)
|
|
Q721. Tx for diarrhea from Shigella
|
A721. TMP-SMX
|
|
Q722. Tx of diarrhea from Campylobacter
|
A722. Erythromycin
|
|
Q723. Tx for diarrhea from C. Difficile; (2 together)
|
A723. 1. Metronidazole; 2. Vancomycin
|
|
Q724. First test if suspecting Hirshprung's Disease; Diagnostic test?
|
A724. First: Barium Enema; Dx test: Colon Biposy
|
|
Q725. Dx:; chronic problem in infant consisting of cough, vomiting and apnea; Dx test?
|
A725. GERD; Dx test in infant: pH probe
|
|
Q726. Dx:; Bilious vomiting and Double-bubble sign on abdominal X- ray; What is it assoc with?
|
A726. Duodenal Atresia; assoc with: Down's Syndrome
|
|
Q727. Dx:; Nonbilious, Projectile vomiting; RUQ pain in infant; First Dx test?
|
A727. Pyloric Stenosis; first test: Ultrasound
|
|
Q728. what acid/base problem is seen with pyloric stenosis?
|
A728. Hypochloremic, Hypokalemic Metabolic Alkalosis
|
|
Q729. MCC of GI blood from neonate?; Dx Test?
|
A729. Anal Fissure; Dx test: Apt test (to confirm Dx: tells if fetal Hb versus mother Hb)
|
|
Q730. If a neonate has a positive Apt test, what is the cause of the GI blood?
|
A730. Swallowing maternal blood
|
|
Q731. Dx:; Premature infant with Low Apgar and when fed the baby has bloody stools and abdominal distention; What is seen on Abdominal x-ray?
|
A731. Necrotizing Enterocolitis; Abd x-ray: Pneumatosis intestinalis (Air in bowel wall)
|
|
Q732. Dx:; a child between the ages of 6 – 18 months presents with crampy abdominal pain, Currant jelly-like stool, Sausage- shaped abdominal mass; Dx test?
|
A732. Intussusception; Dx test: Barium Enema (will see "Coil spring sign"; also treats problem)
|
|
Q733. Dx:; Painless rectal bleed in 2 yo that can cause intussusception; Dx test?
|
A733. Meckel’s diverticulum; (disease of 2’s: 2% of population, 2:1 males, 2 years of age, 2 types of tissue, 2 feet from ileocecal valve, 2 cm in size); Dx Test: Technetium scan (Lights-up gastric tissue)
|
|
Q734. Dx:; Hematuria, Edema, Hypertension, Azotemia and Oligouria; What infection does it follow?; Dx Test? (2 plus results)
|
A734. Acute Glomerulonephritis; follows: Group A Strep infection; Dx Test:; 1. Urine: Red cell Casts; 2. Blood: C3 decreased
|
|
Q735. Dx:; Renal failure in child with hearing loss and possible cataracts; Genetics?
|
A735. Alport's Syndrome; (Mutation coding type IV collagen; Problem in basement membrane); genetics: X-linked Dominant
|
|
Q736. Dx:; Periorbital Edema / Ascites, High Proteinuria, Hypoalbuminemia, Hyperlipidemia
|
A736. Nephrotic Syndrome; (MCC in children: Minimal Change Disease)
|
|
Q737. What is the MCC of Nephrotic syndrome in Pediatrics?; Tx?; Main possible Complication?
|
A737. Minimal Change Disease (MCD); Tx: Steroids; Complication: Spontaneous Peritonitis
|
|
Q738. Dx:; infant with Toes AND heel deviated inward; Cannot place in neutral, dorsiflex or plantarflex; Tx?
|
A738. Talipes equinovarus ("Club Foot"); Tx: Serial Casting (only intoeing needing treatment)
|
|
Q739. MCC of Limping and hip problem in age 0 - 3 yo; Dx test? (2 together); Tx?
|
A739. Congenital Hip Dysplasia; Dx test:; 1. Ordalani or Barlows procedure (Hear a click on PE); 2. Ultrasound; Tx: Harness or Casting
|
|
Q740. MCC of limping in Age: 4 – 8 years (Begins as Painless limping leading to limping and pain); Dx test?
|
A740. Legg-Perthes (Avascular necrosis of femoral head); Dx test: Hip x-ray
|
|
Q741. MCC of hip problems in a > 11 year-old obese adolescent, that may complain of Knee pain; Dx Test? (2 together)
|
A741. Slipped Capital Femoral Epiphysis (Will externally rotate leg in an antalgic position); Dx Test:; (1) Hip x-ray; (2) Thyroid, LH and FSH (for obesity; think deficient gonads)
|
|
Q742. Dx:; Toddler with sudden traction to arm causing it to hang limp; Tx?
|
A742. Radial head subluxation ("nursemaid injury"); Tx: gentle Supination pops it back into place
|
|
Q743. MC adolescent bone tumor. It occurs in a Metaphyseal area on the Distal Femur, Proximal Tibia or Proximal Humerus; what is seen on x-ray?; Who has an increased risk?
|
A743. Osteosarcoma; x-ray: Codman triangle (bony sclerosis); Inc risk: patients with Bilateral Retinoblastoma
|
|
Q744. Dx:; child who has painful bones that wake him from sleep but are relieved by aspirin
|
A744. Osteoid Osteoma
|
|
Q745. Dx:; Bone tumor causing "onion-skinning" of mid-shaft of femur; what chromosomal problem?
|
A745. Ewing's Sarcoma; chromosome: t(11;22)
|
|
Q746. Dx:; A child presents with recurrent episodes of non-pitting edema on the skin (including swelling of eyelids and lips), GI tract and respiratory system and a family history of the same problem; C4 complement is low; What is the deficiency?; Genetics?; Tx?
|
A746. Hereditary Angioedema; Deficiency: C1 Esterase Inhibitor; Genetics: Autosomal Dominant; Tx: Epinepherine and airway (like for anaphylaxis)
|
|
Q747. Dx:; a male infant between the ages of 6 – 12 months presents with recurrent lung and sinus infections, especially pneumococcus and H.influenzae; All Immunoglobulins are Low and B-cells are low or absent; Tx?
|
A747. Bruton's Agammaglobinemia (X-linked recessive); Tx: replace IgG
|
|
Q748. Dx:; A newborn child presents with hypocalcemia, truncus arteriosus, Fishmouth, tetany and Micrognathia; What is deficient?
|
A748. DiGeorge syndrome; Deficiency: T-cells (from hypoplasia of 3rd and 4th pharyngeal pouches; thymus)
|
|
Q749. Dx:; Chorioretinitis, gingivitis, Granulomas in GI tract, Lupus syndromes; Recurrent Infections of Pneumonia, Abscesses, Lymphadenitis, Osteomyelitis, Bacterimia / Fungemia, and superficial skin infections (cellulitis and impetigo); Dx Test?; Tx?; Cure?
|
A749. Chronic Granulomatous Disease (Deficiency in a step of NADPH oxidase w/i cells; X-linked recessive); Dx Test: Nitroblue Tetrazolium dye reduction (NBT); Tx: Long-term TMP-SMX (or Dicloxacillin); Cure: Bone Marrow Transplant
|
|
Q750. What are the symptoms of Wiskott-Aldrich syndrome?; (5)*
|
A750. MENTAL RETARDATION. TExT:; Ig(M) deficient;; Recurrent respiratory infections;; Thrombocytopenia;; Eczema;; (x-linked recessive);; T and B-cell deficiency
|
|
Q751. Patient develops anaphylaxis after IgG exposure. What is the first possibility?
|
A751. IgA Deficiency; (MC primary immunodeficiency)
|
|
Q752. Dx:; recurrent respiratory, GU and GI infections; IgG subclass 2 and IgA are low; eveything else is normal
|
A752. IgA Deficiency
|
|
Q753. What is the deficiency in most cases of Severe Combined Immunodeficiency (SCID)?; The incidence of what cancer is greater in this patient?
