FOEM Peds Flashcards
(130 cards)
1
Q
Etiology of neonatal jaundice within first 24h of life
A
ABO incompatibility, RH incompatibility, TORCH infxn, G6PD def
2
Q
Next steps for neonatal jaundice within first 24h of life
A
admit, hydrate, and coombs test
3
Q
Etiology of neonatal jaundice 24-72h
A
physiologic - check bilirubin nomogram
4
Q
Etiology of neonatal jaundice >72 h
A
sepsis, breastfeeding jaundice, breast milk jaundice, gilberts syndrome
5
Q
breastfeeding jaundice
A
suboptimal breast milk supply
tx: hydration & supplementation
6
Q
breast milk jaundice
A
liver not developed to handle breaking down breast milk
7
Q
dx: 1 month with jaundice and direct hyperbili
A
biliary atresia
(obstructive jaundice, cirrhosis, and death)
8
Q
Tx biliary atresia
A
surgery with Kasai procedure
9
Q
necrotizing enterocolitis pathophys
A
inflamm and necrosis of bowel wall from translocation of gut bacteria
10
Q
RF for necrotizing enterocolitis
A
prematurity
11
Q
ssx necrotizing enterocolitis
A
bilious emesis, bloody stools, ab wall erythema
12
Q
dx necrotizing enterocolitis
A
pneumatosis intestinalis on XR & portal vein air
13
Q
tx necrotizing enterocolitis
A
IVF, abx, NG tube, surgery consult, admit to ICU
14
Q
pathophys of Hirschsprung disease
A
lack of ganglion cells in rectosigmoid colon > lack of distal bowel motility
15
Q
ssx Hirschsprung disease
A
delayed passage of meconium > obstruction & bilious emesis
16
Q
Hirschsprung disease complications
A
enterocolitis/toxic megacolon
17
Q
dx Hirschsprung disease
A
rectal suction biopsy, contrast enema
18
Q
tx Hirschsprung disease
A
surgery and admit
19
Q
pathophys midgut volvulus
A
1st month of life
congenital malrotation > volvulus > midgut ischemia
20
Q
ssx midgut volvulus
A
bilious vomiting, ab distention/distention, +/- rectal bleeding/hematochezia
21
Q
Dx midgut volvulus
A
double bubble; upper GI series - corkscrew
22
Q
Tx midgut volvulus
A
NGT & surgery consult
23
Q
associated conditions for midgut volvulus
A
congenital diaphragmatic hernia, congenital heart disease, omphalocele
24
Q
pathophys of intussusception
A
6 month- 3 years; telescoping (ileoceceal); usually from tumor, Meckel’s, post viral, HSP
25
ssx intussusception
colicky abdominal pain with lethargy; sausage mass RUQ, currant jelly stools
26
dx intussusception
obstruction on XR, US with target sign, Dance's sign (pathognomonic)
27
tx intussusception
OR vs air/contrast enema
28
pathophys of meckel diverticulum
incomplete closure of vitelline duct > heterotopic gastric mucosass
29
ssx meckel diverticulum
painless rectal bleeding d/t ulceration -> leads to obstruction
30
dx meckel diverticulum
technetium 99m scan
31
tx meckel diverticulum
surgical consult
32
at what anatomical levels do ingested FB get stuck
cricopharyngeus (C6) > GE junction > Aortic arch
33
coin in esophagus vs trachea
esophagus: flat on AP view
trachea: Flat on lateral
34
indications for emergent endoscopy for ingested FB
high grade obstruction
object in esophagus > 24 h, object > 6cm
sharp objects, mult objects, button battery in esophagus, button battery in stomach > 48 h
35
pyloric stenosis pathophysiology
age 2-8 weeks; hypertrophied pylorus
RFs: first born males, macrolide exposure
36
ssx pyloric stenosis
non-bilious projectile vom, hungry vomiter, olive shaped mass
37
pyloric stenosis dx
hypocl, hypok, metabolic alkalosis, dehydration, US = target sign, string sign = upper GI series
38
pyloric stenosis tx
fluids, electrolyte corrections (FIRST), surgery
39
MC location of traumatic c spine injury in young kids
<8: C1-3
40
normal variants in peds c-spine imaging
