Child and Adolescent Medicine Flashcards
Caput Succedaneum vs Cephalohematoma vs Subgaleal Hemorrhage
Caput Succedaneum - swelling of the scalp caused by pressure on the head, crosses suture lines.(edema)
Cephalohematoma - bleeding between the skull and periosteum, does not cross suture lines.(hematoma)
Subgaleal Hemorrhage - bleeding beneath the scalp, can results from extensive blood loss, crosses suture lines.
Genu Varum is normal until age —-
2 (bow legs)
Genu Valgum is normal until age —
8 (knock knee)
Internal rotation of the leg between the knee and the ankle(Tibial torsion) is normal until…
18 months
Difference in bilirubin levels with physiologic jaundice vs pathologic jaundice
Pathologic appears within 24hrs, lasts >1 week, fast rise >5 mg/dl/day & bili > 15 mg/dl w/direct bili >2mg/dl
*physiologic rises w/in 24hrs, peaks 3-5 days and lasts about 1 week
CXR in transient tachypnea of the newborn vs RDS in infant
TTN: streaky perihilar opacities w/fluid in fissures
RDS: ground glass
When should you refer for cryptochidism?
1 yoa
Breastfeeding decreases the risks of…
DM, obesity, allergies. Also facilitates bounding & improves immune system
What babies need vitamin D supplementation? How much and for how long?
0-12 months; 400 IU Vit D daily or formula fortified with vita D
When should formula fed babies be transitioned to cows milk?
1 yoa
When should you introduce iron rich foods into babies diet?
6 months of age
Between what age is whole milk best?
1-2 years then introduce low fat milk
Describe the growth curb and hx of kid with Familial Short Stature.
born at normal weight and length but adjust to a lower percentile within the first 2 years of life then follow along that curve. parents are short. skeletal maturation and timing of puberty are WNL.
Describe the growth curb and hx of kid with Constitutional Growth Delay
“late bloomer” in family history. Growth pattern simular to familial short stature - follows along curve but linear curve continues beyond typical age for reaching full height. SKELETAL MATURATION & PUBERTY ARE DELAYED
Describe the growth curb and hx of kid with GH Deficiency
decrease in growth velocity, delays in skeletal maturation
Rule of 3s for colic
3 hours a day, 3 days a week, 3 weeks or more
When should colic resolve?
4 months of age
What should you screen for in an infant with colic?
child abuse! - kids are at increased risk!
Tx of colic?
parent education & PPI if suspect GERD
how often do newborns poop?
after every feed but this decreases around 2-3 months
how many wet diapers should a newborn have a day?
6-8 per day
Nocturnal enuresis is abnormal after…
7 yoa
Up to what age is Esotropia(cross eye’d) normal?
5-6 months
When does teething begin?
3-12 months - encourage use of cup at 1 yoa
Kids have to ride in the back seat till age
13
When can a child use a lap/shoulder seatbelt?
4’9’’ which is usually on or after 8 yoa
Common bugs for pneumonia in newborns
GBS, Gram neg enteric bacteria, CMV, listeria
Common bugs for pneumonia in infants
chlamydia, RSV, S pneumoniae, S.Aureus
Common bugs for pneumonia in Toddlers
viruses, S.pneumoniae, H flu
Common bugs for pneumonia in children 4-14 yoa
mycoplasma, pneumococcus, chlamydia
Fever unknown origin in newborns less than what age require the kitchen sink?
<30 days (technically less than 21 days)- after that its basically tailored to what u think is the cause starting with UA and progressing from there.
tx of kawasaki disease, echo?
High dose ASA + IVIG for acute phase then low dose ASA x6-8 weeks or untill coronary aneurysm resolves
ECHO: at time of dx, again at 2-4 weeks & 6-8 week or untill aneurysm resolves
Most common food allergy in infancy
cows milk! - more common in families with atopy. Symptoms resolve with avoidance by 3 week. Avoid soy protein as they often have allergy to this too. Will outgrow allergy usually by 2-3 yoa
When will most kids outgrow cows milk allergy?
2-3 yoa
Kids with cows milk allergy should also avoid..
soy protein ! they are usually allergic to this too
At what angle do you need to refer to ortho for scoliosis
> 20
Still’s Disease
JIA that is systemic: Arthritis(waxs & wanes), fever, rash, hepatosplenomegly & leukocytosis
Precocious Puberty age in M & F?
M: 9, F: 8
Delayed puberty age in M & F?
M: 14, F: 13
When do you need to do an ultrasound for a kid with a urinary tract infection?
If there are less than two years of age or they are getting recurrent urinary tract infections. Would get a VCUG if abnormal or recurrent UTIs
CENTOR criteria for GAS
1 point for each: fever, absence of cough, swollen/tender anterior cervical nodes, tonsillar swelling and/or exudate, age 3 through 14
Score: Less than one no testing is needed, between two and three points rapid testing. 4+ points no testing as needed just treat
For how long would it be appropriate to watch asymptomatic lymphadenopathy in children?
Up to four weeks then consider work up with ultrasound if under the age of 14 or CT if over the age of 14. If persistent needs FNA
Treatment of bronchiolitis versus croup
Croup steroids(>2 yoa), bronchiolitis is supportive only.
Stages of pertussis and duration
Catarrhal stage - most contagious lasting 1 to 2 weeks with URI symptoms
Proximal stage-whoops and posttussive emesis lasting 2 to 6 weeks but can last up to 10 weeks
Convalescent stage – 2-3 weeks

What antibiotic is used for prophylaxis of those you’ve come in contact with someone with pertussis?
Azithromycin
Drug of choice for pneumonia in a kid less than five years old and a kid older than five ?
Less than five use amoxicillin, older than five uses azithromycin
