Pediatrics Flashcards by maisa morrar

What is German measles also known as?

Rubella

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How many days old is a yellow bruise?

Purple - day 1-5 Green - day 5-7 Yellow - day 7-10 Brown - day 10-14

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Pain with movement of the pinna or tragus should make you think of what Dx?

Otitis Externa

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What is the first line treatment of pertussis?

Erythromycin - macrolides

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By what age should a child be able to hold up head?

3 months

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A salter Harris type I fx affects what area of bone?

Only the physis (growth plate)

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By what age should a child be able sit?

6 months

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Premature infant with hyaline membrane disease will have what appearance on CXR?

Bilateral atelectasis or ground glass appearance

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A pt is having seizures along with a mouse-like odor from the urine. What Dx should you be thinking of?

Phenylketonuria

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The description of a dew drop on a rose petal should make you think of what Dx?

Chicken pox

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List the 5 major jones criteria for Dx rheumatic Fever

Polyarthritis Carditis Subcuticular nodules Erythema Marginatum Chorea

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Describe erythema marginatum

Pink rings on the trunk and Inner surfaces of the limbs The rash is round, with a pale-pink center, surrounded by a slightly raised red outline. The rash can appear in rings or have less regular, larger, or elongated shapes.

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At what age should an infant begin cooing

2 months

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MC cause of URI

Rhinovirus

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Koplik spots are white clustered lesions one buccal mucosa. What virus are they pathognomonic for?

Measles/Rubeola

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How do you treat a pt with RSV?

Albuterol, steroids, and fluids

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A child presents with painful ulcers in mouth. On PE you find more of the same type of ulcers on hands and feet. What virus is most likely causing these sx?

Coxsackie virus

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What age should a child be able to walk?

12 mo

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If worried about foreign body obstructing a child’s breathing what type of CXR should you order?

Expiratory view looking for hyperinflation due to air trapping

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What is the medical term for lazy eye?

Amblyopia

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2-month milestones (Xenia)

February Valentines day “lift your head” for a kiss and “smile”, tracking midline, reacts to sound, coos

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4 - month milestones

April’s fools day, Rolling over in laughter, baby cobra, reach for things, babbling

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6 - month milestones

June’s summer solstice. Sitting up at a picnic and stranger anxiety at mom’s weird work friends trying to pinch your cheeks. Transfers objects, rolls both ways, making noises

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9 - month (waleed) milestones

Fulls sits, crawls, pulls self up, responds to name, full hand pick up, pincer grasps w/ small things

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12 - month milestones

it's Christmas walking over to Santa Claus, but getting separation anxiety.

15-month milestones

Gross: walks well, walks backward, may run or walk-up steps Fine: scribbles, stacks 2 block Social: uses spoon + fork, "helps in housework" Language: says 3-6 words, follows commands

What type of anemia is iron deficiency anemia?

Microcytic hypochromic

What labs will you see for iron deficiency anemia?

Dec ferritin Inc TIBC Dec serum iron Inc RDW Dec Transferrin

What will you see on a blood smear for alpha thalassemia? Gold standard for Dx

Target cells, basophilic stippling, Heinz bodies Hgb electrophoresis

What will you see on labs for acute lymphocytic leukemia?

Bone marrow - hypercellular w/ \>20% blasts, anemia, thrombocytopenia

What do you see on peripheral smear of someone with chronic lymphocytic leukemia and who gets it?

MC in adults You would see Peripheral smear → incompetent, well-differentiated, lymphocytes w/ scattered “Smudge cells”

How to differentiate acute myelogenous leukemia AML?

Auer rods on bone marrow

What do you see for chronic myelogenous leukemia?

+ Philadelphia chromosome, strikingly elevated wbc count

What is pathognominic for HODKIN’s lymphoma? What is it commonly associated with?

Reed-sternberg calls Mediastinal LAD Epstein- Barr virus - MC in males

Which Hemophilia is hemarthrosis associated with?

Hemophilia A

What factor is hemophilia B associated with? What is the clinical manifestation?

B - deep tissue bleeding

Pt present with staccato cough but no fever, what is the most likely Dx?

Chlamydia pneumoniae

What is the most serious complication of Kawasaki syndrome?

Aortic aneurysm

A musical vibratory murmur best heard at the apex in a child should make you think of what Dx?

Still’s murmur - benign

At what age should a child be able to use a spoon and stack 3-4 blocks?

18 months

Which viral exAnthem often has conjunctivitis as one of its symptoms?

Measles/ Rubeola

What is the MC congenital heart defect?

Ventricular septal defect

What is the tx for a volvulus in a child?

Barium enema

You hear a loud harsh holosystolic murmur in a child, heard best at the LLSB. What is the most likely Dx?

Ventricular septal defect

What age should a child begin to feed himself?

6 months

Describe barlow’s test?

Addict and internal rotation of the hips

A CXR of notched ribs in a child should make you think of what Dx?

Coarctation of the aorta?

A 4 yo M presents bw October and March with WHEEZING, coughing, runny nose and inc RR, what is most likely pathogen?

RSV

Describe wt gain in infant in follow time periods 1 week 6 months 12 months 3 yrs 4 yrs

1 week - Lose 10% of birth wt back back to birth wt at 10d 6 months - 2x birth wt 12 months-3x birthweight 3 yrs - 30 lb and 30 inches 4 yrs - 40 lb and 40 inches

What age should a child kick a ball?

24 month

Fever lasting longer than 5 days should make you think of what?

Kawasaki syndrome

A widely split fixed s2 should make you think of what Dx?

Atrial septal defect

Nasal polyps should make you think of what Dx?

Cystic fibrosis

In order to Dx rheumatic fever what thing must you have?

