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DIDACTICPediatrics_all lectures Flashcards

1
Q

Koplik spots

A

measles

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2
Q

how long does measles usually last?

A

1 week

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3
Q

What are the 4 D’s and 3 C’s of measles?

A

4 D’s and 3C’s:

4 days of high fever
Cough, coryza and conjunctivitis

(coryza = rhinitis)

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4
Q

virus for Rubella?

A

Togavirus

“toGA! toGA! toGA!” think of a red toga…rubella means “little red”

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5
Q

why do we vaccinate against rubella?

A

Rubella is the leading vaccine-preventable cause of birth defects

we want to avoid congenital rubella syndrome - must avoid this for women who could get pregnant.

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6
Q

bacteria causing diptheria?

A

Corynebacterium diphtheria

toxin-producing strains!

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7
Q

itch worse at night - so bad the pt can’t sleep

A

scabies

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8
Q

how long do scabies live?

A

15-30 days

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9
Q

how long does it take for scabies eggs to hatch?

A

3-4 days

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10
Q

most common treatment for scabies

A

Permethrin 5% cream applied neck down

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11
Q

treatment regiment for scabies

A

two Permethrin treatments, 7 days apart

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12
Q

what is important for the household of a scabies pt?

A

must treat the whole household

affected people, 2 treatments 7 days apart, unaffected people, 1 treatment

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13
Q

key to scabies dx?

A

itch that’s worse at night

siblings have it too

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14
Q

what does atopic dermatitis respond to?

A

moisturizers

topical steroids

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15
Q

common places for atopic dermatitis rash?

A

antecubital
pop fossa
(flexure spots)

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16
Q

“islands of plaques”

A

psoriasis

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17
Q

atopic dermatitis vs psoriasis

A

atopic dermatitis is very itchy, vs. psoriasis which is mildly or not itchy

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18
Q

how long does topical steroid stay in the skin?

A

12 hours

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19
Q

one sternocleidomastoid is shorter than the other

A

torticollis

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20
Q

flat spot on head

A

plagiocephaly

"plagio" = oblique, slanting, flat, spread
"cephaly" = head, skull, brain
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21
Q

high fever + 3 C’s (cough, coryza, conjunctivitis) and a brick-red rash that begins at hairline (and spreads down)

A

measles

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22
Q

what is coryza?

A

commonly used synonym for rhinitis

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23
Q

most common cause of measles-related deaths

A

pneumonia

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24
Q

live, attenuated vaccines

A

(MOVR, “mover”, they’re live, so they move)

M: MMR
O: Oral polio
V: Varicella Zoster
R: Rotavirus

also - 
smallpox
yellow fever
oral typhoid
Franciscella tularensis
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25
Q

why do we care if vaccine is live, attenuated?

A

good immune response of both humoral (antibody) and cell-mediated immunity

don’t usually need booster

don’t give them to immunocompromised or pregnant pts!!!!!

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26
Q

killed, inactivated vaccines

A

PIRV A

Polio SalK (K for killed)
Influenza
Rabies
Vibrio Cholerae
Hep A
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27
Q

“food under age of 1….

A

…is just for fun”

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28
Q

rotavirus is most commonly seen in

A

unimmunized children between 6 mo - 2 yrs of age

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29
Q

most common complication of mumps

A

epididymo-orchitis

postpubertal males, 15-30%, usually unilateral
about 5-10 days after parotitis

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30
Q

Hib vaccine timing

A

2mo
4 mo
6 mo
12 or 15 mo.

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31
Q

EMBRYOLOGY

all organs are formed by week

A

8

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32
Q

EMBRYOLOGY

ovulation day

A

day 14

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33
Q

EMBRYOLOGY

fertilization day

A

day 15

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34
Q

EMBRYOLOGY

implantation day

A

day 22-24

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35
Q

EMBRYOLOGY

expected menses

A

day 28

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36
Q

EMBRYOLOGY

three components of primitive streak

A

primitive groove
primitive node
primitive pit

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37
Q

EMBRYOLOGY

what happens to primitive streak by end of 4th week?

A

primitive streak shows regressive changes, shrinks, disappears

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38
Q

EMBRYOLOGY

primitive streak will be

A

caudal

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39
Q

EMBRYOLOGY

primitive groove will be

A

mouth

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40
Q

EMBRYOLOGY

what is holoprosencephaly?

A

structures are affected as they are laid out midline on the axis - no reference for laying out structures

(cyclops, close spaced eyes, brain doesn’t have its hemispheres)

"holo" = whole
"prosencephalon" = forebrain
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41
Q

EMBRYOLOGY

what is caudal dysgenesis/regression syndrome?

