Pediatrics Flashcards

1
Q

Workup for constitutional growth delay

A

IGF1, thyroid, kidney, wrist XR

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2
Q

Laryngomalacia

A

Floppy larynx, presents with squeaking stridor

No need for treatment unless severe/resulting in breathing difficulty

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3
Q

Normal weight gain at two weeks

A

1 ounce per day, 25-30g per day

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4
Q

Three most common causes of ear infections/sinus infeections/PNA in children

A

Strep pneumoniae
H. Flu
Moraxella catarrhalis

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5
Q

First line treatment for ear infections

A

Amoxicillin (90mg/kg) or cephalexin
Pink, bubblegum flavor
-If using to treat strep throat, dose is 50mg/kg

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6
Q

First line treatment for bacterial sinus infection

A

Augment (amoxicillin + clavulonic acid) or ceftanir

-ceftanir is better tasting

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7
Q

Treatment for croup

A

Dexamethasone 0.6mg/kg for one dose, oral of injectable because has no flavor
-prednisolone if the above is not available

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8
Q

Symptoms of pediatric sinus infection

A

ALWAYS has cough

  1. Cold-like sxs that fail to get better after 10 days
  2. Cold-like sxs that get better for a day or two and then get way worse
  3. Typical adult sinusitis symptoms (HA, sinus tenderness, drainage)
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9
Q

What are characteristics of bad lymph nodes?

A

Firm, nonmobile, nontender, and subclavicular are the worst

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10
Q

Treatment of colds

A

NO COUGH MEDICINE UNDER THE AGE OF SIX! Only treat the fever if it’s bothersome

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11
Q

Failure to thrive

A

<2% and decreased velocity of weight gain, disproportionate to length

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12
Q

Familial short stature

A

Parent’s height is short and so is patient’s adult height but young growth pattern is normal

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13
Q

Constitutional growth delay

A

Parental height is normal, patient has delayed puberty and slow growth

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14
Q

Anorexia

A

Short stature from poor nutrition

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15
Q

Turner’s syndrome

A
  1. Mild growth retardation in utero
  2. Slow growth during infancy
  3. Delayed onset of childhood component of growth
  4. Slow growth during childhood
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16
Q

Cause of anemia in infants

A

Can be Vitamin A deficiency

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17
Q

Milestone categories

A

Communication
Gross motor
Fine motor
Other (object permanence, etc)

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18
Q

Appointment schedule

A

Newborn, 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 14 months, 16 months, 18 months, 2 yeras, 2.5 years, every year

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19
Q

Hip exam

A

Ortolani, Barlow & Galeazzi maneuvers

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20
Q

Encopresis

A

Severe constipation that causes stretching of the bowel wall and hardening of old stool - new stool gets liquefied and slides around stool - presents as leakage in the underwear

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21
Q

Red flags of HA

A
worst headache of life
thunderclap headache
woke from sleep
LOC with an injury
early morning onset with vomiting
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22
Q

Exam for headache

A

Full neuro, including:

  • ophthalmoscope to look for papilledema
  • cranial bruits on head and orbits
  • visual fields
  • rapid alternating hand movements
  • back for scoliosis
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23
Q

Treatment for conjunctivitis

A

Fluoroquinolones, such as oflaxacin

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24
Q

Systematic approach for differential diagnoses

A
Vascular
Infectious
Neoplasm
Drugs
Inflammatory/idiopathic
Congenital
Autoimmune
Trauma
Endocrine/metabolic
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25
Q

When to do post-partum depression screening

A

2 months
4 months
6 months

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26
Q

Pediatric physical exam

A

Ears
Eye exam if not seeing eye doctor (light reflex, EOM, visual fields). Starting at age 5-6, do fundoscopic if no eye doctor
Quick neuro (eyes shut and open, cheek puff, upper extremity strength)
Neck
Heart sitting and lying down
Lung
Belly
GU (at age 5-6 for girls, ask about hair. always check testes for boys)
Leg mobility lying down
Sitting up, check knee reflexes
Standing up: squat, duck walk, toe walk, heel, walk, scoliosis check

