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Online Med Ed notes DF > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

erythema infectiosum is caused by what and another name

A

parvovirus B19

slapped cheek

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2
Q

f/u problems with erythema infectiosum

A

aplastic crisis especially in sickle cell

hydrops fetalis

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3
Q

infectious disease high fever over ___ and rash after fever breaks disease?

distribution

f/u

A

104

roseola

starts trunk then spreads out

f/u: febrile seizures

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4
Q

varicella zoster rash without what

what stages

A

without fever

rash in different stages

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5
Q

what does shingles never do

tx

A

crosses midline

it is in dermatomal pattern

tx: acyclovir
ppx: vaccine over 60

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6
Q

measles is from what virus

what prodrome

associated syptoms

F/U

A

parvomixovirus

fever and rash at same time on face then down trunk
clears this way as well

cough
coryza
conjunctivits
koplik spots (white dots on mouth)

f/u: SSPE

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7
Q

rubella is called what

lesion distribution

prodrome

A

german measles

rash on face then trunk and arms

fever and rash at same time

**prodrome: generalized and tender LAD

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8
Q

what is a possible consequence of mumps to f/u on

A

infertility with orchitis

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9
Q

hand foot and mouth disease looks like what in that distribution

caused by what

A

varicella looking

coxsackie A

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10
Q

URI bugs in otitis media

A

strep, moraxella, h flu

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11
Q

OM is infection of what

A

middle ear, tympanic membrane

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12
Q

diagnosing OM

A

pneumatic insulflation

air in and TM stays rigid

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13
Q

treatment of OM

1st

recurs

recurs a lot

if pen allergy non life threat

if life threat pen allergy

A

amoxicillin first

if recurrs then amox-clav

if recurs a lot then ear tubes (3x in 6 months or 4x in a year)

if have penicillin allergy thats non life threatening use cefdinir

if have severe anaphylaxis use azithromycin

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14
Q

otitis externa

path: location
bugs

pain worse with what, looks how

A

outer ear

swimmer–> pseudomonnas
digtial–> staph

pain worse with pulling, erythema, angry canal

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15
Q

tx of OE

A

spontaneously resolved
abx drops (cipro)
steroids

only if bad use abx and steroids

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16
Q

when do you treat sinusitis and with what

A

if temp over 38 degrees celcius
duration of 10 days or more
or keeps getting worse

amoxicillin-clav
PCN

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17
Q

mastoiditis path

pt from what disease, looks how

dx

tx

A

URI bugs

tympanoplasty (hole from surgery)

acute OM, mastoid swelling behind the ear, anterior rotated ear

dx: clinical or CT
tx: surgery

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18
Q

pharyngitis viral or bacteria?

1 or less
2-3
4 or above

A 
Cough +1
Exudates +1
Nodes +1
Temp at or over 38 degrees C +1
Or at/under 14, at/over 44 +1

CENTOr

1 or less = viral
2-3 = get rapid strep, if negative and still suspicious then culture

if 4 or above then abx: amoxicillin-clav

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19
Q

urtricaria (rash) all over, hyptension and wheezing is what

A

anaphylaxis

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20
Q

how to treat anaphylaxis

A

epi 1:1000 IM
support airway with intubation, and BP with IV fluids and presors if needed

H1 and H2 blockers and albuterol and maybe steroids
-adjunctive therapy

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21
Q

urtricaria sx

A

wheal
whelt
erythema

NO hypotension

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22
Q

tx for utricaria

A

2nd generation H1 antihistamines and remove/avoid the offending agent

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23
Q

angioedema sx

A

swelling with no wheal from ACEi

swelling of airway with NO hypotension

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24
Q

angioedema tx

f/u?

