Clipp cases Flashcards
1
Q
What are the TORCH infections?
A
Toxoplasmosis, other (HepB, Syphillis, Parovirus, HIV), rubella, CMV, Herpes virus 2
2
Q
What are the signs of a Torch infection?
A
Microcephaly, organomegaly, rash
3
Q
What are the manifestations of an infection with CMV?
A
Microcephaly, intracranial calcifications, enlarged ventricles, bilateral hearing loss, choreoretinitis, hepatosplenomegaly, rash
4
Q
What is the caloric requirement for a term infant?
A
100cal/kg/day-120cal/kg/day
5
Q
What is the caloric requirement for a pre-term infant?
A
115cal/kg/day-130cal/kg/day
6
Q
What is the caloric requirement for a very low birth weight infant?
A
150cal/kg/day
7
Q
When is a baby ready to transition to regular cows milk?
A
12months
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.
9
Q
When should the Moro reflex disappear?
A
At 4 months
10
Q
Whats the daily requirement of vitamin D in pediatrics?
A
400units
11
Q
What is the age that most babies sleep through the night?
A
4-6months
12
Q
When are the MMR, varicella and Hep A vaccines given?
A
12months
13
Q
What vaccines are given at the 2month visit?
A
Rotavirus, H. flu type b, pneumococcus, IPV, DTaP, second dose of Hep B
14
Q
How many doses of MMR, Varicella, and Hep A should kids get?
A
2 doses of each
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
16
Q
What could cause an absent red reflex in a baby?
A
- Cataracts
- Glaucoma
- Retinoblastoma
- Chorioretinitis
17
Q
What is the height that children should stay in a booster seat until?
A
4’9in (142cm)
18
Q
What things should a 3 yr old be doing?
A
- Dress self
- Feed self
- Speaks in 2-3 word sentences
- Knows name and use of cup
- Builds tower of 6 cubes, throws ball, rides tricycle, copies circle
19
Q
What is the medical term for eczema?
A
Atopic dermatitis
20
Q
What are some treatments for eczema?
A
- Lubricating the skin
- Short burst of anti-inflammatories (hydrocortizone)
- Antihistamines for itching (loratidine and cetirizine)
21
Q
What is the cover/uncover and hirschberg light reflex test used for?
A
Assess for strabismus
22
Q
When do you screen children for anemia?
A
At 12 months and again when they enter preschool or kindergarten
23
Q
At what age should you start measuring blood pressure?
A
Age 3
24
Q
What is obese and overweight in pediatrics?
A
Overweight is BMI >85%-95%
Obese is BMI > 95%
25
What are the stages of HTN in pediatrics?
Norma BP 99
26
What sort of things should come to mind when you have a child with high BP
Renal parenchymal disease or corarctation of the aorta
27
Whats the most common treatment for ADHD?
Methylphenidate (concerta) 18mg daily
28
Most common side effect of stimulants like methylphenidate?
Appetite suppression
29
How many calories does a 1 yr old require?
1000kcal/day
30
What does deficiency in vitamin A cause?
Bitot spots, blindness, hyperkeratosis, increase susceptibility to infection
31
What does a deficiency in vitamin B1/thiamine cause?
Beri-beri
32
What does a deficiency in vitamin B2/riboflavin cause?
Glossitis, keratitis, seborrheic dermatitis
33
What does a deficiency in vitamin B3/ Niacin cause?
Pellagra (dementia, diarrhea, dermatitis)
34
What does a deficiency in vitamin B6/Pyridoxine cause?
Convulsions, irritability, hypochromic anemia
35
What does a deficiency in vitamin C cause?
Scurvy
36
What does a deficiency in vitamin D cause?
Rickets and osteomalacia
37
What does a deficiency in vitamin E cause?
Hemolytic anemia in premies
38
What does a deficiency in vitamin K cause?
Hemorrhagic disease of the newborn
39
What are the symptoms of copper deficiency?
Hypochromic normocytic anemia, hypotonia, and osteoporosis
40
What are the symptoms of zinc deficiency?
Diarrhea, rashes, altered taste, behavior changes
41
What are the symptoms of selenium deficiency?
Pigment loss in skin and hair, macrocytosis, cardiomyopathy
42
When does the anterior frontanelle close?
Between 6-18 months
43
What are the two causes of precocious puberty?
