Deck 1 Flashcards
1
Q
what are some consequenses of gestational diabetes on the newborn
A
macrosomia (–> shoulder/hip dislocation), hypoglycemia from overactive beta cells during pregnancy, heart defects, polycythemia, organomegaly, hypertrophic cardiomyopathy
2
Q
what is myositis ossificans
A
this is when there is trauma to a muscle and it filled with new lamellar bone instead of repaird (heterotropic ossification)
3
Q
myositis ossificans presentation
A
pain on movement, no pain at night, following an injury, swelling/induration
4
Q
adolescent privacy allowances
A
adolescents have a right to protect certain aspects of their care such as sexual, drug use, and mental health topics so records should be transferred very carefully
5
Q
how does labial adhesion present
A
itching and normal development
6
Q
treatment of labial adhesions
A
estrogen cream due to low estrogen in a child
7
Q
what is spondylosis
A
this is just a general term for degenerative disc changes that cause pain in the spine due to nerve compression
8
Q
how does spondylosis present in a child
A
typically they will be in sports and forward extension of the spine makes the pain worse
9
Q
should you do a CT scan in a child
A
NO!!
10
Q
what should you do if you suspect GBS in a child
A
spirometry then intubate based on function
11
Q
fetal alcohol presentation
A
thin vermillion border, small palpebral fissures, smooth philtrum
12
Q
eosinophilic esophagitis presentation in a toddler
A
food aversions especially solid foods! eczema, weight loss
13
Q
how do you dx EoE in a child
A
endoscopy and biopsy
14
Q
signs of opiod overdose in a child
A
sleepy, low bp, low HR, prolonged QT, acute change in mental status
15
Q
history findings of an opiod OD in a child
A
child with grandparents, recent surgery etc.
16
Q
signs of alcohol ingestion in a child
A
drowsiness, bradycardia, hypotension (no miosis)
17
Q
signs of clonidine injestion by a child
A
obtundation, miosis, bradycardia, NO QT prolongation
18
Q
immediate eval of a possible ingestion of a toxic drug
A
spot glucose to make sure the obtundation is not due to hypo/hyperglycemia
19
Q
what is a pulmonary finding (as in function test) of opioid toxicity
A
decreased tidal volume, residual volume does not change
20
Q
what is a morbilliform rash
A
this is a macular rash that has big macules that merge into each other to form one big macule, typically from a drug reaction
21
Q
signs of acute mono infection
A
fatigue, cervical lymphadenopathy, tonsillar exudates, fever, splenomegaly
22
Q
dx of mono
A
monospot- tests for heterophile Ab
23
Q
CBC results from a pt. with acute mono
A
abnormal lymphocytes (downy cells which are T cells!) and lymphocytosis
24
Q
describe what type of virus EBV is
A
EBV is a DNA virus, it is a herpesvirus
25
treatment of mono
rest and rehydration. No trtment. Pts with splenomegaly should avoid contact sports for 3 months
26
what is a complication of mono
tonsillar hypertrophy trt with steroids
27
differ between EBV (mono) and ALL CBC findings
all same symptoms except mono will have only 1 cell line of atypical cells, whereas ALL will have many atypical cells in the smear
28
how do you verify a mono dx in a young child
antibody tests because the monospot is not as reliable in a child
29
when do babies start to coo or smile back
about 6-8 weeks old
30
neonate HR range
100-205
31
infant HR range
100-180
32
toddler HR range
98-140
33
preschooler HR range
80-120
34
school aged child (6-11) HR range
75-118
35
adolescent-adult HR range
60-100
36
what are the most common bugs that cause otitis media
strep pneumo, H flu, moraxella
37
what typically precedes otitis media
a viral URI
38
treatment of OM
amoxicillin unless they have been prescribed it in the past 30 days then they can use a betalactam
39
what does the TM look like in OM
bulging and erythematous
40
what is a complication of OM
mastoiditis
41
what do you see in the urine of PSGN
RBC casts, proteinuria (+2),
42
how long after GAS infection does PSGN show up
~2 weeks later
43
presentation of PSGN
gross hematuria, periorbital edema, hypertension
44
treatment of psgn
