General Pediatrics Flashcards

1
Q

Cystic neck masses

A

In general need to be removed because can become infected or blood-filled after hemorrhage

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2
Q

Painless midline neck mass that moves with tongue protrusion; may increase in size with URI or inflammation

A

Thyroglossal duct cyst

** most common congenital cystic lesion **

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3
Q

Nontender, fluctuant mass in lateral anterior triangle, may have associated drainage or inflammation

A

Branchial cleft cyst

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4
Q

Soft, smooth, nontender, compressible mass in posterior triangle, +transilluminates

A

Lymphatic malformation (cystic hygroma)

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5
Q

Red or bluish soft mass of variable location, + changes with valsalva

A

Hemangioma

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6
Q

Neck mass just lateral to midline that may have associated stridor, cough, or hoarseness, + changes with valsalva

A

Laryngocele

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7
Q

Supraclavicular mass more noticeable with crying, straining or coughing, increases with valsalva

A

Cervical lung hernia

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8
Q

Suprahyoid, nontender, smooth, rubbery mass

A

Dermoid cyst

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9
Q

Midline mass associated with hypo or hyperthyroidism

A

Goiter

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10
Q

Cystic hygroma

A

Only lesion that consistently transilluminates

Noonan Syndrome
Down Syndrome
Turner Syndrome

But only need to send testing if other features

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11
Q

How many external hemangiomas necessitate search for internal hemangiomas?

A

> 5

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12
Q

Empiric ABX for lymphadenitis

A

Clindamycin
Augmentin
1st/2nd gen cephalosporin in younger children

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13
Q

What is the most common cause of conductive hearing loss

A

OME

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14
Q

Most common non-syndromic sensorineural hearing loss

A

connexin 26 gene defect (AR)

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15
Q

Fainting + Long QT + SNHL

A

Jervelle Lange-Nielsen (AR)

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16
Q

Retinitis pigmentosa + SNHL

A

Usher Syndrome (AR)

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17
Q

Glomerulonephritis + high frequency SNHL

A

Alport’s Syndome (AR)

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18
Q

Pigment defects, different colored eyes, white forelock, SNHL

A

Waardenburg

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19
Q

Goiter + SNHL +/- balance abnormalities

A

Pendrid Syndrome

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20
Q

SNHL + vertigo after trauma

A

perilymphatic fistula

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21
Q

Single best predictor of school success

A

speech/language skills

22
Q

What type of hearing loss with newborn hearing screen identify

A

Moderate/severe hearing loss, not mild (<40dB)

23
Q

Universal screening by ___ month, confirm by ___ months, receive early interventions by ___ months

A

Universal screening by 1 month, confirm by 3 months, receive early interventions by 6 months

24
Q

Air conduction: abnormal

Bone conduction: normal

A

CHL

25
Q

Air and Bone conduction abnormal

A

SNHL (w/i 10 dB of each other) and Mixed hearing loss (bone >10 dB better)

26
Q

Normal peak compliance at 0 P, normal volume

A

Type A = normal

27
Q

Flat tympanogram, normal volume

A

Type B, likely middle ear effusion

28
Q

Flat tympanogram, low volume

A

Type B, likely cerumen impaction of probe against canal wall

29
Q

Flat tympanogram, high volume

A

Type B, TM perf or tympanostomy tubes

30
Q

Peak compliance at negative P, normal P

A

Type C, retracted TM (URI, Eustachian tube dysfunction)

31
Q

What additional vaccines should children with cochlear implants receive

A

PPSV-23

32
Q

Typical PCN resistance pattern for organisms causing AOM

A

S pneumoniae 40%
H influenzae 50%
M catarrhalis 99%

33
Q

Recurrent AOM

A

> 3 episodes in 6 months or >4 in 1 year

34
Q

AOM + PCN Allergy (urticaria or anaphylaxis)

A

Type 1 hypersensitivity

Macrolid (1st)
Trimethoprim/Sulfamethoxazole or Clindamycin (2nd)

35
Q

AOM + PCN Allergy (non-type 1 hypersensitivity)

A

Cephalosporin

36
Q

AOM + …

  • Amox within last 30 days
  • conjunctivitis (H flu)
  • severe diesease on presentation
A

Rx: Augmentin

37
Q

Percent of children with an effusion after 2 weeks of ABX for AOM

A

60-70%

38
Q

Most common complication of AOM

A

TM perforation

39
Q

Most common SERIOUS complication of AOM

A

Mastoiditis

40
Q

Rx for bullous myringitis

A

Rx same as routine AOM

41
Q

Indications for PE tubes

A
  • recurrent AOM

- persistent OME associated with high-risk patient or hearing loss

42
Q

What is the most common risk factor for acute bacterial sinusitis

A

Viral URI (allergic rhinitis #2)

43
Q

Sinus development

A

Ethmoid/Maxillary: birth
5phenoid: 5 years
Frontal > 7 years –> adolescence (clinically significant around 10-11)

44
Q

Gold standard for sinusitis diagnosis

A

Sinus aspiration

Sinus and nasopharyngeal cultures do not correlate

45
Q

Pott puffy tumor

A

osteomyelitis frontal bone

46
Q

Tympanogram with poor compliance and high volume

A

perforated TM

47
Q

Tympanogram with poor compliance and low volume

A

Cerumen or against canal wall

48
Q

Tympanogram with poor compliance, normal volume

A

Effusion or tympanosclerosis

49
Q

Peak compliance at a negative pressure

A

Eustachian tube dysfunction, early AOM

50
Q

Normal bone conduction, abnormal air conduction

A

CHL

51
Q

Abnormal air and bone conduction

A

SNHL (mixed if difference between bone and air is >10dB)