Uworld 7/11/13

Front 1

Continuous flow murmur in infant=?
What else might they have?

Back 1

PDA
-mildly accentuated peripheral pulses

Front 2

Endocardial cushion defect in newborn=?

Back 2

Down's syndrome (AV septal defect)

Front 3

TMT of amebic liver abscess?
Dx Test?
Story

Back 3

Metronidazole
-trophozoites (protozoa) in stool exam, serology, liver imaging
(look for mexico trip w/ bloody diarrhea from colon infxn now w/ liver pathology)

Front 4

What is seen in Charcot's Joint?
What causes it?

Back 4

XR foot shows: loss cartilage, osteophyte development, loos boney fragments, may have effusion
-Neurogenic arthropathy (nerve damage): in diabetic nephropathy, syringomyelia, B12 def, tabes dorsalis, spinal cord injury
-TMT w/ mechanical device/special shoe assist in weight bearing

Front 5

Use of raloxifene?
Contraindication?

Back 5

SERM (selective estrogen receptor modulator=mixed agon/antag of ER, agon in bone, antagon in breast/vag)-decreased risk breast ca/vag ca, TMT of osteoporosis (1st line, but less effective than bisphosph and estrogen)
-DVT!!!
-may cause hot flashes, leg cramps

Front 6

When do you give demsopressin preoperatively?

Back 6

Pt w/ mild hemophilia A, factor deficiency->increased factor VIII and vWF release

Front 7

Apgar scoring?

Back 7

appearance/color: 0 blue, 1 pink except extrem, 2 pink
pulse: 0 <60/asystole, 1 60-100, 2, >100
Grimace/reflex/irritable: 0 no response, 1 grimace/feeble cry, 2 sneeze/cough
Activity/tone: 0 none, 1 some flexion, 2 active moving
Resp: 0 none, 1 weak/irregular, 2 strong

Front 8

Order of newborn care in delivery room:

Back 8

1. suction mouth and nose
2. clamp/cut umbilical cord
3. dry and keep warm infant
4 rubb heals/stimulate to stim crying/breathing
5. assess APGAR at 1min
6. Eye Care w/ silver nitrate and erythromycin/tetracycline
7. Vitamin K IM
8. Hep B vaccine (later) and HBIG (if HBsAg+ mom)

Front 9

TMT of mastitis?
What if abscess?
Most likely organism?

Back 9

abx (dicloxacillin or cephalosporins), analgesics, continue breast feeding from it (decreases progression to abscess)
-I & D (if fluctuance noted)
-S. aureus

Front 10

What is beriberi?

Back 10

Thiamine deficiency->fulminant cardiac syndrome w/ cardiomegaly, tachy, cyanosis, SOB, vomiting in NEWBORN), in adult: dry only has peripheral neuropathy w/ sensory/motor impairment extrem, Wet has both cardiac (CHF + cardiomyop) w/ nerve findings

Front 11

Findings in riboflavin def?

Back 11

Either from 3rd world or have malabsorptive dz/anorexia nervosa: sore throat, cheilitis, stomatitis, glossitis, seborrheic dermatitis, hyperemic edematous OP

Front 12

What is scurvy?

Back 12

vitamin C (ascorbic acid def): impaired collagen synthesis and damaged connective tissue: ecchymoses, petechiae, bleeding gum, arthralgias, impaired wound hearing, coiled hair, Sjogren's syndrome!!

Front 13

What are odd vit A def findings?

Back 13

Bitot spots (dry silver gray plaques on bulbur conjunctiva), cloudy cornea (keratomalacia), dry skin and conjunctiva (xerosis conjunctiva), follicular hyperkeratosis on extensors/butt/shoulder

Front 14

Best long-term relief tmt for duodenal ulcer?

Back 14

abx (CAP) + PPI: since all duodenal ulcers are caused by H. pylori so no relief until that is taken care of (even if ETOH drinker)

Front 15

What is the murmur of IV drug user endocarditis?
What other findings?

Back 15

Tricuspid Regurg: holosystolic murmur increase w/ inspiration
-septic pulm emboli->cough, chest pain, hemop, round alveolar infiltrates on CXR
-immune-complex glomerulonephritis->ptnuria
-Janeway lesions (painless/flat), osler nodes (painful/raised), roth spots (eyes), splinter hemorrhage, conjunctival petechiae
-From Staph aureus (more common in HIV pts)
-Dx w/ blood cx, TTE, TEE
-empiric TMT: vanc/gent: if MSSA: ox/clox/diclox, if MRSA: vanco

Front 16

parodoxical split S2=?

