A & L Usmle Step 2 Review / Pediatrics

Front 1

hosehold and sex contacts of kids/teens with hep A should receive what?

Back 1

immunoglobulin to prevent hep A

Front 2

any superficial eye tear...NSiM?

Back 2

fluorescence to checkfor corneal abrasion and topical antibiotics

Front 3

intracranial trauma without obvious external findings in baby; think?

Back 3

shaken baby syndrome

Front 4

person who gets hives after bee sting. what NSiM?

Back 4

give Epi-pen at all times (bc had systemic rxn) as well as give prescription for diphenydramine

Front 5

hyponasal speech plus mouth breathing, think?

Back 5

NASAL POLYP

Front 6

urinalysis of > 1.015 makes what highly unlikely?

Back 6

dibetes insipidus

Front 7

primary vs secondary enuresis

Back 7

2ndary = bedwetting after 3 or more months of dry nights; is usually due to psych factors or changes

Front 8

therpay for child over 6 with enuresis?

Back 8

consider conditiouning therapy with bedwetting alarm (works in 30-60%)

Front 9

any uti in baby with vomiting and dehydration, think? caused by? tx with ? what folow up tests?

Back 9

pyelonephritis;
ecoli
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

Front 10

rash post GAS pharyngitis, think?

Back 10

Scarlet fever!!!

Front 11

boggy mass on scalp? tx?

Back 11

most likely kerion = inflammatory form of tinea capitis (.Trich. tonsurans or Microsporum canis).tx = 8-12 wks oral griseofulvin and shampooing with selenium sulfide

Front 12

oral, feet, and mouth ulcers, think?

Back 12

hand foot andmouth disease!! = coxsackie A16

Front 13

ehrlichosis contracted how?

Back 13

by tick bite

Front 14

adults with e. infectiousum may also have what sx?

Back 14

ARTHROPATHY

Front 15

parvo B19 ( slapped cheek/ E. infectiousum )in hemolytic anemias may cause?

Back 15

aplastic anemia

Front 16

high and persistent fever that is not very responsive to normal doses of paracetamol ; with red cracked lips and red mucous membranes?

Back 16

kawasaki's disease

Front 17

swelling of one eyelid + proptosis, limited ocular movements?

Back 17

orbital cellulitis; if just swelling of eyelid think periorbital cellulitis

Front 18

1 y/o black baby solely breastfed may develop?

Back 18

ricketts due to VitD def in br milk and poor skin conversion of vit D

Front 19

torsion of testicular appendix vs torsion of testicle?

Back 19

t: in kids over 12
ta: in kids 2-11

Front 20

acute pain in scrotum of sexually active teen, think?

Back 20

epididymitis

Front 21

m/c pathogens of otitis media?

Back 21

Spneum, h influ, m catarrhalis

Front 22

what constitutes increased risk for post-traumatic seizure? what % get? tx if these?

Back 22

depressed cranial fracture
intracranial hemorrhage
cerebral contusion
or
unconsc > 24 hrs.
75% of these will seizure
so must tx with anticonvulsants prophylactically

Front 23

main pathogen causing croup? epiglottitis?

Back 23

parainfluenza; s pneum, aureus or GBS -- H infl in non vaccinated

Front 24

cow milk feeding causes?

Back 24

iron def anemia!!!

Front 25

hirsutism, deepened voice, acne, clitoromegaly, think?

Back 25

CAH

Front 26

can you have allergic rhinitis that presents with rhinitis with NO seasonal variation?

Back 26

YES = perenial allergic rhinitis ie exposure to house dust, pet danders that are there year round

Front 27

bilateral PURULENT discharge with fever, cough, sinus tenderness?

Back 27

sinusitis

Front 28

3 common pathogens in human bites?

Back 28

eikenella corrodens
peptostreptococcus
alpha streptococcus

Front 29

during AB tx , diaper rash due to?

Back 29

candida dermatitis!!

Front 30

m/c cause of round pneumonia?

Back 30

strep pneumonia

Front 31

HUS is most common in what age?

Back 31

under 2 y/o's!

Front 32

live vaccines?

Back 32

MMR; varicella

Front 33

Guillan Barre has what CSF finding?

Back 33

increased protein; mild mononuclear pleocytosis (<10 cells/ml)

Front 34

when do you treat lead poisoning with chelation?

