Peds Flashcards
1
Q
Late preterm
A
34-37
2
Q
Term
A
38 or more
3
Q
Newborn RR
A
40-60
4
Q
Newborn HR
A
120-160
5
Q
First step after child delivered
A
Suction mouth and nose
6
Q
1min APGAR measures
A
Conditions during labor and delivery
7
Q
5min APGAR measures
A
Response to resuscitative efforts
8
Q
Is a low APGAR associated with cerebral palsy
A
No
9
Q
Neonatal conjuctivitis cause at 1 day
A
Chemical irritation
10
Q
Neonatal conjuctivitis cause at 2-7 days
A
Gonorrhea
11
Q
Neonatal conjuctivitis cause at >7 day
A
Chlamydia
12
Q
Neonatal conjuctivitis cause at 3 weeks or more
A
Herpes
13
Q
Abx drops to prevent opthamia neonatorum (neonatal conjunctivitis)
A
Erythro or Tetra
Silver nitrate
14
Q
Sx of intercranial bleeding
A
Lethargy
15
Q
Sx of mucosal bleeding
A
BRBPR
16
Q
What causes vit K def in newborns
A
Colonic flora not adequate so E.coli not present to make vit K
17
Q
Why is there bleeding in vit K def
A
Cannot make factors II, VII, IX, X, protein C and S
18
Q
Prophylactic Rx for vit K def
A
Single IM Vit K
19
Q
Newborn screening tests
A
PKU CAH Biotinidase B-thalasemia Galactosemia Hypothyroidism Homocysteinuria CF
20
Q
G6PD facts
A
XR
Hemolytic crisis
Reduce oxidative stress and special diet
21
Q
PKU facts
A
AR
Deficiency in PAH
Mental retardation
Low phenylalanine diet for first 16yrs
22
Q
Galactosemia facts
A
Precludes normal metabolism of galactose
Cut out all lactose-containing products
23
Q
CAH facts
A
AR
Errors in steroidogenesis
Replace mineralocorticoid and glucocorticoid
Genetal reconstruction surgery
24
Q
Congenital hypothyroidism facts
A
1 in 40,000
Cretinism
25
Why do hearing test in newborns
Exclude congenital sensory-neural hearing loss
| Assess need for cochlear implant
26
CF facts
Abnormally thick mucous
Elevated sweat chloride
Mutation in CFTR
Abnormal function in at least 1 organ system
27
Best initial test for CF
Sweat chloride
28
Most accurate test for Cf
CFTR gene mutation
29
Who gets Hep B IG
HbsAg+ mother
30
Pathogenesis of transient polycythemia of newborn
Hypoxia in delivery
Increase in EPO
Increase in RBCs
31
How does transient polycythemia of newborn resolve
First breath increases O2
Decrease in EPO
Normalization of Hb
32
Pathogenesis of transient tachypnea of newborn
Compression of rib cage in delivery
Removes fluid from lungs
Therefore C-section babies have excess fluid
33
Newborn tachypnea lasts >4hrs, think
Sepsis
34
Evaluation of newborn sepsis
Blood + Urine Cx
| LP w/ CSF analysis and Cx if neuro signs
35
Cause of newborn subconjunctival hemorrhage
Rapid rise in intrathoracic pressure as chest is compressed while passing through birth canal
No Rx
36
3 types of skull fractures in newborns
Linear - MC
Depressed - Can cause cortical damage
Basilar - Most fatal
37
What is caput succedameum
Swelling of the soft tissues of the scalp that DOES cross suture lines
38
What is cephalohematoma
Swelling of the soft tissues of the scalp that DOES NOT cross suture lines
39
What is brachial plexus injury in a newborn secondary to
Shoulder dystocia
40
Who is most likely to get brachial plexus injury
Macrosomic infants of diabetic mothers
41
2 types of brachial plexus injuries
Duchenne-Erb paralysis: C5-6
| Klumpke paralysis: C7-8 +/- T1
42
MC newborn fracture as a result of shoulder dystocia
Clavicular
43
Best diagnostic test for clavicular Fx
XR
44
Rx clavicular Fx
Immobilization, splinting, PT
45
What causes facial nerve palsy in delivery
Trauma from forceps use
46
Rx facial nerve palsy in neonate
Spontaneous recovery
| Surgical nerve repair if necessary
47
Causes of polyhydramnios
Neuro
- Werdnig-Hoffman (infant can't swallow)
