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What are 5 common signs or symptoms of congestive heart failure?
- 1) Tachypnea
- 2) Pallor
- 3) Poor feeding
- 4) Lethargy
- 5) Hepatomegaly
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What are the 5 P's of compartment syndrome?
- 1) Pain
- 2) Pallor
- 3) Paresthesia
- 4) Paralysis
- 5) Pulselessness
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Which of the 5 P's of compartment syndrome is NOT a late finding?
Pain - the rest are all LATE findings
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What is the test of choice for diagnosis of compartment syndrome?
Measurement of muscle compartment pressures
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What is the MOST common cause of rectal prolapse in children?
Chronic functional constipation
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What are 5 causes of rectal prolapse in children?
- 1) Functional constipation (30%)
- 2) Cystic fibrosis (10%)
- 3) Rectal polyps
- 4) Repaired anorectal malformation
- 5) Constipation secondary to myelomeningocele
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What is the mode of inheritance of hypertrophic cardiomyopathy?
Autosomal dominant
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How do you estimate general population risk?
2 x square root of disease incidence
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When someone tells you that a disease is rare, what is a good estimate of the incidence?
1 in 10,000 to 1 in 50,000
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Copious, purulent penile discharge in a sexually active male indicates what type of urethritis?
Gonococcal urethritis
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What are 7 examples of nongonococcal urethritis?
- 1) Chlamydia trachomatis
- 2) Ureaplasma urealyticum
- 3) Mycoplasma genitalium
- 4) Trichomonas vaginalis
- 5) Herpes simplez virus
- 6) Adenovirus
- 7) Enteric bacteria
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In a pre-pubertal boy, what are the effects of exogenous androgen exposure, virilizing adrenal tumor, or late-onset congenital adrenal hyperplasia? (3)
- 1) Pubic hair growth
- 2) Penile enlargement
- 3) Growth spurt (with bone age advancement)
- *** Testes remain < 4ml
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What are possible causes of isolated premature thelarche?
- 1) Exogenous estrogen
- 2) Estrogen-secreting tumor
- 3) Early activation of HPA
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At what age do children have enough refined finger coordination to button and unbutton clothing?
36 months (or 3 years)
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At what age do most kids achieve day-time continence?
36 months (or 3 years)
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For infants born to HIV-positive mothers, empiric antiretroviral therapy should be started within what time frame?
6-12 hours
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What is the test of choice to confirm HIV infection in an infant with positive antibodies to HIV on serology testing?
HIV DNA polymerase chain reaction
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Why is HIV serology not a good test in an infant younger than 18 months?
Because positive results can be attributed to passive transfer of maternal antibodies
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What are 3 classic lab findings in Fanconi SYNDROME?
- Proximal tubulopathy
- 1) Hypophosphatemia
- 2) Hypokalemia
- 3) Metabolic acidosis
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What are 3 classic symptoms in Fanconi SYNDROME?
- 1) Polydipsia/polyuria (with subsequent dehydration)
- 2) Failure to thrive
- 3) Photophobia
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What causes the photophobia in kids with Fanconi SYNDROME?
Cystine crystal accumulation in the cornea
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What diagnostic exam tool do you use in a kid suspected of having Fanconi SYNDROME? (not a lab!)
Slitlamp ophthalmic exam
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What are 2 electrolyte abnormalities in kids with cystic fibrosis?
- 1) Severe hypochloremia
- 2) Metabolic alkalosis
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What are 3 electrolyte abnormalities in kids with hyperparathyroidism?
- 1) Hypercalcemia
- 2) Hypophosphatemia
- 3) Slightly low bicarb
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What are 4 electrolyte abnormalities in kids with salt-wasting nephropathy (Bartter syndrome, Gitelman syndrome)?
- 1) Hypokalemia
- 2) Hypomagnesemia
- 3) Hypochloremia
- 4) Metabolic alkalosis
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When do skin symptoms of serum sickness typically manifest?
1-2 weeks after starting offending agent (i.e. penicillin)
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What are symptoms of serum sickness?
- 1) Fever
- 2) Malaise
- 3) Lymphadenopathy
- 4) Arthralgia/arthritis
- 5) Urticarial plaques
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Besides supportive therapy, what is the treatment for serum sickness? (2)
- 1) Antihistamines
- 2) Corticosteroids
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Which hypersensitivity classification is serum sickness?
Type III hypersensitivity: immune complex reaction
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What are the 2 most common viral etiologies of erythema multiforme?
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What are 6 common drug etiologies of erythema multiforme?
- 1) Sulfonamides
- 2) Phenytoin
- 3) Barbiturates
- 4) Phenylbutazone
- 5) Penicillin
- 6) Allopurinol
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Zinc absorption is impaired when given at the same time as what food product?
Dairy
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Which 2 elements Interfere with intestinal copper absorption?
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What is the etiology of Menkes syndrome?
Mutation of copper ATPases that impairs copper absorption and transport
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What are 3 clinical features of Menkes syndrome?
- 1) Developmental delay
- 2) Seizure
- 3) "Steely hair"
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What are 3 classic clinical features of an infant with copper deficiency?
- 1) Hypochromic normocytic anemia
- 2) Hypotonia
- 3) Osteoporosis
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Where is zinc absorbed?
Intestines
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Where is copper absorbed?
Intestines
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What is the etiology of Wilson disease?
Copper accumulation caused by mutation in hepatic copper transport; copper cannot be excreted from liver
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What are 4 classic clinical features of zinc deficiency in kids?
- 1) Diarrhea
- 2) Skin lesions
- 3) Altered taste
- 4) Behavioral abnormalities
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What is the etiology of acrodermatitis enteropathica?
Congenital defect in zinc transport
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How does acrodermatitis enteropathica present?
- 1) Severe oral and perianal rash
- 2) Intractable chronic diarrhea
- 3) Growth failure
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Beside low serum zinc level (duh), what is an expected lab value associated with zinc deficiency? (1)
Decreased alkaline phosphatase
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How does cool mist work for the treatment of croup?
Cool mist thins and moistens airway secretions to improve clearance
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When is nebulized racemic epinephrine indicated?
Moderate-to-severe croup (with respiratory distress or inspiratory stridor)
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When counseling teens about illicit activity, what are 2 nonhelpful tips?
- 1) Lecturing about long-term sequelae (i.e. cancer)
- 2) Discussing ilegality of such activity
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The parents of a delayed kid think she's deteriorating. What are 3 things you can verify to rule out degenerative CNS disorder?
- 1) No decline in IQ (school evaluation)
- 2) No loss in acquired skills
- 3) Stable neuro exam
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What 3 electrolyte abnormalities are associated with use of furosemide?
- 1) Hypokalemia
- 2) Hypomagnesemia
- 3) Metabolic alkalosis
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For patients with history of "penicillin allergy," which cephalosporin is less likely to cause reaction?
2nd or 3rd generation cephalosporins (less allergenic than 1st gen)
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Toxic appearance, high fever, brassy cough, inspiratory stridor, "ragged" tracheal air column on neck radiograph - diagnosis?
Bacterial tracheitis
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