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Pediatrics > Peds 101, part 2 > Flashcards

Peds 101, part 2 Flashcards

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1
Q

itchy webs of hands and axilla, maybe in whole family: dx? tx?

A

Scabies

dx: scrape skin to see eggs on scope
tx: topical permethrin or lindane

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2
Q

itchy scalp +/- nits: dx? tx?

A

Lice

dx: clinical
tx: permethrin, hair cut

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3
Q

itchy butt: dx? tx?

A

Pinworm

dx: tape test
tx: albendazole

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4
Q

PCP ppx

A

bactrim, dapsone

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5
Q

toxo, MAC, ppx

A

bactrim, azithromycin

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6
Q

fussy baby with bulging fontanel: most common organisms, empiric treatment?

A

Meningitis:

  • GBS, Ecoli, Listeria
  • Ceftriaxone, Vanc, Ampicilin +/- steroids
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7
Q

dx meningitis

A

LP w/ cx and sensitivities

CT if signs of increased ICP

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8
Q

adolescent with HA, N/V, nuchal rigidity: MC organisms and empiric treatment?

A

Meningitis:

  • H flu, S. pne, Neisseria
  • Ceftriaxone, Van, +/- steroids
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9
Q

MCC viral meningitis; tx?

A

HSV, acyclovir

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10
Q

petechial rash = ___ until proven otherwise

A

N. meningitides

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11
Q

MCC osteomyelitis

  • everyone
  • puncture wound
  • sicle cell
  • animal bites
A
  • S. aureus
  • Pseudomonas
  • Salmonella
  • Pasturella
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12
Q

active TB tx

A

Rifampin
INH
Pyrazinamide
Ethambutol

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13
Q

latent TB tx

A

INH

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14
Q

bilateral facial rash after non-specific prodrome. Greatest risk?

A 
Erythema infectiosum (Parvo B19)
- if mom is pregnant, separate (hydrops fetalis)
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15
Q

Parvo B19 increases risk for __

A

aplastic crisis

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16
Q

low-grade fever, cough coryza, conjunctivitis and Coplik spots

A

Measles (paramyxovirus)

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17
Q

after prodrome, rash spreads from head to toe in conjunction with fever (kid looks very sick)

A

Measles

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18
Q

macular rash starts of face and spreads to toes (kid not too sick)

A

Rubella

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19
Q

potentially lethal complication of measles?

A

subacute sclerosing panencephalitis

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20
Q

prodrome of tender lymphadenitis (periorbital, periauricular)

A

rubella

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21
Q

prodrome of high fever (>40C) with rash starting as fever breaks

A

Roseola (HHV-6)

*risk of febrile seizures!

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22
Q

macular rash that begins on trunk and spreads to face

A

roseola

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23
Q

non-specific prodrome leads to bl parotid swelling + orchitis in pubertal males: dx?

A

Mumps

- Pickle test (inducing salivation)

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24
Q

oral pain + vesicles with erythematous bases (non-specific prodrome) on feet and hands

