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45 Cards in this Set
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Question 1: A child with chronic constipation and soming who had delayed passage of meconium and has an empyyu rectum and a tight sphinctyer may have
A Hirschprung disease B Cystic fibrosis C Intestinal obstruction D Nasty hemorrhoids E Meconium ileus |
A Hirschprung disease***
B Cystic fibrosis C Intestinal obstruction D Nasty hemorrhoids E Meconium ileus |
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Question 2: Which options for eneuresis include the following?
A Conditioning therapy B Pharmacothereapy C Hypnotherapy D Eneruresis Alarm E All of the above (Tx of choice is D) |
A Conditioning therapy
B Pharmacothereapy C Hypnotherapy D Eneruresis Alarm E All of the above** (Tx of choice is D) |
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Question 3: Which Dx test are you going to do on recurring UTIs on children up to 6yo?
A Voiding cystourethrogram B Magnetic resonance imaging C CAT scan D X ray E Nuclear resonance |
A Voiding cystourethrogram**
B Magnetic resonance imaging C CAT scan D X ray E Nuclear resonance |
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Question 4: which threesome best characterizines the triad of helytic uremic syndrome?
A epistaxis, hematuria and heoptusios B Anuria, thrombocytopenia, bleeding diasthesis C microangiopathic hemolytic anemia, thrombocytopenia, and renal injury |
A epistaxis, hematuria and heoptusios
B Anuria, thrombocytopenia, bleeding diasthesis C microangiopathic hemolytic anemia, thrombocytopenia, and renal injury |
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Question 5: In a male, physical signs of GONADARCHE includee all of the following except?
A pubic hair B axillary hair C increased muscularity D Deeper voice E Decreased testicular volume |
A pubic hair
B axillary hair C increased muscularity D Deeper voice E Decreased testicular volume*** |
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Question 6: Kallmann sundrome combines isolated gonadotropin deficiency with what?
A Sensation B Olfaction C Hearing D Speech E Muscle tone |
A Sensation
B Olfaction *** C Hearing D Speech E Muscle tone |
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Quuestion 7: The normal developmental sequencei nh irls is
A menarche pubarche thelarche B pubarche thelarche menarche C enarche thelarche pubarche D thelarche menarche pubarche E thelarche pubarche menarche |
A menarche pubarche thelarche
B pubarche thelarche menarche C enarche thelarche pubarche D thelarche menarche pubarche E thelarche pubarche menarche* |
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Which of the choices is the most common form of tracheoesophageal fistula?
*A - esophageal atresia with distal TEF B - esophageal atresia with no TEF C - H-type TEF D - esophageal atresia with procimal TEF E - esophageal atresia with procimal and distal TEF |
*A - esophageal atresia with distal TEF
B - esophageal atresia with no TEF C - H-type TEF D - esophageal atresia with procimal TEF E - esophageal atresia with procimal and distal TEF |
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For suspected pyloric stenosis, ultrasound is the preferred stdy. If a barium upper GI is done what finding would lead one to diagnose puloric stenosis?
A - Hey hole sign *B - string sign C - telescoping sign D - steeple sign E - kerley B sign |
A - Hey hole sign
*B - string sign C - telescoping sign D - steeple sign E - kerley B sign |
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Whitis the classic laboratory finding in pyloric stenosis?
