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Peds Flashcards

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1
Q

5 categories of things to cover in well-child visit

A 
vaccinations
growth
development
safety
abuse/neglect
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2
Q

evaluate growth at well-child visit

A

weight
height
head circumference

trend, if fall off growth curve, or in bottom 5th percentile, work up further
e.g. CF, heart disease, pyloric stenosis, GERD
malnutrition

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3
Q

in failure to thrive and malnutrition, which aspects of child growth suffer first?

A

1 weight
2 height
3 head circumference

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4
Q

well-child fell off growth curve into bottom 5%, what do you look for now

A

failure to thrive
(e.g. genetic (CF), heart disease, pyloric stenosis, GERD)
malnutrition
(formula, feed, frequency – do mom and dad know what they are doing? type, amount, freq?)

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5
Q

bare bones child development timeline

A

2mo - lift head, social smile
4mo - roll over
6mo - sit up, stranger danger (anxiety

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6
Q

bare bones child development timeline

A 
2mo - lift head, social smile
4mo - roll over
6mo - sit up, stranger danger (anxiety)
1y - walk, separation anxiety, 1 word
2y - stairs, 2 words
3y - tricycle, 3 words, circle
4y - hop, 4 words, cross
5y - skip, 5 words, triangle
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7
Q

bare bones motor milestones

2mo, 4mo, 6mo, 1y, 2y, 3y, 4y, 5y

A 
lift head
roll over
sit up
walk
stairs
tricycle circle
hop cross
skip triangle
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8
Q

bare bones social/language milesones

2mo, 4mo, 6mo, 1y, 2y, 3y, 4y, 5y

A 
social smile
-
stranger danger anxiety
separation anxiety 1 word
2 word sentences
3 word sentences
4 word sentences
5 word sentences
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9
Q

tf

you will die from a tetanus toxin dose lower than can be recognized by immune system

A

t

that is why we vaccinate w tetanus toxoid

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10
Q

when does maternal immunity typically wear off in a newborn

A

~6mos

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11
Q

reactions to watch out for when administering vaccines

A

made w egg CI egg allergy
-yellow fever vac
-some flu vacs but changing
x can now give MMRV

live attenuated CI immunocompromise aids chemo transplant biologics careful w pregnancy
-MMRV
-intranasal flu vac
x IM flu ok

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12
Q

MMRV vaccine stands for

A

measles
mumps
rubella
varicella

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13
Q

vaccs CI w egg allergy

A

yellow fever vac
some flu vacs but changing
MMRV ok now

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14
Q

vaccs CI w immunocompromise

A

live attenuated
-MMRV
-intranasal flu vac
IM flu ok

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15
Q

vaccine reactions considered normal

A

temp v104F (babies only?)
erythema
baby consolable

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16
Q

vaccine reactions considered abnormal

A

temp ^104F (babies only?)
anaphylaxis
baby inconsolable

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17
Q

normal vs abnormal vaccine rxns

A

temp v104 vs ^104
erythema vs anaphylaxis
consolable vs inconsolable baby

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18
Q

tf

acute illness is CI to vaccine

A

f

give vaccine

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19
Q

tf

family hx of abnormal rxn to vaccine is CI to vaccine

A

f

only personal hx of abnormal rxn to THAT specific vaccine

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20
Q

when does baby get Hep B vaccine

A

mom + baby hep b ivig and hep b vacc asap
mom - baby hep b vacc w/in 2mos
mom ? baby hep b vacc now, check mom’s HBsAg

