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160 Cards in this Set
- Front
- Back
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Murmur associated with patent ductus arteriosus
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Continuous machine like murmur
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Venous hum
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Infraclavicular hum, continuous R/L
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Murmur associated with ASD
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soft, blowing, upper left sternal border
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CHD with down syndrome
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Atrioventricular septal defect
VSD ASD |
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CHD with DiGeorges
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Aortic arch anomalies
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CHD with Noonan syndrome
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Pulmonary stenosis
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CHD with osteogenesis imperfecta
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Aortic incompetence
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CHD associated with Turner
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Coarctation
Bicuspid aortic valve |
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Risk of having CHD if previous baby had one?
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2-4%
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CHD associated with DMII
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TGA
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CHD associated with SLE
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Complete heart block
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CHD associated with phenylketonuria
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TOF
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CHD associated with alcohol consumption
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VSD
ASD |
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CHD associated with Phenytoin Use
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VSD, ASD, PS, AS, Coarctation
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Boot shaped heart on Xray
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TOF
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Egg shaped heart
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TGA
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Snowman heart
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Total anomalous pulmonary venous return
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Most common cancer occurring in first year of life?
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Neuroblastoma
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Cervical spinal nerves affected in Erb's Palsy?
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C5-C6
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When to refer a patient to a urologist if he has an undescented testicle?
Medical name for this condition |
6 Months
Cryptocorshidism |
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Children typically manifest anxiety towards strangers at what age?
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9 months
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Advantage of Pneumococcal 7 valent vaccine Vs Pneumovax in children < 1 year
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It is more immunogenic.
Pneumovax causes a good immunogenic response in individuals > 2 years |
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Radiologic sign of Croup
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Steeple's sign
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Treatment of Croup/Faux croup
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1. Racemic epinephrine
2. Dexamethasone 3. Ventilation assistance if necessary |
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Association between eczema/atopic dermatitis and asthma?
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They both increase the risk of asthma compared to the general population.
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Most suggestive sign of selective mutism?
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Child who does not speak with teachers and classmates
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Criteria for selective mutism
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No speaking in social / specific situations
Child is able to speak in specific environments > 1 month No underlying communication disorder (i.e. stuttering) Social and school dysnfunction |
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Most common cause of neonatal death in children of mothers known to have diabetes mellitus before pregnancy?
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Congenital anomalies
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APGAR
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Appearance
Pulse Grimace (nothing / grimace / cry) Activity (nothing / flexion / active) Respiration |
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Treatment of femoral anteversion
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Observation.
Treatment is only warranted children 8-10 years old who still have cosmetically unacceptable, dysfinctional gaits. |
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Management of congenital heart block caused by SLE?
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Permanent pacemaker
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Bone age vs heigh age vs chronologic in :
- hypothyroidism - cystic fibrosis - genetic syndromes |
HypoT4 : BA< HA = CA
FKP : BA = HA < CA Genetic : HA < BA |
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Most common cause of central cyanosis in newborns
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Lung disease > cardiac disease > sepsis
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Is head banging normal in children < 3 years old?
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Yes. It should stop before 3 years old.
If other signs are present, suspect abuse. Head banging is increased in children with developmental disorders (T21, Lesch-Nyhan, autism) |
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Presentation of radial head sub luxation
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arm in flexion and hand in pronation.
innocent injury commonly inflicted by lifting the child by one arm. |
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Management of lice in children?
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Management of pediculosis :
1) Permethrin 1% (cream or shampoo) 2) comb hair with fine toothed comb using dilute vinegar solution to remove nits 3) repeat in 7 days 4) bedding, clothing and towels should be changed and washed with detergent in hot water cycle then machine dried. |
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Prophylaxis of ophtalmia neonatorum
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Erythromycin ointment
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Most common cause of newborn ophtalmia?
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Chlamydia > gonorrhea
PO erythromycin is better than ointment |
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Is it safe to administer MMR vaccine to children with egg allergies?
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Give the child the MMR vaccine under medical supervision.
The current MMR vaccine does not contain a significant amount of egg proteins. The benefits of the vaccine outweigh the risks. |
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Initial presentation of Duchenne's dystrophy?
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Difficulty walking. Late walking.