|
A753. Adenosine Deaminase deficiency; cancer: Lymphoma
|
|
Q754. Dx:; a patient has a specific component of the complement system that is low and continues to get Neisseria infections.
|
A754. Complement deficiency in any complement from C5 - C9
|
|
Q755. What type of juvenile RA occurs in a few large joints (like knee, hip shoulder)?
|
A755. Pauciarticular JRA
|
|
Q756. What is positive and what sex is predominant in JRA pauciarticular arthritis type 1 versus type 2?
|
A756. Type 1: ANA+, Females; Type 2: HLA B27+, Males
|
|
Q757. What does a baby have a risk of contracting when born to a mother with SLE?
|
A757. Congenital Heart block
|
|
Q758. Immunizations:; 1. less then 1 month; 2. at 2 months; 3. at 4 months; 4. at 6 months
|
A758. 1. less then 1 month: (B) Hep-B; 2. at 2 months: (DHIP) DTP, HiB, IPV, Pneumo; 3. at 4 months: (BDHIP) Hep-B, DTP, HiB, IPV, Pneumo; 4. at 6 months: (DHP) DTP, HiB, Pneumo
|
|
Q759. Immunizations:; 1. at 15 months; 2. at 18 months; 3. at 4 - 6 years
|
A759. 1. at 15 months: (HeMP) HiB, MMR, Pneumo; 2. at 18 months: (BDIAV) Hep-B, DTP, IPV, Hep-A, Varicella; 3. at 4 - 6 years: (DIM) DTP, IPV, MMR
|
|
Q760. Another name for Kawasaki disease?
|
A760. Mucocutaneous LN syndrome
|
|
Q761. Dx:; Child presents with Fever (for at least 5 days) + 4 of 5 of following: Bilateral, non-purulent Conjunctivitis, Mucous membrane changes, hot red Tongue or red, cracked lips, Peripheral extremity changes, Edema or peeling of the skin on fingers, Rash (leather-like) and cervical lymph nodes; Dx test?; Tx? (2 together)
|
A761. Kawasaki Disease (Mucocutaneous LN syndrome); Dx test: Echocardiogram (rule-out possible Coronary Vasculitis or Anneurysm); Tx:; 1. Aspirin (not high dose); 2. IV-IgG therapy
|
|
Q762. Dx:; Child had a viral or Group A Strep infection, then later gets a rash from the Waist downward, Elbows downward and Face, in addition to Sx of Vomiting, Abdominal pain, Ileus, and possible Upper and Lower GI bleeding; Immuno problem?; Tx? (2 together)
|
A762. Henoch-Schoenlein purpura; Immuno problem: IgA-mediated Vasculitis; Tx:; (1) Supportive (recovery in 4 – 6 weeks); (2) Corticosteroids for GI Sx
|
|
Q763. MCC of iron deficiency in newborn?; in child 9 - 24 months?
|
A763. newborn: Low Birth Weight; 9 - 24 months: Diet
|
|
Q764. What can drinking cows milk before 1 year-old cause in an baby?
|
A764. Iron Deficiency Anemia from gastric bleeding
|
|
Q765. Dx;; Young child with pallor, scleral icterus and mild splenomegaly. CBC shows reticulocytosis, anemia with an Increased Mean Corpuscular Hemoglobin (MCH) concentration and indirect hyperbilirubinemia; Genetics?; What can Dx lead to?; Next Dx Test?; Tx? (2)
|
A765. Hereditary Spherocytosis; genetics: Autosomal Dominant; leads to: Aplastic Anemia (especially after parvovirus B-19); next Dx Test: OSMOTIC FRAGILITY TEST; Tx:; 1. Folic acid supplementation; 2. Splenectomy (in patient > 6yo)
|
|
Q766. What is the first test if you suspect you have a Sickle cell patient?; How is Sickle cell Diagnosis confirmed?; Ongoing Tx? (3)
|
A766. First test: CBC w/ peripheral smear; Dx test: Hemoglobin Electrophoresis; Tx:; 1. Prophylactic Penicillin; 2. Folate supplementation; 3. Hydration
|
|
Q767. Dx:; a patient w/ sickle cell begins to have pain in various areas of the body. Tx? (3 together)
|
A767. Sickle cell crisis; Tx:; 1. Oxygen; 2. IV fluids; 3. Analgesics (Narcotics)
|
|
Q768. Dx:; A 2 month-old develops Dactylitis (hand and foot swelling), vaso-occlusion causing Splenic and bone infarcts, multiple Infections
|
A768. Sickle cell anemia
|
|
Q769. Dx:; A child has Sx of Petechiae (that do not blanch), but patient appears well and possible bleeding of mucous membranes; very low platelet count; Bone marrow is normal (or an increase in Megakaryocytes); Tx? (3 together)
|
A769. Idiopathic Thrombocytopenia (ITP); Tx:; (1) IV-IG; (2) Steroids (must do bone marrow first); (3) Anti-D globulin
|
|
Q770. What (2) coagulopathies present with:; Normal PT,; Normal PTT,; High Bleeding time; What else in blood work differentiates the two?
|
A770. ITP and TTP; Both have low platelets, but TTP also has LOW RBC
|
|
Q771. What (2) coagulopathies present with:; Normal PT,; High PTT,; Normal Bleeding time; What medication also presents this way?; What else in blood work differentiates it?
|
A771. Coags:; Hemophilia A and Hemophilia B (X-linked recessive); Med: Heparin; Difference: Thrombocytopenia
|
|
Q772. What coagulopathy presents with:; High PT,; High PTT,; High Bleeding Time
|
A772. DIC; (will also see low platelet count)
|
|
Q773. What coagulopathy presents with:; Normal PT,; High PTT,; High Bleeding time
|
A773. vonWillebrand's Disease; (Autosomal dominant)
|
|
Q774. What coagulopathy presents with:; High PT,; Normal PTT,; Normal Bleeding Time
|
A774. Warfarin toxicity
|
|
Q775. Dx:; a boy presents with a high PTT and Hemarthrosis; Tx?
|
A775. Hemophilia A; Tx: replace Factor VIII
|
|
Q776. Dx:; A 3 – 5 yo child w/ an acute onset of Anorexia, pallor, fever, bone pain in 1/4 of patients, Pancytopenia. Dx Test?; Tx? (3); MC places for Relapse? (2)
|
A776. Acute Lymphocytic Leukemia (MC childhood cancer); Dx test: Bone Marrow biopsy; Tx:; 1. Chemotherapy,; 2. Radiation,; 3. Transplant; Relapse:; 1. TESTES; 2. CNS
|
|
Q777. What Non-Hodgekin's Lymphoma presents as an abdominal mass and is associated with EBV?; what is seen on LN bx?; Chromosomal anomaly and gene?
|
A777. Burkitt Lymphoma; LN Bx: "Starry sky" pattern; Chromosomes: t(8;14); Gene: c-myc
|
|
Q778. Dx:; Persistant cervical lymphadenopathy, night sweats, otherwise normal adolescent; Dx test?
|
A778. Hodgkin Lymphoma; Dx test: LN biopsy (Reed-Sternberg cells)
|
|
Q779. How is a Neuroblastoma and Wilms Tumor distinguished by CT scan?
|
A779. Neuroblastoma:; 1. on Adrenal gland; 2. Calcifications seen; Wilm's Tumor:; 1. in Kidney; 2. no calcifications
|
|
Q780. Dx:; child with morning Headache, vomiting (causing HA to go away); Ataxia, nystagmus, head-tilt, intention tremor; Specific site?
