Pediatrics Flashcards
What percentage of children will meet criteria for constipation?
30%
What are etiologies of delayed meconium passage?
- imperforate anus
- Hirschprung’s
- Hypothyroidism
- Cystic fibrosis
- Prematurity
- Sacral abnormalities
How often do babies stool?
In breastfed babies, once every 10 days to 10 times per day
What are the Rome III criteria for constipation in pediatrics? *must not meet criteria for IBS
2 months hx + 2 of: Pooping in their pants (incontinence >1/week) Posturing (retentive) Pain with BM's Palpable large stool in rectum Plugging the toilet
= 2 BM’s per week
What are 5 complications of infant GE reflex
parental anxiety esophagitis failure to thrive apnea/choking (ALTE) recurrent aspiration/cough/wheeze
When does the umbilical stump fall off?
5-10 days on average
2 weeks ULN
3 weeks = abnormal
How much do neonates need to feed per day?
150 mL/kg/day
What’s the rule of thumb for urine output in neonates?
1 pee day 1 2 pees day 2 3 pees day 3 4 pees day 4 increases from there
What is the concern with macrolides in babies?
association with hypertrophic pyloric stenosis
What are symptoms of chlamydial pneumonia?
stacatto cough
well appearing
crepitus, wheezes, patchy infiltrates and hyperinflation
What is the risk to the infant with mothers with untreated chlamydia?
40% risk of infection
conjunctivitis, pneumonia
What are 2 types of breath holding spells
Cyanotic: upset, vigorous crying and end expiratory apnea
followed by cyanosis, opisthotonus, rigidity, loss of tone +/- brief jerking, lasting 10-60 seconds
Pallid: minimal crying, usually bad stimulus (pain) -> child goes pale, quiet then loses consciousness
What is the definition of colic?
Excessive crying for: >3 hours per day >3 times per week >3 weeks usually around 3 weeks - 3 months
What are some considerations in the ddx of colic?
incarcerated hernia corneal abrasion hair tourniquet intussusception child abuse meningitis UTI
What are contraindications to manual reduction of inguinal hernias?
hemodynamic instability
sick appearing
peritonitis
bowel obstruction
What are 4 risk factors for rectal prolapse
CF
constipation
diarrhea
pinworms
How to remove hair tourniquet?
Nair (not always effective)
Cut across with scalpel or 16 gauge needle
What can happens to neonates whose mothers are on SSRIs?
Withdrawal
Rare - pulmonary hypertension
easily confused with sepsis - irritable, tachycardia, temperature instability
often will get admitted for observation
What is the limit of prolonged rupture of membranes in labour?
18 hours
What is a normal glucose in a brand new neonate?
After 24 hours?
> 2.6
After 24 hours >3.3
Up to what age can you put in an umbilical vein?
7 days
What is the age range for early onset neonatal sepsis?
0-7 days
What are the 3 most common pathogens in neonatal sepsis
GBS
E. coli
Listeria
Which neonates need acyclovir?
Unwell
CSF WBC
Skin lesions
Why do you avoid ceftriaxone in babies?
Binds to albumin
Displaces bilirubin
Risk of kernicterus
List the association of disease on CXR
Boot
Egg on a string
Snowman
Boot = TOF
Egg on string = TGA
Snowman = TAPVR
What are 5 causes of bilious vomiting?
Malrotation Meconium ileus Intussusception Bowel atresia (duodenal, imperforate anus) Hisrschprung's
What drugs to use in neonatal intubation?
Atropine 20 mcg/kg
Fentanyl 3-5 mcg/kg
Succinylcholine 2 mg/kg
What are 5 ddx considerations of pediatric stridor?
Anaphylaxis Tumor Heart failure Asthma Trauma/PTX Infection Cystic fibrosis
