Ped's things

Question 1

Rubeola:

1. Also known as?
2. What presents?
3. How can we prevent?

Answer 1

1. Measles or Koplic spots
   (rubeoLa-measLes-kopLickspots)
2. “3 C’s”
   -cough (coryza)
   -conjunctivitis
   -congestion
   -rash
3. MMR Vaccine

Question 2

Rubella

Answer 2

“3-day measles”

(decrease in severity, increase in contagion)

-pregnant women at risk
-adenopathy
-pink rash
-very contagious

+ Rubella titer= pt is immune

“RUB my BELLa- ive been rubbing your belly for 3 days- your skin is pink now. I’m positive i want to stop an do on the TITER totter”

Question 3

Roseola

Answer 3

Sixth Disease
-rash after fever
-rose colored, BLANCHable papules
-no longer contagious when the rash appears

“6-pink-ROSEs for BLANCH- im good just getting red”

Question 4

Erythema Infectiosum

Answer 4

Fifths disease
-“slap-cheek” , lacy/net-like rash
-from the Parvovirus B19
-pregnant women usually okay
-Draw tider from exposed mom

“oh so..infectioso (with her 5 fingered lacy gloves), dont want that parvo! SLAP, so go away”

Question 5

Hand, foot, & mouth disease

Answer 5

-Coxsacki virus
-rash/ulcers start in mouth
-spreads to hands and feet
-vesicle formation/peeling

Question 6

Common causes of death:
Infants?
Age 1-4?
Older children?

Answer 6

Infants- congenital malformations

Age 1-4- Drowning

Older children- MVA’s

Question 7

newborn wt:
back to birthweight by_
Double birthweight by_
tripple birthweight by_

Answer 7

2 wks

6 months

12 months

Question 8

Precocious puberty_

Delayed puberty_

Answer 8

Precocious puberty
males < 9
females < 8

Delayed puberty_
no 2ndary sex characteristcs by age:
-14 in males
-13 in females

Question 9

live vaccines at age

Answer 9

12 months

-varicella
-MMR

Question 10

DTAP vs TDAP

what component causes fever?

age to get DTAP?

age to get TDAP?

Answer 10

Pertussis component causes fever

age to get DTAP? <7 yrs

age to get TDAP? >7 yrs

Question 11

HVP:

age of administration and why?

protects against strains_

Answer 11

9-11 years old

-we want to give before sexually active

protects against strains: 16 and 18

(6 and 11 –> genital warts)

Question 12

What will you do if you have an older child with an unclear vaccination status?

which vaccine prevents Epiglottitis in children?

Answer 12

Its Time for Many Happy Happy Vaccines

IPV
Tdap
MMR
Hep B
Hib
Varicella

-Hib (prevents Epiglottitis in children)

-consider age; are they eligible for HPV or meningitis?
(both 11-12 yrs)

The epiglottis is a flap of tissue that sits beneath the tongue at the back of the throat.

Question 13

Seborrheic Dermatitis

Answer 13

Cradle Cap
-dead skin cells
-soften w/oil or shampoo
-resolve in a few months

“SEBORdinate to let your babies DERMis get that way!”

Question 14

Hemangioma

Answer 14

-bright red spot on skin at birth
-flat or raised
-may grow initially

tx: resolves by age 4

only refer if- ulcerations or vision changes (close to eye)

“HE-MAN woman haters –> Spanky slaps forehead –> redspot

Question 15

Slate Grey Nevus (congenital Melanocytosis)

Answer 15

-blue/grey birthmark
-Lumbosacral area
-self resolve or fade
-dont mistake for bruises
-asian decent

“sitting on a SLATE- bum turns blue grey”

Question 16

Jaundice

Answer 16

-yellowing skin
-Bilirubin build-up
-initiate phototherapy when bilirubin is >15

Question 17

Varicella SS/TX

Answer 17

chicken pox
-pruritic vesicles in various stages of healing

**contagious until all lesions have crusted over

tx:
Calamine lotion, oatmeal baths

Question 18

Kawasaki disease

presentation:

tx:

Answer 18

considered a vasculitis
-fever > 5 days
-peeling rash over whole body
-“strawberry tongue”
-swelling hands/feet