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27
Q

1 month milestones

A

Lift head, track with eyes, coo, recognizes parents

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28
Q

6 month milestones

A

Sit up, raking grasp, babbles, stranger anxiety

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29
Q

9 month milestones

A

Walk with assistance, 3 finger grasp, maybe mama/dada?, wave bye/patacake

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30
Q

12 month milestones

A

Walk without assistance, pincer grasp, imitate parents, mama/dada

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31
Q

24 month milestones

A

2 steps, 2 word sentences, 2 step commands, 6 blocks

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32
Q

3 year milestones

A

Tricycle, 3 word sentences, brush teeth, circle, know colors and maybe 123

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33
Q

4 year milestones

A

Hops, copy cross, plays with kids

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34
Q

What is paronychia?

A

Bacterial infection along lateral nail fold

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35
Q

What is herpetic whitlow?

A

Viral infection of HSV of the finger. Bimodal: <10years, 20-30 years, vesicles that appear purulent

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36
Q

Treatment of depression in children

A

Fluoxetine

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37
Q

Bronchopulmonary dysplasis

A

Decreased surfactant, increased oxygen demands
XR shows ground glass
Tx: surfactant postnatal and steroids prenatal
Becomes diffuse parenchymal lung disease

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38
Q

Retinopathy of prematurity

A

Due to premature, increased O2 demands
Dx: eye exam
Tx: Laser
Can lead to glaucoma

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39
Q

Intraventricular hemorrhage

A

Babies susceptible given highly vascular ventricles
Be careful of blood pressures!
Premie, have increased ICP
Dx: Cranial doppler
Tx: Decrease ICP with VP shunts and drains
Can lead to seizure, mental retardation

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40
Q

Necrotizing enterocolitis

A
Dead gut
Premie with bloody bowel movement
XR: pneumotosis intestinal (air in the wall of the gut)
Tx: NPO, IV antibiotics, TPN
Need surgery
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41
Q

Failure to pass meconium

A

Nothing comes out within 48 hours!

  1. Imperforate anus- no hole. Get cross table XR (determine severity). Mild: fix now. Severe: colostomy now, fix later.
    - Vertebral anomaly (US sacral)
    - Imperforate anus
    - Cardiac issues (echo)
    - Tracheoesophageal fistula
    - Esophageal atresia (catheter with XR)
    - Renal (voiding cystourethrogram)
    - Limb (XR of the wrist)
  2. Meconium ileus: CF (not enough water in the lumen so get meconium plug)
    - Should be screened for CF
    - XR shows transition point and possibly gas-filled plug
    - Tx: water enema to dx and dissolve the plug
    - Confirm CF with chloride test
    - If CF: give vitamins ADEK, pancreatic enzymes, pulmonary toilet (prevent pulmonary infection)
  3. Hirschprungs: (failure of migration of inhibitory neurons of distal colon - muscle can’t relax so stool can not get through)
    Palpable colon because distended
    -Explosive diarrhea on DRE
    -Patients can present with chronic constipation with overflow diarrhea
    XR; good colon dilated, bad colon looks normal
    TX: if at birth: do contrast enema like barium to see transition point
    If later in life, do anal-rectal manometry - increased tone due to lack of inhibition
    BEST TEST is biopsy that shows no Auerbach plexus -
    Tx: surgically resect bad colon (looks normal but biopsies abnormal)
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42
Q

constipation

A
  1. Hirschprungs
  2. Voluntary holding
    -Cognitive impairment are at a higher risk
    -Usually when they begin toilet training or when they begin school for the first time
    -Starts as voluntary but may become involuntary
    -LIkely to see overflow incontinence and encopresis (stooling in the bed)
    Dx: clinical
    Tx: Bowel regimen - stool softeners and motility agents and behavior (tell kid it’s ok to poop), disimpaction (under anesthesia)
  3. Medication
  4. Diet
  5. Anatomy
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43
Q

Emesis

A

Normal feeds: formula colored, non-projectile, occurs after eating.

