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Step 2 CK > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Normal HR and RR for neonates

A

RR 40-60
HR 120-160
(babies always faster)

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2
Q

Purpose of APGAR

A

need resuscitation?
1: L&D condition
2: response to resuscitation
not a predictor or morbidity and mortality

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3
Q

How to grade appearance and pulse for apgar

A

0: blue baby 1: blue limbs 2: pink
0: none 1: 60-100 2: 100+

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4
Q

How to grade grimace and activity for apgar

A

0: none 1: feeble cry 2: cough and gag
0: no activity 1: flexion 2: active

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5
Q

Neonatal conjunctivitis at 3+ weeks is

A

herpes

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6
Q

Two prophylactic eye ointments for babes

A

silver nitrate; e-mycin/tetra

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7
Q

How to TREAT gonococcal/chlamydial conjunctivitis

A

ceftriaxone/ emycin

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8
Q

Why are babies prone to GI bleed

A

no gut flora –> no ecoli –> no vitamin K

need single dose vitamin K

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9
Q

Vaccine series started at birth

A

Hep B

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10
Q

What congenital disorders are on all newborn screens nationally?

A 
(CHB)2 PG 
Creepy Hitmen Befriend Private Gypsies
C-CAH, CF 
H- homocystinura, HypoTH
B-Bthatl/biotinidase 
P- PKU
G- Galactosemia
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11
Q

Most newborn heritable disease (esp enzyme related) are AR but which enzyme deficiency is XR?

A

G6PD def

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12
Q

Galactosemia diet

A

eliminate lactose, no breast feeding

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13
Q

Tachypnea in newborn lasting more than 4 hours is

A

no longer transient rule out sepsis

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14
Q

Treatment of subconjunctival hemorrhage

A

none will resolve

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15
Q

3 types of neonatal skull fractures

A

linear common resolves
depressed must repair
basilar fatal

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16
Q

Constrast caput and cephalohematoma

A

hematoma confined to suture lines

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17
Q

Cephalohematoma is aka

A

subperiosteal hemorrhage

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18
Q

Best treatment for brachial plexus injury

A

immobilization

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19
Q

Two common brachial plexus injuries:

A

upper: 5-6; adducted/internally rotated arm (waiters tip)

lower 7-8/1: claw hand + horners (MAP)

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20
Q

What causes facial nerve paralysis in delivery

A

forceps

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21
Q

Common causes of polyhydramnios

A

unable to swallow

werdnig Hoffman-neuro; intestinal atresia

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22
Q

Causes of oligohydramnios

A

prune belly (no muscles); renal agenesis/potts

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23
Q

Appearance of baby with oligohydramnios

A

flat face because compression/ no buffer with amniotic fluid

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24
Q

Two types of CDH

A

Bochdalek- posterolateral, L

Morgagni- retro/parasternal

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25
Q

Causes of high AFP

A 
#1 wrong dates 
abdominal wall defects 
NTDs
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26
Q

Cause of omphalocele

A

failure to retract at 10-12 wks GA

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27
Q

At what age must umbilical hernia be repaired

A

4 but most regress before this time

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28
Q

Location of gastroschisis

A

lateral

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29
Q

WAGR syndrome features and chromosome

A

wilms, aniridia, gu malformation, retardation…. chromosome 11

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30
Q

First test for wilms tumor

A

US

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31
Q

Neuroblastoma clues

A

dancing eyes and feet, hypsarrythmia on EEG; high VMA/ metanephrines

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32
Q

Hydrocele clinical appearance + cause

A

painless, transluminates

origin: tunica vaginalis remnant

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33
Q

Varicocele appearance + cause

A

bag of worms; check both sides usually bilateral; dilated pampiniform plexus

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34
Q

Cryptorchidism is assc with what risk

A

malignancy

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35
Q

When must cryptorchidism be repaired

A

before age 1 to avoid sterility

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36
Q

Hypo vs epi spadias

A

hypo- under- ventral

epi- on top- dorsal (like a fin)

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37
Q

What is hypospadias assc with

A

cryptorchidism, ingiuinal hernias

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38
Q

What is epispadias assc with

A

bladder exstrophy

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39
Q

Chromosome assc with TOF

A

22

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40
Q

TOF murmur-

A

VSD murmur (holosystolic, LSB)

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41
Q

VSDs are common in what disorders?

