Peds Shelf 6

Front 1

Cause of death in Reye's

Back 1

Cerebral edema and subsequent herniation

Front 2

What is Ekiri syndrome?

Back 2

Rare and fatal toxic encephalopathy seen with Shigella infection

Front 3

Rx for shigellosis

Back 3

Supportive care and third generation cephalosporin

Front 4

Major cause of tinea capitis

Back 4

Tricophyton tonsurans

Front 5

Rx for trichophyton tonsurans

Back 5

Oral griseofulvin

Front 6

Linear hair loss + regional adenopathy

Back 6

Traction alopecia

Front 7

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 7

Alopecia areata

Front 8

Clinical course of leptospirosis (zoonosis)

Back 8

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 9

Rx for leptospirosis

Back 9

Penicillin and doxycycline

Front 10

Typical age of Kawasaki disease

Back 10

<5yo

Front 11

Rx for newborn baby with pertussis

Back 11

Erythromycin (mom's Ig is insufficient)

Front 12

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

Back 12

EBV

Front 13

Diff in EBV

Back 13

Lymphocyte predominance w/ at least 10% atypicals

Front 14

Rx for mono

Back 14

Avoid contacts sports b/c of enlarged spleen

Front 15

When is it not Kawasaki disease?

Back 15

Teenage pt

Front 16

What is dacrocystitis?

Back 16

Infection of nasolacrimal sac

Front 17

Most common cause of dacrocystitis

Back 17

Nasolacrimal duct obstruction

Front 18

Rx for nasolacrimal duct obstruction

Back 18

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

Front 19

What is a hyphema

Back 19

Blood in anterior chamber of eye

Front 20

Virus causing erythema infectiosum

Back 20

Parvovirus B19 (Fifth disease)

Front 21

Other systems involved in mumps

Back 21

Renal, pancreas, CNS

Front 22

Common cause of death in Wiskott-Aldrich

Back 22

Malignancy 2/2 EBV infection in teenage years

Front 23

Rx for Lyme disease

Back 23

Penicillin or tetracycline

Front 24

Family of ticks associated w/ Lyme vs. RMSF

Back 24

Ixodes vs. Dermacantor

Front 25

What type of bug is Borrelia?

Back 25

Spirochete

Front 26

Pinworm bug

Back 26

Enterobius vernicularis

Front 27

Persistent, nonsuppurative diarrhea

Back 27

Crypto or Giardia

Front 28

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

Back 28

Trichinella spiralis infection from undercooked pork

Front 29

Close contacts of meningococcemia pt need

Back 29

Rifampin prophylaxis

Front 30

Contraindications to LP

Back 30

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

Front 31

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

Back 31

Job-Buckley syndrome (disorder of phagocytic chemotaxis)

Front 32

Rash after administration of amoxicillin

Back 32

EBV (unknown pathophys, but pathognomonic)

Front 33

Culture medium for onorrhea

Back 33

Thayer-Martin media

Front 34

Lab test suggestive of chlamydia pneumonia

Back 34

Increased eosinophils in blood

Front 35

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

Back 35

Staph pneumonia

Front 36

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

Back 36

Pneumococcal PNA

Front 37

4 contraindications for contact sports

Back 37

One eye, hemophilia, single kidney, unexplained syncope

Front 38

Radionuclide scan results in testicular torsion vs. epididymitis

Back 38

Decreased uptake in torsion, increased uptake in epididymitis

Front 39

Test for herpes

Back 39

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

Front 40

Unilateral draining lyphadenitis

Back 40

Lymphogranuloma venereum (caused by subtype of C. trachomatis)

Front 41

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

Back 41

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

Front 42

Culture medium for Haemophilus ducreyi (chancroid)

Back 42

Chocolate agar

Front 43

Most common injuries in swimmers

Back 43

Shoulder injuries (rotator cuff tendonitis)

Front 44

Most common injuries in basketball players

Back 44

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

Front 45

Common skin conditions in wrestlers

Back 45

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

Front 46

Most common ski injury

Back 46

Skier's thumb (hyperextension and abduction of thumb)

