1
Q
What vaccine is CI to give after 15 weeks?
A
Rotavirus
2
Q
What is the super important patient education when prescribing a pt Prozac?
A
Thoughts of suicide
3
Q
How would you describe lichen straie?
A
4
Q
What is a factor of a superficial burn?
A
Stays in the epidermis
5
Q
What pathogen causes white dots on the nails?
A
Trichophyton rubrum
(Dermatophyte)
6
Q
What is the Latin name for pinworms?
A
Enterobius vermicularis
7
Q
Pt has nasal polyps, what cell type would be the most prominent in their nasal secretions?
A
Eosinophils
8
Q
Presentation of acute mastoiditis, what imaging?
A
CT scan
9
Q
What is the peripheral blood smear going to show in lead poisoning?
A
Basophilic stippling
10
Q
Drooling, anxiety, fever and stridor in a pt sitting in a tripod position is indicative of what dx?
A
acute epiglottitis
11
Q
Congenital dermal melanocytosis is most commonly seen over what 2 areas?
A
sacrum and shoulders
12
Q
Ocular erythromycin is given to infants to cover for what pathogen?
A
Neisseria gonorrhoeae
13
Q
What is the triad of infantile spasms? What is the MC age range?
A
-clusters of myoclonic seizures on awakening
-hypsarrhythmia pattern on electroencephalogram
-developmental delay
4-8 months old
14
Q
What will the lumbar puncture show in a pt with Guillain-Barré syndrome?
A
-elevated protein level, typically twice the upper limit of normal.
-WBC count in the CSF is within normal limits.
-glucose level falls within the normal range
This dissociation between high CSF protein and normal cell counts (albuminocytologic dissociation) is diagnostic for Guillain-Barré syndrome.
15
Q
What is kerion? What is the treatment?
A
kerion is an abscess caused by a fungal infection, most commonly on the scalp, but may also present on the upper limbs and the face. It appears as a boggy, pus-filled lesion with significant inflammation. The overlying skin often has an eczematous, itchy rash as well as hair loss.
oral griseofulvin
16
Q
What is the tx for whooping cough?
A
macrolide
17
Q
What test differentiates fetal from maternal blood?
A
apt test
18
Q
What is the underlying cause of epiglottis in unvaccinated children (think kiddos from abroad)?
A
HIB
19
Q
What is the underlying cause of Meckel’s diverticulum? What age range?
A
usually presents with painless rectal bleeding and is due to incomplete obliteration of the vitelline duct
Congenital anomaly due to incomplete obliteration of the omphalomesenteric duct
20
Q
What is the xray finding associated with slipped capital femoral epiphysis?
A
widened and irregular femoral physis
21
Q
crescent-shaped radiolucency surrounding a subchondral bony fragment at the medial femoral condyle is associated with what condition?
A
osteochondritis dissecans (OCD)
22
Q
What is the xray finding associated with croup?
A
steeple sign
symmetric narrowing of the subglottic trachea
23
Q
What virus causes croup?
A
parainfluenza virus
24
Q
What are the signs and symptoms of increased intracranial pressure?
A
HTN, widened pulse pressure, bradycardia, irregular respirations, unilateral pupillary dilation, extensor posturing
25
What is another name for group B strep?
Streptococcus agalactiae
26
What is another name for group A strep?
Streptococcus pyogenes
27
tissue adhesives are equivalent in strength to _____ sutures
5-0 nylon
28
______ is a continuous murmur that is accentuated with head extension while seated. Best heard over the left or right upper sternal border
cervical venous hum
(innocent murmur)
29
Hirschsprung disease is associated with what other condition?
trisomy 21
30
What is the MC cause of intestinal obstruction in infants between 6-36 months of age?
intussusception
31
What is the first line treatment for recent-onset, functional constipation in children?
parental and patient education and initiation of oral laxatives
32
What is the initial treatment dose for a kiddo older than 12 months old who has low vitamin D (less than 12)? What is the maintenance dose?
Treatment for children > 12 months of age begins with vitamin D 50 mcg daily for at least 6 weeks
maintenance dosing of 600 to 1,000 international units (15–25 mcg) once daily.