Back 16

P2 b4 A2 during expiration= aortic stenosis, LBBB (LV outflow obstruction)

Front 17

TMT for PCP in HIV/ADS?
What if sulfa allergy?

Back 17

BACTRIM!
-add STEROIDS if PaO2 <70, A-a gradient >35
-sulfa allergy: give pentamidine instead of bactrim
(will know PCP from low O2sat/hypoxia out of proportion to CXR findings of bilat interstitial infiltrate, hi LDH)

Front 18

What is enthesitis?
Where do you get it?
What does it equal?

Back 18

pain/inflammation at sites tendon/ligs attach to bone
-achilles tendon/HEEL, iliac crests, tibial tuber
-Ankylosing Spondylitis

Front 19

Triad of ectopic pregnancy?

Back 19

amenorrhea, abd pain, vag bleeding, esp in pt w/ hx PID

Front 20

Solitary ring enhancing lesion on brain CT w/ fluid collection in L maxillary sinus, pt hving neuro sx=?

Back 20

brain abscess from anaerobic bacteria and aerobes and Bacteroides from maxillary sinusitis

Front 21

6mo old child w/ poor feeding, fussy, bulging anterior fontanelle, wide suturs, growth chart w/ rapid enlarging head circumference=?
Dx Test?
TMT?

Back 21

Hydrocephalus (may also have vomiting, decreased activity, scalp veins)
-CT scan w/ dilated ventricles or MRI (better in u/s, only U/S if <6mo since need wide open fontanelle)
-shunt from ventricle to peritoneum/pleura for CSF drainage

Front 22

Differentiate tension pneumo from shift of ET tube to R main bronchus?

Back 22

tension pneumo will also have hypotension, tachy from impaired RV filling (since compressing the mediastinum)
-Shift ET tube causes atelectasis L lung so will have decreased breath sound, cough, down O2sat, but no change in BP or HR

Front 23

Swelling cheeck and puruelent saliva postop in pt w/ dementia=?
What could have prevented this?

Back 23

Parotitis (most likely staph aureus)
-fluid intake and oral hygiene

Front 24

Brocas vs Wernickes aphasia?

Back 24

Brocas: expressive aphasia (difficulty forming words/speaking, frustrated by it can understand)->dominant frontal lobe

Wernickes: receptive aphasia->superior temporal gyrus

Front 25

Steps for acute preterm labor 24-36wga?

Back 25

Deliver if: pree/eclampsia, maternal cardiac dz, cervix >4cm, hemorrhage/abruptio/DIC, fetal death, chorioamniotis
1. betamethasone (systemic corticosteroids) to prevent RDS (resp distress synd)
2. Tocolysis (mg sulfate, CCB, terbutaline) w/ goal of stopping delivery for at least 48hrs for steroids to work

Front 26

What does SVT mean?
How do they look?

What are paroxysmal SVT (PSVTs)?
Workup?

Back 26

any tachy that is above the His-bundle (sinus tach, afib, aflut, multifoc atrial tach, AV nodal reentrant tach, AV reentrant tach, junctional tach)
-narrow QRS <120ms, rate 160 or >, burried P waves or inverted P waves appearing as spikes on QRS
-AVNRT, AVRT, atrial tach, junctional tach
Steps: evaluate to identify by vagal maneuvers (carotid sinus massage, vasalva, eyeball pressure) or IV adenosine)->will slow conduction via AV node unmaksing "hidden" P waves in a tachy or aflut AND will terminate AV node-dependent arrythmia (AVNRT)

Front 27

TMT of PVCs in clinic?
What about premature atrial beats

Back 27

Observation. If sx or worens-> TMT w/ b blockers
observation (never require tmt always benign)

Front 28

what is R heart failure in pt w/ COPD or pulm dz?
-what to look for?

Back 28

Cor pulmonale (clear lungs w/ prominent RV and pulm artery, flattened diaphragms in copd, JVP, RV heave, hepatomegaly, ascites, edema)

Front 29

Steps in caustic ingestion?

Back 29

1. ensure breaths sounds/patent airways
2. upper GI endoscopy w/in 24hrs to assess injury

do NOT do NG lavage or try to neutralize it, steroids do NOT help

Front 30

Child w/ steatorrhea, failure to thrive, neonatal jaundice, clubbing, wheezing=?

