1. impulsivity 2. inattention 3. hyperactivity before 7 y/o

Peds Flashcards by Kaylie Sniff

Musical, vibratory, high-pitched, systolic, LLSB or apex, carotid bruit, radiate to axilla, preschool age (2y/o- pre adolescence), decr with sitting/standing/valsalva

Still’s murmur

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soft, continuous, under clavicle, right >left infraclavicular, preschool age (after 2y/o), best heard sitting, decr supine/jugular compression

Venous hum

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systolic, eliminated by carotid compression, preschool +

Carotid bruit

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elevation of nipple only

Tanner 1

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elevation of breast and nipple, enlarged areola

Tanner 2

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areola and nipple form secondary mound above breast

Tanner 4

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projection of nipple only, not areola

Tanner 5

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male, vellus hair

Tanner 1

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long downy straight hair at base of penis, testes larger

Tanner 2

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curlier hair, testes larger, penis length incr

Tanner 3

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adult curly hair, penis length and width, testes larger

Tanner 4

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female, hair on medial thigh

Tanner 5

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female, straight hair on labia

Tanner 2

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female, curly hair on pubic symphysis

Tanner 3

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Brushfield’s spots

Downs

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white plaques do not rub off

oral candidiasis

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7days old-3mo. >3 hrs/day, >3days/wk, >3wks. Crying normal growth, healthy

colic

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MCC young gastroenteritis

rotavirus

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MCC old gastroenteritis

norwalk v

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study in GERD to r/o others

upper GI Xray

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projectile non-bilious vomit, FTT, olive mass RLQ, <12wks old

pyloric stenosis

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Dx pyloric stenosis

abdom U/S

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Dx & Tx intussusception

barium/air enema, admit all

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age intussusception

3mo-6y/o (MC 5-12 mo)

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don’t pass meconium 1st 24 hrs, constipation, NB= Dx test

Hirschsprung

abdom Xray

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Hirschsprung assoc with

Downs

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MC fetus intestinal obstruction

duodenal atresia/stenosis

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vomit within hrs of birth, pass meconium in 1st 24 hrs

duodenal atresia/stenosis

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duodenal atresia/stenosis Dx

abdom Xray, prenatal U/S

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Anti-HBs

immunity

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HBsAg

ongoing

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Tx neonate with HBsAg pos mom

HBIG

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jaundice 1st 24 hrs, coombs neg

hereditary sphero, G6PD

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umbilical hernia RF

full term, AA, close by 4y/o

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Bitot’s spots

vit A def

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Dx lactose intol

hydrogen breath test

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ITP Dx & Tx

isolated thrombocytopenia, corticosteroids short-term

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TMA pentad (TTP, HUS) +

hemolytic anemia, thrombocytopenia, fever, renal insuff, neuro— shistocytes

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TTP Sx +

hemolytic anemia, thrombocytopenia, fever, neuro (no renal)— decr ADAMST13

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HUS Sx +

hemolytic anemia, thrombocytopenia, renal insuff (no neuro, no fever)— pos stool cult E.coli O157:H7

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TTP Tx

plasma exchange

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HUS Tx

supportive

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hemophilia pain reliever

celebrex (COX2)

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MC inherited bleeding disorder

vWD

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vWD Tx

DDAVP

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lead poisoning Tx (2)

EDTA, dimercaprol

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ADHD criteria

impulsivity 2. inattention 3. hyperactivity before 7 y/o

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non-stimulant

Strattera

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OCD Tx

SSRI: fluvosamine, sertraline

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depression Tx

SSRI: fluoxetine, escitalopram

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spiculated, sunburst periosteum

osteosarcoma

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<3mo sepsis causes & Tx

GBS, E.coli, Listeria

ampicillin + ceftriaxone

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> 3mo septic meningitis causes & Tx

S. pneumo, N. gonorrhea, H. flu

ceftriaxone + vanco (not ampicillin)

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preseptal/periorbital cellulitis

Sx & Tx

low fever, edema/erythema eyelid, pain, normal vision, EOMI

ceftriaxone

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orbital cellulitis Sx

high fever, edema/erythema eyelid, pain, decr EOM, decr vision, proptosis (protruding), APD (no rxn)

