Midterm - TO KNOW Flashcards
The American Association of Ophthalmic Oncologist
and Pathologists (AAOOP) screening
recommendations for children at risk for retinoblastoma.
All infants and children should have a red reflex exam before discharge from the newborn
nursery and after that at every health maintenance visit.
All infants should receive hearing screening before…
1 month of age
Education for preventing eye injuries
● Using safety gates and cushions/pads at sharp corners, storing sharp utensils/tools out of reach of children, and storing chemicals securely
● Restraining children properly in the car (seatbelt), not allowing children under 12 years of age to sit in the front seat
● Limiting/supervising the use of laser pointers, BB guns, air rifles, paintball devices, darts, and fireworks
Treatment for scabies
Treat with permethrin 5%, repeated in 1 week; use an antihistamine, hydrocortisone, or non-steroidal anti-inflammatory drugs (NSAIDs) for itching; simultaneously treat family members (even if asymptomatic), friends, and school/daycare contacts
Education for scabies
Educate the family about the course of the disease. Rash and itching persists for up to 3 weeks following treatment.
● The child should not be infectious 24 hours after treatment and may return to school or daycare.
The six components that need to be present in a patient with suspected Kawasaki’s Disease but an incomplete diagnosis include:
(1) albumin ≤3.0 g/dL
(2) urine ≥10 WBC/HPF
(3) platelet count ≥450,000 after 7 days of fever;
(4) anemia consistent with age values
(5) total white blood cell count ≥15,000/mm3
(6) elevation of alanine aminotransferase
Management of Kawasaki’s Disease
IVIG therapy (a single dose of 2 g/kg over 8 to 12 hours, ideally in the first 10 days of the illness)
American Heart Association recommendations for Kawasaki’s Disease
High-dose aspirin be given for its anti-inflammatory properties (80 to 100 mg/kg/day in four divided doses, every 6 hours
initially) until afebrile for at least 48 to 72 hours, then lowering the aspirin dose to 3 to 5 mg/kg/day for 6 to 8
weeks with discontinuation if the echocardiogram is
normal.
Baseline screening for Kawasaki’s Disease
A baseline echocardiogram at diagnosis
subsequent studies at 2 weeks and 6 to 8 weeks after onset of illness.
Cardiac MRI may give a better view of anatomy and cardiac function;
CT angiography not recommended.
Meningococcal vaccine
High morbidity and mortality rate.
Vaccinate age 11years with a booster at 16 years. Know when to give. Highest risk late high school/ college.
How often should an adult receive a TDAP booster?
Every 10 years
○ TDAP is given multiple times throughout life, even to the elderly.
○ The adult version is actually recommended antenatal vaccination at 27-36 weeks
(third trimester) pregnant (Tdap),
DTap vaccine
DtAP (4 doses)-Diphtheria-Tetanus-Acellular Pertussis Vaccine- given to children under age 7. Pertussis is not long-acting and needs to be given multiple times.
Puncture wounds
● Children with simple, uncomplicated puncture wounds do not need antibiotics. Exceptions include: signs of infection; cat bites; hand, foot, or genitalia wounds; the puncture is near a joint or bone; or the wound is deep of contains debris
● Obtain plain film radiography if there is suspicion of a retained foreign object
○ Antibiotics for animal/ human bites: Augmentin 7-10 days Toxic
Infantile hemangioma
Current standard of care for infantile hemangiomas is the
β-blocker . Treatment is the most effective in the proliferation phase but may help in later stages. Potential side effects include hypotension,bradycardia, bronchospasm, hypoglycemia, and hypothermia. The topical β-blocker timolol has been used with some success in small, primarily superficial, uncomplicated, and functionally insignificant hemangiomas
How often is spirometry recommended for asthma patients?
Every 1-2 years
When is an x-ray helpful for asthma?
