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Master the Boards > Paeds > Flashcards

Paeds Flashcards

1
Q

normal RR newborn

A

40-60 BrPM

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2
Q

normal HR newborn

A

120-160 bpm

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3
Q

things that are done for every baby

A
  • mouth and nose suctioning
  • clamping and cutting umbilical cord
  • dried, wrapped–> warmer
  • gentle rubbing or stimulating the heels
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4
Q

one minute APGAR score

A

during labour and delivery conditions

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5
Q

five minute APGAR score

A

response to resuscitative efforts

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6
Q

appearance 0 point APGAR

A

blue all over

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7
Q

appearance 1 point APGAR

A

blue extremities

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8
Q

appearance 2 point APGAR

A

normal all over

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9
Q

pulse 0 point APGAR

A

Asystole or less than 60

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10
Q

pulse 1 point APGAR

A

60-100bpm

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11
Q

pulse 2 point APGAR

A

greater than 100bpm

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12
Q

grimace 0 point APGAR

A

no response

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13
Q

grimace 1 point APGAR

A

grimace/ feeble cry

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14
Q

grimace 2 point APGAR

A

sneeze/cough

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15
Q

activity 0 point APGAR

A

none

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16
Q

activity 1 point APGAR

A

some flexion

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17
Q

activity 2 point APGAR

A

active movement

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18
Q

resp 0 point APGAR

A

absent

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19
Q

resp 1 point APGAR

A

weak or irregular

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20
Q

resp 2 point APGAR

A

strong

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21
Q

all newborns receive eye care…

A
  • erthromycin or tetracycline ointment

- silver nitrate solution

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22
Q

day 1 red eye

A

silver nitrate

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23
Q

days 2-7 red eye

A

gonorrhoea
PREVENTABLE with ointments
Tx: ceftriaxone

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24
Q

days +1 week red eye

A

chalmydia
NOT preventable with ointments
Tx: oral erythromycin

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25
Q

days +3weeks red eye

A

herpes

Tx: acyclovir systemic

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26
Q

decrease mortality of vit K bleeding

A

IM vit K dose

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27
Q

national screening tests newborn USA:

A
  • PKU
  • CAH
  • CF
  • hypothyroidism
  • beta thalassemia
  • homocyteinuria
  • biotinidase
  • hearring test
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28
Q

mum is hep B positive, what does baby get?

A

BOTH active and passive

  • active: vaccine
  • passive: HBIG
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29
Q

3 transient conditions in the newborn

A
  • transient polycythemia
  • TTN
  • transient hyperbilirubinemia
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30
Q

splenomegaly normal in newborns

A

yessssss

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31
Q

TTN timing

A

first 4 hours

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32
Q

if tachypnea greater than 4 hrs

A

SEPSIS– do blood and urine cultures, and LP if neuro/irritable

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33
Q

what % of newborns are jaundiced?

A

60%

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34
Q

delivery associated injuries

A
  • subconjunctival hemorrhage
  • skull fractures
  • scalp injuries
  • brachial
  • clavicular fracture
  • facial nerve palsy
  • AF abnormalities
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35
Q

most common skull fracture during delivery

A

LINEAR fracture

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36
Q

most fata skull fracture during delivery

A

BASILAR fracture

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37
Q

caput succedaneum

A

CROSSES the midline

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38
Q

cephalohaematoma

A

DOES NOT cross the midline

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39
Q

prune belly

A

oligohydramnios: lack abdo muscles, unable to bear down and urinate

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40
Q

tx prune belly

A

serial foley catheter !!!! UTI risk

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41
Q

werdnig hoffman AF

A

POLY– since cannot swallow

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42
Q

tx for facial palsy delivery injury

A

NOPE

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43
Q

air fluid levels in chest, and bowel sounds heard in back

A

congenital diaphragmatic hernia

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44
Q

morgagni

A

CDH– retrosternal or parasternal

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45
Q

bochdalek

A

CDH- MORE COMMON, L side posterolateral

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46
Q

most common cause for elevated AFP

A

incorrect dating

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47
Q

mcc abdo mass in children

A

WILMS TUMOR

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48
Q

best initial test for wilms tumors

A

abdo US

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49
Q

most accurate test for wilms tumor

A

CT with contrast

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50
Q

tx wilms

A

TOTAL nephrectomy + Ctx, Rtx

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51
Q

most common cancer in infancy

A

neuroblastoma

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52
Q

most common extra cranial solid malignancy in infancy

A

neuroblastoma

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53
Q

PC neuroblastoma

A
  • hypsarrhythmia EEG
  • opsomyoclonus and cerebellar ataxia
  • increase VMA and metanephrine on urine
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54
Q

varicocele imaging

A

ALWAYS US the OTHER testicle

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55
Q

when to tx varicocele

A
  • delayed testes growth

- evidence of testicular atrophy

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56
Q

risk of malignancy and cryptorchidism with sx

A

MALIGNANCY RISK CONTINUES despite surgery

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57
Q

most common cyanotic heart lesion in children

A

TOF

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58
Q

most common cyanotic heart lesion in neonates

A

TGV

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59
Q

TOF a/w

A

chromosome 22 deletions

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60
Q

murmur in TOF

A

holosystolic in LLSB

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61
Q

squatting in TOF

A

increase preload

increase SVR

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62
Q

VSDs a/w

A

TRISOMIES

  • downs
  • edwards
  • pataus
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63
Q

