Pediatric Board Study Flashcards

Rheumatic fever
Terms Definitions
Introducing solid foods to an infant less than 6 months old, increases the risk of _________________.
having GI illnesses.
Acute liver failure is when ___________________.
liver function decreases in the weeks to months after being diagnosed with liver disease
Stage 1 encephalopathy means that the _______________ is disturbed.
sleep cycle
Stage 2 encephalopathy means that there is a sleep ccle disturbance and ________________.
drowsiness
A patient with liver disease, worsening liver synthetic function tests, need what 3 things immediately?
1. ICU admission
2. Metabolic support
3. Liver transplant consulation
What are the 3 liver synthetic function tests?
1. Glucose
2. Albumin
3. Coagulation panel
In a patient with liver failure, what are the 2 risk factors for death and/or the need for liver transplantation?
1. Encephalopathy
2. Coagulopathy
A patient with stage 2 encephalopathy and a coagulopathy, needs what intervention immediately?
Liver transplant consultation
Kids with Sturge-Weber have 3 neuro-opthalmologic findings. They are ____________________.
1. Vascular malformation of choroid of eye associated with GLAUCOMA
2. IL CNS malformation of leptomeningeal vessels
3. Dermal cpillary malformation of ophthalmic (V1) and maxillary (V2) branches of the trigeminal nerve
Kids with Sturge-Weber may present with ______________.
1. Port-wine stain
2. Seizures
3. DD
4. LD
5. Intell. disability
Hint:
There are 5
All kids with a port-wine stain need an evaluation by an ______________ and also need __________________.
Ophthalmologist
Neuroimaging
The clinical triad of congenital glaucoma is ______________________________.
1. Photophobia
2. Epiphora
3. Blepharospasm
Congenital glaucoma is associated with the following 4 diagnosis: ___________________________________________.
1. Sturge-Weber
2. Rubella Syndrome
3. Lowe's Syndrome
4. Axenfeld-Rieger Anomaly
Aniridia can be associated with ____________ tumor.
Wilm's tumor
Neonatal cataracts are associated with ______________, _____________, ________________, _____________, and ________________.
viral syndromes
inborn errors of metabolism
genetic diseases
trauma
others
Coloboma can be isolated or affiliated with _____________________ syndrome or __________________ syndrome.
CHARGE
Cat-eye syndrome
HCCM has 3 cardiac findings on echo. They are _________________________________.
1. Mitral regurgitation
2. Obstruction of bood flow from narrowed LV outflow tract
3. Diastolic dysfunction
The murmur is aortic stenosis is _________________________.
SEM at LMS border and radiates to R infraclavicular area
Arthrogryposis is a clinical description that means _________________________________________________.
Congenital contractures of 2 or more different areas of the body
The 3 pre- and peri-natal findings associated with arthrogryposis are _______________________________.
1. Short umbilical cord
2. Polyhydraminos
3. Decreased fetal movement
To diagnose genital chlamydia or gonorrhea via NAATs testing, what are the appropriate samples?
Urine
Vaginal
Sodium polystyrene phosphate resin is used to treat _______________, by binding ____________.
Hyperkalemia
Potassium
In a child with meningitis, what are the 2 electrolyte abnormalities concerning for SIADH?
Low sodium
Low potassium
When SIADH is a concern, what is the first step in treatment?
Fluid restriction
A great majority of children with CP have spasticity, but only 10-15% of them have ____________________.
Dyskinetic CP that presents with dystonia
Children with CP very often have ________________ symptoms in addition to their neurologic manifestations.
GI
Most staphylococcal organisms are resistant to ______________ and ______________.
Penicillins
Ampicillins
The treatment of choice for children with a staphylococcal bacteremia is _______________.
Nafcillin or oxacillin
Nafcillin works by preventing bacteria to make ______________; it binds to ___________ and interferes with the synthesis of peptidoglycans.
Cell walls
Penicillinase binding proteins
3 examples of an aminoglycoside are _____________________________________.
1. Tobramycin
2. Gentamicin
3. Amikacin
Aminoglycosides most common adverse effects are ___________________ and ________________.
Ototoxicity
Nephrotoxicity
Fluoroquinolones, such as _____________, have the adverse effect of _________________.
Cipro
Tendonitis (Achilles, in particular)
Chloramphenical's most famous adverse effect is _________________________.
Aplastic anemia
An adverse side effect of ceftriaxone is ________________________.
Gallbladder sludging (pseudocholelithiasis)
Nitrofurantoin's most common adverse side effect is ______________________________.
Interstitial pneumonitis or fibrosis
The 4 most common adverse effects of cephalosporins are ______________________________________________.
1. Rash
2. C. difficile-induced diarrhea
3. Thrombocytopenia
4. Leukopenia
Biphasic stridor is specific for ______________________.
Subglottic stenosis
Legg-Calve-Perthes disease occurs most commonly in ______year olds to ___________year olds.
3-10 year olds
The classic radiologic finding in a child with Legg-Calve-Perthes disease is ___________________________________.
A cresentic, subchondral lucency about the epiphysis
Legg-Calve-Perthes disease is the __________________ of the capital femoral epiphysis.
avascular necrosis
Slipped Capital Femoral Epiphysis (SCFE) is most common in kids _____________years old to ________________years old.
10-16 years old
The classic radiologic finding in a child with SCFE is _________________________________________________.
Failure of a line drawn along the superior femoral neck (Klein line) to intersect the femoral head
While Toxic Synovitis and Legg-Calve-Perthes disease are common in presentation, the radiograph of a child with TS show ___________________________.
a normal femoral epiphysis
________________ is the result of decreased visual input to the brain resulting in decreased neuroophthalmologic pathways.
Amblyopia
What is a child with a hemangioma encroahing on her path of vision most at risk for?
Amblyopia
PROM
Prolonged rupture of membranes
PreMATURE ROM is _________________________.
Rupturing of amniotic sac without labor starting in 8 hours
PROM is _____________________.
Rupture of amniotic sac for longer than 18 hours
Preterm ROM is ____________________.
Rupture of amniotic sac before 37 wks gestation
Two maternal conditions that increase the risk of early-onset neonatal sepsis are __________________.
1. Chorioamnionitis
2. GBS colonization
Maternal GBS colonization is the most important factor in deciding whether to evaluate and treat a _________ infant, but not a __________ infant without symptoms.
PREterm
Term
Capillary lead levels greater than _______, need to be verified with a venipuncture sample.
10
Immediate post-natal signs/symptoms in a infant exposed to alcohol in-utero are _________________________________________________.
1. Pre- or post-natal growth restriction
2. Irritability/tremulousness that can last for months
3. Hiruste (resolves in 1st 6 months)
Children with oral allergy syndrome have cross-reactivity to __________________________________.
environmental allergens
The symptoms associated with a sedative-hypnotic overdose are ________________, ______________, ________________, _________________, _______________, ______________, _______________, _________________.
coma
bradycardia
bradypnea
hypotension
hypothermia
hypoactive bowel sounds
decreased muscular activity
Common type of drug to induce the sedative-hypnotic overdose is __________________.
Barbituates
Common cause of gassiness in infant less than 4 months old is ______________________.
incomplete starch digestion caused by developmentally normal immaturity of pancreas to produce approriate enzymes
__________ and __________ are more likely to cause chronic headaches than other medications used to treat headaches.
Opiates
barbituates
_______________ is one of the minor criteria for diagnosing Marfan's syndrome and is very uncommonly seen in the general population.
Spontaneous pneumothorax
Children with Marfan's syndrome typically have one or more of these 4 ocular/ophthalmologic findings.
1. Ectopia lentis
2. Flat cornea
3. Hypoplastic iris
4. Increased axial length of the globe
The major cardiac features in children with Marfan's syndrome are ___________________.
Dilation/dissection of the ascending aorta
The minor cardiac features in children with Marfan's syndrome are ___________________.
