ALL Flashcards
German Measles is also known as
Rubella
pain with movement of the Pinna or Tragus should make you think of what dx?
Otitis Externa
first line treatment for pertussis?
Erythromycin (Macrolides)
if allergy = Bactrim
Atypical or walking pneumonia is caused by what pathogen?
Mycoplasma pneumoniae
child with fever lasting longer than 5 days should make you think of what dx?
Kawasaki
Widely split fixed S2 that does not vary with respiration
Atrial septal defect
5 major jones criteria for diagnosing rheumatic fever.
- Joints - migratory polyarthritis
- carditis
- nodules (subcutaneous)
- Erythema marginatum
- Sydenham’s chorea
pale and boggy nasal mucosa
allergic rhinitis
what organism is the MC cause of Otitis Media
strep pneumonia
viral exanthem that has conjunctivitis as one of its symptoms?
MEasles/RubEola
what age should child be able to roll over?
4 months
CXR finding of rib notching
Coarctation of the Aorta
child w/ Bulky greasy stool
Cystic fibrosis
Describe erythema marginatum (major jones for ARF)
pink rings on the trunk & inner surfaces of the limbs
palpable olive-shaped epigastric mass in a 1 month old
pyloric stenosis
what age should child be able to hold up their head?
3 months
what age should child begin to say momma and dadda?
1 year
medical term for cross-eyed?
strabismus
koplik spots are white clustered lesions on the buccal mucosa. what virus are they pathognomonic for?
Measles/Rubeola
an URI that includes hoarseness - is it most likely bacterial or viral?
viral
what must you have in order to diagnose rheumatic fever?
evidence of recent strep infection (+ titer or + culture) plus 2 major or 1 major and 2 minor jones criteria.
treatment for a volvulus in a child
barium enema
atypical mycobacterial disease = walking PNA
what is the first line treatment?
Azithromycin x5d
pertussis is also known as
whooping cough
15y overweight boy present to office c/o knee pain and limping.
what is most likely dx
Slipped capital femoral epiphysis
premature infant with hyaline membrane disease will have what appearance on CXR?
Bilateral ground glass appearance (atelectasis)
+/- Air bronchograms
unilateral purulent rhinitis should make you think of what dx?
foreign body
describe Barlows test
adduct & internal rotate of the hips
what age should child be able to sit up
6 months
what age should child be able to use spoon and stack 3-4 blocks?
18 months
you think there may be a foreign body obstructing a Childs breathing - what type of CXR should you order?
expiratory view looking for hyperinflation due to air trapping
current jelly stool
intussusception
what age should child begin to feed himself
6 months
Lacey pink rash on the face of a child should make you think of what dx?
erythema infectiosum = 5th dz = slapped cheek
what is gold standard for dx cystic fibrosis
sweat chloride test
what heart valve is most associated with rheumatic fever
mitral
what age should child be able to kick ball
2 years
what is the MC congenital heart defect?
Ventricular septal defect
how would you treat a pt with RSV?
albuterol, steroids, fluids
you hear a loud harsh holosystolic murmur best heard at LLSB.
VSD
description of dew drop on a rose petal
chickenpox
foscheimer spots are associated with what dz?
rubella - German measles
what is the MC cause of URI
rhinovirus
nasal polyps should make you think of what dx
recurrent respiratory infections (pseudomonas and staph aureus); chronic sinusitis
cystic fibrosis
a patient presents with a staccato cough but no fever. what dx should you be thinking?
chlamydia pneumoniae
most serious complication of Kawasaki dz?
