Peds Case Files

Front 1

Poor growth cause by underlying medical conditions?

Name 3 examples

Back 1

Organic FTT

IBD, Renal disease, congenital heart conditions

Front 2

How much food do infants need in the first year of life?

After the first year?

How much to catch up from FTT?

Back 2

120 kcal/kg/day

100 kcal/kg/day

Additional 50-100%

Front 3

FTT c low bicarb. and acidotic urine

Tx?

Back 3

Renal tubular acidosis

Oral bicarbonate supplementation

Front 4

infant c developmental delay, intrauterine growth retardation (including microcephaly), cataracts, seizures, hepatosplenomegaly, prolonged neonate jaundice, and purpura at birth

CT findings?

Back 4

CMV or toxoplasmosis infection

CMV - Calcified brain densities of CMZ in periventricular pattern

Toxo - throughout the cortex

Front 5

When do kids go through "picky eater" phase?

Back 5

18-30 months

Front 6

What recreational drug is associate with nystagmus?

Back 6

PCP

Front 7

Incidence of down syndrome?

Back 7

35 = 1:400
40 = 1:100
45 = 1:10

Front 8

What does a triple screen measure and when should one do it?

Sensitivity?

Back 8

AFP, hCG, estriol

15-20 weeks

60% of DS, and
90% neural tube defects are detected

Front 9

What are the 2 major complications of infants with Down Syndrome?

Frequency?

Back 9

50% c cardiac defects
60% endocardial cushion, 30%VSD, Tetralogy of Fallot 5%

12% c intestinal atresia (usually duodenal) "double bubble sign"

Front 10

MAO of Down syndrome

Back 10

95% nondysjunction, or failure of chromosomal migration

Others are Translocation or Mosaics

Front 12

How is HIV transmitted to infants?

Back 12

Vertical Transmission

Front 13

How do you dx HIV in child <18months? Why?

Back 13

HIV PCR, bc of maternal antigen

Front 14

How do you dx HIV in ages >18 months?

Back 14

HIV antibody ELISA and subsequent Western blot for comfirmation

Front 15

Tx for infant of HIV + mother? (2)

Back 15

Zidovudine 6 weeks of prophylaxis started in first few hours of life

TMP SMZ for PCP prophylaxis at 6weeks of age if infant is HIV +

Front 16

What immunizations does one avoid c HIV+ infants?

Back 16

Live Attenuated

ex. MMR, Varicella

Front 17

What sign and sx would lead one to expect LAD? (leukocyte adhesion defiency) (2)

Back 17

neutrophilia

intact umbilical cord

Front 18

Boot shaped heart and thyroid aplasia?
MAO?

Back 18

DiGeorge Syndrome 22q11 microdeletion

Front 19

Best diagnostic test for Fragile X?

Back 19

DNA analysis showing expanded Xq27.3 (distal long arm???)

Front 20

Breast milk contains high concentrations of what Ig?

Back 20

IgA

Front 21

3 disadvantages of human breast milk?

Back 21

1. HIV transmitting
2. Jaundice exacerbation due to inc. uncon. bilirubin
3. Low Vit K level - contributes to hemorrhagic disease of newborns

Front 22

Define these

Back 22

fancone, edwards, patua

Front 23

What kind of milk for infant with PKU?

Back 23

low in phenyalanine

Front 24

Mothers and infants that are vegan need what supplement?

Back 24

B12

Front 25

Breastfeeding is associated with a lower incidence of what?

Back 25

Diarrhea, reduction of enteric pathogens

Front 26

What test is need for Vitamins KADE def?

S/S?

Back 26

Sweat test for CF

K - bleeding probs, A - fontanelle fullness, E - hemolytic anemia

Front 27

Which immunizations are CI c egg allergy?

Back 27

Yellow Fever, Influenza

Yellow, Flu, Egg

Front 28

What vaccines are CI in immunosupressed (except assymptomatic HIV) and pregnancy

Back 28

Live vaccine:

Front 29

Name common flu:
neonate
6 week
toddler
adolescent

Back 29

neonate - GBS
6 week - chlamydia
toddler - RSV
adolescent - Mycoplasma

Front 30

Common test for C. trachomatis, N. gonorrhoeae

Back 30

Nucleic acid amplification test (naat)
followed by definitive culture

Front 31

Genetic finding in CF?