A

secure airway
h1/h2 blockers
steroids

f/u: C1esterase deficiencey causing angioedema give FFP

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25
Q

sx allergic rhinitis

A

shiners under eyes
transverse nasal crease (allergic salute)

pale boggy mucosa

polyps
cobblestoning of posterior oropharynx

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26
Q

tx of allergic rhinitis

A 
intrnasal steroids (for test)
and avoid trigger

intranasal antihistamines are also considered 1st line
oral antihist and LTA too

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27
Q

food allergy sx

disease associated

A

N/V/D

eczema, atopic dermatitis

anaphylaxis so have epi pen

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28
Q

milk protein allergy sx

A

N/V/D (bloody stool)

FTT

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29
Q

tx milk protein allergy

A

switch to cow milk, breast milk, or hydrolyzed formula from soy formula

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30
Q

anaphylaxis needs involvement of how many organ systems

examples

A

2

CV: hypotension
GI: diarrhea
skin (hives)
pulmonary (airway edema)

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31
Q

pathogenesis of urticaria

A

type I HS
non immunologic mast cell degranulation (contrast, opiates, red man syndrome from vanco)

wheals and erythema limited to superficial layers of dermis

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32
Q

compared to urticaria, angioedema has what involvmeent

A

deeper involvement of tissue and potential for mucous membrane involvement

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33
Q

diagnostic testing of allergic rhinitis if needed

A

skin testing

then serum testing (RAST)

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34
Q

treatment of allergic conjunctivits

A

avoid triggers
combo eye drops (mast cell stabilizers and antihist)
oral antihistamines

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35
Q

scaly skin on the extensor surfaces of infants and young children or flexor surface in older children

A

atopic dermatitis

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36
Q

dx crohns and tx (is it curative?)

A

EGD and colonoscopy see skip lesions

meds, still recurs

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37
Q

dx ulcerative colitis

tx is curative?

monitor

A

colonscopy, continuous lesion

surgery cures

8 yrs after dx do colonscopy every year

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38
Q

preamture baby with GI bleed

A

NEC

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39
Q

tx for NEC

A

NPO< IVF, TPN, IV abx

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40
Q

apt for intusssuception

A

abrupt sudden onset of colicky abdominal pain with knee chest relief

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41
Q

currant jelly diarrhea

A

intussusception from dead bowel sloughing off

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42
Q

what will you see on a PE of intuss

A

sausage shaped mass in RUQ

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43
Q

dx intuss

3 of them

A

KUB shows evidence of late disease: perforation or obstruction, not useful in dx

U/S is sensitive and can track it see target sign

air enema diagnose and treats it

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44
Q

when do you go to surgery with intuss

A

peritonitis
perforation
failed air enema

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45
Q

how do you diagnose bloody stool if baby swallowed moms blood

A

APT test

fetal blood is resistant to denaturation so positive test = further investigation

maternal blood will yield negative test, so reassurance

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46
Q

other reasons kids have bloody stool besides disease

A

swallow mom blood
swallow own blood (epistaxis)
iron supplements, beats, meds

47
Q

painless intermittenet hematochezia (bright red stool) in children (toddler)

A

meckels diverticulum

48
Q

dx meckels diverticulum in kids

teens?

A

technicium-99

teens would be CT

49
Q

dx NEC

A

babygram

50
Q

what is the most common cause of hematochezia in infants and associated with what

in older children think what?

A

anal fissure from tear in anal mucosa associated with constipation

in older children think IBD

51
Q

age of intuss most common

A

3 months to 3 years

espn shows NFL highlights of intusserceptions

52
Q

meckels diverticulum is a remnant of what

A

omphalomesenteric (vitelline) duct which can contain gastric tissue, can lead to acid secretion and cause ulcers to form