GI
- Intestinal atresias
48
Causes of oligohydramnios
Prune belly (no abd muscles so can't bear down to urinate)
Renal agenesis
High atmospheric pressure causing flat faces
49
Rx Prune belly causing oligohydramnios
Serial foley - high risk of UTI
50
Association w/ renal agenesis
Potter sequence
51
Bowel sounds in chest and impaired ventilation
Diaphragmatic hernia
52
CXR in diaphragmatic hernia
Air fluid levels
53
Types of diaphragmatic hernias
Morgagni - Retrosternal/Parasternal (central)
| Bochdalek - Posterolateral (peripheral)
54
What is an omphalocele
Intestines and organs form beyond abd wall w/ a sac covering
55
Why does omphalocele occur
Failure of GI sac to retract at 10-12 weeks
56
What is umbilical hernia associated with
Congenital hypothyroidism
57
Rx umbilical hernia
90% close spontaneously by age 3
| Surgical intervention if still present at age 4
58
What does elevated AFP in utero indicate
Neural tube defects
| Abd wall defects
59
MCC elevated AFP
Incorrect dating
60
What is gastroschisis
Wall defect lateral to midline
Intestines and organs outside abd wall
No sac
61
Rx gastroschisis
Immediate surgery with gradual introduction of bowel and silo formation
62
Consequence of overly aggressive surgical management of gastroschisis
Third spacing and bowel infarction
63
PE finding w/ Wilms tumor
Large palpable mass felt
64
Cause of Wilms tumor
Hemihypertrophy of one kidney due to increased vascular demands
65
Highly associated with Wilms tumor
Aniridia
66
MC abdominal mass in children
Wilm's tumor
67
Best initial test for Wilms
ABD U/S
68
Most accurate test for Wilms
Contrast CT
69
WAGR syndrome
Chr 11 deletion
- Wilms Tumor
- Aniridia
- GU malformations
- Retardation
70
Rx Wilms
Total nephrectomy with chemo and radiation
71
Most important findings in Neuroblastoma
Hypsarrythmia and opsoclonus (Dancing eyes and feet)
| Increased urine VMA and metanepherines (diagnostic)
72
MC cancers in infancy
Neuroblastoma
73
MC extracranial solid malignancy
Neuroblastoma
74
Features of Hydrocele
Painless swollen fluid-filled sac containing spermatic cords
Transilluminates
Resolves in 6 months
Differentiate from inguinal hernia
75
Features of Varicocele
Varicose vein of scrotal veins
Swelling of pampiniform plexus
Dull ache and heaviness
76
Best initial test for varicocele
PE showing "bag of worms" sensation
77
Most accurate test for varicocele
U/S scrotum showing dilation of pampiniform plexus vessels >2mm
78
When to rx varicocele
Delayed growth of testes or testicular atrophy
79
What must you always do when diagnosing varicocele
U/S the other testicle
80
What is cryptorchidism
Absence of one teste in scrotum
| Found in inguinal canal
81
Rx cryptorchidism
Orchiplexy to bring it down after age 1 to prevent infertility
82
Risk associated w/ cryptorchidism
Increased risk of malignancy regardless of surgical intervention
83
What is hypospadias associated with
Cryptorchidism
| Inguinal hernias
84
Rx hypospadias
Surgical
85
Contraindicated in hypospadias
Circumcision
86
Associations with epispadias
Urinary incontinence
87
Must also be evaluated in epispadias
Concomitant bladder extrophy
88
Rx epispadias
Surgery
89
Developmental reflexes
```
Sucking
Grasping
Babinski
Moro
Stepping
Superman
```
90
Pathognomonic for tetralogy of fallot
Exercise intolerance
| Squatting while playing outside
91
Components of tetralogy of fallot
Overriding aorta
Pulm stenosis
RVH
VSD
92
Association with tetralogy of fallot
Chr 22 deletions
93
Presentation of tetralogy of fallot
Cyanosis of lips and extremities
Holosystolic murmur (left lower sternal border)
Squatting (tet spells)
94
