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Flashcards in peds Deck (166):
1

cyanotic infant with L. axis deviation
decreased pulmonary markings on CXR
ASD or VSD

tricuspid valve atresia

2

down syndrome heart

complete AV canal defect

3

maternal lithium use
defect?

ebstein's anomaly (malformed TC valve into the R ventricle)

4

tetralogy of fallot on CXR

boot shaped heart (right v hypertrophy)

5

normal heart deviation newborn

r

6

total anomalous pulmonary venous return

all 4 pulmonary veins dump into r. atrium (R enlargement) or otherwise the systemic circulation (brachiocephalic veins, SVC, portal/renal veins))

7

digeorge syndrome heart defect

truncus arteriosus

8

Gray visicles in posterior oropharynx. Dz and virus

Herpangina
Coxsackie

9

abx for unilateral cervical adenitis in kids

clinda (strep/staph)
must do I & D too

10

odynophagia

pain with eating

11

2 characteristics of niemann-pick dz but not tay sachs

hepatomegaly
arreflexia

12

enzymes in niemann-pick vs tay sachs

NP: sphingomyelinase
TS: B-hexosaminidase

13

1 year old
thrombocytopenia
recurrent bacterial infections
eczema

Wiskott-Aldrich Syndrome (X-linked)

14

Maculopapular rash
started head spread to body
low fever
arthritis

rubella

15

class of meds to use for tourette's disorder

antipsychotics

16

child less than 1
macrocytic anemia w/ low retic count
congenital anomalies

diamond-blackfan anemia

17

general tx for OCD

high dose SSRI therapy

18

infection associated (rare) with OCD onset

group A strep infection

19

1st test in torticollis

c-spine radiographs

20

erb-duchenne's palsy noted. 1st step?

reassurance

21

preterm neonate with:
+gastric volume, vomiting, abdominal distention

w/pneumatosis intestinalis and portal venous air

necrotizing enterocolitis

22

neonate w/ air in stomach, duodenum. but nothing distal

(double bubble) = duodenal atresia

23

neonate w/failure to pass mec w/in 48 hours (2)

Hirschsprung dz or CF

24

infant with virilization
hyponatremia

21-hydroxyase deficiency

25

2 tests for 21-hydroxylase deficiency

consyntropin stim test
+17 hydroxyprogesterone levels

26

Kid with recurrent infections - pneumonias, and suppurative adenitis

chronic granulomatous disease

27

newborn with bilious vomiting and triple bubble sign

jejunal atresia

28

timeline difference of gonococcal vs chlamydial conjunctivitis

reverse alphabetical order:

less than 5 days = gonococcal
greater then 5 days = chlamydial

29

differences in bruton's agammaglobulinemia VS CVID in
a) gender
b) # B cells
c) age of onset

a) Bruton's is just boys
b) B cells reduced in Bruton's
c) CVID later onset (15-35)

30

biggest risk of rotavirus vacc

small risk intussusception

31

timing or weight for sweat test

greater than 2 weeks
or
greater than 2 kg

32

laboratory abnormalities of seminoma vs germ cell tumor (2)

seminoma can give +BHCG
germ cell tumors have +BHCG and +AFP

33

rate over which is tachypnea in a neonate

60

34

AFP level in aneuplodies

reduced

35

AFP w/ neural tube defects, ventral wall defects, or multip

increased

36

infant w/no stool in 24 hours, small colon

meconium ileus (CF)

37

apgar requiring intervention

less than 7

38

missense vs nonsense mutations

both point mutations - missense = one different aa. Nonsense makes a stop codon

39

when to consider adding inhaled steroid to asthmatic tx?

if 3 or more exacerbations/week

40

pallid spell

minor trauma followed by apnea

41

association (even with parents) of kids w/cyclic vomiting syndrome

migraines

42

tx for abnormal uterine bleeding, esp. adolescents

high dose estrogen therapy

43

4 classes of hypersensitivities

ACID
Anaphylactic
Cytotoxic (Ab-mediated)
Immune complex
Delayed (cell-mediated)

44

normal HR range of newborn

120-160 BPM

45

conjunctivitis on newborn at day 1

chemical irritation

46

baby with aniridia. what association?