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conjunctivitis causes (5)

S. pneumo, S. aureus, moraxella, H. flu, adenovirus

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bact conjunctivitis Tx

erythromycin

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gonococcal Tx conjunctivitis

ceftriaxone IM

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orbital cellulitis cause, Tx

S. pneumo, S. aureus, sinusitis infection

amp-sulbactam, ceph

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AOM causes

S. pneumo!! H. flu, moraxella

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Tx AOM

amoxicillin, azithromycin (complicated: ceph)

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Tx pseudomonas

aminoglycosides (mycins), ceftriaxone, pipercillin-tazobactam

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epiglottitis Tx

IV cephalosporin, steroids

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GAS pharyngitis criteria, Tx

fever, no cough, exudate tonsillitis, ant cervical LAD

PCN (amox)

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MCC perioral dermatitis

topical steroids

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fixed drug eruption causes (30m-8hrs)

abx, PCN, beta lactam, ceph, NSAIDs, sulfa, tetracycline, metronidazole

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urticaria causes

food, infection, ASA, NSAID, ACEI, PCN, morphine, codeine

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burns fluid calc (parkland)

LR 3mL x wt(kg) x %BSA

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MCC erythema multiforme

HSV

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impetigo Tx

mupirocin (bactroban), bacitractin

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lichen planus Tx

top steroids high strength (betamethasone, diflorasone)
PUVA, UVB
PO retinoid

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pityriasis rosea Tx

none

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mild acne Tx

top abx (clindamycin, erythromycin)
benzoyl peroxide
top tretinoin

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mod acne Tx

PO abx (doxy)
benzoyl peroxide
top tretinoin

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severe acne Tx

accutane (isotretinoin)

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harsh, holosystolic, 3rd left intercostal, acyanotic

VSD

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fixed S2 wide split, systolic ejection murmur, 2nd intercostal, RVH

ASD

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continuous, machinery, Gibson’s, diamond shaped, 2nd left intercostal, wide pulse pressure, LVH

PDA

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when does PDA close

1-5 days

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Tx PDA

indomethacin (close)

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VSD, RVH, pulm outflow obstruction, overriding aorta

tetralogy of fallot

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presentation tetralogy of fallot at birth

acyanotic at birth, cyanosis incr over 6 mo

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cyanosis at birth, egg shaped heart

transposition of great arteries

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transposition of great arteries Tx

prostaglandins (keep PDA open) until surg

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mitral valve, diastolic murmur, carey-coombs

rheum fever

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bisferiens carotid pulse

HCM

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HCM Tx

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6mo-6y/o, worse in evening, stridor, bark cough

croup

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cause CAP NB

GBS, Ecoli

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cause CAP 3wks-4y/o

virus!!, S. pneumo, GAS, staph, Hflu

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cause CAP >5y/o

S. pneumo, mycoplasma

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normal urine output

> 0.5 mL/kg/hr

>30 mL/hr

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howell jolly bodies, hyperseg PMN, lg PLTS, incr homocysteine, incr methylmalonic acid (MMA), periph neuropathy

vit B12 def

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hyperseg PMN, lg PLTS, incr homocysteine, no neuro Sx

folate def

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iron def gold std Dx

BM prussian blue stain

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incr LDH, decr haptoglobin

hemolytic anemia, alpha thalassemia

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heinz bodies

beta thal major

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Tx sideroblastic anemia

B6 (pyridoxine)

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pancytopenia, hypocellular BM, petechia

aplastic anemia

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Hep B vaccine schedule

3 times; 0,2,6 mo

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rotavirus vaccine schedule

3 times; 2,4,6 mo

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DTaP vaccine schedule

5 times; 2,4,6,15 mo 4-6 y/o

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Hib & PCV vaccine schedule

4 times; 2,4,6,12 mo

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IPV vaccine schedule

4 times; 2,4,6 mo 4-6 y/o

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influenza vaccine schedule

greater than 6 mo

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MMR & varicella vaccine schedule

