Pediatrics Flashcards
Timing of Neisseria conjunctivitis?
Days 1-5
Best treatment for Neisseria conjunctivitis?
IM ceftriaxone, Topical erythromycin
Description of discharge in Neisseria conjunctivitis?
Purulent
Timing of Chlamydia conjunctivitis?
2 Weeks
Best treatment for Chlamydia conjunctivitis?
IM ceftriaxone,
Description of discharge in Chlamydia conjunctivitis?
Systemic erythromycin
Timing of Chemical conjunctivitis?
Day 1
Best treatment for Chemical conjunctivitis?
Irrigation + reassurance
How long are children with strep pharyngitis considered to be contagious?
2 days after starting ABX
Deviation of uvula in setting of peritonsillar abscess?
Towards unaffected side
Best IV ABX for peritonsillar abscess?
Clindamycin
Best IV ABX for epiglottitis?
Ceftriaxone
Complication of RSV?
Increased risk of asthma
Best treatment for RSV?
Symptomatic
Best treatment for RSV in immunocompromised patients?
Ribavirin
Best treatment for pertussis infection?
Erythromycin, 14 days
2 best tests for diagnosis of pertussis infection?
Nasopharyngeal swabs on Bordet agar; PCR testing
Difference between DPT and TDaP vaccines?
DPT = contains whole killed pertussis cells; TDaP = contains acellular pertussis
2 most common viral pathogens responsible for otitis media?
Influenza A, Parainfluenza
Clinical presentation of Mastoiditis?
Tenderness, erythema, edema of retroauricular region
DOC for treatment of otitis media?
Amoxicillin for 10 days
DOC for treatment of otitis media that does not improve with 3-4 day course of amoxicillin?
Amoxicillin-clavulanate
4 yo male presents with honey crusted perioral lesions – best ABX?
Dicloxacillin
When is chickenpox contagious?
2 days before onset of rash … Until crusting of all lesions
Post-exposure prophylaxis for varicella?
Varicella Zoster Ig (VZIG)
3 steps in spread of measles infection?
Upper respiratory tract >> Reticuloendothelial cells in LN >> Blood
Oral manifestation of measles?
Koplik spots
Treatment that improves the morbidity + mortality of measles?
Vitamin A
Where does Rubella virus multiply?
Nasopharynx
What type of vaccine is MMR?
Live attenuated … contraindicated in pregnancy
Classic tetrad seen in Congenital Rubella?
Sensorineural deafness, Congenital cataracts, Blueberry muffin rash, PDA
Why is retinoblastoma so dangerous?
Early metastasis to liver, brain, bones
Which virus is associated with postauricular LAD?
Rubella
Name of rash associated with Parvovirus B19 infection?
Erythema infectiosum
Structure of Parvovirus B19?
ssDNA
Virus associated with Roseola?
HHV-6
Name of rash associated with HHV-6 infection?
Exanthem subitum
Description of rash in Transient Neonatal Pustular Melanosis?
Pus-filled blisters that are not surrounded by erythema … rupture, then leave behind pigmented macules
Epidemiology of Transient Neonatal Pustular Melanosis?
AA, Full-term
Clinical manifestation of Coxsackie A infection?
Hand-Foot-Mouth syndrome, Conjunctivitis
Clinical manifestation of Coxsackie B infection?
Myocarditis
Pathognomonic finding within infected neurons in Rabies infection?
Negri bodies
Best treatment after animal bite from animal with suspected rabies infection?
Human Rabies Ig + Vaccination
Cave explorer was attacked by bat; Died in a week – diagnosis?
Rabies
Cave explorer was attacked by bat; Few weeks later presents with hepatosplenomegaly, erythema nodosum, lung lesions – diagnosis?
Histoplasmosis
Is deafness or blindness associated with congenital toxoplasmosis?
Blindness
Best treatment for toxoplasmosis?
Pyramidine + sulfadiazine
Age of pincer grip?
9 mo
Age of pull to stand?
9 mo
Age of non-specific Mama + Dada?
9 mo
Age of lifting head?
2 mo
Age of coo?
2 mo
Age of social smile?
2 mo
Age of rolling?
4-5 mo
Age of sitting alone?
6 mo
Age of stranger anxiety beginning?
6 mo
Age of walking?
12 mo
Age of 2-cube tower?
12 mo
Age of climbing stairs, no alternation of feet?
2 yo
Age of imitating others?
2 yo
Age of babbling?
6 mo
Age of rolling from back to front?
6 mo
Age of climbing stairs, alternation of feet?
3 yo
Age of specific Mama + Dada?
12 mo
Age of 4-6 word vocab?
15 mo
Age of 4-20 word vocab?
18 mo
Age of 2-word phrases?
2 yo
Age of 6-cube tower?
