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Online Med Ed notes DF > Pediatrics > Flashcards

Pediatrics Flashcards

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1
Q

erythema infectiosum is caused by what and another name

A

parvovirus B19

slapped cheek

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2
Q

f/u problems with erythema infectiosum

A

aplastic crisis especially in sickle cell

hydrops fetalis

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3
Q

infectious disease high fever over ___ and rash after fever breaks disease?

distribution

f/u

A

104

roseola

starts trunk then spreads out

f/u: febrile seizures

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4
Q

varicella zoster rash without what

what stages

A

without fever

rash in different stages

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5
Q

what does shingles never do

tx

A

crosses midline

it is in dermatomal pattern

tx: acyclovir
ppx: vaccine over 60

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6
Q

measles is from what virus

what prodrome

associated syptoms

F/U

A

parvomixovirus

fever and rash at same time on face then down trunk
clears this way as well

cough
coryza
conjunctivits
koplik spots (white dots on mouth)

f/u: SSPE

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7
Q

rubella is called what

lesion distribution

prodrome

A

german measles

rash on face then trunk and arms

fever and rash at same time

**prodrome: generalized and tender LAD

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8
Q

what is a possible consequence of mumps to f/u on

A

infertility with orchitis

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9
Q

hand foot and mouth disease looks like what in that distribution

caused by what

A

varicella looking

coxsackie A

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10
Q

URI bugs in otitis media

A

strep, moraxella, h flu

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11
Q

OM is infection of what

A

middle ear, tympanic membrane

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12
Q

diagnosing OM

A

pneumatic insulflation

air in and TM stays rigid

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13
Q

treatment of OM

1st

recurs

recurs a lot

if pen allergy non life threat

if life threat pen allergy

A

amoxicillin first

if recurrs then amox-clav

if recurs a lot then ear tubes (3x in 6 months or 4x in a year)

if have penicillin allergy thats non life threatening use cefdinir

if have severe anaphylaxis use azithromycin

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14
Q

otitis externa

path: location
bugs

pain worse with what, looks how

A

outer ear

swimmer–> pseudomonnas
digtial–> staph

pain worse with pulling, erythema, angry canal

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15
Q

tx of OE

A

spontaneously resolved
abx drops (cipro)
steroids

only if bad use abx and steroids

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16
Q

when do you treat sinusitis and with what

A

if temp over 38 degrees celcius
duration of 10 days or more
or keeps getting worse

amoxicillin-clav
PCN

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17
Q

mastoiditis path

pt from what disease, looks how

dx

tx

A

URI bugs

tympanoplasty (hole from surgery)

acute OM, mastoid swelling behind the ear, anterior rotated ear

dx: clinical or CT
tx: surgery

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18
Q

pharyngitis viral or bacteria?

1 or less
2-3
4 or above

A 
Cough +1
Exudates +1
Nodes +1
Temp at or over 38 degrees C +1
Or at/under 14, at/over 44 +1

CENTOr

1 or less = viral
2-3 = get rapid strep, if negative and still suspicious then culture

if 4 or above then abx: amoxicillin-clav

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19
Q

urtricaria (rash) all over, hyptension and wheezing is what

A

anaphylaxis

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20
Q

how to treat anaphylaxis

A

epi 1:1000 IM
support airway with intubation, and BP with IV fluids and presors if needed

H1 and H2 blockers and albuterol and maybe steroids
-adjunctive therapy

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21
Q

urtricaria sx

A

wheal
whelt
erythema

NO hypotension

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22
Q

tx for utricaria

A

2nd generation H1 antihistamines and remove/avoid the offending agent

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23
Q

angioedema sx

A

swelling with no wheal from ACEi

swelling of airway with NO hypotension

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24
Q

angioedema tx

f/u?

