Pediatrics Flashcards
Milestones of a 2mth old
Can lift himself up with 2 arms when lying on tummy.
Responds 2 sounds.
Smiles when smiled 2.
Milestones at 4 months
Reaches 4 a toy or other object smiles 4 fun (spontaneously)
Rolls from tummy to back
Milestones at 6 mths
Looks like the number 6 when sitting up.
Rolls from back to tummy and back
Milestones at 8 mths
Once able to sit up, child can transfer objects from hand to hand with ease.
Milestones at 12 mths
Stands tall like the number 1 and walks on 2 legs
Milestones at 18 mths
Can name single word objects.
Says “no” a lot like an 18 year old.
Acts like an 18 year old by copying work that adults do (play vacuum, mowing)
Milestones at 2 years
Speaks in 2 word sentences.
Follows 2 step commands.
Can walk up stairs one leg, then bringing the other leg up to meet.
Builds a tower of 2 blocks.
Milestones at 3 years
Builds a tower of 3 blocks.
Rides a tricycle.
Speaks in 3 word sentences.
Can draw a circle.
Milestones at 4 years
Speaks in 4 word sentences.
Can build a tower with 4 blocks.
Can draw a cross.
Milestones at 5 years
Speaks in 5 word sentences.
Can draw a square.
Milestones at 6 years
Speaks in 6 word sentences.
Can draw a triangle.
Tooth eruption begins at what age?
Adult teeth at what age?
As early as 6 mths
Adult teeth beginning at 6 years
At what age does the baby return to birth weight?
2 weeks
Pyloric stenosis
Thickening of pylorus muscle, preventing food from moving from the stomach to the small intestine.
Projectile NON-BILIOUS vomiting, RUQ OLIVE SHAPED MASS
Intussusception
When sections of intestines invaginates into the adjoining intestinal lumen, causing bowel obstruction. Can be fatal in 3-5 days if untreated. Palpable SAUSAGE SHAPED MASS in abdomen.
Contrast enema is diagnostic and sometimes curative
Tanner I
Pre-puberty
Tanner 2
Early changes
Male- testes enlarge, scrotal skin reddens, changes in texture, sparse growth of long slightly pigmented hair at base of penis.
Female- breast buds and papilla elevate, downy pigmented pubic hair along labia majora
Tanner 3
Growth spurt, penile length growth/breast enlargement
Tanner 4
Peak of growth spurt
Male-increase in penile length and width with development of glans.
Female- areola and papilla elevate to form a second mound above level of the rest of breast
Tanner 5
Full adult genitalia with hair growth extended to the medial thigh.
Scarlet fever presentation, Tx
Anterior cervical adenopathy. Sand-paper rash with exudative pharyngitis, fever, headache.
Tx- same as strep throat (Pcn, macrolide)
Roseola presentation, Tx
Rosy pink maculopapular rash lasting hours to 3 days, follows a 3-7 day period of fever. Febrile seizures common 10%
Tx- supportive (viral)
Rubella presentation, Tx
Mild fever, sore throat, malaise, nasal discharge, diffuse maculopapular rash lasting 3days.
Posterior and post-auricular lymphadenopathy 5-10 days prior to rash onset.
80% rate congenital rubella syndrome (esp in pregnancy 1st trimester exposure)
Tx- supportive (viral) PREVENT EXPOSURE TO PREGNANT WOMEN
VACCINE PREVENTABLE
Measles presentation, Tx
Acute fever, nasal discharge, cough, generalized lymphadenopathy, conjunctivitis, photophobia, KOPLIK SPOTS (white spots w/ blue rings in the oral mucosa)
Permanent neuro impairment or death possible
Tx- supportive, complications intervention, VACCINE PREVENTABLE
Mononucleosis presentation, Tx
Fever, “shaggy” purple-white exudative pharyngitis, malaise, diffuse lymphadenopathy, hepatic/spleen tenderness.
Dx- mono spot test, leukopenia and lymphocytosis (atypical lymphocytes)
Tx- steroids prn, avoid contact sports >1mth.
>90% will develop rash if given PCN (misdiagnosed for strep throat)
Hand, foot, mouth (coxsackie) virus presentation, Tx
Fever, malaise, sore mouth, anorexia. Blistering and peeling of mouth, hands, feet.
Tx- supportive, analgesia. HIGHLY CONTAGIOUS-transmission thru oral-fecal or droplet
Fifth disease presentation
3-4 days of mild flu-like illness followed by 7-10 days of red rash that begins on face with SLAPPED CHEEK appearance, spreads to trunk and extremities.
Tx- supportive, avoid exposure with pregnancy due to high risk of HYDROPS FETALIS. Transmission thru droplet
Kawasaki presentation, Tx
Fever >104 lasting >5 days, polymorphic exanthem on trunk, flexor regions, erythema of oral cavity STRAWBERRY TONGUE, extensive chapped lips, bilateral conjunctivitis, cervical lymphadenopathy
Tx- IVIG, Asa po high dose for anti platelet effect, ER!
What age should iron supplements start in breast fed babies?
4-6 mths ( due to depletion of maternal iron stores)
When should vitamin D supplementation begin in breast fed babies?
400IU/day shortly after birth, until baby is weaned and consuming >1,000 ml/day of vitamin D fortified milk/ formula
Treatment of croup (viral)
Supportive treatment, systemic steroids po if severe
Prevention of RSV in premature babies
Palivizumab (Synagis)
First line treatment for AOM (after watchful waiting or severe sx)
Amoxicillin (high dose) 80-90mg/kg/day or Augmentin 90/6.4mg/kg/day
*Pcn allergy- Cefdinir, cefuroxime
First line treatment of OME
Watchful waiting, 75-90% resolve within 3 months without tx. Antibiotic not indicated.
Treatment of pediatric UTI
Amoxicillin 20-40mg/kg/d x3 days
Bactrim (TMP/SMX) 6-12/30-60 mg/kg/d
Cephalosporin
Treatment of CAP in pediatric pt
Amoxicillin alt Augmentin
Treatment of atypical CAP in pediatric pt
Azithromycin alt clarithromycin
