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Pediatrics > Clinic > Flashcards

Clinic Flashcards

1
Q

How to differentiate E. tox from herpes rash

A

Well appearance…(vesicles w/ rash)

E.tox- comes and goes
Herpes- consistent and more clustered

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2
Q

2 treatments for tumor lysis syndrome

A

Give allopurinol to prevent uric acid production => prevent uric acid crystalization in the kidneys to prevent AKI

Acutely give calcium to stabilize cardiac myocytes to prevent arrhythmias (due to hyperkalemia)

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3
Q

Indication for Keflex

A

Keflex = Cephalexin = 1st gen cephalosporin
Covers MSSA, Strep, GNR
-first line for cellulitis since covers strep and staph
-used for UTI (covers E. coli) and soft tissue infections (that aren’t MRSA)

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4
Q

‘Sunken chest’

A

= Pectus Excavatum- some of the ribs + sternum grow abnormally

  • usually sporadic, but associated w/ connective tissue d/o (Marfans and Ehler Danlos)
  • typically present as cosmetic concern
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5
Q

4 electrolyte/lab abnormalities seen in tumor lysis syndrome

A

Tumor lysis syndrome

  • hyperkalemia: K+ released from inside of cells
  • hypocalcemia: K+ released from inside cells, but then binds to phosphorus and unbound Ca2+ isnt measurable
  • elevated uric acid
  • elevated phosphorus: bound phosphorus can be measured
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6
Q

Why are the electrolyte abnormalities seen in tumor lysis syndrome dangerous?

A

Tumor lysis syndrome
Hyperkalemia => arrhythmia
Calcium phosphate and uric acid crystalize in the kidney => AKI

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7
Q

Port wine stain

A

Sturge-Weber syndrome = rare neurocutaneous (nerve and skin) d/o present at birth

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8
Q

After what age is thrush worrisome

A

After about 1 yoa- if you see thrush (white that doesnt rub off), start concern for immunodeficiency

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9
Q

Coverage of 3rd vs. 4th gen cephalosporin

A

Both cover MSSA, Strep, GNR

-then 4th gen (Cefepime) and one specific 3rd gen (Cefazidime) cover pseudomonas

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10
Q

Features of Sturge-Weber syndrome

A
  • port wine stain
  • seizures
  • glaucoma
  • MR
  • cerebral malformation and tumors
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11
Q

Which TORCH infxn do you think of if newborn fails the BAERs test?

A

Failing newborn hearing test- think of congenital CMV = most common cause of nonhereditary sensorineural hearing loss

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12
Q

3 main side effects of Penicillins

A

Penicillins

  • hypersensitivity: rash, hives
  • diarrhea
  • neutropenia (especially PenG and Nafcillin)
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13
Q

2 most common places of ALL recurrence

A

Two places where cancer cells can hide: immunoprivaledged sites specifically gonads and CNS

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14
Q

Abx indicated for sinus and ear infections

A

Most common bugs for sinus and ear infxns (otitis media) = moraxella, untypable H. flu, strep pneumo
-all 3 covered by 2nd gen cephalosporins = Cefotetan, Cefoxitin

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15
Q

Differentiate Penicillin vs. Nafcillin coverage

A

Well Penicillin is PO and Nafcillin/Oxacillin are IV

  • penicillin covers strep
  • nafcillin covers staph, specifically MSSA
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16
Q

1st line tx for community acquired pneumonia

A

Amoxicillin

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17
Q

Single most common cause of bacterial sinus infections

A

Strep pneumo 30%

-then Moraxella and non-typbale H. flu 20% each

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18
Q

Hallmark feature of juvenile dermatomyositis

A

Muscle weakness- symmetric and proximal

Then also

  • characteristic rashes: Gottron’s papules (erythematous eruption over knuckles), heliotrope rash (red/purple upper eyelid discoloration), nailfold capillary change
  • calcinosis
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19
Q

Ancef

A

Ancef = Cefazolin = 1st gen cephalosporin
-covers staph and strep, E. coli, Klensiella => used in post -op kids

Major indication = surgery prophylaxis

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20
Q

Differentiate signs of gonorrhea vs. chlamydia conjunctivitis

(a) Tx

A

Gonorrhea conjunctivitis is purulent

Chlamydia conjunctivitis is mucopurulent

(a) Azithromycin can be used against both gonorrhea and chlamydia

21
Q

Adverse rxn of bata-lactamase inhibitors

A

Similar to penicillins

  • hypersensitivity: rash, hives
  • diarrhea
  • possibly neutropenia
22
Q

Abx for GBS prophylaxis

A

PenG

23
Q

Triad for congenital toxoplasmosis

A

Congenital toxoplasmosis

  • chorioretinitis (most common late finding)
  • hydrocephalus
  • intracranial calcification => intellectual disability
24
Q