  1. Bilious: (
    - projectile
    - green
    - XR shows double bubble

a. malrotation: failure to rotate appropriately - could have strangulation of bowel. Normal uterine course (no polyhydramnios, no Down syndrome)
Dx: XR shows double bubble but normal gas pattern beyond. Can be confirmed with upper GI series
Tx: NG tube, intermittent suction, decompress. Will need surgery (especially if with volvulus)

b. Duodenal atresia: Failure to recanalize - leads to SBO. Can’t absorb amniotic fluid so have polyhydramnios
-Associated with downs
-XR with double bubble with NO gas beyond
Tx: surgery

c. Annular pancreas: failure of apoptosis of pancreas - squeezes down on bowel
-Polyhydramnios, associated with Downs
-XR: double bubble with no gas beyond
Tx: surgery

d. Intestinal atresia: Caused by vascular accidents en utero such as cocaine
-Doesn’t always have polyhydramnios
-NOT associated with downs
-XR: double bubble and multiple air fluid levels
Tx: surgery
Worried about short gut syndrome - malabsorption syndrome
Confront mom about medical issue or substance use

  1. Non-billious:
    - non-projectile
    - not green

a. Tracheoesophageal fistula (5 different types)
- Gurgling/bubbling because breathing through gastric secretions
- Dx: NG tube that coils on XR because of blind pouch
- Tx: TPN, surgery

b. Pyloric stenosis

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44
Q

Neonatal Jaundice causes

A

Prehepatic (unconjugated): hemolysis or hemorrhage
Intrahepatic (mixed):
-Crigler Nigar - look like pre
-Gaillvair - looks like pre
-Dubin-Johnson - excretion - looks like post
-Rotars: excretiion - looks like post
-hepatitis
Posthepatic(conjugated, direct): biliary atresia, sepsis, metabolic derangements

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45
Q

Kernicterus

A

Conjugated bilirubin cannot cross BBB and is water soluble - easily excreted in urine
Indirect/unconjugated is fat soluble - can pass membranes easily. Not excreted in urine and CAN cause BBB and lead to kernicterus

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46
Q

Physiologic jaundice

A
Onset: after 72 hours
Resolution: <1 week
Bili: Unconjugated
Rise: <5 units/day
Workup: Coombs test 
-if positive - treat with isoimmunization
-if negative - look at hemoglobin 

If hemoglobin low - indication of hemorrhage which could be cephalohematoma. If elevated, there is some transfusion (twin-twin transfusion, delayed clamping, maternal)
-if normal - check reticulocyte.

If reticulocyte count elevated then there is hemolysis (G6PD deficiency, pyruvate kinase, or Hgb SS disease). If normal - reabsorption issue (breast milk and breast-feeding)

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47
Q

Pathologic jaundice

A
Onset: within one day
Resolution: >1 week
Bili: Conjugated
Rise: >5 units/day
Workup: US, HIDA after phenobarb, causes of sepsis, metabolic disease?
48
Q

Breast feeding jaundice versus breast milk jaundice

A

Breast feeding: problem with quantity - not fed enough so bili sits around and gets reabsorbed. Feed baby more. Unconjugated.

Breast milk: Problem with quality.
Inhibits conjugation so unconjugated bili. Feed baby with hydrolyzed formula.