Back 34

only if levels over 45 ug/mL !!! otherwise just treat by removing source ie investigating house for lead content, etc

Front 35

name 4 advantages of OPV? 1 of IPV?

Back 35

OPV:
costs less
increased mucuosal immunity
fewer shots
herd immunity through 2ndary transmission
still recommended for global polio eradication
IPV: less paralytic polio

Front 36

m/c cause of htn in kids?

Back 36

2ndary (not essential) Renal causes!! ie infection, pckd, gnephritis, vascular anomalies, tumors

Front 37

2 tx's for Increased ICP

Back 37

intubation with hyperventilation
Mannitol to induce osmotic shift

Front 38

after what type of wounds/pts do you give Td, vs Td + Tet Immune Globulin, vs DTaP?

Back 38

DTaP: give only in kids under age 7
Td only: if pt has had < 3 immunizations or status unknown AND: minor wound w/o contamination
Td + TIG: if pt has had < 3 immunizations or status unknown AND:contaminated wounds

Front 39

only 2 exceptions to IC kids NOT receiving varicella vacc (b/c it is live)

Back 39

ALL kid in remission with lymphocyte **** over 700;
HIV infected kid in CDC class I =CD4 lcytes>25%.
All other immunodef's, dont give!!

Front 40

live viruses not to be given to ?

Back 40

IC pts (see exceptions above) or pregnant women

Front 41

m/c organism causing ANY otitis externa?

Back 41

p.aeruginosa

Front 42

causes of intoeing?

Back 42

adducted great toe, metatarsus adductus, medial tibila torson, femoral anteversion

Front 43

m/c back deformity in kids?

Back 43

idiopathic scoliosis

Front 44

tx of b pertussis?

Back 44

e-mycin

Front 45

hacking cough + absolute lymphocytosis, + thick, clear n/p mucus?

Back 45

think b pertussis

Front 46

TCA poisoning?

Back 46

anticholinergic sx, mental status changes, arrhythmias

Front 47

otherwise normal 7 y/o with hypospadias. What next step in tx?

Back 47

renal US to check for enlarged prostatic utricle which predisposes to UTI's

Front 48

snuffles =?
acral rash?

Back 48

mucocutaneous lesions producing persistent, purulent, often bloody nasal discharge!!
acral = on extremities ie hands and feet = syphilis

Front 49

febrile seizures do/dont increase risk for epilepsy?

Back 49

DO ! but by only 7%

Front 50

painful swollen fingeres and toes for 2 days?

Back 50

think sickle cell hand-foot syndrome

Front 51

most common manifestation of sickle cell disease?

Back 51

acute PAINFUL episodes ie in legs, arms, in younger kids; head, chest, back, abd in older kids

Front 52

shortness from GH deficiency usually shows by how many yrs?

Back 52

3 yrs old!

Front 53

chest pain in young 12 y/o girl athlete during exercise?

Back 53

asthma!!!! give ihnaled albuterol!!

Front 54

5 days of high fever
bilateral bulbar nonexuadative conjunctivitis, rash, hand and foot edema-->desquamation, strawberry tongue and mouth erythema, cervical lad?

Back 54

kawasaki's!!

Front 55

m/c cyanotic heart disease in newborn?

Back 55

Transposition!!

Front 56

presentation of transposition?

Back 56

blue baby with low sat, no change with 02 given, otherwise looks in no distress; egg on string (narrow mediastinum) cxray...

Front 57

a typical, physiological "flow"murmur?

Back 57

Still's murmur - heard at left lower sternal border

Front 58

systolic murmur heard in ASD is really what?

Back 58

increased flow across pulmonic valve and tricusp regurg

Front 59

systole ejection murmur heard best at upper sternal bordere but radiating to axilla and back? vs carotids?

Back 59

axilla and back = perpheral pulmonic stenosis (due to flow past sharp angle of pa and its branches = resolves in 6 mo
carotids = ao stenosis/bicuspd ao

Front 60

m/c congenital heart lesions?

Back 60

VSD's!!

Front 61

what's a positive PPD?

Back 61

5mm if CLOSE CONTACTS w/known or suspected cases
10mm if greater risk for disseminated disease ie <4y/o's, DM, CKD, malnut, lymphoma, or at greater risk of exposure to tb ie born in, paretns born in high prev regions, travel to these regions, exposure to adults at high risk, (ie hiv infectedd, homeless, drugabusers)
15mm in normal, age over 4 w/o any risk factors