Peds Flashcards
(338 cards)
1
Q
Musical, vibratory, high-pitched, systolic, LLSB or apex, carotid bruit, radiate to axilla, preschool age (2y/o- pre adolescence), decr with sitting/standing/valsalva
A
Still’s murmur
2
Q
soft, continuous, under clavicle, right >left infraclavicular, preschool age (after 2y/o), best heard sitting, decr supine/jugular compression
A
Venous hum
3
Q
systolic, eliminated by carotid compression, preschool +
A
Carotid bruit
4
Q
elevation of nipple only
A
Tanner 1
5
Q
elevation of breast and nipple, enlarged areola
A
Tanner 2
6
Q
areola and nipple form secondary mound above breast
A
Tanner 4
7
Q
projection of nipple only, not areola
A
Tanner 5
8
Q
male, vellus hair
A
Tanner 1
9
Q
long downy straight hair at base of penis, testes larger
A
Tanner 2
10
Q
curlier hair, testes larger, penis length incr
A
Tanner 3
11
Q
adult curly hair, penis length and width, testes larger
A
Tanner 4
12
Q
female, hair on medial thigh
A
Tanner 5
13
Q
female, straight hair on labia
A
Tanner 2
14
Q
female, curly hair on pubic symphysis
A
Tanner 3
15
Q
Brushfield’s spots
A
Downs
16
Q
white plaques do not rub off
A
oral candidiasis
17
Q
7days old-3mo. >3 hrs/day, >3days/wk, >3wks. Crying normal growth, healthy
A
colic
18
Q
MCC young gastroenteritis
A
rotavirus
19
Q
MCC old gastroenteritis
A
norwalk v
20
Q
study in GERD to r/o others
A
upper GI Xray
21
Q
projectile non-bilious vomit, FTT, olive mass RLQ, <12wks old
A
pyloric stenosis
22
Q
Dx pyloric stenosis
A
abdom U/S
23
Q
Dx & Tx intussusception
A
barium/air enema, admit all
24
Q
age intussusception
A
3mo-6y/o (MC 5-12 mo)
25
don't pass meconium 1st 24 hrs, constipation, NB= Dx test
Hirschsprung
| abdom Xray
26
Hirschsprung assoc with
Downs
27
MC fetus intestinal obstruction
duodenal atresia/stenosis
28
vomit within hrs of birth, pass meconium in 1st 24 hrs
duodenal atresia/stenosis
29
duodenal atresia/stenosis Dx
abdom Xray, prenatal U/S
30
Anti-HBs
immunity
31
HBsAg
ongoing
32
Tx neonate with HBsAg pos mom
HBIG
33
jaundice 1st 24 hrs, coombs neg
hereditary sphero, G6PD
34
umbilical hernia RF
full term, AA, close by 4y/o
35
Bitot's spots
vit A def
36
Dx lactose intol
hydrogen breath test
37
ITP Dx & Tx
isolated thrombocytopenia, corticosteroids short-term
38
TMA pentad (TTP, HUS) +
hemolytic anemia, thrombocytopenia, fever, renal insuff, neuro--- shistocytes
39
TTP Sx +
hemolytic anemia, thrombocytopenia, fever, neuro (no renal)--- decr ADAMST13
40
HUS Sx +
hemolytic anemia, thrombocytopenia, renal insuff (no neuro, no fever)--- pos stool cult E.coli O157:H7
41
TTP Tx
plasma exchange
42
HUS Tx
supportive
43
hemophilia pain reliever
celebrex (COX2)
44
MC inherited bleeding disorder
vWD
45
vWD Tx
DDAVP
46
lead poisoning Tx (2)
EDTA, dimercaprol
47
ADHD criteria
1. impulsivity 2. inattention 3. hyperactivity before 7 y/o
48
non-stimulant
Strattera
49
OCD Tx
SSRI: fluvosamine, sertraline
50
depression Tx
SSRI: fluoxetine, escitalopram
51
spiculated, sunburst periosteum
osteosarcoma
52
<3mo sepsis causes & Tx
GBS, E.coli, Listeria
| ampicillin + ceftriaxone
