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AANP Exam > Peds > Flashcards

Peds Flashcards

1
Q

Virus causing- Roseola

A

Human Herpesvirus 6

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2
Q

Virus causing- Fifths disease

A

Parvovirus B19

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3
Q

Virus causing- Rubella

A

Rubella virus

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4
Q

Virus causing- Rubeola aka——-

A

Measles
Rubeola virus

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5
Q

Virus causing- Chicken pox aka——

A

Varicella zoster- herpes

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6
Q

Virus causing- Herpangina

A

Coxsackie A virus

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7
Q

Virus causing- Hand, foot and mouth?

A

Coxsackie virus A16

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8
Q

Maculopapular rash “ brick red” starts on the head and neck spreads to trunk and extremities

A

Measles aka rubeola

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9
Q

Slapped cheek rash; lacy; macular rash

A

Fifths disease aka erythema infectiosum

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10
Q

Maculopapular rash, looks like measles rash, remarkable lymphadenopathy, macules on soft palate (Forschheimer spots)

A

Rubella

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11
Q

High fever, 2-4 days, abrupt end + maculopapular rash- not on face

A

Roseola/ exanthem subitum

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12
Q

Vesicular lesions on erythematous base appearing in crops

A

Chickenpox

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13
Q

Exotoxin Rash secondary to group a strep infection, sandpaper like rash that desquamates

A

Scarlet fever

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14
Q

Exanthem subitum

A

Roseola

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15
Q

Erythema infectiosum

A

Fifth disease

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16
Q

Forscheimer spots

A

Macules on soft palate- Rubella

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17
Q

Lacy macular rash

A

5ths disease

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18
Q

When can a child with a viral exanthem return to daycare/school

A

24 hours without fever

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19
Q

When can a child with chickenpox return to daycare/school

A

When all the vesicles have crusted over + 24h fever free

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20
Q

Group A Step can be followed by what viral Exanthem

A

Scarlet fever

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21
Q

What disease manifests as vesicles that rupture and produce painful ulcers on the soft palate in the mouth

A

Herpangina

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22
Q

What viral infection can cause pass on the tonsils

A

Mono

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23
Q

What is the usual age to see roseola

A

7-13 months

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24
Q

What age and time of year is hand foot and mouth disease most common?
How long does it take to resolve?

A
  • < 5y/o
  • Summer months
  • 2-3 days
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25
Q

Three C’s of Measles/ Rubeola

A

Conjunctivitis
Coryza (runny nose/ congestion)
Cough

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26
Q

1-3mm Whitish, blueish or gray elevations on the buccal mucosa, hard and soft palate

A

Kopliks spots —— Measles!!!

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27
Q

Bulging, cloudy tympanic membrane, decreased mobility, +/- redness

A

AOM

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28
Q

Common pathogen for CAP? Treatment?

A

S. pneumo
Amoxicillin

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29
Q

Croup treatment

A

Single oral dose / dexamethasone

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30
Q

Sickle cell disease goals of care?
Prophylaxis abx?

A

Keep them healthy!
Infections cause sickle cell crisis!
—-Penicillin prophylaxis

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31
Q

Lead toxicity masks as—

A

IDA- microcytic anemia

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32
Q

Screening test CF

A

Sweat test

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33
Q

Recurrent lower Resp infections in a kid, + greasy stools, + weight loss—- think?

A

CF

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34
Q

When spacing immunizations, what is the maximum days a vaccine can be given early?

A

4

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35
Q

MMR & Varicella vaccine type?
When given/ spaced?

A

Live attenuated vaccines
Given together at 1 year
If NOT Given together, wait 4 weeks before giving the second

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36
Q

When are these lymphnodes classified as enlarged?
Epitrochlear-
Inguinal-
Cervical-

A

Epitrochlear- >5mm
Inguinal- >15mm
Cervical- >20mm

All others >10mm

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37
Q

When treating children with headaches- avoid daily analgesic use due to

A

Rebound headaches

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38
Q

Projectile, nonbilious vomitting-

A

Pyloric stenosis

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39
Q

Pyloric stenosis is most common at what ages

A

4-6 weeks

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40
Q

Pyloric stenosis is diagnosed via what imaging-
What clinical signs suggestive emergency referral?

A

Ultrasound
Unable to keep fluids down

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41
Q

“Olive shaped mass” think——

A

Pyloric stenosis

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42
Q

Red flags with presentation of reflux

A

Choking/ coughing with eating
Refusal to feed
Forceful vomit
GI bleeding
Poor weight gain
Fever
Abdo pain
Bowel changes/ constipation or diarrhea -?bowel obstruction

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43
Q

GER is likely to resolve by what age

A

1 year

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44
Q

In children with GER- what non-pharm management tips? X5

A

Breast feeding!
Place supine to sleep
Small, frequent, thickened meals- rice cereal
Avoid tobacco smoke exposure
Trial other formulas ie. non cows milk, hypoallergenic formula- 1-2 week trials

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45
Q

Acid suppression therapy in children should be used for how long?

