Past CMS Peds Things to Remember

What condition is characterized by papules on dorsal fingers and weakness of proximal muscles?

Dermatomyositis

What is the condition when leukocyte and platelets are low?

Aplastic anemia

What type of inheritance pattern does Duchenne muscular dystrophy follow?

X-linked recessive

What medications should be administered for any exposure to Chlamydia or gonorrhea?

Doxycycline and ceftriaxone

What condition should be suspected with distal thigh swelling without redness?

Fracture; obtain an X-ray

What is the idiopathic avascular necrosis condition that shows normal X-ray but decreased uptake?

Legg-Calve-Perthes disease

What are the symptoms that should make you think of pertussis?

Paroxysmal cough and vomiting

What type of ulcers are caused by Entamoeba?

Flask shaped ulcers

What should be suspected if a child with recurrent infections has a maternal history of mycobacterial infection or Pneumocystis jirovecii infection?

HIV

What happens to pulmonary vascular resistance after birth in relation to VSD murmurs?

PVR decreases, LV pressure > RV pressure, making VSD murmurs more intense.

What leads to persistent pulmonary hypertension of the newborn?

PVR fails to decrease (vasodilate); oxygen will not fix the hypoxemia.

Why does hypertension occur in post-streptococcal glomerulonephritis (PSGN)?

Due to salt and water (volume) overload.

What should be suspected if there is acute onset of difficulty breathing and nebulized albuterol doesn’t provide relief?

Foreign body aspiration; endoscopy should be done.

What is the first step if length stays stable but there's failure to gain weight?

Try dietary intervention like a diet diary.

What causes obstructive sleep apnea (OSA) in children?

Hypertrophy of adenoids and tonsils.

What is the first step for someone in respiratory distress with altered mental status?

Intubation.

When should HBIg be administered if maternal HBsAg is positive or unknown?

Within 1 week of birth.

What causes Down syndrome patients to fail to pass stool?

Hirschsprung's disease.

What is most important for determining progression in patients suspected to have systemic lupus erythematosus (SLE)?

Renal involvement; get renal biopsy.

What procedures are necessary for a patient suspected of Peutz-Jeghers syndrome (PJS)?

Upper endoscopy and colonoscopy.

What can lead to hypoglycemia due to diarrhea and vomiting?

Inadequate caloric intake.

What condition can gastroenteritis lead to that may result in lactic acidosis?

Hypovolemia.

What should be assessed in instances of blunt kidney injury?

Hematuria.

What differentiates appendix testis torsion from testicular torsion?

Intact cremasteric reflex.

What characterizes Hashimoto's thyroiditis?

High anti-TPO antibody concentration.

What indicates hemolytic uremic syndrome (HUS)?

Onset of pallor and lethargy with hematuria.

What can space heaters generate, and what is the treatment?

Carbon monoxide; treatment is oxygen.

What should be done if the newborn screen shows increased TSH and mother takes hyperthyroid meds?

Repeat the screening for TSH and T4 levels.

What is Tinea capitis treated with?

Oral griseofulvin

How does spinal muscular atrophy present?

Develops over months with lower motor neuron defects.

What can nephrotic syndrome lead to that predisposes to peritonitis?

Ascites; characterized by distention and tenderness in all quadrants.

What is polycystic ovary syndrome (PCOS) associated with?

Diabetes.

What happens if the endotracheal tube is placed too far?

Right mainstem bronchus collapse, leading to haziness in the affected lobe.

What are the signs/symptoms of systemic lupus erythematosus (SLE)?

High grade fever, diffuse joint pain, rash.

What condition can cause potentially fatal hyperkalemia in SLE?

Myocarditis; treat with calcium chloride.

What infections can cause SIADH?

Meningitis.

What should be done first if a newborn isn’t breathing well immediately after birth?

Tactile stimulation.

What should you consider with fever and rash along with a family history of meningococcemia?

Meningococcemia.

What causes hyperkalemia in patients on ACE inhibitors?

Aldosterone suppression.

What do you expect to see in cases of volvulus?

Dilated loops of bowel with air-fluid levels.

What does positive occult bleeding from stool without pain indicate?

Meckel diverticulum.