Central means GnRH is being released
| Peripheral means androgens are being released
44
When does puberty start in girls?
8-13yrs
45
When does puberty start in boys
10-14yrs
46
What happens in the different stages of puberty
```
Thelarche--> breast production
Adrenarche--> production of adrenal hormones-->pubic and axillary hair
Growth spurt--> growth in height
Menarche--> menstruation
Gonadarche--> sex hormone production
```
47
What are the things you can check looking for dehydration?
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)
48
How does dehydration affect the BUN: creatine ratio?
Causes an elevation in BUN: creatine ratio.
49
What is oliguria?
Decrease in urine output.
50
Normal heart rate for a newborn?
120-160
51
Normal respiratory rate for a newborn?
40-60
52
Normal Blood pressure for a newborn?
65/50
53
What is the Apgar score?
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
Is a low apgar score predictive of cerebral palsy?
NO!!!!!
55
What are the causes of eye redness in newborns?
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
What are the prophylactic eye treatments given to babies after thery are delivered?
1. Erythromycin
2. Tetracycline
3. Sliver nitrate drops
57
What clotting factors are Vitamin K responsible for?
Factors 2, 7, 9, 10 protein C and S
58
What diseases are screened for in newborns?
1. PKU
2. Congenital adrenal hyperplasia
3. Galactosemia
4. Hypothyroidism
5. G6PD deficiency
6. Hearing test
7. Homocysteinuria
8. Beta thalassemia
59
What is transient polycythemia?
Benign condition in newborms where cord clamping can cause hypoxia which leads to the production of EPO
60
What is the cause of transient hyperbilirubinemia?
Caused by increased production of unconjugated bilirubin. Benign condition
61
What causes polyhydriamnois in babies?
CNS malformations and GI malformations
62
What causes oligohydramnios in babies?
Post term pregnancies and renal agenesis/renal failure
63
What is the most common complication of oligohydramnios?
Cord compression
64
What antihypertensive medication should never be given to a pregnant patient?
ACE-inhibitors
65
What congenital condition is associated with renal agenesis, pulmonary hypoplasia and abnormal facies?
Potters syndrome
66
What is Wilms tumor?
Most common primary renal malignancy. Asymptomatic flank mass, hematuria, HTN, aniridia. First test is abdominal ultrasound. Diagnostic test is CT syndrome
67
What is Neuroblastoma?
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
What is the difference between the Tdap and the Dtap vaccine?
Tdap is for adults and should be given at 11or 12yrs of age
| Dtap is for children
69
What is the most common congenital heart defect?
Ventral Septal defect
70
What is the murmur for ASD?
wide and fixed split S2 and systolic ejection murmur at upper left sternal border
71
What is used to close a PDA? When is surgery required?
Indomethacin. If indomethacin fails or child is >6-8months
72
What is associated with coarctation of the aorta?
Bicuspid aortic valves
73
What is the heart defect in Turners syndrome?
Coarctation of the aorta
74
What are the risk factors for transposition of the great vessels?
Diabetic mothers and digeorge syndrome
75
Which two genetic diseases are associated with a horseshoe kidney?
Edwards syndrome and Turners syndrome
76
What is the genetic abnormality in PKU?
Decreased Phenylalanine hydroxylase or decreased tetrahydrobiopterin cofactor
77
What syndrome has a person with macro-orchidism, long face, large jaws, large everted ear, and autism
Fragile X syndrome
78
What syndrome gives you fair skin, eczema, mental retardation, and a musty or mousy smelling urine?
PKU
79
What disease is most commonly associated with meconium ileus?
Cystic fibrosis
80
What is the diagnostic and therapeutic test for intersucception?
Air contrast barium enema
81
What is choanal atresia?
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
What would you suspect in a baby that turns cyanotic when feeding by turns pink again when they cry?
Choanal atresia
83
What are risk factors for developmental dysplasia of the hip and when do you screen for it?
1. Risk factors are breech delivery, family history, female gender
2. Screen up until 18months
84
What is the Barlow manuever and Ortolani maneuver associated with?
Developmental dysplasia of the hip
85
What is the main problem is RDS?
Deficiency in lung surfactant
86
What is the most common type of diaphragmatic hernia?
