Pediatrics Flashcards
Birth weight is doubled at
4 months
Birth length increases by _____ at 1 year
50%
Physiologic weight loss occurs on the _____ days of life
First 10 (to 14) days of life
Average head circumference _____ increased by _____ by 1st year
35cm
10cm
Average length of a newborn infant
50cm
myelination of cortex begins at
7-8 months of age
Weaning period
6 months
Sits without support
6 months
Walks alone
12 months
Speaks 10-15 words
18 months
Pincer grasp well-developed at
12 months
Bed wetting is normal up to _____ in girls and _____ in boys
4 years old in girls
5 years old in boys
Knows full name
30 months
climbs stairs one step at a time
24 months
Copies a circle
36 months
Tells stories
48 months
Hallmark of adolescent development
Separation from parents
ASO titer in rheumatic fever
more than 333 TU
Significant risk factor for development of RDS in newborn
Maternal diabetes
Pyuria of ____ WBC/hpf in spun urine is indicative of UTI in children
5
10 if unspun
Gold standard for acute pyelonephritis
DMSA renal scan
Most common cause of acute pyelonephriis in <2 years old
VUR
Duration of Treatment of acute cystitis and pyelonephritis respectively
5-7 days
10-14 days
Isolated glomerular hematuria with low C3
PSGN
MPGN
Hep B
HIV
What differentiates PSGN from MPGN?
C3 levels normalize in 6-8 weeks
Most common chronic glomerular disease worldwide
IgA nephropathy
Berger disease
X-linked hereditary nephritis assoc w/ sensorineural hearing loss and anterior lenticonus
Alport Syndrome
Multisystem glomerular hematuria with low C3
SLE
Most common cause of AKI in children <4 y/o
HUS
most common manifestation of SLE in childhood (>8 y/o)
SLE nephritis
Random urine protein:crea ratio in nephrotic syndrome
> 2
Hypoalbuminemia in nephrotic syndrome
<2.5 mg/dL
Tx for minimal change disease
Pred 60mg/m2/day
in 3 divided doses
for 4-6 weeks
Final common pathway of glomerular destruction
Hyperfiltration injury
Formula for estimated crea clearance
k (0.55) x length in cm
divided by plasma crea
In neonatal lupus, fetal echocardiography should be done at what AOG
16 weeks AOG until delivery
Gottron’s papules in dermatomyositis seen at
knuckles (MCP), PIP, elbows, knees, ankles
Rheumatologic disease with equal prevalence among men and women
JIA (systemic type)
Risk factor for development of inflammatory eye disease (uveitis)
ANA
positive in pauci
Polyarticular type of JIA involves how many joints
5 or more
<16 y/o
arthritis >6 weeks
quotidian fever (q24h)
salmon-colored evanescent rash
JIA systemic type
antibodies present in limited systemic scleroderma
Anticentromere
antibodies present in diffuse systemic scleroderma
Anti-scl 70
Most common organ involvement in systemic scleroderma
Pulmonary
Tx for pulmonary alveolitis in systemic scleroderma
Cyclophosphamide
Tx for systemic scleroderma
Methotrexate +/- steroids
5 days fever + 4 of the ff: bilateral conjunctival injection strawberry tongue hand erythema/periungual desquamation truncal rash cervical LN, unilateral, >1.5cm
Kawasaki disease
mucocutaneous lymph node syndrome
Most common cause of acquired heart disease in children in developed countries
Kawasaki disease
Tx of Kawasaki
IVIG + highdose aspirin
Most common infectious trigger of polyarteritis nodosa
GABHS
hep B in adults
Rheumatologic disease characterized by necrotizing granulomas in respi tract and kidneys
