Uw

Front 1

screening for dyslipidemia

Back 1

9-11 and 17-21, high risk of cvd and men age>35,

Front 2

screening for chlamydia

Back 2

all sexually active women <24 years, new partner in past 2 months, multiple partners,illicit drug use, contact with sex workers , incarceration, history of sti

Front 3

rx of entrobious vermicularis in pregnancy

Back 3

pyrantel pamoate. in nonpregnant use albendazole

Front 4

1st like anti-trypanosomal agent

Back 4

benznidazole

Front 5

1st line agent for strongyloides

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ivermectin

Front 6

the most common type of intracranial lesion in NM-1 and typically manifests during toddlerhood.

Back 6

Optic pathwéy glioma

Front 7

best initial screening test for NM-2?

Back 7

audiometry

Front 8

diagnostic test for malrotation with volvulus in children

Back 8

An upper gastrointestinal (GI) contrast series is the best initial examination to visualize the duodenum and assess for malrotation and midgut volvulus in children

Front 9

goal bp in acute ischemic stroke if not recieved thrombolytic therapy?

Back 9

For patients with acute ischemic stroke who are not treated with thrombolytic therapy, we suggest treating high blood pressure only if the hypertension is extreme (systolic blood pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if the patient has another clear indication (active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre-eclampsia/eclampsia) When treatment is indicated, we suggest cautious lowering of blood pressure by approximately 15 percent during the first 24 hours after stroke onset

Front 10

goal bp in ischemic stroke if recieved thrombolytics?

Back 10

For patients with acute ischemic stroke who will receive thrombolytic therapy, antihypertensive treatment is recommended so that systolic blood pressure is ≤185 mmHg and diastolic blood pressure is ≤110 mmHg

treat with labetalol or nicardipine

Front 11

lab to differentiate between hereditary vs acquired angioedema

Back 11

c1q - normal in hereditary type. depressed in acquirred. c4 levels low in all types.

Front 12

stridor in baby that worsen in supine position and improves in prone??

Back 12

laryngomalacia. improves in prone position or when infant held upright.

Front 13

voiding cystourethrogram indications

Back 13

1. if hydronephrosis or scarring is seen in renal ultrasound.

2. It is also indicated in newborns age <1 month 3. children age <2 years with recurrent UTls or a first UTl from an organism other than Escherichia coli.

Front 14

alopecia areata vs tinea capitis??

Back 14

scaling only in tina capitis. Patients usually develop an initial asymptomatic, scaly, erythematous patch on the scalp that can progress to patchy alopecia with a residual black dot. Other findings can include inflammation, painful occipital or postauricular lymphadenopathy, and scarring.

Front 15

how to confirm lyme arthritis?

Back 15

The diagnosis of Lyme arthritis should be confirmed with serum ELISA and Western blot testing- Oral doxycycline or amoxicillin are the first-line treatments for Lyme arthritis in the absence of other manifestations of Lyme disease-

Front 16

finding that differentiates acute otitis media from otitis media with effusion??

Back 16

bulging of tympanic membrane in acute otitis media.

Front 17

indication of myringotomy with tympanic tube placement?

Back 17

recurrent acute otitis media >3 time in 6 months or >4 times in 1 year despite ntibiotic therapy

Front 18

difference btw strep pharyngitis and inf.mono

Back 18

inf mono has posterior or diffuse cervical lymphadenopathy .

Front 19

difference between apthous stomatitis and herpes gingivostomatitis

Back 19

fever only in herpetic gingivstomatitis

Front 20

hisotry of uncorrected congenital malformations of git are contraindication to rota virus vaccine . T/F

Back 20

true

Front 21

confirmatory syphilis tests

Back 21

fta-abs and tppa

Front 22

3 differences between meconium aspiration and resp distress syndrome newborn

Back 22

meconium aspiration occurs in term or post term infants with amniotic fluid stained with meconium. pathy infiltrates and flattening of diagphragm on xray.

Respiratory distress syndrome should be suspected when a premature infant presents with grunting, flaring, and retractions immediately after birth- Chest—x ray includes characteristic fine reticular granularity of the lungs. Treatment includes early continuous positive air pressure ventilation.

Front 23

osteogenesis imperfecta inheritance and gene??

Back 23

autosomal dominant COL1A1

Front 24

ewing sarcoma metastasizes. yes or no?

Back 24

yes. early metastasis to lymph nodes and lung

Front 25

3 features of chondrosarcoma?

Back 25

It occurs in the fifth or sixth decade of life. People with disorders like multiple enchondromas and hemangiomas are at a higher risk than the general population.

X—ray typically reveals a fusiform defect with scalloping.

