Peds 101 Flashcards
(110 cards)
1
Q
given for immediate relief of allergies
A
intranasal corticosteroids
2
Q
name of skin test for allergic triggers
A
RAST skin test
3
Q
eczema has high assoc. with __ and __
A
asthma, seasonal allergies
4
Q
in very young kids, eczema appears on the __ in response to a ___
A
face; new food exposure
5
Q
in older kids, eczema occurs on the ___ and is ___
A
flexor surfaces; pruritic
6
Q
eczema excoriations can lead to __ and __ (in adulthood)
A
infection - Strep/impetigo, Staph; lichenification
7
Q
tx eczema
A
topical corticosteroids,
8
Q
VACTERL
A
Vertebral (XR) Anal (imperforate) Cardiac (ECHO) Tracheal Esophageal Renal (U/S) Limbs (thumbs, especially)
9
Q
newborn presents with choking with feeds and excessive salivation
A
esophageal atresia
10
Q
dx esophageal atresia
A
NG tube coils on CXR
11
Q
tx esophageal atresia
A
surgical and look for VACTERL anomalies, especially cardiac and renal
12
Q
after dx imperforate anus, get a ___ and tx how?
A
babygram - if blind end of colon is near anus, correct now. if far, colostomy then repair before potty training begins
13
Q
hear bowel sounds over lungs, scaphoid abdomen and dyspnea in a baby:
A
congenital diaphragmatic hernia
14
Q
term for anterolateral diaphragmatic hernia
A
morgagni hernia
15
Q
what is the problem with a diaphragmatic hernia?
A
hypoplastic lung - may require ventilation
16
Q
gastroschisis presents R or L of midline?
A
R (no membrane, too)
17
Q
tx gastroschisis and omphalocele?
A
create a silo, slowly reduce contents over time
18
Q
tx extrophy of bladder
A
surgical emergency
19
Q
bilious vomiting + multiple air fluid levels on babygram
A
intestinal atresia (tell mom to stop the cocaine)
20
Q
bilious vomiting + double bubble + normal gas patterns beyond
A
malrotation
21
Q
if suspect malrotation, f/u with
A
contrast enema and upper GI series
22
Q
bilious vomiting + double bubble + T21
A
duodenal atresia
23
Q
tx malrotation
A
emergent surgery
24
Q
Premie w/ bloody diarrhea, drop in platelet count and abdominal distention
A
necrotizing enterocolitis
25
dx necrotizing enterocolitis
babygram: pneumatosis intestinalis
26
tx premie with nec. enterocolitis
stop feeds and switch to TPN, give IV abx. surgery if pneumatosis intestinalis is present
look for RDS and IVH (CXR and brain U/S)
27
CF + bilious vomiting + no BM
meconium ileus
28
CXR: meconium ileus
multiple dilated loops of bowel + ground glass appearance
29
tx pyloric stenosis
fix electrolytes then myomectomy
30
lytes w/ pyloric stenosis
hypochloremic, hypokalemic metabolic alkalosis
31
neonatal jaundice not resolved at 6-8 wks, r/o __ with ___
biliary atresia; HIDA scan after 1wk phenobarbital (failure of bile to reach duodenum, even after phenobarbital stimulation)
32
dx/tx intussusception
air enema
33
most common URI bugs and how to treat them:
```
S. pne
H. inf
Moraxella
Catarrhalis
Tx: Amox +/- clavulanate
```
34
most common otitis externa bug and tx? 2nd most common?
