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Primary PNP > Developmental + Others PNP-PC Part 1 > Flashcards

Developmental + Others PNP-PC Part 1 Flashcards

1
Q

Pulls a pull toy, walks forward and backwards, drinks from cup; holds utensils, some attempts to use

A

15-month-old

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2
Q

Aims and throws a ball; stacks up to six blocks; removes own socks; scribbles spontaneously

A

18-month-old

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3
Q

Turns a doorknob; kicks a ball; climbs up on furniture; turns pages one at a time

A

24-month-old

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4
Q

Walks on tiptoes; buttons large buttons; jumps with both feet; build a tower with nine cubes

A

30-month-old

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5
Q

Muscle weakness, ataxia, confusion, anorexia, tachycardia, and heart failure in infants

A

Thiamin/Vitamin B1 deficiency

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6
Q

Colic, gastroenteritis, viral illness, dietary protein allergy, UTI, intussusception, incarcerated hernia, testicular torsion

A

Infant Acute Abdominal Pain

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7
Q

Gastroenteritis, viral illness, constipation, pharyngitis, UTI, appendicitis, intussusception, pneumonia, trauma

A

Preschool Acute Abdominal Pain

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8
Q

Gastroenteritis, viral illness, pharyngitis, UTI, constipation, appendicitis, pneumonia, pancreatitis, trauma

A

School-Age Acute Abdominal Pain

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9
Q

Gastroenteritis, viral illness, UTI, constipation, appendicitis, pancreatitis, cholelithiasis, IBD

A

Adolescent Acute Abdominal Pain

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10
Q

PID, dysmenorrhea, ectopic pregnancy, ovarian cyst

A

Female Adolescent Acute Adominal Pain

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11
Q

What is the dose for a child 10-30 kg of polyethylene glycol 3350?

A

0.2-0.82 mg/kg/day

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12
Q

What is the dose for a child >30 kg of polyethylene glycol 3350?

A

17 g/day

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13
Q

When do you start weaning polyethylene glycol 3350?

A

After 2 months and all symptoms have resolved for 1 month

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14
Q

Which infections can intussusception follow?

A

Gastroenteritis, otitis media, URI, adenovirus

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15
Q

What is the recommended fiber daily?

A

Age + 5= grams/day

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16
Q

Abdominal discomfort/pain associated with 2 of the following: -improved with defecation; change in frequency of stool; change in the appearance of stool ALONG WITH no evidence of inflammatory anatomic metabolic or neoplastic process

A

Diagnosis of irritable bowel syndrome

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17
Q

Hx of chronic/intermittent diarrhea, persistent/unexplained GI symptoms, sudden or unexplained weight loss, prolonged fatigue

A

Celiac disease

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18
Q

Hx of abdominal pain, diarrhea, nausea, gas, bloating related to amount of lactose ingested

A

Lactose intolerance

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19
Q

What do you use to test for celiac disease?

A

Serologic (IgA tissue transglutaminase antibody, IgA endomysial antibody)

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20
Q

What do you use to test for cow’s protein intolerance and allergy?

A

Skin patch for true allergy; serum IgE, elimination diet

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21
Q

What do you use to test for lactose intolerance?

A

Lactose hydrogen breath test

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22
Q

Impaired growth, failure to thrive, unexplained iron anemia, abdominal distention, bloating/cramping pain

A

Celiac disease

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23
Q

Abdominal distention

A

Lactose intolerance

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24
Q

Nausea/vomiting, abdominal pain, diarrhea, bloody stool, GERD, eczema, failure to thrive

A

Cow’s protein intolerance and allergy

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25
Q

What is the expected weight gain from birth to 3 months?

A

25-30 g/day or 1 oz/day

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26
Q

What is the expected weight gain from 3-6 months?

A

15-20 g/day or 0.5 oz/day

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27
Q

What is the expected weight gain from 6-12 months?

A

10-15 g/day or 0.5 oz/day

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28
Q

What is the expected weight gain from 12+months?

A

5-10 g/day

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29
Q

Slow onset of pain that gradually worsens with dysuria, swollen/inflamed scrotum, and tenderness along the epididymis

A

Epididymitis

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30
Q

What is the treatment for epididymitis?

A

Cephalaxin 40 mg/kg/day for 14 days

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31
Q

Sudden onset of unilateral, unrelenting scrotal pain; swollen/inflamed scrotum (ipsilateral), can occur after physical exertion, trauma, or upon waking up

A

Testicular Torsion

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32
Q

Edematous, erythematous, and warm on ipsilateral scrotum; “blue dot” sign; cremasteric reflex is absent

A

Testicular Torsion

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33
Q

Jaundice, hypothermia, failure to thrive, sepsis, vomiting, diarrhea, cyanosis, abdominal distention, lethargy

A

Neonate UTI

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34
Q

What is the most common pathogen for UTI in neonates?

A

GBS

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35
Q

What is the most common pathogen for UTI in all ages?

A

E. coli

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36
Q

Malaise, irritability, difficulty feeding, poor weight gain, fever, vomiting, diarrhea, malodor, dribbling, abdominal pain, colic

A

Infant UTI

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37
Q

Altered voiding patterns, malodor, abdominal/flank pain, enuresis, vomiting/diarrhea, malaise, fever, diaper rash

A

Toddlers UTI

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38
Q

“Classic dysuria”, malodor, enuresis, abdominal/flank pain, fever/chills, vomiting/diarrhea, malaise

A

School-age UTI

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39
Q

At what age do you need to do a straight in-and-out catheter for UTI diagnosis?

A

Younger than 2 years of age

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40
Q

What will show up on urinalysis for a UTI?

