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Peds Flashcards

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1
Q

Foreign body ingestion Rx?

A
  1. < 24 HR + no resp Sx
    Foley Cath
    Bougienage
  2. > 24 or resp Sx
    Endoscopic removal
  3. > 2wks
    Need surgical
    Risk of erosion!
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2
Q

Murmurs in:

  1. PDA
  2. Tetralogy of Fallot
  3. Tricuspid atresia
  4. Aortic coarctation
  5. Total anomalous
A
  1. PDA = continues machinery murmur at left upper sternal
  2. Tetralogy = SEM at left upper/mid-sternal + loud S2
  3. Tricuspid atresia = SEM at left lower sternal
  4. Coarctation = SEM at left upper sternal radiates to inter-scapular space + wide pulse pressure.
  5. Total anomalous = SEM + diastolic rumble + fixed wide split S2
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3
Q

Gasoline poisoning Rx?

A

CVS + Resp support
No antidote
Gasoline poorly absorbed by gut = no need for lavage or charcoal.

If Sx present = CXR 2hr post ingestion + observed in ER for 6 hrs.

Abnormal CXR = admit for blood gas + re-CXR + resp support.

Normal CXR + no Sx = discharge.

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4
Q

Organism of erythema infectiosum / 5th Dz?

A

Parvovirus B19

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5
Q

How to determine if wheeze in child is foreign body?

A

CXR:
Focal infiltration or atelectasis
+
Radio-opacities

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6
Q

Dx of Hirschsprung?

A

Rectal Bx

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7
Q

CPR in children Compression-to-Ventilation ratio.

A
  1. Single rescuer:
    30:2
    Compression = 100 bpm
  2. 2 rescuers:
    15: 2
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8
Q

What drug can be used in croup but not bronchiolitis

A

Oral steroid.

NB: neb epi is beneficial in both.

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9
Q

Apnea in infant? Rx

A
  1. If self-correcting, ass w/ feeds = no admission.

2. If sever, life-threatening = admit for observation.

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10
Q

Facts about club foot:

  • M:F
  • Deformity affects walking?
  • Rigid type Rx?
  • Corrected deformity needs long FU?
  • After Rx participate in usual activity?
A
  • 2:1
  • Rigid can be Rx w/ cast but may need surgery
  • affects walking
  • need FU, risk of recurrence
  • Go back to normal after Rx
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11
Q

Neonate hours after birth develops tachypnea + cyanosis?

Dx?

A

TTN
Supplement O2
CXR

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12
Q

What’s herpangina?

A

Ferbrile disease by Coxasackie virus.

Sx = oropharyngeal vesicles + ulcers

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13
Q

Sx of herpangina

Rx?

A

Sudden fever
Neck pain
Then 2 days later grey plaques => vesicles

Mostly on tonsillar pillars

Rx: symptomatic

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14
Q

When is the age for bladder and fecal control?

A

Bladder: 5
Fecal: 4

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15
Q

1ry vs 2ry enuresis

A

1ry: no dry period
2ry: dry period > 6months

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16
Q

Investigation in 2ry enuresis?

A

UA

R/o: DM, DI, over active bladder, cystitis, psychological, seizures.

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17
Q

Child safety seat:

  • Stage 1 (Rear facing)
  • Stage 2 (Forward)
  • Stage 3 (Booster)
  • Stage 4 (Seatbelt)
A
  • Stage 1:
    At birth
    In infant seat.
  • Stage 2:
    At least 1 Yr + 10 Kg
    Forward in infant/child seat
  • Stage 3:
    At least 18 kg
    Child/booster seat

Stage 4:
At 36 Kg and 145 cm
Seatbelt

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18
Q

Henoch-Schonlein purpura triad?

A

Purpuric rash
Abdominal pain/renal failure
Joint pain

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19
Q

Type of purpura in HSP?

A

Non-thrombocytopenic purpura

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20
Q 
Causes of neonatal jaundice by time? 
<24
1 - 3 days
3 - 4 days
> 1 week
A
  1. <24 hr:
    ABO/Rh
    Sepsis
2. 1-3:
Physiological
Breast feeding 
Hemolysis 
Sepsis
  1. 3-4:
    Physiological
    Breast feeding
    Sepsis
4. > week:
Hypothyroid 
Hepatitis 
Gilbert's : Crigler-Nijjar
Biliary obstruction 
Metabolic error
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21
Q

Rx of viral URTI in neonates?