How does squatting help kids w/ tetralogy of fallot
Increases preload and systemic venous return
| Decreases R to L shunt increasing pulm blood flow and O2 sat
95
CXR findings in tetralogy of fallot
Boot shaped heart
| Decreased pulm vascular markings
96
Only definitive therapy for tetralogy of fallot
Surgery
97
VSDs are common in
Down
Edward
Patau
98
MC congenital heart defect in Down
Endocardial cushion defect of AV canal
99
The only 3 holosystolic murmurs
MR
TR
VSD
100
What does transposition require for child to live
PDA or ASD or VSD
101
Presentation of transposition
Early, severe cyanosis
Single S2
Egg on a string on CXR
102
Initial management of transposition
PGE1 to keep PDA open
103
Contraindicated in transposition
NSAIDs esp indomethacin b/c it can close PDA
104
Rx tranposition
2 surgeries each having 50% mortality rate
105
MC cyanotic heart disease during neonatal period
Transposition
106
MC cyanotic heart disease after neonatal period
Tetralogy
107
Pulsus alternans
LV systolic dysfunction
108
Pulsus bigeminus
HOCM
109
Pulsus bisferiens
AR
110
Pulsus tardus et parvus
AS
111
Pulsus paradoxus
Cardiac tamponade, tension PTX
112
Irregularly irregular
A-fib
113
Components of hypoplastic left heart syndrome
LV hypoplasia
Mitral valve atresion
Aortic valve lesions
114
Presentation of hypoplastic left heart syndrome
Absent pulses w/ single S2
Increased RV impulse
Gray cyanosis
115
CXR in hypoplastic left heart syndrome
Globular shaped heart
| Pulm edema
116
Most accurate test in hypoplastic left heart syndrome
Echo
117
Rx hypoplastic left heart syndrome
3 separate surgeries
118
Sx truncus arteriosus
Dyspnea
Early and frequent resp infections
Single S2
Bounding peripheral pulses
119
CXR in truncus arteriosus
Cardiomegaly with increased vascular markings
120
Rx truncus arteriosus
Early surgery to prevent pulm HTN which can develop in 4 months
121
Features of total anomalous pulmonary venous return
No venous return b/w pulm veins and LA
Oxygenated blood goes to SVC
Can be w/ or w/o obstruction
122
What constitutes obstruction in TAPVR
Angle at which veins enter sinus
123
Rx Either type of TAPVR
Surgery
124
CXR TAPVR w/ obstruction
Pulm edema
| Echo definitive
125
CXR TAPVR w/o obstruction
Snowman or figure 8 sign
| Echo most accurate (used to actually diagnose)
126
Age of TAPVR w/ obstruction
Early in life w/ resp distress and severe cyanosis
127
Age of TAPVR w/o obstruction
1-2yrs w/ RHF and tachypnea
128
Child, otherwise healthy presents w/ holosystolic murmur and failure to thrive
VSD
| RVH on EKG
129
MC congenital heart lesion
VSD
130
Presentation of VSD
Dyspnea w/ resp distress
Holosystolic murmur at left lower sternal border
Loud pulmonic S2
131
Rx VSD
Small will close in 1-2yrs
Large need surgery
Diuretics and digoxin for conservative managment
132
Sequelae of untreated VSD
CHF
Endocarditis
Pulm HTN
133
Kid had stroke from DVT, how
ASD
134
Types of ASD
Primum - Concomitant mitral valve anomalies
Secundum - MC
Sinus venoses defect
135
Presentation of ASD
Fixed wide split S2
136
Most definitive test for ASD
Cardiac catheterization
| Can do echo
137
Rx ASD
Close spontaneously
| Surgery or transcatheter closure for symptomatic pts
138
Complications of ASD
Dysrhythmias
| Paradoxic emboli from DVTs
139
When does PDA close
PO2 rises above 50mmHg
| Therefore more prevalent in prematurity and high altitude
140
How long after birth is PDA considered normal
12hrs
141
Presentation of PDA
"Machine-like" murmur
Wide pulse pressure
Bounding pulses
142
MC complications later in life w/ PDA
Resp infections
| Infective endocarditis
143
Best initial test for PDA
Echo