33
_______ is the hallmark lab finding for anorexia nervosa
hypophosphatemia
34
greater than ____% BMI percentile in kiddos older than 2 years old is considered obese
greater than or equal to 95th% is obese
35
greater than ____% BMI percentile in kiddos older than 2 years old is considered overweight
85-94th % is overweight
36
What is considered a healthy weight BMI percentiles?
5-84th percentile is healthy weight
37
What is the inheritance pattern of CF?
autosomal recessive
38
What is the MC cause of acute bronchiolitis?
RSV
respiratory syncytial virus
39
chronic cough that produces foul-smelling sputum, what dx? What is the test of choice?
bronchiectasis
high resolution CT
40
What is the first abx used in an UTI in kiddos?
1. cephalosporin
2. Augmentin
3. Bactrim
4. Cipro ( used in severe PCN allergy as well)
41
What virus most frequently causes croup?
parainfluenza
42
"thumb/thumb print sign is associated with what dx? What pathogen?
epiglottis
group A strep
43
What is the difference between caput succedaneum and a cephalohematoma?
caput succedaneum CAN EXTEND across suture lines
cephalohematoma does NOT cross suture lines
44
At what age should a child begin to take independent walking steps?
12 months
45
What is the work up for an ingested blunt object?
Ingested blunt objects can be observed for 24 hours, after which they should be removed if they fail to pass through the esophagus. If the object passes to the stomach, the patient can be observed for another week without intervention
46
What is the MC cause of neonatal eye discharge?
lacrimal duct obstruction
47
What is coprolalia?
the involuntary, compulsive use of obscenities.
One-third of cases are familial, and the underlying pathology is felt to lie within the caudate nucleus.
48
What is glossolalia?
speaking elaborate but meaningless speech, or speaking an unknown language
49
What is palilalia?
involuntary repetition or echoing of one’s own words
50
What is xenolalia?
is the use of an invented or artificial language
51
What is the MC congential heart disease?
ventricular septal defect
52
A harsh, medium- to high-pitched pansystolic murmur heard best at the left sternal border in the third and fourth intercostal spaces. This murmur radiates over the entire precordium. What dx?
ventricular septal defect
53
skin biopsy that comes back full-thickness keratinocyte epidermal necrosis. What dx?
steven-johnson syndrome
54
What is the treatment for scalded skin syndrome?
nafcillin or oxacillin
vanc if ^ fails
55
slipped capital femoral epiphysis (SCFE) often present with decreased _______ rotation of the hip hip
internal rotation
56
rash starting on the neck or trunk and spreading to the face and extremities, what dx?
roseola
57
rash most prominent on the face or cheeks, with or without subsequent spreading to the trunk and extremities. What dx?
erythema infectiousum (5th disease)
parvovirus B19
58
rash starting on the head and spreading to the face and extremities, what dx?
rubella or rubeola
59
rash starting on the trunk and spreading to the extremities, sparing the soles of hands and feet. What dx?
scarlet fever
60
What is important to note about retinal hemorrhages and child abuse?
the severity of retinal hemorrhages likely correlates with the likelihood of abuse
61
What is the most common cause of aortic stenosis in pediatric patients?
bicuspid aortic valve
62
"double bubble"sign on xray is associated with what 2 dx?
duodenal atresia and volvulus
63
What virus causes erythema infectiosum?
parvovirus B19- slapped cheeks
64
How is measles transmitted?
person-to-person contact and airborne spread
65
What is the first line med used in HCMO?
BB
then non-CCB
66
a harsh holosystolic murmur is auscultated at the mid-left sternal border, and a thrill is palpated at the third left intercostal space. What dx? What maneuver makes it worse?
ventricular septal defect
hand-gripping and squatting increase the murmur
67
CF patients with weight loss, steatorrhea, increased bulky, pale and foul-smelling stools need to supplement _____ and _______
pancreatic enzymes and fat soluble vitamins (DAKE)
68
When should symptoms of colic start to improve?
typically improves by 12-16 weeks of age
69
infants double their birth weight by _____ and triple by ______
double by 4 months
triple by 12 months
70
What are some triggers of erythema multiforme?