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Unfavorable risk factors in ALL
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Age < 2 or > 10
L2 or L3 morphologies or PAS staining Very low platelet count (<100 000) Hb > 10 Favorable age between 2 and 10 L1 morphology |
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What does a normal PCO2 in acute asthma exacerbation indicate?
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It may indicate that the patient is going into respiratory failure, because the pCO2 should be low since the patient should be hyperventilating.
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When is DEET safe to use?
(mosquito repellant) |
DEET (10-30%) is safe to use in children over 2 months of age and is associated with a very rare incidence of major adverse effects.
Do not use over 30%. |
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Genetic disease associated with rectal prolapse
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FKP (20%)
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Most successful intervention for obese children?
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Those that are family based and behaviour oriented
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When should birth weight be regained?
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within 2 weeks
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Most common cause of neonatal death in children of mothers known to have diabetes mellitus before pregnancy?
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Congenital anomalies
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APGAR
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Appearance
Pulse Grimace (nothing / grimace / cry) Activity (nothing / flexion / active) Respiration |
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Treatment of femoral anteversion
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Observation.
Treatment is only warranted children 8-10 years old who still have cosmetically unacceptable, dysfinctional gaits. |
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Management of congenital heart block caused by SLE?
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Permanent pacemaker
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Bone age vs heigh age vs chronologic in :
- hypothyroidism - cystic fibrosis - genetic syndromes |
HypoT4 : BA< HA = CA
FKP : BA = HA < CA Genetic : HA < BA |
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Most common cause of central cyanosis in newborns
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Lung disease > cardiac disease > sepsis
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Is head banging normal in children < 3 years old?
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Yes. It should stop before 3 years old.
If other signs are present, suspect abuse. Head banging is increased in children with developmental disorders (T21, Lesch-Nyhan, autism) |
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Presentation of radial head sub luxation
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arm in flexion and hand in pronation.
innocent injury commonly inflicted by lifting the child by one arm. |
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Management of lice in children?
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Management of pediculosis :
1) Permethrin 1% (cream or shampoo) 2) comb hair with fine toothed comb using dilute vinegar solution to remove nits 3) repeat in 7 days 4) bedding, clothing and towels should be changed and washed with detergent in hot water cycle then machine dried. |
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Prophylaxis of ophtalmia neonatorum
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Erythromycin ointment
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Symptoms of congestive heart failure in infants are often related to feedings. Only small feedgins may be tolerated and dyspnea may develop with feedings.
Profuse perspiration with feedings is characteristic. |
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Treatment of milk protein allergy
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Breastfeeding + mother not taking milk
or Hydrolated casein formulas (nutramigen or pregestimil) |
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Presentation of milk protein allergy
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chronic diarrhea
poor weight gain + sometimes associated to : - eczema - occult blood in stool - intolerance to soy milk |
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Classic presentation of slipped femoral epiphysis
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adolescent male who has probably had a recent growth spurt.
Pain with activity is the most common presenting symptom. Typically in the anterior thigh, but can be referred elsewhere. Limited internal rotation of the hip, especially with the hip in 90 degrees flexion, is a reliable and specific finding for SCFE. |
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Management of caustic chemical burns
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Wash with water then ER.
Do not bandage or put anything that increases that allows the chemical agent to stay in touch with the skin. |
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Most common cause of hemoptysis in 6 year olds?
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Foreign bodies
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Most common posterior mediastinal tumour in children?
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Neuroblastoma
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Most common cause of proteinuria in children
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Orthostatic proteinuria
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Puberty stages in girls
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Thelarche
Adrenarche Pubarche Growth spurt Mearche (mean 13 years, 2 years after breast development) |
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Most common cause of visual loss in children?
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Amblyopia - often related to strabismus, in which the image from one wye is suppressed in order to eliminate diplopia.
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CXR of TTPN
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Diffuse parenchymal infiltrates.
Most common cause of neonatal respiratory distress. It is a benign condition due to residual pulmonary fluid remaining in the lungs after delivery. |
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Possible significant side effect of pertussis vaccine
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hypotonic-hyporesponsive episodes
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Antibiotic used for the treatment of Acne
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Tazarotene
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RIsk factors associated with child sexual abuse
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Female
Physical disabilities (blindness, deafness, mental retardation) Family constellation : - absence of one or both parents - presence of step father in home doubles the risk for girls. |
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Rx causes of gynecomastia
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Hormones (androgens, anabolics, estrogen)
Antiandrogens Antibiotics (INH, Ketoconazole, metronidazole) Anti-ulcer (cimetidine) Chemotherapy Captopril Digitalis |
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Presentation of lead intoxication
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Microcytic anemia with basophilic stippling.