A

insufficient amt of migration of mesoderm

Mermaid body, sirenomelia

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42
Q

EMBRYOLOGY

what is sacrococcygeal teratoma?

A

remnants of primitive streak derived from all 3 germ layers

so you find allll types of tissues - teeth, hair, etc.

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43
Q

PEDS 101

after 12 years old, pediatric vitals are…

A

…more like adults

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44
Q

PEDS 101

pediatric HR are usually

A

higher than adults

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45
Q

PEDS 101

pediatric bp ranges are usually

A

lower than adults

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46
Q

PEDS 101

pediatric RR are usually

A

higher than adults

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47
Q

PEDS 101

heads that suddenly stop growing are….

A

…concerning

  • check cranial sutures
  • follow closely and refer quickly
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48
Q

PEDS 101

when is newborn screening blood collected (heel prick)?

A

MUST BE COLLECTED AFTER 24 HOURS OLD

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49
Q

PEDS 101

who is Dr. Bob Sears?

A

some guy with his own vaccination schedule which is not supported by CDC or AAP

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50
Q

PEDS 101

It’s a good idea to avoid honey until baby is 1 year old to avoid botulism. True or false?

A

True

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51
Q

PEDS 101

what food is best for starting a 4-6 month old on food?

A

cereals

cereals are best to start as they are easy to change consistency– multigrain, barely, oatmeal (not rice only per FDA due to arsenic risk); mix with breastmilk, formula, water

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52
Q

PEDS 101

Should 6-9 month old baby still get breastmilk? What class should parents take at this point?

A

yes -

baby should still be getting 24-32 oz of bm/formula daily

parents should take Heimlich maneuver/baby CPR

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53
Q

PEDS 101

eating milestone for the 9-12 month old

A

may be using spoon or fork

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54
Q

PEDS 101

two key changes in eating at 12 months

A

transition to whole milk

discontinue bottles/pacifiers

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55
Q

PEDS 101

typical age of readiness for toilet training

A

22-30 months

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56
Q

PEDS 101

ideally kids should have toilet training complete so that they have daytime dryness by….

A

5 years old

57
Q

PEDS 101

rear-facing car seat is appropriate for children until about ages…

A

rear facing car seats are from birth to

AGES 2-4

Keep children rear-facing as long as possible.

58
Q

Did you do the practice med dosing calculation problems provided by Dr. Banderas?

A

“of course I did”

Good! She says there will be 1-2 questions on the exam that are dosing problems!

59
Q

which hormone, released from the liver, is responsible for bone growth?

A

IGF-1, aka somatomedin C

“IGF-1 (along with sex steroids) is responsible for bone growth”

60
Q

adrenarche

A

development of pubic and axillary hair

61
Q

breast budding term

A

Thelarche

62
Q

teens should consume ______ mg/day of elemental calcium

A

1300

63
Q

teens should consume ______ amount of Vitamin D every day

A

400 IU

64
Q

teens should participate in _____type of daily exercise

A

bone-bearing

65
Q

why do we no longer give MMRV? in other words, why is Varicella separated from MMR vaccine?

A

there is a risk of febrile seizures with first dose of MMRV (so we give them separately now)

(MMRV CAN be used as a second dose though…)

66
Q

BCG vaccine

A

protects against

miliary TB and
TB meningitis

(in first five yrs of life, given in areas where TB risk is high, not in US)

67
Q

what children do NOT get live viral vaccine or live bacterial vaccine?

A

severely immunocompromised kids (those with T cell defects)

68
Q

how long do we wait after prolonged steroid administration (for 2 weeks or more) to give live virus vaccine?

A

wait at least 3 months

69
Q

common side effects for Hep B vaccine

A

soreness
pain
LOW GRADE fever
very very very low chance of anaphylaxis

70
Q

common side effects for Rotavirus vaccine

A

RARELY - intussusception
(but rotavirus itself can cause intussusception)

mild v/d

LOW GRADE fever

71
Q

common side effects for Tetanus vaccine

A

hives
trouble breathing
low bp

pain
soreness
LOW GRADE fever

72
Q

common side effects for Diphtheria vaccine

A

pain
soreness
fever

73
Q

common side effects for Pertussis vaccine

A

mild -
pain
tenderness
fever fretfulness

rarely -
inconsolable crying
febrile sz (super rare)

74
Q

common side effects for Polio vaccine

A

“well tolerated”

75
Q

common side effects for HiB vaccine

A

pain
soreness
LOW GRADE fever

76
Q

common side effects for PCV vaccine

A

fever in 1:100 infants
muscle aches in 1:100

pain
redness
swelling

77
Q

common side effects for MMR vaccine

A

may have mild breakthrough disease for kids <14 months

fever
soreness

78
Q

common side effects for varicella vaccine

A

mild chickenpox-like rash
pain
redness

runny nose
cough

79
Q

Does the child have a syndrome?