144
Most accurate test for PDA
Cardiac cath
145
Rx PDA
Indomethacin
146
Mitral lesions radiate to
Axilla
147
Tricuspid and pulmonic lesions radiate to
Back
148
Aortic lesions radiate to
Neck
149
Pear shaped heart on CXR
Pericardial effusion
150
Boot shaped heart on CXR
Tetralogy of fallot
151
Jug handle heart on CXR
Primary pulmary artery hypertension
152
3-like appearance of heart or rib notching on CXR
Coarctation
153
Important sx for Long QT
Hearing loss
Syncope
NL vitals and PE
FHx sudden cardiac death
154
What is coarctation associated with
Turner's
155
Common features of Turner's
```
Short
Webbed neck
Shield chest
Streak gonads
Horseshoe kidneys
Shortened 4th metacarpal
```
156
Presentation of Coarctation
Severe CHF and resp failure in first few months
| Reduced pulses in LE, HTN in UE
157
Most accurate test for coarctation
Cardiac cath
158
Rx coarctation
Resection of narrow segment
| Balloon dilation if recurrence
159
When is hyperbilirubinemia pathological
```
First day of life
Rises > 5mg/dL/day
Above 19.5 in term child
Direct bili rises >2 at any time
Persists after 2nd week of life
```
160
Dx hyperbilirubinemia
Direct and indirect bili levels
Check mother/infant blood type for ABO incompatibility
Peripheral smear and retic count for hemolysis
161
Rx hyperbilirubinemia
Blue-green light phototherapy
| Exchange transfusion if bili >20-25
162
MC complication of esophageal atresia w/ TEF
Recurrent aspiration PN
163
Presentation of TEF
Vomitting w/ first feeding
Choking, coughing, cyanosis
Hx of polyhydramnios
164
Dx TEF
Gastric air bubble on CXR
| Coiling of NGT on CXR
165
Rx TEF
Surgery
ABX coverage for anaerobes
Fluid resuscitation before surgery
166
String sign
Pyloric stenosis
167
Doughnut sign
Intussusception
168
Birt's beak sign
Achalasia
169
Steeple sign
Croup
170
What causes pyloric stenosis
Hypertrophic pyloric sphincter
171
When does pyloric stenosis manifest
1st month of life
172
Auscultation finding w/ pyloric stenosis
Succussion splash
173
Hallmark feature of pyloric stenosis
Nonbilious projectile vomitting
174
Metabolic imbalances in pyloric stenosis
Hypochloremia
Hypokalemia
Metabolic acidosis
175
What is olive sign
Mass size of olive palpated in epigastrum in pyloric stenosis
176
Best initial test for pyloric stenosis
ABD U/S
177
Most accurate test for pyloric stenosis
Upper GI series
178
4 signs in Upper GI series for pyloric stenosis
String sign - Thin barium column
Shoulder sign - Antrum filling defect 2/2 muscle prolapse
Mushroom sign - Hypertrophic pylorus against duodenum
Railroad track sign - Excess mucosa: 2 barium columns
179
Rx pyloric stenosis
Replace lost volume and electrolytes esp K
NGT to decompress bowel
Myotomy
180
What is choanal atresia associated with
```
Colobalma
Heart defects
Atresia of the chonae
Retardation of grown and/or development
GU defects
Ear abnormalities
```
181
Presentation of choanal atresia
Child turns blue when feeding, Pink when crying
182
Confirm dx in choanal atresia
CT
183
Rx Choanal atresia
Surgical perforation of membrane
184
What is choanal atresia
Membrane between nostrils and pharyngeal space preventing breathing when feeding
185
What is hirschsprung
Lack of innervation of distal bowel by aurbach plexus
186
Associations w/ hirschprung
Down
187
Presentation of hirschprung
Do not pass meconium for over 48hrs
Extreme constipation and large bowel obstruction
Extremely tight sphincter
Innability to pass flatus
188
Hirschprung XR
Distended bowel loops
| Retention of barium >24hrs
189
Hirschprung Manometry
High pressures in anal sphincter
190
Most accurate dx hirschprung
