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Step III - Peds 5

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Question
Answer
what are the rule of 2s for Meckel’s   2 feet prox ileocecal (60-100cm), 2 inches long, 2 yo, 2% population, 2% symptomatic, 2 types of ectopic tissue (pancreatic and gastric), Males 2x > females  
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Diagnostic study for Meckel’s   Techn99scan  
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Tx for meckel’s   surgery  
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bilious emesis, which begins several hours following the initial post-delivery feeding, double bubble XR, malrotation of intestines, congenital heart dz   Duodenal atresia  
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what is the patho phys of duodenal atresia   Failure intestines to canalize in 8th and 10th week gestation leading to polyhydramnios in utero  
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type of abdominal wall defect that occurs when the abdominal viscera herniates through the umbilicus into a sac covered by peritoneal tissue and amniotic membrane   Omphalocele  
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exopthalmos, macroglossia, gigantism, hyperinsulinemia and hypoglycemia + wilms tumor   Beckwith-Wiedemann syndrome  
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Omphalocele is also a/w what condition/dz   Beckwith-Wiedemann syndrome  
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evisceration of intestine through the abdominal wall, just lateral to the umbilicus. mass is edematous, dark in color, and typically appears to be covered by a gelatinous matrix of greenish material   Gastroschisis  
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Infants who are exclusively breast-fed should have what supplements   vitamin D supplemented via formula mixture  
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Human milk contains significantly higher levels of what vitamin c/w cow’s milk   vitamin C (approximately 4 times)  
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Protein levels are almost twice as high in what kind of milk compared to mother’s milk   Cow’s milk (not good for baby kidneys  
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Iron from what milk source is better absorbed by baby   Mom > cow  
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What vitamins/nutrients are higher in cow’s milk c/w mother milk   Vita K, protein  
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Etio of erythema infectiosum   Parvovirus B19 (5th dz)  
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Rash on hands/extremities and spreads caudally   RMSF  
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rash usually starts on the head and spreads caudally   Rubeola/ measles  
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desquamating skin rash on palms, soles   Neonatal syphilis  
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morbiliform rash on his head that spread to his palms and soles + recent cough, runy nose and red watery eyes   Measles/rubeola  
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rash hands and feet +/- buttocks, ulcers in posterior palate and pharynx   Coxsackie A; hand, foot mouth disease  
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“slapped cheek” rash + erythematous, pruritic, maculopapular rash starts arms and spreads to the trunk and legs   5th dz/erythema infectiosum  
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generalized lymphadenopathy, an erythematous and tender maculopapular rash, and polyarthritis   Rubella  
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etio of measles   Paramyxo virus  
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MCC epistaxis in kids   Nose picking (trauma) to Kiesselbach’s plexus > nasal foreign body > deviated septum > prolonged dry air inhalation  
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The following sequence of treatment modalites should be performed for children presenting with epistaxis   Direct pressure > topical nasal vasoconstriction > anterior nasal packing > ENT consultation for posterior nasal packing (blocking choana)  
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Tetanus toxoid should be administered intramuscularly to patients suffering from tetanus-prone wounds such as   present >6 hrs, deeper than 1 cm, contaminated, infected, exposed to saliva or feces, crush injuries and puncture wounds  
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What age groups / timeline require tetanus toxoid injection   if they are less than 7 years of age, or if it has been more than 5 years since their last booster (everyone gets booster q10yrs)  
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Tetanus immunoglobulin (TIG) should be administered to   Pts >60yo, pts who have received < 3 doses of tetanus toxoid in their lifetime.  
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