A

Nasal rubber suction bulbs

NS nasal drops

Cool-mist humidifiers

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22
Q

MCC of anemia in children?

A

Iron deficiency

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23
Q

Average birth weight? What happens in first few days then 1-2 wks?

A

3.5 kg

Baby drops 10% (loss of excess fluid)

In 1-2 weeks baby regain weight

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24
Q

What must be supplemented in breast fed infants?

A

Vit D

Risk of rickets

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25
Diarrhea by Aeromonas enteritis?
Short IP: 1-2 days Watery diarrhea + fever In developing countries
26
MCC of travelers diarrhea?
Enterotoxiigenic E. coli Short IP: 1-2 days.
27
IP of giardia lambilia?
1-2 weeks
28
MCC of CAH?
21-hydroxylase
29
Signs of premature infant?
Scant ear cartilage Absent breast buds Thin skin Hypotonic posture at rest
30
Vaccines at 2 mo
``` DTaP Hib IPV PCV-13 Rot-1 ```
31
Drugs cause gynecomastia
Antibiotics (isoniazid, ketoconazole, metronidazole) Cimetidine Captopril Digoxin Hormones
32
Assess severity of dehydration
``` 1. Mild: HR: N or high BP: N Sunken eyes: no Urine: normal ``` ``` 2. Moderate: HR: high BP: N Eye: sunken Urine: low ``` ``` 3. Sever: HR: High BP: L Eyes: sunken Urine: none ```
33
Accetaminophen toxicity
< 2 HR Activated charcoal < 8 HR N-acetylcysteine (Oral > IV)
34
T/F: Rotavirus is not associated with URTI
T
35
MC nutritional def in kids
Iron def anemia
36
Sx of Atlanto-axaial instability in down
``` Torticollis UMN Sx (gait, DTR, clonus..) ```
37
What's head tilt test?
Tilt patients bed to Dx syncope. Cardio = HR < 40 Vasodepressor = HR drops <10%
38
T/F: orchitis is more common in kids than torsion
Testicular torsion is more common
39
MCC of otitis media
S. pneumonia
40
New born foot deformity: | Convex lateral border + adduction of forefoot + normal ankle
Metatarsus adductus
41
Facts about metatarsus adductus
LFT > Rt F > M 80% spontaneous resolution w/in 1 Yr If not resolved w/ stretches => serial casting
42
MC complication of carniopharyngioma
Central DI
43
Innocent murmur in strept. Infection
SEM Grade < 3 Not Sx No thrill or radiation
44
``` Central DI labs? Serum Na Urine Na Extra cellular fluid Plasma arginine vasopressin ```
High serum Na Low urine Na Normal ECF Low plasma arginine
45
Source of carniopharyngioma
Rathke's pouch
46
MCC of septicemia in infants
GBS = strep. Agalactia
47
Risks of GBS septicemia
Pre-mature rupture > 24 hrs before delivery Chorioamnionitis
48
``` What's syndesmotic sprain? Injury? Dx? Rx? Complications? ```
High ankle sprain Affects anterior, posterior, transverse tibiofibular ligaments + interosseous membrane. Contact sports = dorsiflexion +/- inversion of ankle Dx: squeeze test (compress fibula against tibia at mid-calf) pain if +ve. External rotation stress test by stabilizing leg and externally rotate foot > pain if +ve Crossed leg test: place involved ankle opposite to knee and pressure applied to medial side of ankle > pain if +ve Rx: semirigid support Complication: ankle instability > hypertrophic ossification
49
Fragile X mutation
CGG repeats on Ch X
50
MCC of inherited mental retardation
FXS
51
Hallmark of constitutional delay
Being <50th most of childhood Bone age < real age
52
Before Dx constitutional delay what must be checked?
Signs of puberty by age 14. | If no Sx = needs work up
53
Bug in erythema infectiosum (5th)
Parvovirus B19
54
Labs in failure to thrive
Normal
55
MCC of UTI in kids
E. coli 75-90%
56
Risk factors for UTI in kids
Female gender Vesicouretral reflux Anatomical abnormalities: (posterior urethral valve, ectopic ureter) DM Wiping techniques
57
Approach to baby w/ UTI
1st time: UA + C/S Recurrent: UA + C/S + US + VCUG ``` VCUG indications: F < 2 yrs F > 5 yrs w/ recurrent UTI Male w/ UTI Febrile child w/ UTI ```