A

Trial 2 weeks, if no improvement- refer to GI
If improved- continue for 2-3 months then TAPER

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46
Q

Colicky abdo pain, red current jelly stool, ++ pain, child hunched over

A

Intussusception

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47
Q

What age range is most common for intussusception

A

3 months to 2 yrs

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48
Q

Treatment of constipstion in kids- pharmacological

A

PEG daily until normal stools- 1 soft BM/day
Then taper

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49
Q

-Can mothers breast feed baby with viral gastroenteritis?
-Are antidiarrheals recommended in children with gastroenteritis?
-Are anti-emetics recommended in children with gastroenteritis?

A

-Yes
- No & No- get it out!
Except if unable to keep fluids down/ becoming dehydrated

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50
Q

Oral fluid replacement for mild & moderate dehydration?

A

Mild- 5 tsp/ lb in 4h
Mod- 10 tsp/ lb in 4h

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51
Q

Cryptorchidism

A

Undescended teste- not in scrotum

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52
Q

Retractile testes

A

Move between scrotum and inguinal ring via cremasteric reflex
Ages 5-6 yrs
Can be concerning if doesn’t stay down

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53
Q

Refer child to Urology if testicles are not palpated in scrotum by ——-?

A

6 months

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54
Q

When should hydrocele resolve in an infant?
Etiology?

A

12 months
Hernia

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55
Q

What is the most common cause of UTI in children (40%)

A

Vesicouretal Reflex
Refer to Urology

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56
Q

Gold standard diagnostic for UTI in kids?

A

Get specimens and culture

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57
Q

Best diagnostic test for vesicouretal reflex

A

Voiding cystourethrogram

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58
Q

UTI in child < 2yrs warrants what diagnostic test?

A

KUB US

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59
Q

EmpIric Antibiotic treatment for UTI in peds- Afebrile vs febrile?

A

1st gen Cephalosporin- Cefixime
Afebrile- 3-7d
Febrile 10-14d

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60
Q

Kawasaki mnemonic-

A

CRASH & Burn

C- conjunctivitis- non purple t
R- rash, polymorphic, macular
A- adenopathy- cervical
S- strawberry tongue / swollen lips
H- Hands +/- feet swollen!!!!!
Burn- fever >5d

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61
Q

Work-up for suspected kawasakis?

A

CBC, CRP/ESR, ALT/AST
UA
Throat culture- r/o GAS

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62
Q

Kawasaki is a vasculitis of

A

Medium sized vessels

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63
Q

Treatment of Kawasakis dx

A

ASA +/- IV IG

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64
Q

Strawberry tongue- 2 diff

A

Kawasaki disease
GAS

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65
Q

Nurse Maids Elbow

A

When annular ligament slips over radial head

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66
Q

Reducing nurse maids elbow

A
  1. Extend elbow
  2. supinate F/a
  3. Flex elbow
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67
Q

Acute lymphocytic leukaemia clinical findings

A

++ elevated WBC
> 50 000 cells/mm3
Affects immature white cells- lymphoblasts

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68
Q

Acute myelogenous leukemia

A

Fast growing cancer of the bone marrow
Affects WBCs, RBCs, Platelets, macrophage, monocutes

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69
Q

Hx of febrile viral illness + ASA/ salicylate intake- causes what serious illness

A

Reye’s syndrome

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70
Q
  1. Severe vomitting, lethargy, diarrhea, elevated AST/ALT
  2. Personality changes, aggressive behaviour, hyperactive reflexes
    3/4/5- confusion, delirium, cerebral edema, coma, seizures, death
A

Reyes syndrome

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71
Q

Theoretical risk of Reye’s syndrome after what vaccine-
Recommend not using what medication before during or after

A

Varicella
Aspirin

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72
Q

All kids with Down syndrome who want to participate in sport require what imagine

A

C-spine
Due to atlantoaxial instability = increased distance between C1 and C2

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73
Q

Systolic murmur, musical/ vibratory quality, louder when supine, grade 1-2

A

Stills murmur

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74
Q

All children aged ——- should have received single dose quadrivalent meningococcal vaccine

A

11-12yrs

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75
Q

At 11 & 12 yrs- what vaccines are needed (x3)

A

Tdap
HPV
MCV4

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76
Q

Earl abstract thinking stage occurs at what age

A

11yrs

77
Q

Molloscum is caused by what virus?

