939.

Anticonvulsant hypersensitivity syndrome due to carbamazipene, phenytoin,

phenobarbital. Fever + Rash + lymphadinopathy + visceral involvement
940. Cefalor, amoxicillin, antivenom causes serum sickness =Fever, rash, polyarthritis+
nephritis.
941. 11 months old with ANC of 1050 is not neutropenic.
942. Tonsils are present in Hyper IgM but absent in Bruton’s and SCID.
943. T Cell defect = recurrent viral / fungal and bacterial.
944. Combined deficiency = chronic or recurrent candida.
945. T cell defect increased risk of lymphoma / cancer as they age.
946. If PPD is negative, then consider further testing (candida, tetanus).
947. SCID = Small thymus present around 3 months.
948. Pure B cell deficiency after 6 months.
949. PC Pneumonia = Consider SCID and HIV
950. If Thymus is present BMC can be done.
951. Both SCID and WAS have no lymph nodes.
952. Lymphopenia = Combined or T cell defect

Wiskott Aldrich =  IgM, IgA

953. Digeorge Syndrome = Has no thymus so No BMT possible

954. Velocardiofacial Syndrome present only in some patients of Digeorge
955. Velo (cleft uvula/palate
cardio (VSD, TOF, TA, Interrupted aorticarch )
Facial (narrow upper lip, broad nose, unusual palpebral fissure).
956. No live vaccines in SCID and Digeorge.
957. Ataxia - telangiectasia = Recurrent.
Pneumonia / Sinusitis + AFP + mainly neurologic symptoms in childhood.
958. Common variable immune deficiency. Deficiency of all immonoglobulins + some T-cell
defect.
959. Encapsulated organism = common in Bruton and Sickle cell. S. pneumonia, N
meningitis, H influenza, Klebsiella, Salmonella, Pareugenosa, cyptococcus neoformans.
Total six.
960. Hyper IgM Syndrome = 6 Months of age
Neutropenia, lymphocytosis, Apart from IgM, all other immunoglobulins short.
961. HIV negative patient + PCP = Hyper IgM.
Bruton's: - No tonsils and lymph nodes
962. PCP: SCID or Hyper IgM never bruton.
963. 80% of patients with isolated IgA deficiency are asymptomatic.
964. Hyper - IgE Syndrome = Eczema + Eosinophils + high IgE + delayed dentation + coarse
facies pneumatoceles and recurrent cold abscess should alter one to Hyper IgE.
965. If CH-50 normal, than all complement pathways normal.
966. C1-4 deficiency presents like Bruton agammaglobulinemia.
967. C5-9 deficiency. Both N. Meningitis and N. gonorrhea common.
968. C-1 esterase deficiency patient don't have pruritis.
969. Recurrent swelling + Abdominal pain = Hereditary Angioedema.
970. Low complement levels.
a) Past streptococal GN
b) SLE
c) Cryoglobinemia
d) Hepatitis C
e) Membranoproliferative GN
f) Multiple Myeloma
g) Leukemia
h) Lymphoma
971. Normal complement levels.
a) Henoch-Scholein purpura
b) IgA nephropathy
c) Hemolytic uremic syndrome
d) Rapidly progressive GN.
972. Neutropenia is always associated with muscosal ulcerations.
973. Chronic benign neutropenia cures by 2 years of age.
974. Cyclic Neutropenia = Prone to clostridium perfringens + anal lesions (ulcerations /
periodontitis)
975. Chronic granulomatous deficiency = No lymphopenia + No neutropenia + catalase
positive organisms (Staph Ecoli, Serretia - Aspergillous, candida + Liver abscess /
osteomylitis / recurrent skin + lymphadenitis).
976. CGD present at 5 years.
977. Leukocyte adhesion defect = Infected umbilical cord without pus + delayed separation of
cord + delayed wound healing.
978. LAD die by 1 year if BMT not done.
979. Abcesses in chronic granulomatous, LAD, Hyper Ig.
980. Chediak - Higashi Syndrome.
Oculocutaneous albinism + skin / lung infections
981. Neotropenia + large neutrophils granules = chediak Higashi.
982. Neutropenia + Lymphocytosis - Hyper IgM.
983. Shwachman - Diamond is differentiated from cystic fibrosis by pancytopenia /
Neutropenia.
