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Emma Peds > Aquifer Case Summaries > Flashcards

Aquifer Case Summaries Flashcards

1
Q

ill appearing and suspect GBS

A

CBC, blood culture, lumbar puncture, IV abx

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2
Q

APGAR indicating resuscitation

A

Score below 7 at 5 minutes

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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

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4
Q

SGA

A

<10th percentile for gestational age

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5
Q

Term

A

> 37 wk

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6
Q

Asymmetric IUGR

A

Dec length and/or weight without affecting head circumference

Poor delivery of nutrition to fetus (exp maternal smoking)

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7
Q

Ruddy skin newborn

A

Polycythemia

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8
Q

Asymmetric tonic neck response

A

Fencer

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9
Q

IM admin at birth

A

Vitamin K

*esp if mom used INH or anti-epileptics

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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

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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

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12
Q

Ophthalmia neonatorum

A

ID and treat, can cause perf in globe

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13
Q

Chlamydia conjunctivitis

A

7-14d post birth

Neonatal prophylaxis does little to prevent chlamydia conjunctivitis

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14
Q

When to admin developmental screening

A

9, 18, 30 mo

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15
Q

Autism screening

A

18, 24 mo

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16
Q

Post partum depression scale

A

1, 2, 4, 6

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17
Q

Suppl vit D

A

400 IU daily soon after birth for breastfed babies

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18
Q

AAP recommendations of breast feeding/formula duration

A

12 mo

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19
Q

Infant should regain BW by

A

2 wk

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20
Q

Term infant calorie req

A

100-120 kcal/kg/d

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21
Q

Preterm infant calorie req

A

115-130 kcal/kg/d

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22
Q

Very preterm infant calorie req

A

(<32 wk)

Up to 150 kcal/kg/d

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23
Q

Solid foods

A

4-6 mo

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24
Q

rear-facing carseat until

A

2 y/o

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25
Q

flu vaccine at what age

A

> 6 mo

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26
Q

6 mo old naps

A

2/d and prob sleep thru night

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27
Q

Best choice for 1st imaging study of abd mass

A

abd US

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28
Q

Best imaging choice if bowel obstruction suspected

A

abd XR

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29
Q

Best imaging to reveal calcifications, anatomy, lungs (mets)

A

abd CT

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30
Q

hydronephrosis causing _cm palpable mass would usu present with UTI

A

6

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31
Q

tumor may present as painless mass in neck/chest/abd

A

neuroblastoma

most freq dx neoplasm in infants

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32
Q

infant <1 y/o w/ asymptomatic RUQ abd mass and pallor and no jaundice

A

likely neuroblastoma

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33
Q

asymptomatic RUQ abd mass with no lymphadenopathy or jaundice on exam w/ normal growth and development

A

Wilms’

smooth, rarely cross midline
abd pain, vom, HTN

median age dx 3 y/o

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34
Q

AAP dental recs

A

children screened by 6 mo

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35
Q

location of psoriasis in children

A

generalized

guttate=droplet-shaped, usu precip via strep infec

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36
Q

AAP recs blood lead testing

A

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

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37
Q

severe anemia (9 g/dL)

A

aplastic anemia
hemolytic anemia
folate and B6 deficiency

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38
Q

3 y/o developmental exam

A 
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)
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39
Q

anemia screening

A

12 mo

And again at preschool or kindergarten entry

40
Q

intoeing in toddlers

A

usu via tibial torsion (foot inward), resolves naturally w/ weight bearing by 4 y/o

41
Q

intoeing in preschool/school age

A

femoral anteversion

(feet and knees inward), usu resolves by 8-12 y/o

42
Q

red flags of syncope

A

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
Q

suggest seizure rather than syncope

A

syncope in the supine position
LOC >5 min
convulsion before LOC
warm, flushed, cyanotic skin rather than pallor and diaphoresis

44
Q

precordial catch syndrome localization

A

LSB

45
Q

precordial catch can be broken w/

A

forced deep inspiration

46
Q

precordial catch syndrome etiology

A

benign, MSK
unknown etiology
often not associated with exercise

47
Q

When is Tdap used

A

Adults and children 7 years and older when they need booster doses

48
Q

CRAFFT

A

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
Q

Murmur red flag

A

III
IV/VI (assoc w/ thrill)
Diastolic
Murmur inc with standing or valsalva

50
Q

T/F: ECG is good screening tool for HCM

A

F
May be normal in about 10%

Get echo

51
Q

primary anabolic hormone for fetal growth

A

insulin

high levels in 3rd trimester –> inc growth of insulin-sensitive organs (heart, liver, muscle) and general inc in fat synthesis and deposition

