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CMN 568 > Pediatrics --E1 > Flashcards

Pediatrics --E1 Flashcards

1
Q

Red reflex is performed to assess for

A

eye opacities (cataracts or corneal clouding) and retinal abnormalities (retinal detachment or retinoblastoma)

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2
Q

at what age should an infant should be able to track or visually follow a moving object with both eyes

A

3 months

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3
Q

what age do you start using the E chart or allen chart

A

3 years

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4
Q

how do you screen for strabismus on a 3mo?

A

corneal light reflex test

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5
Q

how do you screen for strabismus on a 6mo?

A

cover test

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6
Q

what red reflex response would necessitate a referral

A

asymmetry of the red reflex or partially obscured red reflex

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7
Q

what age should not have temperature checked by tympanic measurement?

A

<3mo

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8
Q

minimum age for acetaminophen administration and dosage

A

2mo

15mg/kg/dose q4hr

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9
Q

minimum age for ibuprofen administration and dosage

A

> 6mo

10mg/kg

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10
Q

which type of growth deficiency is caused by inadquate caloric intake, excessive loss of calories, or inability to use calories peripherally

A

Type 1

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11
Q

which type of growth deficiency is characterized by All 3 parameters of growth – head circumference, weight, and height – are lower than normal

A

Type 2

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12
Q

which type of growth deficiency is characterized by a preserved head circumference with weight being more depressed than height

A

Type 1

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13
Q

Purulent discharge of the eye

A

bacterial conjunctivitis

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14
Q

causes of watery discharge of the eye

A
  • viral conjunctivitis/keratitis
  • iritis
  • corneal abrasions/foreign bodies
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15
Q

mucoid discharge from the eye

A

allergic conjunctivitis or nasolacrimal obstruction

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16
Q

yellow crusts around the eye, but the eye remains white

A

nasolacrimal obstruction

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17
Q

inequality of the refractive state between the two eyes

A

anisometropia

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18
Q

reduced vision caused by conditions affecting normal vision development

A

amblyopia

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19
Q

squinting to see far (pinhole effect)

A

myopia

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20
Q

when either the cornea or the crystalline lens is not perfectly spherical

A

astigmatism

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21
Q

what is the hirschberg test

A

corneal light reflex evaluation– which is performed by shining a penlight at the patient’s eyes, observing the reflections of each cornea, and estimating whether the lights appear to be positioned symmetrically

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22
Q

what is a normal finding of a red reflex test

A

light orange-yellow in lightly pigmented eyes or dark red in brown eyes

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23
Q

Dx: s/s

  • sudden severe pain
  • decreased vision s/t pain and tearing
  • eyelid edema
  • tearing
  • injection of the conjunctiva
A

Corneal abrasion

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24
Q

corneal abrasion treatment

A

erythromycin ointment

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25
Q

Vertical corneal abrasions can be a sign of

A

foreign bodies under the eyelid so eyelid eversion should be performed

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26
Q

signs of perforating ocular injuries (3)

A

irregularly shaped pupil, shallow anterior chamber, hyphema or dark tissue showing through the white sclera

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27
Q

a chronic inflammatory disorder of the eyelid and ocular surface that can be sight-threatening

A

Blepharokeratoconjunctivitis

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28
Q

treatment for blepharitis/Blepharokeratoconjunctivitis

A

Erythromycin ointment
azithromycin drops
PO azithromycin

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29
Q

an aseptic, nontender eyelid nodule

A

chalazion

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30
Q

A painful red bump on the eyelid caused by an acute bacterial infection of eyelash hair follicle or meibomian glands

A

Hordeolum

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31
Q

__ presents as a bluish mass located below the medial canthus

A

congenital dacrocystocele

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32
Q

Dx: S/S

  • inflammation, swelling, tenderness, and pain over the lacrimal sac
  • Fever may be present
  • Purulent discharge within the lacrimal sac may reflux with sac pressure
A

