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Clerkship Prep > Pediatric Specific > Flashcards

Pediatric Specific Flashcards

1
Q

BRUE looks like

A

Cyanosis/pallor, breathing changes, marked change in tone, altered level of responsiveness

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2
Q

Subdural hematoma in an infant

A

Violent shaking, accidental trauma, rare delivery complication, often you can see retinal hemorrhage too

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3
Q

Non accidental head trauma

A

Violent shaking, throwing, blunt trauma, can have subdural hemorrhage, often there will be retinal hemorrhage

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4
Q

Suspicious fracture in ped

A

Multiple at diff stages, femur or tibia in non walking child, posterior rib fracture, skull fracture

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5
Q

Calorie requirement of term infant

A

100-120 kcal/kg/day

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6
Q

Daily weight gain for a term infant

A

20-30g/day

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7
Q

Neonatal acne

A

Neonatal cephalic pustulosis (inflammatory, due to yeast)

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8
Q

Vitamin D supplementation in infants

A

400 IU per day til 12 months

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9
Q

Absence of a symmetric red reflex in infants DDx

A

Cataracts, glaucoma, retinoblastoma, chorioretinitis

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10
Q

DDx for RUQ mass in infant

A

Hepatic neoplasm, hydronephrosis, neuroblastoma, teratoma, wilms tumour

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11
Q

APGAR score categories

A 
Appearance (skin colour)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
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12
Q

Symmetric IUGR

A

Head, length, weight are decrease proportionately

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13
Q

Asymmetric IUGR

A

Greater decrease in length/weight without affecting the head

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14
Q

Causes of asymmetric IUGR

A

Poor delivery of nutrition to the fetus

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15
Q

Primitive reflexes in infant

A

Rooting, sucking, Moro/startle, asymmetric tonic neck, palmar and plantar grasps, stepping

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16
Q

Preventing hemorrhagic disease of the newborn

A

Admin vitamin K at birth

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17
Q

Infants born to hep B positive moms should

A

Receive hep B Ca vine and hep b IvIg within 12 hrs of delivery

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18
Q

Routine newborn medications

A

Vitamin K, Hep B vaccination, erythromycin on the eyes

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19
Q

Signs of heroin withdrawal in the newborn

A

High pitched cry, tremulous, hypertonicity, feeding difficulty

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20
Q

Examples of live attenuated vaccines

A

MMR, varicella

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21
Q

After a live vaccine, when can you expect a fever?

A

6-14 days post immunization

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22
Q

Inactivated, subunit, or toxoid vaccines: when can you expect a fever post vac?

A

A few days later

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23
Q

Bacterial meningitis (gluc, protein, WBC, type, gram)

A

Glucose low, protein high, WBC high, PMN, + or - gram stain

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24
Q

Viral meningitis (gluc, protein, WBC, type, gram)

A

Normal glucose, normal protein, WBC high or slightly high, lymphocytes, negative gram stain

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25
Q

Pyelonephritis in a healthy kid is usually which organism?

A

E Coli

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26
Q

Ampicillin/gentamycin is a good choice to treat infections by which organism?

A

Enterococcus infection

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27
Q

Meropenem may be indicated for UTI if

A

Increasing resistance due to extended-spectrum beta-lactamases

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28
Q

Ciprofloxacin can be used in which cases of UTI

A

Complicated UTI with resistant organisms

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29
Q

Cephalexin (keflex) covers

A

EColi and other enteric gram neg rods

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30
Q

Nitrofurantoin cannot treat

A

Pyelo, only UTI

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31
Q

Most likely precursor infection to serious bacterial illness in kids

A

UTI

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32
Q

Left shift towards more immature WBCs (reticulocytes) can increase the likelihood that a child has

A

A serious bacterial illness

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33
Q

Pyuria defined

A

> 5 WBC per HPF

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34
Q

Nitrite test is positive when

A

Gram negative bacteria are present (E coli, klebsiella, proteus)

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35
Q

Positive leukocyte esterase indicates

A

Presence of WBC in the urine

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36
Q

Voiding cystourethrogram is recommended in a child

A

With abnormal ultrasound, hydronephrosis, second febrile UTI

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37
Q

Chest xray to rule out pneumonia if

A

Resp findings, and or WBC >15000

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38
Q

Occult bacteremia

A

Positive blood culture in a well appearing kid, usually wont develop into something bad

