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EOR Flashcards

1
Q

when does surfactant production surge?

A

after 36 weeks (steadily increases 33-36 weeks)

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2
Q

When is surfactant produced?

A

20 weeks

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3
Q

what is found on CXR in NRDS?

A

ground glass appearance w/ bronchograms

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4
Q

what endocrinopathy is associated w/ SCFE?

A

hypothyroidism

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5
Q

does mono cause posterior or anterior cervical lymphadenopathy?

A

posterior cervical lymphadenopathy

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6
Q

What risks are associated with gestational DM?

A

hypoglycemia, shoulder dystocia, HCOM, NRDS, congenital anomalies, PCV, jaundice, electrolyte disturbance (hypomag, hypocalcemia), caudal regression syndrome

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7
Q

macrolide use in newborns can cause what complication?

A

pyloric stenosis

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8
Q

which meds exacerbate hypercalcemia?

A

thiazide diuretics & lithium

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9
Q

ADEs of thiazide Diuretics?

A

hyponatremia
hypokalemia
hypomagnesemia
HYPERcalcemia

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10
Q

treatment of non-blistering, non-systemic, confined poison ivy rash?

A

clobetasol propionate 0.05% x 14 days (need longer corse bc it is a delayed Hypersensitivity rxn)

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11
Q

which heavy metal deficiency is associated with telogen effluvium?

A

zinc

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12
Q

Kawasaki Disease Symptoms

A

[CRASH and Burn]

Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hand or foot edema
Uncontrolled high fever (burn)

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13
Q

preferred monitoring for neonates who delivered breech d/t risk of DDH

A

US @4-6 weeks

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14
Q

what is normal BS during first day of life?

A

> 45 mg/dL

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15
Q

erythema toxicum neonatum

A

common, non-threatening rash that affects newborns. It usually appears within the first week of life, but can appear as early as the first few hours, and affects 4–70% of newborns

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16
Q

most common risk factor for developing pulmonary non-tuberculous mycobacterial disease in children?

A

CF

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17
Q

murmur of coarctation of the aorta

A

SYSTOLIC EJECTION MURMUR best heard at LUSB w/ radiation to the L inter-scapular area

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18
Q

otitis media & conjunctivitis (otitis-conjunctivitis syndrome) is a sign of what infection & requires which abx?

A

non-typeable HIB
tx w/ amoxi-clav

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19
Q

what is the most useful lab test to assess degree of dehydration in children?

A

serum bicarb

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20
Q

at what age is bronchiolitis less likely cause of pulmonary symptoms?

A

6+ years old

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21
Q

4-2-1 rule for hourly pediatric maintenance fluids

A

<10 kg: 4 ml/kg/hr

10-20kg: 40 ml + 2 ml/kg for every kg > 10 kg

> 20 kg : 60 + 1 ml/kg for every kg > 20 kg

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22
Q

pneumonia vs bronchiolitis on auscultation

A

bronchiolitis has diffuse crackles & wheezing

pneumonia has more focal findings

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23
Q

treatment for status asthmaticus?

A

SABA + Steroids

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24
Q

substances to kill live insect in the ear canal

A

mineral oil, lidocaine 1%, ethanol 95%

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25
Q

where is atopic dermatitis located on YOUNG kids?

A

EXTENSOR SURFACES

** diff than adults & older kids which is usually on flexoral surfaces

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26
Q

Irritant Diaper Rash spares what?

A

genitocrucal folds

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27
Q

Candidal rash involve or spare genitocrural folds?

A

involves genitocrural folds & is commonly isolated to the perineal area

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28
Q

Burns in Children

A

anterior head: 9%
posterior head: 9%
anterior torso: 18%
posterior torso: 18%
anterior leg, each 6.75%
posterior leg, each 6.75%
anterior arm, each 4.5%
posterior arm, each 4.5%
genitalia/perineum 1%

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29
Q

common cause of erythema multiforme in children

A

mycoplasma pneumoniae

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30
Q

is nikolsky sign +/- in erythema multiforme ?

A

NEGATIVE

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31
Q

6 Ps of Lichen Planus

A

purple, polygonal, planar, pruritic, papules or plaques

(autoimmune disease)

will also see wickham strae = fine white lines on the surface of the lesions

tx = corticosteroids

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32
Q

SJS/TEN where does it start & spread?

A

starts w/ acute onset on face/upper trunk, palms/soles and spreads distally & to extremities

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33
Q

superficial partial vs deep partial 2nd degree burns

A

superficial partial is painful to temp, air, touch

deep partial is painful to deep pressure only.

both blister & blanch with pressure

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34
Q

which degree burn does NOT blanch w/ pressure?

A

3rd degree

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35
Q

what is CI in initial care of a burn?

A

ice or ice water - can cause pain & increase depth of the burn

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36
Q

drugs causing erythema multiforme

A

sulfa
oral hypoglycemics
anticonvulsants
Penicillin
NSAIDs

(SOAPS)

MCC is HSV or mycoplasma infx (think post URI in kids)

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37
Q

isotretinoin monitoring/screening

A

SE:
- hyperlipidemia
- hepatotoxicity
- depression
- inflammatory bowel disease
- ankylosing hyperostosis
- teratogenic

Screening (initiation)
- Depression screening
- baseline liver panels
- lipid panels
- pregnancy test
- confirm x2 BC measures

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38
Q

MC type of psoriasis in children

A

plaque

[guttate is common in children but not MC]

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39
Q

tx for non-systemic poison ivy

A

topical triamcinalone x 2-3 weeks

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40
Q

first line tx verrucae

A

salycylic acid or cryotherapy

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41
Q

do HPV vaccines target strains that cause verrucae (common wart)?

A

NO

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42
Q

rash on newborn babies that appears like acne in first 2-7 days of life?

A

erythema toxicum neonatorum

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43
Q

Which neonatal dermatologic condition occurring around 3 weeks after birth and caused by a reaction to Malassezia species is characterized by inflammatory pustules on the cheeks without the presence of comedones?

A

Neonatal cephalic pustulosis

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44
Q

teratogenic in the first trimester by increasing risk of congenital cataracts, SNHL & heart Disease

A

Rubella

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45
Q

TX OF SEB DERM IN INFANTS

A

MINERAL OIL

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45
Q

hx of tet spells (cyanosis w/ crying/feeding/pooping) and squatting for relief

A

tetraology of fallot

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45
Q

tetraology of fallot four components

A

PROVe

PDA
RVH
Overriding Aorta
VSD

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46
Q

recommended supplementation for breast-feeding infants?

A

vitamin D

400 IUD

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47
Q

what is tx for otitis media?

A

HIGH DOSE amoxicillin
80-90 mg/kg/day in divided doses BID x 10 days

** need high dose to exceed MIC of s. pneumonae & target non-susceptible strains

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48
Q

calcium needs by age

A

0-6 mo: 210 mg
6-12 mo: 270 mg
1-3 yrs: 500 mg
4-8 yrs: 800 mg
9-18 yrs: 1300 mg

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49
Q

when should you start introducing solid foods

A

4 months

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50
Q

when can babies start drinking water?

