DIDACTICPeds 101 Cards

Question 1

TORCH

Answer 1

toxoplasmosis
other (syphilis, zika, parvovirus B19)
rubella
CMV
HSV

acquired in utero in vaginal canal

Question 2

hallmark sign of toxoplasmosis

Answer 2

CNS involvement

Question 3

three most common CNS s/s seen in baby with toxoplasmosis

Answer 3

chorioretinitis (inflammation of choroid and retina)
intracranial calcifications
hydrocephalus

Question 4

when does treatment for toxoplasmosis occur?

Answer 4

prenatally and w/in 1-2 months

to decrease neurologic deficits

Question 5

syphilis pathogen

Answer 5

Treponema pallidum

Question 6

pediatric WNL temperatures

Answer 6

96 - 100 F

Question 7

pediatric fever

Answer 7

100.4 F +

Question 8

when do symptoms appear for newborns with syphilis?

Answer 8

can take weeks (3-14) to months to years (5)

Question 9

serious complications of prenatal and neonatal syphilis

Answer 9

stillbirth,
death shortly after birth, 
miscarriage, 
low birth wt, 
prematurity

Question 10

most common early symptoms of syphilis

Answer 10

fever
low birth weight
skin problems (rash, sloughing of palms/soles)

Question 11

most common late symptoms of syphilis (late = after age 5)

Answer 11

Hutchinson’s triad =

1) Hutchinson teeth - pegshaped upper incisors
2) Intersititial keratitis - blurred vision, tearing, eye pain
3) Sensorineural Defense - 8th CN deafness

Question 12

syphilis treatment

Answer 12

penicillin

“PCN is curative!”

Question 13

key finding of Zika

Answer 13

microcephaly

skull collapsing, brain damage

Question 14

which trimester results in the most serious complications for rubella infection?

Answer 14

first trimester

Question 15

most common single symptom of rubella?

Answer 15

hearing impairment

Question 16

four key symptoms of prenatal rubella

Answer 16

cataracts
congenital heart disease (PDA or peripheral pulm art stenosis)
purpura (blueberry muffin skin lesions)
microcephaly

Question 17

treatment of rubella

Answer 17

“treatment is PREVENTION”

Question 18

what is the most common congenital viral infection?

Answer 18

CMV

Question 19

most common symptom of CMV

Answer 19

sensorineural hearing loss

Question 20

treatment of CMV

Answer 20

prevention

antivirals, for weeks, inpatient

Question 21

when is HSV most commonly acquired?

Answer 21

during birthing process

Question 22

what are the three types of congenital HSV?

Answer 22

SEM (Skin Eyes Mouth)
CNS Disease
Disseminated disease (multiple organ involvement)

Question 23

treatment of HSV?

Answer 23

antivirals and supportive care

Question 24

what happens if HSV is left untreated?

Answer 24

it’s fatal

Question 25

name three causes for pediatric sore throat discussed by Ms. Schulte in Peds 101

Answer 25

Strep pharyngitis Acute Rheumatic Fever Kawasaki Disease

Question 26

Strep Pharyngitis common s/s

Answer 26

``` "beefy red" palate petechiae exudates fever > 100.4 lymphadenopathy worsens quickly ```

Question 27

Strep Pharyngitis can develop into

Answer 27

Scarlet Fever

Question 28

s/s of Strep Pharyngitis-Scarlet Fever

Answer 28

scarlitina rash (sandpaper) in skin folds and spreads fever strawberry tongue

Question 29

treatment of Strep Pharyngitis

Answer 29

amoxicilin - 10 days if pt has PCN allergy, give cephalosporin, azithromycin if secondary otitis occurs, bump amox to higher dosage

Question 30

what develops if strep pharyngitis isn't treated?

Answer 30

acute rheumatic fever | PANDAS

Question 31

PANDAS

Answer 31

``` pediatric autoimmune neuropsychiatric disorders associated with streptococcus ```

Question 32

what are common features of PANDAS?

Answer 32

sudden, severe personality and behavior changes ~4-6 weeks after infection usually ages 3-12 yrs

Question 33

treatment of PANDAS

Answer 33

Treatment of initial Strep infection is key to prevention!

Question 34

tool for diagnosing acute rheumatic fever

Answer 34

Jones Criteria

Question 35

what is Jones Criteria?

Answer 35

JONES joints (they hurt) carditis (new heart murmur) nodules (firm, painless bumps found over joint extensor surfaces) erythema marginatum (macular lesions on trunk and proximal extremities) Sydenham chorea (wierd dancing movements)

Question 36

treatment of acute rheumatic fever

Answer 36

Treatment is multidisciplinary – refer to cardiology, rheumatology, and infectious disease

Question 37

what is Kawasaki Disease?

Answer 37

aka Mucotaneous Lymphnode Syndrome A systemic, inflammatory febrile illness that affects medium sized arteries (particularly coronary arteries)

Question 38

treatment of Kawasaki Disease

Answer 38

Treatment is URGENT - immune globulin (IVIG) and aspirin

Question 39

s/s of Kawasaki Disease

Answer 39

Clinical manifestations: ``` Fever > 5+ days Conjunctivitis Mucositis Rash Cardiovascular Swelling of hands and feet  ```

Question 40

torticollis presents _____ (around what age)

Answer 40

Usually presents around 2-4 weeks old, worsens gradually

Question 41

first line therapy for torticollis

Answer 41

gentle guided neck stretches by parent and tummy time to strengthen neck muscles limit time in car seat, swing, stroller

Question 42

what is encopresis?

