Pediatrics

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pszurnicki
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203960
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Pediatrics
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2013-03-22 21:42:46
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Pediatrics
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  1. After an uncomplicated delivery, what is the next step in management of the baby?
    suction of mouth and nose
  2. what is the normal rr and hr for a newborn?
    • rr- 40 to 60
    • hr- 120-160
  3. what does the apgar score measure?
    • appearance-- blue or not
    • pulse- <60 or >60
    • Grimace- no response vs response
    • activity- some vs active movement
    • Respiration- absent vs strong
  4. what are the causes of conjunctivitis at day 1, day 1 to day 7? day 7 to day 21? post day 21?
    • irritation
    • neisseria
    • chlamydia trachomatis
    • herpes
  5. with what 2 antibiotics is opthalmia neonatorum prevented with?
    • erythromycin
    • silver nitrate
  6. what diseases are screened for before newborn is released?
    PKU
  7. what congenital disorders are being screened for in a newborn?
    • beta thal
    • biotinidase
    • cah
    • galactosemia
    • hypothyroid
    • homocystinuria
  8. which newborns shud get the hep B ig in addition to the vaccine?
    the newborns with mothers that are hepB ag +
  9. tachypnea is normal in newborns i.e 120-160 hr..if it persists past 4 hours it is considered?
    • sepsis and appropriate work up is done i.e-- urine culture
    • blood culture
    • csf culture and analysis
  10. which one crosses the suture lines, cephalohematoma or caput succedaneum
    caput succedaneum
  11. rx for erb-duschene palsy?
    shoulder immobilization
  12. rx for klumpke's palsy?
    immobilization
  13. what is the best initial test for a clavicular fracture in a new born?
    rx?
    • x-ray
    • immobilization, splinting, physical therapy
  14. causes of polyhydramnions?
    causes of oligohydramnios?
    • cant swallow
    • cant absorb

    cant pee it out so you get potter--flat facies and lung hypoplasia
  15. Types of diaphragmatic hernias?
    • midline--morgagni
    • bilateral--bochdalek
  16. what congenital disorders are screnned for at birth?
    • beta thal
    • biotinidase
    • cah
    • galactosemia
    • pku
    • hypothyroid
    • homocystinuria
  17. what conditions elevate afp?
    • neural tube defects
    • abdominal wall defects
  18. most common cause for an elevated afp ?
    incorrect dating
  19. omphalocele vs gastroschesis?
    omphalocele is midline defect in which abdominal contents protrude with a sac covering it

