peds first aid

Question 1

most common congenital heart disease

Answer 1

VSD

Question 2

which closes PDA and which opens?

Answer 2

indomethacin closes

PGs open

Question 3

most common cyanotic congenital heart disease in newbrown vs child

Answer 3

newborn: transposition of great vessels
child: tetralolgy of fallot

Question 4

CXR of tetralogy of fallot

Answer 4

boot shaped heart with decreased pulm vascular markings

Question 5

timeline of rolling, sitting, crawling, walking, stairs

Answer 5

roll: 4-5 mo
sit: 6
crawl/stand: 9-10
walk: 12
stairs: 24

Question 6

timeline of 3 finger vs 2 finger pincer grasp

Answer 6

3: 9-10 mo
2: 12 months

Question 7

cutoffs for precocious vs delayed puberty in boys vs girls

Answer 7

girls: <8, >13
boys: <9, >14

Question 8

klinefelter treatment

Answer 8

testosterone to help remove gynecomastia and improve male sex characteristiscs

Question 9

dx and tx of intusseception

Answer 9

dx: US target sign
tx: air insufflation enema, replete lytes, surgery if periotneal signs

Question 10

dx and tx of meckel diverticulum

Answer 10

dx: technietium 99 m scintragraphy scan
tx: surgery

Question 11

what is this: failure to mass meconium within 48 hrs, and explosive discharge of stool following rectal exam

Answer 11

hirschprung disease

Question 12

dx and tx of hirschprung

Answer 12

dx: barium enema (narrowed colon with proximal dilatation
; rectal biopsy confirms

tx: 2- stage surgery with diverting colostomy

Question 13

necrotizing enterocolitis dx and tx

Answer 13

dx: radiographs- pneumoatosis intestinalis
tx: NPO, TPN, IV abx, surgery if perf or worsening

Question 14

what is the earliest and most sensitive vital sign change in bronchiolitis?

Answer 14

increased resp rate

Question 15

dx and tx of bronchiolitis

Answer 15

dx: clinical
tx: supportive, ribavirin if high risk

Question 16

dx and tx of croup

Answer 16

dx: clinical; steeple sign

tx: mild- OP cool mist therapy
mod: supp O2, steroids, nebulized epi
severe: neb epi, intubation

Question 17

dx and tx of epiglottitis

Answer 17

dx: clinical; definitive by direct fiberoptic visualization, x -ray shows thumbprint sign
tx: emergency! secure airway with intubation, IV ceftriaxone

Question 18

kernig vs brudzinski sign

Answer 18

kernig: reluctance of knee extension to hip flexing
brud: hips flexed in response to flexion of neck

Question 19

tx of meningitis for neonates vs older children

Answer 19

neonates: amp and cefotaxime or gent; acyclovir
kids: ceftriaxone and vancomycin

Question 20

which child resp disorders makes kid want to sit in a neck extended tripod position?

Answer 20

epiglottitis and retropharyngeal abscess

Question 21

age of retropharyngeal vs periotonsillar abscess

Answer 21

r: 6-mo-6 years
peritonsillar: >10 yrs

Question 22

most common bacteria for both retropharyngeal and periotonsillar abscess

Answer 22

group A strep

Question 23

dx of retropharyngeal vs periotonsillar abscess

Answer 23

r: lateral neck x -ray; contrast CT
p: clx

Question 24

treatment for conjunctivitis: chlmaydia vs gonococcal vs HSV(vesicular eruptions)

Answer 24

chlamydia: topical AND oral erythromycin
gon: 3rd gen ceph

HSV: oral acyclovir and topical

Question 25

3 stages of pertussis

Answer 25

1) catarrhal - mild URI 1-2 weeks (contagious!) 2) paroxysmal: 2-3 mo 3) convalescent- sxs wane

Question 26

dx of pertussis

Answer 26

nasopharyngeal culture

Question 27

rash spreads how in measles and rubella

Answer 27

head to toe

Question 28

interpret apgar scores

Answer 28

8-10: healthy 4-7: observe for possible resuscitation 0-3: immediate resuscitation

Question 29

kernitcterus

Answer 29

complication of unconjugated bili (>25) deposition in basal ganglia, pons, cerebellum can be fatal

Question 30

is phototherapy for all types of hyperbilirubenemia?

