Peds Shelf

Front 1

Another name for Henoch-Schonlein purpura

Back 1

Anaphylactoid purpura

Front 2

Rx for encopresis

Back 2

Behavioral modification and reassurance

If retentive, also must clear mass + stool softeners for 3-6mo

Front 3

What are genu varum and Blount disease?

Back 3

Bowed legs; latter is if persists past 2yo

Front 4

What is Legg-Calve-Perthes disease + most common presentation?

Back 4

Avascular necrosis of the femoral head

Painlses limp

Front 5

Limp in overweight adolescents

Back 5

Slipped acpital femoral epiphysis

Front 6

What is Osgood-Schlatter disease + treatment?

Back 6

Repeated microfracture of tibial tubercle at insertion of patellar tendon

Overuse injury w/ swelling and knee pain

Rest

Front 7

Fever, erythema, extremely tender skin, Nikolsky sign, facial crusting

Back 7

Staphylococcal scalded skin disease

Front 8

Rx for human bite

Back 8

Hospitalization for antibitoics and debridgement + healing by secondary intention (granulation)

Front 9

Where are Baker cysts, and how are they managed?

Back 9

Popliteal cysts; observation, typically resolve over several years, surgery if associated symptoms

Front 10

Rx for lice

Back 10

1% lindane, except in babies (risk of neurotoxicity from transdermal absorption, so use 1% permethrin (Nix))

Front 11

Hole in the tympanic membrane and prurulent drainage

Back 11

Acute otitis media

Front 12

White polyp extending thru tympanic membrane

Back 12

Cholesteatoma (congenital or acquired): small sac lined w/ epithelium-containing debris

Can present in childern w/ recurrent otitis media

Front 13

When does umbilical cord normally separate, and what counts as delayed separation?

Back 13

10-14 days post birth

>1mo

Front 14

Cause of delayed separation

Back 14

Leukocyte adhesion deficiency

Front 15

Rx for umbilical granuloma

Back 15

Silver nitrate

Front 16

Omphalocele is covered by -__ but no ___

Back 16

Peritoneum
Skin

Front 17

Best booster vaccine at 14yo

Back 17

Tdap (tetanus toxoid, reduced diphtheria toxoid, acellular pertussis)

Front 18

Rx for mammalian bites

Back 18

Irrigation and cleaning
If infant, diabetic, or i/c, antibiotic prophylaxis

Front 19

Long face, large ears, prominent jaw, macroorchidism, hypotonia, repetitive speech, gaze avoidance, hand flapping, mental retardation

Back 19

Fragile X syndrome

Front 20

Inheritance pattern of fragile X syndrome

Back 20

Dominant X-linked disorder w/ reduced penetrance in females

Front 21

Friendly, hypercalcemia, short, blue irides, cardiopulmonary abnormalities

Back 21

Williams syndrome (ch. 7)

Front 22

Yellow-white lesions w/ surroudning erythema + eosinophils in newborn

Back 22

Erythema toxicum

Front 23

Flat vesicular lesions (splotchy red rash) on nape of neck, eyelids, etc., may persist

Back 23

Salmon patch (nevus simplex)

Front 24

Pustules --> hyperpigmented lesion upon rupture

Back 24

Pustular melanosis

Front 25

Yellow-orange sharply edged hairless lesions on head and neck of infants

Back 25

Sebaceous nevi

Front 26

Yellowish white, 1-2mm cysts scattered over the face and gingivae of the neonate

Back 26

Milia (on the palate, called Epstein pearls)

Front 27

Small, firm, white, cold patches of skin in exposed areas and treatment

Back 27

Frostnip

Rewarm before numb

Front 28

Progression and complications of frostbite

Back 28

Stinging --> aching --> numb
Once rewarmed --> red, blotchy, painful

Gangrene may develop

Front 29

Small ulcerated lesions on exposed areas

Back 29

Chillblains

Front 30

Destruction of fat cells caused by exposure to cold weather or a cold object

Back 30

Cold panniculitis

Front 31

Deficiencies: cheilosis, glossitis, ocular problems (keratitis, conjunctivitis, corneal vascularization), seborrheic dermatitis

Back 31

Riboflavin deficiency

Front 32

Deficiencies: seizures, peripheral neuritis, dermatitis, microcytic anemia

Back 32

Vita B6 deficiency

Front 33

Four signs of folate deficiency

Back 33

Megaloblastic anemia, glossitis, pharyngeal ulcers, impaired immunity

Front 34

Deficiencies: pellagra

Back 34

Niacin

Front 35

Deficiencies: dermatitis/ seborrhea

Back 35

Biotin

Front 36

Congenital abnormality with bushy eyebrows, hirsutism, limb defects, VSD, mental retardation

Back 36

Cornelia de Lange syndrome

Front 37

Painful limp with normal/mildly elevated WBC and ESR (+ recent URI)

Back 37

Transient synovitis (self-limited)

Front 38

How soon should NAC be given for acetaminophen poisoning?

Back 38

16 hours

Front 39

Rx for salicylate poisoning

Back 39

Acetazolamide, IV sodium bicarb (hemodialysis if needed)

Front 40

Toxicity: oculogyric crisis, tremors, torticollis, dysphagia

Back 40

Phenothiazine

Front 41

Rx for phenothiazine ingestion

Back 41

Benadryl (IV or IM)

Front 42

Rx for iron intoxication (GI symptoms + CV collapse)

Back 42

Deferoxamine

Front 43

Rx for methanol intoxication

Back 43

Induce emesis or gastric lavage
IV ethanol
Hemodialysis if severe

Front 44

Excess vitamins: hyperostosis (excess bone growth), hepatomegaly, increased CSF pressure, dry skin

Back 44

Vitamin A

Front 45

Excess vitamins: skin flushing and pruritis (long-term tachycardia, liver damage, hyperglycemia/uricemia)

Back 45

Nicotinic acid (vasodilator)

Front 46

Excess vitamins; kidney stones, diarrhea, cramps

Back 46

Vitamin C

Front 47

Excess vitamins: nausea, diarrhea, weight loss, polyuria, soft tissue calcification

Back 47

Vitamin D

Front 48

Excess vitamins: sensory neuropathy with altered sensation of touch, pain, and fever

Back 48

Pyridoxine (B6)

Front 49

What does the nitroblue tetrazolium test look for?

Back 49

Chronic granulomatous disease (predilection to infection with catalase positive organisms)

Front 50

Thrombocytopenia, recurrent infections, ezcema

Back 50

Wiskott-Aldrich syndrome

Front 51

Heart defects, abnormal facies, hypocalcemia, thymic aplasia

Back 51

DiGeorge syndrome (CATCH)

Front 52

Test for DiGeorge syndrome

Back 52

Intradermal skin test w/ Candida albicans (will have no result b/c of T cell deficiency)

Front 53

Consequences of congenital cystic adenomatoid malformation (CCAM)

Back 53

Cystic illness, compression of affected lung --> pulmonary hypoplasia (Rx is surgical excision of affected lobe)

Front 54

Pharyngitis, fever w/ severe sore throat, refusal of food, drooling, noisy breathing

Back 54

Retropharyngeal abscess

Front 55

Fluctuant mass on neck palpation + sore throat

Back 55

Retropharyngeal abscess

Front 56

Rx for chlamydial infection in newborns

Back 56

Oral macroles (azithromycin): treats both conjunctivitis and pneumonia

Front 57

Acid-base abnormality in tension pneumo

Back 57

Uncompensated respiratory acidosis w/ hypoxia but no metabolic acidosis

Front 58

Rx for bronchiolitis

Back 58

Monitor fluid status/ oxygenation

Front 59

Infants born to moms w/ gestational DM are at risk for these respiratory problems

Back 59

Peripheral nerve injuries (Erb-Duchenne, phrenic nerve paralysis) --> asymmetric diaphragmatic motion in seesaw manner on chest US

Front 60

Rx for gas, kerosene, or furniture polish inhalation (hydrocarbons -->dyspnea, cyanosis, respiratory failure)

Back 60

ABG/ pulse ox, intubation if necessary

Front 61

Recurrent "pneumonias," hemoptysis, digital clubbing, anemia

Back 61

Idiopathic pulmonary hemosiderosis

Front 62

Diagnostic method for idiopathic pulmonary hemosiderosis

Back 62

BAL w/ hemosiderin-laden macrophages

Front 63

Idiopathic pulmonary hemosiderosis and hypersensitivity to cow's milk + Rx

Back 63

Heiner syndrome (Rx: remove cow's milk from diet)

Front 64

Newborn w/ respiratory distress that improves with crying

Back 64

Choanal atresia

Front 65

Croup presentation + fever, toxic appearance, biphasic stridor

Back 65

Bacterial tracheitis

Front 66

Rx for bacterial tracheitis

Back 66

Intubation + IV Abx

Front 67

Comon infection in dirt-eating children

Back 67

Visceral larva migrans from Toxocara canis (common parasite of dogs)

Front 68

Rx for sinusitis

Back 68

Oral Abx for 10-14d

Front 69

When are sinuses large enough to be infected?

Back 69

Maxillary/ ethymoid: infancy
Sphenoid: 3-5yo
Frontal: 6-10yo

Front 70

Drooling, avoidance of foods, cough, choking

Back 70

Foreign object in esophagus

Front 71

Rx for ear infection

Back 71

Amoxicillin 40mg/kg BID, i.e. 80mg/kg daily (high dose for good penetration)

Front 72

Polyps and eosinophilia on nasal smear

Back 72

Allergic rhinitis

Front 73

Respiratory acidosis w/ metabolic compensation

Back 73

Points to chronic airway obstruction, e.g. from hypertrophied tonsils or adenoids

Front 74

Ingestions: lethargy, cma, seizures, widened QRS/BBB

Back 74

TCA poisoning

Front 75

Ingestions: N, V, diaphoresis, RUQ pain

Back 75

Tylenol

Front 76

Rx for TCA ingestion

Back 76

ICU admit, TCA Fab Ab

Front 77

Rx for methanol ingestion

Back 77

Ethanol

Front 78

Jones criteria: major

Back 78

Carditis, arthritis, erythema marginatum, chorea, subQ nodules

Front 79

Jones criteria: minor

Back 79

Arthralgias, fever, Hx of rheumatic fever, increased ESR or CRP, increased WBC, anemia, prolonged PR and QT

Front 80

Tetrology of Fallot

Back 80

VSD
RVH
RV outflow obstruction (pulm stenosis)
Dextroposition of the aorta

Front 81

Transposition of the great vessels often has these other 2 abnormalities

Back 81

PFO, hypoplastic L heart syndrome

Front 82

When should kids w/ FH of early onset CHD be screened hypercholesterolemia?