Drops : feet and wrists Encephalopathy Lead lines on gingivae and epiphysis of long bones Abdominal colic |
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Treatment of lead intoxication (what and when)
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When Lead levels > 45 ug/dl
dimercaptol EDTA chelation (succimer) |
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Until what age is nocturnal enuresis considered normal?
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Until the age of 6
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Marcus Gunn Pupil
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During the swinging flashlight test, the patient's pupil constrict less (therefore appearing dilate) when the light swings from the unaffected eye to the affected eye.
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Who should receive U/S after UTI?
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Every child except girls > 6 years old
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Who should receive retrograde cystography after UTI?
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Every child except girls > 6 years old
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When should a Mag3-furosemide be prescribed?
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To differentiate between obstructive and non obstructive hydronephrosis
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Treatment of UTI in children < 3 months
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Ampi-Genta
Hospitalize IV ad 48 hours no fever, then PO, total 10-14 days (ampi-clavu) Gentamycin dosage |
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Treatment of UTI in children 3 months - 6 years
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Ampi+Genta
IV ad 48 hours no fever, then PO 10-14 days (ampi-clavu) Hospitalize if severe- moderate Genta dosage If no signs of dehydration or fever or... PO can be tried initially |
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Treatment of UTI in children > 6 years old
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Pyelonephritis
- According to severity, same as 3 months-6 years - 15-18 years old : Ciprofloxacin or Bactrin Acute cystitis - Bactrin / Cipro / Cephalexin 3-4 days (10 if congenital anomalies) |
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Presentation of necrotizing enterocolitis
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NE is typically seen in the distressed neonate in ICU (at most at 2 weeks of life).
The child appears ill, with symptoms including irritability, poor feeding, a distended abdomen and bloody stools. AXR : pneumatosis intestinalis |
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Imaging for pyloric stenosis
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U/S
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Most common cause of stridor in children < 2years
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Laryngomalacia
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Supplementation necessary for exclusively breastfed infants?
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Vitamin D
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nursemaid's elbow
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Sub luxation of the radial head
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Most common form of child abuse in Canada
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Child neglect
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Most common cause of asymmetric red reflex in newborns?
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Congenital cataract
ddx -retinoblastoma -congenital glaucoma |
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Most common cause of amblyopia
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Starbismus
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Coronary artery aneurysm prevention in Kawasaki disease?
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Aspirin + immunoglobulins
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Mesenteric lymphadenitis
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Inflammation of the lymph nodes on the wall of the mesentery.
It is very similar to appendicitis and it is difficult to differentiate them. Colicky abdominal pain which just resolves momentarily without any intervention. Characteristically, the pain moves from one spot to the other on the abdomen. Asking the child to turn to the left side will demonstrate this shift as the area of pain and tenderness will move along with the bowel to the left. |
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Leading cause of congenital hearing loss
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CMV infection
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Most common congenital infection
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CMV 2.2%
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Only antidepressant approved for the treatment of depression in children 8-17 years old?
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Fluoxetine (Prozac)
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DTaP
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Diphteria
Tetanus Pertusis < 7 years old |
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DT vaccine
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Diphteria
Tetanus < 7 years old |
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Td vaccine
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Tetanus
Diphteria Booster for adolescents and adults every 10 years or after exposure to tetanus |
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Tdap vaccine
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Tetanus
Diphteria Pertussis Booster for adolescents and adults every 10 years or after exposure to tetanus |
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% of auto resolutive congenital hip dysplasia
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60% after 1 week
90% after 2 months |
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Management of congenital hip dysplasia
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Orthopedic referral
- closed reduction and immobilization in a Pavlik Harness, with ultrasonography of the hip to ensure proper positioning. |
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Developmental milestones : 12 months
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Walk with support
Pincer grasp Throw objects Speak in single words |
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Developmental milestones : 6 months
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Tripod sit
Object transfer from hand to hand Babble Stranger anxiety |
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Developmental milestones : 2 years
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2 word sentences
Understand 2 step commands Up/down steps |
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Developmental milestones : 3 years
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3 word combos
3 digit repeat rides ticycle |
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Developmental milestones : 4 years
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Counts 4 objects
Knows 4 colours Draws 4 sided object (square) |
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Developmental red flags
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Not smiling at 3 months
No peek-a-boo at 9 months Exhibits handedness < 10 months Not walking and < 3 words at 18 months |
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Is cipro safe for children?
