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OME Flashcards

1
Q

Complex febrile seizure have what characteristics?

Treatment?

A

Focal, > 15min duration, recurrent

Anti-epileptic

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2
Q

Unconjugated bilirubinemia w/- Coombs test, normal Hgb, and + retic count means what?

Path?

A

Hemolysis or hemorrhage

HS, G6PD, pyruvate kinase def OR hematoma/bleed

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3
Q

Rubella is what kind of virus?

How does the rash start?

Prodrome presents how?

A

Togavirus

Face and spreads down to toes

tender LAD, Forchheimer spots in mouth

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4
Q

Treatment for BPD?

A

Give O2 and lung protective strategy ventilation

Perinatal surfactant and ante-natal steroids

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5
Q

Brief period where gasping respiration’s start followed by what?

Treatment?

A

Secondary apnea

Bagging

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6
Q

6 months old what can you do?

A

Think June summer solstice

Sitting at a picnic and having stranger anxiety with mom’s weird friends raking your face

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7
Q

What is the workup for suspected in meningitis if FAILS (Inc ICP) Positive?

A

Blood Cx —> Abx —> CT scan —> LP

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9
Q

How do you diagnose Meckel’s?

Treat?

A

Technicium-99 radionucleotide scan

Surgically

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10
Q

What are the most effective treatments for allergic rhinitis?

A

Intranasal corticosteroids

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12
Q

When is Palivizumab used?

A

RSV prevention in premature infant

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13
Q

What is the treatment for bacterial tracheitis?

F/u with what?

A

IV Abx

Scope

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14
Q

Pt that has bloody diarrhea plus fever indicates what?

Treatment?

A

Shigella, salmonella, E. Coil, Yersenia

Stool culture, hydration, electrolyte management

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16
Q

What bugs MC cause OE?

A

Pseudomonas

S. Aureus

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17
Q

Scoliosis suspected, 1st step in diagnosis?
Next?

Treatment?

A

Adam’s test
Xray

Bracing or surgery for severe cases

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18
Q

When does Legg-Calve-Perthe Disease occur?

Can suffer what?

CFs?

Dx and treat how?

A

6 years old

AVN of the hip

Insidious knee pain, antalgic gait

Xray, then cast

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19
Q

What is bronchiolitis?

Caused by what?

A

Inflammatory disorder of the small airways caused by a viral infection

RSV most common

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21
Q

What is Hirschsprung’s?

Always where?

A

Absent ganglion migration of Meissner and Auerbach plexus

Rectum/distal colon

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23
Q

What causes TGA?

Needs what to survive?

A

Pregestational diabetes

PDA

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24
Q

What will the Haptoglobin content be in a sickle cell pt?

LDH?

A

Low

High

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25
Q

What causes HFMD?

Appears how?

A

Coxsackie A

Vesicle on erythematous base, can involve buttocks

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28
Q

What is an osteochondrosis aka traction apophysitis?

A

Osgood-Schlatter disease

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29
Q

Pt with fungal or PCP infection most likely has what?

CBC shows what?

A

DiGeorge syndrome

Dec Lymphocytes

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30
Q

What presents in a premature infant w/acidosis, HoTN, bloody diarrhea?

A

NEC

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31
Q

What flu vaccine is the MC?

What is MC given to kids?