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39
Q

Viral meningitis is commonly caused by

A

Enterovirus

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40
Q

Rosella is caused by what virus

A

HHV6

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41
Q

Roseola treatment

A

Symptomatic only

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42
Q

HSV gingivostomatitis rash

A

Oral lesions that start as vesicles and evolve to ulcerations

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43
Q

AOM physical exam findings

A

Poor mobility and bulging of the tympanic membrane, with erythema

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44
Q

Best prevention against transmission of viral Gastroenteritis

A

Good hand washing

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45
Q

Fluid therapy for severe dehydration

A

Repeated NS boluses 10-20ml/kg until th patient has improved

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46
Q

Maintenance fluids in a dehydrated person should be

A

Isotonic solutions - 0.9% NS, lactated ringers, balanced electrolyte solution

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47
Q

ORT maintenance for mild-moderate dehydration

A

50-100ml/kg over 2-4 hours to correct fluid deficit

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48
Q

ORT with vomiting

A

2ml/kg for each emesis

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49
Q

ORT with diarrhea

A

10ml/kg for each loose stool

50
Q

Kerinicterus is

A

Staining of the basal ganglia and cranial nerve nuclei by bilirubin

51
Q

A patient presenting with kerinicterus on examination looks like

A

Abnormal tone and reflexes, choreoathetosis, tremor, paralysis, SNHL, cognitive impairment

52
Q

Risk factors for bilirubin toxicity

A

Asphyxia, temp instability, sepsis, metabolic acidosis, albumin <3, prematurity

53
Q

Pregnant ABO incompatibility can be an issue when

A

Mom is type O, cause anti A and anti B are predominantly IgG and can cross the placenta

54
Q

ABO incompatibility and hemolysis in pregnant woman is more significant with a positive

A

Direct Coombs test

55
Q

Physiologic jaundice has total bilirubin less than

A

15mg/dl

56
Q

Factors contributing to physiologic jaundice of a newborn

A 
Increased bilirubin production
Deficiency of ADPGT
Lack of flora to metabolize bile
High B-gluc in meconium
Minimal oral intake and slow passage of meconium
57
Q

Breastfeeding jaundice due to

A

Low intake and decreased GI motility leading to retention of meconium

58
Q

Breast milk jaundice is due to

A

B-gluc in breast milk deconjugates bilirubin in the intestinal tract

59
Q

Test for jaundice being caused by hemolysis with what test

A

DAT (Coombs test)

60
Q

Antibody positive hemolysis due to

A

RH incompatibility, ABO incompatibility, minor antigen incompatibility

61
Q

Non hemolytic RBC breakdown jaundice of newborn

A

Bruising from birth trauma, hemorrhage, polycythemia, swallowed blood during delivery

62
Q

Crigler Najjar syndrome

A

AR condition with severe unconjugated hyperbilirubinemia in the first few dace of life from lack of UDPGT (can lead to kerinicterus)

63
Q

Gilbert syndrome

A

AR resulting in decreased enzyme function so that the conjugation of bilirubin is slowed. The hyperbilirubinemia is self resolving and intermittent.

64
Q

Jaundice due to hypothyroid

A

Combo of decreased rate of bili conjugation, decreased gut motility, and impaired feeding

65
Q

Typical BF baby feeds how often

A

8-12 times in 24 hours

66
Q

What age can infants start to drink cows milk

A

12m

67
Q

Major carb in breast milk

A

Lactose

68
Q

Ethnic groups associated with G6PD def

A

Mediterranean and west African

69
Q

Hyperbilirubinemia with G6PD deficiency occurs as a result of

A

Decreased bilirubin conjugation

70
Q

Biliary atresia signs in infant

A

Jaundice, dark urine, acholic stools

71
Q

Biliary atresia is treated with

A

Kasai procedure. Anastomoses of the intrahepatic bile ducts to a loop of intestine so bile drains directly into intestine

72
Q

Cephalohematoma

A

Subperiosteal hemorrhage localized to one cranial bone

73
Q

Caput succedaneum

A

Edematous swelling over the presenting position of the scalp, boggy swelling crossing the suture line

74
Q

Phototherapy

A

Makes unconjugated bilirubin more soluble so it can be excreted in bile and urine without conjugation

75
Q

Vit D supplementation in newborns

A

400 IU a day within days of birth

76
Q

Increasing direct bilirubin at two weeks of life might be

A

Biliary atresia or alpha 1 antitrypsin deficiency

77
Q

Cocaine effect on placenta

A

Causes vasoconstriction leading to placental insufficiency and low birth weight

78
Q

Small for gestational age is detected at

A

Birth

79
Q

IUGR is noted

A

During pregnancy

80
Q

Percentile for SGA

A

<10th %

81
Q

Cause of infant hydronephrosis

A

Obstrucyion at the ureteropelvic junction, multicystic kidney

82
Q

Painless mass in neck, chest, abdo, usually before the age of 2. Fever, pallor, and weight loss are common.