MVP
Dilation of main PA
Calcifiction of mitral annulus
ARDS is defined by acute onset, severe arterial __________, _________________ on CXR, and the absence of ________________.
hypoxemia (PaO2/FiO2 ratio less than 200 mmHg)
bilateral infiltrates
L atrial HTN
The risk factors for developing ARDS are ________________, _______________, _______________, ____________, _____________, and ____________________.
trauma
sepsis
pna
aspiration
near-drowning
multiorgan dysfunction
The only treatment approach in patients with ARDS that have been shown to decrease mortality is _____________________.
to decrease TV to 4-6 mL/kg

Other goals of tx are:
Keep paO2 between 60-80 mmHg
SpO2 of 90% or greater
pH of 7.3-7.45
The definition of "legal blindness" is __________________________.
Corrected vision of 20/200 or worse in the best eye
The most common mumps outbreaks are being seen in the ________________________ population.
college student, young adult
The five most common complications of mumps if it is not self-limited are ___________, ___________, ___________, ___________, and _______________.
orchitis/oophoritis
meningoencephalitis
pancreatitis
myocarditis
parotitis
_______, ________, _______, _______, and __________ are the most common animals in the US that transmit rabies to humans.
Raccoons, skunks, bats, foxes, coyotes
If there is a concern that a child has been exposed to rabies and the animal of exposure is not able to be quarantined, the best treatment plan is to __________________________.
provide RIG and vaccine within 24 hours
A young boy with _______________, may present with isolated hematuria, but not isolated proteinuria.
Alport's nephritis
Craniopharyngiomas are often diagnosed when a child develops ____________, _______________, or __________________.
headache
visual field disturbance
changes in growth velocity (from hypopituitarism)
In a penicillin-allergic child with an infected dogbite, the antibiotic treatment of choice is __________________________.
clindamycin and Bactrim
If there is a maternal history of "illicit drug use" during pregnancy for a child who presents as very ill, consider the diagnosis of ___________________.
HIV
When using Bactrim to treat PCP in a HIV patient, provide the medication IV for ________ weeks for those without AIDS and for ________ weeks for those who do have AIDS.
2
3
PCP prophylaxis in infants born to HIV+ mothers should begin in the ____________________ and continue until HIV has been definitively excluded.
4-6 weeks after birth
An alternative to Bactrim prophylaxis for PCP is ________________.
pentamidine
Children with classic upper GU tract causes of gross hematuria have urine described as ___________________________________.
cola colored urine without clots
Children with lower tract causes of gross hematuria have urine described as ___________________________.
bright-red urine with or without clots
Fortification of breast milk for a preterm infant serves the purpose of ____________________________________.
increasing protein supplementation
Commonly abused hallucinogens are _____________, ____________, _________, _________, and ____________.
LSD, PCP, mescaline, dextromethorphan, Salvia divinorum
Use/abuse of a hallucinogen causes the following symtpoms: ________, _________, ___________, ___________.
agitation
tachycardia
hypertension
hyperthermia
Use/abuse of hallucinogens cause the following behavioral symptoms: __________, _________________, _______________, ______________.
synesthesia (sense of seeing sounds or hearing colors)
time distortion
out-of-body sensation
euphoria or dysphoria
In a child exhibiting signs and symptoms of hallucinogen use/abuse, it is important to do the following three things: ____________, ______________, and _______________.
initiate calming procedures
place child in a low-stim environment
give BZs
In a VLBW infant, the initial parental fluid is _______________.
D10
In ______________, also called calcaneal apophysitis, the child complains of pain in the heel of the foot, typically bilaterally, that worsens with running.
Sever disease
Sever disease is most common in children aged ____ to _____ years and has a ________predominance.
8-13 years
male
In children with Sever disease, they often have positive calcaneal compression test causing pain when ____________________ is performed.
medial and lateral compression of the heel
In a patient with SIADH, you will see ________, ___________, ___________, and ______________.
decreased UOP
hyponatremia
low serum osmolality
high urine osmolality that is out of proportion to serum osmolality
Clinical symptoms associated with SIADH are _____________, ____________, and ______________.
lethargy
mental status changes
seizures
In patients with severe SIADH who are in a coma or having seizures from severe hyponatremia should be treated with ____________________.
3% hypertonic saline to raise serum sodium concentration approximately 6-10 mEq/L
In SIADH that is not severe (i.e., not seizing or in a coma), treatment is _________________________.
fluid restriction and close fluid balance and electrolyte monitoring
Patients who have DI have _____________, _____________, _______________, and __________________.
increased UOP
hypernatremia
high serum osmolality
low urine osmolality that is out of proportion to serum osmolality
Clinical symptoms in a patient with DI reflect __________________.
severe dehydration
The most common adverse effect associated with administration of IVIG is _______________.
aseptic meningitis
The medication used to treat Cryptosporidium is ____________________.
Nitazoxanide
The medication used to treat amebiasis is ______________________.
Paromomycin
______________ can significantly suppress IgE mediated wheel and flare reaction on allergy skin testing.
Amitryptiline
__________ is a common superficial skin infection in children that is similar to impetigo except that it becomes deeper as it persists causing an ___________________________.
Ecthyma
ulcer covered with a tightly adherent crust surrounded by elevated margins
The treatment for ecthyma is __________ and __________.
local wound care
penicillin
In patients with long QT syndrome, they may have ______________ and _______________ in addition to a prolonged QT on EKG.
bizarre or notched T waves
prominent U waves
Patients with long QT syndrome, are at risk for life-threatening ____________, ______________, and ___________.
V tach
torsades de pointe
V fib
_________ of folate for mothers without a history of a child with NTD and ________ of folate in mother who have a history of having a child with NTD reduces the risk of having a child with NTD up to 75%.
0.4 mg/day
4 mg/day
In patients with at least 4 months of amenorrhea after a prodrome of irregular menses, should have their _____________ checked before OCPs or other contraception is used to regulate their menstrual cycle.
FSH
In a patient who has had a caustic ingestion, the presence of ____________ does not preclude the possibility of esophageal injury.
Oral/mucosal injuries
Children with an IQ of ________ and no comoridities are expected to be self-sufficient in ADLs and communication.
50/55-70
Children with an IQ of 50/55-70 can be expectd to learn at a rate of ______ - __________ normal velocity.
1/2 - 2/3
Children with an IQ of ____________, are considered to have a moderate IQ, and are expected to be able to complete ADLs and express basic needs.
35/40-50/55
Children with an IQ of 35/40-50/55 can be expectd to learn at a rate of ______ - __________ normal velocity.
1/3-1/2
Children with a moderate IQ can be expected to obtain a ________ reading level, may be able to work in a supportive employment set-up, but more often require sheltered workshops with constant supervison. They commonly live in group homes as adults.
1st-3rd grade
Infections associated with a deficiency in IgG are generally caused by _________________, such as ____________, ____________.
encapsultated organisms
S pneumonia
H flu
There are several gram negative organims that cause UTIs, but _____________ is the most common. The others are ___________, _______, _________, _________, and ___________.
E coli
Citrobactor, Klebsiella, Enterobacter, Proteus, Pseudomonas
Gram positive organisms that cause UTIs is _________________, and in sexually active females, is _________________.
Enterococcus
Staph. saprophyticus
In a child with a gram + UTI/Pyelo, the antibiotic of choice is _____________.
IV Amp
In a child with a gram + UTI/Pyelo, the antibiotic of choice is IV ampicilin. If this child also has systemic or invasive infection, such as endocarditis, an ________________, should be added to the treatment regimen.
aminoglycoside (gentamicin)
The goal in the management in HSP is to recognize ________ early.
renal involvement
_______ % of HSP patients develop renal abnormalities within 4 weeks of presentation and ____% by 12 weeks after onset.
85%
97%
Children with HSP with normal urinalysis at presentation should have their urine analyzed ________ until systemic symptoms resolve.
weekly
The development of __________ in a child with HSP requires a timely consult with nephro and a renal biopsy.
proteinuria
Proteinuria of _______ on urinalysis OR a urine protein/creatinine ratio __________ is considered significant in a child with HSP.
