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Flashcards in Pediatrics Deck (53):
1

4 week Male with conjunctivitis. What is the likely etiology?

Chlamydia Tracomatis

2

Fleshy colored papa unless with Erythematous base containing eosinophils.
Dx and Mgt?

Erythema toxicum neonatorum
Observe only!

3

Unintentional deaths in Kids.
Cause?

MVA!!!

4

4 year old with BMI of 17.5, between 90-95th percentile
- Classification

In patient less than 2, obese is not used! If >95th percentile: classified as overweight!
If patient is more than 2-18,> 95th percentile is obese! If 85-95: Overweight!

5

True of RSV?

Months of Nov - Apr
Rarely associated with Co infection

6

Mild to Mod CAP in PEDS
Tx?

Amoxicillin

7

Peds with OSAS; normal height and weight
Tx?

Adenotonsillectomy

8

Slipped Capital Femoral Epiphysis
Age group with sex?

11-13 in Female
13-15 in Male

9

12 month with a father that have epilepsy.
Vaccine that can increase the risk of febrile seizures?

MMR - up to 2 weeks from administration

10

Cows milk, not recommended in the US until what age?

Less than 12 months.
Not enough Iron, Vit E and Essential FA

11

When to give 2nd dose of Pneumococcal vaccine in children?

If sickle cell
- also if there is anatomic functional or functional asplenia, leukemia, HIV
- 3 yrs apart between 1st and 2nd dose

12

In-toeing
Surgery?

At age 8-10
If less, just observe

13

Noctural cough in 2 yr old

Give honey
Not for <12 months due to risk of botulism

14

Neck mass in kids
Differentials?

1. Developmental - brachial cleft cyst
2. Inflammatory
3. Neoplastic

15

7 yr old with multiple purple lesions on the leg + limp on walking and stomach pain
DX?
TX?

Henoch-Scholein Purpura
- purpura
- abd pain
- arthritis

TX: Acetaminophen or Ibuprofen

May give prednisone if with renal involvement
May give Amlodipine if with HTN

16

Duchenne muscular dystrophy
Sign?
Milestones for
- rolling prone to supine
- rolling supine to prone
- sitting position unassisted
- walking unassisted

Gower sign
Milestone
- 4 months from prone to supine
- 6 month from supine to prone
- 9 months to sit unassisted
-18 months to walk unassisted

17

Kawasaki
Evalauation?

CREAM
- conjunctivitis bilateral
- rash any
- edema: hands and feet
- adenopathy: >1.5 cm
-Mucocutaneous sign: strawberry tongue

Get ECHO to rule out aneurysm

18

Exclusively breast fed
Supplements?

1. Vit d 400 IU - will prevent Rickets
2. Iron for 4 months

19

7 year old with posterior rib fracture on CXR
What to do?

Child abuse investigation
If less than 2, do a skeletal survey
Skeletal survey not needed for 4 yrs and older

20

Autism...
When to start screening with MCHAT?
Behavior that may provide evidence?

- Screen at 18 months and 24 months
- being upset with normal noise

21

Primary Monosymptomatic enuresis?
Tx?
Meds?

- never achieved continuous dry nights; no daytime enuresis
- Do bed alarm
If it fails--> Desmopressin, Imipramine, Oxybutynin

22

Umbilical Hernia in a 2 year old.
Until when to wait?

Surgical repair if persistent between 3-5 yrs old

23

Most common cause of chest pain in PEDS?

1st- Musculoskeletal
2nd - Psychogenic
3rd - Pulmo

24

In the US, most common form of child abuse?

1st- Neglect
2nd- Physical
3rd- Sexual

25

ADHD in a 5 yr old
Tx?

Behavioral therapy
If >6 yrs old, Meds!

26

3 week old with high fever, does not look toxic.
Management?

Admit! Do septic work up: CBC, LP,UA, Cultures and start antibiotics
Do for PT < 29 days old

27

Acute otitis media
Tx and dose?

Amox 80-90 mg/kg for 10 days
Augmentin if received Amox in the past 30 days or hx of AOM not resposive to amox.

28

Student with Lice.
Tx?
How soon to go back to school?

1st line : Permethrin
May return to school ASAP. Does not need to be nit free
Treat again in 1 week

29

6 y/o with 48 hr hip pain. With a limp, afebrile, Normal labs and X-rays

DX:
Tx:

Transient synovitis: everything normal
Ibuprofen

30

Concussion yesterday. No lost of consciousness. Just headaches and balance problems but can recall everything.

What to do for evaluation?