    gastroschesis is not midline and there is no sac covering it
  20. when are umbilical hernias surgically repaired?
    after the age of 4
  21. best initial test for wilms tumor?
    most accurate test for wilms tumor?
    • ultrasound
    • ct
  22. wagr syndrome?
    • wilms tumor
    • aniridia
    • gernital-urinary malformation
    • Retardation Mental
  23. hallmark findings in Neuroblastoma?
    lab findings?
    • hypsarrythmia--dancing eyes
    • opsoclonus-- dancing feet
    • urine vma and metanephrines
  24. hydrocele produces a fluid filled sac that transilluminates and it is a remnant of ?
    tunica vaginalis
  25. rx of hydrocele/?
    DD?
    • resolves spontaneously
    • inguinal hernia
  26. at what age is orchiopexy indicated?
    at 1
  27. hypospadias or epispadias commonly exists with what other urinary malformation?
    bladder exstrophy
  28. most common cyanotic heart disease in kids?
    TOF
  29. what is associated with chromosome 22 deletions?
    • cleft palat
    • abnormal facies
    • thymic aplasia
    • cardiac defect-TOF
    • Hypoparathyrodism
  30. 3 holocystolic murmurs?
    • mitral regurg
    • tricuspid regurg
    • VSD
  31. Edwards, Patua and Down all have what cardiac  defect in common?
    VSD
  32. What cardiac defect requires PDA, ASD or VSD to maintain oxygenation?
    TOGV
  33. Most common cyanoitic heart lesion during the neonatal period?
    child period?
    • TOGV
    • TOF
  34. Most common form of ASD?
    secundum defect
  35. when is jaundice considered pathological?
    • bilirubin over 20
    • first day of life
    • rise of more than 5/day
    • direct rises above 2ml
    • jaundice persists after 2nd week of life
  36. rx for hyperbilirubinmeia?
    • uv light below 20
    • above 20--exchange transfusion
  37. what condition has the olive sign?
    pyloric stenosis
  38. Diagnostic tests for Tracheoesophadeal fistula?
    • xray--gastric/esophageal bubble
    • coiling of ng tube in the esophagus
  39. Best initial test for pyloric stenosis?
    most accurate test?
    • ultrasound
    • GI series showing string sign
  40. projectile vomiting at birth?
    projectile vomiting at 1 month?
    • tracheoesophageal fistula
    • pyloric stenosis
  41. rx for pyloric stenosis?
    myotomy
  42. choanal atresia?
    membrane between nostrils and pharynx
  43. presentation of choanal atresia?
    child is blue(cyanotic) when feeding and pink when crying
  44. coloboma of the eye?
    eye in any part of the eye
  45. what is the charge syndrome?
    • coloboma of the eye or cns 
    • heart defects
    • ateria of the chonae
    • retardation growth or developmne
    • gential defects
    • Ear anomalies
  46. diagnosis of choanal atresia?
    ct
  47. best initial test for hirshsprung dz?
    most accurate?
    • xray will show air in the large bowel
    • biobsy of the transmural colon wall
  48. what is the vacterl syndrome?
    • vertebral anomalies
    • anal atresia
    • cardiovascular defects
    • tracheoesophageal fistula
    • esophageal fistula
    • renal anomalies
    • limb anomalies
  49. imperforate anus is part of what syndrome?
    choanal atresia is part of what syndrome?
    • vacterl
    • charge
  50. best initial test for volvulus?
    Best initial therapy?
    • xray
    • endoscopy
  51. two pathologies producing a red currant fluid?
    • klebsiella pneumonia
    • intussusseption
  52. best initial test for intussessption?
    most accurate test?
    Best therapy?
    • ultrasound
    • barium enema
    • barium enema
    • endoscopy
  53. most accurate test for meckels?
    Rx?
    • technetium 99 scan
    • surgical removal
  54. diagnostic tests for diarrhea?
    • stool cultures
    • cbc
  55. is loperamide used for neonatal diarrhea?
    no
  56. air in the bowel wall or pneumatosis intestinalis is characteristic of?
    necrotizing intestinalis
  57. best initial therapy for a volvulus?
    intusseption?
    • endoscopical decompression
    • electrolyte replacement and barium enema
  58. most common cause of congenital adrenal hyperplasia?
    21 alpha hydroxylase deficiency
  59. How is Congenital Adrenal Hyperplasia diagnosed?
    • serum electrolytes 
    • high 17 OH progesterone
  60. 4 variants of rickets?
    • vitamin D deficient
    • vitamin D dependent--kidney cant conver 25 to 1,25
    • xlinked hypophosphatemic--kidney cant retain phosphate
  61. Diagnostic tests for rickets?
    • xray of ribs--rosary
    • xray of leg--bowing of bones
  62. Best initial test for toxo?
    syphilis 
    rubella
    cmv
    herpes?
    Most accurate test?
    • igm
    • VDRL
    • IGM
    • Titers
    • Tzanck

    • PCR
    • FTA-abs
    • PCR
    • PCR
  63. best initial step in management of croup?
    racemic epinephrine
  64. in terms of presenatation how does croup differ from epiglottitis?
    croup--hypoxia on presentation