2 times; 12 mo, 4-6 y/o

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Hep A vaccine schedule

2 times; 12 mo, 6mo apart

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hip dysplasia RF

FH, breech, female, 1st born

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autism screening

18 mo

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vision hearing screening

3 y/o, 4 y/o

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anemia lead screening

12 mo

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oral health

6 mo

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start complimentary foods

6 mo

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use cup, table foods, wean bottle

9 mo

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social smile

6 wks

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sits

6 mo

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pulls to stand

9 mo

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stands

12 mo

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crawls

10 mo

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feeds self

4 mo

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uses spoon

12 mo

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walk

12 mo

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stranger anxiety

6 mo

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roll over

4 mo

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CN optic blink reflex

III oculomotor

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rooting reflex, sucking reflex CN

V trigeminal

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corneal reflex CN

V trigeminal

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acoustic blink reflex CN

VIII vestibulocochlear

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suck, swallow CN

XII hypoglossal

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understandable speech

4 y/o

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balance on one foot

3 y/o

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tricycle, hop

4 y/o

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ride bike

6 y/o

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copies figures

5 y/o

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parallel, triangular play

2, 3 y/o

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skip

5 y/o

reflexes at birth

asymm tonic neck, trunk incurvation (-2 mo)
palmar grasp, rooting, moro (-4mo)
landau, support, plantar grasp (-6mo)
anal reflex, babinski

parachute reflex

8 mo

nasal voice + snoring

adenoid hypertrophy

rocks in mouth

tonsillitis

appears in 1st 24 hrs, does not cross suture, after difficult birth, resolves wks

cephalohematoma

bulging ant fontanelle, setting sun sign

hydrocephalus

abnomal growth and shape of skull

craniosynostosis

1st yr: liver 1-2 cm below costal margin, palpable spleen tip, S3, diastasis recti, umbilical hernia

normal

triceps, brachioradialis, abdom reflex

start 6 mo

ant fontanelle closes

4-26 mo

post fontanelle closes

2 mo

wt & ht growth 1st yr

wt doubles 6mo, triples 12 mo

ht incr 50% in 1st yr

knock knees 18mo - 4y/o

normal

doll’s eye reflex

1st 10 days

growth drops 2quartiles, wt <5th%

FTT

extension, flaccidity, hypotonia, asymm reflex, incr DTR in 1st yr, asymm posture

neural tube defect

infant normal heart sound

S3 (gallop, S4 abnormal)

growth after 2 y/o

2-3kg/yr, 5cm/yr

screening tool autism

M-CHAT

screening tool gest age

ballard score

screening tool eating disorder

SCOFF

NB lose how much wt in 1st wk, return to wt when

10%, 10 days

APGAR

Appearance (color)
Pulse rate
Grimace (reflex irritability)
Activity (musc tone)
RR

1st sign female puberty

telarche (breast)

pink/blue extremities, <100 HR, grimace, some musc flexion, slow/irreg RR

APGAR 1

all pink, > 100 HR, cry, active musc tone/flexion, good resp

APGAR 2

umbilical cord gone

2 wks

normal birth wt

> 2500 g (2.5 kg)

preterm

<34 wks

late preterm

34-36 wks

term

37-42 wks

RR: NB, infant, toddler, preschool/school age

60, 50, 40, 30

HR: infant, toddler, preschool, school age, adolescent

160, 150, 140, 120, 100

trends BP, HR

incr BP, decr age

Dx hip dysplasia

ortalani most sensitive, barlow, U/S

rash in diaper area, not in skin folds= Tx

top barrier, petrolatum, zinc oxide
rest without diaper
NO baking soda, borc acid powder, overcleaning

RF irritant dermatitis

diarrhea, formula fed, recent abx (incr diarrhea)

rash in diaper area, beefy red plaques, satellite lesions, skin folds= Tx

nystatin, azoles

rash in diaper area, greasy yellow scale, in skin folds, not isolated to diaper area= Tx

seborrheic dermatitis

low potency steroids

rash in diaper area, fragile pustules, crusted erosions

impetigo, S. aureus

bright red sharply demarcated perianal rash, blood streaked stools, pruritis, pain, fissures= Tx

