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Clipp cases Flashcards

1
Q

What are the TORCH infections?

A

Toxoplasmosis, other (HepB, Syphillis, Parovirus, HIV), rubella, CMV, Herpes virus 2

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2
Q

What are the signs of a Torch infection?

A

Microcephaly, organomegaly, rash

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3
Q

What are the manifestations of an infection with CMV?

A

Microcephaly, intracranial calcifications, enlarged ventricles, bilateral hearing loss, choreoretinitis, hepatosplenomegaly, rash

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4
Q

What is the caloric requirement for a term infant?

A

100cal/kg/day-120cal/kg/day

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5
Q

What is the caloric requirement for a pre-term infant?

A

115cal/kg/day-130cal/kg/day

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6
Q

What is the caloric requirement for a very low birth weight infant?

A

150cal/kg/day

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7
Q

When is a baby ready to transition to regular cows milk?

A

12months

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8
Q

What is the Moro reflex in a baby?

A

Reflex thats used to check for musculoskeletal abnormalities ot neural plexsus injuries. Reflex is elicited by moving the babies head and the baby will abduct their head, extend their arms and adduct their arms and sometimes cry.

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9
Q

When should the Moro reflex disappear?

A

At 4 months

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10
Q

Whats the daily requirement of vitamin D in pediatrics?

A

400units

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11
Q

What is the age that most babies sleep through the night?

A

4-6months

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12
Q

When are the MMR, varicella and Hep A vaccines given?

A

12months

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13
Q

What vaccines are given at the 2month visit?

A

Rotavirus, H. flu type b, pneumococcus, IPV, DTaP, second dose of Hep B

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14
Q

How many doses of MMR, Varicella, and Hep A should kids get?

A

2 doses of each

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15
Q

By what age should an infant double and triple their birth weight?

A

At 5 months an infant should double their weight

At 12months an infant should triple their weight

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16
Q

What could cause an absent red reflex in a baby?

A
  1. Cataracts
  2. Glaucoma
  3. Retinoblastoma
  4. Chorioretinitis
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17
Q

What is the height that children should stay in a booster seat until?

A

4’9in (142cm)

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18
Q

What things should a 3 yr old be doing?

A
  1. Dress self
  2. Feed self
  3. Speaks in 2-3 word sentences
  4. Knows name and use of cup
  5. Builds tower of 6 cubes, throws ball, rides tricycle, copies circle
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19
Q

What is the medical term for eczema?

A

Atopic dermatitis

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20
Q

What are some treatments for eczema?

A
  1. Lubricating the skin
  2. Short burst of anti-inflammatories (hydrocortizone)
  3. Antihistamines for itching (loratidine and cetirizine)
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21
Q

What is the cover/uncover and hirschberg light reflex test used for?

A

Assess for strabismus

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22
Q

When do you screen children for anemia?

A

At 12 months and again when they enter preschool or kindergarten

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23
Q

At what age should you start measuring blood pressure?

A

Age 3

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24
Q

What is obese and overweight in pediatrics?

A

Overweight is BMI >85%-95%

Obese is BMI > 95%

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25
Q

What are the stages of HTN in pediatrics?

A

Norma BP 99

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26
Q

What sort of things should come to mind when you have a child with high BP

A

Renal parenchymal disease or corarctation of the aorta

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27
Q

Whats the most common treatment for ADHD?

A

Methylphenidate (concerta) 18mg daily

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28
Q

Most common side effect of stimulants like methylphenidate?

A

Appetite suppression

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29
Q

How many calories does a 1 yr old require?

A

1000kcal/day

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30
Q

What does deficiency in vitamin A cause?

A

Bitot spots, blindness, hyperkeratosis, increase susceptibility to infection

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31
Q

What does a deficiency in vitamin B1/thiamine cause?

A

Beri-beri

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32
Q

What does a deficiency in vitamin B2/riboflavin cause?

A

Glossitis, keratitis, seborrheic dermatitis

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33
Q

What does a deficiency in vitamin B3/ Niacin cause?