A

6 months

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51
Q

when should a babies weight double from birth weight?

A

4 months

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52
Q

when should routine POCT lead testing performed?

A

12-24 months

[CDC recommends 12 months as this is when children are walking by holding on to furniture & pulling to stand]

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52
Q

spot hemoglobin screening in babies for anemia is indicated when?

A

9-12 months

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52
Q

age indications for RSV vaccination

A

up until 19 months then child ages out

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53
Q

exclusive breastfeeding vitamin supplemention?

A

4000 IUD vit D

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54
Q

causative agent of impetigo?

A

S. Aureus

(GAS ~10%)

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55
Q

Treatment of Disseminated impetigo?

A

cephalexin (keflex)

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56
Q

exanthem of rubella (german measles)

A

pink/red non confluent maculopapular rash that starts on face & spreads to trunk & extremities x 3 days
Spreads more rapid than measles (rubeola) & is much darker & more confluent

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57
Q

rubeola (measles) sx

A

3 Cs [cough, coryza, conjunctivitis] + rash

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58
Q

only viral exanthem that begins on the trunk

A

roseola

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59
Q

which exanthem can be treated with vitamin A

A

measles (rubeola)

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60
Q

pertusis tx

A

azithromycin

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61
Q

TOC If genital lesions are absent or if the lesions are crusted over and no vesicular fluid can be obtained?

A

serologic testing for HSV antibodies

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62
Q

prevention of Congenital CMV

A

high-dose oral valacyclovir administered prior to 14 weeks gestation and within 8 weeks of the maternal infection ↓ vertical transmission

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63
Q

s/sx congenital CMV

A

chorioretinitis, periventricular calcifications, SNHL, hepatosplenomegaly, thrombocytopenia rash (petechiae), IUGR

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64
Q

congenital toxoplasmosis

A

diffuse calcifications/periventricular calcifications, hydrocephalus & chorioretinitis

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65
Q

varicella vaccination schedule

A

dose 1: 12-15 mo
dose 2: 4-6 yrs

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66
Q

PE will show prominent lymphadenopathy (occipital, cervical, postauricular) and a rash that spreads from face down

A

Rubella

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67
Q

premature birth occurs when?

A

born before 37 weeks

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68
Q

Orajel CI in children under 2

A

can cause methemoglobinemia 2/2 to benzocaine in thew product - amt of oxygen carried by RBCs is reduced which can lead to death

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69
Q

obesity definition

A

BMI of 30 kg/m^2 or greater OR body weight 20% over the ideal weight

**Children are considered to have obesity when the body mass index (BMI) is > 95th percentile for age and sex.

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70
Q

somogyi effect

A

Nocturnal hypoglycemia followed by rebound hyperglycemia

[sooo much insulin]

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71
Q

dawn phenomenon

A

Normal glucose until rise in serum glucose between 2-8 am

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72
Q

tx of DKA

A

[SIPS]

Saline, Insulin (regular), Potassium repletion, Search for underlying cause

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73
Q

determining DKA severity

A

bicarb levels more important than glucose
levels in determining severity of DKA

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74
Q

common cause of HHS

A

profound dehydration

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75
Q

true or false: HHS is not usually associated with severe ketosis or acidosis?

A

true

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76
Q

s/sx of congenital hypothyroidism

A
  • large fontanelles
  • hypotonia
  • hypothermia
  • macroglossia
  • hoarse cry
  • umbilical hernias
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77
Q

genetic disorder assoc. w/ hypothyroidism

A

Trisomy 21

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78
Q

What percentile translates to a definition of short stature?

A

23rd percentile

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79
Q

BMI between 5-85th percentile

A

healthy weight

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80
Q

BMI between 85-95th percentile

A

overweight

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81
Q

BMI > 120% of the 95th percentile or > 35 kg/m2

A

severe class II obesity

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82
Q

painLESS rectal bleeding in a pt < 5 y/o

A

Meckel Diverticulum

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83
Q

indications for sending to ED in depression

A
  • have a plan for suicide
  • expressing imminent intent to hurt one’s self
  • having access to the planned means to attempt suicide
  • the inability to contract for safety
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84
Q

murmur of VSD

A

2/6 mid-frequency holosystolic murmur heard best at the fourth left intercostal space, a diastolic rumble, and a prominent apical impulse displaced laterally

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85
Q

egg allergy is a precaution for which vaccine?

A

influenza

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86
Q

plaque

A

elevated area of skin 2 cm or more

(can be considered a wheal and/or present in urticaria)

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87
Q

when to treat a cutaneous wart in children?

A

when it is painful or discomfort is experienced

[watchful waiting is rec. as many resolve spontaneously w/n 2 years]

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88
Q

when are two doses of influenza vaccine are recommended?

A

children 6 mo - 8 years old

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89
Q

s/sx of fetal alcohol syndrome

A
  • short palpebral fissures
  • a short nose
  • a thin upper lip with a smooth philtrum
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90
Q

tx for hereditary spherocytosis?

A

splenectomy

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91
Q

why limit milk to 16 oz / day in newborn children?

A

risk of iron deficiency anemia

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92
Q

adherent white plaques on tongue, palate & inner cheeks that CAN be scraped off (may cause bleeding)

A

oral thrush (candida albicans)

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93
Q

treatment of croup?

A

nebulized racemic epinephrine

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94
Q

Tropia vs Phoria

A

tropia = strabismus

phoria = latent strabismus which is only evident w/ one eye is covered

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95
Q

how long can babies have strabismus?

A

up to 12 months

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96
Q

most appropriate dx test for Acute Rheumatic Fever?

A

echo

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97
Q

ectopic testes vs. undescended testes

A

undescended: once massaged into the scrotal sac, will remain there as cremasteric muscle relaxes

ectopic: will immediately spring back out of the scrotum

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98
Q

RF for pyloric stenosis?

A

1st born male

** also erythromycin use

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99
Q

hypochloremic, hypokalemic metabolic alkalosis

A

pyloric stenosis

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100
Q

reflux in newborn vs. milk protein allergy?

A

reflux = spitting up after feeds, better with raising the head, will resolve as LES tightens ~3-4 months

mil protein allergy= spitting up, fussy after feeds, loosing weight, blood in stool, possible dermatitis

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101
Q

barking cough + inspiratory stridor

A

croup

[parainfluenza virus; tx w/ dexamethasone & racemic epinephrine]

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102
Q

1 tx for allergic rhinitis

A

intranasal glucocorticoids

MOA: act on nasopharynx directly to reduce mucosal inflammation

ex. fluticasone, beclomethasone, mometasone

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103
Q

pathophysiology of hypertrophic cardiomyopathy

A

mutations in the genes for sarcomeric proteins

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104
Q

1st line tx of otitis media w/ perforation

A

PO amoxicillin x 10 days

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105
Q

s/sx of bronchiolitis

A

diffuse crackles & scattered expiratory wheezes w/ subcostal retractions & nasal flaring

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106
Q

characteristics of herald patch of pityriasis rosea

A

large salmon-covered herald patch that gradually regresses

as lesion resolves: center clears & margins develop scale

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107
Q

neonate presenting with fever should always consider what on ddx?