furosemide for the HTN
45
lab findings of psgn
low C3/normal C4 levels due to immune complex formation, ASO titer, etc,
46
dangerous complication of psgn
hypertensive encephalopathy
47
what are the complement levels like in lupus
low C3 AND low C4
48
in rhabdo, what is in the urine
myoglobin, gives false positive for blood on dipstick but does not actually have RBCs
49
what is the presentation of epiglottitis
inspiratory stridor, drooling, dysphagia, hoarseness, refusal to eat
50
what causes epiglottitis
mostly h flu type B but other H flu strains can cause it too
51
how do you treat H flu
ceftriaxone and vanc
52
dx of scoliosis
xray
53
signs of slipped capital femoral epiphysis
patient holds their leg externally rotated (foot angles out), trendelenburg gait, progressive pain, limping
54
how do you dx slipped capital femoral epiphysis
bilateral hip xray
55
rubella presentation in an unvaxxed adolescent
fever, cephalocaudal expansion of maculopapular rash that spares hands, arthralgias, arthritis, lymphadenopathy
56
signs of intussusception in infant
bloody mucusy stools, sudden intermittent abdominal pain, air in abdomen,
57
what is dysentary
this is when you have bloody diarrhea and lymphocytes in the stool
58
affects of antiepileptic use during pregnancy
cleft lip, hypoplasia of the distal phalanges, cardiac abnormalities, neural tube defects (valproate mostly), excessive hair growth
59
adenovirus signs
URI, conjunctivitis, pharyngitis ,
60
kawasaki disease
C: conjunctivitis R: rash A: adenopathy S: strawberry tongue H: hand and foot swelling BURN: high fever
61
measles presentation
4 Cs: cough, coryza, conjunctivitis, koplik spots and fever then maculopapular rash craniocaudal
62
RMSF presentation
fever, headache, rash hands up, myalgia
63
erythema infectiosum (parvo aka 5th disease)
low grade fever followed by facial slapped cheek rash then lacy on body,
64
roseola presntation
high fever for 4 days followed by rash (erythematous macules)
65
how do you treat kawasaki
aspirin and IVIG
66
signs of inhalent use in an adolescent
irritability, nystagmus, normal vitals, perioral rash, hallucinations etc.
67
signs of cannabis use in an adolescent
tachycardia, increased blood pressure, increased respiratory rate, conjunctival injection, dry mouth, and increased appetite
68
signs of cocaine/amphetamine use
increased physical activity, rapid and/or irregular heart rate, increased blood pressure, and decreased appetite
69
long term AE of inhalents
cerebellar atrophy (gait ataxia), restrictive lung disease, dysrhythmias
70
signs of bath salt use
euphoria, dilated pupils, loss of inhibition, involuntary muscle movement, tachycardia, and hypertension
71
signs of IgA vasculitis (HSP)
Purpura, arthralgia, bloody stool, abdominal pain, low grade fever
72
signs of hemolytic uremic syndrome
Irritability, pallor, bloody diarrhea, anemia, thrombocytopenia, decreased urine output, hypertension
73
what is ITP
this is when you have antibodies against platelets, can be primary or secondary to a viral illness
74
signs of ITP
petichiae, purpura, bleeding etc.
75
lab findings of appendicitis
leukocytosis, typically present after first 48 hours of illness
76
describe the location of pain I nappendicitis
starts periumbilically and then moves to mcburneys point (RLQ)
77
describe the ortolani and barlow maneuver
ortolani abducts the hips and barlow adducts the hips
78
describe the hairloss in alopecia acreta
this is patchy hair loss in small circular areas that can be anywhere around teh body (scalp, eyebrows, eyelashes, etc)
79
describe what the hair shaft looks like in alopecia
it is thick at the bottom and thin at teh top called exclamation point hair
80
what is the treatment for alopecia
topical corticosteroids
81
what is a common finding on the hands of kids with alopecia
nail pitting
82
how do you manage IgA vasculitis
symptomatic management with NSAIDs and acetominophen
83
workup of intussusception
if you can see target sign on US, you do not need to do CT just go straight to surgery
84
what is a typical sign that kids have iron def. anemia
PICA
85
how do you treat IDA?
