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Step 2 CK > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Normal RR and HR in Newborn

A

RR 40-60

HR 120-160

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2
Q

APGAR

A

A -appearance - blue all over, blue extremities, normal

P - pulse - <60, 60-100 or > 100

G - grimace - no response, grimace/feeble cry, strong sneeze/cough

Activity - no tone, some flexion, active movement

R - respiration - absent, weak/irregular or strong

**Assesses need for resuscitation at 1 min and response to resuscitation at 5 min

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3
Q

Newborn conjunctivitis

A

Give TOPICAL erythromycin, TOPICAL tetracycline and silver nitrate at birth

Depends on timing
- Day 1 irritation
- Day 1 to 7 - gonorrhea, treat with ceftriaxone (prevented by topicals)
- After Day 7 - chlamydia, treat with ORAL erythromycin (not prevented by topicals)
> 21 days -herpes, treat with acyclovir

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4
Q

8 National Newborn Screening Tests

A

PKU

CAH

Biotinidase

Beta thalassemia

Congenital hypothyroidism

CF

Galactosemia

Homocystinuria

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5
Q

Contraindications to Breastfeeding

A

HIV / HTLV-1

active Tb

Herpes of the nipple

Maternal use of drugs of abuse

Cytotoxic medication use by mom (methotrexate, cyclosporine)

Neonatal galactosemia

NOT HEP C

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6
Q

What is commonly associated with transient tachypnea of newborn? When should you be worried?

A

C - section because no birth canal to compress rib cage and remove fluid from lungs

Worry if lasts > 4 hrs - work up for sepsis (blood and urine culture +/- LP)

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7
Q

What is the most common cause of failure to thrive? What do you do?

A

Psychosocial deprivation

CPS

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8
Q

What vaccine is contraindicated if egg allergy?

A

Yellow fever

NOT flu or MMR

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9
Q

Vaccine Schedule

A

Hep B - birth, 1-2 months, 6-18 months

Rotavirus - 2, 4, 6 mo

DTAP, IPV - 2, 4, 6, 15-18 mo, 4-6 yrs

Hib, PCV13 (bacterial) - 2,4, 6, 12-15 mo,

MMR, Varicella - 12 mo, 4-6 yrs

Hep A - 12 mo then second dose shortly after

Meningitis, HPV, Tdap at 11 yrs old

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10
Q

Caput v. Cephalohematoma

A

Caput - superficial, crosses lines

Cephalohematoma - subperiosteal, does NOT cross lines

NO TX, both improve wks to months, can in bilirubin

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11
Q

CXR Findings in Meconium Aspiration Syndrome + Mgt + Risks

A

CXR - patchy infiltrate, coarse streaking of both lung fields, flat diaphragms

Mgt - ventilate, inhaled NO, surfactant if worsens (breaks down meconium), ECMO severe

Risks - post term baby

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12
Q

Elevated AFP

A

1 reason - wrong dates (check with US)

Associated with neural tube defects AND ab wall defect (omphalocele)

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13
Q

Which genetic disorder is omphalocele associated with?

A

Edwards (trisomy 18)

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14
Q

WAGR

A

Wilms tumor

Aniridia

GU malformations

Retardation

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15
Q

What is the most common heart defect in Down’s?

A

Endocardium cushion defect atrioventricular canal

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16
Q

Name 6 Cyanotic Heart Defects. Which are PDA-dependent? Which have accompanying VSD?

A 
1 - tetralogy 
2 - tricuspid atresia
3- transposition of great arteries
4 - truncus 
5 - hypoplastic L heart 
6 - total anomalous pulmonary venous return

Need PDA - transposition, tricuspid atresia and hypoplastic L heart (give prostaglandin E1)

VSD - tetralogy and truncus (holosystolic murmur at L lower border)

17
Q

Turner Syndrome

A

Associated with coarctation

Short, webbed neck, shield chest, horseshoe kidney

18
Q

What is Long QT associated with? How do you treat it?

A

Hearing loss

Family hx

Syncope

Tx = beta blocker, if multiple episodes consider ICD

19
Q

How do vascular rings present? Dx and tx?