GAS

abx! PCN, amox, macrolide

Tx perioral dermatitis

top: metronidazole, pimecrolimus, erythromycin
PO: tetracyclines

urticaria Tx

H1 antihistamines (hydroxyzine, loratadine, allegra, claritin, zyrtec, cetirizine, diphenhydramine)

rash generalized, palms, soles; target lesions= Tx

erythema multiforme minor (HSV)

no Tx

impetigo cause

S. aureus MCC, GAS

fawn/salmon colored plaques, neg KOH, spares palms/soles/face

pityriasis rosea
Tinea: KOH pos
secondary syphilis: palms and soles, KOH neg

meds that worsen acne

androgenic steroids, steroids, phenytoin (dilantin), isoniazid, OCP

RF for testicular CA

cryptorchism

RF SIDS

cigarette smoke, lying on stomach (NOT side), low birth wt, young mother

babble what age

6 mo

size of avg 4 y/o

40 lbs, 40 in

Normal birth size, deceleration on growth curve first 2 years of life, normal bone age and puberty, target height is short, <2 y/o!

familial short stature

Normal birth size, delayed bone age and puberty, target height normal
“Late bloomers”

Constitutional Growth Delay

Endocrine causes of tall stature

pituitary adenoma, GH excess

MCC short stature

malnutrition

Bacterial infections in neonatal period (5)

Sepsis
Meningitis
Pneumonia
UTI
Omphalitis

pruritic, web spaces, wrists, pustules

scabies

measles aka

rubeola

orbital cellulitis Tx

IV abx, ampicillin-sulbactam, ceph, clindamycin

clear rhinorrhea, sneezing, eye irritation, dry cough, pale/violaceous boggy nasal mucosa= Tx

intranasal corticosteroids (fluticasone, budesonide, beclomethasone)
antihistamines (loratadine, fexofenadine, cetirizine)
ipratropium spray
cromolyn sodium
nasal saline irrigation
montelukast

painful erythema ear canal, exudate, tender tragus= Tx

dry: isopropyl alcohol/white vinegar
abx gtts: fluoroquinolone, aminoglycoside
steroids (polymyxin B/neomycin/hydrocortisone)

fever, ant cervical LAD, no cough, tonsillar exudate= Tx

PCN VK, benzathine PCN IM

amox, macrolide

erythema, fluffy white patches, pain/mouth/throat discomfort= Tx

nystatin, azoles

minor jones criteria

for rheum fever

PR prolonged, fever, polyarthralgias, incr ESR/CRP, leukocytosis, Hx rheum fever

loud S4 gallop, worse with valsalva, better with squatting= Tx

HCM- BB

vomit within hrs of birth, still pass meconium in 1st 24 hrs, U/S: double bubble

duodenal atresia

An 18-month-old boy is brought to the emergency department because he has had fever and
cough for the past three days. While in the waiting room, he has a generalized tonic-clonic
seizure that lasts five minutes. He has no history of a seizure disorder. Physical examination
shows a postictal child with a bright red tympanic membrane and green discharge from the nose.
Temperature is 40.6°C (105.0°F). Which of the following is the most appropriate initial
diagnostic study?

LP (febrile seizures after meningitis common)

criteria for CT

instability following multiple traumas, unreliable history or examination
because of possible alcohol abuse or drug ingestion, loss of consciousness for longer than five
minutes, repeated vomiting or vomiting for more than eight hours after injury, posttraumatic
seizures, progressive headache, physical signs of basilar skull fracture, or amnesia

A previously healthy 15-month-old boy becomes anxious and begins crying and drooling
copiously. A few minutes earlier he had been calmly playing with his toys. Temperature is
36.7°C (98.1°F), pulse rate is 84/min, and respirations are 18/min. On physical examination, the
posterior pharynx is mildly injected but otherwise clear. The lungs are clear to auscultation and
percussion. Findings on chest x-ray study are normal. Within an hour he is calmer, but he
continues to drool heavily. Which of the following is the most appropriate next step?