A - hyperchloremic respiratory acidosis B - hyperchloremic metbaolic alkalosis *C - hypochloremic metabolic alkalosis D - hypochloremic respiratory alkalosis E - hyperchloremic metabolic acidosis |
A - hyperchloremic respiratory acidosis
B - hyperchloremic metbaolic alkalosis *C - hypochloremic metabolic alkalosis D - hypochloremic respiratory alkalosis E - hyperchloremic metabolic acidosis |
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Which is not an association of VACTERL
A - vertebral anomalies B - anal atresia C - cardiac anomalies D - tracheaoesophageal fistula *E - retinoblastoma F - limb anomalies |
A - vertebral anomalies
B - anal atresia C - cardiac anomalies D - tracheaoesophageal fistula *E - retinoblastoma F - limb anomalies |
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A classic late finding in intussusception is
A classic late finding in intussusception is A - Severe persistent bradycardia B - profound marked hypertensions *C - currant helly stools D - peanut buttery stools E - raspberry marmalade stools |
A - Severe persistent bradycardia
B - profound marked hypertensions *C - currant helly stools D - peanut buttery stools E - raspberry marmalade stools |
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what is FUNCTIONAL constipation
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no underlying disorder (no GI, endo, neiro, etc that is causing it)
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whats enchopresis
what is soiling |
regular VOLUNTARY or INVOLUNTARY pooing somewhere other than the toilet after 4 yo
soiling: INVOLUNTARY always, assocaited with fecal impaction, fecal impaction can be palpated |
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when might you think a kid has hirshsprungs disease
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chronic constipation and soliling (soiling is INVOLENTARY and assocaited with fecal impaction)
**delayed passage of meconium, empty rectum and tight sphincter |
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whats the dif btwn 1 and 2 enuresis
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primary: incontinence in a child who was NEVER potty trained
secondary: incontinence in a kid who was previously dry for 6 months |
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what is the spontaneous remission rate of enureis
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15%
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what is common in the hx of a kid w/enuresis
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one of their parents was also a bed wetter
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what goes into teh PE of a kid with enuresis
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1. check social interactions with patents
2. development of kid 3. abd 3. neuro 4. genital exam 5. rectal only if constipated |
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what lab is good for kids with enuresis
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clean catch urine for UA
check for UTI DM renal disease |
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what are parts that go into enuresis tx
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1. conditioning- enuresis alarm is most common
2. drugs 3. hypnotherapy |
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what is retrograde flow of urine from bladder to the ureter or kidney called
what does reflux nephropathy refer to |
VUR- vesiculoureteral reflux
**development/progression of renal scarring , renal scars best picked up with nuclear renal scanning |
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what are 2 thigns that can cause VUR
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1. duplication of ureters
2. neurogenic bladder |
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what tests do kids <6 get who have a confirmed UTI
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1. VCUG- voiding cystourethrogram
2. radionuclide cystogram |
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how is VUR graded
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1-5
1 is best 5 is worst: |
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what is the best way to ID renal scars
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nuclear renal scanning
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what are some complications of reflux nephropathy
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HTN
chronic kidney disease |
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what is the HUS triad
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microangiopathic hemolytic anemia
renal injury thrombocytopenia **HUS is an important cause of renal failure in kids |
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your kid has low platets, renal injury and microangiopathic hemolytic anemia. what is this called, what can it lead to
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HUS
*8can lead to ARF seizures in like 20% 1. irritable, pallow, edema, petechia, HSM 2. dehydration or gluid overload 3. HTN bc of renin or volume |
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what does PE show for HUS
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1. irritable, pallow, edema, petechia, HSM
2. dehydration or gluid overload 3. HTN bc of renin or volume microangiopathic hemolytic anemia thrombocytopenia renal involvement seizures in like 20% |
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HUS appears after diarrhea bc its associated with E coli. what if you have sx of mucroangiopathic hemolytic anemia abd NO diarrhea prodrum?
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its TTP-
theu will have predominant CNS sx, also renal. recurrence is common |
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what does peripheral blood look like in HUS
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schistocytes
helmet burr cells tragmented erythrocytes (intravascular hemolysis) |
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whats adregenarche
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its pubarche- adrenal maturation
Does NOT include breast and testicular development |
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what is NOT included in puberty adrenearche
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breast
testicle |
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whats gonadarche
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secretions of gonadal sex steroids when hypothalamic pit tract matures.
testes- testosterone. hair, deep voice, penile/test enlargement, masculinize face ovary- estrodiol, progesterone. breasts, uterus grows, menarche (menstruation) Growth spurt for all |
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what is the isolated gonadotropin disorder assocated with loss of smell
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kallman
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is anorexia strictly an eating thing
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no its like a psychotic disorder, their perception is all wrong
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what can increased physical activity lead to in adolescents
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amenorrhea
decreased gonadotropins |
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what does hypothyroidism have to do with puberty
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inhibits onset of puberty and delays menstruation. severe primary hypothyroid can lead to precocious puberty
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precouscious puberty can be initiated by what
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SEVERE primary hypothyroid
**but in just regular hypothyroid it can delay puberty- go figure |
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whats turners
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XO female
*gonadal agenesis, ovarian failure, short stature **features of a girl with turners need not be evident on PE or Hx. Dx MUST be considered in any short girl (WTF?) |
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what are the 2 parts for puberty to roll
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1. adrenache- adrenal maturation (no breast or teste)
2. Gonadarche- estrogen and testosterone to get the boobs nad balls |
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whats the normal sequence of puberty in girls
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thelarce (bc of gonadarche)
pubarche (adrenarch) menarche |
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whats central precousous puberty
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normal but early, its familial
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whats McCune Albright
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most common cause of GnRH INDEPENDENT precousious puberty
G>B cafe au lait spots |
