8 Flashcards
Why not use ceftriaxone in pediatrics?
Can cause hyperbilirubinemia
Empiric tx of meningitis?
cofexetime, ampicillin and steroids
How test <18 mo child for HIV?
DNA PCR; Ab test won’t tell you anything since mom’s hang around for awhile
What infection do you want protect against in HIV pt with CD4 < 200?
PCP
What infection do you want protect against in HIV pt with CD4 < 100?
TOXO
What infection do you want protect against in HIV pt with CD4 < 50?
MAC
A child is diagnosed with osteomyelitis. Cultures show infection with salmonella. What do you need to do further?
Osteo is typically s. aureus; salmonella indicates patient likely has SCD.
2 common bugs in septic joints
Gonorrohea and S. aureus
How many WBC of joint aspirate indicate septic joint?
> 50,000
Itchy fingers
Scabies
Tx for scabies
Permethrin, lLindane
itchy butt and tape test
pinworm
tx for pinworm
Albendazole
tx for scabies and lice
Permethrin
Pneumonia in < 5 y/o is likely
viral
In who would 5 mm induration with PPD be concerning for TB?
Immunocompromised and close contact
Insidious onset, antalgic gate, protecting joint
Get XR - likely Legg-Calve-Perthes; will need cast
Joint pain in fat kid in puberty with no history of trauma
Get XR - likely SCFE; will need surgery
Protecting joint and looks sick
Septic joint
Joint pain, no trauma, recent viral URI
Likely transient synovitis, but consider septic joint and whether you need to tap and rule out; otherwise reassure and supportive care
Teenage athlete, enlargement of tibial tuberosity, knee pain
Osgood Schlatters; refrain from exercise and give time to heal
Two bone cancers
Ewing sarcoma, osteosarcoma
Bone tumor with onion skin appearance, mid shaft of long bone
Ewing sarcoma
Retinoblastoma, sunburst pattern, distal femur
Osteosarcoma
Where should fractures of growth plate be taken?
OR, if not addressed can impede growth
Urine sample has RBCs with casts. Where is blood from?
Kidney
Just like BPH in old men, ______ in children can lead to obstruction and hydronephropathy
posterior urethral valves
What will PUV lead to in utero?
oligohydraminos
What is use of voiding cystourethrogram?
rule out reflux
What is a CI to circumcision?
Hypo and Epispadias
What can renal US tell you?
Mass, hydronephrosis
First line tx for AOM?
Amoxicillin
Common bugs in otitis externa?
S. aureus, pseudamonas
What to do for mastoiditis?
Surgical decompression of fluid
When to treat sinusitis?
> 10 days sx, worsening, temp > 38 (100.4)
Recurrent sinusitis. Imaging?
Yes, more likely anatomic defect.
Does treatment of GAS pharyngitis prevent future rheumatic fever?
YES
Does treatment of GAS pharyngitis prevent PSGN?
NO
What are the four symptoms of the modified centor criteria for GAS pharyngitis?
Cough
Exudates
Cervical LAD
Temperature > 38
When to treat strep without rapid strep test?
Centor > 4
When to run rapid strep test?
Centor > 2
What to do for nose bleeds?
Lean forward, apply pressure, cauterize (if anterior bleed), patching (if posterior bleed, risk of TSS so may want ppx abx)
In nursery, baby appears blue, but quickly pinks up with crying. What is up?
Choanal atresia - crying forces to breath through mouth. Test with catheter through nose.
You suspect a kid has swallowed a foreign body. There is an inspiratory wheeze on exam. Where is the FB?
Extrathroacid
Wheeze on exhalation means FB ____
Intrathoracic, call pulm for bronchoscopy to remove
You have a kid with asthma currently on albuterol. You want to add a LABA. What must you do first?
Must start both LABA and ICS! If LABA alone, increases mortality.
A child with CF is diagnosed with pneumonia. What is likely bug?
Pseudomonas, common in CF
What differentiates simple vs complex seizure.
LOC (complex)
Another name for a complex generalized sizure
Grand mal
Commonly used antiseizure med for kids
Keppra/Leviteracetam
Ethosuximide
Used for absance seizures
What medication to abort febrile seizure?
Benzos
What to use to control fever?
Acetaminophen
What is west syndrome?
Infantile spasm
Interictal EEG, hysparrhythmia
infantile spasm/west syndrome – associated with tuberous sclerosis
Ash-leaf spots, angiofibromas, infantile spasm
tuberous sclerosis