53
>3mo septic meningitis causes & Tx
S. pneumo, N. gonorrhea, H. flu
| ceftriaxone + vanco (not ampicillin)
54
preseptal/periorbital cellulitis
| Sx & Tx
low fever, edema/erythema eyelid, pain, normal vision, EOMI
| ceftriaxone
55
orbital cellulitis Sx
high fever, edema/erythema eyelid, pain, decr EOM, decr vision, proptosis (protruding), APD (no rxn)
56
conjunctivitis causes (5)
S. pneumo, S. aureus, moraxella, H. flu, adenovirus
57
bact conjunctivitis Tx
erythromycin
58
gonococcal Tx conjunctivitis
ceftriaxone IM
59
orbital cellulitis cause, Tx
S. pneumo, S. aureus, sinusitis infection
| amp-sulbactam, ceph
60
AOM causes
S. pneumo!! H. flu, moraxella
61
Tx AOM
amoxicillin, azithromycin (complicated: ceph)
62
Tx pseudomonas
aminoglycosides (mycins), ceftriaxone, pipercillin-tazobactam
63
epiglottitis Tx
IV cephalosporin, steroids
64
GAS pharyngitis criteria, Tx
fever, no cough, exudate tonsillitis, ant cervical LAD
| PCN (amox)
65
MCC perioral dermatitis
topical steroids
66
fixed drug eruption causes (30m-8hrs)
abx, PCN, beta lactam, ceph, NSAIDs, sulfa, tetracycline, metronidazole
67
urticaria causes
food, infection, ASA, NSAID, ACEI, PCN, morphine, codeine
68
burns fluid calc (parkland)
LR 3mL x wt(kg) x %BSA
69
MCC erythema multiforme
HSV
70
impetigo Tx
mupirocin (bactroban), bacitractin
71
lichen planus Tx
top steroids high strength (betamethasone, diflorasone)
PUVA, UVB
PO retinoid
72
pityriasis rosea Tx
none
73
mild acne Tx
top abx (clindamycin, erythromycin)
benzoyl peroxide
top tretinoin
74
mod acne Tx
PO abx (doxy)
benzoyl peroxide
top tretinoin
75
severe acne Tx
accutane (isotretinoin)
76
harsh, holosystolic, 3rd left intercostal, acyanotic
VSD
77
fixed S2 wide split, systolic ejection murmur, 2nd intercostal, RVH
ASD
78
continuous, machinery, Gibson's, diamond shaped, 2nd left intercostal, wide pulse pressure, LVH
PDA
79
when does PDA close
1-5 days
80
Tx PDA
indomethacin (close)
81
VSD, RVH, pulm outflow obstruction, overriding aorta
tetralogy of fallot
82
presentation tetralogy of fallot at birth
acyanotic at birth, cyanosis incr over 6 mo
83
cyanosis at birth, egg shaped heart
transposition of great arteries
84
transposition of great arteries Tx
prostaglandins (keep PDA open) until surg
85
mitral valve, diastolic murmur, carey-coombs
rheum fever
86
bisferiens carotid pulse
HCM
87
HCM Tx
BB
88
6mo-6y/o, worse in evening, stridor, bark cough
croup
89
cause CAP NB
GBS, Ecoli
90
cause CAP 3wks-4y/o
virus!!, S. pneumo, GAS, staph, Hflu
91
cause CAP >5y/o
S. pneumo, mycoplasma
92
normal urine output
>0.5 mL/kg/hr
| >30 mL/hr
93
howell jolly bodies, hyperseg PMN, lg PLTS, incr homocysteine, incr methylmalonic acid (MMA), periph neuropathy
vit B12 def
94
hyperseg PMN, lg PLTS, incr homocysteine, no neuro Sx
folate def
95
iron def gold std Dx
BM prussian blue stain
96
incr LDH, decr haptoglobin
hemolytic anemia, alpha thalassemia
97
heinz bodies
beta thal major
98
Tx sideroblastic anemia
B6 (pyridoxine)
99
pancytopenia, hypocellular BM, petechia
aplastic anemia
100
Hep B vaccine schedule
