Pediatrics (BOARD REVIEW) Flashcards

1
Q

Which is the first screening performed for all infants?

A

PKU

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2
Q

What does PKU test for?

A

Lack of enzyme to process phenylalanine amino acid

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3
Q

A PKU can be a potential false negative if obtained before ___ hours

A

48

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4
Q

Head circumference measured EVERY visit until age?

A

2

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5
Q

BP checked at every visit after age?

A

3

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6
Q

When does the posterior fontanelles close?

A

2-3 months

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7
Q

When to the anterior fontanelles close?

A

9-18 months

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8
Q

How much weight should a child gain n the first 3 months of life?

A

1 oz a day

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9
Q

By when does an infant double their birth weight?

A

5 months

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10
Q

By when does an infant triple their birth weight?

A

1 year/12 months

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11
Q

Developmental milestones. 6 months?

A

Sits well without support, passes from hand to hand

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12
Q

Developmental milestones. 18 months?

A

3 word vocabulary, uses spoon with moderate spilling.

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13
Q

Developmental milestones. 12 months?

A

Pincer grasp, says “dada” “mama”, stands, drinks from a cup

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14
Q

Developmental milestones. Spontaneous smile, grasps rattle, rolls back to front, squeals.

A

3-4 months

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15
Q

Developmental milestones. Tower of 8 cubes, 1-3 word sentences, puts on clothing.

A

2-2.5 years

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16
Q

Vaccines: Birth

A

Hep B

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17
Q

Vaccines: 1 month

A

2nd Hep B

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18
Q

Vaccines: 2 months

A

2nd Hep B, Rota, Dtap, H. Flu, Pneumo, Polio

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19
Q

Vaccines: 4 months

A

Rota, Dtap, H. Flu, Pneumo, Polio

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20
Q

Vaccines: 6 months

A

3rd Hep B, Rota (if needed), Dtap, H. Flu, Pneumo, Polio

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21
Q

Vaccines: Flu?

A

Start at 6 months

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22
Q

First dose of measles, varicella, hep A?

A

12 months

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23
Q

4th dose of Dtap? 5th dose?

A

15-18 months. 4-6 years

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24
Q

4th dose polio?

A

4-6 years

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25
Q

What starts at age 11-12?

A

Tdap, HPV, meningococcal

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26
Q

Ages for inactivated vs live influenza?

A

6 months inactivated. 2 years for live

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27
Q

True contraindications for NOT immunizing include.

A

Seizures with past immunization, fever of 105+, specific allergies

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28
Q

A child with fever

A

ADMIT

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29
Q

Fevers in children

A

3 months

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30
Q

You see retinal hemorrhages in a child.

A

Shaken baby

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31
Q

You see a spiral or oblique fracture in a non ambulatory child.

A

Think possible abuse

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32
Q

18mo patient with a 103 degree fever x 3 days. Suddenly it breaks and is followed by a “rash all over her body”.

A

Roseola

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33
Q

Etiology of Roseola

A

HHV - 6, HHV - 7

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34
Q

A 5-15yo pt has a rash that makes her look like “slapped cheeks” as well as a rash on her upper arms moving proximally to distally. The rash appears reticulated.

A

Erythema infectiosum.

35
Q

Another name for 5th disease

A

Erythema infectiosum. Think “5th” = 5 to 15yo

36
Q

Etiology of 5th disease or erythema infectiosum

A

Parvovirus B19

37
Q

What does varicella look like?

A

Macule-vesicle-pustule-crusting

38
Q

Treatment for varicella neonatorum

A

Varicella IgG or IV acyclovir

39
Q

A pt is malaise, irritable, has a sore throat, as well as lesions on their palms and soles. What is the etiology of this disease.

A

Coxsackievirus types A5, A10, A16, and enterovirus 71

40
Q

Cause of Rocky Mountain Spotted Fever?

A

Ricketsia Rickettsii

41
Q

How do you get Rocky Mountain Spotted Fever?

A

Tick exposure

42
Q

Describe the prodrome of RMSF

A

Abrupt fever, muscle aches (myalgias), severe persistent headache, toxicity, N/V

43
Q

Describe the rash of RMSF. When? Where?

A

2-6 days after onset of fever. This rash begins at the WRISTS and ANKLES and spreads centrally to INCLUDE THE PALMS and SOLES

44
Q

Fever of 104 x 2 weeks, conjunctivitis, peripheral edema, splenomegaly, meningismus, myocarditis, renal impairment

A

Rocky Mountain Spotted Fever

45
Q

Honey colored crusts

A

Impetigo

46
Q

Cough, coryza, conjunctivitis, Koplick spots

A

Rubeola (measles)

47
Q

Herald patch with a Christmas tree distribution

A

Pityriasis rosea

48
Q

Grouped whitish yellow papules with the centers eaten out (umbilicated).

A

Molluscum contagiosum.