A

congenital HSV infection

[dx with PCR of cerebrospinal fluid]

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108
Q

Vit D deficiency causes which disorder?

A

Rickets

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109
Q

ASD murmur

A

Mid-systolic pulmonary flow or ejection murmur w/ fixed split second heart sound

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110
Q

topical acne tx that is CI in pregnancy

A
  • Tazarotene (retin A) [category x]
  • Clindamycin
  • Azelaic acid
  • BPO
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111
Q

rule of 2’s is for what dx?

A

Meckel Diverticulum

2 year old
2 feet from ileocecal valve
2 inches long
2% population
2 epithelial types (gastric, pancreatic)

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112
Q

polyehylene glycol is what medication?

A

miralax (stool softner)

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113
Q

gold standard in dx of children w/ lead poisoning

A

venous blood lead level

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114
Q

acyclovir indications for varicella tx?

A
  • unvax adults & child 12+ y/o
  • pregnant
  • immunocompromised
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114
Q

blood lead level requiring chelation therapy

A

> /= 45 mcg/dL

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114
Q

four H’s of Scurvy [vit C aka ascorbic acid deficiency]

A
  1. hemmorhage (petechiae, gingival bleeding)
  2. hyperkeratosis (rough skin, loose teeth)
  3. hypochondriasis( emotional changes)
  4. hematologic abnormalities (easy bruising)
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114
Q

only d/o that causes increased MCHC?

A

hereditary spherocytosis

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115
Q

2 cell lines down on cbc + abnormal sx (bone pain, unspecified limp, bruising) … you should think?

A

Non-Solid Malignancy (Leukemia, Lymphoma)

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116
Q

tx Kawasaki disease?

A

IVIG+Aspirin

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117
Q

mcc of anemia btwn 6-9 weeks

A

physiologic = 2/2 decreased erythropoiesis d/t increased tissue oxygenation

btwn 6-9 wks hg goes from 14 –> 11 g/dL

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118
Q

blanching rash that starts in the groin & axillae, spreads to trunk/extremities & spares palms/soles

A

Scarlett Fever

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119
Q

retropharyngeal abscess vs peritonsillar abscess?

A

Retropharyngeal Abscess: forms between prevertebral fascia & constrictor muscles –> sx include fever, sore throat, NUCHAL RIGIDITY, muffled voice, stridor

Peritonsillar Abscess: sx include unilateral tonsillar swelling, fever, hot potato voice w/ uvular deviation

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120
Q

fever, hypotension, desquamation & mucosal hyperemia?

A

TSS complication of nasal packing

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121
Q

protective factor in otitis media

A

breastfeeding

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122
Q

tx of acute tympanic rupture?

A

PO Amoxicillin or amoxi-clav if otitis-conjunctivitis syndrome

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123
Q

risk associated w/ PO erythromycin for pt < 2 weeks old

A

development of pyloric stenosis

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124
Q

tx of uncomplicated mastoiditis

A

IV abx & myringotomy (middle ear drainage)

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125
Q

tachypnea in the newborn

A

> 70 RR

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126
Q

croup vs. bacterial tracheitis

A

croups is non-toxic appearing w/ barking cough

bacterial trachiectasis has barking cough + toxic appearing

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127
Q

MCC of bacterial tracheitis

A

staph aureus

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128
Q

CAP tx based on age

A

< 6 mo old = inpatient
mild & > 6 mo old = amoxicillin
> 5 y/o = consider azithro or doxy to cover for mycoplasma or chlamydia pneumonae

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129
Q

what sweat chloride value indicates CF?

A

> /= 60 mEq

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130
Q

common asthma trigger in warm environments

A

dust mites

*educate pt on washing sheets & blankets weekly in hot water

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131
Q

meds that exacerbate asthma sx

A

NSAIDs
ASA
non-selective BB
ACEi

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132
Q

medication that decreases hospitalizations in pt born prematurely

A

palivizumab

** monoclonal antibody against RSV glycoprotein

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133
Q

best test for bronchiectasis

A

CT scan of the lungs

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134
Q

common finding in CF HEENT exam?

A

nasal polyps

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135
Q

MCC of bacterial tracheitis

A

staph aureus

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136
Q

what medication is increased in the step up approach to Asthma?

A

increasing the strength of the steroid in the ICS-LABA medication

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137
Q

what is a Cardiorespiratory monitor?

A

mini EKG (not full 5 lead) & RR (but not super accurate)

does NOT give you pulse ox

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138
Q

asthma vs reactive airway disease?

A

typically 2-3 y/o is cut off for pursuing diagnosis of asthma

** tx is relatively the same

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139
Q

URI vs bronchiolitis?

A

in bronchiolitis respiratory exam will improve/exam will change with secretions and coughing

URI: less symptoms in the chest

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140
Q

how many calories = 1 lb

A

500

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141
Q

pt with anorexia who is acidotic on acid-base analysis?

A

most likely abusing laxatives and pooping bicarb

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142
Q

when is MCHAT screening performed?

A

16-30 months

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143
Q

In infants is severity of retinal hemorrhages assoc. with liklihood of abuse?

A

yes

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144
Q

when is D5NS not indicated for pediatric maintenance fluids?

A

children presenting in the ED w/ history of eating disorder

** will push kid into refeeding syndrome 2/2 to insulin surge which decreases lites (K, phos, mag)

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145
Q

in patients < 25 what warning should be given before initiating SSRIs?

A

black box warning for increased risk of suicide ideation & behavior

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146
Q

increased LDH
increased homocysteine
INCREASED methylmalonic acid
Neuro Symptoms

A

B12 deficiency (pernicious anemia)

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147
Q

no neuro symptoms
Increased homocysteine
NORMAL methylmalonic acid

A

folate deficiency

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148
Q

what happens to haptoglobin levels in hemolytic anemia?

A

DECREASED

** binds all the free Hgb released from the RBC destruction

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149
Q

EPISODIC hemolytic anemia assoc. W sulfa drugs, fava beans, infections

A

G6PD

(-) coombs tests, (+) bite cells & heinz bodies

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150
Q

coombs positive

A

think: MAHA

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151
Q

Only anemia where all three cell lines are decreased (WBC, RBC, PLT) - pancytopenia

A

aplastic anemia

** ddx should include non-solid malignancies

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152
Q

causes of prolonged PTT

A

Intrinsic pathway

Heparin, DIC, vWD, Hemophilia A&B, antiphospholipid syndrome

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153
Q

causes of prolonged PT

A

Warfarin therapy, vitamin K defiency, DIC

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154
Q

hemophilia A

A

factor 8 Deficinecy

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155
Q

hemophilia B

A

factor IX deficiency

[Christmas Disease]

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156
Q

patho of factor V leiden

A

Protein C stops fx of factor V to decrease clot formation; in this d/o there is a mutation in factor V so that it does not respond to inhibition from factor C = increase clotting

s/sx: DVT, PE, miscarriages etc.

