peds Flashcards
What is erythema Infectiosum?
This is 5th disease
Lacy/reticular rash to cheeks
very rare it can cause anemia in newborn babies
What virus causes Erythema Infectiosum?
5th disease
Parovirus b19
tell pregnant women to stay away
What medications are given for child ADHD ?
RITALIN
ADDERALL
Vyvanse
Strattera
first line is NOT medications, first line is behavior therapy
When do you screen for Autism and what tool do you use?
Screening 18-24 months; M-Chat screening form
What viruses cause bronchiolitis?
What is the largest risk factor for bronchiolitis?
What treatment is advised?
- RSV
- Adenovirus
- Coronavirus
- Influenza virus
Risk factor: Tobacco smoke, bleach, chloride
treatment: avoid irritants (stop smoking), and BREASTFEEDING
What is Caput Succedaneum? What is the treatment?
After birth, baby has a cone-shaped head
Swelling + puffiness
no trestment
Does Caput Succedaneum cross the midline?
Yes it does cross the midline, and it increases the risk for jaundice
What is a cephalohematoma ?
Diagnosed based off physical exam
Damaged blood vessels a collection of blood sitting ONTOP of the skull
its gradul swelling over hours- days
Does cephalohematoma cross the midline?
No it doesnt, and it creates a weird crater like two bumps
List the 4 fontaneles on a baby’s head
- Posterior
- Anterior
- Sphenoidal
- Mastoidq
List the fontanelles and when they close
Posterior = 2-3 months
Sphenoidal = 6 months (s=six)
Mastoid= 6-18 months
Anterior= 1-3 years of age
What is Coarction of the Aorta ?
This can occur in infants or adolescents
in infants, you will have the typical story of poor feeding, poor weight gain etc
The femoral pulses will be weak or absent, the 4 limb BP will be abnormal
There will be higher blood pressure in the arms than in the legs
IIn adolescent you will have systolic hypertension, headaches, and claudications
What infectious agents often cause croup?
1 = Para influenzae virus
- Mycoplasma pneumoniae
- Corynebacterium diptheriae
What is encopresis? What age does this usually start at?
sometimes called fecal incontinence or soiling, is the repeated passing of stool (usually involuntarily) into clothing.
Age 4
What is the treatment of encopresis?
- Use incentives
- Laxatives
- Address behavior and toilet refusal
other obvious nonp0harm things like assessing childs readiness and keeping bowels soft
What is the difference between primary and secondary enuresis?
Primary = since birth the child has never been able to control their bladder
secondary= the child was able to control their bladder for at least 6 months, then started bed wetting (think adam)
In terms of enuresis, what is the difference between Monosymptomatic and non-monosymptomatic?
Mono = (1) only a night time bed wetter
non mono= 2, has day time and night time bed wetting
At what age can you diagnose enuresis?
THE CHILD MUST BE GREATER THAN 5!!!
if it a 4 yearold with daytime and night time symptoms you cant diagnose them with enuresis, they still have another year to learn how to control their bladder
What work up do you do for a child with enuresis?
- Urinalysis + culture (r/o UTI)
- rule out diabetes, glucose in urine
- Constipation is common cause with LLQ firmness
What is the treatment for enuresis?
After you have ruled out a medical cause, AND the child is GREATER than 5:
First line: Bladder training, rewards, the alarm system at night
second line: desmopressin, antidepressant
What are the symptoms of a blocked lacrimal duct?
What is the treatment?
- Excessive tearing
- Purulent yellow/green discharge - it may look like conjunctivitis
Treatment: massaging eye, apply warm compress
what are the most common causes of neonatal conjunctivitis?
- Gonorrhea
- Chlamydia - watery/bloody discharge
- Pseudomonoas- green
- Chemical irritant
If a 1-2 day old baby presents with purulent discharge from their eyes, what are you concerned for?
Gonorrhea conjunctivitis, as its purulent and typically presents 24-48 hours post labor
If a 5 day old baby presents with watery bloody discharge from their eyes, what are you concerned for?
Chlamydia conjunctivitis, as it often presents 5-14 days post labor and the secetion are watery and bloody
what type of conjunctival discharge would you see in a neonate with pseudomonas conjunctivitis?
GREEN
What are TORCH infections?
TORCH is an acyonym for disease that can transfer from mother to baby and can cause harm or miscarriasge
Toxoplasma gondii
other agents
rubella
cytomegalovirus (CMV),
Herpes simplex virus (HSV).
What is fragile X syndrome?
a congenital developmental disability from inherrited FMR1 gene
What are the symptoms of fragile x syndrome?
Aggression
Macrocephaly
Strabismus
Large everything (ears jaw head)
How do you diagnose fragile x syndrome ?