pseudosubluxation (C2 on C3) looks like anterior wedgign
41
SCIWORA
SC injury without radiologic abnorms; MRI will usually show problem
42
Common causes of peds anemia
physiologic nadir - hgb 9 at 6 weeks
B12/folate deficiency - hypersegmented
iron def - low MCV, pica, breath holding, high milk intake
sickel cell dz - hemolysis, high reticulocyte count
lead poisoning - basophilic stippling, ab pain, AMS
43
weights of newborns, 1y, 5y, 10y
newborn: 3.5kg
1y: 10 kg
5y: 20 kg
10y: 40 kg
44
ETT size, blade, and depth
newborn: 3.5 ETT
ETT = age/4+4 (minus 0.5 if cuffed)
depth = 3x tube size
blade: 1 = newborn to 2y; 2 = 2 to 12y, 3 = >12y
45
ETT size for premature
<1kg : 2.5 uncuffed
1-2 kg: 3.0 uncuffed
46
red flag sx for tic/movement disorders
head bobbing, neuro deficits, nystagmus, choreoathetoid movements
47
blood vol in a child
80cc/kg
48
at what level of blood volume loss does a child drop their BP
30%
49
trauma + hypotension bolus dosing
blood: 10cc/kg
fluids 20cc/kg
50
Measles
rubeola; 3 C's: cough, coryza, conjunctivitis; koplik spots
rash: maculopapular, head to feet
51
rubella
suboccipital auricular LNs, petechiae on hard palate
Rash: maculopapular, head to trunk
52
fifths disease
erythema infectiosum; parvovirus B19
URI > slapped cheek rash with circumoral pallor
aplastic crisis in sickle cell
53
varicella can develop into
encephalitis/pneumonitis
54
Roseola
high fever; blanching maculopapular rash
mimics sepsis/meningitis
55
herpangina
painful ulcers and vesicles in the posterior oropharynx + fever
56
when do you use oral antifungals for a tinea infection
hair
57
kerion
inflammatory head/hair fungal lesion on scalp
58
tx kerion
PO griseofulvin or terbinafine
59
complications of kerion
scarring alopecia
60
impetigo vs bullous impetigo
impetigo: tx with topical mupirocin
bullous impetigo: bullae with honey crusts; tx with topical mupirocin + PO Keflex
61
does SSSS have mucosal involvement
NO
62
tx SSSS
dicloxacillin +/- vanco
63
complication of untx rheumatic fever
mitral stenosis as an adult
64
pastia lines
linear petechiae; sx of scarlett fever
65
bed bug tx
antihistamines, topical steroids, supportive care clean bedding
66
HSP pathophysiology
post infectious vasculitis
6 month- 5 years
67
HSP ssx
colicky ab pain, palpable purpura, arthralgia
68
dx HSP
hemolytic anemia, AKI, lethargy
69
tx HSP
NSAIDs
70
HSP complications
intussusception and renal failure (micro hematuria, proteinuria, elevated BUN/Cr)
71
what type of intussusception for HSP
ileo-ileo
72
simple febrile seizures qualifications
one episode in 24h, <15 mins, no neuro deficits
73
midline congenital neck mass
thyroglossal duct cyst
moves with tongue protrusion
74
lateral congenital neck mass
branchial cleft cysts
75
PALS resus for choking child <1 year old
5 back blows
5 chest compressions
76
Croup tx
dexamethasone (0.6mg/kg)
racemic epi
77
gold standard dx adn tx resp FB
bronch
78
MCC of epiglottits
strep
79
Pathogen for bacterial tracheitis
S. Aureus
80
ssx of bacterial tracheitis
URI prodrome, high fever, inspir adn expir stridor, breathe better when laying flat
sounds like croup but toxic appearing
81
XR of retropharyngeal abscess
widened prevertebral space 7mm at C2
82
abx for retropharyngeal abscess
ampicillin + sulbactam
83
bronchiolitis sx, dx, tx
sx: apnea (<1 month),
dx: CXR with diffuse infiltrates
tx: nasal suctioning, hydration, humidified HFNC
84
MC PNA by age
0-3weeks: GBS
<3 month: chlamydia
3 month - 5 y: RSV
>5y: Mycoplasma; atypicals
85
PNA tx
neonates: amp + gent or cefotaxime
3w-3m: azithromycin +/- cefotaxime
