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Pediatrics > Peds 101, part 2 > Flashcards

Peds 101, part 2 Flashcards

1
Q

itchy webs of hands and axilla, maybe in whole family: dx? tx?

A

Scabies

dx: scrape skin to see eggs on scope
tx: topical permethrin or lindane

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2
Q

itchy scalp +/- nits: dx? tx?

A

Lice

dx: clinical
tx: permethrin, hair cut

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3
Q

itchy butt: dx? tx?

A

Pinworm

dx: tape test
tx: albendazole

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4
Q

PCP ppx

A

bactrim, dapsone

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5
Q

toxo, MAC, ppx

A

bactrim, azithromycin

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6
Q

fussy baby with bulging fontanel: most common organisms, empiric treatment?

A

Meningitis:

  • GBS, Ecoli, Listeria
  • Ceftriaxone, Vanc, Ampicilin +/- steroids
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7
Q

dx meningitis

A

LP w/ cx and sensitivities

CT if signs of increased ICP

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8
Q

adolescent with HA, N/V, nuchal rigidity: MC organisms and empiric treatment?

A

Meningitis:

  • H flu, S. pne, Neisseria
  • Ceftriaxone, Van, +/- steroids
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9
Q

MCC viral meningitis; tx?

A

HSV, acyclovir

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10
Q

petechial rash = ___ until proven otherwise

A

N. meningitides

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11
Q

MCC osteomyelitis

  • everyone
  • puncture wound
  • sicle cell
  • animal bites
A
  • S. aureus
  • Pseudomonas
  • Salmonella
  • Pasturella
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12
Q

active TB tx

A

Rifampin
INH
Pyrazinamide
Ethambutol

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13
Q

latent TB tx

A

INH

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14
Q

bilateral facial rash after non-specific prodrome. Greatest risk?

A 
Erythema infectiosum (Parvo B19)
- if mom is pregnant, separate (hydrops fetalis)
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15
Q

Parvo B19 increases risk for __

A

aplastic crisis

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16
Q

low-grade fever, cough coryza, conjunctivitis and Coplik spots

A

Measles (paramyxovirus)

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17
Q

after prodrome, rash spreads from head to toe in conjunction with fever (kid looks very sick)

A

Measles

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18
Q

macular rash starts of face and spreads to toes (kid not too sick)

A

Rubella

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19
Q

potentially lethal complication of measles?

A

subacute sclerosing panencephalitis

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20
Q

prodrome of tender lymphadenitis (periorbital, periauricular)

A

rubella

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21
Q

prodrome of high fever (>40C) with rash starting as fever breaks

A

Roseola (HHV-6)

*risk of febrile seizures!

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22
Q

macular rash that begins on trunk and spreads to face

A

roseola

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23
Q

non-specific prodrome leads to bl parotid swelling + orchitis in pubertal males: dx?

A

Mumps

- Pickle test (inducing salivation)

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24
Q

oral pain + vesicles with erythematous bases (non-specific prodrome) on feet and hands

A 
Coxsackie A (hand-foot-mouth)
*may also involve buttocks
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25
Q

trauma + LOC with lucid interval: tx?

A

epidural hematoma

- evacation

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26
Q

trauma + LOC /wo lucidity

A

Subdural hematoma

- evacuation, ICP

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27
Q

Tx concussion without LOC or amnesia (grade I)

A

20 min rest

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28
Q

Tx concussion w/ LOC but no amnesia (grade II)

A

1 week rest

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29
Q

Tx concussion w/ LOC + amnesia (grade III)

A

1 month rest

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30
Q

punctate hemorrhage on CT s/p major trauma

A

cerebral contusion, manage ICP

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31
Q

size of child for car booster seat (transition from rear-facing car seat):

A

4ft + 40 lbs

32
Q

salt water drowning is worse than fresh water - why and tx?

A

increased pulmonary edema

- give PEEP

33
Q

drowning prevention: (3)

A

locked gates around pools
supervision
life jackets (not arm floaties)

34
Q

epidermis only: pain + erythema

A

1st degree burn

35
Q

epi + dermis: pain, blisters + erythema

A

2nd degree burn

36
Q

through dermis, white and painless with surrounding 2nd degree

A

3rd degree burn

37
Q

Parkland formula

A

%BSA x Kg x 4 + MIVF

  • 50% in 8hrs
  • 50% in 16hrs
38
Q

Rule of 9s (admit >__% BSA)

A 
admit >10% BSA 
head:  18
front thorax:  18
back:  18
arm/arm:  9/9
legs:  9/9/9
39
Q

1st line tx for epilepsy (3)

A

lamotrigine
valproate
phenytoin

40
Q

2nd line for epilepsy

A

ethosuxamide (absence)

carbamazepine (tic dela reux)

41
Q

infant with bl clonus of UE or head + afebrile: dx? tx?

