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ITE 2015 + 2016 > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

4 week Male with conjunctivitis. What is the likely etiology?

A

Chlamydia Tracomatis

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2
Q

Fleshy colored papa unless with Erythematous base containing eosinophils.
Dx and Mgt?

A

Erythema toxicum neonatorum

Observe only!

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3
Q

Unintentional deaths in Kids.

Cause?

A

MVA!!!

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4
Q

4 year old with BMI of 17.5, between 90-95th percentile

- Classification

A

In patient less than 2, obese is not used! If >95th percentile: classified as overweight!
If patient is more than 2-18,> 95th percentile is obese! If 85-95: Overweight!

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5
Q

True of RSV?

A

Months of Nov - Apr

Rarely associated with Co infection

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6
Q

Mild to Mod CAP in PEDS

Tx?

A

Amoxicillin

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7
Q

Peds with OSAS; normal height and weight

Tx?

A

Adenotonsillectomy

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8
Q

Slipped Capital Femoral Epiphysis

Age group with sex?

A

11-13 in Female

13-15 in Male

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9
Q

12 month with a father that have epilepsy.

Vaccine that can increase the risk of febrile seizures?

A

MMR - up to 2 weeks from administration

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10
Q

Cows milk, not recommended in the US until what age?

A

Less than 12 months.

Not enough Iron, Vit E and Essential FA

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11
Q

When to give 2nd dose of Pneumococcal vaccine in children?

A

If sickle cell

  • also if there is anatomic functional or functional asplenia, leukemia, HIV
  • 3 yrs apart between 1st and 2nd dose
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12
Q

In-toeing

Surgery?

A

At age 8-10

If less, just observe

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13
Q

Noctural cough in 2 yr old

A

Give honey

Not for <12 months due to risk of botulism

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14
Q

Neck mass in kids

Differentials?

A
  1. Developmental - brachial cleft cyst
  2. Inflammatory
  3. Neoplastic
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15
Q

7 yr old with multiple purple lesions on the leg + limp on walking and stomach pain
DX?
TX?

A

Henoch-Scholein Purpura

  • purpura
  • abd pain
  • arthritis

TX: Acetaminophen or Ibuprofen

May give prednisone if with renal involvement
May give Amlodipine if with HTN

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16
Q 
Duchenne muscular dystrophy
Sign? 
Milestones for 
- rolling prone to supine
- rolling supine to prone
- sitting position unassisted
- walking unassisted
A 
Gower sign
Milestone
- 4 months from prone to supine
- 6 month from supine to prone
- 9 months to sit unassisted
-18 months to walk unassisted
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17
Q

Kawasaki

Evalauation?

A

CREAM

  • conjunctivitis bilateral
  • rash any
  • edema: hands and feet
  • adenopathy: >1.5 cm
  • Mucocutaneous sign: strawberry tongue

Get ECHO to rule out aneurysm

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18
Q

Exclusively breast fed

Supplements?

A
  1. Vit d 400 IU - will prevent Rickets

2. Iron for 4 months

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19
Q

7 year old with posterior rib fracture on CXR

What to do?

A

Child abuse investigation
If less than 2, do a skeletal survey
Skeletal survey not needed for 4 yrs and older

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20
Q

Autism…
When to start screening with MCHAT?
Behavior that may provide evidence?

A
  • Screen at 18 months and 24 months

- being upset with normal noise

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21
Q

Primary Monosymptomatic enuresis?
Tx?
Meds?

A
  • never achieved continuous dry nights; no daytime enuresis
  • Do bed alarm
    If it fails–> Desmopressin, Imipramine, Oxybutynin
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22
Q

Umbilical Hernia in a 2 year old.

Until when to wait?

A

Surgical repair if persistent between 3-5 yrs old

23
Q

Most common cause of chest pain in PEDS?

A

1st- Musculoskeletal
2nd - Psychogenic
3rd - Pulmo

24
Q

In the US, most common form of child abuse?