Wilms tumor

47

timeline for orchipexy in case of crypotchidism with infant

after 1 yrs old

48

hyperbilirubinia velocity that is concerning

5 mh/dL per day

49

cherry vs strawberry angiomas

strawberry is on newborns (superficial angiomas), cherry angiomas are the red dots on adults

50

nevus simplex

macular stain

51

breast milk jaundice vs breastfeeding failure jaundice

breastfeeding failure has signs of dehydration (1st week) - brick red crystals in diaper

52

the 2 genetic conjugated hyperbilirubinemias

dubin-johnson (black liver)
rotor (milder)

53

timeline of physiologic jaundice vs pathologic

phys 3 day+
path less than 1 day

54

phys hyperbilirubinemia with +coombs

isoimmunization (Rho or ABO)

55

phys jaundice with +Hg (2)

Twin-twin transfusion
or maternal-baby trx (delayed clamping)

56

baby with bili >20. tx?

exchange transfusion

57

kid less than 2 w/upper limb, head jerking

west syndrome
(infantile spasm)

58

tx for west syndrome (infantile spasm)

ACTH

59

kid 3 mos to 6 yrs with colicky abdominal pain relieved by knee-chest position

intususseception

60

test if suspect blood in GI from ingested maternal blood vs vasa previa

apt test(alkali-denaturation test)
- if maternal blood ingestion
+ if fetal origin (could be vasa previa, etc)

61

2 warning signs of anaphylaxis

urticaria
hypotension

62

empiric tx for meningitis in peds (3)

ceftriaxone, vanco, ampicillin +/- steroids

63

rosela fever/rash sequence and path

fever 1st
HHV-6

64

maintenance fluid for kids (3)

per day:
0-10 kg: 100 cc/kg
10-20 kg: 50 cc/kg
20+ kg: 20 cc/kg

65

parkland formula for IVF (day) w/50 % in 1st 8 hours, 50% in next 16 hours

%BSA X kg X 4

66

dx of asthma (post-dilater improvement) cutoff

FEV1 greater than 12%

67

tx of diptheria

IVIG

68

hip problem in 5-7 yo M

ideopathic osteonecrosis
Legg -Calve-Perthes Dz

69

1st line tx for mild acne

topical retinoids

70

association of transposition of great arteries

DM mother (not gestational - true DM)

71

kid with croup who doesn't get better.

dz?

bacterial tracheitis

72

test for digeorge

mitogen stimulation assay

73

tx of wiskott-aldrich

bone marrow trx

74

test to dx developmental dysplasia of hip

US

75

type of XR for SCFE

frogleg XR

76

tx of retinoblstoma in eye

surgery

77

sequelae to retinoblastoma of eye

osteosarcoma of bone later in life

78

test for imperforate anus

upside down babygram

79

double bubble sign (2 dx possibilities)

duodenal atresia
annular pancreas

80

baby w/intestinal atresia (fluid levels)
association of mom

mom did cocaine

81

babygram showing upper obstruction but normal air below

malrotation

82

girl with normal voiding but constant leak

low implantation of ureters

83

mandatory step w/cryptorchidism, even if pulled down

removal after puberty

84

workup of pediatric hematuria (2)

US
IVP

85

if sickle cell dz and getting regular transfusions, what to do about Fe

deferoxamine

86

if sickle cell dx, and not get regular trx, what 2 supplements

Fe and folate

87

tx for acute sickle crisis

danger - priapism or AMS, etc (2)
OR with joint pain (3)

exchange transfusion, now (if in danger)

otherwise ivf, O2, pain control

88

tx to sickle pt who is a kid for osteo prophylaxis

abx-penicillin

89

tx, including method for chlamydial conjunctivitis

oral erythromycin

90

bilious vomiting
upper GI series
ligament of treitz on R, corscrew appearance

volvulus (malrotation)

91

infant w/FTT
hepatomegaly
cataracts

disorder, enzyme

classic galactosemia
galactose-1-p uridyltransferase deficiency

92

galactokinase def vs classic galactosemia

galactokinase def is cataracts only
(no hepatomegaly, FTT-galactokinase is kind)

93

normal vs not normal cutoff for weight loss in first 5 days

7%

94

nerves (2 each) affected in
Erb-Duchenne palsy
Klumpke palsy

C5-6
C8-T1

95

Birth weight should double by:
Triple by:

5 months
12 months

96

Intoeing should resolve by

4 years

97

Tx of Von willebrand dz

Desmopressin

98

1st sign of puberty in boys

Testicular enlargement

99

Adolescent
Pain on left sternal border exacerbated by deep inspiration

Precordial catch syndrome

100

Cutoff for physiologic jaundice

Needs to be less than 15

101

Time course for breastfeeding jaundice vs breast milk jaundice

Breastfeeding is 1st week
Breast milk jaundice is 2nd week

102

What day should mec stools transition to yello?

3

103

Swelling of head crossing sutures in a neonate

Caput succedaneum

104

FTT (2)

not gaining weight by 10 days
failure to regain birthweight by 2 weeks

105

lethargy (2)

absent eye movements
or
not interacting with others.

