Pediatrics Flashcards
What are the age classifications from 0 days to 18 years?
neonate: 0-28 days old
infant: 1-12 months old
child: 1-12 years old
adolescent: 13-18 years old
What are 2 instances when pediatric patients should seek medical care?
- age <3 months with a temp of 100.4ºF (rectal)
- age 3-6 months with a temp of 101ºF (rectal)
What is an APGAR score? What indicates a healthy score?
- it assesses the newborn’s general condition
- checked at 1 minute and 5 mins after birth
- measures 5 categories, score 0-2 for each
- healthy = 7-10
What standard meds do newborns receive once they are born?
- IM vit K
- opthalmic erythromycin (prevent conjunctivitis)
- first dose of hep B vaccine
What are these conditions that may be seen in preterm babies: patent ductus arteriosus, persistent pulmonary hypertension of the newborn, respiratory distress syndrome
Patent ductus arteriosus (PDA)
- opening between the aorta and pulmonary artery
- treatment: NSAIDs to close
Persistent Pulmonary Hypertension of the Newborn (PPHN)
- constricted blood vessels in the lungs, blocking airflow
- treatment: supportive care, inhaled nitric oxide (NO)
Respiratory Distress Syndrome (RDS)
- deficiency of surfactant (production would be adequate at week 35)
- treatment: surfactant (Curosurf, Infasurf)
What are the common bacterial pathogens causing bacterial meningitis in neonates, 1-23mo old, and 2+ yo? What is preferred treatment?
<1 month (neonate):
- strep agalactiae (group B), E. coli, Listeria monocytogenes, Klebsiella
- treatment: ampicillin + [cefotaxime OR aminoglycoside]
**no ceftriaxone if <1mo due to kernicterus
1-23mo old:
- strep pneumoniae, neisseria meningitidis, S. agalactiae, H. influenzae, E. coli
- treatment: vanc + 3rd generation cephalosporin
2+ years:
- neisseria meningitidis, S. pneumo
- treatment: vanc + 3rd gen cephalosporin
What is RSV? When is RSV “season”? What are some common symptoms? Treatment? Prevention?
RSV: RNA virus that affects the respiratory tract. Lower respiratory tract infection. Common from Nov-April
Presentation: apnea, rhinorrhea, etc.
Treatment:
- supportive care: oxygen, fluids, suction secretion
- consider inhaled rivabirin (Virazole) if high risk
Prevention
- Palivizumab (Synagis): once monthly IM that is only given to high risk patients during RSV season. Recommended for premature infants (<29 weeks).
- Nirsevimab (Beyfortus): single IM dose indicated for neonates/infants ≤ 8 mo old born during or entering their first RSV season
What is croup? What are the distinct symptoms (3)?
Croup - inflammation of the upper airway that leads to erythema and narrowing of the trachea, just below the vocal cords. Common if < 6 years old, more common in boys. Most common in late autumn/winter
Symptoms:
- inspiratory stridor
- cough
- hoarseness
How do we treat croup?
- non-drug: humidified air, calming techniques, endotracheal intubation (severe)
- drug: steroids, nebulized racemic epinephrine, antipyretics if fever, abx if suspected bacterial
- mild and moderate can be treated w/ non-drug treatment + steroids (dexamethasone)
- severe needs steroids and racemic epinephrine
What is nocturnal enuresis?
bed wetting, usually not treated before 5 years of age
start with behavioral approaches and alarm therapy. If these don’t work for three months, can move onto drug treatment
drug treatment:
- desmopressin (DDAVP): synthetic analogue for antiduretic hormone. PO tab is the only DDAVP we would use for nocturnal enuresis; contraindicated if hyponatrenia or CrCl < 50mL/min
What product should we use in infants for these: intestinal gas, nasal congestion
intestinal gas:
- simethicone drops 20mg 1-4x/day PRN
nasal congestion:
- cool mist humidifier
- saline nasal drops/spray
- NO OTC cold/cough meds: Per FDA, shouldn’t use if <2yo, but AAP recommends not <6yo
mild pain & fever:
- NO aspirin (Reye’s syndrom)
- APAP 10-15mg/kg/dose q4-6 hours (max 75mg/kg/day)
- ibuprofen 5-10mg/kg/dose q6-8h; NOT for infants < 6 mo old
constipation:
- polyethylene glycol (MiraLax) for infants ≥ 6 months old
- glycerin suppositories are SAFE
What is one drug that is contraindicated in neonates? What 2 drugs are contraindicated in kids < 2 yo? What 2 drugs are contraindicated in kids <12 years? What 4 drugs are not generally recommended in peds?
Neonates: NO ceftriaxone
< 2yo: NO promethazine, NO OTC teething meds containing benzocaine
<12 yo: NO codeine, NO tramadol
Generally avoid:
- aspirin
- quinolones
- tetracyclines
- OTC cough and cold preparations
What are the classic symptoms of these vaccine-preventable diseases: measles (2), mumps (1), rubella (1), polio (2), pertussis (1), rotavirus (1), chicken pox (1)
measles: Koplik spots, maculopapular rash
mumps: swollen salivary glands
rubella: fine, pink rash
polio: nerve damage, post-polio syndrome
pertussis: whooping cough
rotavirus: severe, watery diarrhea
chicken pox (varicella): itchy rash