3m-18y: vanc +/- ceftriaxone (ICU) ceftriaxone (inpt) amoxicillin or azithromycin (outpt)
86
MC virus for myocarditis and pericarditis
peri: coxsackie
myo: parvovirus
87
ssx of kids with myocarditis
poor feeding, sweating, increased RR, hepatomegaly
88
tx peds myocarditis
diuretics, IVIG, inotropes, ECMO
89
PDA ssx
aorta to pul artery (L > R)
cont. machine murmur, wide PP
90
PDA tx
indomethacin and surgery
91
ASD ssx
L > R shunt with RHF
fixed split S2
92
ssx VSD
loud harsh holosystolic murmur
L > R shunt with RHF
93
tx for ductal dependent PDA
PGE1
94
hyperoxia test
test to differentiate between sick infants with cyanotic congenital heart disease from pul dz
place on 100% O2 for 10 mins > ABG > if PaO2 is <100-150 = cyanotic CHD with R> L shunting
95
Tx ToF
PGE1, bicarb, IVF, blood
96
glucose dosing
<1y: D10
1-8y: D25
>8y: D50
97
virilization with low sodium
congenital adrenal hyperplasia
98
tx congenital adrenal hyperplasia
glucose, IVF, hydrocortisone
99
3-5yo pt with painless abdominal mass
Wilms tumor
100
RFs for SUDI
maternal smoking/drug use, prone sleeping, loose bedding, soft sleeping surface, male, prematurity, +FHx
101
protective for SUDI
breast feeding, pacifier, supine sleeping
102
infant with seizures and financial insecurity
hyponatremia from diluted feeds
103
AMS kid with ETOH ingestion and hx of DM
hypoglycemia
104
Kid at grandma's house with AMS, pinpoint pupils
clonidine ingestion
Tx: Narcan
105
kid with lethargy, intermittent crying, and ab pain
intussusception
106
kid with bloody diarrhea adn lethargy
E.Coli O157:H7 (possibly HUS)
DO NOT GIVE ABX
107
child crying and boyfriend babysitting
non-accidental trauma
108
recurrent PNA in a child
aspirated FB > ball valve effect and post-obstructive PNA
109
phimosis vs paraphimosis
phimosis: unable to retract
TX with topical steroid cream and gentle traction
Paraphimosis: cannot reduce foreskin ; emergency
TX: reduction, urology consult
110
MCC of UTI <1y
vesicoureteral reflux
111
Reye syndrome complications
AMS, fatty degeneration, and cerebral edema
112
neonate meningitis
GBS, EColi, listeria
113
rectal prolapse in a kid
cystic fibrosis
114
neonatal conjunctivitis ages
0-5d: gono
5d-5w: chlamydia
5w-5y: strep or hib 5d
115
leg isseus Legg Calve Perthes disease
limited hip abduction and internal rotation
116
legg calve perthes disease XR
moth eaten, crescent sign
117
leg deformity for SCFE
ext rotation deformity
118
transient synovitis
inflamm + hypertrophy of hip synovium
ssx: URI hx, limp, decreased ROM,
119
transient synovitis leg deformity
hip in flexion, abduction, and ext rotation
120
Kocher criteria
WBC >12k, ESR >40, non weight bearing
121
PSGN dx
proteinuria, RBC casts, +ASO, low C3
122
diseases assoc with biliary colic
1. hemolytic anemia
2. CF
3. obesity
123
apt test
determine if GI bleed in neonate is swallowed mom blood
stool exposed to akali solution > maternal blood degrades, fetal does not
124
Tx infantile spasms
ACTH, prednisone, AEDS
125
infantile spasm assoc with
tuberous sclerosis
126
medications associated with pyloric stenosis
macrolides
127
bilirubin level at risk for kernicterus
total >25
need phototherapy
128
ssx kernicterus
lethargy, hypotonia, poor feeding, cerebral palsy, hearing loss, gaze abnorms
MRI: globus pallidus
129
surgical airway for <10 y
needle cric
3.0mm endotracheal tube adapter directly to angiocatheter of 14-16g and bag ventilate
130
I:E ratios when using BVN through needle cric
incomplete airway obstruction: 1:5 to 1:6 (10-12 breaths per minute)
complete airway obstruction: 1:10-1:12 (5-6 breaths per min)