supplemental iron
86
what labs are seen with Diamond blackfan anemia
normal platelet count
87
physical signs of diamond blackfan anemia
triphalangeal thumbs, multiple craniofacial defects
88
what is the moro reflex
moro is when you startle baby by quickly "dropping" them, they should abduct and extend their arms
89
what does moro reflex test for
brachial plexus injury
90
signs of spondylolithiasis
pain with extension of lumbar spine (bending forward), no pain with flexion of lumbar spine, "drop off" observed during palpation
91
what is spondylolithiasis and who gets it
its when the whole vertebral disk is pushed forward anteriorly seen in overuse injuries like divers, gymnasts, etc or elderly individuals
92
what screening should duchenne MD patients get
echo for cardiac abnormalities due to replacement of the muscle
93
what are signs of an imperforate hymen
this is when you have cyclical pain with bowel movements and can have primary amenorrhea. on exam you will see a bulging red mass from the vagina
94
mean age of menarche
13yo
95
what should you evaluate if a child is undergoing precocious puberty?
bone age evaluation
96
where is pulmonic regurg heard and what type
left sternal border third intercostal space, decresendo diastolic murmur that increases with inspiration
97
lab findings in a newborn of a diabetic mother
hypocalcemia, hypomagnesia, hypoglycemia
98
signs of hypocalcemia in a newborn
jitteriness
99
what is the first step in management of a newborn with pyloric stenosis
first correct their fluids and then surgery
100
how do you treat an acute splenic sequestration
packed red cell infusion
101
signs of acute splecic sequestration
splenomegaly, abdominal pain, signs of anemia, thrombocytopenia
102
signs of anemia
tachy, fatigue, pallor (eyes and nailbeds)
103
when do you lose moro reflex
by 6mo
104
signs of sleep apnea in a child
enuresis >5yo, large tonsils, daytime irritability,
105
what are signs of empyema
pneumonia with pleural effusions, pneumonia that gets worse even after treatment
106
what antibiotics should be given for empyema
vanc and ceftriaxone
107
signs of mccune albright
cafe au lait spots, precocious puberty
108
what is the management of a biliary cyst
surgical resection to prevent malignancy
109
dx of suspected mastoiditis
MRI brain
110
treatment of nonbullous impetigo
topical mupicorin (rna synthetase inhibitor)
111
neurological sequelae of isotretinoin
pseudotumor cerebri (elevated ICP, papilledema, headaches etc)'
112
hypoxic-ischemic injury presenting with HTN and bradycardia
highly elevated ICP, this is the cushings triad where the brain is swelling due to cell death, this occludes small blood vessels which causes the cushing reflex which the body responds with increased blood pressure and decreased HR due to baroreceptor overactivity
113
during DKA what are total body potassium stores like
they are usually low due to ineffective reabsorption in the the kidney bc of the excess diuresis
114
signs of NEC on X ray
air in the bowel and portal veins
115
pathogenesis of anemia of prematurity
babies are oxygenated earlier in life so they have decreased EPO production but their RBCs also have a shorter life span so they have anemia with inadequate reticulocyte response. they should have a reticulocytosis
116
benign murmur characteristics
grade <2, vibratory, decreases or disappears with standing, etc
117
management of benign murmurs
reassurance
118
what is the mutation of marfans
fibrillin 1
119
two treatments of pinworm
albendazole or pyrantel pamoate
120
signs of RMSF
macular/petechial rash on wrists and ankles, general malaise, abdominal pain, fever, headache
121
lab findings RMSF
elevated liver enzymes, low sodium, low platelets,
122
treatment of ITP
Observation
123
what is strabismus
this is when one eye is malaligned, can be deviated inward and have asymmetrical red reflexes
124
how do you ID strabismus
dilated fundoscopic exam
125
management of hydrocele
reassurance and observation
126
what other organ should be surveiled if a baby has trachesophageal fistula
renal ultrasound and echo
127
if a child presents with massive spontaneous intraperitoneal hemorrhage what is the etiology
splenic rupture
128
what can precede splenic rupture
recent viral illnes
129
if a baby has light stools is there bilirubin being excreted
NO!