49
Q

Treatment of epilepsy

A

Levetiracetam (Keppra)
Phenytoin
Valproate
Lamotrigine

Ethosuximide (absence seizures)
Carbamazapine (trigeminal neuralgia)

50
Q

Febrile seizure

A
Fevers reduce seizure threshold
If simple (1 in 24 hours, lasts <15 minutes, generalized)

tx: benzo to abort
for simple: give antipyretics (Tylenol) NO IMAGING

If complex seizure: EEG? LP? MRI? Likely placed on antiepileptics

51
Q

Infantile Spasm

A
<1 yo
bilateral symmetrical limb jerking (not generalized, no fever)
EEG shows interictal hypsarrythmia
Tx: ACTH
Likely end up with mental retardation
52
Q

Tuberous sclerosis

A

Genetic disease
<2 yo
Angiofibromas or ash-leaf spot
Afebrile seizures or complex febrile seizures
Dx: CT or MRI will show tubers
Tx; supportive. Kids will die young and have mental retardation

53
Q

Absence seizures

A
100-1000s seizures per day
\+ LOC but no loss of tone or post-ictal state
Confused with "ADHD"
Dx: EEG
Tx: Ethosuximide (valproate as backup)
Most kids outgrow
54
Q

GI bleed in premature infant

A

NEC
XR: pneumatosis intestinalis (air in the bowel wall)
Tx: NPO, TPN, IVF, IV abx

55
Q

GI bleed in neonate

A

Anal fissure likely caused by fecal incontinence

56
Q

GI bleed in toddler

A

Intususception (telescoping of bowel into itself that leads to bowel compromise)
Sxs: abrupt onset, colicky abd pain. Knee-chest position brings relief. Can result in currant jelly diarrhea
Exam: sausage-shaped mass usually in RUQ
Dx: US to track progression shows target sign
KUB to identifiy perforation and obstruction
Tx: air enema. If not improved, go to surgery (or peritonitis, perforation)

Meckel’s diverticulum: remnant of vitelline duct with gastric contents
Sxs: painless, intermittent, hematochezia
<2 years old
<2% of popul
2x more likely in male
2 feet from iliocecal vale
2 inches in length
kid with “colon cancer” suspect meckel’s (+ Fecal occult test positive or iron deficiency anemia)
Dx: Technician 99 scan
Tx: resection
(CT scan is better in teenagers)

57
Q

Inflammatory bowel disease in kids

A

Crohn’s: watery diarrhea and weight loss

  • See skip lesions
  • medical therapy

Ulcerative colitis: bloody diarrhea

  • colonoscopy shows continuous lesions
  • surgery curative
  • Increased risk of colon cancer (yearly colonoscopy started 8 years after dx)

Infectious: Fever and bloody BM
-Get stool cultures

Milk-protein allergy: GI bleed
-Change to hydrolyzed formula

58
Q

Acute allergies

A
Type 1
Acute: IgE mediated. Exposure to trigger, cross-linking of mast cells which degranulate and release histamine
Anaphylaxis:
-urticaria all over body
-hypotension
-wheezing and loss of airway
Dx: clinical
tx: epinephrine, H1 and H2 blockers, steroids
Urticaria:
-wheal, whelt or erythema
-No hypotension
Dx: clinical
Tx: self-limiting. Observe or topical antihistamines
Angioedema: 
-swelling usually in one spot
-associated with ACE inhibitor 
-swelling airway
-No hypotension
can be C1 esterase deficiency (Tx with FFP)
Dx: Clinical
Tx: secure airway, H1/H2 blockers, steroids
59
Q

Chronic allergies

A

Type 1
Allergic rhinitis: seasonal or perinneal (all the time)
Exam: shriners, salute (nose crease), pale, boggy mucosa, polyps with cobblestoning
Dx: Clinical
Tx: Avoidance of trigger and intranasal steroids (can also use H1/H2 blockers and leukotriene antagonists like montelukast)

Conjunctivitis:

  • Shringers, conjunctival injection, chemosis
  • Same dx and tx as above

Food allergies:
-Wheat, soy, milk, and eggs
-Nuts and shellfish can cause anaphylaxis
Sxs: nausea, vomiting, diarrhea. MIght have eczema or asthma
Dx; food trial
Tx: Avoid triggers. Use epi if anaphylaxis