2+ or greater
>0.2
Recurrent sinusitis, PNA, and decreased Ig levels should prompt an evaluation for a possible humoral immunodeficiency, such as __________.
CVID
_______________, aka X-linked agammaglobulinemia, presents with low Ig levels, but these patients typically present in infancy when passive maternal antibody starts to wane and the baby's inability to produce B cells becomes evident.
Bruton's agammaglobulinemia
In CVID, patient's have normal levels of ___________, but they are not normal.
B Cells
SCID is from a defect in the ___________ that is necessary to produce IC signaling (IL-2, etc.). These patients have low _______ and ________.
common gamma chain
T cells
NK cells
Patients with SCID present within the first 6 mths of life with ______, chronic ________, and ____________.
FTT
diarrhea
eczematous rash
In children with SCID, a ___________ prior to 4 months of age is associated with an improved survival.
BMT
A patient with specific antibody deficiency, presents with sinusitis and PNA from their impaired Ab responses to pneumococcal polysaccharide Ags, but they have normal levels of ________.
Igs
The classic triad in children with Wiscott-Aldrich syndrome is _______, ________, and _______.
severe eczema
sinopulmonary infections
thrombocytopenia
Despite the triad for Wiscott-Aldrich only ____% present with all three.
5-10%
In Wiscott-Aldrich, _______ levels may be low, but _____, _____, ____, and _______ are normal.
IgM
IgA
IgG
B-cell
T-cell
Wiscot-Aldrich is inherited via __________ inheritance.
X-linked
Presentation of hypoxemia and respiratory distress hours after a near-drowning is most likely from ____________.
ARDS
ARDS is characteized by ___________, __________ and __________ caused by the inflammatory response to an inciting stimulus.
worsening dyspnea
oxygen-resistant hypoxemia
bilateral pulmonary inflitrates
In an infant with GER, you would consider a 2 week trial of hypoallergenic protein hydroxylate formula when _______________.
there has been no improvement on thickened feeds
Meconium aspiration syndrome is characterized by the following 5 clinical/radiographic findings: 1. _______________, 2. _________________, 3. ______________, 4________________, and 5. __________________.
1. Post dates
2. Severe oligohydraminos
3. Meconium staining at birth
4. Early onset of respiratory distress
5. Patchy opacification and hyperinflation on CXR
Meconium aspiration syndrome causes lung injury via the following mechanisms: 1. __________, 2. _________, 3. ___________, and 4. __________.
1. Chemical pneumonitis (from inflamm)
2. Mech. obstruction of airways
3. Inactivation of surfactant
4. Vasoconstriction of the pulmonary vessels (PPHN often seen)
In an infant with Meconium Aspirattion Syndrome, at birth, they may appear to have a ___________ and be meconium stained.
barrel chest
In an infant with retained fetal lung fluid, the CXR would show _________________.
diffuse parenchymal infiltrates or fluid in the fissures
In an infant with GBS pneumonia, the CXR would show _____________.
patchy infiltrates and small pleural effusions
The differential diagnosis of preauricular swelling includes ______, __________, __________, and _________.
parotitis, tumor, lymphadenitis, lymphosarcoma
Parotitis from mumps is bilateral in __% of cases.
70%
Bacterial parotitis is often caused by ____________ and they often have purulent discharge from the Stensen duct.
Staph aureus
In children with a swollen parotid gland, the swelling generally crosses _________________ helping to differentiate it from preauricular lymphadenitis
the angle of the mandible
Preauricular lymphadenitis is common in ________ and is accompanied by conjunctivitis.
adenoviral infection
The consistency of the involved LN in lymphoma is often _________ and mediastinal involvement may obstruct venous return resulting in ______________.
rubbery
generalized facial swelling
The five MAJOR criteria for the diagnosis of acute rheumatic fever are: _________, ________, __________, ____________, and ____________.
J=Joints (migratory polyarthritis)
O=Obvious reason for diagnosing and treating these patients (cardiac involvement); Carditis shown as valve dysfunction, myocarditis, pericarditis, valvulitis
N=Nodules (SQ, pea-sized, extensor surfaces of elbows/knees and occiput)
E=Erythema marginatum (serpentine, slightly raised red/pink rash on trunk/ext)
S=Sydenham chorea
Carditis associated with Acute Rheumatic Fever can cause chronic cardiac problems such as __________.
Mitral (sometimes aortic) regurg/stenosis
Migratory arthritis of acute rheumatic fever _________ lead to chronic joint damage.
does not
To diagnose Acute Rheumatic Fever, ______ major criteria must be present and there must be evidence of a preexisting GA hemolytic strep infection.
2
The best evidence for a preexisiting GA hemolytic strep infection is the elevation of __________, such as _____ or __________ OR the presence of _______ major criteria and any 2 of the minor criteria: _____, _________, and ____________.
antistreptococcal titers
ASO titer
antiDNAase B titer

One
Fever
Elevated acute phase reactants
Prolonged PR interval on EKG
__________is used to treat severe acute rheumatic carditis, especially when ventricular dysfunction is leading to CHF. It is unknown whether this changes the risk for long-term valve disease or not.
Oral prednisone
________ can shorten the duration of acute rheumatic fever symptoms but there is no evidence to support that this reduces the risk of long-term outcomes.
ASA
For long-term intervention in acute rheumatic fever patients, the most important treatment is _____________, specifically ___________.
antibiotic prophylaxis
Benzathine PCN IM q21-28 days (better than oral equivalent)
Each attack of GA hemolytic strep infection after the initial acute rheumatic infection increases the risk of ______________.
serious valve damage
Bartonella hensalae is usually benign and seen in children _______ following a cat scratch or bite.
1-2 weeks
Bartonella hensalae typically causes _______, _______, ______, and ___________. It resolves on its own in approximately 1 month.
LA, HA, chills, abd pain
Lyme disease results in __________, _______, ________, and ________. Neurologic disorders and arthritis can occur, but develop ________.
Fever, rash, malaise, muscle soreness
late
__________ is rare with Lyme disease, though ________ have been reported.
Carditis
AV block of varying degrees/other rhythm abnormalities
Pericarditis, myocarditis, cardiomyopathy, and degenerative valvular disease have all been associated with infection with _________.
Borrelia burgdorferi
When a school-aged kid presents with acute to subacute chorea, order the following tests to confirm the diagnosis: __________, ___________, and ____________.
ASO titers
anti-DNAase B
anti-hyaluronidase Ab
Poor social interaction with same-aged peers, a tendency to be a loner, difficulties with reading and writing, and a tall stature should make me think of _______________.
Klinefelter's Syndrome
Klinefelter's syndrome has the _________karyotype but apply to all boys with at least one extra X chromosome or a mosaic chromosome complement (preponderance of X).
47, XXY
Klinefleter's has an incidence of 1.2/1000 males and it is typically diagnosed at one of the following three time points in life: ________, _________, and _________.
Prenatally (amnio)
Adolescense (gynecomastia in 1/3 of these kiddos)
Adulthood (due to infertility)
Males with Klinefelter's are often tall and have minor skeletal differences such as __________ and ________.
increased carrying angle
gynecoid pelvis
__________ is common in males with Klinefelter's and puberty is often ________. After puberty, these males often have _______, ___________, and __________.
Scoliosis
delayed
small testes, decreased body hair, gynecomastia
Males with Klinefleter's may also develop _______ and have poor __________ development.
obesity
muscular
In males with Klinefelter's, elevations in ______ and _______ are associated with decreased testicular function and a lack of feedback inhibition by testosterone.