A

Inactivated

Live attenuated intranasal

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32
Multi physic or to and fro heart lesion is called what?
PDA
33
Pts 5-15 have the highest incidence of GAS, so what can you do?
Jump straight to testing if they do not have viral sx (cough, rhinorrhea)
34
How does choanal atresia present in a baby?
Blue at rest Pink up while crying Childhood snoring
36
Supplemental oxygen use in a premature infant indicates what? What is the pathology behind it?
BPD Decreased surfactant and alveoli
38
What are the indications for Exchange transfusion in sickle cell crisis?
Encephalopathy FND Chest pain Noncardiogenic pulmonary edema
39
Syndrome w/interictal EEG showing hypsarrhythmia is what? Treatment?
West syndrome (Infantile spasm) ACTH aka cosyntropin
42
Meconium aspiration syndrome causes what complications? Treatment in infant w/pulse < 100 and poor tone?
Severe pulmonary complications Endotracheal auctioning w/endotracheal tube
43
What presents as a bone cancer w/fever, leukocytosis and night sweats?
Ewing Sarcoma
44
When do kids need to be admitted to the burn ward for fluid replacement?
> 10% BSA
45
1 year old what can you do?
Think Christmas Walking over to Santa to grasp and pinch him but getting separation anxiety when leaving him
46
What is the CENTOR score?
``` Absent cough = +1 Exudate (tonsillitis) = +1 Nodes (Ant chain LAD) = +1 Temp > 38C = +1 OR: < 14 = + 1 > 44 = -1 ```
47
Major feature of Tuberous sclerosis? 3+1 other assoc CF?
Intellectual disability Ash leaf spots, Lisch nodules, angiofibromas +1 = sebaceous adenoma
48
How do you diagnose Asthma? Describe the condition
PFTs showing decreased FEV1/FVC Reversible bronchoconstriction and inflammation
49
What starts w/a high fever > 40C that breaks as the rash starts? What is the pattern of the rash?
Roseola Begins on trunk, spreads to face
50
Cataracts in newborn, think what? If later on but still early life?
TORCH infection Galactosemia
51
What is an atretic or anatomically stenosis connection between the nose and mouth called?
Choanal atresia
52
What describes a complex partial seizure? Generalized?
Focal, (+) LOC Total body, (+) LOC
53
What is the treatment for tetanus if sx have already started?
Sedation+intubation Muscle relaxers Metronidazole
54
What presents as a sunburst pattern on distal femur?
Osteosarcoma
55
What is the BRUE definition?
< 1 year old + < 1 min duration + | - change in color, tone, respirations or responsiveness
56
1st step in workup of 3/6 hear murmur in child less than 1 y/o is what?
Echocardiogram
57
Breast milk jaundice is what kind of issue? Treat how? What is elevated?
Quality aka enzymes (at 6-14 days), mom’s milk inhibits conjugation Temporarily substitute formula Indirect bili
58
What is TTN? Seen in what? How does the infant present? CXR shows what?
Delayed clearance of fetal lung fluid C section Grunting and tachyons Hyperexpanded and wet
59
Febrile illness w/joint pain points to what? Dx how?
Septic hip Xray, then joint aspiration w//gram stain and Cx
60
Osteomyelitis due to a dog bite, what organism? Sickle cell? Penetrating injury?
Pasteurella Salmonella Coag-negative Staph
61
Inheritance of CF? How do these kids present? Management focused on what?
AR FTT, meconium ileus, frequent respiratory infections Lungs (pseudomonas) and pancreas
62
How does duodenal atresia present? Assoc w/what?
Polyhydramnios, X-ray shows double-bubble w/NO distal air Down syndrome
63
What causes chemical conjunctivitis in newborns? Occurs when?
Silver nitrate 24 hours
65
If assessing for kidney stones bc of hematuria, what test to image it?
Non-contrast CT
68
Pt w/sickle cell crisis has what lab values?
INC bilirubin INC reticulocyte DEC platelets DEC Hgb
73
What high electrolytes can cause FTPM? Low ones?
Ca, Mg hypoglycemia, hypokalemia
74
Albinism, neuropathy, neutropenia w/giant granules, wither recurrent stap aureus infections is what?
Cheddar Higashi
77
What to do if febrile seizure lasts more than 5 min?
Abort seizure w/benzos
78
What do you do in a pt that is older than 3 but younger than a teenager in suspicion of GAS?
