Aquifer Case Summaries Flashcards
1
Q
ill appearing and suspect GBS
A
CBC, blood culture, lumbar puncture, IV abx
2
Q
APGAR indicating resuscitation
A
Score below 7 at 5 minutes
3
Q
Ballard tool
A
Uses signs of physical and neuromuscular maturity to estimate gestational age
Especially if no prenatal US or uncertain maternal dates
4
Q
SGA
A
<10th percentile for gestational age
5
Q
Term
A
> 37 wk
6
Q
Asymmetric IUGR
A
Dec length and/or weight without affecting head circumference
Poor delivery of nutrition to fetus (exp maternal smoking)
7
Q
Ruddy skin newborn
A
Polycythemia
8
Q
Asymmetric tonic neck response
A
Fencer
9
Q
IM admin at birth
A
Vitamin K
*esp if mom used INH or anti-epileptics
10
Q
Neonatal Hep B prevention
A
Hep B vaccine and Hep B Ig within 12 hours of delivery
Then routine vaccine at 1 mo
Then check for antibody protection at 9-18 mo
11
Q
Neonatal Hep B prevention If mom not tested for HBsAg
A
Hep B vaccine within 12 hr of delivery
Can wait 7d post delivery until maternal status known, if >2kg BW
12
Q
Ophthalmia neonatorum
A
ID and treat, can cause perf in globe
13
Q
Chlamydia conjunctivitis
A
7-14d post birth
Neonatal prophylaxis does little to prevent chlamydia conjunctivitis
14
Q
When to admin developmental screening
A
9, 18, 30 mo
15
Q
Autism screening
A
18, 24 mo
16
Q
Post partum depression scale
A
1, 2, 4, 6
17
Q
Suppl vit D
A
400 IU daily soon after birth for breastfed babies
18
Q
AAP recommendations of breast feeding/formula duration
A
12 mo
19
Q
Infant should regain BW by
A
2 wk
20
Q
Term infant calorie req
A
100-120 kcal/kg/d
21
Q
Preterm infant calorie req
A
115-130 kcal/kg/d
22
Q
Very preterm infant calorie req
A
(<32 wk)
Up to 150 kcal/kg/d
23
Q
Solid foods
A
4-6 mo
24
Q
rear-facing carseat until
A
2 y/o
25
flu vaccine at what age
>6 mo
26
6 mo old naps
2/d and prob sleep thru night
27
Best choice for 1st imaging study of abd mass
abd US
28
Best imaging choice if bowel obstruction suspected
abd XR
29
Best imaging to reveal calcifications, anatomy, lungs (mets)
abd CT
30
hydronephrosis causing _cm palpable mass would usu present with UTI
6
31
tumor may present as painless mass in neck/chest/abd
neuroblastoma
most freq dx neoplasm in infants
32
infant <1 y/o w/ asymptomatic RUQ abd mass and pallor and no jaundice
likely neuroblastoma
33
asymptomatic RUQ abd mass with no lymphadenopathy or jaundice on exam w/ normal growth and development
Wilms'
smooth, rarely cross midline
abd pain, vom, HTN
median age dx 3 y/o
34
AAP dental recs
children screened by 6 mo
35
location of psoriasis in children
generalized
| guttate=droplet-shaped, usu precip via strep infec
36
AAP recs blood lead testing
all 12-24 mo in areas where >25% housing was built before 1960 or where prevalence of blood lead levels >5 micrograms/dL in children is 5%or >
and
individual children who live in homes built before 1960 that are in poor repair or have been renovated within past 6 mo
37
severe anemia (9 g/dL)
aplastic anemia
hemolytic anemia
folate and B6 deficiency
38
3 y/o developmental exam
```
language (short sentences, 75% intelligible to a stranger)
fine motor (holds pencil or crayon, copies circle)
gross motor (hops, can ride a tricycle)
cognitive (draws a person with 3 body parts)
```
39
anemia screening
12 mo
| And again at preschool or kindergarten entry
40
intoeing in toddlers
usu via tibial torsion (foot inward), resolves naturally w/ weight bearing by 4 y/o
41
intoeing in preschool/school age
femoral anteversion
| (feet and knees inward), usu resolves by 8-12 y/o
42
red flags of syncope
FHx of seizures, sudden death, MI in fam members <30 y/o
exercise assoc w/ CP or palpitations, abnormal cardiac exam, or h/o cardiac disease
facial cyanosis, aura, frothing at the mouth, tongue biting, slow recovery or postictal drowsiness
43
suggest seizure rather than syncope
syncope in the supine position
LOC >5 min
convulsion before LOC
warm, flushed, cyanotic skin rather than pallor and diaphoresis
44
precordial catch syndrome localization
LSB
45
precordial catch can be broken w/
forced deep inspiration
46
precordial catch syndrome etiology
benign, MSK
unknown etiology
often not associated with exercise
47
When is Tdap used
Adults and children 7 years and older when they need booster doses
48
CRAFFT
Ever ridden in a CAR driven by someone (including self) who was high or using?