** PT & PTT are normal bc not affected

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157
Q

HUSS

A

hemolysis
uremia (inc. BUN & Cr)
shitting (GI sx)
school aged

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158
Q

s/sx of protein C&S defiency in newborns

A

purpura fulminans in newborns - red purpuric lesions at pressure points, progresses to painful black eschars

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159
Q

delayed bleedng or swelling in weight-bearing joints (hemarthrosis) should make you think of what disorder?

A

hemophilia (A or B)

**will have prolonged PTT, normal PT

** PTT will correct with mixing studies

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160
Q

inheritance of VW disease

A

autosomal dominant

[MC inherited bleeding disorder]

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161
Q

anemia, thrombocytopenia w/ 20% blasts on bone marro aspiration

A

ALL

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162
Q

Child + LAD + bone pain + bleeding + fever +
>20% blasts

A

ALL

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163
Q

(+) smudge cells

A

CLL

middle age + asymptomatic + fatigue + LAD + splenomegaly

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164
Q

+ myeloblasts on bone marrow biopsy & (+) auer robs

A

AML

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165
Q

philadelphia chromosome (translocation of 9&22)

A

CML

** must be treated with a tyrosine kinase inhibitor (imatinib)

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166
Q
  • painLESS lymphadenopathy or pain w/ alcohol ingestion
  • mediastinal mass
  • b symptoms
  • (+) reed sternberg cells
A

hodgkin lymphoma

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167
Q

treatment considerations in pediatric patients with hodgkins lymphoma

A

Pretreatment: benzodiazepines to help w/ N/V

Postreatment: 5-HT3 can be helpful in first 24 hours following tx

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168
Q

type of NHL associated with EBV

A

Burkitt Lymphoma

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169
Q

anemia assoc. w/ carbamazepine

A

aplastic anemia

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170
Q

anemia assoc with parovirus B19 in sickle cell patients

A

aplastic anemia

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171
Q

tx for severe aplastic anemia

A

allogenic hematopoeitic stem cell transplant

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172
Q

bone marrow biopsy w/ increased myeloblasts but < 20%

A

myelodysplasia –> can progress to AML

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173
Q

myeloid cell lines

A

RBC
PLT
Granulocytes: eosinophils, basophils, neutrophils

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174
Q

lymphoid cell lines

A

B lymphs –> plasma cells
T lymphs
NK cells

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175
Q

AML vs CML

A

AML involves myeloblasts
CML invovles granulocytes (neutrophils)

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176
Q

ALL

A

anemic, lumpy (hepatosplenomegaly), limping

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177
Q

what is needed in treatment of ALL

A

prophylaxis the CNS w/ methotrexate

ALL can remain dormant in CNS and pt will present with relapse of leukemia w/ meningitis

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178
Q

APL

A

a form of AML

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179
Q

absolute lymphocytosis [WBC 5,000+ ]

A

CLL

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180
Q

fever of unknown origin ddx should include what 3 subcategories of dz?

A

infectious, malignant, rheumatologic

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181
Q

what happens to BP and venous return in asthma attacks?

A

wide pulse pressure (low diastolic) 2/2 to low venous return from increased ITP & expansion that impedes flow in the IVC

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182
Q

paraphimosis

A

EMERGENCY

retracted foreskin that can’t be returned to normal position

(think post foley catheter placement for surger)

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183
Q

phimosis

A

inability to retract foreskin over the glans

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184
Q

when is phimosis considered normal?

A

children < 5 y/o

(typically resolves by 5 y/o)

185
Q

auricular hematoma

A

accumulation of blood in the subperichondrial space, usually secondary to blunt trauma

186
Q

s/sx of auricular hematoma

A

edematous, fluctuant, & ecchymotic pinna with loss of normal cartilaginous landmakrs

187
Q

etiology of auricular hematoma

A

spontaneous in babies, perichondritis, bleeding diathesis

188
Q

MC. innocent murmur

A

pulmonary flow murmur

[2/2 small size of the branched pulmonary arteries d/t the lung receiving only
15% of CO during fetal development]

189
Q

tx of acute cystitis

A

2nd or 3rd gen cephalosporin

cefuroxime, cefdinir

190
Q

wilms tumor

A

firm, nontender abdominal mass that does NOT cross the midline

191
Q

MC kidney malignancy in teens 15-19 y/o

192
Q

HTN, hematuria & periorbital edema

A

nephritic syndrome

193
Q

severity of accessory muscle use

A

subcostal –> intercostal –> tracheal tugging –> nasal flaring

194
Q

Jaundice Progression

A

starts on face and spreads down

195
Q

What happens to K+ with renal hypoperfusion?

A

HYPOkalemia

196
Q

diagnosis criteria of constipation

A

2 of the following:
infrequent bowel movements (<2/week)
Straining
hard stools
feelings of incomplete evacuation
use of digital maneuvers
sensation of anorectal obstruction/blockage w/ 25% of BMs

Above must be fulfilled for last 3 months w/ symptoms onset 6 months prior to discharge

197
Q

sx of dehydration in children

A

pee/pressure
anterior fontanelle
refill (cap)
crying
HR
skin elasticity
dryness (membranes)

198
Q

sterile pyuria is a indication of what disease?

A

kawasaki dz

199
Q

gold standard test for GERD

A

24 hour ambulatory pH monitoring

200
Q

GERD sx < 2x/week

A

antacids, H2 antagonists

201
Q

GERD sx > 2x/week

202
Q

protrusion through the internal inguinal ring & possibly into the scrotum

A

indirect inguinal hernia

d/t patent process vaginalis

203
Q

protrusion through the external inguinal ring

A

direct inguinal hernia

204
Q

severe abdominal PAIN in pt with anorexia

A

Superior mesenteric artery (SMA) syndrome

[weight loss-induced atrophy of the mesenteric fat pad, causing compression of the third part of the duodenum -> small bowel obstruction]

205
Q

vomiting + abdominal pain + bloody stool (currant jelly stool)

A

intussusception

206
Q

pathologic jaundice

A

present in 1st day of life

207
Q

physiologic jaundice

A

typically presents first 3-5 days of life and lasts ~ 1 week

208
Q

Kernicterus

A

cerebral dysfunction and encephalopathy due to bilirubin deposition in brain tissue

s/sx= seizures,
lethargy, irritability, hearing loss, mental developmental delays

associated with bilirubin levels 20 mg/dL+

208
Q

dubin-johnson syndrome

A

hereditary conjugated (direct) hyperbili

dubin + direct + dark liver

** typically presents in adolsecents

209
Q

(+) dirct coombs test in baby

A

Rh incompatibility
ABO incompatibility

209
Q

patho of crigler-najjar syndrome

A

absence of UGT enzyme = unable to conjugate bili = increased indirect bili = jaundice

** this often does not respond to phenobarbitl stimulation

210
Q

Gilbert Syndrome

A

hereditary unconjugated hyperbili w/ transient episodes of jaundice during periods of stress, fasting, alcohol, illness

211
Q

B3 deficiency

A

dermatitis (photosensitive), diarrhea, dementia

212
Q

best test to confirm dx of lactose intolerance?

