Flashcards in Topnotch Deck (288):
Washing of the newborn should be delayed after?
After 6 hours
Cord clamping should be delayed at?
2 to 3 minutes
Non-separation of mother and newborn should for breast feeding should last for?
20 to 60 minutes
Newborn eye prophylaxis
0.5 % erythromycin; 1% tetracycline
Vitamin K dosage for newborn.
1.5 kg - 1.5 mg; less than 1.5 kg - 1.5 mg
CH; CAH; G6PD; PKU; Galactosemia; MSUD
NBS, republic act?
NBS should be done after how many hours?
If NBS was done
2 weeks old
21 hydroxylase deficiency
Enzymes deficient in galactosemia.
Galactose 1 phosphate deficiency; Galactokinase deficiency; Galactose 4 epimerase deficiency
Most common manifestation without treatment of PKU?
Flat, blue gray with well defined margin that can be seen in sacral area.
Most common benign skin lesion.
Lacy pattern on the skin similar to cobblestones.; Vasomotor response to cold stress.
Subperiosteal bleed.; Does not cross the suture line.; Resolves in few weeks.
Swelling of scalp due to birth trauma.; Involves presenting part.; Crosses the suture lines.; Resolves in few days.
Erb duchenne palsy with C4 involvement.
Ipsilateral diaphragmatic paralysis
Klumpke palsy with T1 sympathetic fibers involvelement.
Accumulation of fluid in tunica vaginalis.
Surgical treatment of undescended testis should be done when?
Not later than 9 to 15 months
Funnel shaped chest
Pigeon shape chest.
Post term, AOG?
LGA, NB is hypoglycemic or hyperglycemic?
Hypoglycemic; Due to hyperinsulinism.
Ground glass pattern in CXR.
MCC of persistent pulmonary HPN?
Meconium aspiration syndrome
Contributory factor that leads persistent pulmonary HPN of the NB.
NSAID use during 3rd trimester
TB less than 5mg/kg/day, peaks at 15, DB less than 10% of TB
TB > 5 mg/dl/day peaks at 15; DB > 10% of TB
In ABO incompatibility, what is the blood type mother and baby?
Mother blood type O, baby type A or B
Type of jaundice, decreased milk intake with dehydration, reduced caloric intake.
Type of jaundice, presence of glucoronidase in breast milk.
Breast milk jaundice
Empiric treatment for neonatal sepsis.
Ampicillin + 3rd gen cephalosphorin or aminoglycosides.
Blueberry muffin rash
CMV AND RUBELLA
Most common congenital infection.
DOC for CMV
Cataract, PDA, MR, Deafness, Blueberry muffin
Congenital rubella syndrome
Chorioretinits. Microcephaly. Periventricular calcification. Blueberry muffin rash.
Chorioretinitis. Intracranial calcification. Hydrocephalus. Hepatitis. IUGR
Snuffles. Periostitis of long bone. Hutchinson teeth. Saddle nose.
MC life threatening emergency of the GIT in neonates.
Greatest RF for NEC.
Triad: Intestinal ischemia. Enteral nutrition. Pathogenic organism.
Average weight of the new born
Average birth length of the newborn.
Average head circumference of the newborn.
33 to 35 cm
Approximate age where adult HC is attained.
6 years old
First tooth to erupt.
Mandibular central incisor
True or false, theres a 10% decrease in birth weight on the first week of life of a new born?
Physiologic anorexia occurs when?
2nd year of life
Complete myelination occurs when?
2nd year of life
VA of 20/20
4 years old
All primary teeth errupted at?
3 years old
Best time to read poetry.
3 years old
Vaccines that cannot be given simultaneously
Yellow fever and cholera
Fully immunized child means?
1 dose of BCG at birth, within 12 months. 3 doses of BCG and OPV every 4 weeks. (Starting 2 months) 3 doses of Hepa B after birth. (0,1,6) 1 dose of measles vaccing at 9 months. Plus MMR (6 months after measles vaccine) and Hib (9 moths)
Polyarticular disease type of juvinile RA. HLA TYPE?
Pauciarticular disease type of RA, HLA TYPE?
HLA DR8 & DR5
Reactive AS would present as?
Sacroillitis in xray.
More specific for lupus and reflects the degree of disease activity.
MC of the pediatric inflammatory myopathies.
Earliest manifestation of scleroderma.
Less than 5yo: Bilateral bulbar conjunctival injection, non purulent. Dry fissured lips, Strawberry tongue. Edema and erythema of the hands and feet in acute phase and periungual desquamation in the subacute phase. Truncal rash, polymorphus, non vesicular. Cervical LAD.