During pregnancy:
- Amniocentesis
- CVS
What is gynecomastia?
Enlargement of breast tissue in males
Swelling can impact one or BOTH breasts
Typically this will self resolve by the ag of 17
What medications can cause gynecomastia in teenage males?
This condition occurs because there is a suppression of testosterone and increase in estrogen
- Finasteride
- Spironolactone
- Cimetidine
- Anabolic steroids
- Diazepam
What medical conditions can cause gynecomastia?
- HYPERthyroidism
- Hypogonadism
- Hypoandrogenism
- Testicular tumors/adrenal tumors
What are the first line medications for gynecomastia?
First line: weight loss
second line: anti-estrogens
Tamoxifen
Danazole
What is tamoxifen and danazole?
these are anti-estrogens that can be used (rarley) to treat gynecomastia
What is the treatment of Kawasaki?
IVIG + low dose asprin (suprising i didnt know asprin)
What is Klinefelter syndrome?
A genetic condition where a boy is born with an extra copy of the X chromosome
usually goes undiagnosed until the patient tries to conceive and the have infertility/difficulty conceiving
Tall and thin male with lack of secondary sexual characteristics such as small testes/penis
gynecomastia
sparse body hair such as in genitals, face, axilla. Sterile.
What is Marfan Syndrome?
A genetic condition that impacts the body’s ability to produce connective tissue
Impacts:
- heart
- eyes
** MVP Click** KEY finding
What gene is involved with Marfan Syndrome?
mutation of the FBN1 gene causing long arms fingers too much growth
What is the treatment for Marfan syndrome?
BP medication
Scoliosis tx
Breastbone corrections
avoid competitive sports
emotional support
What is the common organism to cause mastitis?
- poor latch/ cracks in nipples
- blocked mil duct
organism: staph aureus
treat with Keflex
How do you diagnose mastitis?
clinical presentation
if you think the patient has a breast abscess than you can do an ultrasound
What are the symptoms of Rubeola?
airborne measles
3 C’s
Cough
Coryza
Conjunctivitis
KOPLIK spots
If a child has measles what supplement is recommended?
Vitamin A
What development milestones would you see at 2 months?
- Smiling
- Moves head to sound
- Coos and gurgling
- Can hold their head up
What development milestones would you see at 4 months?
- Copies your facial expression
- Babbles
- They cry because they are hungry, tired, need something
- Recognize people
- Uses their hands and eyes together
- Rolls over from tummy to back
What development milestones would you see at 6 months?
- Know if someone is a stranger
- Respond to people’s emotions
- Responds to their names
- Starts to make consonant sounds/vowels
- Brings things to mouth, passes from one hand to the next
- Starting to crawl, roll from front to back
- They can sit without support
What development milestones would you see at 9 months?
Separation anxiety starts.
Recognizes mom.
understands the word NO
Mimics sounds and gestures of others
Fine motor skills, pincer grasp
The baby should be able to feed itself
Starting to stand, pulls to stand
What development milestones would you see at 1 year?
- Cries when mom/dad leaves
- Repeats sounds/actions for attention
- Helps with dressing
- Responds to simple requests
- Follows simple directions
- Copies gestures
- Standing alone
What development milestones would you see in 2 years?
- Gets excited to play with others
- Can say 2-4 words
- Knows names of body parts and people
- Starts to build a tower of blocks 4 or more
- Finds hidden objects under sheets
- Run and jumps, kick a ball, copy straight line and circles
What development milestones would you see at 3 years?
1) dresses and undresses themselves
2) Mine/hers/ shows concern for crying friend
3) Holds conversation using 2-3 sentences
4) follows instructions with 2 or 3 steps
5) plays pretend, dolls, animals and people
6) starts to pedal a tricycle
What development milestones would you see at 4 years?
1) Prefers to play mom and dad
2) telling stories
3) Make a cross
4) uses scissors
5) starts to understand time
6) play hop-scoch
7) catches bouncing ball
White is milia?
benign keratin cyst from hair follicle
DO NOT TOUCH it will go away on its own
What is molluscum contagiosum?
fine bumps
White plug/dome shaped
pearly or shiny
Central dimple
What causes molluscum contagiosum?
HPV virus its very contagious
Its self limiting no need to treat
What is the difference between wilms tumor and neuroblastoma
Wilms- nephroblastoma, does NOT cross midline
Neuroblastoma- crosses the midline travels everywhere
What is osgood-schlatter disease?
adolescent with a painful bump on knee/chronic knee
Due to over-use
Tenderness at the patellar tendon insertion site at the tibial tuberosity
Buzz word: Patella + Tibila tuberosity
What are risk factors for AOM?