A

Increase leukocytes (WBC), RBCs, and nitrates

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41
Q

If + nitrates without RBC on urinalysis, is that a UTI or not?

A

Considered UTI until cultures confirm

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42
Q

Any culture result of ______ for a single organism UTI in catheter, suprapubic, or clean catch?

A

> 100,000

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43
Q

Any culture result of ____-_____ for a single or multiple organism UTI in catheter, or suprapubic?

A

10,000-100,000

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44
Q

In a clean catch urine culture, a result of _____ - _____, means possible UTI?

A

10,000 - 100,000

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45
Q

Spotting, vaginal discharge, painful urination, mild abdominal pain, yellow discharge, postictal bleeding; males–thick, cloudy, penile discharge

A

Chlamydia

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46
Q

What is the treatment for chlamydia?

A

Azithromycin 1 g orally SINGLE or Doxycycline 100 mg twice daily for 7 days

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47
Q

When do you follow up for chlamydia?

A

3 months

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48
Q

Females–profuse thick, green discharge, labial pain/swelling, Skene/Bartholin gland abscess, bleeding between periods and painful periods; Males–dysuria, yellow-green penile discharge, testicular pain

A

Gonorrhea

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49
Q

What is the treatment for gonorrhea?

A

Ceftriaxone 250 mg IM SINGLE PLUS Azithromycin 1g PO SINGLE

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50
Q

Profuse vaginal discharge, frothy greenish/yellowish, fishy discharge, strawberry cervix that bleeds easily

A

Trichomonas

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51
Q

What is the treatment for trichomonas?

A

Metronidazole 2g SINGLE DOSE

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52
Q

Asymptomatic or painful warts/”rash”; cauliflower-like warts that occur 4-6 weeks after exposure

A

Human Papilloma Virus

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53
Q

What education do you provide for trichomonas treatment?

A

Do not take alcohol after metronidazole for 24 hours after the dose

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54
Q

When does acute post-streptococcal glomerulonephritis occur after strep infection?

A

Usually 1-2 weeks after an initial strep infection

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55
Q

Triad of anemia, thrombocytopenia, and renal failure

A

Hemolytic Uremic Syndrome

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56
Q

Pulse normal, systolic BP normal, respirations normal, tacky/slightly dry buccal mucosa, normal anterior fontanelle, normal eyes, normal skin turgor, normal skin, normal/slightly reduced urine output, increased thirst

A

Mild 3-5% dehydration

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57
Q

Rapid heartbeat, normal to low systolic BP, deep, slightly increased respirations, dry buccal mucosa, sunken anterior fontanelle, sunken eyes, reduced skin turgor, cool skin, markedly reduced urine output, and listlessness and irritability

A

Moderate 6-9% dehydration

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58
Q

Rapid and weak pulse or absent pulse; low systolic BP, deep tachypneic respirations or decreased respirations, parched buccal mucosa, markedly sunken anterior fontanelle, markedly sunken eyes, tenting skin turgor, cool mottled skin, anuria, grunting, lethargy, and coma

A

Severe > 10% dehydration

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59
Q

What is the age range of early adolescence?

A

11 to 14 years

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60
Q

What is the age range of middle adolescence?

A

15 to 17 years

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61
Q

What is the age range of late adolescence?

A

18 to 21 years

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62
Q

Characterized by a growth spurt and development of secondary sexual characteristics, cognitive skills may not keep up; *daydreaming is common with emerging reasoning skills; peers are more important and appear *“anti-adult”, *mood swings, conscious of bodies, *development of own value system; believe peers more than adults because adults don’t know what they are talking about

A

Early adolescence (11-14)

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63
Q

Development of separate identify from parents; increased concerns about attractiveness (more comparing occurs during this time); intellectual sophistication, creativity, reasoning, logic, decision-making skills; peer group but less anti-adult, dating, sexual experimentation, developing ego centrism increases, risky behavior

A

Middle adolescence (15-17)

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64
Q

Clearer self-concept and formed a distinct identity; well-formed opinions and ideas; physical development complete; adult reasoning skills, but brain is still developing; relate to family as adults, shaping of identity, committed partner relationships for many

A

Late adolescence (18-21)

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65
Q

Focus on pleasurable sensations and child seeks out stimulation and sexual satisfaction; lasts throughout adulthood; goal: to love and work well

A

Genital stage (Freud) in adolescence

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66
Q

When is the genital stage for Freud?

A

Adolescence

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67
Q

What is the age range for identity vs role confusion?

A

12-18

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68
Q

Development of self; struggle with questions who am I and what do I want with my life; along with trying on many different selves to see which one fits right; attempts to discover oneself; individual successful in this stage has a strong sense of identity and able to remain true to beliefs and values even in the face of problems; failure: develop a weak sense of self and experience role confusion and may be unsure of their identity and struggle with goal for future

A

Identity vs role confusion

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69
Q

What is the age range for intimacy vs isolation?

A

18-21

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70
Q

After developing a sense of self, they are ready to share their lives with others, but if they are not successful in finding identity and self-concept; they have had issues maintaining and developing relationships with others; must have a strong sense of self before developing successful, intimate relationship; may develop feelings of loneliness and isolation so may not develop relationships

A

Intimacy vs isolation

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71
Q

What age range is formal operational?

A

11 years to adulthood

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72
Q

Which theorist is formal operational?

A

Piaget

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73
Q

Develop the ability to think in abstract ways that enable the child to engage in problem-solving methods in developing hypothesis, can think of abstract concepts and combine two different concepts into a new one; by the end, they can use deductive reasoning and use hypothetical ideas and explain different concepts

A

Formal operational

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74
Q

What age groups are in post-conventional?

A

Adolescence

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75
Q

Which theorist is post-conventional?