3 times; 0,2,6 mo
101
rotavirus vaccine schedule
3 times; 2,4,6 mo
102
DTaP vaccine schedule
5 times; 2,4,6,15 mo 4-6 y/o
103
Hib & PCV vaccine schedule
4 times; 2,4,6,12 mo
104
IPV vaccine schedule
4 times; 2,4,6 mo 4-6 y/o
105
influenza vaccine schedule
greater than 6 mo
106
MMR & varicella vaccine schedule
2 times; 12 mo, 4-6 y/o
107
Hep A vaccine schedule
2 times; 12 mo, 6mo apart
108
hip dysplasia RF
FH, breech, female, 1st born
109
autism screening
18 mo
110
vision hearing screening
3 y/o, 4 y/o
111
anemia lead screening
12 mo
112
oral health
6 mo
113
start complimentary foods
6 mo
114
use cup, table foods, wean bottle
9 mo
115
social smile
6 wks
116
sits
6 mo
117
pulls to stand
9 mo
118
stands
12 mo
119
crawls
10 mo
120
feeds self
4 mo
121
uses spoon
12 mo
122
walk
12 mo
123
stranger anxiety
6 mo
124
roll over
4 mo
125
CN optic blink reflex
III oculomotor
126
rooting reflex, sucking reflex CN
V trigeminal
127
corneal reflex CN
V trigeminal
128
acoustic blink reflex CN
VIII vestibulocochlear
129
suck, swallow CN
XII hypoglossal
130
understandable speech
4 y/o
131
balance on one foot
3 y/o
132
tricycle, hop
4 y/o
133
ride bike
6 y/o
134
copies figures
5 y/o
135
parallel, triangular play
2, 3 y/o
136
skip
5 y/o
137
reflexes at birth
asymm tonic neck, trunk incurvation (-2 mo)
palmar grasp, rooting, moro (-4mo)
landau, support, plantar grasp (-6mo)
anal reflex, babinski
138
parachute reflex
8 mo
139
nasal voice + snoring
adenoid hypertrophy
140
rocks in mouth
tonsillitis
141
appears in 1st 24 hrs, does not cross suture, after difficult birth, resolves wks
cephalohematoma
142
bulging ant fontanelle, setting sun sign
hydrocephalus
143
abnomal growth and shape of skull
craniosynostosis
144
1st yr: liver 1-2 cm below costal margin, palpable spleen tip, S3, diastasis recti, umbilical hernia
normal
145
triceps, brachioradialis, abdom reflex
start 6 mo
146
ant fontanelle closes
4-26 mo
147
post fontanelle closes
2 mo
148
wt & ht growth 1st yr
wt doubles 6mo, triples 12 mo
| ht incr 50% in 1st yr
149
knock knees 18mo - 4y/o
normal
150
doll's eye reflex
1st 10 days
151
growth drops 2quartiles, wt <5th%
FTT
152
extension, flaccidity, hypotonia, asymm reflex, incr DTR in 1st yr, asymm posture
neural tube defect
153
infant normal heart sound
S3 (gallop, S4 abnormal)
154
growth after 2 y/o
2-3kg/yr, 5cm/yr
155
screening tool autism
M-CHAT
156
screening tool gest age
ballard score
157
screening tool eating disorder
SCOFF
158
NB lose how much wt in 1st wk, return to wt when
10%, 10 days
159
APGAR
```
Appearance (color)
Pulse rate
Grimace (reflex irritability)
Activity (musc tone)
RR
```
160
1st sign female puberty
telarche (breast)
161
pink/blue extremities, <100 HR, grimace, some musc flexion, slow/irreg RR
APGAR 1
162
all pink, > 100 HR, cry, active musc tone/flexion, good resp
APGAR 2
163
umbilical cord gone
2 wks
164
normal birth wt
>2500 g (2.5 kg)
165
preterm
<34 wks
166
late preterm
34-36 wks
167
term
37-42 wks
168
RR: NB, infant, toddler, preschool/school age
60, 50, 40, 30
169
HR: infant, toddler, preschool, school age, adolescent