Back 30

CF (also anemia, heat intolerance, steatorrhea from pancreatic insufficiency, rectal prolapse)
-do sweat chloride test x2 followed by gen studies
-give hi cal diet, pancreatic enzyme replacement, fat sol-vitamins
-watchout for gallstones, cirrhosis, portal htn, pancreatic fibrosis

Front 31

Most common cause of hypercalcemia in ambulatory pts vs hospitalized pts?

Back 31

primary hyperpth
malignancy

Front 32

What are physical findings in rickets and xr findings?

Back 32

craniotabes (ping pong ball sensation on head bones)
rachitic rosary (enlarged costochondral junctions)
thick wrist and ankles
Harrison groove (horizontal depression lower border chest)
large anterior fontanell
XR w/ cupping and fraying of distal ends long bones, double contour along lateral outline radius
-<2mos age: vit D and sunlight, after just po vit D

Front 33

Describe heme findings ALL

Back 33

hi WBC, hi blast %, low plt, low hgb, blasts have PAS stain w/ TdT immunostaining

Front 34

Describe histo in burkitt lymphoma
what is it associated w/
TMT?

Back 34

Mature B Cells: "starry sky appearnace"
-EBV mono (pt w/ mass on mandible or abd viscera)
-hi dose chemo very effective

Front 35

27yo M w/ recurrent nosebleeds, ruby colored papules on lips blanch to pressure, and hi hct.
ML Dx?
Cause?
Findings?

Back 35

Hereditary Telangiectasia (osler-weber-rendu syndrome)
-aud dom
-telangiectasias, recurrent epistaxis, discolored skin, AVMs (lung, liver, brain) that shunt blood from R to L heart (AVM in lung)->chronic hypoxemia->reactive polycythemia

Front 36

Difference of Rotors Syndrome and Dubin-Johnson's?
Hint=?
Dx Test?

Back 36

Dubin Johnsons does cause black liver (hepatocytes), Rotors does not
-Sephardic Jews!
-icterus triggered by stress, infxn, OCP, pregnancy
=Test: >50% dbili, test w/ urine coproporphyrin I hi

Front 37

Most common cause of lymphadenitis (tender erythematous enlarged lymph node)?

Back 37

staph aureus, 2 strep pyo

Front 38

violaceous unilateral lymph node 3cm nontender=?

Back 38

MAI (affects kids <5yo)

Front 39

Cause of carpal tunnel in hypothyroidism?

Back 39

accumulation of matrix substances from myxedema (deposition of mucopolysaccharides)

Front 40

Describe back pain of metastatic dz compared to DJD?

Back 40

constant and worse at night wherease DJD is better w/ rest, worse on activity

Front 41

4mo old M infant w/ lethargy, poor feeding, pallow, webbed neck, shielded chest, cleft lip, systolic ejection murmur, Hgb 8, retic 0.4%, MCV 104
ML Dx?
Criteria?

Back 41

Diamond-Blackfan Syndrome (congenital hypoplastic anemia)
-macrocytic anemia, low retic count, congenital anomalies (from defect of erythroid progenitor cells causing increased apoptosis)
-give steroids

Front 42

differentiate esophageal dysmotility of scleroderma from achalasia?

Back 42

Achalasia: absent/decreased peristaltic waves w/ INCREASED LES TONE
Sclero: sticking sensation throat/dysphagia, absent peristaltic waves lower 2/3 w/ DECREASED LES TONE

Front 43

older person w/ dark purpurle ecchymotic skin areas over dorsum of both arms=?

Back 43

Senile Purpura: ecchymotic lesion from perivascular connective tissue atrophy in old age (discoloration/brownish purple from hemosiderin deposits), benign

Front 44

Infant w/ oliguria and midline palpable mass=?
-Dx test?

Back 44

posterior urethral valves
-do voiding cystourethrogram

Front 45

Hypospadias =?
assicated w/?
don't do what?

Back 45

ventral surface opening of urethra (down)
-cryptoorchidism, inguinal hernia
-circumcise

Front 46

Epispadias=?
Associated w/ what?

Back 46

urethral opening dorsal surface (up, pee in eye)
-bladder exstrophy (is bladder outside body)

Front 47

neonate w/ hyrdocele
TMT?

Back 47

nothin
will resolve w/in 6mos

Front 48

description of actinic keratoses.
Tell me about it?
TMT?

