PEDIA AMEDEX Flashcards
(158 cards)
1
Q
Rubella
A
German measles
2
Q
Rubeola
A
Measles
3
Q
Roseola infantum is also known as
A
Exanthem subitum / sixth disease and three day fever
4
Q
Roseola infantum is caused by
A
HHV 6 / HHV 7 / Enteroviruses such as coxackie virus A and B, echovirus / adenovirus and parainfluenza type 1
5
Q
Roseola infantum commonly affects
A
infants mostly 6-18 months
6
Q
Roseola infantum course
A
3-5 days of high fever up to 40C or higher then resolves abruptly then rash
7
Q
Roseola infantum rash
A
maculopapular rash from the neck and trunk the to the face and extremities, not purpritic
8
Q
Nagayama spots
A
Roseola infantum
9
Q
Whooping cough is caused by
A
Bordatella pertussis
10
Q
Guidelines for admission of patient with pertussis (2)
A
- infants less than 6 months of age
- any child with complications (apnea cyanosis pneumonia encephalopathy)
11
Q
Indication for antibiotics in a patient with pertussis
A
- patient is diagnosed in catarrhal or early paroxysmal phase (may reduce severity)
- cough for less than 14 days (may reduce spread; reduces exclusion period)
- the patient is admitted to the hospital
- there are complications
12
Q
Chemoprophylaxis for pertussis is indicated
A
- child < 6 months
- < 3 doses of vaccine
13
Q
blisters of varying stages, macules and papules
A
chicken pox
14
Q
school exclusion of chicken pox
A
after all the blisters have dried out
15
Q
PDA
A
- frequently an isolated phenomenon
- pansystolic machinery like murmur at the LSB
- wide pulse pressure
- definitive management: surgical closure
16
Q
difficulty in internal rotation and abduction in children aged 4-10
A
Transient synovitis or irritable hip
17
Q
most sensitive test for TS
A
Log roll test
18
Q
Treatment
A
bed rest for 7-10 days and the use of crutches to avoid weight bearing of the affected joint
Meds: Paracetamol or NSAIDs
19
Q
Oppositional defiant disorder
A
Risperidone
20
Q
Recommendation for premature isolated adrenarche
A
Followup every 3-6 months
21
Q
GI abnormality most associated with Down syndrome
A
Duodenal atresia or stenosis sometimes associated with annular pancreas
22
Q
Delayed passage of meconium
A
Hirschsprung disease
23
Q
Acute bronchiolitis cause
A
RSV
24
Q
Clinical presentation of acute bronchiolitis
A
cough, coryza + wheezy breathing + tachypnea = hyper-inflated chest with subcostal retractions
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LCP features
painless limp
trendelenberg gait or abductor lurch
unilateral or successively with contralateral hip joint
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LCP is also called
AVN of the proximal femoral epiphysis;
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Management of LCP
Ortho referral
Reduce weight from affected joint
Maintain the femur abducted and internally rotated
Assessment of disease progression via xray
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Ultrasound indications for UTI
In all children younger than the age of 3 years of age with the first episode of UTI
< 1 year old = ultrasound should be performed first and if normal the next step is VCU
> 1 year of age = ultrasound alone
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Deficient in breast milk
Vitamin K - can cause intracranial hemorrhage
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Infantile hypertrophic pyloric stenosis metabolic picture
Increased pH, decreased KCl, increased pCO2 and HCO3
immediate non bilous projectile vomiting in a 3-6 week old baby
demands to be re-fed immediately
olive like mass at lateral edge of the rectus abdominis muscle
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vaginal bleeding in the first week after birth
maternal estrogen withdrawal
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most common cuase of bloody vaginal discharge
may also be purulent
Foreign body
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nappy rash
monilial candida vulvovaginitis
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most common suppurative complication of AOM
Acute mastoiditis
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Common pathogen for acute mastoiditis
Streptococcus pneumoniae - 1st
Hib - 2nd
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Treatment of acute mastoiditis
Flucloxacillin + 3 generation cephalosporin
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Acute mastoiditis clinical features
postauricular inflammatory signs such as erythema, edema, tenderness and fluctuance
Edema of auricle and or external canal (prior)
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Laryngomalaicia (5)
1. noisy breathing - audible wheeze when a baby inhales often worse when the baby is agitated, feeding, crying or sleeping on his back
2. high pitched sound
3. difficulty feeding
4. poor weight gain
5. choking while feeding
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croup / LTB is commonly caused by
distinctive seal barking cough and inspiratory stridor
tracheal tug
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cause of LTB
Para influenza virus type 1
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Epiglottitis presentation
may lead to sudden obstruction and death
maintains head extended
noisy breathing
sore throat dysphagia high fever drooling inspiratory stridor
4ds: dysphagia, dysphonia, drooling, and distress
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Treatment goals for epiglotitis
airway protection and antibiotics
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Acute bronchiolitis treatment goal
oxygen and hydration
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hot potato voice
epiglotitis
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Epiglotitis cause
Hib
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Retrophayngeal abscess
similar to epiglotitis but with bacterial upper respiratory tract infection preceding
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until when is the index case of measles excluded from school
4 days after rash
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exclusion of unvaccinated exposures of measles
14 days after the appearance rash on the index case
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Croup treatment is based on severity
mild
- dexa or
- prednisolone or
- budesonide
severe
- adrenaline + dexamethasone or prednisolone
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most common cause of painful rectal bleeding
anal fissure
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SCFE first symptom
hip stiffness that subsides with rest
50
SCFE (4)
limp and irritaility of hip movement
knee pain referred from affected hip
on flexion of the hip it rotates externally - hip is often on external rotation on walking
most movements are restricted especially internal rotation
51
3 important management principles of SCFE
1. cease weight bearing and refer urgently