aortic aneurysm
describe the pattern of weight gain in an infant at:
- first week
- 6 mo
- 12 mo
- 3 y
- 4y
- lose 10% of birth weight initially but are back to birth weight at 10 days
- 6mo = 2x birth weight
- 12 mo = 3x birth weight
- 3 y = 30lb and 30 inches
- 4 y = 40lb and 40 inches
medical term for lazy eye
amblyopia
what age should infant begin cooing
2 months
musical vibratory murmur best heard at the apex
still’s murmur
dermatitis: “wearing diapers”
- contact dermatitis
- miliaria
- candida
dermatitis: “rash in the diaper area as well as other areas”
- atopic dermatitis
2. seborrheic dermaittis
dermatitis: affects diaper area irrespective of diaper use
- scabies
2. bullous impetigo
Perioral Dermatitis
- MC in young women
- lipgloss, toothpaste, +/- h/o topical corticosteroid use
- CLASSIC SPARES VERMILLION BORDER
- papulopustules on erythematous base +/- satellite lesions
tx:
1. Topical Abx: FLAGYL or E-MYCIN
2. PO abx = Tetracyclines
AVOID TOPICAL STEROIDS
androgenetic alopecia
DHT is key androgen.
- Minoxidil = recent onset alopecia of small area
- PO Finasteride = 5 alpha reductase inhibitor for more extensive dz. S/E: decr libido
erythema multiforme
acute, self-limiting type 4 hypersensitivity rxn
- young adults 20-40y
- lesions evolve over 3-5d, last 2w.
HERPES SIMPLEX VIRUS and Mycoplasma**, S.pneumo
Sulfa, beta lactase, AEDs, malignancy
TARGET lesions. afebrile. no epidermal detachment.
Purple Polygonal Planar Pruritic Papules
*Increased incidence with hepatitis C
lichen planus
tx: Topical corticosteroids 1st line; PO antihistamines for itching.
Neonatal conjunctivitis “rule of 5’s”
0-5d = N. gonorrheae 5d-5w = Chlamydia trachomatis 5w-5y = Strep or H.flu
bacterial conjunctivitis
purulent discharge from affected eye.
afebrile
tx = E-mycin drops; TMP/Polymyxin B drops
if contacts = Fluoroquinolone eye drops
anterior vs posterior epistaxis
anterior = keisselbach's plexus posterior = palatine artery
most effective medicine for allergic rhinitis
intranasal steroids
MC pathogen of AOM
strep pneumo
complication of prolonged or inadequately treated otitis media
mastoiditis
- deep ear pain (worse at night), fever.
- Dx = CT scan
- Tx = IV abx + drainage
MCC of conductive hearing loss (external or middle ear disorders)
Cerumen impaction
oral candidiasis
- Candida albicans
- increased risk if use steroid inhalers w/out spacer, or use of abx.
- tx = Nystatin liquid
decreased vision, pain w/ eye movement, proptosis, eyelid erythema and edema
orbital cellulitis
- MC 2/2 sinus infection (Ethmoid*)
- IV abx - vancomycin or clinda
MC pathogen of otitis externa
pseudomonas
tx - cipro/dexa (Ciprodex)
Ofloxacin= safe for TM perf
class of abx that are ototoxic
aminoglycosides
strabismus
malalignment of eyes - should be aligned by 2-3 months.
tx:
1. patch therapy (normal eye covered)
2. corrective surgery if severe or unresponsive to conservative tx.
what can occur if strabismus not corrected by age 2?
amblyopia = decreased visual acuity not correctable by refractive means.
CXR shows Perihilar and interstitial infiltrates
atypical mycobacterial disease (walking pneumonia)
MCC of acute pancreatitis in kids
mumps
gold standard to dx pertussis
PCR of nasopharyngeal swab
Samters triad
asthma
nasal polyps
ASA/NSAID allergy
common cold symptoms that progress to wheeze over 3-7 days
acute bronchiolitis
Colic
Crying for no reason
lasts >3hr per day
occurs 3+ days/wk
in an otherwise healthy infant <3mo old.
Painless scrotal swelling
Hydrocele - cystic fluid collection
treatment for severe acne vulgaris
Isotretinoin (PO) - monotherapy
- highly teratogenic
- 2 prego test prior to start and then monthly while on it
- commit to 2 forms of contraception x1 mo before start until 1 mo after dc meds.
