Pediatrics Flashcards
At 4 months 6 months
9 months
12 months what are the milestones for gross motor
4 mo = roll over
6 mo = sit independently
9 mo = pull up to crawl
12 mo = walk
Language development 6 month 12 month 24 month milestones
At 4 years?
6 mo = babbles
12 month = mom and dad with intent
24 month = combining words 50% comprehensible language
At 4 years old should be able to understand 100% of speech
Social and fine motor mile stone at 6 months
9 months 12months 18 months
6 months = Reaches and feeds their self
*pincer grasp= 9 months
12 months = imitate behaviors
18 months = scribble and feeds w/ spoon [potty training]
In the first week of life NB lose what weight and regained when
Lose 10%
regain birth weight in 10 days
Triple birth weight by 12 months *
FTT is generally what?
Drops to 3-5% on the growth curve
Cross 2 lines
MC cause of FTT
Not enough calories
Not eating enough; poverty
Cystic fibrosis usually presents how in the early presentation
50% FTT
Delayed bone age and puberty is defined as
Constitutional growth delay = family hx is similar for meeting mile stones late
MC virus for viral URI ; common cold
Rhinovirus
Hoarseness is a clue to what
A viral process
Cough and cold medications are generally recommended for children of what age
Older than 2
But cautious in ages 2-11 yrs old
MC age for otitis media
MC bacteria
6-24 months
MC : strep pneumonia
Formula fed infants are at risk for OM why?
The feeding position
Children over 2 years of age give AMOX when
Fevers of 102 or higher and severe sxs
Chronic OM is defined as what
Recurrent 3x in 6 mos or // 4x in a year ; or persistent infection or drainage over 2 weeks
MC pathogens for OE
Staph A
Pseudomonas Aeriginosa
Pain with pinna pull
CROUP [4]
Inflammation of the larynx trachea and bronchi
6 months —> 3 years of age in fall and winter
Barking inspiratory stridor
TXM : dexamethasone —> racemic epi
Ambylopia is lazy eye without what?
CNS pathology
Ambylopia treatment and mc cause
Patch
MC : strabismus resulting in decreased visual acuity
Unilateral purulent rhinitis think what for kids?
FOB!
PNA in neonates MC cause
GBS ; everyone else strep pneumonia
CXR PNA findings
Lobar consolidation ; patchy infiltrates
May see effusions
Atelectasis vs infiltrate - often hard to tell
Conjunctivitis in the first week of life
Staccato rapid short distinct cough
2 weeks - 6 mo of age
A febrile
Chlamydia PNA
TXM = Macrolide
Gradual onset dry cough —> production
Fever
Bullous myringitis
? And what treatment
Mycoplasma PNA
TXM = Macrolide
Whooping cough [4]
Non vaccinated kids
3 stages : Coryza , paroxysmal cough , dry cough convalescent [recovery]
DX GOLD STANDARS = NP culture ; PCR
TXM = Macrolide
CXR shows hypo expansion and B/L atelectasis ground glass air bronchograms
ARDS
TXM = O2 CPAP Intubation Surfactant
Cystic Fibrosis is what genetic anomaly and 3 keys
Autosomal ressive disorder
Dx: Sweat chloride is the gold standard ; if greater 60 = abnormal
Thick sticky meconium pancreatic insuff.
TXM = ABX pancreatic enzymes ; bronchodilators
Heimlich should be performed in who
Upper airway FB
Rigid bronchoscopy should be performed in FOB where
Lower airway
Rheumatic fever triggered by
GBS
RF affects who following what
5-15 yrs old —> untreated strep infection
RF mc affects what valve
Mitral valve
How are joints affected in RF
Poly Arthralgia not arthritis !
Stills murmur [3]
MC childhood
Turbulent flow out of LV
Apex of the heart in supine position
Venous Hum [3]
Age after 3 years
Increased in fever anemia or pregnancy
Musical ; turbulent subclavian and jugular veins
Acyanotic lesions
ASD
VSD
PDA
Coarctation of the Aorta
ASD [3]
Large of untreated = sxs
Respiratory sxs feeding dysfunction
Wide split s2
VSD [4]
MC congenital heart disease
4-6 weeks of life presents with CHF
Large harsh holosystolic murmur
Left to Right Shunt
PDA [4]
Pulmonary artery to aorta are left open
Machinery grinding murmur with bounding peripheral pulses
RF : prematurity ; maternal RUBELLA
TXM = Indomethacin in preemies ; cardiac catheter if older
Coarctation of the aorta
Absence of femoral pulses
Blowing systolic murmur that goes towards the back
Notching of the ribs
HTN in older children
2 cyanotic lesions
TOGV
And
Tetralogy
TOGV [4]
Pulmonary artery connected to the left ventricle
Aorta connected with the right ventricle
CYANOSIS + poor weight gain
Tetrology [4]
VSD ; PS ; overriding aorta ; RVH
Best heard at 3rd ICS ; BOOT SHAPE heart
Tet spells
Surgical treatments PGE-1
Age classic for pyloric stenosis what kind of vomit
2-4 weeks
Non bilious projectile vomiting
Treatment intussusception
Reduction with barium enema [w/ 24 hours of sxs]
+/- surgery
PKU often have what features
Cognitive delay
Decrease melanin compared to family
When to remove :
Lower esoph FOB
Upper esoph FOB
Stomach FOB
Caustic FOB
Lower = remove in less 24 hours
Upper = Foley catheter to reduce aspiration risk
Stomach = less 3-5 cm will pass on its own
Caustic = endoscopy ; toxic = lavage
Most specific findings of pyloric stenosis
Epigastric mass
SALTER Harris classification
S = straight thru phyces
A = thru phyces exits above towards long bone ; MC
L = thru phyces lowered to joint
T = thru above phyces and long bone
R = rammed; reduced growth plate
Epiphyseal plate is equal to what =
Metaphyseal plate =
The phyces
Above the phyces
SCFE [4]
MC RF : obesity teenage males
14 - 16 years old
Acute or chronic +/- knee pain
Limited internal rotation ; ice cream cone femoral neck fx
Pain in is good schlatters =
Worse w activity
Better w rest
Nursemaids =
Subluxation of the radial head ;
By: longitudinal pronational forces
Child: arm in pronated flexed position
Measles =
Rubeola
Measles =
Morbillovirus : paramyxo virus family
Measles rash spreads
Down and out
When does orchit is occur
1 week after mumps
Rubella
Togavirus
Deafness cataracts cardiac defects blueberry rash
Head to tea rash
Incubation period for varicella
10-12 days
Scabbing varicella is ->
No longer contagious
varicella vaccine schedule
12-15 months
And
4-6 years old
same as MMR
Roseaola is
HHV 6
Roseola
High fever —> rash
Fifth disease is
Parvovirus
Red facial rash lacy pink macular rash
Cheek —> extremities
Several wks to rash
HFM
Coxsackie virus
Painful grey red vesicles
lesions in the posterior mouth that are grey red and no where else think
Herpangina
Lesions in the anterior mouth ; lips tongue buccal mucosa
Gingival stomatitis
TXM Kawasaki’s
IVIG
ASA
Fever more than 5 days long
Compli of Kawasaki’s
Coronary artery aneurysms
Erythrovirus think
Parvo b19 slapped cheek
