USMLE3 peds

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  1. pcn are bacterio static or cidal
    cidal
  2. what is given to new borns 2 tings
    • erythromycin drops
    •  vit k
  3. what is given to new born before discharge
    • check for PKU, Hypothyroidism, galactosemia
    • give hep B vaccine if mother is HepAg -ve
    • if +, give hep B vaccine + IVIG
    • hearing test
  4. discoloration on the face hemangioma vs port wine stain, recession
    • port wine does not recede-part of stuge weber
    • hemanioma eventally goes away
  5. sturge weber constellation
    • port wine
    • seizure-If+, give anti-seizure meds
    • MR
    • Gluacoma
  6. charge syndrome
    • coloboma
    • heart defects
    • atresia or nasal chonanae
    • growth retardtion
    • genitourinary abnromaliies
    • ear abnormalities
  7. anirida is seen wiht what tumor
    wilms tumor, screen with us kidneys untill 8 yo
  8. when do intestines migrate into the belly during development
    at 10 weeks
  9. omphalocele present, screen for
    • edwards
    • patau
    • downs
  10. umbilical hernia is associated with
    hypothyroidism
  11. infants get what hernia
    indirect
  12. epispadia is associated with
    bladder exstrophy
  13. infants of diabetic mothers have what abnormalities
    • hypocalcemia
    • hypomagnesemia
    • hypoglycemia
    • polycythemia
    • high bili
  14. best predicive test for RDS
    L to S ratio of amniotic fluid
  15. rx for RDS
    surfactant
  16. 4 causes of respiratory disease ofnew born
    • RDS-premature
    • TTN- term
    • Meconium aspiration-term
    • diaphragmatic henria- term
  17. VACTERL syndomr
    • vertebral defect
    • ateresia anal
    • cardiac
    • tracheoesophagageal
    • radial renal anomalities
    • limb syndrome
  18. duodenal atresia is associated with what syndrome
    downs syndrome
  19. double bubble ddx
    • volvulus
    • annular pancreas
    • malroation
    • duodenal atresia
  20. causes of muconiu plugs vs ileus
    • CF
    • hirshsprung dz
    • maternal drug abuse
    • small left colon of DM

    Ileus is only CF
  21. what increases risk of necrotizing enterocolitis
    formula feeding and prematurity
  22. failure to pass meconium, best first step
    • rectal exam if + stool, hirshsprung
    • then barium enema
    • biopsy is the best test
    • Rx is surgery
  23. jaundice , pathologic will have direct or indi
    direct
  24. when is high bili pathological
    • >2 weeks
    • >12 mg
    • direct is more than 2
    • rises by 5
    • appears on 1st day of life
  25. rx for high bili
    • phototherapy if >12
    • exchange transfusion in encephalopathy
  26. rx for high bili for >weeks and conjugated
    cholestasis
  27. work up in jaundice,
    • direct vs indirect
    • if indirect check coombs, if+ abo/rh, thallase
    • if coombs -ve, check hgb, if normal or low, RBC defect
    • if high polycythemia, IUGR, IODM, Twin twin,
  28. gram postive is purpose staining
  29. cause of early sepsis
    delayed
    pneumonia- Gramp +, Ecoli, Listeria, H, influ

    • late-
    • meningitis-staph, ecoli, pseudmoina, klebsiea
  30. rx for sepsis
    amp and gen, if + meningitis give cefotaxime
  31. febrile seizure increases risk for subsequent seizure?
    yes
  32. all torch infections give what
    • growth retardation
    • hepatosplenomgealy, jaundice
    • MR
  33. toxo findigs
    • chorioretinitis
    • calcifications
    • hydrocephalus
    • test IgM
  34. rubella findigs
    cataract, dearness and blueberry muffin
  35. CMV findings
    calficifations, microcephaly, petechia, low plt, hearing loss
  36. herpes findigs in new born
    • first week sepsis pneumona
    • 2nd week vesicles, keratoconjunctivitis
  37. syphilis findigs
    • hutchinson teeth
    • desquamating rsh
    • snuffles, periostitis
  38. varicella findings
    • pneumonia
    • limb hypoplasia, seizures, MR
  39. what torch infections, you do PCR
    hsv and varicella, all other infections you check igM
  40. diagnostic work up for seizures
    • cbc, lytes
    • eeg
    • lp?
    • sepsis work up
    • aminoacid assay
    • Us of head to look for intraventricular hemorrhage
  41. rx for absence seizures
    ethosuxamide
  42. all substances present with withdrawal within how many days
    • 2
    • exception is methadone, can present up to 2 weeks
  43. Breast feeding jaundice vs breast milk jaaundice
    Breast feeding jaundice pesents first , give more feeds