LH and FSH
As adults, males with Klinefleter's have an increased risk for ______________ neoplasia. A history of ________ increases the risk for breast cancer 20-50 fold.
Leydig cell neoplasia
gynecomastia
Males with Klinefelter's may have delays in _______, ____, ________, and ________.
motor skills
speech
language
reading
Males with Klinefelter's may have difficulty recalling information, _____, and ________.
with new situations
and be inappropriately aggressive
Children with Marfan's syndrome are at risk for having the eye abnormality of ___________.
subluxed lenses
Stickler syndrome is an ______ disorder of ________.
autosomal dominant
connective tissue
The characteristic features of Stickler Syndrome are ______, _______, and ____________. _________ is a complication of the disorder.
prominent eyes
malar hypoplasia
rapidly progressing high myopia
scoliosis
Children with NF-1, first present with __________.
Cafe au lait macules
6 or more measuring at least 5 mm in diameter in prepubertal
In females less than 35 years old, the severe acute adverse effects of combined OCPs are caused by blood clots and are described by the mnemonic ________.
Abdominal
Chest pain
HAs
Eye problems (visual changes)
Swelling or aching in calves/legs
The five most common resevoirs for rabies are ________, _______, ________, _________, and ______.
Bats
Raccoons
Skunks
Foxes
Coyotes
Worldwide, most rabies cases are transmitted by ______.
dog bites
Infants cry up to ________ hours per day. Crying peaks at ________ and decreases by 1 hour every 12 weeks. Crying is the most common between the hours of _____ and ____.
3
6 weeks
3 pm and 11 pm
SARS is a _______virus and causes a _________ infection in children as compared to adults.
coronavirus
milder
In children younger than 5 years old and especially less than 2 years old, _______________ is a common cause of pyogenic arthritis of the knee.
Kingella kingae
The _________ is the most commonly affected bone in Kingella kingae infections and the most common joint affected is _________, followed by ______ and _______.
distal femur
knee
hip
ankle
Kingella kingae is a gram _________ coccobacillus and is difficult to isolate in solid culture medium.
negative
For beta-lactamase strains of Kingella kingae, the treatment of choice is ___________, but _____________ cephalosporins are also effective.
PCN
3rd generation (cefotax)
In addition to PCN and 3rd generation cephalosporins like cefotax, Kingella is also susceptible to _______, ________, ________, _______, and __________.
Gent
Chloramphenicol
Tetracycline
Cipro
TMP-SMX
Kingella is difficult to isolate in the lab so synovial fluid or bone aspirates should be ____________.
innoculated in a blood culture bottle for 7 days
Nonmonosymptomatic enuresis is defined as __________ + ___________.
nighttime incontinence
daytime voiding symptoms
A renal/bladder US can help screen for ________ and _________, both of which increase the risk of UTI.
hydronephrosis
renal stones
In a patient with nonmonosymptomatic enuresis whose urinalysis is suggestive of a UTI, other than urine culture, the child also need to undergo a ___________.
renal/bladder US
DMSA (technetium dimercaptosuccinic acid) scan is most useful as ________________.
a follow-up study to evaluate for renal scarring in a child with a history of pyelonephritis
A MRI of the lumbosacral spine in a child with enuresis is typically a second line study after _______.
RUS
Spiral CT of the abdomen is useful in children where there is a suspicion of ____________.
renal stones
Topical calcineurin inhibitors, such as _________ or __________, were introduced in 2000 for the treatment of eczema in kids older than 2 years but now has a black box warning (2006) and aren't used as commonly.
pimecrolimus
tacrolimus
The causes of polyuria are ______, ____, ___, ___, ______, and ______.
DM, DI, renal dx, hyperthyroidism, hypercalcemia, and hypomagnesemia
In a child with acute onset nocturnal enuresis, if the cause is related to an electrolyte disturbance, it is more likely to be secondary to _______ rather than hypomagnesemia.
hypercalcemia
Hypercalcemia in a patient with acute nocturnal enuresis may be the first sign of _____________ or ________.
hyperparathyroidism
vitamin D toxicity
_______ can affect the kidney's ability to concentrate urine and so lead to nocturnal enuresis, however, it would be a rare cause of acute nocturnal enuresis.
Hypokalemia
Children with CHF and growth failure need ______ to meet their increased metabolic demands.
140-150 kcal/kg per day
An infant with neonatal abstinence syndrome scores less than a 7 on the Finnegan scoring system; this supports the management by _____________________.
swaddling, gentle handling, dark and quiet room, demand feeding
An infant with neonatal abstinence syndrome scores of greater than 8 on the Finnegan scoring system; this supports the management by ________________.
pharmacologic intervention with morphine, methadone, or bupronorphine
Hypocalcemia can result in ___________ on EKG.
prolongation of the QT interval
____________ is the most common cause of seizures in the first 24 hours after birth.
HI injury
In an infant with galactosemia, their formula should be ____________.
soy based
The AAP recommends that preadolescents and adolescents take __________ of calcium and phosphorus daily.
1300 mg
At the age of 6 months old, a child ____________ in response to sound, produces ______________ noises, and _______________ speech.
turns to voice
babbling
imitates
A 4 month old infant shows interest in __________________, makes __________ sounds, __________, and initiates ____________.
his or her own image
squealing
laughs out loud
social interactions
At 9 months of age, the child _________ sounds, says _________ nonspecifically, follows a pointed finger, and recognizes ______________.
imitates
mama
familiar
Smallpox involves the _______ and the __________ which varicella does not.
palms and soles
Smallpox is characterized by a 4-5 day prodrome of _________, _________, _________, ________, __________, and/or ___________ and the patient appears very ill at the time the rash present.
fever
malaise
HA
backache
vomiting
severe abdominal pain
The lesions of smallpox spread ___________ and appear ______________.
centrifugally
homogenous
Transmission of ________ via human milk has never been documented.
HCV
Mothers with HCV who are breastfeeding should only consider deferring breastfeeding if they have cracked or bleeding nipples or if they have _________.
HIV
Prune-belly syndrome is characterized by the triad of ___________, ____________, and ___________.
bilateral hydriureteral nephrosis
undescended testes
diminished/absent anterior abdominal wall musculature
In an anuric infant, the best first test to evaluate the patient is a __________.
renal/bladder ultrasound
____________ ingestion can cause symptoms such as fever, nausea, vomiting, diarrhea and tinnitus all the way to tachypnea, tachycardia, hypoglycemia, metabolic acidosis with elevated AG, altered mental status, and seizures.
ASA
Treatment of a patient following an ASA ingestion includes stabilization, decontamination, and maintaining serum ___________.
alkalemia
Decontamination while treating a patient with an ASA ingestion typically includes __________.
activated charcoal (every 4 hours until asx and ASA conc less than 30 mg/dL)
In a patient with severe symptoms of ASA ingestion such as significant neurologic changes, pulmonary edema, unresponsive metabolic acidosis, renal failure, or plasma ASA conc greater thn 100mg/dL, ___________ is the method of decontamination.
hemodialysis
Selenium deficiency has only been identified in patients requiring _______________.
long term parenteral nutrition
Selenium deficiency has been associated with __________, __________, and ____________.
skin and hair pigment loss
macrocytosis
cardiomyopathy
__________ deficiency leads to acro-oral skin lesions, diarrhea, increased susceptibility to infection and growth retardation.
Zinc
__________ deficiency requires the depletion of liver stores and a dietary inadequacy and leads to neutropenia, hypochromic anemia that is not corrected with iron supplementation, bone abnormalities, and hair and skin depigmentation.
Copper
___________ is an X-linked recessive disorder of copper metabolism that is caused be a defect in the protein ATP7A leading to the inability of the export of intracellular copper.