984. Diamond blackfan = 3 Months + macrocytic anemia + triphalangeal thumb.
985. If anemia +ve jaundice then it can't be diamond blackfan.
986. B cell deficiencies present at 6 Month because of presence of maternal antibodies.
987. If premature ventricular contractions are monomorphic and diminish with exercise =
Benign
988. -Blocks, verapamil, digoxin are contraindicted in WPW. Use procrainamide.
989. Atrial tachycardias do not respond to adenosine or vagal maneuver.
990. prolong QT= Melt Pc (Mg, Erythromycin, Levofloxacin, TCA, K, Ca).
991. In 3rd degree heart Block the child is bradycardic except when crying .
992. A shunt of less than 2:1 is not a contraindication to getting pregnant in ASD
993. ASD are more common in Trisomy 18 or 21 than VSD.
994. Operate VSD when there is pulmonary hypertension, Failure to thrive and a shunt > 2:1
995. AV canal defect is strongly associated with down and digeorge.
996. Stenosis murmur heard in middle of cycle
997. Regurgitation murmurs at the beginning of cycle except a) AR b) MVP
998. Pulmonary stenosis does not progress and does not cause sudden death.
999. Mitral regurgitation is associated with Marfan and Ehlers Danlos Syndrome.
1000. Murmur of MVP & HOCM both increase with standing and decrease with squatting.
1001. Hand grip increase the MVP murmur and diminishes HOCM murmur.
1002. Austin flint murmur is caused by AR.
1003. Still murmur diminishes with standing.
1004. Venous hum decreases with supine.
1005. Wide pulse pressure in AR and PDA.
1006. Carotid bruit are benign in children.
1007. Paradoxical split of S2 occurs in LBBB and Aortic stenosis.

1008. Right leg pulse weaker then right arm=Coarctation

1009. Cyanosis is mild in TA
1010. Cyanosis on Day 1 = TGA
1011. Cyanosis accurs within minutes in Tricuspid atresia and pulmonary atresia.
1012. In persistent fetal circulation there is decreased oxygen saturation in right leg compared
to right arm.
1013. Children with cyanotic congenital heart disease have more developmental problems than
children with acyanotic disease.
1014. Left axis deviation = AV canal defect or Tricuspid atresia.
1015. Order ASOT or Streptozyme in RF because it correlates better with recent infection. Do
not order culture as streptoccocal screen.
1016. RF is caused only by streptococal pharyngitis, not skin infections.
1017. In Kawsaki disease ANA is negative and 'Fever of unknown origin' type of presentation
is common.
1018. Life long prophylaxis
a) Prior endocarditis
b) Prosthetic material used in value.
c) Unrepaired cyanotic congenital heart disease.
6 Month prophylaxis. a) Any other prosthetic material (Not value)
1019. Pulsus paradoxus is seen in severe asthma, myocarditis, pericardial effusion with
temponade.
1020. Chest pain on lying down is pericarditis. Early heart failure = obstructive lesions on the
left side of heart. (Critical aortic stenosis,coarctation, hypoplastic left heart ) and Great
vein of Galen.
1021. HOCM is more likely in IDDM and Noonan.
1022. HOCM = septal hypertrophy + pulmonary stenosis.
1023. cardiomegaly is a normal finding in HOCM while septal hypertrophy is not.
1024. Kartagener and cystic fibrosis history is similar except for medically displaced apex beat.
1025. Start BP at 3 years of age.
1026. First non-fasting total cholesterol. If > 170, obtain a fasting LDL.
1027. If LDL > 160 + family History / risk factor OR > 190 start medications. Before that
change life style.
1028. If rash not improving with steroids / Antibiotics, it could be Eczema herpeticum.
1029. Seborrheic dermatitis is nonpruritic and first 2 months.
1030. Psoriatic each involves the inguinal folds while atopic dermatitis spaces.
1031. Eczema/seborrheic dermatitis + high urine output = Histiocytosis.
1032. Eczema and contact dermatitis spares inguinal folds.
1033. Pruritic rashes are = scabies, tinea, varicella, eczema, atopic dermatitis.
1034. Pruritis rash on Labia= Lichen sclerosis.
1035. Contact dermatitis needs multiple exposure e.g. Ivy leaf.
1036. Rash + Alopecia + Neuological signs (ataxia, coma) + Lactic acidosis = Biotinidase
deficiency.
1037. Recurrent crops is papular urticaria, even when umbilicated.
1038. Newborn + No eye lashes + eyelids inverted = Lamellar icthyosis.
1039. nectrotic, blue ulcers = pyoderma gangrenosum.