3 holosystolic murmurs

A
  • MR
  • TR
  • VSD– thus TOF
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64
Q

TGV imaging

A

egg on string

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65
Q

pulsus alterans

A

alternating strong and weak beats

–>LV systolic dysfunction

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66
Q

pulsus bigeminus

A

two heartbeats close together followed by a longer pause

–> HOCM

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67
Q

pulsus bisferiens

A

on palpation of the pulse, a double peak per cardiac cycle can be appreciated
–> AR

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68
Q

HY a/w hypoplastic L heart

A

GG
G-gray
G-globular heart

69
Q

truncus arteriosus surgery

A

must be completed early to prevent PUL HTN

70
Q

TAPVR

A

no venous return between pulmonary veins and L atrium

71
Q

TAPVR with obstruction PC

A

EARLY LIFE

  • resp distress
  • severe cyanosis
72
Q

TAPVR without obstruction PC

A

AGE 1-2 years old

  • RHF
  • tachypnea
73
Q

TAPVR with obstruction CXR

A

pulmonary edema

74
Q

TAPVR without obstruction CXR

A

snowman appearance or figure 8 sign

75
Q

diagnosis of TAPVR with or without obstruction

A

ECHO

76
Q

purpose of surgery in TAPVR with obstruction

A

DEFINITIVE tx

77
Q

purpose of surgery in TAPVR without obstruction

A

RESTORE proper blood flow

78
Q

VSD PC

A
  • acyanotic
  • FTT
  • holosystolic murmur LLSB
79
Q

2 cyanotic heart lesions a/w VSD

A
  • TOF

- Truncus arteriosus

80
Q

2 cyanotic heart lesions = PDA dependent

A
  • TGV

- HLH

81
Q

most common congenital heart lesion

A

VSD

82
Q

HY a/w ASD

A

fixed wide splitting S2

83
Q

PC ASD ….

A

later in life

  • dyarrhythmias
  • paradoxical emboli– STROKE
84
Q

PDA in first 12hrs

A

normal

85
Q

PDA after 24hrs

A

PATHOLOGIC

86
Q

best initial test for PDA

A

ECHO

87
Q

most accurate test for PDA

A

cardiac catheterization

88
Q

pear shaped heart

A

pericardial effusion

89
Q

jug handle shaped heart

A

primary pulmonary artery HTN

90
Q

PC

  • hearing loss
  • syncope
  • fam Hx SCD
  • normal vitals/exam
A

LONG QT SYNDROME

91
Q

PC kernicterus

A
  • hypotonia
  • choreoathetosis
  • hearing loss
  • seizures
92
Q

big risk with tef

A

aspiration pneumonia

93
Q

vomiting with first feed=

A

TEF

94
Q

4 signs of pyloric stenosis

A
  1. string sign
  2. shoulder sign
  3. mushroom sign
  4. railroad track sign
95
Q

string sign

A

THIN COLUMN of barium leaking through the tightened muscle

96
Q

shoulder sign

A

filling defect in the antrum due to prolapse of muscle inward

97
Q

mushroom sign

A

hypertrophic pylorus against duodeum

98
Q

railroad track sign

A

excess mucosa in pyloric lumen= 2 columns of barium

99
Q

auscultation of pyloric stenosis

A

succussion splash

100
Q

electrolyte disturbance in pyloric stenosis

A

hypochloraemic, hypokalaemic metabolic alkalosis

101
Q

what worsens the potassium loss in pyloric stenosis?

A

ALDOSTERONE

102
Q

choanal atresia by definition

A

membrane between the nostrils and the pharyngeal space, preventing breathing during feeding