106

lab to check to screen for inborn error of metabolism

NH4

107

2 abnormal labs in ornithine transcarbomylase deficiency (OTC)

NH4
urine orotic acid

108

fever without source
vs
fever unknown origin

FUO requires 1 wk investigation

109

kernig's sign

resistance to knee extension

110

brudzinksi sign

flexion of hip w/ passive neck flexion

111

cutoff for pyuria

5

112

F/U after
1. first UTI
2. 2nd UTI

1 US
2. VCUG

113

Tx of Kawasaki dz (2)

Ivig
Aspirin

114

Fever
Rash hands feet
Oral lesions

Pathogen?

Coxsackie A

Hand foot mouth dz

115

Besides lateral and PA, best 2 radiographic tests to get on a kids you suspect foreign body aspiration.

decubitus
inspiratory/expiratory chest films

116

staccato cough between 4 and 12 weeks of age.

chlamydia pneumonia

117

Dennie-Morgan lines

lines under the eyes caused by chronic allergies/facial edema

118

transverse nasal crease

horizontal line on nose caused by chronic allergies

119

age where kids can start using OTC antihistamines and cold syrups

2 years old

120

1st line abx for acute otitis media for kids

amoxicillin

121

cutoff temp to give abx for AOM

>39 (102.2)
(always tx if bilateral and

122

otitis media w/effusion (OME) can persist for how long after AOM?

3 months

123

2nd line tx for AOM or first episode w/high fever

augmentin

124

GCS (2)

EVM 456

125

cutoff for dx DM using A1C

6.5%

126

what to calculate if a hyponatremic dehydration

free salt deficit

127

what to calculate if a hypernatremic dehydration

free water deficit

128

risk to watch out for in managing DKA

cerebral edema

129

OTC topical anesthetic cream that can be applied 30 min prior to needle stick

ELA-max

130

pediatric dose ibu profen

10 mg/kg

131

joint pain that sets in a few weeks after infectious diarrhea

reactive arthritis

132

murmur that is musical or vibratory, and is heard best at the left lower sternal border in the supine position.

Still's murmur

133

Why are VSDs not heard in the nursery?

Newborns have elevated pulmonary vascular resistance

134

path of fetal blood (4)

RA > RV > ductus arteriosus > systemic circulation

135

main finding in CSF of viral meningitis

pleocytosis (most commonly lymphocytosis)

protein, glucose are normal

136

type of seizure: simple vs complex

simple: generalized
complex: focal

137

a "slapped cheek" appearance and a reticular, lacy rash on the extremities

fifth dz (erythema infectiosum)

138

high fever w/bulging fontanelle, the diffuse blanching rash

Roseola

139

Roseola pathogen

HHV-6

140

most common pediatric brain tumor

Medulloblastoma

141

cutoff size for concerning lymph nodes in kids

2 cm

142

7 chars. pain

P=Position (be exact)

Q=Quality (dull, sharp, burning)

R=Radiation (be exact)

S=Severity (scale from 1 to 10, if the patient can do this)

T=Timing (when it happens)

A=Alleviating factors

A=Aggravating factors

A=Associated symptoms

143

HEEADSSS

home
eating
education
activities
drugs
suicide
safety
sex

144

4 categories that cause AMS

(1) Hypoxemia (2) Shock (septic, hypovolemic, cardiac) (3) Hypoglycemia (4) Poisoning

145

prophylaxis for meningicocemia in adults vs children

adults cipro
children rifampin

146

IV tx for hypoglycemia

D25 bolus

147

effects of anticholinergics on pupils

dilate them

148

FTT (3)

below 3rd percentile in weight, weigh for length
OR
weight loss crossing 2 or more major percentiles on growth curve

149

kcal/ day needed to grow in normal baby

100-110 Cal/kg/24 hours

150

nadir of Hg in infant at 2 months

11 g/dL

151

Screening tool for autism. 16, 30 mos.

M-chat

152

Most common reason for cp

Prematurity

153

2 most common surgeries sickle cell pts

cholecystectomy
tonsillectomy

154

prophylactic med for sickle cell, and age to admin to

penicillin
age 5-6

155

2 vaccinations sickle cell pts should have at 2 (in addition to standards)

23-valent PNM
meningococcal

156

anasarca

generalized edema

157

most common nephrotic dz in peds

minimal change dz
90% of cases

158

pathophys of edema in nephrotic syndrome

lowering of plasma colloid osmotic pressure.

159

tx (2) of nephrotic syndrome

steroids
salt restriction

160

lesions that are flat vs raised, less than 1 cm

flat = macule
raised = papule

161

lesions that are flat vs raised more than 1 cm

flat = patch
raised = plaque

162

pustular lesions in axilla, groin, perianal regions

hidradenitis suppurativa

163

tx rosaciea

topical metronidazole

164

lifespan of lice w/o host

26 hours

165

tx for tinea versicolor

selenium sulfide

166

tx tinea capitis

griseofulvin