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Pediatrics Flashcards

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1
Q

Normal HR and RR for neonates

A

RR 40-60
HR 120-160
(babies always faster)

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2
Q

Purpose of APGAR

A

need resuscitation?
1: L&D condition
2: response to resuscitation
not a predictor or morbidity and mortality

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3
Q

How to grade appearance and pulse for apgar

A

0: blue baby 1: blue limbs 2: pink
0: none 1: 60-100 2: 100+

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4
Q

How to grade grimace and activity for apgar

A

0: none 1: feeble cry 2: cough and gag
0: no activity 1: flexion 2: active

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5
Q

Neonatal conjunctivitis at 3+ weeks is

A

herpes

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6
Q

Two prophylactic eye ointments for babes

A

silver nitrate; e-mycin/tetra

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7
Q

How to TREAT gonococcal/chlamydial conjunctivitis

A

ceftriaxone/ emycin

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8
Q

Why are babies prone to GI bleed

A

no gut flora –> no ecoli –> no vitamin K

need single dose vitamin K

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9
Q

Vaccine series started at birth

A

Hep B

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10
Q

What congenital disorders are on all newborn screens nationally?

A 
(CHB)2 PG 
Creepy Hitmen Befriend Private Gypsies
C-CAH, CF 
H- homocystinura, HypoTH
B-Bthatl/biotinidase 
P- PKU
G- Galactosemia
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11
Q

Most newborn heritable disease (esp enzyme related) are AR but which enzyme deficiency is XR?

A

G6PD def

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12
Q

Galactosemia diet

A

eliminate lactose, no breast feeding

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13
Q

Tachypnea in newborn lasting more than 4 hours is

A

no longer transient rule out sepsis

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14
Q

Treatment of subconjunctival hemorrhage

A

none will resolve

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15
Q

3 types of neonatal skull fractures

A

linear common resolves
depressed must repair
basilar fatal

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16
Q

Constrast caput and cephalohematoma

A

hematoma confined to suture lines

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17
Q

Cephalohematoma is aka

A

subperiosteal hemorrhage

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18
Q

Best treatment for brachial plexus injury

A

immobilization

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19
Q

Two common brachial plexus injuries:

A

upper: 5-6; adducted/internally rotated arm (waiters tip)

lower 7-8/1: claw hand + horners (MAP)