Back 82

2yo

Front 83

Edema around neck + FH

Back 83

Hereditary angioedema

Front 84

Turner's is associated w/ this cardiac condition

Back 84

Aortic coarctation

Front 85

Down's Syndrome is associated w/ this cardiac condition

Back 85

VSD/ endocardial cushion defects

Front 86

Marfan's is associated with these cardiac conditions

Back 86

Aortic dilation, AR, MR

Front 87

Risk of congenital heart disease in population, w/ 1 child, w/ 2 children

Back 87

1%, 2-6%, 20-30%

Front 88

Murmur of VSD

Back 88

Harsh or blowing holosystolic best along L lower sternal border

Front 89

2 most common causes of myocarditis

Back 89

Adenovirus and coxsackie virus B

Front 90

Heart rate >250 beats/min indicates

Back 90

Tachyarrhythmia (up to 200 can be CHF from many causes)

Front 91

3 first-line treatments for SVT + 1 second-line

Back 91

Vagal stimulation with:
Carotid massage
Immersion of face in cold water
Voluntary straining
2nd line: IV adenosine

Front 92

Quadruple rhythm (S3 + S4) + TR + middiastolic murmur at lower left sternum

Back 92

Ebstein anomaly

Front 93

What is the Ebstein anomaly

Back 93

Downward displacement of the tricuspid valve

Front 94

Hypoplastic LV --> LAD and LVH is seen in this valvular disease

Back 94

Tricuspid atresia

Front 95

Congenital heart disease w/ marked, fluffy appearing venous congestion (snowman) on CXR

Back 95

Total anomalous pulmonary venous return

Front 96

Early cyanosis, normal sized heart, RAD and RVH

Back 96

Transposition of the great vessels

Front 97

Thrombocytopenia, bilateral absence of radius, abnormal thumbs, TOF and/or ASD

Back 97

Thrombocytopenia absent radius syndrome

Front 98

Short, downslanting palpebral fissues, ptosis, low set malformed ears, webbed neck, shieldlike chest, pulmonic stenosis, cryptorchidism, mental retardation

Back 98

Noonan Syndrome (male Turner Syndrome, seen in both sexes)

Front 99

Noonan syndrome is associated w/

Back 99

Advanced paternal age

Front 100

Main complication of neonatal lupus

Back 100

Congenital heart block (permanent, usually requires pacing); most other manifestations are self-resolved

Front 101

Common complications of pregnancy-induced HTN

Back 101

Neonatal hypoglycemia and polycythemia

(Decreased uteroplacental blood flow --> fetal nutritional deprivation/ hypoxemia --> decreased glycogen storage and relative erythrocytosis)

Front 102

Symptoms of "hyperviscosity syndrome" in newborns

Back 102

Tremulousness/jitteriness --> seizures due to sludging of blood in cerebral microcirculation

Front 103

Rx for hyperviscosity syndrome

Back 103

Parital exchange transfusion

Front 104

Common complication of postmature infants w/ chronic placental insufficiency (SGA and wasted appearance)

Back 104

Asphyxia and/or meconium aspiration

Front 105

Time frame of three types of conjunctivitis

Back 105

Chemical: 6-12hrs of birth, lasts for 1 day, self-limited

Gonococcal: 2-5d after birth

Chlamydial: 5-14d after birth

Front 106

Why are infants born to chlamydia-positive mothers not routinely treated with oral Abx?

Back 106

Increased incidence of hypertrophic pyloric stenosis among neonates having received erythromycin

Front 107

What is hyaline membrane disease?

Back 107

Infant respiratory distress syndrome

Front 108

Lung compliance, volume, and direction of blood shunt in infant respiratory distress syndrome

Back 108

Decreases, decreases, and right --> left (From PDA or PFO or in lungs)

Front 109

Most common TEF is

Back 109

Blind esophageal pouch (below it, distal esophagus is connected to the trachea)

Front 110

Teratogens: when is phenytoin dangerous

Back 110

1st trimester

Front 111

Teratogens: propanolol

Back 111

Growth retardation, decreased ability to increase HR and CO, hypoglycemia, apnea

Front 112

Bile stained vomitus indicates obstruction is where?

Back 112

Distal to ampulla of Vater

Front 113

Goat's milk contains inadequate ___ and ___

Back 113

Folate, iron

Front 114

Complications of cleft lip/ palate

Back 114

Recurrent otitis media, hearing loss, speech defects

Front 115

Which is repaired first, cleft lip or palate?

Back 115

Clef lip within 3mo, cleft palate btwn 6mo and 5 yrs

Front 116

Umbilical hernia, distended abdomen, large head/ fontanelles, hypothermia, feeding difficulties, constipation, jaundice

Back 116

Congenital hypothyroidism

Front 117

How long do babies with HIV+ moms receive zidovudine for?

Back 117

6 wks

Front 118

When is PCP prophylaxis started in HIV+ infants, and with what?

Back 118

6wks, Bactrim

Front 119

Weak cry, single umbilical artery, micrognathia, small pelvis, short sternum

Back 119

Edwards Syndrome (also rocker bottom feet and clenched hands w/ index and third fingers overlapping)

Front 120

Microcephaly, sloping forehead, scalp cutis aplasia (missing portion of skin and hair), microphthalmia, coloboma, omphalocele, single umbilical artery, hypersensitivity to atropine/ pilocarpine

Back 120

Patau Syndrome

Front 121

Another name for endocardial cushion defect?

Back 121

Complete AV canal

Front 122

Common lab finding in leukocyte adherence deficiency?

Back 122

Neutrophilia

Front 123

Rx for SCID

Back 123

BM transplant (otherwise death in first 12-24mo)

Front 124

Supplements needed in infants receiving goat's milk

Back 124

Folate, B12, iron

Front 125

Possible infection in babies receiving goat's milk

Back 125

Brucellosis

Front 126

FTT, bleeding problems, fontanelle fullness, hemolytic anemia

Back 126

Cystic fibrosis (last three are from deficiencies of vitamins K, A, and E, respectively)

Front 127

Type of formula used in galactosemia

Back 127

Soy-based

Front 128

Causes of rickets

Back 128

Inadequate vita D, liver failure, renal failure, primary hypophosphatemia

Front 129

How does liver failure lead to rickets

Back 129

Low bile salts --> decreased absorption of fat soluble vitamins

Front 130

Genetics of primary hypophosphatemia

Back 130

X-linked

Front 131

Lower extremity bowing with low Ca/ PO4

Back 131

Familial primary hypophosphatemia

Front 132

How to distinguish rickets from Schmid metaphyseal dysplasia

Back 132

Latter has normal Ca, PO4, and alk phos (alk phos almost always increased in rickets)

Front 133

Short, leg bowing, waddling gait, fractures, normal labs

Back 133

Schmid metaphyseal dysplasia

Front 134

Deficiencies: nightblindness, conjunctivitis, keratomalacia

Back 134

Vitamin A

Front 135

Deficiencies: hemolytic anemia in premature infants

Back 135

Vitamin E

Front 136

Deficiencies: hoarseness, anorexia, restlessness, aphonia

Back 136

Thiamine (Vita B1)

Front 137

Deficiencies: neuritis, edema, cardiac failure

Back 137

Vita B1 (is beriberi)

Front 138

Deficiencies: cheilosis, glossitis, corneal vascularization

Back 138

Riboflavin (Vita B2)

Front 139

Deficiencies: dermentia, dermatitis, diarrhea

Back 139

Niacin/ Vita B3 (is pellagra)

Front 140

Deficiencies: irritability, convulsions, anemia

Back 140

Pyridoxine/ Vita B6 (diff from presentations in adults)

Front 141

Deficiencies: depression, hypotension, muscle weakness, abd pain

Back 141

Pantothenic acid

Front 142

Deficiencies: dermatitis, seborrhea, anorexia, muscle pain, pallor, alopecia

Back 142

Biotin

Front 143

Excess: increased ICP, anorexia, hyperostosis (pain and swelling of long bones), alopecia, poor growth

Back 143

Vita A

Front 144

Excess: hypercalcemia, azotemia, N/V/D, calcinosis of tissues

Back 144

Vita D

Front 145

Excess: kidney stones

Back 145

Vita C

Front 146

Excess: flushing, pruritis

Back 146

Niacin

Front 147

Excess: sensory neuropathy

Back 147

Pyridoxine

Front 148

Intraventricular hemorrhage is often seen in these newborns and often leads to this complication

Back 148

Preterm

Posthemorrhagic hydrocephalus

Front 149

Tacypnea, retractions, grunting, maybe cyanosis in a newborn

Back 149

Transient tachypnea of the newborn

Front 150

Maculopapular peeling rash, rhinitis, hepatosplenomegaly, lymphadenopathy, saddle nose, interstitial keratitis

Back 150

Congenital syphilis (also Hutchinson teeth, mulberry molars)

Front 151

Risks associated w/ maternal cocaine use

Back 151

Vascular accidents

Front 152

Causes of apnea in premature infants

Back 152

Idiopathic apnea

Front 153

Causes of apnea in term infants

Back 153

Sepsis, reflux, congenital heart disease, seizures, hypoglycemia, airway obstruction

Front 154

Signs of meningitis usually absent in neonates

Back 154

Nuchal rigidity, Kernig/ Brudzinski signs

Front 155

When to suspect twin-twin transfusion

Back 155

Difference in hematocrit > 15, difference in body weight > 20%

Front 156

Donor twin presentation in twin-twin transfusion

Back 156

Oligohydramnios, anemia, hypovolemia, maybe shock

Front 157

Recipient twin presentation in twin-twin transfusion

Back 157

Hydramnios, plethora, hyperviscosity, respiratory distress, hyperbili, hypocalcemia, renal vein thrombosis, CHF, convulsions

Front 158

Hydramnios refers to

Back 158

Polyhydramnios

Front 159

4 conditions associated w/ polyhydramnios

Back 159

Duodenal atresia, TEF, trisomy 18, anencephaly

Front 160

Congenital infections: cataracts, IUGR, myocarditis, macular rash, structural heart defects

Back 160

Rubella

Front 161

Congenital infections: hydrocephalus, chorioretinitis, intracranial calcifications

Back 161

Toxoplasmosis

Front 162

Congenital infections: IUGR, hepatosplenomegaly, jaundice, petechiae, intracranial calcifications, hearing loss

Back 162

CMV

Front 163

Most common congenital infection

Back 163

CMV

Front 164

Dysmorphic child, bilateral renal agenesis, primary pulmonary hypoplasia

Back 164

Potter sequence/ oligohydramnios

Front 165

Aniridia is associated w/

Back 165

Wilms tumor

Front 166

Lateral displacement of medial canthia, broad nasal brige, medial hyperplasia of eyebrows, partial albinism, deafness

Back 166

Waardenburg syndrome

Front 167

Complications of Sturge-Weber

Back 167

Vascular malformation in trigeminal nerve distribution, grand mal seizures, mental deficiency, hemiparesis or hemianopsia

Front 168

Inheritance of tuberous sclerosis

Back 168

AD

Front 169

Soft tissue swelling of scalp involving delivery portion of heart that is ecchymotic

Back 169

Caput succedaneum (self resolves)

Front 170

Difference between caput succedaneum and cephalohematomas)

Back 170

Latter doesn't cross suture lines

Front 171

Fever, muscle rigidity, metabolic and respiratory acidosis, tachycardia, arrhythmia, tachypnea, cyanosis, myoglobinuria, elevated CK, ARF

Back 171

Malignant hyperthermia

Front 172

Inheritance of malignant hyperthermia and what the gene codes for

Back 172

AD
Ryanodine receptor (calcium release channel)

Front 173

Fever, emesis, multiple sclerosis type MRI

Back 173

Acute disseminated encephalomyelitis

Front 174

Rx for ADEM

Back 174

High-dose corticosteroids

Front 175

Poor growth, arachnodactyly, osteoporosis, dislocated lenses, mental retardation, thromboembolism

Back 175

Homocystinuria (thromboemboli can cause acute infantile hemiplegia)

Front 176

Very large head in normal newborn

Back 176

Simple primary craniosynostosis (rx: surgery)

Front 177

Seizure activity with no epileptiform activity on EEG

Back 177

Pseudoseizure

Front 178

Differences between pseudoseizure and seizure on exam

Back 178

Pseudoseizure: no loss of bowel/bladder control, no self-injury, normal pupillary response to light

Front 179

What is Todd paralysis?