Wegener’s granulomatosis
granulomatosis with polyangiitis
Upper RT (sinusitis, hearing loss) Lower RT (chronic cough, hemoptysis) Kidneys (hematuria, proteinuria) saddle nose deformity (+) c-ANCA /anti-PR3
Wegener’s granulomatosis
Reiter’s disease is classically triggered by
Chlamydia trachomatis
Male-predominant
HLA-B27
Enthesitis
Ankylosing spondylitis
Mainstay of tx for SLE
Glucocorticoids
DOC for lupus nephritis and CNS lupus
Cyclophosphamide
anti-Ro and anti-La
Congenital heart block
Neonatal lupus
Complication of untreated Kawasaki disease developing in 2nd-3rd week
Coronary artery aneurysms
Aphthous stomatitis
Genital ulcers
Uveitis
HLA-B5 & B-51
PATHERGY
Behcet’s disease
silk road disease
CREST Syndrome Calcinosis Raynaud’s Esophageal dysmotility Sclerodactyly Telangiectasia
Limted Systemic Sclerosis
Vasculitic rash
Livedo reticularis
Abd pain
PAN
steroids + cyclophosphamide
Most common pathogen assoc w/ common colds
Rhinovirus
Most common pathogen assoc w/ common colds in less than 2y/o
RSV
Most common complication of common colds
Acute Otitis Media
Bacterial pathogens implicated in AOM and sinusitis
Strep pneumo
H influenzae
Moraxella catarrhalis
Bullous myringitis is commonly assoc with what bacterial pathogen
Mycoplasma pneumoniae
Sinuses present at birth
Maxillary
Ethmoid
Sinus(es) pneumatized at birth
Ethmoid
Sinus last to develop (7-8 y/o)
Frontal sinus
What drains in the SuPErior meatus
Sphenoid
Posterior ethmoid
Upper airway obstruction:
Steeple sign
Viral croup (LTB)
Upper airway obstruction:
Thumb sign
Acute epiglottitis
Upper airway obstruction:
Ragged air column
Bacterial tracheitis
Upper airway obstruction:
Tripod position
Acute epiglottitis
Most common LRTI in infants
Bronchiolitis (RSV)
LRTI: 1-3 months staccato-like cough afebrile NO wheezing
Chlamydia trachomatis
vs RSV bronchiolitis
RF for severe disease in bronchiolitis
<12 weeks
premature
comorbid condition
etiologic agent of pneumonia if with rusty sputum
Strep pneumoniae
DOC for fully-susceptible typhoid fever
Chloramphenicol
etiologic agent of pneumonia if with staccato cough and sticky eye discharge
Chlamydia trachomatis
Etiology of pneumonia assoc w/ currant jelly sputum
Klebsiella pneumoniae
Walking pneumonia
with ear and throat involvement
NO coryza
Mycoplasma pneumoniae
Pneumonia presenting with extrapulmonart symptoms (diarrhea, jaundice, vomiting, arthritis)
Legionella pneumophila
Congenital lobar emphysema usually occurs in what lobe of the lung
Left upper lobe
late manifestations of TB
renal and skeletal
Lobe commonly affected in endobronchial TB
RML bronchus
Most common form of extrapulmonary TB in children
Scrofula
Variant of normal growth with
normal growth velocity and
delayed puberty
“Late bloomers”
Constitutional growth delay
Conditions presenting as tall stature
Marfan syndrome
Homocystinuria
Precocious puberty:
before _____ in girls
before _____ in boys
8 y/o
9 y/o
Gonadotropin-dependent premature isosexual puberty in boys would make you suspect
CNS pathology - tumors
request for neuroimaging
High risk to develop neonatal varicella if mother acquires infection during this period
5 days before to 2 days after delivery
infection characterized by congenital skin scarring and limb hypoplasia
congenital varicella syndrome
hoagband sign (edema of eyelids) is seen in which infection?