A

Respiratory sx that improve with neck extension

DiGeorge or Down Syndrome

“Noisy breather”

Dx - CT or MRI

Tx - surgical if symptomatic

20
Q

5 Reasons Hyperbilirubinemia is Pathological

A

First day of life

Persists after 2nd week of life

Inc by more than 5 mg/dL/day

Total >19.5 in term baby

Direct > 2 at any time

21
Q

Kernicterus (acute versus chronic)

A

Acute - sleepy –> hyper-reflexive –> fever, sz, coma

Chronic - CP, hearing loss, upward gaze palsy, dental enamel dysplasia

22
Q

Most Common Esophageal Atresia + Most Common Complication

A

Blind pouch w/ distal TEF

Recurrent aspiration pneumonia - so give anaerobic antibiotics

23
Q

CHARGE

A

C - coloboma of eye

H - heart defects

A - atresia (choanal)

R - retardation

G - GU defects (hypogonadism)

E - ear anomalies, deafness

24
Q

VACTERL

A

V - vertebral anomalies

A - anal atresia

C - cardio anomalies

T - TEF

E - esophageal atresia

R - renal anomalies

L - limb anomalies

25
Q

Antibiotics in Necrotizing Enterocolitis

A

Vancomycin + gentamicin + metro

26
Q

Lead Poisoning Tx by Severity

A

Lead > 70 - IV dimercarpal, BAL

Lead 45-70 - inpatient oral succimer

Lead < 45 - outpatient follow up with lifestyle change

27
Q

Findings in Infants of Diabetic Mothers

A

Hypoglycemia at birth because high insulin with no more mom’s glucose - shaking seizures

Macrosomia of all organs, polycythemia and hyperviscosity

Small left colon syndrome

Asymmetric septal hypertrophy

Renal vein thrombosis

Hypocalcemia, hypomagnesia

Hyperbilirubinemia - icterus

28
Q

3 Types of CAH

A

21 hydroxylase - no aldosterone, no steroids, high testosterone so virilization in girls, hypotension and hyperkalemia

17 hydroxylase - HIGH aldosterone, low cortisol and sex hormones, so HYPERTENSION with HYPOKALEMIA, girls sexually normal at birth

11beta hydroxylase - same as 21 except have high 11-DOC which acts on aldosterone receptor so HTN and hyperkalemia + virilization

29
Q

How do you treat Legg-Calve-Perthes?

A

Rest and NSAIDs

Then surgery on both hips because if one becomes necrotic then other is likely to later

30
Q

Kawasaki Criteria and Tx

A

CRASH and Burn (fever 5 days)

C - conjunctivitis 
R - rash 
A - adenopathy (cervical)
S - strawberry tongue (mucous membranes)
H - hand/foot edema and erythema

Tx = IVIG and ASA (not steroids); prevent coronary aneurysm

31
Q

Organisms and Abx of Neonatal Sepsis

A

Early - group B strep, E. coli, Listeria

Later - Staph, E. coli, Listeria

Tx = amp, gentamicin and cefotaxime

32
Q

Retropharyngeal Abscess

Croup

Epiglossitis

A

Retro - beta hemolytic strep, deviated uvula, do CT neck, I&D + amp-sulbactam

Croup - positive steeple sign and inspiratory stridor, steroids or epinephrine

Epiglossitis - EMERGENCY, Hib infection so give ceftriaxone, INTUBATE because hypoxia is inevitable, thumbprint sign

33
Q

Whooping Cough Tx

A

Erythromycin or azithromycin if in early catarrhal stage (congestion and rhinorrhea)

34
Q

Juvenile Myoclonic Epilepsy

A

Seizures in the morning in adolescence

Irregular spike and wave on EEG

Tx - valproic acid

35
Q

Infantile Spasms

A

Mixed flexor and extensor spasms during first year of life

75% associated with underlying CNS disorder (DS)

Tx - ACTH, prednisone, Vit B6, vigabatrin

36
Q

Vit B5 Deficiency

A

Burning Feet Syndrome

37
Q

UTI Mgt in Kids

A

First febrile UTI - renal US (look for hydronephrosis), if abnormal do voiding cystourethrogram for VUR

If pt has 2+ febrile UTIs - also indication for voiding cystourethrogram

If UTI persists despite treatment with antibiotics for 48 hrs - broaden antibiotics and do renal/bladder US

Tx - 3rd generation cephalosporins

38
Q

Rett Syndrome

A

Regression of speech and loss of purposeful hand movements

Repetitive hand movements - writhing, flapping

Gait abnormalities

Alternating hyper/hypoventilation episodes

39
Q

Associations w/ neuroblastoma

A

Abdominal mass

Opsoclonus-myoclonus

Periorbital ecchymoses from mets

Step 2 CK (28 decks)

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