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93 Cards in this Set

  • Front
  • Back
Glaucoma treatment
Acute:
Acetazolamide
Mannitol
Pilocarpine
Beta blockers

Long-term:
Iridotimy
Viral conjunctivitis
Viral:
Bilateral
Itchy
Lymphadenopathy

Bacterial:
Unilateral
Purulent discharge
Which nerve roots are affected in Erb-duchenne and klumpke's palsy? what is the clinical presentation
Erb-duchenne: C5-c6
Waiter's tip

Klumpke's: C7-C8 +/- T1
Claw hand
+/- Horner's syndrome
How can you differentiate mongolian spots from child abuse?
Mongolian spots are sharply demarcated
Migratory erythematous rash with papules, appears 24 hrs after birth, with eosinophils on scraping
Erythema toxicum
Cataracts in infancy
Galactosemia
Congenital rubella
Branchial cleft cyst vs. thyroglossal duct cyst
Branchial cleft: Lateral to midline

Thyroglossal duct cyst: In midline
Fair skin, fair haired infant with musky smell and mental retardation
PKU
Baby with cataracts, mental retardation, and e. coli sepsis
Galactosemia
Best initial test for respiratory distress syndrome in newborn
Initial: Chest Xray (ground glass opacity; air bronchograms)
Baby with bilious vomiting from the first feeds
Duodenal atresia
Pre-term baby with bloody stools and pneumatosis intestinale
Necrotizing enterocolitis
Physiologic jaundice
Not present in first 24 hours of life
Peaks by days 3-5, resolves by 2 weeks
Indirect hyperbilirubinemia
Most common organisms causing sepsis in newborn (4)
GBS
E. coli
Listeria
Treatment for neonatal sepsis
Ampicillin and gentamicin
MRI in CMV vs. toxoplasmosis
CMV - Periventricular calcifications
Toxoplasmosis - Scattered
Signs of thiamine (B1) deficiency
Beriberi:
Neuritis
Heart failure
Encephalopathy
When do hands go to midline, head lag disappears, roll over onto back?
4 months old
When do babies have social smiles and coo?
2 months old
Rolls over both ways, turns body to reach things, tripod sitting?
6 months old
Baby sits unsupported, has pincer grasp, plays peekaboo
9 months
Cruising and walks when you hold their hand, at least 1 word
12 mos
3 cube tower
4 cube tower
7 cube tower
3 tower cube - 15 months
4 tower cube - 18 months
7 cube tower - 24 months
Walk on their own
15 months
Runs, 10 words, say no
18 months
Can handle spoon, helps undress, *2 words
24 months
Knows age and gender
3 yrs old
Counts 4 objects, copies square, group play, toilet trained
4 yrs
Skipping
60 mos
Live attenuated vaccines (3)
MMR
Varicella
Nasal influenza
Baby boy with pyogenic infections, small lymph nodes, low levels of all Ig types

Diagnosis and treatment?
Bruton's agammaglobulinemia

Treatment: IVIg
Recurrent infection in boy or girl, normal lymphoid tissue, normal B-cell numbers but don't make Ig
CVID
Recurrent sinopulmonary infections (strep and Hib) and episodes of diarrhea (giardia)
Selective IgA deficiency
Baby with hypocalcemic seizure, abnormal facial features, truncus arteriosus, thymic and parathyroid hypoplasia
DiGeorge
Boy with petichiae, eczema, recurrent infections, normal lymph nodes, low IgM
Wiskott-Aldrich
Which 3 organisms cause periorbital cellulitis
Strep pneumonia
Staph aureus
Hib
Murmur of ASD
Wide, fixed split of S2
Systolic ejection murmur
Tetralogy of fallot
Pulmonary stenosis
VSD
Overriding aorta
RVH
Systolic ejection murmur at left sternal border, single S2
Tetralogy of fallot
Machine like murur with wide pulse pressure/bounding pulses
Patent ductus arteriosus
Complications of PDA
Respiratory infections, endocarditis
Complications of ASD
Arrhythmias
Paradoxical emboli from DVT
Hearing loss, sudden syncope, family history of early cardiac death, normal physical exam
Congenital long QT syndrome
CHF and respiratory distress in an infant with hypertension in arms and weak pulses in legs
Coarctation of aorta (associated with Turner's syndrome)
3 holosystolic murmurs
Mitral regurgitation
Tricuspid regurgitationO
VSD
Presentation of 21-hydroxylase deficiency (CAH)?
Presentation:
1. Electrolyte abnormalities (Low Na, Cl, glucose; High potassium