1040. Neutropenic patient + narcoticulcerativelesions + diaper area =Ecthyma gangrenosum.
1041. Ringworm + No scaling = Granuloma Annulare.
1042. Rash with central clearing = urticaria, Tinea, Erythema marginatum.
1043. Rash with central darkness = STS / TEN, Lyme.
1044. Acne before 8 years = exogenous steroids use, precocious puberty, tuberous sclerosis.
1045. Apthous ulcers in Bachet disease or schwachman diamond syndrome.
1046. Peg shaped teeth in Incontinentia pigmentosa and hypohidrotic Ectodermal
dysplasia.
1047. Vascular malformations are morbid, homogenous are not.
1048. Hemihypertrophy + portwine stain = Klippel trenaunay syndrome.
1049. Hypertrophy syndromes = Beckwith - Wiedmans Klippel - Trenaunay, Russel
silver, proteus.
1050. Dandy walker and spinal dyraphism have congenital melenocytic nevus.
1051. Adenoma Sabeceum is misdiagnosed as acne and spares the forehead.
1052. Tubecous sclerosis and neurofibromatosis have high rate of mutation so
family history may be absent.
1053. Delayed dentation in hypohidrotic ectodermal dysplasia and incontinentia
pigmenta.
1054. In SJS/TEN lesions are in the eye and month while in SSSS the lesions
are around the eyes and mouth.
1055. In pityrasis rosea, no lesions on palm and soles as against secondary
syphyllis.
1056. HPV 16 and 18 - cervical
1057. Blue berry muffin is seen in Rubella, CMV, HSV, Privovirus and
coxasachie.
1058. Erythema nodusom = CUTIS
crohin, UC, Drgs, Infections, steroids.
1059. Unwell baby + cutis marmorata = sepsis.
1060. Zinc deficiency starts after breast feeding over.
1061. Alopecia + Rash + poor taste = Zinc deficiency
1062. Alopecia + scalp dermatitis + thrombocytopenic=
Essential fatty acid deficiency.
1063. In aplasia cutis, look for underlying skull defects, and underlying
spinal dysraphism.
1064. In full term baby, expected weight gain of 20-30gm / day.
1065. In preterm 15-20gms / day.
1066. In most cases the finding of normal development + Macrocephaly =
Familial.
1067. If development abnormal + macrocephaly = Hydrocehaly.
1068. Bulging frontenella = Hydraencephly more likely then macrocephaly.
1069. Papilledema not presnet in mauocephaly and hydrocephaly
1070. Protein requirement in preterm 3.5g /kg/day. While full term need just
2.5g/kg/day.
1071. Look for Vit D and vitamin K deficiencies in exclusively breast fed
babies.
1072. Breast fed babies 4001U,
CF6 Rickets 1600IU/day
1073. Supplement with iron at 2 months for preterms and 6 months for terms.
1074. Whey in breast milk.
1075. Caesin in formula milk
1076. Do not give whole milk before 1 year of age.
1077. Corrections in development milestones no longer necessary after 2 years.
1078. Age and weight should be guide to Retinopathy of prematurity need for
oxygen (<32wks<1500gm)
1079. ABO incompatibility can occur in first born.
1080. Apnea of prematurity is not associated with increased risk of sudden
infant death syndrome.
1081. CAH, sepsis, inborn errors, complex congenital heart disease can all
present with shock.
1082. After 4 months, colic needs to be waked up.
1083. Pregnancy associated hypertension is associated with wt, Lt HC.
1084. In respiratory depression due to opiates, use naloxone when actually
given only.
1085. If mother addicted to opiods, naloxone can result in seizures in
newborn.
1086. Renal tublar Acidosis very common reason for failure to thrive.
1087. Delayed umbilical cord separation = Leucocyte adhession defect OR
leucopenia.
1088. Single Umbilical artery = VACTERL
1089. Hypospadias = SLOB = Silver Russel, Lawrence - Moon Biedle, opitz and
Backwith- Wiedeman syndrome.
1090. In undescended testes, risk of malignancy in both testes even after
operation.
1091. 2m = COOS = Lift two body parts + tracks in two direction.
1092. Six months = sit + switch hands + scroll in 2 directions + screams in 2
ways + sleeps in 2 naps.
1093. Normal pupil size is 3mm.
1094. Meiosis = COPS = clonidine and cholinergics, opaites and
organophosphous, phenothiazines and pilocapine, sedative and
barbiturates.