|
A780. Cerebellar Astrocytoma (MC childhood brain tumor); site: Infratentorial (posterior fossa)
|
|
Q781. Dx:; Child with short stature, Bitemporal hemianopsia and endocrine abnormalities; Dx test?; What can occur post-op?
|
A781. Craniopharyngioma(Supratentorial); Dx test: X-ray of skull: Large Cella Tursica; Post-op: Diabetes Insipidus
|
|
Q782. Dx:; A 3 - 5yo child presents with obstructive hydrocephalus, ataxia and CSF metastasis; Specific site?
|
A782. Medulloblastoma; site: Infratentorial
|
|
Q783. Dx:; Child stares into space in middle of sentence, then 20 seconds later he resumes his sentence; Dx test results?; Tx?
|
A783. Absence seizure; Dx test: EEG showing 3-Hz Spike and Wave pattern; Tx: Ethosuximide
|
|
Q784. MC type of seizure in pediatrics; Tx?
|
A784. Febrile Seizure; Tx: Acetaminophen (for fever) (check for underlying cause of seizure)
|
|
Q785. Dx test for Neonatal seizures; Tx?
|
A785. test: Continuous Bedside EEG; Tx: Phenobarbital
|
|
Q786. Dx:; A child of 2 – 7 months; presents with Recurrent mixed Flexor-Extensor spasms lasting only a few seconds, but repeat more then 100 times in a row; Looks like multiple Startle or Moro response; Dx Test & Result?; Tx? (2 together)
|
A786. Infantile spasms ("West syndrome"); Dx Test: EEG: HYPSARRTHYMIA; Tx:; 1. ACTH; 2. prednisone
|
|
Q787. Difference in presentation with Niemann-Pick Disease and Tay-Sachs Disease?
|
A787. Both have Cherry-red spot on Macula; NP: Hepatosplenomegaly; TS: No hepatosplenomegaly
|
|
Q788. Dx:; child who constantly clears his throat
|
A788. Tourette's syndrome
|
|
Q789. Dx:; MENTAL RETARDATION, spasticity, aggressive behavior, self-mutilation, Gout arthritis
|
A789. Lesch-Nyhan
|
|
Q790. What are the (2) disorders where infants have Hypotonia or Flaccidity?
|
A790. 1. Werding-Hoffmann Disease; 2. Infant Botulism
|
|
Q791. Dx:; Infant with spinal muscular atrophy, Fasciculations, frog-leg posture; Dx Test/results? (3); Tx?
|
A791. Werdnig-Hoffman Disease ("Floppy-Baby" syndrome); Dx Test:; 1. EMG: Fibrillations; 2. Muscle bx: denervation; 3. Nerve bx: slowed conduction; Tx: Supportive
|
|
Q792. Dx:; A child presents following a viral illness with Ascending weakness, Paralysis, Loss DTR, may progress to affect Diaphragm (breathing); Tx? (3 possible)
|
A792. Guillain-Barré; Tx:; (1) Supportive (intubation may be needed); (2) Plasmapheresis; (3) IVIG
|
|
Q793. Dx:; A boy 3 - 7 yo with Muscle and Hip girdle weakness and pseudohypertrophy of the calves; Genetics?; Dx Test?; Confirmatory test?
|
A793. Duchenne muscular dystrophy (MC inherited neuromuscular disease); genetics: X-linked recessive (only boys get it); Dx test: Blood shows greatly elevated Creatine Kinase; Confirmatory test: Muscle Bx
|
|
Q794. Name the sign:; a patient w/ DMD is walking their hands up their legs to sit/stand properly
|
A794. Gower’s sign
|
|
Q795. Dx:; Café-au-lait spots, axillary/inguinal freckling, Learning disorders, Renovascular HTN, Scoliosis, Lisch nodules (seen on slit lamp); Genetics?; what chromosome has the problem?
|
A795. Neurofibromatosis (von Recklinghausen); genetics: Autosomal Dominant, chromosome: 17; (Type 2 - Bilateral Acoustic neuromas is chrom: 22)
|
|
Q796. Dx:; A child presents with pale hypopigmented areas, facial sebaceous adenomas, areas of abnormal skin thickening, MENTAL RETARDATION and Seizures are common; Genetics?; Dx Test/results?
|
A796. Tuberous Sclerosis; genetics: Autosomal Dominant; (Ash leaf spot – pale hypopigmented area); (Shagreen patch – areas of abnormal skin thickening); Dx Test: CT scan of Head: periventricular calcified tubers
|
|
Q797. Dx:; Facial nevus (port wine stain) with trigeminal distribution, MENTAL RETARDATION, seizures difficult to control, visual impairment; Dx Test/results?
|
A797. Sturge-Weber Disease; Dx Test: CT Scan of Head: intracranial calcifications
|
|
Q798. First sign of Puberty in:; 1. Females; 2. Males
|
A798. Females: Breast buds; Males: Testicular enlargement
|
|
Q799. What is the cause of Hypoglycemia in a newborn from a mother with DM?
|
A799. Fetal Hyperinsulinemia
|
|
Q800. What is the highest risk for a child to be born with developmental displasia of the hip?; What is the confirmatory test for DDH?
|
A800. Female Breech birth; test: Ultrasound of hip
|
|
Q801. Why does a mother with type O blood cause hemolysis in newborn if the child has type A or B?
|
A801. Type O people have Antibodies to blood types A and B
|
|
Q802. When should a child have their electrolytes checked if you suspect dehydration?
|
A802. Moderate or Severe dehydration; (not Mild dehydration)
|
|
Q803. Tx for Mild, Moderate and Severe Dehydration in children?
|
A803. Mild: Oral rehydration; Moderate/Severe: IV rehydration
|
|
Q804. What is considered Moderate dehydration percentage-wise?; Severe?
|
A804. moderate: 5-10% dehydrated; severe: > 10% dehydrated
|
|
Q805. Dx:; Baby is tired when feeding, diaphoretic and breathing strangely
|
A805. CHF in newborn; (tired when feeding is #1 sign)
|
|
Q806. what are the (2) criteria for a Dx of failure to Thrive in a newborn?
|
A806. 1. failure to regain birth weight by 3 weeks of age; 2. continuous weight loss after 10 days of life
|
|
Q807. when a child has a decrease in respirations, what does it suggest?; increase in respirations?
|
A807. Dec: CNS depression; Inc: Infection
|
|
Q808. What are the (5) Tanner stages for Pubic hair?
|
A808. 1. None; 2. Scant, Fine hair; 3. Curly, extending laterally; 4. Adult-like hair, NOT on medial thigh; 5. Adult hair on medial thigh
|
|
Q809. At what age are solids introduced in an infant?; what is the average weight gain for a term infant per day?; when should they be 2x the original weight?; 3x?
|
A809. Solid foods: 4 - 6 months; Ave weight gain: 20-30g/day; 2x: 4 - 5 months; 3x: 12 months
|
|
Q810. What is the only vaccination that can cause a fever 7 days after it is given?
|
A810. MMR
|
|
Q811. when should a child's car seat start facing front?
|
A811. > 1 yo + > 10 kg
|
|
Q812. What are (4) developmental milestones at 6 months old?
|
A812. "Six Babbling Strangers Switch Sitting at 6 months":; 1. Babbles; 2. Stranger recognition; 3. Switches hands (transfers objects); 4. Sitting unsupported
|
|
Q813. What are (4) developmental milestones at 9 months old?
|
A813. "Pinches Ma-ma's furniture Bye-Bye to cruise"; 1. Pincher grasp; 2. says: Mama or Dada; 3. waves Bye-Bye; 4. Cruises around furniture
|
|
Q814. What is the MC malignant tumor in infancy?
|
A814. Neuroblastoma
|
|
Q815. A child with sickle cell presents to your office with a fever. Next step?
|
A815. Immediately admit to hospital
|
|
Q816. A child with sickle cell presents with a stroke. Tx?