A

hydrogen breath test

213
Q

test to r/o IBD?

A

fecal calprotectin

214
Q

(+) serum tissue transglutimase antibody

215
Q

tx of intussusception?

A

air or contrast enema

(pressure will straighten out the intestine)

216
Q

abdominal distention & postive squirt sign

A

Hirschsprung Disease

217
Q

string sign on UGI series?

A

pyloric stenosis

218
Q

vomiting first day of life should make you think?

A

duodenal atresia

219
Q

colic age group and tme duration

A

occurs in children < 3 mo

resolves typically by 9 weeks

220
Q

otherwise healthy infant who is < 3 months of age who cries for ≥ 3 hours per day ≥ 3 days per week without a clear explanation,

221
Q

when and what are the first teeth to erupt?

A

central incisors @ 5-8 months

222
Q

when should all teeth be in?

223
Q

when do secondary teeth begin to grow?

224
Q

what cardiovascualr d/o is assoc w/ turner syndrome?

A

coarctation of aorta (30%)

225
Q

labs assoc with turner syndrome

A

Low Estrogen
high FSH & LH

226
Q

rocker bottom feet are associated with which genetic d/o?

A

trisomy 18 (Edward syndrome)

227
Q

short stature, webbing of the neck, low hairline, and widely spaced nipples, Sheild chest

A

Turner syndrome (45 XO)

228
Q

which congenital heart defet is associated with down syndrome

229
Q

simple febrile seizure

A

number of seizures: 1
duration: < 15 mins
type: generalized

230
Q

complex febrile seizures

A

number of seizures: >1 in 24 hours
duration: >15 mins
type: focal or generalized

231
Q

empiric abx coverage for meningitis in pt < 1 mo

A

cetoximin + amp OR gentamicin + amp

232
Q

CI to ceftriaxone

A

hyperbili in infants

233
Q

growth during growth spurt?

A

limbs grow before truck

234
Q

MC benign primary brai tumor of childhood?

A

grade I astrocytoma

235
Q

brain tumor sx by location

A

cerebellum: weakness, tremor, ataxia

visual pathway: visual loss nystagmus, proptosis

spinal cord: pain, weakness, gait disturbance

236
Q

MC malignant brain tumor of childhood?

A

medulloblastoma

237
Q

enterobius vermicularis

238
Q
  • recurrent upper tract bacterial infections
  • renal scarring
  • hyperntension
A

vesicoureteral reflux complications

239
Q

treatment of vesicouretral reflux

A

< 2 m = TMP-SMX, nitrofuratonin

> 2 m = cephalexin, ampicillin, amoxicillin

241
Q

CXR finding in aspiration?

A

unilateral hyperinfaltion, mediastinal shift, atelectasis

242
Q

black box warnings of gentamicin

A

neurotoxicity, ototoxicity, nephrotoxicity, neuromuscular blockade

243
Q

atypical pneumonia

A

MCC is mycoplasma pneumoanie

typically less severe symptoms –> less toxic appearing (low grade, temp, URI sx)

244
Q

1st line uncomplicated cystitis

A

cephalosporins (cefixime)

245
Q

inital tx of encoporesis?

A

colonic dissimpaction & longterm oral laxative therapy

246
Q

mcc of intestinal obstruction btw 6-36 mo of age?

A

intussusception

247
Q

Ortolani Maneuver

A

abduction & elevation to feel for reducibilyt –> audible click/clunk

this can temporarily reduce the dislocation

248
Q

barlow Maneuver

A

gentle adduction w/o downward presure to feel for dislocatability

249
Q

how long is pt in hip spica splint for DDH

A

6-15 months

250
Q

MC site of osteosarcoma

A

90% occur in **metaphysis of long bones **

distal femur > promimal tibia & proximal humerus

251
Q

when do you start screening BP in kids?

252
Q

Osteogensis Imperfecta

A

autosomal dominant d/o 2/2 to mutations in collagen

multiple fx, HL, blue sclera, increased laxity of joints

** can treat with bisphosphonates or surgery

253
Q

joint pain or antalgic gait in child who was recently sick

A

transient synovitis

254
Q

Tx threshold for ASD

A

> 3-5 mm requires frequent f/u

symptomatic mgmt = diuretics, ACEi, digoxin

surgery = 1 cm + symptoms

255
Q

Continuous machine-like murmur loudest @ pulmonic area (LUSB - 2nd intercostal space)

256
Q

coarctation of the aorta

A

SYSTOLIC EJECTION MURMUR best heard at LUSB w/ radiation to the L interscapular area

257
Q

Late systolic ejection murmur/continuous murmur radiating to the left back, left
scapula or chest, heard in the aortic area

A

coarctation of the aorta

258
Q

gold standard test for coarctation of aorta

A

angiography

259
Q

young child w/ HTN

A

r/o coarctation of the aorta

260
Q

Harsh systolic murmur @ left mid to upper sternal border

A

Tetralogy of Fallot

261
Q

boot shaped heart

A

Tetralogy of Fallot

262
Q

annual screening needed in pt with Tetralogy of Fallot

263
Q

two congenital HD that require PGE prophylaxis

A

Coarctation of aorta & tetralogy of fallot

264
Q

Medium pitched harsh mid-systolic crescendo-decrescendo murmur heard @ LSB

A

murmur of HCOM

265
Q

does valsava/standing increase or decrease murmur of HCOM

decreased venous return

266
Q

does squatting, supine or leg raise increase/decrease HCOM murmur?

A

decrease

increase venous return

267
Q

murmur w/ a loud S4 gallop and apical lift

268
Q

1st line tx of HCOM

A

beta blockers

269
Q

HCOM precuations

A

AVOID dehydration, extreme exertion, exercise

Caution w/ digoxin, nitrates, diuretics

(Digoxin ↑ contractility, nitrates & diuretics ↓ LV volume)

270
Q

MC congenital HD

271
Q

High-pitched harsh holosystolic murmur best heard @ LLSB w/ palpable thrill

thrill increased in small abnormality

272
Q

when should a VSD close by?

273
Q

MCC of pediatric syncope

A

vasovagal or idiopathic

274
Q

syncope Red Flags

A

syncope during exercise
multiple recurrence w/n short time
older age
heart murmur
injury during syncope
Fhx of sudden unexpected death

275
Q

does direct or indirect bili cross the bbb

A

indirect –> leading to kernicterus

276
Q

HR in infants ages 0-3 mo

A

100-204 bpm (when awake)

277
Q

when do peds HR reach adult values of 60-100

278
Q

fifth percentile of BP

A

70 mmhg + 2x age in years

279
Q

diastolic murmurs

A

MS.PRARTs Died

280
Q

MR vs. MVP murmur

A

MR = pansystolic
MVP = mid systolic click

281
Q

radiographic finding in tetralogy of fallot?