A

Pellagra (dementia, diarrhea, dermatitis)

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34
Q

What does a deficiency in vitamin B6/Pyridoxine cause?

A

Convulsions, irritability, hypochromic anemia

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35
Q

What does a deficiency in vitamin C cause?

A

Scurvy

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36
Q

What does a deficiency in vitamin D cause?

A

Rickets and osteomalacia

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37
Q

What does a deficiency in vitamin E cause?

A

Hemolytic anemia in premies

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38
Q

What does a deficiency in vitamin K cause?

A

Hemorrhagic disease of the newborn

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39
Q

What are the symptoms of copper deficiency?

A

Hypochromic normocytic anemia, hypotonia, and osteoporosis

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40
Q

What are the symptoms of zinc deficiency?

A

Diarrhea, rashes, altered taste, behavior changes

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41
Q

What are the symptoms of selenium deficiency?

A

Pigment loss in skin and hair, macrocytosis, cardiomyopathy

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42
Q

When does the anterior frontanelle close?

A

Between 6-18 months

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43
Q

What are the two causes of precocious puberty?

A

Central means GnRH is being released

Peripheral means androgens are being released

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44
Q

When does puberty start in girls?

A

8-13yrs

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45
Q

When does puberty start in boys

A

10-14yrs

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46
Q

What happens in the different stages of puberty

A 
Thelarche--> breast production
Adrenarche--> production of adrenal hormones-->pubic and axillary hair
Growth spurt--> growth in height
Menarche--> menstruation
Gonadarche--> sex hormone production
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47
Q

What are the things you can check looking for dehydration?

A
  1. Fontanells (sunken or not)
  2. Eyes (sunken or not)
  3. Mucous membranes (dry or parched or not)
  4. Blood pressure (normal, orthostatic, hypotension)
  5. Skin turgor (normal, 2 sec)
  6. Urine output (normal, oliguria, anuria)
  7. Pulse (normal, rapid, thready)
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48
Q

How does dehydration affect the BUN: creatine ratio?

A

Causes an elevation in BUN: creatine ratio.

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49
Q

What is oliguria?

A

Decrease in urine output.

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50
Q

Normal heart rate for a newborn?

A

120-160

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51
Q

Normal respiratory rate for a newborn?

52
Q

Normal Blood pressure for a newborn?

53
Q

What is the Apgar score?

A

Scores calculated at 1min and 5min. The score at 1min tells us what was happening with the baby during labor and delivery. At 5 min it tells us how good our resuscitation efforts were. Total score 7-10 is normal. 4-6 is maybe resuscitation. 0-3 needs resuscitation.

  1. Appearance (skin color)
  2. Pulse
  3. Grimace (level of irritability)
  4. Activity (Muscle tone)
  5. Respiration( quality of breathing)
54
Q

Is a low apgar score predictive of cerebral palsy?

55
Q

What are the causes of eye redness in newborns?

A
  1. Day 0-2–> chemical irritation (due to silver nitrate drops)
  2. Day 2-7–> Gonoccocal conjunctivitis. treat with ceftriaxone
  3. Day7-21–> Chlamydia trachomatis. Treat with oral erythromycin
  4. Day 21 and beyond–> Herpes simplex
56
Q

What are the prophylactic eye treatments given to babies after thery are delivered?

A
  1. Erythromycin
  2. Tetracycline
  3. Sliver nitrate drops
57
Q

What clotting factors are Vitamin K responsible for?

A

Factors 2, 7, 9, 10 protein C and S

58
Q

What diseases are screened for in newborns?

A
  1. PKU
  2. Congenital adrenal hyperplasia
  3. Galactosemia
  4. Hypothyroidism
  5. G6PD deficiency
  6. Hearing test
  7. Homocysteinuria
  8. Beta thalassemia
59
Q

What is transient polycythemia?

A

Benign condition in newborms where cord clamping can cause hypoxia which leads to the production of EPO

60
Q

What is the cause of transient hyperbilirubinemia?

A

Caused by increased production of unconjugated bilirubin. Benign condition

61
Q

What causes polyhydriamnois in babies?