1095. My driasis = AAAs = Antihistamines, Antidepresent, Antichlinergic and
sympathomimetics (Amphetamine cocaine, phenecycline).
1096. Diaphoresis =  sweating = SOAP = sympathomimetic, organophosphates,
Aspirin, phynecycldine
1097. Nystagmus caused by anticonvulsants, pheneyclidine.
1098. Syrup of Ipecac is no longer recommended
1099. Charcoal = use within one hour of ingestion = AAAAm = Aspiring,
anticholinegies, Acetominophen and Asthma med (theophylline)
1100. Dont' use charcoal in MML metals (Iron or lead), liquid (Ethanol,
organophosphates, Acid, Alkalis, cyanide), Lithium
1101. Gastric Lavage within 60 minutes of presentation.
1102. No gastric lavage in hydrocarbon, acid and base.
1103. use Haloperidol in amphetamine, cocaine, and phenecyclidine.
1104. Osmolar gap is very high > 20 in ethylene glycol and calcium oxalate
crystals in urine.
1105. The anion gap is high in all alcohols except in isopropyl Alcohol.
1106. N-acetylcysteinic can be given 1V or PO with 8 hours of ingestion.
1107. LEFTs are deranged on Day3.
1108. Cholinergics = DUMBELLS = Diarrhea, Urination, Miosis, Brochospasm,
emesis, lacrimation, lethargy, salivation.
1109. Anticholineigies = Mad as a halter, blind as a bat, dry as a bone, red
as beet, hot as a hare.
1110. Treat TCA toxicity with sodium bicarbonate alone. Which is also used in
Aspirin toxicity.
1111. Given charcoal even after 1 hour in Aspirin and anticholinergics
poisoning and theophylline.
1112. Obtain Abdominal X-ray at presentation in iron poisoning.
1113. Stages of Iron Toxicity - IRON = Indigestion, Recovery, Cardiovascular
collapse and liver damage, Narrowing of pylorus.
1114. In carbonmonoxide poisoning pulse oximetry is normal.
1115. Cyanide poisoning presentation is similar to CO poisoning.
1116. In Methemoglobinemia. Pulse oximetry is normal.
1117. Chest X-ray is normal at 6 hours of post ingestion of hydrocarbons.
1118. If Acid / base ingestion is suspected, undergo upper GI endoscopy.
1119. Acids are bitter, alkalis are tasteless.
1120. Alkalis injure the esphagus and are neutralized in stomach.
1121. Acids leave both, esophageal and stomach burns.
1122. Rabies = HR 16 + 4 vaccines dose.
1123. Rabbits, rats and squirrels are not associated with rabies.
1124. Brown recluse cause ulcer while black widow causes pain.
1125. 20% of pediatric burns from abuse.
1126. Near drowning patients die after a asymptomatic period.
1127. The most common cause of death in epileptic patients is drowning.
1128. The patient who crashes or ventilator has DOPE=Displacement,
obstruction, pneumothorax, equipment failure, extubation bag and mask.
1129. 3 tries for 1/v then intraosseous.
1130. Pulse oximetey is unreliable in case of impaired perfusion or
hypovolumia, Hypotension is a late finding.
1131. High quality compression are more important then breath in CPR.
1132. Fat soluble vitamins = FAKED.
1133.  ICP (Pseudotumor Cerebri) is caused by excessive Vit A thyroxine,
isotretinoin & tetracycline.
1134. Vit K deficiency is more common in brest fed.
1135. Oral vit K at birth does not prevent Hemorrhagic disease of newborn.
1136. Antibiotics and diarrhea precipitate late vitamin K deficiency.
1137. Polyuria and polydipsia are caused by vitamin D excess.
1138. 25-OH Vit D3 is good for deficiency but treat like 1, 25 vitamin D3.
1139. Normal Calcium + Low phosphate = X- Linked hypophosphatamic rickets.
1140. Low Calcium + Low Phosphate = Vitamin D deficiency.
1141. Low Calcium + High phosphorus = hypoparathyroidism, phosphorus overload.
1142. Normal calcium + high phosphorus = renal disease, growth hormone
excess, high phosphorus diet.
1143. Phototherapy can decrease riboflavin levels, important for premature
hyperbilirubinemia baby.