A

Boot shaped heart

282
Q

radiographic findings in coarctation of aorta?

A

aortic 3 sign & posterior rib notching

283
Q

tx of coarctation of the aorta?

A

balloon angioplasty or open surgical repair

284
Q

aortic diseases that cause BP to be lower in LE than UE

A

coarctation of aorta
Aortic dissection
supravalvular aortic stenosis

285
Q

coarctation assoc with ANTERIOR or POSTERIOR rib notching?

A

posterior

not anterior bc intercostal arteries do not run along grooves in the ate

286
Q

when should a PDA close?

A

before 3 days of life –> if extends beyond 3 days of life, is considered pathological

287
Q

murmur + respiratory distress, bounding pulses, wide pulse pressure, abdominal distention, and prominent left ventricular impulse.

A

PDA

(machine like murmur)

288
Q

Tx of a PDA

A

indomethacin

289
Q

holosystolic murmur loudest at the apex (2/2 to MR) + S3 or S4

290
Q

digoxin MOA

A

positive inotrope which makes LV pump harder

worsens sx of HCOM

291
Q

isosorbide dinitrate

A

vasoldilator –> decrease peripheral resistance

increased LV outle obstruction in HCOM

292
Q

unilateral cervical lymphadenopathy

A

kawasaki disease

293
Q

cyanosis worse w/ crying & feeding

A

Tetraology of Fallot

294
Q

A harsh, medium- to high-pitched pansystolic murmur is heard best at the left sternal border in the third and fourth intercostal spaces with radiation over the entire precordium.

295
Q

frequent respiratory infections and slow weight gain in addition to dyspnea, diaphoresis, and fatigue as early as 1–6 months of age.

296
Q

Sequelae of VSD

A

irreversible pulmonary HTN

297
Q

valsalva affect on venous return

A

decreased = decreased preload = increased murmur of HCOM

298
Q

cervical venous hum

A

innocent murmur during > 1 y/o

continuous murmur heard best over L or R USB, infraclavicular area or supraclavicular area

accentuated w/ head extension while seated

lessens with supine position

299
Q

most serious complication of kawasaki dz

A

coronary artery abnormalities

300
Q

rare complication of KD?

A

macrophage activation syndrome

301
Q

consequence of ASD

A

right atrial hypertrophy

302
Q

maneuvers that increased VSD?

A

handgrip, squatting

2/2 to increased PVR

303
Q

Amyl Nitrate

A

decreases afterload

304
Q

characteristics of innocent murmurs

A

vibratory or musical
grade 2 intensity
short systolic duration (not holosystolic of diastolic)
crescendo-decrescendo w/o radiation
standing decreases intensity

305
Q

inutero infx associated with PDA

306
Q

rash of kawasaki dz

A

polymorphous rash

307
Q

MC pathogen of infective endocarditis

A

Staph Aureus

308
Q

MCC of pediatric aortic stenosis

A

bicuspid aortic valve

309
Q

murmur of VSD

A

harsh holosystolic murmur is auscultated at the mid-left sternal border, and a thrill is palpated at the third left intercostal space

310
Q

OCP recommended for PMDD

A

Drospirenone

progesterone-only OCP

311
Q

first line tx for complex partial seizures

(focal onset impaired awareness seizure)

A

levetiracetam

312
Q

common tx in generalized seizures

A

lamotrigiene & valproic acid

313
Q

rash that starts behind the ears (on face) & spreads to trunk

commonly appears 2-4 days after fever & spares palms/soles

A

measles (rubeola)

314
Q

definitive dx of measles

A

anti-measles IgM

detected 3 days after onset of rash

anti-measles IgM detected until 14 days after rash appears

315
Q

otitis media w/ effusion presentation

A

retracted tympanic membrane w/ DECREASED motility on insufflation

316
Q

can you use topical therapy in tinea capitus

A

no –> inadequate penetration

tx w/ oral antifungals [terbinafine, griseofluvin x6-8 weeks]

griseofluvin = 1st line

317
Q

ADE of repeated oxymetazoline use

A

rhinitis medicamentosa

318
Q

tx of anterior vs posterior epistaxis

A

anterior: pressure, Afrin, silver nitrate cuatery
posterior: packing & consult ENT

319
Q

s/sx primary congenital hypothyroidism

A

slow growth, hypotonia, umbilical hernia, macroglossia, large fontanelle, dry skin, hypothermia, jaundice, intellectual disability

** not usually present at birth

320
Q

dx of congenital hypothyroidism

A

heel sticxk measurement of free T4 & TSH in every newborn

321
Q

emergent mgmt of epiglottitis

A

bag mask ventillation

after emergent mgmt –> humidified oxygen + ceftriaxone/vancomycin

322
Q

thumb print sign on lateral xray

A

epiglottitis

323
Q

simple febrile seizure tx

A

acetominophen

324
Q

HL screening in children of average risk

A

4,5,6,8 and 10 years

inc. risk –> 24 & 30 months (e.g. those with NICU stay, ototoxic drug exposure - gent)

325
Q

tx of severe otitis externa w/ edema & occlusion

A

wick placement & topical otic solution w/ abx + glucocorticoids

326
Q

RF necrotizing otitis externa

A

DM, immunocompromised

327
Q

common skeletal abnormality seen in Marfan Syndrome

A

scoliosis

** also assoc. with AA & dissection

328
Q

RF for cleft palate

A

cigarette smoking
Alchol consumption
Folate deficiency

** majority cleft palates are unilateral

329
Q

gingivostomatitis

A

HSV1 infx w/ prodrome of fever, irritability, HA or tingling/burning sensation

presents with ulcerations of gingiva or mucous membranes –> perioral vesicular lesions

330
Q

Herpangia

A

etiology: coxsackie virus
painful, posterior pharyngeal lesions that DO NOT bleed
eryhtematous-based macules –> papules –> vesicules –> central ulcers w/ erythemous halo

331
Q

LT mgmt of SVT

A

radiofreuqency catheter ablation

332
Q

typical presentation of osteosarcoma

A

pain + soft tissue mass

333
Q

weakest part of pediatric bone

A

diaphysis (growth plate)

334
Q

most effects med for MDD in children & adolescences

A

fluoxetine

also an SSRI w/ longer half-life, best for when kids miss doses

335
Q

when does kawasaki dz require labratory testing?

A

incomplete KD –> pt w/ fever of unknown origin & absence of 4+ classic findings

  • leukocytosis (neut dominant)
  • anemia
  • ESR/CRP elevation
  • liver transaminases
  • thrombocytosis
  • sterile pyuria
336
Q

pediculosis capitus tx

presents with scalp purityus & excoriations in multiple fam members

A

topical permethrin

337
Q

how does eye move in a cover-uncover test w/ strabismus

A

will move in direction opposite of which it is deviated (corrects itself)

ex. eye that moves outward to fixate demonstrates esotropia)

338
Q

at what age is new onset esotropia suspicious for CNS disease?

339
Q

worsening cyanosis w/ poor feeding & tachypnea is sx of what d/o?

