CLIPP Pediatrics Flashcards
What are the lab findings associated with post-strep GN?
Elevated ASO
+ streptozyme
Elevated anti-DNAase B antibodies
Low C3
Why would you see hyponatremia in nephrotic syndrome?
Increased total body water leads to dilutional hyponatremia. Hyperlipidemia exacerbates this on labs
Why are you at risk of venous thrombosis in nephrotic syndrome?
Urinary loss of anticoagulants
Hyperlipidemia causes platelet dysfunction
Increased fibrinogen
Increased hct means increased viscosity
Treatment of primary nephrotic syndrome
Trial of corticosteroids
Sodium restriction to
When do you give IV glucose to newborns?
Symptomatic hypoglycemia with blood glucose
How can you differentiate between RDS and TTN on CXR?
RDS: ground glass infiltrates with air bronchograms
TTN: wet lungs but no air bronchograms or consolidation
What bilirubin levels can you expect for physiologic jaundice of the newborn? When do levels peak?
Tbili
What metabolic errors can present with jaundice?
Crigler-Najjar
Galactosemia
Hypothyroidism
What pattern should be observed in the weight of a healthy newborn?
Can lose up to 10% of birth weight in the first 4-5 days but should regain that weight by at least 2 weeks of age
When does biliary atresia normally present?
Between 3 and 6 weeks of age
How do you differentiate between cephalohematoma and caput succedaneum?
Caput succedaneum crosses suture lines, cephalohematoma does not
What should you do for female infants that presented in breech position?
US of hip at 4-6wks or radiograph of hip at 4mo to screen for developmental dysplasia of the hip
What is the laboratory work up for infants with hyperbilirubinemia?
Maternal ABO and Rh type/screen
Infant cord blood ABO and Rh type and direct Coomb’s
G6PD screen for +fam history
Total serum bili
Direct bili in kids with acholic stools/persistent jaundice at 3 wks
CBC and retics if suspicion for hemolysis
Tests for work up of sepsis in a newborn?
CBC with diff
CRP
Blood cultures
LP with Chem and cultures
How do you define failure to thrive?
Failure to regain birth weight by 3 wks or continuous weight loss for 10 consecutive days
Compare clonus in newborn to clonus in 1-2mo old
Up to 10 beats of clonus can be normal in newborn
More than 3 beats is abnormal in 1-2mo old
What is the goal TSH for infants with hypothyroidism?
1mIU/L
Measure at 2 and 4 weeks after starting therapy and then q2mo until 1 year old, q3 until 3 years old, q12mo until an adult
What is the 24hr urine protein and urine protein:creatinine that define nephrotic syndrome in children?
24hr urine protein >40mg/m^2/hr
Urine protein:creatinine >2.5
What are the most commonly isolated organisms from blood cultures of febrile pediatric patients?
Strep pneumo
Then less commonly:
H flu type b (Hib)
N meningitidis
Salmonella
What WBC essentially rules out bacteremia in pediatric patients?
What WBC warrants CXR even without lung findings on exam?
> 20000
What antibiotics would you use to treat pyelo?
Amp/gent - covers E. coli and enterococcus
Ceftriaxone - covers G- bacilli except pseudomonas
Pip/tazo - covers G- and pseudomonas
Cipro only in kids >1yo with complicated and resistant UTI
ORAL:
Cephalexin
Amox/clav - avoid 2/2 rxns
TMP-SMX - avoid 2/2 rxns