GERD
Pacifier use
NOT breastfeeding
craniofacial abnormalities
What is precocious puberty?
child’s body begins changing too soon
Females: before 8
Males: before 9
What physical changes would draw concern in regard to puberty for males and females?
female: no breast development by age 13
male: no testicular development by age 14
What is primary amenorrhea vs. Secondary amenorrhea?
primary: girl after the age of 15 has never had a period
Secondary: you had your period and then it has been skipped for 3 cycles of more than 6 months
What are the causes of amenorrhea?
- obesity
- PCOS
- Low BMI
- Use of contraceptives
- Overactive thyroid gland
- Excessive stress
- Galactorrhea (check prolactin)
Describe pyloric stenosis
Olive shaped mass @ xiphoid process
2 weeks - 5.5 months
Projectile vomit
when completing the red light reflex on a child, how would you differentiate a cataract from retinoblastoma?
Retinoblastomas occur in children less than 5, and you will see a white reflection
in Cataracts you will see opacity or NO red light reflex
When are we concerned for Rh incompatibility?
we only care if mom is RH negative, and baby is rh positive
then @ 28 weeks they will get the injection and within 72 hours of birth
When does surgery occur for scoliosis?
only if the curve is greater than 45 degree
when would you refer a pediatrician with scoliosis?
-Age less than 10: curvature greater than 10 degree
- Age greater than 10: curvature greater than 20 degree
What in the mnemonic to remember the male tanner stages?
1= nothing
2= Balls drop, straight pubes
3= Long dick, voice drop
4= Wide dick, acne, armpit hair, coarse pubic hair
5= facial hair
What in the mnemonic to remember the female tanner stages?
1 = nothing
2= Buds (breast buds, and straight pubs)
3= Boobs (primary mound formation, aerola, acne)
4= Nips ( nipple formation, secondary mound formation, curly pubes)
5= all done
In what Tanner stage of men does facial hair present?
stage 5
In what Tanner stage of men does their voice crack?
stage 3
What signs and symptoms do you see with Turner syndrome?
females missing X chromosome
ovarian failure, estrogen deficiency, INFERTILITY
webbed neck
short/lack of height
What are the similarities between Turner syndrome and Klinefer Syndrome?
BOTH are diagnosed with amniocentesis
Turner (female) = missing X chromosome
Klinefer (male)= extra X chromosome
both have difficulty with conceiving
What condition would you expect your female patient to have:
short with a webbed neck, low set eyes and ears.
Chest diameter is wider than normal.
Amenorrhea and sterile.
Turner syndrome
What condition would you expect your male patient to have:
Tall and thin male
lack of secondary sexual characteristics
small testes/penis, gynecomastia,
sparse body hair such as in genitals, face, axilla.
Sterile.
Klinefer Syndrome
Please list the treatment for scoliosis based off the degree of change
Curves less than 20 degrees: Observe and monitor for changes in spinal curvature.
Curves of 20 to 40 degrees: Bracing (e.g., Milwaukee Brace).
40 + = surgery
If a patient has Cryptorchism, what are you concerned for?
This is undescended testes, by 3-6 months of ag they should descend and if not then send surgical referral
patients with undescended testes are at the highest risk for testicular torsion
What two diseases can cause Reyes ?
varicella or influenza if you give asprin
What are 4 risk factors for SIDS?
1) Maternal smoking/druge use
2) premature birth
3) low birth weight
4) poverty
When do babies start to produce tears?
the lacriminal duct matures by age 2-3 months, before that newborns do not have tears
At what age do you test children for vision using the Snellen chart?
5-6 years of age
How do you test for color blindness?
Ishihara chart
When do you screen for hemoglobin and hematocrit in children?
at 9-12 months of age
At what age do you screen children for led poisoning?
1-2 years only if high risk
True or false?
Avoid cow’s milk the first year of life
True
causes GI bleeding
Common cause of iron deficiency anemia in babies younger than 12 months.
At what age does a child show their first tooth? And at what age do they have their first PERMANENT tooth?
first tooth, lower central incisor 5-6 months
first permanent tooth 5-7 years of age first molar
When does birth weight double and when does it triple?
doubles: 6 months
triples: 12 months
Your patient is not immunized and they are 7 years of age, what vaccines do you need to give still?
Td (3 doses primary, then every 10 years)
IPV (3 doses)
Hepatitis B (3 doses)
MMR (2 doses)
At what Tanner stage does puberty start for females and males
stage 2
age 8 for females
age 9 for males
What is spermarch and when does it occur?
the first ejaculation in males about 13 years of age
What would define delayed male puberty?
delayed puberty if no testicular growth by age 14 years
What would define delayed puberty in females?
delayed puberty if no breast development by age 13 years
