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Pediatric Board Prep > Gen Peds/EM > Flashcards

Gen Peds/EM Flashcards

0
Q

What is the 50% for HC for term infant?

A

35 cm for girls, 36 cm for boys

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1
Q

When is birth weight doubled, tripled, and quadrupled?

A

4 months, 12 months, 24 months

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2
Q

When does birth length double, triple?

A

4 years, 13 years

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3
Q

Define mild v moderate/severe MR:

A

Mild: 50-75

Moderate/severe: <50

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4
Q

What percent of kids with mild MR have a chromosomal abnormality?

A

4-8%

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5
Q

When should fluoride supplementation begin?

A

> 6 months of age, for water with < 0.3 PPM of fluoride.
0.25 mg at 6 months
0.5 mg 3-6 years
1 mg 6-16 years

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6
Q

What should you put a knocked out tooth in:

A

In order or preference: save a tooth solution, cold milk, saliva, physiologic saline, isotonic solution

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7
Q

3 subQ vaccines:

A

MMR, varicella, IPV

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8
Q

The live vaccines:

A

Rotavirus, MMR, varicella, yellow fever, oral typhoid

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9
Q

Anaphylactic suspects in vaccines:

A

Egg- flu, yellow fever
Streptomycin, neomycin- IPV
Neomycin- MMR, varicella
Gelatin- MMR, varicella, yellow fever

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10
Q

How long must you wait to place a PPD after receiving MMR vaccine?

A

Place same day as MMR or wait 4-6 weeks to place PPD.

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11
Q

What is the upper age limit after which colic should not be considered?

A

4 months

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12
Q

What vaccines should not be given in a pregnant adolescent female?

A

MMR, varicella, intranasal flu, HPV, OPV

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13
Q

Describe the tympanograms: A(s), A(d), B, C

A

A(s): shallow, curve in normal position but compliance low, assoc with ossicular fixation or TM scarring.

A(d): disarticulation, curve normally positioned but compliance very high. Assoc with ossicular disarticulation.

B: retracted poorly mobile. Curve shifted left (negative middle ear pressure) but peak is absent, compliance lower than normal. Suggests fluid behind TM.

C*: negative pressure, curve shifted left, clear peak. Suggests Eustachian tube dysfunction and conductive loss.

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14
Q

Causes of miosis:

A 
COPS
Cholinergics, clonidine
Opiates, organophosphates
Phencyclidine, phenothiazine, pilocarpine
Sedatives (barbs)
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15
Q

Causes of mydriasis:

A 
AAAS
Anthicholinergics
Antihistamines
Antidepressants (tca)
Sympathimimetics (inc cocaine, LSD)
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16
Q

Activated charcoal is not effective for:

A 
CHEMICAL CamP
Caustics
Hydrocarbons
Electrolytes 
Metals
Iron
Cyanide
Alcohols
Lithium
Camphor
Phosphorous
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17
Q

Tylenol rule of 150’s:

A

150mg/kg=toxic dose
150=level at 4 hours->hepatotoxicity
150mg/kg=loading dose of NAC

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18
Q

When should iron ingestion be evaluated?

A

> 40mg/kg dose, symptoms within 6 hours, > 500 mcg/dL level at 4-6 hours.

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19
Q

When should you treat iron I ingestion?

A

Iron level >500 mcg/dL or moderate to severe symptoms. Poor signs are WBC > 15, glucose >150, severe AG acidosis.

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20
Q

Things/pills that show up on xray:

A 
CHIPES
Chloral hydrate, Calcium
Heavy metals
Iron
Phenothiazine
Enteric coated tablets
Sustained release tablets
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21
Q

Acute clinical and lab findings of salicylate ingestion:

A

N/V, hyperpnea, tinnitus

AG metabolic acidosis mixed with reap alkalosis, hypoglycemia, hypokalemia

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22
Q

Common electrolyte abnormalities with theophylline ingestion:

A

Hyperglycemia, hypercalcemia,
Hypokalemia, low phos
Metabolic acidosis

23
Q

What medication is given in TCA toxicity to prevent dysrhythmias? Treat dysrhythmias?

A

Prevent- sodium bicarbonate

Treat- lidocaine treats many

24
Q

Name some alkaline caustics and their effects:

A

Bleach, ammonia, oven/drain cleaners, dishwasher detergent, lye. -> deep liquefaction necrosis -> stricture

25
Q

Name some acidic caustics and their effects:

A

Toilet bowl cleaner, grout cleaner, pool cleaner, rust remover, battery liquid, gun bluing. Eschar, severe gastritis, metabolic acidosis, ARF.

