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Step 3 > Peds > Flashcards

Peds Flashcards

1
Q

How do you work up unilateral red eye and mucoid drainage?

A

visual acuity neonate or sexually active teenager: gram stain and culture for N. gonorrhea and PCR or antigen test for Chlamydia trachomatis

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2
Q

How do you treat bacterial conjunctivitis?

A

Topical abx drops (bactrum, polymixin-bacitracin, fluoroquinolone)

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3
Q

What is the most common cause of conjunctivitis in the first 24 hours of life?

A

chemical conjunctivitis from the silver nitrate or erythromycin

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4
Q

How do you treat neonatal conjunctivitis due to gonorrhea?

A

CTX IM x1 and cover oral chlamydia w/ erythromycin x14 days w/ eye irrigation

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5
Q

How do you treat neonatal conjunctivitis due to chlamydia?

A

oral erythromycin x14 days and eye irrigation

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6
Q

When does chlamydia conjunctivitis present in the neonate?

A

days 5-14

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7
Q

How does neonatal glaucoma present?

A

megalocornea, tearing, photophobia, blepharospasm refer to ophthalmologist

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8
Q

How do you treat chemical conjunctivitis?

A

irrigate and refer to ophtho

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9
Q

How do you treat foreign body in eye?

A

examine, irrigate if non-penetrating foreign body, otherwise refer to ophtho

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10
Q

How do you dx corneal abrasion?

A

put anesthesia on eye do fluorescein test w/ wood’s lamp

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11
Q

How do you tx corneal abrasion?

A

topical ophtho abx drops and f/u in 48 hours

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12
Q

How do you tx dacrycocystitis?

A

massage 3-4 times per day and warm compresses until resolves

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13
Q

How do you tx periorbital cellulitis?

A

oral abx

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14
Q

What are concerning signs of orbital cellulitis?

A

eye pain! Can not move eye or it is limited

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15
Q

How do you evaluate orbital cellulitis?

A

CT/MRI urgent ophtho surgery!

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16
Q

How do you tx impetigo and what is the causative organism?

A

usually strep pyogenes (group A strep) or staph aureus

tx: mupirocin x 7days

if wide spread - oral cephalexin or clindamycin

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17
Q

What is a complication of impetigo caused by strep?

A

post-strep glomerulonephritis

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18
Q

Ddx for respiratory distress in the newborn

A

Respiratory distress syndrome

Pneumonia

Meconium aspiration

Transient tachypnea of the newborn

Congenital heart disease

Diaphragmatic hernia

primary pulmonary hypertension of the newborn

19
Q

Why do babies get RDS?

A

Surfactant immaturity and deficiency

20
Q

What are the steps to stablize a newborn with respiratory distress?

A

Place baby on the warmer

place cardiac and respiratory monitors

start oxygen, place pulse ox

wean oxygen as able

order chest x-ray and echo

place UVC for IV fluids and meds and UAC for blood draws and ABGs

start D10 W, send ABG, CBC, glucose, electrolytes, blood culture

start nasal CPAP if indicated

start ampicillin and gentamicin (if worried about meningitis - cefotaxime and ampicillin)

21
Q

How to evaluate for and treat pyloric stenosis?

A

Ultrasound and pyloromyotomy

IV fluids and manage electrolytes

22
Q

What acid-base disturbance is seen with prolonged vomiting?

A

hypokalemic, hypochloremic metabolic acidosis

23
Q

How to work up and treat concern for intussuception?

A

CBC, place IV and give bolus 20 cc/kg if dehydrated + IV hydration

ultrasound to dx

abdominal flat plate (look for perforation, if present cannot do air contrast enema)

air contrast enema to dx and tx

surgery if can’t reduce it

24
Q

W/U of Gi bleed in child older than 3 months?

A

stool guaiac, CBC, PLTs, retic, PT/PTT, bleeding time, CMP, could do stool cultures if indicated

25
Q

How to work up short stature?

A
  1. Look at parents height, if both short it’s likely familial short stature
  2. look at growth curve
  3. get bone age xray of wrist/hand, if younger than actual age = constitutional growth delay
26
Q

What is the definition of short stature?

A

Growth below the 3rd percentile

27
Q

What is the definition of tall stature?

A

Growth above the 97th percentile

28
Q

How to w/u a dusky newborn with low o2 sat and abnormal cardiac exam?

A

pulse ox, oxygen

ABG on room air

start IV with D10W, start Prostaglandin E1 drip (to keep open PDA)

ABG on oxygen (if PaO2 doesn’t correct - probably a heart issue)

CBC, blood culture, urine culture, UA, serum glucose and ca

CXR, EKG

amp and gent

ECHO

29
Q

What is the most common cyanotic congenital heart lesion?

A

Tetralogy of fallot (5-7%)

30
Q

What is the most common overall congenital heart legion?

A

Ventricular septal defect (25-30%)

31
Q

Diagnostic criteria for Kawasaki disease

A

Fever for five days and 4 of the following:

Conjunctival injection

Oral manifestations (cracked lips, strawberry tongue)

Skin rash

Adenopathy/adenitis

Hand findings including swelling or desquamation

32
Q

How to diagnose and treat Kawasaki disease?

A

CBC, ESR, AMP, BUN, CMP, glucose, liver enzymes, UA

start IV fluids

begin IVIG and high dose aspirin

CXR

EKG

ECHO

*continue high dose aspirin until afebrile x48 hrs, then low dose for 4-6 wks

*cardiology follow ECHO at 2-3 wks, 4-6wks, then q2-3 monthsuntil normal

33
Q

s/sx of lead poisoning?

A

abdominal pain, live in old building, behavioral issues, lethargy, pica

34
Q

How to w/u lead poisoning?

A

CBC and smear (shows anemia and basophilic stipling)

serum lead level

35
Q

When does lead poisoning require treatment?

A

44-70 give dimercaptosuccinic acid (oral)

>70 give EDTA (versenate) IV

36
Q

How to evaluate minor head trauma?

A

if no LOC, observe with competent care provider at home

if LOC <1 min observe in hospital or do CT scan

37
Q

What typical work up should be done in a child if concerned for NAT?

A

check coags (PT/PTT), CBC, skeletal survey if <2 yrs,

38
Q

What is the ddx for painless abdominal mass/

A

wilms tumor

neuroblastoma

choledochal cyst

ectopic or horseshoe kindey

teratoma

poop

39
Q

What is a Wilms tumor?

A

mixed embryonal tumor of the kidney

age 2-5 yrs

presents with painless mass and HTN

tx with surgery and chemo (if advanced or can’t resect)

40
Q

What is neuroblastoma?

A

embryonal cancer of peripheral sympathetic nervous system

~2 yo

usually near adrenal glands, increased VMA and HVA

*if child <1 yo, usually regresses on own

*if older than 1, poor prognosis

41
Q

How to tx fetal alcohol syndrome?

A

PT, OT, speech, psychosocial counseling

42
Q

s/sx of CF in newborn?

A

FTT despite good intake

thick meconium and delayed production

bulky, greasy stools

repeated respiratory symptoms

salty

nasal polyps

43
Q

How to w/u CF?

A

CXR, CMP

sweat chloride

44
Q

How to manage CF?

A

bronchodilators (albuterol/saline)

antibiotics when sick

steroids

chest PT

pancreatic enzymes and ADEK vitamins

Step 3 (15 decks)

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