A

Pox

78
Q

HPV vacc can be given at the earliest-

A

9yrs

79
Q

Large head circumference, cognitive disability, long face, prominent forehead, jaw, large ears. Large body, flat feet.

A

Fragile X syndrome

80
Q

Hand-foot- and mouth management

A

Symptomatic care
Self-limiting
Resolves in 5-7 days

81
Q

Pel-Ebstein sign

A

Supraclavicular lymph nodes with fever
Hodgkin Lymphoma

82
Q

Congenital tumour of the kidneys that rarely crosses midline

A

Wilms tumour

83
Q

Child presents- sitting posture, hyperextended neck, open mouth breathing

A

Epiglottitis

84
Q

Speech of a ——- year old should be understood by family

A

2 y/o

85
Q

Speech of a ——- should be understood by strangers

A

3 y/o

86
Q

Ride a tricycle by —-
Ride a bike by ——

A

3 yrs
6-7 yrs

87
Q

Can draw a circle by age

A

3

88
Q

—- y/o can cope a cross

A

4

89
Q

Oedipal stage

A

When a child wants to marry parent of opposite sex
Ages 3-6yrs

90
Q

Can draw a stick person with 3 body parts by age-
6 body parts by age-

A

4yrs
5yrs

91
Q

Rear facing car seats until age?

A

2 yrs

92
Q

Kids are ready for potty training at what age?

A

18-24 months
May not be ready at 36 months

93
Q

Complete bowel/bladder control in the day is achieved around ——-
Complete control at night is achieved by ——

A

Day- 3-4 y/o
Night- 4/5 y/o

94
Q

Pointing/ waving/ grasping by age

A

12 months

95
Q

5 behavioural signs suggestive of autism

A
  1. No wave/grasp/point by 12 months
  2. No cooing/babbling by 12 months/ no words by 16 months
  3. No 2 word phrases by 24 months
  4. Any regression in language or social skills by 24 months
  5. No gesturing (wave/point/grasp) by 24 months
96
Q

T/F. At 3 years old- it would be expected for a child to cry, scream and cling to mother when dropped off at a day care.

A

True- if suspected autism- child will not demonstrate these behaviours

97
Q

Nephroblastoma aka ——-
More common in what patients-
Peak age-

A

Wilms tumour
African American female sex
2-3 yrs

98
Q

Epiglottitis is most common between ages—-
Most common pathogen?

A

2-6 yrs
H. Flu- Hib vaccine greatly reduced incidence
**reportable disease

99
Q

What assessment finding would require you to r/o congenital hip dysplasia or hip fracture in an infant

A

Asymmetry of thigh/ gluteal folds

100
Q

Rolls from front to back by ——

A

6 months

101
Q

Plays pat a cake by —-

A

9 months

102
Q

Most common ages to screen for hip dysplasia

A

Birth to 3 months

103
Q

Assessing for hip dysplasia in older infants x3

A
  1. Leg turned outward
  2. One femur appears shorter than the other when infant is supine aka Galeazzi sign
  3. Limited hip ROM

Ultrasound hip and send to ortho!

104
Q

Booster seats are to be used in cars until when-

A

Child is 8-12 years old
Or 4’ 9”

105
Q

Neonatal unconjugated hyperbilirubinemia & neonatal icterus aka———-
Appears when-
Resolves when-

A

Physiologic jaundice
-After 24 hours
-2-3 weeks

106
Q

Breast Milk Jaundice
Onset-
Peak-
Time to clear-

A

After 7 days of life
Peaks 2-3 weeks
Can take more than 4 weeks to clear
- cause is suspected not enough breast milk

107
Q

Conjugated hyperbilirubinemia aka——
Onset-

A

Pathological Jaundice
Birth / within 24h

108
Q

Specific test used to evaluate suspected pathological jaundice in new born

A

Coombs test***

109
Q

Hemoglobin drops at the lowest levels in life at 6-8 weeks

A

Physiological anemia of infancy
Temporary decreased in EPO prod of kidneys

110
Q

Dacryostenosis

A

Congenital nasolacrimal duct obstruction
Occurs in up to 20% of newborns
Spontaneously resolves in 6 months (95%)

111
Q

Acute dacryocystitis is usually caused by what pathogens?
Length of abx tx?
** assess for progression to —-

A

Strep & staph
7-10 days
Orbital cellulitis

112
Q

How to perform lacrimal sac massage

A

Finger on lacrimal sad and massage downward towards mouth
Perform 2-3 times a day

113
Q

Infant Colic rule of 3s

A
  1. < 3 months old
  2. Crying > 3h a day *usually the same time each day
  3. Crying > 3 days per week

Usually resolves by 3-4 months

114
Q

Coarctation of the aorta
How to assess-

A

Palpate brachial and femoral pulses simultaneously
Diagnostic = absence or delay of femoral pulse compared to brachial

115
Q

Normal vs abnormal BP findings in infants-
1. Systolic BP is higher in legs than arms
2. Systolic higher in arms than thighs

A

Normal = Syst BP is higher in legs than arms

Concerned for coarctation of aorta if arm BP higher!