Back 179

Paralysis after focal or Jacksonian seizure; lasts 24-48hrs

Front 180

Macular cherry red spots, developmental deterioration and sensitivity to noise

Back 180

Tay Sachs disease

Front 181

Enzyme absent in Tay Sachs

Back 181

Beta-hexosaminidase A

Front 182

Beta-glucosidase deficiency --> increased tone, strabismus, organomegaly, FTT, stridor, psychomotor regression

Back 182

Gaucher disease

Front 183

Beta-galactosidase --> angiokeratomas in bathing suit area + severe pain

Back 183

Fabry disease

Front 184

Galactocerebroside beta-galactosidase deficiency --> irritability, seizures, hypertonia, optic atrophy

Back 184

Krabbe disease

Front 185

Sphingomyelinase deficiency --> hepatosplenomegaly, LAD, psychomotor retardation w/in first 6mo

Back 185

Niemann-Pick disease

Front 186

Psychomotor retardation, ptosis, baldness, hypogonadism, facial immobility, neonatal respiratory distress, cataracts

Back 186

Myotonic muscular dystophy

Front 187

Difference btwn myotonic muscular dystrophy and other myopathies

Back 187

Distal muscle weakness (instead of proximal)

Front 188

Two things that can terminate migraine headaches

Back 188

Vomiting or sleep

Front 189

Three causes of CSF lymphocytosis with elevated protein and low glucose

Back 189

TB meninigitis, viral meninigitis, meningeal leukemia, and medulloblastoma

Front 190

Cranial nerve abnormalities, unsteady gait 2/2 spasticity, behavioral changes, UMN signs

Back 190

Pontine glioma

Front 191

Brain abscess are more commonly seen in patients with

Back 191

Cardiac defects that have R --> L shunts associated

Front 192

When are spinal taps contraindicated?

Back 192

Increasing intracranial pressure

Front 193

Unilateral pupillary dilation, hemiplegia, focal seizures, depressed conciousness after a fall

Back 193

Epidural hematoma

Front 194

3 components of Cushing's triad for increasing ICP

Back 194

Increasing BP, decreasing HR, irregular respiration

Front 195

Tumor causing poor growth, diabetes inspidus, papilledema

Back 195

Craniopharyngioma

Front 196

Acute ataxia in kids

Back 196

Infection or drug intoxication (others would be more chronic)

Front 197

Most common tumors in kids 1-10yo (vs. <1 or >10)

Back 197

Infratentorial (posterior fossa: cerebellar and brainstem) vs. supratentorial

Front 198

Storage diseases: acroparesthesia, intermittent painful crises of extremities or abdomen, cataracts

Back 198

Fabry disease (deficiency of alpha-galactosidase)

Front 199

Girl who has lost the use of her hands and ability to communicate/socialize

Back 199

Rett syndrome

Front 200

Storage diseases: progressive ataxia, weakness, progressive ataxia, gray macular lesions

Back 200

Metachromatic leukodystrophy (deficient activity of galactosyl-3-sulfate-ceramide sulfatase)

Front 201

CSF abnormality in Guillain Barre

Back 201

High protein

Front 202

Peroneal and intrinsic foot muscle atrophy, later extending to intrinsic hand muscles and proximal legs

Back 202

Charcot-Marie-Tooth

Front 203

Where are the intracranial calcifications in congenital CMV vs. toxo?

Back 203

CMV: periventricular
Toxo: cortex

Front 204

Alternative name, cause, and presentation of Werdnig-Hoffman disease

Back 204

(Infantile progressive) spinal muscular atrophy: anterior horn disease --> hypotonia, weakness, and delayed developmental motor milestones

Front 205

Migraine headache + aura that involves unilateral sensory or motor signs

Back 205

Hemiplegic migraine

Front 206

Migraines are also known as

Back 206

Migraines

Front 207

Headache associated w/ menstruation

Back 207

Vascular headache

Front 208

What is echolalia?

Back 208

Automatic repetition of vocalizations made by someone else

Front 209

Common drug reaction from phenothiazines

Back 209

Dystonia (neck, arm, or leg spasms)

Front 210

Rx for dystonia induced by phenothiazines

Back 210

Diphenhydramine

Front 211

What is Sydenham chorea?

Back 211

Acquired chorea of childhood, seeen after group A strep infections (associated w/ rheumatic heart disease)

Front 212

Other signs seen with Sydenham chorea

Back 212

Hypotonia, emotionally labile, milkmaid grip, darting tongue, spooning of an extended hand (flexion at wrist and extension of fingers)

Front 213

Cafe au laits, axillary freckling, Lisch nodules (hamartomas), bony lesions, optic glioma

Back 213

Neurofibromatosis Type 1 (usually also have neurofibromas)

Front 214

PHACE syndrome

Back 214

Posterior fossa malformations
Hemangiomas
Arterial anomalies
Coarctation or other heart problems
Eye abnormalities

Front 215

Most common first sign of PHACE syndrome

Back 215

Unilateral facial lesion (similar to Sturge-Weber) + blindness

Front 216

Large unilateral cafe au lait spots, fibrous dysplasia of bones, precocious puberty, goiter

Back 216

McCune-Albright Syndrome

Front 217

Cause of hyaline membrane disease in newborns

Back 217

Inadequate surfactant production in premies (--> atelectasis --> perfused but non-ventilated alveoli --> hypoxemia)

Front 218

Most common cause of stroke in childhood

Back 218

SCA

Front 219

Teenager with gait ataxia, dysarthria, absence of DTRs, nystagmus

Back 219

Friedrich ataxia

Front 220

Affected spinal regions and inheritance of Friedreich ataxia

Back 220

AR

Spinocerebellar tracts, posterior column, pyramidal tract

Front 221

Non-neuro complications of Friedreich ataxia

Back 221

HCOM, diabetes, skeletal deformities (scoliosis and hammer toes); cardiomyopathy is most common cause of death

Front 222

Macrosomia, macroglossia, visceromegaly, omphalocele, hypoglycemia, hyperinsulinemia

Back 222

Beckwith-Widermann syndrome

Front 223

Differentiating congenital hypothyroidism from Beckwith-Wiedemann syndrome

Back 223

Hypothyroid: umbilical hernia, macrocephaly

BW: omphalocele, microcephaly, pancreatic overactivitiy (hypoglycemia/ hyperinsulinemia)

Front 224

4 complications of infants of diabetic mothers

Back 224

Caudal regression syndrome
Duodenal atresia and small L colon
Transposition of great vessels
Anencephaly and NTDs

Front 225

Findings of WAGR syndrome

Back 225

Wilms tumor
Aniridia
Genitourinary anomaly
mental Retardation

Front 226

Most common symptom with sickle cell trait

Back 226

Painless hematuria

Front 227

Complications of severe cough in pertussis

Back 227

Recal prolapse, epistaxis, pneumothoraces

Front 228

5 times when jaundice in a newborn should be investigated

Back 228

- If it presents before 24hrs of life
- If > 12 (or >10-14 in premies)
- If direct bili > 2
- Rate of increase is > 5/day
- Persists after 10-14 days

Front 229

Progressive pancytopenia and macrocytosis, cafe au lait spots, microcephaly, short, horshoe kidneys, absent thumbs

Back 229

Fanconi's anemia

Front 230

Macrocytic pure red aplasia w/ congenital anomalies (short stature, webbed neck, clef lip, shielded chest, triphalangeal thumbs

Back 230

Diamond-Blackfan syndrome (congenital hypoplastic anemia) (Rx is corticosteroids)

Front 231

Therapy to remove lesions in Sturge-Weber

Back 231

Argon laser therapy

Front 232

Rubeola

Back 232

Measles

Front 233

Underlying abnormality in HSP

Back 233

Small vessel vasculitis

Front 234

Tetrad of HSP

Back 234

Lower extremity palpable purpura, arthritis/ athralgias, abdominal pain, renal disease

Front 235

Rx for HSP

Back 235

Supportive, NSAIDs if in significant pain

Front 236

What type of infections are most commonly seen in DiGeorge syndrome?

Back 236

Fungal

Front 237

Rx for Kawasaki disease

Back 237

Aspirin and IVIG

Front 238

Cyanotic infant with left axis deviation

Back 238

Tricuspid atresia

Front 239

Glomerular abnormality in HSP

Back 239

Mesangial deposition of IgA

Front 240

Risk factors for infant respiratory distress syndrome

Back 240

Prematurity, maternal diabetes, male sex, cesarean section, perinatal asphyxia

Front 241

What decreases the risk of infant RDS?

Back 241

Stress in utero stimulates fetal lung maturity, e.g. prolonged ROM, IUGR, maternal HTN

Front 242

Rx for Turner's Syndrome with 46X/46XY

Back 242

Bilateral abdominal gonadectomy (risk of gonadoblastoma)

Front 243

Congenital infections: hepatomegaly, cutaneous lesions, jaundice, anemia, rhinorrhea

Back 243

Syphilis

Front 244

Gland responsible for adrenarche (e.g. axillary hair growth)

Back 244

Adrenal gland

Front 245

Clinical concern with premature adrenarche and thelarche?

Back 245

Limited, usually benign

Front 246

Clinical concern with premature pubarche (pubic hair growth before the age of 8)

Back 246

CNS disorder associated in 50%

Front 247

Which is covered by a protective membrane, gastroschisis or omphalocele?

Back 247

Ophalocele

Front 248

Which is associated with other congenital abnormalities gastroschisis or omphalocele?

Back 248

Omphalocele

Front 249

Treatment for both gastroschisis and omphalocele?

Back 249

Vaginal delivery, protective wrapping, orogastric tube, IV antibiotics, surgery

Front 250

Vitamin deficiency: sore through, hyperemic and edematous oropharyngeal mucous membranes, cheilitis, stomatitis, glossitis, normocytic-normochromic anemia, seborrheic dermatitis, photophobia

Back 250

Riboflavin

Front 251

Vitamin deficiency: infantile fulminant cardiac syndrome with cardiomegaly, tachycardia, cyanosis, dyspnea, and vomiting

Back 251

Infantile beriberi

Front 252

Vitamin deficiency: symmetric peripheral neuropathy

Back 252

Dry beriberi

Front 253

Vitamin deficiency: neuropathy + cardiac involvement (cardiomegaly, cardiomyopathy, CHF, peripheral edema, tachy)

Back 253

Wet beriberi

Front 254

Hypoglycemic seizures, lactic acidosis, and hyperlipidemia in a 3mo w/ a doll face, thin extremities, and protuberant abdomen

Back 254

Von Gierke's disease/ Type 1 glycogen storage disease

Front 255

Von Gierke's disease is a deficiency of ?

Back 255

Glucose-6-phosphatase

Front 256

Floppy baby in first few weeks of life with hepatomegaly, feeding difficulties, macroglossia, and heart failure (disease + deficiency)

Back 256

Pompe's disease, acid maltase deficiency

Front 257

How to distinguish type 1 glycogen storage disease from type III?

Back 257

Type III has elevated liver transaminases, fasting ketosis, and normal lactate and uric acid concentrations

Front 258

Presentation and major complication of branching enzyme deficiency (type IV glycogen storage disease)

Back 258

Hepatosplenomegaly and FTT --> cirrhosis

Front 259

Rx for clavicular fracture during delivery

Back 259

Nothing!

Front 260

Most common first symptom of autism

Back 260

Lack of a social smile

Front 261

Triad of McCune Albright syndrome

Back 261

Precocious puberty, cafe au lait spots, and polyostotic fibrous dysplasia (--> multiple bone defects)

Front 262

GI tract polyposis and mucocutaneous pigmentation

Back 262

Peutz-Jeghers syndrome

Front 263

Marfan's + thromboembolic events

Back 263

Homocystinuria

Front 264

Homocystinuria is a deficiency of

Back 264

Cystathionine synthase

Front 265

Lab findings in homocystinuria

Back 265

Elevation of both homocysteine and methionine

Front 266

Rx for homocystinuria

Back 266

High doses of vita B6; if unresponsive, restriction of methionine along with supplementation of cysteine

Front 267

When does Becker's muscular dystrophy present?

Back 267

After 5yo (Duchenne's is before), usually around age 12

Front 268

Rx for liquid alkali ingestion?

Back 268

Assess airway; if patent, next step is upper GI endoscopy to assess damage

Front 269

How and when does transposition usually present?