A

1st- Neglect
2nd- Physical
3rd- Sexual

25
ADHD in a 5 yr old | Tx?
Behavioral therapy | If >6 yrs old, Meds!
26
3 week old with high fever, does not look toxic. | Management?
Admit! Do septic work up: CBC, LP,UA, Cultures and start antibiotics Do for PT < 29 days old
27
Acute otitis media | Tx and dose?
Amox 80-90 mg/kg for 10 days | Augmentin if received Amox in the past 30 days or hx of AOM not resposive to amox.
28
Student with Lice. Tx? How soon to go back to school?
1st line : Permethrin May return to school ASAP. Does not need to be nit free Treat again in 1 week
29
6 y/o with 48 hr hip pain. With a limp, afebrile, Normal labs and X-rays DX: Tx:
Transient synovitis: everything normal | Ibuprofen
30
Concussion yesterday. No lost of consciousness. Just headaches and balance problems but can recall everything. What to do for evaluation?
Do physical and cognitive rest CT only if focal sx or LOC > 60 seconds
31
When to screen for Autism
18 months and 24 months
32
Most common cause of hearing loss in New born?
Genetic inheritance
33
4 y/o with 6 day hx of fever 103.2 PE: maculopapular rash, bilateral eye injection, shorty bilateral lymphadenopathy, erythematous lips, strawberry tongue and pharyngeal edema. DX? Mgt?
``` Kawasaki. --> fever for at least 5 days Conjunctivitis Rash Edema Adenopathy >1.5cm Mucocutaneous involvement ``` Tx. 1. Aspirin 80- 100mg/kg /day divided by 6 hrs 2. If no fever anymore, Aspirin 3-5 mg/kg/day q 6 hrs 3. IVIG within 10 days 4. Cardio referral for echo in 6 wks 5. Low dose aspirin while waiting for Cardio
34
6month female with bronchiolitis | When to give nebulized hypertonic saline?
1. On hospitalized patient | 2. Do not give in the ER
35
Term baby Exclusively breastfed When do you start iron supplement to prevent Iron def anemia? What if the baby is preterm
4 months | 1 month
36
Newborn found to have ear deformity Mom had GDM What test to order for the baby?
Renal US!
37
13 y/o brought to ED for worsening asthma Already on inhaled Fluticasone and Albuterol What drug to give to prevent hospitalization?
Oral prednisone!
38
New born male brought in for first exam DX with Downs test indicated for all downs?
Echo!!! - 50 % has cardiac defects Screen also for 1. Feeding 2. Vision 3. Hearing 4. Thyroid 5. Hematologic : myeloproliferative d/o ; leukemoid rxn; polycythemia Do Polysomnography between 1-4 yrs old
39
8 yr old with ADHD | TX?
Psychostimulant: Ritalin or Dextroamphetamine If below 6 y/o, can do behavioral therapy first
40
Risk factors for SIDS (6)?
``` Side sleeping or prone sleeping! Bed sharing Others: 1. Male 2. Native American 3. BW < 2500g 4. AOG < 37 weeks ``` Use of Pacifier decreases RISK for SIDS + exclusive breastfeeding per AAP
41
5 wk old female visits in December. Born at 28 wks because of preeclamsia. Need what immunoprophylaxis?
Palivizumab (Synagis) for RSV | Given in infants born < 29 wks
42
6 y/o with limp No fever, pain on the anterior hip joint increased on internal rotation which is limited DX?
Osteonecrosis of the femoral head (Legg-Calve'-Perthes) | Male, 2-12
43
Blood pressure in children... What is a pre HTN? What is hypertensive?
Pre HTN is 120/80 or less or between 90-95th percentile Determined by Age, sex and length Above 95th percentile is HTN!
44
Day care center needs:
Director has degree in child related field Staff knows CPR Care giver ratio is 1:2 Discipline is standard
45
MMR can be given at age? | Side effects?
Between 12-15 months If given before 12 months, needs 2 doses at least 1 month apart Second dose between 4-6 yrs old -Measles can caused Thrombocytopenia
46
Vaccines for 2 month old?
1. DTap 2. Prevnar: Pneumococcal 3. IPV! Not oral 4. HIB 5. Rota 6. Hep B
47
Car seats guidelines?
- till age of 2: rear facing - till 13 yrs old: rear seat - booster: lap and shoulder strap - Safest: rear middle seat
48
PPD in children
Not routine! | Only in positive exposure, immunocompromise, immigrants
49
Genetic testing to be repeated is went home before 12 hrs of life?
Phenylketonuria!!!!- baby did not ingest enough phenylalanine.
50
Heart murmur in 13 y/o, Systolic, Ejection Murmur at Left upper sternal boarder, second sound has splitting with inspiration, louder when supine , softeners with Valsalva or standing Diagnosis?
Pulmonary flow murmur! ``` Others: ASD - Left upper sternal Venous hum - Right upper sternum Hypertrophic cardiomyopathy - left lower sternal border VSD- Left lower sternal boarder ``` Diastolic murmur: always pathologic
51
Fluoride supplementation: How much? What age?
0.5 ppm | Start at age 6 months
52
HPV in males? | Age
9- 26 y/o Two dose if below 15 y/o - 1st dose should be 0 then the second dose is at 6 months- 12 months - if second is given less than 5 months from first dose, RPT! Hence 3 doses, 12 weeks after 2nd dose
53
Iron supplement in <37 weeks
Start at 1 month for exclusively breastfed
54
Definition HTN in children and adolescents?
> 95% for age, sex and length x 3 or more measurements 120/80 or less than 95 percentile is pre htn

ITE 2015 + 2016 (16 decks)

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