340
Q

common trigger for constipation in young children?

A

change in diet e.g. introduction of cows milk

341
Q

initial therapy for enuresis

A

education & motivational therapies

342
Q

primary nocturnal enuresis

A

occurs after age 5 w/o ever achieving bladder control

2/2 is when pt has achieved bladder control and now has enuresis after age 5

343
Q

MCC of CHL in children

A

otitis media

344
Q

sits w/o assistance

345
Q

pulls to stand w/o assistance

346
Q

narrowed angle between the SMA & aorta –> duodenal compression

A

SMA syndrome in anorexia nervosa

occurs 2/2 to loss of mesenteric fat

dx with abdominal Xray or upper GI series

347
Q

flue vaccine schedule in young children

A

6 months–> requires 2 doses 1 month apart

348
Q

CI to rotavirus vaccine

A

hx of intussusception

349
Q

T/F psychosis can manifest in some children w/ MDD as delusions or hallucinations?

350
Q

protective factors against RSV

A

prenatal vit D supplementation & breastfeeding

351
Q

when should you suspect vesicoureteral reflux?

A

recurrent UTIS

352
Q

Indications for voiding cytourethrogram?

A

children not toilet trained, recurrent utis, abnl kidney US, s/sx of CKD

OR
**
fever > 102.2 & known urinary pathogen other than E.Coli**

abx prophylaxis w/ TMP-SMX or nitrofuratonin

353
Q

med assoc with oral candidiasis

A

inhaled glucocorticoids

tx: nystatin suspension 100,000 units to each cheeck 4x/day

354
Q

PE finding assoc with neonatal ARDS

A

expiratory grunting

355
Q

Ages & Stages Questionarrie

A

reference for gross motor, fine motor, communication, problem-solving & personal socail domains

administered by 9,18, 30 months of age

356
Q

diet recommendations for CF

A

high fat
high energy
fat soluable vitamins (ADEK)

358
Q

(+) fitzpatrick sign

A

dermatofibroma

dimpling of skin w/ lateral pressure

359
Q

elevated anti-thyroglobulin

A

hashimoto thyroiditis

360
Q

diaper dermatitis tx

A

zinc oxide & nystatin

361
Q

type of psoriasis common after strep infx

A

guttate psoriasis

362
Q

tx of pityriasis rosea

A

reassurance

363
Q

assoc. hx of atopy + dry/scaling skin on extensor surfaces

A

ichthyosis vlugaris

described kinda like lichen planus, 1st line tx is moisturizer

364
Q

sx of complete airway obstruction

A

inability to speak

365
Q

which reflex persists through life?

366
Q

TOC for suspected partial KD (mucocutaneous lymph node syndrome)

367
Q

“DK no A”

A

pt is presenting in DKA w/o meeting w/o ph of 7.3 or HCO3 < 16

368
Q

does throwing up make you more acidotic in DKA?

A

yes

this is why kids on insulin drips for DKA should be NPO

369
Q

is Type 1 or 2 more aggressive in pediatric patients?

A

type 2 is more aggressive in pediatric pt

370
Q

tx of measles pneumonia

371
Q

petechiae on soft palate (forscheimer’s spots)

372
Q

congenital rubella syndrome

A

fetal death
delivery
congenital defects

373
Q

complications of congenital HSV

A

2/2 bacterial infx, pneumonia, encephalitis, reyes syndrome

374
Q

difference btw KD and SF tongue findings

A

KD = red strawberry tngue
SF = white strawberry tongue

375
Q

Punctate erythema beginning on trunk

spreading to extremities, becoming confluent

“sandpaper” feel to the rash.

flushed face with perioral pallor

rash fading in 4 - 5 days and followed by desquamation

A

scarlett fever

376
Q

questionnaire offered at 6 months

A

ages & stages

377
Q

2 month milestones

A
    1. turns head 180
    1. traks objects
    1. vocalizes in play (coo)
    1. smiles, knows parents
378
Q

4 mo milestones

A
    1. clutches rattle/rolls
    1. hands together
    1. laughs
    1. enjoys looking around
379
Q

6 month milestones

A
  • sits up
  • raking grasp
  • vocal imitates
  • responds to name
380
Q

9- 11 months

A
  • stands/cruises
  • sits w/o support
  • pincer grasp
  • understands” no”
  • feeds self
  • waves
381
Q

12-14 months

A
  • walks with one hand
  • builds two blocks
  • uses one word with meaning
  • hugs stuffed animals
382
Q

15-17 months

A
  • stoops & recovers
  • builds 2-3 blocks
  • 4-5 words
  • uses spoon
383
Q

18 months

A
  • runs
  • scribbles, 3 block tower
  • 7-10 words, body parts
  • copies parents in task
384
Q

24 months

A
  • throws ball
  • 6-7 block tower
  • two words combined
  • turns book pages
385
Q

3 years

A
  • rides tricycle
  • alternates feet upstairs
  • copies a cricle
  • uses min 250 words, 3 word sentences
  • group play
  • shares toys
  • knows age & gender
386
Q

4 years

A
  • skips
  • copies a square
  • knows colors, songs, ask questions
  • plays cooperative
387
Q

5 years

A
  • walks backwards
  • grabs pencil
  • prints letters
  • prints first name
  • abides by rules
388
Q

vanderbilt scale

A

for ADHD in kids 6-19 y/o

389
Q

Ages & stages questionairre

A

for cognitive/motor screening in children 4-60 months old

390
Q

when do majority of the primitive reflexes dissipate?

A

4-6 months

391
Q

which primitive reflex persists through life

392
Q

Tanner Staging 1

A

M = no pubic hair, bone age < 12 y/o
F = no pubic hair, no breasts

393
Q

Tanner stage 2

A

M = minimal pubic hair/voice changes, bone age < 12
F = minimal pubic hair, breast puds, bone age < 11

394
Q

Tanner Stage 3 (pubescent)

A

M= pubic hair over penis, voice changes, bone age 13-14
F = pubic hair on mons, enlargement of breasts, axillary hair, bone age 12-13

395
Q

Tanner Stage IV

A

M= adult pubic hair, axillary hair, bone age 13-14
F = adult pubic hair, areola enlargement, bone age 12-13

396
Q

Tanner Stage V

A

M= as adult, bone age 14-16
F = adult, bone age 13-14

397
Q

T/F in females pubic hair before breasts?

398
Q

when does birth weight triple

399
Q

when does birth length double

400
Q

what level of bili is neurotoxic & causes kernicterus?

401
Q

tx of pyloric stenosis

A

NG placemore for decompression, hydration, surgical pyloromyotomy

402
Q

bilious vomiting

A

duodenal atresia

403
Q

gold standard dx test for hirschsprung disease

A

rectal biopsy

404
Q

abdominal pain, palpable sausage mass, currant jelly stools

A

intussusception

tx w/ hydrostatic or pneumatic enema (1st line)

405
Q

MC involved site in intussusception?

A

ileocecal valve

406
Q

bronchiolitis

A

clinical syndrome in kids < 2 y/o 2/2 to RSV infx.

