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pediatrics > CLIPP Cases > Flashcards

CLIPP Cases Flashcards

1
Q

Things to ask in well child visit

A

Interval hx, development, growth, diet and social history

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2
Q

Calories an infant requires a day? pre term? very low birth?

A

100-120 for full term
130 for pre-term
150 for very low birth weight

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3
Q

Baby weight course

A

Lose some in first week, expected to gain back birth weight by 2 weeks

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4
Q

What is the moro reflex

A

Abrupt change in infants head causes symmetric abduction and extension of arms followed by abduction and sometimes cry

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5
Q

Solid foods start when

A

Cereal at 4 months (rice)

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6
Q

Two month vaccines

A 
DTaP 
RotaV
Hib 
IPV 
PCV13
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7
Q

When should an infants birth weight double and triple?

A

Double by 5 months, triple by 12 months

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8
Q

4 things absence of red reflex could be

A

Cataracts
Glaucoma
Retinoblastoma
Chorioretinitis

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9
Q

6 month milestones

A

Rolls over and sits up
Reaches for items and looks at drops items
Turns towards voices and babbles
Feeds self and demonstrates stranger recognition

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10
Q

1 year milestones

A

Stands alone
Neat pincer grasp
Says mama and dada and a few other words
Points to things and can hand things

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11
Q

Mass in baby for constipation

A

likely LUQ

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12
Q

What is the HHEADS interview

A

For young adults about all the fun/bad stuff (more comfortable questions go first)

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13
Q

3 big things seen in mono

A

fatigue, pharyngitis, and lymphadenopathy

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14
Q

What depression feature is more common in adolescents that adults

A

Early morning waking

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15
Q

Progression in severe anorexia

A

Bradycardia, electrolyte imbalances, arrhythmias, circulatory collapse, death

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16
Q

Girls vs Boys starting puberty

A

Girls b/w 8-13 years of age

Boys b/w 10-15

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17
Q

VWD tx

A

Desmopression (releases factor 8)

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18
Q

75% of newborn bilirubin comes from

A

Breakdown of hemoglobin

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19
Q

Manifestations of kernicterus

A

lose the suck reflex
become lethargic
develop hyperirritability and seizures, and
ultimately die

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20
Q

Physiologic jaundice of newborn def

A

total bilirubin level ≤ 15 mg/dL (≤ 257 μmol/L) in full-term infants who are otherwise healthy and have no other demonstrable cause for elevated bilirubin.

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21
Q

deficient or completely absent UDPGT causes

A

Crigler-Najjar syndrome

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22
Q

Normal breast fed baby timing

A

typically nurses 8–12 times in 24 hours

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23
Q

Day 3 and 6 after birth pee patterns

A

Day 3: The baby should be voiding 3-4 times a day.

Day 6: Baby should be voiding at least 6–8 times a day.

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24
Q

Day 3 and 6 poo patterns

A

Day 3: Meconium should no longer appear in the stool and bowel movements should begin to appear yellow.

Day 6 or 7: Most newborns have 3–4 stools per day, although many infants pass stool with every feeding.

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25
Q

A healthy-appearing infant who develops jaundice, dark urine, and acholic (pale) stools between 3 and 6 weeks of age may have

A

Biliary atresia

Tx is surgery

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26
Q

What should solely breast fed infants start on after 6 months

A

Iron and fluoride (if water levels are low)

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27
Q

Where does jaundice start on a baby

A

Face and moves down to trunk

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28
Q

When do you worry about hemolysis as a cause for jaundice in newborn

A

If jaundice started in the first 24 hours

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29
Q

Test for CAH

A

17-OH progesterone level

30
Q

Galactosemia in baby can cause

A

Direct hyperbilirubinemia, vomiting, and lethargy, can lead to death

31
Q

When would you stop breast feeding for a few days in breast milk jaundice? How long can breast milk jaundice persist?

A

16-25 mg/dL

Can last up to 12 weeks

32
Q

Physiologic jaundice timeline

A

peaks at 3–4 days of life and generally resolves within a day or two

33
Q

Things to remember to ask two week old mom

A

Preg history, hep B status and hearing screen, feeding history, and developmental milestones

34
Q

How much vit D should breast fed babies get

A

400 IU

35
Q

Lethargy def in children

A

poor or absent eye movements or as the failure of a child to recognize parents or to interact with persons or objects in the environment.