    breast milk jaundice presents 2nd,
  44. side effects of nsaids, acei, sulfanamides, phenobarb, isotretinoin, phenytoin, DES, tetracycline, lithium, warfarin, valproate on the neonate
    • nsaid premature pda closure
    • acei craniofacial
    • sulfa displaces bilirubin
    • phenobarb bleeding
    • isotretinoin- facial and ear anomalies, heart
    • phenytoin-hypoplastic nails, iugr, typical faci
    • des vaginal adenoca
    • tetra discolored teeth enamel hypopla
    • lithium ebstein anomaly
    • warfarin facial dysmorophism chondro
    • valproate/carbameza-MR, NTB
  45. cause of trisomy
    non disjunction
  46. associations with downs
    • vsd, endocardial cushion defect
    • leukoemia
    • alzheimrs
    • duodenal atresia, TEF, hypothyroidism
  47. edwards syndrome findings vs patau
    • rocker bottom feet
    • micrognathia, microcephaly, low set ears

    patau0 everything is midline pprobelms, holoprosencephaly, midafce defects
  48. what trisomy has single umbilical artery
    apatua
  49. wilms tumor component(wagr)
    • wilms
    • aniridia
    • gu anomalies
    • retartation
  50. klinefelter
    low iq, gynecomastia hypogonadism
  51. turner sydnrome association
    • hypothyroid
    • horseshoe kidney
    • aortic valve bicuspid and coarctation, lymphedema, streak gonads, can get pregnant
  52. most cc of MR in boys
    fragile x syndrome, everything is large, ADD
  53. beckman wiederman syndrome via IGF disrupted at 11p15.5
    macrosomian, macroglossia, hypoglycemia, large kidney, neonatal polycythemia, high risk of abdominal tumors, trend AFP  for wilms tumor and hepatoblastom
  54. prader willi syndom
    • paternal deletion of chr 15
    • obesity, MR, binge eating
  55. angelman syndomre-maternally derived
    • happy pupper syndorme
    • seizures
  56. robin sequence
    mandibular hypoplasia, cleft palate, monitor airway for 1st 4 weeks
  57. birth weight does what by 6 months, 1 year
    • doubles by 6 mo
    • triples by 1 year
  58. height percentile at 2 yo correleates with
    final adult height
  59. best indicator of malnutrition
    weight/heigh<5th percentile
  60. best inidator for under or overweight
    bmi
  61. skeletal maturity relates to
    sexual maturity
  62. mcc social of failure  to thrive
    psychosocial deprivation
  63. a child who has crossed 2 major growth percentiles, you must do what
    work them up
  64. how is the weight in genetic short stature or constitutional delay
    birth weight is normal
  65. decrease in weight gain more then decrease in length/heigh
    malnutrition-do stool fat, sweat cl test
  66. normal weight gain but decreased length/height
    • rule out growth hormone def
    • thyroid hormone
    • cortisol secretion
    • skeletal dysplasia
  67. decreased weight gain equals decreased length/height
    chronic diseases i.e HF, renal, hepatic or genetic short stature or constitutional growth delay
  68. genetic short stature vs constituational growth delay
    bone age is close to chronological age in genetic short stature and puberty occurs at the same time as other children
  69. iGM is pentamer
  70. contraindication to breast feeding
    • hsv active
    • hiv
    • galactosemia
    • active infection
    • cancer
    • substance abuse
  71. all primitive reflexes dissapear when except
    • 6 months
    • parachute
  72. enuresis stop sby
    5 yo
  73. work up for enuresis
    ua, uti, bladder/renal u.s
  74. encopresis should stop by
    4 yo
  75. next step with encopresis
    abd xray-rule out constipation, rule spinal cord injury, hirshprung, anal fissure, crohsn
  76. premature or low birth weight,give immunizations
    yes at chronological age
  77. yellow fever vaccine and egg allergye dont give vacicine
  78. active immunization after measles

    varicella
    • measles   Ig-0 to 6 mo
    • ig + vaccine 6-12 mo
    • >12 months-vaccine within 72 hours
    • pregnant or immunocompromized ig only

