Peds Flashcards
Musical, vibratory, high-pitched, systolic, LLSB or apex, carotid bruit, radiate to axilla, preschool age (2y/o- pre adolescence), decr with sitting/standing/valsalva
Still’s murmur
soft, continuous, under clavicle, right >left infraclavicular, preschool age (after 2y/o), best heard sitting, decr supine/jugular compression
Venous hum
systolic, eliminated by carotid compression, preschool +
Carotid bruit
elevation of nipple only
Tanner 1
elevation of breast and nipple, enlarged areola
Tanner 2
areola and nipple form secondary mound above breast
Tanner 4
projection of nipple only, not areola
Tanner 5
male, vellus hair
Tanner 1
long downy straight hair at base of penis, testes larger
Tanner 2
curlier hair, testes larger, penis length incr
Tanner 3
adult curly hair, penis length and width, testes larger
Tanner 4
female, hair on medial thigh
Tanner 5
female, straight hair on labia
Tanner 2
female, curly hair on pubic symphysis
Tanner 3
Brushfield’s spots
Downs
white plaques do not rub off
oral candidiasis
7days old-3mo. >3 hrs/day, >3days/wk, >3wks. Crying normal growth, healthy
colic
MCC young gastroenteritis
rotavirus
MCC old gastroenteritis
norwalk v
study in GERD to r/o others
upper GI Xray
projectile non-bilious vomit, FTT, olive mass RLQ, <12wks old
pyloric stenosis
Dx pyloric stenosis
abdom U/S
Dx & Tx intussusception
barium/air enema, admit all
age intussusception
3mo-6y/o (MC 5-12 mo)
don’t pass meconium 1st 24 hrs, constipation, NB= Dx test
Hirschsprung
abdom Xray
Hirschsprung assoc with
Downs
MC fetus intestinal obstruction
duodenal atresia/stenosis
vomit within hrs of birth, pass meconium in 1st 24 hrs
duodenal atresia/stenosis
duodenal atresia/stenosis Dx
abdom Xray, prenatal U/S
Anti-HBs
immunity
HBsAg
ongoing
Tx neonate with HBsAg pos mom
HBIG
jaundice 1st 24 hrs, coombs neg
hereditary sphero, G6PD
umbilical hernia RF
full term, AA, close by 4y/o
Bitot’s spots
vit A def
Dx lactose intol
hydrogen breath test
ITP Dx & Tx
isolated thrombocytopenia, corticosteroids short-term
TMA pentad (TTP, HUS) +
hemolytic anemia, thrombocytopenia, fever, renal insuff, neuro— shistocytes
TTP Sx +
hemolytic anemia, thrombocytopenia, fever, neuro (no renal)— decr ADAMST13
HUS Sx +
hemolytic anemia, thrombocytopenia, renal insuff (no neuro, no fever)— pos stool cult E.coli O157:H7
TTP Tx
plasma exchange
HUS Tx
supportive
hemophilia pain reliever
celebrex (COX2)
MC inherited bleeding disorder
vWD
vWD Tx
DDAVP
lead poisoning Tx (2)
EDTA, dimercaprol
ADHD criteria
- impulsivity 2. inattention 3. hyperactivity before 7 y/o
non-stimulant
Strattera
OCD Tx
SSRI: fluvosamine, sertraline
depression Tx
SSRI: fluoxetine, escitalopram
spiculated, sunburst periosteum
osteosarcoma
<3mo sepsis causes & Tx
GBS, E.coli, Listeria
ampicillin + ceftriaxone
> 3mo septic meningitis causes & Tx
S. pneumo, N. gonorrhea, H. flu
ceftriaxone + vanco (not ampicillin)
preseptal/periorbital cellulitis
Sx & Tx
low fever, edema/erythema eyelid, pain, normal vision, EOMI
ceftriaxone
orbital cellulitis Sx
high fever, edema/erythema eyelid, pain, decr EOM, decr vision, proptosis (protruding), APD (no rxn)
conjunctivitis causes (5)
S. pneumo, S. aureus, moraxella, H. flu, adenovirus
bact conjunctivitis Tx
erythromycin
gonococcal Tx conjunctivitis
ceftriaxone IM
orbital cellulitis cause, Tx
S. pneumo, S. aureus, sinusitis infection
amp-sulbactam, ceph
