Pediatrics Practice Questions Part 2
Terms in this set (133)
What are some CI's to breastfeeding?
Galactosemia, HIV, active TB, HBV, HCV, substance abuse, INH, Iodides. Mastitis NOT a CI
Why is cow milk NOT recommended before age 1?
Low source of iron, can cause cow's milk colitis & hematochezia
When is soy milk recommended?
Galactosemia & lactase deficiency
Why is human milk preferred to cow milk?
Human milk rich in IgA, contains PMN's, macrophages & T & B lymphocytes
When is anemia checked?
9-12 mo, 4-6yo
When is lead screening done?
9-12 mo, up to 5 yrs. In CA, between 1&2 yo
What is blood lead level is considered normal and abnormal?
< 10 NL, > 10 abnormal, > 70 admit
When is a TB screen done in children?
1 yo & prior to entering KG if RF's present
Is a BCG a CI to a TST?
When is a UA screening done in children?
Why is a UA important?
Checks for occult UTI, hematuria, proteinuria
When is pharmacological tx indicated for pt's who fail lifestyle changes to control cholesterol?
Raises head slightly, fist tight, alert to sound, regards face
Holds head midline, chest off table, fist partially open, smiles, recognizes parent
Rolls front to back, sits well with support, moves arms in unison to grasp, coos, enjoys looking around
Sits unsupported, raking grasp, babbles, recognizes strangers
Crawls, pincer grasp, holds bottle, understands no, waves bye bye, stranger anxiety, plays pat a cake
Walks alone, mature pincher, dada mama, comes when called
Walks backward, scribbles, 4-6 words
Runs, feeds self, turns 2-3 pages, knows 8 body parts, plays in company of other children
Walks up/down steps w/o help, removes shoes/pants, turns 1 page at a time, 2 word sentence, parallel play
Pedals tricycle, dries hands, off/on clothes, draws circle, uses pronouns, group play
Tells "tall tales," plays well with others
Which type of cerebral palsy is MC?
What are the 3 steps in newborn resuscitation?
Thermal mgmt, clearing airway, tactile stimulation
Why is it important to check for a red light reflex in newborns?
r/o congenital cataracts & retinoblastoma
Malformed ears (e.g. external pits/tabs) may be a sign of what pathology?
Kidney & bladder
Abnormal square window, scarf sign, and heel to ear are indicative of what?
Infants w/ HSM & thrombocytopenia should be evaluated for what?
Congenital viral infections
What animals are carriers of toxoplasmosis gondii?
Why is toxoplasmosis bad?
Can cause mental retardation
What is the MCC of congenital infections?
What is the leading cause of mental retardation & deafness?
Cutaneous scars/vesicles, microcephaly, conjunctivitis, intracranial calcifications, HSM, and chorioretinitis are all signs of what congenital infections?
What do you treat congenital HSV with?
What organism causes syphilis?
The "Snuffles," HSM, jaundice, skin lesions on the palms and soles, and boney abnormalities in an infant are signs of what congenital infection?
Hutchinson's teet, saber shins, clutton joints, Higoumenaki's signs, saddle nose, blindness, celeray stalk lesions are signs of what congenital infection?
An autosomal dominant dz of CT with a defective coding for fibrillin
A lack of acid hydrolase leads to what autosomal recessive d/o?
Lysosomal storage dz
Brains of pt's w/ Down's syndrome have plaques similar to that of...?
What is the MCC of mortality in Down's syndrome pts?
Which cells are absent or deficient in Klinefelter syndrome? What do they produce?
Sertoli & Leydig; Testosterone
Turner's syndrome is a monosomy of which chromosome?
Patients w/ this syndrome will often all have abnormal kidneys, CoA, bicuspid aortic valve and a short 4th metacarpal
T/F: urterus, ovidects and vagina are abnormal in Turner's syndrome pt's?
False, they are NL and can get pregnant
Brown uniform melanin pigmentation w/ sharp margins
Café au lait spots
Mongolian spots are another name for..?
Beefy red, confluent erosions w/ sharp margins and satellite pustulates is characteristic of what skin d/o?
How do you diagnose tinea capitis?
Green fluorescence on Wood's lamp
What is another name x stork bites & angel kisses?
Capillary malformations that present as pink/red maculs on the eyelid, glabella, or nape of neck
Salmon patch/stork bites/angel kisses
Ectasia of superficial dermal capillaries that present as persistent macular erythema
Port wine stains
Why is a port wine stain over the trigeminal area of the face worrysome?
Can be a sign of Sturge weber syndrome, which can cause Sz's + glaucoma + MR
A bright red papule raised above normal skin is called ?
A raised, skin colored nodule w/ a bluish hue is called?
Marked pruritis & excoriations on the head is a sign of what?
T/F: fever and cervical LAD are assc. Sx of canker sores/apthous stomatitis?
A patient presents w/ weak peripheral pulses, an S2 single & loud, lethargy, poor urine output, and poor feeding. What heart defect do you suspect?
What medication can be given in CoA? Why is this given?
PGE, keeps the PDA open
Decreased pulmonary pressure & left to right shunting is commonly seen in what congenital heart dz?
In VSD, the smaller the defect the ______the murmur, and the larger the defect the _______ the murmur.
In VSD, a large defect causes what?
Volume overload, sx of CHF, dyspnea, feeding difficulties, recurrent pulmonary infxns
A PDA occurs when....?
Ductus arteriosus fails to close postnatally
Metabolic acidosis is a common feature in what congenital heart dz? Why does it happen?
HLHS, d/t poor cardiac output
When does a Tet spell occur in TOF?