Back 48

erythematous papules w/ central scale from hyperkeratosis, may start flat w/ sandpaper like texture but become elevated as "cutaneous horns" no more than 10mm
-seen in 40-60yo w/ excessive sun exposure face, ears, scalp, dorsa arms/hands
-light microscopy w/ thickened epidermis, abnormal keratinization, thickened stratum corneum/hyperkeratosis, may have atypia->premalignant w/ risk of squamous cell ca (based on how big it gets)
-must treat w/ removal or topical 5FU or imiquimod (also used for molluscum contagiosum & condyloma acuminatum/warts)

Front 49

What to do before starting trastuzumab?
What is it used for?

Back 49

echo for cardiac function (EF >55%) since has risk of cardiotoxicity w/ chemo
-HER 2/NEU in breast ca, is ab to that ER receptor

Front 50

When to anticoagulate vs. do more dx steps for PE?

Back 50

The Wells score:[13]
clinically suspected DVT — 3.0 points
alternative diagnosis is less likely than PE — 3.0 points
tachycardia (heart rate > 100) — 1.5 points
immobilization (≥ 3d)/surgery in previous four weeks — 1.5 points
history of DVT or PE — 1.5 points
hemoptysis — 1.0 points
malignancy (with treatment within 6 months) or palliative — 1.0 points
If >4: PE likely: hep infusion, then spiral CT, if 4 or less: other way around

Front 51

5day old infant w/ bloody diarrhea and vomiting, stool exam w/ rbcs and eosinophils=?

Back 51

Milk ptn intolerance: hypersensitivity to cow's milk ptn that usually occurs when given cow's milk but can occur if breast fed (look for hx of atopic dz in family)

Front 52

Chlamydia screening guidelines?

Back 52

annually in sexually active <=25 or women >25 w/ new or multiple sex partners

Front 53

TMT for asymptomatic chlamydia (nucleic acid amp negative for gonorrhea)?

Back 53

single dose azithromycin or doxy course.
(have to treat for gonorrhea if use gram stain to dx instead of nucleic acid amp since less sensitive)

Front 54

How to dx vasovagal syncope in pt w/multiple recurrences (that 24yo white F who faints in stressful sits)?

Back 54

upright tilt table testing w/ or w/out pharmacologic provocation (isoproteronol)->do if recurrent syncopal episodes

Front 55

TMT of cluster headache?

Back 55

1. 100% O2 (best abortive tmt, will not work on migraines)
2. subq sumatriptan
3. ergotamine

ppx w/ VERAPAMIL!

Front 56

pregnant F w/ Ucx showing 150000 colonies e. coli but asx
What to do?

Back 56

Concern for pyelo (>100000 midstream clean catch) that can lead to sepsis, preterm (increase risk in preg since stasis urine)
-TMT w/ amoxicillin, ampicillin, nitrofurantoin, cephalexin

Front 57

Pregnant pt w/ severe vomiting.
STEPS?

Back 57

1. ABCs w/ fluid resucitation
2. bHCG (to r/ow hydatidiform mole or chorioca/gest trophoblastic dz (triad of enlarged uterus, hyperemesis, elevated bHCG >100000))
3. U/S

Front 58

Criteria for hyperemesis gravidum?

Back 58

starts wk 4-10, loss of >5% pre-pregnancy weight, ketonuria, persistant vomiting (will see elevated amylase lipase from salivary gland from vomiting, and up LFTs mildly)

Front 59

What are typical findings in newborns?

Back 59

mammary gland enlargment and nonpurulent vaginal discharge (may be blood-tinged)

Front 60

When do you do a buccal smear?

Back 60

dx Turner's Syndrome

Front 61

What can cause pna and diarrhea in immunocompromised pop?

Back 61

CMV (pneumonitis + GI ulcers->diarrhea and abd pain, arthralgias, myalgias, esophagitis)
Can be seen mos after bone marrow transplant pts

Front 62

10yo boy w/ multiple episodes LOC while playing, immediate regain of consciousness w/out confusion, has impaired hearing since birth, fam hx of cousin w/ sudden cardiac death.
ML Dx?
TMT?

Back 62

Jervell-Lange-Nielson Syndrome=congenital long QT syndrome=Torsades de Pointes (look for pt w/ syncopal episode w/ NO post-ictal period, and hearing impairment and fam hx.)
-Propranolol immediately (if sx, propranolol + DDD pacemaker)

Front 63

What drugs can you take/not take during stress test?

