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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
Q

ADHD in a 5 yr old

Tx?

A

Behavioral therapy

If >6 yrs old, Meds!

26
Q

3 week old with high fever, does not look toxic.

Management?

A

Admit! Do septic work up: CBC, LP,UA, Cultures and start antibiotics
Do for PT < 29 days old

27
Q

Acute otitis media

Tx and dose?

A

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
Q

Student with Lice.
Tx?
How soon to go back to school?

A

1st line : Permethrin
May return to school ASAP. Does not need to be nit free
Treat again in 1 week

29
Q

6 y/o with 48 hr hip pain. With a limp, afebrile, Normal labs and X-rays

DX:
Tx:

A

Transient synovitis: everything normal

Ibuprofen

30
Q

Concussion yesterday. No lost of consciousness. Just headaches and balance problems but can recall everything.

What to do for evaluation?

A

Do physical and cognitive rest

CT only if focal sx or LOC > 60 seconds

31
Q

When to screen for Autism

A

18 months and 24 months

32
Q

Most common cause of hearing loss in New born?

A

Genetic inheritance

33
Q

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?

A 
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

  1. If no fever anymore, Aspirin 3-5 mg/kg/day q 6 hrs
  2. IVIG within 10 days
  3. Cardio referral for echo in 6 wks
  4. Low dose aspirin while waiting for Cardio
34
Q

6month female with bronchiolitis

When to give nebulized hypertonic saline?

A
  1. On hospitalized patient

2. Do not give in the ER

35
Q

Term baby
Exclusively breastfed
When do you start iron supplement to prevent Iron def anemia?
What if the baby is preterm

A

4 months

1 month

36
Q

Newborn found to have ear deformity
Mom had GDM
What test to order for the baby?

A

Renal US!

37
Q

13 y/o brought to ED for worsening asthma
Already on inhaled Fluticasone and Albuterol
What drug to give to prevent hospitalization?

A

Oral prednisone!

38
Q

New born male brought in for first exam
DX with Downs
test indicated for all downs?

A

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
Q

8 yr old with ADHD

TX?

A

Psychostimulant: Ritalin or Dextroamphetamine

If below 6 y/o, can do behavioral therapy first

40
Q

Risk factors for SIDS (6)?

A 
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
Q

5 wk old female visits in December. Born at 28 wks because of preeclamsia.
Need what immunoprophylaxis?

A

Palivizumab (Synagis) for RSV

Given in infants born < 29 wks

42
Q

6 y/o with limp
No fever, pain on the anterior hip joint increased on internal rotation which is limited
DX?

A

Osteonecrosis of the femoral head (Legg-Calve’-Perthes)

Male, 2-12

43
Q

Blood pressure in children…
What is a pre HTN?
What is hypertensive?

A

Pre HTN is 120/80 or less or between 90-95th percentile
Determined by Age, sex and length
Above 95th percentile is HTN!

44
Q

Day care center needs:

A

Director has degree in child related field
Staff knows CPR
Care giver ratio is 1:2
Discipline is standard

45
Q

MMR can be given at age?

Side effects?

A

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
Q

Vaccines for 2 month old?

A
  1. DTap
  2. Prevnar: Pneumococcal
  3. IPV! Not oral
  4. HIB
  5. Rota
  6. Hep B
47
Q

Car seats guidelines?

A
  • till age of 2: rear facing
  • till 13 yrs old: rear seat
  • booster: lap and shoulder strap
  • Safest: rear middle seat
48
Q

PPD in children

A

Not routine!

Only in positive exposure, immunocompromise, immigrants

49
Q

Genetic testing to be repeated is went home before 12 hrs of life?

A

Phenylketonuria!!!!- baby did not ingest enough phenylalanine.

50
Q

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?

A

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
Q

Fluoride supplementation:
How much?
What age?

A

0.5 ppm

Start at age 6 months

52
Q

HPV in males?

Age

A

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
Q

Iron supplement in <37 weeks

A

Start at 1 month for exclusively breastfed

54
Q

Definition HTN in children and adolescents?

A

> 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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