Dacrocystitis

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33
Q

DX: s/s

redness, discharge and swelling of the lids and conjunctiva in an infant <1mo

A

Ophthalmia Neonatorum

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34
Q

Prevention of Ophthalmia Neonatorum

A

Erythromycin ointment

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35
Q

treatment of bacterial conjunctivitis

A

polymyxin/trimethoprim sulfate or fluroquinolones

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36
Q

DX: s/s

-conjunctival injection of one or both eyes (blood shot eyes)
- significant eyelid edema can occur
- Enlarged preauricular lymph nodes can be present

A

Viral Conjunctivitis

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37
Q

Presumed adenoviral keratoconjunctivitis is considered contagious ___

A

10-21 days from the day of onset or as long as the eyes are red

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38
Q

how long must a child stay out of school with adenoviral keratoconjunctivitis

A

until the redness and tearing resolve

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39
Q

__ causes itching associated with redness, tearing, and papillary reaction of palpebral conjunctiva

A

Allergic conjunctivitis

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40
Q

DX: s/s

-intense tearing, itching, and stringy discharge
- cobblestone papillae on the tarsal conjunctiva
- horner-trantas dots (white accumulation of degenerated eosinophils and epithelial cells)
- Phlyctenules (nodular inflammation on conjunctiva or cornea)
- Sterile corneal ulcers (shield ulcers)

A

vernal keratoconjunctivitis

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41
Q

treatment of allergic conjunctivitis

A

Antihistamine and mast cell stabilizers

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42
Q

treatment of mucocutaneous disease

A

topical corticosteroids, cyclosporine, and antibiotcs

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43
Q

a developmental defect due to incomplete closure of the anterior embryonal fissure

A

iris coloboma

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44
Q

DX:

penlight exam revelas a keyhold shaped pupil

A

Iris coloboma

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45
Q

DX:

eye exam reveals little to no visible iris

A

Aniridia

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46
Q

iris appears pink

A

Albinism

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47
Q

The classic triad of symptoms in primary congenital glaucoma (PCG) includes

A

Epiphoria
photophobia
blepharospasm

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48
Q

Primary congenital glaucoma primary sign

A

Buphthalmos (occurs from elevated eye pressure that leads to enlargement of the globe due to low scleral rigidity of an infant eye)

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49
Q

sudden eye pain, redness, corneal clouding, and vision loss suggest …

A

possible pupillary block or angle closure glaucoma (URGENT REFERRAL)

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50
Q

Treatment of uveitis

A

corticosteroids or methotrexate

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51
Q

Patients with pars planitis may complain of

A

floaters and decreased vision

52
Q

DX: Slit-lap exam:

anterior chamber cells and protein flare (fogginess) with an irregular shaped pupil

A

active anterior uveitis

53
Q

treatment for intermediate uveitis

A

corticosteroids

54
Q

Children with ___ may complain of blurred vision and have a white retinal lesion that appears like a “headlight in the fog” owing to the overlying vitritis.

A

ocular toxoplasmosis (posterior uveitis)

55
Q

red reflex response seen with a cloudy cornea

A

decreased or absent

56
Q

DX: on exam

white spot on the cornea with overlying epithelial defect that stains with fluorescein

A

corneal ulcer

57
Q

Absence of asymmetry of a red reflex, leukocoria, poor fixation, strabismus, or nystagmus and requires an urgent referral

A

cataract

58
Q

___ may result in decreased central or peripheral vision, decreased color vison, strabismus, and nystagmus

A

Poor optic nerve function

59
Q

___ assess relative function of each optic nerve

A

Swinging flash light test

60
Q

Normal and abnormal swinging flash light test

A

Abnormal: pupillary dilation
Normal: Pupillary constriction

61
Q

optic nerve appears white with a feathered edge

A

Myelinization of the optic nerve

62
Q

___ is a specific term used for optic nerve edema caused by elevated ICP

A

Papilledema

63
Q

Papilledema treatment

A

treat idiopathic intracranial hypertension w/ acetazolamide, topiramate and furosemide

64
Q

DX: S/S

  • Decreased visual acuity
  • Abnormal color vision (notably red color desaturation)
  • Pain with eye movements
  • Visual field deficits
A

Optic neuritis

65
Q

what does the optic nerve look like with anterior optic nerve neuritits

A

edematous (papillitis)

66
Q

what does the optic nerve look like with posterior optic neuritis?

