pediatric shelf Flashcards
normal respiratory rate for infant less than 1 year
30-53
normal respiratory rate for toddler (1-2 years)
22-37
normal respiratory rate for preschool (3-5)
20-28
normal respiratory rate for 6-11 years
18-25
normal respiratory rate for adolescent (12-15)
12-20
normal HR for neonate
100-205
normal HR for infant (1 mo- 1 year)
100-190
normal HR for toddler (1-2)
98-140
normal HR for preschool (3-5)
80-120
normal HR for school age (6-11)
75-118
normal HR for adolescent (12-15)
60-100
normal blood pressure for birth (12h, less than 1000g)
39-59/16-36
normal blood pressure for birth (12h, 3kg)
60-76/ 31-45
normal blood pressure for neonate (96h)
67-84/ 35-53
normal blood pressure for infant (1-12mo)
72-104/ 37-56
normal blood pressure for toddler (1-2year)
86-106/ 42-63
normal blood pressure for preschooler (3-5)
89-112/ 46-72
normal blood pressure for school age (5-9)
97-115/ 57-76
normal blood pressure for preadolescent (10-11)
102-120/ 61-80
normal blood pressure for adolescent (12-15)
110-131/ 64-83
what TORCHES infection is associated with chorioretinitis, hydrocephalus, intracranial calcifications
toxoplasmosis
what TORCHES infection is associated with cataracts, deafness, and PDA
rubella
what TORCHES infection is associated with hearing loss, seizures, petechial rash, blueberry muffin rash, periventricular calcifications (also hepatosplenomegaly, jaundice)
CMV
what TORCHES infection is associated with recurrent infections and chronic diarrhea
HIV
what TORCHES infection is associated with meningoencephalitis and vesicular lesions
HSV II
what TORCHES infection is associated with notched teeth, saddle nose, short maxilla, sober shins, CN VIII deafness, thrombocytopenia
syphilis
classic tetrad associated with Henoch-Schonlein purpura
lower extremity palpable purpura, LE arthralgia, abdominal pain/intussusception, renal disease
what is the most common serious complication associated with mumps
aseptic meningitis
What is the initial fluid of choice for initial resuscitation in severe hypovolemic hypernatremia
Isotonic solutions such as normal saline
What are the clinical features of iron poisoning within 30 minutes to 4 days
Abdominal pain, vomiting (hematemesis), diarrhea (melena), hypotensive shock, metabolic acidosis
What are the diagnostic findings associated with iron poisoning
Anion gap metabolic acidosis, radiopaque pills
What is the most common presentation of WILMS tumor
Asymptomatic abdominal mass
What are the clinical features associated with hemolytic uremic syndrome
Preceding bloody diarrhea, fatigue/pallor, bruising/petechiae, oliguria/edema
What are the risk factors for a neonatal displaced clavicular fracture
Fetal macrosomia, instrumental delivery, shoulder dystocia
How does herpes simplex keratitis present
Pain, photophobia, decreased vision; vesiculo-ulcerative lesions are commonly present in the corneal epithelium
What are the clinical features of scarlet fever
Fever and pharyngitis, tonsillar erythema and exudates, strawberry tongue, tender anterior cervical nodes, sandpaper rash
What is the term for transient hemiplegia following a seizure
Todd paralysis
What are the major clinical features associated with acute rheumatic fever
JONES- Joints (migratory arthritis), Carditis, Nodules (subcutaneous), erythema marginatum, Sydenham chorea
What is the characteristic murmur associated with mitral valve prolapse
Midsystolic clic with a late systolic murmur
What are some complications associated with acute otitis media
Conductive hearing loss, mastoiditis, meningitis
What are two common causes of BILATERAL acute cervical adenitis in kids
Adenovirus, EBV/CMV
What are some clinical findings specific for congenital infection with syphilis
Rhinorrhea, abnormal long-bone radiographs, desquamating or bullous rash
What is the first line treatment for scabies
Topical 5% permethrin or oral ivermectin
What are the major characteristics of Kawasaki disease
Fever greater than 5 days duration, mucous membrane changes, extremity changes, nonexudative conjunctivitis, cervical LN greater than 1.5 cm, and a polymorphous rash
What is McCune-Albright syndrome characterized by
Peripheral precocious puberty, irregular cafe-au-lait macules, and fibrous dysplasia of the bone
What is the first line treatment for tinea Corporis (ringworm)