103
Q

feeding and choanal atresia

A

BLUE

104
Q

crying and choanal atresia

A

PINK

105
Q

initial step of choanal atresia

A

passing NG tube

106
Q

most diagnostic test for choanal atresia

A

CT scan

107
Q

first step in mgmt of choanal atresia

A

secure airway

108
Q

CHARGE syndrome

A 
C-coloboma and CNS abnormalities
H-heart defects
A-atresia choanae
R-retardation growth and development
G-GU defects (hypogonadism)
E-ear anomalies and or deafness
109
Q

respiratory distress and esophageal atresia

A

ONLY during feeds

110
Q

initial test for esophageal atresia

A

CXR

111
Q

timing for hirschsprungs

A

failure to pass meconium within 48hrs

112
Q

dx of hirschsprungs

A
  • PFA- distension
  • manometry- increase pressure of anal sphincter
  • full thickness bx
113
Q

dx of imperforate anus

A

CLINICAL

114
Q

wrong answers for dx of imperforate anus

A
  • manometry

- barium

115
Q

duodenal atresia=

A

LACK or ABSENCE of apoptosis

116
Q

timing of duodenal atresia

A

12 hours

117
Q

volvulus imaging sign

A

BIRD BEAK

118
Q

two things a/w intussusception

A
  • rotavirus

- HSP

119
Q

triad of symptoms for intussusception

A
  • currant jelly stools
  • abdo pain with sausage like mass in RUQ
  • vomiting billious
120
Q

best initial test for intussusception

A

US– doughnut/ target sign

121
Q

diagnostic and therapeutic test for intussusception

A

BARIUM ENEMA

122
Q

most important first thing for intussusception

A

fluids and electros

123
Q

second most common cause of infant death worldwide

A

GASTRO/DIARRHEA

124
Q

mild case of diarrhea

A

oral fluids

125
Q

severe case of diarrhea

A

IV fluids

126
Q

loperamide in kids diarrhea

A

NO NO NO NO NO

127
Q

rotavirus and adenovirus= blood?

A

NO NO NO NO NO NOT BLOODY

128
Q

after confirmed evidence of NEC

A

Abx:

  • vancomycin
  • gentamicin
  • metronidazole
129
Q

big tx for NEC

A

IV FLUIDS, if failed

SURGERY

130
Q

infant with diabetic mother– GI

A

small L colon syndrome

131
Q

dx small left colon syndrome

A

barium study– congenitally smaller descending colon–> constipation

132
Q

major cardiac change in infants of diabetic mothers

A

asymmetric septal hypertorphy

133
Q

renal vein thrombosis

A

infants of diabetic mothers

  • flank mass
  • possible bruit
  • hematuria
  • thrombocytopenia
134
Q

different types of rickets

A
  • vit d deficient rickets
  • vit d dependent rickets
  • X-linked hypophosphataemic rickets
135
Q

vit d dependent rickets

A

inability to convert 25,OH vit D to 1,25 OH vit D

136
Q

dx of vit D defieicny CXR

A

rachitic rosary

137
Q

infant exclusively breastfed it D supplements starting from

A

2 months of age

138
Q

vit D dependent rickets labs

A

decrease calcium
decreased 1,25
normal phosphate
normal 25,OH

139
Q

X-linked hypophosphataemic rickets

A

everything normal except

DECREASED PHOSPHATE

140
Q

most common causes of neonatal sepsis

A

pneumonia

meningitis

141
Q

early neonatal sepsis causes

A

e.coli

listeria

142
Q

late neonatal sepsis causes

A

e.coli

GBS

143
Q

diagnostic tests for sepsis

A
  • blood and urine culture
  • urinalysis
  • CXR
  • LP
144
Q

tx of neonatal sepsis

A

ampicillin
gentamicin
cefotaxime (if meningitis)

145
Q

best initial test for toxo

A

IgM

146
Q

most accurate test for toxo

A

PCR

147
Q

initial test for rubella

A

maternal IgM + clinical

148
Q

tx for neonatal rubella

A

supportive

149
Q

CMV best intiial test

A

urine or saliva viral titers

150
Q

most accurate test for CMV

A

urine or saliva PCR for viral DNA

151
Q

tx CMV with end organ damage

A

ganciclovir

152
Q

week 1 herpes

A

shock and DIC

153
Q

week 2 herpes

A

vesicular skin lesions

154
Q

week 3 herpes

A

encephalitis

155
Q

measles dx

A

IgM= most accurate

156
Q

emergency tx of croup

A

racemic epinephrine

157
Q

XR for croup

A

NEVER the right answer

158
Q

hypoxia on presentation

A

croup

159
Q

hypoxia imminent

A

epiglottitis

160
Q

most nb for epiglottitis

A

intubation

161
Q

CXR for whooping cough

A

buterfly pattern

162
Q

productive cough lasting 7-10days with fever

A

bronchitis- clinical dx-supportive tx

163
Q

painful limp + ER leg

A

SUFE

164
Q

painful limp only

A

LCP

165
Q

XR LCP vs SUFE

A

BOTH= widening of joint

LCP—-> effusions

166
Q

tx LCP

A

= rest and NSAIDS

—> SURGERY BOTH HIPS (since if one necroses, likely that the other one will swell)

167
Q

tx for SUFE

A

IR and pinning

168
Q

burning feet syndrome

A

vit B5 deficiency

169
Q

random add in for it A deficiency

A

hypoparathyroidism

thus XS= hyperparathyroidism

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