A

normal despite signs of optic nerve dysfunction

67
Q

Pain with eye movements, blurred or double vision, and proptosis (bulging of the eye) suggests

A

orbital cellulitis

68
Q

DX: s/s

red and swollen eyelids, pain, and mild fever. Normal eye, eye movements, and vision.

A

preseptal cellulitis

69
Q

DX: s/s

proptosis, eye movement restriction, decreased vision, and an APD. Eye appears red and chemotic.

A

ortbital cellulitis

70
Q

treatment of preseptal and orbital cellulitis

A

oral antibiotics

71
Q

an involuntary rhythmic oscillation of eyes. It may be unilateral or bilateral or be gaze dependent

A

nystagmus

72
Q

infantile nystagmus is associated with

A

retinal disease

73
Q

__ is defined as a difference of best-corrected visual acuity of two lines or more on an acuity chart between the two eyes

A

Amblyopia

74
Q

misalignment of the eyes resulting in abnormal binocular interaction and amblyopia of the nondominant eye

A

strabismus

75
Q

difference in refractive error between two eyes resulting in poor visual input in one eye

A

anisometropia

76
Q

deviation of the eyes toward the nose and may involve one or both eyes

A

Esotropia

77
Q

onset of esotropia in a child >5 eyars old should cause suspicion for ___

A

CNS disease

78
Q

how do you determine esotropia from pseudostrabismus

A

corneal light reflex – the light reflex with not be centered in one or both eyes if strabismus is present

79
Q

deviation of the eyes toward the ears

A

exotropia

80
Q

how to diagnose exotropia

A

corneal light reflex, cover/uncover test

81
Q

DX: S/S

  • Acute onset of pain, aural fullness, decreased hearing and itching in the ear
  • Symptoms peak within 3 days
  • Pain with pinna or tragus manipulation
  • Clear or purulent discharge
  • Swelling and narrowing of external auditory canal
A

Acute otitis Externa

82
Q

__ is a cellulitis of the soft tissue of the external auditory canal (EAC) which can extend to surrounding structures

A

otitis externa

83
Q

spread of acute otitis externs to the skull base with resultant osteomyelitis

A

malignant otitis externs

84
Q

acute otitis externa treatment without systemic symptoms

A
  • fluoroquinolone drops or cipro/dexamethasone drops
85
Q

acute otitis externa treatment with fever, cellulitits of the face/auricle, or tender periauricular/cervical lymphadenopathy

A

oral antibiotics

86
Q

2 critical findings to establish dx of acute otitis media

A

bulging tympanic membrane and middle ear effusion

87
Q

DX:
otoscopic findings:

Bulging TM, impaired visibility of ossicular landmarks, yellow or white effusion (pus), opacified and inflamed eardrum, and occasionally squamous exudate or bullae on the eardrum.

A

Acute otitis media

88
Q

treatment for acute otitis media

A

amoxicillin 80-90mg/kg/day BID

89
Q

treatment for acute otitis media with a child with a history of papular rash from PCN

A

oral cephalosporins (cefuroxime, cefpodoxime, or cefdinir)

90
Q

treatment of tympanic membrane perforation

A

topical fluoroquinolone otic drops (ofloxacin and ciprofloxacin) with or without steroids

