Pediatrics

Question 1

Normal for babies to have GERD?

Answer 1

Yes from about 1-7 months

Question 2

Management of T1DMs

Answer 2

Adjust insulin rates if 3 highs in a row at the same time, or 2 lows in a row at the same time.

Wait 15 mins after giving treatment for a low to take blood sugar levels. Give about half a box of juice.

Question 3

New Ballard Score

Answer 3

Used to estimate gestation age if unknown

Clinical assessment- neuromuscular maturity, physical exam (skin, breast, eye/ear, genitalia, etc)

Question 4

How many calories is in breast milk?

Answer 4

20kcal

Question 5

How many oz in one bottle?

How many ox in one day for newborn?

Answer 5

1 bottle = 8oz

14-22 oz

Question 6

TFI (not important for our level)

Answer 6

Premature
Fluid Requirements (weight over 2500 grams)

Day 1: 70 ml/kg/day
Day 2: 80 ml/kg/day
Day 3: 100 ml/kg/day
Day 4: 120-150 ml/kg/day

Question 7

Daily wt gain for first 3 months

Answer 7

Approx 30 g/d
3-6 months: 20 grams/d
6-12: 10 g/d

Question 8

Absence of femoral pulses

Answer 8

Aortic coarctation

Question 9

Complication of formula feeding in premature infants

Answer 9

Necrotizing Enterocolitis

Question 10

Contraindications of breast feeding

Answer 10

Do not breastfeed with:

• Infant w/ galactosemia
• Mother HIV infection (active viral load)
• Illicit drugs (cocaine)
• Mother has Ebola

Temporarily do not breastfeed:

• active HSV infection, active lesions on present
• Mother has untreated active tuberculosis

Consider risk in: Hep B and c
active varicella, radioactive isotopes

Question 11

Weight loss tool

Answer 11

NEWT

https://www.newbornweight.org

Question 12

Infantile spasm

Answer 12

Age-specific epileptic disorder of infancy and early childhood.

3-7 mo of age
Classic presentation: stiffens, arm extend, neck flexes, knees flex for a 2-3 seconds

**Serious **

Treat with steriods

Question 13

Absence Seizures

Answer 13

School-aged children between four and ten years of age
present

CF: Short and frequent episodes of profound impairment of consciousness without loss of body tone, lasting about 10 seconds.

Abrupt in onset and termination and easily provoked by hyperventilation

Question 14

Seizures in newborn

Answer 14

Will not see generalized tonic seizures in first year of life

Can see “fifth-day fits”

Question 15

Premature vaccine schedule

Answer 15

NO change in schedule

Question 16

Post-partum questions (4B’S)

Answer 16

Brain (mood ie: depressed)

Boobs (breastfeeding, milk production by day 3, reassure)

Bowel - bowel movement post labour, triggers reflex

Birth Control-
IUD (can get immediately or 4 wks)
Combo pills 4-6 weeks Progesterone pill immediately

Safety- violence, support

Question 17

When can you switch to po feeding?

Answer 17

33-34 weeks

Question 18

Niemann - Pick disease?

Answer 18

Lipid storage disorder, genetic, infantile variant is fatal before the age of 3. Results in toxic build up of cholesterol in the brain, liver, spleen, bone marrow. Progressive neurological decline.

Question 19

Most common benign paediatric heart murmur?

Answer 19

Stills murmur, is a systolic twangy murmur best heard while lying down.

Question 20

Steeple sign on CXR pediatric?

Answer 20

Croup!

Question 21

Common cause of bronchiolitis?

Answer 21

RSV

Question 22

Upper airway concerns not to miss?

Answer 22

Croup, epiglotitis, bacterial tracheitis

Also consider: FB, anaphylaxis, peritonsilar abscess

Question 23

Lower airway concerns?

Answer 23

Asthma, bronchiolitis less than 2, pneumonia

Question 24

Walking pneumonia?

Answer 24

Have pneumonia, are well enough to be walking around with the infection - usually in young people. Usually atypical because of the age range.

Question 25

Excess of growth hormone?

Answer 25

Gigantism in children

Acromegaly in adults