Esophagogastroduodenoscopy

Dx: FB ingestions

neonate/infant with fever and rash- what test?

flushing, Diarrhea, Dermatitis, Dementia, Death= Dx

niacin def, pellagra

urine NMN

dry skin, conjunciva dry, bitots spots, night blindness

vit A def

MCC bronchiolitis

RSV

viral URI, resp distress, fever, wheezing, incr RR

bronchiolitis (RSV)

bronchiolitis Tx

hydrate, O2, albuterol, epi

croup Tx

humidified air, nebulized epi, dexamethasone

tachypnea, tachycardia, low O2, unilateral wheezing, grunting, unequal breath sounds

pneumonia

CAP pneumonia Tx

macrolide

complicated: levo
inpt: ceftriaxone + azithromycin

MC HAP

pseudomonas

use albuterol > 2days/wk, FEV1>80%

mild asthma

step 2: low dose ICS (fluticasone, pulmicort, flovent, beclomethasone) + SABA PRN

use albuteral daily, FEV1> 60% but <80%

mod asthma

step 3: low dose ICS + SABA PRN + LABA (salmeterol, formoterol)

decr turgor, pale, dry mucous membr, incr pulse rate, 3-4 sec cap refill, oliguria, decr tears

6-10% dehydration

tachycardia, >4 sec cap refill, low BP, anuria, absent tears

11-15% dehydration

Tx Guillain-Barre (ascending paralysis)

IVIG, plasmapheresis

GERD Tx

H2 blocker (zantac, pepcid, tagamet)
PPI (omeprazole)

ADR of PPI

C diff, osteoporosis (Fx), decr Fe, decr B12

on abdom U/S see string sign

pyloric stenosis

FB ingestion Tx

esophagogastroscopy

thrombosis, elev PLT= Tx

essential thrombocytosis

Tx: hydroxyurea

teardrop poik, leukoerythroblastic blood, giant PLT

primary myelofibrosis

erythromelagia (numb/burning extremities), high Hct >54% male, >51% female

pruritis after warm shower

pancytopenia, blasts= Dx test

ALL

Dx: TdT staining

pancytopenia, blasts= Tx

ALL

Tx: chemo (vincristine, prednisone, daunorubicin, cyclophosphamide)

auer rod= Dx test

AML

Dx: sudan black stain, myeloperoxidase pos

painless cervical LAD, teens/young adults, reed sternberg cells= Dx

HL assoc with what illness?

EBV

reed sternberg cells

RA, splenomegaly, neutropenia

Felty syndr

MC brain tumor kids

medulloblastoma

HA, seizure, personality changes, focal weakness, esotropia

medulloblastoma

CN 6 palsy= esotropia

medulloblastoma location

cerebellum

4th ventricle brain tumor

ependyoma

IFG-I <84

GH def

hyperthyroidism Tx

BB (propranolol)
methimazole
ablation
iodated contrast agents

nephrocalcinosis, osteomalacia, abdom pain, constipation, lethargy, depression, memory loss

hypercalcemia, hyperparathyroidism

short QT

hypercalcemia, hyperparathyroidism

Tx hypercalcemia

bisphosphonates (alendronate)- stop osteoclast activity

calcitonin

DM, incr blood sugar in AM, natural, incr counter-regulatory hormones, normal/high sugar 2-3 AM

dawn phenomenon

prebreakfast, rebound hyperglycemia, man-made, poor DM mgmt, low sugar 2-3AM = Tx

Somogyi effect

Tx: incr evening insulin, incr snack PM

ADR metformin

LA, GI (diarrhea), wt loss

don’t use in CKD!

kid holding wrist, cry, no swelling, no bruising, pulling theme= Tx

Supination/flexion or hyperpronation

4-9 y/o, afebrile, insidious hip/knee pain, limp, normal WBC, loss of motion= study of choice, findings