Do physical and cognitive rest

CT only if focal sx or LOC > 60 seconds

31

When to screen for Autism

18 months and 24 months

32

Most common cause of hearing loss in New born?

Genetic inheritance

33

4 y/o with 6 day hx of fever 103.2
PE: maculopapular rash, bilateral eye injection, shorty bilateral lymphadenopathy, erythematous lips, strawberry tongue and pharyngeal edema.

DX?
Mgt?

Kawasaki. --> fever for at least 5 days
Conjunctivitis
Rash
Edema
Adenopathy >1.5cm
Mucocutaneous involvement

Tx. 1. Aspirin 80- 100mg/kg /day divided by 6 hrs
2. If no fever anymore, Aspirin 3-5 mg/kg/day q 6 hrs
3. IVIG within 10 days
4. Cardio referral for echo in 6 wks
5. Low dose aspirin while waiting for Cardio

34

6month female with bronchiolitis
When to give nebulized hypertonic saline?

1. On hospitalized patient
2. Do not give in the ER

35

Term baby
Exclusively breastfed
When do you start iron supplement to prevent Iron def anemia?
What if the baby is preterm

4 months
1 month

36

Newborn found to have ear deformity
Mom had GDM
What test to order for the baby?

Renal US!

37

13 y/o brought to ED for worsening asthma
Already on inhaled Fluticasone and Albuterol
What drug to give to prevent hospitalization?

Oral prednisone!

38

New born male brought in for first exam
DX with Downs
test indicated for all downs?

Echo!!! - 50 % has cardiac defects

Screen also for
1. Feeding
2. Vision
3. Hearing
4. Thyroid
5. Hematologic : myeloproliferative d/o ; leukemoid rxn; polycythemia

Do Polysomnography between 1-4 yrs old

39

8 yr old with ADHD
TX?

Psychostimulant: Ritalin or Dextroamphetamine

If below 6 y/o, can do behavioral therapy first

40

Risk factors for SIDS (6)?

Side sleeping or prone sleeping!
Bed sharing
Others:
1. Male
2. Native American
3. BW < 2500g
4. AOG < 37 weeks

Use of Pacifier decreases RISK for SIDS + exclusive breastfeeding per AAP

41

5 wk old female visits in December. Born at 28 wks because of preeclamsia.
Need what immunoprophylaxis?

Palivizumab (Synagis) for RSV
Given in infants born < 29 wks

42

6 y/o with limp
No fever, pain on the anterior hip joint increased on internal rotation which is limited
DX?

Osteonecrosis of the femoral head (Legg-Calve'-Perthes)
Male, 2-12

43

Blood pressure in children...
What is a pre HTN?
What is hypertensive?

Pre HTN is 120/80 or less or between 90-95th percentile
Determined by Age, sex and length
Above 95th percentile is HTN!

44

Day care center needs:

Director has degree in child related field
Staff knows CPR
Care giver ratio is 1:2
Discipline is standard

45

MMR can be given at age?
Side effects?

Between 12-15 months
If given before 12 months, needs 2 doses at least 1 month apart
Second dose between 4-6 yrs old
-Measles can caused Thrombocytopenia

46

Vaccines for 2 month old?

1. DTap
2. Prevnar: Pneumococcal
3. IPV! Not oral
4. HIB
5. Rota
6. Hep B

47

Car seats guidelines?

- till age of 2: rear facing
- till 13 yrs old: rear seat
- booster: lap and shoulder strap
- Safest: rear middle seat

48

PPD in children

Not routine!
Only in positive exposure, immunocompromise, immigrants

49

Genetic testing to be repeated is went home before 12 hrs of life?

Phenylketonuria!!!!- baby did not ingest enough phenylalanine.

50

Heart murmur in 13 y/o, Systolic, Ejection Murmur at Left upper sternal boarder, second sound has splitting with inspiration, louder when supine , softeners with Valsalva or standing
Diagnosis?

Pulmonary flow murmur!

Others:
ASD - Left upper sternal
Venous hum - Right upper sternum
Hypertrophic cardiomyopathy - left lower sternal border
VSD- Left lower sternal boarder

Diastolic murmur: always pathologic

51

Fluoride supplementation:
How much?
What age?

0.5 ppm
Start at age 6 months

52

HPV in males?
Age

9- 26 y/o

Two dose if below 15 y/o
- 1st dose should be 0 then the second dose is at 6 months- 12 months
- if second is given less than 5 months from first dose, RPT! Hence 3 doses, 12 weeks after 2nd dose

53

Iron supplement in <37 weeks

Start at 1 month for exclusively breastfed