Pseudomonas; spontaneously resolves (educate parents to dry ears after swimming)
S. aureus
35
tx bloody nose:
```
cold compress
lean FORWARD
humidified air
ablation
*posterior epistaxis may require packing (tampon)
```
36
viral vs. bacterial
viral: short, low-grade fever, mild
bacterial: longer, high fever, worse symptoms
37
tx otitis media?
| risk of not treating?
amox (add clavulanate if does not resolve)
| spread to mastoid, inner ear, and brain
38
sinusitis >7dd + cough: tx?
presume bacterial, give amox
39
Sensitivity and specificity of rapid strep test
specific, not sensitive, so if neg, get a cx (tx does not need to be started until cx come back)
40
Centor criteria for GAS
+1 for: fever, exudates, adenopathy, -cough, 44y
| 4: empiric tx (augmentin)
41
baby presents blue at rest and pink with crying (or if the kid snores)
choanal atresia (snoring = partial obstruction between mouth and nose)
42
FTPM >48hrs + abd distension at
barium enema, then full thickness bx (Hirschprung's)
43
FTPM >48hrs + abd distension at >1mo, + chronic constipation + explosive diarrhea after DRE, get ___
anorectal manometry then full thickness bx (Hirschprungs)
44
tx meconium ileus
gastrografin enema, enzymes (pancreatic insufficiency) and pulmonary toilet
45
intermittent diarrhea and/or encopresis
think voluntary constipation (colon is working just fine) - take to OR for disimpaction, educate child that it is okay to poop
46
tx anal fissure in baby
heals on its own (babies usually have diarrhea)
47
courant jelly stool
indicates bowel necrosis 2/2 intussusception
48
Meckel's diverticulum = remnant of the ___ and presents with __. Dx __
Vitelline duct (gastric mucosa); painless GI bleeding; technicium-99 scan
49
child presents with melena
| baby presents with melena
look for hx of epistaxis
| perform Apt Test: mom vs. baby's blood
50
maternal Ab are present for __ mo after birth (approximately)
6
51
baby with recurrent infxns, prolonged infxns or wierd bugs, get __ and __
Ig levels + CBC
52
X-linked Agammaglobulinemia of Bruton: all Ig are deficient, low B-cells, compensatory increase in T-cells
53
Tx X-linked Agammaglobulinemia of Bruton
prophylactic abx + monthly Ig
54
most common and most benign immunodeficiency
IgA deficiency
55
pt: anaphylaxis s/p blood transfusion
IgA deficiency
56
low IgA, IgG, high IgM
hyper IgM deficiency (no differentiation)
57
deficiency of the 3rd pharyngeal pouch
22q11.2 deletion syndrome
58
micrognathia + wide-spaced eyes + low-set ears + fungal or PCP infxn
suspect 22q11 del, look for cardiac defect, absent thymic shadow
59
in children w/ 22q11del syndrome, pay close attention to the __ level. why?
Ca; no parathyroids --> hypocalcemia --> seizures
60
boy + normal infxns + thrombocytopenia + eczema: tx?
Wiskott-Aldrich
Bone marrow transplant (still rarely survive to adult hood)
(elevated IgE and IgA)
61
ataxia + leukemia or lymphoma
Ataxia-telangiectaisa (DNA repair defect). incredibly rare, highly tested
62
Adenosine deaminase deficiency
SCID
63
kid with AIDS bugs and no viral load, dx, tx?
SCID; PCP/MAC ppx (bactrim, azithromycin), and BMT
64
chronic staph or aspergillus skin infections? dx?
Chronic granulomatous disease; confirm with negative Nitro Blue test (no respiratory burst)
65
massive leukocytosis + high fever + no puss + hx of delayed cord separation
Leukocyte Adhesion deficiency: PMNs cannot adhere or get out of blood vessels
66
albinism + neuropathy + neutropenia
Chediak-Higashi: AR, impaired microtubule polymerization
| *look for giant granules in PMNs
67
Neisseria infection...think of which zebra?
C5-C9 deficiency
68
angioedema?