Androgenetic alopecia
DHT is key androgen
- vary degrees of non scarring hair loss/hair thinning.
tx:
1. Minoxidil - recent onset of smaller areas
2. Finasteride - 5a reductase inhibitor - caution: lower libido
erythematous, ill-defined blisters/papules/plaques
- later = dry and crust over with scaling
- Flexor creases
- Dermatographism
ACUTE atopic dermatitis Tx: 1. Topical Corticosteroids 2. Antihistamine 3. Wet dressings -- abx if 2ry infection
sharp defined - discoid/Coin shaped lesions, esp on dorsum of hands, feet, Extensor surfaces (knees, elbow)
Nummular eczema
chronic treatment for atopic dermatitis
- daily hydration and emollients
2. PO antihistamines for itch
Burns
CLEAN: mild soap and water; NO ICE DIRECTLY on burn.
DEBRIDE: remove necrotic skin. *Escharotomy for circumferential burns = prevent compartment syndrome.
remove RUPTURED BLISTERS.
PAIN: Tylenol or NSAIDs - mono or with opioids
ABX:
- superficial: aloe vs bacitracin
- non-superficial: Silver Sulfadiazine (Silvadene) vs honey + modern membrane dressings
- *Silvadene NO Go: prego; <2mo; sulfa allergy; facial burns
DRESS: only for non-superficial – Kerlix; individual wrap digits
FLUIDS: Parkland formula = LR @ 4ml/kg/BSA
- given IV x first 24 hours
- half in 8 hours
- second half over remaining 16 hours
Pediatric “Rule of 9’s” for burns
18% BSA on head
14% each extremity
otherwise same as adult rule of 9
Absent red light reflex in the newborn
- congenital cataracts (rubella)
- glaucoma
- retinoblastoma
gray or pale yellow spots at the periphery of the iris
brushfield spots –> Down syndrome
delayed stool (>24h after birth)
Hirschsprung disease
abnormal urethral meatus is proximal and ventral to its normal anterior location
Hypospadias
- do not circumcise
- Bilateral renal US and refer to pets urologist
maneuver that attempts to dislocate the hip via posterior pressure
Barlow
Orolani
attempts to identify the hip that is dislocated or sublimed.
neonatal jaundice within first 24 hours of life
- ABO incompatibility
- RH isoimmunizaiton
- Hereditary spherocytosis
- G6PD deficiency
neonatal jaundice that appears after 24 hours
physiologic jaundice
neonatal jaundice that appears 2-3rd day of life
Breastfeeding jaundice
bili incr. and may persist for 6-8 weeks
supplement with formula; phototherapy if bili >15
lead poisoning
universal screening at ages 1 and 2yr.
venous sample
abrupt onset cough, stridor, choking and cyanosis.
upper airway FB
intermittent cough
unilateral lower lobe wheezes
lower airway FB
- bronchoscopy indicated
- loudest at apex and LSB
- musical quality
- decreases with sitting, standing or Valsalva
- increased with fevers
stills murmur
Kawasaki treatment
IV IG and high-dose aspirin
4 days of fever, now subsided but c/o pink macular rash
roseola
lacy pink macular rash on torso
erythema infectiosum - 5th dz
atypical pneumonia
legionella
mycoplasma
chlamydia
rhinorrhea, sneezing, wheezing, low grade fever
URI prodrome progresses with signs of lower respiratory distress = nasal flaring, tachypnea, retractions
acute bronchiolitis
Tx = supportive (neb albuterol, IV fluids, antipyretics, humidifiers)
- if RSV present - Ribavirin
high retic count (>2)
hemolysis or RBC loss
bite cells
G6PD deficiency
target cells and basophilic stippling seen on peripheral smear
beta thalassemia minor
burning, itching and erythema, dry skin
contact dermatitis
papulopustules on erythematous base surrounding the mouth; satellite lesions present.
topical metronidazole or E-mycin
PO tetracyclines
NO topical steroids
strawberry tongue seen in which two disorders
Scarlet fever (exanthem) Kawasaki disease (5+ day fever)