58
MC organism in 1. human bite 2. Cat/dog 3. Goat/sheep 4. Rabbits 5. Prairie dog/rat flea
1. Human: Eikenella (G-ve rod) 2. Cat/dog: pasturella 3. Goat/sheep: brucella melitensis 4. Rabbits: Francisella tularensis 5. Prairie dog/rat flea: yresinia pestis
59
Heinz bodies are seen in what anemia?
G6PD
60
How to Dx accessory nipple?
Remnants on mammary line
61
Salt wasting variant of congenital adrenal hyperplasia - Enzyme missing - Sx
- 3B-hydroxysteroid dehydrogenase - infancy => vomiting, diarrhea, dehydration, arrhythmia, cyanosis, ambiguous genitalia ( hypospadias, bifid scrotum, cryptorchidism)
62
Sleep apnea test
Polysomnography
63
Most helpful labs in assessment of acute asthma in kids?
FEV1 PEF Pulse oximeter
64
Prolonged bleeding after circumcision in otherwise healthy
Hemophilia A Factor 8 doesn't cross placenta => early Sx
65
MC Sx in spondylosis
Low back pain radiates to buttocks / posterior thigh.
66
Otitis media Rx contraindicated in kids
Fluoroquinolones | Cipro, levo, fluxa,
67
Prophylaxis to HiB
Rifampin
68
Klinefelter (KLINE) Turner (TURNER) Edwards (EDWARDS) Prader Willi (PRADER) Fragile X (FRAGILE)
``` Klinefelter 47 XXY Killer (aggressive + antisocial) Large breast Non disjunction Elevated (tall) ``` ``` Tuner 45XO Tight aorta (coarctation) Undersized (short) Renal (horseshoe) Nipple spacing Edema Reproductive failure (ovarian) ``` ``` Edwards trisomy18 Eighteen Digit overlapping flexion Wide head Absent intellect Rocker-bottom feet Diseased heart Small jaw ``` ``` Praderwilli Imprinted 15q Paternal Runt (short) Almond eye Delay (mental) Eats lots Rt HF ``` ``` Fragile X FMR1 gene Repetitive behavior Anticipation CGC Gnathism (protruded jaw) Intellectual impairment Large ears Everted ears ```
69
Incidence of nasolacrimal duct obstruction? Path? Dx? Sx?
5% infants Obstruction at valve of Hasner (distal end) Dye disappearance test (all fluorescein drains in 5 min) Sx: tearing
70
Causes of nasolacrimal obstruction
Congenital Acquired (sarcoidosis + wegners)
71
Rx of nasolacrimal obstruction
Massage duct area 90% spontaneous resolution
72
What can babies eat at 4-6 mo 12-18 mo 18 mo - 3yr
4-6 mo Solid food + juices 12-18 mo Egg, potatoes, iron-fortified cereal margarine 18 mo - 3yr Meat, bread, fruit
73
Baby Holosystiloc murmur at lower left sternum Can't breath Can't feed Infections
VSD
74
MCC of hearing loss in infants
Genetic
75
Rx of sinusitis
Amoxicillin Cefuroxime Allergic = clarithromycin or azithromycin
76
Role of fundal exam in seizure
To see if it's the 1st seizure Papilledema, retinal hemorrhage = repetitive seizures If febrile seizures to confirm it's one time only.
77
Vaccines at 2 mo
``` DTaP IPV HiB Pneumococcal C-14 Rotavirus ```
78
Vaccines at 4 mo
``` DTaP IPV HiB Pneumo-C-13 Rotavirus ``` Same as 2 mo
79
Vaccines at 6 mo
DTaP- IPV HiB Flu
80
Vaccines at 12 mo
Meningococcal Pneumococcal C13 MMR
81
Vaccines at 15 mo
Varicella; chicken pox
82
Vaccines at 18 mo
DTaP IPV HiB
83
Vaccines 4-6 yr
MMRV Tdap IPV
84
Cow milk should be avoided until baby reaches? Why
12 mo Low Vit E, iron, FFA High protein, Na, K
85
What Sx is a must in necrotizing enterocolitis
Bloody diarrhea
86
MCC of HTN in adolescent
Essential 85-95%
87
When to do cryptorchidism for undescended testis? Why
At 1 Yr To preserve spermatogenesis. 100% chance of infertility if > 1yr
88
Galactosemia Path? Sx?
Galactose-1-phosphate uridyltransferase deficiency ``` Sx: Jaundice Cataract Failure to thrive Vomiting, diarrhea ```
89
What's Developmental dysphasia of hip? M:F Ass
Subluxation + dislocation of hip F> M 1st born F Breech Oligohydramnois
90
DDH Rx
Close reduction + pavlik harness + US
91
T/F: DDH Dx by hip X-ray
F | Not shown on X-ray need US
92
T/F: normal ESR + CRP role out septic arthritis
T
93