A

secure airway
h1/h2 blockers
steroids

f/u: C1esterase deficiencey causing angioedema give FFP

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25
sx allergic rhinitis
shiners under eyes transverse nasal crease (allergic salute) pale boggy mucosa polyps cobblestoning of posterior oropharynx
26
tx of allergic rhinitis
``` intrnasal steroids (for test) and avoid trigger ``` intranasal antihistamines are also considered 1st line oral antihist and LTA too
27
food allergy sx disease associated
N/V/D eczema, atopic dermatitis anaphylaxis so have epi pen
28
milk protein allergy sx
N/V/D (bloody stool) | FTT
29
tx milk protein allergy
switch to cow milk, breast milk, or hydrolyzed formula from soy formula
30
anaphylaxis needs involvement of how many organ systems examples
2 CV: hypotension GI: diarrhea skin (hives) pulmonary (airway edema)
31
pathogenesis of urticaria
type I HS non immunologic mast cell degranulation (contrast, opiates, red man syndrome from vanco) wheals and erythema limited to superficial layers of dermis
32
compared to urticaria, angioedema has what involvmeent
deeper involvement of tissue and potential for mucous membrane involvement
33
diagnostic testing of allergic rhinitis if needed
skin testing | then serum testing (RAST)
34
treatment of allergic conjunctivits
avoid triggers combo eye drops (mast cell stabilizers and antihist) oral antihistamines
35
scaly skin on the extensor surfaces of infants and young children or flexor surface in older children
atopic dermatitis
36
dx crohns and tx (is it curative?)
EGD and colonoscopy see skip lesions meds, still recurs
37
dx ulcerative colitis tx is curative? monitor
colonscopy, continuous lesion surgery cures 8 yrs after dx do colonscopy every year
38
preamture baby with GI bleed
NEC
39
tx for NEC
NPO< IVF, TPN, IV abx
40
apt for intusssuception
abrupt sudden onset of colicky abdominal pain with knee chest relief
41
currant jelly diarrhea
intussusception from dead bowel sloughing off
42
what will you see on a PE of intuss
sausage shaped mass in RUQ
43
dx intuss 3 of them
KUB shows evidence of late disease: perforation or obstruction, not useful in dx U/S is sensitive and can track it see target sign air enema diagnose and treats it
44
when do you go to surgery with intuss
peritonitis perforation failed air enema
45
how do you diagnose bloody stool if baby swallowed moms blood
APT test fetal blood is resistant to denaturation so positive test = further investigation maternal blood will yield negative test, so reassurance
46
other reasons kids have bloody stool besides disease
swallow mom blood swallow own blood (epistaxis) iron supplements, beats, meds
47
painless intermittenet hematochezia (bright red stool) in children (toddler)
meckels diverticulum
48
dx meckels diverticulum in kids teens?
technicium-99 | teens would be CT
49
dx NEC
babygram
50
what is the most common cause of hematochezia in infants and associated with what in older children think what?
anal fissure from tear in anal mucosa associated with constipation in older children think IBD
51
age of intuss most common
3 months to 3 years espn shows NFL highlights of intusserceptions
52
meckels diverticulum is a remnant of what
omphalomesenteric (vitelline) duct which can contain gastric tissue, can lead to acid secretion and cause ulcers to form
53
how does meckels diverticulum present in child
FOBT + IDA or hematochezia in child painless bleeding and may be intermittent
54
rule of 2s meckels diverticulum
``` <2 yrs old 2x more common in males 2 inches long 2 feet from ileocecal valve 2% of population ```
55
peak age IBD
10-20 50-80
56
what is helpful for IBD dx
double contrast enema and colonscopy
57
if a pt has bloody diarrhea plus fever think what
shigela, salmonella, ecoli, yersinia etc
58
workup if think infectious colitis
obtain stool cultures and blood culutres if pt is septic hydration and electrolyte management no abx unless suspect shigella, or immunosuppression patient
59
diagnosing asthma in children
history of intermitent or chronic sx of asthma and muscial wheezing found on PE
60
ominous signs in asthma exacerbation
decreased wheezing or lung sounds and hyperresonance
61
asthma exacerbation no O2 needed, no wheezes and PEFR over 70% then do what
send home with inhaler and prednisone
62
asthma exacerbation need increased O2 increased Co2 decreased lung sounds PEFR under 50% do what
ICU ventilator IV methylprednisone continuous nebs
63
asthma exacerbation sending person to floor
neubs iv steroids transition to inhaler and oral pred
64
sx of asthma exacerbation what do you do
DOSE Duonebs (ipratrop and albut) O2 (keep O2 sat over 90%) Steroids (IV or PO) Experiatory flow rate assessment
65
charcot leyden crystals or curschmann's spirals is what disease
asthma
66
for exercised induced asthma what drugs
nedocromil or cromolyn sulfate used right before exposure
67
rescue therapy for refractory disease in asthma involves what
racemic epin nebs, subcut epi IV magnesium added to attempt to avoid intubation
68
when pt first arrives to ED with asthma exacerbation what should be performed? improve in between no more better
