EOR pearls Flashcards
Birth vaccines
Hep B #1 at birth-4 weeks
Vaccines: 1 mo
Hep B #2
Vaccines: 2 mo
DTaP/HiB/IPV
Prevnar 13 #1
Rotavirus
Vaccines: 4 mo
DTaP/HIB/IPV
Prevnar 13 #2
Rotavirus
Vaccines: 6 mo
DTaP/HIB/IPV
Prevnar 13 #3
Rotavirus
Flu
Vaccines: 9 mo
Hep B #3
Vaccines: 12 mo
MMR
Varicella
Hep A #1
Vaccines: 15 mo
Prevnar 13 #4
HIB #4
Vaccines: 18 mo
DTaP
Hep A #2 (min 6 mo from 1)
Vaccines: 24 mo
Hep A # 2 if not gotten at 18 mo
Vaccines: 30 mo
Hep A #2 if needed
Prevnar 13 # 4 if needed
Vaccines: >4 yo
DTaP/IPV booster
MMR booster
Varicella booster
Vaccines: >5yo
Varicella booster (if not received at age 4)
Vaccines: >11 yo
TDaP
Meningococcal
HPV (3 doses- 0, 1-2, and 6 mo)
Vaccines: > 16yo
Meningococcal booster
Telogen effluvium
Telogen effluvium is a condition of hair thinning that can occur at any age. It is a reaction to a physical or mental stressor. A normal scalp has 10 percent to 15 percent of hairs in the telogen phase at any time, resulting in a normal shedding of 50 to 100 hairs per day. Increased shedding of hairs occurs in telogen effluvium. This results in more hairs being shifted into the telogen phase more quickly. A hair pull with microscopy is the diagnostic test that will indicate an increase in hairs in the telogen phase.
Epiglottitis: etioloties
H. influenzae, Strep pneumo, group A strep
epiglottitis treatment
racemic epinephrine nebulizer + oxygen + antibiotics
Jones fracture
avulsion injury of 5th metatarsal
most common congenital heart condition:
VSD
Tet spell
When a child has tetrology of fallot there are often intermittent periods of cyanosis assosiated with feeding and crying.
Tetralogy of Fallot: defects
VSD, pulmonary stenosis, RV hypertrophy, overriding aorta
How does tetralogy of fallot present
usually intermittent cyanosis during the first year of life. On exam there will be pretty loud systolic ejection murmur over the L 3rd interspace that radiates to the posterior lung fields.
Diagnostic for diabetes:
A1c > 6.5% (5.7-6.4 is preDM)
OR
fasting plasma glucose > 126g/dl (100-125 is preDM) (only once if sx are present).
Marfan syndrome presentation:
Often in adolescence. Slender fingers, flexible joints, easy sprains are most obvious on presentation. Most severe complications come from valvular heart disease.
Granuloma annulare
A benign, self-limited condition characterized by annular lesions- look like tinea without the central scale and pruritis. They begin as small, shiny skin colored dermal papules that enlarge over time with central clearing. There are no epidermal manifestations. GA commonly occurs over bony surfaces, such as the shins or dorsa of the hands. It is frequently misdiagnosed as tinea corporis; however, the absence of epidermal scaling helps rule out this diagnosis.
What micronutrient will an infant become deficient in if breastfed and not supplemented?
Iron- will deplete stores by 5-6 months.
Koplik spot
a blue-white papule with surrounding erythema appearing on the oral mucosa. This is a pathognemonic finding for Measles.
Measles presentation
Exanthem: Macular and papular rash involving the face, arms, legs, trunk
Enanthem: Cough, fever, non-purulent conjunctivitis, coryza
coryza
A word for “inflammation of the mucous membrane of hte nose” aka rhinitis
Croup: etiology
Parainfluenza
Idiopathic thrombocytopenic purpura: When does it occur, and how is it managed?
Can occur after resolution of viral illness. Will cause petechiae and purpura. ALWAYS treat a platelet count
Bronchiectasis- def, etiology
Bronchiectasis is an abnormal dilation of the proximal and medium-sized bronchi (>2 mm in diameter) caused by weakening or destruction of the muscular and elastic components of the bronchial walls. Affected areas may show a variety of changes, including transmural inflammation, edema, scarring, and ulceration, among other findings. Distal lung parenchyma may also be damaged secondary to persistent microbial infection and frequent postobstructive pneumonia.