Back 269

With cyanosis and tachypnea within the first few days of life

Front 270

Ingestions: vomiting and agitation progressing to lethargy and restlessness, with convulsions, hyperammonemia, elevated LFTs and LDH, and hypglycemia

Back 270

Reye's syndrome (salicylate ingestion)

Front 271

Biopsy of liver, kidneys, or brain in Reye's syndrome reveals

Back 271

Microvesicular steatosis

Front 272

Rx for Reye's

Back 272

Supportive

Front 273

Rx for scarlet fever?

Back 273

Penicillin V

Front 274

Rx for swallowed foreign object

Back 274

If in esophagus: immediate endoscopic removal

If distal to esophagus: monitor for excretion

Front 275

Lytic bone lesion + hypercalcemia

Back 275

Langerhans cell histiocytosis (if solitary long bone lesion)

Primary hyperparathyroidism (usually from parathyroid adenoma) causes multiple lesions

Front 276

Low temp and jaundice in a neonate

Back 276

Do FIN work-up: jaundice can be present in sepsis

Front 277

Rx for pertussis

Back 277

Macrolide

Front 278

What are Howell-Jolly bodies, and what do they indicate?

Back 278

Nuclear remnants of RBCs that are normally removed by the spleen; indicate asplenia (e.g. in SCD)

Front 279

Work-up and Rx for transient synovitis

Back 279

None!
Ibuprofen and restriction of weight-bearing

Front 280

4 criteria that make septic arthritis more likely than transient synovitis and justify a work-up

Back 280

- Fever
- WBC count > 12
- Refusal to bear weight
- ESR > 40

Front 281

What does the rash in niacin deficiency look like, and which pts are at risk for niacin deficiency?

Back 281

Sunburn

Pts with bowel diseases (e.g. ulcerative colitis) who have absorption problems

Front 282

Vitamin deficiencies: irritability, depression, dermatitis, stomatitis, elevated homocysteine levels (--> atherosclerosis)

Back 282

Vita B6 (pyridoxine) deficiency

Front 283

How to distinguish myocarditis from rheumatic fever after a viral prodrome?

Back 283

Myocarditis causes CHF symptoms, rheumatic fever causes more systemic symptoms

Front 284

In a CF exacerbation, what bug are you making sure to cover for?

Back 284

Pseudomonas

Front 285

Antibiotic regimen for CF exacerbation?

Back 285

IV ceftazidine (or Zosyn) + IV aminoglycoside (want double coverage)

Front 286

Rx for impetigo

Back 286

Topical mupirocin (or oral erhythromycin)

Front 287

Two most common causative agents of impetigo

Back 287

GAS and S. aureus

Front 288

Impetigo is associated with this disease a few weeks afterward?

Back 288

PSGN

Front 289

When are IV fluids indicated for rehydration after gastro?

Back 289

When clinical symptoms of dehydration are present: decreased skin turgor, dry MM, tachy, decreased urine output, delayed cap refill (2-3sec)

Front 290

Endocrine symptoms, paralysis of vertical gaze, eyelid retraction

Back 290

Pinealoma

Front 291

Presentation and Rx for mild (Type I) cases of metatarsus adductus (congenital foot deformity)

Back 291

Passive and action motion of the foot overcorrect into abduction

Reassurance

Front 292

Presentation and Rx for moderate (Type II) cases of metatarsus adductus

Back 292

Motion of the foot corrects into neutral position

Orthoses

Front 293

Dx and Rx for erythema migrans

Back 293

Lyme Disease

PO Amoxocillin (50mg/kg/day divided TID for 21 days)

Doxycycline if >9yo

Front 294

Two X-linked immunodeficiencies

Back 294

Bruton's and Wiskott-Aldrich

Front 295

How to differentiate common variable immunodeficiency (CVID) from Bruton's agammaglobulinemia

Back 295

CVID has decreased IgM, IgG, IgA, and IgE, but normal numbers of circulating B cells (whereas circulating B cells are decreased in Bruton's) and presents with less severe symptoms at a later age (15-35yo instead of 6-9mo)

Front 296

Bedwetting is normal until what age?

Back 296

5yo

Front 297

Mental retardation, hypoplastic maxilla, long philtrum, and microcephaly

Back 297

Fetal alcohol syndrome

Front 298

Elevated 17-hydroxyprogesterone

Back 298

Congenital adrenal hyperplasia

Front 299

What does the Guthrie test look for?

Back 299

PKU (presence of metabolic products of phenylalanine in the urine)

Front 300

Protein content of human milk vs. formula and advantage it conveys

Back 300

Human milk is 70% whey and 30% casein, and whey is more easily digested and helps improve gastric emptying

Front 301

Human milk is associated with ____ reflux and colic than formula

Back 301

Less

Front 302

Most common complication of untreated ureteral reflux in children

Back 302

Renal scarring --> ESRD/ HTN

Front 303

Most common predisposing factor for acute bacterial sinusitis

Back 303

Viral URI

Front 304

Failure to pass meconium within first 24hrs often indicates

Back 304

Hirschsprung's disease

Front 305

Intramural air in the bowel indicates

Back 305

Pneumatosis intestinalis, indicating necrotizing enterocolitis

Front 306

Rx for NEC

Back 306

Antibiotics

Front 307

Rx for respiratory distress from foreign body aspiration

Back 307

Direct laryngoscopy and rigid (NOT flexible) bronchoscopy

Front 308

Should preemies should be given vaccinations based on their gestational or chronological age?

Back 308

Chronological

Front 309

How much do babies need to weight in order to receive the HBV vaccine?

Back 309

2kg

Front 310

Leukocoria, sensitivity to light, and excessive lacrimation

Back 310

Congenital glaucoma

Front 311

Rx for nursemaid's elbow (child keeps arm pronated, no swelling or deformity)

Back 311

Rotating hand and forearm to supinated position w/ pressure over radial head (to reduce the annular ligament)

Front 312

Most common elbow dislocation

Back 312

Posterior

Front 313

Tenderness of lateral epicondyle + pain w/ passive wrist flexion and resisted wrist extension

Back 313

Tennis elbow

Front 314

Baseball player w/ pain, crepitation, and loss of motion of arm

Back 314

Osteochondrosis of capitellum (Panner disease)

Front 315

Clay colored stools, dark urine, enlarged liver + conjugated hyperbili 1-6wks after birth

Back 315

Biliary atresia

Front 316

Rx for breastfeeding jaundice

Back 316

Increase the frequency and duration of feedings to stimulate more milk production

Front 317

Rx for bili > 17 and for bili > 25

Back 317

Phototherapy
Exchange transfusion

Front 318

2wo with bilious vomiting, abdominal distension, and passage of bloodstained stools

Back 318

Midgut volvulus

Front 319

Non-bilious projectile vomiting in a 6wo first-born male

Back 319

Pyloric stenosis

Front 320

Top 3 causes of ear infections

Back 320

Strep pneumo, non-typable H influenzae, and Moraxella catarrhalis

Front 321

Viral causes of rubeola, rubella, and roseola

Back 321

Measles, german measles, HHV6

Front 322

Descending rash + fever + lymphadenopathy

Back 322

Rubella

Front 323

Risk of rapid drops in sodium level (e.g. from rehydrating with hypotonic solutions)

Back 323

Cerebral edema

Front 324

5 long-term neuro sequelae of bacterial meningitis

Back 324

Hearing loss, loss of cognitive functions (e.g. regression of milestones in kids), seizures, mental retardation, spasticity or paresis

Front 325

What is alexia

Back 325

Acquired reading disorder subsequent to brain injury in previously literate pt

Front 326

Abx choices for septic arthritis

Back 326

<5: nafcillin (or vanc) + 3rd gen cef
>5: nafcillin (or vanc) alone

Front 327

Gait disturbances, pes cavus, ataxia, absent ankle jerks

Back 327

Friedreich's ataxia

Front 328

Proximal and distal hypotonia since birth, normal social and language skills, and tongue fibrillations

Back 328

Infantile spinal muscular atrophy (SMA)

Front 329

Another name for infantile SMA

Back 329

Werdnig-Hoffman's syndrome

Front 330

Triple bubble on abdominal XR

Back 330

Jejunal atresia

Front 331

Knee pain from repetitive injury sports in adolescent males w/ some edema and tenderness over tibial tubercle

Back 331

Osgood-Schlatters Disease

Front 332

Another name for and Rx for Osgood-Schlatters Disease

Back 332

Traction apophysitis

Activity restriction, stretching, NSAIDs

Front 333

How to distinguish patellar tendonitis from traction apophysitis

Back 333

Pts w/ patellar tendonitis have point tenderness at inferior pole of patella

Front 334

Knee XR with irregularity/ fracture of the tibial tubercle

Back 334

Traction apophysitis

Front 335

Feared complication fo meningococcemia

Back 335

Waterhouse-Friderichsen syndrome (sudden vasomotor collapse and purpura on flanks due to adrenal hemorrhage)

Front 336

CF is due to what category of mutation

Back 336

Deletion

Front 337

Opsonization defect is most commonly due to ___ and leads to infections with ___ organisms

Back 337

Asplenia
Encapsulated (e.g. S pneumo)

Front 338

Delayed growth spurt, delayed puberty, and delayed bone age on XR

Back 338

Constitutional growth delay (will eventually reach a normal height)

Front 339

Normal birth weight and height, but then growth velocity slows, and child following growth curve at around 5th percentile for multiple years

Back 339

Constitutional growth delay

Front 340

Rx for gonococcal conjunctivitis (2nd-5th day of life)

Back 340

Ceftriaxone

Front 341

Rx for chlamydial conjunctivitis

Back 341

Oral erythromycin or reduce risk of chlamydial PNA

Front 342

Most common cause of polycythemia in newborns

Back 342

Delayed clamping of the umbilical cord --> excess transfer of placental blood

Front 343

Most common complications of polycythemia in newborns

Back 343

Respiratory distress, poor feeding, neuro symptoms (lethargy, irritability, seizures)

Front 344

Dx and Rx for transposition

Back 344

Echo
Prostaglandin E1 to stabilize (maintains PDA), then surgery

Front 345

What type of virus is rubella?

Back 345

Toga virus

Front 346

Congenital infections: cardiac anomalies (PDA and ASD), "blueberry muffin spots" (purpura), jaundice, hepatosplenomegaly

Back 346

Rubella (+ hearing loss and cataracts)

Front 347

Women are at risk of transmitting rubella during which part of pregnancy

Back 347

First four weeks if primary infection

Front 348

Pain in the hip that gradually progresses in a child with sickle cell anemia

Back 348

Avascular necrosis of the femoral head

Front 349

By 1yo, how much should a child have grown compared to birth weight?

Back 349

Triple birth weight
Increase height by 50%

Front 350

How to distinguish ADHD from hearing impairment?

Back 350

Hearing impairment also has poor language development and social isolation

Front 351

Pt normal at birth, then develops muscle weakness and global wasting

Back 351

Myotonic muscular dystrophy

Front 352

Definition of myotonia

Back 352

Delayed muscle relaxation (e.g. inability to release hand after handshake)

Front 353

Another name for and inheritance of myotonic muscular dystophy

Back 353

Steinert disease
AD

Front 354

Other systems involved in myotonic dystophy

Back 354

Endocrine (DM, testicular atorphy, frontal baldness, hypothyroidism)
Immune
Neuro

Front 355

Dx for suspected severe GERD

Back 355

Modified barium swallow with fluorscopy (allows visualization of swallow reflux)

Front 356

Dx for suspected PUD

Back 356

Endoscopy (allows for biopsy and culture)

Front 357

What is Sandifer syndrome?