Teratogenicity in DM
1. Sacral agenesis + lumbar vertebral anomalies (esp. caudal region) 2. Macrosomia 3. Congenital heart defects 4. Anencephaly + neural tube, myelomenigocele, hydrocephalus, microcehalus
94
Rectal prolapse in kids
CF
95
Labs in anorexia
Low LH+ FSH
96
What sleep disorders occur at 1-2 HR and 2nd half of night
1-2 hr => parasomnia Sleep walk and sleep terrors Late => nightmares
97
Rx of idiopathic thrombocytopenic purpura
Observe
98
Sx of idiopathic thrombocytopenic purpura
Bruise Hx of infection PLT < 100 + large PLT on smear Normal Hg + WBC Normal coagulation profile
99
Pneumonia in infants < 6mo | At winter
Resp syncytial virus
100
Drug cause acne
``` Phenytoin Steroids Anabolic steroid DHEAS OCP ```
101
Baby with low Hg + no lead
Trial of iron for 1 mo
102
RSV vs C. Trachomatis
``` - C. Trachomatis: Conjunctivitis 50% Hyperinflation + diffuse infiltrates. Wheeze + rales Eosinophilia ``` - RSV: Rhinorrhea + pharyngitis Hyperinflation Wheeze + rales
103
EEG of absence seizure
Generalise symmetric three per second spike
104
Risks for deafness in newborn
``` FHx Gentamicin CMV, toxo or herpes Low apgar score Low birth weight Oxygen deprivation in birth ```
105
Risks for sudden infant death
Sleep in prone position or on side. Sleep on soft bedding Sleep with stuffed toys Bed sharing
106
T/F: sleeping with pacifiers reduce risk of sudden infant death
T
107
Rx of nursemaid elbow fracture
Subluxed Radial head reduction (hyperprobation > flexion) Sling is helpful No wrist splint No long arm cast
108
Familial vs constitutional vs growth hormone deficiency (short stature)
``` Constitutional; Delayed bone age Delayed puberty Normal velocity FHx ``` Familial: Normal bone age Puberty on time Growth hormone: Delayed bone age Growth <3rd percentile Low growth velocity
109
MCC of epistaxis in kids
Nose picking > mucosal irritation (allergic rhinitis)
110
Sx of osteogenesis imperfecta
``` Blue sclera Multiple fracture Barrel chest Joint laxity Microcephaly Translucent teeth (opalescent) Hearing loss ```
111
Defect in osteogenesis imperfecta
De novo mutation in collagen 1 | Sometime FHx
112
MC sequela of congenital CMV
Hearing loss
113
What's an innocent murmur
At 2-6 yr Systolic grade 1-2 Pitched murmur at lower left sternum Changes with sitting and standing
114
Complication of stills murmur
None its innocent
115
Pathology in total anomalous pulmonary venous return
Pulm. veins don't connect to left atrium Pulm. venous return enters systemic venous circulation via embryonic connection
116
Sx of TAPVR
Pulm HTN + edema Cyanosis Parastenal loud S2
117
Bilateral parotid gland enlargement
Bulimia
118
Russell sign in bulimia
Callosities on knuckles
119
Rx pediculosis in kids
Permethrin 1%
120
Bacterial conjunctivitis is infectious until?
Rx started
121
Viral infection has late neuro complication (baby seizure, ataxia, quadriplegic)
Measles
122
Sx of perinatal asphyxia
Hypotonia + low movement Loss of primitive reflexes Seizures Abnormal posture
123
Koplik spots
Measles
124
Infant suddenly flexes arms + forward lean of trunk + extends legs 5 sec
Infantile spasm
125
T/F: infantile spasm asso. with other seizure
True
126
What's rabies
Viral infection in saliva and peripheral nerve
127
Sx of rabies
Pain at site of bite Encephalitis, confusion, hallucination, Hydrophobia = can't drink because of laryngeal spasm. Paralysis.
128
Dx of rabies
Skin biopsy form neck | Animal brain tested
129
Rx of rabies
Death in 3-10 day if not Rx Prevention: - pre-exposure: vaccine - post-exposure: Clean area w/ soap + water Vaccine + IG
130
Rabies post-exposure
1. Demotic animal + no Sx Observe animal 10 days: No Sx = nothing Sx = vaccine + IG 2. Domestic + Sx Vet check animal to Dx If confirmed => vaccine + IG 3. Wild animal Capture + kill animal + test brain for rabies. If + => vaccine + IG 4. Wild animal Can't capture => give vaccine + IG