160, 150, 140, 120, 100
170
trends BP, HR
incr BP, decr age
171
Dx hip dysplasia
ortalani most sensitive, barlow, U/S
172
rash in diaper area, not in skin folds= Tx
top barrier, petrolatum, zinc oxide
rest without diaper
NO baking soda, borc acid powder, overcleaning
173
RF irritant dermatitis
diarrhea, formula fed, recent abx (incr diarrhea)
174
rash in diaper area, beefy red plaques, satellite lesions, skin folds= Tx
nystatin, azoles
175
rash in diaper area, greasy yellow scale, in skin folds, not isolated to diaper area= Tx
seborrheic dermatitis
| low potency steroids
176
rash in diaper area, fragile pustules, crusted erosions
impetigo, S. aureus
177
bright red sharply demarcated perianal rash, blood streaked stools, pruritis, pain, fissures= Tx
GAS
| abx! PCN, amox, macrolide
178
Tx perioral dermatitis
top: metronidazole, pimecrolimus, erythromycin
PO: tetracyclines
179
urticaria Tx
H1 antihistamines (hydroxyzine, loratadine, allegra, claritin, zyrtec, cetirizine, diphenhydramine)
180
rash generalized, palms, soles; target lesions= Tx
erythema multiforme minor (HSV)
| no Tx
181
impetigo cause
S. aureus MCC, GAS
182
fawn/salmon colored plaques, neg KOH, spares palms/soles/face
pityriasis rosea
Tinea: KOH pos
secondary syphilis: palms and soles, KOH neg
183
meds that worsen acne
androgenic steroids, steroids, phenytoin (dilantin), isoniazid, OCP
184
RF for testicular CA
cryptorchism
185
RF SIDS
cigarette smoke, lying on stomach (NOT side), low birth wt, young mother
186
babble what age
6 mo
187
size of avg 4 y/o
40 lbs, 40 in
188
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
189
Normal birth size, delayed bone age and puberty, target height normal
"Late bloomers"
Constitutional Growth Delay
190
Endocrine causes of tall stature
pituitary adenoma, GH excess
191
MCC short stature
malnutrition
192
Bacterial infections in neonatal period (5)
```
Sepsis
Meningitis
Pneumonia
UTI
Omphalitis
```
193
pruritic, web spaces, wrists, pustules
scabies
194
measles aka
rubeola
195
orbital cellulitis Tx
IV abx, ampicillin-sulbactam, ceph, clindamycin
196
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
197
painful erythema ear canal, exudate, tender tragus= Tx
dry: isopropyl alcohol/white vinegar
abx gtts: fluoroquinolone, aminoglycoside
steroids (polymyxin B/neomycin/hydrocortisone)
198
fever, ant cervical LAD, no cough, tonsillar exudate= Tx
PCN VK, benzathine PCN IM
| amox, macrolide
199
erythema, fluffy white patches, pain/mouth/throat discomfort= Tx
nystatin, azoles
200
minor jones criteria
for rheum fever
| PR prolonged, fever, polyarthralgias, incr ESR/CRP, leukocytosis, Hx rheum fever
201
loud S4 gallop, worse with valsalva, better with squatting= Tx
HCM- BB
202
vomit within hrs of birth, still pass meconium in 1st 24 hrs, U/S: double bubble
duodenal atresia
203
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)
204
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
205
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
206
neonate/infant with fever and rash- what test?