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20
Q

What causes facial nerve paralysis in delivery

A

forceps

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21
Q

Common causes of polyhydramnios

A

unable to swallow

werdnig Hoffman-neuro; intestinal atresia

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22
Q

Causes of oligohydramnios

A

prune belly (no muscles); renal agenesis/potts

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23
Q

Appearance of baby with oligohydramnios

A

flat face because compression/ no buffer with amniotic fluid

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24
Q

Two types of CDH

A

Bochdalek- posterolateral, L

Morgagni- retro/parasternal

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25
Causes of high AFP
``` #1 wrong dates abdominal wall defects NTDs ```
26
Cause of omphalocele
failure to retract at 10-12 wks GA
27
At what age must umbilical hernia be repaired
4 but most regress before this time
28
Location of gastroschisis
lateral
29
WAGR syndrome features and chromosome
wilms, aniridia, gu malformation, retardation.... chromosome 11
30
First test for wilms tumor
US
31
Neuroblastoma clues
dancing eyes and feet, hypsarrythmia on EEG; high VMA/ metanephrines
32
Hydrocele clinical appearance + cause
painless, transluminates | origin: tunica vaginalis remnant
33
Varicocele appearance + cause
bag of worms; check both sides usually bilateral; dilated pampiniform plexus
34
Cryptorchidism is assc with what risk
malignancy
35
When must cryptorchidism be repaired
before age 1 to avoid sterility
36
Hypo vs epi spadias
hypo- under- ventral | epi- on top- dorsal (like a fin)
37
What is hypospadias assc with
cryptorchidism, ingiuinal hernias
38
What is epispadias assc with
bladder exstrophy
39
Chromosome assc with TOF
22
40
TOF murmur-
VSD murmur (holosystolic, LSB)
41
VSDs are common in what disorders?
all trisomies
42
What are the 3 holosystolic murmurs
VSD TR MR
43
TGA murmur + xray findings
single S2 heard; egg on a string
44
Percentage of patients that survive TGA surgery
1/4
45
Pulsus paradoxus assc
TPTX; Tamponade
46
Hypoplastic left heart murmur + pulse + CXR findings
single S2; NO PULSE globular shaped heart very few survive surgery
47
TA murmur + pulse
systolic ejection murmur, single S2; bounding pulses
48
TA sequelae if not repaired
repair within 4 months or get PHTN
49
TAPVR w or w/o obstruction....what does the obstruction refer to?
angle that the vein enters sinus
50
All heart defects with L --> R shunt have what EKG finding
RVH
51
Cyanotic heart defects have what shunt type? Get what treatment?
R --> L; all get surgery
52
What are the cyanotic heart defects ?
``` 5 T's transposition Truncus TOF TAPVR TINY left heart ```
53
Which of the 5 cyanotic defects have VSDs
TOF; Truncus
54
Which of the cyanotic defects are PDA dependent
Transposition | Tiny left heart
55
Conservative medical treatment of VSD
diuretics and dig
56
Heart defect assc with paradoxical emboli
ASD
57
During what window is PDA normal?
24 hours after birth
58
Where do sounds from each valve radiate?
aortic-neck mitral-axilla tricuspid and pulm- back
59
``` Match the CXR finding to the cardiac defect: pear- boot- egg on a string- globular- jug handle- rib notching- ```
``` pear- pericardial effusion boot- TOF egg on a string- TGA globular- Tiny LH jug handle- PPAHTN rib notching- Aortic Coarctation ```
60
Syncope, hearing loss, normal vitals & exam=
Long QT syndrome
61
Treatment of coarctation
surg
62
When is jaundice concerning
day 1; week 2 more than 5+/day more than 19.5 t bili more than 2 direct
63
When to do exchange for jaundice
20-25 total
64
Most common type of esophageal atresia
proximal atresia and distal TEF
65
Pre-op care for TEF
px abx for anaerobic coverage | fluids bc cant swallow
66
To what GI conditions do each of the radiographic "signs" apply? - string sign - doughnut sign - birds beak - steeple
- string: PS - doughnut: intussusception - birds beak: achalasia - steeple: croup
67
PE signs of pyloric stenosis
succusion splash | olive
68
Choanal atresia description
membrane between nostrils and pharyngeal space
69
Clinical presentation choanal atresia
blue with feeds; pink when crying
70
How to dx choanal atresia
ct
71
CHARGE assc
``` coloboma/CNS heart defects atresia, choanal retardation of growth GU abnl ear abnl ```
72
Duodenal atresia clinical signs +assc syndrome
bilious vomiting, no respiratory distress | assc with downs
73
Test for duodenal atresia
AXR --> double bubble
74
Clinical signs of hirschspruings
tight rectal sphincter unable to pass stool or flatus, no meconium first 48 hours
75
Mainstay dx of hirschsprungs + assc syndrome
downs, full thickness rectal bx (no ganglionic cells in submucosa)
76
Cause of duodenal atresia
lack of apoptosis
77
Most common location volvulus in childhood
midgut (ileum) | --> see birds beak like in achalasia
78
Two assc with intussusception
rotavirus vaccine, HSP
79
Onset of duodenal atresia vs volvulus
duodenal atresia at birth volvulus within first year
80
Only true congenital diverticulum + tissue makeup
meckles, all three layers, ectopic gastric tissue + pancreatic
81
Rules of 2's for meckels
``` within 2 ft ileocecal valve 2 in long 2 tissue types 2% pop; 2% symptomatic males 2x more common ```
82
Diagnostic tests for diarrhea in kiddos
1) stool for blood and leukocytes 2) O&P 3) +/- c diff
83
What is always bad for diarrheal illness in kiddos?
loperamide
84
Three common viral illnesses causing diarrhea
rota, noro, adeno
85
Which diarrheal illness is most common in the winter?
rota
86
Which diarrheal illness is 1-2 days instead of a week?
noro- short
87
What is literally never ever ever the answer on step 2?
calling a consult
88
Management of NEC
abx (vanc, gent or metro) fluids bowel rest NGT for decompression
89
Metabolic derangement in IDM
-low glucose NOT HIGH! They overproduce insulin -Low Ca,mag -High bili
90
Phyiscal abnormalities in IDM
- macrosomia (all organs but brain) - small left colon - cardiac abnl - RVT
91
MCC CAH
21 hydroxylase def
92
How to dx CAH
17OHprog/electrolyte levels
93
Cortisol, test, aldo = three products of steroid synthesis. In 11/17/21 def, which of these products are high?
21- sex hormones (test) high 11- sex hormones + DOC high 17- aldo high
94
Which of the CAH forms have hypertension?
all hypertensive except 21 = salt wasting shock
95
3 forms of rickets in which is phosphate normal?
1) lack of vitamin D 2) inability to convert D --> OHD 3) X linked hypophos (inability to retain phosphate) #2= normal phosphate
96
Treatment for rickets
ergocalciferol or 1,2/calcitriol and monitoring
97
Supplements for breast fed babes
D starting at 2 months
98
Early causes of neonatal sepsis
GBS, e coli, listeria
99
Late causes of neonatal sepsis
staph, e coli, GBS
100
Abx for neonatal sepsis
Amp and Gent +/- cefotaxime
101
TORCH infection treatment
``` T-toxo- pyrimethamine O/syphilis- penicillin R-rubella-support C- CMV- ganciclovir H- HSV- acyclovir ```
102
Toxo presentation (neonate_
chorioretinitis, hydrocephalus, intracranial calcifications
103
Syphilis presentation in babe
rash on hands and feet snuffles, saddle nose, 8th nerve palsy
104
Rubella presentation in babe
blueberry rash, PDA, deagness, cataracts etc
105
CMV presentation in babe
cross between toxo and rubella BUT: periventricular calcifications
106
HSV presentation in babe
shock/DIC wk 1 --> skin lesions wk 2 --> encephalitis wk 3
107
Rubeola (measles) presentation in kiddos
3 C's --> koplik spot in mouth
108
Roseola virus + presentation
HHV 6-7 | high fever --> rash
109
Scarlet fever is different than Kawasaki because?
assc with PHARYNGITIS concurrently.
110
Treatment of scarlet fever
penicillins, azithro, cephalosporin
111
Treatment of croup +assc viruses
racemic epi | Parainfluenza, RSV
112
Croup clinical signs
inspiratory stridor, barking cough
113
Epiglottitis treatment
intubate + treat with ceftriaxone for at least a week; rifampin for close contacts
114
Dx & Treatment of pertussis
PCR of nasal secretions Treat with emycin/azithromycin in catarrhal stage (early before bad cough) *Macrolides for contacts
115
Treatment of diphtheria
antitoxin (abx don't work) | **don't scrape the membranes
116
Age group for Legg Calves Perthes + pathogenesis
2-8 avascular necrosis if happens to one side will happen to the other
117
B2/riboflavin def symptoms
angular chelosis stomatitis glossitis
118
B5/B6 def
B5: burning feet B6: peripheral neuropathy + anemia
119
What are B1-3
1: thiamine; 2: riboflavin; 3: niacin
120
Vitamin A and PTH function
low- hypoparathyroid | high- hyperparathyroid

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