Check on these three things

A
  • failure to thrive?
  • feeding difficulties?
  • delayed milestones?
80
Q

When suspecting a syndrome, when do we refer to genetics?

A
  • single MAJOR birth defect discovered
  • combination of multiple birth defects
  • FH of particular defect (i.e. deafness)
  • multiple miscarriages/stillbirths
81
Q

List seven medical issues for children with Down’s Syndrome

A

OD’CLOTH

Obesity- 56%
Diabetes

Cardiac defects - 50%
Leukemia
OSA- 30-75%
Thyroid disorders- 54%
Hearing loss- 38-78%
82
Q

what is the most common chromosomal abnormality among live born infants?

A

Down’s Syndrome

83
Q

majority of preemies are born in what category of prematurity?

A

LATE PRETERM

84
Q

gestational age of LATE PRETERM category

A

34 - 36 6/7 weeks

85
Q

define TERM category based on gestational age

A

TERM = 37 - 41 6/7 weeks

86
Q

what is the independent risk for mortality for a preemie immediately after delivery?

A

thermoregulation

87
Q

what is the leading cause of morbidity and mortality in the newborn period?

A

RDS

Respiratory
Distress
Syndrome

88
Q

what is RDS?

A

a lack of surfactant

89
Q

what does RDS look like on chest xray?

A

diffuse reticulogranular pattern
air bronchograms
atelectasis

90
Q

what is BPD?

A

BronchoPulmonary Dysplasia

impaired pulmonary function

91
Q

what is a common risk of BPD?

A

CP

cerebral palsy

92
Q

where is a PDA?

A

between the aorta and pulmonary artery

93
Q

what closes the PDA medically?

A

indocin or ibuprofen (NSAIDS close the ductus)

94
Q

what is an intestinal emergency for the preemie?

A

NEC (necrotizing enterocolitis)

95
Q

what is the treatment of NEC?

A

decompress the abdomen, either via
NG/OG tubes, or
surgery

96
Q

common s/s of NEC?

A

grossly bloody stools or
occult blood in stool

distended abdomen

97
Q

one key radiographic findings of NEC?

A

Pneumatosis intestinalis: air in the wall of the bowel itself

98
Q

duration of cessation of breathing of preemie to qualify for apnea of prematurity?

A

> 20 seconds

99
Q

treatment of apnea of prematurity?

A

caffeine

100
Q

treatment of anemia of prematurity?

A

resolves spontaneously in 3-6 months

101
Q

three factors of care for PCP for preemie after discharged home

A

GROWTH
(expect baby to catch up for first 2 yrs)

PREVENTIVE CARE
(IZ schedule based on chronological age)

MILESTONES/NEURODEVELOPMENTAL ASSESSMENTS
(utilize CORRECTED age until 2 yrs (subtract # of weeks born early))

102
Q

ankyloglossia -
define
name treatment

A

= the frenulum is connected to end of tongue

snip it

103
Q

dacryostenosis
define
name treatment

A

= clogged tear ducts

<6 months, just use warm washcloth to clean
>6 months, consider referral to opthamology

104
Q

omphalitis -

define and describe

A

infection of umbilical cord

nasty smelling discharge
go to hospital; this baby gets admitted!

105
Q

Diastasis Recti

what is it? what do we do about it?

A

abdominal muscles haven’t met yet

nothing - they’ll come together

106
Q

umbilical hernia -

testing and treatment

A

push it in with your thumb - if baby doesn’t cry, no signs of pain, leave it alone - it will heal by the time baby is 5 years old.

just watch out for it to become firm or red, this means trouble for baby

107
Q

baby MSK

what are Ortolani and Barlow tests?

A

Barlow - try to dislocate the hips
Ortolani - try to push back into socket

not sure - something to do with making sure hip joints are okay

108
Q

baby MSK

what hip advice to we give to parents?

A

Advise parents to keep them in frog leg position as much as possible bc the femur heads in the joint is what develops the deep cartilage socket

109
Q

what five skin changes are vascular malformations?