BV most affect by kawasaki.
Medium sized artery (coronary artery)
Important PE finding in patient with kawasaki less than 1yo.
Fibrosis affecting the dermis and arteries of the lung, kidney and GIT.
Vasculitis of all blood vessel esp medium sized arteries.
IgA mediated vasculitis of small vessel.
MCC of nonthrombocytopenic purpura in children.
2 to 8 yo. Male. Palpable, raised purpura, red to brown, lasts for 3 to 10 days. Intermittent abdominal pain.
Hallmark of HSP.
Palpable petichae or purpura that evolve from red to brown that last from 3 to 10 days.
Skin biopsy finding of HSP.
Renal biopsy finding of HSP.
IgA mesangial deposition
6yo; Female; Heliotrophic rash (periorbital violaceous erythema may cross the nasal bridge); Gottron papules (alligator skin like appearance); (+) ANA with speckled pattern in >60%.
Tightness, thickening, non-pitting induration involving proximal to the MCP or MTP joints. Sclerodactyly. Digital pitting scars resulting from digital ischemia. Bibasilar pulmonary fibrosis not attributable to primary lung disease.
Most common esophageal disorder in children of all ages
MC foreign object swallowed by 6 months to 3 years old?
MCC of nonbilious vomiting.
Acid base balance abnormality in patient with pyloric stenosis.
Hypochloremic metabolic acidosis
Firm, olive-shaped mass, post-prandial vomiting.
Barium: shoulder sign, double tract sign
Surgical procedure for pyloric stenosis.
Bird's beak sign. Inverted U sign. Coffee bean sign.
Double bubble sign. Bilious vomiting. Polyhydramnios. Jaundice. Failure to recanalize the lumen during 4th and 5th week AOG.
MC type of malrotation.
Failure of the cecum to move into RLQ
Remnant of omphalomesenteric duct which connects the yolk sac to the gut in the embryo.
Intermittent painless rectal bleeding and brick colored stool. MC congenital GI anomaly
Delayed passage of meconium. Chronic constipation. Dec blood flow and deterioration of mucosal barrier leading to enterocolitis.
Currarino triad: Anorectal malformation. Sacral bone anomalies. Presacral masses.
Hirschprung disease in older patient.
Currant jelly stool. Doubles up (legs and knee are flexed with loud crying). Severe paroxysmal colicky pain that recurs at frequent intervals with straining efforts. Sausage shape mass in RUQ. BARIUM: coiled spring sign. UTZ: doughnut or target sign.
Standard ORS composition
Glucose : 75, Na: 75, Cl: 65, K: 20, Citrate: 10, Osm: 245mmol/l
Sentinel loop. Colon cut off sign. Ileus. Blurring in left psoas margin. Peripancreatic extraluminal gas bubbles.
Prognostic system for acute pancreatitis in adult. Not in children.
Ransons criteria and APACHE score
First clinical evidence of HBV infection.
Window phase of HBV infection.
IgM anti HBC
Inc risk of transmitting HBV.
Most valuable single serologic marker of acute HBV infection.
Presence of this will confer lower risk of transmitting HBV.
Microangiopathic hemolytic anemia, thrombocytopenia, uremia.
Helmet cell, Burr cell, Fragmented RBCs
Most common chronic glomerular disease worldwide.
Complement decreases in APSGN.
What major noxious products of complement activation are produced after c3 activation in APSGN?
Anaphylotoxin and c5a
Tea colored urine, hematuria. Periorbital edema. Hypertension. Oliguria.
Best single Ab titer to document skin infection in patient with APSGN.
Mangement for APSGN.
Ten day course of penicilline. Furosemide 1mg/kg/dose IV. Sodium restriction. ACE inhibitor or CCB.
Bilateral flank mass. Potter facies.
Most common cause of acute renal failure in young children.
Essential for newborn's functioning of the visual pigment rhodopsin.
Docosahexaenoic acid (DHA)
Most commom acyanotic heart disease.
Major energy source in breastmilk.
MC type of VSD.
Initial manifestation of vitamin A deficiency.
What chamber of heart enlarges in VSD?
Left side and PA
General softening of the bones. Rachitic rosary. Harrison groove. Winswept groove.
Systolic regurgitant murmur at the left lower sternal border, loud and single s2.
Chamber of the heart that enlarges in PDA.
Left side and PA
Most common cause of cyanotic congenital heart disease in new born.
Egg shaped cardiac silhouette.
RV tap along left sternal border. Systolic ejection murmur radiates at the back.