A

West syndrome (infantile spasm)
dx: interictal EEG –> hypsarrhythmia
tx: ACTH (will not treat psychmotor retardation)
f/u: mental retardation and poor prognosis

42
Q

seizures + ash-leaf spots, with or without fevers: dx? tx? f/u?

A

Tuberous sclerosus
dx: CT - tubers
tx: supportive
f/u: mental retardation + sebacious adenomas

43
Q

prognosis for absence szs?

A

kids will generally outgrow

44
Q

common misdiagnosis for absence szs?

A

ADHD

45
Q

inspiratory wheezing

A

upper airway

46
Q

expiratory wheezing

A

lower airway

47
Q

CXR finding with foreign body aspiration

A

+ coin sign (tracheal rings prevent object from protruding, except posteriorly)

48
Q

bronchiolitis age range

A
49
Q

infant or young toddler in winter with wheezing that does not respond to B2-agonists and normal CXR

A

bronchiolitis

50
Q

criteria for hospitalization with b’litis

A

SpO2

51
Q
A

foreign body aspiration

52
Q

inspiratory wheeze of the upper airway

A

stridor

53
Q

low-pitched inspiratory sound, resembling snoring or gasping

A

stertor

54
Q

toddler with mild viral prodrome, followed by barking cough worse at night and inspiratory stridor: organism? cxr sign? tx?

A

Croup (laryngo-tracheo-bronchitis)

  • parainfluenza > RSV
  • steeple sign on CXR
  • tx significant respiratory impairment with supplemental O2 and racemic epinephrine (improvement confirms dx)
55
Q

3-7yo with sudden onset high fever, tripoding and drooling: cxr finding? organism? tx?

A

Epiglottitis

  • thumb print on cxr
  • Hib
  • OR for controlled intubation, abx
56
Q

3-7yo with fever and drooling, lying supine with neck extended - suspect __?

A

retropharyngeal abscess (staph/strep)

57
Q

suspect croup, but child does not respond to racemic epi and appears quite ill - dx? organism? dx? tx?

A

bacterial tracheitis

  • S. aureus, S. pne
  • cx or visualize pus
  • abx
58
Q

> 10y with hot potato voice and drooling: dx? organisms?

A

peritonsillar abcess

- strep/staph

59
Q

newborn with 0 UOP, suspect __ and do __. confirm dx with ___

A

obstructive renal failure (posterior urethral valves); cath to relieve pressure on bladder; voiding cystourethrogram

60
Q

colicky flank pain s/p 1st EtOH binge

A

ureteropelvic junction obstruction - confirm with IVP

61
Q

female with constant urinary leak, suspect __

A

low implantation of ureter (surgical correction)

62
Q

frequent UTIs or pyeolnephritis, suspect __, get ___

A

vesicoureteral reflux; VCUG

- tx surgically, or give abx and wait for kit to grow out of it

63
Q

hematuria in a kid: think ___

A

always warrants dx workup

  • cancer, congenital anomaly
  • U/S, and IVP (avoid CT)
64
Q

egg allergy/hypersensitivity is a contraindication for which vaccines?

A

MMR
yellow fever
influenza

65
Q

immunodeficiency is a contraindication for which vaccines?

A

Varicella
MMR
influenza

66
Q

normal reaction to vaccine in infant

A

fever

67
Q

pathologic reaction to vaccine

A

seizures
>105F
anaphylaxis
>3hrs inconsolable crying

68
Q

presents with high fever, dyspnea and dysphagia: what vaccine is missing?

A

DTaP

69
Q

tx lockjaw and painful spasms in anti-vaccer’s kid?

A

IVIg, sedation and support and immunize (infection does not convey immunity!)

70
Q

+HBV mom: give baby ___ and ___

A

IVIg and HepB vaccine NOW

71
Q

-HBV mom: give baby __ at __

A

HepB vaccine within 2 months

72
Q

unknown HBV mom: give baby ___

A

HepB NOW

73
Q

DTaP: requires __ doses in 1st year
__ doses before 4yrs old
______ booster q__yrs

A

3
2
tetanus booster q10yrs
*if dirty wound >5yrs after vaccination, give IVIg and tetanus toxoid

74
Q

give MMRV vaccine and booster before ___

A

school

75
Q

vaccinate all >65 + lung dz q5yrs and all asplenics and immunocompromised

A

pneumococcal

76
Q

HAV and HBV vaccines require __ doses

A

3

Pediatrics (5 decks)

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