A

Kohlberg

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76
Q

Standards that are beyond a certain group or authority figure; social contract orientation or universal ethical principle orientation or mystical/religious reflection

A

Post-conventional

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77
Q

What is the first physical sign of the onset of female puberty?

A

Breast buds

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78
Q

What is the first physical sign of the onset of male puberty?

A

Enlargement of testicles

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79
Q

What are the three components of sexual orientation?

A

Sexual imagery, sexual behavior responsiveness, self-identification (heterosexual, bisexual, homosexual)

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80
Q

How many kcal will an adolescent need daily?

A

45 kcal/kg/day

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81
Q

What are the average daily calories needed for adolescents?

A

2200-300 calories/day

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82
Q

What electrolytes and vitamins are really important for adolescents?

A

Calcium and vitamin D level

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83
Q

What might strict vegetarians be missing from their diet?

A

Protein. vitamin B12, zinc, iron

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84
Q

What sleep is recommended for adolescents?

A

8-9 hours

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85
Q

What is sports injury is higher in female athletes?

A

Anterior cruciate ligament

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86
Q

What fracture is more common with amenorrhea?

A

Stress fractures

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87
Q

What is the female athlete triad?

A

Low energy availability with or without disordered eating pattern; menstrual dysfunction; and low bone density

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88
Q

Flat, circumscribed change of skin; used for lesions <1 cm

A

Macule

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89
Q

What are examples of macule?

A

Tinea versicolor, small cafe au last spot, freckles

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90
Q

Flat, circumscribed lesion with color change that is >1 cm

A

Patch

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91
Q

What are examples of patch?

A

Mongolian spot, vitiligo, larger cafe au lait spots

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92
Q

Circumscribed, nonvesicular, nonpustular, elevated lesion that measures <1 cm

A

Papule

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93
Q

What are examples of papule?

A

Milia, molluscum contagiosum, acne

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94
Q

Broad, elevated, disk-like lesion that occupies more than >1 cm; formed by confluence of papules

A

Plaque

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95
Q

What are examples of plaque?

A

Tinea corporis, eczema, psoriasis

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96
Q

Circumscribed, elevated, 0.5-2 cm, that involves dermis with the greatest mass below the surface of the skin

A

Nodule

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97
Q

What are examples of nodules?

A

Furuncle, melanoma

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98
Q

Circumscribed elevation <1 cm in diameter that contains purulent exudate

A

Pustule

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99
Q

What are examples of pustule?

A

Folliculitis, acne

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100
Q

Circumscribed elevated lesion >1 cm in diameter, deeper component and filled with purulent material

A

Abscess

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101
Q

What are examples of abscess?

A

Staphylococcal abscess

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102
Q

Sharply circumscribed, elevated, fluid-containing, that measures <1 cm in diameter

A

Vesicle

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103
Q

What are examples of vesicle?

A

Chickenpox, impetigo, herpes simplex

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104
Q

Circumscribed, elevated, fluid-containing >1 cm

A

Bulla

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105
Q

What are examples of bulla?

A

Fixed drug eruption

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106
Q

Firm, edematous plaque

A

wheal

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107
Q

What are examples of wheal?

A

Hives, dermographism

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108
Q

Pearly, yellow, 1-3 mm papules on face, chin, and forehead; resolves during first month of life

A

Milia

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109
Q

Erythematous, 1-2 mm papules and pustules; can occur anywhere but mainly on forehead, upper trunk, and flexural or covered surfaces; may come and go; appears after the first week of life, but can be on SCALP; cooling skin and loosening clothes can cause resolution; “heat rash/prickly heat”

A

Miliaria Rubra

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110
Q

Multiple 1-2 mm yellow papules; clusters around *nose and cheeks; resolves within 4-6 months

A

Sebaceous gland hyperplasia

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111
Q

Barely elevated yellowish *papules/pustules, 1-3 mm, surrounding irregular macular flare or wheal of erythema; appear first on face and spread to trunk and extremities; usually between first 3 days of life and usually fades over 5- 7 days, “flea-bitten appearance”

A

Erythema toxicum

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112
Q

Multiple, tiny, monomorphous papulopustules on erythematous base; primarily on cheeks and extends on to the scalp, usually appears at 3 weeks of age and spontaneously within 1-3 months

A

Neonatal acne

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113
Q

Chapped, shiny, erythematous, parchment-like skin with possible erosions on convex surfaces, but *creases are spared; peak 9-12 months

A

Irritant contact dermatitis

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114
Q

How to treat irritant contact dermatitis?

A

Frequent diaper changes, gentle cleansing, barrier cream, air dry, 0.5-1% hydrocortisone

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115
Q

Shallow pustules; fiery red plaques on convex surfaces, inguinal folds, labia, and scrotum; *satellite lesions and common after recent antibiotic use or diarrhea

A

Candidiasis

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116
Q

Erythematous, denuded areas or fragile blisters, crusting, pustules in suprapubic areas and periumbilicus; usually occurs in newborns

A

Bacterial dermatitis

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117
Q

How to treat candidiasis?

A

Antifungal cream, frequent diaper changes, gentle cleansing, barrier cream, air dry

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118
Q

How to treat bacterial dermatitis?

A

Nystatin if yeast is present; mupirocin in minimal; augment/cephalexin if severe

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119
Q

Erythematous, flaky crusts of yellow, greasy scales on scalp, face, diaper area, mild flakes with dandruff, not pruritic

A

Seborrheic dermatitis

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120
Q

What causes bacterial dermatitis?

A

Staphylococcal or streptococcal

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121
Q

What is the treatment for seborrheic dermatitis?

A

Antifungal agents (-azole, selenium sulfide); anti-inflammatory agents (topical steroids, calcineurin inhibitors), keratolytic agents (salicylic acid, urea)

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122
Q

What causes scarlet fever?