MC in the morning, or after crying, feeding, defacating
T/F: A Tet spell increases a murmur in TOF?
T/F: Oxygen helps in treating TOF?
What is the MC genetic CV dz?
An enlarged left ventricle w/ decreased CO
What is the MC cardiomyopathy?
Dilated cardiomyopathy (DCM)
What is the MC known cause of cardiomyopathy?
Myocarditis caused by viruses (Coxsackie, adeno)
Tachycardia, cadiomegaly, HSM, an S3 or S4, CHF, and decreased CO are signs of what cardiac dz?
What is the gold standard test for diagnosing cardiomyopathies?
How is Dilated cardiomyopathy treated?
IVIG, diuretics, steroids, digoxin, BB's, Heparin, transplant
How is HSP treated?
Steroids (controversial), cyclophosphamide, AZA, plasmapharesis
A child comes in to your practice holding his elbow flexed and forearm pronated. What do you suspect?
What are common complications of syndactyly?
Web creep, nail deformities
Infantile scoliosis is seen MC in the left or right thoracic curve?
Adolescent scoliosis is seen MC in the left or right thoracic curve?
What is the MC orthopedic d/o in newborns?
Lumbar lordosis, limb length discrepancy, toe walking, and + trendelenberg gait are signs of what d/o?
8 yo boy presents w/ hip stiffness and loss of internal rotation & abduction w/ intermittent knee pain. On PE, there is also evidence of one leg being shorter than the other and there is a (+) trendelenberg gait. What do you suspect?
Legg-Calves Perthes dz
What is the MC d/o affecting adolescent hips?
13 yo obese boy presents w/ groin and thigh pain. On PE, you note that he walks with an externally rotated gait in attempt to relief the pain. What do you suspect?
A 4 yo boy presents to the clinic crying & rubbing his hip. Physical exam reveals a toxic appearing boy with a fever of 103°F and CBC reveals a WBC count of 15K. What do you suspect?
What is the MC location of genu valgum?
A congenitally derformed foot that points downwar and is turned inward
What is the MCC of in-toeing?
Where does a Torus fx MC occur?
Reticuloglandular ground glass appearance and decreased lung volume are characteristic CXR findings of what infant pulmonary dz?
A defect in the diaphragm in which the abdominal viscera herniate into the chest
Congenital diaphragmatic hernia
MCC of allergic rhinitis
At what age is asthma commonly diagnosed?
Besides asthma, what must be ruled out in a child presenting w/ dyspnea, wheezing, chronic cough, or recurrent PNA?
100 % of pt's with this pulmonary dz will have nasal polyps and chronic sinusitis
What is the etiology behind cystic fibrosis?
CFTR mutation, deranged chloride transport
Mucopurulent nasal d/c x > 10days
Chronic infectious rhinitis is another name for..?
What are the MC pathogens in bacteremia in a child?
S pneumonia, salmonella
What 2 d/o's can lead to Scarlet Fever?
What children are most at risk of developing meningococcemia?
A child presents w/ a mild URI prodrome, high fever, HA, nausea, marked toxicity, hypoTN, and purpura/petichiae on the extremities? What is the likely dx?
How can meningitis and meningococcemia be differentiated?
meningococcemia presents w/ rash/petichiae/purpura; meningitis does not
What must be done after a pt recovers from meningitis?
Check hearing to make sure cranial nerve 8 has not been damaged
What imaging study is performed to distinguish b/w a retropharyngeal abscess & a PTA?
What respiratory d/o has the highest mortality in infants < 6mo?
What labs are needed to dx an upper GI bleed?
NGT w/ gastric lavage, barium swallow, EGD
What labs are needed to dx a lower GI bleed?
FOBT, barium enema, colonoscopy
What medication is used to treat vomiting in children?
"coiled spring" sign
What is the tx x jaundice caused by hyperbilirubinemia?
What is the diagnostic criteria x neonatal cholestasis?
Direct bili > 1mg/dl during 1st month of life
Acute periumbilical/epigastric pain localized @ RLQ
What must pt's w/ unilateral renal agenesis avoid?
Delay in walking, difficulty rising from a sitting/lying position, frequent falling, shoulder/pelvic muscle weakness
Duchenne's muscular dystrophy
How is neuroblastoma diagnosed?
BM bx, urine x VMA (catecholamines)
A 4th heart sound (Kentucky) is associated w/ what cardiac dz?
Idiopathic hypertrophic subaortic stenosis (IHSS)
Benign inflammation of the costal cartilages that presents w/ acute chest pain
physical, chemical or biological agents that cause developmental anomalies
MCC of teratogens
What time period in pregnancy is the fetus most susceptible to teratogens?
< 3 mo
Down syndrome is strongly associated w/ what maternal factor?
increased maternal age
Women that are 45 yo have what risk of delivering a baby with down syndrome?
horseshow kidney, CoA, and bicuspid aortic valve are assc with what d/o?
rupture of arteries, hollow viscus, and kyphoscoliosis are complications of this d/o
hearing loss & blue sclera are assc w/ this d/o
recurrent brochiolar mucus obstruction, chronic bronchiolitis, bronchitis, and bronchiectasis are all signs of what d/o?
A honey comb lung, cor pulmonale, chronic pancreatitis, and secondary biliary cirrhosis are complications of this d/o
What do trophoblasts secrete?
Why is gastrulation important?
Gives rise to endoderm, mesoderm, and ectoderm 14 days post ovulation
Clusters of tissues that form the bases of multiple structures (vertebrae, muscle, nervous tissue)
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