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Pediatrics Flashcards

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1
Q

Management of HR <100bpm at 1 minute of life

A

PPV

NOTE: if hr<60, cardiac problem –> initiate CPR

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2
Q

APGAR scores

A

7-10 good
<7 bad

Appearance
Pulse
Grimace
Activity
Respirations
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3
Q

Transient tachypneic of the new born

A

most often seen in term babies delivered by c-section

CXR: lungs hyperextended and wet

Tx with ppv

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4
Q

spO2 goals at 0 minutes, 1 and 5 minutes

A

0: 60-65% (stimulate to overcome primary apnea)
1: 80-85%
5: 90-95%

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5
Q

Pneumatosis intestinalis =

A

necrotizing enterocolitis

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6
Q

NEC: TX

A

NPO, IV antibx

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7
Q

VACTERL

A 
Vetebrak anomolies
Anus (imperforate) dx on cross table xray
Cardiac
TE fistula
Esophageal atresia
Renal
Limb hypoplasia

US sacrum, Echo, catheter xray, voiding cystourethrogram

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8
Q

Meconium ileus: TX

A

Diagnostic and therapeutic water enema

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9
Q

Malrotation vs duodenal atresia: imaging findings

A

Malrotation: xray showing double bubble and air distally (there has been time to swallow air)

Duodenal atresia: double bubble with no air

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10
Q

Double bubble d/os

A

duodenal atresia
annular pancreas
malrotation–>volvulous

NOTE: all cause bilious emesis

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11
Q

Double bubble d/os that are associated with downs

A

duodenal atresia

annular pancreas

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12
Q

Pyloric stenosis: Dx and Tx

A

Dx with US showing donut sign

get CMP (to find hypochloremic, hypokalemic metabolic alkylosis) and create electrolyte abnormalities before performing pyelorectomy

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13
Q

Physiologic vs pathologic jaundice

A

physiologic: onset after 72hrs, resolves w/in 2 weeks, unconj bili, rises <5/day
pathologic: onset w/in first day, resolves w/in 2 weeks, conj bili, rises >5/day

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14
Q

Work-up of physiologic jaundice

A

get coombs test:
if positive, mom was isoimmunized

if negative, get Hgb:
if Hgb low, cephalotoma
if high, twin-twin trasnfusion a possibility in multiple gestation
if normal, get reticulocyte count

If retic normal, breast milk or breast milk jaundice

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15
Q

Breast feeding vs breast milk jaundice

A

Breast feeding: product of not enough PO and bowl hypomotility

Breast milk: breast milk has enzyme that inhibits conjugation, give hydrolyzed formula

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16
Q

Baby with scaphoid abdomen and bowel in chest on xray

A

diaphragmatic hernia

NOTE: associated with hypoplastic lung

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17
Q

Hypospadia:associations

A

cryptochidism and inguinal hernias

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18
Q

Epispadia: associations

A

opening on dorsal surface

urinary incontinence and bladder exstrophy

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19
Q

Boot-shaped heart and decreased pulmonary vascular markings on CXR of child

A

tetrology of fallot

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20
Q

CXR of infant showing an egg on a string =

A

transposition

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21
Q

CXR of child showing globular-shaped heart with pulmonary edema =

A

hypoplastic left heart syndrome

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22
Q

CHARGE syndrome

A 
Coloboma of the eye, CNS abnormalities
Heart defects
Atresia of the choanae
Retardation of growth and/or development
Genital or urinary defects (hypogonadism)
Ear anomolies or deafness
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23
Q

