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USMLE2 Pediatrics 04
Mistakes - PedsAssessments
Question | Answer |
---|---|
Neurofibromatosis inheritance pattern | autosomal dominant |
What is the major malfunction that causes neurofibromatosis? | abnormal neural crest differentiation during embryogenesis |
Diagnosis criteria for neurofibromatosis 1 | 2 or more: 1. >6 cafe-au-lait (>5mm prepub, >15mm post-pubertal), 2. >2 NFs, 3. freckling - axillary or inguinal, 4. optic glioma, 5. >2 Lisch nodules - nevi on iris, 6. bone - sphenoid dysplasia or thinning long bone cortex, 7. hx of 1st deg relative. |
Diagnosis criteria for neurofibromatosis 2 | BL 8th nerve acoustic neuroma 1st degree relative with NF 2 |
treatment for neurofibromatosis | no treatment, genetic counseling since autosomal dominant |
jaw cysts | Gorlin (basal cell nevus) syndrome - ass with palm and sole pitting and basal cell CA |
osteopoikilosis | Golz syndrome - focal dermal hypoplasia, X linked dominant, only females affected. Linear and whorled Blashko lined-papules and plaques, fat herniation on skin, MR and convulsions. |
train track calcifications of the skull | Sturge Weber |
retrograde urethrogram | used to eval urethral injuries males with pelvic fractures and blood at the meatus |
Osgood Schlatter | traction apophysitis of tibial tubercle, athletic adolescents, xray to exclude other conditions, tx with rest, resolves completely in 1-2y |
steeple sign | croup, parainfluenza, looks like pencil |
epiglottitis | HiB - high fever, airway obstruction, toxic looking, drooling |
bronchiolitis and PNA in infants | RSV |
Otitis Media and PNA in children | S. PNA |
two most common causes of microcytic anemia on routine testing at 1yo | Fe deficiency and thalassemia trait |
classic presentation for STD Gonorrhea | urethritis, cervicitis, dysuria (burning), purulent discharge |
Neiserria gonorrhea on Gram stain | G- intracellular diplococci in PMNs |
all pts with gonorrhea should be tested for | Chlamydia, HIV, and syphillis |
tx for gonorrhea | IM CTX x1 PLUS doxy or azithromycin for presumed Chlamydia |
Chancroid | Haemophilus ducreyi, superficial PAINFUL ulcer, with painful inguinal adenitis |
Syphillis | Treponema pallidum (spirochete); small red papule --> crusted indurated erosion oozing fluid; painless LAD |
Genital herpes | PAINFUL grouped vesicles with erythematous base, painful small ulcerations, PAINFUL inguinal LAD; affects cervix in women |
guillian barre - what bacteria | Campylobacter, mycoplasma PNA |
guillian barre - ascending or descending weakness | ascending, starting in legs, symmetric |
can a 3-day old turn toward human voice? | yes |
Can a 3-day old fixate on a familiar face (i.e. mom)? | yes |
Does 3-day old have grasp reflex? | yes |
Does 3-day old have fencing reflex? | NO. only at 2 weeks to 6 months. |
when does an infant roll over? | 4-8 months |
how to diagnose RSV | RSV antigen in nasopharyngeal aspirate. causes bronchiolitis (inflammation of small airways, rhinitis --> blocked nasal passages with mucus, with obstruction of small airways and air trapping --> hyperinflated lungs) |
retropharyngeal abscess | Group A strep, S aurea, or anaerobes. Drooling, sore throat, fever, won't flex neck, bulge in posterior pharyngeal wall with erythema and oral secretions collected there. |
mode of inheritance for albinism | autosomal recessive - because both boys and girls can get it, but not very many people we meet have it! |
mode of inheritance for congenital adrenal hyperplasia | autosomal recessive - causes hermaphrodites --> both sexes, but again, rare. |
mode of inheritance for diabetes insipidus | X-linked recessive - actually didn't know, but I guess there might be a male predominance?? |
mode of inheritance for testicular feminization | X-linked recessive - it would have to be boys only since it's testicular! |
mode of inheritance for hypophosphatemic rickets | X linked dominant |
marker for neural tube defects | AFP |
cause of night blindness, dry scaling papular rash, inability to see bright light | Vit A deficiency |
marker for neural tube defects | AFP |
cause of night blindness, dry scaling papular rash, inability to see bright light | Vit A deficiency |
cheilitis (inflammation of lip), atrophic magenta colored tongue, seborrheic dermatitis on face and genitals, photophobia, blepharitis (inflammation of eyelids) | Vit B2 deficiency |
tx for Wilson's disease | penicillinamine - binds to Cu and increases its elimination through the urine. |
tremor, drooling, fixed smile, dysarthria, choreoathetosis, yellow-brown corneal deposits | Wilson's disease |
sabouraud's dextrose agar | to grow fungi |
pull test | diagnose alopecia areata |
turner's karyotype | XO, 45 |
why do Turner's pts have hypertension? | coarctation of the aorta |