Peds

Question 1

BRUE

Answer 1

age greater than 60 days
born greater than 32 weeks gestation
no CPR performed by a trained medical provider
event lasted less than one minute
first episode

Question 2

Seizure treatment in order

Answer 2

1. Lorazepam, diazepam, midazolam
2. Phenytoin, valproic acid, Keppra
3. Phenobarb, propofol

Question 3

Febrile seizure criteria

Answer 3

Generalized
6m-5y
<15m
No recurrence

Question 4

Croup treatment

Answer 4

Everyone: Oral dexamethasone 0.6 mg/kg once
Severe: nebulized epinephrine

Question 5

Infantile spasms

Answer 5

Clusters of myoclonic seizures when waking, hypsarrhythmia on EEG, developmental delay
Sx start at 4-8m of age
Give ACTH, pregnisone and antiepileptics

Question 6

Defibrillation

Answer 6

2 j/kg follow with 2mins CPR and recheck pulse

4 j/kg for each shock after

Question 7

Cardioversion

Answer 7

0.5 J/kg

Double after first attempt

Question 8

Epi doses

Answer 8

IV/IO: 0.01 mg/kg

ET: 0.1 mg/kg

Question 9

Adenosine dose

Answer 9

0. 1 mg/kg (max 6) initial

0. 2 mg/kg (max 12) subsequent

Question 10

ET tube size in peds

Answer 10

(Age/4)+4

Question 11

Estimate blade length for intubation

Answer 11

Edge of incisor to angle of mandible

Question 12

How old do kids need to be for surgical cricothyrotomy?

Answer 12

10

<10 gets needle cric

Question 13

Bradycardia in a neonate

Answer 13

Hypoxia/respiratory failure

Question 14

Empirical abx in a neonate suspicious for septicemia or meningitis

Answer 14

Ampicillin and gent

Avoid rocephin due to kernicterus

Question 15

Neonatal hypothyroidism

Answer 15

Constipation, difficulty feeding, weak cry, large anterior fontanelle, hypothermia, hypotonia, peripheral edema

Question 16

Start PALS

Answer 16

HR<60 w/ hypotension despite fluids, AMS despite oxygen

Question 17

Metaphyseal fx

Answer 17

Pathopneumonic for non-accidental trauma

Question 18

Intussception

Answer 18

Intermittent abd pain, legs to chest
Target sign and telescoping on US
Associated with HSP, rotavirus
Treat with air contrast enema

Question 19

Necrotizing enterocolitis

Answer 19

Premature infants in first 3 weeks of life
Abd distension, poor feeding, vomiting, bloody stool
Pneumatosis intestinalis
NG decompression -> bowel rest -> abx for enteric bacteria

Question 20

HSP

Answer 20

IgA vasculitis
Complications: intussusception; periarticular disease of knees and ankles
Hematuria, proteinuria, elevated BUN/Cr
Normal platelets

Question 21

Croup

Answer 21

Tracheolaryngitis
Parainfluenza
Worse at night
Steeple sign

Question 22

Pretreatment for intubation atropine dose

Answer 22

0.02 mg/kg

Question 23

Most common dysrhythmia in children

Answer 23

SVT

Question 24

Croup

Answer 24

6m-3y
Peaks day 3 and 4
Dexamethasone 0.6 mg/kg
Recepi for mod/severe

Question 25

Retropharyngeal abscess

Answer 25

Usually <4 Retropharyngeal space at C2 is 2x diameter for vertebral body Zosyn or clinda

Question 26

Displacement of tonsil in peritonsillar abscess

Answer 26

Anterior and medial

Question 27

ToGV

Answer 27

Most common cyanotic defect in 1st week of life | Egg on a string heart on XR

Question 28

Toddlers fracture

Answer 28

Spiral fracture of tibia

Question 29

TEN-4

Answer 29

Bruising to torso, ear or neck under 4m

Question 30

Hirschsprung Diseaee

Answer 30

Most common cause of distal bowel obstruction in neonates Failure of neural crest cells to migrate M>F, often with other congenital issues Bilious emesis, failure to tolerate feeds, failure to pass meconium Rectal suction biopsy

Question 31

Neonatal omphalitis

Answer 31

3-5d old Increased risk w/home birth Umbilical stump with purulent discharge, erythema, warmth Triple coverage abx: PCN or vanco, aminoglycicide and aneorobic (flagyl) if mother has chorioamnitis

Question 32

Hirschsrpung disease

Answer 32

Lack of colonic ganglion cells usually go the rectosigmoid segment Delayed passage of meconium Cone shaped transitional zone

Question 33

Holliday-Segar for Maintenace fluids

Answer 33

4/2/1

Question 34

Bronchiolitis

Answer 34

<2 yo 7-14d w/ 3-5d peak RSV

Question 35

Ankylosing spondylitis

Answer 35

Anterior uveitis (most common), IBS, psoriasis, aortic regurg, restrictive pulmonary disease

Question 36

Neuroblastoma

Answer 36

Adrenal gland mass, non-tender Proptosis, periorbital ecchymosis, periorbital edema Opsoclonus-myoclonus; VMA <1 y good prognosis

Question 37

Neonatal hypoglycemia treatment

Answer 37

5ml/kg 10% dextrose

Question 38

Estimate lowest BP in kids

Answer 38

2x age + 70

Question 39

Most common cancer seen in peds

Answer 39

ALL Anemia, neutropenia, thrombocytopenia

Question 40

Tetralogy of Fallot

Answer 40

Overriding aorta, pulmonic stenosis, rt ventricular outflow obstruction, VSD

Question 41

Major Jones criteria

Answer 41

Carditis, polyarthritis, chorea, subcut nodules, erythema marginatum

Question 42

Hypertonic saline dose

Answer 42

2-6 ml/kg

Question 43

Most specific for neonatal cardiogenic shock secondary to CHF

Answer 43

Hepatomegaly