    epiglottitis--impending hypoxia
  65. diagnosis of each
    varicella
    measles
    parvob19
    roseala
    mumps
    • tzank is best initial--culture is most accurate
    • measles--clinical--most accurate is culture
    • parvo--clinical
    • roseola--clinical
    • mumps--clinical
  66. best initial management of croup vs epiglottitis?
    • croup--epinephrine
    • epiglottitis--intubation
  67. rx for epiglottitis-
    • intubate
    • ceftrixaone
    • rifampin for close contact
  68. most accurate test for bortadella pertussis?
    Rx?
    • pcr or elisa
    • erythromycin
  69. Congenital Hip Dysplasia affects what age?
    Slipped Capital Femoral Epiphysis?
    legg-calve EPthese disease
    • infants
    • obese adolescents
    • infants to 10 year olds--avascular necrosis
  70. causes of subcutaneous fat necrosis
    ?
    • difficult labor
    • perinatal hypoxia
    • forcep delivery
  71. erbs palsy affecting the diaphragm?
    next best step in management?
    xray--elevated diaphragm
  72. predisposing factor to a clavicular fracture?
    macrosomia
  73. what causes subconjunctival hemmorhages
    increased pressure
  74. cutis marmorata is normal or abnormal?
    normal--looks like livedo reticularis
  75. what are salmon pathc?
    normal?
    • birthmarks on back of neck, face--normal variation
    • it is normal
  76. port wine stain is what part of syndrome?
    sturge weber
  77. strawberry hemangioma
    resolves spontaneously
  78. mongolian spots occur where?
    dd?
    • lumbo-sacral area
    • child abuse
  79. dd for erythema toxicum?
    SSS
  80. Milia?
    plugging up  pores on the nose
  81. 2 causes of cataract in a newborn?
    • rubella
    • galactosemia
  82. ear malformations tend to accompany what other malformations?
    renal
  83. what is the location of a branchial cleft cyst cs thyroglossal cyst?
    • branchial cleft cyst is lateral to the midline
    • thyroglossal cyst is midline
  84. abnormalities of the limbs is associated with ?
    heart defects
  85. what congenital disorder is a contraindication to breast feeding?
    galactosemia
  86. symmetric IUGR causes?
    causes of assymetric IUGR?
    • syndromes--genetic
    • torches infections

    • htn
    • smoking
    • hypoxia
  87. Macrosomia weight?
    >4.5 kg
  88. preterm weeks?
    <37 weeks
  89. in respiratory distress syndrome, 100% oxygen will?
    • fix the saturation 
    • but if its cardiac then it wont be fixed
  90. what is the transient tachypnea of the newborn? TTN?
    respiratory distress due to fluid in the lungs
  91. Respiratory causes of Respiratory Distress Syndrome?
    • not enough surfactant
    • Transietnt Tachypnea of the newborn
    • Meconium Aspiration Syndrome
    • pneumonia
    • diaphragmatic hornia--bowel sounds in chest
  92. Best initial test for RDS?
    most accurate?
    • chest xray--ground class appearance
    • Lecithin/sphingomyelin ration
  93. Fast second stage of labor or cessarian section and respiratory distress?
    cause?
    Transient Tachypnea of the newborn
  94. cause of high direct bilirubin and clay colored stool?
    biliary atresia
  95. breast feeding janudice?rx?
    breast milk jaundice?rx?
    not enough feeding-->baby is dehydrated jaundice <1 week..rx is to increase breastfeeding