HSV
mycoplasma
sulfonamides
PCN
barbiturates
phenytoin
lupus
hepatitis
lymphoma
71
Sweat chloride test has to be ______ to be diagnostic for CF
over 60 mEq/L
72
Draw the char for Tanner staging
73
What is the test of choice to confirm lactose intolerance?
hydrogen breath test
74
What is the pathophys behind anemia of infancy? What age range?
decreased erythropoiesis due to increased tissue oxygenation after birth
low hemoglobin between 6-9 weeks old
75
What GI pathogen can cause high fever and seizures in children under 2 year old?
Shigella
so will also have diarrhea, tenesmus etc etc
76
What are the 3 main causes of physiologic jaundice in a newborn?
1. newborns have a higher hematocrit than adults and their red blood cell lifespan is shortened to less than 90 days so they have increases bilirubin
2. newborns have delayed clearance of bilirubin due to decreased activity of the conjugation enzymes within the liver
3. newborns have increased enterophepatic recirculation of bilirubin compared to older children
77
What is the MC manifestation of congenital rubella syndrome? What are 2 additional common findings?
sensorineural hearing loss
heart disease
congenital cararacts
78
When does the rooting reflex dissappear?
2-3 months old
79
as a rough, crescendo-decrescendo systolic ejection murmur that is heard best at the left sternal border in the third intercostal space with radiation to the back. What dx?
Tetralogy of Fallot
80
What virus causes mumps?
Paramyxoviridae
81
_____ is a common complication of the flu
otitis media
82
What is the treatment for congenital adrenal hyperplasia?
hydrocortisone, fludrocortisone and sodium chloride
83
What is congenital adrenal hyperplasia caused by? What lab value will be high?
mutation of the CYP21A2 gene
increase in 17-hydroxyprogesterone
84
What medication is administered during pregnancy if congenital adrenal hyperplasia is discovered during the prenatal period?
dexamethasone
85
What abx when used in pregnancy is associated with hypertrophic pyloric stenosis?
macrolides
erythromycin and azithromycin
86
What murmur is associated with rheumatic fever? What does it sound like?
mitral regurg
pansystolic murmur
87
midsystolic click is related to _____
mitral valve prolapse
88
early diastolic high frequency snap is a finding associated with ______
mitral stenosis
89
What is the name for the short mid-diastolic murmur that indicates moderate-severe mitral regurgitation secondary to increased blood flow across this valve?
Carey Coombs murmur
90
Bronchiectasis in a pt with CF, what is the most likely pathogen?
Pseudomonas aeruginosa
91
What ages are the MCHAT screening used?
18 and 24 months
92
Leads levels between ____ and ____ need to be repeated in 1-4 weeks
15-44 mcg/dl
93
What lead level requires urgent evaluation and treatment?
blood lead levels > 45 mcg/dL
94
What therapeutics are used for chelation therapy?
Succimer, calcium disodium edetate, or penicillamine
95
What pathogen typically causes a peritonsillar abscess?
Streptococcus pyogenes or is polymicrobial
96
Philadelphia chromosome is associated with what diagnosis?
chronic myelogenous leukemia (CML)
97
Reed-Steinburg cells are associated with what diagnosis? What age range?
Hodgkin Lymphoma
15-19 years old
98
Smudge cells on peripheral blood smear is associated with what dx? How will it present?
chronic lymphocytic leukemia (CLL)
lymphadenopathy, splenomegaly, and hepatomegaly
99
What is the MC cause of primary hypogonadism in boys? in girls?
Boys: Klinefelter syndrome
Girls: Turner syndrome
100
What is the age you start to be concerned about secondary hypogonadism in boys? girls? What tx is approperiate?
A short-term trial of testosterone in boys > 14 years of age and a short-term trial of estradiol in girls > 12 years of age who show few to no signs of puberty are appropriate in children with secondary hypogonadism
101
coin shaped lesion, should instantly think?
nummular eczema
102
What is the tx of choice for impetigo?
mupirocin
103
What are Pastia lines? What dx?