91
Q

otitis media with effusion should not be treated with ___

A

antibiotics

92
Q

failure of the ear canal to form

A

atresia

93
Q

external ear that is small, collapsed, or only has an earlobe present

A

microtia

94
Q

absent external ear

A

anotia

95
Q

ears that protrude from the skull due to lack of proper folds

A

prominotia

96
Q

tx for acute bacterial rhinosinusitis

A

amoxicillin or augmentin

97
Q

tx for acute bacterial rhinosinusitis in patients with type 1 hypersensitivity to PCN

A

cefuroxime, cefpodoxime, or cefdinir

98
Q

treatment for allergic rhinitis

A
  • intranasal corticosteroids (budesonide, fluticasone)
  • oral/intranasal antihistamines (benadryl/cetirizine)/Azelastine
  • leukotriene antagonists (Montelukast)
  • decongestants (pseudoephedrine)
99
Q

inflammation in the oral cavity and can arise from infection, autoimmune disorders, drug reactions, and chemoradiation.

A

stomatitis

100
Q

3mm ulcers surrounded by a halo found on the anterior tonsillar pillars, soft palate, and uvula

A

herpangina

101
Q

treatment for Acute group A streptococcal pharyngitis

A

PO or IM PCN or amoxicillin

102
Q

DX: S/S

 Severe sore throat
 Unilateral tonsillar swelling
 Deviation of the uvula
 Trismus (limited mouth opening)

A

peritonsillar cellulitis or abscess

103
Q

how to evaluate for acute cervical adenitis

A

rapid GAS test & CBC

104
Q

contraindications for tonsillectomy or adenoidectomy

A

cleft palate
bleeding disorder
acute tonsilits

105
Q

how is supprurative parotitis diagnosed

A

expression of purulent material from stenson duct

106
Q

___ to identify allergen-specific IgE is the most sensitive and specific test for inhalant allergies

A

Skin testing

107
Q

tx of mild intermittent rhinitis

A
  • oral and intranasal H1-antihistamines
  • intranasal decongestants (phenylephrine or oxymetazoline)

(oral decongestants are not recommended for kids)

108
Q

nasal corticosteroid examples

A

mometasone and fluticasone furoate (approved for >2)
fluticasone propionate (approved for >4)
Budesonide and triamcinolone (Approved for >6)

109
Q

mast cell stabilizer examples

A

intranasal ipratropium or cromolyn

110
Q

topic nasal decongestants examples

A

phenylephrine and oxymetazoline

111
Q

clinical findings of an IgE-mediated reaction to a medication (6)

A

Pruritis
erythema
urticaria
angioedema
bronchospasm
anaphylaxis

112
Q

how long does it take an IgE-mediated reaction to occur after a dose of medication

A

1hr

113
Q

___ are the first line treatments for community acquired PNA and otitis media

A

amoxicillin and ampicillin

114
Q

___ are good for treating
dog bites
tonsillar and parapharyngeal abscesss
orbital cellulitis
refractory sinusitis
otitis media

A

Augmentin or ampicillin/sulbactam

115
Q

example of a first generation cephalosporin

A

cephalexin

116
Q

3rd generation cephalosporin

A

cefdinir

117
Q

4th generation cephalosporin

A

cefepime

118
Q

ex of antimicrobials (sulfonamides)

A

trimethoprim/sulfamethoxazole

119
Q

erythromycin/azithromycin/clarithromycin are resistant to ___

A

s pneumoniae

120
Q

first line treatment for UTIs in children

A

cephalexin

121
Q

__ is used to treat sinusitis, dental/oral/neck abscesses

A

clindamycin

122
Q

examples of tetracyclines

A

doxycycline
minocycline
tigecycline

123
Q

aminoglycoside examples

A

gentamicin
tobramycin
amikacin
streptomycin

124
Q

___ is the prefered rifamycin in patients co-infected with HIV

A

Rifabutin

125
Q

Examples of fluroquinolones

A

Norfloxacin
oflaxacin
ciprofloxacin
moxifloxaxin
gatifloxacin

CMN 568 (3 decks)

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