Community CPS Flashcards
Management of ankyloglossia
Usually conservative - parental education, lactation support, and reassurance
Frenotomy can improve feeding with significant breastfeeding difficulties
4 complications from a frenotomy
Bleeding
Infection
Injury to Wharton’s duct
Post operative scarring that limits tongue movement, requiring reoperation
3 non pharm therapies for GERD
Thickened feeds
Avoiding cow’s milk (2-4 week trial)
Infant positioning (discourage)
What type of bacteria produce nitrites?
Gram negative
6 common bacteria causing UTIs
E coli
Klebsiella pneumoniae
Enterobacter
Citrobacter
Serratia
Staph saphrophyticus (adolescent females)
How long should febrile UTIs be treated for?
7 to 10 days
How long does cystitis need to be treated for
2 to 4 days
Signs of a complicated UTI
Hemodynamically unstable
Elevated creatinine
Bladder or abdominal mass
Poor urine flow
Not improving clinically within 24 hours
Fever not decreasing within 48 hours of abx
Which children need a RBUS for UTI
Children <2 with first febrile UTI
During or within 2 weeks of their acute illness
What grades of VUR need antibiotic prophylaxis
Grade 4 and 5
And see uro or nephro
What are the issues with a nuclear cystogram for UTI
Less radiation than VCUG but less available
Poor anatomic details for male urethra (can miss posterior urethral valves)
Red flags for specific learning disorders on history
school avoidance
mood disorder symptoms anxiety about attending school
discrepancy between effort into work and objective achievement
Vascular tumors vs malformations
Tumors are prolferative
Malformations are defined by anomalous vessels
Hemangiomas and granulomas are tumors
Capillary/venous/lymphatic/arterial malformations
Complications from hemangiomas
Ulceration
Pain
Permanent functional impairment
Negative cosmetic outcome
Untreated hemangiomas can leave residual fibro-fatty tissue, atrophy, scars, and telangiectasia
Phases of infantile hemangioma growth and how long they last
Proliferative phase: usually begins in first 4 weeks of life, grows rapidly for first 1-3 months
Plateau phase: occurs between 12-18 months
Involution phase: occurs between 1-7 years
Main treatment and dose for infantile hemangiomas
Propranolol
1 mg/kg start, titrate up to 3 mg/kg/day
Typically continued for 6 months
Congenital hemangiomas vs infantile hemangiomas
Congenital version are present at birth, do not show early proliferation, do not respond to beta blockers
Which hemangiomas needs peds vs derm
Peds: small, non-ulcerated, not in cosmetically sensitive area
Derm: eye, nose, urethra, anus, liver, or large facial hemangiomas
When to do abdo US for hemangiomas
5 or more cutaneous hemangiomas
How do you detect an active lice infestation
Visualization of a living louse
Having only nits does not indicate that a live infestation is underway or will occur
Treatment for lice
First line is pyrethrins or permethrin 1%
Topical noninsecticidals can also be used