Linear petechiae over the antecubital fossa and axillary folds seen with scarlet fever are known as Pastia lines.
scarlett fever
104
erythema toxicum neonatorum, what will the wright-stained smear of the contents of the pustule show?
numerous eosinophils
105
What is the virus behind roseola?
Human herpesvirus 6
106
atypical B cell morphology, what dx?
acute lymphoblastic leukemia
107
preseptal cellulitis spread from the _____ sinuses
ethmoid sinuses
108
strep pneumoniae is responsible for meningitis in what age range?
3 months to 10 years old
109
Kawasaki disease is MC in what descent? MC in males or female?
Asian Males (Japanese)
110
_____ can be done in office to precipitate an absence seizure
hyperventilation for 3-5 minutes
111
What is the term given for a localized paralysis that may last minutes to hours after an epileptic episode?
Todd paralysis
112
What is the abx of choice for pyelo in children?
ceftriaxone, cefotaxime, cefepime
or gentamicin
113
What is the first line therapy for molluscum contagiosum if there are MULTIPLE patches? What virus?
curettage and cantharidin
poxvirus
114
What is the triad of west Syndrome?
infantile spasms
hypsarrhythmia on EEG
developmental delay
115
What is the classic presentation of infantile spasms? What age range?
This is a severe type of epilepsy syndrome with a peak incidence between approximately 4 and 12 months of age. Children experience brief jerking spells of flexion, extension or a combination of both, involving the head, neck, arms, trunk and legs that usually last a few seconds or less. Spasms often occur in clusters during sleep-wake transitions. The presence of hypsarrhythmia in the electroencephalogram
116
What are the 2 common lab findings in Rocky Mountain Spotted Fever?
thrombocytopenia and hyponatremia
117
What is the most-specific antibody for lupus?
anti-Smith antibody
118
Describe the rash present in Kawasaki disease.
Generalized nonbullous, nonvesicular rash
119
What are the major criteria for rheumatic fever?
carditis
erythema marginatum
Sydenham chorea
polyarthritis
subcutaneous nodules
120
What are the minor criteria for rheumatic fever?
fever
arthralgia
elevated acute phase reactants prolonged PR interval on electrocardiogram
121
______ is teratogenic in the first trimester and may result in fetal decreased hearing, infantile glaucoma, and cardiac disease.
Rubella
122
What will leg xrays reveal on a pt with lead poisoning?
bands of increased density at the metaphyses of growing bone
will also see basophilic stippling on peripheral blood smear
123
What heart defect is very common in kiddos with Down Syndrome?
atrioventricular septal defects
124
1 week of cough and congestion, no fever, CXR: bilateral interstitial infiltrates and hyperexpansion. What dx?
Chlamydia trachomatis
tx: macrolide
125
What is the MC cause of myasthenia gravis?
Antibodies to the acetylcholine receptor
126
It is a low-grade, midsystolic murmur localized near the apex to lower left sternal border. It decreases in intensity with inspiration, sitting up, or standing. What dx?
Still murmur
127
What is a common side effect of ceftriaxone in neonates?
Hyperbilirubinemia
128
What are the major difference between Neisseria gonorrhoeae conjunctivitis and chlamydia trachomatis conjunctivitis?
129
Urine output is typically preserved. Urinalysis may show white blood cells and hyaline or granular casts, as well as mild proteinuria. With OTC medication use. What dx?
acute interstitial nephritis
type of AKI, will have elevated creatinine level, BUN to creatinine ration is less than 15
130
It is characterized by hematuria, proteinuria, edema, hypertension, and kidney insufficiency. Red blood cell casts are often seen. What dx?
acute glomerulonephritis
131
typically seen in critically ill children with sepsis, hypotension, or exposure to nephrotoxic medications. characterized by elevated creatinine and a urinalysis showing brown granular casts. What dx?
acute tubular necrosis
132
______ is strongly associated with early disseminated Lyme disease
cranial nerve VII palsy
133
______ is the most common neonatal GI emergency. What imaging is indicated?
necrotizing enterocolitis (NEC)
abdominal xray
134
cafe-au-lait macules and cognitive disability raise concern for ______
neurofibromatosis type 1
135
neurofibromatosis type 1 is caused by what mutation?