49
Q

Etiology of molluscum contagious

A

Poxvirus

50
Q

T/F. Any hyperbilirubinemia is ok in the first 24 hours.

A

FALSE. NONE in first 24 hours is normal

51
Q

When does physiological jaundice occur? How high should it be? When does it resolve?

A

3-5 days. Total should still be LESS than 15. Should resolve within a week.

52
Q

What does a positive COOMBS test mean?

A

ABO incompatability (mom O, baby A or B), Rh incompatability

53
Q

What if there is unconjugated hyperbilirubinemia with a negative coombs test?

A

Can be caused by red cell defects (spherocytosis), metabolic issues (G6PD) or bacterial sepsis.

54
Q

A young patient of BLACK, MEDITERRANEAN, or ASIAN ancestry has unconjugated hyperbilirubinemia with a negative coombs test. What are you thinking?

A

G6PD is more common in this population.

55
Q

When unconjugated bilirubin enters a nerve cell and causes death.

A

Kernicterus.

56
Q

When do you see breast milk jaundice?

A

Peaks at 6-14 days.

57
Q

What is the Jones Criteria and what is required for a dx.

A
Rheumatic fever dx:
2 Major or 1 Major and 2 Minor of the following:
Major:
1) Polyarthritis (large joints)
2) Carditis
3) Erythema marginatum (trunk, proximal limbs)
4) Subcutaneous nodules
5) Chorea
Minor:
1) Fever
2) Polyarthralgia
3) Previous RA
4) Elevated ESR or CRP
5) Prolonged PR
6) Leukocytosis
May have supporting evidence of preceding strep infection
58
Q

What sign might you see in epiglottis?

A

Thumb sign. Send to OR for emergent airway placement

59
Q

What sign will you see with croup?

A

Steeple sign

60
Q

What will you see with Kawasaki’s?

A

Fever for > 5 days, conjunctivitis, cervical lymphadenopathy, peripheral edema, red soles/palms, desquamation, oral cracking, strawberry tongue, trunk rash, OFEENDS

61
Q

Treatment for Kawasaki’s

A

High dose IVIG and ASA

62
Q

What is the danger with Kawasaki’s?

A

Coronary arteritis (aneurysm of coronary vessels.

63
Q

White curd like plaques on infants buccal mucosa that is NOT easily removed.

A

Candida A. (thrush)

64
Q

Pain and itching with ear. Pain with movement of the pinna or tragus

A

OE

65
Q

Main bugs for otitis and sinusitis

A

Strep pneumo, H flu, Morax. C., Group A. Strep, Staph A.

66
Q

What is the most common cause of respiratory distress in a preterm infant? What will you see?

A

Hyaline membrane disease. Deficiency in pulmonary surfactant. Xray will show bilateral atelectasis (ground glass). You will see cyanosis, tachypnea, retractions, grunting, nasal flaring

67
Q

A young child presents with URI symptoms, fever, diffuse wheezes and tachypnea.

A

Bronchiolitis

68
Q

What is the most common cause of bronchiolitis?

A

RSV

69
Q

How is RSV detected?

A

Fluorescent antibody or ELISA

70
Q

Treatment for RSV

A

Supportive

71
Q

What will you see with pertussis?

A

A pt that is sick with URI type symptoms. They run a mild fever. After 2 weeks the coughing becomes paroxysmal with 10 to 30 coughs in a row followed by a deep inspiration. This can often cause vomiting.

72
Q

The most common lethal genetic disease affecting Caucasians

A

Cystic fibrosis

73
Q

What GI findings might you see with cystic fibrosis?

A

Many have meconium ileus and rectal prolapse.

74
Q

What are the two components to cystic fibrosis?

A

Respiratory (impaired mucociliary transport), GI (pancreatic insufficiency)

75
Q

What is the test for cystic fibrosis?

A

Chloride sweat test

76
Q

What might you see on someone you suspect might have neurofibromatosis 1?

A

6 or more cafe au lait spots greater than 1.5cm thick

77
Q

What direction can the babiski reflex go in children under 2?

A

Up. Which would be abnormal in children older than two.

78
Q

What does a slipped capital femoral epiphysis look like?

A

Fat boy, painful limp, pain radiating into thigh and medial leg, limitation of internal rotation and abduction of the hip.

79
Q

Tests dislocatability

A

Barlow

80
Q

Tests relocatability

A

Ortolania

81
Q

Osteonecrosis of the femoral head

A

Legg-Calve-Perthes

82
Q

SALTR

A

Straight (no displacement), Above (through metaphysics), Lower (through epiphysis), Through (through both), Rammed

83
Q

What are the 3 P’s of ALL

A

Pallor, petechiae, purpura.

84
Q

What other findings will you see with ALL?

A

Hepatosplenomegaly, lymphadenopathy, cytopenias (multiple kinds). Diagnosed by bone marrow exam