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Clinical Rotations > Peds > Flashcards

Peds Flashcards

1
Q

What is encopresis?

A

Involuntary loss of stool in children who are already toilet trained

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2
Q

What is the initial treatment for retained stool in the rectum in a child with encopresis?

A

Oral laxative

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3
Q

What are treatment options for functional constipation in children?

A

Osmotic laxatives: polyethylene glycol, lactulose
Stimulants: senna, bisacodyl
Stool softeners: docusate
Fleet enema contraindicated in infants (due to hypocalcemia)

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4
Q

By what age should kids be having at least 1 BM per day?

A

3

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5
Q

What type of hypersensitivity reaction is allergic conjunctivitis?

A

Type I IgE mediated

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6
Q

What bug causes typical community acquired pneumonia?

A

Strep pneumo

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7
Q

What bug commonly causes ATYPICAL community acquired pneumonia?

A

Mycoplasma pneumo

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8
Q

What test is used to determine lactose intolerance?

A

Hydrogen breath test

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9
Q

When would you order an emergent endoscopy for an ingested foreign body?

A

FB is a battery, is sharp, is two magnets, or has signs of obstruction

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10
Q

How long should you observe most esophageal foreign bodies for?

A

24 hrs

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11
Q

What are the symptoms of bronchiectasis?

A

Cough
Large amounts of mucopurulent sputum
Foul smelling sputum

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12
Q

What is shown on chest x-ray in a patient with bronchiectasis?

A

Tram tracks (dilated & thickened airways)

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13
Q

What are signs/symptoms of scabies?

A

Severe itching that is worse at night
Small papules, vesicles, and burrows in the webbed spaces of the fingers and toes

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14
Q

What is the treatment for scabies?

A

Permethrin 5% (infants > 2 months old) or
Oral ivermectin (ivermectin not first-line in pregnancy or children < 15 kg)

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15
Q

What are characteristics of absence seizures?

A

Brief, sudden impaired consciousness
Appear to be staring into space
EEG shows 3 mHz spike & wave

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16
Q

What is the treatment for absence seizures?

A

Ethosuximide

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17
Q

What causes indirect inguinal hernias to occur?

A

Patent processus vaginalis

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18
Q

Does a direct or indirect inguinal hernia appear in the scrotum of a male child?

A

Indirect

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19
Q

Which type of hernia is most common in children?

A

Indirect inguinal hernia

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20
Q

What is the most common type of psoriasis in children?

A

Chronic plaque psoriasis

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21
Q

What is the most common cyanotic congenital heart disease in children?

A

Tetralogy of Fallot

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22
Q

How is a murmur of tetralogy of fallot described?

A

Rough, crescendo-decrescendo systolic ejection murmur that is heard best at the left sternal border in the third intercostal space with radiation to the back.

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23
Q

What is seen on chest x-ray of a child with tetralogy of fallot?

A

Boot shaped heart

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24
Q

If a patient is being treated for strep throat with Amoxicillin and returns to clinic in 7-10 days with a morbilliform rash, what is your suspected diagnosis?

A

The pt actually has mono and should stop abx

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25
Q

What are the characteristics of Osgood-Schlatter disease?

A

Young athlete (10-15 yo)
Knee pain while running
Tenderness over tibial tubercle

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26
Q

What is the treatment for Osgood-Schlatter disease?

A

Ice
NSAIDs
Tylenol
Quad stretches

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27
Q

What is neonatal respiratory distress syndrome?

A

Respiratory difficulty in a premature infant within the first few hours after birth

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28
Q

What most commonly causes neonatal respiratory distress syndrome?

A

Deficiency of surfactant

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29
Q

What should be given to women less than 34 weeks gestation at high risk for preterm delivery (e.g., preeclampsia) to reduce fetal morbidity & mortality?

A

Dexamethasone

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30
Q

What are the characteristics of pyloric stenosis?

A

Babies between 2-8 weeks
Non-bilious projectile vomiting
Olive-like mass in RUQ
Target sign on abd ultrasound

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31
Q

What is the treatment for pyloric stenosis?

A

Surgical pyloromyotomy

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32
Q

What test can be done to diagnose vesicoureteral reflux?

