Pediatrics Flashcards

Question 1

Q

Sick neonate evaluation

Answer

A

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Question 2

Q

Congenital heart dis, what are the indications for intubation?

Answer

A

Profound dyspnea Lethargy Safety in transport Anticipated apnea with prostaglandin infusion

Question 3

Q

What are three ductal-dependent cyanotic congenital heart lesions?

Answer

A

<ol> <li>Tetralogy of Fallot,</li> <li>Tricuspid atresia,</li> <li>Pulmonic atresia or stenosis</li> </ol>

Question 4

Q

<ul> <li>Name three metabolic complications that patients are at risk for following drowning and/or accidental hypothermia:</li> </ul>

Answer

A

<ul> <li>Rhabdomyolysis,</li> <li>hyperkalemia,</li> <li>hypokalemia,</li> <li>hypoglycaemia,</li> <li>acidosis,</li> <li>DIC</li> </ul>

Question 5

Q

<ul> <li>Name three indications for ECMO in a patient with accidental hypothermia:</li> </ul>

Answer

A

<ol> <li>Prehospital cardiac instability (arrest),</li> <li>systolic BP <90mmHg,</li> <li>ventricular arrhythmias,</li> <li>core temperature < 28 degrees</li> </ol>

Question 6

Q

ED preparation for imminent labor:

Answer

A

<ul> <li>Move patient to resuscitation room,</li> <li>get ED delivery bundle (towels, kelly clamps, scissors, ring forceps, umbilical cord clamp, etc),</li> <li>prepare infant warmer,</li> <li>call for help</li> </ul>

Question 7

Q

Important questions to ask in NRP

Answer

A

Term or not How many babies Any complication during pregnancy No of previous pregnancies PMH

Question 8

Q

<ul> <li>You successfully deliver the baby after reducing a tight nuchal cord. Babe does not make any spontaneous cries and in fact seems a bit blue. What are the first 4 actions you would take in management?</li> </ul>

Answer

A

<ul> <li>Dry, stimulate, clear and position the airway, place in the warmer</li> </ul>

Question 9

Q

<ul> <li>Baby’s HR is 90bpm: what 3 interventions would you perform next?</li> </ul>

Answer

A

<ul> <li>PPV with BVM at 30-60 breaths/min,</li> <li>apply O2 sat probe,</li> <li>apply ECG monitors for accurate HR monitoring</li> </ul>

Question 10

Q

<ul> <li>At what point would chest compressions be started and at what rate?</li> </ul>

Answer

A

<ul> <li>HR < 60bpm, 3:1 with respirations;</li> <li>advanced airway strongly recommended</li> </ul>

Question 11

Q

NRP

Answer

A

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Question 12

Q

<ul> <li>What is the compression rate in children?</li> </ul>

Answer

A

<ul> <li>100-120/minute (same as adults)</li> </ul>

Question 13

Q

What is the recommended depth for compressions?

Answer

A

1/3 AP chest diameter (4cm infants, 5cm children)

Question 14

Q

What is the compression:ventilation ratio if no advanced airway is in place?

Answer

A

30:2 single rescuer, 15:2 two rescuer If advanced airway: one breath every 2-3 seconds with continuous compressions (NEW in 2020)

Question 15

Q

Peds assessment

Answer

A

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Question 16

Q

Name three features of the paediatric airway that differ from the adult airway

Answer

A

smaller diameter, smaller mandible, large occiput, large tongue, anterior larynx, long epiglottis, angular vocal cords, highly compliant trachea, short trachea

Question 17

Q

What is the formula for estimating ET tube size?

Answer

A

age/4+4 (uncuffed traditionally) • AAP/PALS now recommends cuffed ET tubes to decrease the need for tube changes

Question 18

Q

Name five non-infectious causes of stridor:

Answer

A

anaphylaxis, foreign body, subglottic hemangioma, laryngomalacia, tracheomalacia, tumor

Question 19

Q

Croup, indicationd for admission

Answer

A

Ongoing increased WOB, respiratory distress, or stridor 4hrs after steroid administration or repeated doses of epinephrine

Question 20

Q

Epiglotis enlargement, name 2 non-infectious causes:

Answer

A

Steam inhalation Caustic ingestion

Question 21

Q

Epiglotitis, common bacteria?