116
Q

Post acetaminophen overdose, how long until labs will be accurate?
Antidote?

A

4h
Acetylcystein

117
Q

Precocious puberty

A

M- <9yrs
F- <8 yrs

118
Q

Delayed puberty

A

M- no testicular growth by age 14y
F- no breast development (Tanner 2) by 12y

119
Q

In female sex- when does majority of skeletal growth take place- relative to menses

A

Before- slows after

120
Q

Average age of spermarche

A

13.3 yrs

121
Q

Unilateral midcycle pelvic pain that is caused by an enlarged ovarian follicle

A

Mittelschmerz

122
Q

Menarche average age

A

12

123
Q

After tanner stage ___ menses occurs within 1-2 yrs

A

2= breast bud

124
Q

Delayed puberty if no 2nd sex characteristics by age

A

12-13y

125
Q

Most fertile period in menstrual cycle is when

A

3 days before/ during ovulation - approx day 11-14

126
Q

Enlarged lymph nodes with fever, night sweats, and pain after drinking alcohol

A

Hodgkin’s lymphoma

127
Q

What tanner stage does puberty start and end at

A

Start at 2
End at 5

128
Q

Describe tanner stages 2,3,4 in MALEs

A

2- testicular enlargement and colour darkens
3- elongation of the penis
4- penis thickens and increases in size- testes are larger and scrotal skin darker

129
Q

Describe tanner stages 2,3,4 in FEMALEs

A
  1. Breast bud formation
  2. Breast tissue and areola form singular mound
  3. Areola/ nipple separate to form secondary mound
130
Q

Lanugo, peripheral edema, amenorrhea, and weight loss > 10% of body weight

A

Anorexia

131
Q

No menarche by 15yrs +/- development of secondary sex characteristics

A

Primary amenorrhea
50% due to chromosomal disorders

132
Q

No menses for 3 cycles or 6 months

A

Secondary amenorrhea

133
Q

Most common cause of secondary amenorrhea
+ 2 diff

A

1st Pregnancy
Anorexia
PCOS

134
Q

Measure bone density if amenorrhoea for more than

A

6 months

135
Q

In adolescence with amenorrhea 2nd to execessive exercise/ weight loss- prescribe 3 supps

A

Vit D, Calcium, Vit E

136
Q

Telogen effluvium

A

Form of hair loss- 2nd to stress response/ malnutrition

137
Q

Gynecomastia is most common in what ages-
Course-

A

Peaks at age 14
40% pubertal males
Resolves in 6 months to 2 years

138
Q

Adams forward bend test is used for assessment of ?
What other diagnostic is used in evaluation?

A

Scoliosis
Full spine x-ray

139
Q

Treatment of Cobb angle (degree of spinal curvature) curve -
<20 deg
20 - 40 deg
> 40 deg

A

<20 deg - monitor
20- 40- brace
>40 - surgical correction

140
Q

Causes primary hypogonadism
Testes are small and firm with small penis
Tall stature, wide hips, reduce facial and body hair, higher risk osteoporosis

What’s the condition?

A

Klinefelter syndrome
Extra X chromosome

141
Q

Congenital lymphedema of hands & feet
Webbed neck
High-arch palate
Short 4th metacarpal
Short stature (<50%)

A

Turners syndrome
Partial absence of second sex chromosome

142
Q

Bilateral enlarged breasts, soft to touch, nontender, no breast buds or disklike breast tissue palpable

A

Pseudogynecomastia

143
Q

T/F- No parental consent is needed for health services related to sexual activity in adolescence

A

True

144
Q

Low albumin may cause what clinical findings

A

Peripheral edema

145
Q

Nevus simplex aka

A

Stork bite
Benign

146
Q

Nevus flammeus-

A

Port wine stain

147
Q

Ant Fontanelle close-
Post Fontanelle close-

A

Ant- 9- 18 months - open at birth
Post- 2-3 months - not always open at birth

148
Q

Hypertelorism

A

Eyes spaced further apart
Associate with many syndromes

149
Q

How long is breast-feeding considered sufficient nutrition?
When are foods initiate it?