LP
207
flushing, Diarrhea, Dermatitis, Dementia, Death= Dx
niacin def, pellagra
| urine NMN
208
dry skin, conjunciva dry, bitots spots, night blindness
vit A def
209
MCC bronchiolitis
RSV
210
viral URI, resp distress, fever, wheezing, incr RR
bronchiolitis (RSV)
211
bronchiolitis Tx
hydrate, O2, albuterol, epi
212
croup Tx
humidified air, nebulized epi, dexamethasone
213
tachypnea, tachycardia, low O2, unilateral wheezing, grunting, unequal breath sounds
pneumonia
214
CAP pneumonia Tx
macrolide
complicated: levo
inpt: ceftriaxone + azithromycin
215
MC HAP
pseudomonas
216
use albuterol > 2days/wk, FEV1>80%
mild asthma
| step 2: low dose ICS (fluticasone, pulmicort, flovent, beclomethasone) + SABA PRN
217
use albuteral daily, FEV1> 60% but <80%
mod asthma
| step 3: low dose ICS + SABA PRN + LABA (salmeterol, formoterol)
218
decr turgor, pale, dry mucous membr, incr pulse rate, 3-4 sec cap refill, oliguria, decr tears
6-10% dehydration
219
tachycardia, >4 sec cap refill, low BP, anuria, absent tears
11-15% dehydration
220
Tx Guillain-Barre (ascending paralysis)
IVIG, plasmapheresis
221
GERD Tx
```
H2 blocker (zantac, pepcid, tagamet)
PPI (omeprazole)
```
222
ADR of PPI
C diff, osteoporosis (Fx), decr Fe, decr B12
223
on abdom U/S see string sign
pyloric stenosis
224
FB ingestion Tx
esophagogastroscopy
225
thrombosis, elev PLT= Tx
essential thrombocytosis
| Tx: hydroxyurea
226
teardrop poik, leukoerythroblastic blood, giant PLT
primary myelofibrosis
227
erythromelagia (numb/burning extremities), high Hct >54% male, >51% female
PV
| pruritis after warm shower
228
pancytopenia, blasts= Dx test
ALL
| Dx: TdT staining
229
pancytopenia, blasts= Tx
ALL
| Tx: chemo (vincristine, prednisone, daunorubicin, cyclophosphamide)
230
auer rod= Dx test
AML
| Dx: sudan black stain, myeloperoxidase pos
231
painless cervical LAD, teens/young adults, reed sternberg cells= Dx
HL
232
HL assoc with what illness?
EBV
233
reed sternberg cells
HL
234
RA, splenomegaly, neutropenia
Felty syndr
235
MC brain tumor kids
medulloblastoma
236
HA, seizure, personality changes, focal weakness, esotropia
medulloblastoma
| CN 6 palsy= esotropia
237
medulloblastoma location
cerebellum
238
4th ventricle brain tumor
ependyoma
239
IFG-I <84
GH def
240
hyperthyroidism Tx
BB (propranolol)
methimazole
ablation
iodated contrast agents
241
nephrocalcinosis, osteomalacia, abdom pain, constipation, lethargy, depression, memory loss
hypercalcemia, hyperparathyroidism
242
short QT
hypercalcemia, hyperparathyroidism
243
Tx hypercalcemia
bisphosphonates (alendronate)- stop osteoclast activity
| calcitonin
244
DM, incr blood sugar in AM, natural, incr counter-regulatory hormones, normal/high sugar 2-3 AM
dawn phenomenon
245
prebreakfast, rebound hyperglycemia, man-made, poor DM mgmt, low sugar 2-3AM = Tx
Somogyi effect
| Tx: incr evening insulin, incr snack PM
246
ADR metformin
LA, GI (diarrhea), wt loss
| don't use in CKD!