|
A816. Exchange Transfusion
|
|
Q817. What is the first sign of Nephrotic syndrome in a child?
|
A817. Pitting Edema of the extremities
|
|
Q818. Dx:; A child is involved in a MVA and presents with a HR that goes from 110 to 56 and BP that is 156/96, with irregular respirations.
|
A818. Increased ICP
|
|
Q819. Dx:; A child presents with a rash that began on his neck and then spread to his trunk. On exam, you notice both new and old vesicles in the same area
|
A819. Varicella (Chicken pox)
|
|
Q820. What is the difference b/t HUS and TTP?; (2)
|
A820. No Fever and Neurological signs in HUS; HUS = "RAT" (Renal failure, Anemia, Thrombocytopenia); TTP = "FAT RN" (Fever, Anemia, Thrombocytopenia, Renal problems, Neuro problems)
|
|
Q821. What GI complaint can HENOCH-SCHONLEIN PURPURA lead to causing sevre morbidity?
|
A821. Intussusception
|
|
Q822. What is the Tx for a sickle cell patient who presents with anemia and an enlarged spleen?
|
A822. Blood Transfusion
|
|
Q823. What (5)* medications can cause Thrombocytopenia?
|
A823. PT CCS:; 1. Phenytoin; 2. TMP-SMX; 3. Chloramphenicol; 4. Carbamazepine; 5. Sulfonamides
|
|
Q824. In assessing dehydration, what are the (7)* main findings to evaluate?; How many findings equal <5% dehydration?; More then 10% dehydration?
|
A824. having Dehydration is "BUM NEWS":; 1. BP and HR; 2. Urine output; 3. Mucous membranes and Tears; 4. Neurological status; 5. Eye and Fontanels; 6. Weight; 7. Skin turgor/color and Capillary refill; <5% = <3 findings; >10% = >6 findings
|
|
Q825. How many mL/kg water loss is considered Mild, Moderate and Severe?
|
A825. Mild = < 50mL/kg; Moderate = 50 - 99mL/kg; Severe = > 100mL/kg
|
|
Q826. in the steps of fluid management in children, when is the only time normal (0.9%) saline is given?; why is it given?; what is given the other times?
|
A826. 0.9% = Initial 20cc/kg Bolus (continue boluses until patient urinates, except for DKA...for them monitor vitals and neuro status); Given to Restore Intravascular Volume; 0.45% (1/2 normal) saline is used to correct dehydration and for maintenance fluids in a child
|
|
Q827. When is the earliest time to initiate testing for Type 2 DM in children?; How frequent do you test?; What is the best test?
|
A827. Age of Initiation: 10-yo or at onset of Puberty (whichever is first); Frequency: every 2 years; Test: Fasting Plasma Glucose
|
|
Q828. Pediatrics are usually started on 3 insulin injections per day. What is the dosing pattern?
|
A828. 1. 2/3 of total dose in morning (1/3 rapid or short-acting, 2/3 intermediate-acting); 2. 1/6 of total at dinner (as rapid or short-acting); 3. 1/6 of total before bed (as intermediate-acting)
|
|
Q829. A child has a seizure following the immunization. What is the cause?; What is done on the next immunization?
|
A829. Pertussis; Do NOT ever give that immunization again!
|
|
Q830. When a child is bit by a snake, how do you determine the venom dose?
|
A830. Based on the childs symptoms; (amount of envenomization)
|
|
Q831. Dx:; A 6-month-old infant presents to the emergency department with the new onset of weak cry, decreased activity, and poor feeding. The mother also states that the infant has been constipated for the past 2 days. On physical examination, the infant has a very weak cry, poor muscle tone, and absent deep tendon reflexes. Tx?
|
A831. Botulism; Tx: Supportive care (Airway PRN)
|
|
Q832. Dx:; A 16-year-old boy presents with a temperature of 38.4 C (101 F) and low back, wrist, and knee pain. He had a sore throat 1 month earlier. His arthritis is diffuse. Pea-sized swellings are noted over the skin on his knees. He has a serpiginous erythematous area on his anterior trunk. His blood and throat cultures are negative, and his CBC is unremarkable. His antistreptolysin-O (ASO) titer is high. Tx? (2 together)
|
A832. Rheumatic Fever; Tx:; 1. Penicillin; 2. Aspirin
|
|
Q833. On physical examination, the infant is afebrile with stable vital signs. She can lift her head to 90 degrees, her eyes follow past the midline, she laughs, regards her own hand and has slight awareness of her mother. How old is she?
|
A833. 4 months
|
|
Q834. Dx:; A 5-year-old girl presents with a 3-day history of fever, dyspnea, and intermittent joint pain. She has a history of sore throat about 1 month ago. On physical examination, her temperature is 39.6 C (103.2 F), blood pressure is 94/60 mm Hg, pulse is 114/min, and respirations are 22/min. Her knees and elbow joints are swollen and tender to palpation. There is a grade III/VI diastolic murmur best heard at the apex. Multiple fine, pink macules are noted on her trunk. These macules are blanching in the middle. Tx?
|
A834. Rheumatic Fever; Tx: Penicillin
|
|
Q835. A 4-week-old infant presents with tachycardia, tachypnea, and poor weight gain. His arterial blood gas shows a pH of 7.34, a PaCO2 of 41 mm Hg, and a PaO2 of 74 mm Hg. A chest radiograph shows cardiomegaly. Echocardiography reveals a structurally normal heart, left ventricular dilatation, a left ventricular ejection fraction of 20%, and mild mitral and tricuspid regurgitation. What IV med is the best first step in management?
|
A835. Furosemide; (patient has CHF)
|
|
Q836. Dx:; A term male infant is found to be cyanotic shortly after birth and requires endotracheal intubation. On physical examination, his blood pressure is 68/34 mm Hg (equal in all four extremities), pulse is 180/min, and respirations are 32/min. His precordium is dynamic, has a grade III systolic murmur, and a single S2. Chest radiography shows a normal heart size and increased pulmonary vascular markings. An arterial blood gas on an FiO2 of 100% shows pH 7.34; PaCO2, 47 mm Hg; PaO2, 46 mm Hg
|
A836. Total Anomalous Pulmonary Venous Return; (characterized by the pulmonary veins forming a confluence behind the left atrium, and draining into the right atrium. Complete mixing takes place in the right atrium, with a right- to-left shunt through the foramen ovale to the left side of the heart)
|
|
Q837. Dx:; A 1-month-old baby boy has bloody diarrhea. No infectious agent is identified, but the baby is found to be profoundly thrombocytopenic. The baby is also noted to have a skin rash, and a dermatologist diagnoses eczema. By three months of age, the baby begins to develop recurrent respiratory infections. If this child survives until adolescence, he is at particularly high risk of developing what?
|
A837. Wiskott-Aldrich syndrome; can lead to: Lymphoma
|
|
Q838. Dx:; A 9-month-old girl has had one serious infection after another since about 3 months of age, including thrush, pneumonias, and diarrhea. The baby is small for age. An older brother died at age 2 of pneumonia. Immunologic evaluation demonstrates lymphopenia and very low gamma globulin levels. Both T and B cell numbers are very low. Radiologic studies demonstrate "frayed" long bones, abnormally thick growth arrest lines, and dysplasia of the costochondral junctions
|
A838. Severe Combined Immunodeficiency (SCID); (an Adenosine deaminase deficiency)
|
|
Q839. Dx:; A 17-year-old girl presents to the office with a 5-day history of a malodorous vaginal discharge. She is sexually active and uses condoms for sexual intercourse. On examination, a thin, white discharge is seen. A "fishy" odor is produced when KOH is added to the discharge. The vaginal fluid has a pH of 5. What is the most likely finding on a microscopic examination of the vaginal fluid?