131
Infantile colic criteria
Excessive crying >3 Hr day > or = 3x week for 3 weeks
132
T/F: premature infants should use safety seats with restraints that don't have shields, pads, arm rests.
T | Case neck injury during impact
133
T/F: safety seat is secure if it moves < 5 cm in each direction
F | < 2.5
134
Pyloric stenosis facts: 1. M:F 2. MC age 3. Rarely affects babies older than
M > F MC at 3-5 wks Rare after 12 wks
135
MCC of unilateral breast mass in males < 12
Breast development | Assure + repeat in 1 yr
136
Papile Grading system for internevtricular hemorrhage + ventricular dilatation
Grade 1: Subependymal Mostly asymptomatic Grade 2: Intraventricular w/o ventricular dilatation Grade 3: Intraventricular + dilatation Grade 4: Intraventricular + parenchyma
137
Strider when baby lies down
Laryngialacia Immature cartilage = collapse of airway in inspiration
138
Dx laryngiomalacia
Scope
139
Cause of neonatal physiological jaundice
Temporarily impaired hepatic clearance of bilirubin
140
Congenital hypothyroid Sx
``` Hypotonic Big tongue Big forehead Umbilical hernia Dry yellow skin Brittle hair ```
141
Jones criteria for rheumatic fever
``` Major: Joint Carditis (MV) Nodules Erythema marginatum Sydenham chorea ```
142
Antiviral contraindicated in babies < 7
Zanamivir
143
Antiviral not for influenza A
Amantadine | Rimantadine
144
Rx of derm herpitiformis
Dapsone | Gluten free diet
145
Scaly papular rash after pharyngitis
Guttate psoriasis
146
Peak age for febrile seizure
6 mo - 5 yrs
147
Rx of impetigo
Dicloxacillin | Cephalexin
148
Skin infection and its fluctuant area? Rx
IV vanco for MRSA | Till culture result
149
Complication of meningitis
Sensorineural deafness 6 wks post Rx
150
Resp distress in neonate CXR
Ground glass atelectasis | Air bronchogram
151
How to divert child attention during abd. exam
Place child hand on top of yours give him sense of control
152
T/F: kids 2-6 Yrs feel responsible for death of loved ones
T
153
Can 2-6 Yr olds attend funerals
Yes but must be accompanied by adults for support
154
Minor jones criteria
``` Arthralgia Fever ESR CRP Prolonged PR ```
155
Heart X-ray in tetralogy of fallot
Boot shaped heart
156
Malformations tetralogy of fallot
Pulm valve stenosis VSD Overriding aorta Rt ventricular hypertrophy
157
Cause of systolic murmur tetralogy of fallot
Pulm. stenosis
158
MCC of scoliosis
Idiopathic
159
Inheritance in hemophilia A + B
XL-recessive
160
XL-recessive transmission to kids
All girls carries | No boy affected
161
MC child abuse in Canada
Child neglect
162
When is scoliosis significant
> 10 degrees
163
Rx of functional abdominal pain
Spontaneous resolution in 2 wks. Remain active Address emotional stress Cope with Sx and prevent 2dry gain of child.
164
Rx of primary enuresis
Motivational + positive reinforcement for 6 mo
165
Nasal polyps in child Dx?
CF
166
Athlete with proteinuria
Exercise induced | Transient + nonpathological
167
Approach to exercise induced proteinuria
UA repeated 48-72 HR from exercise
168
New born in distress | CXR: fluid in fissure
TTN
169
NSAIDs SE?
``` N/V Diarrhea / constipation Low appetite Rash Dizziness + headache Tinnitus Edema Kidney failure, liver failure Ulcer ```
170
Rx tet spells
Rt-Lt shunt => cyanosis Rx; Neosynephrine Knee-chest IV morphine (last)
171
Nitroglycerin in tet spells
Worsen Sx
172
T/F: pertussis vaccine could cause infantile spasm
F
173
MCC of poor weight in babies
Inadequate caloric intake
174
Survival rate in patau
90% die in first year
175
1st line Rx impetigo
Topical Abx
176
Head banging in kids Prevalence? Age? Prognosis?
3-15% of 5-11 mo old Sx resolve spontaneously by age 3
177
T/F: head banging is higher in developmental delay syndrome
T | More in down , autism , leach-nyhan
178