Front 47

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

Back 47

Hereditary fructose intolerance

Front 48

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

Back 48

Liver (progressive cirrhosis not preventable), kidney, CNS

Front 49

Storage disease seen in teens + enzyme deficeincy

Back 49

Gaucher disease, Beta-glucocerebrosidase

Front 50

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

Back 50

Gaucher disease

Front 51

Cause of neonatal thyrotoxicosis

Back 51

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

Front 52

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

Back 52

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

Front 53

White forelock, heterochromia irides, congenital deafness

Back 53

Waardenburg syndrome (AD)

Front 54

Most common cause of hypothyroidism (thyromegaly) in kids

Back 54

Lymphocytic (Hashimoto's) thyroiditis

Front 55

2 common causes of Cushing's

Back 55

Glucocorticoid administration and bilateral adrenal hyperplasia

Front 56

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 56

Noonan Syndrome

Front 57

ITP is usually preceded by a?

Back 57

Viral infection

Front 58

RX for severe ITP

Back 58

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

Front 59

Levels of free erythrocyte proporphyrin are elevated in these 2 conditions

Back 59

Iron deficiency and lead poisoning

Front 60

Most common acquired RBC aplasia in kids

Back 60

Transient erythroblastopenia of childhood

Front 61

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

Back 61

Diamond-Blackfan anemia

Front 62

Increased levels of HbA2 is seen in

Back 62

Beta-thal train

Front 63

What is the Kasabach-Merritt phenomenon?

Back 63

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

Front 64

Rx for Kasabach-Merritt phenomenon

Back 64

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

Front 65

Another name for port wine stain

Back 65

Nevus flammeus

Front 66

Cells seen in G6PD deficiency

Back 66

Bite cells (RBCs after removal of Heinz bodies)

Front 67

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

Back 67

Spontaneous and unilateral

Front 68

Cure rate of retinoblastoma

Back 68

90%, though vision loss is common

Front 69

Pts w/ hereditary retinoblastoma are at increased risk of

Back 69

Osteosarcoma

Front 70

When is physiologic anemia of infancy seen?

Back 70

Nadir 6-8wks, as erythropoiesis decreases

Front 71

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

Back 71

Fetomaternal transfusion

Front 72

How to test for fetomaternal transfusion

Back 72

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

Front 73

Most common childhood malignancy

Back 73

Leukemia

Front 74

Horseshoe kidney and hemihypertrophy are associated w/

Back 74

Wilms tumor

Front 75

Wilms associated w/ abnormalities on chromosome

Back 75

11

Front 76

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

Back 76

Neuroblastoma

Front 77

Causes of peripheral eosinophilia

Back 77

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

Front 78

Allergic rhinitis causes eosinophilia where?

Back 78

Nasal secretions, not peripheral blood

Front 79

5 lab findings in DIC

Back 79

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

Front 80

3 causes of spherocytes other than hereditary spherocytosis

Back 80

Hyperthermia, G6PD deficiency, ABO incompatibility

Front 81

Rx for von Willebrand's disease

Back 81

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

Front 82

Sunburst pattern of bone formation

Back 82

Osteosarcoma

Front 83

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

Back 83

Hodgkin's

Front 84

Dx of suspected Hodgkin's

Back 84

CXR to look for mediastinal mass, then LN biopsy

Front 85

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

Back 85

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

Front 86

Severe anemia requiring transfusions, heart failure, hepatosplenomegaly, weakness

Back 86

Thalassemia major

Front 87

Most common finding on peripheral smear in thalassemia

Back 87

Target cells

Front 88

What are target cells?

Back 88

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

Front 89

Pregnancy complications more common in teens

Back 89

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

Front 90

Male Tanner Stages

Back 90

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 91

Female Tanner Stages

Back 91

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 92

Rx for suicide attempt w/ nml exam and labs

Back 92

Hospitalize

Front 93

Swollen, red, irritated uvula and dental decay

Back 93

Bulimia

Front 94

Sport concussion recommendations

Back 94

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

Front 95

Side effects of isoretinoin

Back 95

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

Front 96

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

Back 96

Anorexia

Front 97

Joint swelling in pt with hemophilia

Back 97

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

Front 98

Next option when IV access can't be obtained

Back 98

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

Front 99

Why do we avoid subclavian lines in kids

Back 99

High incidence of complications (pneumothorax, hemothorax)

Front 100

Differential for T-wave inversion

Back 100

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