Menkes
Menkes syndrome is characterized by ____, _______, and ___________.
anemia
steely hair
progressive cerebral degeneration
________ functions as a cofactor for insulin.
Chromium
___________ ingestion/overdose can lead to HTN, hyperreflexia, dilated pupils, talkativeness, irritability, weakness, hyperpyrexia, palpitations, tachycardia, nausea, vomiting, diarrhea, abdominal cramps, seizure, coma and stroke.
Amphetamine
__________ ingestion/overdose leads to palpitations from atrial and ventricular arrhythmias, nausea and vomiting, and visual disturbances including blurred vision and xanthopsia (disturbance of color vision with greens and yellows). On EKG, I might see bradycardia, AV block, and slurring of the upstroke of the PR interval.
Digoxin
Bilateral hemianopsia (loss of vision in lateral fields) is a concerning feature for ___________.
suprasellar lesion pressing on the optic chiasm
_____________ are slow growing tumors and often present in the first decade with HAs, visual findings, and endocrinopathies.
Craniopharyngiomas
Growth failure may be the first sign of a ______________.
cranipharyngioma
The most common malignant brain tumor of childhood is __________ which commonly presents with ataxia secondary to its common location in the cerebellum.
primitive neuroectodermal tumors
____________ are tumors located along the walls of the lateral ventricles and not in the suprasellar region. These are common tumors in patients with tuberous sclerosis.
Subependymal giant cell astrocytomas
Women with pre-pregnancy diabetes of any type are at a higher risk of delivering a child with congenital anomalies. These women should be offered a ______________.
second trimester US
The most common congenital malformations in infants born to diabetic mothers typically include the ____________ and __________ systems.
cardiac and neurologic
Multiple types of cardiac malformations can be seen in IDMs,but _________, __________, ___________, and ___________ seem to be the most common.
TGA
truncus
tricuspid atresia
HLHS
_________ is seen in 15-45% of IDMs which is a 3 fold increase over the non diabetic population.
Macrosomia
Hypercarbia is defined as a PaCO2 of __________.
>50 mmHg
Respiratory failure is defined by the inability to maintain adequate oxygenation. Hypoxemia is defined as a PaO2 of __________.
<60 mmHg
The best way to prevent drowning in pools is _______________.
barriers to access like fences (4 sided, 4 feet tall, with gate that swings inward with self-closing latch or lock)
The pH of granulated drain cleaner is makes it a __________.
strong base
Any patient with signs or ora injury or symptoms of dysphagia/odynophagia (drooling, choking, solid food refusal) following a suspected caustic ingestion should undergo an __________ within 12-24 hours.
Upper endoscopy
The most common type of caustic ingestion is _______________, followed by _______ ingestions and _______ ingestions.
acids and alkalis (oven, toilet bowl, tile, drain cleaners)
bleach
laundry detergents
___________ products are more commonly ingested than ______ products.
Alkali
acid
Hint:
Referring to pH
_______ products result in more postingestion complications than ______.
Alkali
acid
Hint:
Referring to pH
Acidic products cause __________ and have a _________ taste which limits the amount ingested. They are rapidly transported to the __________ where most of the injury occurs.
immediate oral pain
bitter
stomach
Alkaline products have __________ taste leading to increased amounts of the product being ingested. The site of greatest injury after an alkali ingestion is the ____________ by _____________.
no
esophagus
liquéfaction nevrosis
Products with a pH of greater than 11 (drain cleaner) are associated with a high rate of caustic burns and __________ products cause a higher rate of injury as compared to __________.
granular
liquid
Hint:
physical state of the product
Asymptomatic kids for whom there is a suspicion of ingestion of a caustic substance should be treated by __________. If symptoms of dysphagia develop, then a ____________ needs to be completed; however if the symptoms develop early after suspected ingestion, this may not be helpful, so ___________ should be performed instead.
Obs +/- allowed to take liquids
barium swallow
upper endoscopy
If grade 0-1 injuries are noted on upper endoscopy in a child with suspected caustic ingestion, they can be __________ if _____________.
sent home
they are tolerating feeds
If grade 2 injuries are noted on upper endoscopy in a child with suspected caustic ingestion, they should ____________ so long as no signs or symptoms of perforation develop.
remain on IV and be fed
If grade 3 injuries (______________) are noted on upper endoscopy in a child with suspected caustic ingestion, they require ________________________.
circumferential mucosal necrosis
long term parenteral nutrition
Up to 11% of kids with congenital diaphragmatic hernia have _________ problems.
cardiac
Herniation of intestinal contents into pulmonary cavity leads to two primary medical problems, _________ and ___________.
pulmonary hypoplasia and pulmonary HTN
Classic presentation of an infant with congenital diaphragmatic hernia is _______ and _______ from the displaced intestinal contents.
scaphoid abdomen
barrel chest
Delivery room management of an infant with congenital diaphragmatic hernia is __________ and ______________. After this, the next step is to obtain a _______, provide _________ and allow ________ to decrease the incidence of PTX and CLD. Then central arterial access should be obtained.
intubation
OG tube/replogele
CXR
gentle ventilation
hypercarbia
Infants with congenital diaphragmatic hernia have a survival rate of ___%, but this decreases to _____% if they also have cardiac disease.
70
40
Infants who survive congenital diaphragmatic hernia are at risk for the following: _______, _________, __________, __________, _______, __________, and ________.
neurodev issues
hearing loss (SN and 50%)
feeding and growth difficulties (50%)
GER (50%)
pectus excavatum
scoliosis
CLD (50% and 25% with infants demonstrating obstructive airway disease at 5 yo)
Neurolodev outcome in an infant with congenital diaphragmatic hernia is predicted by _________.
need for supplemental O2 at discharge from hospital
Sensorineural HL is seen in ____% of infants with congenital diaphragmatic hernia. Even if hearing tests are normal shortly after birth, the infant needs to follow-up at _________.
50
6-12 months of age
In a patient with pityriasis rosea, you must consider the alternate diagnosis of ____________.
secondary syphilis
In a teenage girl with a breast mass and strong family history of breast cancer, the first test should be _______________. If this is not helpful, then _____________ should be ordered.
a breast ultrasound
FNA
An adolescent with the loss of both bowel and bladder control, inability to walk, and lower body sensory loss, the diagnosis is _______________.
spinal cord dysfunction from spin bifida
A ________ is a fluid filled cavity in the central spinal cord that is commonly located in the cervical region. As it grows, it affects first the ability to feel __________. Eventuall, ______, ______, and ______ can occur.
syrinx
temperature
cape like distribution of pain over the back
hand tremors
distal hand wasting
Spinal cord tumors can present with localized pain and tenderness to percussion as well as motor loss, bowel and bladder loss, and sensory loss below a particular dermatome. Typically, __________ and ___________ are lost as well.
vibration
proprioception
A stroke in the spinal artery is associated with _____________ and presents with acute ________, loss of ___________ and ______ sensation.
atherosclerosis
bilateral weakness
temperature
pain
Treacher-Collins Syndrome is autosomal _________ and is caused by ______________ mutations in 60% of individuals.
dominant
spontaneous gene
The typical features of Treacher Collins Syndrome are __________, ________, __________, ______________, ____________, and ________.
downslanted eyes
lower lid coloboma (notching)
no eyelashes medial to the notching
malar hypoplasia
hypoplastic/malformed external ears with conductive and/or SN hearing loss
microretrognathia
Treacher Collins Syndrome is associated with the gene, ______.
TCOF1
Diabetic embryopathy can be associated with malformation/hypoplasia of the ______.
ears
Pierre Robin Sequence has the following clinical features: _______, ______, and _________.
retrognathia
retroglossia
cleft palate
Pierre Robin Sequence may be isolated or be a part of a larger picture such as in _______ syndrome and ________ syndrome.