Bochdalek hernia
87
1. Air-filled loops of bowel in left side of chest
| 2. Displacement of heart and mediastinum to contralateral side
Chest x-ray findings for Congenital diaphragmatic hernia
88
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
Chest x ray finding for Transient Tachypnea of the newbor
89
1. Air bronchograms
| 2. Diffuse reticulogranular appearance of the lung fields (ground glass appearance)
Chest x-ray findings for RDS
90
When do you see physiologic jaundice?
Around 3-4 days of life and has a total bilirubin
91
What is the most serious complication of unconjugated hyperbilirubinemia(jaundice)?
Kernicterus
92
What is Kernicterus?
Staining of the basal ganglia and cranial nerve nuclei with bilirubin. Its the clinical condition that results from high levels of unconjugated bilirubin
93
Hypotonia, constipation, jaundice, umbilical hernia and large fontanels are a sign of what?
Congenital hypothyroidism
94
World wide what is the most common cause of hypothyroidism at birth?
Iodine deficiency
95
What sorts of things cause large fontanels?
Osteogenesis imperfecta, rickets, down syndrome, hypothyroidism, malnutrition, ICP, shaken baby syndrome
96
What should you think of with a bulging fontanel?
Elevated ICP (meningitis, subdural hematoma, hydrocephalus, lead poisoning)
97
What is a Fever?
Temperature of 100.4 or greater (38 C)
98
What is Roseola?
Childhood viral infection that presents with a fever and once the fever resolves the patient develops a erythematous maculopapular rash
99
What causes roseola?
HHV-6
100
What are IV treatment options for treating a UTI in kids?
1. Amp &Gent
2. Ceftriaxone
3. Pipercillin&Tazobactam
3. Ciprofloxacin
101
What are oral outpatient options for treating UTI in kids?
1. Trimethoprim/sulfamethoxazole
2. Amoxicillin/Clavulanate
3. Cephalexin
102
What gives you a fever >5 days, conjunctivitis, unilateral cervical adenopathy, rash, and swelling and erythema of extremities?
Kawasaki disease
103
Fever, cough, coryza, and conjunctivitis and rash?
Measles
104
What causes catch scratch disease?
Bartonella henselae
105
What is the most concerning complication of kawasaki disease?
Coronary aneurysms
106
What is the treatment for kawasaki disease?
Aspirin and IVIG
107
Complications of pertussis?
Apnea and poor feeding
108
What is the most common cause of pneumonia in children?
Virus like RSV, adenovirus, influenza, and parainfluenza
109
What is the most common cause of bacterial pneumonia in the neonate?
1. Group B Strep
2. E.coli
3. Listeria
110
What is the most common cause of pneumonia in the infant up to 5yr of age?
Step pneumoniae
111
What is the most common cause of pneumonia in school age and older children?
1. Mycoplasma pneumonia
| 2. Strep pneumonia
112
Tuberculosis skin test is considered positive in high risk groups if the test is?
>5mm
113
Tuberculosis skin test is considered positive in moderate risk groups if the test is?
>10mm
114
Tuberculosis skin test is considered positive in low risk groups if the test is?
>15mm
115
Should children under the age of 2 be given antihistamines and decongestants?
NO!
116
Whar are the bugs that cause acute otitis media?
H.flue nontypeable
Strep pneumo
Moraxella catarrhalis
strep pyogenes
117
What is the first line treatment for Acute otitis media?
High dose amoxicillin
118
What kind of electrolyte abnormality do you get with pyloric stenosis?
Hyperchloremic hypokalemic metabolic alkalosis
119
what is considered mild-moderate dehydration?
5-9% dehydrated
120
What is considered moderate-severe dehydration?
10-15%
121
How would you treat a patient with mild to moderate dehydration
With an oral rehydration solution of 50-100ml/kg over 2-4hrs
122
How would you treat a patient with moderate to severe dehydration?
IV fluid bolus 20ml/kg until patient is rehydrated
123
What is a basic metabolic panel?
Its a lab study that shows you serum electrolytes, BUN, creatine, calcium and glucose
124
If you do an upper GI study and see the string sign what does that tell you?
Pyloric stenosis
125
What is the glascow coma scale?
Method used to assess level of consciousness in a patient. Looks at eye response, verbal response and motor response
126
What is the criteria for diagnosing DKA?
1. Random blood glucose of >200mg/dL
| 2. Venous pH