Back 63

48hrs b4 hold: bblockers, ccbs, nitrates
48hrs b4 vasodilator stress: dipyridamole
12hrs b4 vasodilator stress: caffeine
Continue: ACEi/ARB, digoxin, statins, diuretics

Front 64

Acute Migraine tmt?

Back 64

Antiemetics (prochlorperazine, metoclopramide, chlorpromazine)
Triptans (only useful early b4 severe sx, b4 vomiting, photophobia)

PPx w/ propranolol

Front 65

12wk old infant w/ umbilical hernia=think what?
Describe findings?
TMT?

Back 65

Congenital hypothyroidism (cretinism results)
-normal at birth (from maternal hormones present), then develop apathy/no emotion, hypotonia, weakness, large tongue, sluggish, abd bloatin, UMBILICAL HERNIA, jaundice, resp distress, noisy resp, hypothermia, macrocytic anemia (from hypoxemia)
-screening mandated in all states w/ serum TSH, T4
-Levothyroxine

Front 66

long-term neurologic sequelae of bacterial meningitis?

Back 66

1. hearing loss
2. loss cognition
3. seizures
4. mental retardation
5. spasticity or paresis

Front 67

1mo old infant to ED w/ projectile vom, fair hair and skin, eczematous rash, urine w/ mousy odor
ML Dx?
Cause?
Dx Test?
TMT?

Back 67

Phenylketonuria (eczema rash/dermatitis, mental retard/seizure, growth retard, musty body odor, fair skin, normal at birth from maternal products)
-lack of phenylalinine dehydroxalase so phenylalanine builds up and tyrosine becomes essential
-blood phenylalanine levels or Guthrie test:urine coloration for phenylalanine metabolic products
-Diet lo in phenylalanine (no hi ptn, aspartam, nutrasweet)

Front 68

Define an innocent murmur.
TMT?

Back 68

systolic ejection, less than or equal II/VI, varies w/ position, no other sounds, child asx
-observation

Front 69

What causes zenker's diverticulum?

Back 69

Not GERD! It is due to upper esophageal sphincter dysfunction and esophageal dysmotility causing incoodrination leading to herniation of mucosa via a pulsion mech, in pts>50

Front 70

Initial management of suspected infective endocarditis?

Back 70

Draw blood cx then start empiric abx (vanco/gent)

Front 71

Triad of a glucagonoma?
Where does it occur?

Back 71

hyperglycemia (pt may describe need to drink a lot from hypergluc), necrotizing dermatitis!, weight loss

Front 72

What are the uncommon presentations of RA (2)?

Back 72

Felty: RA, splenomegaly, Neutropenia
Caplan: RA, pneumoconiosis, Lung nodules

Front 73

Pt P-ANCA + w/ bloody diarrhea and low back pain w/ sacroiliac inflammation.
ML Dx?

Back 73

Ulcerative Colitis: will have e. nodosum, p-anca, pyoderma gangrenosum, arthritis (similar to AS),episcleritis, cholangitis as extracolonic findings

Front 74

What electrolyte changes cause hyperactive DTRs?
When does this typically happen?

Back 74

Hypocalcemia and hypomagnesimia: typically after surgery w/ lots of RBCs given (citrate can bind to ionized calcium decreasing its total) Remember hypoCa=Tetany
Remember:
Na=weak & delirious
K=weak and paralyzed
Mg=Ca

Front 75

When to think tropical sprue?

Back 75

chronic diarrhea, pt from endemic area, malabsorption (B12, folate=megaloblastic anemia), borborygmi, hyperactive bowel sounds
Dx w/ bx showing blunt villi and lots of eosinophils/lymphocytes/plasma cells et.

Front 76

What is best to influence long term prognosis of STEM?

Back 76

restore coronary blood flow (PTCA or thromoblytic)

Front 77

Summarize differences of mineralization in rickets vs. osteomalacia vs osteogenesis imperfecta vs osteoporosis vs pagets

Back 77

Rickets: defect mineralization bone and cartilage
Osteom: defect mineralization bone only
Osteo I: defective formation collagen (type 1=bone, tendon, ligament, skin, sclera) give bisphosphonates
OsteoP: low bone mass and normal mineralization
Pagets: disordered skeletal remodeling

Front 78

What is Friedreich ataxia?

Back 78

Aut recessive, b4 22yo, spinocerebellar ataxia w/ neuro (gait ataxia, falling, dysarthria) w/ concentric hypertrophic cardiomyopathy, DM, scoliosis, pes cavus, "hammer toes" (death by cardio and resp)
-"Fiedrich is Fratastic (frataxin): he's your favorite frat brother always stumbling, staggering, falling, but big hearted and big toed

Front 79

What is the main long term complication of vesicoureteral reflux?

