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Spring ClinMed > PEDs > Flashcards

PEDs Flashcards

1
Q

Child doubles their weight by

A

4 months old

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2
Q

Social smile by

A

8 weeks old

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3
Q

Common CC after 2/3months when child starts to bring hands to midline

A

Corneal Abrasion

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4
Q

Ear temps measured by infared scanner NOT reliable under

A

3 months of age

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5
Q

Are rectal temps affected by bundling with clothes/blankets?

A

No

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6
Q

Fever considered normal until above

A

38

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7
Q

Anti-pyretics only lower temp by

A

1/2 to 1 degree

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8
Q

Maximal effect of anti-pyretics _____ after dose

A

2 hours

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9
Q

Temps of ____ and higher usually indicate a bacterial focus

A

41

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10
Q

T/F Degree of tem relates to severity of illness

A

FALSE

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11
Q

Greatest majority of pts with fever present on day

A

3, but get clear picture of time

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12
Q

Viral infections typically cause problems for

A

4 to 4 1/2 days

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13
Q

T/F Teething has some bearing on fever

A

FALSE

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14
Q

Fevers less than _____ degress centigrade do NOT lead to brain damage

A

42

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15
Q

Neonates is less than

A

28 days

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16
Q

Leading cause of infection in neonates

A

Group B Strep

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17
Q

When is DPT shot more likely to cause fever

A

Not first shot, likely 2nd or 3rd

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18
Q

Neonatal physiological jaundice will peak

A

day 3 1/2-4 1/2

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19
Q

If fever > 4-4.5 days also get

A

CXR

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20
Q

Consider checking urine on febrile patient age

A

males <2 yrs

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21
Q

What ethnicity has a higher chance of AOM in the first year

A

AA

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22
Q

Does breast feeding reduce AOM risk

A

yes, limited protection

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23
Q

What quadrant is most important to view when considering AOM

A

Posterior Superior Quadrant

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24
Q

Dx for sinusitis requires

A

purulent drainage 7-10 days

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25
Q

Anterior vessicles in mouth likely

A

Herpes stomatitis

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26
Q

Posterior vesicles in mouth likely

A

Coxsacie

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27
Q

Oral candidiasis very rare after

A

6 months old

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28
Q

Centor criteria for strep throat

A

fever, tonsillar exudates, no cough, tender anterior nodes, <15yo

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29
Q

How can you check adenoid inflammation?

A

Mouth breathers/ cant breath with mout closed. Say number 9 before and after occluding nose)

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30
Q

Is a yellow exudate following tonsilectomy okay?

A

Yeah

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31
Q

Peak time for diaper rash

A

6-12m

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32
Q

MC Diaper Rash

A

Chafing Dermatitis

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33
Q

If diaper rash greater than 4 days with treatment consider

A

yeast infection

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34
Q

What organism implicated in seborrheic dermatitis

A

Pitysporum ovale

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35
Q

Perianal cellulitis caused by

A

superficial GABHS infection

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36
Q

Perianal cellulitis more common in

A

males, 3-4 yrs

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37
Q

When does stranger anxiety begin?

A

7 months of age

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38
Q

Extraabdominal causes of belly pain

A

Strep pharyngitis, DKA, Nephrotic syndrome, UTI, poisonings, Sickle cell disease/crisis, PNA

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39
Q

When are plain films indicated during abdominal pain?

A

distension, abnormal b.s., peritoneal signs (rebound tenderness), previous sx

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40
Q

When does colic peak and abate?

A

peak 4-6weeks, abate at 3 months

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41
Q

Most important therapy for colic

A

Reassurance, don?t make dx in 1-3mo w/no prior problems

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42
Q

Ddx fussy afebrile infant

A

corneal abrasion, hernia, reaction to meds, hair tourniquet, constipation

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43
Q

Formula with iron a factor in constipation?

A

NO

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44
Q

MCC pain and cramping in school aged kids

A

Constipation

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45
Q

What is Hirschsprung’s Disease?

A

Absence of ganglioin cells in distal or entire colon

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46
Q

Most common GI complaint is dt

A

Gastroenteritis

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47
Q

Leading cause of gastroenteritis

A

Norovirus (used to be rotavirus)

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48
Q

Mild-moderate dehydraion is ______ loss body weight

A

3-9%

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49
Q

Severe dehydration is ____ loss body weight

A

> 9%

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50
Q

Best ways to determine hydration status

A

Body wt loss (hard to be accurate, activity status, HR (most important), mucous membranes, perfusion status (capillary refill)

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51
Q

Sudden bilious greenish vomiting is ominous for

A

Malrotation w/Midgut volvulus

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52
Q

Afebrile, truly irritable child peak 6-12m consider

A

Intussusception

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53
Q

currant jelly stool (very foul smelling) is a late sign of

A

intussusception

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54
Q

Tx for intussusception

A

Air contrast enemas

If unsuccessfull to OR ASAP

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55
Q

Intussusception occurs at what age?

A

Kinda any age

3m- 6yrs?

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56
Q

What is a risk factor for appendicitis?