Failure of development of the spiral septum.
Vitamin C deficiency
All pulmonary veins drain to the RA. RV Volume overload.
Extreme exogenous obesity in which patient have severe cardiorespiratory distress with alveolar hypoventilation.
Aim for the treatment of obesity.
Not weight loss but to slow or halt weight gain - weight maintenance
In truncus arteriosus what septal defect is always present?
Vitamin A dosage for ages 6 to 12 months
MC location of coarctation of aorta.
Vitamin A dosage for age one year and older.
Congenital anomaly related to coarctation of aorta.
NTD is a failure of spontaneous closure of neural tube during?
3rd and 4th week
Hypertension in upper extremities. Rib notching in children 7 yo.
Coarctation of aorta
Folic acid will prevent the occurance of NTD from preconception until?
12th week AOG
Associated with congenital rubella, noonan, and william syndrome.
Folic acid dosage
Harsh systolic ejection murmur at the Right upper sternal border. Systolic thrill - Suprasternal notch.
Failure to closure of the rostral neuropore.
Systolic ejection murmur at the left upper sternal border with radiation to the back.
Severe form of NTD
Surgery done in pulmonary stenosis.
Absent cerebral convolution and a poorly formed sylvian fissure.
Surgery done in aortic stenosis.
Ross procedure; Valve translocation from pulmonary valve.
Uni or bilateral clefts within the cerebral hemispheres.
Presence of cyst or cavities within the brain.
Most common valvular involvement in adults.
Due to defective cleavage of the prosencephalon and inadequate induction of the forebrain structure.
Most common valvular involvement in children with RHD.
CSF is reabsorbed through what process?
Fish mouth buttonhole deformity. Weak peripheral pulses with narrow pulse pressure. Hemoptysis.
CSF is reabsorbed by what cell?
Arachnoid villus cells
Systolic regurgitant murmur at the apex with transmission to the left axilla.
Setting sun sign, Long tract sign, Cracked pot sensation or mace wen sign, Chiari malformation (foreshortened occiput), Dandy walker malformation (prominent occiput)
Chamber enlarge in MS.
LA and RV
Major complication of shunts?
S. epidermidis infection
Wide pulse pressure and bounding water hammer pulse. Diastolic murmur heard best at 3rd and 4th LCIS.
Treatment for infantile spasm.
Most common valvular heart disease.
Most common seizure disorders in childhood?
Most common complaint, MVP.
DOC for status epilepticus.
Murmur at 2nd LICS with widely split S2.
Most prevalent type of migraine
Migraine without aura
Murmur at 2nd LICS with radiation to the upper back.
Brain lesion consist of tubers located in the covolutions of the cerebral hemispheres at subependymal region that calcified and may produce a candle dripping appearance.
Murmur at 2nd LICS with radiation to the interscapular area.
Hamartomas located within iris
Murmur at 2nd RICS.
Ash leaf skin, Shagreen path, Subungual or periungual fibromas
Murmur at LLSB.
Murmur at LLSB with radiation to the left anterior axillary line.
Sterile endocarditis, SLE
Libman sacks endocarditis
MCC of viral meningitis.
Osler nodes. Janeway lesion. Splinter hge. Roth spots.
Brain abscess if common in age?
4 to 8 yo
Use to diagnose hyperpituitarism.
Serum somatomedin c (IGF-1)
MC site of brain abscess.
Earliest sign of graves disease.
Emotional disturbance with motor hyperactivity.
Earliest and most constant sign of myasthenia gravis.
Ptosis and EOM weakness
Proximal muscle weakness, symptomatic late in the day.
MC cause of thyroid disease in children and adolescent.
Thought to be the site of Ach receptor antibodies.
MC endocrine metabolic disorder of childhood and adolescent.
A short acting cholinestearse inhibitor use for clinical test of patient with guillain barret syndrome. Slight improvement in ptosis and ophthalmoplegia.
Edrophonium chloride IV Or Tensilon test
Aplastic anemia with microcephaly, microphthalmia, hearing loss, limb abnormalities.
Not associated with other cranial neuropathies or brainstem dusfunction. Occurs after a systemic viral infection.
Most impt sign of IDA.
Virus associated with bells palsy.
EBV, HSV, Mumps virus
Definitive diagnostis test for alpha thalasemia.
Acute demyelinating polyradiculoneuropathy / symmetric ascending muscle weakness or paralysis.
Guillain barre syndrome
Target cell, heinz bodies
Landry ascending paralysis.
Gullain Barre Syndrome
Crew cut or hair on end appearance in skull radiograph.