Back 79

renal scarring->can cause ESRD in young children

Front 80

What is respiratory quotient on ventilator?

Back 80

CO2 produced: O2 consumed per time
=1 if mostly carbohydrate major nutrient (>1 if excess)
=0.8 if protein
=0.7 if fatty acid

Front 81

TMT of GBS=?

Back 81

IVIG or Plasmapheresis

Front 82

Screening for diabetes in pregnancy?

Back 82

-If pregestational DM: switch to insulin (NPH and lispro), do EKG, 24hr urin for baseline renal collecting Cr clearance and ptn, HbA1C, eye exam
-if normal: at 24 and 28wga, give 50g 1hr oral glucose tolerance test (OGTT)->if >140->do 3hr 100g OGTT, if any level > than expected=Gest DM: tmt 1st line w/ diet and excercise->if fails to gets fasting <95 or 1hr postprandial <140: start insulin w/ NPH/aspart

Front 83

McCune-Albright Syndrome?

Back 83

4Ps: precocious puberty, Polycystic ovaries, Pigmented cafe-au-lait spots, Polyostotic fibrous dysplasia of bone

think "the young girl w/ big boobs and cafe au lait spots"

Front 84

TMT of UTI in pregnancy (drugs contraindicated?)

Back 84

Nitrof, amoxicillin, amox-clavulonate, cephalexin
Contrai: tetracyclines, fluoroquin, bactrim

Front 85

Stages of labor?

Back 85

Stage 1 (onset labor->fully dilated): 20hr prima, 14hr multiparous (broken into latent and active phases)
-Latent: 0-4cm dilation (variable, 6hr prima, 4hr multi)
-Active: 4-10cm dilation (1cm/h4 prima, 1.2cm/hr multi)
Stage 2: fully dilate->baby delivered (30m-3hr, 5-30min)
Stage 3: baby->placenta (0-30min both)

Front 86

Signs of placental separation?

Back 86

In stage 3: gush of fresh blood, umbilical cord lengthens, uterine fundus rises, uterus becoming firm

Front 87

Define protracted cervical dilation?
Arrest of cervical dilation?
Arrest of fetal descent?

Back 87

Protracted: less than 1cm or 1.2cm/hr in primi and multi
Arrest dilation: no dilation 2hrs
arrest descent: no descent 1hr
(add an hour to these if epidural anesthesia)

Front 88

What is the proper presentation of fetus in delivery?

Back 88

LOA: Left occipitoanterior position

Front 89

What are adequate contractions in delivery?

Back 89

3-5contractions lasting 40-60sec per 10min

Front 90

Workup of asymptomatic primary hyperparathyroidism?

Back 90

Need surgery if: serum Ca>1mg than max limit OR <50yo OR bone min density <T-2.5 anywhere OR reduced renal function eGFR<60ml/min
-If need surgery: do sestamibi scan (if negative or equival->bilat neck exploration w/ intraop PTH level and gamma probe, if +scan w/ adenoma->resect)

Front 91

Differentiate neurofibromatosis 1 and 2

Back 91

1: cafe au lait, macrocephaly, short stature, feeding problems, learning difficulty, later: fibromas, neurofibromas, Wilms tumor, leukemia, pheocrhomo
2: hilateral acoustic neuromas, cataracts, and neurofibromas

Front 92

When thinking tumor in abdomen palpable in child, what to and how to differentiate?

Back 92

<1yo: neuroblastoma (crosses midline, has urine metabolites of catecholamines, HTN, fever hepatomegaly, ewight loss)
2-5yo: Wilm's (HTN, HEMATURIA, abd pain, vomit)

Front 93

Where do medulloblastomas vs astrocytomas occur?

Back 93

medulloblastoma: cerebellar vermis
astroctyoma: cerebellar hemispheres

Front 94

Conotruncal abnormalities (truncus arteriosus, tet of fallot)=what congenital thing?

Back 94

CATCH-22 syndromes: DiGeorge and velocardiofacial syndromes

Front 95

What should be added to breast milk in all premature babies?

Back 95

iron supplement

Front 96

What should you do if pregant F has chronic hepatitis 2/2 hep C virus?

Back 96

Vaccination against hep A and Hep B! (both are safe in pregnancy)
-breast-feeding is safe if hepC infected mother