A

Decreased fiber, M>F, peak age 6-15

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57
Q

Name four common positive symptoms of appendiciits

A

vomiting, RLQ pain, abd tender, guarding

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58
Q

Does diarrhea rule out appendicitis?

A

NO, present 10% of time

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59
Q

Highest risk for pyloric stenosis

A

If mother had it as a child

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60
Q

When does hypertrophic pyloric stenosis occur?

A

first 3 weeks, rare at >7-8 weeks

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61
Q

“string sign” in upper GI swallow seen in

A

hypertrophic pyloric stenosis

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62
Q

Is surgery urgent for hypertrophic pyloric stenosis?

A

No, check electrolytes and hydration

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63
Q

Who is at risk for hernias?

A

M, preemies

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64
Q

Tx for hernia

A

reduce with firm manipulation, avoid ice, sedation prn. Incarcerated needs sx

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65
Q

When does an umbilical hernia need to be operated on?

A

By 4-5 y/o of age if it doesn’t close or if incarcerated

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66
Q

Sickle cell anemia pts at higher risk

A

appendicitis, gallstones, splenic sequestration crisis

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67
Q

Places FB can get stuck

A

cricopharyngeus, level or aortic arch, low GE junction

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68
Q

What items need aggressive tx/removal in FB swallow

A

Magnets, button batteries

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69
Q

MCC GI bleed in under 2yrs

A

Anal fissures

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70
Q

What med used for UTI can cause red stools

A

Omnicef

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71
Q

MCC GI bleed in preschool kids

A

polyps

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72
Q

Reflux and GERD usually abates by

A

6-7 months

73
Q

GERD should be treated in what kind of PEDS pt?

A

Failure to thrive, apnea

74
Q

Caustic burns require what

A

need stat endoscopy, long term care

75
Q

DX cdiff by

A

stool toxins

76
Q

Early morning vomitting is

A

brain tumor until determined otherwise

77
Q

Hep A is spread

A

fecal-oral route

78
Q

Where can Hep A sxs first be seen?

A

sclera- jaundice

79
Q

Hep B spread to PEDS most likely

A

newborn to mother, contaminated blood

80
Q

cholelithiais mc in

A

fat, forty, female, fertile

81
Q

Best diagnostic technique for cholelithiasis

A

US

82
Q

What is phimosis

A

inabiltiy to retract prepuce over glans; pain, hematuria

83
Q

What is paraphimosis

A

unable to reduce foreskin over glans, foreskin retracted and cant get back

84
Q

What is balanoposthitis

A

inlammation of glans and foreskin

if reccurent needs circumcision

85
Q

MCC pre-school boys with dysuria “it hurts to pee”

A

Meatal stenosis

86
Q

Priapism is

A

constat erection, engorgement of dorsal corpora

87
Q

MC age for torsion is

A

pre pubertal, age 13

88
Q

Testicular torsion must be treated within

A

4-6hrs

89
Q

“bag or worms”

A

varicocele

90
Q

leading cause of dysuria in pre-school girls

A

labial adhesions

91
Q

hematuria and proteinuria dx think of

A

nephritis

92
Q

post infectious hematuriand proteinuria

A

glomerulonephritis

93
Q

tea colored urine

A

glomerulonephritis

94
Q

Tx for nephrotic syndrome (nil disease)

A

started on steroids

95
Q

oliguria is

A

decreased urine output

96
Q

Kidney defects will likely show

A

failure to thrive and acidosis

97
Q

Predominant cause of UTI

A

E.coli

98
Q

UTI under age _____ should be admitted

A

2-3months

99
Q

At what age does child figure out right vs left handedness

A

Around 2-3yrs

100
Q

Hemolytic uremic syndrome caused by

A

E.coli

101
Q

What is the area of growing bone

A

physis

102
Q

Sprain is

A

ligamentous injury

103
Q

What is the center of ossification at bony prominences

A

apophysis

tendons insert here

104
Q

What is thicker top layer of bone

A

periosteum

105
Q

Best xray view for sublte buckle fractures

A

Lateral

106
Q

Where do buckle fractures occur?

A

Metaphysis

107
Q

Tx for buckle fracture

A

Splint for pain relief

108
Q

Most common growth plate fracture is

A

Salter-Harris II

109
Q

Tx for clavicle fracture

A

Sling, ice, meds (NO Fig 8)

110
Q

What is nursemaid’s elbow and who is it common in

A

Annular ligament torn/dislocated

common in girls, left arm

111
Q

Does nursemaid’s elbow require xrays?