A

Group A beta-hemolytic streptococcus

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123
Q

How does scarlet fever begin?

A

Fever and pharyngitis followed by enanthem and exanthem in 24-28 hours

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124
Q

Face appears flushed; tongue initially has white coating that fades by 4th day with *very erythematous tongue with prominent papillae underneath; cervical and submandibular lymphadenopathy; diffuse erythema with small-fine papules give *sandpaper-like quality that begins on neck and spreads rapidly to trunk and extremities; rash resolves in 4-5 days with *fine peeling of skin

A

Scarlet Fever

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125
Q

High fever, severe headache, malaise, myalgia, edema around eyes and back of hands, GI symptoms (N/V, anorexia)

A

Rocky Mountain Spotted Tick Fever

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126
Q

What is the incubation period for rocky mountain spotted tick fever?

A

3-12 days

127
Q

Erythema migrans, malaise, headache, fever, myalgia, arthralgia, lymphadenopathy

A

Lyme Disease

128
Q

What is the incubation period for Lyme disease?

A

3-30 days

129
Q

Fever, chills, malaise, muscle pain, GI symptoms (N/V, diarrhea, anorexia), altered mental status, rash (more common)

A

Ehrlichiosis

130
Q

What is the incubation period for ehrlichiosis?

A

5-14 days

131
Q

Fever followed by rash on 4th day

A

Rocky Mountain Spotted Tick Fever

132
Q

Small, flat, pink macules initially on wrists, forearms, and ankles that spreads to trunk and involves palms and soles within 2 days (early); petechiae not seen until day 6 or later (later); generalized *periorbital edema

A

Rocky Mountain Spotted Tick Fever

133
Q

“Bull’s Eye” rash; red ring-like or homogenous expanding rash; flu-like symptoms; lymphadenopathy

A

Lyme disease

134
Q

Fever, severe headache, malaise, and myalgia skin rash is not common feature

A

Ehrlichiosis

135
Q

How to treat Rocky Mountain Spotted Tick Fever?

A

Doxycycline

136
Q

How to treat Lyme disease?

A

amoxicillin for 14-21 days or doxycycline for 10-21 days

137
Q

How to treat ehrlichiosis?

A

Doxycycline

138
Q

How to diagnose Rocky Mountain Spotted Tick Fever?

A

Rocky Mountain Spotted Tick Fever IgG titer

139
Q

How to diagnose Lyme disease?

A

Sensitive enzyme immunoassay (EIA) or immunofluorescence assay (IFA)

140
Q

How to diagnosis ehrlichiosis?

A

Detection of DNA by PCR

141
Q

1-2 mm erythematous papules/pustules, progresses to vesicle or bullae which rupture–honey-colored crusts?

A

Non-bullous impetigo

142
Q

Large, flaccid, thin-wall, superficial, annular or oval blisters/bullae

A

Bullous impetigo

143
Q

How to treat superficial, nonbullous, localized impetigo?

A

Topical mupirocin

144
Q

How to treat multiple, nonbullous, and widespread lesions of impetigo?

A

Augmentin, cephalexin, clindamycin, or dicloxacillin

145
Q

Do they require being home from school with impetigo?

A

Yes, exclude from school/daycare until treated for 24 hours

146
Q

Pruritis, follicular pustules, and follicular erythematous papules; discrete, erythematous 1-2 mm papules or pustules on inflamed base near follicle; pruritis papules/pustules, deep red/purple nodules in areas under swimsuit

A

Folliculitis

147
Q

Where does s. aureus folliculitis occur?

A

Scalp and face

148
Q

Where does p. aeruginosa folliculitis occur?

A

Usually below neck

149
Q

When does hot tub folliculitis appear?

A

8-48 hours after exposure

150
Q

Where is hot tub folliculitis normally appear?

A

Areas of swimsuit contact

151
Q

Collection of pus within dermis and surrounding soft tissues

A

Furuncle/Abscess

152
Q

Painful, tender, fluctuant, and erythematous nodules that eventually will have pustule; regional lymphadenopathy; deep red/purple nodules, painful; “boil”

A

Furuncle

153
Q

What is the management for furuncle/abscess?

A

I&D alone

154
Q

Erythematous, defined borders with central clearing

A

Tinea corporis

155
Q

Annular, oval, circinate lesions with red, scaly borders; clear centrally; often prominent over hair follicles

A

Tinea capitis/corporis

156
Q

What can occur during inflammatory stage of tinea capitis/corporis

A

Kerion

157
Q

Pustular, boggy mass; diffuse scalping to scalp without much hair breakage around it

A

Kerion

158
Q

How to treat kerion?

A

treat tinea capitis, but do not use steroids or antibiotics

159
Q

What is the management for tinea capitis/corporis?

A

Topical antifungals until the lesion has resolved and then 2-3 days more, treat 1 inch beyond edge without covering the lesion with bandaid or gauze; griseofulvin for places where there is hair (treat for 4 weeks and give with fatty foods, but check CBC, LFTs every 4 weeks); treat contacts

160
Q

Do you need to be excluded for tinea capitis/corporis?

A

Exclude until 24 hours

161
Q

Multiple annular, scaling macules/patches, hypo/hyperpigmented, raindrop pattern, that occurs in warm, humid weather, occurs mostly on back and upper shoulders

A

Tinea versicolor

162
Q

What is management for tinea versicolor?

A

Selenium sulfide lotion/shampoo; sun exposure can make pigmentation work; evidence of flaking means its been an effective treatment

163
Q

Pruritis, dry skin, papules, vesicles, edema, serous discharge/crusts, lichenification, scratch marks, generalized dry skin

A

Eczema

164
Q

What is management for eczema?