Topical antifungals (clotrimazole, terbinafine)
What is the characteristic finding with a vascular ring
Presents in infants with a biphasic strider that improves with neck extension
How do medulloblastomas typically clinically present
Vomiting, headache and ataxia
What is the primary medication for preeclampsia treatment
Magnesium sulfate
How does necrotizing enterocolitis typically present
Abdominal distension, bloody stools and vital sign instability in premature infants
What are some contraindications to receiving the rotavirus vaccine
Anaphylaxis to vaccine ingredients, Hx of intussusception, hx of uncorrected congenital malformation of the GI tract, SCID
What treatment is recommended for strawberry hemangiomas that are complicated
Beta blockers
What is the definitive diagnosis of vesicoureteral reflux made by
Voiding cystourethrogram
What is the most common cause of chronic renal insuffficiency/failure in kids
Posterior urethral valves
What is the first and second step for evaluation of primary amenorrhea
First is to get pelvic US to determine the presence/absence of a uterus; second step is to obtain an FSH level (distinguishes between central and peripheral causes of amenorrhea)
What is becks triad and what is it assocaited with
Progression to tamponade: distant heart sounds, distended jugular veins, and hypotension
What is the first line treatment for whooping cough
Macrolides
What is the classic clinical presentation associated with hereditary spherocytosis
Hemolytic anemia, jaundice, splenomegaly
What are complications associated with Kawasaki disease
Coronary artery aneurysms; Myocardial infarction and ischemia
What is seen on chest X-ray with transient tachypnea of the newborn
Bilateral perihilar linear streaking
What are the clinical findings associated with Fanconi anemia
Short stature, hypo/hyperpigmented macules, abnormal thumbs, GU malformations
What are the lab findings associated with Fanconi anemia
Pancytopenia, positive chromosomal breakage testing
What are the things included in CHARGE syndrome
Coloboma, heart defects, atresia choanae, retardation of growth/development, GU anomalies, and ear abnormalities/deafness
How does perianal streptococcus present on examination
Bright, sharply demarcated erythema over perianal/perineal area
What are the clinical features associated with BREASTFEEDING jaundice
Suboptimal breastfeeding, signs of dehydration
What are the clinical features of BREAST MILK jaundice
Adequate breastfeeding, normal exam
What is the treatment of breastfeeding jaundice in otherwise healthy, full-term newborns
Increase the frequency and duration of feeds
What are the clinical findings associated with Diamond-Blackman anemia
Craniofacial abnormalities, triphalangeal thumbs, increased risk of malignancy
What are the lab findings with diamond-blackfan anemia
Macrocytic anemia, reticulocytopenia, normal platelets/WBC
What is the characteristic murmur associated with VSD
Holosystolic at the left lower sternal border
What are the classic manifestations of serum sickness
Fever, urticaria, and polyarthralgia with no mucosal involvement after admin of beta lactams or trimethoprim-sulfamethoxazole
What are some distinguishing features of homocystinuria when compared to Marfan syndrome
AR, intellectual disability, thrombosis, downward lens dislocation, megaloblastic anemia, fair complexion
common antibiotics given for outpatient pneumonia
doxy, azithromycin, moxifloxacin
common antibiotics given for neutropenic fever
4th generation cephalosporin (cefepime), carbapenems
common antibiotics for cellulitis
cefazolin, bacterium, clindamycin, IV vanco
what vaccines are given at 2 months and 4 months
Rota, DTap, HIB, PCV, IPV
what vaccines are given at 6 months
Hep B number3; number 3 for Rota, DTap, HIB, PCV
what vaccines are given at 12 months
PCV number 4; number 1 varicella and Hep A
what vaccines are given at 15 months
Tap number 4, HIB number 4, IPV number 3, MMR number 1
what vaccine is given at 18 months
Hep A number 2
what vaccine is given at 4-5 years
Dtap number 5, IPV number 4, MMR number 2, varicella number 2
when is Meningitis number 1 and 2 given
11-12 years and 16-18 years
What are the most common sites of osteonecrosis (avascular necrosis) associated with sickle cell disease
Humeral and femoral heads
