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78 Cards in this Set
- Front
- Back
What is the definition of apnea?
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cessation of respiration for 20 sec or more or for any duration if pallor, cyanosis, or bradycardia is present
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When evaluating apnea, what are signs that indicate an apparent life-threatening event (ALTE)?
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• change in color (ex. pallor, cyanosis)
• change in muscle tone • change in mental status |
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Why may urinalysis show WBCs in patients with appendicits?
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• due to appendix lying on ureter and causing inflammation
• causes a sterile pyuria (presence of WBCs without infectious organism) |
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What can be used to treat severe cases of asthma?
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• epinephrine or terbutaline (SQ or IV)
• Heliox • Mg Sulfate |
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What are risk factors for bronchiolitis?
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• age < 3 months
• immunocompromised state • prematurity • underlying pulmonary or cardiac disease |
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What is the MCC of congestive heart failure in pediatrics?
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congenital heart disease
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What is the MCC of dehydration in kids?
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extensive vomiting or diarrhea
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What is the gold standard for diagnosis of an esophageal foreign body?
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chest xray
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What are different techniques used to remove a foreign body?
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• esophagoscopy
• bougienage • foley catheter * don't use foley cath or Bougienage technique if objecy lodged > 1-2 days |
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What is Bullous Impetigo?
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• superfical, thin-walled bullae, usually on extremities
• rupture easily, leaving a denuded base, dry to shiny coating |
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What bacteria causes Bullous Impetigo?
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Staph aureus
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What is the treatment for Bullous Impetigo?
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• Cephalexin (Keflex)
OR • Dicloxacillin OR • topical mupirocin |
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What is the most common skin infection in children?
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Impetigo Contagiosum
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What are the causative agents of Impetigo?
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• group A ß-hemolytic strep (strep pyogenes)
• Staph aureus |
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Describe the course of impetigo
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• starts as red macules/papules
• then forms vesicles/pustules • ruptures and leaves golden "Honey colored" crusts |
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What is the Erysipelas? What is the bacterial cause?
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• cellulitis and lymphangitis of the skin
• caused by group A B-hemolytic strep |
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What is the most common site of erysipelas?
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face (from skin wound/pimple)
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What bacteria should be suspected in school-ages child with pneumonia (or URI) and a rash?
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• Mycoplasma
• Tx: Macrolide PO |
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What bacteria causes scarlet fever?
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group A B-hemolytic streptococci
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What are characteristics of the rash caused by scarlet fever?
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• starts on neck, groin, axillae & accentuations in flexural creases (Pastia lines)
• sandpaper feel • 1-2 days after illness onsetDescribe the skin lesion associated with lyme disease |
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Describe the skin lesion associated with lyme disease
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bull's eye lesion (Erythema Migrans)
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What is the bacterial cause of Rocky Mountain Spotted Fever? What is the treatment?
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• caused by Rickettsia rickettsii
• Tx: Tetracycline or Chloramphenicol |
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What are characteristics of the rash caused by Rocky Mountain Spotted Fever?
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• rash on 2nd/3rd day of illness on ankles, wrists, and spreads centrally to trunk
• + palm/sole involvement |
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What is the enterovirus that causes Hand-foot-mouth disease?
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coxsackie
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Describe the typical course of hand-foot-mouth disease
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• onset: fever, anorexia, malaise, sore mouth
• painful oral vesivles on erythematous base on days 2-3 that then ulcerate • followed by skin lesions (red papules that change to gray vesicles that heal on days 7-10 • lesions on palms, soles, buttock |
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Which viral infection causes a "slapped-cheek appearance"?
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Erythema infectiosum (5th's disease)
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What is the virus that causes fifth's disease?
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human parvovirus B19
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What are first, second, third, fourth, fifth, & sixth disease?
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• first: measles
• second: scarlet fever • third: rubella • fourth: Dukes' disease • fifth: Erythema infectiosum • sixth: roseola |
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What is the skin lesion that is pathognomonic for measles?
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Koplik spots (white "grains of sand" on buccal mucosa)
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What viral infection presents with a fine, irregular pink macular/papular rash at the hairline that spreads down to the neck, trunk, and arms?
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Rubella "German Measles"
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What is the incubation period for Rubella (German Measles)?
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12-25 days
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What is a Forchheimer's sign?
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soft palate petechiae (seen in Rubella)
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Patients with Rubella typically have lymphadenopathy in which lymph nodes?
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suboccipital/post-auricular
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What are characteristics of the rash caused by Varicella (aka Chicken Pox)?
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• starts as red macules on scalp or trunk
• within 1st day the lesions vesiculate with red base • simulatneous multiple stages of the lesions • spreads centrifugally (outward from center) • palms/soles are spared |
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What are characteristics of the rash caused by Roseola Infantum (Exanthem Subitum)?
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• as fever resolves, blanching maculpapular, rose/pink discrete lesions develop
• typically on neck, trunk, & buttock (usually spares face) • rash lasts 1-2 days and rapidly fades |
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What virus is believed to cause Roseola Infantum?
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Herpesvirus 6
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Roseola Infantum is common in what age group?
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6 months - 3 y/o
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Which inflammatory exanthem typically presents with tender nodules less than 5 cm on the shin and the skin overlying the nodules is red, smooth, and shiny?
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Erythema Nodosum
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What are some possible causes of Erythema Nodosum?
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• fungal disease
• inflammatory bowel disease • leukemia • medications (ex. OCP) • sarcoid • strep infections • TB • vasculitis • Yersinia infections |
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A diagnosis of Kawasaki Disease is made by several days of fever and 4 out of 5 criteria. What are the 5 criteria?