Congenital defects associated with Downs syndrome

A

hirschsprung disease
imperforate anus
duodenal atresia

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24
Q

Prolonged QT: PPX

A

beta blockers with pacemaker placement

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25
Postural neck deformity that presents with a sternocleidomastoid muscle mass, ipsilateral head tilt, and contralateral chin deviation =
congenital muscular torticollis
26
Congenital muscular torticollis: risk factors and tx
risk factors: multiple gesteation, breech position, oligohydraminos Tx: increased tummy time, passive stretching, and PT. AVOID positional plagiocephally
27
Best initial diagnostic testing for laryngomalacia
direct laryngoscopy showing collapse of the supraglottic structures
28
TX severe hypovolemic hypernatremia in peds
0.9% saline
29
triple bubble sign and gasless colon =
jejunal atresia
30
Bilious vomiting and abdominal distension in newborn of mom who used cocaine
jejunal atresia
31
Specific test for lead toxicity
venous blood draw (can confirm positive capillary blood specimen)
32
Measles: transmission
airborne
33
Measles: clinical presentation
prodrome: cough, coryza, conjunctivitis, fever, koplik spots Maculopapular exanthem: cephalocaudal and centrifugal spread, spares palsms and soles NOTE: watch out for subacute sclerosing panencephalitis
34
Mullerian agenesis: clinical features
Karyotype: 46, XX breast development, axillary and pubic hair, ovariess No uterus or upper vagina
35
Doll-like face, thin extremities, short stature, hypoglycemia, lactic acidosis, and hyperlipidemia
glucose-6-phosphatase deficiency (type 1 glycogen storage disease, von Gierke)
36
Riboflavin deficiency
``` angular cheilitis stomatitis glossitis normocytic-normochromic anemia seborrheic dermatitis (erythematous scaly patchs on eyebrows, cheeks, and nose) ```
37
Nephrotic syndrome associated with what virus?
hep B
38
Roseola: clinical presentation
prodrome: high-spiking fever (over 104), which breaks when rash arises Rash moves from trunk out NOTE: watch out for febrile seizures
39
Rubella: clinical presentatio
Prodrome of generalized tender LDN (UNLIKE measles) fever and rash (like measles) rash moves cephalocaudal and centrifugal, does not involve palms and soles
40
Mumps: clinical presentation
pubertal male with parotid swelling and orchitis Can lead to infertility
41
Hand, foot, mouth: clinical presentation
varicella zoster-like vesicles on hands, feet, and mouth
42
Meningitis: Tx peds vs adult
peds (kids less than 30 days): vancomycin, cefotoxine (bili doesnt get as high with this), ampicillin (covers listeria), steroids adult: vanc, ceftriaxone, steroid
43
Polyps, pale/boggy mucosa, and cobblestonning
allergic rhinitus
44
Allergic rhinitus: TX
internasal steroids
45
Kid being fed with soy formula with FTT and a bloody bowel movement
Milk protein allergy
46
Conjunctivitis: TX
H2 blockers and leukotriene antagonists
47
Otitis media: pathogens
strep, H flu, moraxella
48
Otitis media: TX
1st time: amoxicillin 2nd time: amox-clav if 3x/6months or 4x in a year: consider myringotomy
49
Otitis media vs externa
media: infection of middle ear (with URI bugs like strep) externa: infection of outer ear and canal (with pseudomonas or staph)
50
Otitis externa: TX
Cipro and steroid drops
51
Air fluid levels on head xray and opacification on CT
bacterial sinusitis
52
TX indications for amox-clav in sinusitis
``` worsening OR 10days OR fever ```
53
Imaging for recurrent sinusitic
CT
54
CENTOR criteria for GAS
``` No Cough Exudates Nodes (anterior LDN) Temp (fever) OR age <14 (+1), older 44 (-1) ``` <1 viral, symptomatic tx 2-3, rapid strep >4, tx with amox-clav
55
3yo with URI that progresses to barking cough and inspiratory stridor
Croup Tx moderate cases with racemic epinephrine, steroids, and O2
56
Bacterial trachietis
Caused by staph aureus Croup that does not improve with racemic epi and kid looks toxic Do tracheal culture and initiate IV antibx
57
Epiglottis
rapid onset fever drooling (as swallowing hurts) hot potato/muffled voice Xray shows thumbprint sign
58
Imaging in retropharyngeal abscess
CT (peritonsillar abscess, which happens in older children, does not need)
59
Inrathoracic foreign body aspiration
expiratory wheeze
60
extrathoracic foreign body aspiration
Inspiratory stridor
61
Brionchiolitis: TX
O2 and IVF Watch for any progression toward respiratory failure and ARDS
62
Chronic granulomatous disease: clinical features and dx