IP of varicella (chickenpox)?
10-20 days
179
T/F: chickenpox patient should be in resp isolation till no new lesions appear
T
180
When is varicella not infectious
Lesions are crusted
181
Labs in bone age < real age
TSH
182
Age of anterior fontanelle closure
13 mo
183
FU of early anterior fontanelle closure
Head measurements to R/o: craniosynostosis + abnormal brain development.
184
When to give Abx in sinusitis
1. Sx for 2 weeks 2. Fever 39 3. Facial pain / swelling
185
MCC of pneumonia in kids? | Rx?
M. Pneumonia Macrolides
186
MCC of otitis externa
P. Aruginosa
187
MC congenital abnormality of small bowel
Meckles
188
``` What's spermatocele? Dx? Contents? Rx? Fertility? ```
Spermatic cyst Cyst on upper pile of testis next to epididymis Painless Benign Clear fluid Dead sperms No Rx No effect on fertility
189
MCC of leukocoria in well newborn
Cataract DDx: retinoblastoma
190
Rx of neonatal lupus heart block
Pacemaker
191
Antibodies in neonatal lupus
Anti-SSA/Ro
192
Chubby 10 YO with hip pain + / - referred knee pain Comfort in external rotation
Slipped capital femoral epiphysis
193
Which one improves nutrition: - Play feeding games w/ healthy meals - healthy food for all meals including snack
Healthy food all day erry day
194
T/F: stool culture is not part of septic work up
T
195
Prepubertal with labial adhesions! Cause? Sx? Rx?
Idiopathic Girl fails pulled, can't pee, UTI Rx: topical estrogen
196
Can bacterial conjunctivitis cause permanent damage
No
197
What ophthalmological risk premature infants are at high risk of?
Retinopathy of prematurity
198
Eye problem in cerebral palsy
Strabismus
199
T/F: 5% permethrin is safe in 2 month baby
T
200
1st sign of puberty in boys
Testicular enlargement
201
At what tanner stage boys reach adult height
4
202
What do you tell a short boy tanner <4?
He'll grow taller
203
Rx of vW disease
DDAVP Cryoprecipitate Factor 8
204
``` Baby with: Nasal polyps Rectal prolapse Malnutrition Infertile ``` Dx?
CF
205
How much do babies with CF need to eat?
120-140% of daily recommended calorie intake
206
T/F: inguinal hernia in kids closes spontaneously
F
207
When to Rx inguinal hernia in kids?
ASAP | Risk of Ca and necrosis
208
MCC of unilateral blindness in kids
Amblyopia
209
When does autospleenoectomy occurs in Sickle cell?
5 Yr
210
Shaving vs permethrin 1% I. Pediculosis
Permethrin 1% is better
211
What disease cause disproportionate short stature
Rickets
212
T/F: teratogens cause disproportionate short stature
F | Proportionate
213
MCC of proportionate short stature
Constitutional delay
214
MCC of HTN in < 10 Yrs
Renal disease = UA, US, Culture
215
Most specific sign of peritonsillar abscess
Can't open mouth = trismus
216
Organism of cut. larva migrans
Hookworm from dogs + cats
217
MCC of chronic otitis media in kids
Environmental i.e daycare + smoking + crowds + cleft palate
218
Rx of absence seizure
Ethosuximide
219
Occult bacteremia Sx
Fever only
220
Palivizumab uses
RSV prevention in high-risk kids Qmonths for 4mo starting nov - feb
221
T/F: Norwalk virus sheds even after acute illness
T
222
Is Norwalk virus resistant to environmental factors?
Yes! Even cont to shed after illness
223
MCC of viral diarrhea in adults
Norwalk
224
Best Rx in obese kids
Family-based + behavior-oriented programs
225
Mom with DM | When to start screening her kids
``` At 10 Yrs if have other risks the q2yr i.e obese FHx Black Sx of DM ```
226
What's little league elbow
Medial epicondyle
227
T/F: preschool speech screening is strongly recommended
F | There's no enough evidence to not do it but not very helpful.
228
Flank painless mass in < 5 Yr DDx
Willms tumor
229
What kind of Ca is willms tumor
Embryonal
230
MCC of wheeze in infants
GERD
231
T/F: infantile GERD resolves at 1 year
T
232
Most effective Rx for asthma
Inhaled steroids
233
In asthma leukotriebne vs LABA