Front 26

WHATTTT is a vascular benign tumor characterized by the triad of severe intermittent pain, tenderness, and sensitivity to touch. The most common site is subungual in 70% of the cases; the other sites are the palm and wrist- These are usually found in the fourth decade, and affect females more than males.

Back 26

glomus tumor

Front 27

murmur in TOF is due to??

Back 27

pulm stenotis. vsd is usually large so doesnt produce murmur

Front 28

patient with cyanosis, single s2, systolic murmur at left sternal border, cardiomegaly and increased pulm blood flow on xray . diagnosis?

Back 28

TGA(murmur here is from a possible associated vsd) , because of increased flow to lungs. TOF causes decreased bloof flow to lungs.

Front 29

hypoplastic left heart VS TOF?

Back 29

both have single s2 , cyanosis, increase heart size. but usually there is no murmur in HLHS

Front 30

reye syndrome liver biopsy shows??

Back 30

mIcrovesicular steatosis

Front 31

empiric antibiotic therapy for septic arthritis in child <3months?

Back 31

Birth to 3 months Organisms - Staphylococcus, group B streptococcus & Gram-negative bacilli - Antibiotics - Antistaphylococcal agent (nafcillin or vancomycin) PLUS gentamicin or cefotaxime

Front 32

septic arthriti in children oldren than 3 months Rx??

Back 32

Older than 3 months Organisms - Staphylococcus, group A streptococci & Streptococcus pneumoniae - Antibiotics - Nafcillin, clindamycin, cefazolin, or vancomycin

Front 33

septic arthritis patient, tell the step wise approach??

Back 33

arthrocentesis then blood and synovial cultures then empiric antibiotics. if doesnt improve after 48 hours of antibiotics rx then do MRI to rule out concomitant osteomylitis

Front 34

in osteosarcoma, contitutional symptoms eg fever are usually absent. T or F ?

Back 34

true. Constitutional symptoms such as fever, weight loss, and malaise are usually absent- On physical examination, the most important finding is a tender sottissue mass. Alkaline phosphatase and lactate dehydrogenase are elevated from turnover of damaged osteocytes; high levels may correlate with adverse prognosis. Increased erythrocyte sedimentation rate is a non-specic marker of inflammation- Treatment includes tumor excision and chemotherapy.

Front 35

anterior knee pain and point tenderness at inferior pole of paella. diagnosis?

Back 35

patellar tendonitis. in osgood schlatter tenderness is at tibial tubercle.

Front 36

indications of PCV13(conjugate vaccine)

Back 36

all children<5 years

all aduls>65

all patients <65 but with VERY high risk i.e sickle cell, immunocompromized, csf leak, asplenia, cochlear implant

Front 37

9 year old child with nephrotic syndrome features. next step?

Back 37

steroids. children <10 years do not require biopsy as the minimal change disease is high likely. Therefore, biopsy is reserved for steroid-resistant or progressive disease. Older children or adolescents should undergo renal biopsy to exclude other causes of nephrotic syndrome.

Front 38

mesangial hypercellularity in ?

Back 38

membranoproliferative gn

Front 39

crescent formation in which gn?

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focal segmental gn

Front 40

ADPKD is usually asymptomatic in childhood.

Back 40

true. dominant presents in adulthood.

Front 41

initial drug of choice for partial seizures?

Back 41

phenytoin

Front 42

first abnormality on peripheral blood smear in iron deficiency is??

Back 42

Anisocytosis (red blood cells of unequal size) is often the rst nding on peripheral smear, and the increased red blood cell distribution width (RDW) is a quantication of this abnormality.

Front 43

how to recognize left axis deviation on ecg?

Back 43

both I and aVF +ve = normal axis

Left Axis Deviation: leads I and aVL are positive; leads II and aVF are negative

Front 44

Rx of impetigo??

Back 44

Topical antibiotics(eg, mupirocin) for nonbullous

Oral antibiotics (eg, cephalexin, dicloxacillin, or clindamycin for bullous impetigo

Front 45

staph causes both bullous impetigo and SSSS?? but whats the difference??

Back 45

painless, no systemic signs and nikolskys sign -ve in bullous impetigo. opposite findings in ssss.

Front 46

child with clubbing and barrel chest. diagnosis?

Back 46

cystic fibrosis. Hyperination of the lungs causes the rib cage to remain partially expanded, giving the appearance of a "barrel chest." Chronic hypoxia causes bulbous enlargement of the tips of the digits (clubbing)

Front 47

babies with biliary atresia present at ..... age??

Back 47

jaundice and acholic stools by 2 months of age.

Front 48

delayed passage of meconium is considered delayed when???

