Step 2 pediatrics 2 (10-12-15) and vax timeline

ruhland1's version from 2015-10-12 17:50

Section 1

Question Answer
defined male delayed pubertyno changes by 14yo
calcneal squeez testfrx or cyst
thompson testachilles tendon rupture
thompson test normalsqueeze calf therefore ankle plantar flexes
friebergs infarctosteochondoris 2 metatarsal head, young woman
kienbocks dzavasc nec of lunate,
kienbook classicoveruse wrist through repititive compressive loading
kohlers dzosteonec of tarsal navicular, childhood
panners disease"pitchers disease" osteochondosis of capitellum, little leauge baseball
osteochondrosisfocal distubance of endochondral ossification
osteochondrosis=aseptic avascular necrosis
severs diseaseyoung pt, cartilage apophyseal injury
severs disease txrest/ change activitty
apophyseal thinkfacet joint
severs disease pathophysosteochondrosis at insertion of achilles tendone on the calaneal tuberosity
severs dz txibu,heel cord stretching, heel cups or lifts

Section 2

Question Answer
animal bite ABXamox-clav
bug of dog/cat bitepasturella multocida
dog bite inf sxcelluitis, abscess, tenosynovitis, osteomyelolitis
2nd dog bite bugcapnocytophagia caninemorsus (also tx with amox/clav)
dog bite post ppxtetanus and rabies
cariini txTMP-SMX
dog bite -cillin allergicciproflox + clindamycin
non eryth pustules in toddlermolluscum
molluscum txresolve (wk/mo)

Section 3

Question Answer
intussusception vomitbilious
intussusception palpsausage shaped mass
intussusception positionknee drawn to chest
intussusception poopcurrant jelly
meckles divertassoc with yolk cyst and omaphocele
dicloxicillinto tx impetigo of GAStrep or Staph
mastitis txdicloxicillin
MRSA txvanco
why avoid penicillin in impetigoactive against strep, but deactivated by S.Aureus
dicloxicillin isB-lactamase resistant abx

Section 4

Question Answer
atopy=predisposition to asthma, allergies and dermatitis
atopy cluedermatographism
dermatographismwrite word on skin and makes eryth wheal
dermatographism isIgE mediated (mast cell and histamine release)
dermatographism HSN1
atopy txavoid allergens, antihist/steroid/epi for anaph
arthus reactionT III HSN due to intra dermal inj of antigen, up edmea/nec/ complement activation
T 1 HSNIgE mediated
T 2 HSNIgG IgM mediated
T 4 HSNcell-mediated

Section 5

Question Answer
simple vs complex febrile szsimple= <15 min and generalized. complex=focal,>15min
penicillin allergysx urticaria, rash, full anaphylaxis
febrile sz txif only 1 in 24 hours, tylenol, if >18 mo can be discharged with no further workup
chance of having a 2nd feb sz30% (also doubles chance of developing epilepsy later in life)
CNS infxn cluesaltered mind, bulging ant fontanelle, abnormal neuro
shaken baby syndromeup subdural hematoma
subdural hematoma sxcontinued depressed lvl of consciousness, focal sz,
febrile sz age6mo-5yr
fever + generalized sz + once only in 24 hoursfebrile sz

Section 6

Question Answer
slipped capital femoral epiphysismale 10-14 yo obese
SCFEpiphysis pxexpt supine, flex hip 90 degrees and cannot be internally rotated
DDH=developmental dysplasia hip
DDH dxU/S. X-ray is useless
DDH classicfemale neonate, breech delivery left side
DDH pxexassymetrical creases in thigh of newborn
DDH txPAWLICK brace/cast
Legg Calve PerthsAvascular Necrosis of femoral head, age 4-8
post-ictalpost sz state
shigella dysentieraG-, glc fermenting
shigella dysentiere featureblood/muscus -rrhea, Seizure preceding diarrhea
Salmonelli typhityphoid F, chill diaphoresis anorexia dry cough frontal headache mylagia and high fever
Yersinia Enteroliticarrhea, low F, abd pain for 1-3 wk.
seizures, hi F, rrhea w/ blood and mucusshigellosis

Section 7

Question Answer
neonate worsening V for 1 monthGERD
GERD dx gold24 hour esophageal pH monitoring
GERD neonate txsmaller more frequent meals, thickening formula with rice and elevating head 30 degrees
gold dx for pyloric stenosisabdominal u/s
gold dx for esph damageendoscopy
tx neonate GERDformula thicken
when to reeval GERDno up sx by 18-24 mo
iron s/edysmotility
when to begin cows milkone year old (milk lacks iron)
when use H2 antag / PPI in infant GERDwhen conservative therapy fails

Section 8

Question Answer
achilles tendon rupture testThompson test
Thompson testsqueeze calf, lack of plantarflexion
achille rupture sxsudden pain superior heel
pain in sole worse upon wakingplantar fascitis
calififactions in achilees tendonbone spurs
(-) thompson but tender achilles upon palpachilles tendonitis
cholelithiasis rememberfat female forty flatulent
cholelithiasis sxcolicy RUQ pain worse with eating
what contracts GB following a mealCCK(cholecystokinin)
Cholelithiasis labsnormal AST/ALT/bili/lipase,
Cholithitiasis negativeMurphys sign
cholecystitiscytsic duct
acute cholecystitis px exfever, jaundice, Murphy+, guarding
U/S finding Cholecystitispericholecystic fluid, thickend GB, Gas in GB, +murphy with US pushing on it
ascending cholangitisbact inf of bili tree due to common bile duct obstruct
ascending cholangitis findingCharcot Triad
Charcot TriadRUQ pain, F, jaundice
Reynolds pentadCharcot Triad + altered mental + septic shock (critical illness ascending cholangitis)
Gallstone pancreatitisepig pain to back, worse w food, esp fats and ETOH
Gallstone pancreatitis labselevated serum lipase

Section 9

Question Answer
ankolosing spondylitisbamboo spine, fusion of sacroiliac joint
finding in ankolosing spondylitissyndesmophystes
syndesmosphytesbony growths inside ligaments
chronic tendonopathyenthesophytes
enthesophytesbonyprojections forming at atachment sites of tendon/lig
spine instability thinksponylolithesis
loss of ? in intervertebral discshydrophillic glycosaminoglycans (dessications), up w age
where do osteophytes formalong join margins
osteoarthritis findosteophytes
scheurman diseaserigid thoracic kyphosis, vertebral wdgeing, and degenerative endplates
dx scheurman dzanterior wedging greater than 5 degrees in atleast 3 adjacent vertebrate
when to not brace scheurman patientwhen reached skeletal maturity
age to brace scheurman dzbefore skeletal maturity (13-15 females, 15-17 males)
scheurman initial txOMT/physical exercise

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