407
Q

sudden onset LRT sx that do not respond to mgmt of other respiratory conditions

A

foreign body aspiration

408
Q

idiopathic avascular necrosis of the hip

A

Legg Calve Perthes

409
Q

Growth Plate Fx

A

S: straight across (I)
A: above (II)
L: lower (III)
T: through (IV)
ER: eraser - crushed growth plate (V)

410
Q

what type of salter harris fx is most common?

A

II (above)

411
Q

if question stem indicates abuse

A

correct answer is typically contact CPS

412
Q

bronchitis vs. bronchiolitis

A

bronchitis: older children, trachea & large airway infx & mucus presenting w/ persistent productive cough

bronchiolitis: 2 y/o, small airway infx. w/ wheeze, tachypnea, RD

413
Q

tx of RDS

A

Antenatal therapy → steroids (24 hours before delivery)

Ventilation → CPAP, intubate (continuous positive pressure w/ NO)

Surfactant → endotracheal administration

O2 + intubation + CPAP + surfactant

Antenatal glucocorticoids given to mature lungs if premature delivery is suspected (between 24-36 weeks)

414
Q

benefits of tx scarlet fever

A

prevents RF

** does NOT prevent APSGN**

415
Q

tx of lime disease if < 8 y/o

A

amoxicillin

416
Q

mcc meningitis

A

strep pneumo

[tx w/ ceftriaxone & vanco]

417
Q

stoccato cough

A

chlamydia pneumonia

418
Q

bad prognostic factor in JIA

419
Q

best first test in KD

A

echo + ekg

420
Q

pt w/ scd c/o point tenderness on femur, fever and malaise

A

osteomyelitis (Mc bug is salmonella)

421
Q

pt w/ scd w/ decreased hct and decreased retics

A

aplastic crisis

422
Q

howell jolley body

A

sx of autosplenectomy

423
Q

mcc of sepsis in scd pt

A

strep pneumo

424
Q

tx of stroke in scd

A

exchange transfusion

425
Q

Tx of HUSS

A

periotoneal dialysis

DO NOT give plt

426
Q

when does plantar grasp extinguish?

427
Q

when does palmar grasp extinguish?

428
Q

when does babinski extinguish?

429
Q

empiric tx for neonatal meningitis

A

amp + gent

covers for GBS & E.coli

430
Q

Blueberry Muffin Rash

431
Q

vaccines at birth

432
Q

vaccines 2-6 mo

A

babies Run Play HIDe

Hep B
RV
PCV13
Hib
IPV
Dtap

[no hep B at 4 months]

433
Q

12 mo vaccines

A

1st MMR, Varicella, Hep A

[2nd dose @ 4-6 years]

434
Q

4-6 year vaccines

A

2nd MMR, Varicella

435
Q

11-12 y/o vaccines

A

HPV
Tdap
MCV

436
Q

16 y/o vaccines

A

MCV

MCV before you’re free (to drive)

437
Q

nasal polyps in young kid with chronic cough, SOB, hemoptysis?

438
Q

Tx of non-severe bronchiolitis

A

Supportive care

439
Q

cough + fever

A

think pneumonia

440
Q

most reliable predictors of pneumonia in pediatric patients

A

hypoxia & increased work of breathing

441
Q

bronchial breathe sounds

A

sign of obstruction –> think pneumonia

442
Q

MC etiology of afebrile pneumonia in children 1-4 mo

A

chlamydia trich. (staccato cough)

443
Q

development of nonproductive cough after recent abx use should make you think?

A

possible progression of URI to pneumonia

444
Q

first step after seeing microscopic hematuria on UA?

A

check how UA was obtained –> cath can lead to some blood

445
Q

2-14 y/o boy w/ facial edema up to 3 weeks after strep
Cola-colored urine
(+) anti-streptolysin (ASO) titers
Low serum complement (C3)

A

post strep GN

446
Q

MCC of GN in pediatric pt

A

IGA

occurs after 24-48 hr URI or GI infx.

447
Q

systemic form of IgA nephropathy. It’s characterized by a purpuric skin rash, arthritis, and abdominal pain.

448
Q

when does rooting reflex dissipate?

A

2-3 months

449
Q

What are the five levels of alertness in infants?

A

Quiet sleep
active sleep
awake/drowsy
alert
crying.

450
Q

MCC of bacterial meningitis for ages 3-10 y/o vs. >/= 10

A

3-10: strep pneumo
>10: N. meningitidis

451
Q

hyperventilation effect on absence seizures?

A

leads to hypercapnia and respiratory alkolsis - increase in ph decreases neuronal excitability –> absence seizure trigger

Studies have shown that absence seizures are highly sensitive to changes in arterial CO2 levels

452
Q

effects of feeding on wt gain in infants

A

breastfed = gain wt more rapidly in beginning
formula fed = gain weight slower in first 3-4 mo

453
Q

when does baby roll back to front?

453
Q

is there an age cut off for rear facing car seat recommendations?

A

NO - use until pt exceeds height/wt restrictions for safe use

454
Q

labs of secondary hypogonadism

A

Low T or E
N FSH/LH

455
Q

labs of primary hypogonadism

A

Low T or E
HIGH FSH/LH

456
Q

flu vaccine recs for child with MILD egg allergy

A

2x dose of inactivated vaccine

** no assoc with severe rxn in pt with history of egg allergy

inactivated = shot
live/activated = mist

** both CI in children with severe egg allergy

457
Q

URI x 10+ days w/o resolution of sx

A

amoxi-clav for bacterial sinusitis

458
Q

Synovial fluid white blood cell count is typically elevated in the inflammatory range of 20,000 to 60,000 cells/µL

A

lyme arthritis

not as high as in septic arthritis

459
Q

headache and fever for 3 days and erythematous PETECHIAL rash on her wrists and ankles

A

RMSF

give doxycycline

** common in NC, oklahoma, arkansas, MS

460
Q

tx of CAH

A

hydrocortisone, fludrocortisone, sodium chloride

461
Q

inspiratory stridor indicates?

A

d/o occuring ABOVE the vocal cords

think laryngomalacia

462
Q

can children < 3 y/o get strep throat?

A

No - not considered pathologic because not enough tissue to infect/apart of normal flora

+/- data on giving amox for RF prevention

463
Q

normal APGAR score

464
Q

chorioamnionitis

A
  • maternal fever (100.4)
  • significant maternal tachy (> 120)
  • fetal tachycardia (> 160-180)
  • IL-6 is possible marker for chorioamnionitis
  • tx with ampicillin & gentamicin (careful w/ gentamicin bc of SNHL in pregnancy)
465
Q

tx of TM performation

A

contaminated TM perf = ofloxacin drops
TM perf in setting of otitis media = PO abx

466
Q

best initial evaluation of child abuse in ED in pt presenting with lethargy?

A

CT Brain

pt showing sx of AMS

467
Q

murmur that is louder supine?

A

still (inocent) murmur

PEDS EOR (1 decks)

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