52
Q

LGA

A

> 90th percentile

OR

weight greater than 2 standard deviations (97th percentile)

53
Q

AGA

A

between 10th and 90th percentiles

54
Q

SGA

A

below the 10th percentile

OR

less than 3rd percentile

55
Q

late-preterm

A

34-36 6/7

56
Q

Newborns glucose levels stabilize by __ hrs at lean levels of __ mg/dL

A

3-4 hr

65-71 mg/dL

57
Q

reagent strip reading of whole blood glucose <40 mg/dL

A

confirm w lab analysis of serum or plasma glucose

58
Q

stable blood glucose in newborn

A

> 45 mg/dL

59
Q

developmental dysplasia of the hip

A

breech
gender (female)
FHx

60
Q

AAP hip exam recs

A

serial exams in infants to 12 mo

hip imaging for females born in breech (optional for males)

61
Q

TTN

A

wet lungs
NO consolidations

delayed clearance of fluid from lungs post birth
more comm in maternal diabetes infants and c/s

62
Q

RDS

A

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
Q

maternal diabetes is a risk factor for developmental of which cardiac abnml?

A

structural congenital heart disease

transient hypertrophic cardiomyopathy (insulin=gfac)

64
Q

When does tachypnea due to pulm venous congestion occur?

A

3-7d of age as PDA closes

coarctation of the aorta

65
Q

When does tachypnea due to heart defect causing pulmonary over circulation occur?

A

6-8 wk of age as pulmonary vascular resistance falls

ASD
VSD
PDA
AVC

66
Q

Newborn enterohepatic circulation

A

b-glucuronidase in the meconium hydrolyzes conjugated bilirubin back int UC bili

UC bili is reabsorbed into blood stream –> binds to albumin

67
Q

jaundice is usu clinically elevated at total serum bili levels

A

> 5 mg/dL

68
Q

severely elevated bili

A

> 20-25 mg/dL

69
Q

ABO incompatability

A

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
Q

physiologic jaundice

A

bili <15 mg/dL in full term infants who are otherwise healthy

71
Q

What present in the meconium allows newborn to hydrolyze conjugated bili to UC bili

A

B-glucuronindase

72
Q

Most comm diaphragmatic hernnia

A

L posterior

B

73
Q

dark urine, acholic stools

birth-6 mo

A

biliary atresia

74
Q

day 3 voids

A

3-4x

75
Q

day 6 voids

A

6-8x

76
Q

kasai procedure

A

biliary atresia

anastomosis of intrahepatic bile ducts to loop of intestine to allow bile to drain directly into intestine

77
Q

congenital infections leading to HSM

A 
CMV
toxoplasmosis
syphillis
rubella
herpes
78
Q

liver edge palpable __cm below inferior costal margin is normal

A

1 cm

79
Q

AAP feeding recommendations for jaundiced infants

A

no cessation of breastfeeding

80
Q

increasing direct bilirubin at 2 weeks of life

A

biliary atresia

alpha-1-antitrypsin deficiency

81
Q

CAH with dec cortisol and aldo

A

21-OH deficiency

  • females are virilized
  • males more subtle (inc penile length or darker pigment)
  • hyponatremia and hyperkalemia (vom, Dehydration, shock in newborn)
82
Q

tx of E. coli pyelonephritis

A

Ampicillin/gentamicin

amp also against enterococci

83
Q

tx of gram - bacilli UTI

A

ceftriaxone

no pseudomonas or enterococci protection

84
Q

use of ciprofloxacin in UTI

A

for children >1 with complicated UTI with resistant organisms

AE***

85
Q

cephalexin (reflex) use

A

good coverage E. coli

86
Q

bactrim

A

UTI yes but SJS risk

no pseudomonas

87
Q

nitrofurantoin

A

cystitis

88
Q

amoxicillin/clavulanate

A

skin/GI AE

89
Q

pyuria

A

> 5 wbc in centrifuged urine

90
Q

When to get a CXR to screen for pneumonia

A

if respiratory findings or wbc >20,000

91
Q

occult bacteremia

A

positive BC, well appearing child

92
Q

kawasaki tx

A

aspirin

IVIG (reduces coronary a aneurysm)

93
Q

kawasaki cbc

A

leukocytosis
normocytic anemia
thrombocytosis (usu 2nd week)

94
Q

maintenance fluids

A

first 10kg –> 4mL
10kg –> 2mL
addnl kg –> 1mL

95
Q

S_ heard in on auscultation in child is always pathological

A

S4

96
Q

hypOcomplement

A

Membranoproliferative glomerulonephritis
PSGN
SLE

Emma Peds (2 decks)

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