Evidence of strep infection, pos titer or pos Dx. Plus 2 major criteria OR 1 major and 2 minor

Forchheimer spots are associated with what dz?

Rubella

Salter Harris type III affects what area of the bone?

The physis ( growth plate) + epiphysis

Unilateral purulent rhinitis should make you think of what Dx?

Foreign body

What is the medical term or cross eyed?

Strabismus

What is the most common site for pneumonia in the lung?

lower lobe; crackle sounds

what is a speech audiometry used for?

it is a fundamental tool in **hearing loss assessment**. Together with pure-tone audiometry, it can aid in _determining the degree and type of hearing loss_. Speech audiometry provides information on word recognition and about discomfort or tolerance to speech stimuli.

What is shows up on labs for in vitamin D deficiency?

hypophosphatemia, hypocalcemia and elevated parathyroid hormone

you see costochondral junctions, bowed legs or architecture rosary, dental problems, muscle weakness and developmental delays what Dx is this?

Vitamin D deficiency - Rickets

what is this?

alopecia areata

what other tests can you use to test for cystic fibrosis?

Elevated **fecal elastase** is another supporting test, as it indicates malabsorption caused by inadequate function of the exocrine pancreas.

what medication would you give for febrile a seizure that is more than 5 min?

Diazepam

what seizure medication do you give for petit mal or absence seizures?

Ethosuximide

appropriate acne vulgaris tx for pregnant 18 yr old woman?

oral erythromycin

if you suspect a bug in the ear, what can you do first?

irrigation with warm mineral water

what medication will exacerbate hypercalcemia

thiazide diuretics and lithium

what viral exanthem has a rash that appears after a fever and when the pt begins to recover?

Roseola

what medication can you give for allergic contact dermatitis due to poison ivy?

clobetasol propionate 0.05% ointment twice daily for 14 days

what is the most sensitive diagnostic study is the Meckel diverticulum?

technetium scan

firs line treatment for androgenetic alopecia (male pattern baldness) is

finasteride

fixed split s2 on cardiac auscultation should make you think of...?

Atrial Septal Defect

Treatment for Severe Kawasaki Dz?

IVIG and high dose aspirin

what is the best test for neonatal herpes simplex virus?

PCR

When does the surfactant begin to be expressed in the fetal lung?

20 weeks gestation

what treatment do you give for nasal congestion, red eyes, and fever, bilateral purulent conjunctivitis, and purulent nasal discharge?

amoxicillin-clavulanate

what can you give for ant- emetic for kids doing treatment for Hodgkin's lymphoma?

benzodiazepines

Acne vulgaris treatment?

topical retinoids antibiotics benzoyl peroxide

A teenager presents with asthma, allergic rhinitis and is having skin problems in the antecubital fossa. What is this likely Dx?

Atopic Dermatitis, aks Eczema

first-line topical agent for irritant diaper dermatitis?

topical petroleum jelly )vaseline or zinc oxide

how would you diagnose scabies? how should they be treated?

scrape with oil and view on a scope permethrin topical apply for 8-14 hours, repeat in 1 week; make sure everyone in house gets treated at the same time

what instruction do you want to give to someone taking griseofulvin PO for tinea capitis?

take with milk or ice cream to increase absorption

single or multiple, flat, dome-shaped cauliflower-shaped, filiform, fungating, pedunculated, cerebriform, plaque, like, smooth (penile shaft), verrucous, or lobulated should make you think of what dx. (**plaques and papules**)

verrucae Vulgaris aka Condyloma Acuminata

the first-line tx for pityriasis rosea

emollients and calamine (antihistamine lotion)

what two valves are MC affected with pt with a Hx of Rheumatic fever?

Mitral and Aortic

If a pt has mono what tx can you give them? + they have enlarged tonsils

Prednisone used for enlarged tonsils

Best initial tx for a pt that is a nose picker and has been bleeding for 20 min already?

cauterization

what can cause sensorineural heating loss?

aminoglycosides like ## Footnote Gentamicin (generic version is IV only) Amikacin (IV only) Tobramycin. Kanamycin.

how would you treat mastoiditis?

vancomycin + ceftriaxone

what imaging would you use for orbital cellulitis? how would you manage it?

High-resolution CT? Nafcillin, or Pepercillin/tazobactam (zosyn)

how can you treat otitis externa? what should you avoid for perf TM?

FQ drops; ofloxacin otic drops Water/moisture/ topical AG

what virus is associated with mumps?

Paramyxovirus

Rubella is a TORCH infection, list some signs that would make you think the baby got it from mom?

cataracts, sensorineural deafness, heart disease

list clinical manifestation for Kawasaki Dz CRACH and Burn

Conjunctivitis Rash Adenopathy Strawberry tongue Hand swelling and Fever! x 5 days

How do you tx Kawasaki and what HM do you want to make sure to do?

IVIG + high dose ASA & subsequent echocardiogram in the future bc of potential residual cardiac problems

Continuous Machine like murmur makes you think of?

Patent Ductus Arteriosis and tx with indomethacin iv

baby/infant has upper extremities BP different from lower - systolic murmur radiates to back & scapula, notched ribs

coarctation of the aorta

the gold standard to diagnose tetralogy of Fallot

echo

blue baby syndrome (cyanosis), has tet spells X-ray shows, boot-shaped heart, what is is

tetralogy of Fallot

what would you give a baby with GERD?

H2 blocker - Zantac

abdominal distension, no stool, newborn, meconium, vomiting what do you think of

Hirschsprung Dz

what do you give a pt with vitamin D deficiency

Ergocalciferol (vitamin D)

How many pneumococcus vaccines does a 2 yr old receive

CI for Bacterial Pneumonia

Azithromycin 15mg/kg