A

Neuroblastoma

83
Q

Wilms tumour median age of diagnosis

A

3 years

84
Q

Breath holding spells occur during

A

Expiration

85
Q

Tet spells are

A

Acute episodes of cyanosis associated with a drop in pulmonary blood flow

86
Q

Most common respiratory bug that causes apnea

A

Respiratory syncytial virus (RSV) infection

87
Q

Rapid response protocol in pediatrics

A

Call team, gather ppl and equipment, IV, head CT, call peds ICU for transfe

88
Q

Retinal hemorrhages in infant with head trauma

A

Highly suggestive of abusive head trauma

89
Q

Respiratory distress syndrome is due to

A

Deficiency of lung surfactant and delayed lung maturation

90
Q

Transient tachypnea of the newborn is due to

A

Delayed clearance of fluid from the lungs following birth

91
Q

TTN is most common in newborns born

A

By c section, and to diabetic mothers

92
Q

CHF in a newborn is usually due to

A

A congenital heart defect

93
Q

Symptoms of a coarctation of the aorta arise when

A

The ductus arteriosus closes at 1-3 days of life

94
Q

Perfect APGAR score

A

Heart rate more than 100, resp good and infant crying, tone well flexed, coughs or sneezes, baby is completely pink

95
Q

Average newborn sleep

A

15-18 hours per day

96
Q

Average number of breast feeds per day

A

8-12

97
Q

Tracheoesophageal fistula presents with

A

Copious oral secretions and choking, coughing, vomiting with feeding

98
Q

Diagnosis of tracheoesophageal fistula can be confirmed by

A

Insertion of an NG tube which encounters resistance at the proximal esophageal pouch

99
Q

Pts with fragile x syndrome life expectancy is

A

Normal

100
Q

The most common cause of eye discharge in infants is

A

Congenital nasolacrimal duct obstruction (aka dacryostenosis)

101
Q

Management of nasolacrimal duct obstruction in infants is with

A

Lacrimal sac massage with downward pressure performed several times daily to open the duct

102
Q

Gonooccal eye infection most commonly presents at how old

A

2-5 days of life

103
Q

Viral conjunctivitis presents with

A

Clear/mucoid discharge and red conjunctiva often associated with a viral prodrome (fever and congestion, etc)

104
Q

Blood streaked stool in infant less than 6m is commonly due to (2)

A

Anal fissures, protein-induced allergic-proctocolitis

105
Q

First line therapy for acute otitis media in children is

A

Amoxicillin

106
Q

Treating pediatric labial agglutination

A

Twice daily topical estrogen cream up to 4 weeks

107
Q

HIV antibody testing for infants born to infected mother

A

Done at 12-15 months and again at 18m if necessary

108
Q

Infants born to hep B infected moms

A

Treated with HbIG and their first hep B immunization within 12 hours of birth, followed by later doses and testing

109
Q

Which immunoglobulins can cross the placenta

A

IgG

110
Q

Management of neonatal sepsis

A

Ampicillin and gentamycin plus or minus acyclovir

111
Q

Osteomyelitis in kids commonly caused by what bug

A

Staph aureus

112
Q

Treat osteomyelitis with

A

Vanco

113
Q

Biggest risk factor for bed wetting

A

Family history

114
Q

Milia rubra, often seen in infants, is also known as

A

Heat rash

115
Q

Pityriasis rosea has two characteristic rash signs

A

Initial herald patch, followed by a most diffuse spotty rash

116
Q

Rash that goes with acute rheumatic fever

A

Erythema marginatum

117
Q

Idiopathic avascular necrosis of the femoral head in a young child is called

A

Legg-calve-perthes disease

118
Q

When does scoliosis usually present?

A

Around age 10, with periods of rapid growth

119
Q

When should the first well infant/postpartum visit occur?

A

Around the 1 week mark

120
Q

What % of birth weight is normal to lose in the first week of life?

A

10%

121
Q

What language milestone should a 1 year old meet?

A

Speaking a few words, 3 or more

122
Q

What age can solids be introduced?

A

Between 4 and 6 months of age

Clerkship Prep (34 decks)

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