    something in the milk, kills rbcs -->1 week jaundice..rx is observe
  96. empiric rx for sepsis in neonate?
    amp and gent
  97. best initial test in suspecting torch infections?
    titers
  98. Rx of toxo in mother?
    kid?
    • spiramycin
    • pyrimethamine sulfonomaide
  99. How to prevent folate depletion with sulfonomaide or mtx?
    leucovorin
  100. Torch infection that causes snuffles?
    syphilis
  101. 3 causes of cholestatic jaundice?
    • choledochal cyst
    • annular pancreas
    • biliary atresia
  102. benefit of breast feeding?
    • better protein--so less diarhhea
    • better iron absorption
  103. weight gain of neonates?
    1lb/month for first 6 months
  104. most common cause of failure to thrive?
    poor mom and baby interaction
  105. what food are fed to the baby and when?
    • 4 months--cereal
    • 8 months--mashed food
    • 12 months--table foods
  106. feeding proetins too early leads to?
    allergies--ezcema
  107. prolactin inhibits what hormone?
    GnRH
  108. 2 diseases with cafe au lait spots?
    • mccune albright syndrome--precocious puberty
    • neurofibromatosis
  109. ashen leaf spots?
    tuberous sclerosis
  110. abnormalities of the facial bones and nail abnormalities, fetus was exposed to what drug?
    phenytoin
  111. which one do you repair first? cleft palate or cleft lip?
    cleft palate
  112. hemihypetrophy of one limb + wilms tumore
    WAGR complex
  113. congenital hip dysplasia maneuvers
    • ortolani
    • barlow
  114. rx for congenital hip dysplasia?
    pavlik harness
  115. extra finger, next step?
    xray
  116. most common cause of language delay?
    hearing loss
  117. when do you remove adenoids or tonsills?
    when there is snoring
  118. all reflexes dissapear by how many months?
    except one?
    • 4 months
    • babinski---by 18 months
  119. most common cause of miscarriage?
    chromosomal defects
  120. test of choice for intraventricular hemorrhage in the preterm?
    term baby?
    • ultrasound
    • ct
  121. which syndrome has midline defects such as cleft lip, palate, holoprosencephaly?
    Patau
  122. heart defect in turner syndrome?
    coarctation
  123. syndrome where everything is large due to beta  islet hyperplasia?
    Beckwith-Wiedman SYndomre
  124. prader will syndomre chromosome?
    15-paternal inheritance
  125. Pierre robin sequence?
    mandibular hypoplasia--large tougne--airway obstruction
  126. Waardenburg syndrome is what inheritance?
    characteristic?
    • autosomal dominant
    • white lock of hair
    • albinism
  127. what has lens dislocation and mitral valve prolapse and dissecting aortic aneurysm?
    marfan
  128. smooth filtrum is seen where?
    fetal alcohol syndrome
  129. noonan syndrome?
    • like turners except
    • boys are affected
    • pulmonary stenosis
  130. in the pressence of a single umbilical artery, next best step?
    echo of the heart
  131. pigmentation of the lips and multiple polyps of the colon?
    puetz jeghers syndrome
  132. what is the leopard association?
    • lentigenes
    • ekg abnormalities
    • ocular hypertelorism
    • p stenosis
    • abnormal genitalia
    • retarded growth
    • Deafness
  133. how much weight does the baby gain in the first 6 months?
    12 months?
    • 6 months--double body weight
    • 12 months-triple body weight
  134. contraindications to breast feeding?
    • galactosemia
    • hiv
    • sepsis
    • some drugs
    • some substances
    • cmv
  135. when a baby is fed what milk, do you need to supplement folate?
    goats milk
  136. when do you give flouride and iron to a baby?
    after 6 months
  137. how many calories per ounce of breast milk?
    20cal
  138. when is cow milk ok?
    after 1 year of age
  139. foods to avoid in 1st year ?
    • no egg whites
    • citrus
    • nuts
    • honey
  140. predisposition to osteosarcoma and ewings?
    • osteo--bilateral retinoblastoma
    • ewings--none
  141. best initial test for sle?
    most accurate?
    • ana
    • anti-ds
  142. what antibody in pregnant sle mothers causes a heart block?
    anti-rho
  143. diagnostic criteria for kawasaki?
    • fever
    • rash
    • strawberry tounge
    • conjunctivitis
  144. next best step when suspecting kawasaki?
    echo--look for aneurysms
  145. rx for kawasaki?
    • IVIg
    • aspirin
  146. purpura with normal platelts?
    hsp
  147. when are steroids given for hsp?
    when there are extra renal manifestations
  148. most accurate test for lead poisoning?
    venous blood lead level
  149. blackfan diamond vs fanconi anemia?
    • blackfan--pure rbc aplasia 
    • short stature
    • triphalangeal thumb

    • fanconi--all cell lines decreased
    • short stature
    • absent thumbs
  150. cause of transient erythroblastenia of chilhood/
    viral--self limited
  151. what milk has low folate?
    goat
  152. most accurate test of liver function in cirrhosis?
    platelets
  153. palpable cancer or courvesier sign means?
    gallbladder cnacer
  154. most common lekemia in childhood?
    all
  155. what leukemia likes to relapse in the cns?
    ALL
  156. rx for tumor lysis syndrome?
    • hydration
    • allopurinol
    • alkalanize urine
  157. what 2 tests are done for staging in hd?
    • xray
    • ct of abdomen
  158. best initial test for hodgkin and non hodgkin lymphoma?
    excisiional biopsy of the lymph node
  159. best initial test for brain tumor?
    ct
  160. 2 most common brain tumores?
    • astrocytoma
    • medulloblastoma
  161. craniopharyngioma causes what?
    hypopituitarism
  162. best initial test and most accurate test for wilms?
    • ultrasound
    • ct
  163. rx for stage 3 and 4 for hd?
    • adriamycin
    • bleomycin
    • vincristine
    • decarbazine
  164. MBIG is used for diagnosis of what tumor?
    pheochromocytoma
  165. patients with myelomeningiocele have what allerigies??
    latex
  166. rx for atypical febrile seizure?
    rectal diazapam
  167. best iniital test for wilsons disease?
    plasma cerruloplasmin
  168. enzyme in metachromatic leukodystrophy?
    arylsulfatase A
  169. poor muscle tone in an infant?
    werdnig hoffman syndome
  170. most accurate test for wednig hoffman?
    gene marker
  171. most accurate test for myasthenia gravis?
    emg studies
  172. best initial test for mg?
    most accurate test?
    • antibodies
    • edrophonium

