EM EXAM
# Term Definition
1 symptoms of hypercalcemia bones-bony pain, groans-abdo pain,n/v
stones-biliary,renal, thrones-polyuria,
psychiatric overtones-depression,AMS, anxiety
2 Signs of vitamin b3 deficiency pellagra. 4 d's. diarrhea, dermatitis, dementia,
death
3 thiamine deficiency syndromes wernickes encephalopathy - ataxia, nystagmus,
AMS korsakoff - permanent short term memory
loss wet beri beri- high output heart failure
4 neonatal fever(0-28days) e.coli listeria klebsiella GBS chlamydia neisseria
pathogens gonorrhea
5 neonatal fever (1-3mo) strep pneumo *h. flu Ecoli neisseria
pathogens meningitides
6 bacterial fevers 3mo's-3years strep pneumo neisseria meningitides e.coli
7 management fever <28d cbc, blood C+S, LP, Urine, +-CXR amp +
cefotaxime +-acyclovir till cultures back
8 colic rule of 3's crying >3days/week, >3weeks, >3hours per day
9 ddx of baby colic C onstipation, corneal abrasion Appendicitis,
anal fissure iNtussception, infxn T esticular
torsion Formula intolerance, FB eye Abuse
Recent immunization Tourniquet
10 ddx of jaundice <24h of life 1. cephalohematoma from birth trauma 2.
acquired infxn 3. congenital infxn (CMV,
rubella,Toxo) 4. Hemolysis due to ABO, Rh
incompatibility physiologic jaundice occurs2-3d
breast milk jaundice >1week
11 causes of conjugated always pathological TORCH Sepsis biliary
hyperbilirubinemia obstruction metabolic causes
12 treatment of inc bilirubin photo rx for bili >5x bwt exchange transfusion if
neonatal bill >10x bwt
,EM EXAM
# Term Definition
13 workup of jaundice in neonate total + conjugated bili coombs test retic count
sepsis w/u peripheral blood smear
14 most worrisome complication of hepatic encephalopathy leading to kernicterus
neonatal jaundice
15 most common viral cause rotavirus
paediatric diarrhea
16 dx of infant with billious vomiting malrotation with volvulus
17 ddx of paediatric vomiting 1. obstructive intestinal: pyloric stenosis,
Hirschsprungs dz, intusscusception, Malrotation
+ volvulus, incarcerated hernia 2. Neurologic:
intracranial mass/bleed, hydrocephalus,
cerebral edema 3. Renal: UTI, obstructive
uropathy 4. Infxn: gastroenteritis, meningitis,
sepsis 5. Metabolic: inborn errors of metabolism
6. GERD
18 ddx of newborn constipation meconium ileus (CF) meconium plug
imperforate anus hirschsprung dz (Down
syndrome) anal stenosis volvulus
hypothyroidism
19 ddx of infant constipation functional dietary too much cows milk, not
enough formula cerebral palsy anal fissure
hypothyroidism hypocalcemia medications:
anticholinergics, opiates, antihistamines
20 abdo xray suggestive of double bubble sign dilated proximal bowel with
malrotation + volvulus little distal bowel gas
21 what test to order if suspicious of upper GI series with oral contrast
malrotation with volvulus
22 treatment of malrotation NGT to decompress prom small bowel IVF IV
abx surgical consult
23 child with painless massive lower meckels diverticulum
GI Bleeding
24 rule of 2's for meckels 2% prevalence 2:1 male to female ratio 2 feet
prox to ileocecal valve over half are < 2 years old
,EM EXAM
# Term Definition
25 dx test for meckels meckel scan
26 complications of meckels 1. lead point for intussusception 2. perforation
diverticulum 3. massive lower GI bleed (shock + anemia)
27 Hirschsprungs presentation lifelong stooling difficulties painless empty
rectal vault on exam
28 dx of hirschsprung barium enema with cone-shaped transition
zone
29 complications of hirschsprungs obstruction *enterocolitis failure to thrive
30 presentation of pyloric stenosis NONBILLIOUS projectile vomiting 3-4 weeks of
life
31 physical exam sign of pyloric olive sign - RUQ mass
stenosis
32 necrotizing enterocolitis premature infant with: abdo distention < 1mo of
presentation age nonbilious emesis grossly bloody stools
sepsis abdo wall erythema, firm loops of bowel
33 diagnostic test for NEC abdo xray showing pneumatosis intestinalis =
gas in wall of bowel may see perforation
34 treatment of NEC NPO IVF NG for decompression broad spectrum
abx surgical consult
35 presentation of intusscusception 1. colicky abdo pain with child appearing well
between episodes. 2. currant jelly stools 3.