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no.
It is no approved for patients < 18 years old |
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Palivizumab indications
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MAB administered IM for childern with RSV infection to reduce the risk of hospitalization.
It is indicated if : - chronic lugn disease - preterm birth - congenital heard disease |
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Role of ipratropium added to ventolin in acute asthma exacerbation in children
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lessens the need for hospitalization
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double bubble sign
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duodenal atresia
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Treatment of severely symptomatic salmonella gastroenteritis
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< 18 years old : Bactrim
> 18 years old : Cipro |
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Management of seborrheic dermatitis
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Mild tar shampoo
Oatmeal baths Avoidance of soaps Mild topical sterois Baby oil applicant to scalp Keep diapers as dry as possible |
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What is Reye syndrome
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Acute encephalopathy associated with high ammonia levels.
It occurs after administration of aspirin following a viral illness |
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Hyperoxic test interpretation
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With 100% FiO2 :
PaO2 < 150 = cardiac lesion - if PaO2 < 50 : cardiac lesion with restricted pulmonary flow or a separate venous and arterial circulation - if PaO2 50-150 : no restriction of pulmonary blood flow. |
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McIsaac Criteria
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No cough
Fever > 38 Cervical Lymphadenopathy Sore throat with exudates Age 3-14 Score 0-1 : No culture, no treatment Score 2-3 : Culture, treat if positive Score 4: Antibiotics (First, rapid antigen test, if negative : throat culture) |
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Treatment of GAS pharyngitis
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1) Amoxil 40/kg bid x 10 days
PCN allergy : erythromycin Can prevent rheumatic disease if treated within 9-10 days No effect on prevention post streptococcal GN |
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Relating to baby car seats, until when should the baby face rearward?
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Until he weighs 9 kgs
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When can a child put on a seatbelt in a car?
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When he weighs 36 Kgs or is 8 years old
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Treatment of prepubertal labial adhesions
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Local estrogen application
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When should screening for type II diabetes begin in children?
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Children at risk should be screened at age 10.
At risk = BMI > 85th percentile + - family history, or - race risk, or - signs / symptoms of insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, PCOS) Screening should be done every 2 years. |
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Most common cause of sudden cardiac death in young athletes?
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Hypertrophic cardiomyopathy
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Treatment of impetigo
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1 : Muciprocin topical or Fucidin x 10 days
2 : Oral cloxacillin or cephalexin |
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Anticonvulsant resistant seizures in meningitis patient
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Hyponatremia from SIADH
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Most significant risk factor for the development of childhood asthma?
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Parental asthma
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Example of positive reinforcement
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Reward for a negative or undesirable behaviour
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Example of negative reinforcement
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"Time out" for a negative or undesirable behaviour
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Fetal Alcohol syndrome characteristics
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Thin upper lip
Smooth philtrum Flat nasal bridge Clinodcatyly Prenatal and postnatal growth retardation Functional or structural CNS abnormalities |
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Management of inguinal hernias in children
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Herniorrhapy should be scheduled at the earliest convenient time
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Median age of closure of anterior fontanelle
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13.8 months
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Treatment for nocturnal enuresis that has both the highest cure rate and the lowest relapse rate?
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Bed wetting alarm
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Grades of intraventricular hemorrhage
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grade 1 : isolated subependymal hemorrhage
grade 2 : intraventricular hemorrhage without ventricular dilatation grade 3 : intraventricular hemorrhage with ventricular dilatation grade 4 : intraventricular hemorrhage with parenchymal extension |
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Tuberous Sclerosis
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Autosomal dominant disorder characterized by :
- ash leaf spots (flat, hypopigmented macules) - shagreen patches (areas of anormal skin thickening) - sebaceous adenomas (confused with acne) - facial angiofibromas Can be associated with mental retardation and seizures |
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Sturge Weber syndrome
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Port-wine lesions on the face in the distribution of the trigeminal nerve.
