PEDs Flashcards
1
Q
Child doubles their weight by
A
4 months old
2
Q
Social smile by
A
8 weeks old
3
Q
Common CC after 2/3months when child starts to bring hands to midline
A
Corneal Abrasion
4
Q
Ear temps measured by infared scanner NOT reliable under
A
3 months of age
5
Q
Are rectal temps affected by bundling with clothes/blankets?
A
No
6
Q
Fever considered normal until above
A
38
7
Q
Anti-pyretics only lower temp by
A
1/2 to 1 degree
8
Q
Maximal effect of anti-pyretics _____ after dose
A
2 hours
9
Q
Temps of ____ and higher usually indicate a bacterial focus
A
41
10
Q
T/F Degree of tem relates to severity of illness
A
FALSE
11
Q
Greatest majority of pts with fever present on day
A
3, but get clear picture of time
12
Q
Viral infections typically cause problems for
A
4 to 4 1/2 days
13
Q
T/F Teething has some bearing on fever
A
FALSE
14
Q
Fevers less than _____ degress centigrade do NOT lead to brain damage
A
42
15
Q
Neonates is less than
A
28 days
16
Q
Leading cause of infection in neonates
A
Group B Strep
17
Q
When is DPT shot more likely to cause fever
A
Not first shot, likely 2nd or 3rd
18
Q
Neonatal physiological jaundice will peak
A
day 3 1/2-4 1/2
19
Q
If fever > 4-4.5 days also get
A
CXR
20
Q
Consider checking urine on febrile patient age
A
males <2 yrs
21
Q
What ethnicity has a higher chance of AOM in the first year
A
AA
22
Q
Does breast feeding reduce AOM risk
A
yes, limited protection
23
Q
What quadrant is most important to view when considering AOM
A
Posterior Superior Quadrant
24
Q
Dx for sinusitis requires
A
purulent drainage 7-10 days
25
Anterior vessicles in mouth likely
Herpes stomatitis
26
Posterior vesicles in mouth likely
Coxsacie
27
Oral candidiasis very rare after
6 months old
28
Centor criteria for strep throat
fever, tonsillar exudates, no cough, tender anterior nodes, <15yo
29
How can you check adenoid inflammation?
Mouth breathers/ cant breath with mout closed. Say number 9 before and after occluding nose)
30
Is a yellow exudate following tonsilectomy okay?
Yeah
31
Peak time for diaper rash
6-12m
32
MC Diaper Rash
Chafing Dermatitis
33
If diaper rash greater than 4 days with treatment consider
yeast infection
34
What organism implicated in seborrheic dermatitis
Pitysporum ovale
35
Perianal cellulitis caused by
superficial GABHS infection
36
Perianal cellulitis more common in
males, 3-4 yrs
37
When does stranger anxiety begin?
7 months of age
38
Extraabdominal causes of belly pain
Strep pharyngitis, DKA, Nephrotic syndrome, UTI, poisonings, Sickle cell disease/crisis, PNA
39
When are plain films indicated during abdominal pain?
distension, abnormal b.s., peritoneal signs (rebound tenderness), previous sx
40
When does colic peak and abate?
peak 4-6weeks, abate at 3 months
41
Most important therapy for colic
Reassurance, don?t make dx in 1-3mo w/no prior problems
42
Ddx fussy afebrile infant
corneal abrasion, hernia, reaction to meds, hair tourniquet, constipation
43
Formula with iron a factor in constipation?
NO
44
MCC pain and cramping in school aged kids
Constipation
45
What is Hirschsprung's Disease?
Absence of ganglioin cells in distal or entire colon
46
Most common GI complaint is dt
Gastroenteritis
47
Leading cause of gastroenteritis
Norovirus (used to be rotavirus)
48
Mild-moderate dehydraion is ______ loss body weight
3-9%
49
Severe dehydration is ____ loss body weight
>9%
50
Best ways to determine hydration status
Body wt loss (hard to be accurate, activity status, HR (most important), mucous membranes, perfusion status (capillary refill)
51
Sudden bilious greenish vomiting is ominous for
Malrotation w/Midgut volvulus
52
Afebrile, truly irritable child peak 6-12m consider
Intussusception
53
currant jelly stool (very foul smelling) is a late sign of
intussusception
54
Tx for intussusception
Air contrast enemas
| If unsuccessfull to OR ASAP
55
Intussusception occurs at what age?
Kinda any age
| 3m- 6yrs?