Full thickness Bx w/ lack of ganglionic cells in submucosa
191
What is imperforate anus associated with
Down
192
What is imperforate anus a component of
```
Vertebral anomalies
Anal atresia
Cardio anomalies
TEF
Esophageal atresia
Renal anomalies
Limb anomalies
```
193
Presentation of imperforate anus
No meconium
| No anus
194
What is duodenal atresia associated with
Down
| Annular pancreas
195
Dx duodenal atresia
Bilious vomitting within 12hrs of birth
| Double bubble sign on CT
196
Rx duodenal atresia
Replace fluids and K
NGT to decompress bowel
Surgical duodenostomy
197
Where in the bowel does volvulus usually occur in children
Midgut, ileum
198
Presentation of volvulus
Vomitting, colickly abd pain
199
Dx volvulus
Multiple air fluid levels on XR
| Bird beak on upper GI series
200
Best initial therapy for volvulus
Endoscopic decompression
201
Most effective therapy for volvulus
Surgical decompression
202
What is intussusception associated with
Rotavirus vaccine
| Henoch-Schonlein purpura
203
Causes of intussusception
```
Polyp
Hard stool
Lymphoma
Viral
Idiopathic
```
204
Presentation of intussusception
Colichy abd pain
Bilious vomitting
Currant jelly stool
Sausage shaped mass
205
Best initial test for intussusception
U/S showing doughnut sign
206
Most accurate test for intussusception
Barium enema
| Diagnostic and therapeutic
207
When is barium enema contraindicated in intussusception
Peritonitis, shock, perforation
208
Rx Intussusception
Fluid resuscitation FIRST
NGT decompression of bowel
Barium enema
Surgery if fails
209
Painless BRBPR in male
Meckel's
210
Most accurate test for Meckel's
Technetium-99m pertechnetate scan
| ie. meckel's scan
211
What is a meckel's diverticulum
Persistant vitelline duct in small intestine
| Can contain gastric or pancreatic tissue
212
Presentation of meckel's
Painless rectal bleeding
213
Rx Meckel's
Surgery
214
Second most common cause of infant death worldwide
Acute fluid and electrolyte loss 2/2 acute diarrhea
215
Presentation of inflammatory diarrhea
Fever
ABD pain
Bloody diarrhea
216
Presentation of noninflammatory diarrhea
Vomitting
Crampy abd pain
Watery diarrhea
217
Dx tests in diarrhea
Stool for blood and leukocytes
Stool Cx w/ O and P
Sigmoidoscopy in the setting of C. diff
218
Most important next step in acute diarrhea
Rehydration
Mild = oral
Severe = IV
219
ABX of choice in NEC
Vanco
Genta
Metro
220
Presentation of NEC
Severely premature baby, LBW
Vomitting and abdominal distension
Fever
221
Dx tests for NEC
ABD XR showing pneumatosis intestinalis
| Frank or occult blood
222
Rx NEC
Stop feeding (bowel res)
IV fluids
NGT
Surgery if ABX fail
223
Description of shoulder dystocia
Arm adducted and internally rotated
224
Most common wrong answer in newborn w/ DM
Insulin
225
Effects of macrosomia in IDM
Polycythemia, hyperviscosity
Shoulder dystocia
Brachial plexus palsy
226
Dx and Rx of small left colon syndrome in IDM
Barium
| Smaller, more frequent meals
227
Major cardiac change in IDM
Asymmetric septal hypertrophy → decreased CO
228
Dx Asymmetric septal hypertrophy in IDM
EKG and Echo
229
Rx Asymmetric septal hypertrophy in IDM
BBs
| IVF
230
Features of renal vein throbosis in IDM
Flak mass and possible bruit
| Hematuria and thrombocytopenia
231
Metabolic findings and effects in IDM
Hypoglycemia → seizures
Hypocalcemia → tetany, lethargy
Hypomagnesemia → hypocalcemia, decreased PTH
Hyperbilirubinemia → icterus and jaundice
232
Most cases of CAH are due to
Deficiency of 21-hydroxylase
233
3 forms of CAH
21-hydroxylase
17-hydroxylase
11-beta-hydroxylase
234
MC presentation of CAH
Hypotensive child w/ severe electrolyte abnormalities
