Aaron: Pediatrics Flashcards
Bacterial Conjunctivus is differentiated from viral conjunctivitis how?
bacterial conjunctivus immediately reaccumulates after being wiped away
Viral conjunctivus is no longer contagious when?
the eye discharge stops
Assuming a patient is positive for lyme disease, what is the next test to order?
ELISA test, do not order bacterial cultures on the patient
Infantile hypertrophic pyloric stenosis can be cause by what?
Macrolide abx exposure
Early daycare exposure can cause what?
Atopic dermatitis prevention
A patient has recurrent abscesses, what type of organisms are they vulnerable to?
What disease is this?
Catalase +
Chronic Granulomatous Disease
If there is a pediatric emergency, and no parent, what should be done?
Do the procedure
If patient has intusception, and the patient has extreme pain after an enema, what is the next step?
An Abdominal X-ray
RSV is very dangerous for infants, what is the one symptom that is particularly scary?
Apenic episodes
Iron deficiency anemia in patients can cause what?
Developmental Delay
A pediatric patient has scoliosis, and the patient’s Cobb angle is less than 10. What is the next best step?
Follow up only if the patient is symptomatic
Bilious emesis, abdominal distention, delayed meconium passing and a family history of recurrent sinus infections, what is this disease?
Cystic Fibrosis
Meningicoccal Meningitis has what abx given for prophylatic treatment
Rifampin
When Syphilis is suspected what other tests should be ordered?
Gonorrhea, Chlamydia, and HIV
Elder abuse, what are three things to order?
Patient has rib pain
Chest Xray
Tylenol/Toradol
Social Work Consult, get them to the ER
Does Minimal Change Disease have a night relapse risk?
Yes
What is a big risk factor for Sudden Infant Death Syndrome?
Maternal Smoking
Cranky toddler, pulling on his ear, purulent ear fluid cannot see the tympanic membrane, what could this disease be?
Suppurative Otitis media
Chlamydia Conjunctivus can cause what problems?
When is it seen?
Bilateral Purulent Drainage
5-15 Days
When Children have leg pain at night, what leg pain attribute is most concerning?
Unilateral pain
A patient has bow legs between ages 0-2. What is the next step in management?
Observe and Reassure
Hepatotoxicity and thrombocytopenia are side effects of what seizure medication?
Valproic Acid
What pediatric disease has an EEG with bilateral polyspike and slow wave discharges? Worse with alcohol and sleep deprivation
Juvenile Myoclonic Epilepsy
Are patient’s that have a febrile seizure at risk of having another febrile seizure?
Yes, can be caused 2/2 a viral illness. First day, must be observed.
If a patient does not tolerate milk around 3 months. Milk is eliminated from the diet. Then what should happen?
The patient should not re-introduce milk into their diet until 1 year old.
Strept throat, what lymph nodes are usually enlarged?
Anterior Lymph nodes
What is another name for keratitis?
Cornea infection
Hordeolum is a bacterial infection of what?
Sebaceous gland
Uveitis is due to an infection of what?
What type of diseases are they usually associated with?
Choroid, Vitreous, iris, ciliary body
Autoimmune diseases
Keratitis has what three symptoms?
What is the next best step?
Photophobia
Impaired Vision
Foreign Body Sensation
Referral to an ophthalmologist
Egg allergy with influenza, what should be done?
Give vaccine but make sure it is inactivated IM influenza vaccine
Non-classical adrenal hyperplasia has a 21 hydroxylase deficiency. What will they not have?
No testicular enlargement, early puberty and bone aging.
What are concerning pediatric hematoma features?
Greater than 4 cm
What is a big EBV/mono side effect?
Persistent fatigue for months
Non-classical adrenal hyperplasia has a 21-hydroxylase deficiency. What will they not have?
No testicular enlargement, early puberty and bone aging.
Pediatric patients that have iron deficiency supplementation should see what changes first?
Increase Reticulocyte Count
For Kawaski disease, ibuprofen is the first treatment. What is the next treatment?
IV Immunoglobulin
Fever for 5 days, rash (inguinal folds), nonexudative conjunctivitis, mucositis,, in a pediatric patinet?
Kawaski Disease
What type of tumor is unilateral, painful, causes hypertension and hematuria?
Wilms Tumor
What type of tumor has unilateral abdominal mass, flushing, sweating, and non-painful mass? There is catecholamine release.
Neuroblastoma
If a patient has a seizure, low Ca, high phosphate, high PTH, what is going on?
Pseudohypoparathyroidism, the patient has end organ resistance to PTH
What rash appears as a single patch, eventually causes an itchy, rash, spares palms and soles???? Viral symptoms
Pityriasis Rosea “Hearld patch”
What can cause dental carries and problems with patient’s teeth?
Feeding at Night
If an infant is drinking soy milk and he starts to have blood stools, what is the next best step?
Switch to formula
What are two things that d/c someone from an organ donation?