2. if acute slip, gentle reduction via traction is better than manipulation
3. once reduced pinning is performed
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most common intraabdominal tumor of childhood
Wilms tumor or nephroblastoma
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classic presentation of neproblastoma on physical examination
smooth firm non tender palpable abdominal mass that usually does not cross the midline
other manifestations; hematuria, fever, hypertension, abdominal pain
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most common solid extracrainail tumor in children
neuroblastoma
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Neuroblastoma clinical presentation
hard, irregular, non tender, extends beyond the midline
loss of apetite
protrusion of both eyes
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lobar pneumonia clinical features
fever + dob + pale ill and grunting, shallow respiration, normal chest auscultation
57
bronchiolitis most characteristic findings
inspiratory fine crackles
58
intentional unauthorized or illegal absence from compulsory schooling
Truancy
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Truancy
attempt to draw attention or to make an impression on pears
caused by anger at school or problems at home
children sometimes go on to break laws more seriously when they are older
child tries to hide his or her action from parents
common in low socioeconomic status
60
Encopresis defenition
Voluntary or involuntary passage of formed semiformed or liquid stool into a place other than the toilet for more than 1 time per month for at least 3 months in a child > 4 years
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delay to pass meconium
scybalous pebble like hard stool for at least 2 weeks
anal canal devoid of stool on examination with sudden evacuation of stool on digital examination
Hirschsprung disease
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Hirschsprung disease pathophysiology
absence of ganglia in the distal colon resuling in functional obstruction
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meconium ileus due to obstruction of the ileum by viscid meconium may be the earliest sign of
cystic fibrosis
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Hirschsprung disease diagnosis
full thickness rectal biospy
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congenital megacolon
Hirschsprung disease
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ribbon like stools
Hirschsprung disease
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vaccine that has the highest amount of egg protein and contraindicated to patient hypersensitive to eggs
Yellow fever vaccine
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dilated bowel loops with air fluid levels and a granular ground glass material
Hirschsprung disease
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bilous vomiting + schaphoid abdomen
midgut volvulus
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Medications for postherpetic neuralgia
- TCA: amitriptyline and noretriptylline
- Anticonvulsants: gabapentin
- opiods: morphine and tramadol
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Egg containing vaccines
mmr
influenza
yellow fever
typhoid
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medication that decrease both acute and postherpetic pain
valacyclovir
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acquired malabsorption that resolves when the patient is exposed to gluten free diet
celiac sprue
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type of anemia associated with celiac disease
microcytic anemia with low serum ferritin levels
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curant jelly stools
intussusception
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HFMD is casued by
coxscakie virus type A
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Incubation period of varciella
11-21 days
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right hypochondrium sausage shaped-mass and emptiness in the right lower quadrant
Dance sign of intussuception
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currant jelly stools
intussusception
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medications for varicella zoster should be given within __ houRs to prevent viral replication
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when should influenza virus be given
2nd and 3rd trimester
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Diagnostic PE finding in patients with NEC
pneumatosis intestinalis
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NEC is typically seen in the
NICU in premature infants
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Molluscum contagiosum (4)
2-5mm slightly umbilicated flesh colored dome shaped papules
spread by inoculation
self limited
clear spontaneously in 6-9 months
84
Wassel definition
infantile colic
unexplained paroxysmal bouts of fussing and crying that lasted >3 hours per day for > 3 days a week for > 3 weeks duration
no vomitting, normal stools, no weight loss
85
leading cause of congenital hearing loss
cmv
86
shallow oral ulcerations confined to the posterior pharynx
Herpangina
87
gingivostomatitis that involves the anterior mounth
herpes infection
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petechiae on the soft palate in infectious mononucleosis are referred to as
Forchheimer spots
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treatment of volvulus in the elderly
decompression by a sigmoidoscope
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treatment for hypertropic pyloric stenosis
longitudinal pylorotomy
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measles is caused by
paramyxovirus
92
roseola is caused by
HV6
93
german measles is also called
rubella
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Erythema infectiosum or 5th disease is caused by
Pravovirus B19
95
Orchitis/ (3)
pain or orchitis is relieved by gently elevating the testis
when diagnosed in prepubertal males, no need for antibiotics
incidence has diminished since the introduction of mmr
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mid abdominal pain and diaphoretic but elicits no intensity of pain during abdominal palpation
intestinal ischemia
97
pain in the right lower quadrant
celcal volvulus
appendicitis
98
common causes of acute onset facial nerve palsy in children
AOM
Lyme disease
99
subacute sclerosing panecephalitis is associated with
measles
100
throglossal duct cyst most common complication
infection
100
medication for herpes simplex keratitis
idoxuridine
101
SVT >6 months
ice pack
101
SVT in neonates
immersion of face in water
102
SVT toodlers
103
most common cause of AOM in children >6 weeks
S. pneumoniae (1)
H. influenzae
104
most common cause of AOM in neonates
RSV
105
cyanotic when laid on back (mild) however O2 increases when the baby is crying. next step?