A

Voiding cystourethrography (VCUG)

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33
Q

What is a Russell sign and what disorder is it commonly seen in?

A

Abrasions on the dorsal aspect of fingers and the hand
Bulimia nervosa

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34
Q

What serum electrolyte is most commonly decreased in patients with bulimia that involves purging via vomiting?

A

Potassium

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35
Q

What are characteristics of Kawasaki’s disease?

A

CRASH & burn
Kids < 5 yo
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hand or foot edema
High fever x 5 days

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36
Q

What is the treatment for Kawasaki’s?

A

IVIG and aspirin

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37
Q

What Cobb angle diagnoses scoliosis?

A

> or = 10*

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38
Q

What is the treatment for scoliosis based on Cobb angle?

A

20-29: observation
> or = 30: bracing
> or = 50*: surgery

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39
Q

What is the only surgical treatment for sensorineural hearing loss?

A

Cochlear implant

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40
Q

What is the most common cancer of childhood?

A

Acute lymphoblastic leukemia (ALL)

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41
Q

What are the signs/symptoms of acute lymphoblastic leukemia (ALL)?

A

Limping
Bone pain
Fever
Lymphadenopathy
Hepatosplenomegaly

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42
Q

What would you see on blood work in a pt with ALL?

A

Anemia
Thrombocytopenia
Lymphoblasts on peripheral smear

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43
Q

What is preseptal cellulitis (periorbital cellulitis)?

A

An infection that affects the anterior portion of eye, and does NOT involve the globe

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44
Q

What is the most common route of infection in preseptal/periorbital cellulitis?

A

Via the ethmoid sinuses

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45
Q

What are the characteristics of Legg-Calve-Perthes disease?

A

Boys > girls
4–10 years of age
Unilateral, intermittent limp (worse after activity)
Most commonly caused by osteonecrosis of the proximal femoral head

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46
Q

What are the signs/symptoms of SCFE?

A

Boy 12–16 yo with obesity
Progressive limp & hip/knee pain
Loss of hip internal rotation
X-ray will show scoop of ice cream slipping off cone

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47
Q

What is the treatment for SCFE?

A

Non-weight-bearing and urgent ortho consult

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48
Q

What is conduct disorder?

A

Disruptive behavior disorder characterized by a repetitive and persistent pattern of defiant, dissocial, and aggressive behaviors that violate age-appropriate social norms

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49
Q

How is ODD different than conduct disorder?

A

They do not violate societal norms or rules and are not violent toward other people or animals

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50
Q

What is the differences between roseola, rubeola, and rubella?

A

Roseola: caused by herpes virus-6
Rubeola: measles
Rubella: German measels

51
Q

What are the signs/symptoms of rubeola (measles)?

A

Unvaccinated
Maculopapular rash that started on head and spread toward feet
High fever
Cough
Conjunctivitis
Red spots with blue or white center on buccal mucosa (Koplik spots)

52
Q

How does erythema multiforme usually present?

A

Acute onset of symmetric target lesions on palms and soles, face and trunk may also be involved

53
Q

What is the treatment for erythema multiforme?

A

Supportive care

54
Q

What most commonly causes erythema multiforme?

A

HSV

55
Q

What is the most common solid kidney tumor of childhood?

A

Wilms tumor

56
Q

What are the signs/symptoms of Wilms tumor?

A

< 15 years old
Abdominal pain
Anorexia
Abdominal distention
Vomiting
Hematuria
PE will show abdominal mass

57
Q

When does tooth eruption occur?

A

Most frequently occurs in children around 7 months of age but may manifest as early as 3 to 4 months of age or as late as 12 to 16 months of age

58
Q

How is status epilepticus defined?

A

≥ 5 minutes of continuous seizure or two or more discrete episodes of seizure between which there is incomplete recovery of consciousness

59
Q

What is 1st line treatment for status epilepticus?

A

Benzos (lorazepam)

60
Q

What are signs/symptoms of peritonsillar abscess?

A

Dysphagia
Drooling
Trismus
Hot potato voice
Uvula displaced away from abscess

61
Q

What is the treatment for peritonsillar abscess?

A

I&D or needle aspiration
Abx 7–10 days

62
Q

What is patent ductus arteriosus (PDA)?