Back 357

Condition in which infants arch and become tonic when feeding to protect their airway from refluxing gastric contents

Front 358

Dx for suspected Sandifer syndrome

Back 358

Esophageal pH probe

Front 359

Rx for eosinophilic esophagitis

Back 359

Corticosteroids and trigger avoidance

Front 360

XR with dilated loops of bowel and stomach + "curly Q twist of barium

Back 360

Malrotation

Front 361

Rx for malro/volvulus

Back 361

Surgery

Front 362

Echogenic bowel on prenatal ultrasound, then dilated loops of bowel w/ bubbly or granular appearance on XR at birth

Back 362

Meconium ileus

Front 363

Meconium ileus is pathognomonic for

Back 363

CF

Front 364

ASCA is often positive in ___ while p-ANCA is often positive in ____

Back 364

Crohn's
UC

Front 365

Most serious complication of ulcerative colitis

Back 365

Toxic megacolon

Front 366

Rx for Hirschsprung's disease

Back 366

Surgery

Front 367

When are reflux meds indicated

Back 367

Other medical problems (reflux-induced apnea or bradycardia, aspiration PNA, poor weight gain)

Front 368

Diagnosis of Meckel's diverticulum

Back 368

Radionucleotide scan (technetium)

Front 369

Rx of Meckel's

Back 369

Surgical excision

Front 370

Dx of lactose intolerance

Back 370

Hydrogen excretion in breath after oral admin of lactose (or acidic stool pH in presence of reducing substances)

Front 371

Causes of direct hyperbili (>20) in infants

Back 371

CF, alpha-1 antitrypsin deficiency, galactosemia, tyrosinemia, infection, choledochal cyst

Front 372

Moribund appearance indicates dehydration to what extent

Back 372

>10%

Front 373

First teeth to erupt

Back 373

Mandibular central incisors (last are second molars)

Front 374

Infantile tooth decay, maxillary worse than mandibular

Back 374

From bottles

Front 375

Rx for completely avulsed secondary teeth

Back 375

Dental eval w/in 30 min, ensure not a partial avulsion, transport teeth in milk, saline, or someone's mouth

Front 376

Caues and largest risk factor for indirect inguinal hernia

Back 376

Patent processus vaginalis
Prematurity

Front 377

Cause of direct inguinal hernia

Back 377

Weak musculature in inguinal canal

Front 378

Rx for indirect inguinal hernia

Back 378

Surgery b/c incarceration is common

Front 379

How to distinguish swallowed maternal blood from fetal hemorrhage

Back 379

Apt test (fetal Hb unchanged in response to alkali, adult Hb changes to hematin)

Front 380

Rx for NEC

Back 380

Abx, surgery only if perforated

Front 381

Dx of EHEC (from uncooked beef)

Back 381

Stool Cx on sorbitol-MacKonkey agar or assay for shiga toxin

Front 382

Vitamin deficiency: diffuse tenderness (esp on legs), poor wound healing, evidence of hemorrhage, irritability, swelling, tachypnea, poor appetite

Back 382

Vitamin C

Front 383

Vita deficiency: dry skin, poor growth, impaired cognition

Back 383

Vita A (+ night blindness)

Front 384

Ingestions: N/V/D, abd pain, GI bleeding, metabolic acidosis, small opacities on XR

Back 384

Iron poisoning

Front 385

Ingestions: lethargy, fever, hyperpnea, vomiting, tinnitus, metabolic acidosis, unremarkable XR

Back 385

Aspirin poisoning

Front 386

Ingestions: anorexia, bulging fontanelle (pseudotumor cerebri), hyperirritability, vomiting

Back 386

Vita A

Front 387

Ingestions: anorexia, N/V/D, headache, polyuria and polydipsia

Back 387

Vita D

Front 388

Infant with equinus and varus of the calcaneum and talus, varus of midfoot, and adduction of forefoot

Back 388

Clubfoot (talipes equinovarus)

Front 389

Rx for clubfoot

Back 389

Stretching and manipulation, followed by serial plastar casts

Front 390

Rx for RSV

Back 390

Aerosolized ribavirin

Front 391

Most serious complications of Kawasaki disease

Back 391

Giant aneurysm formation, thrombosis, or rupture of the coronary arteries --> MI (so need to perform an echo)

Front 392

5 major Jones Criteria

Back 392

Polyarthritis
Carditis
Chorea
SubQ nodules
Erythema marginatum

Front 393

3 minor Jones criteria

Back 393

Fever
Arthralgia
Previous rheumatic fever

Front 394

Rx for rheumatic fever

Back 394

Benzathine penicillin G (+ AEDs, salicylates, and codeine for chorea, pericarditis, and arthritis, respectively)

Front 395

Embryologic precursor of neuroblastoma

Back 395

Neural crest cells

Front 396

Embryologic precursor of Wilms' tumor

Back 396

Metanephros

Front 397

Cause of thrombocytopenia in Wiskott-Aldrich syndrome

Back 397

Impaired production

Front 398

Cause of thrombocytopenia in ITP

Back 398

Production of Abs against platelets

Front 399

Cause of thrombocytopenia in HUS

Back 399

Platelet activation and consumption (also seen in DIC and TTP)

Front 400

Storage disease: adolescent w/ chronic fatigue (anemia), easy bruisability (thrombocytopenia), bone pain, pathologic fractures (Erlenmyer flask deformity of distal femur) and wrinkled paper cells in bone marrow

Back 400

Gaucher's disease (deficiency of acid beta-glucosidase)

Front 401

Storage disease: infant w/ FTT, hepatospenomegaly, neurodegeneration

Back 401

Niemann-Pick disease (deficient sphingomyelinase)

Front 402

Storage disease: infant w/ hepatospenomegaly and skeletal abnormalities

Back 402

GM1 gangliosidosis (deficient beta-galactosidase)

Front 403

Storage disease: child with cherry red macula, neuro symptoms, hepatosplenomegaly

Back 403

GM2 gangliosidoses, incl. Tay-Sachs' and Sandhoff's (deficiency of hexosaminidase)

Front 404

Storage disease: bone pain and joint swelling

Back 404

Farber disease (deficiency of ceramidase --> accumulation of ceramide esp in joints)

Front 405

Formula mixing for powder and concentrate

Back 405

Formula: 2 scoops to 4oz water
Concentrate: 1 part concentrate to 1 part water

Front 406

Caloric requirement from birth to 2mo per day and for pre-emies

Back 406

100-200cal/kg/day
More (up to 150) for small pre-emies

Front 407

Pharyngitis, fever, dysphagia, neck stiffness, muffled voice

Back 407

Retropharyngeal abscess (look for increased space btwn trachea and vertebrae on XR)

Front 408

Pts with Turner Syndrome are at increased risk for

Back 408

Osteoporosis

Front 409

Rx for nephrotic syndrome in kids

Back 409

Prednisone: 60% is minimal change disease, which is very steroid responsive (add cyclophosphamide if needed)

Front 410

Differentiate bacterial and viral lymphadenitis

Back 410

Bacterial is usually unilateral (+ tender, warm, and erythematous); S. aureus is most common; viral may have more systemic symptoms (bilateral, fever, pharyngitis, hepatosplenomegaly)

Front 411

Non-TB mycobacteria lymphadenopathy

Back 411

Firm, nontender, small lymphadenopathy
Skin becomes thin and violaceous

Front 412

What is the only congenital heart disorder that does not develop endocarditis

Back 412

ASD

Front 413

Side effect of hydroxyurea

Back 413

Bone marrow suppression --> leukopenia, anemia, thrombocytopenia

Front 414

Kids with bronchiolitis (RSV infection) are at increased risk for what later in life?

Back 414

Asthma

Front 415

Incidence of cyclic vomiting is high in children whose parents have a history of

Back 415

Migraine headaches

Front 416

What is the reticulocyte count in spherocytosis?

Back 416

High (up to 9%)

Front 417

Adverse reactions to the DTaP vaccine are usually attributed to which component?

Back 417

Pertussis

Front 418

Recurrent infections with staph and aspergillus

Back 418

Chronic granulomatous disease (impaired oxidative metabolism, predisposing to abscesses from catalase-producing organisms)

Front 419

Most common congenital obstructive urethral lesion in males (--> oliguria in newborns)

Back 419

Posterior urethral valves (can lead to a distended bladder, palpable as abdominal mass)

Front 420

Diagnostic test of choice for suspected posterior urethral valves

Back 420

VCUG

Front 421

Worrisome xray finding in NEC

Back 421

Pneumoperitoneum (indicating intestinal perforation)

Front 422

Neonate with hypocalcemia seizures

Back 422

Think about DiGeorge syndrome

Front 423

Neonate with vomiting, bloody diarhea, stool with RBCs and eosinophils

Back 423

Milk protein intolerance (may have a FH of atopy)

Front 424

Most common cause of congenital hypothyroidim

Back 424

Thyroid dysgenesis

Front 425

Most common complication of supracondylar fracture

Back 425

Entrapment of brachial artery (so check the radial pulse)

Front 426

Newborn with evanescent rash with red halos and eosinophils in the skin lesions

Back 426

Erythema toxicum

Front 427

Strongest risk factor for intraventricular hemorrhage

Back 427

Prematurity/ low birth weight (also exposure to vascular perfusion injuries)

Front 428

Rx for severe asthma exacerbation that is unresponsive to meds

Back 428

Mechanical ventilation (intubation)

Front 429

How to distinguish preseptal and orbital cellulitis

Back 429

Eyelid symptoms (e.g. discoloration) indicate preseptal

Decreased eye movements or visual acuity, double vision, or proptosis indicate orbital cellulitis (as well as systemic symptoms)

Front 430

Rx for preseptal vs. orbital cellulitis

Back 430

Antibiotics for both, but orbital cellulitis requires hospitalization (and possibly surgical decompression)

Front 431

Neonatal hypoglycemia, macroglossia, visceromegaly, omphalocele, earlobe crease

Back 431

Beckwith-Widemann syndrome

Front 432

Self-mutilation, mental retardation, hyperuricemia, dystonia, choreoathetosis, cerebral palsy

Back 432

Lesch-Nyhan syndrome (deficiency in hypoxanthine-guanine phosphoribosyl transferase)

Front 433

Diagnostic test for pyloric stenosis

Back 433

Ultrasound of the abdomen

Front 434

Penicillin and amoxicillin have no activity against this common skin flora bug

Back 434

S. aureus

Front 435

Rx for bacterial lymphadenitis

Back 435

Dicloxacillin (covers both staph and strep, 2 most common agents)

Front 436

Microcephaly and IUGR most likely indicate which class of problems

Back 436

TORCH infection

Front 437

Pathogenesis of Meckel's diverticulus

Back 437

Failure of vitelline duct to obliterate during fetal development

Front 438

Murmur of large VSDs is generally ____ compared to that of small VSDs

Back 438

Soft

Front 439

Newborn with hypoplastic nails, cleft palate, vita K deficiency

Back 439

Fetal hydantoin syndrome (phentyoin use in pregnancy)

Front 440

5 common GI complications of Down's

Back 440

Duodenal atresia
Hirschsprung's
Esophageal atresia
Pyloric stenosis
Malro

Front 441

Type of anemia seen in sickle cell anemia

Back 441

Hemolytic anemia (hemolysis of sickled cells --> reticulocytosis, hyperbili, elevated LDH with low haptoglobin)

Front 442

Rx for SCFE

Back 442

Surgical fixation at current degree of slippage to avoid risk of avascular necrosis

Front 443

Is an LP necessary with a febrile seizure?

Back 443

No, unless signs of meningitis present, child already on Abx, or not immunized

Front 444

How to distinguish a microcytic anemia from iron deficiency vs. thalassemia?