|
A839. Bacterial Vaginosis; micro: Clue Cells
|
|
Q840. A 7-yo patient presents with Lyme disease. Tx?
|
A840. oral Amoxicillin; (doxycycline is not given to kids under age 8)
|
|
Q841. In a patient diagnosed with vesicoureteral reflux, what is the first Dx step?; What is the Dx/confirmatory Test (2nd step)?
|
A841. first: Renal Ultrasound; Dx/confirm Test:; Voiding Cystourethrogram
|
|
Q842. Dx:; a 12-yo girl presents with a fever and skin rash of 2 days duration. She complained of a sore throat and mild neck pain several days ago. The PE shows lymphadenopathy of the posterior occipital, retroauricular and cervical LN, plus an erythematous macules on the soft palate and a rash on the face, chest and proximal extremities.
|
A842. Rubella
|
|
Q843. Tx for Candida-induced oral thrush?
|
A843. Nystatin therapy
|
|
Q844. A child presents with "cat-scratch Disease."; what is the bug?; what is the Dx/confirmatory test?
|
A844. Bartonella henselae; test: Serum antibody titers
|
|
Q845. what is the bone complication of NF-1?
|
A845. Thinning of the Long Bone Cortex
|
|
Q846. what is the difference in RDW levels b/t thalassemia and Iron-deficiency anemia?
|
A846. RDW:; normal in Thalassemia; High in Iron-deficiency anemia
|
|
Q847. A patient presents with painful ulcers on his penis. You think it is HSV. What is the Dx test?
|
A847. Tzanck preparation
|
|
Q848. what is the Dx test for RSV?
|
A848. Nasopharyngeal aspirate
|
|
Q849. Dx:; a 9-yo boy presents with increasing clumsiness, change in speech, wide-based unsteady gait, nystagmus and no DTRs. what heart problem can it lead to in the future?
|
A849. Friedrich Ataxia; leads to:; Hypertrophic Cardiomyopathy
|
|
Q850. Dx:; a 20-mo girl presents with loss of developmental milestones, repetitive movements and acquired microcephalopathy
|
A850. Rett syndrome
|
|
Q851. What is the confirmatory test for DMD?
|
A851. Muscle biopsy
|
|
Q852. What type of exercise induces "exercise-induced" asthma?
|
A852. High intensity, continuous, prolonged exercise; (ex: a 5-K run)
|
|
Q853. what deformities of the head are associated with congenital toxoplasmosis?; (2)
|
A853. 1. Microcephaly; 2. Hydrocephalus
|
|
Q854. What vitamin is most likely to cause a pseudotumor cerebri?
|
A854. Vitamin A
|
|
Q855. Dx:; a child with strep pharyngitis is given penicillin. The next day he develops a fine, papular rash over his body, which is accentuated in his axilla and groin.
|
A855. Scarlet Fever; (a rash from the penicillin would be urticarial in nature)
|
|
Q856. What are the (11)* criteria (of which 4 or more need to be present) to diagnose SLE?
|
A856. SOAP BRAIN MD:; 1. Serositis (pleuritis/pericarditis); 2. Oral ulcers; 3. Arthritis; 4. Photosensitivity; 5. Blood (any can be low); 6. Renal problems; 7. ANA+; 8. Immunological (ds-DNA+); 9. Nero Sx (psych, seizures); 10. Malar Rash; 11. Discoid Rash
|
|
Q857. what is seen in the serum of someone with a pneumonia caused by Mycoplasma?
|
A857. Cold Agglutinins
|
|
Q858. A 13-yo girl presents with lethargy, fever, severe HA and a stiff neck. On exam she has a unilateral fixed, dilated pupil and papilledema. What is the initial step in management?
|
A858. Intubation and Hyperventilation
|
|
Q859. what is antibiotic used for the initial therapy of acute sinusitis?
|
A859. Amoxicillin-clavulanic acid
|
|
Q860. In a child, if the monospot test comes back negative and you think the Dx is Mono, what is the next step?
|
A860. EBV titer; (heterophil test has a poor response in children)
|
|
Q861. How does a child with Breast milk Jaundice present?
|
A861. Prolonged unconjugated hyperbilirubinemia in first weeks/months of life
|
|
Q862. A 4-yo child presents with a platelet count of 30K and you diagnose her with ITP. what is the most appropriate Tx at this time?
|
A862. No specific therapy; (when platelets go below 20K start on oral prednisone; a splenectomy is done for those with no response to prenisone or those with recurrent ITP)
|
|
Q863. Dx:; A 12-yo athelete presents with chest pain and dyspnea on exertion that resolves with rest. First step in Tx?
|
A863. Asthma (exercise-induced); (<5% of kids have heart problems, aside from congenital anomalies); Tx: Trial of Albuterol inhaler
|
|
Q864. A 2-mo is admitted with constipation and an abdominal mass, fever, feeding poorly and vomiting for the past 2 days. A barium enema is ordered and shows Hirschprung's Disease. what is the most important next step?
|
A864. IV fluid hydration and IV antibiotics; (reestablish IV volume and prevent sepsis)
|
|
Q865. What (2) electrolyte disorders accompany Rhabdomyolysis?
|
A865. 1. Hyperphosphatemia (leading to...); 2. Hypocalcemia
|
|
Q866. What are the minor criteria of Rheumatic fever?; (5)
|
A866. FAILS:; 1. Fever; 2. Arthralgia; 3. Increased CRP or ESR; 4. Long PR interval; 5. Strep culture + or ASO+
|
|
Q867. what type of acid/base disorder do you see with a 2 day history of diarrhea?
|
A867. Hyperchloremic Normal Anion gap Acidosis; (loss of bicarb in the stool stimulates renal tubular reabsorption of chloride ions)
|
|
Q868. What (3) malignancies are associated with EBV?
|
A868. 1. Burkitt Lymphoma; 2. Hodgkin Disease; 3. Nasopharyngeal CA
|
|
Q869. What is the difference in AST/ALT initially between Hepatitis B and Hepatitis C?
|
A869. Hep B: AST/ALT in Thousands; Hep C: minimal or no elevation of AST/ALT
|
|
Q870. What electrolyte abnormality is commonly seen in a newborn macrosomic infant from a mother with diabetes?
|
A870. Hypocalcemia; (and hypomagnesemia)
|
|
Q871. A 3000g female is born at 38 weeks to a mother that is positive for GBS. What is the next step in managing the baby?
|
A871. CBC and blood culture; (in addition to 48 hours of observation in the hospital)
|
|
Q872. An infant is crawling around on the floor at home and suddenly become cyanotic. what is the first step?
|
A872. Back blows followed by chest thrusts; (never perform a blind finger sweep in a child, b/c it can push the aspirated object further)
|
|
Q873. why does a CF patient present with Metabolic Alkalosis?
|
A873. Potassium is lost in urine
|
|
Q874. MC presentation of Strep throat?; (4)*
|
A874. FEAT:; 1. Fever; 2. Exudate on Tonsils; 3. Anterior Cervical lymphadenopathy; 4. Throat pain
|
|
Q875. A full-term newborn is born vaginally after a pregnancy complicated by gestational diabetes that was poorly controlled. He is born with scleral icterus. Three hours after birth the baby is plethoric, irritable and cyanotic. Six hours after birth he has a seizure. What hematological abnormality is most likely seen on his CBC?
|
A875. Polycythemia; (a known complication in the infant of a diabetic mother)
|
|
Q876. Dx:; A previously healthy 3-mo term boy presents to ED with tachypnea, poor feeding and pallor for 24 hours. He is tachycardic with a HR of 240 with narrow QRS complexes. Vagal maneuvers are attempted and unsuccessful. What drug should be given?
|
A876. Supraventricular Tachycardia (SVT); drug: Adenosine (blocks AV conduction and SA-node pacemaker activity; DOC for SVT; if unavailable, can Cardiovert)
|
|
Q877. What is the most important risk factor for a PE in children?