vomiting 4. lethargy
36 physcial exam finding of sausage shaped mass RUQ
intusscusception
37 treatment of intusscusception 1. NG 2. IVF 3. NPO 4. IV abx 5. *air contrast
enema
38 presentation of wilms tumor HTN, hematuria and abdo mass
, EM EXAM
# Term Definition
39 presentation of testicular torsion severe scrotal pain n/v high riding testicle with
horizontal lie decreased cremasteric reflex
40 blue dot sign torsion of appendix testes
41 postinfectious GN presentation 1-2 weeks post strep hematuria HTN nephrotic
syndrome with edema
42 cause of hemolytic uremic shiga like toxin of e.coli 0157:H7
syndrome
43 presentation of HUS prodrome of bloody diarrhea 1-2 weeks after
develop pallor + petechial rash
44 lab findings of HUS anemia thrombocytopenia shistocytes on blood
smear renal failure hematuria inc retic count,
dec haptoglobin, inc LDH
45 treatment of HUS 1. **avoid abx, antidiarrheal agents in children
with bloody diarrhea IVF prbc transfusion if
severe anemia consider plasma exchange if CNS
sx consider dialysis if persistent hyperkalemia,
anuria or fluid overload
46 cyanotic heart disease ddx 1. Truncus arteriosis 2. Transposition of great
vessels 3. Tricuspid atresia 4. Tetrology of fallot
5. total anomalous pulmonary venous return
47 presentation of congenital heart central cyanosis (resp more consistent with
dz peripheral cyanosis) diaphoresis poor feeding
failure to thrive worsening cyanosis with crying
or eating sudden decomp after 1-2 weeks likely
ductal dependant defect decreased pulses/bp
lower extremities =coarct
48 what is hyperoxia test and how room air ABG followed by ABG after several
can it help? minutes of 100% o2 if pao2> 220 pulmonary dz
pao2 <100 congenital heart dx pao2< 40
transposition
49 causes of nephrotic syndrome GN HIV SLE HSP
50 presentation of nephrotic generalized edema, initially periorbital
syndrome
# Term Definition
1 symptoms of hypercalcemia bones-bony pain, groans-abdo pain,n/v
stones-biliary,renal, thrones-polyuria,
psychiatric overtones-depression,AMS, anxiety
2 Signs of vitamin b3 deficiency pellagra. 4 d's. diarrhea, dermatitis, dementia,
death
3 thiamine deficiency syndromes wernickes encephalopathy - ataxia, nystagmus,
AMS korsakoff - permanent short term memory
loss wet beri beri- high output heart failure
4 neonatal fever(0-28days) e.coli listeria klebsiella GBS chlamydia neisseria
pathogens gonorrhea
5 neonatal fever (1-3mo) strep pneumo *h. flu Ecoli neisseria
pathogens meningitides
6 bacterial fevers 3mo's-3years strep pneumo neisseria meningitides e.coli
7 management fever <28d cbc, blood C+S, LP, Urine, +-CXR amp +
cefotaxime +-acyclovir till cultures back
8 colic rule of 3's crying >3days/week, >3weeks, >3hours per day
9 ddx of baby colic C onstipation, corneal abrasion Appendicitis,
anal fissure iNtussception, infxn T esticular
torsion Formula intolerance, FB eye Abuse
Recent immunization Tourniquet
10 ddx of jaundice <24h of life 1. cephalohematoma from birth trauma 2.