A

Moisturize!!! (vasoline, Cetaphil, Crisco, Aquaphor, eucerin); mild topical corticosteroids; antihistamines, wet wrap therapy, no topical antibiotics or systemic steroids

165
Q

Widespread papulovesicular rash from repeat exposures to substance that child is already sensitized to

A

Id Reaction

166
Q

Follicular plug, localized on face and trunk

A

Microcomedome

167
Q

Papule; blockage at mouth of follicle; appears on face, upper back, shoulder, chest

A

Open comedome/Blackhead

168
Q

Semisoft, precursor to inflammatory acne

A

Closed comedome/whitehead

169
Q

Fewer than 20 whitehead/blackhead, fewer than 15 inflamed bumps or fewer than 30 total lesions

A

Mild Acne

170
Q

Between 20 to 100 whiteheads or blackheads, 15 to 50 inflamed bumps, or 30-125 total lesions

A

Moderate Acne

171
Q

Multiple inflamed cysts and nodules; acne may turn deep red or purple and leaves scars

A

Severe acne

172
Q

Rash preceded by fever, cough, red eyes, Koplik’s spots; begins as pink then evolved to erythematous that starts on face, then chest and abdomen then arms and legs

A

Rubeola/Measles

173
Q

Rose-pink, maculopapular rash begins on face spreads to trunk and extremities lasting less than 72 hours; malaise, joint pain, lymphadenopathy

A

Rubella/Three-day Measles

174
Q

3 days of high fever with rapid decline then afterwards a diffuse, faint, blanchable, erythematous reticulated rash appears

A

Roseola Infantum/Herpesvirus 6

175
Q

Fever, pharyngitis, malaise, coryza, then “slapped check” erythema then *lacy, reticulated, erythematous exanthem

A

Erythema infectiosum

176
Q

Fever, malaise, headache, pharyngitis, or diarrhea; small gray-white vesicles and erosions with erythematous rings on hard palate, buccal mucosa, tongue, gingiva and then small oval vesicles with erythematous ring are seen on lateral aspects of hands and feet as well as palms and soles

A

Coxsackievirus

177
Q

Progression of lesions from erythematous macules to papules of fluid-filled vesicles to crusted lesions and fever/malaise; pruritic crops of lesions appear on face, trunk, and scalp; “Dew on a rose”

A

Varicella

178
Q

(Herald patch usually on trunk (2-5 cm ovoid lesion) and after that will see symmetric, small macular/papular pale pink lesions in *Christmas tree pattern

A

Pityriasis Rosea

179
Q

Burning, stinging pain, hyperesthesia, tingling (itching may be more common than burning) that does not cross midline; 2-3 *clustered groups of macules/papules progressing to vesicles that last 7-10 days

A

Herpes Zoster

180
Q

small, firm, pink-flesh-colored papules that become umbilicated with cheesy core/surrounding dermatitis; itching at the site

A

Molluscum contagiosum

181
Q

What is management for warts/verruca vulgarism?

A

Salicylic acid and lactic acid

182
Q

Solitary papule, irregular, rough; common around the cuticle of fingers and roes that can spread through trauma

A

Verruca vulgarus

183
Q

Spiny projections from the skin with stalk on eyes, lips, nose, or eyelids

A

Filiform warts

184
Q

Flat-topped, smooth surfaces that is skin or tan-colored; common on areas of trauma

A

Flat warts

185
Q

Rough papule that disrupts dermal ridges; painful

A

Plantar warts

186
Q

Cauliflower-like lesions; discrete or confluent papules with rough surface that can be on genitals, oral mucosa, respiratory tract

A

Condylomata acuminate/Venereal warts

187
Q

3 linear, erythematous papules in a row; pruritic

A

Bed Bug Bites

188
Q

May cause intense itching behind ears and at neck; “flakes” that do not wipe away easily; nits are small white/brown oval cases attached to the hair shaft

A

Pediculosis/Head Lice

189
Q

What is the management for pediculosis?

A

Permethrin, then remove nits and cleanse environment; anything that cannot be washed needs to be placed in a plastic bag for 2 weeks

190
Q

Itching; worse at night; progressively intense; multiple erythematous papules; s-shaped burrows, webs of fingers, sides of hands, folds of wrists; vesiculopustular lesion sin infants/young children

A

Scabies

191
Q

What is the management for scabies?

A

Permethrin 5% applied from the neck down and rinse off in 8-14 hours and repeat in 1 week; treat close contacts and wash linens and clothing

192
Q

Highest mortality rate of all mental health disorders

A

Anorexia Nervosa

193
Q

Athletes are more likely to develop; depressed mood, social withdrawal, insomnia, OCD related to food, body shape, and weight; sometimes there is a family history of anorexia, alcoholism, or affective disorder

A

Anorexia Nervosa

194
Q

Less than 85% of expected weight for age; BMI <17.5

A

Anorexia Nervosa

195
Q

Weight is often average or overweight; binging and/or purging for at least once a week for more than 3 months; self-criticism; laxative use; vomit for gag reflex, diuretics, laxatives; may have family history of obesity

A

Bulimia Nervosa

196
Q

What does the SCOFF questionnaire check for?

A

Anorexia and Bulimia

197
Q

What are the components of SCOFF questionnaire?

A

Do you make yourself *sick because you feel full?
Do you worry that you have lost *control over what you eat?
Have you lost *over 10 lbs in the last 3 months?
Do you believe you are *fat when others say you are thin?
Would you say *food dominates your life?

198
Q

What are the lab tests for anorexia and bulimia?

A

CBC, electrolytes, fasting glucose, LFTs, thyroid, FSH, LH, urinalysis, ECG

199
Q

What is expected weight gain for refeeding?