A 
port wine stains
stork bites
angel kisses
hemangiomas
congenital hemangiomas
110
Q

baby neuro

what’s the difference between infantile spasm (seizure) and natural sleep jerking motion?

A

sz = sustained, rhythmic movement, eye deviation - - go to hospital!

natural sleep jerking = one small jerk motion when falling asleep

111
Q

Meconium stools should transition to normal stools by ______.

describe meconium stools

A

by 2 days

meconium stools are black and tarry

112
Q

by ______, mom’s full milk should be present

A

by 3-5 days

113
Q

physiological jaundice is a diagnosis of

A

exclusion

114
Q

physiological jaundice peaks at _____ days of age, usually gone by ____.

A

physiological jaundice peaks at TWO TO FOUR DAYS of age and is usually gone BY TWO WEEKS OF AGE.

115
Q

physiological jaundice should not exceed _____ level of indirect bilirubin

A

12 mg/dL

116
Q

15-17 mg/dL peak of indirect bilirubin is consistent with ______

A

breast milk jaundice, or indirect hyperbilirubinemia

117
Q

how long do breast milk jaundice, or indirect hyperbilirubinemia, last?

A

can last a month or more

118
Q

characteristics of pathologic jaundice

A
  • appears w/in 24 hrs of birth
  • any direct hyperbilirubinemia
    >17 total serum bilirubin (TSB) in newborns
119
Q

possible causes of pathologic jaundice

A 
rubella
sepsis
toxoplasmosis
ABO incompatibility
Rh neg mother with second Rh positive baby
120
Q

labs for jaundice?

A

Transcutaneous Bilirubin: Very close estimation of TSB. Non-invasive

Total Serum Bilirubin: The total amount of Bilirubin circulating in the blood

Coombs’ - are there antibodies attached to RBC’s

Antibody-mediated hemolysis

ABO: Blood type - does it match mom’s? (Tested at birth)

Type O moms are most commonly affected since they can carry both antiA and antiB antibodies. If the infant is A, B or AB then they are vulnerable

Rh testing: Is mom (-) and infant (+)? Erythroblastosis fetalis

121
Q

jaundice: when do I worry?

A

1 major risk factor + high Bhutani score

known FH of inherited disorder

infant not responding to phototherapy

122
Q

Erythema infectiosum is also known as:

A

Fifth Disease

123
Q

“slapped cheeks”

lace pattern

name that disease and the virus that causes it

A

Fifth Disease

parvovirus B19

124
Q

treatment for moderate viral croup

A

Nebulized/racemic Epinephrine (give 1st)

mainstay of treatment is dexamethasone, but you have to open the airway first

125
Q

“herald patch”

A

Pityriasis rosea

126
Q

Christmas tree pattern

A

Pityriasis rosea

127
Q

in cases of FEVER, which children get empiric antibiotics?

A 
Neonates
Immunocompromised children 
Ill appearing infants
Toxic appearing children 
Well appearing infants and abnormal labs (e.g. UA, CSF analysis)
128
Q

in cases of FEVER, what antibiotics are given to infants 0-30 days who need them?

A

Ampicillin and gentamicin

or

ampicillin and cefotaxime

129
Q

in cases of FEVER, what antibiotics are given to infants >31 days and older children who need them?

A

Ceftriaxone ± vancomycin

130
Q

how many kids with FEVER need antibiotics?

A

not many - The most common cause of fever in childhood are viruses

Viral testing is not commonly indicated

131
Q

define FEVER in physiologic terms

A

Centrally mediated rise of body temperature above the normal daily variation in response to many different pathologic insults

132
Q

how is FEVER defined in temperatures?

A

> 100.4 F (38 C) in neonates and babies < 3 mo)

> 101.1 F (38.4 C) in older children

(no single, widely accepted value)

133
Q

Greek word for leather

A

diptheria

refers to the pharyngeal membrane that is the clinical hallmark of infection

134
Q

initial finding on oropharyngeal examination of diptheria

A

initial finding on oropharyngeal examination is

mild erythema, which can progress to isolated spots of gray and white exudates

135
Q

unique finding of diptheria

A

In at least one-third of cases, patients present with the classic coalescing pseudomembrane, which adheres tightly to the underlying tissue and bleeds with scrapping

136
Q

another name for croup

A

Laryngotracheitis

137
Q

What is the treatment for gonococcal conjunctivitis?

A

1 gram of intramuscular ceftriaxone.

138
Q

key finding of intussusception

imaging used in intussusception

A

CURRANT JELLY bloody stools

ultrasound (“target sign”)

Pediatrics_JD (4 decks)

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