1144. Hartnup disease has pellagra like rash.
1145. Corn=pellegra.
1146. Macroglossia in folate and pyridoxine.
1147. Bone fractures + bleeding gums = vitamin C deficiency.
1148. Deficiency of both C & D causes nephrolithiasis.
1149. In deficiency can occur after weaning from breast milk.
1150. Crohn’s disease is likely to suffer from zinc-deficiency (in case of
diarrhea).
1151. Rash + Alopecia + Neurologic signs = Biotin deficiency.
1152. Kinky hair = copper deficiency.
1153. Alopecia + Scaly dermatitis + thrompocytopenia = Essential fatty acids.
1154. Hepatomegaly = 1 cm below costal maegin or liver that crosses the
midline.
1155. Gall bladder hydrops = Fasting, HSP, Kwasaki, TPN, Streptococcol,
Pharyngitis.
1156. Hepatoblastoma, 3 years, poor prognosis  AFP.
1157. Ulcerative colitis +  PANCA = Primary sclerosing cholangitis.
1158. PSC = Bilirubin late , GGT early.
1159. HIDA Scan – no gall bladder.
1160. Cystic duct obstruction or cholecystitis.
1161. Transaminases – thousands = viral hepatitis, hundreds = viral
infection/ enteric.
1162. ALT>AST = Viral hepatitis.
1163. AST> ALT = Alcoholic hepatitis.
1164. Alkaline phophatase  +  GGT= hepatic disease.
1165. Alkaline phosphatase  + Normal GGT = Bone disease.
1166. Billiary obstruction = AST first then alkaline phosphatase.
1167. Hepatic disease + jaundice = hepatocellular if increase transaminases.
1168. Hepatic disease + jaundice = cholestatic if increase Alkaline
phosphatase.
1169. Choledochal cysts = Jaundice + abdominal mass + RUQ pain + nausea,
vomiting.
1170. Progressive familial intrahepatic cholestasis = sevese pruritus + Direct
hyperbilirubinemia. GGT levels increased only on Type iii.
1171. Allagille syndrome = Jaundice + Liver + heart (Pulmonary stenosis).
1172. Idiopathic neonatal hepatitis resolve by 8 months.
1173. Hepatitis A can be a symptomatic in children.
1174. HBsAg > 6m = chronic infection.
1175. Criggler – Najjar Type I = no direct bilirubin (zero).
1176. Rye syndrome occurs are once in life only.
1177. Cholecystitis causes jaundice in children unlike adults.
1178. Cholelithiasis can present with hepatoplenomegaly unlike cholecystitis.
1179. cystic fibrosis, TPN, ceftriaxone increases risk of cholelithiasis.
1180.  Gastrin levels = Zollinger collusion syndrome = MEN 1= PPP
(pituitary, pancrease, parathroid).
1181. Ulcerative colitis can turn into cancer while crohn’s does not.
1182. Consider appendicitis in any child > 2years with abdominal pain. (who is
not hungry).
1183. Pancreatitis can cause increased bowel sound.
1184. Intussesption – 3 month – 6 years no fever.
1185. Hydrogen breath test = lactose intolerance.
1186. Urea breath test = H.pylori.
1187. Lactose intolerance diarrhea is not malodorous, does not contain food
particles, does not have an assoiated rash.
1188. Bacterial overgrowth =  D-Lactic acid level  + hydrogen breath test
(fasting).
1189. Celiac disease = reducing substance because of villous atrophy.
1190. If diabetic patient loses weight = celiac.
1191. Diarrhea + bloating + constipation = IBS= irritable bowel syndrome.
1192. Constipation + delay closure of Anterior fontenella + horse cry + poor
growth + umbilical hernia = congential hypothyroidism.
1193. Newborn + no stoots for 48 hours = cystic fibrosis.
1194. If there is soiling it is not hirshsprung.
1195. Consider Hirshsprung in all patients with down and cystic fibrosis.
1196. Birth + Abdominal distension + vomiting = Meconium ilues.
1197. Metoclopromide and sitting upright during feeds does not decreases
reflux.
1198. Non-Billious vomiting + Hungry child = Hypertophic pyloric stenosis.
1199. If serum PH is normal or acidotic = not pyloric stenosis.
1200. Confirm volvulus with Barium enema rather than upper GI series because
it can lead to aspiration.
1201. Neonate + polyhydrominos + vomiting = Annular pancreas.
1202. Newborn + bilious vomiting on Day I = Deudenal atresia or Malrotation.
1203. Newborn + bilious vomiting at 2M = pyloric stenosis.
1204. There is no risk of polyp in juvenile polyp.
1205. Painless rectal bleeding = Anal fissures, polyps, hemorrhoids and
Meckels diverticulum.