Under 18 or have uncontrolled psych history
What infectious disease can cause oculoglandular swelling and enlarged lymph nodes?
Bartonella Hensala
Are steroids recommended for viral meningitis?
No
Rocky Mountain Spotted Fever, what is the treatment of choice?
Doxycycline
Puberty development: breasts, no pubic hair, no menstrual cycle at age 15 and no breast/no menarche at age 13 is what?
Androgen Insensitivty Syndrome
Higher fever at presentation with bloody diarrhea does or does not hint a Shiga toxin E.coli?
High Fever points away Shiga toxin E. coli
A teenager in concussion protocol has dizziness and nausea, what is the next step?
Rest 24 hours and start light activity again
Septic Arthritis in a pediatric hip, what is the first treatment step and the respective abx?
Vancomycin and aspirate the hip
If you receive ampicillin for GBS and give birth, do you need another round of ampicillin?
No you do not
Pediatric Tinea Capitis, what is the treatment of choice?
Oral Griseofulvin or Oral Terbinafine
If I have a low reticulocyte count and arrest of erythropoesis, after an infection, what is this disease?
Aplastic Crisis 2/2 parvovirus
Delayed testicle enlargement by what age is concerning?
14 years old
If a patient’s testicle does not descend before what age, should the patient have surgery?
6 months, should have an orchiopexy
What is the most common side effect of spina bifida?
Neurogenic bladder
A pediatric patient has family that passed away from a heart attack at age 45, what screening test should be done early on?
Lipid panel
NF-1 the patient has cafe au late spots and what else?
Optic Gliomas
NF-2 patients typically have problems where?
Ears, deafness
Lipid screening happens universally in children between what two age brackets?
Age 9-11
Age 17-21
If a pediatric patient has being hinted at cystic fibrosis based on the PMHX, what is the abx tx of choice?
Cefepime and amikacin
Balanitis is what?
infection of the glans penis
Balanoposthitis is what?
infection of the glans penis and foreskin
Assuming there is glans penis inflammation and potential fungal infection, what should be evaluated next?
Blood Glucose level
Cough, Coryza, and Conjunctivitis are what?
What direction does the rash spread?
Measles, Vitamin A
Rash spreads from head to feet
A patient (healthy) and sibling (post kidney transplant) need a Varicella vaccine, what are the next best steps?
What should be monitored
Patient should get, sister should not
Patient should be monitored for a rash, if he gets a rash, could hurt the sister (immunocompromised)
A young girl has scoliosis, what would be concerning symptom regarding this?
Back Pain that awakens patients during the middle of the night, concerning for a spinal cord tumor
What is a pediatric physiologic response that has 5-10 second breath pauses followed by rapid shallow breaths? Treatment?
Periodic breathing, watch and wait, should resolve around 6 months
Apnea of prematurity, episodes last how long? When they should resolve by?
Greater than 20 seconds, 1st week of life
In diaper rash ddx, what should be given for big red beefy plaques? Involves the skin folds
Clotrimazole, fungal infection
Irritant contact dermatitis spare what areas, what is the treatment?
Spares skin Folds, irritant, use a topical barrier, zinc oxide
Do cate bite puncture wounds require prophylactic abx, even if domestic animal?
Yes, i know
How many fever days are needed to start to worry about kawaski disease?
5 days of fever
How long should a patient take oral penicillin after a S. Pyogenes infection?
10 days, cannot prevent glomerulonephritis
A young patient was sick a week ago, never sexually active. Arthritis, joint pain, and a slight facial, malar rash is seen. How does one differentiate between Lupus and Viral Arthritis?
Viral Arthritis is usually seen a week or so after the patient’s illness. SLE is much more gradual and over time
Knock Knee in patients, symmetric angulation inward, the patient should do what, age 3?
Do nothing, no walking/corrective shoes are needed, will resolve on its own
Acne that does not respond to treatment, regardless of the type, what is usually the next medication step?
oral abx (macrolide or doxycycline)
If a patient has a 7 minute seizure, and she has a 104F fever, and is not back to her neuo baseline in 10 minutes, why should she have an LP?
AMS, not back at baseline, concern for meningitis
Mastoidites requires what?
Middle Ear Drainage and IV abxs
An egg allergy only impacts what vaccination?
Yellow Fever
What is the SPF number that is suggested for pediatric Sunscreen?
30 or higher
What age should their be concern if a young female patient has not had her period yet?
15 years old
Do oral steroids help in RSV?
Is a nasal swab necessary for an RSV diagnosis?
No
No
If a baby has an RSV disease, what is something that could potentially cause/recurr?
Recurrent Wheezing
Chronic Cough lasting for more than 4 weeks, what should be done?
Spirometry
Croup, barking cough, what should the patient be given?
IM corticosteroids and nebulized epinephrine
Croup has the steeple sign on chest xray, will that be needed to diagnostically treat the patient?
No
True or False, Eczema will resolve by adulthood
True
Spine Kyphosis or increased spine curvature between 20-40 degrees, what is the treatment?