130
what does UDP-glucoronidase do
this conjugates bilirubin so it is making DIRECT bili
131
if the patient has a direct bilirubinemia what is the problem
this is an excretion problem
132
what bili would be high if they have crigler najar
indirect
133
how do you dx biliary atresia
liver biopsy
134
how do you workup primary amenhorrhea
you first get an FSH
135
signs of congenital rubella
bilateral sensorineuronal hearing loss, PDA, cataracts
136
signs of urinary tract obstruction in a newborn
Xray with diminished lung volume, minimal wet diapers, distended abdomen
137
most common cause of urinary tract obstruction in boys
posterior urethral valves
138
signs of congenital hypothyroidism
apathy, weakness, hypotonia, large tongue, sluggish, abdominal bloating, umbilical hernia
139
main causes of meningitis in newborns
GBS, listeria, E coli
140
meningitis pathogens children
streptococcus pneumoniae or neisseria meningitidis (rarely H flue type b)
141
neonatal trtment meningitis
gent, amp, cef
142
child trtment meningitis
vanc and ceftriaxone
143
manifestation of salmonella in gi
bloody diarrhea +/- neurologic symptoms
144
treatment of bloody diarrhea
typically just rehydration
145
what bug causes HUS
EHEC
146
what should make you suspect abuse
abrupt onset of mood changes, bedwetting, and/or academic difficulties.
147
what is transient synovitis
transient inflammation of the hip joint, commonly following a viral illness
148
management of transient synovitis
conservative manatement with NSAIDS
149
what is the squirt sign
expulsion of stool or gas following rectal exam
150
what does the squirt sign mean
patient has Hirschsprungs
151
signs of congenital toxo
hydrocephalus, intracranial calcifications, chorioretinitis, petechiae (blueberry muffin rash), lymphadenopathy
152
signs of congenital CMV
small for gestational age, petechiae (blueberry muffin rash), sensorineuronal hearing loss, chorioretinitis, seizures
153
signs of croup
inspiratory stridor, barking cough, worse at night, hoarseness
154
signs of croup on xray
steeple sign
155
what causes croup
parainfluenza
156
haptoglobin levels in RBC hemolysis
decreased haptoglobin bc the hemoglobin in the RBC binds to it
157
what is the treatment for infantile hemangioma
beta blockers
158
signs of ALL
pancytopenia, diffuse nontender lymphadenopathy, splenomegaly, weight loss
159
signs of fanconi anemia
short stature, hypo/hyper- pigmented macules, thumb hypoplasia, genitourinary malformations
160
pathophys of fanconi anemia
dna repair defect
161
what are the signs of hyperbilirubinemia in a neonate
lethargy, change in tone, jaundice
162
when should transfusion therapy be started for hyperbilirubinemia
>25 or if it is unresponsive to light therapy and still rising
163
signs of acute rheumatic fever
arthritis, carditis, subcutaneous nodules, erythema marginatum, syndeha chorea, fever, elevated ESR, prolonged PR
164
what is erythema marginatum
annular pink rash with sharp, raised edges and central clearing
165
what is the most commo risk factor for orbital cellulitis
bacterial sinusitis
166
when does galactosemia present in newborns
first few days of birth
167
galactosemia enzyme deficiency
galactose-1-phosphate-uridylyltransferase
168
description of seborrheic dermatitis
scalp/face/retroauricular greasy scales, interriginous regions with glistening confluent erythema
169
long term complication of vesicoureteral reflux in children
fibrosis of the interstitial space
170
describe methemeglobinemia
this is when the Fe2+ gets oxidized to Fe3+ and does not bind oxygen.