Back 444

RDW: high (>20%) indicates iron deficiency, normal in thalassemia or anemia of chronic disease

Front 445

Peripheral blood smear findings in sickle cell

Back 445

Sickled cells and reticulocytosis

Front 446

Nocturnal vaginal itching: presumed diagnosis, diagnostic test, and treatment

Back 446

Vulvovaginitis from pinworm infection
Scotch tape test
Mebendazole

Front 447

Most common causes of acute bacterial sinusitis

Back 447

Same as ear infections:
Strep pneumo
Non-typable H flu
Moraxella

Front 448

Most common cause of viral meningitis

Back 448

Enteroviruses (PERCH, though not polio: usually echo or coxsackie)

Front 449

Physical exam manifestation of endocardial cushion defect

Back 449

Endocardial cushion defect --> pulmonary HTN --> Loud P2 (Rx is early surgery)

Front 450

Inspiratory noises w/o other complaints; "epiglottis rolling in from side to side" on direct laryngoscopy

Back 450

Laryngomalacia (aka congenital flaccid larynx)

Front 451

Rx for laryngomalacia

Back 451

Reflux precautions
Should resolve by 2yo

Front 452

Organ with highest M&M after HUS

Back 452

Kidneys

Front 453

Why is their jaundice in HUS?

Back 453

Hemolysis (NOT b/c of liver involvement)

Front 454

Down's patient w/ torticollis, urinary incontinence, dizzines, UMN signs (leg spasticity, hyperreflexia, positive Babinski)

Back 454

Alantoaxial instability (due to excessive laxity in posterior transverse ligament, causing increased mobility btwn atlas and axis)

Front 455

Rx for atlantoaxial instability

Back 455

Surgical fusion of C1 to C2

Front 456

How long must disruptive behavior last for conduct disorder diagnosis

Back 456

1yr

Front 457

Differentiate btwn conduct disorder and antisocial personality disorder

Back 457

<18yo for conduct, >18 for antisocial

Front 458

Differentiate btwn conduct disorder and oppositional defiant disorder

Back 458

Conduct: older teens, violation of social norms
ODD: late childhood, negativity, hostility, defiance

Front 459

Definition of infantile colic

Back 459

Starts before 3wks, crying >3hrs/day, >3 days/wk, >3wks/mo

Front 460

Rx for infantile colic

Back 460

Nothing universal: soothing, simethicone, probiotics

Usually resolves by 4mo

Front 461

Drug that opens PDA

Back 461

Prostaglandin E1

Front 462

Drug that closes PDA

Back 462

Indomethacin

Front 463

Rx for labial adhesions (benign fusion of labia minora)

Back 463

Nightly application of estrogen cream + daily petrolatam for 1mo

Front 464

Lax, wrinkled abdominal wall, dilated urinary tract, intra-abdominal testes, renal dysfunction

Back 464

Prune belly syndrome

Front 465

Prune belly syndrome is associated w/ these extra-abdominal effects

Back 465

Oligohydramnios, clubfeet, hip dislocation, malro

Front 466

Anorexia, V, polydipsia, polyuria, fevers, glucosuria w/ normal serum glucose, high urine pH, hyperchloremic metabolic acidosis, albuminuria w/ normal serum protein and albumin

Back 466

Fanconi Syndrome

Front 467

How to distinguish Type 1 from Type 2 RTA

Back 467

Type 2 has a normal urine anior gap, where Type 1 (and type 4) have positive urine anion gaps

Front 468

What is phimosis

Back 468

Inability to retract the foreskin

Front 469

When is phimosis normal?

Back 469

Before 3yo

Front 470

What is acute lobar nephronia

Back 470

In between pyelonephritis and renal abscess

Front 471

Rx for nephronia

Back 471

Prolonged IV and then PO antibiotics

Front 472

Orchiopexy (moving an undescended testicle into the scrotum) reduces the risk of?

Back 472

Testicular torsion (b/c decreases mobility)
Doesn't reduce the risk of testicular malignancy, though does make accessible for periodic exams

Front 473

What counts as the most sterile urine collection in a child?

Back 473

Suprapubic tap

Front 474

PSGN can occur after which two types of strep infections

Back 474

Pharyngitis or impetigo

Front 475

Microangiopathic hemolytic anemia, thrombocytopenia from increased platelet utilization, and renal insufficiency from vascular endothelial injury and local fibrin deposition + bloody diarrhea

Back 475

HUS

Front 476

Pain relief upon elevation of the testicle

Back 476

Prehn sign: indicates epididymitis

Front 477

What is HSP

Back 477

Systemic IgA-mediated vasculitis

Front 478

Bag of worms

Back 478

Varicocele

Front 479

Rx for varicocele?

Back 479

Reassurance
May require surgery for infertility later on

Front 480

Fluid-filled area surrounding testicle that transilluminates

Back 480

Hydrocele

Front 481

Rx for hydrocele

Back 481

Observe, usually resolves by 1yo; larger ones that persist may need surgery

Front 482

Genetics of Alport syndrome

Back 482

X-linked dominant

Front 483

Recurrent gross hematuria + dysuria/abdominal pain

Back 483

Idiopathic hypercalciuria (stones may form over time)

Front 484

Rx for acute glomerulonephritis with oliguria

Back 484

Restrict fluid intake to avoid hypervolemia

Front 485

Elevated cholesterol and triglycerides + edema

Back 485

Nephrotic syndrome

Front 486

Is HTN more likely associate with glomerulonephritis or nephrotic syndrome

Back 486

Glomerulonephritis, apparently

Front 487

FTT with constipation, weakness, vomiting, polyuria/polydipsia, dehydration + hypokalemia, hypercalciuria, alkalosis

Back 487

Bartter Syndrome (juxtaglomerular hyperplasia): also have hyperaldosteronism and hyperreninemia

Front 488

Is mumps usually unilateral or bilateral?

Back 488

Unilateral and spreads to the opposite side

Front 489

Viral infection + sleepiness, emesis, abnormal liver fxn, seizures, coma, respiratory distress, loss of DTRs, posturing

Back 489

Reye's syndrome

Front 490

Reye's is a ____ caused by ___ and ____

Back 490

Mitochondrial hepatopathy
Influenza or varicella infection + aspirin use

Front 491

Cause of death in Reye's

Back 491

Cerebral edema and subsequent herniation

Front 492

What is Ekiri syndrome?

Back 492

Rare and fatal toxic encephalopathy seen with Shigella infection

Front 493

Rx for shigellosis

Back 493

Supportive care and third generation cephalosporin

Front 494

Major cause of tinea capitis

Back 494

Tricophyton tonsurans

Front 495

Rx for trichophyton tonsurans

Back 495

Oral griseofulvin

Front 496

Linear hair loss + regional adenopathy

Back 496

Traction alopecia

Front 497

Hairs near area of hair loss that can be extracted w/ gentle traction --> attenuated or catagen bulb at termination of hair shaft (exclamation hair)

Back 497

Alopecia areata

Front 498

Is mumps usually unilateral or bilateral?

Back 498

Unilateral and spreads to the opposite side

Front 499

Viral infection + sleepiness, emesis, abnormal liver fxn, seizures, coma, respiratory distress, loss of DTRs, posturing

Back 499

Reye's syndrome

Front 500

Reye's is a ____ caused by ___ and ____

Back 500

Mitochondrial hepatopathy
Influenza or varicella infection + aspirin use

Front 501

Cause of death in Reye's

Back 501

Cerebral edema and subsequent herniation

Front 502

What is Ekiri syndrome?

Back 502

Rare and fatal toxic encephalopathy seen with Shigella infection

Front 503

Rx for shigellosis

Back 503

Supportive care and third generation cephalosporin

Front 504

Major cause of tinea capitis

Back 504

Tricophyton tonsurans

Front 505

Rx for trichophyton tonsurans

Back 505

Oral griseofulvin

Front 506

Linear hair loss + regional adenopathy

Back 506

Traction alopecia

Front 507

Hairs near area of hair loss that can be extracted w/ gentle traction --> attenuated or catagen bulb at termination of hair shaft (exclamation hair)

Back 507

Alopecia areata

Front 508

Clinical course of leptospirosis (zoonosis)

Back 508

Septicemic phase; then most are anicteric and go on to immune phase w/ meningitic symptoms
10% are icteric and can have liver and kidney dysfunction

Front 509

Rx for leptospirosis

Back 509

Penicillin and doxycycline

Front 510

Typical age of Kawasaki disease

Back 510

<5yo

Front 511

Rx for newborn baby with pertussis

Back 511

Erythromycin (mom's Ig is insufficient)

Front 512

Diffuse adenopathy, tonsillar enlargement, enlarged spleen, small hemorrhages on soft palate, periorbital swelling

Back 512

EBV

Front 513

Diff in EBV

Back 513

Lymphocyte predominance w/ at least 10% atypicals

Front 514

Rx for mono

Back 514

Avoid contacts sports b/c of enlarged spleen

Front 515

When is it not Kawasaki disease?

Back 515

Teenage pt

Front 516

What is dacrocystitis?

Back 516

Infection of nasolacrimal sac

Front 517

Most common cause of dacrocystitis

Back 517

Nasolacrimal duct obstruction

Front 518

Rx for nasolacrimal duct obstruction

Back 518

Massage and clean w/ warm washcloths; optho referral is not open by 6mo

Front 519

What is a hyphema

Back 519

Blood in anterior chamber of eye

Front 520

Virus causing erythema infectiosum

Back 520

Parvovirus B19 (Fifth disease)

Front 521

Other systems involved in mumps

Back 521

Renal, pancreas, CNS

Front 522

Common cause of death in Wiskott-Aldrich

Back 522

Malignancy 2/2 EBV infection in teenage years

Front 523

Rx for Lyme disease

Back 523

Penicillin or tetracycline

Front 524

Family of ticks associated w/ Lyme vs. RMSF

Back 524

Ixodes vs. Dermacantor

Front 525

What type of bug is Borrelia?

Back 525

Spirochete

Front 526

Pinworm bug

Back 526

Enterobius vernicularis

Front 527

Persistent, nonsuppurative diarrhea

Back 527

Crypto or Giardia

Front 528

Abdominal pain, N/V; then eyelid edema, myalgia, fever, and eosinophilia

Back 528

Trichinella spiralis infection from undercooked pork

Front 529

Close contacts of meningococcemia pt need

Back 529

Rifampin prophylaxis

Front 530

Contraindications to LP

Back 530

Increased ICP WITHOUT open fontanelle; severe thrombocytopenia/ coagulation disorder; CVR distress; skin infection at puncture site

Front 531

Hypergammaglobulin E, eczema-like rash, and recurrent severe staph infections

Back 531

Job-Buckley syndrome (disorder of phagocytic chemotaxis)

Front 532

Rash after administration of amoxicillin

Back 532

EBV (unknown pathophys, but pathognomonic)

Front 533

Culture medium for onorrhea

Back 533

Thayer-Martin media

Front 534

Lab test suggestive of chlamydia pneumonia

Back 534

Increased eosinophils in blood

Front 535

<1yo w/ URI --> severe respiratory distress, pneumatocele, and pneumothorax

Back 535

Staph pneumonia

Front 536

Rx-resistant PNA that develops empyema and needs chest tubes placed

Back 536

Pneumococcal PNA

Front 537

4 contraindications for contact sports

Back 537

One eye, hemophilia, single kidney, unexplained syncope

Front 538

Radionuclide scan results in testicular torsion vs. epididymitis

Back 538

Decreased uptake in torsion, increased uptake in epididymitis

Front 539

Test for herpes

Back 539

Tzanck prep scraping from ulcer w/ multinucleated giant cells and intranuclear inclusions

Front 540

Unilateral draining lyphadenitis

Back 540

Lymphogranuloma venereum (caused by subtype of C. trachomatis)

Front 541

How to distinguish suppurative adenopathy of chancroid from that of LGV?

