Gen Peds Flashcards
When does height velocity begin in girls? In boys?
9 years in girls. 11 years in boys
when does heigh velocity peak in girls? in boys?
11.5 girls 13.5 boys
electrolyte abnormalities of MDMA ingestion
hyponatremia
vital signs changes in MDMA ingestion
hyperthermia and respiratory depression
signs of opioid withdrawal
yawning, restlessness, dysphoria, rhinorrhea, lacrimation, mydriasis, diarrhea, myalgia/arthralgia, tachycardia and systolic hypertension
how to fix nursemaids elbow
hypertronation and extension
or supinating forearm followed by flexion of the elbow
Erb Palsy
C5 and C6 injry with adduction and internal rotation with forearm extended
Klumpke Palsy are what levels of injury
C8-T1
Horner syndrome findings
miosis, anhidrosis and ptosis
What spinal level can cause horner syndrome
T1 injury in neonates- klumpke
When does the voluntary grasp develops
4 months
When do infants have pincer grasp
10 months
When do infants have a fine pincer grasp between fingertips and thumb
9-12 months
when can infants rake for small objects
6 months
when can infants transfer object hand to hand
6 months
when do infants start the scissor grasp. thumb and inside curled index finger
8 months
when does parachute reflex present and how long does it last
presents 6-9 months and lasts throughout life
What is the moro reflex
holding infant 45 degrees from bed and letting head fall backwards. Arms abduct and extend the flex and adduct.
When does moro reflex go away
5-6 months
When does palmar grasp disappear
3 months
when does the stepping reflex disappear
1-2 months of age
what are the live vaccines
MMR, MMRV, varicella, rotavirus
When can you give vaccines after 14 dys steroids
at least 4 weeks after
what is the cutoff for giving shots to kids who are taking steroids
can give is less than 2mg/kg/day or <20mg/day if greater than 10 kg
vernix is present during what weeks gestation
24-38
areola is raised but no breast tissue during what weeks gestation
34-35
When does cartilage in the ear pinna start to form and spring back ininfants
36-39 weeks
when does the pinna remain folded on exam (gestation)
24-31
When does lanugo cover the entire body of an infant
until 32 weeks gestation
when is lanugo only on the shoulders during gestation
38-41 weeks
when do the testes descend into the scrotum in gestation
36-39 weeks
When can a child alternate steps one foot at a time
3 years
what is gross motor development for 30 month old
jump off the ground with 2 feet up
when can children start to balance on 1 foot for up to 10 seconds
4 years old
what conditions are associated with avascular necrosis of the hip
hemoglobinopathies, systemic corticosteroid use, connective tissue disorders like rheumatoid, SLE and chronic renal disease
signs of late congenital rubella
ocular problems, hearing loss, cardiovascular disease
when do slapped cheek rash appear for Parvo
when no longer contagious
Gianotti Crosti Syndrome- characteristics
acute illness and small pink papular rash symmetrically distributed usually over face, buttocks and extensor surfaces
where are branchial cleft cysts found
sternocleidomastoid
where are thyroglossal duct cysts found
midline or slightly off midline
What is associated with growth failure later in childhood (after toddler years)
craniopharyngioma
how many mL/kg IVF do you give for burns
3mL/kg
What are causes of renal vein thrombosis in an infant
birth asphyxia, shock and or sepsis, maternal DM and use of central venous catheters
classic triad of renal vein thrombosis
thrombocytopenia, gross hematuria and a unilateral or bilateral flank mass
what contraception should a teen with seizures be on?
Depot due to side effects of AEDs with OCPs
What AEDs interact with OCPs or other methods of contraception
phenytoin, carbamazepine, primidone, topiramate, oxcarbazepine
inheritance of polydactyly
autosomal dominant
causes of early hypocalcemia
IGUR, infant of diabetic mother, sepsis, birth asphyxia
Which is a risk of idiopathic nephrotic syndrome- minimal change
renal vein thrombosis
elevated alpha fetal protein is associated with what malformations
neural tube defects
what medications can cause increased risk of neural tube defects
valproate and carbamazepine
next step in infant born to mother with active gonorrhea during labor
IM or IV ceftriaxone
acute neonatal conjunctivitis in 2-7 day period is most likely what organism
neisseria gonorrhea
timing of chlamydial conjunctivits in newborn
5-14 days
xray finding of osteochondroma
bony projection with cartilaginous cap
sharply marginated eccentric lucency in metaphyseal cortex
metaphyseal fibroma
Xray finding: eccentric lytic destruction and expansion of the metaphysis surrounded by rim of sclerotic bone
aneurysmal bone cyst
xray findings: oval metaphyseal lucency surrounded by sclerotic bone
osteoid osteoma
what is a treatment for acute migraine without aura in a 12 and under age child
rizatriptan
what are shockable rhythms?