Stickler
22q11 deletion syndrome
The more severe and prolonged the _______ in DKA, the more likely they will develop cerebral edema.
acidosis
The risk of developing Type 1 DM if the father has dDM is __% and ____% if the mother has it.
6
4
A disease that shows up in multiple generations but seems to affect the females less severely makes you consider the disease is heritable via _______.
XL inheritance
________ presents with microscopic hematuria progressing to hematuria with proteinuria by age 10 and ESRD in adolescent and young adults.
Alport's
________ occurs in 50% of patients with Alport's syndrome.
High frequency SN hearing loss
The most common opthalmologic abnormality in patients with Alport's syndrome is _____________.
anterior lenticonus
Alport's is inherited via __________ in 85% of cases and involves the ______ gene.
X-linked disease
COL4A5 (alpha-5 chain of type IV collagen)
______% of the male children from female carriers of Alport Syndrome, have Alport's.
50
The disease that is most commonly mistaken for Alport's is ___________.
thin glomerluar basement membrane disease
Thin glomerular basement membrane disease is familial and presents with _______, like in Alport's.
microscopic hematuria
Thin glomerluar basement membrane disease affects males and females equally, which is unlike ________.
Alport's
Thin glomerular basement membrane disease is a _________ condition.
heterozygous
Juvenile nephronopthisis is an autosomal _________ disorder characterized by ___________ and maifests with _______, ________, and lab features of _______ and __________.
recessive
chronic tubulointerstitial disease
polyuria
polydipsia
anemia
azotemia
Lowe's syndrome is a ________ disorder that presents with _______, _________, and ________.
XL
congenital cataracts
Fanconi's anemia (met acid, glycosuria, hypo-phos, hypo-kalemia, and amino acuduria)
intellectual disability
Plant ingestions often have cardiac toxicities, so a _________ should be ordered.
EKG
________ is a synthetic prostaglandin-2 analog and is a cytoprotective agent. It has shown to reduce the frequency of gastric and duodenal ulcers in peds patients who need long-term NSAID therapy.
Misoprostol
Pregnant women with chronic HTN are at risk for _____________.
uteroplacental insufficiency and intrauterine growth restriction
Growth of a fetus at risk for uteroplacental insufficency is monitored by ________ _________, _______, and if this is negative, a ________ should be performed.
serial ultrasounds
NST
CST (contraction stress test)
A NST assesses the __________. This should increase with fetal movement. If it does not in a fetus greater than 28 weeks gestation, then a ________ should be ordered.
fetal heart rate
contraction stress test
A positive NST includes ____________________.
2 or more heart rate accelerations within 20 minutes
A CST examines ________________.
response of the fetal heart rate to uterine contractions
A CST is performed via _________ or ____________, if less than 3 spontaneous contractions occur in 10 minutes
nipple stimulation
oxytocin IV
CST is negative if _________________.
there are no late or significant variable decelerations with at least 50% of the contractions
A BPP is a score compiled from ___________, __________, _________, ___________, and _________.
the results of the NST
fetal breathing movements
fetal body movements
fetal reflex movements
amniotic fluid volume
_________ appears as a focal lesion of subchondral bone and overlying cartilage. It affects kids < 10 years old. Pain is ______.
Avascular necrosis or osteochondrosis of the capitellum (Panner disease)
lateral
________ occurs with forceful triceps contractions during overhead throwing. It presents with acute pain and swelling over the posterior elbow and decreased range of motion.
Olecranaon apophyseal injury
DKA develops approximately _ hours after the failure of an insulin pump utilizing ultrashort acting insulin because there is no depot supply of insulin.
6
A child whose insulin pump stops working, even if it appears to be working again, who cannot get to medical care right away can be treated at home with _______.
(0.1 unit/kg/dose) ultrashort short acting insulin via insulin pen or syringe and needle every 2-3 hours
If glc does not decrease by 75-100 mg/dL per hour then insulin does can be increased
________ lasts for 24 hours but it is released slowly so it is not a good treatment for DKA.
Glargine insulin
Diphteria is a gram ________________.
gram + pleomorphic bacillus
The mainstay of treatment of diphtheria is ______________. It works by ___________ and protects against neurotoxiity if given within the first 1-2 days of illness. Additionally, antibiotics are used to treat. The three acceptable regimens are _______________________.
Diphtheria antitoxin
neutralizes toxin
Erthromycin po or IV for 14 days
Pen G procaine IM for 14 days
Pen G IM or IV for 14 days
Diptheria antitoxin is likely of no benefit in ___________ diphtheria.
cutaneous
Treatment for close contacts of a patient with diphtheria should be provided regardless of immunization status. The appropriate two regimens are ____________________.
one IM dose of Pen G benzathine
10 days of po erythromycin
All those exposed to diphtheria should have ________ and be monitored for 1 week for evidence of disease.
pharyngeal cultures
Pharyngeal carriers of diphtheria should be treated with one of the the following three regimens: ____________________.
po Pen G for 10-14 days
po erythromycin for 10-14 days
single IM pen G benzathine
2 follow-up pharyngeal cultures for diphtheria should be taken 24 hours apart, 24 hours after completing antimicrobial therapy. If culture is positive, then ____________ should be given.
10 day po erythromycin
Previously immunized folks exposed to diphtheria should receive prophylaxis and _________________.
a booster of an age-appropriate diphtheria toxoid-containing vaccine
The differential diagnosis of microscopic hematuria is usually broken down into _________ and __________ causes.
glomerular
non-glomerular
Glomerular causes of microscopic hematuria include ___________ that can be renal-limited or be systemic in cause.
glomerulonephritis
The evaluation for glomerular causes of microscopic hematuria is _________, _________, _________, __________, __________, ______, ________, ________, and ___________.
BUN
creatinine
albumin
urine creatinine
urine protein
serum C3
serum C4
ANA
anti-ds DNA Ab
The evaluation of nonglomerular causes of microscopic hematuria includes __________.
RBUS
A ketogenic diet increases the risk of developing ________ and __________.
hypercalicuria
renal stones
Renal stones in kids on ketogenic diet are typically made up of _______ or __________.
uric acid
mixed calcium/uric acid
Therapeutic or multiple doses of beta-2 adrenergic agonists can result in transient ________, _______, _______, and ____________.
decreases in PaO2
prolonged QTc interval
arrhythmias
electrolyte abnormalities
Continuous beta-2-agonist nebulizations may have _________ due to glycogenolysis, ___________, and _________.
hyperglycemia
hypomagnesemia
hypokalemia
The most common form of intussusception occurs in the ________, but it can occur anywhere.
terminal ileum
Intussusception is most frequent in males between the ages of _____ and _______.
3 and 12 months old
__________ should be suspected in any child who presents with some combo of the classic triad of signs and symptoms that includes __________, ___________, and _____________.
episodic cramping pain
palpable sausage-shaped mass in right abdomen
"currant jelly" stools
When recovering from major surgery or trauma, the acute onset of upper abdominal pain should make me think about________ , __________, and ___________.
peptic ulcer
inflammatory pancreatic disease
inflammatory gallbladder disease
When cholecystitis is suspected, the first diagnostic test of choice is ______________.
abdominal US
ERCP is considered when there is a suspicion for _____________.
choledocholithiasis
Otoacoustic emission testing assesses the function of the ___________, but it is unable to screen for ________.
peripheral nervous system
neural dysfunction associated with the auditory nerve and BS
OAE testing can be used to measure _______ hearing loss.
SN
ABR testing can detect _______ hearing loss and ____________.