4 factors dictating prognosis of ALL (risk stratification)

A

Risk stratification of ALL

  • age: best prognosis 1-10 yoa
  • presenting white count: better if lower
  • response to initial therapy
  • cell markers: cytometry
25
Q

Management of juvenile dermatomyositis

A

Combo high dose glucocorticoids + MTX

26
Q

Abx for osteomyelitis

A

Nafcillin/Oxacillin = narrow spectrum penicillin

27
Q

Acrocyanosis

A

= benign peripheral cyanosis in newborns

28
Q

Most common idiopathic inflammatory myopathy of childhood

A

Juvenile Dermatomyositis = rare autoimmune myopathy in children where there is an autoimmune rxn in the small blood vessels and/or muscle tissue

29
Q

Tx for neonatal sepsis

A

Ampicillin (covers strep, staph, E. coli, Listeria) + Gentamicin (aminoglycoside)

Gentamicin expands go cover all G(-): enterobacter, proteus, pseudomonas, serratia

30
Q

2 indications for vanco

A
  1. MRSA

2. PO for C. dif

31
Q

Blueberry muffin baby

A

Blueberry muffin baby = congenital rubella b/c of purpura + hyperbilirubinemia

32
Q

What would be found on scrape of E. tox rash

A

Tons of eosinophils

33
Q

Which abx do you need to monitor for potential risk of C. dif?

A

Cephalosporins

34
Q

Coverage of 2nd gen cephalosporins

A

Strep,staph, anaerobes, H. flu, moraxella, E. coli and Klebsiella

35
Q

Differentiate two types of cyanosis detected by looking at newborn’s lips

A

Peri-oral cyanosis = blue around the mouth, but NOT the lips

  • benign
  • due to venous drainage around mouth

Central cyansois- blue lips
-this is worrisome

36
Q

Differentiate Unasyn vs. Zosyn coverage

A

Unasyn (Amp/Sulbactam) and Zosyn (Piperacillin/Tazobactam) both cover MSSA, Strep, E. Coli, GNR, and anaerobes

-then in addition Zosyn covers Pseudomonas (Piperacillin covers Pseudomonas)

37
Q

Why do we obtain LHD in pts w/ potential neoplastic process?

A

Lactate dehydrogenase as a marker of cell turnover

38
Q

Classic description of fungal diaper rash

A

Candida (fungal) diaper rash: beefy red, most at places where skin overly (creases) w/ satellite lesions
-NOT tender to palpation

39
Q

Differentiate penicillin vs. amoxicillin coverage

A

PenG: susceptible to beta-lactamases- covers GAS, GBS, Neisseria, syphillis
-but not strep pneumo anymore

Amox: Strep (not Staph), E. Coli, GNR (Salmonella, Shigella, Enterobacter)

40
Q

Distinguish pathologic vs. physiologic lymphadenopathy

A

Signs that an enlarged LN is worrisome = rubbery, painless, immobile (cancer latches down to underlying tissue)

So good signs if a LN is painful to the touch and mobile

41
Q

Side effect of meropenem

A

Almost all given Meropenem/imipenem go into AKI

42
Q

Which TORCH infxn correlates w/ newborn presenting w/

(a) chorioretinitis
(b) hydrops fetalis

A

TORCH infxns

(a) Chorioretinitis- toxoplasmosis and CMV
(b) Hydrops fetalis- congenital syphilis and rubella

43
Q

What abx is used after a pt remains febrile after a course of Cefepime + Vanco

A

Cefepime (4th gen cephalo) covers G+ and G- both well, then Vanco covers MRSA

-Biggest gun left = Meropenem/Imipenem to add anaerobic coverage

44
Q

Tx for syphilis

A

PenG

45
Q

Why do you want to avoid giving bactrum to ppl in liver failure?

A

Bactrum = trimethoprim/sulfa, sulfa displaces bilirubin from plasma proteins => increases risk for kernicterus

46
Q

8 yo’s brother has pertussis, so he is started on prophylactic abx, he starts acutely vomiting (non-bileous)

(a) Which prophylactic abx was he put on
(b) Cause of vomiting

A

Pertussis prophylaxis- can use Erythromycin (macrolide)

(a) Erythromycin
(b) Erythromycin can cause pyloric stenosis

47
Q

How to differentiate peripheral vs. central Bell’s Palsy

A

It’s all in the forehead

Peripheral Bell’s palsy- can’t raise forehead
Central Bell’s palsy- can raise forehead

-so actually a good sign wen can’t move the forehead

48
Q

Transient neonatal pustular melanosis

A

Benign, idiopathic, skin condition of newborns

  • only in skin of color
  • present at birth: pustules rupture easily and resolve w/in 48 hrs, leaving brown macules that may persist for months

Pediatrics (10 decks)

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