247
kid holding wrist, cry, no swelling, no bruising, pulling theme= Tx
Supination/flexion or hyperpronation
248
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
249
legg-calve-perthes Tx
protected wt bearing
250
Tx scoliosis <15 degrees
watch, f/u
251
Tx scoliosis 15-20 degrees
serial AP Xrays
252
Tx scoliosis >20 degrees
brace
253
trendelenburg pos
hip dysplasia
254
distal femur, prox tibia, metaphysis, incr ALP 2-3fold, sunburst sign
osteosarcoma
255
onion skin appearance, diaphysis, metastasizes early
ewing sarcoma
256
MC benign neoplasia bone
osteochondroma
257
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
258
painless scrotal swelling, worsen through day, present in NB= Dx test
Hydrocele
| Scrotal U/S
259
foreskin retracted
paraphimosis
260
inability to retract foreskin
phimosis
261
MCC testicular pain boys >12 y/o
testicular torsion
262
cremaster reflex absent, during sleep/trauma/excercise, unilateral scrotal pain, edema, erythema, neg Phren sign= Dx test
testicular torsion
| U/S
263
Asymptomatic abdominal swelling in 4 yo
Wilms tumor
| Wilms tumor
264
Wilms tumor Dx
U/S, CT
265
medical Tx for nocturnal enuresis
desmopressin (DDAVP)
266
palpable purpura on buttocks and legs in kids, abdom pain, hematuria= Dx
HSP (Henoch-Schonlein purpura)
| Tx none
267
hypoalbuminemia, hyperlipidemia, proteinuria, edema, young kids= Tx
minimal change dz
| Tx prednisone
268
wks after GABH strep infection, azotemia, incr ASO= Tx
postinfectious GN
| Tx none
269
1st line agent in Tx UTI in kids
3rd gen ceph ( cefpodoxime, cefixime, cefdinir, ceftibuten, cefotaxime, ceftriaxone)
270
pruritic, dewdrops on rose petals, rash everywhere
varicella zoster
271
high fever, cough, resp Sx, febrile seizures, fever resolves then rash, rash starts on neck and spreads to body
roseola, HHV 6
272
cough, coryza (runny nose), conjunctivitis, koplik spots, rash 5 days after prodrome, rash starts on face and spreads to body
measles
273
pruritic rash starts on face, spreads to body, blueberry muffin baby, suboccipital LAD
rubella
274
pregnancy high risk for this infection, esp in 1st 4 mo
rubella
275
rubella aka
german measles
276
slapped cheek, lacy rash, flu-like illness, arthritis
5th dz, erythema infectiosum, parvovirus B19
277
5th dz high risk for 2 things
```
hydrops fatalis (during preg)
aplastic crisis (dangerous in sickle cell)
```
278
spasms of rapid coughing fits, whooping cough, no fever, sneezing, coryza, malaise= Tx
pertussis
| erythromycin!!
279
elec abnorm in anorexia/bulimia
hypoCl, hypoK, incr BUN, metab alkalosis
280
Sx after stressful event, unconscious feelings and Sx result in secondary gain
conversion disorder
281
short, normal GH, epicanthal folds, low pos hairline, short 4th metacarpals, broad chest, wide spaced nipples, no secondary sex characteristics, hypogonadism
turner syndrome
282
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
283
pathophys seizure
glutamate- excitatory, Ca influx
GABA- inhibitory
NMDA channels open- Ca influx
284
elec causes seizure
hypoNa, hypoCa, hyperthyroidism
285
age of absence seizures
5-18 y/o
286
no aura, eye blinking, incontinent, head movement, postictal picking/etc= Tx
absence seizure
| Tx depakote, zarontin
287
MCC infant resp distress (3)
aspiration, congenital pneumonia, transient tachypnea
288
infant with hypospadia. what test do you order?