Back 31

Long arm of Ch 7
MC single phenylalanine deletion at AA 508

Front 32

What is meconium ileus?

It is almost always ass. c what?

TX?

Back 32

insipissated meconium obstructing the distal ileum

CF

Surgical emergency

Front 33

How can CF cause bulging fontanelles?

Back 33

Vit A def resulting in pseudotumor cerebri

Front 34

What are two types of FTT and what is the difference?

Back 34

Nonorganic FTT - poor growth s medical etiology. 33% of cases. Related to poverty, poor mom-baby relationship

Organic - caused by underlying medical reason

Front 35

MC workup for FTT?

Back 35

CBC
lead lvl
UA and culture
Serum e- (Ca, BUN, Cr)

Front 36

MC presentation of adolescent new onset behavior change declining grades, depression, problems c law?

Back 36

Drug abuse

Front 37

What drug causes hypersalivation, nystagmus, inc. verbal swearing?

Back 37

pcp (phencyclidine)

Front 38

What is the dif. bt association, syndrome, sequence?

Back 38

association - features of an unknown cause with higher freq. than expected

Syndrome - constellation of features c common cause

sequence - single defect c subsequent abnormalities

Front 39

What is the association, VATER?

Back 39

Vertebral, Anal, Trachea, Esophageal, Radius/Renal

Front 40

Presentation of duodenal atresia? Association?

Back 40

(10% complication of DS)
polyhydramnios
persistent bilious vomiting after feeding
"double bubble" XR

Front 41

Other newborn complication of DS?

Back 41

hearing loss, strabismus, cataracts, congenital hypothyriodism, cervical vertebrae instability,

Front 42

Low set, malformed ears, microcephaly, rocker bottom feet, inguinal hernias, cleft lip/palate, micrognathia?

Back 42

trisomy 18, Edward's Syndrome

Front 43

Microcephaly, sloping forehead, cutis aplasia (missing portion of hair/skin) of scalp, polydactlyl, microphthalmia (small eye), omphalocele?

Back 43

trisomy 13, Patau syndrome

Front 44

What is vertical transmission?

Back 44

Vertical transmission, also known as Mother-to-child transmission refers to transmission of an infection, such as HIV, hepatitis B, or hepatitis C, from mother to child during the perinatal period, the period immediately before and after birth. It is a term also used in population genetics to describe inheritance of an allele or condition from either the father or mother.

Front 45

In AIDs, what amt. of RNA is ass. c worse outcome?

Back 45

RNA >100,000/mL

Front 46

What are the types of HIV drugs?

Back 46

pg 62

Front 47

SCID has what type of inheritance?

Back 47

x-linked or AR

Front 48

What is Leukocyte adhesion disorder?

Back 48

d/o of leukocyte chemotaxis and adherence, recurrent infections c delayed wound healing (cord still attached)

Front 49

What is the MC inheritable form of MR and what is the incidence?

Typical IQ range?

Back 49

Fragile X, Xq27.3, 1 in 2000

30-55

Front 50

What would be a concern of a baby drinking only goat's milk? (3)

Back 50

Megablastic anemia from folate or B12 def.
Low in Iron, Vit D, Vit K
Brucellosis if milk is unpasteurized

Front 51

Which Ig is high conc. in breast milk?

Back 51

IgA

Front 52

What is methylmalonic acidemia and what is given to prevent it?

Back 52

Infant dev. from vegan mom's - an aa d/o involving a defect in the conversion of mm CoA to succinyl CoA

B12

Front 53

What race is rickets more common? Why?

Back 53

Blacks, less converstion of Vit D

Front 54

8 mo old c chronic biliary atresia, poor bone mineralization, and a fracture

Back 54

ricketts

Front 55

Best dx test for rickets?

Back 55

serum 25(OH) vit d?