None, continue to observe
What is physiologic jaundice?
Will there be anemia?
Jaundice that appears after birth in most infants, due to increased RBC count with a shorter RBC life span, and decreased hepatic bilirubin clearance
No anemia
When should pureed foods be introduced into the patient’s diet?
6 months
Can breast milk incidentally cause iron deficiency anemia?
Yes
Mentzer index (MCV/RBC) can help differentiate what diseases?
What is the hemoglobin usually under?
Mentzer Index > 13, think iron deficiency anemia
Mentzer Index < 13, think about alpha and beta thalassemia
Hemoglobin less than 3
When should cow’s milk start to be introduced with babys?
One year old
Platelet count under 30,000, ITP, what should the patient be given?
Immunoglobulins
Cephalic swelling at birth that crosses the midline is called what? Treatment?
Caput Succedaneum, resolves within a few days
Cephalohematoma and subperiosteal bleed is a concerning head finding. What will be seen on physical exam?
Swelling that does not cross the midline
Lead levels between 0-44, what should be given?
Lead levels between 45-69, what should be given?
Lead levels above 70+, what should be given?
0-44: No medications
45-69: DMSA, succimer
70+: Dimercaprol and EDTA
In order for lead poisoning to be treated with activated charcoal, when should be given?
Appear in an hour
IgA nephropathy shows up with painless hematuria after a viral URI, what other disease symptoms are concerning with the patient after the hematuria has resolved?
HTN, elevated creatinine, and persistent proteinuria
What is the magic number that if bilirubin is above it, the patient needs a blood transfusion/exchange?
Bilirubin 20-25 mg/dL
Corticosteroid suppression over what length needs a taper?
3 weeks, otherwise, no taper
What disease pathology occurs when a patient progresses from stable (able to bear weight) to unstable cannot bear weight? The patient is young, obese, no trauma, no fever
Slipped Capital femoral epiphysis
If an infant is an IV drug user, what should they have done regarding hepatitis B treatment?
Hepatitis Vaccine and immunoglobulin within 12 hours of birth, should be given promptly
New Type 1 DM, elevated A1c and Vaginal candidiasis, what is other test that should be ordered?
Thyroid function
Scoliosis with a Cobb angle greater than 40 degrees needs what? Less than 40 degrees means what?
Ortho consult
Less than 40 degrees leave alone
Hyperglycemic baby can have what heart problem?
Thickened IV septum, resolves without surgery
Legg-Calve-Perthes disease is seen in what pediatric age group?
5-7 years old
What empiric abx Sickle Cell Coverage should be given? Concerned for osteomyelitis?
Clindamycin and Ceftriaxone
What type of cellulitis is worse with eye movement? Tx?
Orbital Cellulitis, IV abx plus or minus surgical debridement
What type of cellulitis is not worse with eye movements?
Septal Cellulitis
What type of cellulitis is worse with eye movement? Tx?
periobital Cellulitis, IV abx plus or minus surgical debridement
Stressful situations can have a potential complications with elevated glucose and ketones with a sickness and illness is what?
Stress hyperglycemia
TSC Patients have elevated chance of what? What test should be ordered?
Epilepsy and EEGs evaluate the problems
Walking on the lateral part of the foot as an infant is what?
What is the treatment?
Clubfeet
Tx: Applying molding casts to the feet can improve the condition
In babies, is ceftriaxone recommended in babies?
why or why not?
No ceftriaxone in the first month of life
Can displace bilirubin from albumin, can make kenicterius worse
A baby has sepsis the first month of life, what are the best meds?
Ampicillin and Gentamicin
S. Pharyngitis typically has what kind of lymphadenopathy?
Anterior Cervical Lymphadenopathy
Sickle Cell patient has macrocytic anemia, what is the first thing to evaluate?
B9 deficiency
Speech regression, loss of purposeful hand movements, gait disturbances, and seizures in a pediatric patient. What is this?
Rett Syndrome (MECP2 gene)
Wilms tumor
Anirida
Genitoiurinary Syndrome
Mental Retardation
Where is the malignancy based?
Renal Mass
If a patient presents with drinking a lot of water and is not in DKA, what is the first test?
Water Deprivation test, concern for polydypsia
If patient has a penicillin allergy and needs pre-surgery abx, what is an alternative?
Vancomycin
Recurrent headache, minutes to hours, 30 year old male, little past medical history, what is the most likely diagnosis?
Rupture AVM
Focal Nodular Hyperplasia is characterized by what?
hyperdense lesion that has central, stellate scar
A young child has stridor when laying supine, but resolves when prone. What is this?
laryngomalacia, should do flexible fiberoptic larygnscopy
After having the flu, a patient takes an aspirin, this causes hepatomegaly with jaundice, cerebral edema, low glucose, and elevated liver enzymes, what is this?
Reye Syndrome
Patient has a cold, runny nose one week, and the symptoms have resolved, the patient has a murmur and bilateral wheezing, what is this?
Viral Myocarditis