Answer

A

Strep pneumoniae Strep pyogenes Staph aureus (Used to be H.influenzae type B)

Question 22

Q

What are indications on history of potentially severe asthma exacerbation? Name five:

Answer

A

Previous life threatening exacerbations, previous ICU admission, previous intubation, deterioration while on steroids, use of 2 or more salbutamol canisters in a month, cardiopulmonary or psychiatric comorbidities

Question 23

Q

What are the components of the PRAM score?

Answer

A

suprasternal indrawing, scalene retractions, wheeze, air entry, oxygen saturation

Question 24

Q

What medications are evidence based treatment for severe asthma exacerbations? Name 3:

Answer

A

continuous nebulized salbutamol, three doses nebulized atrovent, IV steroids (methylprednisolone 1mg/kg or hydrocortisone 8mg/kg), (IV fluid bolus), IV MgSO4 (40-50mg/kg over 20min, beware BP)

Question 25

Q

What other medications might you consider if nothing is helping?

Answer

A

IM epinephrine (anaphylaxis dosing), BiPAP/HFNC, IV salbutamol, subdissociative dose ketamine, heliox

Question 26

Q

What are the admission criteria for asthma exacerbation?

Answer

A

• ongoing need for supplemental O2 • persistently increased WOB • beta agonist needed more frequently than q4h after 4-8hrs of treatment • deterioration on systemic steroids

Question 27

Q

What are the discharge criteria for asthma exacerbation?

Answer

A

• O2 sat > 94% on RA • minimal or no respiratory distress • improved air entry • beta agonist use > q4h after 4-8 hours of treatment

Question 28

Q

Severe resp distress,Name 5 specific pieces of information you wish to obtain on history

Answer

A

Term delivery? NICU stay? Known cardiopulmonary issues? Recent hospitalizations? Vaccination status? History of recent fever? Feeding? Making urine?

Question 29

Q

When would you consider a CXR in this patient?

Answer

A

Unclear diagnosis, focal lung findings, response to treatment is not as expected, ‘toxic’ appearance, severe respiratory distress

Question 30

Q

Bronchiolitis,What initial treatments would you offer in the emergency department?

Answer

A

Nasal suctioning, observation, oxygen therapy if needed

Question 31

Q

What treatments would you NOT use for bronchiolitis? Name 4:

Answer

A

Salbutamol, ipratropium bromide (atrovent), inhaled corticosteroids, systemic corticosteroids, antibiotics

Question 32

Q

What are 3 risk factors for severe bronchiolitis?

Answer

A

Age <2mo, history of prematurity, underlying cardio-respiratory disease or immunodeficiency

Question 33

Q

What are admission criteria for bronchiolitis? Name 4:

Answer

A

Ongoing moderate to severe respiratory distress, need for supplemental O2 to maintain sats >90%, cyanosis or history of apnea, dehydration/poor fluid intake, infant at high risk for severe disease, family unable to cope

Question 34

Q

What elements on history and physical examination are highly suggestive of true seizure activity? Name 3:

Answer

A

Lateralized tongue biting, flickering eyelids, dilated pupils, blank stare, lip smacking, increased HR and BP during event, post-ictal phase

Question 35

Q

Simple febrile seizure:

Answer

A

Age 6mo-5yrs, associated with elevated temperature greater than 38, single seizure in 24hrs, generalized, lasts <15 min, post-ictal with return to baseline (usually within 1 hour), and normal neurological exam

Question 36

Q

What are 3 features of a complex febrile seizure?

Answer

A

Focal seizure, seizure lasting greater than 15 minutes, multiple seizures in 24 hours

Question 37

Q

Status epilepticus:

Answer

A

seizure lasting >5min (and/or ongoing seizure on arrival to ED) OR 2 or more consecutive seizures without a return to baseline in between

Question 38

Q

Status Epilepticus • What are your first steps in management? Name 5

Answer

A

Supplemental oxygen, airway assessment, IV access, cardiac monitors, administration of benzodiazepines, check the glucose and treat hypoglycemia

Question 39

Q

You are not able to obtain IV access. Name two different drugs and three different routes of administration you could use:

Answer

A

• IM midazolam 0.2 mg/kg (max 10mg) • intranasal midazolam 0.2mg/kg (max 5mg/nare) • rectal diazepam 0.5mg/kg (max 20mg)

Question 40

Q

The seizure continues after you administer IM midazolam and IV midazolam. Name two medications other than benzodiazepines you could administer next:

Answer

A

fosphenytoin 20mg/kg IV (1st); levetiracetam 60mg/kg/dose (1st); phenytoin 20mg/kg (2nd); phenobarbital 20mg/kg IV (2nd)

Question 41

Q

What is the risk of epilepsy for this child?