Milk protein allergies:
-Soy formula
-Sxs: nausea, vomiting, diarrhea, could have bloody bowel movement. FTT
-Dx: clinical
Tx: change formula (use cow milk, breast, or hydrolyzed formula)

60
Q

Developmental Quick

A
2mo lift head, social smile
4mo roll over
6mo sit up, stranger anxiety
1yr walk, stranger anxiety, 1 word
2yr steps, 2 word
3yr tricycle, 3 word, circle
4yr hopping, 4 word, cross
5yr skipping, 5 word, triangle
61
Q

Meningitis

A

Fails positive: increased ICP so give abx, CT then LP. If Fails negative: LP and abx
Tx: Adult: Vanco, cephtriaxone, steroids
Peds (kids <30 days): Vanco, steroids, ampicillin, cefetaxime

62
Q

Tx for scabies and lice

A

Permethrin

63
Q

Tx for pinworm

A

Albendazole

64
Q

HIV/AIDS

A
For kids <18 months, test with DNA PCR
HAART for any positive
Prophylaxis: 200 PCP with bactrim (then dapzone or atorvaquone)
100 toxo with bactrim or atovoquone
50 MAC with azithromycin
65
Q

Causes of osteomyelitis

A

Staph aureus

Salmonella (sickle cell kids)

66
Q

Causes of septic joint

A

Staph aureus, gonorrhea

67
Q

Pneumonia

A

<5year: mostly viral
TB: Ignore BCG
<5: get PPD
>5: get interferon gamma

Tx: RIPE for full blown or isoniazid with B6 for latent

68
Q

Erythema infectiosum

A
Slapped cheek disease 
Parvo B19
fever AND rash
Tx: supportive
IF hemoglobinopathy then worry about aplastic crisis and hydrops fetalis
69
Q

Measles versus german measles (rubella)

A

Measles:
Parvomyxovirus
Prodrome: Cough, coryza, conjunctivitis, koplik spots
Fever AND rash: rash begins on face and spreads downward
Tx: supportive
Prophylaxis: MMRV
Can develop subacute sclerosing panencephalitis (brain disease later in life)

German measles (Rubella):
Prodrome: Generalized and tender lymphadenopathy
Fever AND rash:
Rash on face that spreads downward
Tx: supportive
Prophylaxis: MMRV
70
Q

Roseola

A

HHV 6
Prodrome: Very high spiking fever (>104 degrees)
Rash occurs after fever breaks (Fever THEN rash)
Rash starts on trunk and extends outward
Tx: Supportive

71
Q

Varicella zoster

A

Adult: shingles
Baby: chicken pox

Sxs: rash without fever - diffuse rash: vesicles on erythematous base in different stages of healing
Tx: Supportive
Prophylaxis: MMRV1

72
Q

Mumps

A

Mostly in pubertal males that have parotid swelling and orchitis
Tx: supportive
Prophylaxis: MMRV
Orchitis may lead to infertility

73
Q

Hand food and mouth disease

A

Cocksackie A
Looks like varicella but only on the hands, feet, and mouth
Tx: supportive

74
Q

Head trauma

A

Epidural: Strike to head (ball sports and skiing)

  • walk, talk, and die
  • middle meningeal artery
  • CT: lens shaped

Subdural: significant amount of trauma (pedestrian struck, MVA where thrown, shaken baby)

  • LOC and coma
  • CT: Crescent shaped

Contusion: deceleration injury

  • LOC
  • CT: punctate hemorrhages

Concussion: Head trauma with no bleed

  • Sports injury
  • Mild does not need CT
  • Severe needs CT scan. If negative, still admit
75
Q

burns

A

Parkland formula calculated by percent of body affected by burn (2nd and 3rd degree) x 4 x body weight
50% given in first 8 hours, 50% given in next 16 hours

76
Q

Vaccinations

A

DTaP for kids: five doses
TDaP for adults: once in adolescence, then every 10 years
Pneumococcal mostly adults but can be kids too
Meningococcal everyone but especially college or military
HPV everyone
Heb A 3 doses, Heb B 2 doses
Flu everyone