|
A877. Central Venous catheter; (followed by immobility)
|
|
Q878. What hormone is responsible for growth plate fusion?
|
A878. Estradiol
|
|
Q879. Dx:; A patient presents with mild MENTAL RETARDATION, prominent lips and a long philtrum, a systolic ejection murmur and hypercalcemia.
|
A879. Williams syndrome
|
|
Q880. What are the erruption times of permanent teeth?; (8)*
|
A880. "Mama Is In Pain, Papa Can Make Medicine":; 1st Molar: 6 years; 1st Incisor: 7 years; 2nd Incisor: 8 years; 1st Premolar: 9 years; 2nd Premolar: 10 years; Canine: 11 years; 2nd Molar: 12 years; 3rd Molar: 18-25 years
|
|
Q881. What is the MCC of retinopathy in a premie?
|
A881. Too much Oxygen saturation; (should be <95%)
|
|
Q882. What occurs if you correct the following problems too fast?; 1. DI; 2. DKA; 3. SIADH
|
A882. 1. DI -> Seizures; 2. DKA -> Cerebral edema -> Herniation; 3. SIADH -> CPM
|
|
Q883. What additional (3) things are needed in formula for premature infants?
|
A883. 1. Extra Calories (22kcal/oz); 2. Extra Calcium; 3. Extra Phosphorus
|
|
Q884. What is a normal systolic BP in the following ages of children?; 1. Premie; 2. up to 1mo; 3. 1mo - 1yo; 4. > 1yo
|
A884. 1. Premie = meanBP > gestational age at birth; 2. up to 1mo = >60; 3. 1mo - 1yo = >70; 4. > 1yo = 70 + (2 x age)
|
|
Q885. Diarrhea that is caused by "chitlins" at a picnic
|
A885. Vibrio
|
|
Q886. Dx:; Patient presents with absent LN, tonsils, lymphopenia, no thymus, recurrent infections of oral candida, diarrhea, pulmonary infections and viral infections
|
A886. SCID; (Severe Combined Immunodeficiency Disease)
|
|
Q887. MC heart defect in congenital Rubella
|
A887. PDA
|
|
Q888. Dx:; An infant presents with noisy breathing and on laryngoscopy the epiglottis is seen "rolling from side-to-side"; Tx?
|
A888. Laryngomalacia; Tx: hold infant upright for 30 minutes after feeding; (most disappear by 2 yo)
|
|
Q889. What type of Pneumonia is seen in Hyper-IgM syndrome?
|
A889. PCP
|
|
Q890. what are the (4)* MC congenital problems in infant of a diabetic mother?
|
A890. "A Diabetic Causes Trouble":; 1. Ancephaly / NT defects; 2. Duodenal Atresia / small left colon; 3. Caudal Regression syndrome; 4. Transposition of the Great Vessels
|
|
Q891. Dx:; a child presents with a slowly developing back pain and neuro degeneration with a "step-off" palpated at lumbosacral area
|
A891. Spondylolisthesis
|
|
Q892. Dx:; an infant presents with Cyanosis, Left Axis Deviation and VSD; what does EKG show?
|
A892. Tricuspid Atresia; EKG: LVH (and hypoplastic RV)
|
|
Q893. Dx:; a cyanotic newborn with a CXR showing cardiomegaly, increased vascular markings and right aortic arch. what does the EKG show?
|
A893. Truncus Arteriosus; EKG: Biventricular Hypertrophy
|
|
Q894. what are the (4)* main features of Beckwith-Wiedmann syndrome?
|
A894. HOMO:; 1. Hypoglycemia & Hyperinsulinemia; 2. Omphalocele; 3. Macroglossia & Macrosomia; 4. Organomegaly
|
|
Q895. If a child presents with asthma and other allergic disorders (allergic rhinitis or eczema), what is the best long term medication?
|
A895. Mast Cell Stabilizers; (inhaled Cromolyn)
|
|
Q896. Dx;; A 12-mo with foul-smelling, non-bloody stool 7-8 times/day, irritable, pre-tibial edema, erythematous vesicles on extensor surfaces of elbows and knees and microcytic anemia
|
A896. Celiac Disease; (begins at age 12 - 15 mo)
|
|
Q897. MCC of Meningitis in following ages:; 1. Newborn; 2. 1-mo to 2-yo; 3. 2-yo to 18-yo; 4. > 18-yo
|
A897. 1. Newborn = GBS; 2. 1-mo to 2-yo = S. Pneumonia; 3. 2-yo to 18-yo = N. Meningitis; 4. > 18-yo = S. Pneumonia
|
|
Q898. Dx:; a few days after birth a mother realizes that her child cannot move his hand on the right side and also has right lid ptosis
|
A898. Klumpke Paralysis; (birth injury to CN-7,8 and T1)
|
|
Q899. What reflex is affected by a child born with E-D palsy?
|
A899. Moro relex is absent
|
|
Q900. What is the test of choice in evaluating a child for Hyperlipidemia?
|
A900. Screening Total Cholesterol level; (not Fasting Lipid Profile)
|
|
Q901. What are the nodular swellings of the irises in NF-1 patients?
|
A901. Hammartomas
|
|
Q902. When does Physiologic Jaundice begin?; Breast milk Jaundice?
|
A902. Physiologic Jaundice: starts 2nd or 3rd day of life; (resolves in several weeks); Breast milk Jaundice: starts after 1 week-old
|
|
Q903. If an infant presents with a fever and no other Sx, what is the best first test?
|
A903. Catheterized UA with culture
|
|
Q904. what is the first step in Tx for a patient with Allergic Rhinitis?
|
A904. Antihistamines; (do be fooled with "environmental change")
|
|
Q905. what one sign is most suggestive of Primary TB?
|
A905. Hilar lymphadenopathy
|
|
Q906. Dx:; a 15-yo boy presents with pain in the right knee, History of easy bruising and chronic fatigue. PE shows mild HSM. X-ray of femur shows "Erlenmeyer Flask deformity." Labs show anemia and thrombocytopenia. Bone marrow shows "wrinkled paper" appearance. Deficient enzyme?
|
A906. Gaucher's Disease Type 1 (seen in adolescent ashkenazi jewish population); enzyme: Acid Beta-Glucosidase
|
|
Q907. A 2-yo boy undergoes end-to-end repair of an aortic coarctation. Seven years later he has HTN symptoms again. Tx?
|
A907. Angioplasty via balloon; (TOC for re-coarctation)
|
|
Q908. Dx:; Marfan features + Thromboembolic events; enzyme deficiency?
|
A908. Homocystinuria; enzyme: Cystathionine Synthase
|
|
Q909. Dx:; Onset of HA with focal neurological sx soon after acute otitis media?
|
A909. Brain Abscess
|
|
Q910. Dx:; A <1-mo child with bilious vomiting, abdominal distention and passage of bloody stools
|
A910. Midgut Volvuvus
|
|
Q911. MCC of Jaundice in premature infant?
|
A911. TPN-induced jaundice
|
|
Q912. Dx:; a child presents with a wide-based gait, decreased vibratory and position sense in lower extremities, absent ankle jerk bilaterally, atrophy of cervical spinal cord and T-wave inversions
|
A912. Friedreich Ataxia; (Trinucleotide repeats; Autosomal Recessive)
|
|
Q913. Dx:; severe dehydration in neonate with HypoN, HyperK and HypoG plus Metabolic Acidosis
|
A913. Congenital Adrenal Hyperplasia; (21-hydroxylase deficiency)
|
|
Q914. A premature infant on a vent has signs of pneumonia. MC bug?