56
What is a risk factor for appendicitis?
Decreased fiber, M>F, peak age 6-15
57
Name four common positive symptoms of appendiciits
vomiting, RLQ pain, abd tender, guarding
58
Does diarrhea rule out appendicitis?
NO, present 10% of time
59
Highest risk for pyloric stenosis
If mother had it as a child
60
When does hypertrophic pyloric stenosis occur?
first 3 weeks, rare at >7-8 weeks
61
"string sign" in upper GI swallow seen in
hypertrophic pyloric stenosis
62
Is surgery urgent for hypertrophic pyloric stenosis?
No, check electrolytes and hydration
63
Who is at risk for hernias?
M, preemies
64
Tx for hernia
reduce with firm manipulation, avoid ice, sedation prn. Incarcerated needs sx
65
When does an umbilical hernia need to be operated on?
By 4-5 y/o of age if it doesn't close or if incarcerated
66
Sickle cell anemia pts at higher risk
appendicitis, gallstones, splenic sequestration crisis
67
Places FB can get stuck
cricopharyngeus, level or aortic arch, low GE junction
68
What items need aggressive tx/removal in FB swallow
Magnets, button batteries
69
MCC GI bleed in under 2yrs
Anal fissures
70
What med used for UTI can cause red stools
Omnicef
71
MCC GI bleed in preschool kids
polyps
72
Reflux and GERD usually abates by
6-7 months
73
GERD should be treated in what kind of PEDS pt?
Failure to thrive, apnea
74
Caustic burns require what
need stat endoscopy, long term care
75
DX cdiff by
stool toxins
76
Early morning vomitting is
brain tumor until determined otherwise
77
Hep A is spread
fecal-oral route
78
Where can Hep A sxs first be seen?
sclera- jaundice
79
Hep B spread to PEDS most likely
newborn to mother, contaminated blood
80
cholelithiais mc in
fat, forty, female, fertile
81
Best diagnostic technique for cholelithiasis
US
82
What is phimosis
inabiltiy to retract prepuce over glans; pain, hematuria
83
What is paraphimosis
unable to reduce foreskin over glans, foreskin retracted and cant get back
84
What is balanoposthitis
inlammation of glans and foreskin
| if reccurent needs circumcision
85
MCC pre-school boys with dysuria "it hurts to pee"
Meatal stenosis
86
Priapism is
constat erection, engorgement of dorsal corpora
87
MC age for torsion is
pre pubertal, age 13
88
Testicular torsion must be treated within
4-6hrs
89
"bag or worms"
varicocele
90
leading cause of dysuria in pre-school girls
labial adhesions
91
hematuria and proteinuria dx think of
nephritis
92
post infectious hematuriand proteinuria
glomerulonephritis
93
tea colored urine
glomerulonephritis
94
Tx for nephrotic syndrome (nil disease)
started on steroids
95
oliguria is
decreased urine output
96
Kidney defects will likely show
failure to thrive and acidosis
97
Predominant cause of UTI
E.coli
98
UTI under age _____ should be admitted
2-3months
99
At what age does child figure out right vs left handedness
Around 2-3yrs
100
Hemolytic uremic syndrome caused by
E.coli
101
What is the area of growing bone
physis
102
Sprain is
ligamentous injury
103
What is the center of ossification at bony prominences
apophysis
| tendons insert here
104
What is thicker top layer of bone
periosteum
105
Best xray view for sublte buckle fractures
Lateral
106
Where do buckle fractures occur?
Metaphysis
107
Tx for buckle fracture
Splint for pain relief
108
Most common growth plate fracture is
Salter-Harris II
109
Tx for clavicle fracture
Sling, ice, meds (NO Fig 8)
110
What is nursemaid's elbow and who is it common in
Annular ligament torn/dislocated
| common in girls, left arm
111
Does nursemaid's elbow require xrays?
