Pediatric Shelf

Question 1

What are the risk factors for neonatal sepsis?

6

Answer 1

1. Prematurity
2. Chorioamnionitis
3. Intrapartum fever
4. Maternal leukocytosis
5. Prolonged rupture of membranes (>18hrs)
6. GBS+ mom

Question 2

Treatment of neonatal sepsis? (2)

Answer 2

usually due to GBS, Listeria, and Ecoli

1. Amp + gent until 48 hour b/c are neg
2. Cefotaxime + AMP if meningitis is suspected

Question 3

If you see in newborn: limb hypoplasia, cutaneous scars, cataracts, chorioretinitis, cortical atrophy what was the baby infected with?

Answer 3

Congenital Varicella – mother infected 1st or 2nd trimester. If mom is exposed 5 days before–2 days after delivery, baby gets VZIG.

52-VZ (roman numerals– David Box)

Question 4

Treatment of Gonococcal conjunctivitis in Newborn?

Answer 4

topical erythromycin and IV 3rd gen ceph

Question 5

Treatment of chlamydia conjunctivitis? Complications of infection? How does that present – clinical signs and CXR?

Answer 5

oral erythromycin.

Complication: Chlamydial pneumoia = cough, nasal drainage, scattered crackles and bilateral infiltrates on CXR

Question 6

If you see on NB: Omphalocele, Rocker-bottom feet/hammer toe, microcephaly, and clenched hand

Answer 6

Edward’s Syndrome (Trisomy 18)

Question 7

If you see on NB: holoprosencephaly, severe mental retardation and microcephaly, cleft lip/palate, multiple others

Answer 7

Patau’s syndrome (Trisomy 13)

Question 8

14 yo old girl with no breast development, short stature, and HIGH FSH

Answer 8

Turner syndrome
(high FSH because of "ovarian failure"-- streak ovaries)

Question 9

Kid with: Mandibular hypoplasia, glossoptosis, cleft soft palate. W/ Fetal alcohol syndrome or Edwards

Answer 9

Pierre Robin sequence ( Bird facies)

- tongue falls back into throat: glossoptosis– airway obstruction caused by backwards displacement of tongue base.

Question 10

Kid with: broad, square face, short stature, self-injurious behavior. deletion of chr 17.

Answer 10

Smith Magenis

Question 11

IUGR, hypertonia, distinctive facies, limb malformation, self-injurous behavior, hyperactive

Answer 11

Cornelia de Lange

Question 12

Autosomal dominant, or associated with advanced paternal age. Short palpebral fissures, white forelock and deafness

Answer 12

Waardenburg syndrome

Question 13

contraindications for MMR vaccine?

Answer 13

Neomycin or streptomycin allergy

Question 14

Systolic murmur, 2/6, soft, vibratory and musical, heard best at lower mid-sternum. If patient sits up or stands up, murmur disappears.

Answer 14

Stills murmur

- 2-6 year olds, sometimes infants, sometimes older

Question 15

Murmur heard best in anterior neck, disappears when jugular vein is compressed; blowing, roaring, wheezing, distant-sounding continuous murmur with diastolic accentuation.

Answer 15

Venous hum

-2-6 years old, rarely younger

Question 16

Cyanosis at birth with holosytolic murmur, depends on VSD or ASD for life. EKG shows LVH

Answer 16

Tricuspid Atresia

- give PGE1 until surgery

Question 17

Fine, mac-papular desquamating rash begins on chest and spreads to neck, trunk, and extremities + strawberry tongue. Sore throat 1-2 weeks prior. What is this an how do you treat it?

Answer 17

Scarlett fever – Group A strep

Tx: Penicillin prevents rheumatic fever ( won’t help reduce change of APSGN – acute post-streptococcal glomerulonephritis)

Question 18

Treatment of lyme for a kid 8yo

Answer 18

8 yo = doxycycline

If meningitis = IV ceftriaxone

Question 19

Treatment of scabies?

Answer 19

5 % permetrin for whole family

Question 20

Treatment of impetigo

Answer 20

topical muciprocin if localized

Question 21

Treatment for Staph scaled skin syndrome from exfoliative toxin

Answer 21

IV oxacillin or naficillin

Question 22

Inflamed conjunctiva and multiple blisters with positive Nikolay’s sign is what kid of illness?

Answer 22

Staph scalded skin syndrome

Question 23

vaccination and prophylaxis for Sickle cell patients

Answer 23

23 valent pneumococcal vaccine at age 2.
Hib and N. meningitides.

Penicillin prophylaxis from 2 mo until age 6 years.

Question 24

treatment of HUS

Answer 24

early peritoneal dialysis w/ aggressive nutrition (TPN)

Question 25

Treatment of RSV? (2)

Answer 25

Ribavirin ( inhibits synthesis of guanine nucleotides by competitively

Palivizumab – monoclonal antibody used for prophylaxis in children especially those