Back 48

after 48 hours

Front 49

in a child with epilepsy when shud the antiepileptic drugs be stopped?

Back 49

stopping with tapering of antiepileptic drug (AED) therapy should be considered in most children after two years without seizures regardless of the etiology of the seizures.

Front 50

absence seizure first time in a child. will u do brain imaging or not??

Back 50

Patients who have clearly defined epileptic syndromes, such as petit mal epilepsy do not necessarily require neuroimaging.

Front 51

3 findings of sever dehydration in children

Back 51

sunken eyes, sunken fontanelle, capillary refill >3 seconds

Front 52

henz bodies stain on ??

Back 52

crystal violet. remember violet henz ketchup.

wright stain used for howel jolly bodies

Front 53

retinoblastoma ct findings?

Back 53

diagnosis is suspected with US or CT findings of mass with calcifications

Front 54

_____month-old child should have a vocabulary of about 150-300 words and be able to combine words into short sentences.

Back 54

24 months/ 2 years

Front 55

3 findings of fetal alcohol syndrome

Back 55

1. Small palpebral ssures 2. Smooth philtrum (vertical groove above the upper lip) 3. Thin vermilion border

Front 56

vitamin deficiency causing sebhoreic dermatitis

Back 56

riboflavin

Front 57

nutritional cause of hepatomegaly, alopecia, fissuring of mouth, pruritis, irritability

Back 57

hypervitaminosis A

Front 58

Vin gierkes disease enzyme??

Back 58

Glucose 6 phosphatase deficiency.

Front 59

Which glycogen storage disease presents like floppy baby??

Back 59

Acid maltase deficiency. Pompes disease

Front 60

Duchen 💪 dystropy inheritance??

Back 60

X linked recenssive DELETION of dystrophin gene on p21

Front 61

hammer toes in??

Back 61

friedrich ataxia

Front 62

friedrich ataxia inheritance??

Back 62

autosomal receesive. Friedreich ataxia is the most common type of spinocerebeliar ataxias. Remember the combination of neurologic (ataxia, dysarthria), skeletal (scoliosis, feet deformities) and cardiac (concentric hypertrophic cardiomyopathy) manifestations of the disease- The most common causes of death are cardiomyopathy and respiratory complications.

Front 63

why loss of coginitive fucntions can occur in meningitis

Back 63

loss of cognitive functions (due to the neuronal loss in the dentate gyrus of the hippocampus)

Front 64

precocious puberty + cafe aulait spots=???

Back 64

Remember the 3 P's of McCune-Albright syndrome: precocious puberty, pigmentation (cafe au lait spots) and polyostotic brous dysplasia.

Front 65

precocious puberty + GI polyps

Back 65

putz jegherz . also has mucocutaneous pigmentation

Front 66

port wine stain over trigerminal nerve teritory

Back 66

sturge weber

Front 67

only lllife saving rx in cystic fibrosis?

Back 67

bilateral lung transplant

Front 68

leukocyte adhesion deficiency is due to deficienct expression of???

Back 68

cd18

Front 69

dihydrorhodamine test for??

Back 69

chronic granulomatous disease

Front 70

first step in choanal atresia??

Back 70

oral airway and gavage feeding

Front 71

elbow pain is felt with passive wrist exion and resisted wrist extension in __________

Back 71

tennis elbow(lateral epicondilitis)

Front 72

lactose intolerance Rx?

Back 72

Patients should be advised to not eliminate dietary lactose but restrict their intake of lactose to two cups of milk (or its lactose equivalent) daily, taken in divided doses with two meals.

Front 73

lactose intolerance confirm by??

Back 73

hydrogen breath test

Front 74

rx of Cow's milk allergy

Back 74

complete avoidance of milk protein

Front 75

atlantoaxial instability defect??

Back 75

due to excessive laxity in the posterior transverse ligament, which causes increased mobility between the atlas (C1) and the axis (C2).

behavioral changes, torticollis, urinary incontinence, and vertebrobasilar symptoms such as dizziness, vertigo, and diplopia. On examination, upper motor neuron symptoms such as leg spasticity, hyperreflexia, a positive Babinski sign, and clonus are often present. Patients with Down syndrome are normally hypotonic, and they may remain hypotonic or have increased tone with symptomatic atlantoaxial instability.

Front 76

brutons agama... affects boys only?

Back 76

yep . its xlinked recessive

Front 77

transient hypogammagloubulinemia ig levels?

Back 77

IgG low. IgA normal. IgM variable

Front 78

Rx of scarlet fever?

Back 78

treatment is Penicillin V (drug of choice). Erythromycin, clindamycin, and first generation cephalosporins are good alternatives for patients who are allergic to penicillin.