Mega Review Flashcards
Apgar scores- classify scores 0-9
0-4: poor
5-7: fair
8-10: good
What is a +2 rating for pulse? grimace?
pulse: 100+
grimace: cough +2; grimace +1
Hemangioma in baby is what type?
strawberry, capillary
What hemangioma type causes stridor?
supraglottic
Buzzword for mongolian spot
“sharply demarcated”
Oval bald spot on infant is called?
nevus sebaceous
remove in adolescence, risk malignancy
“Milk bumps” on nose are termed?
milia
Nerve roots effected by Erbs? Klumpkes?
Erbs: C5-6
Klumpkes: C8, T1
Which brachial plexus injury is assc with phrenic palsy?
Erbs (C4)
Which brachial plexus injury is assc with Horners?
Klumpkes
First test in respiratory distress
CXR
“Big three” conditions screened for in newborns
CHT, PKU, galactosemia
Galactosemia + PKU inheritance patterns
AR
Cutaneous findings assc with PKU
fair hair and skin + blue eyes
Galactosemia findings
- jaundice
- hypoglycemia
- cataracts
Two physical exam findings assc with CHT
umbilical hernia
large fontanel
Preterm baby with resp difficulty=
Term=
Preterm- RDS
Term- TTN
Meconium aspiration causes _____
chemical pneumonitis
In addition to lung related causes of RD, what other systems may be involved?
intracranial process
metabolic disease
cardiac disease
In addition to C/S, what puts baby at risk of TTN?
rapid descent
Cephalohematoma= blood in what area?
subperiosteal, doesnt cross sutures
When should fontanels close?
anterior: 9-18 months
posterior: 4-5 months
Lens opacity on PE=
cataracts
What is the CHARGE assc?
Coloboma Heart Defects Atresia, choanal Renal Defect GU Ear Deformity
Gastroschisis vs Omphalocele:
which is midline?
omhalocele= midline gastro= lateral
First two tests in case of ambiguous genitalia
17 OH prog
Karyotype
When does umbilical hernia spontaneously close?
5 years
When does physiologic jaundice peak and resolve?
peak-3 days
resolve- 1 week
Values assc with physiologic jaundice
less than 13/2
Differential diagnosis of direct hyperbili
TORCH
biliary atresia
hepatitis
Rate of bili rise assc with kernicterus?
Total bili assc with kernicterus?
rate greater than 0.5/hr
total greater than 25
When should iron supplementation start in breast fed babies?
6 months, can be with cereal
Calories in formula
20 cal/oz
Describe bone age in constitutional vs familial short stature
constitutional-bone age = height age, room left
familial- bone age = chrono age
Which patients have short parents:
constitutional or familial short stature
familial
Normal growth velocity
4 cm/ year
Common cause of abrupt falling of growth curve
hypothyroid
Most newborn reflexes disappear by when?
4-6 months, except babinski= 18
Which way does baby roll first?
back 4 months –> stomach 5 months
When is social smile seen?
4-8 weeks
How many cubes should be stacked at 15,18,24 months?
15-3
18-4
24-7
When should all potty training be complete?
5 years
Renal threshold for gluc spilling
180-200
Diabetes insipidus urine finding
low specific gravity, less than or equal to 1
Diurnal enuresis may be caused by?
anatomic lesion
Most effecient test to order in case of enuresis
U/A
DOC in noctural enuresis
DDAVP
When are MMR effects seen?
1-2 weeks later
Treatment of neonatal sepsis? meningitis?
sepsis- amp & gent
meningitis- amp & cefotaxime
Most common cause sepsis older than 2 months?
strep pneumo
Cephalosporin contraindicated before 2 months?
ceftriaxone
When to use steroids in meningitis?
prevents deafness in H flu meningitis
Prophylaxis for nmen/hflu?
rifampin for close contacts
Seasonal encephalitis causes
arbo,entero viruses
MC sporadic cause of encephalitis
HSV
Osteomyelitis testing:
xray –> MRI –> culture
1 cause osteo in all patients
staph aureus
When is patient at risk of pseudomonas osteomyelitis
after sneaker puncture
Gold standard for diagnosis in joint disease
arthrocentesis
Duration of pertussis
8 or more weeks
All pregnant moms get what vaccine?
Tdap
What abx decreases duration of illness in pertussis
erythromycin
Measles: aka
rubeola
Roseola distinguishing factors
rash AFTER fever
Rubella distinguishing factors
low grade fever
3 day duration
posterior lymphadenopathy
Lacy reticular rash=
evanescent rash=
bullet rah=
lacy reticular= fifths disease
evanescent= RF
Bullet= erythma chronicum migrans (lyme)
Lyme vs RMSF- who gets doxy
lyme; all over 8 doxy, rest amoxicillin
RMSF: all get doxy
CSD treatment
azithromycin
Antibiotic classically assc with rash in mono
ampicillin
Antidote for acetaminophen tox
nacetylcysteine (mucomist)
Aspirin findings
metabolic acidosis
Treatment for CO poisoning
hyperbaric O2
Toxicity assc with hemorrhagic GE + antidote
iron, deferoxime
Lead antidotes
EDTA, succimer at 45 or higher
Organophosphate antidote
atropine +/- 2PAM
Leading cause of death assc with ingestions
TCAs- seizures, arrythmia
Most common cause of conjunctivits at 24 hours or less
chemical
When is strabismus normal?