infectious mononucleosis
triad of infectious mononucleosis
pharyngitis
lymphadenopathy
splenomegaly
downey cells are seen in PBS of
infectious mononucleosis
faget sign is seen in
typhoid fever
yellow fever
tularemia
Period of communicability in diphtheria
2 to 6 weeks after infection
cause of mortality in 50-60% of patients with diphtheria
myocarditis
toxic cardiomyopathy
100% attack rate on the first stage of this infectious disease
Pertussis (catarrhal stage)
Most common cause of bloody diarrhea in children
Shigella
Most common location of volvulus
Sigmoid and cecum
Most common etiology of LTB
Parainfluenza virus
Most common cause of bronchiolitis
RSV
APGAR parameter that is last to disappear in a sick baby
Cardiac rate
APGAR parameter that is first to reappear in a resuscitated baby
Cardiac rate
Most common cause of hemolytic disease of the newborn
ABO incompatibility
First carpal bone to appear in xray showing its center of ossification
capitate
2 months
rib notching is seen in which congenital heart defect
coarctation of the aorta
most common cause of thyroid disease in children and adolescents
hashimoto / autoimmune / lymphocytic thyroiditis
major complication of nephrotic syndrome
spontaneous bacterial peritonitis
Strep pneumo or E coli
most common cause of thrombocytopenic purpura in childhood
ITP
most common inherited bleeding disorder
Von Willebrand Disease
most common soft tissue sarcoma in children
rhabdomyosarcoma
Major risk factors for recurrence of febrile seizures
less than 1 y/o
<24 hours duration of fever
38-39 degrees
transient paralysis post-ictus of a generalized tonic clonic seizure
Todd’s paresis / paralysis
Test with the highest specificity in diagnosing UTI
Nitrite test
1 cause of neonatal seizures
hypoxia
Hallmark of atopic dermatitis
Dry skin
Cornerstone of anti inflammatory teeatment for AD
topical corticosteroids
physiologic anemia in term neonates
6-8 weeks
physiologic anemia in preterm neonates
3-4 weeks
proper breastmilk storage period if left at room temp (<25C)
4 hours
most common cause of bronchiolitis
RSV
causative agents of acute otitis media
strep pneumo
h influenza
moraxella catarrhalis
Conditions with increased upper to lower body ratio
rickets
achondroplasia
untreated hypothyroidism
dysfluency and stuttering usually manifest in this age group
preschool
treatment of cholera in children
azithromycin
doxycycline for adults
treatment for crohn’s disease
mesalamine
treatment for ulcerative colitis
sulfasalazine
mixed IgE and cell mediated hypersensitivities
atopic dermatitis
asthma
eosinophilic esophagitis and gastroenteritis
food allergies that are likely to be outgrown in later years
cow milk
eggs
food allergies that tend to persist in life
peanuts
nuts
seafoods
major RF for developing persistent asthma in later life
parental history of asthma
eczema
minor RF for developing persistent asthma in later life
allergic rhinitis
>4% eosinophilia
food allergies
autoimmune defect in T and NK cells
severe progressive infectious mononucleosis
X-linked lymphoproliferative syndrome (Duncan)
triad of AD, thrombocytopenic purpura, draining ears
Wiskott-Aldrich syndrome
immune deficiency with chronic enterovirus infection and absent lymph nodes (as opposed to common variable immune deficiency)
X-linked agammaglobulinemia
Bruton
inmune deficiency with impaired chemotaxis and regulation of cytokine production
coarse facial features, staph pneumonia with pneumatoceles, staph abscesses
HyperIgE syndrome
Job
how long before B12 stored in the liver gets depleted?