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• conjuctivitis
• rash • lymphadenopathy • oropharyngeal changes (injected pharynx/strawberry tongue) • extremity erythema and edema |
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What are other findings of patients with Kawaski Disease?
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• arthritis
• arthralgia • increased ESR/CRP • increased LFTs • irritability • leukocytosis |
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What are later findings of Kawaski disease?
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• coronary artery aneurysms
• desquamation of fingers/toes • increased platelets |
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What is the treatment for Kawaski disease?
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• IV gamma globulin
• ASA • steroids (controversial) |
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What are characteristics of the rash caused by Pityriasis Rosea?
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• begins with "Herald Patch" (one red lesion with rasied border on trunk)
• 1-2 weeks later a widespread eruption of pink maculopapular oval patches on trunk in "Christmas Tree" pattern lasting 3-8 weeks |
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What are maternal flora pathogens that infants < 30 days are at high risk for?
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• E. coli
• Enterococci • group B strep • Herpes simplex virus • H. Flu • Klebsiella • Listeria monocytogenes • strep pneumo |
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What infectious agents can cause Hemolytic Uremic Syndrome?
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• E. coli 0157:57 (most common cause)
• Coxsackie virus • Echovirus • Campylobacter • Salmonella • S. pneumoniae • Shigella • Varicella • Yersinia |
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Diagnosis of HUS is made by clinical presentation of what three conditions?
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• hemolytic anemia
• thrombocytopenia • acute renal failure |
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What are characteristics of Henoch-Schonlein Purpura?
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• small vessel vasculitis
• characterized by purpura, arthritis, abd pain, hematuria, & occasional scrotal involvement • symmetrical involving legs/buttocks • polymigratory arthritis/arthralgias in large joints • history of gastroenteritis, HTN, and seizures |
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What is an important distinguishing feature between Henoch-Schonlein Purpura and meningococcemia?
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patients with Henoch-Schonlein Purpura have a rash that generally looks bad but the patient feels well
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What is the most common cause of intestinal obstruction in 3-12 month-old?
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Intussusception
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What is the most common area of the bowel that intususception occurs?
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iliocecal area
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What is the classic triad of intussusception?
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• intermittent abdominal pain
• vomiting • bloody currant jelly stools |
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What is the rule of 2's for Meckel Diveticulum?
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• 2% of the population
• 2% with Meckel's develop problem • most common in 2 y/o • 2 inches in length • typically located with 2 feet of ileocecal valve |
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What is the most common clinical presentation of Meckel Diverticulum?
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rectal bleeding
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What is the diagnostic test of choice for Meckel Diverticulum?
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nuclear scintigraphy
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What is the most common viral cause of meningitis?
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enterovirus
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What is the most common bacterial cause of meningitis from 0-3 months? older than 3 months?
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• 0-3 months:
- group B strep - E. coli • > 3 months: - strep pneumo - N. meningitidis - H. Flu |
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What are the 2 routes of infection of osteomyelitis?
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• hematogenous
• direct (ex. inoculation via penetrating wound) |
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What are x-ray findings of osteomyelitis?
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• soft tissue swelling 3-4 days post symptoms
• lytic bone @ 7-10 days |
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What is the treatment for acute otitis media?
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• 1st line: amoxicillin
• 2nd line: augmentin or cephalosporin |
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Differentiate between periorbital and orbital cellulitis
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• periorbital cellulitis is an infection of the eyelids that does not extend into the posterior orbit
• orbital cellulitis may potentially affect vision and become life threatening * can be differentiated with a CT scan of orbits |
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What is the most common cause of pharyngitis?
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respiratory viruses (70-80%)
• adenovirus • CMV • coxsackie • EBV • parainfluenza • rhinovirus |
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What is the most common bacterial cause of pharyngitis in children?
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group A B-hemolytic streptococcus
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Pharyngitis with conjunctivits is most likely cause by what?
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adenovirus
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Pharyngitis with erythematous ulcers on post palate is most likely caused by what?
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coxsackievirus A (herpangina)
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Treatment for GABHS pharyngitis is penicillin or amoxicillin x 10 days. What is the treatment if the patient is penicillin allergic?
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• erythromycin
• clindamycin |
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What is the most common cause of pneumonia in infants or younger children?
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viral
• adenovirus • influenza • parainfluenza • RSV |
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What are bacterial causes for pneumonia in neonates?
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• group B strep
• E. coli • Listeria monocytogenes |
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What is a common bacterial cause of pneumonia in 1-3 year-olds?
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chlamydia trachomatis
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What is a common bacterial cause of pneumonia in children ages 3 months - 5 years?
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s. pneumoniae
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What are bacterial causes of pneumonia in school-aged children?
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• mycoplasma pneumoniae
• chlamydia pneumoniae • strep pneumoniae |
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2-6 week old infant with projectile vomiting without bile suggests what cause?
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pyloric stenosis
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What is the most common cause of intestinal obstruction in infancy?
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pyloric stenosis
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What is the test of choice to confirm pyloric stenosis?
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ultrasound
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What are classic findings of pyloric stenosis?
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• olive mass in RUQ
• hypochloremic • hypokalemic • metabolic alkalosis |
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What is the most common site of septic arthritis?
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lower extremity (knee or hip)
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What is the cause of bacterial tracheitis? What is the presentation?
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• caused by Staph aureus
• presents with high fever, painful cough, and toxic appearance • xray shows shaggy trachea |
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What is the abdominal xray finding of patients with a volvulus?
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double-bubble sign
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