NF1 on chromosome 17
136
What is important to note between febrile seizures and the long term risk of developing epilepsy?
Treatment with long-term anticonvulsants does not affect the long-term risk of developing epilepsy and is rarely warranted
Children with simple febrile seizures have a 1-2% rate of epilepsy when compared to the general population which is < 1%.
137
How will immunoglobulin A vasculitis (Henoch-Schönlein purpura) most commonly present? What is known complication?
intermittent abdominal pain and anorexia, pain in his knees and ankles, intermittent headaches and fever
intususception is known complication
138
frothy, green-yellow malodorous discharge, vaginal pruritus. What am I? What dx? What is the tx?
Trichomoniasis
wet mount
metro twice daily for 7 days
139
What finding on wet mount is dx for bacterial vaginosis? What is the tx?
clue cells
metro
140
What is the tx of choice for Lyme disease in a kiddo less than 8?
amoxicillin
141
What is the recommendation for HIV positive kids to get screened for TB?
annual TB skin test
142
little or no prodrome, low-grade fever, rash spreads head to toe, postauricular or occipital lymphadenopathy. What dx?
Rubella
143
What virus causes West Nile and St. Louis encephalitis?
flavivirus
144
What virus causes HFM dz?
coxsackievirus
145
What virus causes mumps?
paramyxovirus
146
What is the virus that causes erythema infectiosum?
Parvovirus
147
gallop and a grade 4/6 holosystolic murmur at the apex. What dx?
mitral regurg murmur
148
yellow eyes, abdominal pain, N/V/D and just returned from a trip to Mexico. What dx?
hep A
149
poison ivy is a type _____ hypersensitivity and it considered to be ______ mediated
type IV hypersensitivity
cell mediated: activation of T lymphocytes and is delayed approximately 4-96 hours after exposure
150
immune complex mediated is type _____ and occurrs when ____ binds to soluble antigens producing a complex that is deposited in blood vessels causing local inflammation. _______ is a good example
immune complex: type III
IgG
serum-sickness
151
What vaccines are live attentuated? These should be postponed 8 months if treated with _____ for Kawaski dz
MMR
Varicella
Rotavirus
Flu (nasal)
IVIG
152
slipped capital femoral epiphysis (SCFE) is related to what endocrine disorder? Especially in what population?
hypothyroidism
children less than 10 years old
153
What vitamin deficiency has been shown to be associated with increased morbidity and mortality in measles?
Vitamin A
154
Name this rash. What are the 2 major triggers?
erythema multiforme
Mycoplasma pneumoniae
and HSV
155
Match the side of the penis with both dorsal/ventral and hypo/epi
Blue: ventral, hypospadias
Red: dorsal, epispadias
156
s/s of congestive heart failure with a harsh pansystolic murmur over the left lower sternal boarder. What dx?
ventricular septal defect
157
What is the imaging of choice for mastoiditis?
CT scan of temporal bone
158
Cow milks only diet for infants can cause _____ and ____ deficiency
iron and vit C
159
prolonged QT interval can be brought on by what decreased _____ or ____ levels
low potassium and low magnesium
160
Name this rash. What STI?
pityriasis rosea
syphilis
161
What age should you start checking a ped pt BMI?
2 years old
162
anemia, thrombocytopenia and acute kidney injury with bloody diarrhea. What am I? What is the causative organism?
hemolytic uremic syndrome (HUS
Shiga toxin-producing Escherichia coli O157:H7
163
______ questionnaire should be obtained when disordered eating or any type of adverse experience is suspected in a patient
HEADSS
home, education, activities, drugs/diet, sexuality, and suicidality/depression
164
When is a DEXA scan appropriate to order if you are concerned about female athlete triad disorder?
amenorrhea persists for more than 6 months
165
What is the empiric abx treatment for bacterial meningitis?
vanc and ceftriaxone/cefotaxime
166
What is breast milk jaundice?
Unconjugated hyperbilirubinemia caused by a molecule in breast milk that increases enterohepatic recirculation of bilirubin. It presents after the first 3–5 days of life and peaks about 2 weeks after birth.