    • varicella
    • VZIG to all but not pregnant
    • pregnant-vzig within 48 hours or birth or 5 days before delivery

    • hepatiti b
    • vaccine +Ig
    • hep a >2 years- ig +vaccine
  79. acitve immunizations for mumps and rubella
    none evailable
  80. Dtap a total of how many vaccines
    5
  81. hib conjugated vaccine
    not given after age 5
  82. meningococcal vaccine
    • age 12
    • all ppl living in dormitories
    • menomune for children 2-10
  83. chils abuse work up
    • cbc
    • cmp
    • pt, ptt
    • ua
    • skeletal surbeyr
    • ct +/- MRI
    • abd ct, lipase , hepatic, urine and stool for blood
  84. influenza is a what type of virus
    rna
  85. croup
    • parainfluenza
    • barking cough
    • oxygen 
    • nebuilzed epinephrone and steroddiors
    • steeple sign
  86. epiglottitis
    • thumb print sign
    • dysphagia, drooling, fever
    • ceftriaxone
    • rifampin ppx
  87. baterial tracheitis
    • brassy cough, after viral infection
    • subglottic stenosis
    • s.aureaus
  88. diphteria cough
    gray white pharyngeal memebraine, report to cdc
  89. pertussis
    whooping paroxysmal cough
  90. best protection against bronchiolotis
    what causes it
    • breast feeding
    • RSV, adeno,
  91. best test for bronchiolitis
    • ELISA of nasopharyngeal 
    • supposrive rx, beta agonist ,no steroids
  92. prevention of bronchiotlitis
    IVIG, monoclonal antibody-palivizumab
  93. most common cause of pneumonia <5 yo
    >5 yo
    • rsv
    • bacterial pneumonia
  94. staccato cough and eosinophilia
    chlamydia trachomatis
  95. pneumonia at 1-3 weeks of age + no fever, wheezing but has staccato cough
    c.trachomatis
  96. orders for pediatric pneumonia
    • cbc
    • blood cultures
    • mycoplasma
    • legionella
  97. rx for op pneumonia
    amoxacillin
  98. allergic bronchopulmonary aspergiloosis  association with
    cystic fibrosis
  99. best initial test for cf
    sweat chloride >60
  100. newborn screen for cf
    blood spot trypsinogen
  101. mutation in cf
    g551D
  102. rx for cf
    ivacaftor vx770
  103. resistant pathogens in cf
    inhaled tobramycin
  104. cyanotic heart diseases
    • tetrology of fallot
    • transposition of great vessels
  105. shock hypoxia, cyanosis , next step
    treat for sepsis and rule out chd
  106. best initial test for chd
    • cxr
    • ekg
  107. what chd give increase pulmonary vascular markings
    • TGA
    • hypoplastic left heart syndrome
    • truncus arteriousus
  108. vsd vs asd murmur
    • vsd-lower left sternal border
    • as-left upper sternal border
  109. murmur that gives wide fixed s2 splitting
    asd
  110. which type of asd needs repair
    sinus and primary
  111. rx for atrioventricular canal
    surgery early before pulmonary htn develops
  112. rx for pulmonary stenosis
    give e1 at birth
  113. what virus can cause pda
    rubella
  114. wide pulse pressure, bounding pulses
    pda
  115. rx for coarctation of aorta
    give pge1 infusion to maintain pda patent
  116. rx for tetraology
    • bb
    • oxygen
    • prostaglandin to keep pda open before surgery
  117. TOGV occurs commonly in what maternal chronic medical problem
    dm
  118. abx prophylaxis whe
    • prior endocarditic
    • chd 
    • prosthetic heart valves
    • cardiac trasnplant with valve problems
  119. htn is based on what in infants
    normograms
  120. htn in new born, next step
    early child hood
    adolescents
    • umbilical artery catheter-renal artery/vein thrombosis
    • early childhood- renal parenchymal dz, coarctation, endocrine, medications
    • adolescents-
  121. most common cause of htn in kids
    renal etiology
  122. most common cause of diarrhea inkids
    rotavirus
  123. mcc of bloody diarrhea
    campylobacter, emoeaba, shigella, e.coli, salmonella.
  124. rotavirus double strnaded dna visur
  125. when are antibiotis recommended for diarrhea
    • shigella
    • severe campylobacter
    • severe salmonella, <3 you
    • c.diff
    • .giardia or entamoeba
