USMLE STEP 2 CK PEDIATRICS UPDATED STUDY GUIDE
QUESTIONS AND CORRECT ANSWERS
Normal Vital Signs Newborn RR-40-60
RR HR-120-160
HR SBP-65
SBP DBP-50
DBP
Conjunctivitis Cause: Day 1- chemical irritation
Day 1- Day 2-7- Neisseria gonorrhea
Day2-7- >7 Days- Chlamydia trachomatis
>7 Days- >3 weeks- herpes
>3 weeks-
What Dx of Newborn: G-6-PD
X-linked, hemolytic crises. Tx: reduce oxidative stress and special diet
Tx?
What Dx of Newborn: PKU
AR, mental retardation, deficiency in enzyme Tx: special diet low in phenylalanine for first 16 years
phenylalanine hydroxylase
What Dx of Newborn: Galactosemia
mental and developmental retardation, inability to Tx: cut out all lactose
breast feed, inability to metabolize galactose
What Dx of Newborn: Congenital hypothyroidism
Cretinism Tx: replace hormone
What Dx of Newborn: Congenital adrenal hyperplasia
multiple AR disease resulting in errors of Tx: replace mineralocorticoids and glucocorticoids
steroidogenesis
Palmar Grasp Presents: birth
Presents: Disappears:2-3 months
Disappears:
Rooting Presents:birth
Presents: Disappears: <1 month
Disappears:
Moro Presents:birth
Presents: Disappears:4-6 months
Disappears:
Tonic neck Presents:birth
Presents: Disappears: 6-7 months
Disappears:
, Babinksi Presents:birth
Presents: Disappears:18 months
Disappears:
Parachute Presents:6-8 months
Presents: Disappears: never
Disappears:
What is Dx? Tetralogy of Fallot
cyanosis of lips and extremities, holosystolic murmur,
squatting
Tetralogy of Fallot 4 aspects 1) VSC
2) pulmonary stenosis
3) RVH
4) Overriding aorta
a/w chromosome 22 deletion
3 holosystolic murmurs 1) VSD
2) mitral regurg
3) tricuspid regurg
What is Dx? Transposition of Great Vessels
Early, severe cyanosis. Single S2. CXR "egg on string" Tx: PGE1, until surgery
Pulsus paradoxus cardiac tamponade and tensions pneumothorax
Pulsus alternans left ventricular systolic dysfunction
Irregularly irregular atrial fibrillation
Pulsus tardus et parvus aortic stenosis
What is Dx? hypoplastic left heart syndrome
-absent pulses with single S2 -LV hypoplasia
-increased right ventricular impulse -mitral valve atresia
-gray rather than bluish cyanosis, -aortic valve lesions
Tx: PGE1 until surgery
pulmonary edema
globular shaped heart
What is Dx? Truncus Arteriosus
Sxs in first few days of life -single truck emerges from R and L ventricles
severe dyspnea
early and frequent respiratory infxns
single S2, systolic ejection murmur
Cyanotic Heart Lesions Tetralogy of Fallot
Transposition Great Vessels
Hypoplastic LH syndrome
Truncus Arteriosus
TAPVR
QUESTIONS AND CORRECT ANSWERS
Normal Vital Signs Newborn RR-40-60
RR HR-120-160
HR SBP-65
SBP DBP-50
DBP
Conjunctivitis Cause: Day 1- chemical irritation
Day 1- Day 2-7- Neisseria gonorrhea
Day2-7- >7 Days- Chlamydia trachomatis
>7 Days- >3 weeks- herpes
>3 weeks-
What Dx of Newborn: G-6-PD
X-linked, hemolytic crises. Tx: reduce oxidative stress and special diet
Tx?
What Dx of Newborn: PKU
AR, mental retardation, deficiency in enzyme Tx: special diet low in phenylalanine for first 16 years
phenylalanine hydroxylase
What Dx of Newborn: Galactosemia
mental and developmental retardation, inability to Tx: cut out all lactose
breast feed, inability to metabolize galactose
What Dx of Newborn: Congenital hypothyroidism
Cretinism Tx: replace hormone
What Dx of Newborn: Congenital adrenal hyperplasia
multiple AR disease resulting in errors of Tx: replace mineralocorticoids and glucocorticoids
steroidogenesis
Palmar Grasp Presents: birth
Presents: Disappears:2-3 months
Disappears:
Rooting Presents:birth
Presents: Disappears: <1 month
Disappears:
Moro Presents:birth
Presents: Disappears:4-6 months
Disappears:
Tonic neck Presents:birth
Presents: Disappears: 6-7 months
Disappears:
, Babinksi Presents:birth
Presents: Disappears:18 months
Disappears:
Parachute Presents:6-8 months
Presents: Disappears: never
Disappears:
What is Dx? Tetralogy of Fallot
cyanosis of lips and extremities, holosystolic murmur,
squatting
Tetralogy of Fallot 4 aspects 1) VSC
2) pulmonary stenosis
3) RVH
4) Overriding aorta
a/w chromosome 22 deletion
3 holosystolic murmurs 1) VSD
2) mitral regurg
3) tricuspid regurg
What is Dx? Transposition of Great Vessels
Early, severe cyanosis. Single S2. CXR "egg on string" Tx: PGE1, until surgery
Pulsus paradoxus cardiac tamponade and tensions pneumothorax
Pulsus alternans left ventricular systolic dysfunction
Irregularly irregular atrial fibrillation
Pulsus tardus et parvus aortic stenosis
What is Dx? hypoplastic left heart syndrome
-absent pulses with single S2 -LV hypoplasia
-increased right ventricular impulse -mitral valve atresia
-gray rather than bluish cyanosis, -aortic valve lesions
Tx: PGE1 until surgery
pulmonary edema
globular shaped heart
What is Dx? Truncus Arteriosus
Sxs in first few days of life -single truck emerges from R and L ventricles
severe dyspnea
early and frequent respiratory infxns
single S2, systolic ejection murmur
Cyanotic Heart Lesions Tetralogy of Fallot
Transposition Great Vessels
Hypoplastic LH syndrome
Truncus Arteriosus
TAPVR