What can childhood obesity be attributed to?

Excessive consumption of total calories.

What syndrome is associated with macroglossia, omphalocele, visceromegaly, and hypoglycemia?

Beckwith-Wiedemann syndrome.

What is the progression for renal scarring due to vesicoureteral reflux (VUR)?

VUR leads to renal scarring, chronic kidney disease (CKD), and hypertension.

What does atopic dermatitis involve?

Lichenification on the face and diaper area.

What can occur when a baby spends the first 3 months of life on mechanical ventilation?

Bronchopulmonary dysplasia (BPD), which leads to pulmonary hypertension.

What can prevent allergies during the first 6 months of life?

Exclusive breastfeeding.

How is supraventricular tachycardia (SVT) characterized?

Rapid, narrow tachycardia.

What indicates maturation delay in children experiencing bedwetting after the age of 5?

Continued bedwetting.

What is the biggest concern in cases of gastroenteritis?

Correcting hydration status.

What vaccinations should be given to newborns within the first 6 months?

Dtap, IPV, Hep B, HiB, Prevnar, and Rotavirus.

What can result from excessive water consumption leading to vomiting and weakness?

Hyponatremia.

What should 9-month-olds be able to do?

Sit without support.

What does chronic granulomatous disease (CGD) indicate?

Impaired leukocyte microbicidal activity.

What indicates sexual abuse in young children when trichomonas is present?

The mere presence of Trichomonas

What distinguishes CMV from Toxoplasmosis on imaging?

CMV has periventricular calcifications, while Toxoplasmosis has ring-enhancing lesions.

What does a small laceration following a punch in the mouth suggest?

An unintentional human bite; mixed flora cause swelling.

What includes the initial treatment for asthma?

Daily inhaled corticosteroid and SABA as needed.

What should be done immediately after caustic ingestion?

Esophagoscopy/upper endoscopy.

What condition may occur as a side effect of amoxicillin?

Stevens-Johnson Syndrome (SJS) if there is desquamation, fever, and malaise.

What may recurring infections due to SHiN bugs indicate?

Wiskott-Aldrich syndrome.

What features are indicative of achondroplasia?

Macrocephaly, frontal bossing, varus, and hypotonia.

What symptoms characterize intussusception?

Colicky abdominal pain, nausea, vomiting, and bloody diarrhea.

What can be the outcome of otitis media with effusion on mobility?

Decreased mobility; treatment is supportive due to lack of active infection.

What complication can arise from a bicuspid aortic valve?

Increased risk of developing bacterial endocarditis.

What is a classic symptom of Rocky Mountain spotted fever (RMSF)?

Rash on palms and soles that follows fever.

What do tet spells in Tetralogy of Fallot present as?

Crying and sudden drops in oxygen saturation to hypoxemia levels.

How is androgen insensitivity syndrome (AIS) diagnosed?

Karyotype analysis.

What lab finding is characteristic of lupus?

Low complement levels.

What should be considered if recurrent pneumonia occurs with a very low T cell count?

Haemophilus influenzae type b (Hib); suggest administration of the Hib vaccine.

What indicates recurrent infections and could suggest HIV?

Hepatosplenomegaly and lymphadenopathy.

What is the most common cause of bloody diarrhea?

Salmonella, associated with reptiles, turtles, and chickens.

What typically occurs with pyloric stenosis?

Vomiting immediately after feeds.

What to do if automatic blood pressure measurement indicates hypertension?

Try the manual method before anything else.

Which diagnostic test should be carried out for acute lymphoblastic leukemia (ALL) when multiple symptoms are present?

Bone marrow biopsy.

What condition should be suspected with a thyroid region mass?

Thyroglossal duct cyst; becomes painful when infected.

How do common variable immunodeficiency (CVID) and X-linked agammaglobulinemia differ?

CVID and X-linked agammaglobulinemia have low Ig levels but X-linked is seen in boys.

What is another name for autism spectrum disorder?

Pervasive developmental disorder.

What does the JONES criteria for rheumatic fever include?

Joint pain, O (like myocarditis), Nodules, Erythema marginatum, Sydenham chorea.

What causes developmental dysplasia of the hip (DDH)?

Poorly developed acetabulum.