Rapid strep test
79
Delayed separation of the cord most likely has what? Labs should what?
LAD WBC VERY high
80
When is the median age of onset for neuroblastoma? How to tell it apart from Wilms tumor?
19 months It crosses midline
81
Pharyngitis plus rash on palms/soles is what Dx?
Coxsackie
82
How does annular pancreas present?
Double-bubble with or w/out distal air
83
What presents as sudden onset dyspnea in a young child? Do what?
Foreign body aspiration Chest XRay
84
Pt that is persistently hypoxic that does not improve w/oxygenation has what? How do you know? Treat how?
TGA None of the inspired oxygen is getting into the systemic circulation PGE1, then surgery
85
CMP in baby w/pyloric stenosis shows what?
Hypochloremic Hypokalemic Metabolic alkalosis
86
6 mo old baby w/FTT after feeding most likely has what? Treat how?
Milk-soy protein allergy Hydrolyzed formula
87
What are some Non-organic causes of FTT?
Formula Feeding Frequency
88
Premature infant what are the 4 diseases to consider?
IVH BPD ROP Necrotizing enterocolitis
89
Pt w/X-ray showing air fluid levels with a gas filled plug has what? Treatment?
Meconium ileus Water-soluble contrast enema or surgery
90
How to treat NEC? Surgery can cause what?
NPO, IV Abx (against g negs), and TPN Short guy syndrome
91
what has a 3 Hx spike on EEG?
Absence seizure
92
Mild Concussion describe the following: FND LOC HA Amnesia CT
None < 60 seconds None, improving None No CT, go home
94
What is the response to high pressure in the pulmonary circulation?
RVH and Pulm HTN
95
What age group does bacterial trancheitis? What is seen on xray? Looks like what? But what?
5-7 years Subglottic narrowing Croup but they are more ill-appearing
96
Adolescent w/hot potato voice and uvula displaced to one side indicates what? MC pathogens?
Peritonsillar abscess GAS, S. Aureus, anaerobes
97
What kind of virus is measles? Sx? Biggest concern?
Paramyxovirus Cough, coryza, conjunctivitis, Koplik spots SSPE
98
Premature infant w/blood bowel movement must r/o what first?
Necrotizing Enterocolitis
99
Sickle cell pts have what other than sickled cells on blood smear?
Howell-Jolly bodies
101
What describes a loss of consciousness and the CT shows punctuate intracerebral hemorrhages?
Cerebral contusion | Coup and contra-coup injuries
102
For a pt w/3 or more lifetime doses of Tetanus vaccine, what is the treatment for a dirty wound if it has been more than 10 years since the last dose of vaccine? Less than 10 years?
Tdap Home
104
Premature baby and bloody diarrhea = what? Dx how? Tx?
NEC Babygram xray NPO, TPN, IV Abx
105
Arthrocentesis that shows wbc > 50,000 means what?
Septic joint
106
What is a good first test for immunodeficiency?
QIGs and CBC w/diff
107
What does the X-ray show in a Hirschsprung’s pt? Treatment?
Dilated proximal colon (normal) Normal distal colon (ABNORMAL) Pull-through procedure, colostomy
108
A teenager with a heart murmur < 3/6 w/no palpable thrill, what is the workup prior to starting sports?
NONE - he can play, yeah i said HE
109
For a pt w/less than 3 lifetime doses of Tetanus vaccine, what is the treatment for a clean wound? Dirty?
Tdap Tdap + TIG
110
What presents w/altered mental status, no tonic-clonic activity and the pt will have mild confusion after?
Complex partial seizure
112
What is an absolute contraindication to DTap? Relative?
Hx of encephalopathy Fever > 40C w/in 48 hours, shock, persistent crying (3+ hours), seizures w/in 3 days
113
Pharyngitis plus conjunctivitis in kid, what is it?
Adenovirus
113
Pt with CGD has what kind of NBT test? Treat how?
Negative Bactria, itraconazole, bone marrow transplant
114
Tx for Hyper-IgM syndrome?
IVIG
115
What is primary apnea?
Apnea from any perinatal insult, it will quickly respond to stimulation
116
What presents w/recurrent sinusitis, OM, PNA and shows that there is a B-cell deficiency? What Ig levels present? Tx?
Bruton’s Agammaglobulinemia All Igs are LOW. —> A, G, E, M IVIG
117
What is the parkland formula? Used for what?
%BSA x Kg x 4 2nd and 3rd degree only
119
What must you check for in the head?