77
Q

Tetanus

A

Dirty wound
Lock jaw, spastic paralysis
Tx: Intubate, sedate, muscle relaxers, IV antibiotics (metronidazole)

78
Q

Diphtheria

A

Fever, dysphagia, dypsnea
Pseudmembrane in mouth
Tx: Intubate to secure airway, anti-toxin and antibiotics

79
Q

Pertussis

A

Phase 1: Catarrhal (infectious), nonspecific looks like cold
Phase 2: Paroxysmal cough with intermittent wheezing
Phase 3: Resolution
Tx: supportive and erythromycin

80
Q

When to use tympanoplasty?

A

3 ear infections in 6 months or 4 ear infections in 12 months

81
Q

Otitis externa

A
Swimmers ear: pseudomonas
Digital injury/picking: Staph
Worse with pulling of pinna
Tx: waiting. If ear is nasty, then use cipro drops and steroid drops.
Ensure they don't have mastoiditis
82
Q

CENTOR criteria

A
For strep:
Cough
Exudates
Nodes
Temp >38deg
OR <14yo (+1), >44 (-1)
<1 viral 
2-3 do rapid strep. Can do culture
>4 treat with Abx
83
Q

Epistaxis

A

Usually trauma
Normal if unilateral, lasts less than 30 minutes
Tx: lean forward, apply pressure or ice
Anterior bleed: cauterize with nitrate sticks
Posterior: packing and prophylactic antibiotics

84
Q

Choanal atresia

A
Pathway from nose to trachea is blcoked
baby turns blue when feeding, pink when crying 
Childhood snoring
Dx: pass catheter
Tx: surgery
85
Q

Croup

A
caused by parainfluenza
3mo-3year
Barking, seal-like cough with stridor
Moderate: Give racemic epi or dexamethasone
Severe: admit
86
Q

Bacterial tracheitis

A
Staph aureus
Wide age group, mostly 4 years
Croup that does not improve with treatment
Might be toxic-appearing
Dx: Tracheal culture
Tx: Abx
87
Q

Epiglottitis

A

H flu - vaccine so decreased prevalance
3-7 years old
VERY sick- rapdi onset high fever, tripod, drooling, using accessory muscles, hot potato/muffled voice
Visualize cherry-red epiglottis with endotracheal tube in the OR to secure airway
Then Abx

88
Q

Retropharyngeal abscess

A

Oral flora
Very sick, abrupt onset of high fever, drooling, neck extended, neck stiffness, drooling with hot potato voice
Anterior chain unilateral lymphadenopathy and tender mass (abscess)
Dx: CT scan
Tx: I&D and antibiotics

89
Q

Peritonsillar abscess

A
Oral flora
Age >10
Hot potato voice, drooling, dysphagia/odynophagia, uvular deviation (tonsils shifted)
Dx: clinical
Tx: drain and antibiotics
90
Q

Foreign body airway obstruction

A

Foreign body
<3, unattended, sudden onset of SOB
Intrathoracic causes expiratory wheeze
Extrathoracic causes inspiratory stridor
Dx: XR 2 view - coin sign (neg on AP, + on lateral =in the trachea)
Tx: Abx if bacterial infection developing. Otherwise remove with bronchoscopy (lungs), endoscope (GI), or laryngoscope (ENT)

91
Q

Bronchiolitis

A

RSV
<2yo
Wheezing, dyspnea but in winter months and no other symptoms of asthma
Tx: Oxygen and fluids

92
Q

Cystic fibrosis

A
Autosomal recessive of CFTR gene
Diagnosed by prenatal screens
See with meconeum ileus on day of birth
Recurrent pulmonary infections
Failure to thrive
Baby tastes salty
Dx: screen, then sweat chloride (>40 infant, >60 older)
Tx: lung: pulmonary toilet to move secretions, fight pseudomonal pneumonia