Answer

A

2% after simple febrile seizure and 5% after complex febrile seizure (compared to 1% in the general population)

Question 42

Q

Seizure DDx:

Answer

A

Breath holding spell, BRUE, hyponatremia, sepsis, meningitis, hypoglycaemia, metabolic disorders, trauma (accidental or non accidental), bleeding disorder, mass lesion

Question 43

Q

What are high risk factors on history and physical that should prompt consideration of imaging? Name 3:

Answer

A

• Focal seizure or persistent seizure activity • Focal neurologic deficit • VP shunt • Neurocutaneous disorder • Signs of elevated ICP • History of trauma • Immunocompromise • Hypercoagulable state or bleeding disorder

Question 44

Q

Name two surgical causes of abdominal pain in each age group:

Answer

A

• Neonates (0-30d): • Malrotation, NEC, Hirschsprung • Infant and toddler (1mo - 2yrs): • Pyloric Stenosis, Intussusception • Young child - older (2 yrs and up): • Appendicitis, Obstruction

Question 45

Q

Name 4 non-abdominal causes of paediatric abdominal pain:

Answer

A

Pneumonia, AOM, pharyngitis, DKA, HSP, testicular torsion

Question 46

Q

Name 4 non-abdominal causes of vomiting:

Answer

A

Intracranial mass, meningitis, strep throat, pneumonia, myocarditis, DKA

Question 47

Q

Best measures to predict 5% dehydration:

Answer

A

prolonged capillary refill, abnormal skin turgor, and tachypnea

Question 48

Q

Oral rehydration indicated for children with “mild” or “some” dehydration

Answer

A

Rehydrate with pedialyte or dilute juice: 1mL/kg q 5min; goal for 30mL/kg in first hour and 50-100mL/kg within 2-4hrs • Give single dose zofran and start rehydration after 15min

Question 49

Q

Noah is in his mother’s arms looking very limp and his skin is pale with mottled extremities. Name five non-infectious causes of this presentation:

Answer

A

Trauma, heart disease, hypovolemia, endocrine emergency, electrolyte abnormality, inborn error of metabolism, seizure, toxin

Question 50

Q

What three management steps do you want to take first?

Answer

A

(Call for help, get the Broselow out), Monitors, IV access (or IO), supplemental O2, check a sugar, get ECG

Question 51

Q

What are the recommendations for glucose administration in children?

Answer

A

• 0.5-1g/kg IV or IO: use D25W (2-4mL/kg age >1year) or D10W (5-10mL/kg in infants) • Follow bolus with an infusion of D10W at maintenance

Question 52

Q

What are some common signs of neonatal sepsis? Name 4:

Answer

A

Jaundice, hepatomegaly, poor feeding, irritability, hypoglycaemia, respiratory distress, vomiting

Question 53

Q

What are the 3 most common bacteria implicated in neonatal sepsis?

Answer

A

Group B strep, E.coli, Listeria

Question 54

Q

What are 3 risk factors for neonatal sepsis?

Answer

A

Prematurity, low birth weight, maternal GBS positive, prolonged ruptured membranes

Question 55

Q

Neonatal Sepsis,What antibiotics will you order

Answer

A

• IV ampicillin • IV gentamicin • +/- IV cefotaxime (if suspected meningitis) • Consider IV acyclovir

Question 56

Q

Fever 29-60 days old,if stable, well appearing, and no evident source of infection

Answer

A

UA and microscopy urine culture (catheter or clean catch sample) blood cultures CBC CRP procalcitonin

Question 57

Q

What are the low risk criteria that baby must satisfy ALL of prior to discharge? Name 5

Answer

A

• Greater than 37 weeks gestation • No prior hospitalization • No prolonged newborn nursery care • WBC 5-15x109/L • Bands less than 1.5x109/L • Urine WBC < 5/HPF • Urine negative for nitrites or leukocyte esterase • CRP <20mg/L (if available) • Procalcitonin < 0.5mcg/L (if available) • No chronic illness • No prior antibiotics • No unexplained jaundice

Question 58

Q

If Discharging • What 3 actions would you take if Noah met ALL low risk criteria and you planned outpatient management?