167
What is the most likely cause of a 4-day old infant neonate's sepsis and meningitis?
strep agalactiae (group B strep)
168
Newborn screen comes back positive for congenital hypothyroidism, what should you do next?
check TSH
169
What is the treatment for impetigo when is affects the mouth plus one other area?
keflex
170
What am I? What pathogen?
bullous impetigo
staph aureus
171
If live vaccines are not given concurrently, how long do you need to wait between live vaccines?
4 weeks
172
Define central cord syndrome
characterized by bilateral motor paresis with the upper extremities affected to a greater degree than the lower extremities. Sensory loss is variable
173
define posterior cord syndrome
results in impaired proprioception, fine touch, and vibration sensations. Motor function and pain and temperature sensations are preserved
174
What is the bulbocavernosus reflex?
Involuntary reflex contraction of the anal sphincter in response to squeezing the glans penis or tugging on the Foley catheter. Loss of this reflex is a marker of spinal shock.
175
A milk intake______ a day raises concern for iron deficiency anemia.
> 24 oz
176
If not vaccinated as a young child, at what age should a pt get hep B vaccine?
11-12 years old
177
What is the most sensitive and specific test for pertussis?
polymerase chain reaction (PCR) of nasopharyngeal secretions
178
The presence of what number of bruises is suspicious for child abuse in infants?
Any bruising in infants < 6 months of age, more than one bruise in a premobile infant, and more than two bruises in a crawling child.
179
What antibiotic is used for antibiotic prophylaxis during the first 5 years of life for patients with sickle cell disease who have a penicillin allergy?
erythromycin
180
prophylactic _______ is recommended for all patients with sickle cell disease until age 5 because studies show it reduces the risk for pneumococcal infection and death
PCN
181
The ________ vaccination is administered to infants with sickle cell disease as a four-dose series, with doses at 2 months, 4 months, 6 months, and 12 months
meningococcal
182
At what age can a kiddo with sickle cell disease begin to take hydroxyurea?
can start at 9 MONTHS old
183
______ is a known adverse effect of prostaglandin E1 (PGE1) infusion that is commonly given to keep the ductus arteriosius patent to preserve blood flow from the aorta to the pumonary arteries. What should you do before the start of the infusion?
apnea
secure the airway prior to start of infusion
184
What is the tx for tinea capitis?
ORAL griseofulvin
topical treatments are ineffective
185
A 4-year-old presents with impetigo associated with the knee. No other areas are involved. What is the most appropriate treatment?
TOPICAL mupirocin
186
What is a NOT normal absolute CI to MMR vaccine?
anaphylactic reaction to neomycin
187
What is a not normal vaccine reaction to DTaP?
whole limb swelling
188
What 2 locations are classic lymphadenopathy associated with rubella?
Lymphadenopathy is characteristically posterior auricular and suboccipital in location.
189
rash then fever. What dx?
rubella
190
What are the timeline differences for gonorrhea vs chlamydia conjunctivitis in a newborn?
gonorrhea is 2-5 days old and chlamydia is 7-14 days old
191
______ and ______ are complications of Hirschsprung disease.
Enterocolitis and toxic megacolon
192
What type of cough is classic of Chlamydia trachomatis pneumonia?
staccato cough
a distinctive, rapid, and spasmodic cough characterized by a short inspiration between each cough, often described as a burst of short, abrupt coughs
193
PANCE prep
flashcards
Decks in class (32)
# Cards
-
MC90
-
Things I Want to Remember200
-
Cardio105
-
Heart Murmurs Sounds26
-
Pulm42
-
Things -part 257
-
Peds193
-
ER201
-
Derm28
-
MSK79
-
Endo26
-
EENT47
-
Women's Health129
-
Psych143
-
GI51
-
Hem41
-
Pulm3
-
Urology21
-
Nephro29
-
Neuro38
-
ER- Part 2191
-
Antibody, labs test, etc key associations79
-
High yield questions23
-
Surgery EOR101
-
Infectious Disease38
-
Surgery EOR part 2106
-
Surgery EOR part 329
-
Professionalism12
-
Preventative screening guidelines6
-
Internal Med EOR100
-
Cardio- Part 228
-
Peds - part 29