A

An acyanotic heart disease that is characterized by the failure of normal closure of the ductus arteriosus after birth

63
Q

How is PDA described on auscultation?

A

Continuous, rough, machine-like murmur, heard best in the first interspaces of the left sternal border

64
Q

What is the treatment for a PDA?

A

Indomethacin

65
Q

What is pathognomonic for Wilson’s disease?

A

Kayser-Fleischer rings in the cornea (brown/copper deposit rings around the iris)

66
Q

Bronchiectasis is commonly seen in what disease process?

A

Cystic Fibrosis

67
Q

What are signs/symptoms of pertussis (whooping cough)?

A

Rapid-fire repetitive coughing followed by an inspiratory whoop and post-tussive emesis

68
Q

What is the treatment for pertussis?

A

Azithromycin

69
Q

What vaccine prevents pertussis?

A

DTap

70
Q

Most drug exanthems are caused by what type of hypersensitivity?

A

Delayed-type T cell-mediated type IV immune reactions

71
Q

At what age do you administer an M-CHAT to screen for ASD?

A

18-24 months

72
Q

What are the most common sources of epistaxsis?

A

Anterior bleeds: Kiesselbach plexus
Posterior bleeds: sphenopalatine artery

73
Q

How should infant’s weight change over the course of the first year of life?

A

Double their birth weight by 4 months and triple their birth weight by 12 months

74
Q

What is 1st line treatment for cutaneous warts?

A

Salicylic acid or cyrotherapy

75
Q

What is the treatment for a neonate (< or = 1 mo) with bacterial meningitis?

A

Cefotaxime + ampicillin

76
Q

What is the treatment for bacterial meningitis in children > 1 mo - 18 yo?

A

Ceftriaxone + vanc

77
Q

What commonly causes bacterial meningitis in neonates?

A

E. coli
Group B strep
Listeria monocytogenes
Gram-neg bacilli

78
Q

What commonly causes bacterial meningitis in children > 1 mo - 18 yo?

A

Strep pneumo
N. meningitidis
H. influenza

79
Q

What is the hallmark laboratory finding indicating overly aggressive initial outpatient nutritional therapy?

A

Refeeding syndrome
Labs show hypophosphotemia

80
Q

At what age does the rooting reflex disappear?

A

2-3 months

81
Q

Acute otitis media with tympanic membrane perforation is initially treated with what?

A

Amoxicillin

82
Q

What is the most common pathologic murmur in childhood?

A

Ventricular septal defect (VSD)

83
Q

How does ventricular septal defect sound on auscultation?

A

Loud, harsh, holosystolic murmur at the lower left sternal border

84
Q

What is immune thrombocytopenia (ITP)?

A

A condition characterized by isolated thrombocytopenia that occurs in otherwise healthy individuals; often preceded by a recent viral illness

85
Q

What is 1st line treatment for head lice?

A

Permethrin

86
Q

What most commonly causes viral conjunctivitis?

A

Adenovirus

87
Q

What are characteristics of rheumatic fever?

A

History of group A strep infection
Fever, red skin lesions on the trunk and proximal extremities, and small, nontender lumps located over the joints
PE: Jones criteria: joints, oh no—carditis!, nodules, erythema marginatum, Sydenham chorea

88
Q

What are signs/symptoms of coarctation of the aorta?

A

Headaches, dyspnea, leg claudication
Higher BP in the arms than in the legs
Delayed femoral pulse
ECG: LVH
CXR: notching of ribs, “3 sign” (indentation of aorta)

89
Q

What is the treatment for coarctation of the aorta?

A

Balloon angioplasty with stent placement or surgical correction

90
Q

What presents with small skin-colored waxy, dome-shaped papules with umbilicated appearance that is highly contagious but self-limited?

A

Molluscum contagiosum

91
Q

What is the most common complication of mumps?

A

Orchitis

92
Q

What most commonly causes mumps?

A

Paramyxoviridae

93
Q

What are signs/symptoms of aortic stenosis?

A

Dyspnea, chest pain, syncope
Crescendo-decrescendo systolic murmur that radiates to the carotids, paradoxically split S2, S4 gallop
Murmur decreases with Valsalva

94
Q

What are the characteristics of laryngotracheitis (croup)?