Caput succedaneum (CROSSES sutures) or cephalohematoma
120
What are peak incidences of IBD?
10-20 and 50-80
121
Acute OM and swelling behind the ear that is anteriorly rotated indicates what? What cause?
Mastoiditis Pseudomonas
122
Female pt w/constant leak that has never been dry has what? Dx how? Tx?
Ectopic ureter US, VCUG, radionuclide scan Surgery
123
How do you treat active pertussis?
Erythromycin
124
What is an inspiratory sound of the upper airway that indicates a partial obstruction near the trachea or larynx?
Stridor
125
Bilious vomiting means what?
Obstruction is distal to biliary tree or NO obstruction at all
128
Direct hyperbilirubinemia requires a workup for what?
``` Sepsis (wbc, blood Cx) Obstruction (HIDA scan) metabolic diseases (Rotor, Dubin, etc) ```
129
Unconjugated bilirubin w/+ Coombs test means what? Path?
Isoimmunization Rh or ABO incapability
130
A pulse between 60-100 requires what in newborn? < 60? If no improvement upon treatment do what?
Ongoing ventilation Chest compressions at 3:1 ratio Epinephrine via umbilical vein catheter
131
What presents as a harsh holosystolic murmur at the left sternal border? Assoc w/what?
VSD FTT, HF, Down syndrome
132
Severe Concussion describe the following: FND LOC HA Amnesia CT
Positive > 60 seconds Present or worsening Retro/anterograde Get it to r/o Bleeding
133
Prophylactic PCN is indicated for kids w/sickle cell in what age?
Def < 5 | Probably until Age 18
134
How do you interpret the CENTOR criteria?
< 1 no further testing 2-3 perform rapid testing >/= 4 empiric Abx
135
1st step in pyloric stenosis? Diagnose how? Then what?
Immediate IVF for rehydration US showing donut sign Pyloromyotomy
136
Pnematosis intestinalis means what else? Seen in what condition?
Air in the wall of the bowel Necrotizing enterocolitis
136
What is the biggest issue of cleft lip/palate? Others?
Feeding - FTT OM, feeding problems, hearing difficulties, speech pathology
138
How does a pt w/UPJ present? What is the MC pt population?
Colicky ABD pain Teenager after binge drinking
139
When does CVID usually present? Ig levels will show what? Thx?
Mid to late childhood 2/3 Igs will be low - A, G, M IVIG
140
How to prevent SIDS?
Sleep on back Don’t share beds Smoking cessation
142
What causes croup? MC age group? AP film shows what? Treat how?
Parainfluenza virus 6mo - 3yr Steeple sign (clear lungs w/subglottic narrowing) Racemic Epi and steroids
143
What does derecruitment mean?
Alveoli that get stuck together and fail to open
144
What is an enanthem?
Rash on the mucous membranes
145
What presents as double-bubble and multiple air-fluid levels? What pathology? Due to what?
Intestinal atresia Vascular accident in utero —> cocaine
146
Baby w/imperforate anus, what do you want to do first? Never do what?
Cross table X-ray Take temp rectally
146
Baby that has FTT, what is the first thing to go? Next? Last?
Weight Height Head circumference
148
What are some organic causes of FTT?
``` Genetic (CF) Cardiac disease Pyloric stenosis GERD Hyperthyroid ```
149
What causes ROP? Why? Treat how?
Prematurity High oxygen delivery Laser photocoagulation
151
What medications can cause FTPM?
Magnesium | Opiates
153
Newborn male that presents w/low or no urine output and a palpable bladder has what? May be PMHx of what?
Posterior urethral valve Oligohydramnios
154
What is the definitive way to treat biliary atresia?
Kasai procedure - hepatoportoenterostomy
155
What gives away HSV encephalitis?
Mention to hippocampus | Bloody LP
156
4 months old what can you do?
Think April Fool’s Rolling over in Laughter
156
If it is a situation of hereditary angioedema, how do you treat?
FFP
157
How to treat PNA when it is a typical pathogen? Atypical?
Amoxicillin Azithromycin
158
When should congenital esotropia be corrected?
6 months
159
What do you use to determine if if blood in stool of newborn is maternal or fetal origin? What yields a + test?
Apt test (alkali desaturation test) Fetal blood resistant to denaturation
162
Ewing sarcoma found what part of bone? Diagnose how? Buzz words?
Diaphysis (shaft) MRI Onion skin, moth eaten
165