3-5 years
contents of cryoprecipitate
factor 8 factor 13 VWF fibrinogen fibrin
frequent cause of premature isosexual puberty in boys
CNS pathology
hypothalamic hamartoma
often the first symptom of congenital hypothyroidism
prolonged jaundice
hallmark of acquired hypothyroidism
slow linear growth
most common cause of hypercortisolism in children >7y/o
pituitary tumor (oversecretion of ACTH)
disorder of neuronal migration characterized by presence of unilateral or bilateral clefts within the cerebral hemispheres
schizencephaly
disorder of neuronal migration characterized by absence of cerebral convolutions (agyria)
lissencephaly
causes of communicating hydrocephalus
subarachnoid hemorrhage
meningitis
meningeal malignancy
most severe phenotypic expression of febrile seizure
Dravet syndrome
period of communicability of mumps
1-2 days before to 5 days after parotid gland swelling
most common complications of mumps
meningitis and orchitis
Period of acquisition of neonatal varicella
5 days before to 2 days after delivery
originally described as glandular fever
EBV (infectious mononucleosis)
causes of infectious mononucleosis-like illnesses
CMV Toxoplasma adenovirus hepatitis virus primary HIV rubella
classic triad of EBV
fatigue
pharyngitis
generalized lymphadenopathy
most common tumor of adrenal medulla in children
neuroblastoma
Forscheimer spots are seen in
German measles
Infectious mononucleosis
Scarlet fever
Roseola infantum
major RF for recurrence of febrile seizures (3)
age < 1 year old
fever 38-39 C
fever duration < 24 hours
Timing of migraine with aura
Aura lasts 5 to 60 minutes
Headache follows within 60 min of aura
most common cause of death in measles
pneumonia
most common complication of measles
pneumonia
more than 90% of anaphylactic biphasic responses occur within
4 hours
most effective medication class for allergic rhinitis
intranasal corticosteroids
most common life-threatening emergency of GI in the newborn
NEC
autoantibody-mediated deficiency of metalloproteinase (ADAMTS-13) responsible for cleaving VWF
Thrombotic thrombocytopenic purpura
Syndrome: Agenesis of corpus callosum Retinal lacunae, colonoma of iris Seizures (infatile spasms) MR Xlinked dominant (girls)
Aicardi syndrome
NF type 1
cafe-au-lait spots
VonRecklinghausen Disease
Most common and most severe form of lupus nephritis
Class IV (diffuse proliferative subendothelial deposits)
recommended immunosuppressive therapy for pulmonary alveolitis and to prevent pulmonary fibrosis in scleroderma
Cyclophosphamide
Criteria for perinatal asphyxia (4)
- profound acidemia pH <7
- persistent APGAR 0-3 >5min
- neurologic sequelae (HIE)
- multiorgan failure
functional closure of DA?
foramen ovale?
10-15 hours of birth
3rd month of life
BP should be checked starting at age
3 y/o
double bubble sign (2)
duodenal atresia
midgut volvulus
most common cause of drug-induced angioedema
ACE inhibitors
bradykinin-mediated
triad of:
AD
thrombocytopenic purpura
increased susceptibility to infx
Wiskott-Alsrich syndrome
Combined T and B cell immunodeficiencies (4)
SCID
Wiskott-Aldrick syndrome
Duncan’s syndrome (progressive infx mononuc)
Ataxia - Telangiectasia
Leukocyte/granulocyte/phagocyte deficiencies
LAD
CGD
Chediak-Higashi
Hyper-IgE (Job syndrome)
triad of skin lesions, seizures and MR
tuberous sclerosis (imaging: intracranial nodules)
6 or more cafe au lait spots lisch nodules (iris hamartoma)
NF 1
6 or more cafe au lait spots
bilateral acoustic neuromas
NF 2
von recklinghausen
portwine stain over trigeminal area
sturge weber
congenital heart defects assoc with:
Turner syndrome
Infant of a diabetic mother
DiGeorge syndrome
CoA
ToGA
Truncus arteriosus
head control is achieved at ___ months
6 months
assoc with HLA B27
Juvenile spondyloarthropathy
used to monitor disease activity in SLE nephritis
antidsDNA and C3
timing of typhoid isolates in blood, urine and stool
blood - “early”
urine and stool - after 1st week
causative agent of LTB (viral croup)
parainfluenza virus
blood malignancy characterized by: blueberry muffin lesions/nodules gingival infiltration chloroma Auer Rods
adolescence
AML