    • cryptosporidium
  126. hus is caused by
    • e.coli
    • shigella
    • campylobacter
    • salmonella
  127. abx in HUS
    no
  128. chronic diarrhea cause
    • low fat intake
    • high fruit juice
    • carbonated fluids
    • no fat
  129. initial test for malabsortipins
    • sudan black stain
    • fecal fat
    • serum trypsinogen sceen
  130. test for protein malabsorption
    spot stool alpha 1 antitrypsin level
    test for iron, folate, ca, zn
  131. dx for celia dx
    • antitransglutaminse abx
    • histooloy with bluting of villi
  132. malignancy associated with celia
    enteropathy associated  T. cell lymphoma
  133. test for giardia
    duodenal aspirate/biopsy
  134. best initial test for gerd in kids
    best medciations
    • esophageal pH monitor
    • H2
  135. test for poyloric stenosis
    u.s
  136. best initial test for volvulus
    u/s or barium enema
  137. 2 types of tissue in meckels
    gastric and pancreatic
  138. black currant jelly seen in
    intussusception
  139. best rx for intusssception
    air enema
  140. rx for pyelo in kids
    amp and gent or ceftriaxone
  141. nitrofurantoin can be given in kids older then 
    tetra can be given to kids older
    quinolones can be given to kids older
    • 1mo
    • 7 years
    •  16 years
  142. managemet of UTI after rx
    uc 1 week then 1-2 years after
  143. voiding cystourethrogram is indicated in
    • kids of any age with >2 febrile uti
    • 1 uti with HTN, hx of renal, bugs other than e.coli
  144. rx for VUR
    • nitrofurantoin or bactrim ppx
    • surgery for breaktrough UTI, scars, failure to resolve
  145. best test for obstructive uropathy
    renal us and VCUG
  146. rx for APGN
    • prn and supportive care
    • no steroids or acei
  147. most common cause of chronic glomerular disease
    IGA nephropathy(berger's
  148. test for apgn
    • ua
    • low c3
    • +throat cx and dnase
  149. autosoma recessive pckd
    flank masses, htn, oliguria, acute renal failure
  150. rx for minimal change dz
    steroids
  151. minimal change disease refractory to steroids
    • cyclophosphamide
    • cyclosporine
  152. most common complication of minimal change disease
    • SBP, vaccinate gainst pneumoccous and varicllea, 
    • risk of thrombolembolism
  153. proteinusira can be
    • transient
    • orthostatic
    • glomerular or tubular
  154. best initial test for 21 oh def
    most accurate
    • 17 oh progesterone
    • 17 oh progesterone levels after acth stimulation
  155. rx for cah
    • hydrocrtoisone
    • fludrocotrison
  156. rx for kawasaki
    • asa
    • ivig
    • warfarin if plt is high
  157. criteria for kawasak
    • fever for 5 days
    • conjunctivitis
    • strawberry tongue
    • desquamation
    • rash
    • lymphadenitis
  158. diagnostic findings in kawasaki
    • esr, crp
    • plt are high
  159. rx for henoch shloein purpurua
    supportive, +/- aspirin if +anticardiolipin ab
  160. palpable purpura, fever, abd pain, recent uri
    HSP
  161. chelation for lead with levels
    >45
  162. screening for sickle cell
    • CVs at 10 weeks
    • amniocenteiss at 16 weeks
  163. exchange transfusion
    stroke, acute chest syndrome, splenic crisis
  164. hydroxyurea indications for sickle cell
    • >3 cries/yr
    • anemia
    • complications
  165. prophylaxis for sickle cells
    • aspirin untill 5 you
    • immunizations
    • folate
  166. rx for thallasemia major
    • prbc transfusion
    • deferozmine
    • splenectomyfolate
    • vaccination
    • growth hormone,
    • bmt
  167. what congential bleeding disorder leads to deep bleedings
    hemophilia
  168. von willebrand dz vs hemophilia
    • hemophilia just PT, PTT are increased
    • in von willebran both are increased

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Author:
pszurnicki
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320940
Filename:
USMLE3 peds
Updated:
2016-06-12 04:04:53
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USMLE3 peds
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