A

Non-toxic-appearing (6 mo - 3 yo)
Barky seal-like cough
Inspiratory stridor
Low-grade fever
Steeple sign on x-ray

95
Q

What is croup most commonly caused by?

A

Parainfluenza

96
Q

What is the treatment for croup?

A

Steroids and racemic epi

97
Q

What is the most common bacterial cause of acute pharyngotonsillitis?

A

Group A strep

98
Q

What are the signs/symptoms of congenital hypothyroidism?

A

Lethargy
Coarse facies
Hoarse cry
Hypotonia
Dry skin
Hypothermia

99
Q

What is a blueberry muffin rash?

A

Nickname given to the purpura or petechial rash of cytomegalovirus (CMV) due to its spotted blue or purple appearance on the skin, resembling a blueberry muffin.

100
Q

What result of a sweat chloride test is indicative of cystic fibrosis?

A

> 60 mEq/L

101
Q

What are the characteristics of cystic fibrosis?

A

Autosomal recessive, CFTR gene
Hx of multiple recurrent respiratory infections or failure to thrive
Pseudomonas most common infecting bacteria in recurrent pulmonary infections

102
Q

What exanthema is teratogenic in the first trimester and may result in fetal hearing impairment, infantile glaucoma, and cardiac disease?

A

Rubella (german measles)

103
Q

What is the most common cause of epiglottitis (esp in unvaccinated children)?

A

HIB

104
Q

How is colic defined?

A

An otherwise healthy infant who is < 3 months of age who cries for ≥ 3 hours per day ≥ 3 days per week without a clear explanation

105
Q

When should colic resolve by?

A

9 weeks

106
Q

What are the signs/symptoms of hypercalcemia?

A

Bone pain (bones)
Kidney stones (stones)
Abdominal pain (groans)
Constipation (thrones)
Lethargy, psychosis/depression (psychiatric overtones)

107
Q

What is the difference between croup and bacterial tracheitis?

A

Pt appears toxic with bacterial tracheitis

108
Q

What is the most common cause of intestinal obstruction in infants between 6 and 36 months of age?

A

Intussusception

109
Q

What is a common complication of influenza in children?

A

Otitis media

110
Q

What are the characteristics of osteosarcoma?

A

Patient will be 10 to 20 yo
Pain, swelling that awakens at night
Codman triangle or sunburst pattern on x-ray
long bone metaphyses (most common)
Most common malignant bone tumor

111
Q

What presents with a sandpaper rash, strawberry tongue, circumoral pallor, & pastia lines (petechiae in skin folds)?

A

Scarlet fever

112
Q

What is the treatment for scarlet fever?

A

Amoxicillin

113
Q

What is the causative agent of roseola?

A

Human herpesvirus 6 (sixth disease)

114
Q

How does a roseola rash distribute?

A

Begins at the neck and trunk region and spreads to the face and extremities

115
Q

What are the signs/symptoms of lead toxicity?

A

Headache
Joint pain
Abdominal pain and constipation
Lead lines on x-ray
Labs: basophilic stippling

116
Q

What is the treatment for lead toxicity?

A

Oral succimer or IV EDTA

117
Q

What are the characteristics of nephrotic syndrome?

A

Pitting edema
Proteinuria > 3.5 g/24 hr
Hyperlipidemia
Hypercoagulability (renal vein thrombosis)
Fatty casts
Minimal change disease: children, preceded by URI

118
Q

What happens on a positive Barlow manuever?

A

Hip dislocates posteriorly

119
Q

What is heard on auscultation of ASD?

A

Wide, fixed split S2

120
Q

What is the most common inherited disorder of bilirubin glucuronidation, resulting in recurrent episodes of jaundice?

A

Gilbert syndrome

121
Q

What presents with hypertension, hematuria, and periorbital edema with recent history of group A strep exposure?

A

Poststreptococcal glomerulonephritis

122
Q

What are the signs/symptoms of osteogenesis imperfecta (brittle bone disease)?

A

Multiple fractures with no history of significant trauma
Hearing loss
Easy bruising
Blue sclera

123
Q

What is characterized by the lack of peristalsis and involuntary relaxation of the internal anal sphincter, leading to bowel obstruction?

A

Hirschsprung disease

124
Q
A

Clinical Rotations (9 decks)

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