A 
Coxsackie A (hand-foot-mouth)
*may also involve buttocks
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25
trauma + LOC with lucid interval: tx?
epidural hematoma | - evacation
26
trauma + LOC /wo lucidity
Subdural hematoma | - evacuation, ICP
27
Tx concussion without LOC or amnesia (grade I)
20 min rest
28
Tx concussion w/ LOC but no amnesia (grade II)
1 week rest
29
Tx concussion w/ LOC + amnesia (grade III)
1 month rest
30
punctate hemorrhage on CT s/p major trauma
cerebral contusion, manage ICP
31
size of child for car booster seat (transition from rear-facing car seat):
4ft + 40 lbs
32
salt water drowning is worse than fresh water - why and tx?
increased pulmonary edema | - give PEEP
33
drowning prevention: (3)
locked gates around pools supervision life jackets (not arm floaties)
34
epidermis only: pain + erythema
1st degree burn
35
epi + dermis: pain, blisters + erythema
2nd degree burn
36
through dermis, white and painless with surrounding 2nd degree
3rd degree burn
37
Parkland formula
%BSA x Kg x 4 + MIVF - 50% in 8hrs - 50% in 16hrs
38
Rule of 9s (admit >__% BSA)
``` admit >10% BSA head: 18 front thorax: 18 back: 18 arm/arm: 9/9 legs: 9/9/9 ```
39
1st line tx for epilepsy (3)
lamotrigine valproate phenytoin
40
2nd line for epilepsy
ethosuxamide (absence) | carbamazepine (tic dela reux)
41
infant with bl clonus of UE or head + afebrile: dx? tx?
West syndrome (infantile spasm) dx: interictal EEG --> hypsarrhythmia tx: ACTH (will not treat psychmotor retardation) f/u: mental retardation and poor prognosis
42
seizures + ash-leaf spots, with or without fevers: dx? tx? f/u?
Tuberous sclerosus dx: CT - tubers tx: supportive f/u: mental retardation + sebacious adenomas
43
prognosis for absence szs?
kids will generally outgrow
44
common misdiagnosis for absence szs?
ADHD
45
inspiratory wheezing
upper airway
46
expiratory wheezing
lower airway
47
CXR finding with foreign body aspiration
+ coin sign (tracheal rings prevent object from protruding, except posteriorly)
48
bronchiolitis age range
49
infant or young toddler in winter with wheezing that does not respond to B2-agonists and normal CXR
bronchiolitis
50
criteria for hospitalization with b'litis
SpO2
51
foreign body aspiration
52
inspiratory wheeze of the upper airway
stridor
53
low-pitched inspiratory sound, resembling snoring or gasping
stertor
54
toddler with mild viral prodrome, followed by barking cough worse at night and inspiratory stridor: organism? cxr sign? tx?
Croup (laryngo-tracheo-bronchitis) - parainfluenza > RSV - steeple sign on CXR - tx significant respiratory impairment with supplemental O2 and racemic epinephrine (improvement confirms dx)
55
3-7yo with sudden onset high fever, tripoding and drooling: cxr finding? organism? tx?
Epiglottitis - thumb print on cxr - Hib - OR for controlled intubation, abx
56
3-7yo with fever and drooling, lying supine with neck extended - suspect __?
retropharyngeal abscess (staph/strep)
57
suspect croup, but child does not respond to racemic epi and appears quite ill - dx? organism? dx? tx?
bacterial tracheitis - S. aureus, S. pne - cx or visualize pus - abx
58
>10y with hot potato voice and drooling: dx? organisms?
peritonsillar abcess | - strep/staph
59
newborn with 0 UOP, suspect __ and do __. confirm dx with ___
obstructive renal failure (posterior urethral valves); cath to relieve pressure on bladder; voiding cystourethrogram
60
colicky flank pain s/p 1st EtOH binge
ureteropelvic junction obstruction - confirm with IVP
61
female with constant urinary leak, suspect __
low implantation of ureter (surgical correction)
62
frequent UTIs or pyeolnephritis, suspect __, get ___
vesicoureteral reflux; VCUG | - tx surgically, or give abx and wait for kit to grow out of it
63
hematuria in a kid: think ___
always warrants dx workup - cancer, congenital anomaly - U/S, and IVP (avoid CT)
64
egg allergy/hypersensitivity is a contraindication for which vaccines?
MMR yellow fever influenza
65
immunodeficiency is a contraindication for which vaccines?
Varicella MMR influenza
66
normal reaction to vaccine in infant
fever
67
pathologic reaction to vaccine
seizures >105F anaphylaxis >3hrs inconsolable crying
68
presents with high fever, dyspnea and dysphagia: what vaccine is missing?
DTaP
69
tx lockjaw and painful spasms in anti-vaccer's kid?
IVIg, sedation and support and immunize (infection does not convey immunity!)
70
+HBV mom: give baby ___ and ___
IVIg and HepB vaccine NOW
71
-HBV mom: give baby __ at __
HepB vaccine within 2 months
72
unknown HBV mom: give baby ___
HepB NOW
73
DTaP: requires __ doses in 1st year __ doses before 4yrs old ______ booster q__yrs
3 2 tetanus booster q10yrs *if dirty wound >5yrs after vaccination, give IVIg and tetanus toxoid
74
give MMRV vaccine and booster before ___
school
75
vaccinate all >65 + lung dz q5yrs and all asplenics and immunocompromised
pneumococcal
76
HAV and HBV vaccines require __ doses
3

Pediatrics (5 decks)

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