2. Ambiguous genitalia in girls; loss of secondary sex characteristics in males
How is 21-hydroxylase deficiency diagnosed?
Elevated 17-hydroxyprogesterone
Criteria for kawasaki's disease (4)
Fever for more than 5 days
Conjunctival changes (strawberry tongue, cracked lips)
Extremity changes (edema, desquamation)
Cervical lymph node >1.5 cm
Treatment for dog/cat bites
Amoxicillin/clavulinate (for pasteurella)
Infant who appeared normal at birth gradually develops hypotonia, apathy, sluggish movement, large tongue, abdominal bloating and umbilical hernia
Congenital hypothyroidism
Persistent oral thrush, lymphadenopathy, diarrhea, hepatosplenomegaly in the first month of life
HIV
Marfan's features + mental retardation + strokes +downward lens dislocation
Homocystinuria
Treatment of homocystinuria
Vitamin B6
Child with sore-throat, fever, pericarditis, arthritis, chorea, subcutaneous nodules, arthritis, and erythema marginatum
Rheumatic fever (group A strep)
What 3 features differentiate hyper-IgM syndrome from other hypogammaglobulinemias?
1. Opportunistic sinopulmonary infections
2. Neutropenia
3. High IgM, low IgA and IgG
Recurrent sinusitis, bronchiectasis, and dextrocardia
Kartenager's syndrome
What type of liver problem causes these findings?

Balloon degeneration with polymorphic cellular infiltrates
Balloon degeneration with polymorphic cellular infiltrates: Alcoholic hepatitis

Panlobular mononuclear cells infiltrates with hepatic cell necrosis: Acute viral hepatitis

Extensive fatty vacuolization of liver: Reye's syndrome

Portal piecemeal necrosis and/or bridging fibrosis: Chronic active hepatitis

Inflammatory destruction of small intrahepatic biliary ducts: Primary biliary cirrhosis
What is the most likely cause of limping in these age groups?

Birth to 3 yrs
4-12 years
Older than 12
Birth to 3: Hip dysplasia
4-12 yrs: Legg-Calve-Perthes
Over 12: Slipped capital femoral epiphysis
Jones criteria for rheumatic fever
Joints (migratory polyarthritis)
Carditis
Erythemia marginatum
Subcutaneous nodules
Sydenham's chorea
Describe the skin changes in scarlet fever (3)we
Sand-paper rash
Circumoral pallor
Strawberry tongue
What is the pattern of appropriate height and weight gain?
Weight:
Double birth weight by 6 mos
Triple birth weight by 1 year

Height:
Increased 50% by 1 year
Doubles by 4 years
Normal development until 6 months of age, then regress. Develop seizures, hypotonia, blindness, and cherry red macula.
Tay-Sachs (beta-hexosaminosidase deficiency)
Mental retardation
Blindness
Deafness
Paralysis
Peripheral motor and sensory neuropathy
Seizures
Krabbe's disease (beta-galactosidase deficiency)
Angiokeratomas
Peripheral neuropathy
Asymptomatic corneal dystrophy
Fabry's disease (alpha-galactosidase deficiency)
Most common cause of sepsis and osteomyelitis in sickle cell
Sepsis - Strep pneumonia
Osteomyelitis - Salmonella
Most common cause of leukocoria (white reflex)
Retinoblastoma
Unilateral conjunctivitis with purulent discharge
Bacterial
What 2 things do you use a fluroscein stain for?
Keratitis
Corneal abrasions
Which murmurs radiate to:
Axilla
Back
Neck
Axilla: Mitral
Back: Tricuspid and pulmonic
Neck: Aortic
What is CHARGE syndrome?
Coloboma, CNS anomalies
Heart defects
Atresia of the choanae
Retardiation of growth/development
Genital/urinary defects
Ear anomalies, deafness
Aplastic anemia, poor growth, morphologic abnormalities, macrocytic anemia, skin signs
Fanconi anemia
What are the differences between osteogenic and ewing's sarcoma in histology and xray
Histology:
Osteo: Spindle cell-producing osteoid