Answer

A

• Give caregivers clear direction regarding monitoring treatment, and when to return • Arrange followup within 24 hours • Follow up all relevant culture results

Question 59

Q

What is the dosing of antipyretic agents in children?

Answer

A

Acetaminophen 15mg/kg or ibuprofen 10mg/kg

Question 60

Q

Name 3 commonly diagnosed conditions presenting with fever (and other symptoms) that do not routinely need immediate antibiotics:

Answer

A

Otitis media (children over age 2), uncomplicated pharyngitis, URTI

Question 61

Q

Fever > 3 Months,What are 3 occult bacterial infections to consider in your differential diagnosis?

Answer

A

UTI, pneumonia, soft tissue infection, septic arthritis, osteomyelitis, appendicitis, meningitis

Question 62

Q

What are 3 non-infectious causes of acute fever?

Answer

A

Heat-related illness, thyrotoxicosis, toxin ingestion, intracranial hemorrhage, neuroleptic malignant syndrome

Question 63

Q

Factors associated with increased risk of occult bacteremia in children aged 3-36 months are:

Answer

A

fever >38.9degrees and WBC 15 or greater

Question 64

Q

What are signs of severe sepsis in children > 28 days? Name 5

Answer

A

Fever > 38 or hypothermia <36, tachycardia, prolonged capillary refill, cold extremities, decreased urine output, SpO2 < 94%, mottled skin, mental status changes (lethargy, confusion, inconsolability)

Answer 65

A

Bolus: 10-20mL/kg initial (IV PUSH) then 10-20mL/kg repeat boluses: aim for approx 60mL/kg total in first hour (*if PICU level care is available)

Answer 66

A

• IV Ceftriaxone 100mg/kg/dose • IV Vancomycin if suspected meningitis 15mg/kg/dose

Answer 67

A

• History of prior UTI • Temperature 40 degrees or more • Fever > 24 hours • Suprapubic tenderness • Jaundice • Uncircumcised male

Answer 68

A

• Febrile, less 2 months: EVERYBODY (needs UA and Cx) • Febrile, 2-24 months: Suggest use of UTI Calc to assist in determining risk of UTI and likelihood of UTI based on UA findings • Febrile, >24 months: presence of urinary symptoms can be used as a criterion to determine need for UA and Cx • In kids <2months: catheter or clean catch specimen • In kids >2months: bag ok for screen, catheter or clean catch specimen for culture if leuk est or nitrite +, or leuks/bacteria on microscopic analysis

Answer 69

A

• Fever >5 days • Cough >10 days • Persistently high temperature (>40) with no other explanation • WBC 20 or greater • Or if respiratory symptoms …

Answer 70

A

Malaria, TB, Tularemia, Toxoplasmosis, Cat Scratch Disease

Answer 71

A

Leukemia, lymphoma, Kawasaki disease, juvenile idiopathic arthritis, drug fever, diabetes insipidus, inflammatory bowel disease, periodic fever disorders

Answer 72

A

Season, Travel history, Geographic location, Exposures (insects, plants, animals, sick contacts), Medications, Immunization status, Immunologic status

Answer 73

A

• Lesion characteristics • Distribution and progression of rash • Timing of rash onset in relationship to fever • Changes in morphology (ie papules to vesicles) • Symptoms associated with the rash (pruritus, pain)

Answer 74

A

• Vasculitis of unknown cause • Fever for 5 days plus four of: • Bilateral conjunctivitis • Oral mucous membrane changes • Peripheral extremity changes (erythema, edema, or desquamation) • Polymorphous rash • Cervical adenopathy • Treatment: IVIG, ASA • Complications: coronary artery aneurysm, heart failure, MI, arrythmias

Answer 75

A

Predischarge bilirubin in high risk zone, jaundice in first 24 hours, ABO incompatibility, hemolytic disease, Prematurity previous sibling received phototherapy, cephalohematoma or significant bruising, exclusive breastfeeding, East Asian race

Answer 76

A

Biliary atresia, hepatitis, biliary cholestasis, alpha-1-antitrypsin deficiency

Answer 77

A

Sepsis, ABO incompatibility, hereditary spherocytosis, Gilbert’s syndrome, G6P deficiency, breastfeeding

Answer 78

A

• Caregiver: criminal history, mental health history, substance abuse, young/single parent, former victim of abuse/neglect • Child: young age, behavioural problems, chronic illness, disability, non-biologic, premature, low birth weight • Family/environment: High unemployment, IPV, poverty, social isolation, lack of support