2 yo
Age of 3-word phrases?
3 yo
Age of copying circle?
3 yo
Age of brushing teeth?
3 yo
Age of washing hands?
3 yo
Age of eating with fork + spoon?
3 yo
Age of copying cross?
4 yo
Age of hopping?
4 yo
Age of counting to 10?
4 yo
Age of cooperative play?
4 yo
When is medication indicated for nocturnal enuresis?
After 5 yo
Most effective treatment for nocturnal enuresis?
Bet-wetting alarms
2 DOC for nocturnal enuresis?
DDAVP, Imipramine
5 steps of tooth eruption?
Central incisors, lateral incisors, first molars, canines, second molars
In females, puberty begins with …
Breast budding
Immediate puberty step before menarche?
Axillary hair
In females, puberty ends with …
Menarche
In males, puberty begins with …
Testes enlargement
In males, puberty ends with …
Body growth
Etiology of vaginal bleeding?
Transplacental transfer of estrogen to fetus
Etiology of testicular feminization?
Lack androgen receptors … inability of DHT to act
Genotype of testicular feminization?
46 XY
Etiology of feminization of penis + scrotum?
5a-reductase deficiency … Decreased DHT
Genotype of feminization of penis + scrotum?
46 XY
Structures that are driven into development by DHT?
External sexual organs, prostate, epididymis, seminal vesicles, vas deferens
Significance of 1-minute APGAR score?
Condition during labor/delivery … need to resuscitation
Significance of 5-minute APGAR score?
Effectiveness of resuscitation efforts, Survival prognosis
Best treatment for APGAR score 4-7?
Observation … may need respiratory support
Low-dose steroid?
< 10 mg/day
Medium-dose steroid?
10-20 mg/day
High-dose steroid?
> 20 mg/day
Best location of vaccine placement for children/infants?
Anterolateral thigh
Best location of vaccine placement for children/infants?
Deltoid
When do infants double their birth weight?
4-5 months
Best treatment for children with galactosemia?
Diet that avoids lactose
Safest position for baby’s to sleep?
Supine
Most likely complication during first 24 hours for patients who are small for gestational age?
Hypoglycemia
When should children begin eating baby foods?
6 mo
Most common cause of PNA in children ages 2-5 yo?
RSV >> Strep pneumoniae >> Haemophilus influenzae
Best treatment for RSV bronchiolitis?
Supportive care
Who should receive DTAP vaccine?
Children < 7 yo
Who should receive TDAP vaccine?
Children > 11 yo
Best treatment for suspected Transposition of Great Vessels?
Prostaglandin E1
Role of PGE1 as treatment for Transposition of Great Vessels?
Maintains patent ductus arteriosus
Clinical presentation of Transposition of Great Vessels?
Development of cyanosis during first few days of life
Cobblestoning of oropharynx in patient with nasal discharge is suggestive of …
Allergic rhinitis
Name the Tanner Stage – growth of nipple + areola without separation in contours; Pubic hair is coarse but sparse?
Tanner Stage 3
Name the Tanner Stage – nipple + areola form a separate mound; Pubic hair is similar in adult appearance, without spread to thighs?
Tanner Stage 4
Inheritance pattern of Wiskott-Aldrich Syndrome?
X-linked recessive
Change to Ig levels in Wiskott-Aldrich Syndrome?
Low IgM, High IgA, NML IgE
Change to Ig levels in Ataxia Telangiectasia?
Low IgE + IgA
2 types of CA associated with Ataxia Telangiectasia?
Non-Hodgkin lymphoma, Gastric CA
Inheritance pattern of Chediak-Higashi Syndrome?
AR
Which pathogens are patients with Chediak-Higashi Syndrome more susceptible to?
Staph + Strep
At what age can patients be diagnosed with Cystic Fibrosis?
Age > 15 yo
___ refers to premature fusion/ossification of skull stutures … leading to abnormal pattern of skull growth
Craniosynostoses
Most common congenital heart disease in all patients?
VSD
Most common cause of primary amenorrhea?
Turners Syndrome
Best management of atrophic ovaries in Turner Syndrome?
Bilateral oophorectomy
Most common heart defect seen in Turner Syndrome?
Bicuspid aorta
2nd most common heart defect seen in Turner Syndrome?
Aortic coarctation
Fabry’s disease results in accumulation of …
Trihexosyl ceramide
4 most common organs affected by Fabry’s disease?
Heart, skin, CNS, kidneys
Hunter Syndrome results in accumulation of …
Mucopolysaccharide
Is corneal clouding more common in Hunter Syndrome or Hurler Syndrome?
Hurler
Inheritance pattern of Hunter Syndrome?
AR
Inheritance pattern of Hurler Syndrome?