Can lead to:
-inflammation in heart
(leading cause of acquired heart disease in children)

ASAP TX:
-Aspirin
-IVIG (immunoglobulin therapy)

“this Asian guy who was trying to turn kids tongue into things- ends up giving them HF instead”

Question 19

Scarlatina

Answer 19

Scarlet Fever
-complication of STREP throat

SS:
-“sandpaper” maculopapular rash
-sore throat/straberry(scarlet) tongue

TX: treat the origin (Strep)
-Amoxicillin

Question 20

Strep Throat vs. Mono

SS / TX

what if a patient has both strep throat and mono?

Answer 20

Strep ss:
-group A strep
-tonsillar exudates
-Palatal petechiae

Mono SS:
-Epstein-Barr Virus
-Enlarged Spleen
-fatigue
___________________________

Strep Tx:
antibiotics (amoxicillin)

Mono Tx:
treat symptoms

___________________________

both strep throat and mono:
DONT give any “-cillins”
-these can cause a morbiform rash (only Penicillin VK is ok)

better options=
-macrolides
-cephalosporins

Question 21

Strabismus

Answer 21

Cross-eye

-normal until 4-6 mo
-common cause of amblyopia
-not corrected = blurry/double vision

Question 22

Dacryosenosis

Answer 22

“DA baby- cant- el-CRYO”

-blocked/clogged tear duct
-warm compress
-the eye itself is CLEAR (vs in conjunctivitis- its red)

Question 23

Acute Otitis Media

typically preceded by:

s/s:

commonly caused by which bacteria?

Answer 23

typically preceded by:
-post upper respiratory infection

s/s:
-tugging ear
-bulging, erythmetous, tympanic membrane

TX:
watch 2-3 days
worse?
-amoxicillin

commonly caused by which bacteria?
Strep Pneumoniae

Question 24

Otitis Externa

commonly caused by which bacteria?

Answer 24

Swimmers ear

-red swollen outer ear
-pain with TRAGUS movement
-oderous discharge

TX:
-ofloxacin (antibiotic) drops
-Cortisporin (steroid) drops

commonly caused by which bacteria?
Pseudomonas Aeruginosa

Question 25

Coarctation of the Aorta

Answer 25

Congenital. Aorta too narrow.

-decreased femoral pulse
-BP at birth in lower and upper extremities:
– higher BP in upper, lower BP in lower
(the blood cant travel effectively)

TX: Refer

trying to COARCe the blood to come through the narrow cannal

Question 26

Genu Varum

Answer 26

Bowl legged

-should go away by 2-3 yrs old’’

Gen..U..AR….UM… walking weird

Question 27

preterm babies catch up on milestones by

Answer 27

24 months

Question 28

Leukocoria

Answer 28

white reflex in eye

could be:
-retinoblastoma
-congenital cateracts

Question 29

Anorexia

Answer 29

eating disorder that causes
-bone loss
-heart disease
-dental erosion

Question 30

Salter-Harris Fractures

Answer 30

Fractures that occur along the growth plate

-may cause stunted growth

“mike HARRISon - his injury stunted his growth”

Question 31

Hydrocele

Answer 31

Abnormal accumulation of fluid around the testes

-can occur before and right after birth

-self resolvable

water up to the testie celing

Question 32

Cholesteatoma

Answer 32

collection of skin cells deep in the ear
-“cauliflower like growth”
-effects balance/hearing

Question 33

Tempanic Membrane Rupture

Answer 33

typical pt HX: ear is hurting, hurting, hurting- then there is a sudden bloody discharge and relief

-this will heal on its own

Question 34

Vesicoureteral Reflex (VUR)

when to refer

dx tool?

Answer 34

Backflow of urin in ureter

-stage/grade 1-5
-begin referring out at stage 3
-usually resolves on its own
-DX: voiding cystogram.

Question 35

Fetal Alcohol Syndrome

Answer 35

-thin upper lip

-smooth philtrum (the vertical groove between the base of the nose and the border of the upper lip)

-low nasal bridge

Question 36

Acne

normal TX:

What if their face is getting irritated?