Typically it occurs in kids with CF. Etiology is S. Pneumo
Hgb A2
A normal Hgb variant with 2 alpha and 2 delta chains. It is elevated in sickle cell,
Hgb A1
aka Hgb A- normal Hgb with two alpha and 2 beta chains. It will be low in beta thalassemia minor and absent in beta thalassemia major (ONLY HgF).
Hgb Barts
Defective Hgb- 4 gamma chains that precipitate. It occurs in Alpha Thallassemia
Acute tonsillitis: etiology
GAS, then GCS, then Strep pneumo
Heterophile antibody
In rapid monoSPOT test, this is the actual molecule being detected.
Most common leukemia in children?
ALL
Most common etiology of acute bacterial meningitis in kids:
(1) Strep pneumo (despite vaccination); (2) HiB; (3) N meningitides. In Neonates, Listeria is an important cause.
Tx for acute bacterial meningitis in child > 1 mo:
Vancomycin bid + ceftriaxone bid
Tx for acute bacterial meningitis in a child
Ampicillin qid + Cefotaxime
Jones criteria for acute rheumatic fever:
(2) major OR (1) major + (2) minor Major: Polyarthritis carditis erythema marginatum, subQ nodules Sydenham chorea
Minor: fever arthralgia ESR or CRP elevation prolonged P-R Interval
Hemophelia B
factor IX deficiency.
Tanner stages: Female
I: Prepubescent
II: Breast budding; sparse fine hair
III: enlargement of breast and alveola without difference in contour; pigmented curly hair on mons
IV: Areola papillae formation (areola has different contour than rest of breast); courser with labia coverd
V: Mature breast with alveola contour=breast contour; hair spreads to medial thighs
Infant growth rules:
Birth weight by 2 weeks; double birth weight by 4 months; triple by 1 year.
Genu varum
bowleggedness
Genu valgum
knock-kneed
Still’s murmur
Most common innocent murmur in newborns up to 3-6 yo. Loudest supine, may disappear with valsalva.
12 hour old newborn with jaundice, microcephaly, hepatosplenomegaly likely has congenital…
CMV infection. THis is the most common neonatal vertical infection.
Retinal hemmorrhage in an infant suggests…
child abuse.
Acne severity: non-inflammatory def and treatment
Open and closed comedones. Treat with topical retinoid. Treat with topical retinoid (tretinoin, Adapalene, Tazorotene)
Acne severity: mild inflammatory
comedones + few papules and pustules. Give topical retinoid + benzoyl peroxide
Acne severity: moderate inflammatory
comedones, papules, pustules, and few nodules. Give topical retinoid, benzoyl peroxide, AND oral or topical antibiotic. Use oral if nodules are present, topical if not. Switch topical to oral antibiotic if ineffective.
Acne severity: severe inflammatory
comedones, papules, pustules, many nodules, SCARRING. If nodules are present, treat with isotretinoin (accutane), topical retinoid, benzoyl peroxide.
Newborn, cyanotic with feeding, systolic ejection click and systolic murmur over L 2nd interspace… name the congenital defect
Congenital pulmonic stenosis. Intervention is balloon angioplasty if symptomatic. May be part of tetrology of fallot.
ALL symptoms/signs:
low fever, lethargy, fatigue, petechiae on lower extremeties, pallor, BONE PAIN, weight loss
Tx of allergic conjunctivitis
Olopatadine opthalmic- Mast cell stabilizer
bronchiolitis
cough, low fever, mild tachypnea, nasal flaring, resp distress in CHILD
Systemic juvenile rheumatoid arthritis: clinical and diagnostic findings
Presents like RA in a child, with symmetric nodules of hands (5+ joints) sparing the DIPs. Xray will show erosions. RF may be positive or negative.
Why shouldn’t parents use soap to wash infant’s faces?
Infant atopic dermatitis frequently occurs in response to soap. Just was them with water on face. Use moisturizer, and topical hydrocortisone.
Acne rosacea symptoms:
Pustules and red bumps on face, worsened by spicy food, heat, and EtOH
Rash that looks like tinea but history started with a single large spot on trunk. Mild pruritis.
Pityriasis rosea
Henoch Schonlein purpura: signs and symptoms
Commonly described as palpable purpura. It is precipitated by an upper respiratory infection and can also be associated with abdominal pain and joint pain.
Murmur heard over apex increased by isometric hands grip exercises is…
Mitral regurgitation