Pancreas: pancreatic enzymes, vitamin ADEK supplement

93
Q

Tobacco use in pregnancy

A

Low birth weight

94
Q

Alcohol use in pregnancy

A

FAS: facial abnormalities, growth deficiencies, CNS dysfunction

95
Q

Heroin use in pregnancy

A

Increased risk of fetal growth restriction, placental abruption, fetal death, preterm labor, meconium

96
Q

Cocaine use in pregnancy

A

vasoconstriction - placental insufficiency and low birth weight

97
Q

Term infant caloric requirement

A

100-120 cal/kg/day = gain of 20-30g/day

98
Q

Vaccines

A
DTaP - five doses
IPV (Polio) - 4
Hib - 3 or 4
PCV13 - 4
MMR - 2
Varicella - 2
RotaV - 2 or 3
HepA - 2
HepB - 3
99
Q

Neuroblastoma

A

Infants less than one year - tumors may spontaneously regress
elevated urine catecholamines (VMA and HVA)
Painless mass in the neck, chest, or abdomen but could be chronically ill or have bone pain from mets
Fever, pallor, weight loss
Commonly RUQ mass

100
Q

Nephroblastoma (Wilms’ tumor)

A

Asymptomatic RUQ abdominal mass
Rarely cross the midline
May be associated with abd pain and vomiting, may be hypertensive

101
Q

Non-sedating antihistamines

A

loratadine, fexofenadine, cetirizine

102
Q

Screening for DM

A
overweight (BMI>85th%, weight >120% of ideal)
Any two of following:
family hx of DM
race/ethnicity at higher risk
signs of insulin resistance
maternal hx of GDM

Screen at 10 years of age, q3 years

103
Q

Management of prehypertension in children

A

90-95th%ile
lifestyle changes
Follow up in six months

104
Q

Order of puberty stages

A
Girls: 8-13
Breast
Hair
Growth spurt
Periods
Boys 10-15
Testicles
Hair
Penis, scrotum
Ejaculations (13)
Growth spurt
105
Q

Precordial catch syndrome

A

most common cp
sudden, sharp pain, worse with inspiration
resolve spontaneously

106
Q

Transient tachypnea of newborn

A

Delayed clearance of fluid from lungs at birth
More common in diabetic mothers and C-section delivery
XR: “wet” looking lungs, no consolidation

107
Q

Respiratory distress syndrome

A

Def. of lung surfactant
Most common cause in premies
Increased risk in diabetic mothers
XR: “Ground glass appearance” - diffuse reticulogranular appearance

108
Q

Congenital adrenal hyperplasia (21 OH def)

A

Decreased production of cortisol and aldosterone
Elevated 17-Oh progesterone
Increased androgens

109
Q

Bronchiectasis

A

XR: Hyperinflation, increased interstitial markings, peribronchial cuffing, scattered atelectasis

110
Q

Diagnostic criteria for DKA

A

A random blood glucose of > 200 mg/dL (> 11.1 mmol/L)

A venous pH < 7.3 or serum bicarbonate < 15 mEq/L (< 15 mmol/L), and Moderate or large ketonuria or ketonemia

111
Q

Maintenance fluids

A

100 mL/kg/day for the first 10 kg of body weight
50 mL/kg/day for the second 10 kg of body weight
20 mL/kg/day for each additional 1 kg of body weight

112
Q

Ibuprofen dosing

A

Pediatric dose: 10 mg/kg every 6-8 hrs PO (maximum dose = 40mg/kg/24 hr PO) Concentration of oral suspension: 100 mg/5 mL (20 mg/1 mL)

113
Q

Murmur of ASD

A

Fixed, split S2 and systolic murmur (increased flow across pulmnonic valve)

114
Q

Sound of bicuspid aortic valve

A

Early systolic click

115
Q

Murmur of VSD

A

Holosystolic, blowing

116
Q

Pulmonic stenosis

A

Harsh systolic ejection murmur with click just after S1

117
Q

PDA

A

Continuous murmur