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Pediatrics > Peds 101 > Flashcards

Peds 101 Flashcards

1
Q

given for immediate relief of allergies

A

intranasal corticosteroids

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2
Q

name of skin test for allergic triggers

A

RAST skin test

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3
Q

eczema has high assoc. with __ and __

A

asthma, seasonal allergies

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4
Q

in very young kids, eczema appears on the __ in response to a ___

A

face; new food exposure

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5
Q

in older kids, eczema occurs on the ___ and is ___

A

flexor surfaces; pruritic

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6
Q

eczema excoriations can lead to __ and __ (in adulthood)

A

infection - Strep/impetigo, Staph; lichenification

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7
Q

tx eczema

A

topical corticosteroids,

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8
Q

VACTERL

A 
Vertebral (XR)
Anal (imperforate)
Cardiac (ECHO)
Tracheal
Esophageal
Renal (U/S)
Limbs (thumbs, especially)
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9
Q

newborn presents with choking with feeds and excessive salivation

A

esophageal atresia

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10
Q

dx esophageal atresia

A

NG tube coils on CXR

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11
Q

tx esophageal atresia

A

surgical and look for VACTERL anomalies, especially cardiac and renal

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12
Q

after dx imperforate anus, get a ___ and tx how?

A

babygram - if blind end of colon is near anus, correct now. if far, colostomy then repair before potty training begins

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13
Q

hear bowel sounds over lungs, scaphoid abdomen and dyspnea in a baby:

A

congenital diaphragmatic hernia

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14
Q

term for anterolateral diaphragmatic hernia

A

morgagni hernia

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15
Q

what is the problem with a diaphragmatic hernia?

A

hypoplastic lung - may require ventilation

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16
Q

gastroschisis presents R or L of midline?

A

R (no membrane, too)

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17
Q

tx gastroschisis and omphalocele?

A

create a silo, slowly reduce contents over time

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18
Q

tx extrophy of bladder

A

surgical emergency

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19
Q

bilious vomiting + multiple air fluid levels on babygram

A

intestinal atresia (tell mom to stop the cocaine)

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20
Q

bilious vomiting + double bubble + normal gas patterns beyond

A

malrotation

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21
Q

if suspect malrotation, f/u with

A

contrast enema and upper GI series

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22
Q

bilious vomiting + double bubble + T21

A

duodenal atresia

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23
Q

tx malrotation

A

emergent surgery

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24
Q

Premie w/ bloody diarrhea, drop in platelet count and abdominal distention

A

necrotizing enterocolitis

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25
Q

dx necrotizing enterocolitis

A

babygram: pneumatosis intestinalis

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26
Q

tx premie with nec. enterocolitis

A

stop feeds and switch to TPN, give IV abx. surgery if pneumatosis intestinalis is present
look for RDS and IVH (CXR and brain U/S)

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27
Q

CF + bilious vomiting + no BM

A

meconium ileus

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28
Q

CXR: meconium ileus

A

multiple dilated loops of bowel + ground glass appearance

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29
Q

tx pyloric stenosis

A

fix electrolytes then myomectomy

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30
Q

lytes w/ pyloric stenosis

A

hypochloremic, hypokalemic metabolic alkalosis

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31
Q

neonatal jaundice not resolved at 6-8 wks, r/o __ with ___

A

biliary atresia; HIDA scan after 1wk phenobarbital (failure of bile to reach duodenum, even after phenobarbital stimulation)

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32
Q

dx/tx intussusception

A

air enema

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33
Q

most common URI bugs and how to treat them:

A 
S. pne
H. inf
Moraxella
Catarrhalis
Tx:  Amox +/- clavulanate
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34
Q

most common otitis externa bug and tx? 2nd most common?

A

Pseudomonas; spontaneously resolves (educate parents to dry ears after swimming)
S. aureus

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35
Q

tx bloody nose:

A 
cold compress
lean FORWARD
humidified air
ablation 
*posterior epistaxis may require packing (tampon)
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36
Q

viral vs. bacterial

A

viral: short, low-grade fever, mild
bacterial: longer, high fever, worse symptoms

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37
Q

tx otitis media?

risk of not treating?

A

amox (add clavulanate if does not resolve)

spread to mastoid, inner ear, and brain

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38
Q

sinusitis >7dd + cough: tx?