No, not if H&P consistent
112
If penetrating injury near joint you should
check for air
113
Crutches should be avoided under age
9
114
metaphyseal chips/ bucket handle fxs are
child abuse until proven otherwise
115
spiral diaphyseal fx is
child abuse until proven otherwise
116
MCC rib fracctures in children
child abuse
117
mcc limping in children
simple contusion, then transient synovitis
118
Any child complaining of knee, groin, or thigh pain, first thing to examine is
Hip
119
MC site of septic arthritis
Knee
120
MC infectious agent of septic arthritis
Staph aureus
121
Septic arthritis aspiration ususally has _____ WBCs
>100K
122
SCFE best seen on what view
Frog lateral view
123
What is a SCFE
Femoral (neck) metaphysis displacement
124
What gender is scoliosis more common in
Females
125
2mc sites for osteomyelitis
Knee and hip
126
What infectious agent of osteomyelitis is higher in sickle cell patients
salmonella
127
MC infectious agent of osteomyelitis
Staph aureus
128
Ewing's sarcoma (tubular bones) mc age
1-10y/o
129
Osteosarcoma mc age
10-30y/o
130
MC type of JIA
oligoarticular (<4joints, usually larger ones)
131
What is stridor?
Inspiratory noise
132
When does wheezing occur?
Expiration
133
Stridor is usually a upper, middle, or lower noise?
Usually Middle Airway
134
Foreign Body Aspiration below one year treatment
five back blows and five chest thrusts
135
Foreign Body Aspiration over 1 year treatment
Heimlich maneuver
136
Where does bronchiolitis occur
lower respiratory
137
90% bronchiolitis is caused by
RSV respiratory synctial virus
138
2 things to check in bronchiolitis is considering admittion
Oxygen status, is baby ablee to feed
139
Duration of bronchiolitis
7-14days, but can be weeks
140
At risk for bronchiolitis
chronic lung disease, premature babyies, congenital heart disease, immunodeficiency
-Likely have option of receiving preventative Synagis (palivizumab) $$$$
141
Where does croup occur?
Middle airway disease
142
Xray sign for croup
Steeple sign
143
What is important to document during croup?
Presence or lack of stridor at rest
144
How long does croup last? When is it worst?
7-10days, always worse in the evening (esp 2nd and 3rd night)
145
Treatment for croup
Decadron 0.6mg/kg
| helps some kids, sometimes
146
If you give a croup pt racemic epi nebulizer what should you do?
Watch for rebound for atleast 3 hrs
147
MCC bacterial tracheitis
Staph aureus
148
Tx for laryngomalacia
Usually get scoped, but will subside gradually with age
149
Cause of pertussis
Bordetella pertussis
150
Bacterial cause of supraglottitis
H. influenza type B (almost nonexistent now)
151
Xray sign for supraglottitis
"Thumb" sign on lateral neck
152
Tx for supraglottitis
airway control and antibiotics
153
Risk factors for asthma inlcude
cigarette smoke, chemical odors, exercise, cold air
154
What is status asthmaticus
Severe, not responding, dehydrated, exhausted
155
Best predictor of PNA
tachypnea
156
Sleeping position to prevent SIDS
sleep on back
157
Risk factors for SIDS
prone sleeping, soft surface sleep, maternal smoke in pregnancy, young mom, preterm birth, LBW, males
158
What electrolyte is important to monitor during treatment of DKA
K+
159
In treatment of DKA, if BS hits 250 or lower, hydrate with
D5 solution
160
Hypoglycemia treatment for children
D25 2-4mL/kg
161
What electrolytes are abnormal in congenital adrenal hyperplasia
low Na, high K, low BS
162
3 most common causes of allergy/anaphylaxis
IV PCN, hymenoptera stings, food related
163
What cardiac conditions are more common in females?
Atrial septal defect, patent ductus arteriosus, mitral valve prolapse
164
S3 implies
poor cardiac function
165
A thrill implues murmur of what grade?
4 or more
166
Abnormal qtc is greater than
0.44/.45 seconds
167
Most common dysrhythmia is
SVT
168
SVT therapy for infants
Vagal maneuver- ice bag on face, rectal exam
Adenosine 0.1mg/kg, double on second try
Unstable(rare)- synchronized cardioversion 0.5-1J/kg
169
Max dose of adenosine
12mg
170
Most common congenital heart defect is
VSD
171
VSD sounds like____ and heard best at_____
Holosystolic murmur
| lower left sternal border
172
Patent ductus is a _____ murmur heard at______
diamond shaped/cres decres
| 2nd left ICS
173
Rib notcing on CXR from collateral seen in
coarctation of aorta
174
Rheumatic fever is a result of _____ infection
GABHS (certain ones)
175
Myocarditis 2 leading causes:
coxsackie B
| Adenovirus
176
Bradycarida, HTN, irregular breathing-increased ICP is
Cushing's Triad
177
A blown pupil is
impending herniation- CN3 compressed
178
What kind of line is used for TPN
Broviac line