What is a Mongolian spot? Seen in whom? Mistaken for what?
Dermal melanocytosis Latin America and east Asia Bruising
165
What is the definitive test for OM?
Pneumatic insufflation (tense immobile membrane)
166
Pt w/severe jaundice needs what? Decide how? If it fails then what?
Phototherapy, look at a nomogram Exchange transfusion
167
Describe features of simple febrile seizure
Generalized < 15 min in duration 1 episode in 24 hours No underlying neurological problems
168
Pt w/GAS that is treated appropriately is still at risk for what? Untreated can lead to what?
PSGN Rheumatic fever
169
What is the SE of Ceftriaxone if used in kids < 30 days old? What to use instead?
Hyperbilirubinemia Cefotaxime
170
What kind of vomiting means there is an obstruction distal to ampulla of Vater? 1st step in workup?
Bilious X-ray —> gas patterns
171
RDS can cause what? Infant presents how? CXR shows what?
Surfactant deficiency causing atelectasis Premature w/grunting Low lung volumes w/uniform granular pattern
172
Pt w/TEF can be diagnosed how?
NG tube coils up, use X-ray
173
Baby w/biliary atresia what is the 1st step in workup? Next? Last?
US plus LFTs HIDA after phenobarbital Liver biopsy —> intraoperative cholangiogram
174
What makes a high-risk BRUE?
Hx suggestive of Dz Physical suggestive of dz CPR performed Multiple, recurring
175
What is the cut off for failure to pass meconium?
48 hours | But most do so w/in 24 hours
175
2 months old, what can you do?
Think Valentines Day Lift your head to Smile
175
How do you treat acute crisis in sickle cell?
IVF O2 IV pain meds Abx if infection present
176
Breast feeding jaundice is what kind of issue? Treat how? What is elevated?
Quantity (newborn < 7 days), bowel moves too slow Increase # of feeds Indirect bili
177
How to treat apnea of prematurity?
Give caffeine
177
What is the MC SE for the HPV vaccine? Recommended in what age groups?
Syncope 9-26
177
How do you treat shingles outbreak?
TCA | Gabapentin
179
Colicky ABD pain w/abrupt onset in kids 3mo - 3 years indicates what? Diagnose how? Treatment?
Intussusception US Air-contrast barium enema, if it fails, then surgery
181
What is characterized as low glucose? How to treat SYMPTOMATIC hypoglycemia? If it is persistent?
< 40-45 2mL/kg of D10W Dextrose infusion
181
What presents w/double-bubble but Normal gas pattern? Diagnose how?
Malrotation/volvulus Upper GI series, contrast enema
181
Unconjugated bilirubinemia w/- Coombs test but high Hgb means what? Path?
Blood transfusion Twin-twin, maternal-baby, delayed cord clamping
181
What is right of midline and without a membrane congenital defect?
Gastroschisis
181
Retinal hemorrhages in a baby indicate what? What else?
Shaken baby syndrome Subdural hematoma
181
How do you treat scabies?
Permethrin or lindane
181
Newborn w/clicky hip has what? Diagnose how? Treatment?
DDH US in 4-6 weeks Harness
181
Bleeding with pattern of dysmorphic urinary rbcs, rbc casts, and coca-colored urine points to what cause?
Glomerular
181
Chediak-Higashi is what inheritance? CFs?
AR Neutropenia, necrosyphilis
181
Job syndrome is what? Present how?
Hyper IgE Cold abscesses (Staph, H.flu, Strep pneumo0
181
Fungal or PCP infections with underlying heart defect in newborn think what? Treat how?
DiGeorge Prophylaxis w/Bactrim and scheduled IVIG
182
What is the MC heart defect in kid > 1 y/o
ASD
183
``` Describe how much BSA is in each of the following areas: Head Front thorax Back thorax Arms Legs Genitals ```
``` 9+9 = 18 9+9 = 18 9+9 = 18 (4.5 per side) L=9, R=9, 18 total 9+9+9 = 27 1 ```
184
How do you treat lice?
Permethrin or malathion
184
Paralysis + encephalitis?
West Nile
184
What will classify anaphylaxis?
``` 2 of the following: HoTN or End-organ damage (syncope) GI sx Skin/mucosa Respiratory sx ```
187
What is normal hemoglobin composed of? Sickle cell?
a2B2 A2B2 with Valine substitution
188
What can Parvo virus cause in adults?
Arthritis
189
How to treat TTN?
O2 and CPAP/intubation aka PPV
189
Femoral or skull fracture in a kid indicates what?
Child abuse
190
What is the MC primary immunodeficiency? How do they present?