SN
neural dysfunction
If a parent voices concern for hearing loss, the infant should be _________.
tested even if there is a previously normal test
In older children and adults with sarcoidosis , the most affected organ is the _______. However, _____, ___, ____, ___, and ______ can also be affected.
lung
LN
eyes,skin
liver
spleen
Pulmonary symptoms of sarcoidosis include _____, ______, _____, and the physical exam findings are varied.
dry cough
dyspnea
chest pain
Systemic symptoms of sarcoidosis are ___, _____, and ______.
fever
malaise
weight loss
Opthalmologic symptoms of sarcoidosis are _______, __________, _________, and ________. Eye exam may show ________ with __________, _________, or _____________.
redness
eye pain
blurry vision
photophobia
uveitis with firmly edged keratitic precipitates
conjunctival granulomas
peripheral multifocal choroiditis
Skin manifestations of sarcoidosis are varied and include _______, _________, ________< _______________________.
red, flat topped papules involving the face
erythema nodosum
nonspecific macules, papules, nodules, plaques, ulcers, SQ tumors
Pain in multiple joints is common in sarcoidosis, but __________ is maintained.
range of motion
In prepubertal children with sarcoidosis, pituitary dysfunction may lead to ____________, ___________, and __________.
growth failure
DI
delayed sexual maturation
Sarcoidosis patients can also have heart dysfunction that presents as ______, ________, or _________.
heart block
ventricular arrhythmias
cardiomyopathy
Sarcoidosis in children less than 5 years old presents as a the triad of ______, _________, and __________.
arthritis
rash
uveitis
The first neurologic symptom in children less than 5 years old with sarcoidosis may be __________.
seizure
The diagnosis of sarcoidosis is based on clinical suspicion and confirmed by __________. The preferred sites for biopsy are ______.
biopsy demonstrating noncaseating granulomas
LN, skin lesions, enlarged salivary glands, lacrimal glands, conjunctivalnodules
CXRs in sarcoidosis typically show ____________________.
bilateral hilar adenopathy with or without pulmonary infiltrates
Children with sarcoidosis may show _____ sedimentation rates, _____, ________, __________, ______gammaglobulinemia, _____calcemia, _______calciuria.
elevated ESR
anemia
leukopenia
eosinophilia
hyper-gamma . . .
hyper-calciuria
hyper-calcemia
_________ is the mainstay of treatment for sarcoidosis.
Steroids
In children with prolonged fever and uveitis, _____________ should be considered.
rheumatologic diseases such as JIA and SLE
The most common associated illnesses in children with febrile seizures are ______, _________, and __________.
URI
OM
roseola (HHV-6)
__________ presents with high temperatures, chills, rigor, sweats, and headaches. Other symptoms include N/V, D, cough, tachypnea, arthralgia, myalgia,abdominal and back pain. HYPO-glycemia, LOW-output RF, noncardiogenic pulmonary edema, resp failure, and shock can also be seen.
Malaria
In patients with malaria, ______ with resultant ___________, __________, and __________ may occur.
hemolysis
anemia
thrombocytopenia
jaundice
Plsmodium _________ causes the most severe form of malaria.
falciparum
Cerebral malaria can cause _______, _______, ________, and ________.
decreased LOC
Szs
RH
hemiplegia
______ events are not associated with malaria.
Thromboembolic events
Avian flu, also known as __________, frequently develop severe lower resp tract disease.
H5N1
Those with avian flu have a _____ % mortality rate.
50
If travelling to areas where avian flu is endemic, you should avoid ________ including _________.
live poultry
markets where live poultry are sold
The following areas are endemic areas for avian flu: ________, _________, __________, __________,
SE Asia across to the ME into Africa and Europe
(mostly in SE Asia, Iraq, Turkey, Egypt)
In an outbreak of E coli O157:H7, the daycare should __________ and all symptomatic children should not be allowed to attend daycare until the diarrhea has passed.
not accept new admissions
E coli O157:H7 is the _______-producing E. coli.
shiga toxin-
STEC (E coli O157:H7) starts with _____ diarrhea, then changes to ___________. Severe abdominal pain occurs, but _______ is present in less than 1/3 of cases.
nonbloody diarrhea
bloody diarrrhea
fever
_____ benefit has been shown in providing abx in cases of E coli O157:H7.
No
Enterotoxigenic strains of E coli ("____________ ____________") present with _________ and ____________.
Traveler's Diarrhea
moderately severe, self-limited abdominal cramping
watery diarrhea
Enteropathogenic strains of E coli produce _____________ predominantly in children <2 years old in developing countries.
severe, watery diarrhea
Enteroinvasive E coli causes ___________ and patients often have fever, fatigue, abdominal cramping, and tenesmus. The diarrhea is usually ___________, but progresses to _____________.
mild-severe dysentery
watery, nonbloody
blood streaked, mucoid diarrhea
EIEC lasts _________ and _________ may be present.
1-2 weeks
fecal leukocytes
Enteroaccregative E coli presents as ________ diarrhea without fever or fecal leukocytes. It occurs in all age groups and in developed and developing countries. It can last ______________.
watery
more than 14 days
Most treatments for nocturnal enuresis are withheld until the patient is ________.
7 years old
Behavior therapy for enuresis can begin by having the child ____________ and restricting fluid consumption ________ before bedtime.
void right before bed
2 hours
________ are the most effective strategy for nocturnal enuresis.
Bedwetting alarms
________ reduces the urine volume at night but does not grate children with reduced bladder capacity, bladder instability, or daytime symptoms.
Desmopressin
Intranasal preparation of Desmopressin can be associated with __________, so this should not be used.
hyponatremic szs
Anticholinergic agents such as ___________ reduce bladder contractions. This is a good option for children with nocturnal enuresis with daytime symptoms of incontinence, urgency, frequency.
Oxybutynin chloride
SIADH is charcterized by euvolemic ______natremia, _______ UOP, _______ serum osmolality, and _________ urine osmolality.
Hypo-natremia
decreased UOP
decreased SERUM osmolality
increased URINE osmolality
Treatment for SIADH is ___________.
fluid restriction and close monitoring of electrolytes and fluid volume
Children with SIADH who have acute neurologic changes (szs, coma) from severe hyponatremia should be treated with __________.
3% hypertonic saline to increase [Na]serum ~6-10 mEq/L
___________ is characterized by a relative greater increase in total body water content compared with total sodium content. It manifests with _____ and _______.
Hypervolemic hypo-natremia
JVD
generalized edema
Hypervolemic hypernatremia is commonly caused by ______ and ___________.
RF
CHF
______________ results from a loss of sodium and water though sodium loss is relatively greater.
Hypovolemic dehydration
Causes of hypovolemic dehydration include _______________.
Extrarenal losses-D, V, ileostomy,
Renal losses-diuretic use, cerebral salt wasting, mineralocorticoid deficiency
Differential diagnosis for primary amenorrhea includes ______________.
constitutional delay
eating d/o
chronic disease causing low weight for height
severe androgen resistance
Rokitansky syndrome (absence of uterus)
imperforate hymen
gonadotropin deficiency
primary ovarian failure
In a female patient with short stature, absence of breast development and short height for weight, you should consider ___________ as the cause and a ________ should be ordered.
Turner's Syndrome
karyotype
Absence of breast development indicates ________ of pubertal estradiol concentrations.
absence
Children at ___ months of age can say mama and dada with meaning and can say at least one additional specific word.
12
At _____ months old, an child can imitate speech, babble, say "mama" without specificity, follow a pointed finger, and recognize familiar people.
9
At _____ months old, a child can say 3-5 words, has mature margining, greets people and shows empathy.
15
At ____ months old, a child can say 10-25 words, can name a picture on demand, and engages in pretend play with others.
18
A _____ month old child has a vocabulary of more than 50 words, speaks in 2-word sentences, points to pictures and names them, uses "I," "me," and "mine," in speech, walk downstairs while holding a rail, throw a ball overhand, and imitate drawinga horizontal line, and engages in parallel play.