235
Other features of CAH
Ambiguous genitalia in girls
Boys lose sexually defining characteristics w/ age
Decreased Na, K, Cl, glucose
Acidosis
236
Dx tests in CAH
Serum electrolytes
| Increased 17-OH progesterone
237
Rx CAH
Fluid and electrolyte replacement
Lifelong steroids
Psych counselling
238
Cause of Rickets
Lack of Vit D, Ca, or PO4
239
When are children at highest risk of rickets
6-24mos
240
3 main etiologies of rickets
Vit D def
Vit D dependent
X-linked hyperphosphatemic
241
What causes Vit D def rickets
Lack of Vit D in diet
242
What causes Vit D dependent rickets
Inability to convert 25-OH to 1,25-OH
| Child dependent on Vit D supplementation
243
What causes X-linked hyperphosphatemic rickets
Innate kidney defect
| Inability to retain phosphate
244
Presentation of rickets
Ulnar/radial bowing
| Waddling gait
245
Risk factors for rickets
Sunless environment
| Doesn't drink milk
246
CXR finding in rickets
```
Rachitic rosary
(costochondral joints w/ cupping and fraying or epiphyses)
```
247
Rx rickets
Ergocalciferol
Calcitrol
Annual VIt D monitoring
248
Who gets vit D supplementation
All infants exclusively breastfed starting at 2mos
249
Child with febrile seizure, what is next step
Evaluate for underlying sepsis
250
What is a full sepsis evaluation in children
```
CBC + diff
UCx
U/A
CXR
LP
```
251
MCC neonatal sepsis
PN
| Meningitis
252
MC organisms in neonatal sepsis
GBS #1
E. coli
S. aureus
L. monocytogenes
253
Dx tests in neonatal sepsis
Blood and urine Cx
| CXR
254
Rx neonatal sepsis
Amicillin and gentamicin
255
What are TORCH infections
```
Toxo
Other infections (syphilis)
Rubella
CMB
HSV
```
256
Presentation of neonatal toxo
Chorioretinitis
| Multiple ring enhancing lesions on CT
257
Best initial test for neonatal toxo
Elevated IgM
258
Most accurate test for neonatal toxo
PCR
259
Rx neonatal toxo
Pyrimethamine and sulfadiazine
260
Presentation of neonatal syphilis
Rash on palms and soles, snuffles, frontal bossing
| Hutchinson 8th nerve palsy and saddle nose
261
Best initial test for neonatal syphilis
VDRL or RPR
262
Most accurate test for neonatal syphilis
FTA ABS or dark field
263
Rx neonatal syphilis
PCN
264
Presentation of neonatal rubella
PDA, VSD, ASD
Cataracts, deafness, hepatosplenomegaly
Thrombocytopenia
Blueberry muffin rash and hyperbilirubinemia
265
Diagnosis of neonatal rubella
Maternal IgM
266
Rx neonatal rubella
Supportive
267
Presentation neonatal CMV
Periventricular calcifications
Microencephaly, chorioretinitis
Hearing loss, petechiae
268
Best initial test for neonatal CMV
Urine or saliva viral titres
269
Most accurate test for neonatal CMV
Urine or saliva for PCR for viral DNA
270
Rx neonatal CMV
Ganciclovir if end organ damage
271
Presentation of neonatal herpes
Week 1: Shock and DIC
Week 2: Vesicular skin lesions
Week 3: Encephalitis
272
Best initial test for neonatal herpes
Tzank
273
Most accurate test for neonatal herpes
PCR
274
Rx neonatal herpes
Acyclovir and supportive care
275
Rx for all childhood viral illness
Supportive
276
Best initial test for varicella
Tzank
277
Most accurate test for varicella
Viral Cx
278
Presentation of rubeola (measles)
Cough, Coryza, Conjunctivitis
| Koplik spots
279
Most accurate test in measles
IgM
280
Presentation of 5th disease
Fever, URI
| Progresses to slapped cheek rash
281
Presentation of roseola
Fever and URI
| Progresses to diffuse rash
282
Presentation of Mumps
Fever precedes parotid gland swelling and possible orchitis
283
Cause of scarlet fever
Strep pyogenes
284
Presentation of scarlet fever
Fever, Pharyngitis, Diffuse sandpaper rash, Strawberry tongue, Cervical lymphadenopathy