Answer 79

A

• Bruises: in pre-mobile infant, in unusual or protected area (torso, ears, neck), bruises in patterns, significant number of bruises • Breaks: any fracture in a non-ambulatory child, femur fracture in an infant, humerus fracture in an infant, multiple fractures, healing fractures, skull fractures, metaphysical fractures (bucket handle), posterior rib fractures • Bonks: head trauma - especially if skull fractures that are depressed, bilateral, complex, or open • Burns : immersion scald, contact burns, patterns • Bites: stereotypical pattern to human bites

Answer 80

A

Cardiac dysrhythmia, ectopic pregnancy, vasovagal, seizure, hypoglycemia, anemia, hypokalemia, orthostatic, substance use

Answer 81

A

Exertional, family history of sudden cardiac death, chest pain/dyspnea, no prodrome, history of structural cardiac disease, abnormal cardiovascular exam, focal neurologic signs, fever

Answer 82

A

ECG, accu check, POCUS for ectopic

Answer 83

A

• Short PR: WPW • Long PR: AV conduction block • Narrow, deep QRS: HCM • Wide QRS and epsilon waves: arrhythmogenic RV hypertrophy • Wide QRS: Vtach, WPW • QT interval: long or short • Also look for Brugada, ACS, myocarditis

Answer 84

A

Arrhythmogenic RVH 1. TWI in R precordial leads 2. Epsilon waves (low amplitude notches after QRS and before T waves) in R precordial leads

Answer 85

A

-Sleeping position -Antecedent events such as seizure activity, feeding, recent URTI -Duration of episode -Resuscitative efforts provided by the parents (eg. mouth to mouth, stimulation) -Any previous similar episodes? -Pregnancy history (incl. maternal substance abuse) -Gestational age at birth / prematurity -Family history of SIDS

Answer 86

A

-Bruises in non-mobile children -Multiple bruises in various stages of healing -Concerning bruise location (away from bony prominences) -Patterned bruising -Ligature marks -Bites with an intercanine diameter >3cm (adult bite) -Lacerations of frenulum / oral mucosa -Burn patterns suggestive of immersion -Cigarette burns -Contact or caustic burns

Answer 87

A

-Sepsis -Congenital airway anomalies -Seizures -CNS lesions -Hypoglycaemia -Inborn errors of metabolism -Congenital heart disease -Dysrhythmias -GERD -Sepsis -Meningoencephalitis -Pneumonia -UTI -RSV/ Croup/ Pertussis -Infantile botulism -Accidental poisoning/ drug ingestion

Answer 88

A

Lorazepam 0.05-0.1 mg/kg IV -or Midazolam 0.2-0.5 mg/kg intranasal -or midazolam 0.05-0.2 mg/kg IM -or Diazepam 0.2-0.5 mg/kg IV/PR Dilantin 20mg/kg IV (rate 1mg/kg per minute) -or fosphenytoin 20 mg/kg IV (rate 1-3mg/kg per minute) If refractory: -Secure the airway -Phenobarbital 20 mg/kg IV

Answer 89

A

-Croup -Anaphylaxis -Angioedema -Foreign body (airway or esophagus) -Retropharyngeal abscess -Bacterial tracheitis -Epiglottitis -Peritonsillar abscess

Answer 90

A

-Fever Features of impending respiratory failure: -Tachycardia -Tachypnea -Hypoxia -Significant distress or agitation -Stridor at rest -Marked retractions or intercostal/subcostal indrawing -Tracheal tugging -Decreased breath sounds -Cyanosis or pallor -Lethargy

Answer 91

A

-Unvaccinated status -Tripoding/ sniffing position -Drooling -High fever -Dysphagia -Dysphonia -Sore throat

Answer 92

A

“-No investigations are required: clinical diagnosis”

Answer 93

A

Single dose of dexamethasone (0.6 mg/kg to max of 10 mg) PO plus one of the following: -Observation in ER for improvement -Parental education with discharge

Answer 94

A

-Age less than 6 months -History of previous severe croup -Known structural airway anomaly -Significant degree of respiratory distress -Poor response to initial therapy -Inadequate fluid intake/ clinical dehydration -Parental anxiety -Living far from the hospital/ difficult access to return to hospital -Uncertain diagnosis