Vtach and Vfib
how can you assess age based off drawing a stick figure
1/4 point per body part with a base of 3
discrete firm papules and annular plaques without scales on dorsal surfaces hands, feet wrists and ankles
granuloma annulare
heart sound heart with pneumomediastinum
harsh, crunchlike mediastinal systolic sound “hamman sign”
at what age can 90% infants voluntarily grasp a rattle
5 months
signs of neonatal lupus
bradycardia, plaque skin lesions on areas with sun exposure, thrombocytopenia, neutropenia
signs of congenital rubell
cataracts, hearing loss, congenital heart defects
infant with fould smelling stools, recurrent infections
shwachman diamond syndrome
petechiae on cervix
trichomonas
Tx for trichomonas
metronidazole or tinidazole
adverse effects of guanfacine and clonidine
sedation, bradycardia, hypotension
Signs of serum like sickeness
generalized urticaria with central violaceous discoloration- malaise, irritability, headache, diarrhea, hyperthermia, lymphadenopathy, facial edema and arthralgias
what is the extensor plantar response and when does it go away
babinski reflex. usually disappears 9-12 months but can be seen 24 months
when does rooting reflex disappear
3-4 months
which medications cause stevens johnson syndrome
phenytoin, sulfa based antibiotics, phenobarbital, carbamazepine, lamotrigine and penicillins
what happens if mother takes warfarin during pregnancy
nasal hypoplasia and stippled epiphysis
how to diagnose epidermolysis bullosa
immunofluorescence
SCFE is associated with what underlying endocrine condition
hypothyroidism
exam findings of SCFE
external rotation, shortened with restriction in internal rotation, abduction and hip flexion
which ellicit drug is associated with rhabdomyolysis
PCP
caudal regression syndrome is associated with infants born to mothers with what condition
DM type I
niacin deficiency results in what
pellagra- dermatitis, dementia and diarrhea
when can infants roll from front to back
4-5 months
PDA murmur
continuous harsh machine like murmur 2nd intercostal space
infant in NBN with hypoglycemia, and micropenis- likely underlying diagnosis
growth hormone deficiency
causes of asymmetrical IUGR
uteroplacental insufficiency, chronic HTN, multiple gestation, abrnomal placental structure, high altitude
what are causes of symmetrical IUGR
chronic alcohol use, genetic abnormalities, in utero infections, smoking, maternal SLE
leukocyte count in leukocyte adhesions deficiency
elevated
most common cause of intoeing in child older than 2 years of age
femoral anteversion
at what age do you stop giving Hib for catch up immunization needs`
If last dose was at or greater than 15 months
what infants are at risk for Developmental dysplasia of hip
breech girls
what week gestation do anterior sole creases arise
32-33 weeks
age infants can smile at a mirror
4-5 months
age infants reciprocate smile to adult
2 months
next step with flail chest
intubation and mechanical ventilation
tanning salons emit what UV rays
UVA
back pain with what motion in spondylolysis
extension
aggressive behaviors in toddlers is associated with what prenatal risk
exposure to cocaine alcohol and tobacco in utero
ANA level in juvenile idiopathic arthritis
negative
amount of time between dose 3 and 4 for IPV vaccine
6 months minimum
neonate with hematocrit greater than 70%– treatment
partial exchange transfusion
neonate with hematocrit greater than 60% and tachypneic
symptomatic- to partial exchange transfusion
what test helps diagnose asthma
spirometry. don’t choose methacholine challenge if spirometry is listed
when should infants have conjugate gaze by
6 months
thyroid nodule hypoechoic 1.5cm and normal Thyroid studies. next step?
FNA. NOT US! NOT REASSURANCE!
delayed eruption of teeth and conical in shape
hypohydrotic ectodermal dysplasia