A

CNS malformations and GI malformations

62
Q

What causes oligohydramnios in babies?

A

Post term pregnancies and renal agenesis/renal failure

63
Q

What is the most common complication of oligohydramnios?

A

Cord compression

64
Q

What antihypertensive medication should never be given to a pregnant patient?

A

ACE-inhibitors

65
Q

What congenital condition is associated with renal agenesis, pulmonary hypoplasia and abnormal facies?

A

Potters syndrome

66
Q

What is Wilms tumor?

A

Most common primary renal malignancy. Asymptomatic flank mass, hematuria, HTN, aniridia. First test is abdominal ultrasound. Diagnostic test is CT syndrome

67
Q

What is Neuroblastoma?

A

Tumor of the sympathetic ganglia found near the adrenal glands. Painful abdominal mass with neurologic findings, diarrhea. Look at urine catecholamines like VMA , HVA

68
Q

What is the difference between the Tdap and the Dtap vaccine?

A

Tdap is for adults and should be given at 11or 12yrs of age

Dtap is for children

69
Q

What is the most common congenital heart defect?

A

Ventral Septal defect

70
Q

What is the murmur for ASD?

A

wide and fixed split S2 and systolic ejection murmur at upper left sternal border

71
Q

What is used to close a PDA? When is surgery required?

A

Indomethacin. If indomethacin fails or child is >6-8months

72
Q

What is associated with coarctation of the aorta?

A

Bicuspid aortic valves

73
Q

What is the heart defect in Turners syndrome?

A

Coarctation of the aorta

74
Q

What are the risk factors for transposition of the great vessels?

A

Diabetic mothers and digeorge syndrome

75
Q

Which two genetic diseases are associated with a horseshoe kidney?

A

Edwards syndrome and Turners syndrome

76
Q

What is the genetic abnormality in PKU?

A

Decreased Phenylalanine hydroxylase or decreased tetrahydrobiopterin cofactor

77
Q

What syndrome has a person with macro-orchidism, long face, large jaws, large everted ear, and autism

A

Fragile X syndrome

78
Q

What syndrome gives you fair skin, eczema, mental retardation, and a musty or mousy smelling urine?

79
Q

What disease is most commonly associated with meconium ileus?

A

Cystic fibrosis

80
Q

What is the diagnostic and therapeutic test for intersucception?

A

Air contrast barium enema

81
Q

What is choanal atresia?

A

Congenital disorder where nasal recanalization has failed in fetal development and one or both of the nasal passages are blocked leading to cyanosis in the baby.

82
Q

What would you suspect in a baby that turns cyanotic when feeding by turns pink again when they cry?

A

Choanal atresia

83
Q

What are risk factors for developmental dysplasia of the hip and when do you screen for it?

A
  1. Risk factors are breech delivery, family history, female gender
  2. Screen up until 18months
84
Q

What is the Barlow manuever and Ortolani maneuver associated with?

A

Developmental dysplasia of the hip

85
Q

What is the main problem is RDS?

A

Deficiency in lung surfactant

86
Q

What is the most common type of diaphragmatic hernia?

A

Bochdalek hernia

87
Q
  1. Air-filled loops of bowel in left side of chest

2. Displacement of heart and mediastinum to contralateral side

A

Chest x-ray findings for Congenital diaphragmatic hernia

88
Q
  1. Significant perihilar streaking due to interstitial fluid and engorged lymphatics
  2. Coarse fluffy densities that represent fluid filled alveoli
  3. Fluid in the pleural space and fissures
A

Chest x ray finding for Transient Tachypnea of the newbor

89
Q
  1. Air bronchograms

2. Diffuse reticulogranular appearance of the lung fields (ground glass appearance)

A

Chest x-ray findings for RDS

90
Q

When do you see physiologic jaundice?

A

Around 3-4 days of life and has a total bilirubin

91
Q

What is the most serious complication of unconjugated hyperbilirubinemia(jaundice)?

A

Kernicterus

92
Q

What is Kernicterus?