Answer 42

diarrhea leaking around a hard stool blockage

Question 43

define constipation

Answer 43

Constipation = infrequent, painful, difficult, and/or incomplete evacuation of hard stool

Question 44

what charts do we use to dx constipation?

Answer 44

Diagnositic tools – Bristol Stool Chart and Rome III Criteria (2006)

Question 45

Rome III Dx Criteria: must include two or more of the following, for a child at least 4 years old (there are six):

Answer 45

Two or fewer defecations in the toilet per week. At least one episode of fecal incontinence per week. History of retentive posturing or excessive volitional stool retention. History of painful or hard bowel movements. Presence of a large fecal mass in the rectum. History of large diameter stools that may obstruct the toilet.

Question 46

treatment for constipation

Answer 46

``` fecal disimpaction (intially) miralax bomb ``` ``` F/U: behavior modification daily maint w/ stool softeners (daily Miralax for ~3 months) dietary mod pt/family ed ```

Question 47

when to refer for constipation?

Answer 47

Refer to GI specialists if not improving, abnormal findings/responses, or recurrent or non-compliant patient/family

Question 48

what should never been used during teething?

Answer 48

numbing agents

Question 49

treatment for teething

Answer 49

cold teething ring soft chew toys tylenol (ibuprofen if >6 mo old)

Question 50

"period of purple crying"

Answer 50

This is a phrase used to describe a time in infant's life when they cry the most (2 weeks- 3 months). ``` Peak of Crying Unexpected Resists Soothing Pain-like face Long lasting Evening ```

Question 51

what improves colic?

Answer 51

Improves with increased body tone/strength to sit up | Improves with intro of solid foods

Question 52

what is colic?

Answer 52

An otherwise healthy 2-3 month old infant seems to be in pain, cries for > 3 hours a day, for > 3 days a week, for > 3 weeks

Question 53

colic treatment?

Answer 53

Must rule out other possible causes of excessive crying in an infant (Corneal abrasion, UTI, trauma injuries, child abuse, parent/child interaction) Keep child safely propped up for 15-30 minutes after every feed Smaller feeds more frequently with effective burping If projective vomiting after feeds with immediate hunger and weight loss ----> ultrasound for Pyloric Stenosis

Question 54

when/where to refer non-resolving colic

Answer 54

If not improving, can refer to Peds GI, social work, family psychology

Question 55

what is milia?

Answer 55

tiny white bumps on nose/cheeks/chin

Question 56

treatment of cradle cap?

Answer 56

Medical term = Seborrheic dermatitis Supportive/conservative treatments: Soft brush, baby oil, Aquaphor/Vaseline Happy Cappy et al washes Low potency corticosteroid daily for 1- 2 weeks max if severe

Question 57

if diaper rash is left untreated, what may develop?

Answer 57

If left untreated, can develop secondary yeast or bacterial infections

Question 58

if diaper rash persists after first line adjustments (drying, Aquaphor, zinc oxide pastes), what treatment is used?

Answer 58

If persists for > 3 days, likely to have secondary C. albincans (Nystatin) If not improving, think bacterial, allergic, contact, eczema 

Question 59

what causes Roseola?

Answer 59

Caused by Human Herpes Virus 6 (HHV-6)

Question 60

when is roseola most often seen? and with what age group?

Answer 60

Common < 3 yrs old | Usually seen in Fall and Spring

Question 61

prodrome for Roseola?

Answer 61

Prodrome: 3-5 days of high fever (102+)  Fever often prompts office visit before rash is seen Lethargy, irritability, vomiting/diarrhea

Question 62

evolution pattern of Roseola?

Answer 62

as fever resolves, rash starts  Pink maculopapular rash Trunk, then face, neck, and ext Lasts 1-2 days NOT itchy or painful – bothers caregivers to see it but not child to have it! 

Question 63

treatment of Roseola?

Answer 63

Does not require antiviral therapy – all supportive Family/patient education Tylenol PRN Keep skin cool and dry, hypoallergenic lotions or calamine if needed to soothe

Question 64

"slapped cheek" rash that fades as LACY ERYTHEMATOUS trunk rash develops

Answer 64

Erythema Infectiosum = Fifth Disease (caused by Parvovirus B19)

Question 65

treatment of Fifth Disease

Answer 65

Does not require antiviral therapy – all supportive Family/patient education Tylenol PRN Keep skin cool and dry, hypoallergenic lotions or calamine if needed to soothe

Question 66

who are high risk groups for Fifth Disease?

Answer 66

``` pregnant women (fetal death) sickle cell or immune deficiencies (severe acute anemia) ```

Question 67

herald patch Christmas Tree pattern

Answer 67

Pityriasis Rosea  | might be caused by HSV, but we're not sure

Question 68

common features of Pityriasis Rosea

Answer 68

Lasts 4-8 weeks Usually itchy especially with heat/cold Common older children, teenagers, young adults (75% are 10 – 35 yrs old)

Question 69

treatment of Pityriasis Rosea?

Answer 69

Self-limited after 1-2 months, no specific treatment suggested Family/patient education Tylenol/Ibuprofen PRN Keep skin cool and dry, hypoallergenic lotions or calamine if needed to soothe UV therapy