peak flow if no improvement after 3 hrs of continuous nebs then go to ICU if better (100% improvement and sx free) go home with rescue inhaler and PO steroids if in between then floor for further managment (duonebs Q4 hrs with ongoing oral or IV steroids)
69
if pt has to go to ICU for asthma exacerbation then what managment
Intubation IV steroids( high dose) ECMO (life support)
70
grand mal seizure LOC and general or partial
yes LOC general
71
generalized with no LOC
pseudo seizure
72
if you lose consciousness what kind of seizure, what if do not
LOC = complex no LOC = simple
73
infantile spasms aka what? age parts affected fever? dx tx f/u
west syndrome pt under 1 b/l symmetric limb jerk not generalized no fever dx: interictal EEG shows hypsarrhytmia tx: ACTH f/u intellectual disability
74
pt age for febrile seizures
6-60 months
75
febrile seizures if longer than 5 mintues do what
abort with benzos
76
never use what with febrile seizures
aspirin bc of Reye syndrome
77
simple febrile seizure workup dx
doesn't need one its 1 in 24 hrs less less than 15 mintues generalized
78
is a seizure focal, >___ min in duration or ____ within the day then workup for what
15, recurrent complex febrile seizure EEG, MRI, LP
79
asthma: intermittent Day episodes, night, FEV1, treatment
less than 2 a week, 2 or less a month at night, 80% -SABA PRN
80
asthma: mild Day episodes, night, FEV1, treatment
not daily during day, more than 2 month at night 80% SABA + ICS
81
asthma: moderate Day episodes, night, FEV1, treatment
once or more a day and over once a week 60-80% -SABA, ICS, LABA
82
asthma: severe Day episodes, night, FEV1, treatment
one or more a day, night time frequently, 60% or less SABA, higher dose ICS, LABA,
83
asthma: refractory tx
oral steroids
84
what to watch for in asthmatics with tx not working
can they use correctly add spacer med adherance
85
severe asthma exacerbation what is first step
DOSE Duonebs, Oxygen, steroids, expiratory flow rate assessment
86
severe asthma exacerbation if going to floor do what
IN the floor IV steroids Nebulizer
87
severe asthma exacerbation if going to ICU do what
ventilator IV methylpred continue nebs
88
kid fracture, when to go to ORIF what next
open communited + growth plate fracture then cast
89
age for developmental dysplasia of hip sx dx tx
newborn, clicky hip US @ 4 weeks harness
90
age for legg C P disease sx dx tx
age: 6 yrs old patient: insidious antalgic gait (spend less time on painful leg) dx: Xray tx: cast
91
SCPE age and pt and Dx and tx
13, growth spurt or fat ass with non traumatic joint pain, frog legg XRay surgery
92
septic joint age pt dx tx
age: any pt: fever, increased WBCs, incresaed inflammatory markers, cannot bear weight dx: arthrocentisis with over 50,000 species tx: drain and abx
93
severe scoliosis can lead to what
dyspnea
94
test for scoliosis
adams test | xray too
95
tx for scoliosis
brace or surgery
96
pt witll always be what on test question for scoliosis
teenage girl
97
location of osteosarcoma
distal femur
98
kocher criteria is for dx what and tell me what it is
septic joint non weight bearing ESR >40 Fever >38 C WBC >12,000 1: not septic 2: not sure 3: 93% septic 4) 99% septic
99
transient synovitis sx tx
synovial inflammation up to 4 weeks afer URI or GI viral illness no fever, leukocytosis, and decreased inflammatory markers treat supportively
100
diagnosing chronic granulmatous disesae
nitroblue or Dihydrotamine test
101
on quantitative Ig what would you see for CGD tx?
increased IgM and IgG BM transplant
102
what would you see in labs for LAD and what infections and treatment
incrased peripheral leukocytosis with increased neutrophils recurrent skin and mucosal bacterial infections BM transplant
103
giant granules in neutrophils is what cx features
chidiak hagashi syndrome neuropathies and neutrophenia and albinism
104
CGD what would you see on CBC and Quant IG
increased WBC incrased IgM and IgG
105
what pouch messed up in digeorge syndrome
3rd
106
x linked agammaglobinemia presents when b cells and Igs confirm with what treatment
early no b cells now Ig MAG confirm with BTK gene scheduled IVIG and then BM transplant
107
CVID age presentation cbc quant IG tx
later in life like teens normal CBC quant IG shows 2/3 dcreased Igs (MAG) scheduled IVIG may be warrented but may not need
108
which inherited immunodef has anaphylaxis with blood transfusion
IgA defieiency
109
general rules immunodefieicny 6-9 month problem? 6-12 month problem? over 12 months?
6-9 T 6-12 T and B >12 B
110
treatment for hyper IgM syndrome
scheduled IVIG
111
fungal or PCP pneumonia in baby should be red flag for which inherited disease imunnodef
digeorge so give tmp smx and scheduled IVIG and thymic transplant
112
ataxia telangiectasia
telangiectasias + ataxia poor DNA repair lymphoma and leukemia
113
Hyper IgE (job) syndrome IgE, peripheral levels infections with what other related stuff
severely elevated IgE levels peripheral eosinophilia recurrent cold abscesses (strep, h flu, strep pneumo) exzema, retained primary teeth

Online Med Ed notes DF (4 decks)

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