|
A914. Oxacillin-Resistant Staph Aureus; (MRSA would also cause skin pustules of periumbilical and diaper areas)
|
|
Q915. What is the difference in presentation of ABO incompatability and Rh incompatability?
|
A915. ABO: Fetal anemia and Jaundice; Rh: Hydrops (anemia, edema, ascites, cariomegaly and hepatomegaly)
|
|
Q916. What is the difference in Tx wth Ewings Sarcoma and Osteosarcoma?
|
A916. Ewings: Surgery, Chemo, Radiation; Osteosarcoma: Surgery & Chemo only!
|
|
Q917. Aside from blood lead level, what else is increased in the blood with lead poisoning?
|
A917. Erythrocyte Protoporphyrin; (usually seen w/ > 55mg/dL of lead)
|
|
Q918. What is the best way to test for acid-fast bacilli of TB?
|
A918. Early-morning Gastric Aspiration
|
|
Q919. Dx:; A 6-yo female child with constant leaking of urine
|
A919. Low implantation of Ureter; (into vagina)
|
|
Q920. What is the age of precocious puberty in boy and girl?; What is the best Initial test for Evaluation of Precocious puberty?
|
A920. Boy: < 9-yo; Girl: < 8-yo; test: Radiograph of Hand and Wrist to determine Bone Age
|
|
Q921. Tx:; Hereditary Angioedema
|
A921. Danazol (and Epi if needed)
|
|
Q922. Dx:; Superoxide deficiency in Macrophages
|
A922. Chronic Granulomatous Disease
|
|
Q923. Dx test:; Chronic Granulomatous Disease
|
A923. Nitroblue Tetrazolium
|
|
Q924. Dx:; Defect in neutrophil chemotaxis
|
A924. Chediak-Higashi syndrome
|
|
Q925. Dx:; MENTAL RETARDATION with rocker-bottom feet and clenched fist
|
A925. Edward's syndrome; (Trisomy 18)
|
|
Q926. Dx:; MENTAL RETARDATION with midline defects, cleft lip/palate
|
A926. Patau syndrome; (Trisomy 13)
|
|
Q927. Dx:; Tall, infertile, gynecomastia, microtestes
|
A927. Klinefelter's syndrome; (XXY)
|
|
Q928. Age:; Social smile
|
A928. 1 - 2 months
|
|
Q929. Age:; Rolls onto Back
|
A929. 4 months
|
|
Q930. Age:; Rolls onto Stomach
|
A930. 5 months
|
|
Q931. Age:; Walks alone
|
A931. 15 months
|
|
Q932. Age:; Copies Circle
|
A932. 3 years
|
|
Q933. Age:; Copies Cross or Square
|
A933. 4 years
|
|
Q934. Tanner stage:; Penile "growth spurt"
|
A934. Tanner stage 3
|
|
Q935. Dx:; Vaccination that cannot be taken if allergic to eggs
|
A935. Influenza A
|
|
Q936. Dx:; Place of foreign body aspiration in a child that was standing
|
A936. Right Bronchi in Superior Segment of Lower Lobe
|
|
Q937. Dx:; Place of foreign body aspiration in a child that was supine or is an epileptic
|
A937. Right Bronchi in Posterior Segment of Lower Lobe
|
|
Q938. Dx:; possible Kidney problem in Turner's Disease
|
A938. Horseshoe kidney
|
|
Q939. Dx test:; Duodenal Atresia
|
A939. AXR; (Double bubble)
|
|
Q940. Dx test:; Rotavirus
|
A940. Immunoassay
|
|
Q941. Dx test:; steathorrhea plus protozoal cysts in stool
|
A941. Duodenal Aspirate
|
|
Q942. Bacterial Diarrhea:; Ulcerative colitis-like Sx plus Arthritis
|
A942. Campylobacter; (MCC of infectious diarrhea)
|
|
Q943. Bacterial Diarrhea:; Child with acute onset of RLQ pain (like appendicitis) plus diarrhea
|
A943. Yersinia
|
|
Q944. Bacterial Diarrhea:; Daycare outbreak plus child with diarrhea and new onset seizure
|
A944. Shigella
|
|
Q945. Dx test:; Tuberous Sclerosis
|
A945. CT scan of head; (Calcified periventricular tubers)
|
|
Q946. Tx:; West syndrome (Infantile spasms); (2)
|
A946. ACTH and Prednisone
|
|
Q947. Dx:; Anaphylaxis after blood trasnfusion
|
A947. IgA deficiency
|
|
Q948. Dx:; very low T- and B-cells (lymphopenia) with bacterial and fungal infections
|
A948. SCID
|
|
Q949. Prophylaxis needed for SCID
|
A949. PCP
|
|
Q950. Tx:; SCID
|
A950. Bone Marrow Transplant; (or stem cell transplant with IgG)
|
|
Q951. Dx:; baby less then 2-yo presents with tachypnea and wheezing
|
A951. Bronchiolitis (RSV)
|
|
Q952. Dx test:; Bronchiolitis (RSV)
|
A952. ELISA nasal washings
|
|
Q953. Bug:; Assoc with Guillain-Barre
|
A953. Campylobacter Jejuni
|
|
Q954. Dx:; Corneal clouding, cataracts, early renal failure
|
A954. Fabry's Disease
|
|
Q955. Dx:; Optic atrophy, spasticity, Globoid bodies in brain
|
A955. Krabbe's Disease
|
|
Q956. Dx:; Inspiratory stridor, barking cough
|
A956. Croup (Parainfluenza)
|
|
Q957. Tx:; Croup
|
A957. Steroids and humidified air
|
|
Q958. Dx:; Hearing loss, cataracts, microscopic hematuria
|
A958. Alport's syndrome
|
|
Q959. Dx:; salmon-colored rash with daily fever spikes, knee pain, leukocytosis, thrombocytosis, Inc ESR
|
A959. Still's Disease; (Systemic juvenile RA)
|
|
Q960. Dx:; Surfactant deficiency in preterm infant
|
A960. Respiratory Distress Syndrome; (RDS)
|
|
Q961. Dx:; Heart disorder assoc with DiGeorge syndrome
|
A961. Transposition of the Great Vessels
|
|
Q962. Dx:; short, Inc calcium, developmental delay, overly friendly, supravalvular aortic stenosis
|
A962. Williams syndrome
|
|
Q963. Dx:; Heart problem with Kartagener's syndrome
|
A963. Dextrocardia
|
|
Q964. Next step:; positive PPD
|
A964. Chest X-Ray; (before medicine)
|
|
Q965. First test:; Nasal polyps found in child
|
A965. Pilocarpine Sweat Test; (polyps in child = CF)
|
|
Q966. Dx:; Infant gets repeated pneumonias at beginning of life due to exhaustion of maternal IgG in system
|
A966. Transient Hypogammaglobinemia
|
|
Q967. Dx:; child with increased AA in urine, photosensitivity, ataxia and neuro problems
|
A967. Hartnup Disease
|
|
Q968. Dx:; 6-yo boy presents with dark pubic hair, enlarged penis/testis, growth spurt and acne
|
A968. Hypothalamic tumor; (without growth spurt may be 21-hydroxylase deficiency)
|
|
Q969. Dx:; Hereditary eye problem with progressive night blindness, field constriction and loss of acuity
|
A969. Retinitis Pigmentosa
|
|
Q970. First step:; Emergency airway in ER on patient < 12-yo
|
A970. Needle Cricothyroidotomy
|
|
Q971. Dx:; "sea-blue" histiocytes
|
A971. Niemann-Pick
|
|
Q972. Dx:; Acanthocytes (spiny RBC)
|
A972. Abetalipoproteinemia
|
|
Q973. Child Brain Tumor:; Originates from cerebellar vermis and grows to the fourth ventricle
|
A973. Medulloblastoma
|
|
Q974. Child Brain Tumor:; Cyst and mural nodule assoc with vonHipple-Lindau
|
A974. Hemangioblastoma
|
|
Q975. Child Brain Tumor:; Cyst with a mural nodule in the cerebellum
|
A975. PiloCYSTIC Astrocytoma; (similar to Hemangioblastoma)
|
|
Q976. Dx:; Delayed passage of meconium, chronic constipation, FAILURE TO THRIVE, air in bowel
|
A976. Hirschprung's Disease
|
|
Q977. Dx:; High fever for 3 days, then macular rash
|
A977. Roseola
|
|
Q978. Virus assoc with Roseola
|
A978. HSV-6
|
|
Q979. another name for Measles
|
A979. Rubeola; (not Roseola)
|
|
Q980. First test:; Infant with seizures
|
A980. Serum chemistries
|
|
Q981. Dx:; BRBPR in infant 1 week to 3 months old
|
A981. Food Allergy-induced Colitis
|
|
Q982. Dx:; slight fever, sore throat, suboccipital and posterior auricular LN enlargement, rash starts on face and moves down body
|
A982. Rubella
|
|
Q983. MC genetic defect in CF
|
A983. CFTR-508 Deletion on chromosome 7
|
|
Q984. Dx:; Sickle cell patient with acute severe anemia without reticulocytes, but with normal platelets and WBC
|
A984. Aplastic Anemia
|
|
Q985. First step:; child is cyanotic from congenital diaphragmatic hernia
|
A985. Orogastric Tube placement; (with continuous suction to prevent bowel from decompressing lung)
|
|
Q986. Dx:; 2-week-old infant presents with jaundice. He is exclusively breastfed, his stool has a lighter color, has hepatomegaly and direct bilirubin of 4
|
A986. Biliary Atresia; (light stool, hepatomegaly and inc direct bilirubin)
|
|
Q987. An increase in what lab in a 2-week-old infant would lead to breastfed jaundice conclusion?