A

6 months
4-6 months

150
Q

What does introducing foods too soon increase risk of?

A

Atopic dermatitis and atomic sensitization

151
Q

What is often recommended is the first food for a newborn

A

Single ingredient food.
Ie meat.
Rice is least allergenic

152
Q

When to introduce juice?

A

When they can drink from a cup ie.6 months

153
Q

Cows milk is introduced when?

A

12 months

154
Q

Finger foods are introduced when?

A

8-10 months

155
Q

Painful abdominal mass that’s fixed, firm, irregular and frequently crosses the midline

A

Neuroblastoma
Usually btw 1 & 4y
Initial imaging is US

156
Q

Corneal light reflects and cover/uncover test are used for assessing

A

strabismus

157
Q

A form of vision loss that is preceded by an inability for two eyes to focus on the same object at the same time

A

Amblyopia

158
Q

At what age should Eye alignment occur

A

2-4 months

159
Q

First teeth at what age?
What teeth?
All primary teeth should be in by what age?

A

6 months
Central incisors
2 yrs

160
Q

Permanent teeth begin to come in at what age

A

6-8 years
Until 20 years

161
Q

Fluoride supplementation at what age

A

6 months- when teeth come in

162
Q

When should a infant be able to track and follow with both eyes

A

2-4 monthd

163
Q

Visual acuity testing begins at what age?

A

3/4yrs

164
Q

Visual acuity at 3 y/o?

At 6 y/o?

A

20/50

20/20

165
Q

Serrous OM can persist for up to —-?

A

3 months

166
Q

If BP in upper extremities is greater than lower extremities in an infant— think?

A

Coarctation of aorta

167
Q

Normal progression of hip/leg orientation x 4 steps

A

Bow legs at 6 months
Straighten when walking
Valgus at 4 yrs
Correct and straighten in adolescence

168
Q

Scoliosis is defined by what degree of curvature

A

> /= 10 degree

169
Q

Ideal X-ray order for scoliosis

A

PA view full spine - cervical through to sacrum
PA rather than AP to minimize radiation from front

170
Q

In an infant with in-towing, what warrants referral to ortho versus monitoring

A

Rigid metatarsus = refer
Inability to turn both feet to midline

If able to turn to midline bilateral - flexible metatarsus- tell care giver to turn feet to midline 10x every time they change their diaper

171
Q

Cobb method via x-ray is used for what

A

Measuring scoliosis angle

172
Q

When do babes double and triple their BW?

A

2x @ 6 months
3x @ 12 months

173
Q

Head circ increases by ___ in 12 months

A

12 cm

174
Q

Does caput succedaneum cross midline?
Ceohalohematoma?

A

Yes caput succedaneum

No cephalohematoma

175
Q

Colostrum contains what

A

IgG antibodies

176
Q

Strong Morro reflex at 6 months

A

Concerning- ? Brain damage

177
Q

Youngest age for influenza vaccine

A

6 months

178
Q

DTaP in ages?
TDaP in ages?

A

DTaP < 7y
TDaP booster at 11/12yrs

179
Q

Indications for oral antibiotic treatment in AOM?

A

< 6 months old
> 6 months + bilateral / fever / ++ pain

180
Q

Antibiotic treatment of AOM and common pathogens

A

S. pneumo, H. Flu

Amoxicillin (high-dose)

181
Q

E. Colo, Shigella, and Campylobacter all cause what illness/ symptoms in children?

A

Acute bacterial gastroenteritis
Bloody diarrhea

182
Q

When is depression screening recommended in adolescence?

A

Ages 12-18 yrs
Annually

183
Q

Common cause of impetigo -
Trichophyton Rubrum causes-

A

Staph Aureus

Common cause of Tinea Corporis

184
Q

When is spontaneous closure of umbilical hernias in infants less likely?

A

> 1.5cm

185
Q

Chronic progressive leg pain, with limp, in hip/ thigh/ groin region.
PE- decreased ROM with internal rotation and abduction of the hip + atrophy of the thigh muscle.
X-ray = flattened or fragmented femoral head

A

Legg- Claves-Perthes
Ie. idiopathic avascular necrosis

Peak incidence 5-7y

186
Q

Chronic progressive pain in the long bones with ‘sunburst’ pattern on x-ray

A

Osteosarcoma

187
Q

An overweight adolescent presents with hip pain.
X-ray shows posteriorly displaced femoral epiphysis-

A

Slipped capital femoral epiphysis

188
Q

Pertussis treatment?

How long can cough last?

A

Azythromycin

> 8 weeks

AANP Exam (11 decks)

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