A

No, not if H&P consistent

112
Q

If penetrating injury near joint you should

A

check for air

113
Q

Crutches should be avoided under age

A

9

114
Q

metaphyseal chips/ bucket handle fxs are

A

child abuse until proven otherwise

115
Q

spiral diaphyseal fx is

A

child abuse until proven otherwise

116
Q

MCC rib fracctures in children

A

child abuse

117
Q

mcc limping in children

A

simple contusion, then transient synovitis

118
Q

Any child complaining of knee, groin, or thigh pain, first thing to examine is

A

Hip

119
Q

MC site of septic arthritis

A

Knee

120
Q

MC infectious agent of septic arthritis

A

Staph aureus

121
Q

Septic arthritis aspiration ususally has _____ WBCs

A

> 100K

122
Q

SCFE best seen on what view

A

Frog lateral view

123
Q

What is a SCFE

A

Femoral (neck) metaphysis displacement

124
Q

What gender is scoliosis more common in

A

Females

125
Q

2mc sites for osteomyelitis

A

Knee and hip

126
Q

What infectious agent of osteomyelitis is higher in sickle cell patients

A

salmonella

127
Q

MC infectious agent of osteomyelitis

A

Staph aureus

128
Q

Ewing’s sarcoma (tubular bones) mc age

A

1-10y/o

129
Q

Osteosarcoma mc age

A

10-30y/o

130
Q

MC type of JIA

A

oligoarticular (<4joints, usually larger ones)

131
Q

What is stridor?

A

Inspiratory noise

132
Q

When does wheezing occur?

A

Expiration

133
Q

Stridor is usually a upper, middle, or lower noise?

A

Usually Middle Airway

134
Q

Foreign Body Aspiration below one year treatment

A

five back blows and five chest thrusts

135
Q

Foreign Body Aspiration over 1 year treatment

A

Heimlich maneuver

136
Q

Where does bronchiolitis occur

A

lower respiratory

137
Q

90% bronchiolitis is caused by

A

RSV respiratory synctial virus

138
Q

2 things to check in bronchiolitis is considering admittion

A

Oxygen status, is baby ablee to feed

139
Q

Duration of bronchiolitis

A

7-14days, but can be weeks

140
Q

At risk for bronchiolitis

A

chronic lung disease, premature babyies, congenital heart disease, immunodeficiency
-Likely have option of receiving preventative Synagis (palivizumab) $$$$

141
Q

Where does croup occur?

A

Middle airway disease

142
Q

Xray sign for croup

A

Steeple sign

143
Q

What is important to document during croup?

A

Presence or lack of stridor at rest

144
Q

How long does croup last? When is it worst?

A

7-10days, always worse in the evening (esp 2nd and 3rd night)

145
Q

Treatment for croup

A

Decadron 0.6mg/kg

helps some kids, sometimes

146
Q

If you give a croup pt racemic epi nebulizer what should you do?

A

Watch for rebound for atleast 3 hrs

147
Q

MCC bacterial tracheitis

A

Staph aureus

148
Q

Tx for laryngomalacia

A

Usually get scoped, but will subside gradually with age

149
Q

Cause of pertussis

A

Bordetella pertussis

150
Q

Bacterial cause of supraglottitis

A

H. influenza type B (almost nonexistent now)

151
Q

Xray sign for supraglottitis

A

“Thumb” sign on lateral neck

152
Q

Tx for supraglottitis

A

airway control and antibiotics

153
Q

Risk factors for asthma inlcude

A

cigarette smoke, chemical odors, exercise, cold air

154
Q

What is status asthmaticus

A

Severe, not responding, dehydrated, exhausted

155
Q

Best predictor of PNA

A

tachypnea

156
Q

Sleeping position to prevent SIDS

A

sleep on back

157
Q

Risk factors for SIDS

A

prone sleeping, soft surface sleep, maternal smoke in pregnancy, young mom, preterm birth, LBW, males

158
Q

What electrolyte is important to monitor during treatment of DKA

A

K+

159
Q

In treatment of DKA, if BS hits 250 or lower, hydrate with

A

D5 solution

160
Q

Hypoglycemia treatment for children

A

D25 2-4mL/kg

161
Q

What electrolytes are abnormal in congenital adrenal hyperplasia

A

low Na, high K, low BS

162
Q

3 most common causes of allergy/anaphylaxis

A

IV PCN, hymenoptera stings, food related

163
Q

What cardiac conditions are more common in females?

A

Atrial septal defect, patent ductus arteriosus, mitral valve prolapse

164
Q

S3 implies

A

poor cardiac function

165
Q

A thrill implues murmur of what grade?

A

4 or more

166
Q

Abnormal qtc is greater than

A

0.44/.45 seconds

167
Q

Most common dysrhythmia is

A

SVT

168
Q

SVT therapy for infants

A

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
Q

Max dose of adenosine

A

12mg

170
Q

Most common congenital heart defect is

A

VSD

171
Q

VSD sounds like____ and heard best at_____

A

Holosystolic murmur

lower left sternal border

172
Q

Patent ductus is a _____ murmur heard at______

A

diamond shaped/cres decres

2nd left ICS

173
Q

Rib notcing on CXR from collateral seen in

A

coarctation of aorta

174
Q

Rheumatic fever is a result of _____ infection

A

GABHS (certain ones)

175
Q

Myocarditis 2 leading causes:

A

coxsackie B

Adenovirus

176
Q

Bradycarida, HTN, irregular breathing-increased ICP is

A

Cushing’s Triad

177
Q

A blown pupil is

A

impending herniation- CN3 compressed

178
Q

What kind of line is used for TPN

A

Broviac line

Spring ClinMed (4 decks)

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