53
Q

how does meckels diverticulum present in child

A

FOBT +
IDA
or hematochezia in child

painless bleeding and may be intermittent

54
Q

rule of 2s meckels diverticulum

A 
<2 yrs old
2x more common in males
2 inches long
2 feet from ileocecal valve
2% of population
55
Q

peak age IBD

A

10-20

50-80

56
Q

what is helpful for IBD dx

A

double contrast enema and colonscopy

57
Q

if a pt has bloody diarrhea plus fever think what

A

shigela, salmonella, ecoli, yersinia etc

58
Q

workup if think infectious colitis

A

obtain stool cultures and blood culutres if pt is septic

hydration and electrolyte management

no abx unless suspect shigella, or immunosuppression patient

59
Q

diagnosing asthma in children

A

history of intermitent or chronic sx of asthma and muscial wheezing found on PE

60
Q

ominous signs in asthma exacerbation

A

decreased wheezing or lung sounds and hyperresonance

61
Q

asthma exacerbation

no O2 needed, no wheezes and PEFR over 70% then do what

A

send home with inhaler and prednisone

62
Q

asthma exacerbation

need increased O2
increased Co2
decreased lung sounds
PEFR under 50%

do what

A

ICU

ventilator
IV methylprednisone
continuous nebs

63
Q

asthma exacerbation sending person to floor

A

neubs
iv steroids

transition to inhaler and oral pred

64
Q

sx of asthma exacerbation what do you do

A

DOSE

Duonebs (ipratrop and albut)
O2 (keep O2 sat over 90%)
Steroids (IV or PO)
Experiatory flow rate assessment

65
Q

charcot leyden crystals or curschmann’s spirals is what disease

A

asthma

66
Q

for exercised induced asthma what drugs

A

nedocromil or cromolyn sulfate used right before exposure

67
Q

rescue therapy for refractory disease in asthma involves what

A

racemic epin
nebs, subcut epi
IV magnesium

added to attempt to avoid intubation

68
Q

when pt first arrives to ED with asthma exacerbation what should be performed?

improve

in between

no more better

A

peak flow

if no improvement after 3 hrs of continuous nebs then go to ICU

if better (100% improvement and sx free) go home with rescue inhaler and PO steroids

if in between then floor for further managment (duonebs Q4 hrs with ongoing oral or IV steroids)

69
Q

if pt has to go to ICU for asthma exacerbation then what managment

A

Intubation
IV steroids( high dose)
ECMO (life support)

70
Q

grand mal seizure LOC and general or partial

A

yes LOC

general

71
Q

generalized with no LOC

A

pseudo seizure

72
Q

if you lose consciousness what kind of seizure, what if do not

A

LOC = complex

no LOC = simple

73
Q

infantile spasms aka what?

age

parts affected

fever?

dx

tx

f/u

A

west syndrome

pt under 1

b/l symmetric limb jerk
not generalized

no fever

dx: interictal EEG shows hypsarrhytmia
tx: ACTH

f/u intellectual disability

74
Q

pt age for febrile seizures

A

6-60 months

75
Q

febrile seizures

if longer than 5 mintues do what

A

abort with benzos

76
Q

never use what with febrile seizures

A

aspirin bc of Reye syndrome

77
Q

simple febrile seizure workup

dx

A

doesn’t need one

its 1 in 24 hrs less
less than 15 mintues
generalized

78
Q

is a seizure focal, >___ min in duration or ____ within the day then workup for what