Selected cases of asthma or suspected asthma or if the child has persistent wheezing without a clinical explanation, and children with hypoxia, fever, suspected pneumonia, and/or localized rales requiring admission
FEV1- levels for asthma
● >75%: Normal
● 60% to 75%: Mild obstruction
● 50% to 59%: Moderate obstruction
● <49%: Severe obstruction
What is the most common finding in patients with retinoblastoma?
Strabismus
(eyes don’t look exactly the same direction at the same time)
Removal of foreign body and when
● Obtain plain film radiograph if there is suspicion of a retained foreign object
● Ultrasound is best for evaluation of radiolucent foreign objects, including wood and plastic.
Treatment for AOM
Amoxicillin remains the first-line antibiotic for AOM if there has not been a previous treated AOM in the previous 30 days, 80-90 mg/kg/day divided twice a day (maximum dose 2 to 3 gm daily)
Ceftriaxone may be effective for the vomiting child, the child unable to tolerate oral medications or the child who has failed amoxicillin/clavulanate.
ECHO for hypertension in children
Yearly echocardiograms are recommended to evaluate LVH.-left
ventricular hypertrophy
What level should a child with hypertension be at?
95% percentile or less than 130/80
Osgood Schlatter disease
caused by microtrauma in the deep fibers of the patellar tendon at its insertion on the tibial tuberosity. The diagnosis is usually based on history and physical examination
Focal swelling, heat, and point tenderness found at the tibial tuberosity
● Tx- Self-limiting condition w/ symp management
Characteristics of Trisomy 21
Down syndrome
○ Brachycephaly (flat back of head)
* Midface hypoplasia with flat nasal bridge
* Brushfield spots
○ Epicanthal folds with upslanting palpebral fissures
○ Small mouth with protruding tongue
○ Myopia/cataracts- increase eye diseases
○ Small ears/narrow canals, increased ear infections, HEARING LOSS
○ Extra skin at nape of neck
○ Lax joints (atlantoaxial instability)
○ Short broad hands/feet/digits Short stature
○ Single palmar crease
* Clinodactyly
* Exaggerated space/plantar
groove between great and second toes
○ Congenital heart disease, heart defects
○ At risk for leukemia, hypothyroidism, Alzheimer’s disease
○ Intellectual/cognitive disability/developmental delays, low IQ,
obstructive sleep apnea
○ Hypotonia (infant
Modes of transmission for enterovirus in childcare setting
● Resp
● fecal/oral
● Person to person via skin contact
● Contact with blood, urine, or saliva,
● Vertical- prenatally, breastfeeding
Diagnosing enterovirus
The PCR assay is highly sensitive for all enteroviruses, results can be available in hours, and the test is more sensitive than cell culture.
Cultures can be obtained from the
throat, stool, rectum, cerebrospinal fluid (CSF), urine, and blood
Port-Wine stains
0.2% to 0.3% of newborns - if over the
forehead/eyelid it could be several syndromes and it recommended for
Optho referral
Vascular birth mark
Diagnostic studies for pediculosis
Microscopic examination of a hair shaft can more clearly
identify nits.
○ Test for other sexually transmitted infections if pubic lice
are found; specifically gonorrhea and syphilis.
Management of pediculosis
● Pediculicides are a first-line treatment option(proper application is key)
■ Over counter Permethrin 1% and pyrethrins are inexpensive but resistance is widespread - safer treatment of choice
● Spinosad is approved for use in patients 6 months of age
and older
● Topical ivermectin lotion is a single-dose, 10-minute
application to dry hair. It is approved for children 6 months old and older
● May return after no nits are seen
● Body lice are treated by improving hygiene and cleaning clothes.
● Wash infested clothing and dry at hot temperatures every week for several weeks.
When to get the HPV vaccine?
Ages 9-26 mild with safe effects.
Pregnant should not get.
2 doses 6 months apart.
Who should get PCV13 vaccine?
Given to children until 59 months. High-risk should get the PCV23. (vulnerable
population: infant, elderly)