Answer 30

no- only unconjugated | conj can lead to skin bronzing

Question 31

which type of bili is physiologic?

Answer 31

unconjugated

Question 32

how to prevent resp distress syndrome in premature fetus

Answer 32

<30 weeks: pretreat mom with corticosteroids >30 weeks: monitor lecithin:spingomyelin ratio and phosphatidylglycerol in amniotic fluid

Question 33

resp distress syn confirmed how?

Answer 33

CXR- air bronchograms, ground glass

Question 34

CXR of transient tachypnea of newborn

Answer 34

perihilar streaking in interlobular fissures

Question 35

two categories of cerebral palsy

Answer 35

pyramidal (spastic)- also ID- more common extrapyrimdal (dyskinetic)= ataxic, choreo, or dystonic

Question 36

definite hand preference before 1 year is a red flag for

Answer 36

cerebral palsy

Question 37

treat spasticity sxs with

Answer 37

baclofen, dantrolene, diazepam

Question 38

febrile seizures occur in which ages

Answer 38

6 mo- 5 years

Question 39

differentiate simple vs complex seizure

Answer 39

simple: short, generalized, 1/day, high fever, return to bl complex: long, focal, >1/day, low fever, not return to bl

Question 40

no work up needed for first time simple seizure if infant is older than

Answer 40

18 mo

Question 41

which can cross abdominal midline? neuroblastoma or wilms?

Answer 41

neuroblastoma

Question 42

which has systemic sxs? ewing sarcoma or osteosarcoma?

Answer 42

ewing

Question 43

locations of ewing sarcoma vs osteosarcoma?

Answer 43

both long bone! ewing: midshaft osteosarcoma: metaphyses, + mets

Question 44

ewing sarcoma or osteosarcoma: onion skin or sunburst

Answer 44

ewing: onion skin osteosarcoma: sunburst

Question 45

most common fractured long bone in kids

Answer 45

clavicle

Question 46

greenstick fracture

Answer 46

imcomplete fracture- 1 side of cortex

Question 47

nursemaids elbow

Answer 47

radial head subluxation- 2/2 being pulled/lifted

Question 48

torus fracture

Answer 48

bucking of cortex 2/2 trauma (distal radius/ulna)

Question 49

most common pediatric elbow fracture in kids 5-8

Answer 49

supracondylar humerus fracture

Question 50

complications of supracondylar humerus fracture

Answer 50

- brachial artery entrapment | - volkmann contracture - from compartment syn

Question 51

osgood schlatter is overuse of the

Answer 51

tibial tubercle

Question 52

salter-harris is fracture of the

Answer 52

growth plate in kids

Question 53

which is painful and which painless? slipped capital femoral epiphysis vs legg calves perthes

Answer 53

painless- leg calves perthes painfuk: slipped

Question 54

which is self limiting and can be observed and which needs immediate surgical screw fixation? slipped capital femoral epiphysis vs legg calves perthes

Answer 54

self limiting: legg surgery: slipped

Question 55

treatment for various degrees of scoliosis

Answer 55

<20: observe 20-49: brace >50: surgery

Question 56

keep water heater at

Answer 56

<48.8 C or 120 F

Question 57

no solid food before ___ months. No cows milk until ___ months.

Answer 57

6 12

Question 58

strabismus is normal until ___ months

Answer 58

3

Question 59

lead is screened (fingerstick) at

Answer 59

12 ane 24 months

Question 60

presentation of lead poisoning

Answer 60

intermittent abdominal pain peripheral neuopathy- eg wrist drop irritable, N/V

Question 61

treatment of lead poisoning at various levels

Answer 61

<45: asx- retest in 1-3 mo, remove sources 45-69: chelation- IP EDTA or OP DMSA >70: chelation- IP EDTA + BAL

Question 62

dx of vesicoureteral reflux

Answer 62

voiding cystourethrogram for kids 2-24 months with multiple UTIs, have US first

Question 63

vesicoureteral reflux is caused by

Answer 63

- posterior urethral valves - urethral or meatal stenosis - neurogenic bladder

Question 64

risk factor for cryptorchidism

Answer 64

low birth weight