Answer 36

-genetics and androgens

1. Benzoyl Peroxide
2. Topical Antibiotics
3. Oral Antibiotics

What if their face is getting irritated? – decrease frequency of regimen

Question 37

Osgood-Schlatter Disease

Answer 37

Anterior tibial tubercle pain/ bone growth

-NSAIDS
-ICE

likely to outgrow once bones stop growing

Question 38

Foreign Object

Answer 38

when to suspect a nasal foreign body vs. sinusitis;

-drainage from ONE nare (nostril) only
-foul smell
-mouth breathing
-mild swelling in face
-sneezing

Question 39

Keloid and Hypertrophic Scars

Answer 39

Keloid:
Rubbery growth- extends past boarders of trauma

Question 40

Pyloric Stenosis vs Intussusception

Answer 40

Pyloris Stenosis:
-projectile vomiting
-olive shaped mass

“PYe full of olives…Bleh”

TX:
-US mass
-Refer

IntuSSusception
-jelly-like stools
-Sausage Shaped mass

TX:
-US mass
-Refer

ugh your breath is SUS! you have been eating sausage and jelly!

Question 41

Acute Suppurative Otitis Media =

Answer 41

tympanic membrane rupture

Question 42

Infants with congenital rubella often have _____

-

Answer 42

-cataracts

-Sensorineural hearing loss

-patent ductus arteriosus (PDA).
—PDA presents with a continuous machine-like murmur at the upper left sternal border.
“public display of affection- im a freaking MACHINE”

—which can cause prolonged left to right shunting and congestive heart failure

Question 43

Cystic Fibrosis

when is this dx?

how is ti dx?

s/s?

biggest goal?

Answer 43

when is this dx? <2 years old

how is ti dx?
-sweat chloride test
-genetic testing

s/s?
-cough
-wheezing
-increased mucous
-slowed growth
-salty skin

biggest goal?
-to prevent infection
(lifespan of 30 years)

Question 44

Respiratory Syncytial Virus (RSV)

s/s?

tx?

complications?

Answer 44

s/s?
-fever
-upper resp. symptoms (wheezing, rhinitis, cough, sneeze)

tx?
symptoms; antipyretics, fluids

complications?
-bronchitis
-pneumonia

Question 45

Croup

s/s?

tx?

complications?

Answer 45

s/s?
-barky cough
-stridor
—-> high pitched musical wheezing
-fever

tx?
xray—-> steeple sign
-Dexamethasone (Deladron)

complications?
worsening stridor or severe dyspnea = ED

Question 46

Pertussis

s/s?

contagion?

tx?

prevention?

Answer 46

AKA Whooping cough

s/s?
-dry-whooping cough
-can cause vomiting

contagion?
-for 2 weeks after cough begins

tx?
-Azithromycin
**antibiotics will NOT shorten length of s/s

prevention?
DTAP/TDAP (preggo’s 3rd trimester)

Question 47

Sickle Cell

when is this dx?

how is it dx?

more common in:

what happens in this type of anemia?

how can this be prevented?

Answer 47

when is this dx?
-newborn screening test

how is it dx?
-Hemoglobin Electrophoresis

more common in:
African Decent

what happens in this type of anemia?
-abnormal shaped Hemoglobin
-sickle cell Crisis—-> due to dehydration/ illness
causes intense pain

—- send to hospital for IV pain/hydration

how can this be prevented?
avoid high atmosphere pressures
avoid extreme weather
stay hydrated
take multiple breaks

Question 48

Thalassemia

this is:

dx:

commonly seen in:

complicaitons:

Answer 48

this is: Genetically inherited ANEMIA

dx: Hemoglobin Electrophoresis

commonly seen in:
southeast/Mediterranean descent

complicaitons:
-infusion dependent
-iron overload (organ injury)

Question 49

Encopresis

Nocturnal Enuresis

Answer 49

Encopresis:
Fecal incontinence after potty training

-chronic constipation after ignoring urge to go
—-colon enlarges and desensitizes

tx:
-not a quick fix
-must retrain colon

Nocturnal Enuresis:
-bed wetting
-normal when first potty training
-may be caused by stress (regression)