Back 541

In chancroid is concurrent; in LGV is after ulcer has healed

Front 542

Culture medium for Haemophilus ducreyi (chancroid)

Back 542

Chocolate agar

Front 543

Most common injuries in swimmers

Back 543

Shoulder injuries (rotator cuff tendonitis)

Front 544

Most common injuries in basketball players

Back 544

Knees (and ankles), esp patellar tendonitis and Osgood-Schlatter

Front 545

Common skin conditions in wrestlers

Back 545

Contact dermatitis, fungal infection, HSV, impetigo, staph furunculosis or staph folliculitis

Front 546

Most common ski injury

Back 546

Skier's thumb (hyperextension and abduction of thumb)

Front 547

Jaundice, hepatomegaly, vomiting, seizures on intro of fruit juice

Back 547

Hereditary fructose intolerance

Front 548

Children w/ tyrosinemia have problems w/ these 3 organs, one of which is not improved w/ dietary management

Back 548

Liver (progressive cirrhosis not preventable), kidney, CNS

Front 549

Storage disease seen in teens + enzyme deficeincy

Back 549

Gaucher disease, Beta-glucocerebrosidase

Front 550

Erlenmeyer flask appearance of bone + anemia, leukopenia, and thrombocytopenia

Back 550

Gaucher disease

Front 551

Cause of neonatal thyrotoxicosis

Back 551

Maternally acquired thyrotropin receptor stimulating antibody (which crosses the placenta, unlike TSH)

Front 552

How to distinguish btwn ovarian tumor/ exogenous estrogen and precocious puberty

Back 552

Former suppresses pituitary, so no secondary sex characteristics, just isolated premature thelarche or vaginal bleeding w/o pubic hair

Front 553

White forelock, heterochromia irides, congenital deafness

Back 553

Waardenburg syndrome (AD)

Front 554

Most common cause of hypothyroidism (thyromegaly) in kids

Back 554

Lymphocytic (Hashimoto's) thyroiditis

Front 555

2 common causes of Cushing's

Back 555

Glucocorticoid administration and bilateral adrenal hyperplasia

Front 556

Short, downslanting palpebral fissues, ptosis, low set and malformed ears, broad and webbed neck, shield chest, cryptorchidism, pulmonary stenosis, hearing loss, bleeding diathesis, mental retardation in 25%

Back 556

Noonan Syndrome

Front 557

ITP is usually preceded by a?

Back 557

Viral infection

Front 558

RX for severe ITP

Back 558

IVIG, steroids, anti-D Ig, splenectomy if chronic

Front 559

Levels of free erythrocyte proporphyrin are elevated in these 2 conditions

Back 559

Iron deficiency and lead poisoning

Front 560

Most common acquired RBC aplasia in kids

Back 560

Transient erythroblastopenia of childhood

Front 561

Congenital anemia with increased RBC ADA levels, short stature, and cranial/ upper extremity abnormalities

Back 561

Diamond-Blackfan anemia

Front 562

Increased levels of HbA2 is seen in

Back 562

Beta-thal train

Front 563

What is the Kasabach-Merritt phenomenon?

Back 563

Large vascular anomalies (kaposiform hemangioendothelioma and tufted angioma) sequest platelets and RBCs --> thrombocytopenia, coagulopathy, and microangiopathic hemolytic anemia

Front 564

Rx for Kasabach-Merritt phenomenon

Back 564

Steroids, alpha-INF, and vincristine (no surgery! --> excessive bleeding

Front 565

Another name for port wine stain

Back 565

Nevus flammeus

Front 566

Cells seen in G6PD deficiency

Back 566

Bite cells (RBCs after removal of Heinz bodies)

Front 567

Retinoblastoma is most commonly (spontaneous vs. hereditary) and (unilateral vs. bilateral)

Back 567

Spontaneous and unilateral

Front 568

Cure rate of retinoblastoma

Back 568

90%, though vision loss is common

Front 569

Pts w/ hereditary retinoblastoma are at increased risk of

Back 569

Osteosarcoma

Front 570

When is physiologic anemia of infancy seen?

Back 570

Nadir 6-8wks, as erythropoiesis decreases

Front 571

Anemia in newborn w/ normal retic count and no ABO incompatibility

Back 571

Fetomaternal transfusion

Front 572

How to test for fetomaternal transfusion

Back 572

Keihauer-Betke stain for fetal Hb-containing RBCs in mom's blood

Front 573

Most common childhood malignancy

Back 573

Leukemia

Front 574

Horseshoe kidney and hemihypertrophy are associated w/

Back 574

Wilms tumor

Front 575

Wilms associated w/ abnormalities on chromosome

Back 575

11

Front 576

Abdominal mass + fever, irritability, bone pain, limp, and diarrhea

Back 576

Neuroblastoma

Front 577

Causes of peripheral eosinophilia

Back 577

Asthma, urticaria, infantile eczema, drug reactions, helminth infections, collagen vascular disease

Front 578

Allergic rhinitis causes eosinophilia where?

Back 578

Nasal secretions, not peripheral blood

Front 579

5 lab findings in DIC

Back 579

Prolonged PT and PTT, decreased fibrinogen, fibrin split products, increased D-dimer

Front 580

3 causes of spherocytes other than hereditary spherocytosis

Back 580

Hyperthermia, G6PD deficiency, ABO incompatibility

Front 581

Rx for von Willebrand's disease

Back 581

DDAVP (can also give vWF + Factor VIII if severe)

Front 582

Sunburst pattern of bone formation

Back 582

Osteosarcoma

Front 583

Diffuse LAD, fever, night sweats, malaise, weight loss, pruritis

Back 583

Hodgkin's

Front 584

Dx of suspected Hodgkin's

Back 584

CXR to look for mediastinal mass, then LN biopsy

Front 585

What are Howell-Jolly bodies and when are they seen?

Back 585

Small spherical nuclear remnants seen in reticulocytes of pts w/ asplenia or hyposplenia (e.g. in SCA)

Front 586

Severe anemia requiring transfusions, heart failure, hepatosplenomegaly, weakness

Back 586

Thalassemia major

Front 587

Most common finding on peripheral smear in thalassemia

Back 587

Target cells

Front 588

What are target cells?

Back 588

Erythrocyte with membrane too large for its Hb content, seen in alpha-thal, HbC, and liver diseaes

Front 589

Pregnancy complications more common in teens

Back 589

Premature delivery, low birth weight, pregnancy-induced HTN, violence risk

Front 590

Male Tanner Stages

Back 590

SMR 2: sparse, thin, long pubic hair
SMR 3: darker, curlier pubic hair
SMR 4: adult pubic hair w/o full coverage
SMR 5: pubic hair to inner thigh
(penis lengthening throughout)

Front 591

Female Tanner Stages

Back 591

Sparse pubic hair in SMR 2 --> medial thigh by SMR5
SMR 2: breast buds
SMR 3: larger breasts and areola w/o separate areolar contour
SMR 4: elevation of areola
SMR 5: areola part of general breast contour

Front 592

Rx for suicide attempt w/ nml exam and labs

Back 592

Hospitalize

Front 593

Swollen, red, irritated uvula and dental decay

Back 593

Bulimia

Front 594

Sport concussion recommendations

Back 594

LOC --> evaluate at hospital
No LOC, nml w/in 15 min --> return to game
Confusion > 15 min --> out for 1wk
Confusion > 1hr --> hospital

Front 595

Side effects of isoretinoin

Back 595

Dry skin/eyes/mucous membranes, MSK pain, IBD, pseudotumor cerebri, corneal opacities, abnormal LFTs, increased TGs and cholesterol

Front 596

Dehydration, facial and arm hirsutism w/ loss of head hair, bradycardia, amenorrhea

Back 596

Anorexia

Front 597

Joint swelling in pt with hemophilia

Back 597

Hemarthroses (hemophilic arthropathy), w/ iron deposition and synovial thickening + fibrosis

Front 598

Next option when IV access can't be obtained

Back 598

Intraosseous access (easier than in adults b/c have less bone density)

Front 599

Why do we avoid subclavian lines in kids

Back 599

High incidence of complications (pneumothorax, hemothorax)

Front 600

Differential for T-wave inversion

Back 600

MI, myocarditis, old pericarditis, myocardial contusion, dig toxicity

Front 601

Wide-based gait, decreased vibratory/position sense in legs, absent lower DTRs + inheritance pattern

Back 601

Friedrich's ataxia (AR)

Front 602

Most common non=CNS complication of Friedrich's ataxia

Back 602

Necrosis and degeneration of cardiac muscle fibers --> myocarditis, myocardial fibrosis, and cardiomyopathy (--> arrhythmias and CHF)

Front 603

Unilateral gynecomastia in a 14yo

Back 603

Pubertal gynecomastia: reassure

Front 604

Rx for platelets <30,000

Back 604

Corticosteroids (platelet transfusion only if actively bleeding, as can often cause further destruction of platelets; splenectomy if life-threatening bleed)

Front 605

Why does a hyperextended neck provide relief in epiglottitis?

Back 605

Maximizes the airway diameter

Front 606

Signs of chronic upper airway obstruction since birth, worse while supine, relieved with neck extension

Back 606

Vascular ring (rx: surgery)

Front 607

Cyanosis aggravated by feeding and improved with crying

Back 607

Choanal atresia

Front 608

Inspiratory stridor exacerbated by any exertion; symptoms appear w/in first 2 weeks of life with progressive increase in severity; no cyanosis

Back 608

Laryngomalacia

Front 609

Precocious puberty + signs of severe androgen excess (e.g. severe acne, rapid growth)

Back 609

Precocious pseudo-puberty, a gonadotropin-independent process, often caused by late-onset CAH

Front 610

Heart disease associated w/ neonatal lupus

Back 610

Congenital heart block

Front 611

Heart disease associated w/ congenital rubella

Back 611

PDA

Front 612

Heart disease associated w/ Edward's syndrome

Back 612

VSD

Front 613

Heart disease associated w/ Williams' Syndrome

Back 613

Supravalvular aortic stenosis

Front 614

Breathholding spells may be associated w/ this abnormality

Back 614

Anemia

Front 615

Craniotabes (ping-pong ball sensation over occiput), rachitic rosary (enlargement of costochondral junctions) and thickening of wrists and ankles

Back 615

Vitamin D deficiency rickets

Front 616

Lab findings in Vita D deficiency rickets

Back 616

Serum calcifediol level is decreased, alk phos is increased

Front 617

XR findings in rickets

Back 617

Cupping and fraying of distal ends of long bones; double contour along lateral outline of radius

Front 618

General tenderness, pseudoparalysis (frog position), bluish-purple and spongy/swollen gums over incisors, and depression of sternum

Back 618

Vita C deficiency

Front 619

XR findings in scurvy

Back 619

Pencil-point thinness of long bone cortex and sharply outlined epiphyseal ends

Front 620

How to differentiate autism and Asperger's

Back 620

Asperger kids are more socially aware and communicative; have normal language development

Front 621

Baby born at home with poor suckling and fatigue followed by rigidity, spasms, and opisthotonus + red and inflamed umbilical stump

Back 621

Neonatal tetanus

Front 622

Main causes of death in neonatal tetanus

Back 622

Apnea or septicemia

Front 623

Prevention of neonatal tetanus

Back 623

Maternal immunization

Front 624

Tests used for neonatal HIV diagnosis

Back 624

PCR, viral culture, p24 antigen testing (can't test antibodies b/c maternal Abs cross the placenta)

Front 625

Average survival with neonatal HIV

Back 625

AIDS by 1yo, death by 3yo (progresses more rapidly)

Front 626

Empiric Abx for septic arthritis

Back 626

IV nafcillin or IV cefazolin

Front 627

Mechanism for improvement of tet spells w/ squatting

Back 627

Increased systemic vascular resistance (--> increased blood flow ot pulmonary circulation)

Front 628

In child w/ epidural hematoma, features that necessitate emergent craniotomy

Back 628

GCS < 8, increased ICP, pupillary abnormalities, hemiparesis, or cerebellar signs

Front 629

Rx for pts with a small epidural hematoma and no focal neuro signs

Back 629

F/u CT in 24 hrs

Front 630

Kids with HSP are at risk for this GI problem

Back 630

Intussusception

Front 631

Holosystolic murmur over LLSB and rumbling diastolic murmur over apex

Back 631

VSD

Front 632

Rx for vaginal foreign body

Back 632

Irrigation with warmed fluid first; if unsuccessful, exam and removal with sedation or under general anesthesia

Front 633

Infants who are SGA are at risk for these 7 complications

Back 633

Hypoxia, perinatal asphyxia, meconium aspiration, polycythemia, hypothermia, hypoglycemia, hypocalcemia

Front 634

Paralysis of the left hand and ipsilateral Horner syndrome (miosis and ptosis) after delivery

Back 634

Klumpke paralysis (brachial plexus injury to C7, C8, and T1)

Front 635

Absent Moro reflex and intact grasp reflex of affected arm; adduction and internal rotation/ pronation of arm

Back 635

Erb-Duchenne palsy (C5 and C6)

Front 636

Craniofacial anomalies, fingernail hypoplasia, growth deficiency, dev't delay, cardiac defects, facial clefts

Back 636

Phenytoin use during pregnancy

Front 637

Structure affected in Guillain-Barre

Back 637

Peripheral nerves

Front 638

What test should always be done in patients w/ apparent subQ emphysema 2/2 severe coughing paroxysms

Back 638

CXR to r/o pneumothorax

Front 639

Rx for chronic granulomatous disease?