24
Prophylaxis for contacts of pateints with neisseria meningitidis is ___________.
rifampin po, 4 doses over 2 days
Alternate regimens are single IM Ceftriaxone or single po dose of cipro
_______ is effective in treatment of invasive menigococcal infections.
IV Pen G
Rifampin has the following uses in the pediatric population: ______, ________, ______, ______, ______, and _______.
prophylaxis in patients exposed to N. meningitidis
prophylaxis in vulnerable patients exposed to H flu
as part of std TB tx regimen (may be used as alternative regimen for preventive therapy when INH is not an option)
in combo with vanc or a beta-lactam abc in certain staph infections (osteo, VP shunt, endocarditis)
in combo with beta-lactam abx in attempt o clear persistent group A strep pharyngitis
in select instances in an attempt to eradicate MRSA carriage
To treat PID in a patient who cannot take cephalosporins, _________ is recommended.
Clinda + Gent-IV then 14 days of po doxy
The formula to calculate anion gap is _________.
Na - [Cl + HCO3]
The formula to calculate osmolality is _________.
2Na +(glc/18) + (BUN/2.8)
Osmolar gap is calculated by ________.
Measured Posm - Calculated Posm
The best method of reducing the effects of dust mite allergies indoors is to _________.
consistently keep the humidity <50%
An asymptomatic patient who has ingested a hydrocarbon-containing substance (kerosene, furniture polish, mineral spirits, gasoline, lamp oil) should be treated by _________________ and ____________.
obs for 6 hrs
a CXR should be obtained 4-6 hs after exposure
Evaluation of symptomatic patients who have ingested hydrocarbon-containing substances includes _____ or ____, and ______.
eval oxygen sat or ABG
CXR
Alpha-tocopherol is another name for ________.
Vitamin E
________ is a chronic disease of the conducting airways characterized by irreversible dilation of the bronchilal tree and manifested by chronic cough with production of thick, often purulent, sputum.
Bronchiectasis
In the developed world, ______ is the most common cause of bronchiectasis.
CF
Innocent heart murmurs ______ in intensity when sitting up versus lying down.
decrease
A higher blood pressure in the arms versus the legs should make you think of ________.
coarc
A "continuous" machinery murmur at infraclavicular region is suggestive of a _____________.
PDA
A high pitched systolic murmur heard over the neck is typical of __________.
aortic stenosis
An ______________ can show great variability of symptoms in family members.
autosomal dominant condition with incomplete penetrance
Palpable, fibroglandular breast tissue unfer the nipple-areolar complex in a male that measure at lease 0.5 cm in diameter is called ________________.
gynecomastia
In males with gynecomastia, it is typically __________ and becomes _________ in 75% of cases.
UL
BL
Rapid enlargement or a size of greater than _______ in a male with gynecomastia is usually pathologic.
4 cm
Hemoptysis as opposed to hematemesis produces ________ blood.
bright, frothy
Hemoptysis is ______ and hematemesis is acidic.
alkaline
The most common causes of hemoptysis are ______, ____, ________, _______, ________, _________, and ________.
infection
tracheostomy-related trauma
FB
CF
CHD
AV malform
hemosiderosis
Diagnostic screening studies for a child with hemoptysis are ____, _______, ______.
CBC
coag studies
CXR
_______________ is characterized by a parenetal history of later pubertal development and reassuring growth curve.
Constitutional delay of puberty
If considering constitutional delay of puberty in a patient, obtain a __________ because this should reaffirm your diagnosis.
bone age
At _____ months, a child can use pronouns appropriately, alternate feet when walking up stairs with a railing, jump in place, and make an 8 cube tower.
30
At ____ months, a child has a vocabulary of 250 words, balance on one foot for 3 seconds, pedal a tricycle, and copy a circle.
36
Meningococcal vaccines are approved for ages ___________.
> 2 years old only
____________ is the treatment of choice for treatment and prophylaxis for pertussis in infants <1 month old.
Azithro
PO erythromycin in an infant has been associated with ________________.
hypertrophic pyloric stenosis
Azithromycin can be used in children for the following reasons: ___________, __________, _________, ____________, ___________, ____________, ____________, _______, ___________.
CAPna
sinsusitis
AOM
strep pharyngitis is kids w/severe PCN allergy
atypical PNA
STIs (G/C)
H flu and moraxella
GI pathogens (salmonella, shigella, campylobacter, E coli)
possibly B hensalae
Clarithromycin can be used for treatment or prophylaxis of pertussis in children ___________.
>1 month old
Clarithromycin used in prevention of ________.
MAC infections in HIV patients
_________, ________, and _________ are treatment for H pylori.
Clarithromycin, amoxicillin, PPI
Bactrim could be used to treat and prophylax pertussis in children _________.
>2 months old
In a patient with HYPOnatremia secondary to dehydration (AGE), the urine is likely to be __________.
relatively normal, except for ketonuria and high urine sp grav
_________ or ________ increases the risk for lower respiratory tract infections but is protective against the development of atopy.
Early child care (<6 mths old)
multiple siblings
More than ___% of transient wheezers who begin before age 1 year have the condition resolve by age 3 years.
80
Children who begin wheezing _________ are at increased risk for IgE mediated aeroallergen sensitization and the development of allergic asthma.
after age 3 years
Breastfeeding for at least _________ decreases the risk for developing eczema.
3 months
If an infant presents with a picture of distal bowel obstruction, the next step in management is _____________, followed by _________ if necessary.
contrast enema
surgical decompression
More than 95% of cases of meconium ileus are associated with _______.
CF
Maternal presentation of preterm labor accompanied by fever and GI symptoms combined with meconium stained amniotic fluid is suggestive of ______________.
maternal listeriosis
Infants of mothers with maternal listeriosis, may present with a faint, erythematous rash with small, pale nodules called _____________.
granulomatosis infantisepticum
Most common cause of early onset neonatal sepsis is ______, followed by ______.
GBS
E coli
Treatment regimen with antibiotics in infants with early-onset sepsis is ___________.
Amp + Gent ( many centers change to or add a 3rd gen cephalosporin (not ceftriaxone) if meningitis is suspected)
__________ are ineffective against Listeria and eneterococcus.
3rd gen cephalosporins
__________ is defined as 3 infections with positive cultures in the preceding year.
Recurrent lower urinary tract infection or cystitis
In patients with cystitis/recurrent lower urinary tract infection who associate their symptoms with intercourse should be treated by _____________.
single dose postcoital antibiotic (nitrofurantoin, Bactrim, or cephalexin)
The correlation between ABGs and CBGs is compromised with the patient is _________.
hypotensive
At ____ months, a child can copy a cross and a square, draw a simple figure of a person, and hop on one foot two to three times.
48
At _____ months, a child can alternate feet while walking down stairs holding a railing, hop on foot 15 times, skip, copy a triangle, and write their name.
60
_________ is used in prevention or modification of measles infection in susceptible unimmunized exposed kids and in immunocompromised individuals regardless of immunization status.
IM Ig (within 6 days of exposure)
In an infant with severe eczema and no other symptoms, the infant should undergo ____________.
food allergy testing
Therapy for HCV is not recommended in children __________ in the absence of hepatic decompensation.
<2 years of age
In a male infant with UL undescended testis, surgical intervention should occur by _______.
6 months of age
Children who have acute/subacute generalized weakness require evaluation by _____________ or __________ to assess respiratory competence.
FVC or neg inspiratory force
In a child who presents with progressive proximal muscle weakness and normal neuro exam, should have ______ ordered.
serum CK
A mother with a family history of hemophilia A (XL recessive) has a ___ % chance of being a carrier and a ____ % of having a son affected.
50
25
Almost all contrast reactions are _________ mediated. Therefore, in a patient with a history of a reaction to contrast, before using it again, you should _____________.
non-IgE
pretreat with corticosteroids and antihistamines
If have a patient who has positive serum or clinical suspicion for H pylori, the next test is ______________.
upper gi endoscopy
Abx for dog bite are _______ OR __________.
Augmentin
Clinda + Bactrim
/ 444
Term:
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Definition:

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