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Pediatrics > CLIPP Cases 2 > Flashcards

CLIPP Cases 2 Flashcards

1
Q

Infants born to teen mom risks

A

Lower birth weight, higher risk of vertical transmission, poorer developmental outcomes, and higher risk of fetal death

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2
Q

APGAR score

A 
Appearance (skin color)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
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3
Q

Metabolic risks for SGA babies

A

Hypoglycemia, hypothermia, and polycythemia

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4
Q

TORCH testing

A

Hepatitis B- Maternal hepatitis B surface antigen (HBsAg)
Rubella- Maternal and infant rubella titer
Toxoplasma- Infant toxoplasma titer
CMV- Infant urine culture

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5
Q

Brain imaging of congenital CMV

A
  • Intracranial calcifications (these appear as bright areas on CT)
  • Diminished number of gyri and abnormally thick cortex (a condition known as lissencephaly or agyria-pachygyria)
  • Enlarged ventricles
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6
Q

Use of bottles at age 2 leads to risk of

A

Dental cavities

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7
Q

2nd gen antihistamines ok for kids

A

loratidine (Claritin) and cetirizine (Zyrtec)

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8
Q

Typical anemia screening

A

At 12 months and again before starting school

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9
Q

Three core symptoms of ADHD

A

Inattention
Hyperactivity
Impulsivity

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10
Q

When should you begin to screen for DM

A

10 years old every 3 years

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11
Q

Most elevated BP in children are

A

Not true HTN, but errors in measurement

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12
Q

Labs for a fat young teenager

A

fasting glucose, lipid profile, AST, ALT

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13
Q

Things to ask a kid who passed out

A

Chest pain, trouble breathing, heart beating fast, LOC

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14
Q

Most common cause of chest pain in adolescent

A

Precordial catch syndrome - benign sharp pain over left sternum

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15
Q

3 quick things you check in orthopedic exam

A

Strength, muscle bulk, and range of motion

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16
Q

When do you give first Tdap

A

11-12 years old (different from Dtap given to babies)

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17
Q

What causes transient tachypnea of the newborn

A

delayed clearance of fluid from the lungs following birth

more common in IDM and c-sections

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18
Q

APGAR scores acts as

A

mechanism to record fetal-to-neonatal transition

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19
Q

HR and RR in first and second hour of life

A

First hour: 160–180 per minute, and the respiratory rate is often 60–80 per minute
2nd hour: Heart rate is usually 120–160 per minute, and the respiratory rate is usually 40–60 per minute.

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20
Q

Two most common cyanotic heart defects

A

TOF and TGA

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21
Q

Primary anabolic hormone for fetal growth

A

Insulin

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22
Q

Target glucose screening for babies prior to feeds

A

> 45

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23
Q

When is urine culture helpful in newborn

A

After 4 days old

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24
Q

TTN chest xray

A

This x-ray will show “wet” looking lungs, no consolidation, and no air bronchograms.

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25
Q

3 big DDH risk factors

A

Breech presentation, Females, family history

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26
Q

Majority of AE to vaccines come

A

24-48 hours

Live like MMR and varicella can take 7 days

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27
Q

Fever of unknown origin when? Vs fever without a source

A

Defined as a temperature greater than 38.3 C (101 F) for at least two weeks’ duration with failure to reach a diagnosis after one week of evaluation
Fever without a source when a complete H and P done and no source identified

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28
Q

Kernigs and Brudzinkis positive tests

A

Kernig’s sign is resistance to extension of the knee.

Brudzinski’s sign is flexion of the hip and knee in response to flexion of the neck by the examiner.

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29
Q

Good Ab for severe UTI in infant (IV)?

A

Ceftriaxone (or Amp/Gent)

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30
Q

Good oral Ab for pyelonephritis

A

Cephalexin

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31
Q

Follow up for resolved severe UTI in kid

A

Renal and bladder US

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32
Q

3 key asthma features

A

Airway inflammation
Mucus hyper secretion
Reversible airflow obstruction due to bronchoconstriction

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33
Q

What is paradoxical breathing

A

When force of contraction of the diaphragm exceeds ability of chest wall to expand ribcage, and chest gets drawn inward with inspiration

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34
Q

3 stages of pertussis

A
  1. catarrhal stage - 1 to 2 weeks of URI type symptoms
  2. paroxysmal stage- 4 to 6 weeks of whooping type cough
  3. convalescent stage- episodic cough that may persist for months
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35
Q

Significant asymmetry of airway highly suggestive of? Imaging?

A

Foreign body aspiration

Imaging: Bilateral decubitus or inspiratory/expiratory chest films

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36
Q

How long for a cough to be chronic

A

> 4 weeks

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37
Q

What are Dennie-Organ lines

A

This is the name for the infraorbital creases that appear due to intermittent edema caused by allergies.

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38
Q

3 things to help dx sinusitis

A
  1. nasal discharge lasting > 10 days
  2. Worsening after initial improvement
  3. high fever and purulent nasal d/c lasting more than 3 days
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39
Q

Characteristic wheezes of asthma

A

Musical or polyphonic noises that occur in a continuous fashion during respiration, usually expiratory

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40
Q

What is thought to cause ronchi

A

due to mucus/secretions in the airways.