Associated with vascular proliferation within the brain leading to hemiatrophy and seizures as well as vascular proliferation in the eye which may lead to glaucoma. |
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Von Hippel-Lindau disease
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Characterized by vascular hamartomas in the eye and brain
+ renal cell tumours + pheochromocytoma |
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Neurofibromatosis
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Multiple Café au Lait macules on the skin + fibromas
+ hypertension secondary to renal artery stenosis |
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How to differentiate between Asperger's and autism
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In both condition, children have significant difficulties with social interactions, although the impairment is more severe and sustained in autism. Both Asperger's and autism may be associated with symptoms of repetitive motor mannerisms, restricted patterns of interest, or preoccupation with parts of objects.
However, unlike children with Asperger's syndrome, autistic children have serious problems with communication skills, either in the development of speech itself on in the ability to carry on a conversation. Normal, age appropriate language skills in a 3 year old would r/o a diagnosis of autism. |
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Age where an abdominal hernia should disappear
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1-3 years of age
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Piaget's stages
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Sensorimotor stage (0-2) : children learning by activity, explanation and manipulation of environment.
Preoperational stage (2-7) : the child engages in symbolic representation of the world Concrete opearations (7-11) : the child is capable of limited, logical thought process Formal operations (12-adult) : the child can reason logically and abstractly |
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Eye pathology associated with pauci-articular JRA
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Uveitis
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Most common posterior fossa tumours in children
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Medulloblastoma
Cerebellar astrocytoma Ependymoma |
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Most common Brain tumour in children
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Low grade pilocytic astrocytoma
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Most common brain cancer in children
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Medulloblastoma
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Three most common knee conditions in children
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Patellar sub luxation
Tibial apophysitis Patellar tendonitis |
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Most common cause of hypertension in adolescents
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Essential hypertension
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At what age are tears produced?
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3 weeks of age
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Pubertal stages in boys
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1. Growth of scrotum and testes
2. Lengthening of penis + growth of prostate 3. Pubarche 4. Axillary and facial hair (2 years after pubic hair) 5. Growth spurt (1 year after pubarche) 6. ejaculation |
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What is infantile esotropia
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constant inward turning of the eyes that develops before 6 months of age. It often runs in families and tends to be severe.
Exotropia is a constant outward turning of the eye. |
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Tests to order for suspected early puberty in boys?
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Testosterone
DHEA and DHEA-S Bone age X-Ray Urinary 17-Ketosteroids |
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What does C1 esterase inhibitor deficiency signify?
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Hereditary angioedema
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At what age can cow milk be started?
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12 months
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Human milk conservation
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10 hours at room temperature
8 days in refrigerator 12 months in freezer When frozen, it should be thawed slowly Should not be refrozren Human milk naturally separates and can be easily re-emulsified by shaking |
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Characteristics of growing pains?
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Age 9 - 14
Pain is poorly localized Can awaken child at nigh Pain abates with reassurance and massage |
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Osgood Schlatter disease
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irritation of the patellar tendon at the tibial tuberosity.
Mainly in patients 10-15 years of age. ACtive in sports that involve a lot of jumping. 2nd to repetitive microtrauma and traction apophysistis of the tibial tuberosity. Bilateral symptoms can be present. Self limited condition. Treat with rest, NSAIDs, physio and infrapatellar strap during activities. |
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What is a post traumatic air-fluid level in the sphenoid sinus associated with?
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Basilar skull fracture
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Myelomeningocele is associated with which allergy?
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Latex
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Most likely cause of hearing loss in newborns?
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Genetic disorders
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Complications of NRDS
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Bronchopulmonary dysplasia
Persisten ductus arteriosus Interventiruclar hemorrhage Necrotizing enterocolits Prematurity retinopathy (because of Oxygen supplementation for NRDS) |
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West syndrome
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Infantile Spasms
Arrest of psychomotor development Hypsarrhythmia pattern on EEG |
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Lesh Nyhan syndrome
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X linked recessive
Causes build up of uric acid Neuro + Renal symptoms Allopurinol for renal Usually at 1 year old |
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Neurodegenerative disease that affects children when they get 5 months olds causing loss of acquired skills
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Rett syndrome
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