A

1.1 lb (0.5 kg) per week

200
Q

Markedly depressed/irritable mood or diminished interest in usual activities for a *period > 2 weeks

A

Major Depressive Disorder (MDD)

201
Q

Depressed or irritable mood for majority of days in past 2 years *less intense but more chronic then depressed episodes

A

Dysthymic disorder

202
Q

Occurs within 3 months of a major life stressor less severe symptoms usually *mild and brief

A

Adjustment Disorder with Depressed Mood

203
Q

Sadness, irritability, impulsive, crying spells, loss of pleasure/interest in activities, somatic complaints, externalizing behaviors, comorbidity with anxiety is common, often misdiagnosed as ADHD

A

Major Depressive Disorder in School-Age

204
Q

Sadness, hopelessness, self-hatred, anger, withdrawal, loss of pleasure/interest in activities, neurologic vegetative symptoms; decrease sleep, appetite, concentration; drug/alcohol use are common

A

Major Depressive Disorder in Adolescents

205
Q

What is treatment for mild MDD?

A

Cognitive-behavioral therapy

206
Q

What is treatment for moderate MDD?

A

Cognitive-behavioral therapy and possibly SSRIs

207
Q

What is treatment for severe MDD?

A

Cognitive-behavioral therapy + SSRIs

208
Q

What is are SSRIs that approved for children?

A

Fluoxetine/Prozac >8 years

Escitalopram/Lexapro >12 years

209
Q

How long do children need to take SSRIs for MDD?

A

Should be used 1-year past resolution

210
Q

What are the common side effects of SSRIs?

A

Excitation, agitation, n/v, diarrhea, dizziness, chills

211
Q

What is the risk for SSRIs?

A

Serotonin Syndrome

212
Q

Increase in body temperature, pupils are dilated, rapid heart rate, increasingly agitated, tremors, sweating that occurs within 8-10 days hours of ingestion of SSRI

A

Serotonin Syndrome

213
Q

When is suicide risk at the greatest risk?

A

During the first 4 weeks of depressive episode

214
Q

Which psychiatric disorder has the highest risk of suicide?

A

Bipolar disorder

215
Q

Characteristic pattern fo manic episodes before or after major depressive episodes

A

Bipolar disorder

216
Q

When does the onset of symptoms for bipolar disorder typically occur?

A

15-19 years

217
Q

What are comorbid conditions with bipolar disorder?

A

Conduct disorder, substance abuse, ODD, disruptive disorder, personality disorders

218
Q

When a child with depression begins to exhibit mild ADHD symptoms, what is the possible cause and what happens next?

A

Bipolar disorder; evaluation by a psychiatrist

219
Q

What drugs should patients with bipolar disorder NOT take?

A

Antidepressants alone may cause manic response

Stimulants may worsen manic symptoms

220
Q

“Worriers” and most prevalent psychiatric disorder; diagnosed most often ages 9-18; very hard on themselves; difficulty concentrating; muscle tension; unexplained fatigue

A

General Anxiety Disorder

221
Q

What screening tools for you use for general anxiety disorder?

A

Spielberg State-Trait Anxiety Inventory for Children (STAC) for 9-12 years and Screen for Child Anxiety Related Disorders (SCARED) for 8-18 years

222
Q

What is the management for general anxiety disorder?

A

Cognitive-Behavioral Therapy + parental education/training

223
Q

What is the management for obsessive-compulsive disorder?

A

Mild to moderate use cognitive behavioral therapy

Moderate to severe use cognitive-behavioral therapy + SSRIs

224
Q

What clinical findings separate PANDS from classic OCD?

A

Urinary frequency, hyperactivity, impulsivity, worsening handwriting

225
Q

Visual hallucinations are more common in children; disorganized speech and behavior can occur; develops between late teens to mild 30x; onset can be abrupt or insidious and around 1/2 will have depressive symptoms

A

Schizophrenia

226
Q

Unexplained injuries, bedwetting, fear of going home, changes in behavior, appetite changes, sleep disturbances, anxiety, self-harm, suicidal ideations

A

Post-Traumatic Stress Disorder

227
Q

Acting out, nightmares, insomnia, extreme startling, social withdrawal, tears, anxiety, depression, panic attacks, anger/rage, internalizing, suicidal ideation, impaired concentration, impaired school performance

A

Adolescence with PTSD

228
Q

Sleep problems, nightmares, development regression, repetitive themes in play, social withdrawal, new onset of anxiety/fears, panic attacks, impaired concentration, impaired school performance, avoidance symptoms, somatic complaints

A

School-age PTSD

229
Q

Sleep problems, nightmares, developmental regression, aggression, extreme temper tantrums, anxiety symptoms, sudden worsening of fears, irritability, avoidance symptoms

A

Preschool PTSD

230
Q

Feeding problems, FTT, sleep problems, irritability

A

Infancy PTSD

231
Q

Formal diagnosis around age 7; associated with history of harsh discipline, abuse, neglect; high rate of comorbidity with depression leading to substance abuse and suicide; repetitive/persistent pattern of behavior in which rights of others and rules are violated

A

Conduct Disorder

232
Q

Open defiance/non-compliance with authority; must persist minimum of 6 months; recurrent pattern of negative, defiant, disobedient, hostile behavior usually directed at family members, teachers, or peers known well to child

A

Oppositional Defiant Disorder

233
Q

What is substance abuse most commonly comorbid with?