LABA are more effective
234
In allergic rhinitis: | Intranasal steroids vs leukotriene inhibitors
Intranasal steroids more effective
235
What vaccine associated with egg allergy
Yellow fever > flu or MMR
236
Fetal Alcohol syndrome Sx
``` Smooth philtrum Thin upper lip Flat nose Clinodactyly (bent finger) Wide palmar crease end b/w 2-3 fingers Railroad ears Small eyes ```
237
Anemia of lead poisoning
``` Abdominal pain Neuro Sx (wrist drop) Micocytic anemia ```
238
Normal stages of puberty in F
Thelarche (breast) Pubarche (hair) Height peak Menarche
239
T/F: ovulatory cycles start 2 yrs after menarche
T
240
What's Dance Sign in intussusception
Rt hypochondrium sausage-shaped mass + empty RLQ
241
Risks for sudden infant death
1. Prone sleep 2. Overheating (clothes, blankets) 3. Cold weather 4. Soft bedding 5. Stuffed toys 6. Smoke
242
Best estimate of volume loss in dehydration
Weight change since disease.
243
Lab indicates sever iron deficiency
High free erythrocyte protoporphyrin
244
Roseola Sx
3 days of high fever then rash that fades in 2 days
245
Rash in roseola
Maculopapular Starts on trunk Not itchy Blanching
246
HIV screen in babies of HIV+ mom
HIV DNA PCR at 48 HR, 2mo, 6mo
247
Erb's palsy effect on normal baby reflexes
Grasp reflex: not affected Moro, biceps, radial reflexes: absent
248
Is Philadelphia chromosome a good or bad prognostic sign in ALL
Good
249
Rx of bullous impetigo
Oral cephalexin
250
What's DEET N,N-diethyl-3-methylbenzamide
Insect repellant
251
Safety of DEET in kids
Not safe in kids < 6mo
252
How to use DEET
Spray least concentrated 10% Avoid hands + face 3x/d max
253
BB antidote? | MOA?
Glucagon Increase intercellular cAMP independent of blocked beta receptors.
254
Mastoiditis on CT scan
Clouding to destruction of septa b/w mastoid cells and soft tissue swelling +/- temporal bone destruction
255
MCC of neonatal death in babies with DM mom?
Congenital anomalies esp. cardiac + CNS
256
Vaginal exam in prepubertal girls > 2 yr < 2 yr Adolescent
> 2 yr Knee-chest on exam table Without instrument < 2 yr Lying supine in mom lap Adolescent Knee spread apart Exam table
257
Rx of croup
Dexamethasone single dose Racemic epi
258
MCC of ambylopia
Strabismus
259
What's amblyopia
Lazy eye
260
T/F: in acute asthma ipratropium + inhaled SABA reduce hospitalization rate
T
261
MCC of occult bacteremia in kids
Strep. Pneumonia
262
Boy with itchy anus at night
Enterobiasis | Pinworm helminth
263
Name of enterobiasis pinworm? Where does it live in bowel? How does it cause itchiness?
Enterobious vermicualris In ileocecal region Itchiness from egg deposit in anus at nighttime Egg survives 3 wk before hatching
264
How's pinworm Dx + Rx
Tape at anus at early morning = see worms under microscope Rx: albendazole or mebendazole
265
What can mom do to cause her baby necrotizing enterocolitis?
Cocaine
266
Snowman in a storm on CXR
TAPVR
267
MCC of osteomyelitis in kids Rx?
Staph aureus | Rx IV Vanco
268
Sx of retinitis pigmentosa
Night blindness
269
Role of ABG in dehydration
None
270
Cause of encephalopathy in Reye's syndrome (ASA)
High ammonia
271
Rx of genu varus
Observation | Spontaneous correction in 2 yrs
272
How a bay holds arm in nursemaid fracture
Adducted + pronated + flexed elbow
273
MCC of buckle/torus fracture
Fall on outstretched hand
274
What's buckle, greenstick fractures
Buckle: compression Greenstick: incomplete
275
``` Whats osgood-schlatter disease? Age? X-ray? Uni or bilateral? Rx? ```
It's apophysitis of tibial tubercle In athletic kids esp. jumping Almost exclusive to kids No need for X-ray If done = irregular tubercle + hazy metaphyseal border Rx: self-limited Rest, ice, NSAIDs Can resume activity in 2-3 wk
276
Pathophysiology of omphalocele?