1206. Large volume painless bleed Meckels.
1207. Small volume painless bleed = polyps, fissures, hemorrhoids.
1208. Painless Meckel, rectal bleeding more common then polyps.
1209. Juvenile polyps before 10 years = genetic testing fo adenomatous
polyposis late mutations.
1210. Esophageal perforation is common in Marfans, Ehler Danlos, epidermolysis
bullosa.
1211. No feeding for NEC kids for 3 weeks.
1212. Older child + NEC like picture + Neutropenia = typhitis.
1213. MgSO4 infusions given to mothers can cause severe hypocalcemia and
hypomagensemia.
1214. Terbutaline causes maternal hyperglycemia and neonatal hypocalcemia.
1215. ACE inhibitors can cause PDA.
1216. Anti seizure, medication = TAP, TOF, AS, PS.
1217. Carbamazepine Exposure = spina bifida + facial deformities.
1218. Valproic acid = small mouth, small eyes, small chin, mid facial
hypoplasia, spina bifida.
1219. Vitamin A exposure = TGA.
1220. Isotretinion Exposure = small ears, small eyes, small head, small jaw,
small thymus+ TOF + hydrocephalus.
1221. Do not give oral antibiotics in stye.
1222. Refer chalazion to ophthalmology.
1223. Do not order eye patch in corneal abrasion.
1224. If vision is 20/20 the patient may still have papilledema.
1225. Unilateral papilledema is not caused by raised ICP.
1226. Papillitis can cause loss of vision, pain in photophobia and can be
unilateral.
1227. Cataracts = Galactosemia/ Rubella Neurofibromatosis type 2.
1228. Estropia is common until 3 months of age.
1229. Exotropia is also common until 3 months of age.
1230. Colour vision at 3 months of age.
1231. 4 months baby look at patterns and faces.
1232. Autosomal dominant disorders = MANTRA, Marfan, Apert, Nail patella,
Noonan, Tuberous sclerosis, Retinoblastoma, Achondroplasia.
1233. Consider Noonan in HOCM.
1234. Only 20% of Achondroplasia are autosomal dominant, rest are spontaneous
mutations.
1235. Peutz jeghers syndrome can cause intestinal obstructon.
1236. Gadner= Supernumenary teeth, polyps, thoughout the intestine, tumours in
other body parts.
1237. First Retinoblastoma then osteosarcoma.
1238. Retinoblastoma is a prime disorder example due to spontaneous mutations.
So positive family history is not forth coming.
1239. Male neonate + jaundice after 24 hours= G6PD deficiency.
1240. In ITP, platelets are bigger.
1241. The most common cause of mental retardation is Down syndrome.
1242. The most common inherited cause of down syndrome is.
1243. The most common inherited case of mental retardation is fragile X.
1244. Small phallus = Down + Prader willi.
1245. Male down is infertile , female are not.
1246. Trisomy 18 are dead by 1 year, Trisomy 13 by 6 months.
1247. The recurrence risk for cleft disorder is 5%.
1248. Cleft palate is more likely to be associated with other anomalies then
cleft lip.
1249. Get a Karyotype in cleft palate.
1250. Cleft lip / palate associations.
1251. PAD, CT = Pierre- Robin, Apert, Digeorge, Cruzon, Treacher Collins.
1252. Bifid uvula is associated with submucous cleft palate.
1253. Rett syndrome is X-Linked but girls more affected.
1254. Subluxation of lens in Ehlers-Donlas, Marfans, Homocytinuria.
1255. Skin laxity is the difference between Ehler Danlos and Marfans.
1256. Upward subluxation of lens = Marfan, Downward i.e homocystinuria.
1257. Vacter have normal IQ.
1258. Clinodactaly = Down, Fetal alcohol syndrome, Russel Silver and Pierre
robin syndrome.
1259. 2-3 syndactaly = smith – Lemi opitz syndrome.
1260. Small 5th finger nail = Fetal alcohol syndrome.
1261. Short 4th and 5th finger = Turner.
1262. Triphalengeal thumbs = Holt arom syndrome and Diamond Blackfan syndrome.
1263. Both Leukemias and lymphomas lymphoblastic disorder of B and T cells.
1264. Leukemia = BMB > 25% BLAST.
1265. Lymphoma = BMB <25% blast + Non tender lymphadenopathy t (4:11) = ALL, t
(9,22) = CML.