AR
Gaucher Disease results in accumulation of …
Glucocerebroside
3 aspects of clinical presentation for Gaucher Disease?
Hepatosplenomegaly, pancytopenia, aspectic necrosis
Classic cell seen in Gaucher Disease?
Tissue paper macrophages … lipid-filled
Niemann-Pick Disease results in accumulation of …
Sphingomyelin
Classic cell seen in Niemann-Pick Disease?
Foam cells
Clinical presentation of Niemann-Pick Disease – Type A?
CNS disturbance, Life span ~ 3 yo
Clinical presentation of Niemann-Pick Disease – Type B?
Progressive pulmonary disease
Inheritance pattern of Niemann-Pick Disease?
AR
Inheritance pattern of all glycogen storage diseases?
AR
Type I glycogen storage disease?
Von Gierke Disease
2 lab changes in Von Gierke Disease?
Lactic acidosis, Hyperuricemia
Von Gierke Disease results from accumulation of glycogen in …
Liver
Type II glycogen storage disease?
Pompe Disease
Pompe Disease results from accumulation of glycogen in …
Lysosomes
Clinical presentation of Pompe Disease?
Cardiomyopathy
Type III glycogen storage disease?
Cori Disease
Etiology of Cori Disease?
Incomplete breakdown of glycogen
Clinical presentation for Cori Disease?
Myopathy
3 lab changes seen in Cori Disease?
Hypoglycemia, NML lactate, hyperlipidemia
Type V glycogen storage disease?
McArdle Disease
McArdle Disease results from accumulation of glycogen in …
Muscle
Complication of McArdle Disease?
Renal failure
What accounts for risk of renal failure in McArdle Disease?
Myoglobinuria … muscle cramps, high CPK
21a hydroxylase deficiency – hypertension OR hypotension?
Hypotension
11a hydroxylase deficiency – hypertension OR hypotension?
HTN
17a hydroxylase deficiency – hypertension OR hypotension?
HTN
21a hydroxylase deficiency – electrolyte changes?
Hyponatremia, Hyperkalemia
11a hydroxylase deficiency – electrolyte changes?
Hypernatremia, Hypokalemia
17a hydroxylase deficiency – electrolyte changes?
Hypernatremia, Hypokalemia
Location of brachial cleft cysts in relation to SCM?
Anterior
Location of cystic hygroma in relation to SCM?
Posterior
___ refers to rapidly-progressing swelling of submandibular space with cellulits
Ludwig angina
Most common etiology of Ludwig angina?
Dental disease
___ refers to physically NML eye in which visual stimulation fails to transmit via optic nerve
Amblyopia
Best treatment for Amblyopia?
Patch good eye … to enforce use of amblyotic eye
___ refers to genetic disorder that presents with night blindness, then tunnel vision
Retinitis pigmentosa
Which direction of heart shunting results in cyanosis?
R-to-L
Next step of workup for retinal hemorrhages … (after alerting social services)
CT scan to look for SAH
Which nerve roots are responsible for Klumpke’s Palsy?
C8/T1
Which aspect of clinical presentation can distinguish Erb’s Palsy from Klumpke’s Palsy?
Erb = intact grip strength; Klumpke = weak grip strength
___ fracture refers to bending of periosteum without fracture
Buckle
___ fracture refers to bending of periosteum with contralateral bone fracture
Greenstick
Type I Salter Harris fracture?
Through growth plate
Type II Salter Harris fracture?
Through growth plate + metaphysis
Type III Salter Harris fracture?
Through growth plate + epiphysis
Type IV Salter Harris fracture?
Through growth plate + epiphysis + metaphysis
Type V Salter Harris fracture?
Compression of growth plate
Lab change associated with osteosarcoma?
Elevated alkaline phosphatase
Most common cause of diarrhea in children ages 6 mo – 2 yo?
Rotavirus
Most common cause of pediatric pancreatitis?
Blunt abdominal trauma
Main aspect of clinical presentation for Riboflavin deficiency?
Cheilosis
Pulmonary immaturity occurs before gestational age …
26 weeks
Most common cause of death in children < 15 yo?
MVC
NML hydration during first 24 hours of life?
1 wet diaper
Only vaccination given to neonates (0-1 mo)?
Hepatitis B
Vaccines given at 2 months?
Haemophilus, Polio, DTAP, Pneumococcal
Vaccines given at 4 months?
Haemophilus, Polio, DTAP, Pneumococcal
Vaccines given at 6 months?
Haemophilus, Polio, DTAP, Pneumococcal
When should birth weight double?
3 months
Most common timeframe for risk of SIDS?
2-4 months
Contraindication for circumcision?
Hypospadias
5 contraindications for breastfeeding?