|
A987. Increased Indirect Bilirubin; (as high as 10 - 30mg/dL)
|
|
Q988. Next step:; after confirming Dx of Septic Arthritis
|
A988. Emergent Surgical Drainage
|
|
Q989. Dx:; Jaundice within 24 hours of life and an increased direct and indirect bilirubin, anemia, pallor, HSM and reticulocytosis
|
A989. Erythroblastosis Fetalis
|
|
Q990. Dx:; Jaundice appearing after the 5 days of life, but within the first week
|
A990. Neonatal Sepsis; (causing Jaundice)
|
|
Q991. Dx:; Child of 13-yo with femoral head off the metaphysis, with new bone formation
|
A991. Slipped Capital Femoral Epiphysis
|
|
Q992. First step:; Slipped Capital Femoral Epiphysis
|
A992. Emergency Surgery
|
|
Q993. Tx:; Kawasaki Disease
|
A993. IV immunoglobulins and Aspirin
|
|
Q994. Dx:; IgG, IgM and IgA are all very low, very low B-cells, bacterial infections in the first 5 years of life
|
A994. X-linked Agammaglobinemia
|
|
Q995. Dx:; low IgG, IgM and IgA levels, normal B-cells and T-cells; Sx begin at 15 - 35 years old.
|
A995. Common Variable Immunodeficiency; (CVID)
|
|
Q996. Dx:; infant with Meningitis from Gonorrhea (meningococcemia) begins to get large purpuric lesions on flank
|
A996. Waterhouse-Friderichsen syndrome; (acute adrenal failure/hemorrhage from meningococcemia)
|
|
Q997. COD:; Meningococcemia
|
A997. Adrenal Failure/Hemorrhage; (from advancing to Waterhouse-Friderichsen syndrome)
|
|
Q998. Tx:; Homocystinuria
|
A998. Vitamin B6
|
|
Q999. Dx:; Beta-Galactosidase deficiency
|
A999. KraBBe's Disease
|
|
Q1000. Dx:; Alpha-Galactosidase deficiency
|
A1000. fAbry's Disease; (fAAAAAbry's)
|
|
Q1001. Dx:; Hyperinsulinemia, omphalocele, macroglossia, organomegaly
|
A1001. Beckwith-Wiedemann syndrome; (HOMO)
|
|
Q1002. Dx:; short child with hypoglycemia, lactic acidosis, hyperuricemia and hyperlipidemia. Enlarged liver and kidneys and possible seizures
|
A1002. Von-Gierke's syndrome; (G6P deficiency)
|
|
Q1003. Dx:; G-6-P deficiency
|
A1003. Von-Gierke's syndrome
|
|
Q1004. Dx:; Floppy baby with macroglossia and heart failure
|
A1004. Pompe's syndrome; (Maltase deficiency)
|
|
Q1005. Dx:; Maltase deficiency
|
A1005. Pompe's syndrome
|
|
Q1006. Age:; walks alone, speaks 2 words, throws objects
|
A1006. 12 months old
|
|
Q1007. Age:; walks up and down stairs without help and has 2 - 3 word phrases
|
A1007. 24 months old
|
|
Q1008. First step:; Pyloric Stenosis
|
A1008. Rehydrate and correct Electrolytes
|
|
Q1009. When does stranger anxiety start and peak?
|
A1009. starts: 6 - 8 months; peaks: 12 - 15 months
|
|
Q1010. Dx:; IVP shows focal renal parenchymal scarring and blunting of calices
|
A1010. Chronic Pyelonephritis
|
|
Q1011. Dx:; Bilateral ptosis, difficulty getting up from chair and muscle weakness
|
A1011. Myasthenia Gravis
|
|
Q1012. Dx:; palpable purpura, glomerulonephritis, decreased complement, arthralgias, HSM, peripheral neuropathy and positive HCV
|
A1012. Mixed Essential Cryoglobinemia; (hCv = Cryoglobinemia)
|
|
Q1013. MC Sx of mixed Sickle cell trait
|
A1013. painless Hematuria
|
|
Q1014. When is the best time to give VZ-Ig to child who was playing with others that had chickenpox
|
A1014. within 3 - 5 days of exposure; (otherwise tell parents he will get Sx)
|
|
Q1015. Dx:; Non-immunized mother brings 2-week-old in b/c of spasms involving whole body and erythematous, tender umbilical cord and poor suckling
|
A1015. Tetanus
|
|
Q1016. Dx:; newborn lung problem due to right-to-left shunt from PDA or foramen ovale
|
A1016. Persistent Pulmonary HTN of Newborn
|
|
Q1017. Deficient enzyme:; FAILURE TO THRIVE, bilateral cataracts, jaundice and hypoglycemia at birth
|
A1017. Galactose-1-phosphate
|
|
Q1018. Tx:; prevents painful episodes of Sickle cell crisis
|
A1018. Hydroxyurea
|
|
Q1019. MC child brain tumor in cerebrum
|
A1019. Benign Astrocytoma
|
|
Q1020. Next step:; Foreign Body aspiration removal
|
A1020. RIGID bronchoscopy
|
|
Q1021. Define:; Meconium Ileus
|
A1021. Failure to pass meconium within the first 24 hours of birth
|
|
Q1022. MCC of high fever and chills or sepsis in Sickle cell patient
|
A1022. Strep Pneumococcus; (encapsulated organism that cannot be handled well due to asplenia)
|
|
Q1023. Dx:; Sickle cell patient with pain in the hip including restriction of abduction and internal rotation
|
A1023. Avascular necrosis; (common in sickle cell adolescent)
|
|
Q1024. Dx:; premature neonate with "increased gastric residues"
|
A1024. Necrotizing Entercolitis
|
|
Q1025. Dx:; child born normal and asymptomatic until teens, when he began to have delayed muscle relaxation, progressive muscle weakness, thinning cheeks and atrophy of thenar and hypothenar eminences
|
A1025. Myotonic Muscular Dystrophy
|