A

Staining of the basal ganglia and cranial nerve nuclei with bilirubin. Its the clinical condition that results from high levels of unconjugated bilirubin

93
Q

Hypotonia, constipation, jaundice, umbilical hernia and large fontanels are a sign of what?

A

Congenital hypothyroidism

94
Q

World wide what is the most common cause of hypothyroidism at birth?

A

Iodine deficiency

95
Q

What sorts of things cause large fontanels?

A

Osteogenesis imperfecta, rickets, down syndrome, hypothyroidism, malnutrition, ICP, shaken baby syndrome

96
Q

What should you think of with a bulging fontanel?

A

Elevated ICP (meningitis, subdural hematoma, hydrocephalus, lead poisoning)

97
Q

What is a Fever?

A

Temperature of 100.4 or greater (38 C)

98
Q

What is Roseola?

A

Childhood viral infection that presents with a fever and once the fever resolves the patient develops a erythematous maculopapular rash

99
Q

What causes roseola?

100
Q

What are IV treatment options for treating a UTI in kids?

A
  1. Amp &Gent
  2. Ceftriaxone
  3. Pipercillin&Tazobactam
  4. Ciprofloxacin
101
Q

What are oral outpatient options for treating UTI in kids?

A
  1. Trimethoprim/sulfamethoxazole
  2. Amoxicillin/Clavulanate
  3. Cephalexin
102
Q

What gives you a fever >5 days, conjunctivitis, unilateral cervical adenopathy, rash, and swelling and erythema of extremities?

A

Kawasaki disease

103
Q

Fever, cough, coryza, and conjunctivitis and rash?

104
Q

What causes catch scratch disease?

A

Bartonella henselae

105
Q

What is the most concerning complication of kawasaki disease?

A

Coronary aneurysms

106
Q

What is the treatment for kawasaki disease?

A

Aspirin and IVIG

107
Q

Complications of pertussis?

A

Apnea and poor feeding

108
Q

What is the most common cause of pneumonia in children?

A

Virus like RSV, adenovirus, influenza, and parainfluenza

109
Q

What is the most common cause of bacterial pneumonia in the neonate?

A
  1. Group B Strep
  2. E.coli
  3. Listeria
110
Q

What is the most common cause of pneumonia in the infant up to 5yr of age?

A

Step pneumoniae

111
Q

What is the most common cause of pneumonia in school age and older children?

A
  1. Mycoplasma pneumonia

2. Strep pneumonia

112
Q

Tuberculosis skin test is considered positive in high risk groups if the test is?

113
Q

Tuberculosis skin test is considered positive in moderate risk groups if the test is?

114
Q

Tuberculosis skin test is considered positive in low risk groups if the test is?

115
Q

Should children under the age of 2 be given antihistamines and decongestants?

116
Q

Whar are the bugs that cause acute otitis media?

A

H.flue nontypeable
Strep pneumo
Moraxella catarrhalis
strep pyogenes

117
Q

What is the first line treatment for Acute otitis media?

A

High dose amoxicillin

118
Q

What kind of electrolyte abnormality do you get with pyloric stenosis?

A

Hyperchloremic hypokalemic metabolic alkalosis

119
Q

what is considered mild-moderate dehydration?

A

5-9% dehydrated

120
Q

What is considered moderate-severe dehydration?

121
Q

How would you treat a patient with mild to moderate dehydration

A

With an oral rehydration solution of 50-100ml/kg over 2-4hrs

122
Q

How would you treat a patient with moderate to severe dehydration?

A

IV fluid bolus 20ml/kg until patient is rehydrated

123
Q

What is a basic metabolic panel?

A

Its a lab study that shows you serum electrolytes, BUN, creatine, calcium and glucose

124
Q

If you do an upper GI study and see the string sign what does that tell you?

A

Pyloric stenosis

125
Q

What is the glascow coma scale?

A

Method used to assess level of consciousness in a patient. Looks at eye response, verbal response and motor response

126
Q

What is the criteria for diagnosing DKA?

A
  1. Random blood glucose of >200mg/dL

2. Venous pH

Pediatrics (3 decks)

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