HIV, active TB, HSV lesion on breast, illicit drug use, XRT + CXTX
___ refers to benign condition in which skin turns blue with mottled appearance when neonate is exposed to cold; Skin returns to NML with warming
Cutis marmorata
___ refers to cutaneous vascular disorder that is present at birth, skin turns blue with mottled appearance when neonate is exposed to cold; Skin does not return to NML after warming
Cutis marmorata telangiectatica
Next step in management of suspected tracheoesophageal fistula?
Surgical repair
Condition associated with tracheoesophageal fistula?
Down Syndrome
Complication of surgical repair of tracheoesophageal fistula?
Thoracic duct injury … chylothorax
Condition associated with Congenital Pyloric Stenosis?
Turner Syndrome
Diagnostic tool for Congenital Pyloric Stenosis?
Abdominal US
Change to amniotic fluid in Congenital Pyloric Stenosis?
Polyhydramnios
Condition associated with Duodenal Atresia?
Down Syndrome
Is Meckel Diverticulum a true or false diverticulum?
True
Appearance of Hirschsprung Disease on abdominal XR?
Dilated sigmoid colon, with narrowing of bowel distally
Appearance of donor in Twin-to-Twin transfusion?
Stick to amniotic sac
Appearance of recipient in Twin-to-Twin transfusion?
Hemolysis, jaundice
Alternate name for Mongolian Spots?
Congenital dermal melanocytosis
Prognosis for Mongolian Spots?
Disappears by age 3-5 yo
MSK condition associated with Prune Belly Syndrome?
Clubfoot
2 tumors associated with NF-1?
Pheochromocytoma, Optic glioma
2 tumors associated with NF-2?
Acoustic neuroma, Meningioma
Ocular condition associated with NF-2?
Cataracts
Appearance of ash-leaf lesions in Tuberous Sclerosis?
Hypopigmented
Immunodeficiency seen in Ataxia Telangiectasia?
Combined immunodeficiency … Low Ig, T cell dysfunction
What accounts for T cell dysfunction in Ataxia Telangiectasia?
Thymic hypoplasia
2 aspect of clinical presentation for Sturge-Weber Syndrome?
Port-Wine Stains, Seizures
2 tumors associated with VHL Syndrome?
Pheochromocytoma, Renal cell carcinoma
Role of VHL gene?
TSG
Location of VHL gene?
Chromosome 3
Ocular portion affected by VHL Syndrome?
Retina … (angiomatosis)
Ocular portion affected by NF-1 Syndrome?
Iris … (hamartomas)
Sign of pathologic jaundice in neonates?
Present beyond 1 week in term infants; 2 weeks in pre-term infants
Onset of pathologic jaundice?
Hyperbilirubinemia present < 24 hours old
Indication for Phototherapy in neonatal Hyperbilirubinemia?
Total Bilirubin > 15
Role of Phototherapy in neonatal Hyperbilirubinemia?
Isomerization of bilirubin … water-soluble isomers
Peak of Transient Hyperbilirubinemia?
2-3 days of life
XR appearance of Necrotizing Enterocolitis?
Portal venous gas, Pneumatosis intestinalis
Onset of Transient Tachypnea of Newborn?
First few hours of life
NML RR of newborns?
40-60 x per minute
Prognosis of Transient Tachypnea of Newborn?
Self-limited
3 pathogens responsible for early sepsis in neonates?
GBS, E. coli, Listeria
3 pathogens responsible for late sepsis in neonates?
GBS, E. coli, Staph
Most common cause of Retinopathy of prematurity?
Excessive O2 supplementation
Change to vitals in Intraventricular Hemorrhage?
Bradycardia
Next step of workup for neonate who presents with rectal bleeding or hematemesis shortly after delivery?
Apt test … (not EGD or colonoscopy)
Role of Apt test in fetal rectal bleeding or fetal hematemesis?
Checks HGB of blood to distinguish maternal blood from fetal blood
Which route of delivery is needed for Vitamin K at birth?
IM
Clinical presentation of acute neonatal narcotic withdrawal?
Sneezing, rhinorrhea, diarrhea
Treatment of choice for acute neonatal narcotic withdrawal?
Opium solution
Etiology of Neonatal RDS?
Deficiency of surfactant
Appearance of Neonatal RDS on CXR?
Ground glass, Reticulogranulocyte densities
2 aspects of treatment for Neonatal RDS?
Surfactant replacement, O2 supplementation
2 complications of excessive O2 supplementation in neonates?
Bronchopulmonary Dysplasia, Retinopathy of prematurity
Etiology of Bronchopulmonary Dysplasia?
Necrotizing bronchiolitis
Etiology of Retinopathy of prematurity?
Fibrovascular proliferation of retinal vessels
Which vaccine is indicated for patients with chronic lung conditions?
Influenza