MRI

Xray: incr density, flattening, deformed

legg-calve-perthes Tx

protected wt bearing

Tx scoliosis <15 degrees

watch, f/u

Tx scoliosis 15-20 degrees

serial AP Xrays

Tx scoliosis >20 degrees

brace

trendelenburg pos

hip dysplasia

distal femur, prox tibia, metaphysis, incr ALP 2-3fold, sunburst sign

osteosarcoma

onion skin appearance, diaphysis, metastasizes early

ewing sarcoma

MC benign neoplasia bone

osteochondroma

chronic synovitis, extra-articular (fever, rash, wt loss), uveitis, spiking fever

juvenile rheum/idiopathic arthritis

pauciarticular: <4 lg joints, MC, pos ANA
systemic: spiking fever, polyarthralgia, MP rash

painless scrotal swelling, worsen through day, present in NB= Dx test

Hydrocele

Scrotal U/S

foreskin retracted

paraphimosis

inability to retract foreskin

phimosis

MCC testicular pain boys >12 y/o

testicular torsion

cremaster reflex absent, during sleep/trauma/excercise, unilateral scrotal pain, edema, erythema, neg Phren sign= Dx test

testicular torsion

U/S

Asymptomatic abdominal swelling in 4 yo

Wilms tumor

Wilms tumor Dx

U/S, CT

medical Tx for nocturnal enuresis

desmopressin (DDAVP)

palpable purpura on buttocks and legs in kids, abdom pain, hematuria= Dx

HSP (Henoch-Schonlein purpura)

Tx none

hypoalbuminemia, hyperlipidemia, proteinuria, edema, young kids= Tx

minimal change dz

Tx prednisone

wks after GABH strep infection, azotemia, incr ASO= Tx

postinfectious GN

Tx none

1st line agent in Tx UTI in kids

3rd gen ceph ( cefpodoxime, cefixime, cefdinir, ceftibuten, cefotaxime, ceftriaxone)

pruritic, dewdrops on rose petals, rash everywhere

varicella zoster

high fever, cough, resp Sx, febrile seizures, fever resolves then rash, rash starts on neck and spreads to body

roseola, HHV 6

cough, coryza (runny nose), conjunctivitis, koplik spots, rash 5 days after prodrome, rash starts on face and spreads to body

measles

pruritic rash starts on face, spreads to body, blueberry muffin baby, suboccipital LAD

rubella

pregnancy high risk for this infection, esp in 1st 4 mo

rubella

rubella aka

german measles

slapped cheek, lacy rash, flu-like illness, arthritis

5th dz, erythema infectiosum, parvovirus B19

5th dz high risk for 2 things

hydrops fatalis (during preg)
aplastic crisis (dangerous in sickle cell)

spasms of rapid coughing fits, whooping cough, no fever, sneezing, coryza, malaise= Tx

pertussis

erythromycin!!

elec abnorm in anorexia/bulimia

hypoCl, hypoK, incr BUN, metab alkalosis

Sx after stressful event, unconscious feelings and Sx result in secondary gain

conversion disorder

short, normal GH, epicanthal folds, low pos hairline, short 4th metacarpals, broad chest, wide spaced nipples, no secondary sex characteristics, hypogonadism

turner syndrome

hypotonia, poor moro, hypermobility of joints, simian palmar crease, macrosomia, mental retardation, brushfield spots= common complication/sequelae

Downs

congenital heart dz- AV septal defect MC

pathophys seizure

glutamate- excitatory, Ca influx
GABA- inhibitory
NMDA channels open- Ca influx

elec causes seizure

hypoNa, hypoCa, hyperthyroidism

age of absence seizures

5-18 y/o

no aura, eye blinking, incontinent, head movement, postictal picking/etc= Tx

absence seizure

Tx depakote, zarontin

MCC infant resp distress (3)

aspiration, congenital pneumonia, transient tachypnea

infant with hypospadia. what test do you order?

bilateral renal U/S (to r/o ascending pathology)

ear pain, drainage, hearing loss

FB in ear

funcional/innocent murmurs

still’s, venous hum, carotid bruits (older), pulm ejection murmur (older kids)

upper left sternal border, systolic ejection murmur, 3y/o- adolescence, louder supine, decr valsalva

pulm ejection murmur (functional murmur)

posterior pharyngeal vesicles

herpangina (coxsackie A)

drug causing prolonged QT

TCA

drug poisoning: mucosal irritation, vomit, bloody diarrhea, resp distress, cyanosis, tachycardia, CNS depression, fever

hydrocarbons (benzene, gas, petroleum)