A

15, recurrent

complex febrile seizure

EEG, MRI, LP

79
Q

asthma: intermittent

Day episodes, night, FEV1, treatment

A

less than 2 a week, 2 or less a month at night, 80%

-SABA PRN

80
Q

asthma: mild

Day episodes, night, FEV1, treatment

A

not daily during day, more than 2 month at night 80%

SABA + ICS

81
Q

asthma: moderate

Day episodes, night, FEV1, treatment

A

once or more a day and over once a week 60-80%

-SABA, ICS, LABA

82
Q

asthma: severe

Day episodes, night, FEV1, treatment

A

one or more a day, night time frequently, 60% or less

SABA, higher dose ICS, LABA,

83
Q

asthma: refractory tx

A

oral steroids

84
Q

what to watch for in asthmatics with tx not working

A

can they use correctly
add spacer
med adherance

85
Q

severe asthma exacerbation what is first step

A

DOSE

Duonebs, Oxygen, steroids, expiratory flow rate assessment

86
Q

severe asthma exacerbation if going to floor do what

A

IN the floor

IV steroids
Nebulizer

87
Q

severe asthma exacerbation if going to ICU do what

A

ventilator
IV methylpred
continue nebs

88
Q

kid fracture, when to go to ORIF

what next

A

open
communited

+ growth plate fracture

then cast

89
Q

age for developmental dysplasia of hip

sx

dx

tx

A

newborn, clicky hip

US @ 4 weeks

harness

90
Q

age for legg C P disease

sx

dx

tx

A

age: 6 yrs old
patient: insidious antalgic gait (spend less time on painful leg)

dx: Xray
tx: cast

91
Q

SCPE age and pt and Dx and tx

A

13, growth spurt or fat ass with non traumatic joint pain, frog legg XRay
surgery

92
Q

septic joint

age
pt
dx
tx

A

age: any
pt: fever, increased WBCs, incresaed inflammatory markers, cannot bear weight
dx: arthrocentisis with over 50,000 species
tx: drain and abx

93
Q

severe scoliosis can lead to what

A

dyspnea

94
Q

test for scoliosis

A

adams test

xray too

95
Q

tx for scoliosis

A

brace or surgery

96
Q

pt witll always be what on test question for scoliosis

A

teenage girl

97
Q

location of osteosarcoma

A

distal femur

98
Q

kocher criteria is for dx what and tell me what it is

A

septic joint

non weight bearing
ESR >40
Fever >38 C
WBC >12,000

1: not septic
2: not sure
3: 93% septic
4) 99% septic

99
Q

transient synovitis

sx

tx

A

synovial inflammation up to 4 weeks afer URI or GI viral illness
no fever, leukocytosis, and decreased inflammatory markers

treat supportively

100
Q

diagnosing chronic granulmatous disesae

A

nitroblue or Dihydrotamine test

101
Q

on quantitative Ig what would you see for CGD

tx?

A

increased IgM and IgG

BM transplant

102
Q

what would you see in labs for LAD and what infections and treatment

A

incrased peripheral leukocytosis with increased neutrophils

recurrent skin and mucosal bacterial infections

BM transplant

103
Q

giant granules in neutrophils is what

cx features

A

chidiak hagashi syndrome

neuropathies and neutrophenia and albinism

104
Q

CGD what would you see on CBC and Quant IG

A

increased WBC

incrased IgM and IgG

105
Q

what pouch messed up in digeorge syndrome

A

3rd

106
Q

x linked agammaglobinemia presents when

b cells and Igs

confirm with what

treatment

A

early

no b cells

now Ig MAG

confirm with BTK gene

scheduled IVIG and then BM transplant

107
Q

CVID age presentation

cbc

quant IG

tx

A

later in life like teens

normal CBC

quant IG shows 2/3 dcreased Igs (MAG)

scheduled IVIG may be warrented but may not need

108
Q

which inherited immunodef has anaphylaxis with blood transfusion

A

IgA defieiency

109
Q

general rules immunodefieicny

6-9 month problem?

6-12 month problem?

over 12 months?

A

6-9 T

6-12 T and B

> 12 B

110
Q

treatment for hyper IgM syndrome

A

scheduled IVIG

111
Q

fungal or PCP pneumonia in baby should be red flag for which inherited disease imunnodef

A

digeorge

so give tmp smx and scheduled IVIG and thymic transplant

112
Q

ataxia telangiectasia

A

telangiectasias + ataxia poor DNA repair lymphoma and leukemia

113
Q

Hyper IgE (job) syndrome

IgE, peripheral levels

infections with what

other related stuff

A

severely elevated IgE levels

peripheral eosinophilia

recurrent cold abscesses (strep, h flu, strep pneumo)

exzema, retained primary teeth

Online Med Ed notes DF (4 decks)

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