Answer 95

A

-Nebulized epinephrine [L-epinepherine 1:1000 (5mls)] -Repeat steroid dose (dexamethasone 0.6mg/kg PO or budesonide 2mg neb) -Intubation -Admission to hospital -Pediatric consultation

Answer 96

A

-Altered mental status -Focal neurologic deficits -Seizures -Sacral radiculopathy (includes urinary retention, constipation, paresthesia, and motor weakness) -Acyclovir 10mg/kg IV q8hr

Answer 97

A

Any ONE of: -Rifampin 600mg PO BID x2 days -Ciprofloxacin 500mg PO x1 dose -Ceftriaxone 250mg IM x1 dose

Answer 98

A

“-Drug fever/ toxic exposures -Antibiotics: beta-lactams, sulfonamides, and nitrofurantoin -Anticholinergic drugs/ antihistamines: -Malignancy: leukemia, lymphoma -Kawasaki’s disease (½ mark for ‘vasculitis’) -Systemic lupus erythematosus (SLE) (½ mark for ‘vasculitis’) -Polyarteritis nodosa (½ mark for ‘vasculitis’) -Juvenile idiopathic arthritis -Inflammatory bowel disease: Crohn’s or Ulcerative Colitis -Diabetes insipidus -Familial Mediterranean fever -Immunoglobulin deficiency (congenital or acquired) -Non-accidental conditions/ Munchausens by proxy/ Factitious fever”

Answer 99

A

“-Infective Endocarditis (viridans streptococci, enterococci, staphylococci) -Brucellosis -Bartonellosis -Leptospirosis -Salmonellosis -Toxoplasmosis -Tularemia -Tuberculosis/Mycobacterium (no marks for conditions with localized pain, resp or urinary symptoms, etc)”

Answer 100

A

Pneumonia/Bronchiolitis Gastroenteritis/ Hepatitis Encephalitis/ deafness Myocarditis/ pericarditis Keratitis/ corneal ulceration

Answer 101

A

Cellulitis/impetigo/necrotizing fasciitis Encephalitis/Reye’s syndrome Pneumonia/Pharyngitis/Otitis media Gastroenteritis/ Hepatitis Septicemia/disseminated VZV Myocarditis Glomerulonephritis Thrombocytopenia/ Purpura

Answer 102

A

WEIGHT

BLOOD PRESSURE

<ul> <li>Normal= (Age x2) + 90</li> </ul>

<ul> <li>Lowest tolerable (i.e. decrease BP)= (Age x2) + 70</li> </ul>

Answer 103

A

Jaundice in 1st 24 hrs Elevated conjugated bilirubin Rapidly rising TSB TSB approaching exchange level TSB not responding to phototherapy Rising TSB > 3 wks Sick-appearing neonate

Answer 104

A

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Answer 105

A

<ul> <li>mnemonicWarm C‐R‐E‐A‐M</li> <ul> <li>Warm‐ Fever >39°C for 5 days, PLUS 4 of the 5 following signs (or less in ‘atypical’ form of the disease):</li> <li>C‐ Conjunctivitis, bilateral non‐exudative</li> <li>R‐ Rash, polymorphic (e.g. urticarial, maculopapular) and on the body (not vesicular nor bullous)</li> <li>E –Edema or erythema of the hands, eventually leading to desquamation</li> <li>A‐ Adenopathy with at least one anterior cervical lymph node >1.5cm (not generalized over the whole body)</li> <li>M –Mucosal involvement: fissured red lips, strawberry tongue</li> </ul></ul>

Answer 106

A

<div>· Focal seizure or persistent seizure activity</div>

<div>· Focal neurologic deficit</div>

<div>· VP shunt</div>

<div>· Neurocutaneous disorder</div>

<div>· Signs of elevated ICP</div>

<div>· History of trauma</div>

<div>· Immunocompromise</div>

<div>· Hypercoagulable state or bleeding disorder</div>

Answer 107

A

<div>· Trauma, </div>

<div>· Heart disease, </div>

<div>· Hypovolemia, </div>

<div>· Endocrine emergency, </div>

<div>· Metabolic, </div>

<div>· Inborn error of metabolism, </div>

<div>· Seizure, </div>

<div>· Formula problem, </div>

<div>· Intestinal disaster, </div>

<div>· Toxins, </div>

<div>· Sepsis</div>

Answer 108

A

<div>Jaundice, hepatomegaly, poor feeding, irritability, hypoglycaemia, respiratory distress, vomiting</div>

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Pediatrics Flashcards

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