Peds Flashcards
Define Infantile Colic
Rule of 3s:
unexplained paroxysms of irritability and crying for >3 h/d, >3 d/wk for >3 wk in an
otherwise healthy, well-fed baby
Usually 10d-3mo
Don’t treat primary noctural enuresis with meds until what age due to spontaneous resolution
7 yrs old
4 features of ToF
VSD
RV hypertrophy
Overriding aorta
Subvalvular pulmonit stenosis
Episodes associated with ToF
Child/infant positioning?
Tet spells (after feeding/crying) due to systemic vasodilation
Squat/knee-chest
What are the 5 cyanotic CHDs?
5 Terrible Ts!!
1) Truncus arteriosus (aorta/pulmonary arteria join to make 1)
2) Transposition of great vessels
3) Tricuspid atresia (need ASD + VSD)
4) Tetralogy of Fallot
5) Total anomalous pulmonary vascular return (pulmonary veins back to R atrium, rely on ASD)
Acyanotic CHDs divide into what 2 groups? Name 3-4 in each
L->R shunt: ASD, VSD, PDA, AVSD
Obstructive: coarctation of aorta, aortic stenosis, pulmonic stenosis
ASD is more common in patients with what 2 syndromes?
Down’s and fetal alcohol
Management of ASD
<8mm –> spontaneous closure
Elective surgical closure between 2-5 years of age
Management of VSD
Small (most common CHD) –> spontaneous closure
Large –> surgery by 1yo if required
Management of PDA
Indomethacin (antagonizes prostaglandin E2) in preemies
If persists beyond 3mo or serious sx –> surgical closure
Peds epi dose
0.01 mg/kg
Syndrome with MECP2 mutation and regression of development
Rett syndrome
Workup for precocious puberty
Bone age
If advanced –> measure LH directly & with GnRH stim
Increased LH (or increased with GnRH stim) –> central –> cranial MRI
Otherwise –> peripheral –> hormone analysis, abdo imaging
Elevated LH/FSH in someone with delayed puberty indicates…
Primary hypogonadism
Neonatal pneumonia is most commonly caused by
Group B strep, E coli (organisms acquired from maternal genital tract or nursery)
Dosing peds fluid bolus
Isotonic solution
20mL/kg over 20 minutes or rapid push
● Repeat as needed up to total of 60mL/kg
Peds maintenance fluids rule
4-2-1 (ml/kg/hr)
4 for first 10 kg
2 for 11-20
1 beyond that
Peds fluids
● D5NS: Dextrose 5% +0.9%NaCl to prevent hypoglycemia.
● KCl: Add KCl when voiding (usually 20mEq/L)
● 0.9% NaCl: Use in hyperglycemia, DKA
● D5 0.45% NaCl: Hypotonic solution, risk of
hyponatremia. Consider in hypernatremia.
Calculate fluid deficit peds
χEach 1% dehydration = 10 ml/kg
fluid deficit
χFluid deficit = % Dehydration x
10 x weight