Sickle cell disease * inc erythropoiesis cusing marrow expansion and new bone formation.
Last to resolve in guillain barre syndrome.
Tendon reflex and lower extremities
Howell jolly bodies.
Sickle cell disease
Used to eradicates nasopharyngeal carriage of diphtheria.
Erythromycin 40-50mg/kg/day x14days
MCC of thrombocytopenic purpura in childhood.
Idipathic thrombocytopenic purpura
MOT of diphtheria
Close contact via Airborne respiratory droplets
Fever. Anemia. Thrombocytopenia. Renal dysfunction. Nervous system changes. Inc bun and crea. Deficiency in metalloproteinase (ADAMTS-13).
Thrombotic thrombocytopenic purpura
Essential for new borns functioning of the visual pigment.
Linolenic acid. DHA.
Linoleic acid. Arachidonic acid.
Treatment for von willebrand disease.
Desmopressin and factor 8 concentrate
Explosive outburst in series of 5 to 10 rapid coughs in one expiration and ending in a high pitched whoop (forceful inspiratory gasp) often associated with suffusion of face or popping out of eyes and vomiting. Well in between paroxysm. Have petechial hge on the upper body.
MC posterior fosaa tumor in children.
Blood picture with pertussis.
MC supratentorial tumor in children.
Erythromycin 40-50mg/kg/day q6 x14days
Abdominal mass that does not cross midline.
Person to person through infected droplets
Abdominal mass that crosses the midline.
Fever. Morbiliform rash > petechial rash > purpuric rash >echymotic rash
Pen G 250k-400k IV divided doses for atleast 5to7 days
Onion skin, moth eaten appearance.
Prophylaxis for meningococcemia.
Osteosarcoma, what part of long bone?
Ewing tumor, what part of long bone?
Mainstay of diagnosis for salmonella.
DOC typhoid fever
Chloramphenicol 50-75 mg/kg/day x14-21days
Location of LTB.
2 weeks High grade fever, abdominal pain, hepatosplenomegaly, anorexia, diarrhea, rash
Thumbprint or leaf sign.
Location of acute epiglottitis.
Vitamins given on complicated measles.
Muffled voice, drooling.
3 day fever
Most common cause of brochilitis.
Blueberry muffin skin lesion
Congenital rubella syndrome
Most common significant pediatric cardiac arrhythmia.
DOC for SVT.
Familial nonhemolytic unconjugated hyperbilirubinemia.
Criggler najjar syndrome, Gilberts syndrome
Most frequent complication of mumps.
Inherited conjugated hyperbilirubinemia
Dubin johnson syndrome, Rotor syndrome
Roseola suppresses what cellular lineage within bone marrow?
Maternal treatment for toxoplasmosis.
Nagayama spots - uvulopalatoglossal junction
Interruption of limb development at 6 to 12 weeks AOG. eye and brain involvement in 16-20 weeks AOG.
When is the best time to give acyclovir in VZV.
Within 24 hours the onset of rash
Hydrocephalus with generalized calcifications.
Use to measure the bone age-reference standards.
Radiograph of left hand and wrist
Herpangina causative agent.
Skeletal maturity is linked to? Sexual maturity or chronological age?
Dominant protein in human milk.
Slapped cheek appearance
Dominant milk in cows milk.
Primary cell line affected by erythema infectiosum.
Erythroid cell line
Eczema. Thrombocytopenia. Recurrent infection. Decreased IgM. T and B cell deficiency
Lacy, reticulated appearance rash, sparing the palm and soles without desquamation.
Prolonged detachment of the umbilical cord.
Chronic granulomatous disease
Associated with IM. Symmetric rash on the cheek. Erythematous papules.
Gianotti crosti syndrome
Most common congenital infection.
Moist, honey colored crust
Tender, warm, erythematous plaques with ill defined borders.
Mild rubbing of the skin results in epidermal separation leaving a shiny, moist, red surface.
Malassezia furfur invades what layer of epidermis?
Causative agent of scabies.
Brown crusted nodules on the trunk; s-shaped burrows.
White or yellow 1-6mm discrete papules with a central umbilication
Thick silvery scales, nail involvement and isomorphic phenomenon.
Oval or round, fixed, red skin lesionwith dusky central zone. Target lesion. Iris lesion. No systemic signs and symptoms. Due to HSV specific host response.
Fetal CO depends on?
Functional closure of DA.
Anatomical closure of DA.
Strongest stimulus for constriction of the ductal smooth muscle.
Inc in oxygen saturation
Most common ASD.
Chamber enlarge in ASD.
Right side and PA