Ever use all or drugs to RELAX, feel better about yourself, or fit in?
Ever use alc/drugs while you are by yourself, ALONE?
Do you ever FORGET things you did while using alc or drugs?
Family or FRIENDS ever tell you you should cut down?
Ever gotten into TROUBLE while using?
49
Murmur red flag
III
IV/VI (assoc w/ thrill)
Diastolic
Murmur inc with standing or valsalva
50
T/F: ECG is good screening tool for HCM
F
May be normal in about 10%
Get echo
51
primary anabolic hormone for fetal growth
insulin
high levels in 3rd trimester --> inc growth of insulin-sensitive organs (heart, liver, muscle) and general inc in fat synthesis and deposition
52
LGA
>90th percentile
OR
weight greater than 2 standard deviations (97th percentile)
53
AGA
between 10th and 90th percentiles
54
SGA
below the 10th percentile
OR
less than 3rd percentile
55
late-preterm
34-36 6/7
56
Newborns glucose levels stabilize by __ hrs at lean levels of __ mg/dL
3-4 hr
| 65-71 mg/dL
57
reagent strip reading of whole blood glucose <40 mg/dL
confirm w lab analysis of serum or plasma glucose
58
stable blood glucose in newborn
>45 mg/dL
59
developmental dysplasia of the hip
breech
gender (female)
FHx
60
AAP hip exam recs
serial exams in infants to 12 mo
hip imaging for females born in breech (optional for males)
61
TTN
wet lungs
NO consolidations
delayed clearance of fluid from lungs post birth
more comm in maternal diabetes infants and c/s
62
RDS
reticulogranular appearance of lung fields
deficiency of lung surfactant and delayed lung maturation
can occur as late as 37 wk
inc risk w maternal diabetes (delayed sufficient surfactant production)
63
maternal diabetes is a risk factor for developmental of which cardiac abnml?
structural congenital heart disease
transient hypertrophic cardiomyopathy (insulin=gfac)
64
When does tachypnea due to pulm venous congestion occur?
3-7d of age as PDA closes
coarctation of the aorta
65
When does tachypnea due to heart defect causing pulmonary over circulation occur?
6-8 wk of age as pulmonary vascular resistance falls
ASD
VSD
PDA
AVC
66
Newborn enterohepatic circulation
b-glucuronidase in the meconium hydrolyzes conjugated bilirubin back int UC bili
UC bili is reabsorbed into blood stream --> binds to albumin
67
jaundice is usu clinically elevated at total serum bili levels
> 5 mg/dL
68
severely elevated bili
> 20-25 mg/dL
69
ABO incompatability
maternal blood type O
| IgG Abs to A and B can cross placenta and trigger hemolysis in baby with type A or type B
70
physiologic jaundice
bili <15 mg/dL in full term infants who are otherwise healthy
71
What present in the meconium allows newborn to hydrolyze conjugated bili to UC bili
B-glucuronindase
72
Most comm diaphragmatic hernnia
L posterior
| B
73
dark urine, acholic stools
| birth-6 mo
biliary atresia
74
day 3 voids
3-4x
75
day 6 voids
6-8x
76
kasai procedure
biliary atresia
| anastomosis of intrahepatic bile ducts to loop of intestine to allow bile to drain directly into intestine
77
congenital infections leading to HSM
```
CMV
toxoplasmosis
syphillis
rubella
herpes
```
78
liver edge palpable __cm below inferior costal margin is normal
1 cm
79
AAP feeding recommendations for jaundiced infants
no cessation of breastfeeding
80
increasing direct bilirubin at 2 weeks of life
biliary atresia
| alpha-1-antitrypsin deficiency
81
CAH with dec cortisol and aldo
21-OH deficiency
- females are virilized
- males more subtle (inc penile length or darker pigment)
- hyponatremia and hyperkalemia (vom, Dehydration, shock in newborn)
82
tx of E. coli pyelonephritis
Ampicillin/gentamicin
| amp also against enterococci
83
tx of gram - bacilli UTI
ceftriaxone
| no pseudomonas or enterococci protection
84
use of ciprofloxacin in UTI
for children >1 with complicated UTI with resistant organisms
AE***
85
cephalexin (reflex) use
good coverage E. coli
86
bactrim
UTI yes but SJS risk
| no pseudomonas
87
nitrofurantoin
cystitis
88
amoxicillin/clavulanate
skin/GI AE
89
pyuria
>5 wbc in centrifuged urine
90
When to get a CXR to screen for pneumonia
if respiratory findings or wbc >20,000
91
occult bacteremia
positive BC, well appearing child
92
kawasaki tx
aspirin
| IVIG (reduces coronary a aneurysm)
93
kawasaki cbc
leukocytosis
normocytic anemia
thrombocytosis (usu 2nd week)
94
maintenance fluids
first 10kg --> 4mL
10kg --> 2mL
addnl kg --> 1mL
95
S_ heard in on auscultation in child is always pathological
S4
96
hypOcomplement
Membranoproliferative glomerulonephritis
PSGN
SLE