IgA def Anaphylaxis after blood transfusion
191
Baby w/imperforate anus, what else do you want to look for?
``` Vertebral Anus Cardiac TracheoEsophageal Fistula Esophageal atresia Renal Limb ```
191
1st step in workup of yellow baby? | Next?
Transcutaneous sensor | Draw bilirubin level
191
Bowel sounds over the lungs w/scaphoid abdomen in a dyspneic baby means what? Diagnose how?
Congenital diaphragmatic hernia Babygram - xray
191
What is an exanthem?
Rash on the skin
191
What is the treatment for Toxo/PJP? Alternate? If can’t use alternate?
TMP/SMX Dapsone Atovaquone
191
What are the 2nd gen H1 antihistamines used to treat urticaria?
Cetirizine Loratadine Fexofenadine
191
What presents w/high fever w/rapid onset, pt will be drooling and tripoding? AP film shows what? Treat how?
Epiglottis Thumbprint sign Controlled intubation
191
What presents w/a fixed, wide split S2? How to close?
ASD Catheter-directed device closure
191
What are the features of ToF? See what on xray? Assoc w/what? Due to defect in what?
PROV Pulmonic stenosis, RVH, overriding aorta, VSD Boot-shaped heart Down syndrome, DiGeorge Endocardium cushion
191
Baby w/HTN, claudication (refuses to walk) most likely has what? Dx how? Treat?
Coarctation of the aorta BP on arms and legs, Echo next Surgery
191
What presents w/synovial inflammation up to 4 weeks after uri or GI viral illness?
Septic hip
191
Unilateral conjunctivitis most likely due to what? When? Treat how?
Chlamydia Day 5-14 Erythromycin PO
192
For a pt w/3 or more lifetime doses of Tetanus vaccine, what is the treatment for a dirty wound if it has been more than 5 years since the last dose of vaccine? Less than 5 years?
Tdap Home
193
What does urology pelvic US look at? Can tell you what?
The tubes Hydronephrosis (obstruction) is or NOT
194
Baby that has bubbling and gurgling w/respirations has what?
TEF
195
Meckel’s diverticulum is remnant of what? Presents how?
Omphalomesenteric (vitelline) duct FOBT, Fe def anemia, or hematochezia
196
How long should kids be in booster car seats?
Until 4’9’’ and 8-12 years old
196
What is the workup for suspected in meningitis if FAILS (Inc ICP) Negative?
LP —> CSF and Blood Cx —> ABx
198
Pulse < 100 or respiratory difficulties at 30 seconds means what? Do what ?
Primary apnea PPV
198
Double bubble w/no distal gas pattern indicates what?
Duodenal atresia or annular pancreas
198
Posthepatic jaundice has what pathology?
ASO Atresia Sepsis Obstruction
198
What shape can you make as a 3 year old? What gross motor? 4? G motor? 5? G motor?
Circle, trike Cross, hop Triangle, skip
199
What are the 5 criteria of APGAR and what does normal mean?
``` Appearance - pink Pulse - > 100 Grimace - with stimulation Activity - resists extension Respiration - STRONG ```
200
Pt w/recurrent pulmonary infections, GI infections w/high fever, and massive leukocytosis. No pus in the infections has what?
LAD - CD18
201
When does the intraventricular lining involute? How to screen for it? What happens? Treatment?
34 weeks Cranial US Increases ICP VP shunt
201
Is rotavirus vaccine live or killed? Given how? Biggest SE?
Live, orally Intussusception
201
What presents in a kid w/drooling and a fever w/neck fixed in a sniffing position w/refusal to move and has a muffled voice? What imaging to get? What special Clinical Feature?
Retropharyngeal abscess CT scan Unilateral LAD
201
Pt w/sinopulmnary infections and absent IgA with poor DNA repair has what?
Ataxia Telangiectasia
203
Conjugated bilirubin is always ________ as it is indicative of problems w/________?
Pathologic | Biliary excretion
203
Unconjugated bilirubinemia w/- Coombs test, normal Hgb, and - retic count means what? Path?
Reabsorption problem Hemorrhage, breast feeding jaundice, breast milk jaundice
203
How long should children be in a rear-facing car seat in the back of the car?
2 y/o
204
SCFE occurs in whom? Dx. How?
Obese teen or one in a growth spurt frog-leg Xray
205
What kind of pts are more susceptible to voluntary constipation? Tx?
Retarded kids Manual disimpaction

Pediatrics (1 decks)

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