What are 3 organisms responsible for CHRONIC cervical lymphadenopathy?
1) Bartonella henselae*
2) Francisella tularensis*
3) Mycobacterium avium-intracellulare
* Associated with cat, tick, rabbit exposures
What is the treatment chronic cervical lymphadenopathy caused by M avium-intracellulare?
1) Complete surgical excision
*** Pretreated with clarithromycin or azithromycin PLUS ethambutol or rifabutin
For NICU infants infected with coag-negative staph, what are 3 effective antibiotics?
1) Vancomycin
2) Rifampin
3) Ciprofloxacin
What is the appropriate intervention for a kid with respiratory symptoms MOST likely due to foreign body aspiration?
Rigid bronchoscopy
What are 2 diagnostic studies for a kid with respiratory symptoms that MAYBE is due to foreign body aspiration?
1) Inspiratory/expiratory CXR
2) Chest fluoroscopy
What is the main electrolyte abnormality from getting a lot of albuterol?
Hypokalemia
What are 2 medications for genital warts?
1) Topical podofilox
2) Topical imiquimod
What the 2 main organ systems affected in patients with alpha-1-antitrypsin deficiency?
1) Lung (emphysema)
2) Liver (cirrhosis)
How does alpha-1-antitrypsin deficiency cause cirrhosis?
Accumulation of alpha-1-antitrypsin protein in the endoplasmic reticulum of hepatocytes
How does alpha-1-antitrypsin deficiency cause emphysema?
Accumulation of elastase from pulmomary WBC
Upon receiving the infant at the radiant warmer, what is the FIRST intervention at meconium delivery?
Suction at the mouth and hypopharynx (THEN you can consider laryngoscopy & intubation)
What is the BEST imaging study for diagnosing SCFE?
Bilateral AP and frog leg radiograph of the hips
What is the MOST important initial procedure in a patient presenting with progressive weakness?
Forced vital capacity - to establish involvement of respiratory system
What organism causes human monocytic erlichiosis?
Erlichia chaffeensis
What organism causes human granulocytic erlichiosis?
Anaplasma phagocytophilia
What are 2 tick vectors for transmission of HME?
1) Wood tick (dermacentor andersoni)
2) Lone star tick (amblyomma americanum)
What is the tick vector for transmission of HGE?
Deer tick (ixodes scapularis)
What distinguishes HME from other rickettsial diseases (i.e. RMSF)?
HME & RMSF both have:
-Thrombocytopenia
-Hyponatremia
BUT only HME has:
-Elevated transaminases
-Leukopenia
-Lymphocytopenia
What is the MOST rapid method for diagnosing GBS infection in a newborn?
Rapid antigen test via latex agglutination (best with CSF)
What are 3 UTI bugs that reduce nitrate to nitrite?
1) Escherichia coli
2) Klebsiella pneumoniae
3) Proteus sp.
What are 2 UTI bugs that produce urease and increase urine pH above 8?
1) Proteus mirabilis
2) Staph saprophyticus
What are 2 COMMON side effects of inhaled corticosteroids?
1) Dysphonia
2) Oral candidiasis
Prior to neurosurgery, what is the medical management of epidural hematoma? (3)
1) Oxygenation
2) Ventilation
3) Perfusion (euvolemic or hypervolemic with hot salt)
In the setting of increased ICP, when is an appropriate time to use mannitol?
When an ICP monitor (bolt) is in place
What is the progression of medical therapy for kids with Crohn disease or UC?
*** Everyone gets steroids
1) Start with salicylate (mesalamine)
2) Immunomodulators (6-MP, MTX, azathioprine)
3) Infliximab
4) Tacrolimus or thalidomide
How is IUGR and SGA related to polycythemia?
Maternal or placental disease reduce O2 delivery to fetus and lead to more EPO made
What type of bone cyst typically occur in pre-adolescents?
Unicameral (simple) bone cyst
What type of bone cyst typically occur in adolescents?
Aneurysmal bone cyst
Where do simple bone cysts typically occur?
Proximal humerus or proximal femur, adjacent to epiphyseal plate
How are simple bone cysts diagnosed?
Pathologic fracture after minor trauma
Are simple bone cyst precancerous?
No
Where do aneurysmal bone cysts typically occur?
Long bones (primarily femur and tibia) and spine
(T/F) Aneurysmal bone cyst are associated with pain, while unicameral bone cysts are not.
True
Beside Duchenne and Becker dystophies, what are 2 other hereditary diseases are associated with elevated CK?
1) Limb girdle dystophy
2) Acid maltase deficiency
(T/F) Forceful verbal resistance is ineffective in avoiding rape.
False
(T/F) Most assailants and perpetrators of rape are known to their victims.
True
What happens to calcium and phosphorus in vitamin D deficiency rickets?
-Calcium is low from nutritional deficiency
-Phosphorus is low because of PTH induced diuresis
What is the lab test of choice for diagnosing Toxoplasma gondii infection?
Serum IgM titiers for T gondii
What category of bacteria is pseudomonas aeruginosa?
Gram negative bacillus
What category of bacteria is enterococcus faecalis?
Gram positive cocci
Which 2 vaccines contain egg?
1) Influenza
2) Yellow fever
What component of the MMR vaccine is most likely responsible for anaphylaxis (when it occurs)?
Gelatin component
What is the formula for estimating UNcuffed ET tube diameter?
(age)/4 + 4
What is the formula for estimating cuffed ET tube diameter?
(age)/4 + 3
What is the most important first step after coming in contact with poison ivy?
Washing the toxic plant oils OFF!!!
What is the most likely diagnosis for a kid with painless rectal bleeding with a drop in hematocrit?
Meckel diverticulum
What is the most likely diagnosis for a kid with painless rectal bleeding WITHOUT a drop in hematocrit?
Colonic polyp (requires colonoscopy)
CXR showing: "air bronchograms, diffusely hazy lung fields and low lung volumes" suggest what diagnosis?
Respiratory distress syndrome
CXR showing: "fluid density in the horizontal fissure, hazy lung fields with central vascular prominence, and normal lung volumes" suggest what diagnosis?
Transient tachypnea of the newborn
CXR showing: "gas-filled loops of bowel in left hemithorax and opacification of the right lung field" suggest what diagnosis?
Congenital diaphragmatic hernia
CXR showing: "patchy areas of diffuse atelectasis, focal areas of air trapping, and increased lung volumes" suggest what diagnosis?
Meconium aspiration syndrome
(T/F) Teen drivers are MORE likely to drive after drinking than older drivers.
False - teens generally know that drinking and driving is bad, but when they do drive drunk risk for MVA is higher
What is the best lab test for diagnosing chlamydia pneumonia?
Nucleic acid amplification test
Aside from immunosuppression, what are 3 other etiologies for developing candidiasis?
1) Repeated course of antibiotics
2) Implantation of prosthetic materials (cardiac valves)
3) Repeated/chronic IV catheterizations (IVDU, dialysis, TPN)