Persistence of normal physiological herniation b/c abdomen too small for mid gut formation / liver Herniation occurs at 6 wks Return should occur at 10 wks
277
Pathophysiology of gastrochosis
Failure of lateral abdominal fold to fuse
278
Cause of umbilical hernia
Herniation through linea alba
279
T/F: APGAR Score correlates with risk of necrotizing enterocolitis
T
280
T/F: HTN causes necrotizing enterocolitis
F
281
MC complication of sinusitis
Orbital cellulitis
282
MC cause of pneumonia in preschool kids?
Viruses
283
T/F: pulmonary hemosiderosis associated with milk allergy?
T
284
CXR in pulmonary hemosiderosis
Fluffy infiltrates
285
Lung Bx in pulm hemosiderosis
Hemorrhage with hemosiderin laden macrophages
286
Rx of Lyme in kids
Amoxicillin
287
Chubby boy with painful hip
Slipped capital femoral epiphysis
288
Slipped capital femoral Dx? Rx?
Dx: X-rays frog-leg Wide epiphyseal line Displacement of femoral head Rx: urgent surgery = screw fixation
289
What's in the urine of a baby with galactosemia
Lots of reduced substance No ketone bodies
290
Neonate + reduced substance + low glucose
Galactosemia
291
MCC of diarrhea in kids?
Rotavirus 60% clod weather 50% tropicals
292
Dx unilateral renal agenesis
Doppler US
293
When can baby mobilized arm after Rx of nursemaid fracture
20 min
294
What's flexible flat foot Rx?
Arched when not bearing weight Flat when bares weight Rx: none corrects in 1 year of walking
295
What's tarsal coalition? Dx? Rx?
Fusion of tarsal bones 50% bilateral ``` Dx: Asymptomatic Tenderness on subtalar joint / ankle Rigid flat foot Peroneal tightness ``` Rx: Conservative
296
Associations in nephroblastoma / willms
Willms tumor Aniridia GU abnormalities Mental retardation
297
Sx of willms
Abdominal mass Doesn't cross midline Asymptomatic
298
Becker + Duchenne inherence
XL-R
299
14 + no period + no 2 sexual approach
FSH + LH => high > karyotype FSH + LH => low > wait till 16 (constitutional delay)
300
14 + no periods + has 2 sexual
US
301
MCC of recurrent acute otitis media
Penicillin resistant strep. Pneumonia
302
Foreign body removal from ear?
Water irrigation Fast acting glue If not work or baby not cooperative send to ENT to do it under GA
303
T/F: congenital umbilical hernia resolve spontaneously
T Surgery if not at 2-3 years
304
Rx of PKU?
Phenylalanine free diet Sapropterin tetrahydrobioterin (BH4) helps in 50%
305
If mom gives birth to baby with PKU, | Chances of having another baby with PKU?
25% | It's AR
306
Risks for CMV in preggo
Poor mom Hx of STDs Hx of cervical dysplasia
307
Baby with Hg < 4?
Transfuse PRBC
308
Complications of juvenile idiopathic arthritis
Micrognathia (2/2 early closure of mandibular epiphysis) Iridocyclitis => scarring + glaucoma
309
Storage of breast milk
Stored to 4 HR at room temperature. Stored 48 HR in refrigerator Stored for 3 mo frozen If frozen must be thawed slowly to preserve nutrients
310
Tropical disease could present months after travel?
Malaria
311
Neonate + fever + resp Sx + CXR peribronchiolar edema
RSV | Rx: supportively
312
MCC of bleeding in Meckel's
Ulceration of small bowel 2/2 acid of ectopic gastric mucosa
313
Helpful imaging modality in septic arthritis?
US
314
Storage of breast milk
Stored to 4 HR at room temperature. Stored 48 HR in refrigerator Stored for 3 mo frozen If frozen must be thawed slowly to preserve nutrients
315
T/F: lactose intolerance should avoid all dairy products
F Only lactose containing Can add probiotic
316
1st line Rx of head lice / pediculosis
Permethrin 1% Malathion 0.5% Pyrethrins 0.33% pipernyl butoxide 4%
317
Chances of having a 2 baby with cleft lip
Both genders 3% M sibling 4% F sibling 2.5%
318
Rx of internal tibial intoeing Cause?
``` No Rx (not even stretches) No prone sleep ``` Cause = prone sleep + sitting in feet
319
Fire ant bite
Clean with soap + water only
CanQB
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