bilateral renal U/S (to r/o ascending pathology)
289
ear pain, drainage, hearing loss
FB in ear
290
funcional/innocent murmurs
still's, venous hum, carotid bruits (older), pulm ejection murmur (older kids)
291
upper left sternal border, systolic ejection murmur, 3y/o- adolescence, louder supine, decr valsalva
pulm ejection murmur (functional murmur)
292
posterior pharyngeal vesicles
herpangina (coxsackie A)
293
drug causing prolonged QT
TCA
294
drug poisoning: mucosal irritation, vomit, bloody diarrhea, resp distress, cyanosis, tachycardia, CNS depression, fever
hydrocarbons (benzene, gas, petroleum)
| Tx no emetics. O2
295
drug poisoning: mucosal/skin burns, hematemesis, resp distress, convulsion
caustics (cleaners)
Tx water/milk. no emetics
tests EGD for esophageal injury
296
drug poisoning: irritated mucous memr, resp distress, stomach/esophagus perforation
bases (clorox, drano)
297
vomit, hyperapnea (hyperventilation), renal failure, coma, seizure, lethargy
ASA
| Tx emesis! charcoal, lavage
298
intestinal bleeding, impaired coagulation, acidosis, shock, red urine
iron (vitamins, prenatal vitamins)
| Tx emesis! lavage, whole bowel irrigation
299
0-24hrs: N/V
24-72 hrs: asymptomatic, incr LFT
72-124hrs: jaundice, encephalopathy, pancreatitis, renal failure
acetaminophen
| Tx acetylcysteine
300
appropriate wt gain
1 oz/day 1st 6 mo
| 0.5 oz/day next 6 mo
301
appropriate caloric intake
120 kcal/kg/day 1st 6 mo
| 100 kcal/kg/day after
302
premature infant immunization schedule
same as term
303
contraindication to immunization
anaphylactic rxn
304
immunocompromised can't get what vaccines?
no MMR, varicella
305
gelatin allergy- no vaccine?
varicella
306
baker's yeast allergy- no vaccine?
Hep B
307
egg allergy- no vaccine?
influenza
308
not reasons to postpone vaccines
mild fever <39, mild sick, PMH/FH seizures, using abx, recent pos TB skin test
309
postpone MMR if what illness?
TTP
310
drowning MC
1-3 y/o
| <1y/o in bathtub
311
rear facing car seat until
2 y/o, 35 lbs
312
lap and shoulder belt what age?
8-12 y/o
313
rear car seats until
13 y/o
314
RF vit K def
NB, breast fed NB who didn't receive vit K at birth prophylactically
prolonged PT
315
RF iron def
breast fed infants, untreated mom anemia, prematurity, blood loss
316
skeletal bone age lag behind chronological age, puberty delayed, family normal ht, development normal
constitutional growth delay
317
before 2 y/o, deceleration in ht, normal development, bone age equal to chronologic age
familial short stature
318
decr growth velocity, subnormal growth
GH def
319
galactosemia inborn error of metabolism causes what def?
carb
320
tall, thin, scoliosis common, mild evelopmental delay, hypogonadism, ataxia, espressive lang disorder
klinefelter's XXY
| male and females
321
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
322
SGA, hypogonadism, small hands/feet, almond eyes, mental retardation, short
eventually obesity, pickwickian, DM
prader-willi
323
developmental delay/retardation, tongue thrusting, paroxysmal laughter
angelman's syndr
324
collagen! joint laxity, hyperelastic skin, bruising
ehlers-danlos
325
ehlers-danlos inheritance
autosomal dominant
326
marfan inheritance
autosomal dominant
327
tall, lanky, joint laxity, long digits, myopia, arched palate
Marfan syndr
328
marfan complications
mitral valve prolapse, spontaneous pneumothorax, aneurysm, aorta root dilation
329
born and stay small, microcephaly, long smooth philtrum, thin upper lip, small distal phalanges
FAS
330
FAS complications
developmental delay, hyperactivity, mod retardation, internal organs
331
Turner syndr complications
visual/spatial perceptive disabilities, primary amenorrhea, ovarian dysgenesis, no secondary sex characteristics, horseshoe kidney, aorta stenosis, coarctation aorta
332
phenylketonuria s/s, Tx
mental retardation, seizures, behavior problems
hyperactive, autism
Tx: low protein diet; no meat, dairy, beans, nuts, eggs
333
galactosemia s/s
neonatal N/V, jaundice, hepatic dysfunction, mental retardation
Tx: lactose/galactose free diet
334
spina bifida- aperta
neural tube defect involves overlying skin
335
spina bifida- occulta
hairy tufts, dimples, dermal sinus in lumbosacral region
336
s/s spina bifida
hypotonia, hydrocephalus, incontinence
337
tripoding
6 mo
338
pincer grasp
9 mo