285
Correlation w/ clinical dx of scarlet fever
Elevated antistreptolysin O titre, ESR, CRP
286
Rx scarlet fever
PCN
Azithromycin
Cephalosporins
287
MCC croup
Parainfluenzae 1 and 2
| RSV is #2
288
Most important step in child w/ severe croup
Racemic epi
289
Presentation of croup
Barking cough
Coryza
Inspiratory stridor
290
XR signs of croup (rarely done)
Steeple sign
| Narrowing of air column in trachea
291
How to differentiate croup from epiglottitis
Croup presents w/ hypoxia
292
Rx croup
Mild - steroids
| Moderate/severe - racemic epi
293
Signs of epiglottitis, next best step
Intubate immediately
294
Cause of epiglottitis
H. influenzae type B
295
Presentation of epiglottitis
```
Unvaccinated
Hot potato voice
Fever
Drooling in tripod position
Refuse to lie flat
Hot cherry red epiglottis
```
296
Classic XR sign in epiglottitis
Thumbprint sign
297
Rx epiglottitis
Intubate in OR
Ceftriaxone for 7-10 days
Rifampin for all close contacts
298
Cause of whooping cough
Bordetella pertussis
299
Catarrhal stage in whooping cough
Severe congestion and rhinorrhea
| 14 days
300
Paroxysmal stage in whooping cough
Severe coughing episodes with extra gasp for air followed by vomitting
14-30 days
301
Convalescent stage in whooping cough
Decreased frequency of coughing
| 14 days
302
Clinical Dx of whooping cough
Whooping inspiration
Vomitting
Burst blood vessels in eye
303
CXR in whooping cough
Butterfly pattern
304
Most accurate test for whooping cough
PCR of nasal secretions
| Pertussis toxin ELISA
305
Rx whooping cough
Erythromycin or azithromycin for catarrhal
Isolate child and macrolides for close contacts
DTaP vaccine
306
Bronchitis features
Bacterial/viral inflammation of airways
Productive cough for 7-10 days w/ fever
Clinical Dx
Supportive care
307
Pharyngitis features
Group A hemolytic strep pharynx inflammation
Cervical adenopathy, petechiae, fever > 104, acute rheumatic fever, glomerulonephritis
Rapid DNAse test
PCN 10 days or macrolide if allergy
308
Diphtheria features
Membranous pharynx inflammation by corynebacterium diphtheriae
Gray vascular pseudomembranous plaques
Cx superficial membrane
Antitoxin as Rx
309
Scrape diphtheria pseudomembranes
No
310
Dx congenital hip dysplasia
Ortolani and Barlow maneuver
| Click or clunk in the hip
311
Rx congenital hip dysplasia
Pavlik harness
312
Presentation of legg-calve-perthes
Painful limp
313
Dx legg-calve-perthes
Joint effusions and widening on XR
314
Rx legg-calve-perthes
Rest and NSAIDs
| Surgery on both hips
315
Findings in Vit A deficiency
Poor night vision
| Hypoparathyroidism
316
When does SCFE present
Adolescence, esp obese
317
Presentation of SCFE
Painful limp
| Externally rotated leg
318
Dx SCFE
Widened joint space on XR
319
Rx SCFE
Internal fixation and pinning
320
Findings in Vit A tox
Pseudotumor cerebri
| Hyperparathyroidism
321
Which vitamins have no toxicity
All B vitamins
| Vit C
322
Findings in Vit B1 def
Beriberi
| Wernicke
323
Findings in Vit B2 def
Angular chelosis
Stomatitis
Glossitis
324
Findings in Vit B3 def
Pellagra
- Diarrhea
- Dermatitis
- Dementia
- Death
325
Findings in Vit B5 def
Burning feet syndrome
326
Findings in Vit B6 def
Peripheral neuropathy
| Give w/ INH
327
Findings in Vit B9 def
Megaloblastic anemia
| Hypersegmented neutrophils
328
Findings in Vit B12 def
Megaloblastic anemia
Hypersegmented neutrophils
Peripheral neuropathy
329
Findings in Vit C def
Scurvy
330
Findings in Vit D def
Rickets
331
Findings in Vit K def
Increased PT/INR
Signs and sx of mild to severe bleeding
Analogous to warfarin therapy
332
Findings in Vit D tox
Hypercalemia
Polyuria
Polydipsia
