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Peds Flashcards

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1
Q

abx for OM (decreasing order)

A 
amoxicillin
augmentin
cefdinir (PCN allergic)
azithromycin (last resort)
r/o mastoiditis, tx with surgical decompression
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2
Q

OE tx

A

abx drops: cipro
steroid drops
r/o mastoiditis, tx with surgical decompression

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3
Q

sinusitis tx

A

typically VIRAL
if clearly bacterial: give augmentin
consider foreign body

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4
Q

pharyngitis tx

A

augmentin

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5
Q

what to do if bug in ear

A

Lidocaine to paralyze, don’t shine light! bug will go deeper

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6
Q

blue with feeding, pink with crying + childhood snore

A

choanal atresia

dx: catheter fails to pass, or fiber-optic
tx: surgical

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7
Q

if see croup that does not improve with racemic epi, think?

A 
bacterial tracheitis
may be toxic appearing
dx: tracheal culture
tx: IV abx
f/u: ENT scope
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8
Q

epiglottitis vs retropharyngeal abscess

A

both extend necks, will see tender u/l neck mass with abscess and LAD

dx: CT scan
tx: I/D or aspiration + IV abx

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9
Q

how is peritonsillar abscess different

A

older kids (10+)
see uvular deviation
dx: clinical
tx: drain + abx

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10
Q

extrathoracic vs intrathoracic FB

A

intrathoracic: expiratory wheeze
extrathoracic: inspiratory stridor

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11
Q

FB XR

A

look for “coin sign”
if in trachea, will be A-P oriented, so see face of coin on lateral
if esophagus will be lateral

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12
Q

bronchiolitis tx

A

O2, IVF
peaks 3-4
may not be able to eat so keep in hospital
f/u: hypoxemic resp. failure, ARDS

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13
Q

seizure tx

A

levetiracitam (keppra)
phenytoin
valproate
lamotrigine

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14
Q

simple febrile seizure
3/3 of the following
tx?

A 
1x in 24 hrs
less than 15 minutes
generalized
tx: benzos, acetaminophen
if less than 3/3 it's complex, w/u with EEG, LP or MRI and tx: AEDs
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15
Q

infantile spasms

A 
less than 1 yr, not generalized, no fever, symmetric jerking
dx: EEG shows hypsarrhythmia
tx: ACTH
f/u: MR
associated with tuberous sclerosis
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16
Q

tuberous sclerosis

A

angiofibromas, ash-leaf, afebrile seizures

dx: neuroimaging

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17
Q

intussusception dx

A

KUB: will see perf or obstruction
U/S next: sn, track resolution, “target sign”
dx/tx: air enema, need surgery if fails or peritonitis or perforation

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18
Q

“colon cancer” presentation in adult, think?

A 
Meckel's
i.e. painless hematochezia or FOBT+ or iron-def. anemia
dx: technicium-99 scan
tx: resection
f/u: teenager: CT scan is better
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19
Q

GI bleed distractors

A

babies swallow moms blood (Apt test)
epistaxis
iron pills, beets, medications
give reassurance

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20
Q

other GIB stuff

A 
IBD (UC more bloody)
infectious colitis (stool cx)
milk-protein allergy (change to hydrolyzed formula)
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21
Q

dev. dysplasia of hip

A

dx: U/S after no resolution for 4 wks

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22
Q

LCP (avascular necrosis)

A

6 yo

dx: XR, tx: cast

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23
Q

SCFE

A

13 yo

frog-leg XR tx: surgery

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24
Q

transient synovitis

A

hip pain after viral illness
+/- inability to bear weight
tx: supportive, ddx from septic joint with Kocher criteria (fever, ^WBC, ^ESR, (^CRP), non-weight bearing)