Ewing: Undifferentiated small cell of neural origin

X-ray:
Osteo-Sunburst
Ewing - Onion skin (lytic with periosteal elevation)
What is the difference in complement levels between glomerulonephritis and minimal change disease?
Glomerulonephritis: Low C3, C4
Minimal change disease: Normal C3, C4
Which infection is associated with minimal change disease?
Spontaneous bacterial peritonitis
What is WAGR syndrome?
Wilms tumor
Aniridia
Genitourinary anomalies
Mental retardation
Large head and tongue, visceromegaly, omphalocele, low glucose and high insulin
Beckwith-Wiedemann syndrome
What are 3 differences between congenital hypothyroidism and beckwith-weidemann syndrome?
Congenital hypothyroidism has:
1. Inguinal hernia, not omphalocele
2. Large head, not small
3. No hypoglycemia or hyperinsulinemia
Child with fever, drooling, refusing to lie down, hot potato voice
Eppiglotitis
Treatment for eppiglotitis
1. Intubate
2. Ceftriaxone
3. Rifampin for close contacts
Stages and treatment for whooping cough
1. Catarrhal stage (congestion and rhinorrhea): Macrolide

2. Paroxysmal stage (severe coughing, inspiratory whoop, vomiting)

3. Convalescent: Decreased frequency of coughing

Also - respiratory isolation and macrolides for close contacts
Bacteria:
Gram positive diplococci
Gram positive cocci in clusters
Gram negatice cocci
Gram positive rods (2)
Gram negative rods (4)
Gram positive dipplococci - Strep pneumonia
Gram positive cocci in clusters - Staph
Gram positive rods: Listeria and bacillus
Gram negative cocci - Neisseria
Gram negative rods - Pseudomonas, H. influenza, klebsiella, legionella
3 features of McCune-Albright syndrome
The 3 P's

Precocious puberty
Pigmentation
Polyostotic fibrous dysplasia
Itchy dermatitis, recurrent skin and respiratory staphylococcal infections, eosinophilia, coarse facial features, bone fractures
Hyper-IgE (Job's) syndrome
Patient with recurrent lymphadenitis, liver abscesses, osteomyelitis at multiple sites, unusual infections with catalase positive organisms (s. aureus, aspergillus, serattia)
Chronic granulomatous disease
Which immunodeficiency presents with these infections:

H influenza, strep pneumonia, and giardia
Gonorrhea and neisseria
Viral and fungal infections
Aspergillus, staphylococcus
H influenza, strep pneumonia, giardia: Selective IgA deficiency
Gonorrhea and neiseria: Complement deficienvy
Viral and fungal: T-cell deficiency
Aspergillus, staphylococcus: CGD
Which crosses the midline - Cephalohematoma or caput succedanum
Caput suddenacem
Triad of congenital rubella
Deafness
Cardiac defects
Cataracts
What is the difference in presentation between gonococcal and chlamydia conjunctivitis?
Gonococcal is days 2-5, more severe, purulent drainage
Chlamydia is days 5-14, milder, watery discharge
How do you differentiate between tay-sach's and neimann-pick's?
Neiman-Pick's has hepatosplenomegaly and cervical lymphadenopathy
How do you differentiate the 2 major causes of delayed meconium passage?
Hirschprung: Normal meconium, at rectosigmoid colon
Meconeum ileus: Inspissated meconium, at level of ileum
Young child with recurrent URIs and nasal polyps
Cystic fibrosis
Cyanosis shortly after birth with a single and loud S2
Transposition of the great vessels
Treatment for slipped capital femoral epiphysis
Urgent surgical fixation