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USMLE Step 2 CK > Pediatrics > Flashcards

Flashcards in Pediatrics Deck (42):
1

What diseases cause a rash of the palms of the hands and soles of the feet?

Enterovirus (cocksackie A - hand, foot, mouth disease)

Syphilis

Rocky Mountain Spotted Fever

Kawasaki disease

Toxic shock syndrome (also diffuse rash)

2

2 month anticipatory guidance and screening

Parental well-being Infant behavior Infant-family synchrony Nutritional adequacy Safety Universal screening: metabolic and hemoglobinopathy, hearing Selective screening: blood pressure, vision

3

12 month anticipatory guidance and screening

Family support Establishing routines Feeding and appetite changes Establishing a dental home Safety Universal screening: anemia, lead (high prevalence/Medicaid) Selective: oral health, blood pressure, vision, hearing, TB

4

24 month anticipatory guidance and screening

Assessment of language development Temperament and behavior Toilet training Television viewing Safety Universal screening: autism, lead (high prevalence/Medicaid) Selective: oral health, blood pressure, vision, hearing anemia, TB, dyslipidemia

5

5 year anticipatory guidance and screening

School readiness Mental health Nutrition and physical activity Oral health Safety Universal screening: vision, hearing Selective screening: anemia, lead, TB

6

10 year anticipatory guidance and screening

School Development and mental health Nutrition and physical activity Oral health Safety Universal screening: vision, hearing Selective screening: anemia, TB, dyslipidemia

7

15 year anticipatory guidance and screening

Physical growth and development Social and academic competence Emotional well-being Risk reduction Violence and injury prevention Universal screening: vision Selective: hearing, anemia, TB, dyslipidemia, STIs, pregnancy, alcohol or drug use

8

2 month immunizations

Hepatitis B Rotavirus DTap Hib PCV IPV

9

4 month immunizations

Rotavirus DTap Hib PCV IPV

10

6 month immunizations

Hep B Rotavirus DTap Hib PCV IPV Influenza

11

12 month immunizations

Hib PCV IPV Influenza MMR Varicella Hep A

12

4-6 year immunizations

DTap IPV Influenza MMR Varicella

13

11-12 year immunizations

Influenza Tdap HPV Meningococcal

14

16 year immunizations

Influenza Meningococcal

15

CXR findings of TTN vs. RDS

TTN: wet lungs (fluid in fissure), no bronchograms RDS: ground-glass appearance, bronchograms

16

Treatment of pyelonephritis

IV ampicillin/gentamicin > IV ceftriaxone > IV pipperacilin/tazobactam > IV ciprofloxacin (only if child > 1) Oral cephalexin Renal ultrasound If abnormal ultrasound or recurrent UTI --> VCUC

17

Criteria of Kawasaki disease

Fever > 5 days Changes in oral mucosa Extremity changes (redness/swelling) Unilateral cervical lymphadenopathy Rash Conjunctivitis

18

SCFE

Knee pain Medially rotated foot Limited ROM of hip External rotation of hip upon raising leg Dx: lateral and AP xray Tx: internal fixation

19

Transient synovitis

Recent URI Low-grade fever Tx: rest and ibuprofen; resolves in 3-10 days

20

Reactive arthritis

A few weeks after recent bacterial gastroenteritis or genitourinary infection; antibodies attack joint a/w urethritis, conjunctivitis

21

Septic arthritis

Fever Non weight-bearing Elevated ESR Elevated WBC

22

Henoch-Schonlein Purpura

Non-thrombocytopenic pupura Hematuria Arthritis, esp. of knees and ankles Colicky abdominal pain Recent URI Tx: acetaminophen for pain; self-resolves Complications: chronic kidney disease, intestinal bleeding

23

Idiopathic thrombocytopenic purpura

Often follows URI Asymptomatic petechiae Thrombocytopenia

24

Intussusception

Invagination of bowel Lead point may be peyers patch (viral infection), Meckel's diverticulum, tumor Paroxysms of severe abdominal pain Currant jelly stool Sausage-shaped mass in right abdomen Dx: target sign on ultrasound Tx: air or barium enema

25

Scarlet fever

Group A strep infection Fever Fine, sandpaper rash that starts in the groin, axillae, and neck but spreads rapidly Pastia's sign (linear petechiae in body folds) Tx: abx within 9 days to prevent rheumatic fever (tx will not prevent PSGN)

26

Pyloric stenosis

Projectile, non-bilious vomiting after feeds Palpable olive-shaped epigastric mass Hypochloremic, hypokalemic metabolic alkalosis Dx: pyloric ultrasound Tx: IVF for rehydration, pyloromyotomy

27

Bordetella pertussis

Triphasic: catarrhal, paroxysmal (whooping cough), convalescent

28

Laryngotracheobronchitis (croup)

Caused by parainfluenza virus More common in the winter URI symptoms Barking cough Inspiratory stridor

29

Roseola

Caused by HHV-6 Maculopapular rash that starts on the trunk and spreads outward Rash preceded by fever

30

Parvovirus B19

Erythema infectiosum Slapped-cheek rash, lacy appearance Pain and swelling of joints May precipitate aplastic anemia

31

Measles

Prodrome fever Cough, coryza, conjunctivitis Rash spreads downward Koplik spots on buccal mucosa

32

DKA

Nausea, vomiting, altered mental status, polyuria, abdominal pain, hyperglycemia, hyponatremia, elevated BUN and creatinine (dehydration pre-renal azotemia), normal potassium Dx: random blood glucose > 200, pH

33

What is associated with a port-wine stain in the distribution of CNV1?

Sturge-Weber syndrome Check for vascular abnormalities in the brain

34

What is associated with port-whine stains of the face?

von Hippel-Lindau Check for vascular lesions of the retina and brain

35

Caput succedaneum vs. cephalohematoma

Caput is edema above the periosteum and thus crosses sutures Cephalohematoma is fluctuance below the periosteum and thus doesn't cross sutures

36

Infant growth guidelines

Weight should triple and length should increase by 50% by 12 months

37

Contraindications to rotavirus vaccine

Anaphylaxis to vaccine ingredients

History of intussusception

History of uncorrected congenital malformation of GI tract (e.g. Meckel's diverticulum)

SCID

38

Juvenile arthritis

Autoimmune, symmetric arthritis for at least 6 weeks

Labs: elevated ESR and CRP, hyperferritinemia, hypergammaglobulinemia, thrombocytosis, anemia

39

Presentation and management of Tetrology of Fallot

Clinical features: RVOT obstruction, RV hypertrophy, overriding aorta, VSD

S&S: hypercyanotic, hypoxic "tet" spell, crescendo-decrescendo systolic ejection murmur with agitation or exertion (e.g. feeding, crying, hyperventilation)

Pathophysiology: agitation or exertion → infundibular spasm → increased RVOT obstruction → R to L shunt

Management: knee-chest positioning (kinks femoral arteries → increased systemic vascular resistance → L to R shunt), inhaled oxygen, IV fluids 

 

40

Holosystolic murmur with late diastolic rumble in children

VSD

41

Continuous machine like murmur in newborns

PDA

42

Wide fixed and split S2

ASD