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25
bone cancer | Ewing vs Osteosarcoma
Ewing: mid-shaft Osteosarcoma: distal femur (Rb association) dx: XR then MRI and biopsy to confirm
26
take peds fractures to OR for ORIF if ?
open, commuted, or involves growth plate
27
strabismus tx
congenital: surgery before 6 mo acquired: patch good eye, give glasses
28
congenital cataracts
at birth: TORCH | after birth: galactosemia
29
diseases of prematurity (if you see one look for the others)
retinopathy of prematurity bronchopulmonary dysplasia intracranial hemorrhage NEC
30
conjunctivitis
chemical: <24 hrs gonorrhea: day 2-7, tx: ceftriaxone chlamydia: days 5-14, u/l becomes b/l, mucopurulent, PO erythromycin others: HSV, bacterial (d 5-14)
31
w/u for macroscopic non-glomerular (no RBC casts) hematuria
``` U/S: shows +/- hydro VCUG: shows +/- reflux CT: trauma (use contrast) or stone (non contrast) cystoscopy: intraluminal lesions IVP, renal bx (not usually) ```
32
Posterior urethra valves
"kid with BPH" No UOP + distended bladder +/- oligohydramnios, ^CR dx: U/S (hydro), VCUG (r/o reflux) tx: catheter, sx
33
hypo/epispadias
do NOT do circumcision, need that tissue for reconstruction
34
Uteropelvic Junction Obstruction
presents with colicky abdominal pain with ^urinary flow (i.e. binge drinking) dx: U/S: hydro, (NO hydro in ureter) VCUG: r/o reflux tx: sx +/- stent
35
ectopic ureter
girl with "fistula" boys: asymptomatic (above urinary sphincter) girls: constant leak (below urinary sphincter) dx: U/S: no hydro, VCUG: r/o reflux, radionucleotide (renal function) tx: reimplant
36
vesiculouretural reflux
``` retrograde flow usually found on antenatal U/S + hydro may present with recurrent UTIs +/- pyelo dx: U/S: hydro, VCUG: +reflux tx: abx, surgery ```
37
labs in HgbSS
Hgb: 7-9, ^Bili, ^retic may need transfusion which may result in iron overload (tx: deferoxamine) may need folate supplementation
38
SCD osteomyelitis org
still most likely S. aureus! | Salmonella is commen in SCD
39
avascular necrosis tx
initially conservative, may need sx
40
SCD acute problems
stroke: FND, AMS ACS: CP, SOB tx: exchange transfusion (CVC) priaprism: drainage before exchange transfusion
41
vasoocclusive crisis tx
IVF, O2, IV opiates compare to baseline Hgb, retic, bili +/- abx f/u: psychosocial stressors if no ^labs
42
vasooclusive ppx
hydroxyurea, ^HbF reduce # of crises BM transplant not yet an option
43
HgbSC
low Hgb (around 11) hematuria usually do not get crises others: SB+, SBo
44
recurrent sinopulmonary infections at 6 mos, low B-cells, NO IgG, IgA, IgM
X-linked Bruton's agammaglobulinemia confirm with RTK gene tx: IVIG (scheduled), +/- BM transplant
45
recurrent sinopulmonary infections in teenager, low B-cells, low of 2/3: IgG, IgA, IgM
CVID ("mild Bruton's") | tx: IVIG
46
sinopulmonary or GI infections AND/OR anaphylaxis after blood transfusion
IgA deficiency ^IgG, ^IgM tx: none f/u: take IgA out of donor blood, EPI for anaphylaxis
47
non specific immune deficiency, low B cells, low IgG, low IgA, ^IgM
hyper IgM | tx: none
48
fungi and PCP infections, low absolute lymphocytes
DiGeorge 22q11.2 deletion, 3rd pharyngeal pouch wide eyes, low ears, small face, no thymus tx: TMP-SMX, IVIG bridge to thymic transplant f/u: hypocalcemia (absent PTH)
49
eczema, low platelets, low WBC, normal infections, ^IgM, ^IgG (trying to compensate)
Wiskott-Aldrich (X-linked) | tx: BM transplant
50
Ataxia telangectasia associations
low Igs | DNA repair, leukemia, lymphoma
51
immediate immunodeficiency, NO B/T cells, low WBCs, NO IgG/M/A, adenosine deaminase deficiency
SCID "mega-AIDS" tx: isolate, TMP-SMX, BM transplant
52
S. aureus abscesses, ^WBC, ^IgG/M think?
Chronic granulomatous disease catalase + infections immune system trying to "ramp up" tx: BM transplant
53
^fever, ^WBC, NO pus, delayed cord seperation
LAD: WBC can't leave blood tx: BM transplant
54
giant granules in PMNs, +partial albinism, neuropathy, neutropenia
Chediak Hegashi
55
if has C1 esterase deficiency and get angioedema give ?
FFP
56
who should not get egg containing vaccines
yellow fever MMRV IS SAFE TO GIVE influenza may/may not contain eggs
57
Treatment for tetanus
Intubate, sedate, muscle relaxers, metronidazole IV
58
Wound management if less than 3 lifetime doses of Tdap
If clean, just give Tdap | If dirty, Tdap + TIG
59
Wound management if more than 3 lifetime doses of Tdap
Clean wound: if more than 10 years since Tdap, give Tdap If less than 10 years, no treatment Dirty wound: if more than 5 years since Tdap, give Tdap If less than 5 years, no treatment
60
Diphtheria treatment
Antitoxin, erythromycin or penicillin G, possible intubation, droplet precautions

Peds Step 2 (3 decks)

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