A

all trisomies

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42
Q

What are the 3 holosystolic murmurs

A

VSD
TR
MR

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43
Q

TGA murmur + xray findings

A

single S2 heard; egg on a string

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44
Q

Percentage of patients that survive TGA surgery

A

1/4

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45
Q

Pulsus paradoxus assc

A

TPTX; Tamponade

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46
Q

Hypoplastic left heart murmur + pulse + CXR findings

A

single S2; NO PULSE
globular shaped heart
very few survive surgery

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47
Q

TA murmur + pulse

A

systolic ejection murmur, single S2; bounding pulses

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48
Q

TA sequelae if not repaired

A

repair within 4 months or get PHTN

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49
Q

TAPVR w or w/o obstruction….what does the obstruction refer to?

A

angle that the vein enters sinus

50
Q

All heart defects with L –> R shunt have what EKG finding

A

RVH

51
Q

Cyanotic heart defects have what shunt type? Get what treatment?

A

R –> L; all get surgery

52
Q

What are the cyanotic heart defects ?

A 
5 T's 
transposition
Truncus 
TOF 
TAPVR 
TINY left heart
53
Q

Which of the 5 cyanotic defects have VSDs

A

TOF; Truncus

54
Q

Which of the cyanotic defects are PDA dependent

A

Transposition

Tiny left heart

55
Q

Conservative medical treatment of VSD

A

diuretics and dig

56
Q

Heart defect assc with paradoxical emboli

A

ASD

57
Q

During what window is PDA normal?

A

24 hours after birth

58
Q

Where do sounds from each valve radiate?

A

aortic-neck
mitral-axilla
tricuspid and pulm- back

59
Q 
Match the CXR finding to the cardiac defect: 
pear-
boot-
egg on a string- 
globular- 
jug handle- 
rib notching-
A 
pear- pericardial effusion
boot- TOF 
egg on a string- TGA 
globular- Tiny LH 
jug handle- PPAHTN 
rib notching-  Aortic Coarctation
60
Q

Syncope, hearing loss, normal vitals & exam=

A

Long QT syndrome

61
Q

Treatment of coarctation

A

surg

62
Q

When is jaundice concerning

A

day 1; week 2
more than 5+/day
more than 19.5 t bili
more than 2 direct

63
Q

When to do exchange for jaundice

A

20-25 total

64
Q

Most common type of esophageal atresia

A

proximal atresia and distal TEF

65
Q

Pre-op care for TEF

A

px abx for anaerobic coverage

fluids bc cant swallow

66
Q

To what GI conditions do each of the radiographic “signs” apply?

  • string sign
  • doughnut sign
  • birds beak
  • steeple
A
  • string: PS
  • doughnut: intussusception
  • birds beak: achalasia
  • steeple: croup
67
Q

PE signs of pyloric stenosis

A

succusion splash

olive

68
Q

Choanal atresia description

A

membrane between nostrils and pharyngeal space

69
Q

Clinical presentation choanal atresia

A

blue with feeds; pink when crying

70
Q

How to dx choanal atresia

A

ct

71
Q

CHARGE assc

A 
coloboma/CNS
heart defects 
atresia, choanal 
retardation of growth 
GU abnl
ear abnl
72
Q

Duodenal atresia clinical signs +assc syndrome

A

bilious vomiting, no respiratory distress

assc with downs

73
Q

Test for duodenal atresia

A

AXR –> double bubble

74
Q

Clinical signs of hirschspruings

A

tight rectal sphincter unable to pass stool or flatus, no meconium first 48 hours

75
Q

Mainstay dx of hirschsprungs + assc syndrome

A

downs, full thickness rectal bx (no ganglionic cells in submucosa)

76
Q

Cause of duodenal atresia

A

lack of apoptosis

77
Q

Most common location volvulus in childhood

A

midgut (ileum)

–> see birds beak like in achalasia

78
Q

Two assc with intussusception

A

rotavirus vaccine, HSP

79
Q

Onset of duodenal atresia vs volvulus

A

duodenal atresia at birth volvulus within first year

80
Q

Only true congenital diverticulum + tissue makeup

A

meckles, all three layers, ectopic gastric tissue + pancreatic

81
Q

Rules of 2’s for meckels

A 
within 2 ft ileocecal valve 
2 in long 
2 tissue types 
2% pop; 2% symptomatic 
males 2x more common
82
Q

Diagnostic tests for diarrhea in kiddos

A

1) stool for blood and leukocytes
2) O&P
3) +/- c diff

83
Q

What is always bad for diarrheal illness in kiddos?