Tx no emetics. O2

drug poisoning: mucosal/skin burns, hematemesis, resp distress, convulsion

caustics (cleaners)
Tx water/milk. no emetics
tests EGD for esophageal injury

drug poisoning: irritated mucous memr, resp distress, stomach/esophagus perforation

bases (clorox, drano)

vomit, hyperapnea (hyperventilation), renal failure, coma, seizure, lethargy

ASA

Tx emesis! charcoal, lavage

intestinal bleeding, impaired coagulation, acidosis, shock, red urine

iron (vitamins, prenatal vitamins)

Tx emesis! lavage, whole bowel irrigation

0-24hrs: N/V
24-72 hrs: asymptomatic, incr LFT
72-124hrs: jaundice, encephalopathy, pancreatitis, renal failure

acetaminophen

Tx acetylcysteine

appropriate wt gain

1 oz/day 1st 6 mo

0.5 oz/day next 6 mo

appropriate caloric intake

120 kcal/kg/day 1st 6 mo

100 kcal/kg/day after

premature infant immunization schedule

same as term

contraindication to immunization

anaphylactic rxn

immunocompromised can’t get what vaccines?

no MMR, varicella

gelatin allergy- no vaccine?

varicella

baker’s yeast allergy- no vaccine?

Hep B

egg allergy- no vaccine?

influenza

not reasons to postpone vaccines

mild fever <39, mild sick, PMH/FH seizures, using abx, recent pos TB skin test

postpone MMR if what illness?

TTP

drowning MC

1-3 y/o

<1y/o in bathtub

rear facing car seat until

2 y/o, 35 lbs

lap and shoulder belt what age?

8-12 y/o

rear car seats until

13 y/o

RF vit K def

NB, breast fed NB who didn’t receive vit K at birth prophylactically
prolonged PT

RF iron def

breast fed infants, untreated mom anemia, prematurity, blood loss

skeletal bone age lag behind chronological age, puberty delayed, family normal ht, development normal

constitutional growth delay

before 2 y/o, deceleration in ht, normal development, bone age equal to chronologic age

familial short stature

decr growth velocity, subnormal growth

GH def

galactosemia inborn error of metabolism causes what def?

carb

tall, thin, scoliosis common, mild evelopmental delay, hypogonadism, ataxia, espressive lang disorder

klinefelter’s XXY

male and females

pale blue irides, long narrowed facies, large protruding ears, large protruding jaw, flat feet, hyperextensible fingers, prepubertal large gonads, mod mental retardation, mitral valve prolapse

fragile X syndr

males

SGA, hypogonadism, small hands/feet, almond eyes, mental retardation, short
eventually obesity, pickwickian, DM

prader-willi

developmental delay/retardation, tongue thrusting, paroxysmal laughter

angelman’s syndr

collagen! joint laxity, hyperelastic skin, bruising

ehlers-danlos

ehlers-danlos inheritance

autosomal dominant

marfan inheritance

autosomal dominant

tall, lanky, joint laxity, long digits, myopia, arched palate

Marfan syndr

marfan complications

mitral valve prolapse, spontaneous pneumothorax, aneurysm, aorta root dilation

born and stay small, microcephaly, long smooth philtrum, thin upper lip, small distal phalanges

FAS

FAS complications

developmental delay, hyperactivity, mod retardation, internal organs

Turner syndr complications

visual/spatial perceptive disabilities, primary amenorrhea, ovarian dysgenesis, no secondary sex characteristics, horseshoe kidney, aorta stenosis, coarctation aorta

phenylketonuria s/s, Tx

mental retardation, seizures, behavior problems
hyperactive, autism
Tx: low protein diet; no meat, dairy, beans, nuts, eggs

galactosemia s/s

neonatal N/V, jaundice, hepatic dysfunction, mental retardation
Tx: lactose/galactose free diet

spina bifida- aperta

neural tube defect involves overlying skin

spina bifida- occulta

hairy tufts, dimples, dermal sinus in lumbosacral region

s/s spina bifida

hypotonia, hydrocephalus, incontinence

tripoding

6 mo

pincer grasp

9 mo

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