26
Q

Things that increase is osmolar gap:

A

Ethanol, ethylene glycol
Glycine, mannitol
Isopropyl alcohol
Methanol, uremia

27
Q

Clinical and lab findings with the following ingestions: ethanol, methanol, ethylene glycol

A

Ethanol- hypoglycemia, ataxia etc
Methanol-blurry vision, photophobia, optic n damage, metabolic acidosis, abd pain
Ethylene glycol-hypocalcemia, AG metabolic acidosis, oxalic acid crystals. CNS, ARDS, ARF

28
Q

Symptoms of organophosphate ingestion:

A 
Diarrhea
Urination
Miosis
Bronchospasm
Emesis
Lacrimation
Salivation
*decreased RBC cholinesterase activity
Tmt atropine and 2-PAM
29
Q

What is the rule of nines, rule of Palm?

A

9%: head/neck, UE
18%: front of thorax/abdomen, back, LE

For <10 years of age- palm =0.5-1% of BSA

30
Q

How do you provide IV hydration to a burn victim?

A

With the parkland formula. Lactated ringers 4ml/kg/percent of total burn surface area given over 24 hrs, half in the first 8 half in the next 16 hours

31
Q

Explain the salter harris classification:

A 
SALT
I Slip
II Above
III beLow
IV Through
V crushed

III and IV have risk of growth impairment. V poor prognosis

32
Q

Hyphema treatment, at risk for rebleeding:

A

Topical steroid, protective shield, elevate HOB, monitor IOP. Avoid NSAIDs and ketamine. Risk of rebleeding in SCD, bleeding diastheses, large hyphema.

33
Q

What is the RDA of calcium, phos and vitD for teens?

A

Calcium 1300 mg
Phos 1300 mg
VitD 400-1000

34
Q

What are the diagnostic criteria in anorexia nervosa?

A
  1. Fear of becoming obese
  2. Disturbed view of body weight, size
  3. 15% below norms for weight and height
  4. Absence of 3 consecutive menses
35
Q

Lab and cardiac findings in AN:

A

Hypokalemia, hypochloremic metabolic alkalosis, transamanemia, elevated BUN and cholesterol. Hypophosphatemia, hypomag.
MVP, QT prolongation, ST segment depression on exertion, heart failure

36
Q

Anosmia + amenorrhea

A

Kallman syndrome

37
Q

Lab findings to support PCOS:

A

LH:FSH > 2.5:1, elevated free testosterone, adrostenedione, DHEAS

38
Q

Tmt for PCOS

A

Menstrual irregularities: ocp
Hirsutism: spironolactone
Insulin resistance: metformin

39
Q

What are absolute contraindications to OCP:

A 
Abnormal vaginal bleeding of unknown cause
Estrogen dependent tumor
Liver disease
Thromboembolic dz
CVA
Migraine with aura
\+/- tobacco use, vascular HA, sz
40
Q

How do you diagnose syphillis?

A

1) nontreponemal test (RPR or VDRL), correlate with dz activity
2) treponema Test (FTA-ABS) is positive for life

41
Q

Signs of neurosyphillis:

A

Meningitis, CN palsies, 8th nerve deafness, uveitis

42
Q

Treatment neurosyphillis:

A

Aqueous crystalline PCN G 3-4 million units IV q4h for 10-14 days

43
Q

Congenital syphilis tmt:

A

Aqueous crystalline PCN G 50,000 units/kg/dose q12h for 7 days then q8h to complete 10 days

44
Q

What organism causes lymphogranuloma venereum?

A

Chlamydia trachomatis serovars L1, L2, L3 (the L’s go with lymphogranuloma)

45
Q

Chlamydia tmt:

A

Azithromycin 1 gram once

Doxy 100 mg BID x 7 days

46
Q

Gonorrhea tmt:

A

Rocephin 250 mg IM + chalmydial cov

OR
Azithro 2 grams x1

47
Q

pH in BV

A

> 4.5

48
Q

Name some PID treatments:

A

IV- cefotetan 2g q12 + doxy 100 q12
OR clinda + gent

PO- rocephin 250 x 1 then doxy 100 BID x14 days +/- flagyl 500 BID

49
Q

HPV that causes warts? Cancer?

A

Warts - 6, 11

Cancer- 16,18,31,33,35

50
Q

stages of pubertal development for males and females

A

males: testicular growth (age 10-11)–> pubarche –> penile growth –> peak height velocity (SMR 4)–>axillary hair
females: thelarache (>8, usually 10-11)–> pubarche–>peak height velocity (SMR 3-4) –> menarche (2 yrs after start puberty, age 12-13)

51
Q

most prevalent sti

A

hpv - initial management of genital warts is observation, high spontaneous resolution rate, chlamydia most common bacterial

52
Q

age to switch from DTap to Tdap

A

7

54
Q 
converting from Celsius
36
37
39
40
A 
36=96.8
37=98.6
38=100.4
39=102
40=104
55
Q

most common palpated mass in infants

A

hydronephrosis and multicystic dysplastic kidneys

56
Q

mgmt. ovarian cysts

A

6 cm or causing significant symptoms: lap cyst aspiration

57
Q

ETT size calculation

meds that can be given via ET

A

age + 16/4

LANE (lidocaine, atropine, narcane, epi)

Pediatric Board Prep (11 decks)

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