Pediatrics Flashcards
What are the important elements of the newborn exam?
- Red reflex
- Fontanelles
- Primitive reflexes
- Hips: Barlow & Ortolani manoeuvres
- Spine
- Genitalia
- Measurements
What are the components of the Apgar score?
A = Apparence (coloration)
P = Pouls (fréquence cardiaque)
G = Grimace (réactivité aux stimuli)
A = Activité (tonus musculaire)
R = Respiration (efforts respiratoires)
What Apgar score is worrisome?
7 and under
What are the short-term complications of prematurity?
- Hypothermia
- Respiratory abnormalities: respiratory distress syndrome (RDS), bronchopulmonary dysplasia, apnea and pulmonary hemorrhage
- Cardiovascular abnormalities: patent ductus arteriosus (PDA) and systemic hypotension
- Intraventricular hemorrhage
- Glucose abnormalities: hypo or hyper
- Necrotizing enterocolitis (NEC)
- Infection
- Retinopathy or prematurity
- 3 day old premature baby
- Poor feeding
- Abdominal distension
- Blood in stools
What’s your diagnosis?
Necrotizing enterocolitis (NEC)
You suspect foreign body aspiration in a child. He has an EXPIRATORY wheeze. Where is the object?
Intrathoracic
A baby tastes like salt. What’s your diangosis?
Cystic Fibrosis
What is the medication for absence seizures?
Ethosuximide
What are the characteristics of a simple febrile seizure?
- Only one in 24 hours
- Short (< 15 minutes)
- Generalized
How do you treat simple febrile seizure?
- Benzodiazepine if actively seizing
- Acetaminophen
* *NEVER GIVE NSAIDS BECAUSE IT CAN CAUSE REYE’S SYNDROME**
What is the hallmak of atrial septal defect on physical exam?
Fixed Split S2
What is the hallmak of patent ductus arteriosus on physical exam?
Continuous machine-like murmur (multiphasic)
How do we call a left to right shunt that becomes a right to left shunt?
Eissenminger’s syndrome
What are the types of left to right shunts seen in children?
L –> R = D
- Atrial Septal Defect
- Ventricular Septal Defect
- Patent Ductus Arteriosus
What are the types of right to left shunts seen in children?
R –> L = T
- Transposition of the great vessels
- Tetralogy of Fallot
What are the elements of the tetralogy of Fallot?
- VSD
- Overriding aorta
- Pulmonic stenosis
- Right ventricular hypertrophy
Clicking hip at birth and at 4 weeks, what’s your diagnosis?
Developmental hip dysplagia (DHD)
Insidious onset of antalgic gait in a 6 y/o, what’s your diagnosis?
Legg Calve Perthes disease: Osteonecrosis (avascular necrosis of bone)
13 y/o fat boy with hip pain, what’s your diagnosis?
Slipped Capital Femoral Epiphyis (SCFE)
Hip pain of a 10 y/o post viral illness, what’s your diagnosis?
Transient synovitis (self-limited)
Teenage athlete with knee pain and tibial swelling, what’s your diagnosis?
Osgood-Schlatter disease (osteochondritis of the tibial tubercle)
Unilateral focal atraumatic bone pain in a child, what do you suspect?
Ewing’s sarcoma or Osteosarcoma
What are the possible causes of neonatal conjunctivitis?
- Chemical (silver nitrate) ⇒ we use topical erythromycin now
- Gonnorhea ⇒ erythromycin prevents it
- Chlamydia ⇒ oral
- HSV
- Baterial
Absent red light reflex in a new born (white in the back of the eye), what’s your diagnosis?
Retinoblastoma
You see a child with Salmonella osteomyelitis, what’s the underlying diagnosis?
Sickle Cell disease
Explanation: the sickle cells block capillaries ⇒ ischemia of the bone ⇒ opportunistic infections
- Wide-spaced eyes
- Low-set ears
- Absent thymic shadow
- Small face
- Recurrent fungi and PCP infections
What’s your diagnosis?
DiGeorge Syndrome (22q11.2 deletion ⇒ T-cell disease)