36
Q

Head size in congenital hypothyroidism

A

Large

37
Q

Most common cause of congenital hypothyroidism? PE findings?

A 
Some kind of dysgenesis
Findings: Feeding problems
Decreased activity
Constipation
Prolonged jaundice
Skin mottling
Umbilical hernia
38
Q

Why do most ped docs do amox instead of pen for strep throat

A

It tastes betters

39
Q

4 Big kawasaki criteria

A

Fever > 5 days
Nonpurulent conjunctivitis (may have cleared prior to presentation)
Rash
Swelling and erythema of extremities
Thrombophilia on labs and sterile pyuria on UA

40
Q

“sandpaper like rash” in what

A

Scarlett fever

41
Q

Strawberry tongue with what 3 diseases

A

Streptococcal pharyngitis
Kawasaki disease
Toxic shock syndrome

42
Q

Two kawasaki drugs

A

Aspirin and IVIG

43
Q

Infection workup in kid

A

CBC w/ diff and blood culture

44
Q

Bacterial meningitis Ab regimen

A

3rd gen cef and vanc

45
Q

Only thing elevated in CSF for viral meniningitis

A

WBC, all others normal

46
Q

Complex febrile seizure features

A

> 15 min, focal, more than one in 24 hours,

47
Q

Febrile seizures and blanching rash likely what disease?

A

HHV6 or roseola

48
Q

What children with a fever need to be seen immediately

A

Infants less than 6-8 weeks

49
Q

4 peds emergencies to worry about needing to reverse immediately

A

(1) Hypoxemia (2) Shock (septic, hypovolemic, cardiac) (3) Hypoglycemia (4) Poisoning

50
Q

First and most subtle sign of inadequate perfusion

A

tachycardia

51
Q

Why is hypotension a late sign of shock in kids

A

They compensate so well

52
Q

Meningitis exposure ppx

A

Cipro in adults

Rifampin for children

53
Q

Meningitis complications

A

Hearing loss
Neurologic disability
Digit or limb amputations
Skin scarring

54
Q

Near SIDS is also called

A

ALTE

55
Q

Most common respiratory cause of apnea

A

RSV

56
Q

Normal neuro findings in a 2 month old

A

Can fix and follow easily with their eyes;
Exhibit a meaningful smile in response to voices;
Have a strong suck; and
Are beginning to coo

57
Q

What to do with suspected child physical abuse

A

Skeletal survey

58
Q

Fractures highly suspicious of shaken baby

A

Posterior rib fractures

59
Q

Infants with Zellweger syndrome are usually

A

generally hypotonic and poorly responsive.

60
Q

Most consistent finding in Down’s? Other findings

A

Hypotonia (most consistent finding in infants with Down syndrome)
Upslanting palpebral fissures
Small ears (usually less than 34 mm at maximum dimension in a term infant)
Flattened midface
Epicanthal folds
Redundant skin on back of neck (nuchal skin)

61
Q

Standard lab diagnosis for Down’s

A

Lymphocyte karyotype

62
Q

Infants born with Down’s have an increased risk of

A

Hypothyroidism

63
Q

Cause of fragile X

A

inheritance of an abnormal number of CGG repeats in the FMR1 gene

64
Q

Turner syndrome PE findings

A 
Webbed neck
Low ear placement
Edema of the hands and feet
Hyperconvex nails, and
"Shield" chest, with widely spaced nipples
65
Q

Atopic triad

A

asthma, eczema, and allergies

66
Q

Infant Seborrheic dermatitis tx

A

Oil to remove scale, frequent shampoo, mild topical steroids

67
Q

Factors known to worsen acne lesions

A

Make-up (unless noncomedogenic)
Mechanical factors such as manipulation)
Occlusion, as occurs with some sports gear
Overzealous cleaning

68
Q

Doxy AE

A

photosensitivity, dental staining in children under age 9, teratogenicity, esophagitis, and pseudotumor cerebri

69
Q

Best OTC wart tx

A

Over-the-counter salicylic acid

70
Q

3 main causes of diaper rash

A
  1. Irritant dermatitis (most common)
  2. Diaper candidiasis
  3. Bacterial infection (GAS)
71
Q

Nutritional cause of diaper rash

A

Zinc def

pediatrics (14 decks)

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