A

Conduct disorder, depression, anxiety

234
Q

Excessive crying, poor feeding, failure to thrive, irritability, jitteriness, excessive lethargy, poor eye contact, sleep disorders

A

Substance abuse in infants and young children

235
Q

Decreased school performance, lethargy, hyperactivity, hypervigilance, decreased attention, disinhibition, risk-taking behavior, repeated absences/suspensions, loss of interest in previously enjoyed activities, withdrawal from family and friends, exaggerated mood swings, hypersexuality, sleep disturbances

A

Substance abuse in older children and adolescents

236
Q

What is the starting dose of fluoxetine/Prozac?

A

10-20 mg/day

237
Q

What is the starting dose for escitalopram/Lexapro?

A

10 mg/day

238
Q

If a child is born with trisomy 21, what is the most common heart defect?

A

AV canal defect

239
Q

What are common heart defects with down syndrome/trisomy 21?

A

AV canal defect, ventricular septal defect, tetralogy of Fallot

240
Q

You have a baby in the nursery who has poor pulses in the lower extremities who has a webbed neck and puffy hands and feet, what is the issue?

A

Coarctation of the aorta

241
Q

What is the most common heart defect with Turner syndrome?

A

coarctation of the aorta

242
Q

What are the common heart defects with Digeorge syndrome?

A

Interrupted aortic arch and tetralogy of fallot

243
Q

What chromosome is affected with DiGeorge syndrome?

A

Chromosome 22

244
Q

Where would the apical impulse be located with cardiomegaly?

A

Left mid-clavicular line between 4th and 5th intercostal space

245
Q

If you feel a precordial thrill, what grade murmur does the child have?

A

At least Grade 4

246
Q

Where is the aortic area for auscultation?

A

2nd Right Sternal Border

247
Q

Where is the pulmonic area for auscultation?

A

2nd Left Sternal BOrder

248
Q

Where is Erb’s Point located?

A

3rd Left Sternal Border

249
Q

Where is the tricuspid area for auscultation?

A

4th Left Sternal Border

250
Q

Where is the mitral area for auscultation?

A

4-5th Mid-clavicular line near apex

251
Q

What does S1 heart sound correlate with?

A

Mitral and Tricuspid valve closing; heart best at left lower sternal border

252
Q

What does S2 heart sound correlate with?

A

Aortic and Pulmonary valves; heard best at 2nd intercostal space near pulmonary area

253
Q

What does the presence of S3 mean?

A

High output states (fever) or Congestive heart failure (Ken-tuck-y)

254
Q

What does the presence of S4 mean?

A

Very bad congestive heart failure (Ten-nes-see)

255
Q

What does a fixed S2 split mean?

A

Atrial Septal Defect or Pulmonic Stenosis

256
Q

What heart sound will you hear with atrial septal defect?

A

Fixed S2 sound

257
Q

Low-pitch, vibratory, twangy, systolic murmur heard loudest at LLSB or 2nd/3rd ICS when lying down or after exercise

A

Innocent Heart Murmur

258
Q

You hear a murmur near the clavicle with a continuous bruit. When you turn the child’s head toward the murmur, it gets louder. When you turn the child’s head away from the murmur, it gets softer or disappears. What murmur does the child have?

A

Venous Hum

259
Q

You hear a murmur at the left lower sternal border that is musical in nature, that occurs in mid-systole, grade II/VI, low to medium pitch. What murmur do you hear?

A

Still’s murmur

260
Q

Murmurs that are heart loudest at the base of the heart, at least grade III or above, heard during diastole and does not change with positioning are usually what type of murmurs?

A

Pathologic heart murmurs

261
Q

The most common congenital heart defect in children is:

A

Ventricular Septal Defect

262
Q

What are the components of tetralogy of Fallot?

A 
PROVe
Pulmonic Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular Septal Defect
263
Q

A child has high BP in right upper extremity, lower BP in lower extremities, bounding pulses in the right upper extremity, and weak, absent/delayed pulses in lower extremities

A

Coarctation of aorta

264
Q

What are the most common acyanotic lesions?

A

Atrial Septal Defect
Ventricular Septal Defect
Patent Ductus Arteriosus

265
Q

The child has systolic ejection heartbeat heard best at LUSB with fixed S2 split

A

Atrial Septal Dect

266
Q

The child has holosystolic murmur heard over LLSB and mitral region

A

Ventricular Septal Defect

267
Q

The child is a premature infant with continuous machinery-like murmur without thrill heard over LUSB

A

Patent Ductus Arteriosus

268
Q

A child has diastolic rumble on heart auscultation with upward slanting eyes, Brushfield spots, short neck, and low muscle tone. What heart defect is present?

A

AV Canal

269
Q

Single artery comes from the heart giving origin to coronaries, pulmonary arteries, and aortic arch

A

Truncus Arterieosus

270
Q

What kind of shunting occurs with acyanotic heart defects?

A

Left to right shunting

271
Q

What kind of shunting occurs with cyanotic heart defects?

A

Right to left shunting

272
Q

What are the most common cyanotic heart defects?

A 
Tetrology of Fallot
Transposition of the Great Vessels/Arteries
Pulmonary Atresia
TAPVR
Single Ventricles
273
Q

You hear a systolic ejection murmur over LUSB and the base of the heart that radiates to the lungs with a harsh quality. The intensity of murmur is increased with deep inspiration.

A

Pulmonic Stenosis

274
Q

You hear a midsystolic ejection murmur over RUSB and the base of the heart that radiates to the neck or back with a harsh quality.

A

Aortic Stenosis

275
Q

What is the treatment for transposition of the great arteries?

A

Requests prostaglandins and early surgery (Jatene)

276
Q

What congestion occurs with right-sided heart failure?

A

Systemic Congestion

277
Q

What congestion occurs with left-sided heart failure?