rigid NGT
106
cyanotic when laid on back (mild) however O2 increases when the baby is crying. diagosis and diagnostics?
choanal atresia
rigid NGT
107
CHARGE syndrome
coloboma, heart difect, atresia choanae, retarded growth and development, ear abnormality
females >>
abnormality in upper airway
108
coanal atresia
once confirmed
o2, oropharngeal airway
intubation if life threatening
ct scan
109
treatment for primary nocturnal enuresis
desmopressin (minirin) spray
110
family name
4 years old
111
bleeding post tonsiellectomy management
(late bleeding) cause
infection of tonsillar fossa
112
management of post tonsillectomy hemorrhage
resuscitation - 2 large bore cannula
reservation of crossmated rbc
iv antibiotics 1.2 g benzyl penicillin + metronidazole
analgesia without nsaids
hydrogen peroxide gargle (1:6)
113
diphtheria, tetanus, and acellular pertussis (DTaP) vaccine schedule
Administered at 2, 4, and 6 months of age.
114
enuresis is cutoff
5 years old
115
Management of Pertussis Exposure for symptomatic individuals
If symptoms of pertussis develop, treatment with azithromycin (first-line antibiotic) should be started within the first 21 days of symptom onset to reduce the severity and transmission of the disease.
Infected individuals should be isolated for at least 5 days after starting antibiotics to prevent spreading pertussis to others.
116
very common cause of wheezing in children younger than 12 months
bronchiolitis
117
common cause of wheezing in children younger than 5 years
asthma
118
wheezing associated with feeding
reflux
119
wheezing when supine
laryngomalacia
120
unilateral wheezing
foreign body aspiration
121
benign murmur
murmur increases when the child is supine
122
asymptomatic hematuria in the background of febrile illness other than uti next step
assess after uti
123
hematuria in the background of uti next step
urine culture
124
asymptomatic hematuria confirmation
2 positive urine exams out of 3 in 2-3 weeks before any further assessment
125
Marfan (3)
aneurysms dilatation, aortic regurgitation, aortic root dissection
126
AR murmur
127
mid systolic ejection murmur at the 2nd rics
HOCM
128
Austin flint
> low pitched rumbling mid diastolic mumur over the apex
> heard in severe AR
129
pan systolic murmur at LSE with no radiation
VSD
130
machinery murmur at 2nd lics
PDA
131
murmur in marfan
ASD
132
Daytime bladder control and coordination usually occurs by
4 years of age
133
Night-time bladder control typically takes longer and is not expected until a child is
5–7 years old.
134
Typically treatment is not started before age _____, as there is a high rate of spontaneous resolution
6 years
135
Rotavirus vaccine
first dose cant be given after 12 weeks of age since high incidence of intussuception
136
intermittent fevers well between fevers
roseola
136
rash of roseola
maculopapular or erythematous
beginning on the trunk and may spread to involve the neck and extremities
non pruritic
blanches on pressure
136
Varicella is given at
18 months with MMR as single dose or at 14 years old and up, 2 doses, at 4 week intervals
136
Bronchiolitis obliterans is caused by
adenovirus
136
adenovirus manifestations
folicular conjunctivitis, gastroenteritis, intussuception, hemorrhagic cystitis, myocarditis
initial symptoms: cough, chest pain, hemoptysis
symptoms abate then worsens
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