C1 esterase deficiency
69
4 "characteristics" of unconjugated bilirubin (conjugated is opposite)
lipid soluble
crosses BBB
kernicterus
not excreted in urine
70
physiologic jaundice is associated with conjugated or unconjugated bilirubin?
unconjugated
71
```
pathologic jaundice:
onset __
bilirubin increases at __/day
D. bili ____%total
resolves in __wks (term), __wks (preterm)
```
5/day
>10% total
>1wk (term), >2wks (preterm)
72
yellow baby + elevated direct bili: get __, look for __
HIDA scan, U/S, sepsis, metabolic causes
73
yellow baby + elevated indirect bili + +coomb's:
isoimmunization: Rh disease, ABO incapatability
74
yellow baby + elevated indirect bili + -coomb's: get__
get Hgb level
- high: blood transfusion (twin-twin, maternal-baby, delayed cord clamping)
- normal: get Retic count
75
yellow baby + high indirect bili + -coombs + normal Hgb: get ___
Retic count
+: hemolysis (spherocytosis, G6PD, pyruvate kinase def)
-: Hemorrhage or breast milk jaundice
76
risk of kernicterus with indirect bili >__; tx __
20; exchange transfusion (if
77
purpose of blue lamps?
make indirect bili water soluble
78
how does insufficient breast feeding cause neonatal jaundice?
bowels too slow, body reabsorbs bilirubin --> increase # of feeds
79
does insufficient breast feeding cause elevated direct or indirect bilirubin?
indirect (must be unconjugated to be absorbed from gut)
80
breast milk jaundice MOA
breast milk inhibits glucuronyl transferase (conjugation enzyme)
81
one eye normal, one blind
amblyopia = cortical blindness
82
congenital cataracts and strabismus both put the infant at risk for:
amblyopia
83
light reflex come from different locations in each eye
strabismus
84
white retina
retinoblastoma
85
observe retinoblastoma pt for ___in future
osteosarcoma (in distal femur)
86
pt with congenital cataracts, think __ and __
TORCH and galactose deficiency
87
premie requiring high flow O2 is at risk for:
retinopathy of prematurity, tx with laser ablation
88
premie: look for:
retinopathy of prematurity
IVH
BPD
necrotizing enterocolitis
89
in neonate born to mother ith cervicitis or PID, tx baby for ___ with ___
conjunctivitis; erythromycin (or silver nitrate, though this burns and can produce chemical conjunctivitis)
90
baby develops purulent, bilateral conjunctivitis 2-5 days after birth, think:
Gonorrhea get cx or PCR, start topical erythromycin or neomycin (ppx); CAN TURN TO BLINDNESS
91
baby develops muco-purulent, bilateral conjunctivitis 7-12 days after birth, think:
Chlamydia; get cx or PCR; start oral + topical erythromycin or neomycin ppx; CAN TURN TO PNA
92
newborn with + Barlow's + Ortolani's, get:
U/S for hip dysplasia
93
6yo with insidious onset knee pain and atalgic gait, dx? tx?
Legg-Calve-Perthe Disease (avascular necrosis of hip); XRay and then cast
94
chubby 13yo with sudden onset hip and knee pain: dx? tx?
SCFE; frog-leg Xray; surgery
95
hip pain after febrile illness
septic hip - xray, aspirate w/ smear and culture; drain and give abx
96
teenage athlete with painful (non-edematous knee): tx?
Osgood-Schlatter;
- stop exercising and cast
- work through it (bump will remain for life d/t osteochrondrosis)
97
Adam's test
bending forward, asymmetric shoulders = scoliosis
98
low grade focal pain in distal femur
osteogenic sarcoma (sunburst, onion skin pattern)
99
low grade focal pain in midshaft
Ewing's sarcoma (T11;22)
100
tx fx involving growth plate:
open reduction and internal fixation
101
an innocent murmur is never ___ or > _/6
diastolic; 3
102
fixed wide split s2
ASD
103
most common congenital heart defect
VSD
104
harsh systolic ejection murmur, FTT, dyspnea and/or CHF
VSD
105
PDA must be closed by ___ months
6-8
106
most common cyanotic defect of the newborn, presents with cyanosis on day 1
TGA
107
TGA is associated with what maternal condition?
diabetic with poor control (NOT gestational diabetes - by 20wks, the heart has formed)
108
most common cyanotic defect in children
ToF
- overriding aorta
- pulmonary stenosis
- RV hypertrophy
- VSD
109
ToF CXR ptx:
boot-shaped heart
110
baby with HTN, claudication and temp difference between arms and legs
Coarctation of the Aorta