A

presume bacterial, give amox

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39
Q

Sensitivity and specificity of rapid strep test

A

specific, not sensitive, so if neg, get a cx (tx does not need to be started until cx come back)

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40
Q

Centor criteria for GAS

A

+1 for: fever, exudates, adenopathy, -cough, 44y

4: empiric tx (augmentin)

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41
Q

baby presents blue at rest and pink with crying (or if the kid snores)

A

choanal atresia (snoring = partial obstruction between mouth and nose)

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42
Q

FTPM >48hrs + abd distension at

A

barium enema, then full thickness bx (Hirschprung’s)

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43
Q

FTPM >48hrs + abd distension at >1mo, + chronic constipation + explosive diarrhea after DRE, get ___

A

anorectal manometry then full thickness bx (Hirschprungs)

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44
Q

tx meconium ileus

A

gastrografin enema, enzymes (pancreatic insufficiency) and pulmonary toilet

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45
Q

intermittent diarrhea and/or encopresis

A

think voluntary constipation (colon is working just fine) - take to OR for disimpaction, educate child that it is okay to poop

46
Q

tx anal fissure in baby

A

heals on its own (babies usually have diarrhea)

47
Q

courant jelly stool

A

indicates bowel necrosis 2/2 intussusception

48
Q

Meckel’s diverticulum = remnant of the ___ and presents with __. Dx __

A

Vitelline duct (gastric mucosa); painless GI bleeding; technicium-99 scan

49
Q

child presents with melena

baby presents with melena

A

look for hx of epistaxis

perform Apt Test: mom vs. baby’s blood

50
Q

maternal Ab are present for __ mo after birth (approximately)

A

6

51
Q

baby with recurrent infxns, prolonged infxns or wierd bugs, get __ and __

A

Ig levels + CBC

52
Q
A

X-linked Agammaglobulinemia of Bruton: all Ig are deficient, low B-cells, compensatory increase in T-cells

53
Q

Tx X-linked Agammaglobulinemia of Bruton

A

prophylactic abx + monthly Ig

54
Q

most common and most benign immunodeficiency

A

IgA deficiency

55
Q

pt: anaphylaxis s/p blood transfusion

A

IgA deficiency

56
Q

low IgA, IgG, high IgM

A

hyper IgM deficiency (no differentiation)

57
Q

deficiency of the 3rd pharyngeal pouch

A

22q11.2 deletion syndrome

58
Q

micrognathia + wide-spaced eyes + low-set ears + fungal or PCP infxn

A

suspect 22q11 del, look for cardiac defect, absent thymic shadow

59
Q

in children w/ 22q11del syndrome, pay close attention to the __ level. why?

A

Ca; no parathyroids –> hypocalcemia –> seizures

60
Q

boy + normal infxns + thrombocytopenia + eczema: tx?

A

Wiskott-Aldrich
Bone marrow transplant (still rarely survive to adult hood)
(elevated IgE and IgA)

61
Q

ataxia + leukemia or lymphoma

A

Ataxia-telangiectaisa (DNA repair defect). incredibly rare, highly tested

62
Q

Adenosine deaminase deficiency

A

SCID

63
Q

kid with AIDS bugs and no viral load, dx, tx?

A

SCID; PCP/MAC ppx (bactrim, azithromycin), and BMT

64
Q

chronic staph or aspergillus skin infections? dx?

A

Chronic granulomatous disease; confirm with negative Nitro Blue test (no respiratory burst)

65
Q

massive leukocytosis + high fever + no puss + hx of delayed cord separation

A

Leukocyte Adhesion deficiency: PMNs cannot adhere or get out of blood vessels

66
Q

albinism + neuropathy + neutropenia

A

Chediak-Higashi: AR, impaired microtubule polymerization

*look for giant granules in PMNs

67
Q

Neisseria infection…think of which zebra?

A

C5-C9 deficiency

68
Q

angioedema?

A

C1 esterase deficiency

69
Q

4 “characteristics” of unconjugated bilirubin (conjugated is opposite)

A

lipid soluble
crosses BBB
kernicterus
not excreted in urine

70
Q

physiologic jaundice is associated with conjugated or unconjugated bilirubin?