A

loperamide

84
Q

Three common viral illnesses causing diarrhea

A

rota, noro, adeno

85
Q

Which diarrheal illness is most common in the winter?

A

rota

86
Q

Which diarrheal illness is 1-2 days instead of a week?

A

noro- short

87
Q

What is literally never ever ever the answer on step 2?

A

calling a consult

88
Q

Management of NEC

A

abx (vanc, gent or metro)
fluids
bowel rest
NGT for decompression

89
Q

Metabolic derangement in IDM

A

-low glucose NOT HIGH!
They overproduce insulin
-Low Ca,mag
-High bili

90
Q

Phyiscal abnormalities in IDM

A
  • macrosomia (all organs but brain)
  • small left colon
  • cardiac abnl
  • RVT
91
Q

MCC CAH

A

21 hydroxylase def

92
Q

How to dx CAH

A

17OHprog/electrolyte levels

93
Q

Cortisol, test, aldo = three products of steroid synthesis.

In 11/17/21 def, which of these products are high?

A

21- sex hormones (test) high
11- sex hormones + DOC high
17- aldo high

94
Q

Which of the CAH forms have hypertension?

A

all hypertensive except 21 = salt wasting shock

95
Q

3 forms of rickets

in which is phosphate normal?

A

2= normal phosphate

1) lack of vitamin D
2) inability to convert D –> OHD
3) X linked hypophos (inability to retain phosphate)

96
Q

Treatment for rickets

A

ergocalciferol or 1,2/calcitriol and monitoring

97
Q

Supplements for breast fed babes

A

D starting at 2 months

98
Q

Early causes of neonatal sepsis

A

GBS, e coli, listeria

99
Q

Late causes of neonatal sepsis

A

staph, e coli, GBS

100
Q

Abx for neonatal sepsis

A

Amp and Gent +/- cefotaxime

101
Q

TORCH infection treatment

A 
T-toxo- pyrimethamine 
O/syphilis- penicillin
R-rubella-support
C- CMV- ganciclovir 
H- HSV- acyclovir
102
Q

Toxo presentation (neonate_

A

chorioretinitis, hydrocephalus, intracranial calcifications

103
Q

Syphilis presentation in babe

A

rash on hands and feet snuffles, saddle nose, 8th nerve palsy

104
Q

Rubella presentation in babe

A

blueberry rash, PDA, deagness, cataracts etc

105
Q

CMV presentation in babe

A

cross between toxo and rubella BUT: periventricular calcifications

106
Q

HSV presentation in babe

A

shock/DIC wk 1 –> skin lesions wk 2 –> encephalitis wk 3

107
Q

Rubeola (measles) presentation in kiddos

A

3 C’s –> koplik spot in mouth

108
Q

Roseola virus + presentation

A

HHV 6-7

high fever –> rash

109
Q

Scarlet fever is different than Kawasaki because?

A

assc with PHARYNGITIS concurrently.

110
Q

Treatment of scarlet fever

A

penicillins, azithro, cephalosporin

111
Q

Treatment of croup +assc viruses

A

racemic epi

Parainfluenza, RSV

112
Q

Croup clinical signs

A

inspiratory stridor, barking cough

113
Q

Epiglottitis treatment

A

intubate + treat with ceftriaxone for at least a week; rifampin for close contacts

114
Q

Dx & Treatment of pertussis

A

PCR of nasal secretions
Treat with emycin/azithromycin in catarrhal stage (early before bad cough)

*Macrolides for contacts

115
Q

Treatment of diphtheria

A

antitoxin (abx don’t work)

**don’t scrape the membranes

116
Q

Age group for Legg Calves Perthes + pathogenesis

A

2-8 avascular necrosis if happens to one side will happen to the other

117
Q

B2/riboflavin def symptoms

A

angular chelosis
stomatitis
glossitis

118
Q

B5/B6 def

A

B5: burning feet
B6: peripheral neuropathy + anemia

119
Q

What are B1-3

A

1: thiamine; 2: riboflavin; 3: niacin

120
Q

Vitamin A and PTH function

A

low- hypoparathyroid

high- hyperparathyroid

Step 2 CK (8 decks)

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