What diagnostic testing can confirm adenovirus infection
PCR testing
What is the diagnosis associated with inspiratory stridor that worsens when supine and peaks at age 4-8 months
Laryngomalacia
What is the clinical diagnosis associated with limited upward gaze, upper eyelid retraction (collier sign), and pupils that are non-reactive to light but reactive to accomodation
Parinaud syndrome (dorsal midbrain syndrome)
What are the examination and X-ray findings associated with transposition of the great vessels
Singles S2 and possible VSD murmur; Egg on a string heart (narrow mediastinum)
What are the exam and x-ray findings associated with tetralogy of fallot
Harsh pulmonic stenosis murmur and VSD murmur; boot shaped heart (right-sided ventricular hypertrophy)
What are the exam and x-ray findings associated with tricuspid atresia
Single S2 and VSD murmur; minimal pulmonary blood flow
What are the exam and x-ray findings associated with truncus arteriosus
Single S2, systolic ejection murmur (increased flow through truncal valve); increased pulmonary blood flow, edema
What are the exam and x-ray findings associated with total anomalous pulmonary venous return with obstruction
Severe cyanosis and respiratory distress; pulmonary edema, snowman sign (enlarged supracardiac veins and SVC)
What is the procedure of choice for diagnosis and treatment of intussusception
Ultrasound guided air contract enema
What are the diagnostic tests to confirm Chronic granulomatous disease
Dihydrorhodamine 123 test or nitro blue tetrazolium test
What diagnosis should be expected in a cyanotic infant with left axis deviation and small or absent R waves in the precordial leads
Tricuspid valve atresia
What may physical exam reveal as leg calve perthes disease progresses
Limited internal rotation and abduction of the hip
What is the treatment for mild and moderate/severe croup
Mild treatment with humidified air plus/minus corticosteroids; for moderate/severe treat eight corticosteroids and nebulized epinephrine
How does midgut volvulus typically present
In a neonate with bilious vomiting
What are common laboratory findings with juvenile idiopathic arthritis
Elevated inflammatory markers, hyperferritinemia, hypergammaglobulinemia, thrombocytosis, anemia
What is the most common cause of death in freidrich ataxia
Cardiac dysfunction related to cardiomyopathy
What immunodeficiency should you think of when there is recurrent skin and mucosal bacterial infections and no pus as well as poor wound healing
Leukocyte adhesion deficiency
What is the treatment for methemoglobinemia
Methylene blue
How does ASD typically present
Fixed, split S2 and/Or systolic ejection murmur at the left upper sternal border
What infections are common with CGD
Catalase positive pathogens (staphylococcus aureus, serratia, Burkholderia, aspergillus)
What are some complications (risks) associated with infants that are small for gestational age
Hypoxia, perinatal asphyxia, meconium aspiratio, hypothermia, hypoglycemia, hypocalcemaia, polycythemia
What is the treatment of choice for enterobius vermicularis (pinworm)
Pyrantel pamoate or albendazole
What is deficient in Wiskott-Aldrich syndrome
Impaired cytoskeletal changes in leukocytes, platelets
What is the most common complication associated with sickle cell trait
Hematuria
What two comorbidities are common with Tourette syndrome
ADHD and OCD
What are the lab findings with Reye’s syndrome
Elevated transaminases, coagulopathy (prolonged PT, INR, PTT) and hyperammonemia
What are some common complications of prematurity
RDS, PDA, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing entercolitis, retinopathy of prematurity
What is the classic triad associated with biliary cysts
Pain, jaundice, and palpable mass
What is the antidote for TCA or aspirin overdose
Sodium bicarbonate
What is the treatment (first line) for Tourette syndrome
Behavioral therapy followed by antidopaminergic agents (tetrabenazine, antipsychotics) and alpha 2 adrenergic receptor agonists
What maneuver is likely to increase the intensity of a hypertrophic cardiomyopathy
Valsalva maneuver
What are the lab findings with hereditary spherocytosis
Increased MCHC, spherocytosis on peripheral smear, negative Coombs test, increased osmotic fragility on acidified glycerol lysis test, abnormal eosin-5-maleimide binding test