A

Pulmonary Congestion

278
Q

Periorbital/facial edema, hepatomegaly, sudden weight gain, dependent edema, and ascites

A

Right-sided heart failure

279
Q

Tachypnea, increased respiratory effort, grunting and nasal flaring, retractions, crackles

A

Left-sided heart failure

280
Q

What are the nutritional requirements for congenital heart disease?

A

Small, frequent meals with increased calories (24 kcal or greater)

281
Q

What is the daily kcal requirement for congenital heart disease?

A

120-150 kcal/kg/day

282
Q

Which cardiac conditions require SBE (bacterial infectious endocarditis) prophylaxis?

A

Cyanotic congenital heart disease that has not been fully repaired, has a prosthetic material/device for 6 months after repair, or repaired heart which persistent leaks or abnormal flow

283
Q

What is the most common causative agent of bacterial endocarditis?

A

Streptococcus viridans

284
Q

Unexplained fever, splinter hemorrhages, and petechia on face and upper body

A

Bacterial Endocarditis

285
Q

What are the major criteria for acute rheumatic fever (ARF)?

A 
Migratory polyarthritis (Joints)
Carditis (significant new mumur)
Subcutaneous nodules
Erythema marginatum
Sydenham's chorea
286
Q

What are the minor criteria for acute rheumatic fever (ARF)?

A 
Fever
Arthralgia
Previous rheumatic fever
Elevated acute phase reactants (increased ESR/CRP)
Prolonged PR interval
287
Q

Acute systemic vasculitis under age 5

A

Kawasaki Disease

288
Q

A child has a history of mild upper respiratory illness but has become very irritability and has had a fever for more than 5 days with strawberry tongue, conjunctivitis without discharge, trunk rash, dry lips, flaking of the palms and soles of feet, swelling of hands and feet, and redness. The child is very irritable.

A

Kawasaki Disease

289
Q

Fever/viral illness, lethargy, low-grade fever, exercise intolerance, palpitations, muffled heart sounds, weak pulses, hepatomegaly, pallor

A

Myocarditis and Cardiomyopathy

290
Q

What do you need for hypertension in order to diagnose?

A

Three consecutive readings of high BP

291
Q

Macular erythematous rash with pale center on trunk and extremities

A

Erythema marginatum

292
Q

Homophonic wheeze, brassy cough, dyspnea, cyanosis

A

Tracheal Foreign Body

293
Q

Rapid onset, chronic croupy cough, unilateral wheezing, recurrent pneumonia

A

Laryngeal Foreign body

294
Q

Initial episodes of coughing, gagging, choking, with no signs of respiratory infection, limited chest expansion, decreased vocal fremitus, atelectasis, crackles, rhonchi, wheezes

A

Foreign body aspiration

295
Q

Starts with cough and rhinorrhea and gradually develops respiratory distress (tachypnea, substernal/intercostal retractions), expiratory wheezing, fine/coarse crackles, decreased appetite

A

Bronchiolitis

296
Q

What age range is typically affected by bronchiolitis?

A

Less than 24 months

297
Q

What time of year does bronchiolitis typically occur?

A

Late fall through early spring

298
Q

Inspiratory high pitched “whoop” that lasts up to 6-10 weeks; usually source for infants is adults that have an unrecognized infection

A

Pertussis

299
Q

What is the incubation period for pertussis?

A

7-10 days (5-21 days)

300
Q

What is the treatment for pertussis?

A

Azithromycin (macrolide antibiotics)

TMP-SMX can be alternative medication

301
Q

Do family members and close contacts need to be treated for pertussis for chemoprophylaxis?

A

Yes!

302
Q

Child has a history of mild URI, abrupt high fever, restlessness, shaking chills, apprehension, shortness of breath, malaise, pleuritic chest pain, vomiting

A

Pneumonia

303
Q

What are the common causative agents for pneumonia in infants?

A

Group Beta Strep, Staph, E.coli

304
Q

What are the common causative agents for pneumonia in children less than 5?

A

Strep pnuemonia, h. influenzae

305
Q

What are the common causative agents for pneumonia in children older than 5?

A

Group A strep, mycoplasm, staph pneumonia

306
Q

If you believe if it’s bacterial pneumonia, how would you treat it?

A

Amoxicillin 90 mg/kg/day BID

307
Q

If you believe a child has atypical pneumonia (such as mycoplasm), how would you treat it?

A

Azithromycin 10 mg/kg on day 1 followed by 5 mg/kg/day once daily for day 2-5

308
Q

These are the radiographic findings for bacterial pneumonia with diffuse interstitial, alveolar, apical/upper lobe infiltrates with a “ground glass” appearance

A

Pneumocystis (PCP)

309
Q

Prolonged expiratory phase, diminished breath sounds, increased work of breathing/signs of distress, decreased pulse oximetry, increased heart rate, increased respirate rate, wheezing, breathlessness

A

Asthma

310
Q

Helps assess the severity and reversibility of airflow obstruction and severity of asthma

A

Peak flow measurement

311
Q

Meconium ileus, prolonged jaundice, intestinal atresia

A

Cystic Fibrosis (neonatal)

312
Q

Cough, colonization of bacteria in mucus, bacterial pneumonia, FTT, hypoproteinemia, abdominal distension, cholestasis, rectal prolapse, steatorrhea, distal intestinal obstruction syndrome, hemolytic anemia

A

Cystic Fibrosis (infancy)

313
Q

Polyps, steatorrhea, rectal prolapse, distal intestinal obstruction syndrome, hemolytic anemia

A

Cystic Fibrosis (childhood)

314
Q

Allergic bronchopulmonary aspergillosis, chronic pansinusitis, nasal polyposis, bronchiectasis, hemoptysis, idiopathic pancreatitis, osteoporosis

A

Cystic Fibrosis (adolescence)

Primary PNP (8 decks)

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