Pediatrics Flashcards
how much milk is allowed per day for picky eaters, so as not to suppress appetite?
no more than 16-24 oz
most neonatal umbilical hernias will spontaneously resolve by what age?
5 years old
t/f systemic corticosteroids, elimination diets, and topical antibiotics should be avoided in atopic dermatitis
true
what type of baths are beneficial for moderate to severe cases of atopic dermatitis?
bleach baths
how frequently should you use mid or high potency steroid medication for atopic dermatitis ?
once daily - using twice daily offers minimal improvement
t/f topical steroids and calcineurin inhibitors are safer and less expensive options for treatment of atopic dermatitis compared with Opzelura
true
t/f tolerance to food antigens improves with frequent exposure in infants
true
once remission is achieved for a patient with relapsing atopic dermatitis, what are the two options for maintenance therapy?
once daily midpotency steroid or calcineurin inhibitor two to three times weekly
at what age does the USPSTF start recommending comprehensive intensive behavioral intervention for children with BMI > 95th percentile?
6 years
what medication can be used to treat atopic dermatitis that is mild in whom the patient prefers to avoid steroids and calcineurin inhibitors?
crisaborole (PDE4 inhibitor)
what is the recommended dose of daily ferrous sulfate supplementation for pediatric patients with IDA?
2-6mg/kg/day
what is the most common cause of anemia in children less than 5 yo ?
iron deficiency anemia
universal screening for anemia should be considered in all children at what age timeline?
9-12 months
what is the preferred type of iron to use for supplementation to treat IDA in children?
ferrous sulfate
t/f systolic ejection murmur can be a physical sign of anemia
true
when should iron supplementation start for infants who are exclusively breastfed?
4 months
what 4 studies should be done to further classify normocytic anemia in children?
reticulocyte count, bilirubin, haptoglobin and LDH
G6PD deficiency, pyruvate kinase deficiency, hereditary spherocytosis can cause what type of anemia?
normocytic anemia
what is the most common inherited blood disorder in the US?
sickle cell anemia
if a patient is found to have normocytic anemia with low reticulocyte count, what other test can be performed to further differentiate if this is due to a bone marrow disorder?
peripheral smear
inflammation from a virus such as parvovirus B19 may cause what type of anemia? what relative reticulocyte count?
normocytic anemia with low reticulocyte count
if a patient is found to have microcytic anemia, what three lab tests should be done for further evaluation?
reticulocyte count, iron panel and lead measurement
you diagnose a pediatric patient with IDA. You start oral ferrous sulfate at 2-6mg/kg/day. when should you repeat hemoglobin and reticulocyte count?
2-4 weeks
after 2-4 weeks of oral iron supplementation, by what percentage do you expect an increase in Hb levels for a patient being treated for IDA?
50% increase
what is the USPSTF position on lead screening for children?
insufficient evidence to measure in asymptomatic children less than 5 yo
at what age does the transition from fetal to adult Hb occur?
6 months
what ratio can be used to help differentiate thalassemia from iron deficiency in a patient with evidence of microcytic anemia?
Mentzer index (MCV / RBC)
what nutritional deficiency may be considered in an infant exclusively fed goat’s milk?
folate deficiency
what condition may be considered for a patient with suspected B12 deficiency whose anemia is not improving with B12 supplementation?
intrinsic factor deficiency
what are the two causes of megaloblastic anemia?
B12 and folate deficiency
what type of anemia is characterized by hypersegmented neutrophils?
megaloblastic anemia
if intussusception is suspected, what can be both diagnostic and therapeutic?
air / contrast enema
what is the most common surgical emergency in children?
appendicitis
children with hypertension are how much more likely to experience MACE compared to children without hypertension?
2x as likel;y
what is the most common site for acute bacterial arthritis in children?
hip
what is the most common pathogen causing acute bacterial arthritis in children?
staph aureus
what two lab markers are not helpful in differentiating transient synovitis from bacterial arthritis in children?
procalcitonin and ESR
what is the initial imaging that should be done for suspected bacterial arthritis ?
xray
delaying antibiotic therapy in the case of bacterial arthritis may increase the risk of what complication?
chondrolysis
what two antibiotics can be used orally for treatment of bacterial arthritis if risk of MRSA is low?
cephalexin / clindamycin
what is the preferred oral antibiotic for treatment of bacterial arthritis when risk of MRSA is high?
clindamycin
what is the summary of evidence of use of corticosteroids in the treatment of bacterial arthritis
not recommended
what IV antibiotic is preferred for treatment of possible MRSA bacterial arthritis when there is a high rate of resistance to clindamycin?
ceftaroline
aspiration of joint fluid in suspected cases of bacterial arthritis are culture positive in what percentage of cases?
40%
evaluating for and identifying what comorbid / related condition is important in the evaluation of suspected bacterial arthritis?
osteomyelitis
what is the next step in evaluation if normocytic anemia is found in children
reticulocyte count
what is the classic triad of symptoms for intussusception?
colicky abdominal pain, vomiting, and bloody mucoid stools
for an ill appearing child, what is indicated immediately in the setting of suspicion for acute bacterial arthritis?
antibiotic therapy (prior to joint fluid aspiration for culture)
what are the first line interventions for sleep problems in early childhood?
education and behavioral interventions
pacifier use should be decreased or eliminated between what ages to reduce the risk of otitis media?
6-12 months
pacifier use and thumb sucking should stop by what age to reduce the risk of dental malocclusion
3 years
children 4 -12months should get how much sleep per 24 hours?
12-16 hours
t/f behavioral extinction intervention or modified/graduated extinction can help children learn to self sooth and fall asleep faster on their own
true
what is the concept of bedtime fading?
temporarily delay bedtime to observe the time of sleep onset, then gradually shift the bedtime to an earlier time to prevent the child from lying awake in bed
what is the concept of unmodified extinction in terms of sleep?
putting the baby to bed and letting them cry it out at a consistent designated bedtime
t/f there are no FDA approved medications for sleep problems in children
true
what is the AAP recommendation on pacifier use?
offer pacifier to infants at the start of sleep to reduce the risk of SIDS
what type of reinforcement is encouraged for stopping nonnutritive sucking behavior?
positive reinforcement
t/f habit reversal therapy to increase awareness of the child’s habit of pacifier use / thumb sucking and encouraging an alternative behavior is an effective strategy
true
t/f pressuring a child to eat or punishing a child to eat who is a picky eater should be avoided
true
how many times may a child need to try a food before accepting it as part of their diet?
15 x
what two things should you focus on for picky eating?
structured, positive mealtime environment and offering a variety of healthy foods
what is the most common chronic disease in US children?
dental carries
what is a non inferior alternative to fluoride toothpaste?
microcrystalline hydroxyapatite toothpaste
at what age should oral fluoride be offered for patients with deficient water supply?
6 months
t/f bottle fed children are at higher risk of dental caries compared to breastfed children
true