1266. Teen + Nontender lymphadenopathy (cervical or supraclavicular) + Fever =
Hodgkins lymphoma.
1267. PPD>10 5-10 = Atypical + B < 5= Hodgkins lymphoma.
1268. Growing pain = bilateial + Night + better with NSAIDS + No edema.
1269. Unilateral bone pain + Growth spurt = osteogenic sarcoma.
1270. Ewing Sarcoma is extremely painful + pelvic bones.
1271. Night time both pain is good, if bilateral = growing pains, if
unilateral = osteoid osteoma, Both Benign.
1272. All children with hemihypertrophy are at increased risk of having Wilms
tumours and hepatoblastoma.
1273. Flank mass < 10 years + Asymptomatic = Wilms tumor.
1274. The most common abdominal malignancy is Wilms tumor.
1275. The most common extracranial solid tumor is Neuroblastoma.
1276. Regular headache feel better when they lie down, Brain tumor feel better
standing up.
1277. Medulloblastoma is most common posterior fossa tumor.
1278. Eczema + high urine output = langerhens.
1279. Histiocytosis lesions are papular with petechie and occurs in folds
(inguinal, suprapubic, perianal).
1280. In worsening past traumatic pain, rule out rhabdomyosarcoma.
1281. In newborn, any Hb < 13 is anemia.
1282. Hypoglycemia in polycythemia may not correct with 1/v Dextrose.
1283. Physiologic anemia (6-16 weeks) should not be lower than 9mg/dl for
term and less than 7 for premature.
1284. Rh+ve moms are supposed to get Rhogam at 20week and again after delivery
if baby is Rh+ve.
1285. Pyruvate Kinase deficiency have good exercise tolerance because oxy-Hb
curve to right because  2,3 DP6.
1286. Hereditary spherocytosis is intermittent and  MCHC ..Low Hb +low Retic
count + high MCHC.
1287. Hereditary spherocytosis with aplastic crises.
1288. Two Rashes in erythema infectiosum first slapped cheek then diffuse
macular erythema or extenser surfaces.
1289. Dark coloured urine in the morning is Paroysmal nocturnal hemoglobinemia
1290. In sickle cell anemia, any macrocytosis or microcytosis should alert you
to B12, folate or concomitant thalassemia.
1291. Healthy child + 18-24 months + normocytic anemia = Transient erythro-
blastopenia.
1292. Dysmorphic + Macrocytic anemia + 3-12 years = Diamond blackfen.
1293. ABD and Rh anemia and jaundice may last for weeks as maternal antibodies
clear slowly.
1294. An MCV of 70-90 is normal upto 2 years of age.
1295. In Iron deficiency anemia RDW is high, Menterz index > 12, tranferrin
satuation low.
1296. Alpha thalassemia can cause microcytic anemia and cannot be diagnosed on
Hb electrophoresis.
1297. High ferritin is inflammation or anemia of chronic disease.
1298. Goat milk or vegetarian = Folate acid deficiency.
1299. Diamond Blackfan does not have jaundice because no hemolysis.
1300. Cell line issue + normal lungs + normal electrolytes = shwachman-
diamond.
1301. Macrocytic aplastic anemia = fanconi and Diamond Blackfan.
1302. Normocytic aplastic anemia = sickle + Parvovirus, hereditary
spherocytosis + Parvovirus.
1303. Thrombocytopenia in children = <250 in adolescent adults, <150.
1304. Epistaxis is due to dry air and usually does not require a follow up.
1305. Prolong Bleeding time + large platelets + mild thrombocytopenia.
1306. Bleeding after circumcision = factor deficiency + maternal medication
(Antibiotics, seizure medication, Warfarin).
1307. Penicillin is the treatment of choice for streptoccal pharyngitis,
dental infections.
1308. Enterococus is only caused by vancomycin, Linzolid ampicillin.
1309. First generation cephalosporins = PECK + Staph + Strepto = Proteus,
ecoli, Klebsiella.
1310. Second generation cephalosponin = HEN PECK= Hemophilus, Enterobacter,
Nisseria, Proteus, Ecoli, Klebsiella. No Gram Postive.
1311. Third generation = No gram positive, good for hospital acquired gram
negative infections.
1312. 4th generation = Both gram positive and gram negative. More resistant to
b Lactamases.
1313. Carbopenum for extended spectrum beta Lactamase producing orgamism e.g
Enterobacter.