Back 639

Daily TMP-SMX and gamma-INF 3x/wk

Front 640

Coagulopathy, neuropathy, hepatosplenomegaly, pancytopenia, partial oculocutaneous albinism, frequent bacterial infections (S. aureus) and progressive lymphoproliferative syndrome

Back 640

Chediak-Higashi Syndrome

Front 641

Findings diagnostic of Chediak-Higashi syndrome

Back 641

Neutropenia and giant lysosomes

Front 642

Chronic pruritic dermatitis, recurrent staph infections, eosinophilia, coarse facial features

Back 642

Hyper IgE (Job's) syndrome

Front 643

What must be done prior to surgery for pyloric stenosis?

Back 643

Stabilization w/ IVF and K+

Front 644

2 abnormalities where corrective surgery should be delayed until school age

Back 644

Umbilical hernia
ASD

Front 645

Neck swelling w/ rotation to one side, resisting rotation or flexion + diagnostic test

Back 645

Torticollis
Neck XR to r/o cervical spine fracture or dislocation

Front 646

3 most common causes of acquired torticollis

Back 646

URIs, minor trauma, cervical lymphadenitis

Front 647

How to differentiate HSV meningitis from bacterial meningitis

Back 647

HSV meningitis usually has focal neurologic signs, and fewer band forms on diff

Front 648

Sail sign on CXR

Back 648

Thymic shadow (appears very large in kids, but this is normal in kids <2yo)

Front 649

Infant with FTT, bilateral cataracts, jaundice, and hypoglycemia

Back 649

Galactosemia

Front 650

Enzyme deficiency in galactosemia

Back 650

Galactose-1-phosphate uridyl transferase deficiency

Front 651

Pts with galactosemia are at increased risk for this infection

Back 651

E. coli neonatal sepsis

Front 652

Cataracts in neonatal period

Back 652

Galactokinase deficiency

Front 653

Pertussis prevention for close contacts

Back 653

Erythromycin x 14 days (regardless of age, immunization, or symptoms)

Front 654

Dx and Rx for acute bacterial sinusitis

Back 654

Amoxicillin based on clinical, not radiographic findings

Front 655

Dx for muscular dystrophy

Back 655

Muscle biopsy

Front 656

What is postpericardiotomy syndrome?

Back 656

Reactive pericarditis w/ pericardial effusion that occurs after surgery for congenital heart disease

Front 657

Dx test for proteinuria w/o hematuria

Back 657

Repeat 2 more times (is most likely just transient proteinuria)

Front 658

Rx for Bruton's agammaglobulinemia

Back 658

IVIG infusion

Front 659

Rx for suspected congenital diaphragmatic hernia

Back 659

Orogastric tube w/ continuous suction to prevent bowel distension and further lung compression (followed by intubation)

Front 660

Rx for exposure to varicella

Back 660

Vaccine if within 3-5 days of exposure; varicella IG if immunodeficient

Front 661

When is surgery indicated for umbilical hernias?

Back 661

If persist to 3-4yo, >2cm, symptomatic, strangulated, or progressively enlarges

Front 662

Rx for absence seizures

Back 662

Ethosuximide or valproic acid

Front 663

2 toxoid vaccines

Back 663

Tetanus and diphtheria

Front 664

2 live attenuated vaccines

Back 664

MMR and chicken pox

Front 665

Children with congenital heart disease are at increased risk of this CNS pathology

Back 665

Brain abscess

Front 666

5 risk factors for brain abscess dev't

Back 666

Congenital heart disease, head trauma, infection of jaw/mouth/face/scalp, meningitis, cranial instrumentation

Front 667

Trauma to soft palate + stroke symptoms

Back 667

Internal carotid artery dissection

Front 668

How to distinguish Niemann-Pick from Tay Sachs

Back 668

Hepatomegaly and cervical lymphadenopathy only in NP

Front 669

Pathophys of infantile botulism

Back 669

NOT ingestion of preformed toxin; organisms enter GI tract, where they produce the toxin (a protease that blocks ACh release)

Front 670

Dilation of entire ventricular system w/ distinct enlargement of subarachnoid space over cerebral cortex

Back 670

Communicating hydrocephalus 2/2 subarachnoid hemorrhage (e.g. from intraventricular hemorrhage)

Front 671

Imaging difference btwn Dandy-Walker anomaly and Chiari malformation

Back 671

Dandy-Walker: cystic expansion of fourth ventricle
Chiari: protrusion of structures of posterior fossa thru foramen magnum

Front 672

Diagnostic test for pyloric stenosis

Back 672

Abdominal ultrasound

Front 673

Cause of edema in Turner Syndrome

Back 673

Abnormal development of lymphatic network

Front 674

Distinction btwn the arthritis in JRA and in rheumatic fever

Back 674

Migratory arthritis in rheumatic fever

Front 675

Scalp swelling limited to surface of one cranial bone

Back 675

Cephalohematoma (subperiosteal hemorrhage)

Front 676

Diffuse swelling that crosses suture lines

Back 676

Caput succedaneum

Front 677

Pain, pallor, poikilothermia, paresthesias, pulselessness, paralysis

Back 677

Compartment syndrome

Front 678

Increased gastric residual volume in a preterm neonate

Back 678

NEC

Front 679

Diarrhea, fever, and erythematous rash on abdomen (Rose spots)

Back 679

Salmonella poisoning

Front 680

Common organisms:
G+ diplococci
G+ cocci in clusters
G+ rods
G- cocci
G- rods

Back 680

Strep pneumo
Staph
Listeria and Bacillus
Neisseria
Pseudomonas, Haemophilus, Klebsiella, Legionella

Front 681

Neonate w/ irritability, high-pitched cry, poor sleeping, seizures, sweating, sneezing, tachypnea, V/D

Back 681

Neonatal abstinence syndrome (from opioid withdrawal)

Front 682

Drooling, abdominal distension, rattling breath sounds + atelectasis and gastric distension on XR

Back 682

Esophageal atresia

Front 683

Rx for epiglottitis

Back 683

Intubation w/ preparation for possible tracheostomy

Front 684

Slowly developing back pain, neuro dysfunction (e.g. incontinence), and palpable "step-off" at lumbosacral area

Back 684

High-grade spondyloisthesis

Front 685

Normal at birth, then apathy, weakness, hypotonia, large tongue, sluggish movement, abdominal bloating, umbilical hernia

Back 685

Congenital hypothyroidism

Front 686

Test for CF if can't colelct enough sweat during pilocarpine iontophoresis

Back 686

DNA testing for CFTR mutations

Front 687

Lims shorter than trunk and head disproportionately large

Back 687

Achondroplasia

Front 688

Short but with normal proportions

Back 688

GH deficiency

Front 689

Signs of congenital hypothyroidism

Back 689

Constipation, prolonged jaundice, sluggishness, poor feeding, apnea, choking, macroglossia, excessive sleepiness

Front 690

Newborn w/ macrosomia, macroglossia, abdominal wall defects, linear ear creases, organomegaly, hypoglycemia

Back 690

Beckwith-Wiedemann Syndrome

Front 691

Infants w/ Beckwith-Widemann Syndrome are at increased risk of

Back 691

Malignancies (esp wilms, hepatoblastoma, and gonadoblastoma)

Front 692

Born normal and then loss of milestones, umbilical hernia, kyphoscoliosis, deafness, cloudy corneas, claw hand deformity (disease + deficiency)

Back 692

Hurler syndrome (alpha-L-iduronidase eficiency --> deposition of dermatan and heparan sulfate)

Front 693

What is the bone age in kids with constitutional short stature?

Back 693

Few years behind chronological age (indicating still time for a growth spurt)

Front 694

Inheritance of achondroplasia

Back 694

AD

Front 695

Short w/ delayed bone age, mental retardation, increased bone density esp in skull, brachydactyly, obesity w/ round facies and short neck, subcapsular cataracts, cutaneous and subQ calcifications, perivascular calcifications of basal ganglia

Back 695

Pseudohypoparathyroidism (Albright hereditary osteodystrophy)

Front 696

Lab findings in pseudohypoparathyroidism

Back 696

High PTH w/ low Ca and high phosphorous (receptors are resistance to PTH)

Front 697

Constipation, anorexia, vomiting, polyuria, lethargy after long-term immobilization b/c of fracture

Back 697

Immobilization hypercalcemia

Front 698

Dx test for immobilization hypercalcemia

Back 698

Serum ionized calcium and urinary calcium to creatinine ratio

Front 699

Complicaitons of immobilization hypercalcemia (and resultant hypercalciuria)

Back 699

Nephropathy, nephrocalcinosis, hypertensive encephalopathy, convulsions

Front 700

Hyponatremia, hyperkalemia, hypoglycemia in first 15 days of life

Back 700

CAH

Front 701

Urine that turns black when exposed to air (disease + deficiency)

Back 701

Alkaptonuria (AR), deficiency of homogentisic acid oxidase

Front 702

Rx for alkaptonuria

Back 702

None needed; supplemental ascorbic acid may delay onset of arthritis in adults

Front 703

Cholestasis, elevated LFTs, bleeding into CNS, GI tract, or at umbilical stump

Back 703

alpha-1 antitrypsin deficiency

Front 704

Hypoglycemia in a preemie is due to

Back 704

Decreased glycogen and fat stores

Front 705

Lab values in nutritional rickets

Back 705

Normal serum calcium (decreased absorption, but released from bone and decreased excretion), low phosphate (due to phosphaturia), high PTH (stimulated by transient hypocalcemia, causing the other findings), elevated alk phos

Front 706

Lab findings in vita D resistant rickets + pathophys and inheritance

Back 706

Low phosphate, normal calcium (genetic abnormality in reabsorption of phosphate), X-linked

Front 707

Numbness, tingling, seizures

Back 707

Hypoparathyroidism (--> hypocalcemia and hyperphosphatemia)

Front 708

Obesity, mental retardation, hypogonadism, polydactylyl, retinitis pigmentosa w/ night blindness

Back 708

Laurence-Moon-Biedl syndrome (AR)

Front 709

Sodium and potassium values in pts with central/nephrogenic diabetes insipidus

Back 709

High Na (losing water), somewhat high K+

Front 710

Lab findings in hyperaldosteronism

Back 710

Hypernatremia, hypokalemia (enhancing sodium-potassium exchange), hyperchloremia, alkalosis

Front 711

Lab findings in pts with hyperlipidemia (e.g. von Gierke's)

Back 711

Pseudo hyponatremia and hypokalemia

Front 712

Most common congenital anomaly in Ehlers-Danlos

Back 712

MVP

Front 713

Abnormalities of upper extremities, hypoplastic radii, thumb abnormalities, cardiac anomalies, missing pec major (chest wall musculature)

Back 713

Holt-Oram syndrome