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41
Q

Most specific means of determining asthma

A

PFT before and after bronchodilator treatment

42
Q

Biphasic response of asthma exacerbation

A
  1. Early that lasts an hour, from mast cells and eosinophils

2. 2-3 hours after, infiltration that results in epithelial destruction

43
Q

How old to start getting OTC cold meds

A

2 years

44
Q

Bilateral otitis media with effusion described as

A

fluid in the middle ear space without signs and symptoms of acute inflammation

45
Q

Denver II tests

A

Social, language, fine motor, and gross motor

46
Q

Primary concern in viral gastroenteritis

A

Dehydration

47
Q

Easy way to determine level of dehydration

A

Weight before illness and weight now (% dehydration)

48
Q

UTI in infant can present with only what

A

Vomiting

49
Q

acid/base hallmark of pyloric stenosis

A

A hypochloremic, hypokalemic metabolic alkalosis

50
Q

3 reasons children are at a higher risk of dehydration than adults

A
  1. Greater surface area ratio
  2. Higher basal metabolic rate
  3. Higher % of body weight is water
51
Q

Fluid bolus rate in kids

A

20 mL/kg over 60 minutes

52
Q

Bicarb in DKA? Why creatinine elevated?

A

Low- elevated ketone acid in blood

Renal function normal, but creatinine elevated due to dehydration

53
Q

Pre-illness weight formula

A

Current weight / [(100 - % dehydrated) x 0.01]

54
Q

Maintenance fluid doses

A

100 mL/kg/day for the first 10 kg of body weight (x10)

50 mL/kg/day for the second 10 kg of body weight (x10)

20 mL/kg/day for each additional 1 kg of body weight

55
Q

Two most common autoimmune diseases seen w/ DM 1

A

Thyroid and Celiac dz

56
Q

How old to screen for DM II in kids with risk factors

A

10 years

57
Q

What must always be considered in a child refusing to walk

A

Leukemia

58
Q

Transient synovitis association with

A

recent URI

59
Q

Bone pain in leukemia

A

More chronic in nature, shouldn’t be affected by position

60
Q

Tests for suspected septic arthritis

A

X-ray, CRP, ESR, CBC and blood culture

61
Q

How long and often should babies breast feed

A

10-30 minutes every 2 hours

62
Q

Normal RR in newborns

A

40-60 breaths per minute

63
Q

What causes hepatomegaly in kids with CHF

A

Decreased RBF leads to systemic congestion

64
Q

Things seen in CHF infant

A 
dyspnea with feedings
diaphoresis
poor growth
an active precordium
hepatomegaly
65
Q

Aortic stenosis murmur

A

systolic ejection murmur followed by an early diastolic murmur of AI.

66
Q

Why can VSDs be missed in newborns

A

There is elevated pulmonary vascular resistance

67
Q

3 meds for kids chf

A

Furosemide, Digoxin, Enalapril or Catopril

68
Q

Posterior neck tenderness seen in what kind of headache

A

Tension

69
Q

Cushing’s triad

A

HTN, bradycardia, and irregular respirations

70
Q

MCC of ataxia in kids

A

Post-infectious cerebellitis

71
Q

What do cerebellar hemispheric lesions cause

A

ipsilateral limb abnormalities, nystagmus, tremor/dysmetria and tend to spare speech.

72
Q

Infratentorial lesion features

A

cerebellar signs and signs of raised intracranial pressure (ICP)

73
Q

Cerebellar hemispheric lesions

A

changes in muscle tone and DTRs, but usually lead to hypotonia and hyporeflexia.

74
Q

Supratentorial lesions

A

focal motor and sensory abnormalities on the side opposite to the lesion.

75
Q

How does HSP often present in kids

A

otherwise well appearing child with bruising and leg pain

76
Q

Lymphadenopathy highly suggestive of lymphoma

A

Supraclavicular

77
Q

Lab hallmark of HSP? quick description of HSP?

A

non-thrombocytopenia purpura

self-limited, IgA-mediated, small vessel vasculitis that typically involves the skin, GI tract, joints, and kidneys

78
Q

Where can pain in PID be localized

A

RUQ (swelling of liver capsule)

79
Q

Classic findings of TCA ingestion in kid

A

Agitation, cardiac manifestations (especially hypotension), dilated pupils and dry, hot skin

80
Q

Most common accidental ingestion

A

Acetaminophen

81
Q

What to get accidental drugs out of kids

A

Catharsis and charcoal

82
Q

Weight gain in first 4 months of life

A

20-30 grams per day

83
Q

Normal infant HR

A

100-160

84
Q

Two types of failure to thrive

A

Organic (underlying disease)
Non organic
Underlying cause is inadequate calories to me metabolic needs

85
Q

How much should kids eat in the first four months of life

A

100-110 Cal/kg/24 hours in the first 4 months of life.

86
Q

Greasy stool in neonate with FTT consider?

A

Consider CF

87
Q

hgb neonates and infants

A

Hgb around 16.5 at birth

11.2 around 2 months old, starts to rise around 7-9 weeks

88
Q

MCC of abdominal pain in school age children

A

Functional abdominal pain

89
Q

Two tests to check for Crohns

A

Upper endoscopy and colonoscopy

90
Q

When is developmental screening recommended

A

at 9, 18 and 30 months.

91
Q

Mean age of autism diagnosis

A

48 months

92
Q

Retinopathy of prematurity characterized by

A

extraretinal fibrovascular proliferation

93
Q

MRI findings of CP

A

periventricular leukomalacia and thinned corpus callosum

94
Q

Two most common surgeries in SS kids

A

Tonsillectomy (hypertrophy) and Cholecystectomy (blurbing gallstones)

95
Q

3 things that can be seen in CXR of acute chest syndrome

A

Multilobar infiltrates (more commonly lower and middle lobes)
Effusions
Atelectasis

96
Q

peak growth of lymphoid tissues

A

4-6 years of age

97
Q

S3 gallop indicates

A

Overloaded left ventricle

98
Q

Most common cause of nephrotic syndrome in kids

A

minimal change disease

99
Q

Lipid level in nephrotic syndrome

A

Hyperlipidemia

100
Q

Hypernatremia in nephrotic syndrome due to

A

Volume overload

can also get pseudohypernatremia from elevated TG if blood looks milky

Pediatrics (14 decks)

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