AOM causes
S. pneumo!! H. flu, moraxella
Tx AOM
amoxicillin, azithromycin (complicated: ceph)
Tx pseudomonas
aminoglycosides (mycins), ceftriaxone, pipercillin-tazobactam
epiglottitis Tx
IV cephalosporin, steroids
GAS pharyngitis criteria, Tx
fever, no cough, exudate tonsillitis, ant cervical LAD
PCN (amox)
MCC perioral dermatitis
topical steroids
fixed drug eruption causes (30m-8hrs)
abx, PCN, beta lactam, ceph, NSAIDs, sulfa, tetracycline, metronidazole
urticaria causes
food, infection, ASA, NSAID, ACEI, PCN, morphine, codeine
burns fluid calc (parkland)
LR 3mL x wt(kg) x %BSA
MCC erythema multiforme
HSV
impetigo Tx
mupirocin (bactroban), bacitractin
lichen planus Tx
top steroids high strength (betamethasone, diflorasone)
PUVA, UVB
PO retinoid
pityriasis rosea Tx
none
mild acne Tx
top abx (clindamycin, erythromycin)
benzoyl peroxide
top tretinoin
mod acne Tx
PO abx (doxy)
benzoyl peroxide
top tretinoin
severe acne Tx
accutane (isotretinoin)
harsh, holosystolic, 3rd left intercostal, acyanotic
VSD
fixed S2 wide split, systolic ejection murmur, 2nd intercostal, RVH
ASD
continuous, machinery, Gibson’s, diamond shaped, 2nd left intercostal, wide pulse pressure, LVH
PDA
when does PDA close
1-5 days
Tx PDA
indomethacin (close)
VSD, RVH, pulm outflow obstruction, overriding aorta
tetralogy of fallot
presentation tetralogy of fallot at birth
acyanotic at birth, cyanosis incr over 6 mo
cyanosis at birth, egg shaped heart
transposition of great arteries
transposition of great arteries Tx
prostaglandins (keep PDA open) until surg
mitral valve, diastolic murmur, carey-coombs
rheum fever
bisferiens carotid pulse
HCM
HCM Tx
BB
6mo-6y/o, worse in evening, stridor, bark cough
croup
cause CAP NB
GBS, Ecoli
cause CAP 3wks-4y/o
virus!!, S. pneumo, GAS, staph, Hflu
cause CAP >5y/o
S. pneumo, mycoplasma
normal urine output
> 0.5 mL/kg/hr
>30 mL/hr
howell jolly bodies, hyperseg PMN, lg PLTS, incr homocysteine, incr methylmalonic acid (MMA), periph neuropathy
vit B12 def
hyperseg PMN, lg PLTS, incr homocysteine, no neuro Sx
folate def
iron def gold std Dx
BM prussian blue stain
incr LDH, decr haptoglobin
hemolytic anemia, alpha thalassemia
heinz bodies
beta thal major
Tx sideroblastic anemia
B6 (pyridoxine)
pancytopenia, hypocellular BM, petechia
aplastic anemia
Hep B vaccine schedule
3 times; 0,2,6 mo
rotavirus vaccine schedule
3 times; 2,4,6 mo
DTaP vaccine schedule
5 times; 2,4,6,15 mo 4-6 y/o
Hib & PCV vaccine schedule
4 times; 2,4,6,12 mo
IPV vaccine schedule
4 times; 2,4,6 mo 4-6 y/o
influenza vaccine schedule
greater than 6 mo
MMR & varicella vaccine schedule
2 times; 12 mo, 4-6 y/o
Hep A vaccine schedule
2 times; 12 mo, 6mo apart
hip dysplasia RF
FH, breech, female, 1st born
autism screening
18 mo
vision hearing screening
3 y/o, 4 y/o
anemia lead screening
12 mo
oral health
6 mo
start complimentary foods
6 mo
use cup, table foods, wean bottle
9 mo
social smile
6 wks
sits
6 mo
pulls to stand
9 mo
stands
12 mo
crawls
10 mo
feeds self
4 mo
uses spoon
12 mo
walk
12 mo
stranger anxiety
6 mo
roll over
4 mo
CN optic blink reflex
III oculomotor
rooting reflex, sucking reflex CN
V trigeminal
corneal reflex CN
V trigeminal
acoustic blink reflex CN
VIII vestibulocochlear
suck, swallow CN
XII hypoglossal
understandable speech
4 y/o
balance on one foot
3 y/o
tricycle, hop
4 y/o
ride bike
6 y/o
copies figures
5 y/o
parallel, triangular play
2, 3 y/o