features: majority of cases are x-linked recessive, recurrent pulm and cutaneous infections, catalase positive organisms CBC shows leukocytosis Dx with neutrophil function testing (dihydrorhodamine 123 test or nitroblue tetrazolium test)
63
Trigeminal neuralgia: TX
carbamezepine
64
Simple febrile seizure criteria
(1) Only 1 in 24hours (2) duration less than 15minutes (3) generalized If any of these absent, classify as complex
65
Simple vs complex seizure: TX
Simple: benzos to abort, otherwise acetominophen to keep fever down and no imaging Complex: benzos to abort, consider EEG, LP, CT, initiate anti-epileptic meds
66
Infantile spasm: features and TX
less than 1 yo symmetrical limb jerking, not generalized anad no fever NOT A SEIZURE EEG showing interictal hyparsthria TX: ACTH
67
Tuberous Sclerosis: features and DX
Angiofibroma Ash-leaf spot Seizures (afebrile) DX: Neuroimaging
68
Absence seizures: prognosis
good, will often resolve over time
69
pneumatosis intestinalis =
NEC
70
Age range for intussusception to occur
3months-3years
71
IDA in infant male
meckles diverticlum
72
Full term newborn with bloody stool with no red flags
could have swallowed mom;s blood get Apt test
73
Left-to-right shunts
acyanotic, but can eventually lead to eisenmengers ASD (fixed split S2) VSD (FTT, CHF, asym) PDA (continuous multiphasic/machine like murmur that was not present at birth)
74
Right-to-left shunts
cyanotic at day 0 Transposition of the great vessels (diabetic moms, use prostaglandins) Tetralogy of Fallot (downs syndrome, boot shaped heart)
75
Congenital vs acquired strabsimus: TX
Congenital: surgery before 6mo acquired: patch good eye
76
Imaging for intraventricular hemorrhage of newborn
US doppler
77
Newborn with oliguria and distended bladder
posterior urethral valve
78
Immunedeficiencies involving only B cells (4)
XLA (Brutons) CVID IgA def Hyper IgM
79
Immunedeficiencies involving both B and T cells (3)
Wiscott-aldrich (affects boys, ezcema and low platlets and infections--> increased IgM and G) Ataxia-telanctasia SCID
80
Immunedeficiencies involving phagocytosis (3)
chronic granulomatous disease LAD CH
81
Immunedeficiencies involving complement (2)
C1-esterase def C5-C9 attack complex def
82
XLA
Brutons Affects young boys (6mo to 3yo) recurrent sinopulmonary and ear infections as well as giardia no Igs on quantitative panel no B cells on flow cytometry TX: schedule IgG, consider BM transplant
83
Common variable immunodeficiency
mild XLA in older boy QIg show decrease in 2/3 Ig TX: schedule Ig
84
IgA deficiency
Sinopulmonary infections and recurrent gastroenteritis anaphylaxis after blood transfusion QIg showing decreased levels of IgA but increased IgG and IgM
85
Hyper IgM
B cells cannot convert IgM to IgG QIg shows decreased IgG and A but markedly elevated IgM
86
Delayed separation og cord with infections without pus
leukocyte adhesion deficiency
87
Chediak hedashi
AD Giant granules in PMNS albinism, neuropathy, and neutropenia
88
TX of angioedema
FFP acutely | Longterm management with androgens (danazol and stanazol)
89
Milk/soy protein induced colitis: clinical features
presents ages 2-8weeks regurgitation or vomiting of feeds +/- painless bloody stools +/- eczema
90
Milk/soy protein induced colitis: TX
elimination of milk and soy from maternal diet of exclusively breast fed infants OR initiation of hyrolyzed formula in formula-fed infants
91
Child with fever, pharyngitis, and gray vesicles on the posterior oropharynx =
Herpangina (coxsackie A virus)
92
Henoch-Schonlein purpura
IgA-mediated vasculitis producing palpable purpura on lower extremities, abdominal pain, and renal disease
93
Developmental delay, eye problems, and a marfinoid habitus in s/o stroke/TIA =
Homocystinuria
94
Acute strep throat: DX
Get rapid streptococcal antigen testing (even if high CENTOR score). If positive, tx. if negative, f/u with culture
95
To confirm strep exposure with rheumatic heart disease
antistreptolysin O antibody testing
96
Strep throat: TX
Oral penicillin or amoxicillin
97
Freidrich ataxia: features
Cardiac (cardiomyopathy) Neurologic (ataxia, dysarthria from spinocerebellar involvement) Skeletal (scoliosis, feet deformities) Most common causes of death are from cardiomyopathy and respiratory complications
98
Cancer associated with pernicious anemia
gastric cancer
99
Diagnostic testing of PCP in child
silver stain of bronchoalveolar fluid
100
12 hour old born to mom with untreated gestational diabetes who has generalized tonic clonic seizure, low tone, lethargy, and prolonged QT most likely has ____ in additon to low glucose
hypocalcemia

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