so baby always gets hep b vaccine, but if mom negative can wait v2mos

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21
Q

what will hep b infection at birth from carrier mom mean for baby

A

chronic carrier state for baby

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22
Q

DTaP/TdaP vacc schedule

Study These Flashcards
A

kids get 5 doses DTAP

  • 3 doses yr 1
  • 2 doses yrs 1-4

Td age 11 and q10y after or q5y if wound

23
Q

this bug causes epiglottitis

24
Q

tf

Hib exposure v2yo confers immunity

Study These Flashcards
A

f

so give Hib vaccine

25
tf | Hib vacc covers non-typeable Hib
f
26
MMRV vacc demo
everyone vacc and booster before school | not for immunocompromised because live attenuated
27
pneumococcal vacc demo
13 valent as infant | + 23 valent if risk factors such as immunocompromise or asplenia
28
meningococcal vacc demo
everyone should get it | espec close quarters dorms barracks
29
HPV vacc demo
all boys and girls 9-26
30
how many doses hep A vacc hep B vacc and what to do if pt re-presents after falling off dosing schedule
2 for A 3 for B pick up where you left off
31
flu vacc demo
everyone unless CI | healthcare workers before winter mos
32
what do cap vs lowercase letters mean in DTaP Tdap and Td ?
large dose vs small dose
33
DTaP Tdap Td demos
DTaP x5 for kids Tdap x 1 for all adults incl pregnant( every pregnancy!) and elderly... at least once age 11 and up Td booster
34
tetanus ppx dx tx
DTaPx5 kids Tdap x1 adults + Td booster q10y x2 tetanus ivig dx clinically puncture metal rust mud lockjaw spastic paralysis support intubate sedate muscle relaxants as needed to get through acute phase -iv metronidazole
35
tetanus ppx dx tx
DTaPx5 kids Tdap x1 adults + Td booster q10y x2 tetanus ivig dx clinically puncture metal rust mud saliva feces lockjaw spastic paralysis support intubate sedate muscle relaxants as needed to get through acute phase -iv metronidazole
36
treat wound for possible tetanus exposure
if v 3 lifetime doses (DTaP Tdap Td whatever) - Tdap if wound clean - Tdap + tetanus IVIG if wound dirty if 3 or more lifetime doses - Tdap clean wound ^10y since last dose - Tdap dirty wound ^5y since last dose - send home if wound clean v10y since last; if wound dirty v5y since last
37
tf | give tetanus ivig if last vaccine dose was ^5 years ago but 3 lifetime doses
f no tet ivig if ^ 3 lifetime doses only give tet ivig fewer than 3 lifetime doses and wound dirty
38
diptheria dx tx
clinical dx fever, dysphagia, dyspnea, psudomembrane inubate antitoxin ivabx
39
phases of pertussis infection
I catarrhal = infectious, nonspecific symx II paroxysmal = cough/woop III resolution
40
pertussis dx tx
clinical dx nonspecific infectious sympx, cough,woop, resolution airway support, erythromycin ppx w vaccine!
41
tf | prefererred immunity to varicella is obtained at pox parties
f used to play w chicken pox kid so everyone would get it now MMRV preferred, prevent disfiguration, shingles later in life
42
route of rotavirus vacc and CI
oral | intussusception CI
43
mnemonic for whether LP is unsafe
``` FAILS positive, increased icp FND AMS Immunocompromised Lesion Seizure ```
44
workup meningitis
FAILS positive fnd ams immunocompromised lesion seizure -blood cx, abx, ct, LP FAILS negative -LP, abx
45
Meningitis FAILS positive Fnd ams immunocompromised lesion seizure CT or abx first?
abx before CT -- want patient to live through ct Fails positive - blood cx, anx, ct, lp
46
in peds meningitis, signs of ICP
bulging fontanelles FAILS fnd ams immunocompromised lesion seizure
47
Tx meningitis in adult vs peds
Adult Vanc Ceftriaxone Steroids (plus minus) ``` Newborn v30 days old Vanc Cefotaxime(ceftriaxone causes hyperbilirubinemia in newborns) Ampicillin (Listeria coverage) Steroids ```
48
Meningitis with rash think this bug
Nisseria Meningitis
49
``` HIV baby How does baby get it How to prevent How to diagnose How to treat ```
Vertical transmission from Mom - HAART best case, mom knows and viral load is zero - AZT otherwise PCR, skip ELIZA because baby v18mos not making their own antibodies yet, will just see mom's HAART FOR EVERYONE with HIV, including babies Ppx cd4 (just know these, but cutoffs a little different in 6mos old) v200 pcp - tmpsmx, dapsone, atovaquone v100 toxo - tmpsmx, atovaquone v50 mac - azythromycin
50
Osteomyelitis in peds Dx Tx
Same as in adults But if see salmonella, think sickle cell If toxic, give abx then continue workup If not toxic -xr, bx, abx -mri if xr neg Abx course 4-6 wks Most often STAPH AUREUS any age
51
Most common bug in peds osteomyelitis
STAPH AUREUS most common in peds adults any age If salmonella in kid think sickle cell
52
TF | Bone scan to dx osteomyelitis
F Tough to tell cellulitis from deeper infection on bone scan Abx fast if toxic If not toxic, xr, mri, bx in there
53
``` Septic joint in peds Path Pres Dx Tx ```
Ghonnorhea sexually active teen Staph aureus direct inoculation stab wound Aspirate ^50,000 wbc Abx

Peds (12 decks)

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