171
what will the PaO2 on arterial blood gas be in methemeglobinemia
it will be normal bc this measures dissolved O2 which does not change
172
what organism causes impetigo
staph aureus
173
if a baby has persisent jaundice and they have elevated direct bili what is the haps
they have biliary atresia dx by ultrasound RUQ
174
what do you give to infants with NARDS
give them surfactant
175
what drug do you give for congenital prolonged QT
propanolol
176
most common cause of occult small bowel bleed in a child
meckels diverticulum
177
dx process of GI bleed in a child
stool test for occult blood --> upper and lower endoscopy with biopsy --> meckels scan
178
if a child has prolonged LOC following a syncope episode what is the likely cause
likely a psychogenic pseudosyncope episode which is part of conversion disorder
179
what is constitutional growth delay
this is when the child has short stature and delayed bone age but has linear growth curves, they will eventually catch up
180
what causes the pathology in reyes syndrome
hyperammonemia
181
in divorced parent families with joint custody, what is needed to get consent
only one parents consent for treatment
182
what is first line treatment in suspected NEC
blood cultures then antibiotics
183
what is infant dyschezia
this is a benign functional stooling disorder in whcih the infants do not have coordinated intraabdominal pressure with relaxation of the pelvic floor, totally normal
184
describe signs of infant dyschezia
episodes of straining for 10 minutes with normal stool consistency and frequency
185
what is congenital melanocytic nevus
this is a benign proliferation of melanocyte cells, solitary hyperpigmented patch with dark course hair
186
signs of congenital hypothyroidism
aysmptomatic at birth, lethargy, poor feeding, protuding tongue, constipation, prolonged jaundice, dry skin
187
course of infantile Hypertrophic cardiomyopathy of diabetic mothers
spontaneous regression by 1yr
188
what is the lesion called when an infant spontaneously gets a vascular bright red plaque that proliferates suddenly
this is a strawberry or superficial hemangioma
189
management of baby with GERD
reassurance and positioning therapy
190
signs of viral myocarditis
viraI prodrome, respiratory distress, murmur, hepatomegaly (from RHF)
191
cardinal features of neonates with down syndrome
low birth weight, upslanting palprebral fissures, epicanthic folds, single palmar crease
192
what is erythema toxicum neonatorum
this is a benign neonatal rash with pustules and erythematous bases on the trunk and proximal extremities
193
management of benighn neonatal rashes
observation
194
2 month gross motor
lifts head/chest when prone
195
2 month fine motor
eyes track past midline
196
2 month social/communication
alerts to sound, social smile
197
2 month cognitive
recognizes parent
198
4 month gross motor
rolls front to back
199
4 month fine motor
grasps rattle
200
4 month social
laughs, soothed by parents voice
201
4 month cognitive
orients head to direction of voice
202
6 month gross motor
can sit with little or no support
203
6 month fine motor
reaches with one hand, transfers objects
204
6 month communication/social
babbles, stranger anxiety
205
6 month cognitive
feeds self
206
9mo gross motor
pulls to stand
207
9mo fine motor
bangs together two objects, immature pincer grasp
208
9mo communication/social
waves bye bye, says mama/dada, separation anxiety
209
9mo cognitive
plays gesture games
210
12mo gross motor
stands/walks alone
211
12mo fine motor
finger pincer grasp
212
12 mo communcation/social
one word other than mama/dada
213
12 mo cognitive
uses spoon/cup, points to desired object
214
18 mo gross motor
runs well
215
18mo fine motor
builds tower 3 blocks
216
18mo communication/social
points to 1-3 body parts
217
18mo cognitive
"helps" in house
218
2yr gross motor
throws ball overhand, kicks ball
219
2yr fine motor
copies a line with crayon
220
2yr communication/social
2 word sentences, >50 words
221
2yr cognitive
removes article of clothing
222
3yr gross motor
pedels tricycle
223
3yr fine motor
copies circle
224
3yr communcation/social
speaks in three word sentences, 75% langueage is intelligible
225
3yr cognitive
brushes teeth with help
226
4 yr gross motor
hops on two feet
227
4yr fine motor
copies square
228
4yr communication/social
100% of language intelligible, plays in a group
229
4 yr cognitive
knows 4 colors
230
5 yr gross motor
skips
231
5 yr fine motor
copies triangle
232
5 yr communication/socila
defines simple words, uses 5word sentences
233
5 yr social
dresses self