    emg
  173. rx for mg?
    • acetylcholine enzyme inhibitors 
    • thymectomy under 60
    • over 60- steroids
  174. most accurate test for duchene muscular dystrophy?
    gene marker
  175. how do meninges present in neonates?
    not classically
  176. who gets dexamethasone for meningitis?
    kids >6 weeks old
  177. rifampin for meningitis prophylaxis against what organisms?
    • neissieria
    • h.influaenza
  178. wat bacteria produces leukocytosis with lymphocytosis?
    diphteria
  179. most accurate test for cat scratch disease?
    PCR
  180. rx for lyme dz?
    with no rash?
    rash
    arthritis or cn 7 palsy?
    carditis or neurological other than cn 7 palsy?
    • no rx
    • penicillin
    • penicillin
    • ceftriaxone
  181. best initial test for fungi?
    most accurate?
    • koh
    • culture
  182. what vaccine can be given to hiv +?
    MMR
  183. most accurate test for histo?
    radioimmuno assay
  184. which rash has the prodrome of cough, coryza, conjunctivitis, and koplik's spots?
    Measles
  185. which rash first begans with post auricular lymphadenopathy?
    rubella
  186. which rash has first fever and then a rash?
    Roseola
  187. ebv causes what cancers?
    • nasopharyngeal
    • hodkin
    • burkitts
  188. best initial test for mono?
    most accurate?
    • monospot
    • igm titers
  189. best test for hiv in newborn?
    pcr
  190. what is the concentration of acetominophen thats toxic?
    aspirin?
    • 150
    • 150
  191. rx for organophosphate poisoning?
    atropine
  192. Most accurate test for Organophosphate poisoning/?
    decreased RBC cholinesterase
  193. antidote for benzos?
    antidote for opiates?
    • flumazenil
    • naloxone
  194. untill what age is the baby facing back in the back seat?
    at age and weight is the booster seat used for the kid?
    when can a kid be in the passenger seat?
    • 1 year old-10 kg
    • 4 years or 40 pound-7/9 years
    • 12 years old
  195. battle sign?
    raccon eyes?
    rhinnorhea
    otorhea
    hematoma over the mastoid process--basal skull fracture
  196. best test to determine in a kid spinal cord injury without radiological findings?
    MRI
  197. degress of burn?
    • 1st--sunburn
    • 2nd--blisters
    • 3rd--full thickness
  198. first sign of puberty in girl and boys?
    • breasts enlarge
    • boys--testicles enlarge
  199. most accurate test for gonnorhea?
    chlamydia?
    • culutre
    • pcr
  200. rx for localized impetigo?
    mupirocin
  201. prophylaxis in whooping c/ough?
    prophylaxis for epiglottitis?
    • macrolides
    • rifampin
  202. when does necrotiizng enterocolitis occur?
    in neonates after introducing formula
  203. what are breath holding spells?
    when a child gets irritated and holds their breath and passes out
  204. somoyogi and down phenomenon?
    • somoyogi--too much insulin cause hypoglycemia which in turn causes hyperglycemia via glucagon, epihepnrine
    • down--not enough insulin causes growth hormone to produce hyperglycemia
  205. best initial test for aortic dissection?
    most accurate?
    • tee
    • ct
    • mra

    angiogram is most accurate
  206. when do you treat high LDL with 1 or no risk factors? with statin
    2 risk factors
    CAD/PAD/DM
    with exericise
    • LDL>190   >160
    • LDL>160   >130
    • LDL>130   >100
  207. rx of agitation in young?
    old
    • haloperidol/benzo
    • haloperidol
  208. what disease should not be treated with antipsychotics for delirium?
    lewy body dementia
  209. fibromuscular dysplasia presents in what population?
    women and young children
  210. what two factors warrant a tube thoracostomy?
    • ph <7.2
    • glucose <60
  211. cutis marmorata vs mongolian spot?
    cutis marmorata--looks like livedo reticularis---spider web pattern of disolocation

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