acquired infxn 3. congenital infxn (CMV,
rubella,Toxo) 4. Hemolysis due to ABO, Rh
incompatibility physiologic jaundice occurs2-3d
breast milk jaundice >1week
11 causes of conjugated always pathological TORCH Sepsis biliary
hyperbilirubinemia obstruction metabolic causes
12 treatment of inc bilirubin photo rx for bili >5x bwt exchange transfusion if
neonatal bill >10x bwt
,EM EXAM
# Term Definition
13 workup of jaundice in neonate total + conjugated bili coombs test retic count
sepsis w/u peripheral blood smear
14 most worrisome complication of hepatic encephalopathy leading to kernicterus
neonatal jaundice
15 most common viral cause rotavirus
paediatric diarrhea
16 dx of infant with billious vomiting malrotation with volvulus
17 ddx of paediatric vomiting 1. obstructive intestinal: pyloric stenosis,
Hirschsprungs dz, intusscusception, Malrotation
+ volvulus, incarcerated hernia 2. Neurologic:
intracranial mass/bleed, hydrocephalus,
cerebral edema 3. Renal: UTI, obstructive
uropathy 4. Infxn: gastroenteritis, meningitis,
sepsis 5. Metabolic: inborn errors of metabolism
6. GERD
18 ddx of newborn constipation meconium ileus (CF) meconium plug
imperforate anus hirschsprung dz (Down
syndrome) anal stenosis volvulus
hypothyroidism
19 ddx of infant constipation functional dietary too much cows milk, not
enough formula cerebral palsy anal fissure
hypothyroidism hypocalcemia medications:
anticholinergics, opiates, antihistamines
20 abdo xray suggestive of double bubble sign dilated proximal bowel with
malrotation + volvulus little distal bowel gas
21 what test to order if suspicious of upper GI series with oral contrast
malrotation with volvulus
22 treatment of malrotation NGT to decompress prom small bowel IVF IV
abx surgical consult
23 child with painless massive lower meckels diverticulum
GI Bleeding
24 rule of 2's for meckels 2% prevalence 2:1 male to female ratio 2 feet
prox to ileocecal valve over half are < 2 years old
,EM EXAM
# Term Definition
25 dx test for meckels meckel scan
26 complications of meckels 1. lead point for intussusception 2. perforation
diverticulum 3. massive lower GI bleed (shock + anemia)
27 Hirschsprungs presentation lifelong stooling difficulties painless empty
rectal vault on exam
28 dx of hirschsprung barium enema with cone-shaped transition
zone
29 complications of hirschsprungs obstruction *enterocolitis failure to thrive
30 presentation of pyloric stenosis NONBILLIOUS projectile vomiting 3-4 weeks of
life
31 physical exam sign of pyloric olive sign - RUQ mass
stenosis
32 necrotizing enterocolitis premature infant with: abdo distention < 1mo of
presentation age nonbilious emesis grossly bloody stools
sepsis abdo wall erythema, firm loops of bowel
33 diagnostic test for NEC abdo xray showing pneumatosis intestinalis =
gas in wall of bowel may see perforation
34 treatment of NEC NPO IVF NG for decompression broad spectrum
abx surgical consult
35 presentation of intusscusception 1. colicky abdo pain with child appearing well
between episodes. 2. currant jelly stools 3.
vomiting 4. lethargy
36 physcial exam finding of sausage shaped mass RUQ
intusscusception
37 treatment of intusscusception 1. NG 2. IVF 3. NPO 4. IV abx 5. *air contrast
enema
38 presentation of wilms tumor HTN, hematuria and abdo mass
, EM EXAM
# Term Definition
39 presentation of testicular torsion severe scrotal pain n/v high riding testicle with
horizontal lie decreased cremasteric reflex
40 blue dot sign torsion of appendix testes
41 postinfectious GN presentation 1-2 weeks post strep hematuria HTN nephrotic
syndrome with edema
42 cause of hemolytic uremic shiga like toxin of e.coli 0157:H7
syndrome
43 presentation of HUS prodrome of bloody diarrhea 1-2 weeks after
develop pallor + petechial rash
44 lab findings of HUS anemia thrombocytopenia shistocytes on blood
smear renal failure hematuria inc retic count,
dec haptoglobin, inc LDH
45 treatment of HUS 1. **avoid abx, antidiarrheal agents in children
with bloody diarrhea IVF prbc transfusion if
severe anemia consider plasma exchange if CNS
sx consider dialysis if persistent hyperkalemia,
anuria or fluid overload
46 cyanotic heart disease ddx 1. Truncus arteriosis 2. Transposition of great
vessels 3. Tricuspid atresia 4. Tetrology of fallot
5. total anomalous pulmonary venous return
47 presentation of congenital heart central cyanosis (resp more consistent with
dz peripheral cyanosis) diaphoresis poor feeding
failure to thrive worsening cyanosis with crying
or eating sudden decomp after 1-2 weeks likely
ductal dependant defect decreased pulses/bp
lower extremities =coarct
48 what is hyperoxia test and how room air ABG followed by ABG after several
can it help? minutes of 100% o2 if pao2> 220 pulmonary dz
pao2 <100 congenital heart dx pao2< 40
transposition
49 causes of nephrotic syndrome GN HIV SLE HSP
50 presentation of nephrotic generalized edema, initially periorbital
syndrome