up to 4 months
How is amblyopia treated? What is it called?
lazy eye, patch
Screening test for lead, confirmatory?
screening= capillary confirmatory = venous
MC complication of AOM
meningitis
Most common “resistant” bug
m cat
Gold standard for strep dx
throat culture
FBA finding on CXR
hyperinflation
Treatment never to be used alone in asthma
LABA
Define intermittent asthma
less than 2 days per week, 2 nights per month
Treatment of intermittent asthma
albuterol PRN
Chromosome assc with CF
chromosome 7
Most common cause of death in infants + most common time of year
SIDS, most common in winter, common at 2-3 months
Grade murmur that may be innocent
I-II
Cyanotic heart lesions
5 T’s + Pulm stenosis
TOF murmur
loud single S2
When does VSD usually close?
by one year esp if muscular
Tricuspid atresia murmur
single S2, pansystolic murmur
Egg on a string=
TGA
Snowman=
TAPVR
Five major criteria assc with RF
JONES -joints -carditis -nodules -erythema marginatum (evanescent) s-sydenhams
Requirements for RF dx
2 major
1 major + 2 minor
or just sydenhams
Common cause iatrogenic HTN in newborns
umbilical catheter
MCC diarrheal illness
norovirus
In which two diarrheal illnesses are abx CI?
E coli- increased risk HUS
salmonella- increased length carrier state
Treatment for shigella
TMPSMX
Treatment for campylobacter
e-mycin
Treatment for Giardia
metronidazole
Microcolon v megacolon, which= hirschsprungs?
micro= meconium ileus mega= hirschsprungs
Population with highest rate of pyloric stenosis
first born males
Lab findings assc with pyloric stenosis
hypokalemic hypochloremic metabolic alkalosis
**correct this before surgery, surgery is nonemergent
Test of choice for pyloric stenosis
U/S
CXR finding assc with NEC
pneumatosis intestinalis
Apt test looks for?
swallowed maternal blood in neonate
MCC hematochezia in baby?
anal fissure
UC vs chrons: which= fistula
Chrons
Alports inheritance pattern
XD
C3 or C4 which is decreased in PSGN
C3
Nephrotic syndrome places patients at risk of what secondary condition?
peritonitis
When do males more commonly than females have UTI ?
before one year
Who is worked up for UTI cause?
females under 3
males
first febrile under 2
Workup for UTI cause?
renal US
Gold standard for UTI diagnosis
urine culture
In-toeing + neutral heel=
metatarsus adductus
In-toeing + inward heel=
talipes equinovarus (club foot)
Knee position in tibial torsion vs femoral anteversion
normal knee- tibial torsion
inward knee- femoral anteversion
SCFE should prompt what testing?
TSH, FSH, LH
Population most commonly seen with developmental hip dysplasia
breech girls
Swelling at tibial tubercle
osgood schlatter
Most common bone tumor
osteosarcoma
Osteosarcoma is increased in frequency with
blateral Rb
Sunburst appearance = ______, onion skin= _____
suburst= osteo
onion skin= ewings
Allergic rhinitis is _____ mediated
IgE
When do symptoms begin in Brutons
6-12 months, Recurrent sinopulmonary infection
Type one pauciarticular JIA:
marker + sex
female
ANA
Type two pauciarticular JIA
marker + sex
male
HLA B27
Assc with Type II pauciarticular JIA
HLAB27= ankylosing spondylitis
Systemic JIA=
fever, rash, joints
Neonatal lupus causes
heart block
CRASH + burn, how many are required?
fever +4/5
Complications of HSP
- intussusception
- arthritis
- encephalopathy
All HSP patients need
hospital admission
Hereditary spherocytosis
- test
- inhertiance pattern
- assc
osmotic fragility
AD
gallstones
MC enzyme assc anemia + inheritance pattern
G6PD, XR
When does treatment occur in ITP?
when symptomatic—> give IVG, steroids
Inheritance pattern VWD
AD
VWD lab
prolonged PTT
Where does ALL relapse? (2)
CNS + testis
EEG pattern + tx assc with Infantile Spasms
hypsarrythmia, ACTH
EEG pattern + tx assc with absence seizures?
aka?
3 Hx spike and wave
ethosuximide
petit mal
Mucopolysaccharidoses inheritance
All AR except Hunter= XR
Werdnig Hoffman
inheritance pattern
gene
SMN
AR
Symptoms SMA
pediatric ALS sx
Two types SMA
I-infantile
III-adolescent
worse with younger onset
Treatment of GBS
supportive
plasmapheresis
IVIG
First sign of puberty in males?
females?
males- testicular enlargement
females- breast buds
Normal weirdness during puberty
assymetry
gynecomastia
irregular menses