A

unconjugated

71
Q 
pathologic jaundice: 
onset \_\_
bilirubin increases at \_\_/day
D. bili \_\_\_\_%total
resolves in \_\_wks (term), \_\_wks (preterm)
A

5/day
>10% total
>1wk (term), >2wks (preterm)

72
Q

yellow baby + elevated direct bili: get __, look for __

A

HIDA scan, U/S, sepsis, metabolic causes

73
Q

yellow baby + elevated indirect bili + +coomb’s:

A

isoimmunization: Rh disease, ABO incapatability

74
Q

yellow baby + elevated indirect bili + -coomb’s: get__

A

get Hgb level

  • high: blood transfusion (twin-twin, maternal-baby, delayed cord clamping)
  • normal: get Retic count
75
Q

yellow baby + high indirect bili + -coombs + normal Hgb: get ___

A

Retic count
+: hemolysis (spherocytosis, G6PD, pyruvate kinase def)
-: Hemorrhage or breast milk jaundice

76
Q

risk of kernicterus with indirect bili >__; tx __

A

20; exchange transfusion (if

77
Q

purpose of blue lamps?

A

make indirect bili water soluble

78
Q

how does insufficient breast feeding cause neonatal jaundice?

A

bowels too slow, body reabsorbs bilirubin –> increase # of feeds

79
Q

does insufficient breast feeding cause elevated direct or indirect bilirubin?

A

indirect (must be unconjugated to be absorbed from gut)

80
Q

breast milk jaundice MOA

A

breast milk inhibits glucuronyl transferase (conjugation enzyme)

81
Q

one eye normal, one blind

A

amblyopia = cortical blindness

82
Q

congenital cataracts and strabismus both put the infant at risk for:

A

amblyopia

83
Q

light reflex come from different locations in each eye

A

strabismus

84
Q

white retina

A

retinoblastoma

85
Q

observe retinoblastoma pt for ___in future

A

osteosarcoma (in distal femur)

86
Q

pt with congenital cataracts, think __ and __

A

TORCH and galactose deficiency

87
Q

premie requiring high flow O2 is at risk for:

A

retinopathy of prematurity, tx with laser ablation

88
Q

premie: look for:

A

retinopathy of prematurity
IVH
BPD
necrotizing enterocolitis

89
Q

in neonate born to mother ith cervicitis or PID, tx baby for ___ with ___

A

conjunctivitis; erythromycin (or silver nitrate, though this burns and can produce chemical conjunctivitis)

90
Q

baby develops purulent, bilateral conjunctivitis 2-5 days after birth, think:

A

Gonorrhea get cx or PCR, start topical erythromycin or neomycin (ppx); CAN TURN TO BLINDNESS

91
Q

baby develops muco-purulent, bilateral conjunctivitis 7-12 days after birth, think:

A

Chlamydia; get cx or PCR; start oral + topical erythromycin or neomycin ppx; CAN TURN TO PNA

92
Q

newborn with + Barlow’s + Ortolani’s, get:

A

U/S for hip dysplasia

93
Q

6yo with insidious onset knee pain and atalgic gait, dx? tx?

A

Legg-Calve-Perthe Disease (avascular necrosis of hip); XRay and then cast

94
Q

chubby 13yo with sudden onset hip and knee pain: dx? tx?

A

SCFE; frog-leg Xray; surgery

95
Q

hip pain after febrile illness

A

septic hip - xray, aspirate w/ smear and culture; drain and give abx

96
Q

teenage athlete with painful (non-edematous knee): tx?

A

Osgood-Schlatter;

  • stop exercising and cast
  • work through it (bump will remain for life d/t osteochrondrosis)
97
Q

Adam’s test

A

bending forward, asymmetric shoulders = scoliosis

98
Q

low grade focal pain in distal femur

A

osteogenic sarcoma (sunburst, onion skin pattern)

99
Q

low grade focal pain in midshaft

A

Ewing’s sarcoma (T11;22)

100
Q

tx fx involving growth plate:

A

open reduction and internal fixation

101
Q

an innocent murmur is never ___ or > _/6

A

diastolic; 3

102
Q

fixed wide split s2

A

ASD

103
Q

most common congenital heart defect

A

VSD

104
Q

harsh systolic ejection murmur, FTT, dyspnea and/or CHF

A

VSD

105
Q

PDA must be closed by ___ months

A

6-8

106
Q

most common cyanotic defect of the newborn, presents with cyanosis on day 1

A

TGA

107
Q

TGA is associated with what maternal condition?

A

diabetic with poor control (NOT gestational diabetes - by 20wks, the heart has formed)

108
Q

most common cyanotic defect in children

A

ToF

  • overriding aorta
  • pulmonary stenosis
  • RV hypertrophy
  • VSD
109
Q

ToF CXR ptx:

A

boot-shaped heart

110
Q

baby with HTN, claudication and temp difference between arms and legs

A

Coarctation of the Aorta

Pediatrics (5 decks)

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