1314. Most worm infestation require multiple doses of antihelminthic except
pinworm (one dose).
1315. Metronidozole = GET BCG Giardia, Entameoba, Trichomonas, Bacteriodes,
Clostridum, Gardenella.
1316. Progessive ptosis + baby = Botulism.
1317. Coughing , sneezing, rhinorrhea are viral symptoms so absent in
streptococcal pharyngitis.
1318. Antibiotics in streptococcal pharyngitis are not given to shorten the
duration of illness but to prevent rheumatic fever. Give antibiotics
ever after 9 days of onset of symptoms.
1319. Rheumatic fever is not due to group A streptococcal skin infections.
1320. Antibiotics for GAS can prevent Rheumatic fever but not post
streptococcal glomerulonephritis.
1321. Acute post streptococcal glomerulonephritiss can occur after skin or
throat infection but Rheumatic fever occur only after throat infection.
1322. If C3 level close not come back normal after 6 weeks consider
membranoproliferative or lupus.
1323. If renal impairment, do biopsy for rapidly progressive
glomerulonephretis Drooling + hyperextension of Neck = Reteropharyngeal
abcess.
1324. Drooling + leaning forward posture = epiglotittis.
1325. In Scarlet fever, look for the rash on hidden parts (Axilla and groin).
1326. Do not treat streptococcal pneumonia, D/D of neonatal sepsis = heart
failure, Inborn errors of metabolism, Congenital Adrenal hyperplasia.
1327. The band: Neutrophil Ratio is more important than WBC in Neonatal
sepsis.
1328. Any baby born to a mother who is GBS +ve should be abserved in hospital
for 48 hours.
1329. In secondary bacterial shunt, assure MRSA and treat with Vancomycin.
1330. Cat Scratch disease no treatment until hepatosplenomegaly present.
1331. Bird exposure + Atypical pneumonia = Chlamydia psittaci.
1332. Diagnose Mycoplasma pneumonia with serum IgM titers not cold
agglutinins.
1333. All fungal septisemia should be treated with Amphotericin B.
1334. Bird Exposure + Pneumonia / meningitis = cryptococus.
1335. Histoplasmosis presents like milliary TB, on physical Examination and
chest x-rays.
1336. Exacerbation of Asthma + appropriate treatment = Allergic
bronchopulmonary Aspergellosis.
1337. Herpengioma has no skin lesions.
1338. Flu like symptoms + diarrhea = Adenovirus.
1339. Severe bronchiolitis needs steroids.
1340. Palatal petechiae are present both in streptococcal pharyngitis and
infectious mononucleosis.
1341. Streptococcal screen and culture are positive in carriers.
1342. Look for lymphadenopathy in herpes simplex ginginositomatitis.
1343. Varicella is limited to face and extremities.
1344. Negative pressure isolation is required for measles, Mycobacterium,
tuberculosis and varicella.
1345. In HIV, Do DNA PCR at Birth, 2 months, 4 months and 6 months. If all
negative, baby negative.
1346. Pregnant mothers with HIV should get Zidovudin or Nevirapine prevent
transmission.
1347. If mother had no prophylaxis, start Zidovidine to baby with 72 hours and
continue for 6 weeks.
1348. Start PCP prophylaxis if child diagnosed with HIV, irrespective of CD4
count.
1349. If doctor gets stuck with HIV positive needle, 2 medications for
prophylaxis.
1350. HIV can get MMR, VZV, Flu vaccines but no BCG.
1351. In Measles first 3c, then koplick spots then rash.
1352. Most measles exposures result in Measles immunoglobulin being given
because rash is the last thing to appear.
1353. In Rubella the facial rash disappears as the body rash appears
(disappear in 3 days).
1354. Shifting infiltrates on chest x-ray is Ascaris lumbricoids.
1355. Ground glass appearance + neonate = Respiratory distress syndrome Or
Group B streptococcus.
1356. Ground glass appearance + immunocompromised = pneumocystitis pneumonia =
HIV /Leukemia. Hyper IgM/ server combined immunodeficiency.
1357. Under inflated lungs + air bronchograms = RDS/GBS = Groundglass
appearance.
1358. Fever + hypotension + skin infection = toxic shock syndrome.
1359. Acute sinusitis (< 4weeks) = HMS = Hemophilus influenza, Moraxella
catarrhalis, streptococcal pneumonia.
1360. Chronic sinusitis (>4 weeks) =,cystic fibrosis, immotile cilia,
immunodeficiency, hay fever.